Objective To evaluate the reliability and validity of the brief version of dysfunctional beliefs and attitudes about sleep(DBAS-16).Methods Participants were out-patients who with insomnia or insomnia comorbided depression disorder or anxiety disorder.All of them were assessed by DBAS-16,Pittsburgh sleep quality index (PSQI),self-rating depression scale (SDS),self-rating anxiety scale (SAS).30 of them were evaluated by DBAS-16 two weeks later.Results 230 patients were assessed,212 pieces of questionnaire with integral answers were collected,The Cronbach α Coefficient of DBAS-16 was 0.786,the Cronbach α coefficients of four subscales were 0.424-0.703.Split-half reliability coefficient of total score was 0.775,split-half reliability coefficient of four subscales were 0.424-0.719.Item-total correlation coefficients ranged from 0.602 to 0.283(all P＜0.05).The testretest reliability coefficient was 0.928,and coefficient of each subscales ranged from 0.709 to 0.907 (all P＜0.05).Confirmatory factor analysis was used to estimate the construct validity.The fit indices:x2/dfwas 1.623,the adjusted goodness of fit index (AGFI) was 0.882,root mean square error of approximation (RMSEA) was 0.054,incremental fit index (IFI)was 0.899,non-normed fit index (NNFI) was 0.871,comparative fit index (CFI) was 0.895.Total DBAS-16 score significantly correlated with PSQI(r=-0.311,P＜0.01),SDS(r=-0.192,P＜0.01),SAS(r=-0.162,P＜0.01).Conclusion The reliability and validity of the brief version of DBAS-16 are adequate.

Objective To explore the value of psychological nursing in treatment of children caries.Methods 200 children with caries were divided randomly into the experimental group and the control group with 100 cases in each group.The experimental group was given psychological nursing according to different age groups,while the control group only received routine treatment.The compliance degree of children patients were compared between the two groups. Results The compliance degree of the experimental group was better than the control group. Conclusions Psychological nursing can alleviate intense,anxiety,pain,dread of children patients,enhance medical compliance degree,thus ensure the smooth progress of treatment reduce the treatment time greatly,raise working efficiency in order to achieve high quality service.

A 33-year-old male patient complained of presenting goiter on the low back area for 2 months. Pathological examinations of resected goiter suggested non-Hodgkin lymphoma and showed that T cells, immunoblasts, and hemogram were roughly normal, and 2% sarcoma cells could be found in bone marrow. Stage Ⅳ T-cell non-Hodgkin's lymphoma was diagnosed. Following 4 months of chemotherapy using CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone included), the patient underwent bone marrow activation and autologous peripheral blood stem cell transplantation in combination with recombinant interleukin-2 application in April 1998. The preprocessing was performed under MACC protocol (L-sarcolysinum, cytarabine, cyclophosphamide, and Iomustine included). Ten days after autologous stem cell transplantation, neutrophil concentration was > 0.5×109/L and sixteen days after transplantation, blood platelet concentration was > 50×109/L. Six days after transplantation, the patient exhibited fever, and E. Coli infection was confirmed through blood culture. After antibiotic treatment, body temperature recovered to normal, and fever disappeared. The patient had been followed-up for 10 years and 10 months. During the follow-up period, he lived a normal life and work.

AIM: To test the effect of ERK1/2 on ischemic preconditioning (IPC) in diabetic rat hearts. METHODS: The diabetic rat model was made with alloxan. After eight weeks, 24 rats were divided into 4 groups: non-diabetic IPC rats (group A); non-diabetic non-IPC rats (group B); diabetic IPC rats (group C); diabetic non-IPC rats (group D). ECGⅡ lead, left ventricular development pressure (LVDP), and first derivative of LVDP ~(?dp/dt_~max ) were recorded. Myocardial phosphorylation of extracellular signal regulated kinases1/2 (ERK1/2) was detected by Western-blotting. RESULTS: (1) The ventricular arrythmia score was significantly lower in group A than that in group C (P

