Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group (92 cases) and the control group (50 cases). The observation group received intravenous injection of fentanyl, while the control group was given no sedative medication. The pain and sedation was assessed before ventilation, 1 and 2 hours after ventilation and later every 4 hours by adoption of NPASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group, especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group. But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation. N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.

Objective Compare the analgesia effects of using different intervention method among neonatal infants, and then find out the most effective method. Methods Divided 120 neonatal infants into the control group, the NNS group and the position group, there were 40 cases in every group. Using the N-PASS scale evaluated the pain degree at the points of 1 and 5 minutes respectively after stimulation among the 3 groups. Results There was significant difference between the 3 groups on the pain degree,P

Objective:To understand the supportive care needs of patients with prostate cancer during their illness, so as to construct the supportive care needs intervention program.Methods:Purposive sampling method was used to conduct semi-structured interviews on 17 patients with prostate cancer from June 2019 to January 2020 in Haikou Hospital of Xiangya Affiliated Hospital of Central South University, and the data were analyzed by content analysis method.Results:Seven themes were extracted: the need of health information, the need of social support, the need of health care services, psychological and emotional need, the need of symptom management, the need of economic support and disease specific need.Conclusions:Patients with prostate cancer have multiple supportive care needs. The results of this study could be important reference for medical staff to provide comprehensive, personalized and humanistic care for patients and improve patients′ the quality of life and medical experience.

Objective:To explore the association between non-thyroid illness syndrome(NTIS)and pre-sarcopenia in the elderly.Methods:In the retrospective study, a total of 219 patients aged 60-85 years in Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University from April 2018 to March 2021, included 60 patients with NTIS and 159 patients without NTIS.Clinical data, laboratory results and body composition data were collected.Pre-sarcopenia was diagnosed based on human composition determination data and diagnostic criteria of pre-sarcopenia.Logistic regression analysis, Pearson's correlation analysis and the area under receiver operator characteristic curve(ROC)were used to explore the correlation between serum thyroid hormone levels and diagnostic data level of pre-sarcopenia.Results:Of 54 pre-sarcopenia patients, 30.3%(36/119)were male, 18.0%(18/100)were female with statistically significantly differences( P<0.01). Mean age was higher in both male and female patients in the NTIS group than in the non-NTIS group( P<0.01). The body mass index, levels of triiodothyronine(T3), free triiodothyronine(FT3), hemoglobin, and albumin were lower in NTIS group than in non-NTIS group( P<0.05). The prevalence of presarcopenia in female patients was higher in the NTIS group than in the non-NTIS group[42.9%(10/17) vs.10.6%(8/83), χ2=9.564, P<0.01]. Multivariate logistic regression analysis showed that the risk of pre-morbidity of sarcopenia was significantly higher in NTIS patients than in non-NTIS patients.FT3 was positively correlated with skeletal muscle mass index, fat-free body weight, and phase angle, and negatively correlated with visceral fat area( r=-0.17, P<0.05). While, free thyroxine(FT4)was negatively correlated with skeletal muscle mass index( r=-0.21), fat-free body weight( r=-0.16)and phase Angle( r=-0.2, P<0.01 or P<0.05), and was positively correlated with body fat percentage and visceral fat area( r=0.20 and 0.22, respectively, P<0.01). The use of area under ROC curve(AUC)of FT3 predicting sarcopenia stage showed that the AUC was 0.768(95% CI: 0.691~0.844). Conclusions:In elderly patients, NTIS is correlated with the pre-sarcopenia in the elderly, and FT3 and FT4 are related to muscle mass.The low level of FT3 can predict the pre-validation of pre-sarcopenia.

