Objective:To compare the neonatal end tidal carbon dioxide pressure(PetCO 2) and its correlation with arterial carbon dioxide pressure(PaCO 2) monitored by non-invasive mask, accessory flow nasal catheter and invasive mechanical ventilation. Methods:From October 2017 to January 2020, 53 cases of newborn who were needed respiratory support treatment in our hospital were selected.PetCO 2was detected at admission, respiratory support and after weaning, including nasal catheter, non wound mask and invasive ventilation, and at the same time matching analysis of the corresponding with PaCO 2artery blood gas analysis. Results:(1) PetCO 2monitored by mask was lower than PaCO 2[(40.41 ± 10.21) mmHg vs.(42.85 ± 10.32) mmHg(1 mmHg=0.133 kPa), t=11.88, P<0.01], and there was a significant positive correlation between PetCO 2and PaCO 2( r=0.97, P<0.01); the mean bias of PetCO 2monitored by mask was(1.20 ± 2.31) mmHg, only 4.5%(5/110) was outside the 95% confidence interval.(2) PetCO 2monitored by nasal catheter was also lower than the mean PaCO 2[(40.93 ± 10.55) mmHg vs.(42.01 ± 10.50) mmHg, t=4.12, P<0.01], showing a significant positive correlation( r=0.96, P<0.01); the mean bias of PetCO 2monitored by nasal catheter was(2.44 ± 2.56) mmHg, and only 4.6%(7/150) was beyond the 95% confidence interval.(3) PetCO 2of neonates with endotracheal intubation and mechanical ventilation was also lower than PaCO 2[(43.33±10.26) mmHg vs. (49.37±11.34) mmHg, t=13.83, P<0.01], and there was also a significant positive correlation between the two groups, which was lower than that of neonates with non-invasive ventilation( r=0.94, P<0.01). The mean PetCO 2bias for neonates with invasive positive pressure ventilation was(0.90±0.82) mmHg, and only 3.9%(2/51) were outside the 95% confidence interval.(4) According to gestational age, the PetCO 2of early and late preterm infants was(37.25±11.32) mmHg and(39.58±10.37) mmHg, respectively, which were lower than that of full-term infants[(42.69±10.66) mmHg], and there was a positive correlation between PetCO 2and PaCO 2in all three groups.The correlation between PetCO 2and PaCO 2in early preterm infants was the lowest among the three groups( r=0.89, P<0.01). Conclusion:The monitoring of PetCO 2through nasal catheter, mask and invasive ventilation has a good correlation and consistency with the level of PaCO 2in neonates, which can accurately reflect the level of PaCO 2in neonates.The correlation between PetCO 2and PaCO 2in neonates with non-invasive ventilation is better than that in neonates with invasive ventilation.The correlation between PetCO 2and PaCO 2in late preterm infants and term infants is better than that in early preterm infants.

Objective:To study the variation of recent bladder function of the patients who received radical hysterectomy and evaluate its significance. Methods:Sixty-three patients with cervical carcinoma in International Federation of Gynecology and Obstetrics(FIGO) stage IB1 to ⅡA received urodynamic examination before and after operation. The urodynamic parameters included filling cystometry, pressure-flow rate, and electromyography of sphinctienter. Results:Radical hysterectomy induced significant increase in the first sensation (P<0.01)and post voiding residual of bladder (P<0.01) ;whereas caused significant decrease in the maximum volume(P<0.01), compliance(P<0.01),maximum flow rate(P<0.01) and the pressure at the maximum flow rate(P<0.01), respectively, compared with the corresponding values before the operation. Short-term bladder dysfunctions were observed in 34 patients (54.0%) including bladder detrusor dysfunction, low compliance bladder, bladder outlet obstruction, dyssynergia of urethral external sphincter and detrusor overactivity. The incidences of low compliance bladder and bladder detrusor dysfunction increased significantly after operation (P<0.01). Urinary retention was found in 28.6%(18/63) patients. The incidences of bladder detrusor dysfunction (66.7% vs 20.0%) and detrusor overactivity (33.3% vs 4.4%) in the group with urinary retention were significantly higher than those of corresponding group without urinary retention. Conclusion:The bladder function had obvious short-term changes following radical hysterectomy. In the many types of bladder dysfunction the main dysfunctions were low compliance bladder and bladder detrusor dysfunction. The bladder detrusor dysfunction might be the major cause of the urinary retention following the surgery. Urodynamic test was important for post-operative analysis and treatment of bladder dysfunction.

