Background::Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods::We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018).Results::Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring’s overall crystallized intelligence. Conclusions::Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Stroke is one of the main diseases endangering the health and life of the middle-aged and elderly,and in recent years it shows a younger trend.It has the characteristics of high incidence,mortality and disability rate.Atherosclerosis is the main intervention target for stroke prevention and treatment.CircRNA is highly expressed in the cerebrovascular system and plays an important regulatory role in the pathogenesis of ischemia-reperfusion and ischemic stroke.This paper reviews the mechanism of circRNA and miRNA molecular network in the pathophysiological process of atherosclerosis,ischemic stroke and ischemia-reperfusion injury,so as to provide theoretical support for the application of circRNA in gene diagnosis and drug treatment of atherosclerotic ischemic stroke.

Objective:To understand the true feelings of nursing undergraduates about their professional cultural confidence, and to provide reference for nursing educators and managers to formulate ideological and political education programs.Methods:Totally 33 undergraduate nursing students admitted into Guangzhou Medical University in 2020 were selected by purposive sampling from November to December 2020. This study adopted the phenomenological method in qualitative research. Semi-structured group focus interviews were conducted with the nursing undergraduates, and Colaizzi's 7-step analysis was used to analyze the data and refine the themes.Results:The nursing undergraduates showed both positive and negative psychological experience towards nursing culture. Positive experience themes included recognition, acceptance and love, while negative experience themes included conflict, resistance and confusion.Conclusions:This study reveals the psychological experience of nursing undergraduates' cultural confidence in this profession. It is recommended that nursing educators and managers pay attention to and strengthen the positive experience of nursing undergraduates, and devote themselves to ameliorating their negative experience. They should provide targeted education for general culture and nursing culture, help nursing undergraduates establish a positive and stable nursing culture perception, and cultivate their confidence in nursing culture.

OBJECTIVE: To explore the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis and to construct a risk nomogram model. METHODS: The clinical data of 234 sepsis patients admitted to the intensive care unit (ICU) of Tianjin Hospital from January 2019 to May 2022 were retrospectively analyzed. The patients were divided into non-ARDS group (156 cases) and ARDS group (78 cases) according to the presence or absence of ARDS. The gender, age, hypertension, diabetes, coronary heart disease, smoking history, history of alcoholism, temperature, respiratory rate (RR), mean arterial pressure (MAP), pulmonary infection, white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer, oxygenation index (PaO₂/FiO₂), lactic acid (Lac), procalcitonin (PCT), brain natriuretic peptide (BNP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) were compared between the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of sepsis related ARDS. Based on the screened independent risk factors, a nomogram prediction model was constructed, and Bootstrap method was used for internal verification. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) was calculated to verify the prediction and accuracy of the model. RESULTS: There were no significant differences in gender, age, hypertension, diabetes, coronary heart disease, smoking history, alcoholism history, temperature, WBC, Hb, PLT, PT, APTT, FIB, PCT, BNP and SCr between the two groups. There were significant differences in RR, MAP, pulmonary infection, D-dimer, PaO₂/FiO₂, Lac, ALB, BUN, APACHE II score and SOFA score (all P < 0.05). Multivariate Logistic regression analysis showed that increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score were independent risk factors for sepsis related ARDS [RR: odds ratio (OR) = 1.167, 95% confidence interval (95%CI) was 1.019-1.336; MAP: OR = 0.962, 95%CI was 0.932-0.994; pulmonary infection: OR = 0.428, 95%CI was 0.189-0.966; Lac: OR = 1.684, 95%CI was 1.036-2.735; APACHE II score: OR = 1.577, 95%CI was 1.202-2.067; all P < 0.05]. Based on the above independent risk factors, a risk nomograph model was established to predict sepsis related ARDS (accuracy was 81.62%, sensitivity was 66.67%, specificity was 89.10%). The predicted values were basically consistent with the measured values, and the AUC was 0.866 (95%CI was 0.819-0.914). CONCLUSIONS Increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score are independent risk factors for sepsis related ARDS. Establishment of a risk nomograph model based on these factors may guide to predict the risk of ARDS in sepsis patients.
Humans ; Retrospective Studies ; Alcoholism ; Prognosis ; Respiratory Distress Syndrome ; Pneumonia ; Sepsis ; Intensive Care Units ; Procalcitonin ; Fibrinogen ; ROC Curve

Objective:To evaluate the effect of penile dorsal extension and bandaging after concealed penis surgery.Methods:In this study, 80 children who underwent concealed penile correction were randomly divided into a dorsal extension bandaging group (experimental group) and a traditional bandaging group (control group) from Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University during September 2016 to September 2019. The control group was applied with traditional sleeve-type bandaging, and the test group was treated with penile dorsal extension bandaging. A total of 75 children was summarized in this study. Among them, there were 38 children in the experimental group, with a mean age of 64 months. Thirty-seven children were in the control group, with a mean age of 70 months. The incidence of complications during hospitalization, the number of calls to medical staff within the first 24 hours after surgery, the pain score of the child during dressing removal, and the time taken for dressing removal were compared and recorded. Measurement data were analyzed by t-tests and enumeration data were analyzed by chi-square tests between groups. All data were analyzed using software SPSS 17.0. Results:The incidence of complications during hospitalization was 5.26%(2/38) and 10.81%(4/37) in the experimental and control groups, respectively. This difference was not statistically significant( χ2=0.784, P>0.05). In the dorsal extension bandaging group and the traditional bandaging group, the average number of calls to medical staff 24 hours after surgery was (0.87 ± 0.91) and (1.54 ± 1.02) times, the difference was statistically significant ( t=2.996, P=0.003); as for the highest pain scores of the children when the dressing was removed were 5.21 ± 1.19 and 7.24 ± 1.20, the difference was statistically significant ( t=5.697, P< 0.001); the time taken to remove the dressing was (3.21 ± 1.24) min, (7.56 ± 1.88) min, and the difference was statistically significant ( t=11.917, P<0.001). Conclusions:The penile dorsal extension bandaging method after concealed penis surgery can reduce the number of calls to medical staff, reduce the time of dressing removal and the degree of pain in children.

