Objective: To explore the present perceptions of patient-empowering nurse behaviours, self-efficacy and patient activation among patients with chronic diseases, and analyze the influencing mechanism among these three variables. Methods: Using convenient sampling method, a total of 485 inpatients with chronic diseases were sampled from two tertiary comprehensive hospitals in Guangzhou on the day of discharge between March and October 2017. They were surveyed with the demographic questionnaire, Patient Perceptions of Patient-Empowering Nurse Behaviours Scale , Chronic Disease Self-Efficacy Scale and Patient Activation Measure. Results: Empowerment could positively predict self-efficacy (β=0.402, P<0.01) and patient activation (β=0.169, P<0.01). Self-efficacy could also positively predict patient activation (β=0.887, P<0.01). And self-efficacy, of which the effect accounted for 67.87% of the total effect, played a partial intermediary role between empowerment and patient activation. Conclusions To improve patient activation, empowerment and self-efficacy should be both emphasized and applied by the nurses, so that patients can move smoothly from a care receiver before discharge to one of self-management.

Objective:To explore the current situation of professional identity of intern nursing students in Shandong Province, to analyze the potential characteristics of different categories of intern nursing students' professional identity, and to provide reference for formulating relevant intervention programs.Methods:From September to October 2023, using convenient cluster sampling, selected nursing students from different regions of Shandong Province colleges and universities as the research objects, a total of 1298 questionnaires were released and recovered, with 1221 valid questionnaires, and the effective recovery rate of questionnaires was 94.07%. General demographic data was collected, and information on nursing students' professional identity was investigated with the Nursing Students' Professional Identity Questionnaire, the Work Readiness Scale, and the Feedback Seeking Behavior Scale. Latent potential profiles of nursing students' sense of professional identity were analyzed by Mplus 8.3 software, and the best-fitting model was selected by the test of fitness and difference. The χ 2 test was used for comparison between groups of count data, analysis of variance (ANOVA) was used for comparison between groups of measure data, and the effects of each factor on different potential profiles were analyzed by multivariate logistic analysis. Results:A total of 1221 intern nursing students were 984 (80.6%) females and 237 (19.4%) males, aged (21.12±2.96) years old, with a total score of (64.23±14.99) for nursing students' professional identity. Nursing students' professional identity was divided into 3 categories: 98 (8.0%) in the low identity group, 624 (51.4%) in the medium identity group, and 496 (40.6%) in the high identity group. The gender, region, age, work readiness scores and feedback seeking behavior scores of nursing students in different categories were different, and the differences were statistically significant ( P<0.05). Compared with the high identity group, the nursing students in the low identity group were more likely to be included in the high identity group ( OR=0.390, 0.167, P=0.005, 0.006) with higher work readiness and better feedback seeking behavior. Compared with the high identity group, the higher work readiness and non-Jinan areas of the medium identity group were more likely to be included in the high identity group ( OR=0.597, 1.470, P=0.011, 0.012). Compared with the medium identity group, the more feedback seeking behaviors of the low identity group were more likely to be included in the medium identity group ( OR=10.411, P<0.001) . Conclusion:The level of professional identity of intern nursing students can be classified into 3 categories, and nursing administrators can improve work readiness and increase feedback seeking behaviors according to the potential characteristics of the different types to enhance the professional identity of nursing students.

