Chloride channel CLC-5 is a voltage-dependent gated channel.The voltage-gated characteristic of CLC-5 is not only regulated by glutamate E211 and E268,but also by lysine K210.In proximal renal tubule,CLC-5 can interact with megalin protein,and adjust the reabsorption of albumin together.CLC-5 can also affect the activities of the sodium hydrogen exchanger isoform 3 in proximal renal tubule.CLCN5 gene mutations can lead to Dent disease,and recent studies have found some new pathogenic mutants of CLC-5,VS05G,L266V and G446A,and so on.CLCN5 can also mutate together with ORCL1,and then result in Dent disease.However,the regulatory mechanism of the voltage-gated channel,physiological functions and molecular mechanism,and Dent disease are still not entirely clear.In this paper,we will review these problems of CLC-5.

Objective To compare various CT signs of pancreatic carcinoma (PC) and inflammatory pancreatic mass (IPM), and to study the diagnostic value of these signs for distinguishing two diseases. Methods Eigty-five patients with PC and IPM were proved by surgery, fine needle aspiration or other comprehensive methods. These patients underwent non-enhanced and enhanced CT scans. CT findings were analyzed retrospectively. The occurrance rates of various CT signs in these two diseases were analyzed with Fisher test and were compared with the corresponding clinical and operational results as welL Results Among the 85 patients, 66 patients were proved to have PC, and 19 were proved to have IPM. In PC group,58 were corerectly diagnosed with CT, 3 (4. 5% ) were misdiagnosed, and 5 (7.6%) were omitted. In IPM group, 9 were correctly diagnosed with CT and 10 (52. 6% ) were misdiagnosed. The CT findings were as follows: (1) Pancreatic mass with liver metastases, lymph node metastases, encased celiac arteries, and cancer emboli in portal veins just occurred in PC group. (2) The occurrence rates of mass over 3 cm in diameter, clear boundary, low-density area within the mass, pseudocysts, peripancreatie infiltration, ascites, and slight and moderate pancreatic-bile duct dilation in PC group were 90. 91% (60/66), 15.15% ( 10/66), 54. 55% ( 36/66 ), 10. 61% ( 7/66 ), 4. 55% ( 3/66 ), 22. 73% ( 15/66 ), 24. 24% ( 16/66 ), 45.45% (30/66), and 27. 27% (18/66) respectively, the occurrence rates in IPM group were 94. 74% ( 18/19), 15.79% ( 3/19 ), 52. 63% ( 10/19 ), 15.79% ( 3/19 ), 15. 79% ( 3/19 ), 21.05% (4/19), 31.58% (6/19) ,21.05% (4/19), and 5.26% (1/19) respectively. There was no statistical difference for these CT findings between two groups(P >0. 05). (3) Pancreatic head mass with atrophy of pancreatic body and tail, mass calcification, pancreatic duct-penetrating sign, pancreatic head mass with hypertrophy of pancreatic body and tail, biliary stones with inflammation , and thickening of pre-kidney fascia in PC group were 48.48% ( 32/66 ), 3.03% ( 2/66 ), 1.52% ( 1/66 ), 10. 61% ( 7/66 ), 6. 06% ( 4/66 ) and 3.03% (2/66) respectively, the occurrence rates of those in IPM group were 5. 26% (1/19),47.37% (9/19), 15.79% ( 3/19 ), 84. 21% ( 16/19 ), 36. 84% ( 7/19 ) and 21.05% ( 4/19 ) respectively. There was statistical difference for these CT findings between two groups ( P < 0. 05 ) . Conclusion Accurate evaluation of various CT signs in PC and IPM is of great importance in the diagnosis of the two diseases.

