Objective To investigate the renal function changes of the children with breast milk jaundice(BMJ) and effect of early interference treatment on renal function. Methods Serum bilirubin and urine - minim protein (?2-MG,?1-MG, Alb and IgG) of the 50 patients with BMJ were measured when they were in hospital within 12 hours and the last day separately , at the same time, 20 healthy newborns had been chosen to serve as control group. Results Compared with control group, the urine minim protein of treatment group increased with the rise of serum bilirubin. When serum bilirubin was 205.2 - 256.5 ?mol/L, urine ?2- MG had mild increasing (P

Sofosbuvir is a new type of direct-acting antiviral(DAA)drugs against hepatitis C.By competitive combination to NS5B polymerase activity sites,sofosbuvir can terminate genome synthesis of newly born virus,and finally inhibit the replication of hepatitis C virus(HCV).The research and development process of sofosbuvir is based on the principles of nucleoside antiviral drug metabolism.The subtle structure modification improves the drug′s structure stability and absorption process,which makes sofosbuvir a liver targeted anti-HCV drug.Sofosbuvir has become a clinical fundamental drug for anti-HCV infection,and then used alone or in combination with other drugs,with higher recovery rate,better safety and anti-drug resistance.This article reviews the research back?ground,development process,clinical application and synthetic methods for sofosbuvir.

The clinical manifestations of five children with paroxysmal kinesigenic dyskinesia (PKD) were retrospectively analyzed and their gene mutations were analyzed by high-throughput sequencing and chromosome microarray. The 5 patients consisted of 4 males and 1 female and the age of onset was 6-9 years. Dyskinesia was induced by sudden turn movement, scare, mental stress, or other factors. These patients were conscious and had abnormal posture of unilateral or bilateral extremities, athetosis, facial muscle twitching, and abnormal body posture. The frequency of onset ranged from 3-5 times a month to 2-7 times a day, with a duration of <30 seconds every time. Electroencephalography showed no abnormality in these patients. Three patients had a family history of similar disease. The high-throughput sequencing results showed that a heterozygous mutation in the PRRT2 gene, c.649_650insC (p.R217PfsX8), was found in two patients; the mutation c.436C>T (p.P146S) was found in one patient; a splice site mutation, IVS2-1G>A, was found in one patient. The two mutations c.436C>T and IVS2-1G>A had not been reported previously. The chromosome microarray analysis was performed in one patient with negative results of gene detection, and the chromosome 16p11.2 deletion (0.55 Mb) was observed. Low-dose carbamazepine was effective for treatment of the 5 patients. PKD is a rare neurological disease. The detection of the PRRT2 gene by multiple genetic analysis can help the early diagnosis of PKD.
Carbamazepine ; therapeutic use ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 16 ; Dystonia ; complications ; diagnosis ; drug therapy ; genetics ; Electroencephalography ; Female ; Humans ; Male ; Membrane Proteins ; genetics ; Mutation ; Nerve Tissue Proteins ; genetics

Objective To explore the management method of improving the quality of nursing teaching ward-round. Methods A series of management and innovation were conducted in the important factors influencing the quality of nursing teaching ward-round, such as the organizer, presider and participant of ward rounds. Resuits 95% of nursing students were satisfied with the quality of nursing teaching ward rounds after the innovation. After the innovation, the multiple survey assessments of nursing teaching wardround and the achievements of theory operation of nursing students' surgery practice were obviously superior to those before the innovation (P<0.05). Conclusions To strengthen the management of the organizer, presider and participant of ward rounds improves the quality of nursing teaching ward-round.

Objective To know the contract nurses'professional pressure features in one 3A hospital, nd analyze the factors of influencing the contract nurses'professional pressure.Methods 235 contract nurses ere randomly investigated by a nurse working stress scale and a self-designed general information questionnaire. Nother 125 registered nurses were regarded as the controls.Results The score of contract nurses'working ressure was(85.32±20.49),with low wage and other welfare for ranking first in priority.There was a tatistical meaning compared to the registered nurses(P<0.05).The difference had statistical meanings in the cores of different departments,reasons for selecting the nursing work,attitude to present department,work atisfactory,attitude for switching to another trade,satisfaction degree of wage,numbers of night shift among the ontract nurses(P<0.05).Conclusions The contract nurses'working pressure belongs to the middle level. He stressors for ranking first in priority are low wage and other welfare.Attitude to work.attitude to present epartment,satisfaction degree of wage and objective support have obvious inflences to contract nurese'working ressure.

Objective To explore the effectiveness of hierarchical teaching mode for layered training among clinical teachers.Methods The teachers were screened and relatively fixed with all levels,and they were trained in terms of teaching according to different levels.Results After training,the teaching quality of teachers,teaching satisfaction and nursing theory and skills assessment results among students were obviously improved.Conclusions It is helpful to improve the teachers' specific teaching ability and the quality of teaching by all levels of training.

