Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.

Ovarian cancer is the most fatal malignant tumor in female reproductive system tumors.In most women, it is diagnosed in a late stage, which largely leads to the poor prognosis of ovarian cancer.Breast cancer susceptibility gene (BRCA) is an important DNA homologous repair gene, which plays a major role in the normal cellular DNA repair mechanism.Its mutation will lead to homologous recombination defects, which will affect the stability of the genome and lead to occurrence of tumors.In recent years, BRCA genetic testing has become a key step in the risk assessment, prognosis, treatment and prevention of ovarian cancer.

Objective To evaluate the acceptance of the Mobile Delirium Assessment App based on confusion assessment method for intensive care unit (CAM-ICU )nurses.Methods Using the technology acceptance model as the theoretical framework to design the user acceptance questionnaire,1 03 ICU nurses were selected by convenient sampling to participate in the study from 5 level three class A hospitals in Beijing from October 201 5 to January 201 6.Results Effective collected 1 01 questionnaires showed that the average scores of each dimensions intelligentized CAM-ICU delirium assessment system included perceived usefulness(4.62 ± 0.44)points,perceived ease of use(4.31 ±0.39)points,perceived ease of adoption(4.28 ±0.49)points,trust (4.36 ±0.62)points,attitude toward use (4.46 ±0.50)points and behavioral intention to use (4.61 ± 0.52)points.There were differences in perceived ease of use,trust and attitude toward use among nurses with different ages and different length of service (P <0.05 ).Pearson correlation analysis showed a positive correlation between perceived usefulness,perceived ease of use,trust and attitude toward use (P <0.01 ).A positive correlation was between perceived usefulness,perceived ease of use,attitude toward use and behavioral intention to use (P <0.05).A positive correlation was between perceived usefulness and perceived ease of use (P <0.01 ).Conclusions The acceptance of intelligentized CAM-ICU is satisfactory in ICU nurses,and which examine the from the simple and ease to use of delirium evaluation system subjective view.With the increasing of age and working years in ICU nurses,the acceptance increase for intelligentized CAM-ICU.Except the ease to learn,the correlation analysis showed the correlations in each dimensions are in accordance of hypnosis of theory model.

Objective To investigate the nurses'acceptance for the intelligent admission assessment system. Method The user acceptance questionnaire of intelligent admission assessment system was developed to look into the attitude of 135 nurses. Results The self-designed questionnaire on user acceptance of intelligent admission assessment system was of good reliability and validity. The scores on intention and use behavior of nurses in ICU were lower than those in other departments (P＜0.05).The level of acceptance among the nurses having been worked for 21 to 31 years was higher than those for 1 to 10 years. There were no significant differences in age, education, professional title and position. Conclusions The intelligent admission assessment system is so easy to use that it is well-accepted among the nurses. However, the nurses in different departments and with length of nursing service differ in acceptability. They need more attention during the clinical application and training process.

Objective To explore the effects of nutritional risk assessment combined with individual enteral nutrition management process among critically ill patients.Methods A total of 220 critically ill patients were selected in ICU at Ningbo First Hospital of Zhejiang Province from January 2016 to January 2017. They were coded according to the order of being admitted and were divided into observation group (n=110) and control group (n=110) with the method of random number table. Patients in control group received routine nutritional support following the doctor's advice involving adopting total protein enteral nutrition powder, evaluating gastric residual volume of patients by nurses at four hours interval, increasing dose of nutritive medium according to patients' conditions. Patients in observation group accepted nutritional risk screening with the evaluation standards of nutrition risk screening 2002 (NRS 2002) after being admitted to department along with gastrointestinal function assessment. And then, the individual enteral nutrition management process was carried out. In this process, doctors were responsible for establishing objectives and schemes of nutritional support including nutrition time, types of nutritive medium and nutritional goal. Besides, nurses executed enteral nutrition schemes, and evaluated the tolerance of enteral nutrition dynamically, and adjusted the velocity and quantity of enteral nutrition liquid. Finally, this research compared the indexes of nutrition and amynology, incidences of gastrointestinal dysfunction and infectious complications and time of being admitted to ICU of patients in two groups.Results There were no statistically significant differences in the indexes of nutrition and amynology on the first day of being admitted of patients in two groups (P>0.05). The indexes of nutrition and amynology including total serum protein (57.06±3.31)g/L, blood albumin (32.12±1.49)g/L, hemoglobin (118.34±9.34)g/L, IgA (3.24±0.50)g/L, IgG (2.96±0.38)g/L, IgM (1.92±0.17)g/L of patients in observation group were higher than those in control group with significant differences on the seventh day (t=4.01, 3.59, 2.39, 6.06, 4.05, 6.19;P<0.05). The incidences of gastrointestinal dysfunction and infectious complications were 21.81％ and 12.72％ in observation group significantly lower than those in control group (χ2=11.89, 8.91;P<0.05). The time of being admitted to ICU was (10.01±2.28) d in observation group and (13.99±1.91) d in control group with a significant difference (t=9.91,P<0.05).Conclusions The nutritional risk assessment combined with individual enteral nutrition management process can enhance the overall nutritional level, and effectively improve the nutrition of patients, and reduce the incidence of complications related to enteral nutrition, and promote the rehabilitation of patients. It is worth to be used widely in clinical application.