Objective: To explore the impact of CT image reconstruction methods on the performance of pulmonary nodule detection algorithm based on deep learning (DL). Methods: Lung CT images of 298 cases were labeled by 2 attending doctors, and the inconsistent results between them were checked by a senior doctor. The final labels were regarded as the gold standards of this experiment. Pulmonary nodule detection algorithm was constructed based on a deep neural network and tested on these 298 cases. Comparing the output of the detection algorithm with the doctor's labeling, the sensitivity, accuracy and F1-score of the algorithm were calculated, especially those under different CT image reconstruction methods. Afterwards, the false-positive detections of the algorithm were checked, and the detailed distribution of these false positives was presented. Diagnostic effects of the model were analyzed among different CT image reconstruction algorithms. Results: The sensitivity of pulmonary nodule detection algorithm under mediastinum, lung, and bone CT reconstruction methods was 92.33% (313/339), 86.97% (287/330) and 92.73% (319/344), while the precision was 23.55% (313/1 329), 37.91% (287/757) and 27.84% (319/1 146), respectively. Taken sensitivity and precision into account, F1-socre of these 3 reconstruction methods was 0.38, 0.53 and 0.43, respectively (all P>0.05). Conclusion: Pulmonary nodule detection algorithm based on DL achieves excellent performance under pulmonary window reconstruction, mediastinum window reconstruction and bone window reconstruction, which can help doctors to improve work efficiency and diagnose quality.

Objective To establish a cardiac rehabilitation management program for patients with percutaneous coronary intervention ( PCI ) based on Omaha System. Methods Delphi method was used to interview 27 experts from October to December 2015,and we took two rounds mailing interview. Results The effective returning rates of the first and second round mailing interview were 100% and 92. 60%. The authority coefficient of the experts was 0.92, and the coordination coefficient of experts′opinion was 0.19.Eventually, the cardiac rehabilitation management program included 13 project indicators, 37 assessment indicators, 37 intervention indicators and 5 follow-up time indicators.Conclusions The result of the study is reliable and it may provide references for medical institutions to having a comprehensive knowledge of patients with PCI, thus they can accurately improve the effect of PCI cardiac management and offer evidence for reducing adverse cardiac events.

Objective? To investigate the impact of establishing a follow-up center on the perception of vulnerability and anxiety in the parents of children of congenital heart disease (CHD) undergoing interventional therapy. Methods? A total of 80 parents of children with CHD undergoing interventional therapy in the Cardiology Department of the Second Affiliated Hospital of Harbin Medical University from September 2017 to December 2017 were selected as study subjects by purposive sampling method. The parents of the children admitted to hospital from September to October in 2017 were the control group, while the parents of children in the period from November to December in 2017 were the experimental group. The control group were given general discharge guidance, and the intervention group was included in the Follow-up Center for intervention. Parent Perception of Vulnerability Scale and Self-rating Anxiety Scale (SAS) were applied to evaluate the intervention effects. Results? There was no statistical significance in the difference in scores of Parent Perception of Vulnerability Scale between the two groups before intervention (P＞0.05). The scores of Parent Perception of Vulnerability Scale at the time of discharge and 3 months after intervention of the experimental group were lower than those of the control group, and the difference was statistically significant (P＜ 0.01). There was no statistical significance in the difference in the scores of SAS between the two groups before intervention (P＞0.05). At the time of discharge and 3 months after intervention, the score of SAS was lower in the experimental group than in the control group, and the difference was statistically significant (P＜0.05). Conclusions? Setting up the Follow-up Center for parents of children can effectively reduce the perceived vulnerability and anxiety of them, and it is suggested that they should be further popularized and applied clinically.

