Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

ObjectiveTo inyestigate the effect of miRNA-155 expression on the differentiations and functions of CD4 + T lymphocyte in patients with unstable angina pectoris. MethodsTwenty-one patients with unstable angina pectoris (UAP) were enrolled in this study, and another 18 patients with normal coronary arteries evidenced by angiography were assigned as control group. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression of miRNA-155 in CD4 + T lymphocyte of the peripheral blood. And the levels of IFN-γ and IL-4 in serum were determined by using enzyme-linked immunosorbent assay (ELISA). The CD4 + T lymphocyte were isolated from mononuclear cells prepared with Ficoll-Hypaque density-gradients centrifugation from human peripheral blood by magnetic cell sorting system. Then, the CD4 +T cells (2 × 106 cells/mL) were seeded in culture plates with 6 wells.The CD4 + T lymphocytes were divided into 3 groups in experiment: control group, miRNA-155 group, and miRNA-155 inhibitor group. The numbers of Th1 and Th2 cells were measured by flow cytometry analysis (FACS).The protein levels and expressions of IFN-γRα, T-bet, GATA-3 mRNA were measured by using western blotting and qRT-PCR, respectively. The levels of IFN-γ and IL-4 in culture supernatants of CD4 +T lymphocytes were detected by using ELISA. ResultsIn comparison with the control group, there was significant increase in the expression of miRNA-155 and serum level of IFN-γ in the UAP group (P ＜0. 01 ). There was a positive correlation between miRNA-155 and serum IFN-γ ( r =0. 842, P ＜ 0. 0l ).However, in vitro, the number of Th1, the protein level and expression of T-bet mRNA, and supernatant IFN-γ increased, and the protein level and expression of IFN-γRα protein decreased in miRNA-155 group in comparison with the control group (all P ＜0. 01 ). Interestingly, there were no significant differences in the number of Th2 cells, the expressions of GATA-3mRNA and IFN-γRα mRNA, GATA-3 protein and supernatant IL-4 between control group and miRNA-155 group ( all P ＞ 0. 05 ). And the miRNA-155 inhibitor could attenuate the effect of miRNA-155 effectively. ConclusionsThe miRNA-155 can promote differentiations and improve the function of Thl, playing an important role in the pathogenesis of unstable angina pectoris.

Objective To explore the causes of negtive results on emergency CT and prevent method in craniocerebral trauma.Methods 51 cases of craniocerebral trauma with negtive results on emergency CT were analyzed respectively during 2002 to 2004.Results The causes of negtive results on emergency CT in craniocerebral trauma were:the insufficient experience for technicians and doctors (12.8%);the atypical signs in early phase(48.6%);the delayed lesions after injury(16.2%) and the limitation of CT (24.2%).Conclusion CT technicians and doctors should be well trained primarily. Furthermore, CT images, clinical manifestations and other examinations should be combined with to obtain precise diagnosis. Finally, uncertaint cases should be examined again with CT or MRI.

Objective To examine the effectiveness of simulation newborn simulator in neona-tal resuscitation training for pediatric residents. Methods From June 2011 to June 2012, 11 residents working in neonatal ward of the Third Hospital of Peking University were enrolled into the study. Eval-uation on the residents was made before the training. Training of simulated teaching using simulation newborn simulator was conducted and evaluation was made after the training. SPSS 18.0 was used for statistical analysis. Comparison was made between pre- and post-training test by paired t test. P<0.05 was considered statistical significant. Questionnaire survey was conduct to acquire residents' feedback. Results A total of 11 participants completed the training and finished the questionnaire. The score of pre-training was 37.82±1.17 versus that of post-training 39.18±0.87(t=4.89, P<0.01). All residents were satisfied with the simulation-based training. Conclusion Simulation training can improve pedi-atric residents' knowledge and skills in neonatal resuscitation.

Interleukin-17 (IL-17) plays an important role in the body′s immune response and inflammatory response.High levels of IL-17 are associated with a variety of autoimmune diseases, acute and chronic neurodegenerative diseases, and psychiatric disorders.Autism spectrum disorder (ASD) is a group of common neurodevelopmental disorders in childhood.Recent clinical and experimental studies have linked maternal immune activation (MIA) during pregnancy to the risk of ASD in offspring.Significantly increased IL-17 level is found in MIA-induced progeny ASD, which is the key factor leading to neurodevelopmental abnormalities in progeny mice.This article reviews the latest research progress on the relationship between IL-17 and progeny ASD, and provides new ideas for the prevention and treatment of ASD.

