ObjectiveTo investigate the effects of combination of dexmedetomidine and sufentanil preconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts.MethodsForty male SD rats weighing 180-220 g, aged 8-10 weeks, were anesthetized with intraperitoneal 3％pentobarbital 60 mg/kg and heparin 3000 U/kg.The hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％O2-5％CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 5 groups ( n =8 each):control group (group C),I/R group,dexmedetomidine preconditioning group (group DP),sufentanil preconditioning group (group SP),and dexmedetomidine + sufentanil preconditioning group (group DS).I/R injury was induced by 30 min of ischemia followed by 120 min of reperfusion.Groups DP,SP and DS received 30 min of perfusion with K-H solution containing dexmedetomidine 2.3 ng/ml,sufentanil 3.77 ng/ml and dexmedetomidine 2.3ng/ml + sufentanil 3.77 ng/ml respectively at 30 min before ischemia.Coronary flow (CF),left ventricular developed pressure (LVDP),± dp/dtmax and HR were measured at 15 min of equilibration,immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion.The superoxide didmutase (SOD) and myeloperoxidase (MPO) activities and the malondialdehyde (MDA) content in myocardial tissues and infarct size were determined at 120 min of reperfusion.Results Compared with group C,CF,LVDP, ± dp/dtmax,HR and SOD activity were significantly decreased,and MPO activity,MDA concent and infarct size were significantly increased in the other 4 groups ( P ＜ 0.05).Compared with group I/R,CF was significantly decreased in groups DP and DS,HR was significantly decreased in groups SP and DS,and LVDP, ± dp/dtmax and SOD activity were significantly increased,and MPO activity,MDA content and infarct size were significantly decreased in groups DP,SP and DS ( P ＜0.05).Compared with group DS,CF was significantly decreased and HR increased in group DP,and SOD activity was significantly decreased,CF,MPO activity,MDA content and infarct size were significantly increased in group SP (P ＜ 0.05 ),and no significant change was found in SOD and MPO activities,MDA content and infarct size in group DP ( P ＞ 0.05).Conclusion Dexmedetomidine combined with sufentanil preconditioning can reduce I/R injury in isolated rat hearts,but the myocardial protection is not further enhanced.

Objective To understand the epidemiological characteristics of HIV infection in voluntary blood donors in Liuzhou city to provide the basis for the blood donation recruit launched by the blood collection and tranfusion service agencies and reduce the risk of transfusion transmitted HIV.Methods The epidemiological investigation on the voluntary unpaid blood donors infected with HIV during 2008-2012 was performed for analyzing the infection characteristics.Results HIV infection in blood donors in Liuzhou city had no statistical difference between different years (P >0.05);the differences in different sexes,age groups,married and unmarried persons had statistically significant differences (P <0.01 );the education background less than middle school ac-counted for 52.94%;56.21% of the infectors were the sexual transmission.Conclusion HIV infection in voluntary unpaid blood donors in Liuzhou city is dominated by young adult men and the persons with the education level less than junior high school,and the heterosexual transmission is predominant.The donor recruitment work should pertinently exclude the persons of high-risk be-havior and collect blood in low risk population as far as possible.

Objective To explore the effect of workshop on postoperative function of affected limb in patients with breast cancer. Meth-ods From August, 2015 to June, 2016, 70 patients with breast cancer after modified radical mastectomy were randomly divided into control group (n=35) and observation group (n=35). The control group was instructed by the primary nurse bedside based on the traditional method, while the observation group was guided with workshop mode. Results Ten days and one month after surgery, the range of motion of the shoulder joint in the observation group was superior to the control group (t>2.030, P<0.01);the incidence of lymphedema of the affected limb in the observation group was lower than that in the control group (u=2.195, P<0.05). Conclusion Functional exercise guided with work-shop mode could improve postoperative function of affected limb in patients with breast cancer.

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 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 explore the effects of team management model on the prevention and control of incontinence dermatitis in patients with paraplegia.Methods A total of 113 patients with paraplegia and incontinence who were treated in Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from March 2016 to February 2018 were enrolled in the study.They were divided into observation group and control group according to the sequence of admission.The patients who were admitted from March 2016 to February 2017 were assigned as the control group,with 56 cases.The patients who were admitted from March 2017 to February 2018 were assigned as the observation group,with 57 cases.The control group was treated with routine intervention.Team management was applied in the observation group on the basis of routine nursing for 4 weeks.The incidence of incontinence dermatitis and negative emotion were compared between the two groups.Results After intervention,the incidence of incontinent dermatitis of the observation group (5.26％) was significantly lower than that of the control group (14.29％),and the difference was statistically significant (P＜ 0.05).The scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group were (38.70 ± 6.83) and (41.07 ± 5.62),which were both lower than those of the control group (46.39 ± 8.15) and (47.31 ± 6.52) respectively,and the differences were statistically significant (P ＜ 0.05).Conclusions Team management can effectively reduce the incidence of incontinence dermatitis and negative emotions in paraplegic patients,which is worthy of clinical promotion.

Objective:To understand the current situation of nursing practice environment and clinical innovation ability of pediatric nurses and to explore the effect of nursing practice environment on clinical innovation ability of clinical pediatric nurses.Methods:A cross-sectional survey method was adopted to select 478 pediatric nurses from the Children's Hospital of Nanjing Medical University as the research objects from May to June 2019 by the convenient sampling method. The general data questionnaire, profession practice environment-nursing work index (PES-NWI) and innovation ability of clinical pediatric nurse scale were used to analyze the effect of nursing practice environment on clinical innovation ability of clinical pediatric nurses.Results:The total score of PES-NWI of pediatric nurses was (90.73±13.02) , and the total score of innovation ability of clinical pediatric nurse scale was (120.79±10.84) . There was a positive correlation between the nursing practice environment and the innovation ability score of pediatric nurses ( P<0.05) . The results of stratified regression analysis showed that nurses' participation in hospital affairs and provision of high-quality nursing services in the nursing practice environment of pediatric nurses had a predictive effect on the innovation ability of pediatric nurses ( P<0.05) . Conclusions:The innovation ability of pediatric nurses is at a medium level, and the nursing practice environment has a predictive effect on innovation ability. Nursing managers should pay attention to the improvement of nursing practice environment and take effective measures to improve their innovative ability.

