Objective To analyze the ultrasound findings of urinary calculi caused by melamine. Methods The urinary system of totally 5337 children were examined with high frequency convex ultrasound probe,the characteristics of the images were analysed. CT plain scan method was used when ultrasound result was in difficulty. Results There were 360 cases with calculus in the 5337 children. In the 360 cases, unilateral calculus was in 92 cases, bilateral calculus in 48, bladder stone in 3, urethra stone in 1, kidney calcium deposition in 2, suspicion stone in 214 cases, urinary obstruction in 28 of them. The size of the stones ranged from 3 mm×2 mm to stag-horn calculus. Conclusions The urinary calculi caused by melamine is sandy stone. Ultrasound result is equivocal in the disease, CT plain scan can be a method of choice. High frequency convex probe provides more clear images, more evident adminstrative levels of anatomise than general abdominal probe does. It is beneficial for diagnosing and differential diagnosing of these diseases.

Objective:To investigate the status of evidence-based nursing competence among clinical nurses in tertiary grade A hospitals of Anhui province, and analyze the influencing factors based on random forest model, so as to provide reference for improving the evidence-based nursing ability of clinical nurses and formulating intervention strategies.Methods:The convenience sampling method was used to select 543 clinical nurses from 4 tertiary grade A hospitals in Anhui Province from October to December 2022. The general data questionnaire, Evidence-based Nursing Competence Scale, Information Literacy Scale, and Nurse Innovation Ability Scale were used to investigate. The random forest model was used to evaluate the importance of the influencing factors. The Lasso regression analysis was used to complete the screening of the influencing factors. The influencing factors of the evidence-based nursing competence among clinical nurses were explored by multiple linear regression analysis.Results:A total of 543 valid questionnaires were retrieved. Among 543 clinical nurses, 55 males and 388 females, aged (32.34 ± 6.93) years old. Evidence-based nursing competence scored (45.49 ± 21.18) points, information literacy scored (73.50 ± 10.47) points, innovation ability scored (126.78 ± 21.99) points. The random forest model and Lasso regression analysis showed that the model achieved the best fit with 8 variables. In order of importance, the top 8 variables were information literacy (25.78%), innovation ability (22.37%), night shift per month (9.91%), educational background (9.19%), English proficiency (8.44%), professional title (6.71%), scientific research and innovation experience (5.17%), and professional attitude (4.50%). Multiple linear regression analysis showed that information literacy, innovation ability, and English proficiency were the influencing factors of evidence-based nursing competence among clinical nurses ( t=9.17, 7.31, 2.52, all P<0.05). Conclusions:The level of evidence-based nursing ability among clinical nurses in tertiary grade A hospitals of Anhui province needs to be improved. From the perspective of improving the information literacy among clinical nurses, nursing managers can increase the training of information retrieval ability and English ability, enhance their English literature reading skills, pay attention to the cultivation of nurses' innovation ability, stimulate the innovative consciousness and thinking among clinical nurses, formulate and implement targeted interventions, so as to gradually improve the level of evidence-based nursing ability among clinical nurses.

Objective? To explore the knowledge status of botulinum toxin A (BTX-A) injection in patients with blepharospasm and facial spasm. Methods? A total of 110 patients after BTX-A from Beijing Tongren Hospital of Capital Medical University during September to November 2017 were selected by convenience sampling method. A self-designed questionnaire on BTX-A injection-related knowledge was applied in the investigation. Results? Among 110 patients, 54 (49.09%) were correct on the question of whether long-term drug control was necessary for correct blepharospasm and hemifacial spasm. 61 patients (55.40%) were correct on whether BTX-A treatment need repeated multiple injections. 87 patients (79.09%) were correct on the onset time, and 41 patients (37.27%) were correct on the duration of drug action. There was significant difference in knowledge scores of BTX-A injection among patients with different injection times (P＜ 0.05). Conclusions? BTX-A injection patients are still lacking in the injection-related knowledge. Health education on injection-related knowledge can be strengthened to improve patients' cognitive level.

OBJECTIVE: To explore the genetic basis for a child with clinically suspected nephronophthisis (NPHP). METHODS: Peripheral blood samples of the patient and her parents were collected subjected to high-throughput sequencing. Sanger sequencing was used to verify the gene variants. RESULTS: The patient, a 7-year-old girl with congenital blindness, was admitted to a local hospital due to repeated vomiting for 7-8 days and then transferred to author's hospital due to renal failure. Her urine occult bloods (3+) and urine protein (1+) were abnormal. Her blood urea nitrogen and creatinine showed a significant progressive increase. Renal ultrasound showed a mild enlargement in bilateral renal, increased echogenicity, loss of corticomedullary differentiation, and the presence of cysts in both kidneys. No familial genetic history was found in the family of patient and the child was clinically diagnosed with nephronophthisis. The proband was found to harbor compound heterozygous variants of the CEP290 gene, namely c.2587-2A>T and c.2251C>T, which were inherited from her mother and father, respectively. Based on the ACMG guidelines, both variants were predicted to be pathogenic. CONCLUSION The patient was diagnosed with NPHP type 6 due to variants of the CEP290 gene. Above finding has provided new evidence for the genotype-phenotype correlation of this disease.

Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.

Objective To evaluate the effects of WeChat platform on accurate care for discharged patients after trabeculectomy. Methods A total of 100 patients who had been discharged after trabeculectomy were recruited, and divided into observation group and control group by random number table method, with 50 cases in each group. The patients in the control group received routine discharge education, while the patients in the observation group received accurate care based on WeChat platform. A self-designed questionnaire was used to investigate the treatment compliance after 6 months of discharge, and the compliance behavior was compared between the two groups. Results In the care of filtering blebs, the treatment compliance percentage of the observation group after the implementation of accurate care was 90%,while it was 70% in the control group, and the difference was statistically significant (χ2=6.250, P=0.012). Meanwhile, in the insisting on further consultation, insisting on intraocular pressure monitoring, review of perimetry and fundus stereoscopic image, the performance of the observation group was significantly better than that of the control group (χ2=5.316, 6.353, 4.762, 5.263; P<0.05). However there was no significant difference in medication adherence between the two groups (χ2=1.382,P=0.240). Conclusions The application of WeChat platform in accurate care for discharged patients after trabeculectomy can effectively improve the patients' compliance of medical treatment.

Objective:To explore the effects of helmet-eyeball movement training system in rehabilitation training among orbital fracture patients.Methods:From April to December 2018, we selected 60 patients with orbital fracture surgeries by the same doctor in the Ophthalmology Department, Beijing Tongren Hospital, Capital Medical University, with the method of convenience sampling as the research objects. All patients were randomly divided into experimental group and control group, 30 cases in each group. Control group carried out the eyeball movement training with the fingers of patients as visual markers, while experimental group implemented the training with the helmet-eyeball movement training system. Diplopia rating and binocular stereoscopic vision function of patients of two groups were compared before training, one week, one month and three months after training.Results:At one and three months after training, the diplopia rating and static/dynamic stereoscopic vision function of patients in experimental group were better than those in control group with statistical differences ( P<0.05) . Conclusions:Helmet-eyeball movement training system can improve the training effect of patients and help them restore stereoscopic vision.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.