1.Experience and needs of parental care for premature infants during the transition from hospital to home: a Meta-synthesis of qualitative studies
Xiaojiao WANG ; Li GAO ; Cuilian YANG ; Yaozheng XU
Chinese Journal of Modern Nursing 2024;30(3):299-308
Objective:To systematically evaluate the experience and needs of parental care for premature infants during the transition from hospital to home.Methods:Qualitative studies on the experience and needs of parental care for premature infants transitioning from hospital to home were electronically searched in Cochrane Library, PubMed, Embase, Web of Science, Scopus, PsycINFO, CINAHL, China National Knowledge Infrastructure, VIP, China Biomedical Medline Disc, and WanFang Data. The search period was from the establishment of the database to June 3, 2023. The retrieved studies were evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The qualitative research results were integrated using the method of aggregation integration.Results:A total of 14 articles were included, 39 research results were extracted, categorized into nine categories. These categories were integrated into three synthesized results, namely the dependency period (parents of premature infants coexisted with joy and concern, and relied on professional support from medical and nursing staff), shock period (parents of premature infants developed negative emotions, faced dual difficulties in home care and role switching, and needed internal and external professional support from the family), adaptation period (parents of premature infants actively responded to changes, sought peer support, and transitioned to the "new normal" of life) .Conclusions:The transition from hospital to home is a dynamic process. During the transition process, parents of premature infants undergo complex emotional experiences and role transitions, requiring support from healthcare professionals, family members, and peers. Medical and nursing workers should pay attention to the psychological changes and diverse needs of parents, provide professional support and guidance to help them adapt to the role of parents, and promote the healthy growth of premature infants.
2.Network Meta-analysis of the effect of non-pharmacological intervention on benefit finding of breast cancer patients
Haolan WANG ; Li GAO ; Cuilian YANG ; Yu LIU ; Yaozheng XU ; Jun'e LIU
Chinese Journal of Modern Nursing 2024;30(15):2027-2032
Objective:To evaluate the effect of non-pharmacological interventions on benefit finding of breast cancer patients by using network Meta-analysis.Methods:Randomized controlled trials on the effect of non-pharmacological interventions on the benefit finding of breast cancer patients were retrieved by computer from CNKI, VIP, Wanfang Date, China Biology Medicine disc, PubMed, Web of Science, Cochrane Library, EBSCO, Embase, Medline, Ovid, CINAHL and other databases. The retrieval time was from establishment of the databases to October 15th, 2023. Literature screening and data extraction were carried out independently by two researchers. The Cochrane Manual 5.1.0 randomised Controlled Trial Bias Risk Assessment Scale were used to evaluate the included literature. And the Stata 14.0 were used for Network Meta-analysis.Results:A total of 10 literatures were included. The results of Network Meta-analysis showed that cognitive behavior therapy was the best intervention in improving the benefit finding of breast cancer patients. The effects of different non-pharmacological intervention methods in descending order were cognitive behavior therapy, yoga, acceptance and commitment therapy, self disclosure and muscle stretching.Conclusions:Existing evidence suggests that cognitive behavioral therapy is most effective in improving benefiting finding in breast cancer patients, but more valuable evidence support and high-quality randomized controlled trial studies are needed to further validate.
3.Analysis of the characteristics and drug-resistance of childhood intestinal bacterial infection in Kunming area
Cuilian LI ; Shufang XIAO ; Honglin LIU ; Li JIANG ; Mingbiao MA ; Ling LIU
Chinese Pediatric Emergency Medicine 2024;31(9):673-677
Objective:To analyze the situation of intestinal bacterial infections and drug resistance in children,and provide reference for the rational use of drugs in the treatment of bacterial enteritis.Methods:We collected cases of diarrhea in children admitted to the outpatient and inpatient departments of Kunming Children's Hospital from January 2014 to December 2022,whose fecal samples was detected pathogenic bacteria.The drug resistance of pathogenic bacteria was analyzed.Results:A total of 10 233 children with diarrhea were tested for fecal samples,and 595 cases of pathogenic bacteria were detected through fecal culture,with a detection rate of 5.8%.Among them,456 cases of Salmonella were detected,accounting for 76.6%.There were 128(21.5%) cases of Shigella genus,of which Shigella flexneri was the main subset(58.6%).The distribution of departments was most common in the gastroenterology department,followed by the infectious disease wards.The seasonal distribution of bacterial enteritis showed that the incidence was high in summer and autumn.Infants and young children under three years old was found have the highest incidence.The drug sensitivity results showed that Salmonella and Shigella had high resistance to penicillin and aminoglycosides,and were highly sensitive to amoxicillin/clavulanic acid,quinolones,and carbapenems; Cephalosporins had good antibacterial activity against Salmonella,with a resistance rate of 12.9% to 32.7%.However,the overall resistance rate of Salmonella to ceftriaxone and ceftazidime was on the rise.Cefotaxime and cefepime had good antibacterial activity against Shigella,but Shigella had a high resistance rate of 95.0% to ceftriaxone.Conclusion:Salmonella is the main pathogen causing bacterial diarrhea in Kunming region,with the highest incidence in infants and young children under the age of three.The resistance rate of Salmonella to ceftriaxone is on the rise,and it is highly sensitive to amoxicillin/clavulanic acid,quinolones,and carbapenems.This can provide local medication references for primary clinical pediatricians when they cannot obtain the results of bacterial culture drug sensitivity.
