Objective: To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU). Methods: A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression. Results: The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age (β=-0.484, P<0.01), time of breast milk feeding through mouth (β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease (β=0.587, P=0.050), maternal anxiety (β=0.206, P<0.01), depression (β=0.727, P<0.01) and interaction between maternal anxiety and depression (β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation. Conclusions Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.

Objective:To explore the effect of the teaching reform of "Community Nursing" in our school in different grades of nursing undergraduates.Methods:A total 174 nursing students in Grade 2009, 2010 and 2013, from School of Nursing at Shanghai Jiao Tong University were selected. Various teaching methods were carried out, including continuously carding teaching content, gradually adopting a community assessment approach, participating in community health education, and developing family health education plans and student-centered teaching methods. At the end of the course, all students completed the self-design curriculum evaluation questionnaires. By comparing the evaluation of teaching reform in different grades, the effect of the teaching reform scheme was analyzed. One-way analysis of variance and student Newman Keuls method were performed to compare the differences among different grades with SPSS 19.0 software.Results:The scores of the five dimensions of "curriculum organization", "teaching content", "teaching form", "teaching evaluation" and "teaching arrangement" were much higher in Grade 2013 and 2010 than in Grade 2009 ( P<0.05). After the teaching reform, students' satisfaction with the curriculum organization was improved; simplifying the teaching content reduced the repetition between courses; implementing the diversified teaching form enhanced students' participation; adopting a diversified teaching evaluation system expanded students' understanding of learning content; integrating different teaching locations and equipment brought real service experience to students. Conclusion:The series of teaching reforms of "Community Nursing" have achieved positive results in adjusting the curriculum framework, focusing on community nursing, improving students' participation, combining varied assessment methods and developing multiple teaching points and have been recognized by the students, so that the results may provide a reference for the next teaching rounds of "Community Nursing" with the fourth edition.

Objective:To report a case of developmental epileptic encephalopathy caused by CACNA1E gene mutation and explore C Clinical phenotype and prognosis of 2069G>A (p.Gly690Asp) locus.Methods:The clinical data and follow-up of a case of developmental epilepsy related to CACNA1E gene mutation admitted to the Maternity And Children Health Hospital of Xiangtan City in September 2020 were summarized and analyzed.Results:The male patient, with delayed intellectual and motor development, sought medical attention and gradually developed seizures. The genetic results showed that the CACNA1E gene c. 2069G>A (p.Gly690Asp) was a newly discovered variant, and the parental site was a wild-type. Based on clinical manifestations, the diagnosis was a pathogenic variant.Conclusions:Developmental epileptic encephalopathy caused by mutations in the CACNA1E gene can have intellectual and motor impairments as the initial manifestation; Site C 2069G>A (p.Gly690Asp) presents with severe epilepsy and poor prognosis, with the possibility of brain atrophy. The combination of valproic acid and clonazepam may be effective in treating epilepsy.

Long-term care is a long-term guarantee mechanism to meet the care needs of the old adults and ensure the quality of life. Among them, the professionalism and stability of the care team is a key factor to ensure the development of long-term care work. This paper analyzes the possible reasons for slow development of time bank with volunteers as the main body in the process of localization, and constructs a new model of diversified caring bank from the construction of care team, so as to promote the high-quality and sustainable development of long-term care in China.

Objective To understand the genetic variations of neuraminidase (NA) genes of avian influenza virus H9N2 in Weining,Guizhou Province,and to provide the scientific evidence for the prevention and control of avian influenza virus.Methods Ribonucleic acids (RNA) were extracted and NA genes were amplified and sequenced from 13 randomly selected H9N2 positive samples from the live poultry market (LPM)environments in north of Weining Yi and Hui and Miao autonomous county (Weining),Guizhou Province during 2015 to 2017.Then the homology,genetic evolution,and sites of stalk deletion areas,potential N-glycosylation,receptor binding regions and drug resistance of H9N2 subtype avian influenza viruses were analyzed by a series of bioinformation software.Results Homology analysis revealed that there were 93.0％-100.0％ and 92.1％-100.0％ similarity among 13 strains H9N2 avian influenza viruses in nucleotide and amino acid of the NA gene,respectively.All strains belonged to DK/HK/Y280/97 sub-lineage,but their genetic sources were complex and diverse.Thirteen strains had a stalk deletion of 3 amino acid residues TEI at positions 63-65 and 3 isolates had mutation QN to QK at positions 39-40.The potential N-glycosylation sites at amino acid residues 86,146,200,and 234 of the NA protein of all strains were highly conserved,while other N-glycosylation sites had quantity and site mutations.There were different mutation types at the three sialic acid binding site areas,especially at 399-404 area.All NA protease activity sites and key sites of the 13 strains had no mutations associated with resistance to the neuraminidase inhibitor drugs.Conclusions All 13 strains H9N2 viruses belongs to DK/HK/Y280/97 sub-lineage in Weining,Guizhou Province during 2015-2017,and their genetic sources are complex and diverse.The mutations on sites of stalk areas,potential N-glycosylation and sialic acid binding site areas are presented at different degrees.Hence,enhancing surveillance and controlling H9N2 avian influenza virus is necessary.

Androgen insensitivity syndrome (AIS) is a recessive single gene disease of X chromosome, which is rare clinically and has a very low incidence in newborn boys. This is mainly due to the abnormal pathway in which androgens play a role, resulting in sexual differentiation disorder in patients. A pair of identical twins were admitted to our hospital, and a new pathogenic mutation site of the androgen receptor gene was found, resulting in an androgen insensitivity phenotype.

AIM: To investigate the regulatory effects of silybin on hepatic lipid metabolism in mice with non -alcoholic steatohepatitis (NASH) induced by high - fat and high-cholesterol (HFHD) diet. METHODS: Mice were fed a HFHD diet to construct a NASH model, and serum levels of triacylglycerol (TAG), total cholesterol (T-CHO), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured using biochemical kits. H&E staining and oil red O staining were used to detect histopathological changes in the liver. Lipidomics was used to detect the alterations of hepatic lipid metabolism in NASH mice. RESULTS: Silybin significantly inhibited the increase of body weight, liver weight and abdominal fat, decreased serum T-CHO, TAG and LDL-C levels, improved hepatic lipid droplet accumulation and ballooning degeneration, and back-regulated hepatic palmitoleic acid (C16: 1) and polyunsaturated long-chain fatty acids (PUFAs) in NASH mice. CONCLUSION: Silybin possibly reduced hepatic lipid accumulation and lipotoxicity by modulating abnormal hepatic lipid metabolism in mice induced by HFHC diet.