Objective:To explore the current situation of professional identity of intern nursing students in Shandong Province, to analyze the potential characteristics of different categories of intern nursing students' professional identity, and to provide reference for formulating relevant intervention programs.Methods:From September to October 2023, using convenient cluster sampling, selected nursing students from different regions of Shandong Province colleges and universities as the research objects, a total of 1298 questionnaires were released and recovered, with 1221 valid questionnaires, and the effective recovery rate of questionnaires was 94.07%. General demographic data was collected, and information on nursing students' professional identity was investigated with the Nursing Students' Professional Identity Questionnaire, the Work Readiness Scale, and the Feedback Seeking Behavior Scale. Latent potential profiles of nursing students' sense of professional identity were analyzed by Mplus 8.3 software, and the best-fitting model was selected by the test of fitness and difference. The χ 2 test was used for comparison between groups of count data, analysis of variance (ANOVA) was used for comparison between groups of measure data, and the effects of each factor on different potential profiles were analyzed by multivariate logistic analysis. Results:A total of 1221 intern nursing students were 984 (80.6%) females and 237 (19.4%) males, aged (21.12±2.96) years old, with a total score of (64.23±14.99) for nursing students' professional identity. Nursing students' professional identity was divided into 3 categories: 98 (8.0%) in the low identity group, 624 (51.4%) in the medium identity group, and 496 (40.6%) in the high identity group. The gender, region, age, work readiness scores and feedback seeking behavior scores of nursing students in different categories were different, and the differences were statistically significant ( P<0.05). Compared with the high identity group, the nursing students in the low identity group were more likely to be included in the high identity group ( OR=0.390, 0.167, P=0.005, 0.006) with higher work readiness and better feedback seeking behavior. Compared with the high identity group, the higher work readiness and non-Jinan areas of the medium identity group were more likely to be included in the high identity group ( OR=0.597, 1.470, P=0.011, 0.012). Compared with the medium identity group, the more feedback seeking behaviors of the low identity group were more likely to be included in the medium identity group ( OR=10.411, P<0.001) . Conclusion:The level of professional identity of intern nursing students can be classified into 3 categories, and nursing administrators can improve work readiness and increase feedback seeking behaviors according to the potential characteristics of the different types to enhance the professional identity of nursing students.

OBJECTIVE: To assess the clinical value of non-invasive prenatal testing (NIPT) for the screening of trisomy and copy number variations (CNVs) of chromosomes 21, 18 and 13. METHODS: From January 2015 to December 2019, 40 628 pregnant women underwent NIPT testing using high-throughput sequencing and bioinformatics analysis to test the cell-free fetal DNA in maternal plasma. High-risk pregnant women underwent invasive prenatal diagnosis, while low-risk ones were followed up by telephone. RESULTS: The three most common indications included intermediate risk of serological screening, high risk of serological screening and advanced maternal age. Among all pregnant women, 257 cases were detected as trisomy 21, 18 and 13 (170, 49 and 38 cases, respectively). 227 cases chose invasive prenatal diagnosis, with respectively 122, 28 and 10 cases confirmed. The positive predictive value (PPV) was 81.33% (122/150), 65.12% (28/43), 29.41% (10/34), respectively. Two false negative cases of trisomy 18 were found during follow-up. Meanwhile, NIPT has detected 46 cases (15, 16 and 15 cases, respectively) CNVs on chromosomes 21, 18 and 13, among which 37 cases underwent invasive prenatal diagnosis. There were 5, 3 and 5 positive cases, which yielded a PPV of 41.67% (5/12), 25%(3/12) and 33.33%(5/15), respectively. Two other chromosome CNVs were accidentally discovered among the false positive samples. CONCLUSION The incidence of chromosomal abnormalities in the serological screening high-risk group was 52.02%, which was significantly higher than other groups. NIPT has a high sensitivity and specificity for the screening of trisomies 21, 18 and 13, while its accuracy for detecting CNVs of chromosomes 21, 18 and 13 needs to be improved. As a screening method, NIPT has a great clinical value, though there are still limitations of false positive and false negative results.Comprehensive pre- and post-test genetic counseling should be provided to the patients.
Aneuploidy ; Chromosome Disorders/genetics* ; Chromosomes ; DNA Copy Number Variations ; Down Syndrome/genetics* ; Female ; Humans ; Pregnancy ; Prenatal Diagnosis ; Trisomy/genetics* ; Trisomy 18 Syndrome/genetics*

