Objective To discuss the coping methods of pediatric nurses with adverse psychology and behavior of parents with terminal children. Methods 198 parents who were assessed with adverse psychology and behavior with terminal children were chosen and randomly divided into the observation group(100 cases) and the control group(98 cases). The control group was given conventional care, while in the observation group, nursing intervention of humanistic care and reinforced health education were adopted in addition. The changes of adverse psychology and behavior of the two groups were observed. Χ2 test was used. Results The adverse psychology and behavior in the observation group was reduced significantly than that of the control group after nursing intervention. Conclusions Nursing intervention can effec-tively mitigate the adverse psychology and behavior in parents with terminal children. It plays an active role beth on the terminal children and their parents.

Objective To evaluate the role of adrenal venons sampling (AVS) in differential diagnosis of subtypes in primary aldosteronism.Methods Twenty-two patients diagnosed as primary aldosteronism in the Third Central Hospital of Tianjin from November 201 1 to July 2014, were undergone AVS for measurement of plasma aldosterone and cortisol levels in each adrenal vein and infrarenal inferior vena cava.The data were compared with the results of the thin slice incremental scanning in adrenal and postoperative pathologic diagnosis.Other 8 patients, whose screening test and confirmed diagnosis did not support the primary aldosteronism, with nodule larger than 4 cm pathologically confirmed as non-functioning adrenal adenoma, were also recruited.Results Among all the 22 patients with primary aldosteronism, the incidence rate of hypertention was 95.4％, and the incidence of hypokalemia was 81.8％.Compared with idiopathic hyperaldosteronism patients, the patients with aldosterone producing adenoma had higher blood pressure and aldosterone level in plasma, but lower plasma potassium, while the clinical and biochemical index of the non-functioning adrenal adenoma group were within the normal range.The overall accuracy rate of adrenal CT in the diagnosis of subtypes of primary aldosteronism was 77.27％ (17/22), and the accuracy rates were 78.95％ (15/19) in aldosterone producing adenoma and 66.7％ (2/3) in idiopathic hyperaldosteronism, respectively.The accuracy rate of AVS was 100％ with the ratio of aldosterone to cortisol as the criterion.Conclusions Misdiagnose may occur when using CT scan only to differentially diagnose primary aldosteronism.Compared with CT imaging of the adrenal glands, AVS has higher coincidence rate and is an elective approach to establish the subtype diagnosis of questionable primary aldosteronism.

This study aims to construct the recombinant lentivirus vector containing specific small interfering RNA (siRNA) targeting rat CREB binding protein(CBP)gene and to identify its function of inhibiting the expressions of acetylated histone in primarily cultured hippocampal neurons. Firstly, we constructed four kinds of recombinant lentivirus siCBP. And then we used them to infect the primarily cultured hippocampal neurons, and performed real-time PCR, western blot respectively to detect the expressions of CBP. Afterwards, the most effective lentivirus siCBP was used to infect the primarily cultured hippocampal neurons, and then the HAT activity and protein expressions of acetylated histone Ac-H3, Ac-H4 of the neurons were examined. By using PCR, endonuclease cutting and gene sequencing, we confirmed that the target genes were correctly cloned in lentivirus vector. Besides, CBP mRNA and protein expressions in neurons were found to be with varying degrees of decreases after infections of the four kinds of lentivirus siCBP. Furthermore, the representative and most effective lentivirus GR806 could effectively inhibit the HAT activity and the protein expressions of Ac-H3, Ac-H4 in neurons. It provides the experimental basis for the subsequent application of siCBP to clarify the effects and corresponding molecular mechanism of the CBP-dependent histone acetylation on learning and memory function in hippocampus.
Acetylation ; Animals ; CREB-Binding Protein ; metabolism ; Genetic Vectors ; Hippocampus ; cytology ; Histones ; metabolism ; Lentivirus ; Memory ; Neurons ; metabolism ; Primary Cell Culture ; RNA, Messenger ; RNA, Small Interfering ; Rats ; Real-Time Polymerase Chain Reaction

