Objective:To analyze the current situation of fear, discharge preparation, family function and quality of life of breast cancer patients during chemotherapy, and to explore the influence of fear, discharge preparation and family function on their quality of life by constructing structural equation model.Methods:A total of 274 patients with breast cancer undergoing chemotherapy in Shanxi Cancer Hospital from January to July in 2019 were investigated with Quality of Life Instruments for Cancer Patients-Breast Cancer(QLICP-BR), Fear of Progression Questionnaire-Short Form(FoP-Q-SF), Readiness for Hospital Discharge Scale(RHDS) and Family APGAR Index(APGAR).Results:The total score of the quality of life was 137.78 ± 21.66, the total score of recurrence fear was 34.61±12.36, the total score of discharge preparation was 95.57±18.83, and the total score of family function was 7.53 ± 2.66. The structural model showed that fear, family function and discharge preparation had a direct predictive effect on quality of life, the direct effects were -0.468, 0.331 and 0.509, respectively ( P<0.01); fear had an indirect negative predictive effect on quality of life through the mediation of discharge readiness ( β value was -0.127, P<0.01), and family function had an indirect positive effect on quality of life through the mediation of discharge preparation. The predictive effect was ( β value was 0.124, P<0.01). Conclusions:Fear, discharge preparation and family function are important factors affecting the quality of life of breast cancer patients undergoing chemotherapy. Fear and family function can also indirectly affect the quality of life through discharge preparation.

Objective To study the clinicopathological characteristics,diagnosis and prognosis of anaplastic large cell lymphoma,lymphohistiocytic variant(ALCL-LH).Methods Two cases of ALCL-LH were diagnosed according to the WHO standard of lymphoma classification.Their clinical manifestations were analyzed.Lymphoma sample sections were prepared for pathological features and immunohistochemical assays,and examined by in situ hybridization for Epstein-Barr virus(EBV)DNA.Concerning literatures were reviewed.Results Both 2 cases occurred in children.The clinical manifestations presented with fever and enlarged lymph nodes as well as hepatomegaly and splenomegaly.Microscopically,the neoplastic cells,with irregular nuclei,were more often medium to large in size but smaller than those in the common type,and sparsely intermixed with a large number of histiocytes and lymphocytes that exceeded and masked the tumor cell population.The tumor cells clustered around blood vessels.Case 1 showed evidence of erythrophagocytosis.Immunohistochemical stainings showed that tumor cells of 2 cases were positive to CD30,anaplastic lymphoma kinase(ALK),EMA,and Granzyme B,as well as case 1 to CD43,and case 2 to CD7.But both cases were negative to CD45,CD2,CD3,CD4,CD5,CD8,CD45RO,CD56,CD20,CD79a,CD15,MPO,CK,TdT,and LMP1.In addition,the EBV DNA was not detected in the lymphoma.Case 1 and case 2 died 10 d and 3 months after pathological diagnosis respectively.Conclusion ALCL-LH variant is rare subtype,and often occurs in pediatric patients.Morphologically,ALCL-LH is characterized by a few medium to large size cells admixed with a large number of histiocytes and lymphocytes that exceed and mask the tumor cell population.The expressions of CD30,ALK,EMA and cytotoxic granule associated proteins contribute to diagnosis and differential diagnosis.

Objective To study early face processing of mild cognitive impairment patients by using ERP method．Methods Sixteen healthy old man(normal group)and sixteen mild cognitive impairment patients(MCI group)served as subjects in experiment．Two runs of 300 stimuli(duration：50ms)of 3 facial and 3 non-facial pictures were randomly presented with equal probability(ISI：from 1000ms to 1500ms randomly)，and the subjects were asked to react to facial stimuli and non-facial stimuli by pressing the left button and risht button respectively as quickly as possible．Thirty-two channels electroencephalogram(EEG)Was recorded by Neuroscan Nuamps Systern．Results 1)Specific-face component N170 was found in both groups．Which was distributed at the temporal-occipital region．2)Compared with N170 in normal group，N170 amplitude Was significantly lower((-4．42±0．28)Μv vs(-7．00±0．28)Μv，F=41．52，P<0．01)at temporal-occipital region and delayed((158．91±2．17)ms vs(140．97±2．17)ms，F=34．09，P<0．01) in mild cognitive impairment group．Conclusion The early face processing mechanism of mild cognitive impairment patients may be different from normal people．

