Objective To investigate the impact of umbilical cord around the neck(UCAN) on infants developmental quotient. Methods Intelligence of 60 infants of UCAN under 3 years old were tested by Gesell. Results DQ of UCAN infants was significantly less than normal infants,mainly mild to moderate retardation. DQ between the male and female infants had no significant difference, parents' cognitive level had significant difference with real DQ of infants. Conclusions UCAN has certain influence on mental development of infants,we should strengthen health education,pay close attention to UCAN infants,give regular intelligence surveillance, find early growth retardation,give rehabilitation training to reduce the incidence of intellectual disabilities.

Objective To quantitatively assess severity of movement disability by analyzing physical activities recorded by an actigraph monitor in patients with neurology disorders.Methods Eighty-one patients with Parkinson' s disease(PD)and 61 patients with acute cerebral infarction(ACI)accompanying impaired upper limb motor function were included in the study.PD patients and ACI patients were treated using the international PD and ACI treatment guidelines,respectively.The patients were asked to wear an Actigraph monitor for 6 days before the treatment in both PD and ACI patient groups and at 24-38 days post-treatment in PD patients or at 28 days post-treatment in ACI patients.The recorded data was analyzed by power-law exponent(PLE)and detrended fluctuation analysis(DFA).Clinically,before and after the treatments,PD patients were evaluated using the conventional Unified Parkinson Disease Rating Scale (UPDRS),and ACI patients were evaluated by assessing upper limb motor function using Fugl-Meyer Assessment(FMA)and Functional Independence Measure(FIM).The correlation of the UPDRS scores with PLE was analyzed in PD patients,and the correlation of FMA or FIM with DFA in ACI patients.Results Both the UPDRS scores and the PLE values in PD patients were improved after the drug administration(UPDRS total:32.8 ± 16.2 and 28.8 ± 14.7,Z =2.080,P =0.038; UPDRS Ⅲ:18.6 ± 8.2 and 15.7±6.8,Z=2.155,P=0.031; PLE:0.98 ±0.25 and 0.82 ±0.21,Z=2.212,P=0.027,before and after the treatment,respectively).There were a linear correlation coefficient of 0.699 between the improvements of total UPDRS scores and the PLE values,and of 0.823 between the UPDRS Ⅲ and the PLE values.FMA,FIM scores and DFA were improved significantly than before treatment(FMA:12.39 ± 8.21 and 30.28 ±7.29,Z=3.016,P =0.004; FIM:8.98 ±7.29 and 13.21 ±7.6,Z =2.282,P=0.038; DFA:0.86 ±0.31 and 0.98 ±0.27,Z =2.360,P =0.036,before and after the treatment,respectively).It also showed linear correlations between the improvements of FMA scores and DFA(r =0.638),and between FIM scores and DFA(r =0.712,both P ＜0.05).There was no correlation between UPDRS scores and DFA values in PD patients,nor between FIM scores or FMA scores and PLE values in ACI patients.Conclusions Actigraph device can be used to monitor patients activity in movement disorders.Analysis of its PLE can provide a quantitative evaluation in PD while its DFA may provide useful specific assessment of impaired upper limb motor function in ACI patients.It can also be used in quantitatively assessing new drug efficacy.

Chronic kidney disease (CKD) is a chronic renal structure change and dysfunction caused by a variety of causes.The incidence and prevalence of CKD have been on the rise,becoming a major global health problem.An increasing number of studies had shown that one of the important indicators of CKD progression was the disorder of gut microbiome and elevated levels of sernm endotoxin.Modern physicians of traditional Chinese medicine (TCM) believed that the main pathogenesis of CKD was spleen and kidney deficiency.And the therapeutic regimen was invigorating spleen and nourishing the kidney.Spleen is in the middle burner.It has the function of transportation and resistance to evil,which was extremely similar to the function of gut microbiome in metabolism and immunity.The latter might be one of the biological bases of physiological function of spleen.This comprehensive review presented the modern theoretical basis of spleen-based TCM treatment methods for CKD from the insight of modern gut microbiome and metabolism.Firstly,gut microbiome and its metabolism were associated with the spleen in TCM theory.Gut microbiome affected individual metabolism and immune function,which could provide a modern biological basis for explaining the physiological function of the spleen.Secondly,gut microbiome and its metabolism were correlated with CKD:intestinal flora disturbance occurred in CKD patients,producing enterogenous toxins as their metabolites,which become the important factors affecting prognosis.Thirdly,as for its origin,development and current status based on the spleen theory,CKD was one of various consumptive diseases.Spleen insufficiency was one of their critical pathogenic mechanisms.Therefore,tonifying the spleen should be a treatment method to maintain throughout the entire treatment.On the basis of our previous clinical studies and the hypothesis of gut microbiome and metabolism,we proposed further studies which were also based on system biology and its technology.

