Objective To investigate the association between nucleotide polymorphisms (rs1569723 in CD40 gene) and clinical characteristics in Kawasaki disease (KD) in Han Chinese children. Methods A case-control study was performed,and 179 children with KD and other 197 normal children served as controls were included. The SNP genotypes were detected using PCR-RFLP, and all data were analyzed by SPSS 19.0. Results It was found that the SNP (rs1569723) was associated with KD (P=0.048), and the frequency of A allele in KD group was higher than that in control group (OR=1.505, 95%CI:1.095-2.070, P=0.012). SNP genotypes were associated with rash and lymphadenopathy (P=0.041, 0.047), but not associated with conjunctival hyperemia, hand-foot edema, oral mucosa lesions, and coronary artery lesion (P=0.688,0.758, 0.557, 0.552). Conclusions Genotypes of SNP (rs1569723) were associated with KD susceptibility, and A-allele is a risk allele. The SNP loci might be associated with rash and lymphadenopathy in KD in Han Chinese.

ObjectiveTo investigate the association of two single nucleotide polymorphisms (SNPs) (rs2736340 and rs2618476) inBLK gene with Kawasaki disease (KD) and coronary artery lesion in Chinese Han children.MethodsIn the case-control study, 179 children with KD were selected and 182 healthy check-up children during the same period were selected as normal controls. The genotypes of two SNPs inBLK gene were detected using PCR-RFLP and the data were analyzed. ResultsThere was no difference in distribution of three genotypes (TT, CT, and CC) of SNP rs2736340 between KD group and control group (P=0.093). However, T allele frequency in KD group was signiifcantly higher than that in control group (P=0.021). The distribution of three genotypes (CC, CT, and TT) of SNP rs2618476 between KD group and control group was signiifcantly different (P=0.021). C allele frequency in KD group was signiifcantly higher than that in control group (P=0.006). The two SNPs inBLK gene were not associated with rash, hand-foot edema and coronary artery lesion (CAL), but SNP (rs2618476) was asso-ciated with oral mucosa lesions (P=0.018).ConclusionsThe SNP (rs2736340) inBLK gene was not associated with KD, but the T-allele was associated with KD. The SNP (rs2618476) was associated with KD in Han Chinese, and was also associated with oral mucosa lesions in KD patients.

Objective:To investigate the current situation with regard to a sense of coherence in major caregivers of enterostomy patients and analyze its relationship with self-efficacy and perceived social support.Methods:From July to December 2019, a total of 118 major caregivers of enterostomy patients were investigated using a general information questionnaire, a self-efficacy scale, and a perceived social support scale.Results:The score of sense of coherence in major caregivers of enterostomy patients was 58.40±9.17, and the average scores of all dimensions, from high to low, were “controllable sense，” “understandable sense，”and “meaningful sense.” Sense of coherence was positively correlated with self-efficacy and perceived social support ( r=0.457, P<0.01; r=0.369, P<0.01). Hierarchical multiple regression analysis showed that self-efficacy and perceived social support had a positive predictive effect on sense of coherence and explained 35.2% of the variance ( R′ 2=0.352, F=25.639, P<0.001). Conclusions:The main caregivers of enterostomy patients had a low level of sense of coherence. Self-efficacy and perceived social support have a positive effect on sense of coherence. Medical staff should take targeted measures to help caregivers improve their self-efficacy and social support system in order to improve their sense of coherence.

Objective:To explore benefit finding and its influencing factors among enterostomy patients.Methods:A total of 120 enterostomy patients were investigated with general information questionnaire, Benefit Finding Scale, Simplified Scale of Resilience and Perceived Social Support Scale.Results:The score of benefit finding among enterostomy patients was 49.44±5.86. Multiple regression analysis showed that education level, self-care, complications, resilience, perceived social support were influencing factors of benefit finding, and explained 51.1% of the variance.Conclusions:The benefit finding among enterostomy patients was grim. It is suggested that clinical staff pay more attention to the patients with low education, poor self-care and complications of stoma, and also pay more attention to the positive psychology and the social support system of patients, guide patients to pay attention to the positive significance of the disease, so as to improve the level of benefit finding.

