Objective To analyse the influencing factors of quality of life (QOL)among postoperative children with congenital anorectal malformation (ARM), so as to provide evidence for developing comprehensive interventions and improve QOL of children with ARM.Methods The QOL of 100 children aged at 2 and 5 years old were evaluated by using the Chinese version of PedsQLTM4.0 scale, and the total and 4 dimensions scores of QOL were calculated.Univariate and multiple stepwise regression model was applied to analyse the influencing factors of the QOL.Results The results of univariate analysis among ARM children aged at 2 years old showed that the clinical classification, bowel disorders and family residence have different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of univariate analysis among ARM children aged at 5 years old showed that the clinical classification, bowel disorders and maternal education had different influence on QOL scores of the 4 dimensions and total scale (P ＜ 0.05).The results of multiple stepwise regression model among ARM children aged at 2 years old showed that the major influence factor of QOL scores in physical function was family residence and bowel disorders(P ＜ 0.05), the major influence factor of QOL scores in social functioning was bowel disorders(P ＜ 0.05), the major influence factor of the total scores was bowel disorders and family residence(P ＜0.05).The results of multiple stepwise regression model among ARM children aged at 5 years old showed that the major influence factor of QOL scores in physical function was maternal occupation and clinical classification(P ＜ 0.05), the major influence factor of QOL scores in emotional functioning was bowel disorders(P ＜ 0.05) ,the major influence factor of QOL scores in social functioning was clinical classification and bowel disorders (P ＜ 0.05), the major influence factor of QOL scores in school performance was maternal occupation(P ＜ 0.05), the major influence factor of total scores was bowel disorders and clinical classification(P ＜ 0.05).Conclusion Family residence and bowel disorders have effct on QOL of ARM children aged at 2 years old.Maternal occupation, clinical classification and bowel disorders have effct on QOL of ARM children aged at 5 years old.We should take positive interventions on these influencing factors to improve QOL of children with ARM.

[ ABSTRACT] AIM: To investigate the seroprevalence of neutralizing antibodies to human adenovirus type 5 (AdHu5) , human adenovirus type 26 (AdHu26) and chimpanzee adenovirus type 68 (AdC68) in the patients with chro-nic hepatitis B ( CHB) and the patients with primary liver cancer ( PLC) , and to provide guidance for developing safe and effective biotherapy vectors against CHB and PLC.METHODS:The blood samples from 196 patients with CHB and 193 patients with PLC were examined to assess the presence of neutralizing antibodies against AdHu5, AdHu26 and AdC68 by adenovirus neutralization assays.RESULTS:The seroprevalence rates of neutralizing antibodies to AdHu5, AdHu26 and AdC68 in the CHB patients were 84.7%, 58.2%and 39.8%, respectively.Among the patients with PLC, the prevalence rates of neutralizing antibodies were as follows:AdHu5, 75.1%;AdHu26, 66.8%;AdC68, 32.1%.CONCLUSION:The prevalence rates and titers of neutralizing antibodies against AdC68 were the lowest among the 3 adenoviruses.There-fore, AdC68 serves as more suitable biological therapy vectors for CHB and PLC than AdHu5 and AdHu26.

Objective To observe whether high-level insulin increases serum uric acid level and rosiglitazone improves hyperuricemia, and to explore the mechanism. Methods OLETF rats with spontaneous type 2 diabetes complicated with metabolic syndrome and normal control LETO rats were randomly divided into three groups (n=20 each). The animals were fed with standard chow diet in control group, high-purine diet and adenine administered intragastrically in experimental group, and rosiglitazone in interventional group. Body weight, serum levels of uric acid, insulin, triglyceride ( TG ) , and total cholesterol ( TC ) were measured after 3 weeks. Urate transporter 1 ( URAT1 ) and uric acid transporter (UAT) mRNA expressions in renal cortex were examined. HK-2 cells were incubated with various concentrations of insulin for 24 hours. UAT mRNA expression in HK-2 cells was examined. Results ( 1 ) In control group, the insulin level of OLETF rats was significantly higher than that of LETO rats ( P<0. 05 ), and there was no significant difference in serum uric acid level between OLETF and LETO rats. (2)In experimental groups, the insulin level in OLETF rats was significantly higher than that in LETO rats [(61.83±12.13 vs 36.73±12.73 )μIU/ml ,P<0. 05], and the incidence of hyperuricemia (76.92% vs 36.13%,P<0.01 ) and serum uric acid level[( 327.75 ±45.73 vs 264.40±36.32 ) μmol/L, P<0. 01]in OLETF rats were significantly higher than those in LETO rats. (3) Insulin[(41.3± 10.2 vs 61.8±12. 1 )μIU/ml,P<0. 05]and uric acid[( 198.0±45.4 vs 236.9±29.30 ) μmol/L, P<0. 05]levels in OLETF rats in interventional group were significantly lower than those of OLETF rats in experimental group, meanwhile the amount of urinary uric acid excretion was significantly increased[(5 644±371 vs 4 692±278 ) μ mol/L, P<0. 05]. (4) There was no significant difference in insulin level and the expressions of URAT1 and UAT mRNA in renal cortex between OLETF rats in control group and experimental group. URAT1 mRNA expression of OLETF rats in interventional group was significantly decreased, while UAT mRNA expression was significantly increased. (5)With the increase of insulinconcentration in culture medium, the expression of UAT mRNA expression in HK-2 cells was gradually decreased. Conclusions Rosiglitazone may alleviate hyperinsulinemia-induced hyperuricemia via regulating UAT and URAT1 mRNA expression.