4.Impact of progesterone concentration on hCG trigger day on clinical outcomes with cleavage-stage embryo transfer in in vitro fertilization cycles with an antagonist protocol
Nan JIA ; Haoying HAO ; Bingbing SONG ; Meng LI ; Cuilian ZHANG ; Shaodi ZHANG
Chinese Journal of Obstetrics and Gynecology 2024;59(10):777-785
Objective:To investigate the impact of the progesterone concentration on human chorionic gonadotropin (hCG) trigger day in fresh cycles versus thawed transfer cycles (the freeze-all strategy) with an antagonist protocol, and to compare the differences in clinical outcomes.Methods:This retrospective cohort study included a total of 2 165 cycles conducted at Henan Provincial People′s Hospital with cleavage-stage embryo (at least one top-quality) transfer between January 2017 and December 2023, with serum progesterone levels on hCG trigger day all≤6.34 nmol/L (i.e. 2 ng/ml). Multivariate logsitic regression analysis and curve fitting were performed based on different serum progesterone levels on hCG trigger day [≤3.17 nmol/L (i.e. 1 ng/ml) or 1-2 ng/ml].Results:Multivariate regression analysis, by using cycle type (either fresh or frozen-thawed cycle) as the exposure variable, showed that the clinical pregnancy rate (≤1 ng/ml: OR=0.93, 95% CI: 0.75-1.14; 1-2 ng/ml: OR=1.05, 95% CI: 0.58-1.87) and live birth rate (≤1 ng/ml: OR=0.90, 95% CI: 0.71-1.13; 1-2 ng/ml: OR=1.53, 95% CI: 0.79-3.00) had no statistically significant differences in group of progesterone concentration ≤1 ng/ml or in group of 1-2 ng/ml. Using serum progesterone levels on hCG trigger day as a continuous variable for curve fitting analysis, the clinical pregnancy rate in fresh or thawed cycles showed no significant changes with increasing progesterone levels. Conclusions:In the antagonist protocol with cleavage-stage embryo transfer (at least one top-quality), when the serum progesterone level on hCG day is ≤2 ng/ml, there are no significant differences in clinical outcomes between thawed cycles and fresh cycles, including clinical pregnancy rate and live birth rate. Transferred in fresh cycles or choosing the freeze-all strategy could be selected based on the actual situation of the patients.
5.Meta-analysis of rehabilitation effect of Otago exercise in patients with limb dysfunction
Wenxuan SUN ; Li GAO ; Cuilian YANG ; Shuqin XIAO
Chinese Journal of Modern Nursing 2023;29(16):2197-2201
Objective:To systematically evaluate the rehabilitation effect of Otago exercise in patients with limb dysfunction.Methods:Randomized controlled trials and quasi trials on the rehabilitation effect of Otago exercise in patients with limb dysfunction were searched through computer on PubMed, Cochrane Library, Medline, Embase, Ovid, Scopus, China National Knowledge Infrastructure, VIP, and Wanfang Data. The search period was from the establishment of the database to July 31, 2022. Two researchers independently screened article, evaluated article quality, and extracted data. Meta-analysis was conducted using RevMan 5.3 software.Results:A total of 12 articles were included, including 682 patients with limb dysfunction. Meta-analysis results showed that compared with conventional physical therapy, Otago exercise could improve fall efficacy ( MD=8.64, 95% CI: 7.08-10.20, P<0.01) and balance ability ( MD=2.90, 95% CI: 0.72 -5.08, P<0.01) of patients with limb dysfunction. Conclusions:Otago exercise can improve fall efficiency and balance ability of patients with limb dysfunction, and has a positive impact on patients' limb function rehabilitation.
