Objective To discuss influence of the humidification or non-humidification on oxygen humidity during low-mid volume oxygen inhalation through nasal cannula.Methods A total of 160 patients with low-mid volume oxygen inhalation through nasal cannula for≥12 hours were randomly assigned to the humidified group and the un-humidified group with 80 patients in each.Recording the chases of oxygen humidity from the humidifying bottles.at the same time the indoor air humidity was also observed.Influence of the humidification or non-humidification on oxygen humidity during low-mid volume oxygen inhalation through nasal cannula was observed.Results There was not significant difference in oxygen humidity between the two groups.Conclusions Routine humidifying is not necessary in low-mid volume oxygen inhalation through nasal cannula.

Objective To explore the effect of humidification of oxygen delivered by nasal cannula on the respiratory symptoms. Method A total of 540 patients receiving low-to-mid flow oxygen therapy (<4L/min) by nasal cannula for more than 12 hours were assigned to receive humidified (n=235) or dry (n=305)oxygen. While 226 patients receiving a low-to-mid flow oxygen therapy for more than 24 hours received humidified or dry oxygen respectively. The patients' respiratory symptoms were observed and recorded. Results Dryness over naso-pharyngeal region was the only symptom reported by patients in this study. There was no significant difference on the rate of dryness over naso-pharyngeal region between patients receiving humidified oxygen and patients receiving dry oxygen (P>0.05) either in the same patients when receiving dry and humidified oxygen (P>0.05). Conclusion Routine humidification is not necessary in low-to-mid flow oxygen therapy by nasal cannula.

In this paper , based on the analysis of the facing predicament of current situation of medical ethics education , the authors combined with the practice of medical ethics education and the school experience , based on the theory of life education , put forward to experience the activities of public medical treatment building practice of medical students medical ethics education system , promote the educational work to carry out the practice of medical colleges, improve the teaching quality of medical ethics education .

[Objective] To refer a geographical distribution rule of alpha-L-fucosidase (AFU) reference values for the health adults in China via exploring its spatial distribution trend and its correlation with geographical factors.[Methods] A total of 6564 samples of AFU reference values from 66 administrative units in the years 2004-2015 were collected,male and female of which were 3701 cases (56.4％) and 2863 cases (46.3％).A research concerning AFU reference values in whole country were calculated using methods of information content and ridge regression.[Results] AFU reference values for Chinese healthy adults were influenced by geographical factors and presented autocorrelation,and it showed eastern and northern areas were highery than western and southern areas.[Conclusions] AFU reference values have a spatial variation and the regional disparities should be considered in practice.

Objective To observe the clinical efficacy of Sanyinjiao acupoint sticking with Gushen Yutai Tie on threatened abortion. Methods A total of 216 women diagnosed with threatened abortion were randomly assigned to trial group (108 cases) and control group (108 cases). Both groups were treated with TCM syndrome differentiation treatment and progesterone soft capsule, and the trial group was treated with Gushen Yutai Tie acupoint sticking at Sanyinjiao (SP6) additionally. One treatment course was five days, and both groups were treated for three courses. Vaginal bleeding and lower abdominal pain, lumbar pain, nausea and vomiting were observed, pulsatility index (PI) and resistance index (RI) of the uterine artery were detected after treatment. Results The total effective rate in the trial group was 97.22% (105/108), which was significantly higher than that of 90.74% (98/108) in the control group (P<0.05). Symptom scores in the trial group were also significantly higher than those in the control group (P<0.01). PI and RI in the ineffective (pregnancy failure) group were much lower than that of effective (threatened abortions with normal outcome) group (P<0.01). Conclusion The treatment that Gushen Yutai Tie acupoint sticking at Sanyinjiao combined with TCM syndrome differentiation and progesterone soft capsule had a better effect to improve pregnancy success rate in threatened abortion. PI and RI in uterine artery could be used to evaluate the outcome of pregnancy.