Objective: To investigate the incidence of adolescent depressive symptoms in primary and secondary schools in Guangzhou and the effect of gestational complications on adolescent depression, so to provide scientific basis for depression prevention among adolescent. Methods: Stratified cluster random sampling method was used to select 808 primary and secondary schools in 11 districts of Guangzhou. A total of 96 756 parents of adolescents aged 10-20 were surveyed for adolescents depressive symptoms and maternal gestational complications. Results: The parental reported rates of mild, moderate and major depressive symptoms of adolescents were 5.5%, 3.5%, and 0.5%, respectively. Univariate analysis showed that the severity of adolescent depression symptoms had statistical significance with maternal gestational hypertension, gestational diabetes mellitus, cholestasis, hypothyroidism, hyperthyroidism, gestational anemia and viral hepatitis ( χ 2=12.42~158.91， P <0.01). Multivariate Logistic regression showed that maternal gestational diabetes mellitus ( OR =1.41, 95% CI =1.18- 1.68 ), hypothyroidism during pregnancy ( OR =1.61, 95% CI = 1.15-2.26), and hyperthyroidism during pregnancy ( OR =1.40, 95% CI =1.03-1.91), anemia during pregnancy ( OR = 1.46 , 95% CI =1.35-1.59), and viral hepatitis during pregnancy ( OR =1.67, 95% CI =1.38-2.02) were positively correlated with the severity of adolescent depression symptoms reported by parents( P <0.05). Conclusion Gestational diabetes mellitus, gestational hypothyroidism, gestational hyperthyroidism, gestational anemia and gestational viral hepatitis are associated with adolescent depressive symptom.

: To investigate the current status of milk and dairy product intake of primary and middle school students in Guangzhou and to explore the influencing factors, to provide the basis for promoting the consumption of milk and dairy products for students. Methods: Questionnaire survey was conducted among 7 948 students selected from 3 primary schools and 3 middle schools in Guangzhou. The contents included general information, average amount of the intake of milk and dairy products (including pure milk, yoghurt, milk powder, cheese and other dairy products). Using χ2 test and multivariate Logistic regression to analyze the influencing factors of students’ milk and dairy product intake. Results: About 76.12% of all participants reported milk and dairy products intake<7 times/week, 78.88% reported milk and dairy products intake<300 g/d and the median of milk and dairy products was 178.57 g/d. In the multiple Logistic regression model, girls and high school students were more likely to consume milk and dairy products insufficiently, with the OR of 1.42 (95%CI=1.26-1.60), 1.86 (95%CI=1.51-2.28) respectively. The students with father’s education level being college degree or above (OR= 0.75, 95%CI=0.59-0.94), mother’s education level being high school or above (high school:OR=0.75, 95%CI=0.61-0.93, college degree or above:OR=0.58, 95%CI=0.46-0.72) and annual household income ≥200 000 (OR=0.77,95%CI=0.64-0.92) were more likely to consume sufficient milk and dairy products. Conclusion Consumption of milk and dairy products among primary and middle school students in Guangzhou was high but not meet the recommended amount,should be strengthened. Health and nutritional education for students and their parents,especially girls and senior students,should be strengthened to promote the milk and dairy products consumption.

Objective: To understand the relationship between screen time and dietary behaviors among urban middle school students in Guangzhou, and to provide scientific evidence for improving students’ health. Methods: Based on the regular medical examinations for elementary and middle school students in Guangzhou, a total of 12 357 middle school students (grade 7 and grade 10) were investigated by using a cross-sectional study. The physical indicators and daily routine were collected by physical examination and questionnaire survey. Multiple Logistic regression analysis was used to explore the association between screen time and dietary behaviors among students. Results: The proportion of excessive screen time was 18.80% (2 323). There was no significant difference between boys (18.52%, 1 165/6 292) and girls (19.09%, 1 158/6 065) (χ2=0.67, P>0.05). Logistic regression results showed that excessive screen time was negatively associated with consumption of vegetables and fruits, with the aORs of 0.50 (95%CI=0.42-0.58) and 0.64 (95%CI=0.58-0.70) respectively, and positively associated with consumption of fried food (OR=1.90, 95%CI=1.70-2.09), western fast food (OR=1.90, 95%CI=1.65-2.19), sweets (OR=1.36, 95%CI=1.25-1.49) and sugar-sweetened beverage (OR=1.70, 95%CI=1.57-1.84). Conclusion Excessive screen time was associated with unhealthy dietary behaviors among middle school students in Guangzhou. Intervention should be tailored to screen time as well as dietary behaviors.