6.The role of SLC12A family of cation-chloride cotransporters and drug discovery methodologies
Shiyao ZHANG ; Nur Farah Meor Azlan ; Solomon-Sunday JOSIAH ; Jing ZHOU ; Xiaoxia ZHOU ; Lingjun JIE ; Yanhui ZHANG ; Cuilian DAI ; Dong LIANG ; Peifeng LI ; Zhengqiu LI ; Zhen WANG ; Yun WANG ; Ke DING ; Yan WANG ; Jinwei ZHANG
Journal of Pharmaceutical Analysis 2023;13(12):1471-1495
The solute carrier family 12(SLC12)of cation-chloride cotransporters(CCCs)comprises potassium chlo-ride cotransporters(KCCs,e.g.KCC1,KCC2,KCC3,and KCC4)-mediated Cl-extrusion,and sodium po-tassium chloride cotransporters(N[K]CCs,NKCC1,NKCC2,and NCC)-mediated Cl-loading.The CCCs play vital roles in cell volume regulation and ion homeostasis.Gain-of-function or loss-of-function of these ion transporters can cause diseases in many tissues.In recent years,there have been considerable ad-vances in our understanding of CCCs'control mechanisms in cell volume regulations,with many tech-niques developed in studying the functions and activities of CCCs.Classic approaches to directly measure CCC activity involve assays that measure the transport of potassium substitutes through the CCCs.These techniques include the ammonium pulse technique,radioactive or nonradioactive rubidium ion uptake-assay,and thallium ion-uptake assay.CCCs'activity can also be indirectly observed by measuring y-aminobutyric acid(GABA)activity with patch-clamp electrophysiology and intracellular chloride con-centration with sensitive microelectrodes,radiotracer 36Cl-,and fluorescent dyes.Other techniques include directly looking at kinase regulatory sites phosphorylation,flame photometry,22Na+uptake assay,structural biology,molecular modeling,and high-throughput drug screening.This review sum-marizes the role of CCCs in genetic disorders and cell volume regulation,current methods applied in studying CCCs biology,and compounds developed that directly or indirectly target the CCCs for disease treatments.
7.Analysis of related factors and prediction of poor ovarian response in patients with controlled ovarian stimulation
Xue WANG ; Yingying FAN ; Lei LI ; Shaodi ZHANG ; Cuilian ZHANG
Chinese Journal of Obstetrics and Gynecology 2022;57(2):110-116
Objective:To explore the related factors of poor ovarian response (POR) in patients receiving controlled ovarian stimulation (COS) and to establish the nomogram for predicting POR in patients who received in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI).Methods:In this retrospective research, clinical data of 17 164 cycles of patients who received IVF/ICSI treatment at Henan Provincial People′s Hospital from September 1st, 2016 to September 1st, 2020 were analyzed. Independent correlative factors affecting the occurrence of POR were screened by logistic regression, which were the model enrollment variables in the prediction model. Totally 13 266 cycles with well-record of enrollment variables were screened, and these data were randomly divided into model group (9 896 patients) and validation group (3 370 patients) according to 3∶1. The nomogram was established according to the regression coefficient of the relevant variables. The prediction accuracy of the nomogram was evaluated by calculating area under the receiver operating characteristic curve (AUC).Results:Multivariate logistic regression analysis showed age, infertility type, body mass index, anti-Müllerian hormone, basal follicle stimulating hormone, basal estrogen, antral follicle number, previous times of POR, history of ovarian surgery, ovulation stimulation protocol and average amount of gonadotropin were independent correlative factors affecting the occurrence of POR (all P<0.05). In the model group, according to the above factors, the prediction model and nomogram of POR risk were constructed and the validation group verified the model. The AUC of the model group was 0.893 (95% CI: 0.885-0.900), and the AUC of the validation group was 0.890 (95% CI: 0.878-0.903). Conclusion:The influencing factors of POR after COS in patients treated by IVF/ICSI are screened, and the nomogram for predicting POR established in this study is proved to be effective, simple, intuitive and clear in predicting the occurrence of POR.
8.Effectiveness, safety and cost of urinary follicle stimulating hormone in controlled ovarian stimulation in China: multi-center retrospective cohort study of 102 061 in vitro fertilization cycles
Yimin ZHU ; Yue GAO ; Donghong NAI ; Linli HU ; Lei JIN ; Ying ZHONG ; Ze WU ; Guimin HAO ; Qiongfang WU ; Yichun GUAN ; Hong JIANG ; Cuilian ZHANG ; Minli LIU ; Xiaohong WANG ; Xiaoming TENG ; Jinliang DUAN ; Liran LI ; Yue ZHANG ; Hong YE
Chinese Journal of Obstetrics and Gynecology 2022;57(7):510-518
Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.
