Objective To investigate the clinical and biochemical metabolic features of 12 patients with systemic primary carnitine deficiency(CDSP) and to identify the SLC22A5 gene mutation types of the disease. Method The clinical and biochemical data were collected by retrospective analysis. DNA direct sequencing and multiplex ligation dependent probe amplification(MLPA)were applied for SLC22A5 gene analysis. Result Among 12 patients with CDSP, 3 cases had evident infection factors, 6 cases with convulsions, 5 cases manifested liver hypertrophy, 8 cases with hyperammonemia, and 9 cases showed myocardial damage. All CDSP patients were detected biallelic pathogenic mutation in SLC22A5 gene by direct sequencing. The gene types include IVS2+1G>T, c.3G>T(p.Met1Ile), c.760C>T(p.Arg254X), c.1400C>G(p.Ser467Cys), c.844dupc(p.Arg282fs), c.338G>A(p.Cys113Tyr), c.51C>G(p.Phe17Leu), c.659A>T(p.Glu220Val), and c.1365dupC(p.Thr456fs). c.659A>T(p.Glu220Val) and c.1365dupC(p.Thr456fs)are novel mutations. One female patient was maternal CDSP, her child had abnormal newborn screening. The allele frequency of c.760C>T(p.Arg254X) and c.1400C>G(p.Ser467Cys) were 37.5%(9/24)and 29.2%(7/24)respectively. The MLPA test results of all patients were negative. Conclusion The clinical manifestations are complex and various in patients with CDSP. Point and small InDel(insertions/deletions)mutation constitute the major alteration in SLC22A5 gene. c.1400C>G(p.Ser467Cys) might be another prevalence mutation type in Chinese CDSP patient.

Objective To explore the hardiness and emotional balance relationship of the cancer patients, and to provide the nurses with a scientific references for the health education on cancer patients . Methods 261 cancer patients were tested using the Chinese version of the hardiness scale and emotional balance scale .Results hardiness scale scores was (44.49 ±6.25);the emotional balance scale score was (6.13 ± 1.19).The hardiness and emotional balance were significantly correlated (P <0.05).Conclusions The hardiness of cancer patients is poor and the emotional balance is below the general level .The hardiness is related to emotional balance .For clinical nurse , we should carry out a meticulous health education strategy , according to the psychological characteristics of cancer patients .

Objective To investigate the iodine nutrition status of school-age children in Anyang,and analyze its related influencing factors.Method Monitoring data on urinary iodine of school-aged children and iodized salt were collected from 2011 to 2015,its general situation was described,and differences in age,sex,residential area type and year were compared.Results Totally 13 371 iodized salt samples were collected in Anyang City from 2011 to 2015,and 12 205 were qualified iodized salt.The median of iodized salt was 26.91 mg/kg.Totally 1 282 urinary iodine samples of school-age children were monitored in Anyang City,and its median of urinary iodine was 237.0 μg/L,the constituent ratio of urinary iodine of children under 100 μg/L and above 300 μg/L was 14.5％(186/ 1 282) and 35.3％ (452/1 282),respectively,the results of urinary iodine were different in different years,and the differences were statistically significant (x2 =36A1,P＜ 0.05);the differences of the residential area type,sex and age had no influence on the urinary iodine of school-age children,and the differences were not statistically significant (Z =-1.07,-0.94,x2 =6.50,P ＞ 0.05).Conclusion The iodine-nutritional status of school-age children is more than adequate,the concentration of urinary iodine is high,and the differences of the residential area type,sex and age have no influence on the urinary iodine of school-age children.

Objective To investigate the iodine nutritional status of rural residents in Anyang City of Henan Province,and to provide theoretical basis for making policy adjustment on iodine supplement. Methods In 2015, Tangyin County and Anyang County were chosen from Anyang City, one township was selected from each county based on five orientations of east, west, south, north and centre, four villages were chosen from each township,15 households were taken from each village, and kitchen salt samples were collected to detect salt iodine;tap water samples were collected to detect water iodine.In the selected county,one medical institution was selected, 100 women of childbearing age,pregnant women,lactating women and infants aged 0-2 years old were selected to detect urinary iodine; one primary school was selected in the selected township, and 20 children aged 8 - 10 years old were selected to detect urinary iodine. Salt iodine was determined using direct titration (GB/T 13025.7-1999);urinary iodine and water iodine were determined using arsenic cerium catalytic spectrophotometry(WS/T 107-2006). Results A total of 600 salt samples were collected, half from Anyang County and half from Tangyin County, the medians of salt iodine were 27.59,29.15 mg/kg,respectively,the difference was statistically significant(Z = - 4.92, P <0.05).A total of 47 water samples were collected,21 from Anyang County and 26 from Tangyin County,the medians of water iodine were 9.44,5.37 μg/L,respectively,the difference was not statistically significant(Z=-0.30, P > 0.05). A total of 985 key people were surveyed, children, women of childbearing age, pregnant women, lactating women and infants were 200, 205, 197, 187, 196, respectively, the medians of urinary iodine were 253.05, 249.80, 177.10, 266.40, 247.85 μg/L, respectively, the differences were statistically significant (χ2=29.76, P < 0.05). Urinary iodine levels of childbearing age women (226.60,313.85 μg/L),lactating women(230.85,286.20 μg/L) and infants (222.35, 275.35 μg/L) were compared between Anyang County and Tangyin County, the differences were statistically significant (Z=3.33,2.21,3.13,P<0.05).Conclusion The iodine nutritional status of rural residents in Anyang City is basically good,but the urinary iodine levels of general population are high.

