Objective At present , there is only a small amount of survey scale of caregivers′cognitive level on continuous nursing care for premature infants , which had not been subject to stringent testing of reliability and validity .This paper aims at developing a suitable survey scale of caregivers′cognitive level oncontinuous nursing care for 0-1 year premature infants , and testing its reliability and validity. Methods Convenience sampling method was used and totally 495 caregivers of premature infants of Army General Hospi-tal affiliated BaYi Children hospital from April to August 2016 has been investigated .After we had preliminary content of the question-naire, two-round Delphi consultations were used to identify the draft of the scale , and the reliability and validity were tested . Results Totally 419 valid questionnaires from 495.Questionnaires effective recovery was 84.65%.Critical ratio for each entry was 9.355-23.179 ( P<0.05) , which suggested that entries had good distinction .Coeffi-cient of correlation between scale items and total score was 0.500-0.775(P<0.05), whichindicated highly homogeneity between entries and table.By exploratory factor analysis , 5 entries were removed and 77 entries remained .The final scale of caregivers′cognitive level on continuous nursing care for premature infants included 4 indicators in level one , 15 indicators in level two and 77 indicators in level three .The Cronbach′s alpha was 0.985 for overall questionnaire and 0.848-0.939 for each dimension .The split-half reliability was 0.895 for overall questionnaire and 0.814-0.939 for each dimension .The content validity index was 0.963.The cumulative contribution rate of each dimension was 64.645%-83.236%. Conclusion The scale content was scientific and comprehensive .It can be used to investigate the caregivers′cognitive level on continuous nursing care for 0-1 year pre-mature infants, direct nurses to provide continuous care for premature infants , and evaluate the continuous nursing effect .

AIM:To explore the differential expression of interleukin-19 (IL-19) and its receptors (IL-20R1/IL-20R2) in the samples of chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP and CRSsNP), and to investigate the correlation of IL-19 and its receptors with tissue remodeling factors, including matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in CRS.METHODS:The polyps from CRSwNP patients (n=30), the sinus mucosa from CRSsNP patients (n=15) and the inferior turbinal mucosa of nasal septum de-viation patients (n=15) were collected.The expression of IL-19 and its receptors (IL-20R1/IL-20R2) in each group was detected by real-time RT-PCR and immunohistochemistry.The expression of tissue remodeling factors MMP-2, MMP-9 and TIMP-1 in different groups was detected by real-time RT-PCR and ELISA.RESULTS:Increased mRNA and protein expression levels of IL-19, IL-20R1, IL-20R2 and MMP-9 were observed in CRSwNP group compared with CRSsNP and control group (P<0.05), while elevated expression level of TIMP-1 was observed in CRSsNP group compared with CRSwNP and control group (P<0.05).The relative expression of MMP-2 among the 3 groups showed no obvious difference.The expression of IL-19 and its receptors showed significantly positive correlations with MMP-9 in CRSwNP (P<0.05).No significant correlation between IL-19 and/or its receptors with TIMP-1 in CRSwNP group was observed.CONCLUSION:The high expression levels of IL-19, IL-20R1 and IL-20R2 and their positive correlations with MMP-9 in CRSwNP indica-te that IL-19 and its receptors may be involved in the tissue remodeling of chronic rhinosinusitis.

