Clinical data of a child with leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) diagnosed in the First Affiliated Hospital of Zhengzhou University in June 2020 were retrospectively analyzed.A female patient with 1 year and 2 months old presented with 10 months of developmental delay and 1 month of recurrent seizures.Physical examinations showed grade Ⅲ muscle strength of limbs, slightly higher muscle tone, active reflex of bilateral knee tendons, normal reflex of bilateral achilles tendons, and positive Babinski sign.Brain magnetic resonance imaging (MRI) showed bilateral cerebral hemisphere atrophy and diffuse abnormal signals.The whole exome sequencing test showed two heterozygous mutations of the DARS2 gene in the present case.There are no reports of early-onset LBSL gene mutation in Chinese population.A total of 6 related foreign literatures have been reported.All affected cases present psychomotor development disorders and other encephalopathy manifestations.Brain MRI involvement and DARS2 gene mutations are found in previous reports.Therefore, for children with developmental retardation, epilepsy, and diffuse abnormal signals in both cerebral hemispheres examined by brain MRI, genetic testing is recommended to confirm the diagnosis, guide prenatal diagnosis and genetic counseling.

Objective To investigate the application of digital working system for the serving counter in major operation room. Methods We reestablished the streamline of the work at serving counter, we invented coordinate system of surgery arrangement platform-sign in-clothing changing machine-locker, established the rules of counter gate control system as well as protocol for clothing management in order to improve the overall quality and efficiency of the serving counter in the operation room. Results The digital working system of the serving counter could make the serving process running more programmed, normalized, standardized, institutionalized in the operation room. The satisfaction of first operation attendance rate, the dirty operating clothing collect rate, and operation management satisfaction from doctors were 92. 0%, 96. 0%, 97. 0%, which were higher than those of the control group (χ2 = 89. 90, 145. 72, 15. 34, respectively;P < 0. 01 ). Conclusions The application of digital working system can facilitate the service progress, normalize the management of the operation room, improve the efficiency of the operating room and upgrade the level of the management of infection in the operation room.

Objective To explore the application of standard interaction theory in the nursing care of multidrug resistance patients .Methods 113 cases of multidrug resistance inpatients were randomly divided into the observation group (58 cases) and the control group (55 cases).The observation group was give the nursing care based on the standard interaction theory , while the control group used the conventional nursing method .The psychological condition , medication adherence , treatment effect and satisfaction were compared between the two groups.Results After the intervention, the average score of anxiety in the observation group decreased from (18.51 ±3.71) to (8.20 ±2.82); the average score of depression in the observation group decreased from (57.06 ±8.29) to (35.74 ±10.80).The average score of anxiety in the control group decreased from (18.14 ±3.36) to (13.30 ±4.90); the average score of depression in the control group decreased from (56.94 ±7.24) to (54.74 ±7.25).The differences between groups were significant (t=-6.924,-11.100, respectively;P<0.05).The percentage of medication adherence was 96.5% in the observation group, which was significantly higher than 60.0% in the control group.The treatment effect of the observation group (52 cases) was better than (15 cases) in the control group.The satisfaction was (89.53 ±8.187) in the observation group than (79.53 ±10.563) in the control group.The difference between groups was significant (Z=-7.018,-6.646, respectively;t=5.480;P<0.05).Conclusions The standard interaction theory had remarkable effect in the application of nursing care of multidrug resistance patients .It can improve patients ’ psychological condition and medication adherence and satisfaction , thus it is worthy of promoting .

Objective? To monitor and analyze the temperature of different positions in the cold closet of an air-cooled refrigerator in a Class Ⅲ Grade A hospital, and provide guidance for nurses in the ward to use air-cooled refrigerators properly. Methods? Totally 3 air-cooled refrigerators from a ClassⅢ Grade A hospital in Zhejiang Province were selected by convenient sampling during June to July 2017. Temperature of 23 different positions from 3 compartments of the cold closet of each refrigerator were monitored, compared, and analyzed, covering the front, back, left, right, middle, storage box, air supply outlet, return air inlet, panel, and real- time temperature meter of the refrigerator, etc. Results?(1) The temperature of the front, back, left and right compartment of the air-cooled refrigerator was compared, temperature of the left and right of the middle and lower compartment was compared, temperature of the front and the back of the upper compartment was compared, all difference of the above showed no statistical significance (P＞ 0.05). The difference between the front and the back of the middle and lower compartment showed statistical significance (P＜0.01). (2) The difference between the refrigerator door and the monitoring point in the middle of the refrigerator was statistically significant (P＜0.01). (3)The temperature difference between the air supply outlet and the return air inlet was statistically significant (P＜0.01). (4)The real-time temperature detected in the refrigerator box was statistically different from the temperature detected in the middle of the refrigerator body (P＜0.01). Conclusions? Nurses should master the cold closet temperature features of air-cooled refrigerators, the temperature difference between different spatial positions, and the time difference of temperature changes after temperature modification and use the refrigerators correctly, so as to meet the temperature requirements for medicine storage in the wards.