Objective:To visually analyze the general situation and development of pre-oxygenation research abroad, and provide a reference for further development of pre-oxygenation in China.Methods:Using the WOS core data set as the data source, CiteSpace V software was used to visually analyze the literature published from January 1, 2000 to November 29, 2019.Results:The number of papers has shown a rapid upward trend since 2013, the US has the most papers. Research hotspots mainly focus on tracheal intubation, intensive care unit, apnea oxidation, non-invasive ventilation and complications.Conclusion:The United States is in the leading position in the study of pre-oxygenation, and China is still in the initial stage in the study of pre-oxygenation. We should strengthen cooperation and exchange with developed countries such as Europe and America. The application of pre-oxygenation outside the operating room and the selection of pre oxygenation tools are the direction of further research.

Objective To investigate an effective method of breathing apparatus management. Methods According to the defect in process of breathing machine management, breathing apparatus management center was set up, related standards and procedures were established, the staff training was intensified and the management mode was expanded. Results The qualified rate of ventilator sterilization and breathing apparatus function were improved to 100% by applying zero defect quality management. Conclusion It is an effective method to ensure the safety and accuracy in breathing machine manage- ment with applying zero defect quality management.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with congenital cataracts. METHODS: Clinical data and peripheral blood samples were collected for the pedigree. Following extraction of genomic DNA, whole exome sequencing was carried out to detect genetic variants. Candidate variants were verified by familial co-segregation analysis and Sanger sequencing. Bioinformatics analysis was carried out to predict the function of mutant genes. RESULTS: By comparing variants identified among affected and unaffected individuals, a heterozygous variant, c.110 G>C (p.R37P), was identified in exon 2 of the CRYGC gene among all patients, which also matched the criteria for potential disease-causing mutations. The result was confirmed by Sanger sequencing. CONCLUSION The c.110G>C variant of the CRYGC gene probably underlay the congenital cataracts in this pedigree.
Asian Continental Ancestry Group ; Cataract ; congenital ; genetics ; China ; Heterozygote ; Humans ; Mutation ; Pedigree ; gamma-Crystallins ; genetics