Objective To investigate the situation of oxygen supplement and the incidence and clinical characteristics of long-term oxygen inhalation newborns in neonatal intensive care unit(NICU).Methods The records of oxygen supplement and the related clinical data of 12 155 neonates admitted in our NICU from Oct 2009 to May 2011 were collected and retrospectively analyzed.The results were compared with the data from a survey on 19 hospitals in China which reported by other authors.Results In 12 155 newborns,4 951 were full term,7 204 were preterm.One hundred and two patients (0.84％,102/12 155 ) accepted oxygen for more than 28 days.Among them,88 were preterm,14 were full term,with the average gestational age (31.16 ±3.70) weeks,the average birth weight (1.60 ±0.68) kg and the mean oxygen supplement period (40.60 ± 12.25) d.Finally,98 were cured or improved,4 died.The incidence of bronchopulmonary dysplasia (BPD) in 7 204 preterm infants was 1.22％ ( 88/7 204) according to the standard of continuous oxygen supply more than 28 days after birth.The incidence of BPD in preterm infants less than 32 weeks was 4.92％ (68/1 381 ) according to the standard of continuous oxygen supply more than 28 days after birth,while the rate was only 2.10％ (29/1 381 ) according to the standard of continuous oxygen supply more than 36 weeks postmenstrual age.The rates of BPD according to the two different standards were significantly different ( x2 =16.251,P ＜0.001 ).There were significant differences in the rate of supply oxygen( x2 =119.99) and supply oxygen time( F =109.27 ) among different gestational age groups in overall the 5 499 neonates ( P ＜0.001 ),but no significant differences in the average time of oxygen supply and mechanical ventilation among different gestational age groups in infants with long-term oxygen dependence ( P ＞ 0.05 ).There were significant differences in rates of pulmonary surfactant therapy,heart failure,retinopathy of prematurity,congenital heart disease,other congenital malformation and mortality among different gestational age groups in long-term oxygen dependence infants (x2 =8.789,13.538,23.176,7.778,8.842,8.246,P ＜ 0.05 ).As compared with the data from 19 hospitals,the corrected rate of long-term oxygen supplement in preterm infants in our hospital was obviously lower[0.99％ (71/7204) vsl.54％ (190/12 351),P ＜0.001].Conclusion Theincidence of BPD in our NICU is low.Lower gestational age,immature lung and secondary lung injury may be the mainly cause of neonatal long-term oxygen dependence,but some factors such as congenital heart disease,congenital malformations should be considered in more mature infants.The most appropriate standard for BPD still remains to be discussed.

Objective To summarize the characteristics of treatment and outcomes of extremely low birth weight infants (ELBWI).Methods The clinical data of 81 cases of ELBWI admitted to Bayi Children's Hospital Affiliated to General Hospital of Beijing Military Command from October 1st.2008 to August 31st.2011 were retrospectively analyzed.The survival rate and mortality of ELBWI with different gestational age and birth weight were compared with Chi-square test.Results Of 81 ELBWI,43 were male and 38 were female; the mean gestational age at birth was (28.4 ±2.1) weeks; the average birth weight was (903.5 ± 95.4) g.Complications of them included respiratory distress syndrome (68/81,84.0％),patent ductus arteriosus (47/81,58.0％),retinopathy of prematurity (41/81,50.6％),intraventricular hemorrhage (23/81,28.4％),bronchopulmonary dysplasia (17/81,21.0％),sepsis (15/81,18.5％),periventricular leukomalacia (2/81,2.5％) and necrotizing enterocolitis (1/81,1.2％).Among 81 infants,96.3％ (n =78)received oxygen inhalation with the average time was 19.1 d (median 11 d,0-121 d) ; 70.4％ (n=57)received pulmonary surfactant; 27.2％ (n =22) received nasal continuous positive airway pressure;34.6％ (n =28) received normal frequency mechanicalfrequency ventilation.All 47 ELBWI with patent ductus arteriosus received ibuprofen treatment,among which 6 cases received arterial canal ligation after failure of ibuprofen treatment.20 out of 41 cases of retinopathy of prematurity received laser surgery.Total parenteral nutrition was required in 74 infants(91.4％),the average age of beginning enteral feeding was 5.2 d (median 6 d,0-17 d)and achieved full gastrointestinal feeding time was 31 d (median 28 d,7-65 d).The survival rate of ELBWI with gestational age of ≤26,-28 and ＞28 weeks was 25.0％ (4/16),72.0％ (18/25) and 77.5％ (31/40),respectively; the corresponding mortality was 12.5％ (2/16),8.0％ (2/25) and 2.5％ (1/40),respectively.The survival rate of ELBWI with birth weight ≤800,-900 and ＞900 g was 33.3％ (4/12),58.3％ (14/24) and 77.8％ (35/45),respectively; and corresponding mortality of them was 16.7％ (2/12),8.3％ (2/24) and 2.2％ (1/45),respectively.Conclusions The outcome of ELBWI is closely related to gestational age and birth weight.Professional and sophisticated treatment might improve the survival rate and general outcome of ELBWI.

