Objective To investigate the effect of meridian massage on the growth and development of premature infants.Methods 60 preterm infants were randomly divided into the observation group and the control group with 30 cases in each group,the control group adopted modified domestic simple meridian massage method,and the observation group increase meridian massage based on the control group,2 times a day and 15 minutes one time.Body weight,length,intake of milk,sleep time,time to regain birth weight,and meconium drained time were eomparel between two groups.Results The observation group was significantly better than the control group in body weight,length,intake of milk,sleep time,time to regain birth weight,and meconium drained time.Conclusions Meridian massage based on the domestic simple touch method plays a significant role in promoting the growth and development of premature infants.

Objective To investigate the meridian touching on neonatal hyperbilirubinemia effect of adjuvant therapy.Methods 120 cases of neonatal hyperbilirubinemia were randomly divided into the observation group and the control group,60 cases in the control group were treated with modified simple touch of domestic law,on the basis of modified simple touch,the observation group increased meridian touching,2 times per day,once every 15 min.The nursing effect was compared between two groups.Results The observation group was significantly better than the control group in items such as daily intake of milk,sleep time,meconium drained time,jaundice.Conclusions On the basis of modified simple touch of domestic law,the addition of meridian touching can effectively reduce neonatal hyperbilirubinemia serum bilirubin levels,prevent high bilirubin encephalopathy,and promote the growth and development of newborns.

Objective To investigate effects of hormone replacement therapy with conjugated equine estrogen (CEE) in different doses combined with medroxyprogesterone acetate ( MPA) on mammographic density among postmenopausal women and its clinical significance. Methods Ninety eligible postmenopausal women were randomized into three groups with varied treatment continuously for one year, Croup A receiving 0.3 mg CEE with 2 mg MPA and caltrate 600 mg and vitamin D 125 U daily; Group B receiving 0. 625 mg CEE combined with 2 mg MPA and caltrate 600 mg with vitamin D 125 U daily; and Group C receiving caltrate 600 mg and vitamin D 125 U daily. Mammographic density was analyzed using Wolfe and semi-quantitative methods for all of them and compared each other one year after treatment, as well as mammographic density before and after treatment in Groups A and B. Results One year after treatment, mammogrphic density reached the highest in postmenopausal woman of Group B and the lowest in those of Group C, with significant difference among the three groups (P ＜ 0. 01) and between Groups A and C (P ＜ 0. 01) and between Groups B and C ( P ＜ 0. 05 ). Mammogrphic density with semi-quantitative method increased significantly in Group A ( P ＜ 0. 05 ) and Group B ( P ＜ 0. 01 ), respectively, after treatment as compared with that before it. Change in mammografic density before and after treatment was greater in Group B than that in Group A, but not reaching statistically significant level (P ＞ 0. 05). Conclusions Hormone replacement therapy can cause the increase of mammographic density in postmenopausal women, possibly in a dose-dependent pattern, which suggest that HRT has side effect on breast tissue and the lowest effective dose of estrogen should be selected in HRT. Mammographic density can be used as an indicator to monitor side effect of HRT on breast.

Objective To investigate the position competency of residents in the first year and to search for the standardizing training which aims at advancing position competencies. Method Twenty residents of the first year and 40 of superior doctors were taken as research targets. Question-naires including 8 aspects (basic ability, occupational spirit, communication skills, medical knowl-edge, team work, public health, information and management, and academic research) were con-ducted and were scored namelessly. The scores of items in one kind of ability were summed up to serve as the total score of this ability. The mean score of one kind of ability and the mean score of 8 kinds of abilities of residents and superior doctors was calculated. SPSS 17.0 was adopted to make statistical analysis. t-test was adopted to test the difference between the score from residents and superior doctors with P<0.05 representing statistics significance. Results The scores of 8 kinds of abilities were much lower than full scores. The scores of basic ability, occupational spirit, and team work from residents (78.5, 87.4, 41.9) were higher than those from superior doctors (72.6, 80.5, 39.5), with statistical significances (P=0.020, 0.013, 0.045). Conclusions Residents are lack of position competency and awareness, which demonstrates the gap between the training model and the demand of work. It is sug-gested that we should design the training system and evaluation methods based on doctors' compe-tences, add training for comprehensive ability and evaluate abilities of all aspects. An excellent hu-manity education should be built and quality cultivation should be taken attention to. Objective and measurable indices should be developed to increase residents' knowledge.