By reviewing the concept, content, evaluation tools and significance to clinical practice of preoperative patients' preparedness for selective surgery, this paper aims to provide some reference for enriching the content of preoperative patients' preparedness and improving the surgical satisfaction and quality of life for selective surgery.

Objective:To explore the application effect of non-immersive virtual reality technology in preoperative visit of gynecological robotic surgery patients, and to provide reference for improving the preoperative visit effect in the operating room.Methods:By adopting a quasi-experimental study, a total of 80 patients who underwent Da Vinci robot-assisted gynecological surgery in the First Affiliated Hospital of Zhengzhou University were selected. The eligible patients from January to March 2022 were selected as the control group (39 cases), and the patients from April to June 2022 were selected as the observation group (41 cases). The control group used routine preoperative visit sheet and education video for preoperative visit, while the observation group used preoperative visit sheet combined with virtual reality technology for preoperative visit. The anxiety and tension, the degree of coordination of body position and the satisfaction of preoperative visit were compared between the two groups.Results:After intervention, the anxiety score, blood pressure and heart rate of the observation group patients were (38.12 ± 2.47) points, (76.37 ± 7.53) mmHg(1 mmHg=0.133 kPa), (119.20 ± 5.88) mmHg, and (79.51 ± 8.38) times/minute, respectively, which were significantly lower than the control group′s (44.56 ± 5.10) points, (82.77 ± 8.97) mmHg, (125.74 ± 8.21) mmHg, and (84.92 ± 7.48) times/min, and the differences were statistically significant ( t values were 3.04-7.25, all P<0.05). The proportion of patients in the observation group who did not require assistance and needed partial assistance and needed the full assistance of itinerant nurses in position placement were 51.22% (21/41), 41.46% (17/41), 7.32% (3/41), while those in the control group were 23.08% (9/39), 56.41% (22/39), 20.51% (8/39), and the difference was statistically significant ( Z=2.74, P<0.05). The satisfaction score of preoperative visit in the observation group was (2.66 ± 0.48) points, which was higher than (2.18 ± 0.56) points in the control group, and the difference was statistically significant ( t=-4.12, P<0.05). Conclusions:Non-immersive virtual reality technology makes the preoperative interview of Da Vinci robotic surgery more vivid, which can alleviate the preoperative anxiety of patients, improve the autonomy of patients' position placement and the satisfaction of patients with the preoperative interview.

Objective:To develop the Surgical Readiness Scale for Female Patients with Stress Urinary Incontinence (SUI) and test its predictive performance.Methods:Based on the theory of "patient-centered" during the perioperative period, an initial scale was formed through literature review, semi-structured interviews, expert consultation, and pre-survey. From January 2021 to December 2022, convenience sampling was used to select 585 female SUI patients who underwent elective surgical treatment at the First Affiliated Hospital of Zhengzhou University as participants for a survey to test the reliability and validity of the scale.Results:A total of 585 questionnaires were distributed, and 560 valid questionnaires were collected, with a valid response rate of 95.73% (560/585). The Surgical Readiness Scale for Female Patients with SUI included four dimensions and 28 items. The content validity index of the scale was 0.975. Cronbach's α coefficient of the total scale was 0.909, and Cronbach's α coefficients of each dimension were 0.928, 0.822, 0.958, and 0.880, respectively. The total split-half reliability coefficient was 0.712, and the split-half reliability coefficients for each dimension were 0.921, 0.808, 0.941, and 0.841, respectively. Two exploratory factor analysis showed a cumulative variance contribution rate of 64.25%. Confirmatory factor analysis showed that the chi-square degree of freedom ratio was 1.680, the mean square root of asymptotic residuals was 0.056, the goodness of fit index was 0.840, the modified goodness of fit index was 0.811, and the comparative goodness of fit index was 0.944. The convergence validity and discriminant validity values were within a reasonable range, indicating good fit of the model.Conclusions:The Surgical Readiness Scale for Female Patients with SUI has good reliability and validity, and can be used as an effective evaluation tool for the surgical readiness of female SUI patients.

