Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective To explore the brain network and its topological properties in schizophrenia patients using resting-state functional magnetic resonance imaging(rs-fMRI).Methods Thirty-five schizophrenia patients(patient group)and 35 healthy subjects(control group)from the Center of Biomedical Research Excellence were collected,and the regional homogeneities of the two groups were calculated for statistical analysis.Dosenbach's 160 atlas was used to examine the whole brain functional network,and extract two sub networks of the whole brain network(default mode network and somatic motor network)for constructing a new network.The topological properties of the whole brain network and the new network were calculated.Results In schizophrenia patients,the functional connectivity between default mode network and somatic motor network and that within the default mode networks were significantly weakened(P<0.05,FDR corrected);the clustering coefficient of the whole brain network was decreased;and the global and local efficiencies of the network composed of default mode network and somatic motor network were reduced(P<0.05).Conclusion Abnormal functional connectivity is found between default mode network and somatic motor network and within default mode network in schizophrenia patients,and the significant changes of topological properties between default mode network and somatic motor network may be the key factor.In addition,this conclusion can be applied to qualitative analysis of the brain neuron stochastic differential equations corresponding to default mode network and somatic motor network,which is helpful for the physical therapy for schizophrenia.

Objective:To explore the mediating effect of perceived professional benefits between the humanistic literacy and spiritual care competence among oncology nurses.Methods:From September to October 2022, convenience sampling was used to select 354 oncology nurses from 11 ClassⅢ Grade A hospitals in Sichuan Province, Guangdong Province, and Hubei Province as the research subject. A survey was conducted on oncology nurses using the General Information Questionnaire, Nurses' Perceived Professional Benefit Questionnaire, Nurses' Humanistic Literacy Scale, and the Chinese version of the Spiritual Care Competence Scale (SCCS) . Pearson correlation was used to analyze the relationship between nurses' humanistic literacy, perceived professional benefits, and spiritual care competence. AMOS 26.0 software was used to analyze mediating effects. A total of 354 questionnaires were distributed, and after excluding 7 unqualified questionnaires, 347 valid questionnaires were collected, with a valid response rate of 98.02%.Results:Among 347 oncology nurses, the score of the Chinese version of SCCS was (77.60±19.04) . The total score of the SCCS was positively correlated with the total scores of the Nurses' Humanistic Literacy Scale, the Nurses' Perceived Professional Benefit Questionnaire, and scores of all dimensions, with statistically significant differences ( P<0.01) . Bootstrap test showed that the mediating effect of perceived professional benefits among oncology nurses between humanistic literacy and spiritual care competence was 0.284 [95% CI (0.408, 0.860) ] , accounting for 50.90% of the total effect. Conclusions:The perceived professional benefits of oncology nurses play a partial mediating role between humanistic literacy and spiritual care competence. We should strengthen training on the humanistic literacy of oncology nurses, enhance their perceived professional benefits, form a virtuous cycle of employment, and thereby improve their spiritual care competence.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To explore the incidence, diagnosis and treatment of retinopathy of prematurity(ROP) in preterm infants born in the Guangdong Women and Children′s Hospital and transported from other hospital.Method:s Clinical data of 755 premature infants with ROP at Neonatal Intensive Care Unit, Guangdong Women and Children′s Hospital from January 2013 to December 2015 were retrospectively analyzed.There were 239 cases born in the hospital and 516 cases transported from other hospitals.Their gestational age, birth weight, gender, severity of ROP lesion and clinical data were collected and compared.Result:s The birth weight in the group of transported from other hospital was lower than that in the group of born in the hospital[(1 290.64±392.87) g vs.(1 586.21±512.74) g], and the difference was statistically significant( P<0.001). The ROP diagnosis of gestational age in the group of transported from other hospital was higher than that in the group of born in the hospital[(35.53±2.81)weeks vs.(34.51±2.17)weeks], and the difference was statistically significant( P<0.001). On the proportion of severe condition [such as lesion area Ⅰ, aggressive posterior retinopathy of prematurity(AP-ROP) and plus combined lesions], in the group of transported from other hospital was higher than that in the group of born in the hospital, and the differences was statistically significant( P<0.001). In the comparison of the proportion of laser photocoagulation, vitreous injection, combination of the two operations and supplementary laser therapy, in the group of transported from other hospital were higher than those in the group of born in the hospital[60.1%(310/516 cases) vs.20.9%(50/239 cases); 10.9%(56/516 cases) vs.2.5%(6/239 cases); 8.1%(42/516 cases) vs.1.7%(4/239 cases); 4.5%(23/516 cases) vs.1.3%(3/239 cases)], and the differences were statistically significant(all P<0.001). Conclusions:Premature infants with ROP transported from other hospitals have lower birth weight, severe ROP lesions and high surgical intervention rate.Improving ROP screening level in primary hospitals, timely diagnosis and efficient transportation can help to effectively prevent the deterioration of ROP in premature infants and improve their quality of life.