9.Analysis of 2 957 cases of children with convulsion in emergency
Cuilian LI ; Shufang XIAO ; Honglin LIU ; Litao XIAO ; Lifen DUAN
Chinese Pediatric Emergency Medicine 2020;27(9):683-687
Objective:To summarize the classification of etiology, age of onset, prognosis of children with convulsion, so as to provide experience guidance for clinicians engaged in pediatric emergency department.Methods:The clinical data of children with convulsions received in the emergency department of Children′s Hospital Affiliated to Kunming Medical University from January 2015 to December 2018 were analyzed retrospectively.Results:During the four-year period, 2 957 children with convulsion were received in the emergency department, accounting for 22.20% of the total number of critically ill children in the observation room of the emergency department, and the ratio of male to female was 1.7∶1.The etiological diagnosis of convulsion in emergency are as follows: febrile convulsion(733 cases, 24.79%), central nervous system infection(477 cases, 16.13%), unexplained convulsion(476 cases, 16.09%), epilepsy(371 cases, 12.55%), benign infantile convulsions with mild gastroenteritis(240 cases, 8.12%). The age of onset: 8.25% were in neonatal period, 33.99% were in infant, 34.87% were in toddler′s age, 12.17% were in preschool age, 7.88% were in school age and 2.84% were in adolescence.Destination statistics: 72.00% were admitted to hospital for further treatment, 13.29% were transferred to neurology clinic, 7.85% to pediatric clinic, 1.66% to rehabilitation clinic, and 0.17% died.Inpatient department: 43.64% were admitted to department of neurology, 17.52% to pediatric intensive care unit, 13.71% to department of neonatology, 12.64% to department of gastroenterology and 2.72% to department of rehabilitation.Conclusion:Febrile convulsion is the main cause of convulsion in children who were received emergency treatment in our hospital.Most of the convulsion cases are from birth to preschool age, and the prognosis is good after active treatment.
10.Analysis of endometrial thickness threshold and optimal thickness interval measured by transvaginal ultrasound in blastocyst hormone replacement freeze-thawed embryo transfer
Shaodi ZHANG ; Zhiming ZHAO ; Qiuyuan LI ; Yisha YIN ; Shuna WANG ; Cuilian ZHANG
Chinese Journal of Ultrasonography 2020;29(3):260-265
Objective:To investigate the effect of endometrial thickness(EMT) on the clinical outcome of blastocyst hormone replacement freeze-thawed embryo transfer (HRT-FET) on the first progesterone day, and to analyze the threshold and optimal thickness interval corresponding to ideal clinical pregnancy rate by statistical method.Methods:The endometrial preparation protocols of 2 825 blastocyst HRT-FET cycles from January 2013 to December 2016 in Henan Provincial People′s Hospital and the Second Hospital of Hebei Medical University were studied retrospectively. According to EMT on the first progesterone day, they were divided into 5 subgroups: group Q1(EMT: 3.5-7.9 mm), group Q2(EMT: 8.0-8.9 mm), group Q3(EMT: 9.0-9.5 mm), group Q4(EMT: 9.6-10.7 mm), group Q5(EMT: 10.8-21.0 mm). Univariate analysis, classification multivariate Logistic regression analysis, curve fitting and threshold effect analysis were used to investigate the effect of endometrial thickness on clinical outcome of blastocyst HRT-FET.Results:Group Q1 was set as the control group in classification multivariate Logistic regression analysis, after adjusting for confounding factors, the clinical pregnancy rate and live birth rate in other groups were higher than the control group. The clinical pregnancy rate and live birth rate in group Q3 and Q4 were significantly increased and the differences were statistically significant(all P<0.05). The cut-off value of the endometrial thickness was 9.6 mm. When endometrial thickness was less than 9.6 mm, with 1 mm increase of endometrial thickness, the clinical pregnancy rate increased by 23%( OR=1.23, 95% CI=1.11-1.36) and the live birth rate increased by 21%( OR=1.21, 95% CI=1.10-1.33). When the endometrial thickness was thicker than the threshold, the clinical pregnancy rate did not increase significantly( OR=0.92, 95% CI=0.84-1.02), and the live birth rate showed a downward trend( OR=0.88, 95% CI=0.81-0.96). Conclusions:In the blastocyst HRT-FET cycle, endometrial thickness showes a curvilinear relationship with clinical outcome. The optimal endometrial thickness range for ideal clinical outcome is 9.0-11.0 mm.

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