Objective To study the dynamic changes of blood carnitine and acylcarnitine levels in preterm infants during parenteral and enteral nutritional support,and the relationship between carnitine status and nutritional patterns,gestational age (GA) and weight gain.Method From January 2017 to December 2017,preterm infants admitted to the neonatal intensive care unit (NICU) within 24 hours after birth and received parenteral nutrition support were enrolled.They were assigned into 4 groups according to their GA:ultra-premature infants (＜ 28 weeks),very premature infants (28 ～ 31 weeks),mid premature infants (32 ～ 33 weeks) and late premature infants (34 ～ 36 weeks).They were assigned into 2 groups according to their average daily weight gain:＜ 15 g/(kg · d) group and ≥15 g/(kg · d) group.Blood samples were collected and examined as dried-blood spot specimens on filter paper for four times:after born,given total parenteral nutrition,given enteral combined parenteral nutrition,and given total parenteral nutrition.The concentrations of free carnitine and acylcarnitine were detected using liquid chromatographytandem mass spectrometry (LC-MS/MS).SPSS 21.0 statistical software was used for statistical analysis.Result A total of 124 preterm infants and 410 samples were collected.As the infants experienced gradual transition from parenteral nutrition to enteral nutrition,the free carnitine and most acylcarnitines levels were decreasing (C3,C4,C10DC,C12,C12∶1,C12DC,C14,C16,C16∶ 1,C16-OH and C18,P＜0.05).Preterm infants with small GA showed higher levels of C4-OH (P =0.001) and C5 (P =0.001).Preterm infants with lower velocity of weight gain showed lower concentration of C5-OH (P =0.006) in the early postnatal period.Conclusion Free carnitine and acylcarnitine in preterm infants during the early postnatal period are decreasing with the transition from parenteral nutrition to enteral nutrition,indicating that the exogenous nutrition is relatively insufficient.C4-OH and C5 levels are negatively correlated with GA.In addition,lower level of C5-OH may indicate slow weight gain during the early postnatal period.

Objective:To explore the predictive effect of acute stress disorder (ASD) in patients with acute myocardial infarction (AMI) on subsequent post-traumatic stress disorder (PTSD) , and to clarify the potential mediating role and pathway of type D personality and cognitive evaluation in the evolution of ASD to PTSD in AMI patients.Methods:Using the convenient sampling method, patients with newly diagnosed AMI in Department of Cardiology of the 2nd Affiliated Hospital of Harbin Medical University from September to December 2019 were selected as the research subjects. General Information Questionnaire, Acute Stress Disorder Scale (ASDS) , Type D Personality Scale-14 (DS-14) and Cognitive Appraisal of Health Scale (CAHS) were used for survey 1 to 2 days after hospitalization.One month after discharge from the hospital, a follow-up call was used to complete Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) .Results:A total of 494 questionnaires were distributed in this study, and 457 valid questionnaires were returned.The incidence of ASD in AMI patients was 31.29% (143/457) , and the ASDS score was (40.28±12.74) . The incidence of PTSD was 33.5% (153/457) , and the PCL-C score was (34.49±14.00) .The moderated mediating effect analysis showed that ASD could directly and positively predict PTSD ( P<0.01) , and injury cognition and irrelevant cognition played a mediating role in the transition from ASD to PTSD ( P<0.01) .At the same time, type D personality can influence the process of ASD to PTSD transformation by regulating injury cognition and irrelevant cognition ( P<0.05) . Conclusions:The occurrence of ASD in AMI patients can effectively predict the occurrence of PTSD one month after discharge.At the same time, the cognitive evaluation of type D personality regulation can play an important mediating role in the process of ASD transforming into PTSD.

Objective:To explore the effects of mindfulness-based stress reduction training (MBSRT) on anxiety and depression levels and sleep quality of clinical nurses.Methods:Totally 90 clinical nurses from the Second Hospital of Harbin Medical University were selected by convenient sampling from April 2018 to June 2019, and were divided into experimental and control groups according to the order of enrollment, with 45 cases in each group. Nurses in the control group received routine sleep and emotional guidance, while nurses in the experimental group underwent MBSR training on this basis. Self-Anxiety Scale (SAS) , Self-Depression Scale (SDS) , and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the intervention effect in both groups 1 day before the intervention and the day when the intervention was completed. Finally, 44 nurses in the experiment group and 45 in the control group completed the study.Results:Before the MBSRT intervention, there was no statistically significant difference in the SAS, SDS, and PSQI scores between the two groups of nurses ( P>0.05) . After the intervention, the SAS and SDS scores of nurses in the experimental group were lower than those of the control group, and the differences were statistically significant ( t=-3.117, -3.498; P<0.05) ; the total PSQI score and scores in such dimensions as subjective sleep quality, sleep latency, sleep continuity, sleep efficiency, sleep disorder, hypnotic drug use, and daytime dysfunction in the experimental group were lower than those of the control group, and all differences were statistically significant ( P<0.05) . Conclusions:MBSRT can effectively reduce the level of anxiety and depression and improve the sleep quality of clinical nurses.

