Objective To study the clinical factors of sclerema neonatorum complicated with pneumorrhagia and propose therapy and control measures in order to.improve clinical treatment.Methods27 cases of sclerema neonatorum complicated with pneumorrhagia treated in Chaozhou Central Hospital from January 2005 to December 2007 were investigated retrospectively.Results In all 96 cases of sclerema neonatorum,27 Were complicated with pneumorrhagia.mortality of which was 67%.9 cases of pneumorrhagia without mechanical ventilation died totally.Early tracheal intubation discovered 9 cases of pneumorrhagia,mortality was 56%.5 cases died within the 6 oronasal emissing blood,taking up 83%in mortality.There were significant differences between them(P＜0.05).Conclusion The incidence of pneumorrhagia in sclerema neonatorum was closely related to fetal month,age,scleredema degrees,acidosis,birth weight ect.The more severe scleredema,the lower birth weight and the fewer fetal month were,the higher incidence rate was.

BACKGROUND:Cytokine induced kil er cells therapy as an effective means of adoptive immunotherapy, becomes a new way to treat acute myeloid leukemia. But, the researches about sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation in acute myeloid leukemia patients are stil less, which deserve further research.
OBJECTIVE:To observe the clinical efficiency and safety of sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation in acute myeloid leukemia M2 patients.
METHODS:Total y 45 patients with low-or intermediate-risk acute myeloid leukemia M2 were recruited in this study. Among them, 19 patients received sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation and 26 patients only received autologous peripheral blood stem celltransplantation. The relapse rate, disease-free survival, and overal survival were compared between two groups, and safety of cytokine induced kil er cells therapy was observed.
RESULTS AND CONCLUSION:(1) Compared with the patients only receiving autologous peripheral blood stem celltransplantation, the relapse rate was lower (21.05%vs. 38.46%;P<0.05), and elevated percentages of the disease-free survival and overal survival were observed in the patients receiving sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation (P<0.05). (2) The 19 patients who received sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation al completed the treatment scheme successful y. Only four patients appeared to have chil s and fever, and no more side effects were observed. These findings suggested that the sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation can improve the disease-free survival and overal survival of low-or intermediate-risk acute myeloid leukemia M2 patients without remarkable side effects, which is a safe, effective and feasible way for the treatment of acute myeloid leukemia M2.

Objective? To summarize the nursing practice and coordination skills of endoscopic upper gastrointestinal foreign body. Methods? 120 patients with upper gastrointestinal foreign bodies admitted to the affiliated hospital of shaoxing university of arts and sciences from May 2017 to April 2018 were selected. Endoscopic removal of upper gastrointestinal foreign bodies was performed, and preoperative, intraoperative and postoperative nursing coordination was given to summarize nursing coordination skills and application effects. Results? The success rate of foreign body removal in 120 patients was 96.67%. Conclusions? The endoscopic upper gastrointestinal foreign body undergoing comprehensive nursing evaluation and coordination operation can improve the success rate of foreign body removal, it is worthy of clinical promotion.

Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.

Objective To compare the safety and short-term efficacy of laparoscopic repeat hepatectomy (LRH) with open repeat hepatectomy (ORH) for recurrent hepatocellular carcinoma (rHCC).Methods The clinical data of 33 patients with rHCC who underwent hepatectomy at Nanfang Hospital,Southern Medical University from August 2015 to November 2017 were retrospectively analyzed.There were 24 males and 9 females.The patients were divided into LRH group (n=15) and ORH group (n=18).The preoperative clinical data,operative and postoperative data of the two groups were compared.Results No significant differences were observed in the preoperative clinical data of the two groups,including the extent of the previous hepatectomy,the interval between the two surgeries,the number of tumors,and the maximum diameter of tumors.No significant differences were observed in the liver resection method,portal occlusion time and operation duration between the two groups.Blood loss was significantly lower in the LRH group [(66.7±86.1) ml vs.(251.1±75.6) ml,P＜0.05].The total hospitalization expenses,first postoperative white blood cell count,and hepatic insufficiency in the two groups were not significantly different (P＞0.05).The postoperative diet recovery was significantly shorter (1.2±0.4) days vs.(2.9± 1.4) days,the inflammation indicator NEU％ was significantly decreased (83.6±4.8)％ vs.(88.2±3.7)％,and the length of postoperative hospital stay (6.3±2.9) days vs.(9.8± 3.7)days was significantly shorter in the LRH group (P＜0.05).Conclusions LRH was safe and effective in the treatment of rHCC,LRH was superior in reducing intraoperative blood loss,promoting postoperative recovery and shortening hospital stay when compared to ORH.

