Objective We aimed to explore the real experience of parents of children with acute leukemia during lumbar puncture,so as to provide the theoretical and practice evidence for development of individualized nursing measures.Methods Twenty parents of children with acute leukemia participated in semi-structured interviews regarding their experience of lumbar puncture.The data were colected and analyzed by the Colaizzi phenomenological methodology.Results Three themes were extracted including heavy psychological burden,lack of related knowledge of lumbar puncture and demand of multipolarity.Conclusions Attention should be paid closely to parents of children with acute leukemia during lumbar puncture.The individualized nursing measures should be taken by medical workers in order to truly meet their needs,make them stay in a good state and cooper-ate with medical workers to complete the treatment of children.

Objective To explore the influence of application of health management strategy on quality of life in outpatients with functional dyspepsia (FD). Methods A total of 140 FD patients were divided into the intervention group and the control group by random digits table method with 70 cases in each. The patients in the intervention group received the researchers on the implementation of health management strategy, and the patients in the control group were given routine outpatient health education and telephone follow- up. Before and after the intervention in one month or three, the FD patients Quality of Life Scale (FDDQL) was used to evaluate the quality condition of the patient's life. Results Eventually 65 cases in the intervention group and 61 cases in the control group completed the research. 1 months after intervention in the intervention group, total score of life quality and score of each dimension rose faster, in addition to the dimension of pressure, total score and daily activities, anxiety, diet, sleep, feeling unwell, health, disease control dimension scores were 73.84 ± 3.45, 81.22±4.55, 71.58±6.19, 73.05±5.14, 74.74± 5.58, 74.72±3.91, 79.26±5.85, 73.75±6.32, higher than 60.59 ±5.06, 76.04±6.06, 68.41±9.78, 69.52±6.68,66.63±9.87, 64.37±6.24, 54.50±7.96, 50.76±7.54, the difference was statistically significant (t =2.160-20.590, P < 0.01 or < 0.05). Three months after intervention, the intervention group the total score of life quality and score of daily activities, anxiety, diet, sleep, feeling unwell, health, disease control, pressure dimension scores were 76.35±3.74, 85.21±5.34, 80.15±5.86, 73.21±4.99, 75.49±6.81, 75.46±3.80, 79.35± 6.39, 74.06±6.74, 70.86±7.00, significantly higher than 58.60±5.22, 72.02±6.53, 59.26±7.81, 60.90±6.36, 61.19±9.08, 62.24±6.02, 54.15±8.25, 50.13±7.67, 60.02±5.67 in the control group, the difference of two groups was statistically significant (t = 5.726-19.946, P < 0.01). Conclusions Using health management strategy intervention for FD outpatients will improve FD patient′s quality of life.

OBJECTIVE:To establish a method for simultaneous determination of ephedrine hydrochloride,nitrofural and di-phenhydramine hydrochloride in Compound diphenhydramine nasal drop. METHODS:RP-HPLC method was adopted. The determi-nation was performed on Inertsil ODS-3 C18 column with mobile phase consisted of 0.05 mol/L potassium dihydrogen phosphate buf-fer(pH 7.0)-acetonitrile(gradient elution)with flow rate of 1.0 mL/min. The detection wavelength was set at 256 nm,and the col-umn temperature was 35 ℃. The sample size was 20 μL. RESULTS:The concentrations of phedrine hydrochloride,nitrofural and diphenhydramine hydrochloride ranged 122.1-366.3 μg/mL(r=0.9999),5.2-15.5 μg/mL(r=0.9998)and 31.5-94.5 μg/mL(r=0.9994),respectively. The limits of quantitation were 2.442,0.010,2.520 μg/mL,and the limits of detection were 0.810,0.003, 0.830 μg/mL,respectively. RSDs of precision,stability and reproducibility tests were lower than 1.0%. The recoveries of them were 99.2%-101.7%(RSD=0.9%,n=9),96.4%-102.0%%(RSD=1.7%,n=9),100.2%-101.9%(RSD=0.4%,n=9),respec-tively. CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for simultaneous determination of ephedrine hydrochloride,nitrofural and diphenhydramine hydrochloride in Compound diphenhydramine nasal drop.

Objective: To establish the quality standard for Yuhuang sprays. Methods: Berberine hydrochloride in Yuhuang sprays was qualitatively identified by TLC and determined by UV. The Vanillin-H2 SO4 method was employed for the determination of condensed tannins. Results:The spots obtained from the sample solutions showed the same color as those from the reference substance solution without interference from the negative sample. The calibration curve of berberiny hydrochloride was linear within the range of 1. 13-13. 60μg·ml-1(r=0. 999 9), and the average recovery was 99. 68% with RSD of 1. 53%(n=9). The calibration of catechin was linear within the range of 0. 03-0. 30 mg· ml-1(r=0. 999 3), and the average recovery was 99. 6% with RSD of 1. 76%(n=9). Conclusion:The method can be used in the quality control of Yuhuang sprays.

