Objective To build emergency specialist nurse training evaluation index system model.Methods By Delphi method,21 emergency care specialists participated in the consultation,using the Analytic Hierarchy Process (AHP)to build a hierarchical model,establishing judgment matrix,through statistical calculations to determine the indicators and weight coefficients of the index system of emergency specialist nurse training.Results Four first-level indicators,11 second-level indicators,31 third-level indicators emergency specialist nurse training evaluation system model were established.Conclusions Establishment of emergency nurse specialist training evaluation index system provides an effective method and reference to improve the overall capacity of the emergency specialist nursing team to ensure the quality of training of emergency nurse specialists.

Objective To study the relationship between ammonia concentration levels,Child class in cirrhotic patients with helicobacter pylori(Hp) infection and to observe the Hp eradication effect on ammonia.Methods Group A was consisted of 49 cases of cirrhotic patients with Hp infection.Group B included 46 cirrhotic patients without Hp infection.Group C was non-cirrhotic patients with helicobacter pylori infection.Each patient in all three groups was compared with change in serum ammonia concentration before and 4 weeks after Hp eradication therapy.Results The serum ammonia concentration in group A was significantly higher than group B and group C(P0.05).In group A,the serum ammonia concentration was increased as Child classification from A to C(P

Objective To analyze the proportion of HPV infection among the patients in the gynecology and obstetrics department and urology surgery department of our hospital,distribution of HPV high risk and low risk subtypes and distribution characteristics of high risk HPV predominant subtypes in various age groups,and to understand the HPV infection situation in this area to provide reference for the prevention of cervical cancer and vaccine development aiming at this area.Methods The cervical exfoliated cells in 889 female patients in our hospital during 2014-2015 were detected by PCR reverse spot hybrid technology,26 HPV subtypes were detected,including 17 high-risk subtypes and 9 low-risk subtypes.Results Among 889 cells samples,168 cases of HPV positive were detected with the positive rate of 18.9%,which was dominated by single infection,148 cases of high-risk subtypes were detected,accounting for 84.5% of the total number of positive cases.24 kinds of HPV subtypes were detected.High risk subtype HPV45 and low risk subtype HPV57 were not detected.The top HPV high-risk subtypes in the detection rates were HPV52,HPV16 and HPV58,in young and middle-age women,HPV16 and HPV52 were predominant infection subtype,accounting for 84.5% of total positive cases.Women >60 years old were mainly infected by HPV58.Conclusion Different subtypes of vaccine can be developed and adopted according to these study results and by aiming at different ages for preventing and treating cervical cancer and increasing the female health level.

The beta-secretase is one of prospective targets against Alzheimer's disease (AD). A three-dimensional quan titative structure-activity relationship (3D-QSAR) model of Hydroethylamines (HEAs) as beta-secretase inhibitors was established using Topomer CoMFA. The multiple correlation coefficient of fitting, cross validation and external validation were r2 = 0.928, q(loo)2 = 0.605 and r(pred)2 = 0.626, respectively. The 3D-QSAR model was used to search R groups from ZINC database as the source of structural fragments. As a result, a series of R groups with relatively high activity contribution was obtained to design a total of 15 new compounds, with higher activity than that of the template molecule. The molecular docking was employed to study the interaction mode between the new compounds as ligands and beta-secretase as receptors, displaying that hydrogen bond and hydrophobicity played important roles in the binding affinity between the new compounds and beta-secretase. The results showed that Topomer CoMFA and To pomer Search could be effectively used to screen and design new molecules of HEAs as beta-secretase inhibitors, and the designed compounds could provide new candidates for drug design targeting AD.
Amyloid Precursor Protein Secretases ; antagonists & inhibitors ; Drug Design ; Hydrophobic and Hydrophilic Interactions ; Ligands ; Molecular Docking Simulation ; Quantitative Structure-Activity Relationship

OBJECTIVE:To observe the clinical efficacy of acupoint application of antiemetic cream in the treatment of che-motherapy-induced nausea and vomiting. METHODS:90 cases of non-small cell lung cancer(NSCLC)(stage Ⅱ to Ⅲ)treated by chemotherapy(taxol+cisplatin)were randomly divided into antiemetic cream group,Weifuan group and control group,with 30 cas-es in each groupby drawing lots. Control group was given intravenous injection of ondansetron hydrochloride 8 mg 30 min before chemotherapy;antiemetic cream group was additionally given acupoint application of antiemetic cream 30 min before medication on first-forth day on the basis of control group;Weifuan group was additionally given acupoint injection of metoclopramide(brand name:Weifuan) 30 min before medication on first-forth day on the basis of control group. The clinical efficacy of 3 groups were observed during and 3 days after chemotherapy. RESULTS:After chemotherapy,the total control rates of antiemetic cream group (93.33%)and Weifuan group(90.00%)were apparently higher than the control group(66.67%),with statistical significance(P<0.01 or P<0.05);The total effective rates of TCM syndrome in antiemetic cream group (90.00%) and Weifuan group(83.33%) were apparently higher than in control group(60.00%),with statistical significance(P<0.01 or P<0.05). Therapeutic efficacy of antiemetic cream group was similar to Weifuan group,without any statistical significance(P>0.05). However,8 patients had obvi-ously pain at the injection site in Weifuan group,but tolerated to the drugs basically. CONCLUSIONS:The acupoint application of antiemetic cream combined with intravenous injection of ondansetron is effective and easy to operate in the treatment of nausea and vomiting induced by chemotherapy for stage Ⅱ to Ⅲ of NSCLC without pain,scar and sequela,and easy to be accepted by patients.