Objective:To explore the application effect of health education based on phase-change theory in elderly patients with coronary heart disease.Methods:Using the convenient sampling method, a total of 108 elderly patients with coronary heart disease who were admitted to Zhejiang Hospital from January 2019 to January 2020 were selected as the research objects. Using the random number table method, they were divided into the observation group and the control group, with 54 cases in each group. The control group adopted regular health education, while the observation group adopted health education based on phase-change theory. The medication compliance, self-efficacy and quality of life of patients of the two groups were compared.Results:After the intervention, the medication compliance, self-efficacy and quality of life scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Applying health education based on phase-change theory to elderly patients with coronary heart disease can improve their medication compliance and improve their self-efficacy and quality of life.

OBJECTIVETo introduce and evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis.

METHODSWe retrospectively reviewed our experiences with 17 patients with Mayer- Rokitansky-Kuster-Hauser syndrome treated with primary surgery from September 2010 to April 2013. All patients underwent vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis. We describe the details of this technique, observe the time of epithelization and evaluate the long- term anatomical, functional, and sexual outcomes.

RESULTSThe time of epithelization was 13 d (range: 12-15 d). At a mean follow-up of 15 months (range: 12-24 months), the mean postoperative dependence on the vaginal stent was 11.7 ± 1.64 months (range: 9-15 months), the mean depth of the neovagina was (9.0 ± 0.94) cm (range: 7-11 cm), the mean circumference was (12.3 ± 1.36) cm (range: 10.0-14.5 cm) and the mean volume was (105 ± 10) ml (range 85-120 ml). The mean female sexual function index score of the 12 sexually active patients was 29.5 ± 2.6. No spouse reported discomfort during intercourse.

CONCLUSIONSVaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome. The procedure has satisfactory long-term anatomical and functional results. The use of the acellular allogenic dermis is limited by the high price and the potential infection.

46, XX Disorders of Sex Development ; surgery ; Acellular Dermis ; Coitus ; Congenital Abnormalities ; surgery ; Feasibility Studies ; Female ; Humans ; Mouth Mucosa ; transplantation ; Mullerian Ducts ; abnormalities ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Vagina ; abnormalities ; surgery

Objective To analyze the management and outcomes of patients with ST-segment elevation myocardial infarction (STEMI) in Liaoning province.Methods The data were collected from a prospective and multicenter registry study including 8 tertiary hospitals and 12 secondary hospitals in Liaoning province.Total 1429 patients with acute STEMI admitted to hospitals from June 2009 to June 2010 were included in the study.A unified follow-up questionnaire was applied on patient discharged.Results The average age of patients was (63 ± 13)years.37.4％ of patients recognized the disease as heart disease and 39.7％ were transported by emergency ambulance with a median symptom-to-door time of 150 min.52.9％ patients underwent emergency reperfusion therapy,including fibrinolytic therapy (24.4％) and primary percutaneous coronary intervention (PCI,28.1％).The in-hospital treatment included aspirin (99.6％),clopidogrel (81.9％),statins (90.1％),low molecular weight heparin (89.5％),β-blocker (66.0％),angiotensin converting enzyme inhibitor (ACEI)/ angiotensin receptor blocker (ARB)(66.6％).The in-hospital mortality was 10.7％ ; the mortality in females was higher than that in males (18.3％ vs.7.9％,P ＜ 0.01) and the mortality in older patients (≥ 65 years) was higher than that in younger patients (＜65 years)(17.0％ vs.5.2％,P ＜0.01).The follow-up treatment included:aspirin (81.1％),clopidogrel (45.0％),statins (61.0％),β-blocker (48.3％),ACEI/ARB (42.4％).The follow-up mortality was 5.0％ after hospital discharge.Conclusions Longer pre-hospital delay is commonly seen in STEMI patients.There is still certain gap of emergency reperfusion therapy and the evidence-based medication with related clinical guidelines of STEMI management in Liaoning.

