Objective To investigate the association of residual renal function with intradialysis dialysis hypotension among maintenance hemodialysis patients. Methods Fifty-six patients who had underwent maintenance hemodialysis from March 2014 to November 2015 were enrolled according to researching protocol in this study. Data of baseline and clinical parameter of every hemodialysis session were collected. The patients were divided into two groups by 24 h urine output:urine group (24 h urine output≥100 ml, 22 patients)and no urine group (24 h urine output<100 ml, 34 patients). The clinical data were compared between two groups. Results In the 12 weeks’ treatment, 965 times hemodiafiltration were performed in 56 patients, and the rate of intradialysis hypotension was 24.04%(232/965). The rate of intradialysis hypotension in urine group was 19.28%(80/415), in no urine group was 27.64%(152/550), and there was significant difference (P=0.000). The levels of interdialytic weight gain, ultrafiltration volume, ultrafiltration percentage , pre-dialysis systolic and diastolic blood pressure in urine group were significantly lower than those in no urine group (P<0.01). The levels of pre-dialysis weight, intradialysis systolic blood pressure variability, intradialysis diastolic blood pressure variability, heart rate variability, hemoglobin, serum albumin in two groups had no significant differences (P>0.05). Pearson correlation analysis showed that residual glomerular filtration rate (rGFR) had negative correlation with interdialytic weight gain (r =- 0.257, P = 0.001). Kaplan-Meier analysis showed that with the increase of dialysis time, the rate of intradialysis hypotension increased. The comulative rate of intradialysis hypotension in no urine group was higher than that in urine group (log-rank = 14.67, P =0.000). Conclusions Residual renal function is associated with intradialysis hypotension, and it is important for clinician to consider a residual renal function protection schedule for maintenance hemodialysis patients.

Dietary surveyis a method to evaluate whether dietary intake meets body requirements by recording food consumed during a certain period.Widely-used dietary survey methods include:24 h dietary recall,dietary record,food frequency questionnaire and dietary history questionnaire.Since each method has its own advantages and limitations,researchers need to choose appropriate methods according to research purposes,accuracy requirements,availability of resources,etc.Obese children who are the focus and the major difficulty in dietary survey,it is important to choose an appropriate survey method.This article reviews widely-used dietary survey methods and evaluates them in the study of obese children related dietary surveys.

Objective:To analyze the relationship between the clinical medical college students' time investment (including study, activities, entertainment and exercise) and general self-efficacy (GSE) in a medical university in Liaoning province, China.Methods:The first-year medical students were asked to participate the survey. Their GSE was measured by using general self-efficacy scale (GSES) in 2018. One year later, the independent variable table was used to investigate the extracurricular activity time, and 683 valid questionnaires were collected. Ordered logistic regression method was used to analyze the correlation between students' extracurricular activities and GSE.Results:Medical students' GSE was positively associated with their time in extracurricular study ( OR = 1.94, 95%CI = 1.49-2.54), volunteer activities ( OR=1.36, 95%CI = 1.01-1.83), and physical activities ( OR = 1.37, 95%CI = 1.01-1.85). However, there was no significant correlation with the time in activities organized by students ( OR = 1.09, 95%CI = 0.79-1.50) or activities organized by school ( OR = 1.15, 95%CI = 0.84-1.59). Furthermore, compared with clinical students of "5+3" year program, the 5-year program clinical students had a stronger correlation between medical students' GSE and the input of extracurricular study time. Conclusion:There is a positive correlation between medical students' GSE and their extracurricular time investment, which indicates that increasing medical students' GSE could be an effective method to improve their extracurricular time investment and eventually improve their comprehensive quality.

A cDNA, named Dd-ace-2, encoding an acetylcholinesterase (AChE, EC3.1.1.7), was isolated from sweet-potato-stem nematode, Ditylenchus destructor. The nucleotide and amino acid sequences among different nematode species were compared and analyzed with DNAMAN5.0, MEGA3.0 softwares. The results showed that the complete nucleotide sequence of Dd-ace-2 gene of Ditylenchus destructor contains 2425 base pairs from which deduced 734 amino acids (GenBank accession No. EF583058). The homology rates of amino acid sequences of Dd-ace-2 gene between Ditylenchus destructor and Meloidogyne incognita, Caenorhabditis elegans, Dictyocaulus viviparous were 48.0%, 42.7%, 42.1% respectively. The mature acetylcholinesterase sequences of Ditylenchus destructor may encode by the first 701 residues of deduced 734 amino acids.The conserved motifs involved in the catalytic triad, the choline binding site and 10 aromatic residues lining the catalytic gorge were present in the Dd-ace-2 deduced protein. Phylogenetic analysis based on AChEs of other nematodes and species showed that the deduced AChE formed the same cluster with ACE-2s.
Acetylcholinesterase ; genetics ; Amino Acid Sequence ; Animals ; Cloning, Molecular ; DNA, Complementary ; genetics ; Genes, Helminth ; genetics ; Ipomoea batatas ; parasitology ; Molecular Sequence Data ; Nematoda ; enzymology ; genetics ; Plant Stems ; parasitology ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, Protein