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective To explore the influence of dexmedetomidine combined with sufentanil on postoperative analgesia effect and immune function for patients undergoing lower limb fracture surgery. Methods One hundred cases patients of lower limb fracture undergoing open reduction and internal fixation of elective surgery in our hospital from January 2016 to November 2016 were selected ( ASAⅠ-Ⅱgrade, male 51 cases and female 49 cases, 30-65 years old, 50-75 kg). All cases were randomly divided into sufentanil group (Group S) and dexmedetomidine combined with sufentanil group (Group DS) according to the random number table, who used patient-controlled intravenous analgesia (PCIA). The PCIA drug formulations of two groups were as followings: sufentanil group (Group S) used 3 μg/h sufentanil+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;dexmedetomidine combined with sufentanil group (Group DS) used dexmedetomidine 0.1μg/(kg · h)+sufentanil 2μg/h+ondansetron 16 mg, dissolved in 0.9%sodium chloride injection 100 ml;background infusion rate was 2 ml/h, and loading dose was 2 ml. Dose for patient-controlled analgesia (PCA) was 0.5 ml, and locking time was 15 min. The changes of pain, MAP, HR , sedation scores were recorded at 4 h (T1), 8 h (T2), 24 h (T3) and 48 h (T4) after operation; nausea and vomiting, hypotension, bradycardia, respiratory depression and other adverse reactions were aslo recorded at the same time. At 10 min before induction of anesthesia (T0) and T1-T4 after operation, the CD3+, CD4+, CD8+and NK cell activity of peripheral blood T lymphocyte subsets were determined using flow cytometry, and CD4 +/CD8 + ratio was calculated. Results The levels of MAP and HR in DS group at each time point after operation were lower than those in group S (P<0.05), the level of visual analogue score (VAS) in DS group at different time points were significantly lower than those of s group: (1.8 ± 0.3) scores vs. (2.5 ± 0.5) scores, (1.1 ± 0.5) scores vs. (1.9 ± 0.3) scores, (1.0 ± 0.5) scores vs. (1.8 ± 0.5) scores, (0.8 ± 0.3) scores vs. (1.5 ± 0.6) scores (P < 0.05), Ramsay Sedation score was significantly higher than that of s group: (3.5 ± 0.3) scores vs. (2.4 ± 0.6) scores, (3.3 ± 0.5) scores vs. (2.5 ± 0.3) scores, (3.5 ± 0.6) scores vs. (2.3 ± 0.5) scores, (3.2 ± 0.4) scores vs. (2.2 ± 0.5)scores (P<0.05);nausea and vomiting occurred in two patients after the operation of group DS , which was significantly lower than that of S group (P<0.05);compared with those at T0, CD3+, CD4+, CD4+/CD8+and NK cells in the two groups of patients decreased significantly at the time of T1-T4 (P<0.05);The levels of CD3+, CD4+, CD4+/CD8+and NK cells were significantly higher in group DS at T1- T4 than those in group S(P < 0.05). Conclusions Dexmedetomidine combined with sufentanil for analgesia in patients with lower limb fracture surgery has better effect. It decreases the incidence of nausea and vomiting, and improves the cellular immune function of patients.

Objective To redesign the clinical nursing post by scientific method and formulate a post description for ICU nurses. Methods The methods of data analysis, observation and interview were used to make a questionnaire for ICU nurses′ post in one general tertiary-level hospital, opinions of 15 experts were filtered by Delphi method from two rounds of questionnaires. Results Finally, 9 types nursing posts had been confirmed, and we studied out 9 post job descriptions. The experts′authority coefficient was 0. 84 while the had a good expert′s opinion coordination coefficient with 0. 36 (P<0. 05). Conclusions Experts′ opinions on the description of ICU clinical nursing post were concentrated and had high re liabilities in this study. It is consistent with the clinical practice and can provide foundations which includes work training, post evaluation and performance evaluation for ICU staffs.

Objective To apply the best evidence of airway clearance for ICU patients and promote an application of the best evidence in clinical practice to promte nuring quality.Methods The best evidence of airway clearance for ICU patients was summarised.Based on the best evidence,a system of 11 review indicators was established for clinical baseline review in combination with clinical scenario analysis and professional judgment according to the principle of operability,measurability,and understandability.On the basis of the results of review and the analysis of obstacle factors,strategies of airway clearance for ICU patients were proposed and implemented in clinical practice.Between September and December 2022,72 hospitalised patients and 30 nursing staff in the ICU of a general hospital in Wuhan were recruited in the study.Between September and October 2022,routine nursing care for airway clearances was given to the patients,and evidence-based nursing care for airway clearance was offered to the ICU patients between November and December 2022.Clinical pulmonary infection score,nursing staff's knowledge of airway clearance and implementation rate of review indicators were compared before and after the application of evidence-based nursing.Results All of the patients went through the study.After the application of evidence-based nursing practice,the clinical pulmonary infection score was decreased from(4.94±1.66)to(4.14±1.68).The score of airway clearance knowledge was increased from(49.17±9.38)points to(82.17±10.56)points.The implementation rate of the 11 indicators of evidence-based practice before the evidence-based practice was 0～80.00%,and it was significantly improved up to 96.67%～100.00%after the evidence-based practice(all P<0.05).Conclusion Implementation of evidence-based nursing practice in the airway clearance for ICU patients can reduce clinical pulmonary infections in ICU patients,improve the knowledge of nurses in cognition of airway clearance hence to improve the quality of nursing and promote the recovery of patients.