Objective To develop a rating scale assessing the nursing outcomes of geriatrics with chronic disease,in order to provide valid evaluation tools for health assessment of geriatrics with chronic disease during hospitalization and after discharge.Methods Based on literature reviews,the rating scale was preliminarily developed.Through twice expert consultation,the scale was revised.The validity and reliability of the rating scale was evaluated by 3 clinical nurse specialists through investigation of 187 cases of discharged geriatrics with chronic diseases.Results The rating scale assessing the nursing outcomes of geriatrics with chronic disease included 4 aspects and 38 items:Functional Health (12 items),Physical Health (10 items),Psychosocial Health (5 items),Health Knowledge and Behavior (11 items).The results of scales evaluation showed that the rating scale had good construct validity,content validity and discrimination validity,and the Cronbach' s c of all domains were above 0.70,indicating a good internal consistency.Conclusions The results suggest that the rating scale has good rehability and validity,and can be used to assess the health status of domestic geriatrics with chronic diseases by specialists and researchers.

Objective: To review the application of ileostomy combined with perioperative nutrition support therapy in the treatment of chronic radiation intestinal injury. Methods: The clinical data of patients with chronic radiation intestinal injury who received ileostomy combined with perioperative nutrition support therapy in the department of general surgery, Nanjing General Hospital of Nanjing Military Command from January 2012 to December 2016 were retrospectively analyzed. The short-term complications and perioperative nutrition process were recorded, and the long-term prognoses were followed up. Results: Forty-six patients were included in the study. The overall postoperative complication rate was 36. 96％. All the patients restored total enteral nutrition at the time of discharge (18±15) days. There was no post-operative mortality. Thirty-six patients were followed up (follow-up rate of 78. 26％), and the follow-up time was (25 ± 17) months. Tumor recurrence was occurred in 7 patients (19. 44％) during follow-up and 6 deaths (16. 67％). All of the 30 (83. 33％) survived patients maintained total enteral feeding, 27 of whom (75％) returned to normal diet. Twenty-one patients (58. 33％) underwent a second staging ostomy surgery in our hospital and recovered well. Conclusion: For selected patients with chronic radiation intestinal injury, ileostomy combined with perioperative nutrition support therapy could effectively restore intestinal patency and total enteral nutrition, and reduce the mortality.

OBJECTIVETo explore the changes of cycle and apoptosis of spermatogenic cells and antioxidant capacity of the serum and testis in male rats with diabetes mellitus.

METHODSThirty male rats were divided into two groups, 10 for normal control and 20 for the diabetes group. The rats were injected intraperitoneally with streptozocin (TZ) to develop diabetes, and 12 weeks later, their survival rate and testis weight were recorded. The percentage of G0/G, S and G2/M phases and apoptosis in spermatogenic cells were measured with flow cytometry (FCM). Malondialdehyde (MDA) and nitric oxide (NO) levels, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and NO synthase (NOS) activities in the serum and testis were measured with thiobarbituric acid reactive substances (TBARs), nitric acid reoxidized enzyme, xanthine oxidative enzyme, 5,5 Dithiobis (2,2 nitrobenzoate) (TNB) and visible light photometer methods, respectively.

RESULTSTwelve weeks after the male rats got diabetes, their survival rate, body weight and testis weight were significantly lower (p < 0.05), and the percentages of G0/G1 phases and apoptotic spermatogenic cells were obviously higher (P < 0.05) than the normal control. At the same time, the percentage of S and G2/M phases spermatogenic cells decreased. So the spermatogenic cells were arrested in G0/G1 phase. In the diabetic rat serum and testis, especially in the testis, MDA levels were distinctly higher and SOD activities were significantly lower than those in the control. Serum GSH-Px activities of the diabetic rats were significantly lower (p < 0.05), while testis GSH-Px activities were significantly higher than those in control group (P < 0.01). NO contents in the serum and testis of the diabetic rats (P < 0.01) increased significantly, particularly the former, while NOS activities in the serum decreased significantly as compared with the control (P < 0.5).

CONCLUSIONThe increase in testis and serum MDA levels and NO contents and the decrease in the antioxidant enzyme activity of the diabetic rats may be relevant to spermatogenic disorder caused by the increase of G0/G1 phases arrest and spermatogenic cells apoptosis.

Animals ; Apoptosis ; Cell Cycle ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism ; Testis ; cytology ; metabolism

Objective To survey the training status and demands among ICU nurses and provide the evidence to the reasonable training scheme.Methods A descriptive design Was used in this study.From February to March in 2008.632 ICU nurses from 16 top-level and first-class general hospitals in China completed the questionnaires.Results The rate of professional training for nurses in ICU was 69.6%and 28.9%of them had never received the training.There were 37.6%of ICU nurses who had received the systemic training.24.4%of them had received decentralized training.6.9%of them had received individual training and 2.4%of them had studied by themselves.The average SCOre of the training demands for nurses in ICU was(2.20±0.63).the influential factors of the training demands for nurses in ICU included the age,nursing age,time working in ICU,professional title and training level of different ICU.Conclusions The levelof training demands for nurses in ICU is fairly high.The training causes should he taken according tO thedifferent age.time working,professional title and training level for nurses in ICU.