In this study, the natural biological inducer, rat regenerating pancreatic extract (RPE), was used to induce human amniotic mesenchymal stem cells (hAMSCs) into insulin-secreting cells. We excised 60% of rat pancreas in order to stimulate pancreatic regeneration. RPE was extracted and used to induce hAMSCs at a final concentration of 20 microg/mL. The experiment methods used were as follows: morphological-identification, dithizone staining, immumofluorescence analysis, reverse transcription-PCR (RT-PCR) and insulin secretion stimulated by high glucose. The results show that the cell morphology of passge3 hAMSCs changed significantly after the induction of RPE, resulting in cluster shape after induction for 15 days. Dithizone staining showed that there were scarlet cell masses in RPE-treated culture. Immumofluorescence analysis indicated that induced cells were insulin-positive expression. RT-PCR showed the positive expression of human islet-related genes Pdx1 and insulin in the induced cells. The result of insulin secretion stimulated by high glucose indicated that insulin increasingly secreted and then kept stable with prolongation of high glucose stimulation. In conclusion, hAMSCs had the potential to differentiate into insulin-secreting cells induced by RPE in vitro.
Amnion ; cytology ; Animals ; Cell Differentiation ; physiology ; Cells, Cultured ; Humans ; Insulin-Secreting Cells ; cytology ; Mesenchymal Stromal Cells ; cytology ; Pancreas ; physiology ; surgery ; Pancreatic Extracts ; pharmacology ; Rats ; Regeneration

Objective To investigate th grade of CT in colonic diverticulitis and the value in predicting clinical treatment.Methods CT data of totally 41 patients with colonic diverticulitis were analyzed retrospectively.According to the imaging signs,the grading of diverticulitis cases was performed.Patients with level 1 to 3 were considered as only need non-operative treatment,those with level 4 or 5 were considered as need surgical treatment.The consistency of predictive treatment plans were contrasted with clinical practical treatment results.Results The CT features of colonic diverticulitis were saclike protrusions bulged outside of the bowel wall with colon wall thickening in 40 cases (40/41,97.56％) and fuzzy pericolonal fat space in 39 cases (39/41,97.12％).The diagnostic accuracy of preoperative CT grading in predictive treatment plan was 85.37 ％ (36/41).Conclusion Colonic diverticulitis have certain characteristic CT findings.CT grading of diverticulitis is helpful to formulate appropriate clinical treatment.

Objective:To analyze clinical characteristics and genetic characteristics of children with ATP sensitive potassium passage (K ATP-HI). Methods:Forty-five children with genetically confirmed K ATP-HI and their families admitted to Beijing Children′s Hospital of Capital Medical University between February 2002 and December 2018 were selected as the study subjects. A detailed retrospective analysis of the patient's clinical characteristics, diagnosis and treatment process, disease-causing gene carrying status and later follow-up data was performed. ABCC8/KCNJ11 gene was sequenced by second-generation sequencing technology. Results:Among 45 children with K ATP-HI, 34 cases (75.6%) were neonatal onset, the first symptoms of 21 cases (46.7%) were convulsions. 39 cases had been treated with diazoxide, including 12 cases (30.8%) with good efficacy, 16 cases (41%) with poor efficacy and 11 cases with uncertain efficacy. Octreotide was further applied in 18 patients with uncertain or ineffective efficacy after diazoxide treatment, and 13 cases (72.2%) were effective, 3 cases were ineffective, and 2 cases were uncertain. 10 CHI patients who were ineffective to drug treatment or had clearly focal lesions confirmed by 18F-dopa positron emission by computed tomography ( 18F-DOPA PET) scans had undergone surgical treatment, 8 of which underwent partial pancreatectomy and blood glucose returned to normal after the operation; the other 2 cases underwent subtotal pancreatectomy and both had secondary diabetes after operation. Among 45 children with K ATP-HI, 1 case carried both ABCC8 and KCNJ11 mutations, 10 cases carried ABCC8 compound heterozygous mutations, and the remaining 34 cases carried ABCC8/KCNJ11 single genetic mutation. Among them, 21 cases had paternal inheritance, and 3 cases had maternal inheritance, 6 cases were identified with de novo mutations. Conclusions:Diazoxide treatment was ineffective for most K ATP-HI children, but octreotide had a higher effective rate. Partial pancreatectomy for focal type patients had a higher cure rate, and there was a risk of secondary diabetes after subproximal pancreatectomy, so it was very important to clarify the histological type of children before surgery. ABCC8 gene mutations and KCNJ11 gene mutations were the main pathogenic genes of K ATP-HI. Among patients carrying mutations in single ABCC8 or KCNJ11 gene mutation, K ATP-HI inherited by paternity were the majority. Some K ATP-HI children can relieve the hypoglycemia symptoms by themselves.