Objective:To explore the application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities.Methods:Using the convenient sampling method, a total of 65 patients with soft tissue injury in the skin of extremities after undergoing free skin flap transplantation who were admitted to Henan Provincial People's Hospital from October 2019 to October 2020 were selected. According to the admission time, they were divided into the observation group (34 cases) and the control group (31 cases) . Patients in the observation group received psychological resilience intervention combined with prospective nursing, while patients in the control group only received prospective nursing. The surgical success rate, flap necrosis rate, incidence of vascular crisis and complications were compared between the two groups. Symptom Checklist-90 (SCL-90) was used to evaluate treatment effects of patients in two groups before and after the intervention.Results:There was no statistically significant difference in the surgical success rate, flap necrosis rate and incidence of vascular crisis between the observation group (100.00%, 2.94%, 2.94%) and the control group (96.77%, 12.90%, 16.13%) ( P>0.05) . The observation group had 1 case of deep venous thrombosis (DVT) and 2 cases of other complications, and the control group had 3 cases of pressure injury, 1 case of infection, 2 cases of DVT and 3 cases of other complications. The complication rate in the observation group was 8.82%, which was lower than 29.03% in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the scores of anxiety and paranoia in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Psychological resilience intervention combined with prospective nursing has a good application effect on patients with free skin flap transplantation to repair skin and soft tissue defects of extremities. The complication rate is reduced, and mental health of patients is good.

This study was aimed to verify the hypothesis that Ge-Xia Zhu-Yu (GXZY) decoction protects liver from porcine serum-induced oxidative stress through the thioredoxin system.SD rats were randomly divided into the blank control group,model group,normal rat + GXZY decoction group,model rat + GXZY group.The rat autoimmune hepatic fibrosis model was induced with porcine serum by intraperitoneal injection (0.5 mL/each rat) twice a week.And GXZY decoction (7.37 g raw material/kg· d) was simultaneously administered daily by gavage.Lipid peroxidation (LPO) levels and thioredoxin reductase (TrxR) activity in liver tissues were determined by the colorimetric method.Polymerase chain reaction (PCR) was used to analyze the transcription factor nuclear factor erythroid 2-related factor 2 (Nfe2l2,previously known as Nrf2) mRNA expression.And the western blot was used to analyze the thioredoxin-1 (Trx1) protein expression and Akt phosphorylation in the liver.The results showed that compared to the model control group,the GXZY decoction group attenuated porcine serum-induced oxidative stress,as indicated by the LPO level,in liver tissues.Furthermore,GXZY decoction significantly enhanced TrxR activity,Trx1 protein expression,Nfe2l2 mRNA expression,and Akt phosphorylation (all P＜0.05).It was concluded that the strong antioxidant properties of GXZY decoction in the porcine serum rat model was due to the enhancement of the hepatic thioredoxin system via activating Akt-Nrf2 signaling pathway.The study results provided experimental evidences for the supporting of this hypothesis.

Objective:To investigate the correlation of red blood cell distribution width-to-platelet ratio (RPR) with clinical features and prognosis of patients with multiple myeloma (MM).Methods:The clinical data of 137 patients with MM who were admitted to the Affiliated Hospital of Xuzhou Medical University from April 2013 to July 2019 were collected. The receiver operating characteristic (ROC) curve was used to determine the best cut-off value of RPR. According to the best cut-off value of RPR, the patients were divided into high RPR group and low RPR group, and the differences in clinical characteristics and prognosis between the two groups were analyzed.Results:The best cut-off value of RPR was 0.10, and according to the best cut-off value, the patients were divided into high RPR group (RPR ≥ 0.10, 52 cases) and low RPR group (RPR < 0.10, 85 cases). There were statistical differences between the high RPR group and low RPR group in the proportion of patients between different stratification of Durie-Salmon (DS) staging ( χ2 = 17.110, P < 0.01), International Staging System (ISS) staging ( χ2 = 10.817, P = 0.001), red blood cell distribution width standard deviation(RDW-SD) ( χ2 = 26.937, P < 0.01), hemoglobin ( χ2 = 17.140, P < 0.01), lactate dehydrogenase (LDH) ( χ2 = 7.926, P = 0.005), erythrocyte sedimentation rate (ESR) ( χ2 = 9.513, P = 0.002), β 2-microglobulin (β 2-MG) ( χ2 = 7.726, P = 0.005), and bone marrow plasma cell ratio (BMPC) ( χ2 = 6.621, P = 0.010). The overall response rate (ORR) in the low RPR group was higher than that in the high RPR group [82.4% (70/85) vs. 71.2% (37/52)], but the difference was not statistically significant ( χ2 = 2.366, P = 0.124). The deep remission rate in the low RPR group was higher than that in the high RPR group [56.5% (48/85) vs. 19.2% (10/52)], and the difference was statistically significant ( χ2 = 18.327, P < 0.01). The results of multivariate analysis showed that the albumin, RPR and degree of remission were independent influencing factors for the overall survival (OS) of newly treated MM patients (all P < 0.05). Conclusion:MM patients with elevated peripheral blood RPR have shorter OS time, and RPR may be one of the indicators for evaluating the prognosis of MM.