Objective To investigate the effect of gonadotropin-releasing hormone analogue(GnRH-a) on pregnancy outcome in patients with endometriosis infertility after laparoscopic surgery.Methods Two hundred and twenty two patients treated with laparoscopic surgery for endometriosis infertility in Jiaxing Maternal and Child Health Care Hospital between January 2010 and December 2012 were enrolled and 184 patients completed the study.Patients were randomly assigned to two groups:110 patients in GnRH-a group received long-acting GnRH-a (3.75 mg injection every 28 d for 3 times) before trying to conceive,74 patients in control group were directly trying to conceive for 1 to 36 months.According to endometriosis fertility index (EFI),patients were further subgrouped:GnRH-a group 1 (EFI scores =6-10,n =83),GnRH-a group 2 (EFI scores =0-5,n =27),control group 1 (EFI scores =6-10,n =55) and control group 2 (EFI scores =0-5,n =19).The cumulative pregnancy rate (CPR) and abortion rate were compared among groups and subgroups.Results The patients were followed up for 1 to 36 months after trying to conceive,with a median follow-up time of 14 months.The total CPR was 62％ (114/184),the median time for gestation was 11 months.Within the first 6 months after operation,the CPR in GnRH-a group and its subgroups were lower than those in corresponding control groups,with significant difference between GnRH-a group and control group [9％ (10/110) vs.32％ (24/74),x2 =16.00,P ＜0.01],GnRH-a group 1 and control group 1 [8％ (7/83) vs.38％ (21/55),x2 =18.10,P ＜0.01].Within 12 months,24 months and 36 months,the CPR in GnRH-a group and its subgroups were all higher than those in corresponding control groups [66％ (55/83) vs.49％ (27/55),x2 =4.05,P ＜ 0.05].The pregnant rate within 12 months in GnRH-a group was 88％ (63/72),which was not significantly different to that in control group [76％ (32/42),x2 =2.44,P ＞ 0.05].Kaplan-Meier analysis showed that there were no significant difference in CPR between GnRH-a group and control group,GnRH-a group 1 and control group 1,GnRH-a group 2 and control group 2 (all P ＞ 0.05).The median time for gestation in GnRH-a group and its subgroups were shorter than those in corresponding control group.The median time for gestation in GnRH-a group was 10 (95％ CI:8.2-11.8) months and that in control group was 17 (95％ CI:1l.8-22.1) months.The abortion rate in GnRH-a group and control group was 11％ (7/72) and 26％ (11/42),respectively (x2 =4.34,P ＜ 0.05).Conclusion Administration of GnRH-a for 3 cycles can improve postoperative pregnancy rate within 1 year and reduce the abortion rate for endometriosis infertile patients after laparoscopic surgery especially for these with strong fertility.

Objective To predict and identify liner B-cell epitopes in the hemagglutinin ( HA) of human-infected avian-origin H7N9 influenza virus and analyze the specificity of H7 subtype.Methods Three serum samples collected at different times from the same patient who was confirmed to be infected with H7N9 influenza virus were provided by Shaoxing People’s Hospital, and one serum sample from healthy person was collected as the control.The extracellular region of HA protein was predicted by TMHMM Sever v.2.0.The potential B-cell epitopes were predicted by DNAStar Lasergene’ s Protean, BcePred and ABCpred tools, and the immunogenicity of the predicted B cell antigen epitopes was assessed by indirect enzyme-linked immunosordent assay ( ELISA ) .H7 subtype specificity was analyzed by comparing HA protein amino acid sequence with H7N9 and H1-H16 subtype influenza virus from Genbank using Clustal X 2.1 software, and Cn3D 4.3.1 software was used to detect the distribution and 3D structure of predicted epitopes on the HA protein of H7N9.Results The potential B-cell epitopes may be located in 172-183, 363-380, 452-472 and 491-506 of extracellular N-terminus of HA protein.ELISA showed that four predicted eptiopes specifically reacted with positive serums from patient.Multi-sequence alignment demonstrated that peptide 172-183 and 363-380 had higher H7 subtype specificity compared with amino acid sequences of other subtypes.Moreover, the predicted linear B-cell epitopes all located on the surface of HA protein according to the 3D structure analysis.Conclusion Four potential B-cell epitopes were identified, in which peptide 172-183 and 363-380 have higher H7 subtype specificity, and may be used in the design of epitope-based vaccines and diagnostics tests.

Objective To explore the effect of comprehensive geriatric assessment on the prevention of falls in hospitalized older patients with mental disorders.Methods A total of 150 elderly patients with mental disorders admitted into our hospital from June 2017 to May 2018 were randomly divided into the conventional group (n =75)and the comprehensive geriatric assessment group(n=75).The conventional group received routine nursing interventions based on risk evaluation via the Morse scale,and the comprehensive assessment group adopted targeted nursing interventions based on comprehensive assessment outcomes.The detection rate of risk for falls,the incidence of falls,the compliance with prevention measures and the satisfaction level of nursing services were compared between the groups.Results The detection rate of risk for falls was higher (80.0％ vs.45.3％,x2 =19.263,P=0.000),the incidence of falls was lower(1.3％ vs.9.3％,x2 =4.754,P =0.029),and the compliance with prevention measures(93.3％ vs.82.7％,x2 =4.040,P =0.044) and the satisfaction level of nursing services(96.0 ％ vs.86.7％,x2=4.127,P =0.042)were higher in the comprehensive assessment group than in the routine group.Conclusions Comprehensive geriatric assessment has a forewarning effect on falls in hospitalized older patients with mental disorders.Targeted nursing interventions can help reduce the incidence of falls and improve the satisfaction level of nursing care.