Objective To evaluate the values of continuous subcutaneous insulin/rapid insulin analoguc infusion in desensitization for allergy to recombinant human insulin. Methods Two patients allergic to recombinant human insulin received desensitization therapy by continuous subcutaneous insulin lispro infusion. The diluted insulin lispro solution was pumped with initial basal rate of O. O1 U/h, and the basal rate and insulin lispro concentration increased gradually until the insulin dosage for clinical treatment was reached. After that, continuous subcutaneous insulin lispro infusion was replaced by regimen of insulin lispro subcutaneous injection plus oral hypoglycemic agents. Results Local wheals were not observed in both two patients during continuous subcutaneous insulin lispro infusion or during bolus subcutaneous injection of insulin lispro after desensitization. Conclusion The desensitization therapy by continuous subcutaneous insulin/rapid insulin analogue infusion can be applied for allergy to recombinant human insulin.

Objective To summary therapeutic method for delayed portal vein thrombosis after liver transplantation. Methods In 3100 cases undergoing cadaveric whole liver transplantation in a single center, there were 12 cases of delayed portal vein thrombosis after liver transplantation.Average occurring time was 29. 8 months after liver transplantation. Among these 12 patients, 2 cases were complicated with severe biliary complication (intrahepatic stricture) , 2 cases presented with liver failure of transplanted liver, and one case had portal vein compression by hepatic hilum tumor under the image examination, who received liver re-transplantation; two patients presented upper gastrointestinal bleeding, and they experienced endoscopic ligation and sclerotherapy respectively; the rest five patients without any clinical presentation were subjected to anticoagulation and antiplatelet therapy. Results Among 12 cases, 8 patients survived by the time of follow-up, including two patients undergoing re-transplantation; one patient lost follow-up. The liver function tests of the patients who survived were all normal. Conclusion The individualized therapeutic methods should be adopted for the patients with delayed portal vein thrombosis after liver transplantation.

Objective To observe the influencing of Yiqi Huayu Jiedu Prescription on the growth of HepG2 nude mice transplantation tumor and the expression of related factors of vascular mimicry. Methods Models of transplanted tumors, which were made by HepG2 cells in nude mice, were randomly divided into 7 groups, Yiqi Huayu Jiedu Prescription group, Astragali Radix group, Curcumae Rhizoma group, Paridis Rhizoma group, Gecko group, cis-platinum group, and model group. Except for the model group, the rest groups were given relevant medicine for intervention. 21 days later. HIF-1α, MMP-2, MMP-9, and E-cad were detected by immunohistochemistry, and Twist1 and Bcl-2 were detected by fluorescence quantitative PCR. Results Compared with the model group, tumor volume in the rest groups decreased (P<0.05), and the effect in the Yiqi Huayu Jiedu Prescription group was more obvious than the Astragali Radix group, Paridis Rhizoma group and Gecko group (P<0.05);The expression of vasculogenic mimicry structure was rare in each group, and the model group and cis-platinum group were the most obvious;Except for the Astragali Radix group, the expressions of HIF-1α, MMP-2, and MMP-9 showed statistical significance compared with model group (P<0.05);The expression of E-cad in the Yiqi Huayu Jiedu Prescription group and Astragali Radix group showed statistical significance (P<0.05);The expression of Bcl-2 in the Yiqi Huayu Jiedu prescription group, Paridis Rhizoma group, and Gecko group decreased significantly compared with the model group (P<0.05);The expression of Bcl-2 in the Yiqi Huayu Jiedu prescription group was much better than the other groups (P<0.05);The expression of Twist1 showed statistical significance in the Yiqi Huayu Jiedu Prescription group, Curcumae Rhizoma group, Paridis Rhizoma group, and cis-platinum group (P<0.05). Conclusion Yiqi Huayu Jiedu Prescription can reduce expression of HIF-1α, Twist1, Bcl-2, MMP-2, and MMP-9, and increase expression of E-cad, thereby inhibiting the formation of vascular mimicry.

