With the increasing number of food safety problems caused by the abusing and misusing of plant hormones, it will be increasingly important to strengthen the trace detection of plant hormones in foods. In this study, benzyl methacrylate_methyl methacrylate_based amphiphilic polymer micelles were prepared, and a method for trace determination of five plant hormones was established by using these micelles. This method was rapid, sensitive and reproducible. Through optimization, the best experimental conditions were obtained as follows: 2 g/L polymer micelles, 50 mmol/L NaOH_H3BO3 buffer (pH 9. 2), 15 kV running voltage. Based on this novel method, naphthalene acetic acid in the solution of rooting powder was determined.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of three children with Menkes disease. METHODS: Three children who had presented at the Children's Medical Center, the Affiliated Hospital of Guangdong Medical University from January 2020 to July 2022 were selected as the study subjects. Clinical data of the children were reviewed. Genomic DNA was extracted from peripheral blood samples of the children, their parents and sister of child 1. Whole exome sequencing (WES) was carried out. Candidate variants were verified by Sanger sequencing, copy number variation sequencing (CNV-seq), and bioinformatic analysis. RESULTS: Child 1 was a 1-year-and-4-month male, and children 2 and 3 were monozygotic twin males aged 1-year-and-10-month. The clinical manifestations of the three children have included developmental delay and seizures. WES showed that child 1 has harbored a c.3294+1G>A variant of the ATP7A gene. Sanger sequencing confirmed that his parents and sister did not carry the same variant, suggesting that it was de novo. Children 2 and 3 had carried a c.77266650_77267178del copy number variation. CNV-seq results showed that their mother has carried the same variant. By searching the HGMD, OMIM and ClinVar databases, the c.3294+1G>A was known to be pathogenic. No carrier frequency has been recorded in the 1000 Genomes, ESP, ExAC and gnomAD databases. Based on the Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics (ACMG), the ATP7A gene c.3294+1G>A variant was predicted to be pathogenic. The c.77266650_77267178del variant has involved exons 8 to 9 of the ATP7A gene. ClinGen online system score for it was 1.8, which was also considered to be pathogenic. CONCLUSION The c.3294+1G>A and c.77266650_ 77267178del variants of the ATP7A gene probably underlay the Menkes disease in the three children. Above finding has enriched the mutational spectrum of Menkes disease and provided a basis for clinical diagnosis and genetic counseling.
Humans ; Male ; Computational Biology ; Copper-Transporting ATPases/genetics* ; DNA Copy Number Variations ; Exons ; Menkes Kinky Hair Syndrome/genetics* ; Mutation ; Peptide Fragments ; Seizures ; Infant

Objective To analyze the effect of stratified nursing intervention based on aspiration risk assessment strategy in ICU mechanical ventilation patients. Methods Totally 156 patients with ICU mechanical ventilation admitted between January 2016 and December 2017 were selected as study subjects, and 78 patients were divided into treatment group and control group by random number table method. The control group was given routine nursing interventions for ICU patients undergoing mechanical ventilation, and the treatment group was combined with stratified nursing interventions based on aspiration risk assessment strategy. Compare the two groups of nurses'knowledge, attitude and practice of aspiration prevention, the complications of patient aspiration, patient satisfaction and other indicators. Results The scores of nurses′knowledge, attitude and practice of prevention of aspiration in the treatment group were (46.32 ± 3.24), (51.41 ± 3.56), and (49.36 ± 4.85), respectively, which were significantly higher than those of the control group (41.25 ± 5.32), (47.12 ± 5.45), (44.42 ± 5.46), The difference was statistically significant (t=4.815, 3.899, 4.002, P<0.05);The rate of aspiration, reflux, asphyxia, aspiration pneumonia in the treatment group was 7.69％ (6/78), 19.23％ (15/78), 1.28％ (1/78), 2.56％ (2/78), which were significantly lower than 29.49％ (23/78), 39.74％ (31/78),12.82％ (10/78),20.51％ (16/78) in the control group. The difference were statistically significant (χ2=7.892-12.309, P<0.05 or 0.01);Patient satisfaction 97.87％ (74/78) was significantly higher than the control group 83.33％ (65/78), The difference was statistically significant (χ2=5.347, P<0.05). Conclusion The stratified nursing intervention based on the aspiration risk assessment strategy can help develop nurses′ability in knowledge, attitude and practice of aspiration prevention, reduce the occurrence of complications such as aspiration, and improve patient satisfaction.

