The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.

Objective:To explore the genetic etiology and clinical outcome of a child with co-morbid progressive IgA nephropathy and COQ8B-associated glomerulopathy. Methods:A child who was admitted to Peking University First Hospital on March 2, 2021 was selected as the study subject. Genomic DNA was extracted from peripheral blood samples from the child and his parents and sister. Whole exome sequencing was carried out, and candidate variant was verified by Sanger sequencing. This study was approved by Medical Ethics Committee of the Peking University First Hospital (Ethics No. 2016[1029]).Results:The child, a 7-year-old boy who had developed proteinuria 8 months before, was diagnosed with IgA nephropathy (M1E1S1T1C1). With steroid, cyclophosphamide, cyclosporine and angiotensin-converting enzyme inhibitor therapy, partial remission of proteinuria was achieved. However, his serum creatinine level had increased from 53.8 mol/L at the onset of disease to 86.7 mol/L after 3.9 years, along with massive proteinuria. Kidney biopsy still indicated IgA nephropathy (M0E0S1T0C0). The child was found to harbor a homozygous c. 737G>A (p.Ser246Asn) missense variant of the COQ8B gene, for which his parents and sister were heterozygous carriers. The variant was predicted to be pathogenic (PS1+ PM2_Supporting+ PM3+ PP3+ PP4) based on the guidelines from the American College of Medical Genetics and Genomics. The child was treated with high-dose coenzyme Q10 in combination with steroid and/or mycophenolate mofetil, though his serum creatinine level still increased to 286 mol/L after 7.3 years, which conformed to a chronic kidney disorder with glomerular filtration rate category of G3b. Conclusion:The homozygous c.737G>A missense variants of the COQ8B gene probably underlay the progressive kidney dysfunction in this child. For children with IgA nephropathy presenting with atypical clinical manifestations, unsatisfactory therapeutic effect, and/or early onset of kidney function decline, coexistence of other diseases should be suspected.

Objective To understand the implementation of the nursing group standards for oxygen inhalation therapy in clinical practice,and to provide a reference for improving the nursing practice of oxygen therapy.Methods A convenience sampling method was used to investigate nurses from 902 hospitals in 24 provinces and municipalities directly under the central government using a self-designed questionnaire from December 15th,2022,to January 14th,2023.The content of questionnaire included whether they had implemented the recommendations of the oxygen therapy standards,the knowledge of safety related to oxygen therapy,and the components of oxygen therapy prescriptions,the indications used for patients receiving oxygen therapy and practice status of oxygen therapy.Results A total of 10481 questionnaires were returned,of which 10447 were valid,with a valid questionnaire recovery rate of 99.68%.63.14%of the nurses indicated that the hospital had organized training on oxygen therapy standards.Only 47.82%of nurses know the correct use of the Venturi mask.41.90%of nurses could indicate the correct indicator of flow adjustment.31.88%of the nurses stated that they will adjust the oxygen flow rate based on the oxygenation status of carbon dioxide storage patients.Only 19.56%of nurses indicated that humidification is applied in oxygen therapy based on the oxygen flow and duration.Conclusion Even though nurses had received training related to oxygen therapy standards,the level of knowledge of oxygen therapy standards was still low;therefore continuous systematic training was needed,and the implementation of the content of oxygen therapy standards needed to be further standardized.Healthcare institutions would focus on organizing systematic training and maintaining the training effect,enhancing infrastructure and providing support for implementation.Recommendation to the nursing administration is to explore how to comprehensively and continuously implementing the oxygen therapy nursing standards with the ultimate goal of providing patients safer and more accurate oxygen therapy.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with multiple pterygium syndrome (MPS). METHODS: A child with MPS who was treated at the Orthopedics Department of Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University on August 19, 2020 was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and her parents were also collected. Whole exome sequencing (WES) was carried out for the child. Candidate variant was validated by Sanger sequencing of her parents and bioinformatic analysis. RESULTS: The child, an 11-year-old female, had a complain of "scoliosis found 8 years before and aggravated with unequal shoulder height for 1 year". WES results revealed that she has carried a homozygous c.55+1G>C splice variant of the CHRNG gene, for which both of her parents were heterozygous carriers. By bioinformatic analysis, the c.55+1G>C variant has not been recorded by the CNKI, Wanfang data knowledge service platform and HGMG databases. Analysis with Multain online software suggested that the amino acid encoded by this site is highly conserved among various species. As predicted with the CRYP-SKIP online software, the probability of activation and skipping of the potential splice site in exon 1 caused by this variant is 0.30 and 0.70, respectively. The child was diagnosed with MPS. CONCLUSION The CHRNG gene c.55+1G>C variant probably underlay the MPS in this patient.
Humans ; Child ; Female ; Abnormalities, Multiple/genetics* ; Malignant Hyperthermia/genetics* ; Skin Abnormalities/genetics* ; Heterozygote ; Mutation ; Receptors, Nicotinic/genetics*