Objective:To summarize the clinical and high resolution CT(HRCT) characteristics of 141 patients with COVID-19.Methods:From January 20 to 28, 2020, 141 COVID-19 patients, 77 males and 64 females, with a median age of 49 (9, 87), were enrolled in the study. The clinical features, laboratory test results and HRCT findings of all patients were analyzed retrospectively.Results:In all of the patients, the decreasing leukocyte countin 38 (26.95%) and lymphocyte ratio in 71 (50.35%), a fever over 37.5 ℃ in 139 (98.58%), coughing in 106 (75.18%), headache in 11 (7.80%), expectoration in 41 (29.08%), chest distress in 93 (65.96%), and diarrhea in 4 (2.84%) were found. The HRCT of all patients were abnormal, including ground glass opacity (GGO) with patchy opacity in 52 (36.88%) mainly distributed along subpleural area, GGO with focal consolidation in 23 (16.31%),small patchy opacity in 27 (19.15%),large patchy consolidation in 20 (14.18%),thickened bronchovascular bundleing and blood vessel crossing the lesion in 48 (34.04%), air bronchus sign in 5 (3.55%), small nodule in 7 (4.96%),fibrous stripes and reticular opacities in 5 (3.55%), bilateral pleural effusion in 7 (4.96%), and mediastinal or bilateral hilar lymphadenopathy in 4 (2.84%).Conclusions:The clinical and HRCT manifestations of COVID-19 are various. Under the specific epidemiological background of COVID-19, chest HRCT scan should be carried out as soon as possible for early warning of this disease.

Objective:To investigate the effect of metformin on the microRNA (miRNA) expression and screen potential target with network pharmacology analysis in patients with type 2 diabetes.Methods:Fifteen patients with new diagnosed type 2 diabetes admitted to our hospital were selected, who received metformin during hospitalization and after discharge. The expression of serum matrix metalloproteinase (MMP)-9, transforming growth factor (TGF)-β1, and myocardial fibrosis related miRNAs were compared before and 6 month after metformin treatment. In addition, gene ontology (GO) and KEGG pathway enrichment analysis were applied to analyze differential expression miRNAs showing statistical significance. Meanwhile, the network figure was established to reflect the target gene messenger RNA (mRNA) corresponding to differentially expressed miRNA.Results:Compared with pre-medication, the serum level of MMP-9 was significantly decreased after treatment ( P<0.05). Besides, the expression of homo sapiens microRNA (hsa-miR)29a-3p, hsa-miR133a-5p, hsa-miR21-5p, hsa-miR30c-5p, and hsa-miR1-3p in patients with type 2 diabetes were dramatically down-regulated by metformin ( P<0.05 or P<0.01). Results of GO analysis and KEGG pathway enrichment analysis showed that differentially expressed miRNAs were mainly concentrated in endoplasmic reticulum lumen, synapse, basement membrane and other cell components. The molecular functions such as Rho GTPase binding and participation in extracellular matrix structural constituent were exerted through biological processes such as collagen catabolic process, regulation of short-term neuronal synaptic plasticity, and axon extension, which were mainly enriched in advanced glycation end products-receptor for advanced glycation end products (AGE-RAGE) signaling pathway in diabetic complications, tumor necrosis factor (TNF) signaling pathway, and Wnt signaling pathway, etc. The outcome of miRNA-mRNA network analysis demonstrated that there were 230 target genes mRNAs corresponding to differentially expressed miRNA. Conclusion:Metformin could play its role in the treatment of type 2 diabetes by down regulating the expression of miRNA, participating in the transduction of related cellular signaling pathways, regulating chromatin, nucleic acid binding, and enzyme activities.

Objective:To explore the effectiveness of LEARNS model combined with video health education in patients undergoing painless gastrointestinal endoscopy.Methods:From February 2021 to November 2022, convenience sampling was used to select 128 patients who underwent painless gastrointestinal endoscopy at the Endoscopy Center of Affiliated Hospital of Shaoxing University as research subjects. A total of 64 patients admitted from February to December 2021 served as control group, while 64 patients admitted from January to November 2022 served as observation group. Control group patients received routine health education, while observation group was treated with LEARNS model combined with video health education on the basis of control group. The degree of cooperation, psychological state, and satisfaction with health education were compared between two groups of patients.Results:The proportion of patients in observation group who actively cooperated was higher than that in control group, and there was a statistically significant difference in the degree of cooperation between the two groups ( P<0.05). Thirty minutes before and after the endoscopy, the scores of both subscales of the State-Trait Anxiety Inventory (STAI) in observation group were lower than those in the control group, and the difference was statistically significant ( P<0.05). The satisfaction scores of observation group patients with health education in all dimensions were higher than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:LEARNS model combined with video health education can effectively improve the cooperation of patients undergoing painless gastrointestinal endoscopy, alleviate their pre-examination anxiety, and enhance their satisfaction with health education, which is worthy of clinical practice.