Glucagon⁃like peptide⁃2 (GLP⁃2) is a peptide hormone secreted by L cells in the gut. GLP⁃2 plays an important role in anti⁃inflammation, promoting proliferation and repair, and promoting nutrient absorption through various signaling pathways in the gastrointestinal tract. Long ⁃ acting analogs of GLP ⁃ 2 have been used in the treatment of short bowel syndrome and Crohn’s disease, but using GLP⁃2 also has the risk of promoting tumorigenesis. This article introduces GLP ⁃ 2 and its physiological role in gastrointestinal tract, and expounds the possible mechanism of GLP ⁃ 2 related to tumorigenesis and the tumorigenesis risk of endogenous and exogenous GLP⁃2 therapy.

Objective To evaluate the efficacy and safety of pelvic arterial embolization (PAE) in women with intractable primary postpartum hemorrhage (PPH). Methods Clinical data of 36 cases were analyzed retrospectively in which women underwent PAE for intractable primary PPH in Peking Union Medical College Hospital between Jan 2006 and Jan 2015. The success rate of PAE were measured and possible predictive risk factors associated with treatment failure were analyzed. The complications secondary to PAE were also recorded. Results (1)The etiology of PPH. Among the 36 cases, 21 patients delivered viginally (Group VD) and 15 received cesarean section (Group CS). The most frequent cause of PPH was uterine atony (72%, 26/36). The less common causes were placental problems (28%, 10/36), genital tract trauma (6%, 2/36) and coagulation defects (3%, 1/36) in turn. Three patients (8%, 3/36) had combined causes.(2)Interventions before PAE. Uterotonic medications were used in all patients. 31 patients received carboprost methylate suppositorites,27 received carbetocin and 31 received carboprost tromethamine. Besides, 20 patients received one or more surgical interventions before PAE. PAE was performed when these interventions failed. (3) Characteristics of PAE. Altogether 78 arteries were embolized in 36 cases. Embolization of bilateral uterine arteries was performed in 31 cases, right internal iliac artery and bilateral inferior epigastric arteries were embolized in one case. Right internal pudendal artery, bilateral uterine arteries and bilateral internal iliac arteries were embolized in one case. And bilateral uterine arteries, bilateral internal iliac arteries were embolized in one case. In the other 2 cases, bilateral internal iliac arteries were embolized.(4)Efficacy of PAE. The overall technical success rate of PAE was 100%(36/36), while the clinical success rate was 94%(34/36). All patients survived.(5)Complications of PAE. 15 patients were transferred to ICU after PAE for 1 to 7 days. Except self-limited fever, no puncture site hematoma, buttock necrosis or vessel rupture was observed. The effect on menstrual cycle and fertility were followed in 25 patients. 17 (68%, 17/25) reported resumption of normal menses and 8 (32%, 8/25) reported amenorrhea. Three pregnancies after PAE were observed. Conclusion PAE is a safe and effective treatment for intractable primary PPH which can prevent hysterectomy and preserve fertility of patients.

·AIM: To investigate the clinical efficacy of intravitreal injection of Ranibizumab and 577nm laser in the treatment of retinal vein occlusion combined with macular edema.·METHODS: Totally 64 patients ( 64 eyes ) with retinal vein occlusion accompanied by macular edema were treated in our hospital from June 2014 to March 2017. Among them, 40 cases ( 40 eyes ) were in the central retinal vein occlusion group, 24 cases (24 eyes) were in the branch retinal vein occlusion group. They were treated with intravitreal injection of ranibizumab 0. 5mg, and the laser photocoagulation of 577nm was performed at 5 to 7d after injection. Meanwhile, 42 patients who did not wish to be treated with injection were treated with laser treatment only. The changes of the indexes before and after treatment were compared.·RESULTS: The average number of blocking group repeated injection of branch retinal vein for 1. 71 ± 0. 79, while the average number of patients with repeated injection of central retinal vein occlusion was 2. 11 ± 0. 80. All patients requiring repeated injections interval was greater than 30d. At 1mo after treatment, there was no patients with decreased visual acuity in branch retinal vein occlusion group, while there were 6 eyes with that in central retinal vein occlusion group, 14 eyes in simply laser group. The mean best corrected visual acuity (LogMAR) of the three groups was 0. 87±0. 60, 0. 57±0. 48 and 0. 54±0. 32, respectively, were significantly lower than that before treatment (1.26±0.53, 0.86±0.39, 0.76±0.26;P< 0. 05 ). The mean macular retinal thickness before treatment was 683.24±211.83, 557.39±128.29 and 545.82± 129. 76μm, were significantly higher than those at the last follow-up 412. 09±257. 38, 356. 29 ± 133. 02 and 322. 78 ± 109. 55μm ( P < 0. 05 ). There were 6 cases of subconjunctival hemorrhage in patients treated with laser therapy combined with laser therapy. The intraocular pressure increased to 25mmHg in 2 eyes in 2 patients and recovered after symptomatic treatment.· CONCLUSION: Intravitreal injection of ranibizumab combined with 577nm laser treatment can greatly enhance the visual acuity, effective decrease macular retinal thickness in patients with retinal vein occlusion and macular edema.