0bjective To explore the effects of narrative nursing on posttraumatic growth for patients with amputation. Methods From December 2016 to March 2018,a total of 62 hospitalized patients with amputation were randomly assigned into the control group and the intervention group by random number table.The control group received routine nursing,the intervention group received narrative nursing on the basis of control group.Two groups were evaluated by Posttraumatic Growth Inventory(PTGI) before and after intervention. Results Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the control group were (19.87 ± 5.22), (7.90 ± 2.53), (8.83 ± 3.62), (9.73 ± 3.13), (10.63 ± 3.01), (56.97 ± 17.21) points, respectively. After intervention,the scores were (20.80±5.89), (8.80±2.17), (8.90±3.39), (10.27± 2.75), (11.07 ± 3.12), (59.83 ± 16.91) points, respectively, except new possibilities, the scores of each dimension and total scores of posttraumatic growth in the the control group were higher than before,the differences were statistically significant(t=3.00- 5.34, P＜0.05).Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the intervention group were (20.28±4.94), (8.17±2.58), (8.59±3.48), (9.55± 2.90), (11.07±2.83), (57.66±16.42) points, respectively. After intervention, the scores were (23.79±4.70), (10.10±2.17), (10.72±3.34), (11.69±2.22), (12.79±3.28),(69.10±14.92) points, respectively, the scores of each dimension and total scores of posttraumatic growth in the intervention group were statistically higher than those in the control group and before intervention,the differences were statistically significant (t=10.61-16.75, P＜0.05). Conclusion Narrative nursing can effectively improve the level of posttraumatic growth and psychological state for patients with amputation.

Objective:To construct a preoperative rehabilitation program for gastric cancer patients, aiming to provide scientific and reasonable preoperative guidance for gastric cancer patients.Methods:On the basis of literature research and expert group meeting, the first draft of the preoperative rehabilitation program for gastric cancer patients was constructed. From October 2021 to January 2022, the Delphi method was used to conduct 2 rounds of expert letter inquiries to 16 experts in related fields from 11 hospitals in Jiangsu Province, and the entries were revised according to the experts′ inquiries.Results:In the two rounds of expert correspondence, the positive coefficients of experts were 88.89% and 100.00%, and the authority coefficients of experts were both 0.88. The coordination coefficients of the items in the two rounds of inquiry were 0.279 and 0.290, respectively. The final program consisted of 3 first-level entries, 11 second-level entries and 32 third-level entries.Conclusions:The scheme constructed in this study is scientific, reliable and applicable, and is worth being promoted further in clinical practice.

Objective To evaluate the postoperative imaging features of lung ultrasound on patients undergoing lung transplantation ,and to provide the evidence for diagnosis and therapy . Methods Between October 2016 and March 2017 ,51 patients undergoing lung transplantation ( unilateral:37 ,bilateral:14 ) admitted to the ICU in Wuxi People′s Hospital were examined by bedside lung ultrasound ,and imaging features were analyzed . Results The main features on ultrasound of 51 patients undergoing lung transplantation were:①Pneumothorax :The A-line arising at the pleural line was shown in all of 51 patients , mainly on anterolateral parts of the chest wall initially ,then fade away towards anterosuperior parts over time . ② Hydrothorax :An anechoic fluid collection was detected ( up to 50 mm in width ) ,and became narrow over time in most patients . A mass of floccules or progressive growth of pleural effusion indicated the need for emergency surgery ,and were confirmed bleeding after surgery . ③Subcutaneous emphysema:The E-line was detected mainly in anterior and lateral parts around the surgical incision of postoperative patients ,and gradually fade away over time . ④Pulmonary edema:On the first postoperative day ,multiple B-lines were shown in 49 cases ,lung consolidation in 36 cases ( mainly in the inferior and inferoposterior parts) ,lung consolidation sonographic air bronchogram in 12 cases . Then the area of consolidation and B-lines reduced ,the air bronchogram sign became more prevalent ,and the shred sign appeared on the border of consolidation over time . Conclusions The imaging features of lung ultrasound provides clinic diagnostic and therapeutic value for postoperative patients undergoing lung transplantation .