Objective To analyze the relationship between general gelf-efficacy and life-long learn-ing orientation in medical students of a university for providing scientific evidence for the improvement of their life-long learning orientation. Methods In March 2015, all the fifth grade medical students, altogether 822, were invited to participate in the survey and 748 questionnaires were collected effectively. The instru-ments employed were General Self-efficacy Scale (GSES) and Jefferson Scale of Physician Life-Long Learning Student Version in Chinese (JSPLL-S). The relationship was analyzed by using multiple linear regression. Results The general self-efficacy and life-long learning orientation in medical students had significantly positive correlation (β=0.53,P=0.00). Furthermore the general self-efficacy was significantly correlated with each sub-domain of life-long learning orientation, specifically attention to learning opportunity (β=0.53,P=0.00), technical skills in information seeking (β=0.47,P=0.00) and learning beliefs and motivation (β=0.31, P=0.00) respectively. The results also indicated that the magnitude and significance of these corre-lations were independent from the individual characteristics. Conclusion Medical students' general self-efficacy greatly affects their life-long learning orientation. Thus, the strategy aiming at improving students' general self-efficacy could be affective for the development of life-long learning orientation.

Objective:To investigate the safety of early whole body computed tomography (WBCT) combined with coronary angiography (CAG) in patients with extracorporeal cardiopulmonary resuscitation (ECPR) and its application value in the diagnosis of cardiac arrest and complications of cardiopulmonary resuscitation (CPR).Methods:This was a retrospective study. Patients who underwent ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2021 were enrolled in this research. Patients younger than 18 years or with incomplete clinical data were excluded. The results of WBCT and CAG examinations after ECPR were collected.Results:A total of 89 patients with ECPR, aged (47±17) years, were enrolled in the study, all underwent WBCT examination, and no adverse events such as ECMO and tracheal tube shedding occurred. WBCT found 7 cases of pulmonary embolism, 3 cases of aortic dissection and 2 cases of cerebral hemorrhage. WBCT identified CPR-related complications in 42 cases, including rib fractures ( n=20), pneumothorax ( n=5), mediastinal emphysema ( n=5), subcutaneous emphysema ( n=6), and hematoma or swelling at puncture site ( n=6). Fifty-five patients underwent CAG examination, the most common culprit vessels were the left anterior descending branch disease (58.2%) followed by the left circumflex branch disease (27.3%), the right coronary artery disease (21.8%) and left main artery disease (12.7%). Conclusions:Early WBCT and CAG examinations are of great significance and safety for the guidance of treatment in ECPR patients.

We report a critically ill pregnant woman in the third trimester with severe pneumonia due to COVID-19 who presented to Xiaolan People's Hospital of Zhongshan in February 2020. The 32-year-old patient was admitted at 35 +2 gestational weeks with a 4-day history of a sore throat and a fever for three hours. The patient had been to Xiaogan City, Hubei Province, and the symptoms occurred during a period of self-isolation after back home. The condition of the patient deteriorated rapidly, with left-sided chest and back pain, shortness of breath, dizziness, progressing to respiratory failure and septic shock 7 hours after her admission. In view of her critical condition and a history of two previous cesarean sections, an emergency cesarean section was performed. Blood gas analysis of the mother before the operation suggested respiratory failure, respiratory acidosis, and metabolic acidosis. During the operation, a baby boy was born. The Apgar score of the boy, birth weight of 2 700 g, was one at 1, 5 and 10 minutes despite the resuscitation efforts. The neonate died after withdrawing treatment. The patient was treated with tracheal intubation ventilator and other supportive treatments after the operation. The result of the new coronavirus nucleic acid test, taken on admission, but which was reported after delivery, was positive. The patient was transferred to the designated hospital for further treatment and was recovering with the withdrawal of extracorporeal membrane oxygenation and ventilation support at 26 and 36 days after surgery, respectively.