Objective To analysis the activity of transcriptional factors in endometrial cancer cell lines with different estrogen receptor subtypes. Methods The mRNA levels of estrogen receptor (ER) was detected by quantitative RT-PCR , and the activity of transcriptional factors was also analysed by 345-channel protein/DNA array in RL-952 ( the expression status of ERα and ERβ both positive), HEC-1A [ERα(±),while ERβ negative] and HEC-1B (ERα and ERβ both negative). The transcription factors of NFkBp65 and p38MAPK with different activity were tested by enzyme-linked immunosorbent assay(ELISA) to confirm the results of protein/DNA array. Results The mRNA levels of ERα in RL-952, HEC-1A and HEC-1B were (6780±282 ), ( 684±84 ) and ( 168±38 ) eopy/ng, respectively. Among 345 candidate transcriptional factors, there were 28 factors associated with ER status. Compared with RL-952 cells, 13 transcriptional activity factors were concomitandy up-regulation, while 15 concomitantly down-regulation in HEC-1A and HEC-1B cells. Transcriptional activities of TrF (1)-1, NRF-1, TCE were significantly correlated with the high-expression status of ERα mRNA ( r =0.523, P=0.037 ), while RFX123 and Ikaros were signitleanfly correlated with the low-expression status of ERα mRNA ( r=-0.312, P=0.041 ). Conclusion Transcriptional factors of TTF(1)-1, NBF-1, TCE may be associated with ER-mediated signal pathway, while RFX123 and Ikaros may be associated with non ER-mediatecl signal pathway in endometrial cancer.

Objective To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Methods Seventy-two patients with cervical cancer Ininternational Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ bl to Ⅱ a hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Results Twenty-one patients out of all were found with urinary retention after the operation , the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation[ ( 171 ±61 )ml vs.(126 ±28)ml, (134±39)ml vs. (119 ± 17)ml,all P＜0.05], while the maximum volume[ (337 ±66) and (300 ±66)ml, respectively], the compliance[ (31 ±25) and (29 ± 18) ml/cm H2O (1 cm H2O =0. 098 kPa), respectively], the maximum flow rate[ (10 ±4) and (12 ±5) ml/s, respectively] and the pressure at the maximum flow rate [ (27 ±9) and (32 ±8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention ( all P ＜0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention ( P ＜ 0. 05 ). The single factor analysis results showed that bladder destusor dysfunction ( OR = 8. 20, 95% CI: 2.62 - 25. 66, P ＜0. 01 ) and lack of sensation ( OR = 6. 90, 95% CI: 1.95 - 24. 43, P ＜ 0. 01 ) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder( OR =1.99, 95% CI:0. 70 - 5.63, P = 0. 195 ), detrusor overactivity ( OR = 2. 51, 95% CI: 0. 73 - 8.67, P =0. 144), bladder outlet obstruction ( OR = 3.77, 95% CI: 0. 76 - 18. 57, P = 0. 104 ) or dyssynergia of urethral external sphincter( OR =2. 67, 95% CI:0. 49- 14. 45, P =0. 255 ) and urinary retention following the operation. There were an antagonistic effects ( OR = 7.60, 95% CI: 1.43 - 40. 39, P = 0. 017 ) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction( OR = 7.01, P ＜ 0. 01 ) and lack of sensation( OR = 5.45, P =0. 018)were the independent risk factors influening on the urinary retention post-operation. Conclusions There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