Objective:To establish a disk (CD) microfluidic chip detection platform for the rapid detection of CALR-1 and CALR-2 mutations in patients with cerebral infarction, and summarize its clinical application value.Methods:Based on microfluidic technology and loop mediated isothermal amplification technology, a CD microfluidic chip detection platform for simultaneous detection of CALR-1 and CALR-2 gene mutations were established, and the sensitivity, specificity, repeatability and accuracy of the platform were verified. A total of 124 patients with cerebral infarction treated in Huashan Hospital, Shanghai Medical College, Fudan University from November 2019 to March 2021 were prospectively selected into the experimental group; and 80 healthy subjects were included in the control group. The CALR-1 and CALR-2 gene mutations in anticoagulant peripheral blood samples were detected by the CD microfluidic chip. Each chip could detect 4 samples at the same time and synchronously detect 3 indexes of each sample. The detection results could be obtained after isothermal amplification for 40 min. At the same time, sequencing method was used to verify the test results, and the consistency of the results of the two detection methods was compared.Results:Using this CD microfluidic chip platform, the synchronous amplification of 3 indexes in the sample could be completed within 40 min without the need of thermal circulation, and the whole detection process of the sample could be completed within 60 min. For samples with a high concentration of target nucleic acid, typical positive signals could be visualized after amplification for 10 min, and the test results would be available within 30 minutes after receiving the samples. The detection sensitivity of CD microfluidic chip method for CALR-1 and CALR-2 mutation load concentration was 1.0% and 0.5% respectively. Nonspecific amplification was not observed for the non-target nucleic acid samples, indicating the high specificity of this method. The coincidence rates of intra and inter batch repeatability were 100% (20/20) respectively. Two samples with CALR gene mutation were found in the cerebral infarction group, both of which were CALR-1 mutations (L367fs*46). There was no CALR-1 or CALR-2 mutation in the control group. The detection results of CD microfluidic chip method were completely consistent with the sequencing verification results (100% [204/204]).Conclusions:The CD microfluidic chip method could be used for the detection of CALR-1 and CALR-2 gene mutations in clinical samples of patients with cerebral infarction. This method has the advantages of high detection sensitivity, good detection specificity, fast detection speed and high detection flux, which is helpful to clarify the etiology of patients with cerebral infarction.

Objective:To investigate the characteristics of fragility fractures of pelvis(FFP) in the elderly and compare the clinical efficacy between conservative treatment and minimally invasive surgery.Methods:A retrospective study was conducted in the 56 elderly FFP patients who had been treated at Department of Orthopaedics, The General Hospital of Chinese People＇s Liberation Army from January 2017 to January 2019. They were 16 males and 40 females, with an age of 73.4 years (from 65 to 93 years). By the American Society of Anesthesiologists (ASA) classification, there were 12 cases of grade Ⅰ, 16 cases of grade Ⅱ, 20 cases of grade Ⅲ, and 8 cases of grade Ⅳ; by the FFP classification, there were 6 cases of type Ⅰ, 10 cases of type Ⅱ, 36 cases of type Ⅲ, and 4 cases of type Ⅳ. The morphological characteristics and injury mechanisms of FFP were analyzed. According to the treatment methods, the patients were divided into a conservative treatment group of 32 cases and a minimally invasive surgery group of 24 cases. The 2 groups were compared in terms of complication incidence, mortality and the Koval attenuation rate of walking ability after one-year follow-up.Results:There were mostly the fractures of pubic branches on both sides of the pubic symphysis and compression fractures of the sacral wing caused by lateral crush injury. The 2 groups were comparable due to no significant differences in the preoperative general data between them other than FFP classification ( P>0.05). By one year after treatment, the conservative treatment group had a complication incidence of 34.4% (11/32), a mortality of 9.4% (3/32) and a Koval attenuation rate of walking ability of 13.8% (4/29) while the minimally invasive surgery group had a complication incidence of 20.8% (5/24), a mortality of 4.2% (1/24) and a Koval attenuation rate of walking ability of 8.7%(2/23), showing no significant difference between the 2 groups ( P>0.05). Conclusions:The injury mechanism of geriatric FFP is mostly lateral compression injury. The fracture sites are mostly located on both sides of the pubic symphysis, pubic branches and the sacral wing of anterior and posterior rings simultaneously. Although there may be no significant difference in complication incidence, mortality or Koval attenuation rate of walking ability between conservative treatment and minimally invasive surgery after one year, the minimally invasive surgery deals with more unstable fracture types.

