Objective To understand information on cognitive and demand of chronic kidney disease(CKD) patient to contin‐uing nursing .Methods Adopting stratified random sampling method took samples 200 CKD patiens who were treated at kidney disease of internal of general hospital form March to June 2014 .Self‐made questionnaire was used to survey cognitive and demand of chronic kidney disease patient to continuing nursing .Results Totally 200 questionnaires were gave out and 184 of them were taken back ,efficient rate is 92% .First ,cognition :10 .32% CKD patiens knew the meaning of continuing nursing ,9 .24% CKD patiens knew the content of continuing nursing ,12 .50% CKD patiens knew the role of continuing nursing .Second ,demand :65 .76% -95 .11% CKD patiens had demand on disease treatment knowledge ,individual diet guidance ,regular telephone follow‐up ,and regular follow‐up nurse ;38 .04% - 53 .26% CKD patiens had urgent demand on individual diet guidance ,free health consultation ,and regu‐lar follow‐up nurse ;28 .89% CKD patiens had demand on electronic health record .Conclusion The cognitive of CKD patiens to continuing nursing is low and the demand is high .Hospital should to actively develop the continuation of local nursing service .

Objective To develop a humidification fluid dropping joint for the breathing machine to solve the problems in humidification fluid retension,pipeline leakage,pipeline fixation and etc.Methods A Infusion extension tube was involved in with 10 cm length left at the injector end.A hole was made at the side wall of the L-shaped joint of the breathing machine,whose internal diameter equaled to the external diameter of the extension tube.The extension tube was put into the joint through the hole,and the depth of imbedded tube was within 4 and 6 cm.Sealing and fixation at the connection between the tube and hole were executed with 502 glue and short tourniquet.Results The humidification fluid dropping joint could be connected with infusion apparatus of the pump or the infusion extension tube of the micro pump,which behaved well in eliminating accumulated humidification fluid,sputum suction,humidification and facilitating mechanical ventilation.Conclusion The joint developed gains advantages in easy manufacture,reducing complications and increasing the dependence on artificial airway,and thus is worthy promoting clinically.

This paper reviewed recent advances in clinical and basic researches of scalp acupuncture based on evoked potentials (EPs).The role and significance of various EPs in scalp acupuncture were analyzed and compared.Eventrelated potentials (ERPs) which occupied leading position in EPs application nowadays and the latest advances in the related components of its action were combined to make a prospect of the scientific research methods of scalp acupuncture in the treatment of cerebral apoplexy and other diseases.

OBJECTIVE: To explore the effects of Xuezhikang Capsules (ZXKC) and probucol on blood lipids, vascular endothelial functions and redox status in patients with coronary heart disease. METHODS: One hundred and twelve patients with coronary heart disease were randomly divided into XZKC-treated group and probucol-treated group, 56 in each. Before and after 8-week treatment, the blood levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), nitric oxide (NO), endothelin-1 (ET-1), reduced glutathione (GSH) and oxidized glutathione (GSSG) were all measured in both groups. The GSH/GSSG redox potential (Eh) was calculated according to the Nernst equation. RESULTS: In the XZKC-treated group, the blood levels of TC, LDL-C and TG were significantly decreased after 8-week treatment as compared with those before treatment. The blood levels of TC and LDL-C were also significantly decreased in the probucol-treated group as compared with those before treatment. In the XZKC-treated group, the blood levels of ET-1 and GSSG and the GSH/GSSG Eh after treatment were all significantly lower than those before treatment, whereas the blood levels of GSH and NO, the NO/ET-1 ratio, and the GSH/GSSG ratio after treatment were all significantly higher than those before treatment. CONCLUSION: The XZKC or probucol treatment can yield a significant decrease in blood lipids in patients with coronary heart disease. Furthermore, XZKC exerts effective protection on vascular endothelial function, and can make GSH/GSSG redox status shift towards deoxidation.

Objective To determine LDLR gene mutation in 2 clinically diagnosed FH patients from Hubei province and provide basis for gene diagnosis of FH.Methods Clinical data of 2 FH patients and their parents were collected.The promoter region and exon 1 to exon 18 region of LDLR gene were amplified through PCR and the amplified products were analyzed by forward and reverse DNA sequencing.The mutations were identified after comparison with LDLR gene sequence in GenBank.The pathogenic gene mutations were confirmed according to both genotype and phenotype of FH probands.Results The levels of plasma TC of two probands were 12.79 and 11.98 mmol/L.respectively.No gene mutations were detected in region 3 500 to 3 531 of ApoB100. The mutations of LDLR gene were compound heterozygous mutations. The novel mutation 665G > T detected in the exon 4 of No. 1 proband's LDLR gene was heterozygous missense mutation. The novel mutation 1 358 +32C > T was detected in the exon 9 of No. 1 proband's LDLR gene.The mutations 665G > T ( paternal origin) and 1 358 + 32C > T ( maternal origin) were inherited from the parents. A novel mutation 1 257 C > A was detected in the exon 9 of No. 2 proband's LDLR gene, resulting the presence of a premature termination codon, which was different from 1 257 C > G reported in Belgium.Another heterozygous missense mutation 1 879 G > A was detected in exon 13. They were derived from paternal origin and maternal origin, respectively. Conclusions There are three novel gene mutations:665G >T, 1 358 +32C > T, 1 257C > A found in two probands with compound heterozygous mutations in LDLR respectively. They maybe play a potential role in FH pathogensis.