Objective To establish the weights of risk factors indicators for lower limbs deep vein thrombosis through the scientific research methods.Methods 21 experts were consulted for two rounds of questionnaires survey with Delphi method,according to the experts'opinion,analytic hierarchy process (AHP) was used to calculate the weights of indicators in grade one and the experts'evaluation was used to calculate the weights of indicators in grade two.Results The weight coefficients of grade one including vascular endothelial injury,blood high condensation state and slow blood stream were 0.3325,0.5278 and 0.1396 respectively.The items with maximal weights of the 21 indicators in grade two was vascular trauma,in particular vein injury(0.0770).The Kendall's W of the indicators in grade two was 0.422.Conclusions Through qualitative and quantitative research methods,the risk factors indicators which provide the reference for the prevention of lower limbs deep vein thrombosis are scientific and reliable.

Objective To discuss the effect of neonatal congenital hypothyroidism (CH)screening in preterm infants.Methods The result of 208 713 cases neonatal congenital hypothyroidism screening in Guangzhou neonatal screening center were analyzed,including 11589 cases preterm infant and 197 124 cases of full term.The difference of screening positive rate and incidence between preterm infants and full term infants group were compared and the efficiency of preterm infants congenital hypothyroidism screening were estimated.Results A total of 208 713 newborns were screened and the screening positive rate was 1.39%.123 cases were confirmed positive for CH and the incidence rate was 1 /1 697.124 cases were screening positive in preterm infants and the screening posi-tive rate was 1.06%.14 cases were confirmed positive for CH and the incidence rate was 1 /828 in preterm infants group.2 771 cases were screening positive in full term infants and the screening positive rate was 1.41%.109 cases were confirmed positive for CH and the incidence rate was 1 /1 809 in full term group.The screening positive rate was lower and the incidence rate of preterm infants group(χ2 =4.89,P <0.05)was higher than that of the full term infants group(χ2 =8.26,P <0.05).Conclusion The incidence rate of congenital hypothyroidism is higher in preterm infants.Neonatal screening is an effective measure for early diagnosis of preterm infants congenital hypothyroidism.

Objective To understand the clinical and molecular characteristics of children with Prader-Willi syndrome (PWS) in South China.Methods Clinical and molecular data of children diagnosed as PWS by Methylation-specific PCR(MS-PCR) and/or Array Comparative Genomic Hybridization(Array-CGH)in Guangzhou Women and Children's Medical Center from November 2012 to November 2014 were analyzed.Results A total of 27 children diagnosed as PWS were included in this study,including 21 cases diagnosed by Array Comparative Genomic Hybridization (Array-CGH) and 13 cases diagnosed by methylation-specific PC R (MS-PCR).Within the 27 cases,13 cases were male(48.1％) and 14 cases were female(51.9％).The age on diagnosis was from 16 days to 16 years old.MS-PCR was performed in 13 cases,7 cases of them also performed Array-CGH,both of them showed a 174 bp fragment from the methylated allele and a 100 bp fragment from the unmethylated allele.Array-CGH analysis was performed in 21 cases,paternal deletion in 18 cases and mean interstitial deletions measure (5.48 ± 0.51) Mb in size,paternal duplication in 2 cases,loss of heterozygosity measure approximately 79.58 Mb in 1 case.Eighteen simple chromosome deletion cases were divided into 6 Del Ⅰ and 12 Del Ⅱ according to the location of Array-CGH and query the database to DECIPHER(Database of Chromosomal Imbalance and Phenotype in Humans Using Ensembl Resources).The major phenotype included central hypotonia and feeding difficulty in all cases (100.0％),hypogonadism in 25 cases (92.6％),weak crying in 22 cases(81.5％),and hypopigmentation in 22 cases(81.5％).Fourteen cases beyond 1 year old had varied degrees of development disability and behavioral and psychiatric disturbance:speech articulation defects in 13 cases(92.9％),hyperphagia and weight gain too fast in 13 cases(92.9％) when they were between 1 to 6 years old[(2.80 ± 1.32) years old],and obesity in 12 cases (85.7％).Conclusions For PWS children in South China,there is no statistically significant difference in the clinical manifestation between Del Ⅰ and Del Ⅱ.PWS children in South China have typical clinical characteristics,which can be used as a further screening indication to implement molecular diagnostics.