Objective To analyze the status of occupational disease hazards in Shantou City for 2019 to 2022 and propose corresponding management measures. Methods Technical reports on various occupational-disease-specific activities in Shantou City from 2019 to 2022 were collected and the data were comprehensively analyzed. Results Among the 3 066 enterprises surveyed in the 2020 occupational disease hazard investigation in Shantou City, occupational hazards were reported in 2 982 enterprises (accounting for 97.3%), with 2 955 being small and micro enterprises, accounted for 99.1%(2 955/2 982). The exposure rate of occupational hazards was 58.7% (42 894/73 054) among workers in the surveyed enterprises, with dust and noise exposure rates of 59.7% and 77.8%, respectively. The reported rate of occupational disease hazard projects by employers, regular detection rate of workplace occupational hazards, detection rate of occupational medical examination among workers, and occupational health training rate of key responsible personnel and occupational health management staff were 8.4%, 1.4%, 2.4%, and 4.3%, respectively. The results of occupational hazards monitoring of workplace in key industries from 2019 to 2022 showed that noise had the highest rate of exceeding national standards workplace, followed by silica dust, accounting for 34.2% and 13.8%, with the on-site exceedance rate of 32.2% and 10.0%, respectively. From 2019 to 2022, 31 suspected occupational disease cases were identified in key occupational disease monitoring, including 27 suspected cases of occupational pneumoconiosis and four suspected cases of occupational noise-induced deafness. Conclusion The workers in Shantou City have a high exposure rate to occupational hazards, and the occupational health management level of employers remains low, with noise and silica dust being the most severe occupational hazards. It is essential to improve technical support and service system development for occupational disease prevention and treatment, strengthen supervision and management in key industries and positions, explore occupational health assistance mechanisms for small and micro enterprises, and enforce employers' responsibility in occupational disease prevention to protect workers' occupational health and safety.

Objective To explore the best time of initiating enteral nutrition for patients after thoracoscopic resection of esophageal cancer and impacted on Prognosis. Methods A total of 202 esophageal cancer patients were treated in Department of Thoracic Surgery Fujian Medical University Union Hospital, who were divided into experimental group ( n =88 ) and control group ( n =114 ) by random number table and received enteral nutrition 8-12 h and 24-48 h respectively after operation. At 1 d before operation, 5 d, 8 d after operation, we compared the main nutrition indexes of blood chemistry, and observed the effects of clinical nutrition support and incidence of complications. Results Five days after operation, the total protein and albumin of experimental group were (57. 44 ± 4. 61), (29. 53 ± 3. 05) g/L higher than (53. 58 ± 5. 22), (27. 13 ± 3. 27)g/L of the control group (t=5. 48, 5. 33;P<0. 01); they were (63. 30 ± 4. 80),(32. 33 ± 3. 88)g/L in the experimental group higher than (57. 42 ± 5. 73), (29. 75 ± 3. 66) g/L in the control group (t=7. 75, 3. 35;P<0. 01). The incidence rate of complication in two groups had no statistical significance (P>0. 05). There were 24 cases complications in the control group and 16 cases in the experimental group (χ2 =0. 26,P=0. 612). The discomfort patients of gastrointestinal tract was 26 in the control group while it was 21 persons in the experimental group (χ2 =0. 03,P=0. 860). Conclusions The best time of enteral nutrition after operation is 8-12 hours, which can improve the nutritional status of patients and decrease postoperative complications with the clinical feasibility.

Objective:To explore the effects of genotypes of one-carbon metabolism (OCM)-related enzyme single nucleotide polymorphisms (SNPs) sites and anti-epileptic drugs on OCM metabolite levels in epileptic patients, and to screen valproic acid (VPA) teratogenic susceptibility genes.Methods:Three hundred and seventy-two epileptic patients, admitted to our hospital from January 2019 to December 2020, were enrolled in the study; patients taking VPA, levetiracetam (LEV), lamotrigine (LTG) or oxcarbazepine (OXC) for more than 6 months without attack during regular medication were classified as VPA group ( n=95), LEV group ( n=61), LTG group ( n=57) and OXC group ( n=70); firstly diagnosed epileptic patients who had never taken antiepileptic drugs or had not taken antiepileptic drugs in the previous 6 months were assigned into blank control group ( n=89). Plasma folic acid (FA), vitamin B12 (VitB 12) and homocysteine (Hcy) levels were determined by automatic chemiluminescence immunoassay, and genotypes of OCM-related enzyme SNPs sites were detected by Sequenom iPLEX. Results:(1) As compared with LEV group and blank control group, VPA group had significantly decreased FA level and significantly increased Hcy level ( P<0.05). (2) Patients with DNA methyltransferase (DNMT) 3a rs12987326(-178G>A) GA type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs2288350(82G>C) GC type had significantly higher Hcy level than those with GG type ( P<0.05); patients with DNMT1 rs75616428 (55850G>C) GC type had significantly lower VitB 12 level than those with GG type ( P<0.05). Patients with DNMT1 rs1863771(128G>A) GA+AA type had significantly higher FA level than those with GG type, patients with folate receptor 2 rs2298444(59T>C) CT+CC type had significantly higher Hcy level than those with TT type, patients with 5,10-methylenetetrahydrofolate reductase rs1801131(1298A>C) AC+CC type had significantly higher Hcy level than those with AA type, and patients with DNMT3a rs6722613(2327C>T) CT+TT type had significantly lower VitB 12 level than those with CC type ( P<0.05). Conclusions:Decreased FA and increased Hcy levels can be noted in epileptic patients who used VPA; some gene variations in SNPs of OCM also affect the OCM metabolite levels in epileptic patients. Epileptic patients during pregnancy should avoid using VPA or detecting SNPs genotypes before medication to reduce the incidence of fetal malformation.