Objective To analyse the etiology,clinical characteristics and risk factors of central nervous system (CNS) complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical features of CNS complications in patients who underwent allo-HSCT were observed,and analysis its causes and risk factors.Results 8 cases of CNS complications occured in 69 patients within 6 months after allo-HSCT and the incidence was 11.6 ％,the occurrence rate of CNS complications was 21.4 ％ (6/28) in HLA mismatched group,higher than HLA matehed group [49 ％ (2/41)] (P ＜ 0.05).Analogously,the incidence was 44.4 ％ (4/60) in patients with graft-versus-host disease (GVIID) (＞grade 2),which was significantly higher than patients with 2 or below grade 2 GVHD [6.7 ％ (4/9)] (P ＜ 0.01).But there was no significant difference in the incidence of CNS complications between ≤14 years old and ＞14 years old,with or without ATG,different stages of diseases,whether pretreatment with maryland respectively (P ＞0.05),either.Epilepsy and intracranial infection were the most common CNS complications in allo-HSCT,followed by intracranial hemorrhage.Conclusion HLA mismatched and above grade 2 GVHD are the risk factors of CNS complications in allo-HSCT.Epilepsy,intracranial infection and bleeding are common CNS complications in allo-HSCT.

Objective:To understand the views and suggestions of medical staff on the key nursing techniques and norms of in-hospital treatment of patients with nuclear exposure, so as to provide reference for the continuous optimization of follow-up processes.Methods:From September to October 2021,purpose sampling was adopted to select doctors and nurses who engaged in medical emergency rescue of nuclear exposure-related work in two divisions of the Nuclear Accident Medical Emergency Center of the National Health Commission as the research subjects, using a combination of online and offline methods to carry out semi-structured interviews with 6 research subjects,using content analysis methods in descriptive research for data analysis.Results:A total of four themes were refined including the need for the establishment of nursing technology and process specification for nuclear accident emergency rescue specialty; the need for specialized training of nursing technology in nuclear accident emergency rescue; the need for the construction of specialized nursing team for nuclear accident emergency rescue; the need to strengthen the closeness of multi-team cooperation.Conclusions:The current in-hospital care technology and processes for nuclear exposed patients need to be further refined and standardized, and in the future, we need to establish a perfect in-hospital care technology and processes for nuclear exposed patients, and according to the corresponding technology and processes, strengthen nursing staff professional training and simulation training in nuclear accident emergency rescue, and establish a nuclear emergency rescue professional nursing team to promote the development of nuclear accident emergency rescue nursing specialists.

Objective:To investigate the safety and curative effect of transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy.Methods:The clinical data of 105 patients underwent laparoscopy ovarian cystectomy in Fujian Maternity and Child Health Hospital from June 2018 to December 2021 were retrospectively analyzed. Among them, 45 patients underwent transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy (observation group), and 60 patients underwent multi-port laparoscopy for ovarian cystectomy (control group). The operative time, intraoperative bleeding, conversion to open surgery, cyst rupture, surgical collateral injury, postoperative exhaust time, postoperative hospital stays, hospitalization cost and postoperative infection, etc were recorded. The face rating scale (FRS) was used to evaluate the pain at 6 and 24 h after operation; the incision satisfaction was evaluated by the Kiyak satisfaction scale at 2 months after operation.Results:The operation was carried out successfully in both groups without surgical collateral injury or conversion to open surgery. There were no significant differences in operative time, intraoperative bleeding, postoperative hospital stays, hospitalization cost, cyst rupture rate and postoperative infection rate between 2 groups ( P>0.05); the postoperative exhaust time and FRS 6 and 24 h after operation in observation group were significantly less than those in control group: (22.1 ± 3.5) h vs. (23.9 ± 3.8) h, 1 (0, 2) scores vs. 2 (1, 4) scores and 1 (0, 1) scores vs. 1 (0, 2) scores, the incision satisfaction score was significantly higher than that in control group: 5 (4, 5) scores vs. 4 (3, 4) scores, and there were statistical differences ( P<0.05 or <0.01). Conclusions:Transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy is safe and feasible, with concealed incision and high patient satisfaction, and has good clinical application value.