Objective:To analyze the correlation among social support, positive coping and job burnout among nurses in Department of Infectious Diseases.Methods:From March 2020 to June 2021, convenience sampling was used to select 110 nurses from Department of Infectious Diseases of 8 ClassⅢ hospitals in Hangzhou, Zhejiang Province as the research object. The General Information Questionnaire, Maslach Burnout Inventory, Social Support Rating Scale (SSRS) , and Simple Coping Style Questionnaire (SCSQ) were used to investigate the nurses. Pearson correlation analysis was used analyze the correlation among job burnout, social support and positive coping. A total of 110 questionnaires were distributed, and 102 effective questionnaires were recovered, with an effective recovery rate of 92.73%.Results:Among the 102 nurses in Department of Infectious Diseases, 17.65% (18/102) were in mild burnout, 57.84% (59/102) were in moderate burnout, and 20.59% (21/102) were in severe burnout. The SSRS total score and each dimension score of nurses in Department of Infectious Diseases were positively correlated with the positive coping subscale score of SCSQ ( P<0.05) , and negatively correlated with the emotional exhaustion subscale and depersonalization subscale score of the Maslach Burnout Inventory ( P<0.05) , but it was positively correlated with the personal achievement subscale score ( P<0.05) . Conclusions:The overall job burnout of nurses in Department of Infectious Diseases was moderate to severe level, and social support and positive coping were correlated with job burnout. Nursing managers should develop measures to reduce the job burnout of nurses in Department of Infectious Diseases.

Objective: To evaluate the value of non-invasive prenatal testing (NIPT) in pregnancies with anomaly in prenatal screening. Methods: This was a retrospective study of 2 837 singleton pregnancies who performed NIPT indicated by isolated anomaly in prenatal screening at Guangdong Women and Children Hospital between November 2014 and August 2016. All pregnancies were divided into 3 groups by single indication: advanced maternal age ( AMA, ≥35), abnormal multiples of the median (MoM) in standard screening, increased nuchal translucency thickness (NT, 2.5-3.0 mm). High risk results were verified by prenatal diagnosis. Low risk cases were followed by a 22-26 week anatomical ultrasound examination. All of the cases were followed up and the performance of NIPT for every single indication was evaluated. Results: There were total of 2 837 pregnant women who underwent NIPT. Twenty-five of 2 448 pregnancies indicated by AMA had high risk results, among which 17 were confirmed by invasive genetic testing, except 1 case rejecting prenatal diagnosis. In 351 pregnant women with abnormal MoM, NIPT found 3 cases of sex chromosome aneuploidies (SCA) and 2 of them were validated by invasive prenatal diagnosis. Increased NT group included 38 cases, NIPT found 1 case of trisomy 21 which was consistent with karyotype analysis. For common aneuploidies and SCA, the performance of NIPT in the pregnant women who indicated by AMA, abnormal MoM and increased NT were as the follows: the sensitivity were 17/17, 2/2 and 1/1 respectively, the specificity were 99.7% (2 423/2 431), 99.7% (348/349) and 100%(37/37), the positive predictive value were 68% (17/25), 2/3 and 1/1, the negative predictive value were 100% (2 423/2 423), 100% (348/348) and 100% (38/38), respectively. By follow-up survey, a total of 8 cases of abnormal fetus were recorded in NIPT low-risk women, including 5 cases of termination of pregnancy due to abnormal ultrasound findings, 2 cases of abortion as a result of severe obstetric complications and 1 case of stillbirth. Conclusions To the pregnant women who indicated by advanced maternal age, abnormal MoM and increased NT (2.5-3.0 mm), NIPT had satisfactory performance for common aneuploidies, and also had potential value for SCA, resulting in a significant reduction in diagnostic procedures. However, for NIPT low-risk pregnancies, routine antenatal examination and anatomical ultrasound detection would be highly necessary to avoid missing abnormal fetuses.(Chin J Lab Med, 2018, 41: 509-513)