Objective:To evaluate the utility of whole-exome sequencing (WES) in early diagnosis for children with language delay/disorder.Methods:Children with language delay/disorder who were admitted to the Department of Health Care, Children′s Hospital Affiliated to the Capital Pediatric Institute from January 2019 to December 2020 were analyzed retrospectively. Based on informed consent, the peripheral blood of the children and their parents was collected for WES. Combining the clinical phenotypes of the children, the candidate variants, including single nucleotide variants (SNVs) and copy number variations (CNVs), were selected for validation and family segregation analysis using Sanger sequencing, real-time PCR or CNV-Seq. The pathogenicity of variants was evaluated based on ACMG guideline following with finial genetic diagnosis. Based on whether genetic diagnosis was achieved or not, 125 children with comprehensive examination of the Children Neuropsychological and Behavioral Scale(CNBS-R2016) were sub-grouped (positive/negative group), and the total scores and the detailed scores of five developmental sections (gross motor, fine motor, adaptive ability, language and social behavior ability) between two subgroups were compared.Results:A total of 165 children with language delay/disorder were recruited, including 109 males and 56 females. The ratio of boys to girls was 1.95∶1.The age of the children was (3.2±1.2) years old, the median age was 3.0 years. 45 children carry disease-related pathogenic/likely pathogenic variants, including 36 SNVs and 9 CNVs. The genetic diagnostic yield of this cohort was 27.3% (45/165). The inheritance analysis for core family members showed de novo variant accounted for 86% of genetic diagnosis (31/36). The positive diagnosis rate in girls was 45% (25/56), which was significantly higher than that in boys (18.3%, 20/109, χ2=12.171, P<0.05). There was no significant difference in the rate of positive diagnosis among all age groups (χ2=4.349, P>0.05). Interestingly, the scores of gross motors of positive group were significantly lower than that of negative group (61.5 vs. 69.4, t=-2.610, P<0.05). Otherwise, no significant difference was seen between two groups( t=-0.933, -1.298, -0.114, -0.214, all P>0.05). Conclusions:Language delay/disorder has complex genetic heterogeneity. WES has important application value in early etiological diagnosis for children with language delay/disorder.

Objective:To investigate the phenotypes of Rubinstein-Taybi syndrome (RSTS) caused by variants in the CREBBP or EP300 gene, and the correlation between genotype and phenotype.Methods:This case series study was performed on pediatric patients who were referred to the Children′s Hospital of Capital Institute of Pediatrics between January 2013 and July 2022. Both point variant and copy number deletion in CREBBP or EP300 gene were detected by whole exome sequencing, chromosomal microarray analysis, or copy number variation sequencing (CNV-seq). The variant categories were summarized and phenotype numbers were re-visited for RSTS patients. Based on variant types, the patients were divided into different groups (point variant or copy number deletion, EP300 or CREBBP point variant, and loss of function or missense variant). Phenotype counts between different groups were compared using the rank-sum test of two independent samples.Results:A total of 21 RSTS patients were recruited, including 12 males and 9 females, with ages ranging from 1 month to 14 years and 2 months. Among them, 67% (14/21) had point variants, and 33% (7/21) had copy number deletions. Out of these, 20 variants (95%) were de novo. Among 20 patients finishing phenotype count during re-visit, 95% (19/20) of the patients exhibited developmental delays before the age of 2 years. Additionally, 80% (16/20) of the patients had distinctive facial features. Considering phenotype count, no statistically significant difference was found between point variant (14 cases) and copy number deletion (6 cases) (5.0 (3.0, 7.0) vs. 5.0 (2.5, 5.3), Z=0.75, P=0.452), CREBBP (10 cases) and EP300 gene (4 cases) point variant (5.0 (3.8, 7.0) vs. 4.0 (2.0, 6.0), Z=1.14, P=0.253), and loss of function (9 cases) and missense (5 cases) variant (6.0 (4.5, 7.0) vs. 3.0 (2.5, 5.5), Z=1.54, P=0.121). Conclusions:Patients with RSTS primarily exhibit developmental delays in early childhood. Specific facial features serve as suggested signs of genetic testing. However, no significant genotype-phenotype correlation is found.