Objective:To summarize the clinical features, diagnosis, treatment, and outcomes of necrotizing pneumonia(NP)in children, so as to improve the understanding of NP.Methods:Children with NP admitted to the Children′s Medical Center of Hunan Provincial People′s Hospital from December 2012 to June 2020 were selected and divided into respiratory support group(nine cases) and non-respiratory support group(27 cases) according to whether they received respiratory support; and they were also divided into pleural effusion group(28 cases) and non-pleural effusion group(eight cases) according to whether combined with pleural effusion.The clinical data of all children were collected, and the differences between different groups were compared.Results:There were thirty-six children with NP, included 14 boys and 22 girls, with a median age of 30(12, 49) months, and the disease duration was 34(25, 42)days.All children had cough, 34 cases had fever, and the fever peak was 39.5(39.1, 40.0) ℃.Laboratory tests(all peaks) showed that blood white blood cell count was 20.77(15.65, 28.35)×10 9/L, neutrophil count was 15.11(8.52, 20.65)×10 9/L, C-reactive protein(CRP) was 104.00(23.45, 146.50)mg/L, D-dimer was 5.12(1.88, 8.04)mg/L, and lactate dehydrogenase(LDH) was 347.95(284.68, 447.81)U/L.The detection rate of pathogens was 58.33%(21/36), and the most common was Staphylococcus aureus(28.57%, 6/21). Eight cases underwent surgical treatment, including five cases of thoracoscopic surgery and three cases of thoracotomy.All patients improved and were discharged from hospital.The differences in hospital stay, white blood cell count, CRP, procalcitonin and LDH levels between respiratory support group and non-respiratory support group were statistically significant, and the median age, white blood cell count, CRP, D-dimer and LDH between pleural effusion group and non-pleural effusion group were statistically significant(all P<0.05). Further multivariate Logistic regression analysis showed that LDH was a risk factor for NP children receiving respiratory support( P<0.05), the area under the ROC curve of LDH was 0.802, whose the cut-off value was 471.21 U/L.There were no statistically significant differences in the indexes between effusion group and non-pleural effusion group. Conclusion:Children with NP are prone to repeated high fever, high inflammatory markers, and a long course of disease.Staphylococcus aureus is the most common pathogen.Serum LDH≥471.21 U/L is an early independent predictor of respiratory support for NP.

Objective:To summarize the clinical characteristics of children with Mycoplasma pneumoniae pneumonia(MPP) complicated with pleural effusion, and explore the effect of mixed adenovirus infection on children with MPP complicated with pleural effusion.Methods:The clinical data of children with MPP complicated with pleural effusion diagnosed in Children′s Medical Center at the First Affiliated Hospital of Hunan Normal University (Hunan Provincial People′s Hospital) from January 2013 to December 2019 were collected.MPP cases were divided into single infection group and mixed infection group according to whether mixing adenovirus infection.The clinical characteristics were compared between two groups.Results:A total of 180 children with MPP complicated with pleural effusion were included, the male to female ratio was 1.22∶1 (99/81), the age was 66.13 (44.35, 83.98) months, and the most common cases were children over 5 years old (55.56%). The length of hospitalization was 9.00 (7.00, 12.00) days.Fever (93.33%) and cough (98.33%) were the most common clinical manifestations, and mild increases in C-reactive protein, erythrocyte sedimentation rate and D-dimer were the most common laboratory results.Among included children, right pleural effusion was the most common (54.44%), bilateral pleural effusion accounted for 26.67%, and left pleural effusion accounted for 18.89%.Compared with single infection group, the mixed infection group had a longer hospital stay, a higher proportion of oxygen intake, a higher proportion of gamma globulin use, and a higher value of lactate dehydrogenase and aspartate aminotransferase.The results of multivariate Logistic regression analysis showed that compared with single infection group, although the mixed infection group had a higher proportion of gamma globulin use (36.54% vs.10.93%, P<0.05), the length of hospital stay, clinical manifestations, laboratory examination, chest CT and fiberoptic bronchoscopy showed no statistically significant difference between two groups. Conclusion:MPP complicated with pleural effusion is more common in children over 5 years old, especially in the right side.Mild increases of C-reactive protein, erythrocyte sedimentation rate, and D-dimer are more common.The clinical features of MPP complicated with pleural effusion are similar between mixed adenovirus infection group and single infection group.