Objective To assess the value of non-invasive prenatal screening (NIPS) for the detection of fetal chromosome 16 aneuploidy through multi-method verification and follow-up of pregnancy outcomes.Methods From January 2016 to December 2017,7972 pregnant women with singleton pregnancies accepted the NIPS test after 10th gestational week with informed consent.Those with fetal chromosome 16 abnormality suggestive by the NIPS test were subjectedto prenatal diagnosis including chromosomal karyotyping and chromosomal microarray analysis (CMA).Results Of the 7972 pregnant women tested by NIPS,16 (0.2％) were predicted to have fetal chromosome 16 abnormality.The average age of the 16 pregnant women was 33.5 + 5.24,and the average gestational week was 19.88 ± 2.47.Chromosomal karyotyping verified that 3 fetuses had mosaicisms and 1 carried pericentric inversion of chromosome 9,which yielded a positive predictive value (PPV) of 18.8％.CMA has detected 7 fetuses with genomic abnormalities,which yielded a PPV of 43.8％.Eleven of the 16 women (68.8％) have given birth to healthy babies.Conclusion For pregnant women with a high risk of chromosome 16 aneuploidy suggested by NIPS,the prognosis of fetus should be evaluated by multiple methods.Compared with conventional karyotyping analysis,molecular methods such as CMA are far superior.

Genomic disorders caused by pathogenic copy number variation (pCNV) have proven to underlie a significant proportion of birth defects. With technological advance, improvement of bioinformatics analysis procedure, and accumulation of clinical data, non-invasive prenatal screening of pCNV (NIPS-pCNV) by high-throughput sequencing of maternal plasma cell-free DNA has been put to use in clinical settings. Specialized standards for clinical application of NIPS-pCNV are required. Based on the discussion, 10 pCNV-associated diseases with well-defined conditions and 5 common chromosomal aneuploidy syndromes are recommended as the target of screening in this consensus. Meanwhile, a standardized procedure for NIPS-pCNV is also provided, which may facilitate propagation of this technique in clinical settings.
Aneuploidy ; Cell-Free Nucleic Acids/genetics* ; Consensus ; DNA Copy Number Variations ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pregnancy ; Prenatal Diagnosis

Objective:To analyze the indications for prenatal diagnosis and summarize the pregnancy outcomes and its influencing factors of pregnant women with fetal sex chromosome aneuploidy (SCA).Methods:This study retrospectively enrolled 1 372 fetuses prenatally diagnosed with SCA in Medical Genetics Center of Guangdong Women and Children Hospital from January 2013 to December 2021. The relationship between prenatal diagnosis indications and SCA as well as between ultrasound abnormalities, pregnancy outcomes and SCA types were analyzed by Chi-square test and trend Chi-square test. Results:The most common prenatal diagnosis indication was abnormal non-invasive prenatal testing (NIPT) (61.6%, 845/1 372). The most common SCA type was 47,XXY in cases with indications of abnormal NIPT and advanced maternal age, mosaic in cases with high or borderline risk of Down syndrome, and 45,X in cases with increased nuchal translucency or cystic hygroma. Of 1 372 pregnant women with fetal SCA, 17 were lost to follow-up, seven had intrauterine fetal death, and 1 348 (98.3%) were followed up for pregnancy outcomes including 36.3% (489/1 348) continued pregnancies and 63.7% (859/1 348) terminations. Pregnancy termination rates decreased sequentially in pregnant women carrying fetuses with 45,X, 47,XXY, mosaic, 47,XXX and 47,XYY [99.2% (247/249), 74.5% (307/412), 67.8% (156/230), 36.6% (86/235) and 28.4% (63/222), χ2trend=352.76, P<0.001]. There was no significant difference in pregnancy termination rates among the cases with different mosaic mutations (all P>0.05). The pregnancy termination rate was higher in fetuses with SCA complicated by ultrasound structural abnormalities than in those without ultrasound abnormalities and those with ultrasound soft markers [91.5% (182/199) vs 57.1% (535/937) and 67.0% (142/212), χ2 were 83.68 and 36.85, both P<0.001]. Moreover, the pregnancy termination rate in fetuses with SCA complicated by ultrasound soft markers was higher than those without ultrasound abnormalities ( χ2=7.13, P<0.05). Conclusions:NIPT abnormality is the most common indication for prenatal diagnosis of SCA. The types of SCA and ultrasound findings are important factors determining whether the pregnancy would be continued or not.