Objective To evaluate the role of a color jaundice card (6 colors) as a possible screening tool for detecting neonatal hyperbilirubinemia.Methods During February 1,2016 and May 31,2017,neonates were enrolled in the study,with gestational age ≥35 weeks,birth weight ≥2 000 g,postnatal age 3-28 days,who were the outpatients or inpatients of the 9th People's Hospital of Wuxi Affiliated to Soochow University and the People's Hospital of Anyang.In a well-lighted room,the card measurements were performed at the infants' forehead,the cheek and the sternum.The skin was pressed with a finger for 2 seconds and left quickly,and then the card was used to compare with the exposed yellow skin.Within 2 hours after jaundice card measurement,blood was obtained by venipuncture and total serum bilirubin (TSB) levels were measured.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were calculated at each measurement sites.Results One hundred and thirty-two neonates were enrolled,of whom 68 cases (51.5％) were male and 64 cases(48.5％) were female and 18 cases (13.6％) were preterm and 114 cases (86.4％) were term neonates.Among all neonates,TSB was ＜5.00 mg/dL(1 mg/dL =17.1 μmol/L) in 21 cases (15.9％),5.00-9.99 mg/dL in 26 cases (19.7％),10.00-14.99 mg/dL in 34 cases (25.8％),15.00-19.99 mg/dL in 37 cases (28.0％) and ≥ 20.00 mg/dL in 14 cases (10.6％).The card had the highest cap ability to recognize jaundice at the cheek,slightly lower at the sternum and the worst in the forehead.The cut-off of ≥ 12 on the six-color card at the cheek had a sensitivity of 95.95％,specificity of 74.14％,PPV of 82.56％,NPV of 93.48％,PLR of 3.710 and NLR of 0.055 for identifying neonates with TSB ≥ 12 mg/dL,with sensitivity being 98.08％,specificity 57.50％,PPV 60.00％,NPV 97.87％,PLR 2.308 and NLR 0.033 for TSB≥ 15 mg/dL.The identification rate was as follows:sensitivity of 100.00％,specificity of 46.00％,PPV of 37.21％,NPV of 100.00％ and PLR of 1.852 for predicting TSB ≥ 17 mg/dL.In addition,in the forehead,cheeks and sternum,the sensitivity of the cut-off of ≥ 12 on the card was 100.00％ for identifying neonates with TSB≥20 mg/dL.In the cheeks and the sternum,the cut-off of ≥ 15 on the card was with a sensitivity of 100.00％ for predicting TSB ≥ 20 mg/dL.Conclusion The six-color jaundice card is a potential screening tool for neonatal hyperbilirubinemia,and the cheek is the best measurement site.

Objective To investigate the effectiveness and safety of peritoneal dialysis(PD) in premature infants with acute renal failure(ARF).Methods In the neonatal intensive care unit (NICU) of Guangdong Province Maternal and Children Hospital, 12 premature infants underwent continuous PD due to ARF from March 2012 to March 2015, without using any antibiotics in the dialysis fluid.Before and after dialysis, the changes of serum urea nitrogen, creatinine, potassium and pH were compared.The complications (blockage, leakage, infection and necrotizing enterocolitis) and gastrointestinal nutrition situation were observed.Wilcoxon signed rank sum test was used for statistical analysis.Results Among the 12 premature infants, the underlying causes of ARF were sepsis (n=9), perinatal asphyxia (n=2), twin twin transfusion syndrome (n=l).The average gestational age was (30.9±3.2) weeks, the average body weight (before PD) was (1 461 ±525) g, the duration of PD was (3.8±2.6) d.Complications associated with PD included leakage (n=3) and peritonitis (n=2) in which Candids albicans and Klebsiella pneumonia were identified in ascites.Gastrointestinal nutrition was built up in six cases within one to four days after dialysis, among which one developing necrotizing enterocolitis on the 7th d after feeding.Finally, eight babies died (six died after initiative discontinued treatment and two died because of critically illness) and four patients were cured and discharged.Lower serum urea nitrogen and potassium levels and higher pH value were shown after dialysis than before [(9.16 ± 3.15) vs (12.71 ±6.98) mmol/L;(4.36±0.82) vs (6.24± 1.72) mmol/L;7.32±0.17 vs 7.21 ±0.17;Z=-2.118,-2.197 and-2.981, all P ＜ 0.05).Conclusion PD is an alternative safe and effective treatment for premature infants with ARF due to its simplicity both in manipulation and equipment requirement.