Tracheal intubation is one of the most important emergency techniques, and it is a key and difficult point in advanced life support training for cardiopulmonary resuscitation. Our treatment is trying to combine standard video with visual laryngoscopes for tracheal intubation teaching. Firstly, the students watch the standard video. Then, the teacher shows how to perform a tracheal intubation by visual laryngo-scope. Finally, the students practice the intubation process on the simulation device. In this way, the teach-ing process is more intuitive, easier to be mastered, more normalized and repeatable. This method is worth to be promoted.

Objective To explore the clinical application value of muscle enzymes and high sensitivity cardi-ac troponin T(hs-cTnT)in children with hand foot mouth disease complicated with myocardial injury.Meth-ods 100 children with hand foot mouth disease admitted to the hospital from April 2016 to January 2017 were divided into ECG normal group(n= 40)and ECG abnormal group(n= 60)by electrocardiography.At the same time,50 healthy people were selected as the research group to compare the serum concentration and myo-cardial enzyme index of myocardial enzyme(CK-MB),creatine kinase(CK),α-hydroxybutyrate dehydrogenase (α-HBDH),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST),and high sensitivity cardiac troponin T(hs-cTnT)in three groups.The hs-cTnT and the indexes of myocardial enzymes in acute and re-covery stages of abnormal electrocardiogram for children with hand foot mouth disease were compared.Results The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.in the ECG abnormal group of hand foot mouth disease were significantly higher than those of ECG normal group and control group.The differ-ence was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cT-nT,etc.in the ECG normal group of hand foot mouth disease were significantly higher than those of control group.The difference was statistically significant(P<0.05).The abnormal rate for the indicators of CK-MB, CK,α-HBDH,LDH,AST and hs-cTnT,etc.In the ECG abnormal group of hand foot mouth disease were sig-nificantly higher than those of ECG normal group and normal control group.The difference was statistically significant(P<0.05).The indicators of CK-MB,CK,α-HBDH,LDH,AST and hs-cTnT,etc.Of hand foot mouth disease ECG abnormal group in acute stage were significantly higher than those of recovery stage.The difference was statistically significant(P< 0.05).Conclusion One of the serious complications in children with hand foot and mouth disease is myocardial injury.It is of great clinical value to monitor hs-cTnT and my-ocardial enzymes in the diagnosis of the disease.

Objective: To understand the epidemiological characteristics of product-related injuries among children in Changshan County from 2011 to 2017 and to provide evidence for targeted intervention. Methods: The surveillance data of product-related injuries among children aged below 18 years from 2011 to 2017 was collected from three sentinel hospitals in Changshan County. The characteristics of product-related injuries among children were analyzed,especially those injuries caused by furniture,stationery and sporting goods,commodities and toys. Results: A total of 5 111 product-related injury cases among children were reported,accounting for 13.49% of product-related injury cases of all age. There were 3 138 boys and 1 973 girls,accounting for 61.40% and 38.60%. There were 2 973 cases less than 10 years old,accounting for 58.17%. The main causes of product-related injuries were road traffic injury（49.46%）,blunt（16.02%）,stab/cut（12.39%）and fall（10.37%）. The main categories of products included transportation equipments（not including motor vehicles,36.83%）,motor vehicles（17.82%）,furniture（12.23%）,stationery and sporting goods（8.45%）,commodities（4.89%）and toys（3.25%）. Stab/cut（53.01%）was the main cause of commodities related injuries;blunt was the main cause of furniture,stationery and sporting goods and toys. The stationery and sporting goods related injuries occurred mainly in schools/public places（64.57%）and sports venues（18.48%）when engaging in sports（54.13%）;furniture,commodities and toys related injuries injured cases occurred at home when engaging in leisure activities. Commodities mainly resulted in sharp/bite/open wound（51.50%）;furniture,stationery and sporting goods and toys mainly resulted in bruises. Most cases were injured in head,slight and allowed home after treated. Conclusion The product-related injuries among children in Changshan County are more boys. The products mainly involve transportation equipments（not including motor vehicles）,motor vehicles,furniture,stationery and sporting goods,commodities and toys,with emphasis on the latter four categories in the prevention of product-related child injury.