Objective:To investigate the effect of activation of microglia in prefrontal cortex on long-term spatial memory in post-stroke depression mice.Methods:Forty-eight male C57BL/6 mice were divided into sham operation group, stroke group, post-stroke depression group and depression group according to the random number table method with 12 in each group, and 36 mice were divided into solvent group, enrofloxacin group and minocycline group according to the random number table method with 12 in each group.Middle cerebral artery occlusion (MCAO) was use to establish the stroke model, and forced swimming was used to establish the depression model.The post-stroke depression model mice were received MCAO first and then received forced swimming on the 4th day after stroke to establish the model.Mice in enrofloxacin group and minocycline group were treated with enrofloxacin and minocycline injection once a clay for 14 days from the 5th day after stroke, respectively.Forced swimming test and sugar water preference test were used to evaluate the depression of mice in each group, Morris water maze test was used to detect the spatial memory function of mice in each group, and Nissl staining and immunofluorescence staining were used to detect the neuronal function and the number and type of microglia activation.The expression of inflammatory cytokines IL-6 and IL-1β were detected by Western blot.GraphPad Prism 8.0.1 statistical software was used for statistical analysis.The single factor variance analysis was used to compare the difference among multiple groups, and pairwise comparison was performed with SNK- q test. Results:(1) There were statistically significant differences in depression, learning and memory, neuron damage, activation of microglia, inflammatory factors and other indicators in sham operation group, stroke group, post-stroke depression group and depression group ( F=43.58-255.70, all P<0.05). Compared with stroke group, post-stroke depression group had longer floating immobility time ((222.70±29.12) s, (79.25±46.78) s, P<0.05), the preference rate of sugar water was significantly lower ( (49.44±6.19) %, (84.49±4.73) %, P<0.05), and the average value of platform approach after correction was higher((125.00±9.95) mm, (96.79±12.57) mm, P<0.05), Nissl bodies expression was lower ((53.50±15.78) cells /mm 2, (85.67±17.52) cells /mm 2, P<0.05), NeuN positive expression rate was lower ((29.78±3.70) %, (45.73±4.51) %, P<0.05), the percent of M1 microglia expression was significantly higher ((75.55±8.84) %, (58.19±5.69) %, P<0.05), the percent of M2 microglia expression was lower ((43.46±5.11)%, (57.14±5.40)%, P<0.05), and the expression levels of IL-6 ((1.14±0.03), (0.94±0.05), P<0.05) and IL-1β((1.17±0.03), (0.56±0.04), P<0.05) were significantly higher.(2) Depression, learning and memory, neuron injury, activation of microglia, inflammatory factors and other indicators of mice in solvent group, enrofloxacin group and minocycline group were significantly different ( F=7.13-94.35, all P<0.05). Compared with enrofloxacin group, mice in minocycline group had shorter floating immobility time ((169.30±13.04) s, (224.30±22.60) s, P<0.05) and higher sugar water preference rate ((62.81±7.75) %, (47.71±8.11) %, P<0.05), the mean value of platform approach estimation after water maze correction was lower ((97.66±14.56) mm, (120.20±12.08) mm, P<0.05), and the expression level of Nissl bodies was higher ((80.17±10.55) cells /mm 2, (52.00±8.94) cells /mm 2, P<0.05), NeuN expression rate was high ((45.04±3.62) %, (28.88±4.50) %, P<0.05), Iba-1 expression was lower ((97.33±10.67) cells/mm 2, (112.50±6.54)cells/mm 2, P<0.05), the percent of M1 microglia expression was lower ((54.43±5.22) %, (73.82±6.88) %, P<0.05), and the percent of M2 microglia expression was significantly higher ((51.86±6.22) %, (36.30±5.72) %, P<0.05). The expression levels of IL-6 ((0.75±0.06), (1.21±0.07), P<0.05) and IL-1β ((0.61±0.06) (1.09±0.09), P<0.05) were lower. Conclusion:The long-term spatial memory impairment of post-stroke depression mice is aggravated, which is related to the neuron damage caused by increased activation of M1 microglia in PFC area.Inhibition of M1 microglia by minocycline can effectively improve the spatial memory ability of mice.