Objective:To evaluate the quality of critical patient handover practice between emergency room and intensive care unit (ICU) nurses, and to provide a basis for structured handover process.Methods:From March to July 2023, a total of 223 pairs of nurses in emergency room and ICU (including EICU) of 5 Class 3 Grade A general hospitals in Suzhou were selected as the research objects by using cross-sectional survey method and convenience sampling method. Self-designed general information questionnaire and Patient Handover Practice Quality Scale were used to investigate the included 223 pairs of nurses in emergency room and ICU on the current situation of handover time and quality.Results:A total of 211 pairs of nurses were included, including 286 females (67.8%) and 136 males (32.2%). The average age of emergency department nurses was (27.31 ± 2.17) years old, and ICU nurses was (26.96 ± 3.04) years old. The total scores of the patient handover practice Quality Scale for nurses in the emergency room and ICU were (45.25 ± 6.26) and (43.55 ± 7.19) points respectively, and the scores of the information transmission dimension were (20.47 ± 5.43) and (17.66 ± 3.45) points. The scores of common understanding dimension were (7.59 ± 2.31) and (8.58 ± 2.46) points. The scores of work atmosphere dimension were (7.93 ± 2.11) and (8.39 ± 2.29) points. The scores of handover situation dimension were (5.33 ± 1.30) and (5.70 ± 1.53) points, and the differences were statistically significant ( t values were - 6.35-4.22, all P<0.05). There were statistically significant differences in the scores of handover practice quality between emergency room nurses and ICU nurses according to specialization, education background, working years and job category ( t values were - 4.91-2.56, all P<0.05). Conclusions:Emergency room nurses and ICU nurses have different requirements and expectations for handover procedures, so it is necessary to build a structured handover practice framework and carry out personalized handover practice training, in order to achieve the consistency of handover content and improve the quality of critical patients handover practice.

Objectives:To explore the GAA varient spectrum and the genotype-phenotype correlations in patients with glycogen storage disease type Ⅱ (Pompe disease, PD), as well as to estimate the disease incidence based on carrier rate of GAA varients in Guangzhou population.Methods:A total of 57 PD cases were retrospectively enrolled at Guangzhou Women and Children′s Medical Center from January 1, 2010 to May 31, 2020. All patients presented symptoms before the age of 18 years. Each diagnosis was further confirmed by GAA enzyme activity and GAA variants. The carrier rate of GAA varients was calculated based on variants detected by whole exon sequencing among 2 395 healthy children in Guangzhou.Results:Among the 57 PD patients (including male 26, female 31),twenty-eight patients with infantile onset PD (IOPD) presented with progressive general muscle weakness and cardiomyopathy. The mean ages of symptom onset and diagnosis were (2.5±1.4) and (5.0±3.0) months, respectively. Twenty-six cases died in the first year after birth.Twenty-three patients with late onset PD (LOPD) presented with progressive muscle weakness. Seven of them had respiratory failure at diagnosis. The mean ages of symptom onset and diagnosis were (12.0±5.0) and (17.0±7.5) years, respectively. Six children with atypical IOPD showed motor delay, muscle weakness and cardiomyopathy. Their diagnosis was confirmed at 2.5-7.0 years of age. Among the 57 patients, 47 different variants were identified in the GAA gene. Three variants: c.797C>T, c.1109G>A and c.1757C>T were novel. c.1935C>A (25/114, 21.9%) and c.2238G>C (15/114, 13.2%) were the most common variants, detected in 57.1% of IOPD and 65.2% (15/23) of LOPD patients, respectively. Among the 28 IOPD patients, 26 cases (92.9%) carried at least one missense variant which indicated positive cross-reactive immunologic material (CRIM). The carrier rate of pathogenic variants in GAA gene among healthy children was 24/2 395. The estimated incidence of PD in this population is about 1/40 000. The frequencies of pseudodeficiency variants c.1726G>A and c.2065G>A homozygotes were 26.3% (15/57) and 35.1% (20/57) in PD patients, which were significantly higher than those (1.7% (40/2 395) and 3.9% (94/2 395)) in healthy children (χ2=151.2, 121.9; both P<0.01). Conclusions:PD presents as a spectrum, some as atypical IOPD. The c.1935C>A and c.2238G>C are common variants, correlated with IOPD and LOPD respectively. The c.796C>T and c.1082C>T are usually found in atypical IOPD. The majority of IOPD patients is predicted to be CRIM positive. The estimated incidence of PD is about 1/40 000.