Objective: To observe the killing and clearance effect of an Er:YAG laser combined with sodium hypochlorite on Enterococcus faecalis at different depths of the root canal in vitro to provide a reference for clinical application. Methods : A total of 75 models of Enterococcus faecalis infection were successfully established and randomly divided into three groups (25 per group). Ten random samples per group underwent no processing. The remaining models in group A were treated with an Er:YAG laser combined with sodium hypochlorite 52.5 g/L. Group B was treated with 52.5 g/L sodium hypochlorite (positive control), and group C was treated with normal saline (negative control). The bacterial reduction rate was calculated for each group. The bactericidal effect on the surface of the root canal wall was observed in 5 samples by scanning electron microscopy. Results: There was no statistically significant difference (P > 0.05) between group A (100.00 ± 0.00) and group B (98.62 ± 2.01) but was a statistically significant difference between group A (100.00 ± 0.00) and group C (64.37 ± 2.45) (P < 0.05). The percentage reduction in bacteria was higher in group A (99.46 ± 2.31) than in groups B (92.89 ± 3.07) and C (56.72 ± 4.96) (P < 0.05). The decrease in bacteria was greater in group A (97.62 ± 3.73) than in groups B (72.49 ± 2.35) and C (44.42 ± 4.78) (P < 0.05). The bacterial reduction rate in group A (95.89 ± 2.46) was higher than that in groups B (63.88 ± 1.08) and C (33.31 ± 5.21) (P < 0.05). There were significant differences at different dentin depths in the bacterial reduction rates among groups A, B and C (P < 0.05). Electron microscopy analysis showed that the Er:YAG laser combined with 52.5 g/L sodium hypochlorite was better than either treatment alone at removing bacteria from the surface of the root canal wall. Conclusion An Er:YAG laser can effectively enhance the bactericidal effect of sodium hypochlorite on the inner wall of the root canal.

Objective To analyze the effect of evidence based practice on feeding after spinal operation. Methods To formulate an answerable question, find the best available evidence, appraise the evidence and formulate the recommendations by using the method of evidence-based medicine. A total of 60 postoperative patients who received spinal operation were divided into observation group and control group (30 cases in each group). Those patients in control group received the routine diet guidance and the guidelines for the standardization of intake and consumption after spinal cord surgery were used for patients in observation group. The outcomes were evaluated by postoperative recovery and complications of patients after spinal operation. Results There were no significant difference in the incidence of nausea, vomiting , bloating and celialgia in the 5 hours after surgery and 2 hours after feeding between the two groups (P>0.05). The incidence of thirst and hunger in the 5 hours after surgery in observation group were 3.33％(1/30) and 13.33％(4/30).The incidence of thirst and hunger in the 5 hours after surgery in control group were 80.00％(24/30) and 83.33％(25/30). There were statistically significant in the incidence of thirst and hunger in the 5 hours after surgery between the two groups (χ2=36.27, 24.09, P<0.05). There were not statistically significant in the time of anal exsufflation and first defecation time between the two groups(P>0.05). Conclusions Evidence-based practice in the use of guidelines for the standardization of intake and consumption after spinal cord surgery can guide clinical practice.

Objective:To investigate the classification of head shaking nystagmus（HSN） and its clinical value in vestibular peripheral diseases. Methods:Clinical data of 198 patients with peripheral vestibular disorders presenting with HSN were retrospectively analyzed. Video Nystagmograph（VNG） was applied to detect spontaneous nystagmus（SN）, HSN, and Caloric Test（CT）. The intensity and direction of SN and HSN as well as the unilateral weakness（UW） and direction preponderance（DP） values in caloric test was analyzed in patients. Results:Among the 198 patients with vestibular peripheral disease, there were 105 males and 93 females, with an average age of（49.1±14.4） years （range: 14-87 years）. One hundred and thirty seven patients were diagnosed as Vestibular Neuritis（VN）, 12 as Meniere's Disease（MD）, 41 as sudden deafness（SD） and 8 as Hunt's syndrome accompanied by vertigo. Among them, there were 116 patients in the acute phase, including 68 cases（58.6%） with decreased HSN, 4 cases（3.4%） with increased HSN, 5 cases（4.3%） with biphasic HSN, 38 cases（32.8%） with unchanged HSN, and 1 case（0.9%） with perverted HSN. There were 82 cases in the non-acute phase, 51 cases（62.2%） with decreased HSN, 3 cases（3.6%） with increased HSN, 9 cases（11.0%） with biphasic HSN, and 19 cases（23.2%） with unchanged HSN. In biphasic HSN, the intensity of phase I nystagmus was usually greater than that of phase II, and the difference was statistically significant（P<0.01）. There was no correlation between HSN type and course of disease or DP value. The intensity of HSN was negatively correlated with the course of disease（r=-0.320, P<0.001） and positively correlated with DP value（r=0.364, P<0.001）, respectively. The intensity of unchanged nystagmus and spontaneous nystagmus were（8.0±5.7） °/s and（8.5±6.4）°/s, respectively. There was no statistically significant difference in the intensity of nystagmus before and after shaking the head. Conclusion:HSN can be classified into five types and could be regarded as a potential SN within a specific frequency range （mid-frequency）. Similarly, SN could also be considered as a common sign of unilateral vestibular impairment at different frequencies. HSN intensity can reflect the dynamic process of vestibular compensation, and is valuable for assessing the frequency of damage in peripheral vestibular diseases and monitoring the progress of vestibular rehabilitation.
Male ; Female ; Humans ; Adult ; Middle Aged ; Vestibular Function Tests ; Retrospective Studies ; Nystagmus, Pathologic/diagnosis* ; Vertigo/diagnosis* ; Electronystagmography ; Vestibular Diseases/diagnosis*