Objective To determine the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.Methods Fundus examinations were performed by RetCam Ⅱ ophthalmoscopy on 2185 premature infants (birth weight ≤ 2000 g or gestational age≤34 weeks)admitted into the neonatal intensive care unit of Beijing Bayi Children's Hospital from January 1st 2009 to December 31st 2010.According to the results,all infants were divided into ROP group and nonRO P group.Two-sample t test and Logistic regression analysis were used to investigate the risk factors of ROP.Results Among 2185 premature infants,287 (13.1 ％) cases were diagnosed with RO P.According to International Classification of RO P,34 cases (11.9 ％) were in zone Ⅰ,147 cases (51.2％) in zone Ⅱ,and 106 cases(36.9％) in zone Ⅲ.And there were 117 cases (40.8％) with stage 1 lesion,142 cases (49.5％) with stage 2 lesion,28 cases (9.7％) with stage 3 lesion,and no stage 4 or 5 lesion was identified.Thirty-six cases (12.5 ％) were accompanied by additional diseases.Logistic analysis showed that small gestational age (OR=0.859,95％CI:0.770-0.958,P=0.006),low birth weight (OR=0.729,95％CI:0.6340.838,P=0.000),long duration of oxygen supplement (OR=2.221,95％CI:1.904-2.592,P=0.000),assistant ventilation (OR=3.104,95％CI:2.0964.956,P=0.000),apnea (OR=1.767,95％CI:1.103 2.831,P=0.018) and=anemia (OR=2.242,95％CI:1.641-3.604,P=0.000) were independent risk factors of ROP.Conclusions The incidence of ROP in premature infants is high.Small gestational age and low birth weight,long duration of oxygen supplement,assistant ventilation,apnea and anemia are risk factors of ROP.Preventive measures should be taken against these factors.

Objective To study the clinical characteristics of neonates with Listeriosis sepsis and explore the nursing experience. Methods The clinical data of 22 cases with neonatal Listeriosis sepsis were retrospectively analyzed.Results Twenty-two neonates developed Listeria monocytogenes sepsis 0.5 h~5 d after birth with 13 cases of low birth weight. The stay was 2~77 d,10 were discharged after recovery,7 were discharged after signature of their families due to improvements and 5 died of meningitis and septicemia.Conclusion Timely and accurate collection of samples should be done for laboratory examinations.Close observation of the diseases,attaching importance to infant feeding and implementation of infant developmental nursing are all critical for the improvement of cure rate.

Objective To investigate the effect of magnetic nanocomposites on proliferation ability of human hepatoma carcinoma (HCC)cells (HepG2 cell line).Methods Leucine-rich repeat-containing G protein-coupled receptor (LGR) 5-small interfering ribonucleic acid (siRNA ) was composited with polyethylenimine wrapped superparamagnetic iron oxide nanoparticle (PEI-SPIO)as the gene vector.PEI group was established by transfecting HepG2 cells when cell fusion reached 60% and SI group was established by transfecting HepG2 cells with equivalent simple LGR5-siRNA.Control (Ctrl)group was also established without transfecting.The efficiency of nanocomposites entering cells was scanned with MRI T2.The inhibition rate of cell proliferation was detected by (cell count kit,CCK)-8 assay.The expression level of messenger ribonucleic acid (mRNA)in LGR5 of cells was detected by reverse transcriptase polymerase chain reaction (RT-PCR)and the protein expressions of LGR5 and cyclin D1 were detected by western blotting.Results MRI T2 signal of HepG2 cells in PEI group decreased significantly.Compared with Ctrl group,the inhibition rate of cell proliferation of HepG2 cells in PEI group was significantly increased.The relative expression of LGR5 mRNA and the relative expression of LGR5 and cyclin D1 protein were both significantly decreased (all in P <0.05),while the corresponding indexes of the cells in SI group had no statistical significance (all in P>0.05 ).Conclusions Magnetic nanocomposites PEI-SPIO composited with LGR5-siRNA may effectively transfect HepG2 cells.Its mechanism may take effect through down-regulating the expression of cyclin D1 to inhibit the proliferation ability of hepatocellular carcinoma HepG2 cells.