Objective To analyze the impact of feedforward control nursing intervention on e-mergence agitation and recovery quality in general anesthesia surgery patients.Methods A total of 118 patients undergoing general anesthesia surgery were selected by convenient sampling,and ran-domly divided into control group and observation group,with 59 patients in each group.The control group received routine nursing intervention during emergence anesthesia,while the observation group received feedforward control nursing intervention.The incidence of emergence agitation,recovery quality,pain condition,and nursing quality were compared between the two groups.Results The incidence of emergence agitation during emergence in the observation group was significantly lower than that in the control group(42.37％versus 69.49％,P＜0.05).The Richmond Agitation-Seda-tion Scale(RASS)scores,duration and frequency of agitation were lower or shorter in the observation group than those in the control group(P＜0.05).The observation group exhibited shorter time for spontaneous respiration recovery,eye opening,extubation,full consciousness,and stay in the postan-esthesia care unit compared to the control group(P＜0.05).The Steward emergence score was higher in the observation group(P＜0.05).The postoperative pain score was lower,while nursing quality score was higher in the observation group than those in the control group(P＜0.05).Conclusion Feed-forward control nursing intervention can reduce the incidence of emergence agitation in general anesthesia surgery patients,improve recovery quality,alleviate postoperative pain,and enhance nursing quality.

Objective To analyze the impact of feedforward control nursing intervention on e-mergence agitation and recovery quality in general anesthesia surgery patients.Methods A total of 118 patients undergoing general anesthesia surgery were selected by convenient sampling,and ran-domly divided into control group and observation group,with 59 patients in each group.The control group received routine nursing intervention during emergence anesthesia,while the observation group received feedforward control nursing intervention.The incidence of emergence agitation,recovery quality,pain condition,and nursing quality were compared between the two groups.Results The incidence of emergence agitation during emergence in the observation group was significantly lower than that in the control group(42.37％versus 69.49％,P＜0.05).The Richmond Agitation-Seda-tion Scale(RASS)scores,duration and frequency of agitation were lower or shorter in the observation group than those in the control group(P＜0.05).The observation group exhibited shorter time for spontaneous respiration recovery,eye opening,extubation,full consciousness,and stay in the postan-esthesia care unit compared to the control group(P＜0.05).The Steward emergence score was higher in the observation group(P＜0.05).The postoperative pain score was lower,while nursing quality score was higher in the observation group than those in the control group(P＜0.05).Conclusion Feed-forward control nursing intervention can reduce the incidence of emergence agitation in general anesthesia surgery patients,improve recovery quality,alleviate postoperative pain,and enhance nursing quality.

Objective:To explore rumination status and its influencing factors among enterostomy patients, so as to provide references for the formulation of interventions.Methods:Using convenience sampling method, 120 patients with enterostomy who were treated and followed up in the Fifth Affiliated Hospital of Sun Yat-Sen University from July to December 2019 were selected as the research subjects. General information questionnaire, Event Related Rumination Inventory Scale, Simplified Scale of Resilience and Perceived Social Support Scale were applied in the investigation.Results:The invasive rumination score of enterostomy patients was (13.64±4.88) and the purposive rumination score was (14.90±3.72) . Multiple linear regression analysis showed that age, self-care degree of stoma, resilience and perceived social support explained 38.1% of the variance of invasive rumination ( P<0.01) . Education, occupation, resilience and perceived social support explained 41.9% of the variation of invasive rumination ( P<0.01) . Conclusions:The rumination of enterostomy patients was in the lower middle level. It is suggested that clinical staff pay more attention to the patients with low age, poor self-care ability of colostomy, low education level and unemployed state. At the same time, measures should be taken to improve the level of patients' resilience and improve their social support system, so as to promote the patients' positive psychological adjustment.