Objective To construct a key nursing technology system for the treatment of patients exposed to nuclear radiation in hospitals,and provide technical guidance and support for emergency nursing rescue in hospitals of nuclear radiation accidents.Methods A research group was composed of a team with rich experience in nuclear radiation accidents.Based on 4 scenarios of nuclear radiation accidents(including external irradiation,internal irradiation,external contamination,internal contamination),the literature search was conducted to form the first draft of the system.Delphi method was used to complete 2 rounds of expert letter consultation,and the final draft of the key nursing technology system for hospital treatment of patients with nuclear radiation exposure was constructed according to the revised opinions of experts.Results A total of 16 experts completed 2 rounds of correspondence.The effective recovery rates were 100％and 80％;the recommendation rates were 65％and 50％;the authority coefficients(Cr)were 0.778 and 0.797;the coefficient of variation(CV)of the 2 rounds of expert letter consultation was ≤0.25.Finally,a key nursing technology system for in-hospital treatment of patients with nuclear radiation exposure was formed,including 5 first-level indicators,26 second-level indicators and 74 third-level indicators.Conclusion The constructed key nursing technology system for hospital treatment of patients with nuclear radiation exposure is highly practical and scientific,and it is conducive to the formation of standardized nuclear radiation exposure treatment procedures,and provides a theoretical basis for the training and evaluation of nursing staff related to nuclear radiation exposure.

OBJECTIVE To provide reference for strengthening the quality of pharmaceutical care in retail chain pharmacies and the professional capabilities of licensed pharmacists， and to meet the public’s pharmaceutical care needs. METHODS A combination of questionnaire survey and informant interview was used to investigate the general information of licensed pharmacists in retail chain pharmacies in Guangdong province， the implementation of pharmaceutical care， the competence and knowledge status of the surveyed licensed pharmacists， and the factors affecting the development of pharmaceutical care. RESULTS & CONCLUSIONS A total of 444 questionnaires were sent out and 326 effective questionnaires were collected， with an effective recovery rate of 73.42%. Among 326 surveyed licensed pharmacists， a college degree or higher accounted for 40.18%， and the pharmacy major or related accounted for 79.75%. A total of 185 （56.75%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked had established specified areas of pharmaceutical care； 320 （98.16%）， 137 （42.02%） and 181 （55.52%） of the surveyed licensed pharmacists indicated that the retail chain pharmacies where they worked could provide services such as rational medication guidance for patients， decocting traditional Chinese medicines and establishing health records， etc. The self-assessment scores of the surveyed licensed pharmacists were significantly higher than 3 （median） for competence and knowledge level， but the self-assessment scores for medication therapy management competence and pharmaceutical care practice were relatively low. The surveyed licensed pharmacists believed that the main factors affecting the development of pharmaceutical care in retail chain pharmacies included patients’ lack of trust or cooperation （196， 60.12%）， sales performance requirements （170， 52.15%）， and heavy daily workload （165， 50.61%）. It is recommended that relevant authorities expedite the legislative process of the Pharmacist Law， optimize the continuing education system for licensed pharmacists， and implement a star-rating evaluation system for pharmaceutical care capabilities in pharmacies， so as to encourage retail chain pharmacies and licensed pharmacists to pursue a more specialized development path. At the same time， pharmaceutical retail chain enterprises should shift their business mindset， increase investment in pharmaceutical care， enhance the professional atmosphere in the pharmacies， optimize the compensation structure for licensed pharmacists， and elevate the pharmaceutical care capabilities of both the pharmacies and licensed pharmacists to fulfill the pharmaceutical care needs of the public.