OBJECTIVETo explore the genetic basis for a neonate with bloody stool and thrombocytopenia.

METHODSClinical data of the neonate was collected. Peripheral venous blood samples were extracted from the neonate and his parents. Next generation sequencing through target capturing was carried out to detect potential mutations of genes associated with thrombocytopenia. Suspected mutation was validated by Sanger sequencing.

RESULTSThe 14-day-old male neonate was admitted to hospital for bloody stool for 8 days, decreased platelet count and reduced platelet volume. His liver function and blood coagulation were both normal. Genetic testing revealed a novel deletional mutation in c.1221delG (G407fsX444) of the WAS gene in the patient, which was inherited from his mother.

CONCLUSIONThe c.1221delG (G407fsX444) mutation of the WAS gene probably underlies the X-linked thrombocytopenia in the proband. Next generation sequencing can facilitate the diagnose and genetic counseling of such diseases.

Objective To explore the effects of treatment decision aid on addressing decision-making difficulties and anxiety, depression in patients. Methods Totally 289 patients with lung cancer who were treated in Harbin Medical University Tumor Hospital between July and December 2016 were selected by purposive sampling and randomly divided into treatment group (n=147) and control group (n=142). Patients in the control group received routine guidance and health education from doctors, while patients in the treatment group received decision support manuals and took part in treatment decision-making with medical staff. The Decision Distress Scale and the Hospital Anxiety and Depression Scale were used to assess the intervention effects. Results There was no statistically significant difference between the two groups judging from the scores of the Decision Distress Scale before the intervention (t=0.237, P=0.532). After the intervention, the patients in the treatment group scored lower than the patients in the control group (t=6.437, P<0.001), and there was no statistically significant difference in the level of anxiety (t=0.214, P=0.617) and the level of depression (t=0.105, P=0.874) between the two groups. Conclusions Treatment decision aid can address the decision-making distress and mitigate the sense of uncertainty in patients effectively.

Infectious bronchitis in chickens is a serious threat to the global poultry industry.Despite the availability of commercial vaccines,the epidemic has not been effectively controlled.Therefore,the development of novel vaccines may provide new ways to prevent and control this disease.In this study,BLP-S1,a bacterium-like particle displaying the S1 subunit of infectious bronchitis virus on its surface,was constructed using the GEM-PA system.The immunoprotection results showed that BLP-S1 effectively induced the production of specific IgG and sIgA in commercial chickens and provided effective protection against a heterologous strain with a protection rate of up to 90％.This study demonstrated that BLP-S1 has good immunogenicity and immunoprotection,with the poten-tial to develop a novel vaccine against infectious bronchitis.

Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.

Objective To explore the key initiatives and effective methods for preparing the constructions of emergency-oriented hospitals under COVID-19 pandemic. Methods The wartime mechanism was strengthened by adhering to unified leadership, trengthening the top-level design and clarifying the division of responsibilities. Objective management was used as a means to take into account the key of personnel allocation and training, prevention and control of hospital infection, transformation of contagious ward, logistic support, equipment and material supply and construction of system and process. Results The preparations and constructions of the emergency-oriented hospitals were completed in 72 hours，which passed the acceptance and inspections from infection control experts，who appraised our work to be “the highest in difficulty, the fastest in project progress and the highest in quality". Totally, upon to the preparations，14 medical teams were set up and the layout process reestablishment of 14 wards was completed, the installation and preparation of nearly 10000 sets/pieces of medical equipment and medical materials were completed as well and more than 80 work systems and process systems for 9 major modules were established. Conclusion The preparations and constructions of emergency-oriented hospitals should be performed upon the thorough implementation of the decisions and arrangements by the municipal Party committee and the municipal government, insisting on the wartime thinking and establishment of high-quality management team and effective goal management focusing on details and actual needs of medical staff.

Objective To investigate and analyze the level of the transition shock of newly graduated nurses, and to provide the basis for improving measures to accelerate the transition period of new nurses. Methods A total of 824 new nurses coming from Shandong Province and Heilongjiang Province were recruited and investigated with the Transition Shock of Newly Graduated Nurses Scale ( TSNGNS) . To observe scores of transition shock in new nurses,scores of different conditions in new nurses and influencing factors on transition shock in new nurses. Results The scores of transition shock of new nurses ranged from 85 to 135. The score of physical were the highest of all (28. 96 ± 1. 851), with a percentage of 96. 53%. There were significant differences in different ages, working time, education levels, hospital areas and pre-service training time ( F/t=14. 715, 53. 742, 28. 792, 6. 911, 31. 829, respectively;P <0. 05). The impact factors of transition shock were working time, hospital area, pre-service time and education level. The degree could explain the dependent variable was 23. 2%. Conclusions The transition shock of new nurse is at a high level, and restrains by working time, education level, the hospital area and pre-service training time.

Acute skin failure is a common condition of skin damage in critically ill patients, which seriously affects the prognosis of patients. This article summarizes the evaluation indicators, techniques, and comparison of evaluation indicators and techniques for acute skin failure, in order to provide references for the development of acute skin failure evaluation tools and the formulation of nursing measures.