This study was aimed to explore the immediate effect mechanism of the middle 2/5 of the vertex-temporal anterior oblique line in the treatment of stroke by scalp acupuncture using event-related brain potential (ERP).A total of 30 stroke cases who met the inclusion criteria and 25 healthy subjects were selected.Patients in both groups were treated by scalp acupuncture,with stimulation on the middle 2/5 of the vertex-temporal anterior oblique line on the right side.ERP was detected before acupuncture and 10 min after acupuncture in both groups.The muscle strength and neurological deficit score of the stroke group were also detected.At the end of the experiment,the movement-related cortical potentials (MRCPs) of both the left and right hand were extracted from the ERP.The results showed that after 10 min scalp acupuncture stimulation,the neurological deficit score of the stroke group was lower than that of the pretreatment (P ＜ 0.05);the muscle strength rating was higher than before (P ＜ 0.05).Before and after acupuncture,the amplitude of MRCPs on the diseased side of the stroke group was significantly decreased compared to before (P ＜ 0.05).It was concluded that the immediate effect of scalp acupuncture treatment of hemiplegia patients with stroke was definite.Its mechanism may be that acupuncture stimulates the motor cortex through the vertex-temporal anterior oblique line,reduces the energy loss of brain motion planning,activates the damaged brain movement related area cortex neurons,improves the processing efficiency of movement in the brain,so as to promote the improvement of hemiplegic limb motor function immediately.And we also observed that the healthy side brain has a compensatory effect,which suggested that in our clinical scalp acupuncture,bilateral stimulation may be more effective.

Complex systems exist widely,including medicines from natural products,functional foods,and bio-logical samples.The biological activity of complex systems is often the result of the synergistic effect of multiple components.In the quality evaluation of complex samples,multicomponent quantitative analysis(MCQA)is usually needed.To overcome the difficulty in obtaining standard products,scholars have proposed achieving MCQA through the"single standard to determine multiple components(SSDMC)"approach.This method has been used in the determination of multicomponent content in natural source drugs and the analysis of impurities in chemical drugs and has been included in the Chinese Pharmacopoeia.Depending on a convenient(ultra)high-performance liquid chromatography method,how can the repeatability and robustness of the MCQA method be improved?How can the chromatography conditions be optimized to improve the number of quantitative components?How can computer software technology be introduced to improve the efficiency of multicomponent analysis(MCA)?These are the key problems that remain to be solved in practical MCQA.First,this review article summarizes the calculation methods of relative correction factors in the SSDMC approach in the past five years,as well as the method robustness and accuracy evaluation.Second,it also summarizes methods to improve peak capacity and quantitative accuracy in MCA,including column selection and two-dimensional chromatographic analysis technology.Finally,computer software technologies for predict-ing chromatographic conditions and analytical parameters are introduced,which provides an idea for intelligent method development in MCA.This paper aims to provide methodological ideas for the improvement of complex system analysis,especially MCQA.