Objective:To evaluate the ultrasound diagnostic value of portal vein complications after liver transplantation by monitoring changes in portal vein hemodynamic parameters using the color Doppler ultrasound technology and to determine its clinical significance.Methods:The clinical data of 99 patients who underwent liver transplantation at the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from July 2015 to December 2018 were analyzed retrospectively. There were 81 males and 18 females, aged (51±9) years old. These patients were divided into the portal vein complication ( n=23) and the non-portal vein complication ( n=76) groups, based on whether portal vein complications had developed within 2 years after surgery. In addition, 30 healthy volunteers at the Affiliated Hospital of Qingdao University, including 16 males and 14 females, aged (40±14) years old were selected to form the control group. The patients’ morphology of liver was studied using color Doppler ultrasound at days 1, 7, 14, 30, 180, 365 and 730 after liver transplantation, and the maximum portal vein blood flow velocity and portal blood flow were recorded. Results:Compared with the control group, the maximum portal venous flow velocity and portal venous blood flow significantly increased on days 1, 7, 14, 30, and 180 after liver transplantation in the non-portal complication group (all P<0.05). With time, these changes showed a decreasing trend. By day 365 after surgery, the differences between the maximum portal venous flow velocity and the portal venous blood flow between the two groups became not significant ( P>0.05). Of the 23 patients in the portal vein complication group, 9 developed portal vein stenosis (PVS) and 14 portal vein embolism. The 9 patients with PVS had a maximum portal flow velocity of 63.8 (46.0, 78.6) cm/s at 1 month after surgery, and this flow velocity was significantly higher than that in the non-portal complication group [35.0(29.6, 41.8) cm/s, Z=-3.35, P<0.001]. The portal blood flow was 993 (887, 1168) ml/min in the 9 patients with portal vein stenosis at 1 month after surgery, and it was significantly higher than those in the non-portal complication group [811(682, 1 018) ml/min, Z=-2.37, P=0.020]. Conclusions:After liver transplantation, both the portal venous blood flow velocity and the blood flow were at high levels in the early postoperative period and they returned to normal levels with time. Ultrasound dynamic monitoring of portal venous blood flow changes was of clinical significance in diagnosing portal vein stenosis and portal vein embolism after liver transplantation.