Objective:To evaluate the effect of penile dorsal extension and bandaging after concealed penis surgery.Methods:In this study, 80 children who underwent concealed penile correction were randomly divided into a dorsal extension bandaging group (experimental group) and a traditional bandaging group (control group) from Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University during September 2016 to September 2019. The control group was applied with traditional sleeve-type bandaging, and the test group was treated with penile dorsal extension bandaging. A total of 75 children was summarized in this study. Among them, there were 38 children in the experimental group, with a mean age of 64 months. Thirty-seven children were in the control group, with a mean age of 70 months. The incidence of complications during hospitalization, the number of calls to medical staff within the first 24 hours after surgery, the pain score of the child during dressing removal, and the time taken for dressing removal were compared and recorded. Measurement data were analyzed by t-tests and enumeration data were analyzed by chi-square tests between groups. All data were analyzed using software SPSS 17.0. Results:The incidence of complications during hospitalization was 5.26%(2/38) and 10.81%(4/37) in the experimental and control groups, respectively. This difference was not statistically significant( χ2=0.784, P>0.05). In the dorsal extension bandaging group and the traditional bandaging group, the average number of calls to medical staff 24 hours after surgery was (0.87 ± 0.91) and (1.54 ± 1.02) times, the difference was statistically significant ( t=2.996, P=0.003); as for the highest pain scores of the children when the dressing was removed were 5.21 ± 1.19 and 7.24 ± 1.20, the difference was statistically significant ( t=5.697, P< 0.001); the time taken to remove the dressing was (3.21 ± 1.24) min, (7.56 ± 1.88) min, and the difference was statistically significant ( t=11.917, P<0.001). Conclusions:The penile dorsal extension bandaging method after concealed penis surgery can reduce the number of calls to medical staff, reduce the time of dressing removal and the degree of pain in children.

Objective:To explore the development trend of the combination of medical treatment and endowment and nursing by analyzing the keywords related to the combination of medical treatment and endowment and nursing in China from 2005 to 2017.Methods:Relevant articles about the combination of medical treatment and endowment which were published up to April 22, 2018 were retrieved from Wanfang, CNKI and VIP databases, and descriptive statistical methods were used to analyze the publication sources, number of keywords, word frequency, value of popularity, word meaning, etc.Results:Totally 5 704 articles were identified, and 1 655 were left after screening. The research on nursing started late among all researches on the combination of Chinese medical treatment and endowment, and there were few literatures, which had not received widespread attention from nursing journals. The proportion of Chinese nursing-related research in the combination of medical treatment and endowment was low. The keyword most concerned about was "senior caregivers". There was a lacking of technical and professional nursing research as well as specific discussions related to home care for the elderly.Conclusions:We should promote multi-angle and multi-level systematic nursing research, strengthen professional research in the combination of medical treatment and endowment and home care for the elderly, and provide technical support and practical basis for improving China's knowledge system of "the combination of medical treatment and endowment", and achieving a win-win situation for healthcare providers, caregivers, nurses and patients.

Objective:To explore the teaching of medical record writing based on tutorial system.Methods:The tutors and residents in standardization training both scored the medical record. The observation indexes included the difference of scoring time between the two editions, the difference of scoring value between tutors and doctors, the distribution of deduction points in medical record writing, and the change trend of medical record score in one year.Results:The scoring value of tutors was significantly lower than that of residents undergoing standardization training ( t=8.919, P<0.05); the deduction of medical records was mainly in the aspects of history of present illness, physical examination, diagnosis and analysis, and treatment plan. After one year of implementation, the score of tutors increased, while that of residents decreased. Conclusion:This method can effectively improve the teaching quality of medical record writing and the ability of residents to discerning problems in medical record writing.

Objective: To search new prognosis-related genes in gastric cancer by analyzing the high-throughput sequencing data of gastric cancer in TCGA database, and then provide data support for future studies. Methods: The RNA-seq expression matrix data and patient-related clinical data from 375 gastric cancer tissues and 45 adjacent noncancerous tissues were downloaded from the TCGA database. The data were collated and standardized based on the R language. The difference of gene expression was analyzed by the edgeR and DEseq software packages. The survival analysis of obtained differential genes was performed by the univariate and multivariate COX regressions combined with clinical data of patients, and then the genes with clinical significance were screened out. Results: A total of 364 differential genes were obtained by the edgeR and DEseq analysis. Subsequently, the functional enrichment analysis found that these genes were mainly involved in protein digestion and absorption, cytochrome P450 system of drug and exogenous substance metabolism, chemical carcinogenesis, gastric acid secretion and so on. The univariate COX regression analysis showed that FAP, FAT3, PDK4 and ZNF365 genes had significant influences on the prognosis of gastric cancer patients. The multivariate COX stepwise regression analysis showed that the risk model constructed by FAP and PDK4 could predict the prognosis of gastric cancer patients. Conclusion: FAP, FAT3, PDK4 and ZNF365 genes may be the prognostic markers of gastric cancer, which may provide data supports for future clinical and basic studies.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.