Objective To explore the three-dimensional interesting electrocardiogram (3D-IECG) teaching to strengthen ECG comprehensive application ability for young nurses in CCU. Methods A total of 40 young nurses, who took part in rotary internship in 2013, had been chosen and randomly divided into experimental group and control group on average. The nurses of control group received traditional method of ECG training while the nurses of the experimental group underwent 3D-IECG teaching, and the satisfaction of teaching methods and ECG comprehensive ability were compared. Results The examination of comprehensive ability in the experimental group acquired basic ECG theory (83. 02 ± 10. 01) score, operation (92. 38 ± 4. 23) score, ECG documentation ability (89. 18 ± 9. 32) score, current ECG analysis (90. 01 ± 7. 03), nursing plan making (93. 23 ± 5. 61), personnel nursing round of arhythmia (91. 29 ± 8. 78) score higher those of control group (t=2. 13, 2. 41, 2. 03, 1. 95, 2. 32, 1. 83;P<0. 05). The satisfaction of ECG teaching method in young nurses were 85. 0% of experimental group and 50. 0% of control group with statistical significance between two groups (χ2 =4. 103,P<0. 05). Conclusions The application of 3D-IECG teaching can effectively improve young nurses ECG comprehensive application ability and satisfaction of teaching method, and is worthy of clinical application.

Objective To investigate implementing approach and clinical effect of 4-dimensional innovative model basing on JCI standards on health education to elderly patients with CHD.Methods Following JCI standards, a 4-dimensional model was innovated, regarding 4 aspects of health education for elderly patients with CHD:concept, platform, transmission system and technological application. Totals of 120 elderly patients with CHD were divided randomly into observation group and control group. For the patients in the observation group, health education was conducted according to the 4-dimentional innovative model, while in the control group, routine health education approach for CHD was used, which was to hand out health pamphlets explaining knowledge concerning diet, drug, exercise, follow-up visit, etc. After 5 days of intervention, CHD organism functional status and quality of life of the CHD patients in the two groups were evaluated and compared. Indexes, such as self-management skills, were compared 6 months after discharge. Results In SAQ scoring, there were significant differences between observation group and control group regarding limitation degree of motion, attacking condition of angina or stable condition of angina, scores of satisfaction on treatment and awareness of the disease ( P<0. 05 ) . Conclusions Conducting health education to elderly patients with CHD with the 4-dimensional innovative model basing on JCI standards plays a significant role in promoting guarantee of medical safety, prevention of harmful cardiac incidents, and enhancement of treatment compliance, patients′ self-management abilities and patients′satisfaction.

Objective To explore the application value of the situation-background-assessment-recommendation(SBAR) communication mode in the patients with acute myocardial infarction (AMI).Methods Ninety-four cases of AMI patients who were hospitalized in the department of cardiology in Wuxi No.2 People's Hospital of Nanjing Medical University were included and were randomly divided into the conventional group and the SBAR group. There were 47 cases in each group. The patients in the conventional group were given the routine care; the patient in the SBAR group was given the SBAR communication mode. The nursing satisfaction and the incidence of adverse events in the 2 groups were compared.Results The nursing satisfaction in the SBAR group was 95.74%, which was significantly higher compared to the conventional group (70.21%,P<0.05). The total incidence of adverse events in the SBAR group was 4.25%; in the conventional group the incidence was 25.53%. The difference between the 2 group was significant (χ2=6.42,P<0.05).Conclusions The SBAR communication model can effectively improve the quality of the nurses' disease observation and the nursing satisfaction and reduce the incidence of clinical adverse events, which was worth clinical promotion.

Objective:To explore the effect of continuous nursing model based on family unit in long-term warfarin anticoagulation in elderly patients with mechanical heart valve replacement (MHVR) .Methods:From July 2018 to March 2021, 87 elderly patients who underwent MHVR in Wuxi Second People's Hospital and received long-term warfarin anticoagulation after surgery were selected by convenience sampling as the research subject. The patients were divided into the observation group ( n=46) and the control group ( n=41) by random number table method. The control group adopted the routine nursing model, and the observation group adopted the family unit-based continuous nursing model on this basis. The two groups of patients were compared in terms of 3 indicators, namely treatment compliance, treatment effectiveness, and treatment safety. Results:In terms of treatment compliance, the compliance rates of smoking and drinking cessation, diet control, compliance with medicines and regular review of patients in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . In terms of treatment effectiveness, the international normalized ratio (INR) compliance rate and the quality of life score of the observation group were higher than that of the control group with statistical differences ( P<0.05) . In terms of treatment safety, there was no significant difference in the incidence of bleeding events and thrombosis events between the two groups ( P>0.05) . Conclusions:The continuous nursing model based on family unit is effective and safe, and can improve the compliance of elderly patients with MHVR taking warfarin after surgery, and improve the INR compliance rate and quality of life of elderly patients.