Objective:To investigate the acute stress disorder (ASD) , post-traumatic stress disorder (PTSD) , anxiety, and depression in patients with acute myocardial infarction (AMI) , and analyze the predictive effect of ASD, anxiety, and depression during hospitalization on the PTSD, anxiety and depression in the following month.Methods:From September to December 2019, convenience sampling was used to select 457 AMI patients from a ClassⅢ Grade A hospital in Harbin as the research object. The Acute Stress Disorder Scale (ASDS) , Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) , Beck Anxiety Inventory (BAI) and Beck Depression Inventory-Ⅱ (BDI-Ⅱ) was used to investigate the patients during hospitalization (within one week of admission) and the following month.Results:Among 457 AMI patients, the incidence of ASD, anxiety and depression during hospitalization were 31.29% (143/457) , 42.23% (193/457) and 29.98% (137/457) , respectively. The incidence of PTSD, anxiety, and depression in AMI patients at one month was 30.20% (138/457) , 10.50% (48/457) , and 26.48% (121/457) , respectively. The results of the cross-lagged analysis showed that ASD (β=0.11, P<0.05) , anxiety (β=0.16, P<0.01) , depression (β=0.25, P<0.01) during hospitalization had statistical significance in predicting PTSD at one month. Besides, anxiety during hospitalization had statistical significance in predicting anxiety (β=0.34, P<0.01) and PTSD (β=0.16, P<0.01) at one month, and depression during hospitalization had statistical significance in predicting depression (β =0.59, P<0.01) and PTSD (β=0.25, P<0.01) at one month. Multiple linear regression analysis showed that the high alertness, re-experience and separation of symptoms of ASD had statistical significance on the predictive effect of PTSD ( P<0.01) . Conclusions:ASD, anxiety, and depression during hospitalization of AMI patients have a positive predictive effect on PTSD, anxiety, and depression in the following month. Psychological intervention during hospitalization of AMI patients should be strengthened to relieve their anxiety, depression, fear and other negative emotions in time, so as to effectively reduce the occurrence of later traumatic stress disorder.

Objective:To explore the effect of online and offline blended scenario simulation teaching in the practice of nursing undergraduates.Methods:From August 2020 to May 2021, convenience sampling was used to select 76 nursing undergraduates in the class of 2017 who practiced in the Cardiology Department of the Second Affiliated Hospital of Harbin Medical University as the research object. The undergraduates were randomly divided into the experimental group and the control group, 38 in each group. The control group received the traditional graduation practice training, and the experimental group received online and offline blended scenario simulation teaching on this basis. After the practice, the clinical thinking ability of the two groups of students was evaluated by the Clinical Thinking Ability Evaluation Scale, the clinical practice ability of the two groups of students was evaluated by the Objective Structured Clinical Examination (OSCE) , and a teaching satisfaction survey was conducted.Results:The total score of clinical thinking ability, critical thinking ability, systematic thinking ability, evidence-based thinking ability, OSCE total score of the students in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The students in the experimental group thought that the teaching method was helpful for in-depth understanding and application of theoretical knowledge, improving nursing assessment skills, clinical coping skills and communication skills, and at the same time helping to cultivate critical thinking and teamwork awareness, and arouse learning enthusiasm, and the differences were statistically significant (all P<0.05) . Conclusions:The online and offline blended scenario simulation teaching can effectively improve the clinical thinking ability, clinical practice ability and teaching satisfaction of nursing undergraduates, and it has good effect in the graduation practice of undergraduate nursing students.