OBJECTIVETo explore the relationship between socioeconomic status (SES) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM).

METHODSThe medical records of Tianjin Third Central Hospital were retrospectively reviewed to identify patients who had been hospitalized for treatment of T2DM but without diagnosis of NAFLD between 2007 and 2012 and who had required a second hospitalization during this same period. Each patient was contacted by telephone for self-reporting of SES. Analysis was carried out with patients grouped according to SES (high vs. low) to determine association of SES with incidence of NAFLD at the second hospitalization; the relative risk (RR), attributable risk (AR) and attributable risk percent (ARP) were calculated. Furthermore, the correlation of SES with other clinical and socio-psychological variables was assessed.

RESULTSThe patients in the high and low SES groups showed no significant differences at baseline. For development of NAFLD by the time of the second hospitalization, the low SES group had an RR of 2.19, an AR of 20.74%, and an ARP of 54.39%. Correlation analysis showed that SES was positively correlated with body mass index (r=-0.582) and levels of glycated hemoglobin (r=-0.421), fasting serum insulin (r=-0.570), insulin resistance (as assessed by the HOMA method) (r=-0.487), low-density lipopmtein (r=-0.396) and C-reactive protein (r=-0.353) (all P<0.05), and negatively correlated with high-density lipopmtein (r =0.539) and with the scores for physical functioning (r =0.241), general health (r=0.234), social functioning (r =0.286), emotional health (r=0.251), and mental health (r=0.215) (all P<0.05).

CONCLUSIONSES is an influencing factor of NAFLD in patients with T2DM and is closely related to obesity, insulin resistance, lipid metabolic disorder, chronic inflammation and life quality in patients with NAFLD and T2DM.

Body Mass Index ; C-Reactive Protein ; Diabetes Mellitus, Type 2 ; Humans ; Insulin Resistance ; Non-alcoholic Fatty Liver Disease ; Obesity ; Risk Factors ; Social Class

Objective:To retrospectively analyze clinical efficacy and safety of omalizumab in the treatment of chronic urticaria (CU) in southern Zhejiang, China.Methods:A retrospective observational study was conducted on CU patients who received omalizumab treatment at the First Affiliated Hospital of Wenzhou Medical University from January 1st, 2018 to August 1st, 2021. Through the outpatient follow-up visits, the disease activity, condition control, and quality of life were evaluated using the 7-day urticaria activity score (UAS7) , urticaria control test (UCT) , and dermatology life quality index (DLQI) . In addition, changes in disease condition, recurrence after withdrawal, and adverse events were assessed. Independent-sample t test was used for intergroup comparisons of normally distributed measurement data, Wilcoxon signed-rank sum test or Kruskal-Wallis H test was used for comparisons of non-normally distributed measurement data, and chi-square test or Fisher′s exact test was used for comparisons of enumeration data. Results:A total of 252 CU patients with poor response to antihistamines were included, with a baseline UCT score of 5.0 ± 2.4 points, a UAS7 score of 25.6 ± 6.2 points, and a DLQI score of 17.5 ± 4.7 points; among them, 204 (81.0%) were treated with omalizumab at an initial dose of 300 mg, and 48 (19.0%) with omalizumab at an initial dose of 150 mg. At the end points (12.0 ± 1.4 months after the start of treatment) , an overall control rate of 90.3% (224/248) was achieved after the omalizumab treatment; concretely, 137 (55.2%) patients achieved complete control (UCT = 16 points) , 87 (35.1%) achieved partial control (12 points ≤ UCT < 16 points) , and 24 (9.7%) showed no response (UCT < 12 points) , while 10 with partial response shifted to complete control after dose increase. During the treatment period, recurrence occurred in 50 patients (36.5%) , of whom 32 patients opted for retreatment with omalizumab, and then 30 (93.8%) achieved partial or complete control. Adverse events were reported in 8 patients (3.2%) , and all were mild or moderate.Conclusion:Omalizumab was effective in the real-world treatment of CU, and could improve patients′ quality of life, with a favorable safety profile.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.