Objective:To explore the relationship between AluYb8 insertion in the MUTYH gene and the risk of decreased left ventricular diastolic function in the elderly.Methods:In the retrospective analysis, 498 elderly patients with decreased left ventricular diastolic function(the disease group)and 155 people without left ventricular diastolic function(the control group)were recruited.Polymerase chain reaction was employed to analyze the genotype distribution of AluYb8 insertion in MUTYH gene.Cardiac function was measured by high-resolution color Doppler ultrasound.Results:The frequencies of the A/A, A/P and P/P genotypes were 30.1%(150/498), 48.4%(241/498)and 21.5%(107/498)in patients with decreased left ventricular diastolic function, and 27.7%(43/155), 54.8%(85/155)and 17.5%(27/155)in the control group, respectively.There were no significant differences in genotype( χ2=2.162, P=0.339)and allele frequency( χ2=1.342, P=0.794)between the two groups.Further analysis after stratification revealed that there were statistically significant differences in genotype( χ2=7.173, P=0.028)and allele frequency( χ2=8.352, P=0.015). Multivariate Logistic regression analysis showed that, in elderly patients with diabetes, P-allele carriers had a higher risk of decreased left ventricular diastolic function than non-carriers( OR=3.450, 95% CI: 1.148-10.372, P=0.027). Conclusions:AluYb8 insertion in the MUTYH gene may be associated with the risk of decreased left ventricular diastolic function in the elderly with diabetes.

Objective: To investigate whether topical mucopolysaccharide polysulfate (MPS) cream can reduce the incidence of eczema and skin atrophy in patients with moderate- or low-risk infantile hemangioma after the treatment with topical beta-blockers or 595-nm pulsed dye laser (PDL) , and to analyze factors influencing the occurrence of eczema and skin atrophy. Methods: A total of 722 patients aged 0- 1 years with moderate- or low-risk infantile hemangioma were enrolled from 5 Children′s Hospitals in China. According to the disease condition and therapy acceptability, these patients were divided into 6 groups to be treated with topical beta-blockers and MPS cream (blocker+ MPS group) , topical beta-blockers (blocker group) , 595-nm PDL and topical MPS cream (PDL+ MPS group) , 595-nm PDL (PDL group) , 595-nm PDL combined with topical beta-blockers and MPS cream (PDL+ blocker+ MPS group) , and 595-nm PDL and topical beta-blockers (PDL+ blocker group) , respectively. All the externally applied agents were applied twice a day, and PDL was performed once every 4 weeks. Efficacy and adverse reactions were evaluated after 3-month treatment. Univariate and multivariate Logistic regression analyses were carried out to analyze factors influencing the incidence of eczema and skin atrophy in patients with infantile hemangioma after treatment, and chi-square test was carried out to compare efficacy among the groups. Results: After 3-month treatment, multivariate Logistic regression analysis for comparing the blocker+ MPS group with blocker group showed that the risk factor for eczema on the surface of hemangiomas was no topical treatment with MPS cream (P= 0.007, OR= 3.887, 95% CI: 1.439-10.493) , while no correlations were observed between the occurrence of skin atrophy on the surface of hemangiomas and analyzed factors. Multivariate Logistic regression analysis for comparing the PDL+MPS group with PDL group showed that no topical treatment with MPS cream (P < 0.001, OR= 7.402, 95% CI: 2.604-21.042) and northern areas (P < 0.001, OR= 67.048, 95% CI: 7.977-563.518) were risk factors for eczema on the surface of hemangiomas, and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P = 0.001, OR = 9.371, 95 CI: 2.590 - 33.900) and abundant blood supply of hemangiomas (P = 0.036, OR = 2.971, 95% CI: 1.075-8.208) . Multivariate Logistic regression analysis for comparing the PDL + blocker+ MPS group with PDL+ blocker group showed that risk factors for eczema on the surface of hemangiomas were no topical treatment with MPS cream (P= 0.005, OR= 3.426, 95% CI: 1.446-8.119) and northern areas (P < 0.001, OR= 31.704, 95% CI: 6.924-145.158) , and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P < 0.001, OR= 6.011, 95% CI: 2.558-14.126) and southern areas (P= 0.022, OR= 3.021, 95% CI: 1.177-7.753) . After 3-month treatment, the response rate was significantly higher in the PDL group than in the PDL+ MPS group (χ²= 4.531, P= 0.033) , and significantly higher in the blocker group than in the blocker+ MPS group (χ²= 4.344, P= 0.037) . There were no significant differences in the response rate or cure rate among the other groups (all P > 0.05) . Conclusion During the treatment of moderate- or low-risk infantile hemangioma with topical beta-blockers or 595-nm PDL, the combination with topical MPS cream can reduce the occurrence of eczema and skin atrophy without affecting the therapeutic effect.

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.