Objective:To explore the early predictive value of umbilical cord blood S100β protein and lactate combined with amplitude integrated electroencephalogram（aEEG）in small for gestational age（SGA）preterm infants with brain injury.Methods:One hundred and six cases of SGA preterm infants were enrolled in this study in Neonatology Department of Inner Mongolia People's Hospital from January 2019 to December 2021. Umbilical cord blood serum S100β protein and lactate at birth of All SGA preterm infants were tested，and aEEG was monitored at 6h and 72 h after birth，corrected gestational age of 32 weeks and 37 weeks. According to the diagnostic criteria of brain injury in preterm infants，SGA preterm infants were divided into brain injury group（45 cases）and non-brain injury group（61 cases），and compared the differences of S100β protein，lactate and the designated time aEEG between the two groups.SGA preterm infants with brain injury were further divided into symmetrical group（28 cases）and non-symmetrical group（15 cases）. The differences of umbilical cord blood S100β protein and lactate level between the two groups were compared，and the diagnostic value in different types of SGA preterm infants with brain injury was also compared.Results:SGA preterm infants in the brain injury group had significantly higher levels of umbilical cord blood S100β protein［（0.826±0.218）μg/L vs（0.397±0.196）μg/L， t=8.316， P<0.05］and lactate［（8.5±1.3）mmol/L vs（3.8±0.9）mmol/L， t=3.281， P<0.05］than those in non-brain injury group.Symmetric SGA group had higher level of S100β protein than the asymmetric SGA group［（0.924±0.205）μg/L vs（0.438±0.196）μg/L， t=5.734， P<0.05］.But there was no statistically significant difference in lactate levels［（5.6±1.4）mmol/L vs（3.9±1.2）mmol/L， t=0.932， P>0.05］between symmetric SGA group and asymmetric SGA group. The abnormal rates of aEEG in brain injury group and non-brain injury group were respectively 100%（45/45）vs 22.95%（14/61）at 6 h after birth，95.56%（43/45）vs 16.39%（10/61）at 72 h after birth，62.22%（28/45）vs 6.56%（4/61）at 32 weeks of corrected gestational age，22.22%（10/45）vs 3.28%（2/61）at 37 weeks of corrected gestational age. The abnormal rate of brain injury group was higher than the non-brain injury group in the same nodal time，and the differences were statistically significant（ χ 2 value respectively 62.292，64.913，38.074，9.257，all P<0.05）. Conclusion:There were significant value in umbilical cord blood S100β protein，lactate level and aEEG monitoring in the early diagnosis in preterm infants SGA with brain injury. The combination of the three might be more helpful for the early diagnosis and timely treatment of brain injury in SGA preterm infants.

Objective:To explore the feelings and experiences of female patients with stress urinary incontinence during preoperative self-readiness.Methods:This is a qualitative research. From September to December 2021, a total of 12 female patients with stress urinary incontinence who underwent elective surgery in the Urology Surgery of the First Affiliated Hospital of Zhengzhou University were selected by objective sampling, and semi-structured interviews were conducted. The interview data were sorted and analyzed through Braun's six-step thematic analysis.Results:A total of four themes were extracted including lack of surgical knowledge, high expectation of surgical outcome, heavy psychological burden of surgery, and high demand for external support. The lack of surgical knowledge included three sub-themes, namely, the lack of understanding of informed consent of surgery, the passive acceptance of informed consent information of surgery, and the bias of surgical information recall. The high expectation of surgical outcome included three sub-themes, namely, complete cure of urinary leakage, unrestricted physical and social activities, and getting rid of the negative emotion of "social cancer". The heavy psychological burden of surgery included two sub-themes, namely, concerns about the effects and complications of surgery and the tension of public health events. The high demand for external support included three sub-themes, namely, the need for emotional communication with medical and nursing staff, the need for experience sharing with patients, and the need for emotional support from family members and friends.Conclusions:Medical and nursing staff should pay attention to improving the surgical knowledge of female patients with stress urinary incontinence, respect their autonomy of informed consent, correctly guide patients to establish surgical expectations, and provide them with multi-dimensional emotional support, so as to promote the improvement of patients' preoperative readiness.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.