Objective To evaluate the effect of transcutaneous neuromuscular electrical stimulation on prevention of intensive care unit-acquired weakness (ICU-AW) in chronic obstructive pulmonary disease (COPD) patients with mechanical ventilation. Methods A prospective randomized controlled study was conducted. Sixty COPD patients aged 18-85 years old who were accepted mechanical ventilation therapy admitted to general intensive care unit (ICU) of the First Affiliated Hospital of Hunan University of Medicine from October 2017 to October 2018 were enrolled. Patients were divided into control group (n = 30) and intervention group (n = 30) by random number table method. All patients were accepted routine treatment, and on this basis, the intervention group was applied transcutaneous neuromuscular electrical stimulation on the extremities (twice a day, 30 minutes each time) after 24 hours of admission until ICU discharge. The Medical Research Council muscle strength score (MRC-Score), grip strength, incidence of ICU-AW on the 7th day after admission and on the day of ICU discharge; modified Barthel index score on the day of ICU discharge; and duration of mechanical ventilation, the length of ICU stay, and the length of hospital stay were compared between the two groups. Results Twenty-nine and 27 patients in the control group and the intervention group respectively finally completed the study in dividually. There was no significant difference in gender, age, Barthel index score before 2 weeks of ICU admission, body mass index or acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) in ICU between the two groups. There was no significant difference in the MRC-Score, grip strength or incidence of ICU-AW on the 7th day after ICU admission between the two groups. Compared to the control group, the MRC-Score, grip strength and Barthel index score in the intervention group were significantly increased [MRC-Score: 55.97±8.43 vs. 46.32±7.36, grip strength (kg): 33.46±11.62 vs. 27.42±9.64, Barthel index score:46.04±5.46 vs. 42.13±3.32, all P < 0.05], the incidence rate of ICU-AW was significantly decreased [7.4% (2/27) vs. 31.0% (9/29), P < 0.05], and duration of mechanical ventilation, the length of ICU stay, the length of hospital stay were significantly shortened [duration of mechanical ventilation (days): 5.12±2.01 vs. 7.24±4.35, the length of ICU stay (days): 8.34±2.36 vs. 10.45±2.62, the length of hospital stay (days): 13.21±2.21 vs. 15.38±3.67, all P < 0.05]. Conclusion Transcutaneous neuromuscular electrical stimulation can effectively improve the muscle strength of COPD patients with mechanical ventilation and reduce the incidence of ICU-AW.

Spontaneous intracranial hypotension can frequently result in several complications including subdural hygroma, subdural hematoma and cerebral venous thrombosis, but coma rarely. A case of spontaneous intracranial hypotension presented with orthostatic headaches was described. He experienced somnolence, disorientation, incontinence, and then coma, though received conservative treatment. Brain imaging demonstrated acute-on-chronic subdural hematoma, magnetic resonance myelography using heavily T 2-weighted fast spin-echo pulse sequences showed spinal longitudinal extradural collection, and magnetic resonance myelography with intrathecal gadolinium revealed cerebrospinal fluid leak at the level of T 6, T 7. The patient recovered consciousness after surgical evacuation of the hematoma, and the headache disappeared after a targeted epidural blood patch. The hematoma resolved 2 months later and the patient kept free from headache during follow-up.

Objective:To investigate the factors affecting the accuracy of electronic portal imaging device (EPID)-based in vivo dose verification in radiotherapy for patients with lung and esophageal cancers, and to recommend the workflow and specifications for the application of the in vivo dose verification. Methods:This study randomly selected 32 patients who received radiotherapy for esophageal and lung cancers at the Department of Radiation Oncology, Jinhua Municipal Central Hospital from May to August 2022, including 14 lung cancer cases and 18 esophageal cancer cases. Using a uRT-linac 506c linear accelerator, these patients were treated according to the dynamic intensity-modulated radiotherapy (dIMRT) and EPID-based In vivo dose verification ( In vivo EPID) plans developed with the uRT-TPOIS planning system. The In vivo dose verification performed during the treatment included 238 fractions of In vivo EPID and 80 fractions of image-guided radiotherapy (IGRT) for the lung cancer cases, as well as 414 fractions of In vivo EPID and 105 fractions of IGRT for the esophageal cancer cases. The 2D γ passing rate for each irradiation field was obtained according to the set threshold value. Furthermore, fractioned irradiation fields with γ-passing rates below the threshold value were analyzed, and primary factors decreasing the γ-passing rate were further analyzed by combining the online CT images and 3D reconstruction-derived dose. Results:For lung and esophageal cancers, the mean γ-passing rates were 95.1% ± 5.7% and 96.5% ± 4.5%, respectively at 3 mm/5%; 91.5% ± 8.4% and 92.2% ± 4.9%, respectively at 3 mm/3%, and 79.1% ± 14.7% and 83.7% ± 8.2%, respectively at 2 mm/2%, indicating no statistically significant differences between two cancers ( P > 0.05). The average γ passing rate for beam orientations near 0°/180° (Group A) was higher than those near 90°/270° (Group B) 3 mm/5%: Z = -25.4, P < 0.05; 3 mm/3%: Z = -26.8, P < 0.05). The IGRT correction of setup errors significantly improved the γ passing rates (96.3% ± 5.1% and 96.4% ± 4.9%, respectively at 3 mm/5%, Z = -5.50, P < 0.05; 92.3% ± 8.0% and 91.3% ± 7.7%, respectively at 3 mm/3%, Z = -9.54, P < 0.05). The results of In vivo dose verification were affected by changes in the volumes and motion of tumors and normal tissues, radiotherapy positioning, and adequacy of pre-treatment preparation. Conclusions:EPID-based In vivo dose verification during radiotherapy can avoid incorrect irradiation. However, it is necessary to standardize the workflow of the EPID-based In vivo dose verification to avoid the decrease in the γ passing rate caused by artificial factors.