Objective:To develop a self-management scale for patients with ulcerative colitis and test its reliability and validity,so as to provide a measurement tool for evaluating the self-management level of patients with ulcerative colitis in China.Methods:Guided by the theory of self-management, combined with extensive literature review and semi-structured interview results, the initial item pool was formed, and the initial questionnaire was formed through expert consultation. 324 cases of ulcerative colitis in a third-class Hospital of Tianjin were investigated by convenience sampling.Results:The self-management scale of ulcerative colitis patients included 4 dimensions and 23 items. The content validity of each item was between 0.867 and 1,and the content validity index of the scale was 0.860. Four factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate of variance was 66.395%. The Cronbachs coefficient of overall scale was 0.937,while four dimensions was between 0.820 and 0.916. The retest reliability of the scale was 0.934 ( P<0.01) and the retest reliability of each dimension was between 0.914 and 0.950 ( P<0.01). Conclusions:The self-management scale of patients with ulcerative colitis has been developed. The scale includes four dimensions: disease treatment management,daily life management,psychosocial management and disease information management. It has 23 items in total and has good reliability and validity. It can be used to evaluate the self-management level of patients with ulcerative colitis.

Objective: To investigate effects of personal innovation behaviors, self-efficacy and colleague solidarity of nurses on career success, and to provide the basis for career planning and management of clinical nurses. Methods: A total of 441 registered nurses from eight grade three and first-class hospitals in Tianjin were measured with personal innovation behaviors scale, self-efficacy scale, colleague solidarity of nurses' scale and career success scale. Results: The total score of personal innovation behavior was (21.58±4.81). The total score of self-efficacy was (27.68±6.53). The total score of colleague solidarity of nurses was (95.12±9.42). The total score of career success was (35.75±9.27). The personal innovation behaviors, self-efficacy, colleague solidarity of nurses career success and each dimension showed positive correlation(r=0.115-0.915, P<0.05). Multiple linear regression analysis showed that innovation behaviors, self-efficacy and academic solidarity entered career success regression equation(β=0.090-0.554, P<0.05), and explained 49.7% of the total variation.Path analysis model showed innovative behavior, self-efficacy and colleague solidarity of nurses were positively predictive of career success, and the path coefficients were 0.62, 0.18 and 0.12.Hierarchical regression analysis showed both self-efficacy and colleague solidarity of nurses played mediating roles between innovative behavior and career success(β=0.207-0.104, P<0.05). Conclusion Hospital managers should take measures to improve nurses' innovative behavior, self-efficacy and colleague solidarity of nurses to promote their career success.