Objective:To understand the continuing care needs of patients based on the App and "hospital-community-home" linkage.Methods:With descriptive qualitative research, a semi-structured in-depth interview was conducted in 15 patients with type 2 diabetes in Gongli Hospital, Pudong New Area, Shanghai City, and community hospital from January to February 2020. Thematic analysis and the software NVivo 10.0 were used for data analysis.Results:Five themes were extracted: desire a "hospital-led,community-implemented, family-supported" model of continuing care; desire an appropriate, convenient and personalized access to information and follow-up; expect continuous, comprehensive, professional health guidance; expect to receive continuing care service led by specialized nurses and managed by multidisciplinary team; expect diabetes App to be simple and practical, satisfying various needs such as post-hospitalization condition monitoring, assessment feedback, health education and health intervention,ensure information security and free use.Conclusions:Patients have a strong willingness to receive continuing care based on the App and "hospital-community-family" linkage. A mechanism of "hospital-community-family" linkage continuing care service with clear division of labor should be established, multidisciplinary cooperation should be strengthened, and team advantages should be utilized. Providing comprehensive, professional and evidence-based continuing care services for patients, while further optimizing software functions and focusing on information security construction and following evidence-based guidelines to standardize App content in order to adapt to more patient characteristics and needs.

Objective: To summarize the gene mutation of early onset epileptic spasm with unknown reason. Method: In this prospective study, data of patients with early onset epileptic spasm with unknown reason were collected from neurological department of Children's Hospital of Fudan University between March 2016 and December 2016. Patients with known disorders such as infection, metabolic, structural, immunological problems and known genetic mutations were excluded. Patients with genetic disease that can be diagnosed by clinical manifestations and phenotypic characteristics were also excluded. Genetic research methods included nervous system panel containing 1 427 epilepsy genes, whole exome sequencing (WES), analysis of copy number variation (CNV) and karyotype analysis of chromosome. The basic information, phenotypes, genetic results and the antiepileptic treatment of patients were analyzed. Result: Nine of the 17 cases with early onset epileptic spasm were boys and eight were girls. Patients' age at first seizure onset ranged from 1 day after birth to 8 months (median age of 3 months). The first hospital visit age ranged from 1 month to 2 years (median age of 4.5 months). The time of following-up ranged from 8 months to 3 years and 10 months. All the 17 patients had early onset epileptic spasm. Video electroencephalogram was used to monitor the spasm seizure. Five patients had Ohtahara syndrome, 10 had West syndrome, two had unclear classification. In 17 cases, 10 of them had detected pathogenic genes. Nine cases had point mutations, involving SCN2A, ARX, UNC80, KCNQ2, and GABRB3. Except one case of mutations in GABRB3 gene have been reported, all the other cases had new mutations. One patient had deletion mutation in CDKL5 gene. One CNV case had 6q 22.31 5.5MB repeats. Ten cases out of 17 were using 2-3 antiepileptic drugs (AEDs) and the drugs had no effect. Seven cases used adrenocorticotropic hormone (ACTH) and prednisone besides AEDs (a total course for 8 weeks). Among them, five cases had no effect and two cases were seizure free recently. A case with GABRB3 (C.905A>G) had seizure controlled for 3 mouths. A case with ARX (C.700G>A) had seizure controlled for 6 mouths. Conclusion The early onset epileptic spasm with unknown reason is highly related to genetic disorders. A variety of genetic mutations, especially new mutations were found. Genetic heterogeneity of epileptic spasm is obvious.