Objective: Attentional biases toward emotional scenes may represent vulnerability and maintenance factors in depression. Antidepressant therapy may improve cognitive function and reduce depression, and is considered as the mechanism of action of antidepressants. Therefore, we conducted an eye-tracking test to examine whether selective serotonin re-uptake inhibitor (SSRI) antidepressants can reduce negative attentional biases and elicit clinical responses in depression. Methods: Twenty first-episode depressive patients freely viewed three types of pictures that depicted different emotional scenes (i.e., positive-control, neutral-control, and negative-control) for 4,000 ms while their eye movements were monitored. The attentional bias to different emotional scenes was assessed before and after eight weeks of SSRI treatment using the eye-tracking method. The control group included a group of healthy individuals. Results: The results revealed that first-episode depressive patients oriented their gaze more frequently to negative images and less to happy images, compared to controls. Importantly, the attentional bias in depressive patients was regulated after eight weeks of SSRI treatment. Patients showed an increased tendency to fixate on positive images and a decreased tendency to focus on negative images. Conclusion This suggests that SSRI antidepressants decrease vulnerability to negative images, while having an effect on attention in respect to positive images.

Objective: To explore the application value of endoscope in probing the chronic wound with sinus tract in clinic. Methods: Twenty-eight chronic wounds with sinus tracts from 27 patients conforming to the inclusion criteria admitted to Outpatient Department of Wound Healing Center of Ruijin Hospital from December 2017 to March 2018 were investigated in a prospective and self-controlled trial. After being cleaned, the diameter of the opening of sinus tract was measured with a rule. A probe was used to measure the depth of a sinus tract according to the touch from the probe extremity in operation, and to measure the depth of a sinus tract that could be observed with naked eyes with the help of a pair of hemostatic forceps. Five minutes later, a probe was inserted deeply into the sinus tract to measure the depth under the endoscopic view combined with touch from the probe extremity in operation. Afterwards, the sinus tract was observed with endoscope, and the depth of the tract which could be observed under the endoscopic view was measured using a probe inserted deeply into the sinus tract. After completion of the above exploration, the sinus tract was infused with contrast agent Omnipaque 350 and scanned by computed tomography (CT) later to obtain its depth. The following indicators were calculated: the ratio of the depth of the sinus tract measured by CT to the diameter of the opening of the sinus tract (hereinafter referred to as the depth/diameter ratio of the sinus tract), the deviation rate comparing the depth of the sinus tract measured by conventional method (measured by probe only) and by endoscope (measured by probe under the endoscope view) with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the measured depth of the sinus tract), the deviation rate comparing the depth of the sinus tract that could be observed measured by conventional method and by endoscope with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the depth of the sinus tract that could be observed). Data were processed with paired t test. Pearson correlation analysis was applied to analyze the correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope. Results: The depth/diameter ratio of the sinus tract of this group of wounds was 1-32 (8±7). The deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method were (19±14)% and (79±18)%, respectively, both obviously larger than (9±9)% and (25±25)% by endoscope (t=3.837, 13.626, P<0.01). Positive correlation existed between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by conventional method, and between the depth/diameter ratio of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope (r=0.514, 0.585, 0.651, P<0.01). However, there was no obvious correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by endoscope (r=0.113, P>0.05). Conclusions Compared with the conventional method, application of endoscope is able to get more accurate data of chronic wounds with sinus tracts and observe the wounds with wider range.

Objective To explore the characteristics of opportunistic infections(OIs)in HIV-infected indi-viduals with suboptimal immune reconstitution after ART treatment so as to provide a reference for preventing and managing HIV infections.Methods The clinical data including opportunistic infections specifically were acquired from 112 HIV-infected individuals with suboptimal immune reconstitution from the outpatient department of Wuming Hospital,Guangxi Medical University.The impact of baseline CD4+T lymphocyte counts on the incidence,type,and mixed infection rates of the opportunistic infections were analyzed.Results The opportunistic infection rate among the 112 HIV-infected individuals with suboptimal immune reconstitution was 42.86%,among which fungal infections were the most commonly seen.The opportunistic infection rate of the patients with a baseline of CD4+T lymphocyte counts≤50/μL was significantly higher than that of the patients with a baseline of CD4+T lymphocyte counts>50/μL,and there was no significant difference in the type of opportunistic infections as well as the rate of mixed infections.Conclusion HIV-infected people with suboptimal immune reconstitution in Guangxi are susceptible to HIV OIs.Among them,the group with a baseline CD4+ T lymphocyte counts≤50/μL has a higher rate of OIs,mainly fungal infections.