Objective To systematically evaluate the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection. Methods We searched the CNKI, SinoMed, Wanfang data, VIP, PubMed, Web of Science, EMbase, The Cochrane Library database from inception to September 2022. Case-control studies, and cohort studies on risk factors for postoperative delirium after surgery for Stanford type A aortic dissection were collected to identify studies about the risk factors for postoperative delirium after surgery for Stanford type A aortic dissection. Quality of the included studies was evaluated by the Newcastle-Ottawa scale (NOS). The meta-analysis was performed by RevMan 5.3 software and Stata 15.0 software. Results A total of 21 studies were included involving 3385 patients. The NOS score was 7-8 points. The results of meta-analysis showed that age (MD=2.58, 95%CI 1.44 to 3.72, P＜0.000 01), male (OR=1.33, 95%CI 1.12 to 1.59, P=0.001), drinking history (OR=1.45, 95%CI 1.04 to 2.04, P=0.03), diabetes history (OR=1.44, 95%CI 1.12 to 1.85, P=0.005), preoperative leukocytes (MD=1.17, 95%CI 0.57 to 1.77), P=0.000 1), operation time (MD=21.82, 95%CI 5.84 to 37.80, P=0.007), deep hypothermic circulatory arrest (DHCA) time (MD=3.02, 95%CI 1.04 to 5.01, P=0.003), aortic occlusion time (MD=8.94, 95%CI 2.91 to 14.97, P=0.004), cardiopulmonary bypass time (MD=13.92, 95%CI 5.92 to 21.91, P=0.0006), ICU stay (MD=2.77, 95%CI 1.55 to 3.99, P＜0.000 01), hospital stay (MD=3.46, 95%CI 2.03 to 4.89, P＜0.0001), APACHEⅡ score (MD=2.76, 95%CI 1.59 to 3.93, P＜0.000 01), ventilation support time (MD=6.10, 95%CI 3.48 to 8.72, P＜0.000 01), hypoxemia (OR=2.32, 95%CI 1.40 to 3.82, P=0.001), the minimum postoperative oxygenation index (MD=−79.52, 95%CI −125.80 to −33.24, P=0.000 8), blood oxygen saturation (MD=−3.50, 95%CI −4.49 to −2.51, P＜0.000 01), postoperative hemoglobin (MD=−6.35, 95%CI −9.21 to −3.50, P＜0.000 1), postoperative blood lactate (MD=0.45, 95%CI 0.15 to 0.75, P=0.004), postoperative electrolyte abnormalities (OR=5.94, 95%CI 3.50 to 10.09, P＜0.000 01), acute kidney injury (OR=1.92, 95%CI 1.34 to 2.75, P=0.000 4) and postoperative body temperature (MD=0.79, 95%CI 0.69 to 0.88, P＜0.000 01) were associated with postoperative delirium after surgery for Stanford type A aortic dissection. Conclusion The current evidence shows that age, male, drinking history, diabetes history, operation time, DHCA time, aortic occlusion time, cardiopulmonary bypass time, ICU stay, hospital stay, APACHEⅡ score, ventilation support time, hypoxemia and postoperative body temperature are risk factors for the postoperative delirium after surgery for Stanford type A aortic dissection. Oxygenation index, oxygen saturation, and hemoglobin number are protective factors for delirium after Stanford type A aortic dissection.