Objective To investigate the clinical efficacy and adverse events of methimazole ( MMI ) treatment for children with hyperthyroidism, and to identify the predictors of remission and relapse. Methods A total of379children(260girlsand119boys)diagnosedwithhyperthyroidismandtreatedbyMMIinGuangzhouWomenand Children's Medical Center from March, 2004 to July, 2014 were retrospectively analyzed. The average age at diagnosiswas(9.3±2.3)years(range2.0~15.9years). Results AftertreatmentwithMMIfor3and6months, the thyroid functions of 96. 3%(365/379) and 98. 9%(375/379) patients returned to normal, respectively. By the end of this study, 256(67. 5%) patients continued to use MMI treatment and 44 patients(11. 6%) dropped out. 79 patients(20. 8%) achieved remission, 35 patients (44. 3%) of whom experienced a later relapse. Children who achieved constant remission had significantly lower FT3 and FT4 levels at diagnosis compared with the relapsed children(P<0. 05 or P<0. 01). It was more likely to remain long-term remission for children turned to be euthyroid within 3 months after initiating MMI treatment(P<0. 05). The relieved patients with family history of thyroid diseases weremorelikelytoberelapsed(P<0.05). Therewerenosignificantdifferencesinage,gender,exophthalmos, initial goiter size, thyroid peroxidase autoantibody, and thyroglobulin antibody levels between the relieved and relapsed patients. The overall incidence of adverse events associated with MMI was 27. 7%, mainly elevated alanine aminotransferase, bilirubin, and neutropenia. Most(66. 7%) of adverse events occurred within the first three months of MMI treatment. Conclusion MMI has a good effect on pediatric hyperthyroidism, with low remission and high relapse rate. The low thyroid hormone concentrations at diagnosis and normalization of thyroid function within three months seem to be useful predictors of remission. Vigilance is needed concerning MMI-associated adverse events throughout the MMI treatment period, especially during the first trimester of MMI initiation.

Objective Multiple carboxylase deficiency(MCD) is an autosomal recessively inherited defect of organic acid metabolism.The underlying mechanism is biotinidase(BT) or holocarboxylase synthetase(HLCS) deficiency.The authors reported 15 cases of MCD(clinical characteristics,diagnosis and treatment) and outcomes of long-term follow-up.Methods The clinical data of 15 patients with MCD admitted to Guangzhou Women and Children's Medical Center between Aug.2001 and Feb.2013 were analyzed.The diagnosis was confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS),blood enzymatic determination and gene analysis.The patients consisted of 12 male and 3 female.The onset age ranged from newborn infants to 16 months.Results 1.Remarkable elevations of urinary lactate,3-oxy-butyric acid,3-OH-isovalerate,methylcitrate,3-methylcrontonylglycine,3-OH-propionate were detected in all of 15 cases.Fourteen cases with HLCS deficiency and 1 case with BT deficiency were confirmed by gene analysis.2.Most of patients with HLCS deficiency presented in the neonatal period or early infancy.The main clinical manifestations were skin rash (14 cases),tachypnea (9 cases),developmental retardation (8 cases),vomiting(5 cases),poor feeding (3 cases),developmental regradation (1 case),convulsion (1 case).Laboratory evaluation showed persistent metabolic acidosis and varied degree of ketosis,lactic acidosis,hyperuricacidemia,ammoniemia and hypoglycemia.Biotin was given to 13 patients in 10 mg/d and their metabolic disorders were corrected within 48 h,except one who gave up treatment and died.Treatment with Biotin in 5 mg/d provided clinical stability and normal neurodevelopmental outcome on follow-up for 3-11 (6.47 ± 2.70) years.3.One patient with BT deficiency presented with severe neurological symptoms(impaired consciousness,limbs trembling,tachypnea with irregular respiratory rhythm) at 16 months old.Demyelination of corpus callosum was evident on magnetic resonance imaging.Biotin treatment was given to him on the second of onset,and 1-year follow-up indicated significant improvement of his clinical symptoms,but the right limb weakness did not completely recover.Conclusions The main clinical features of HLCS deficiency include frequent skin rash,tachypnea,and metabolic disorders.BT deficiency may produce variable neurologic manifestations including demyelination of corpus callosum.Urinary organic acid analysis with GC/MS is critical to the early diagnosis of MCD.Prompt biotin treatment is recommended to correct metabolic derangements and continued therapy is essential to the improvement of long-term prognosis.Delayed commencement of therapy in BT deficiency can result in irreversible neurological damage.