Objective:To investigate the short-term efficacy of laparoscopic total gastrec-tomy with hand-sewn esophagojejunostomy versus Roux-en-Y anastomosis.Methods:The propen-sity score matching and retrospective cohort study was conducted. The clinicopathological data of 159 patients who underwent laparoscopic total gastrectomy in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from October 2014 to July 2021 were collected. There were 107 males and 52 females, aged 63(range, 28?79)years. Of 159 patients, 71 cases undergoing totally laparoscopic total gastrectomy with hand-sewn esophagojejunostomy were allocated into totally laparoscopic group and 88 cases undergoing laparoscopic-assisted total gastrectomy with Roux-en-Y anastomosis were allocated into laparoscopic-assisted group, respectively. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and postoperative conditions; (3) perioperative complications. Propensity score matching was done by the 1:1 nearest neighbor matching method. Measurement data with normal distribution were expressed as Mean± SD, and t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M(range), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher's exact probability method. The rank sum test was used for comparison of ordinal data. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of 159 patients, 112 cases were successfully matched, including 56 cases in the totally laparoscopic group and 56 cases in the laparoscopic-assisted group. Before propensity score matching, age, cases with tumor located in cardia or gastric body in the totally laparoscopic group were 61(range, 30?76)years, 26, 45, respectively. The above indicators in the laparoscopic-assisted group were 65(range, 28?79)years, 50, 38, respectively. There were significant differences in the above indicators between the two groups ( Z=?2.89, χ2=6.43, P<0.05). After propensity score matching, the males and females, age, body mass index, cases of American Society of Anesthesiologists classification Ⅰ, Ⅱ, Ⅲ and Ⅳ, tumor diameter, cases with tumor located in cardia or gastric body, cases in TNM stage Ⅰ, Ⅱ and Ⅲ of patients in the totally laparoscopic group were 40, 16, (62±9)years, (22.7±2.8)kg/m 2, 22, 26, 7, 1, 3.5(range, 0.6?17.0)cm, 24, 32, 22, 9, 25. The above indicators of patients in the laparoscopic-assisted group were 38, 18, (62±10)years, (22.7±3.2)kg/m 2, 19, 32, 5, 0, 4.0(range, 0.6?15.0)cm, 23, 33, 21, 7, 28, respectively. There was no significant difference in the above indicators between the two groups ( χ2=0.17, t=?0.09, ?0.04, Z=?0.12, ?0.82, χ2=0.04, Z=?0.42, P>0.05). The elimination of age and tumor location confounding bias ensured comparability between the two groups. (2) Intraoperative and postoperative conditions: after propensity score matching, the total operation time, time of esophagojejunostomy, postopera-tive 24-hour pain numerical score and time to first out-off bed activities were (310±49)minutes, (37±10)minutes, 2.3±0.8 and (2.4±0.7)days for patients in the totally laparoscopic group, versus (344±77)minutes, (44±12)minutes, 3.1±1.2 and (2.9±1.0)days in the laparoscopic-assisted group, showing significant differences between the two groups ( t=?2.85, ?3.05, ?4.20, ?3.10, P<0.05). (3) Perioperative complications: after propensity score matching, 6 cases of the patients in the totally laparoscopic group had Clavien-Dindo grade 2 or higher complications, including 2 cases of anas-tomotic leak, 1 case of anastomotic stenosis, 1 case of pleural effusion, 1 case of abdominal infection and 1 case of intestinal obstruction. The incidence of Clavien-Dindo grade 2 or higher complications was 10.7%(6/56). In the laparoscopic-assisted group, 5 patients had Clavien-Dindo grade 2 or higher complications, including 2 cases of anastomotic leak, 1 case of abdominal infection, 1 case of intestinal obstruction and 1 case of cholangitis. The incidence of Clavien-Dindo grade 2 or higher complications was 8.9%(5/56). There was no significant difference in the incidence of Clavien-Dindo grade 2 or higher complications between the two groups ( χ2=0.10, P>0.05). Patients with anas-tomotic leak were improved after puncture and drainage, secondary surgery and conservative treat-ment, and other complications were improved after symptomatic treatment. Conclusions:Com-pared with Roux-en-Y anastomosis in laparoscopic total gastrectomy, the time of hand-sewn esophagojejunostomy and esophago-jejunal anastomosis are shorter, patients have less postopera-tive pain and faster postoperative recovery. Both methods have good peri-operative safety.

Objective:To study the effects of comprehensive warming intervention strategy on the body temperature of preterm infants (gestational age <32 weeks and birth weight <1 500 g) during inter-hospital transportation.Method:From October 2016 to July 2019, eligible preterm infants transported to our hospital were retrospectively analyzed. From October 2016 to March 2018, preterm infants transported with routine transportation strategy were assigned into the control group. From April 2018 to July 2019, preterm infants transported with the comprehensive warming intervention strategy were assigned into the experiment group. The body temperature, complications and prognosis before and after the transportation to our NICU were compared.Result:A total of 1 194 premature infants with gestational age <32 weeks were included with 630 cases in the control group and 564 cases in the experiment group. No significant differences existed in demographic data of the mothers, infants and the transportation time between the two groups ( P>0.05). The body temperatures before and after transportation in the experimental group were (36.8±0.5)℃ and (36.7±0.5)℃, significantly higher than the control group [(36.0±0.4)℃ and (36.3±0.6)℃] ( P<0.01). The incidences of hypoglycemia and mortality in the experimental group were 3.7% (21/564) and 4.8% (27/564), significantly lower than the control group [8.4% (53/630) and 7.9% (50/630)] ( P<0.05). Conclusion:Comprehensive warming intervention strategy in inter-hospital transport can effectively improve the body temperature of preterm infants before and after transportation, reducing the incidences of hypoglycemia and mortality.