Objective To identify inflammation-related genes in atrial fibrillation(AF)and explore the possible role and mechanism of these genes and infiltrating immune cells in the development of AF.Methods A series of bioinformatics analysis combined with machine learning algorithms to identify biomarkers of AF,the receiver operating characteristic(ROC)curves were used to verify the prediction and diagnostic value of key genes,and Spearman correlation analysis was used to clarify the correlation between key genes and infiltrating immune cells.Results 593 differential genes(| log2(fold change,FC)|>1,P<0.05),7 immune cell subtypes(P<0.05)were selected,190 immune-related differential genes were obtained,3 biomarkers(IGF1,PTGS 2 and PPARG),and the correlation analysis showed that 3 markers were significantly associated with infiltrating immune cells(P<0.05).Conclusion IGF1,PTGS2 and PPARG are inflammation-related genes of AF,which are speculated to be closely related to the process and pathway of immune cell infiltration.

To evaluate the psychological symptoms of patients with Crohn disease (CD), and to explore the risk factors affecting quality of life (QOL) in CD patients, 50 adult patients with CD, and 50 healthy controls were enrolled. Psychological questionnaires including self-rating anxiety scale (SAS), self-rating depression scale (SDS), the inflammatory bowel disease questionnaire (IBDQ) and the short form-36 health survey (SF-36) were completed. The results showed both the SAS (40.3±8.5 VS 37.6±7.0) and the SDS (47.1±11.1 VS 41.8±9.6) in CD patients were significantly higher than those in the healthy controls ( t=5.4, P<0.05; t=10.6, P<0.05). The IBDQ scores revealed the physical symptoms scores were 49.50±7.62, systemic symptoms scores 23.92±5.07, emotional functions scores 57.13±15.62, and social function scores 22.15±9.08 in CD active phase. However, the above scores were 60.12±4.01, 26.24±3.97, 67.34±15.17, and 25.44±2.03 respectively in the remission phase. Four subscale items of IBDQ in CD active phase were significant lower than those in the remission phase (all P<0.05). The subscale items of SF-36 scores (PF, RP, BP, GH, VT, SF, RE, MH) in CD patients were significant lower than those in healthy controls (all P<0.05). The SF-36 items scores of PF,RP and MH in the remission phase were significant higher than those in the active phase (all P<0.05). The SF-36 items scores of GH and VT in patients with malnutrition were significant lower than those with nutrition (both P<0.05). Multivariate regression analysis showed that disease status and nutritional risk ( P<0.05) significantly affected the patients' IBDQ scores. Factors including sex, age, marital status, education background, medical insurance, use of biologicals, surgery treatment had little influence on the total score of IBDQ ( P>0.05). Psychological conseling and treatment in the active phase may improve QOL of CD patients.

Objective To investigate the prenatal diagnosis and genetic counseling of fetal nuchal fold (NF) thickening.Methods This study retrospectively analyzed 17 fetuses with increased NF detected by prenatal ultrasound examination in Peking Union Medical College Hospital,Peking Union Medical College & Chinese Academy of Medical Sciences from December 1,2016 to December 1,2017.All cases were divided into isolated (isolated group) or non-isolated increased NF group (non-isolated group) according to whether the fetus had concomitant ultrasonographic abnormalities or not.Karyotype and chromosomal microarray analysis (CMA) were performed on all cases.Clinical data,prenatal genetic testing results and pregnancy outcomes were analyzed.Results Of those twelve cases in the isolated group,two were terminated due to the identification of chromosomal abnormalities and pathogenic copy number variations (CNVs) and the fetal autopsy results were consistent with the prenatal diagnosis.The rest 10 pregnancies were all continued including one fetus carrying a variant of unknown significance,which was proved to be a paternal heredity by CMA,and nine without genetic abnormalities and all-these infants were healthy during follow-up.Among the five non-isolated cases,one was diagnosed as trisomy 21 by karyotyping and CMA,and the other four were found to have structural abnormalities under ultrasound scan,but without genetic abnormalities in karyotyping and CMA.And all the five pregnancies were terminated after genetic counseling and three of them chose whole exome sequencing (WES) for further test.One homozygous mutation in CHRNA 1 gene and one de novo mutation in SETD2 gene were found in two cases,respectively,while no abnormality was identified in the other one case.Conclusions Once increased NF were indicated by ultrasound examination,prenatal genetic testing should be offered to the patients,including CMA,regardless of other ultrasonographic abnormalities,and WES should also be offered when necessary.Considering a thickened NF is associated with increased risks of structural defects,a close follow-up with fetal echocardiography and ultrasound is required even the prenatal tests are normal.