Objective To analyze the relationship between syndrome differentiation of traditional Chinese medicine (TCM) and the clinical stage of western medicine, histological type and EGFRgene in patients with lung cancer and to find out the regularity among them. Methods From February 2015 to September 2017, 101 patients with lung cancer were enrolled in this study. Statistical analysis of relationship between TCMsyndrome differentiation and clinical stage, histopathological type and EGFRgene expression was carried out. Results There was a significant difference (P＜0. 05) between TCMtypes and histopathological types of lung cancer(P＜0. 05), among which, there was a significant difference (P＜0. 05) between adenocarcinoma and small cell lung cancer and non-adenocarcinoma. There also had a significant difference(P＜0. 05) between TCMtypes and TNMstage of lung cancer. Intergroup analysis demonstrated that there was a significant difference (P＜0. 05) between stage Iand IV, and also stage Ⅱ and IV. There was a significant difference (P＜0. 05) between TCMtypes and positive expression of EGFR. From phlegm-heat syndrome, qi-stagnation syndrome, qiyin deficiency syndrome to cold-dampness syndrome, The positive expression of EGFRwas gradually ascending. There was significant difference between cold-dampness syndrome and phlegm-heat syndrome(P＜0. 05). Conclusion There is a certain correlation between syndrome differentiation of TCMand clinical stage, histopathological classification and EGFRgene expression in lung cancer, which can provide dialectical evidence for objective and standardized TCMsyndrome differentiation.

This paper introduced the background and application method of healthcare failure mode and effect analysis (HFMEA) to understand the application of HFMEA mode in the operation room nursing management at home and abroad, and explored its application value in nursing management of operating room. It can provide experience for the application of HFMEA in nursing process of operating room, so as to better reduce the incidence of nursing risk in operating room, protect patients' life safety and improve the quality of nursing.

Objective To evaluate the efficacy of clinical nursing path in the application of endoscopic colon polyps resection patients. Methods Computer retrieval Chinese database to search relevant randomised controlled trials or clinical controlled trials. Two authors independently screened paper,extracted data and conducted to evaluate quality of literature,finally the meta-analysis was used by the Revman5.3 to analyze the data. Results A total of 13 articles were included. The results of Meta analysis showed that: compared with control group, the CNP group had the significant advantage of a shorter average length of hospital stay(colon polyps group:WMD=0.02,95% CI-3.14--0.91,P<0.01);colon polyps group: WMD = 2.57, 95% CI-2.77--2.36, P < 0.01), the lower average inpatient expenditure (colon polyps group: SMD = 9.98, 95% CI-14.55--5.44, P < 0.01); colon polyps group:SMD=4.57,95% CI-7.37--1.77,P<0.01),the higher nursing satisfaction(OR=5.03,95% CI 3.21-7.90,P<0.01),the higher degree of mastering knowledge(OR=5.31,95% CI 2.08-13.55,P<0.01)and the lower postoperative complications(OR=0.18,95% CI 0.06-0.55,P<0.01). Conclusions Clinical nursing pathway in patients with endoscopic colon polyps resection application effect is superior to the traditional nursing method. Because the quality of literature contained was not high, we still need more large sample,randomized controlled trials of high quality to further verification.

Objective To investigate the knowledge level among patients with ulcerative colitis, and analyze its influencing factors. Methods A total of 147 patients with ulcerative colitis were recruited by using Chinese version of inflammatory bowel disease knowledge questionnaire to assess their knowledge level. The influencing factors were explored by using general information questionnaire and self-efficacy questionnaire of inflammatory bowel disease. Results The total score of disease knowledge among patients with ulcerative colitis was (6.58 ± 1.57) points, Correct rate of disease knowledge was 28.6%; the total score of self-efficacy was (227.45 ± 32.25) points, the score index was 78.28%. The educational level, duration of disease, patients′ age and management of medical and nursing were the influencing factors of disease knowledge, which could explain 44.3% of total variation. Conclusions The knowledge level among patients with ulcerative colitis needs to be improved.Nursing staff should be based on influencing factors, pay attention to improve the knowledge level of patients with nursing intervention or health education,through a variety of ways to meet the patients need of disease knowledge, improve theirquality of life.