Objective? To explore the status quo of subsyndromal delirium (SSD) in surgical intensive care unit (ICU) patients and to analyze its influencing factors. Methods? Totally 135 surgical ICU patients admitted in a Class Ⅲ Grade A hospital in Beijing from June 2016 to February 2017 were selected. Confusion Assessment Model for Intensive Care Unit (CAM-ICU) was used to evaluate the morbidity of SSD on a daily basis. The patients' general information, vision and hearing conditions, Mini-Mental State Examination (MMSE) scores, Acute Physiology and Chronic Health Evaluation Scoring System (APACHEⅡ) scores, mechanical ventilation, constraints, oxygenation index and laboratory measurements such as blood albumin, hemoglobin, Na+, Cl-, K+, Ca2+ and other data were collected until they were transferred from ICU. Univariate analysis was used to analyze potential risk factors, and unconditioned Logistic regression analysis was used to analyze the independent risk factors of SSD in surgical ICU patients. Results? The morbidity rate of SSD was 34.1% (46/135), and the morbidity rate of delirium was 28.9% (39/135). According to univariate analysis, there was statistically significant difference in age, educational background, marital status, operation or not, APACHEⅡscores, MMSE scores, use of constraints, use of mechanical ventilation, and incidence of hypoproteinemia or hyponatremia between patients with SSD and without SSD (P＜0.05). Logistic regression analysis revealed that MMSE, hypoproteinemia and constraints were independent prognostic factors affecting the incidence of SSD in surgical ICU patients (OR=0.848, 3.325, 3.393; P＜ 0.05). Conclusions? The incidence rate of SSD in surgical ICU patients is high. Patients with lower MMSE scores, hypoproteinemia and use of constraints are more susceptible to SSD.

ObjectiveTo explore the application of network information platform in the standardized training of newly recruited nurses in Neurology Department and evaluate its effect. MethodsA total of 34 new nurses recruited by Beijing Tiantan Hospital affiliated to Capital Medical University in 2017 were selected as intervention group and trained through network information platform. A total of 38 newly recruited nurses from Neurology Department of the same hospital from 2015 to 2016 were selected as the control group and trained by routine training methods. The clinical nursing ability, specialty theory results and specialty skills results of the two groups of newly recruited nurses were compared. ResultsIn the intervention group, the self-evaluation leadership of newly recruited nurses was (11.23±1.79), the monitoring of critical patients was (21.56±2.78), the teaching and cooperation was (28.97±4.11), the planning and evaluation was (21.18±2.89), the communication and exchange was (31.82±3.75), the professional development was (32.08±3.54) and the total score was (146.8±6.72). The scores of the above items in the control group were (9.87±1.72), (19.13±2.61), (26.79±3.92), (19.68±2.95), (28.66±3.54), (30.00±3.94) and (134.13±7.25) respectively. There were significantly statistical differences between the two groups (t=-7.69 - -2.16; P＜ 0.05). In the intervention group, the peer evaluation leadership of newly recruited nurses was (10.23±1.79), the monitoring of critically ill patients was (20.97±2.77), the teaching and cooperation was (28.35±4.01), the planning and evaluation was (20.68±2.98), the communication and exchange was (31.47±3.54), the professional development was (31.64±3.33) and the total score was (143.36±6.39). The scores of the control group were (8.71±1.58), (18.07±2.36), (25.76±3.97), (19.08±3.03), (27.61±3.61), (28.55±4.07) and (127.79±6.73). There were significantly statistical differences between the two groups (t= -10.03 - -2.25; P ＜ 0.05). In the control group, the excellence rate and good rate of theoretical knowledge were 13.2%(5/38) and 36.8%(14/38) respectively, and the excellence rate and good rate of professional skills results were 10.5%(4/38) and 55.3%(21/38) respectively. In the intervention group, the excellence rate and good rate of theoretical knowledge were 23.5% (8/34) and 47.0%(16/34) respectively, and the excellence rate and good rate of professional skills results were 20.6%(7/34) and 58.8%(20/34) respectively. The academic and professional skills scores of the intervention group were higher than those of the control group with statistical difference (Z=-2.902, -2.908; P＜ 0.01). ConclusionsApplying the network information platform to standardize the training for newly recruited nurses in neurology department can improve their clinical nursing ability, the results of professional theoretical and practical skills.