Objective: To construct evaluation index system of training effectiveness for new recruiting nurses based on the theory of Kirkpatrick Model. Methods: The draft of evaluation index system of training effectiveness for new recruiting nurses was drawn up through literature survey and interview method first, and then it was constructed by using Delphi method and statistical analysis. Results: Through two rounds of expert consultations, the experts′ suggestions were revised and summarized, and then the evaluation index system was constructed, including 4 grade I indexes, 14 grade Ⅱindexes, and 56 grade Ⅲ indexes. The positive coefficients of the two rounds of expert consultation were 96.15% and 100.00%, respectively, with authoritative coefficient of 0.877. The Kendall Harmony Coefficients of importance and operability of grade I, Ⅱ, and Ⅲ indexes were 0.640, 0.378, 0.296, and 0.707, 0.515, 0.416, respectively (P< 0.01). Conclusions The enthusiasm, authority level and coordination degree of the experts were all at a high level. The evaluation index system of training effectiveness for new recruiting nurses was of high importance and operability.

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient′s medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.

Objective:To identify the relationship between exposure to mobile phones and other electronic products and the ability development in children.Methods:Retrospective study.A total of 218 children aged 0.5-6.0 years presented to the Department of Health Care, Beijing Children′s Hospital, Capital Medical University form September 2019 to June 2020 for developmental examination were included.Those with nervous system, mental system diseases, endocrine system diseases and premature children were excluded.Their development was evaluated and the information about exposure to mobiles phones and other electronic products were collected. Chi- square test and Fisher′ s exact probability method were used to analyze the relationship between the exposure to mobile phones and other electronic products and the ability development in children.The influencing factors of children′s development in various fields were analyzed by the binary Logistic regression. Results:Abnormal fine movements of children aged 0.5-0.9 years were related to the latest time every night of exposure ( P<0.05). Abnormalities of adaptability, language and social self-care in children aged 1.0-2.9 years and abnormality of language in children aged 3.0-5.9 years were correlated with the number of hours of daily exposure (all P<0.05). Abnormalities of language and social self-care in children aged 1.0-2.9 years and abnormalities of adaptability, language and social self-care in children aged 3.0-5.9 years were correlated with the purposes of exposure (all P<0.05). Binary Logistic regression analysis indicated that the children′s gross motor was affected by the number of hours of daily exposure ( OR=1.868, P<0.05). The children′s fine motor movements were affected by mother′s educational level and the latest time every night of exposure ( OR=1.722, 2.355, all P<0.05). The children′s adaptability was affected by mother′s educational level, child caregivers, the number of hours of daily exposure and the latest time every night of exposure ( OR=1.711, 2.866, 1.895, 1.650, all P<0.05). The children′s speech was affected by the number of hours of daily exposure, the latest time every night of exposure, and the purposes of exposure (telephone or video phone, early education or study)( OR=2.348, 1.806, 0.328/0.350, all P<0.05). The children′s social interaction and self-care delay were affected by mother′s educational level, the number of hours of daily exposure and the purposes of exposure (telephone or video phone, early education or study)( OR=1.647, 2.678, 0.307/0.363, all P<0.05). Conclusions:The adverse effects of exposure to mobile phones and other electronic products on children should be well concerned.The exposure time of developing young children should be strictly controlled to prevent the adverse effects on the nervous system and development in children.For children who were already affected, relevant habits and behaviors should be timely corrected to avoid irreversible damages.

Objective:To analyze the relationship between killer cell immunoglobulin-like receptor ( KIR) genes and immune reconstitution failure in human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) patients after anti-retroviral therapy (ART). Methods:HIV/AIDS patients receiving ART for ≥1 year who attended the AIDS outpatient clinics of Wuming Hospital of Guangxi Medical University and People′s Hospital of Mashan from May 2007 to December 2019 were included. Patients were divided into immune reconstitution failure group and full immune reconstitution group. Polymerase chain reaction with sequence specific primers (PCR-SSP) was used to detect KIR genotypes in all subjects, and the genotype frequency (PF) of 16 KIR genotypes was calculated. Statistical analysis was conducted using chi-square test. Multivariate logistic regression was used to analyze the relationship between KIR genotypes and immune reconstitution failure.Results:There were 102 patients with HIV/AIDS, including 44 immunological non-responders and 58 immunological responders. The PF of KIR2 DL5 in immune reconstitution failure group was 59.09%(26/44), which was higher than 36.21%(21/58) in full immune reconstitution group, and the difference was statistically significant ( χ2=5.27, P=0.022). Multivariate logistics regression analysis showed that KIR2 DL5 was associated with immune reconstitution failure when adjusted for age and baseline CD4 + T cell count. Positive expression of KIR2 DL5 may be a risk factor for immune reconstitution failure (adjusted odds ratio (a OR)=2.431, 95% confidence interval 1.012 to 5.844, P=0.047). Conclusions:Positive expression of KIR2 DL5 may be related to immune reconstitution failure in HIV/AIDS patients after ART.