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.

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.

[ 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 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 collect preliminary data of normal Chinese female genital appearance, to compare the parameters of Han and Uygur nationality, and to present the preliminary data for normal female external genitalia database. Methods: This study design recruited healthy females referred to the out-patient clinic for physical examination from October 2014 to March 2015 in Xinjiang Petroleum Geological Survey Department Staff Hospital. The recruitment was based on rigid inclusion and exclusion criteria. Demographic data consists of nationality, age, height, weight, marital status, gravidity, parity, vaginal delivery, and intercourse frequency. Anthropometric measurements were taken in 234 females of Han group whereas 278 females of Uygur group. For each individual 16 parameters were measured. The external genitalia appearance in Han and Uygur nationality was compared. The significance of variations in age, height, weight, BMI, gravidity, parity, vaginal delivery and intercourse frequency were analyzed. Results: Primary measurements of Han and Uygur nationality are presented as mean (95% confidence interval). There are many differences in female genital appearance between Han and Uygur nationality. Several parameters were statistically associated with age, BMI, gravidity, parity, vaginal delivery and intercourse frequency. The females with complete labial asymmetry account for 5.6%(13/234) and 5.8%(16/278) in Han and Uygur normal adults, respectively. Conclusions This study presented the external genitalia measurements of normal Chinese female adults in Xinjiang, thus providing the preliminary data for normal female external genitalia database. Females of Han and Uygur nationality have multiple differences in external genitalia appearances. The parameters are associated with age, BMI, gravidity, parity, vaginal delivery, and intercourse frequency. The labial asymmetry is a universal phenomenon.

Objective:To analyze the distributions of ABO and RhD blood groups by analyzing the basic data of blood group detection among voluntary blood donors in Huainan in 2021, to provide data support for blood recruitment, clinical use of blood, and emergency guarantee of rare groups of blood.Methods:ABO and RhD blood groups of 24 484 voluntary blood donors eligible for blood donation in 2021 were detected using the Metis150-8 automatic blood group analyzer, manual saline method, antihuman globulin method, and manual polybrene test. The blood group results were statistically analyzed.Results:Among 24 484 voluntary blood donors in Huainan in 2021, A blood group accounted for the highest proportion (7 463 cases, 30.48%), followed by O blood group (7 444 cases, 30.40%) and B blood group (7 056 cases, 28.82%), and the last was AB blood group (2 521 cases, 10.30%). A total of 143 cases of RhD-negative blood were detected, and the negative frequency of RhD was 0.58% (143/24 484). Among the RhD-negative blood samples, 43 cases of type A, 41 cases of type B, 46 cases of type O, and 13 cases of type AB were RhD-negative, accounting for 30.07%, 28.67%, 32.17%, and 9.09%, respectively. There was no statistical difference in the detection rate of Rh-negative blood among different ABO blood groups in Huainan ( χ2 = 0.36, P = 0.948). The ABO blood group distribution of voluntary blood donors in Huainan in 2021 was not identical to those of voluntary blood donors in Guangzhou, Yueyang, Xinjiang Bozhou, Zhangzhou, and Liuzhou. The proportion of type A blood donors in Yueyang was higher than those in other regions. The proportions of type B blood donors in Huainan, Xinjiang Bozhou, and Zhangzhou were higher than those in other regions. The proportion of type O blood donors in Liuzhou was higher than those in other regions. The proportions of type AB blood donors in Huainan and Xinjiang Bozhou were higher than those in other regions. Conclusion:The distributions of ABO and RhD blood groups among voluntary blood donors in Huainan region have certain regional characteristics. Central blood banks and medical institutions should reasonably store and supply blood according to the blood collection from voluntary blood donations and the needs of clinical transfusion, to prevent the occurrence of situations such as blood expiration and waste.

Objective To analyze the clinical manifestations, imaging features, histopathology and genes of cerebrotendinous xanthomatosis (CTX) to improve the understanding of clinical workers on the disease. Methods The imaging examination, histopathological and gene detection methods were synthetically applied, and the disease characteristics of two patients with CTX, admitted to our hospital in March 2018 , were analyzed. Results (1) Patient one was a 52-year-old male, with typical neurological symptoms: weakness of both lower limbs, damage of pyramidal tract and extrapyramidal system, cognitive impairment, and ataxia; non-neurological symptoms included cataract, arch foot, and Achilles tendon mass; cranial MR imaging indicated symmetrical abnormal signal of cerebellar dentate nucleus, low signal on T1WI, and slightly high and low signal intensity on T2WI/FLAIR; achilles tendon biopsy showed fibrous connective tissues with multiple xanthoma cells and multinucleated giant cells aggregation, accompanied by cholesterol crystallization. (2) Another 16-year-old male presented with cerebellar ataxia, recurrent seizures, mental and motor retardation, and congenital cataract; two heterozygous mutations of CYP27A1 gene were detected by gene detection; and the mutations were c.373-379 delCCAGTAC and c.1420C>T. Conclusion The clinical manifestations of CTX are varied; early imaging examination lacks specificity; it can be clearly diagnosed by histopathology and CYP27A1 gene detection.

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.