Objective? To explore the incidence of subsyndromal delirium (SSD) in ICU patients after surgery for craniocerebral tumor and its influencing factors. Methods? Totally 100 patients admitted in the General Intensive Care Unit of a ClassⅢ Grade A hospital in Beijing between January and December 2018 were selected. Confusion Assessment Model for Intensive Unit (CAM-ICU) was used to assess the incidence of SSD in these patients on a daily basis. Their clinical data, including general information, vision and listening, Mini-Mental State Examination (MMSE) scores, Acute Physiology and Chronic Health Evaluation Scoring System (APACHEⅡ) scores, mechanical ventilation, restraints, oxygenation index, albumin, hemoglobin, Na+, Cl-, K+ and Ca2+ values until they were transferred out of ICU. Univariate analysis was employed to screen the possible risk factors, and unconditional Logistic stepwise regression analysis was used to identify the independent risk factors of SSD in ICU patients. Results? The incidence rate of SSD in the 100 ICU patients after surgery for craniocerebral tumor was 40%(40/100), and 55.0%(22/40) of the patients sustained SSD since day 1-3 after admission into ICU. The average frequency of incidence was 2.08 times, and it lasted (30.80±10.11) h. Logistic regression analysis revealed that infection, pain, APACHE II scores were the independent predictive factors for SSD in ICU patients after surgery for craniocerebral tumor (P＜0.05). Conclusions? The incidence rate of SSD in ICU patients after surgery for craniocerebral tumor is high, and infection, pain and high APACHE Ⅱ scores are likely to lead to SSD.

Objective: Traditional uterine manipulator is considered as the main reason for short survival of patients with early-stage cervical cancer during minimally invasive surgery. This study aims to assess the sealing effect of magnetic-sealing uterine manipulators (MUMs) in isolated uteruses. Methods: The study was performed on isolated uterus from patients with early-stage cervical cancer who underwent open abdominal radical hysterectomy between November 2019 to April 2021. Right-angle forceps closure tests (groups 1 and 3) were defined as control tests. One experimental MUM closure test (group 2) and 2 control tests were respectively carried out in each of the isolated uterus. DNA ploidy analysis system was used to observe exfoliated cells. Statistical analysis was performed using Wilcoxon signed-rank test to assess the sealing effect of MUM. Results: We identified 36 patients. No regional node metastasis was discovered and only one tumor was larger than 4.0 cm in diameter. The mean of exfoliated tumor cells in groups 1, 2, and 3 were 1, 1, and 2, respectively. There was no significant difference in the quantity of exfoliated cells between groups 1 and 3 (p=0.476), so the results of the 2 groups were merged. Subsequently, a significant difference was observed between combined right-angle forceps closure tests and MUM closure tests (p=0.022). Conclusion The sealing effect of MUM was better than that of right-angle forceps. MUM can effectively seal cervical cancer cells in the cup cover, avoiding the dissemination of tumor cells.

Objective To observe the impact of semi-solidification enteral nutrition on feeding tolerance,nutritional and infection related indicators,and prognosis in neurocritical patients.Methods Adopting the prospective research method,the neurocritical patients who were admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Ningbo University from December 2021 to May 2022 and had to stay in the nasogastric tube for enteral nutrition were selected as the study subjects,pectin was added to achieve the semi-solidification of enteral nutrition,and the patients were divided into pectin group and control group according to the principle of randomized control,with 25 cases in each group.Enteral nutrition was started within 24-48 hours of admission to the ICU in all patients,and pectin plus continuously pumped enteral nutrition preparation was given in the pectin group and continuously pumped enteral nutrition preparation in the control group,all of which was used continuously for more than 7 days.Differences in albumin,prealbumin,Glasgow coma scale(GCS),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),sequential organ failure assessment(SOFA),procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)were compared between the two groups before and after 7 days of treatment,and enteral nutrition compliance rates at 3 days and 7 days of treatment,as well as the incidence of enteral nutrition intolerance(including vomiting,diarrhea,constipation,aspiration and bloating),along with the length of ICU stay and 28 days prognosis were observed.Results There were no statistically significant differences between the two groups in general clinical data[including gender,age and body mass index(BMI)]and pre-treatment GCS score,APACHEⅡ score,SOFA score,albumin,prealbumin,PCT,IL-6 and CRP levels.The incidence of vomiting,diarrhea,constipation,and bloating during enteral nutrition was significantly lower in the pectin group than those in the control group[vomiting:4.0％(1/25)vs.24.0％(6/25),diarrhea:8.0％(2/25)vs.32.0％(8/25),constipation:20.0％(5/25)vs.65.0％(13/25),bloating:12.0％(3/25)vs.36.0％(9/25),all P<0.05],but the difference in the incidence of aspiration compared with the control group was not statistically significant[4.0％(1/25)vs.16.0％(4/25),P>0.05].Caloric compliance with enteral nutrition was significantly higher in the pectin group than in the control group at both 3 days and 7 days of treatment[3 days of treatment:48.0％(12/25)vs.20.0％(5/25),7 days of treatment:88.0％(22/25)vs.60.0％(15/25),both P<0.05],and the prealbumin level was significantly higher in the pectin group than in the control group at the end of 7 days treatment(mg/L:248.08±43.99 vs.221.64±33.95,P<0.05).There was no statistically significant difference in the comparison of GCS score,APACHEⅡ score,SOFA score,PCT,IL-6,CRP,length of ICU stay,and 28 days mortality between the two groups after treatment.Conclusion The administration of semi-solidification enteral nutrition reduces the incidence of enteral nutrition intolerance,improves caloric intake and nutritional status in neurocritical patients,but has no significant effect on infection indicators and prognosis.