Objective To investigate the characteristics and neural mechanisms of visual attention dysfunction in patients with hypertension using the event related potentials(ERPs).Methods Visual Oddball pattern was adopted to analyze P3a and P3b components of 15 essential hypertensives and 15 normotensives,and all the participants were submitted to cognitive assessment by Mini-Mental State Examination (MMSE).Results ①Novelty stimulus:the mean amplitude of N2 in hypertensive patients ((1.56± 1.15) μV) was decreased than normal controls ((-2.19±1.15) μV,P＜0.05),particularly at forehead-central sites (P＜0.05).In addition,the amplitude of P3a of hypertensive patients ((6.27± 1.01) μV) was different from normal controls ((7.09± 1.01) μV),but there was no statistical significance(P＞0.05).The latency of visual P3a was significantly longer in patients with hypertension group ((432.83 ± 8.22) ms) than that in control group ((403.10 ± 8.22) ms,P＞ 0.05).②Target stimulus:compared with control group ((6.75 ±0.90)μV),visual P3b amplitude in hypertension group ((4.08 ± 0.90) μV) was significantly declined (P＜ 0.05).Besides,the latency of visual P3b of hypertensive patients ((440.70 ± 6.42) ms) was different from normal controls ((436.91±6.42) ms),but there was no statistical significance(P＞0.05).③Compared with control group (27.31± 1.22),the M MSE score of patients with hypertension (24.55±2.42) was decreased (P＜0.05).The amplitude of visual P3b was positively correlated with MMSE scores in parietal region(r=0.51,P＜0.05).Conclusions The abilities of visual involuntary attention and voluntary attention are damaged in patients with hypertension,the impact degree of hypertension on two kinds of attention and the neural mechanisms are different.Moreover,there is a significant positive correlation between the amplitude of visual P3b and MMSE,which prompts that visual P3b for clinical early assessment of attention in patients with hypertension provides more objective neurophysiological basis.

Objective To master the serum nickel change rule of acute nickel carbonyl poisoning in rats,and to provide laboratory support for clinical treatment of acute nickel carbonyl poisoning patients.Methods SPF rats were given nickel carbonyl (250mg/m3,500mg/m3) in static inhalation for 30min.Rats were anesthetized by ether for 15 seconds after exposure for 30min,2h,4h,8h,12h,24h,48h,72h and 7d respectively.Anatomized rats,kept blood collection 2-3mL,and separated serum 0.5-1mL.Serum nickel was detected by AA800 (American PE company).Results The average serum nickel levels of 250mg/m3 dose group at 30min,2h,4h,8h,12h,24h,48h,72h,7d were (33.69 ±2.59),(24.61 ±3.03),(27.83 ±5.69),(21.36 ±4.14),(20.39 ±4.14),(18.80 ±7.02),(14.51 ±8.21),(13.58 ± 5.78) and (12.83 ± 4.41)μg/L.30 minutes reached the peak,and was 5.30-fold of those in normal controls.There had significant differences compared with normal control(t =5.959,5.958,5.990,5.998,5.997,5.994,5.990,4.317,4.347,all P ＜ 0.01).The average serum nickel levels of 500mg/m3 dose group at 30min,2h,4h,8h,12h,24h,48h,72h,7d were (72.22 ± 1.62),(57.78 ± 12.99),(42.25 ± 7.25),(103.77 ± 11.11),(79.04 ±12.26),(26.35 ±6.56),(18.58 ±4.92),(17.22 ±9.73),(14.59 ±5.27) μg/L.8h reached the peak,and was 16.33-fold of normal controls.The differences were significant (t =5.960,5.947,5.978,5.927,5.948,5.959,3.143,2.447,2.440,all P ＜ 0.05).Meanwhile,there were significant differences between two groups of 30min,2h,4h,8h,12h(t =5.208,2.447,2.449,5.959,5.959,P =0.001,0.049,0.042,0.000,0.000),but there was no significant difference after 24h.Conclusion There was significant doses-effect relationship between serum nickel content of acute nickel carbonyl poisoning rats and the dosage.Nickel carbonyl or its metabolites were excreted mainly within 24h.

Objective To explore the relationships among pulmonary function,DVH and acute radiation pneumonitis after three-dimensional conformal radiation treatment in patients with non-small-cell lung cancer.MethodsPulmonary function tests were conducted on 68 inoperable patients (male 42,female 26,median age 52,KPS≥80) before and after three months radiotherapy respectively.After 3 months of follow-up,radiation pneumonitis were graded,and V20,V30 and MLD were derived from dose volume histogram (DVH).ResultsAll patients were treated with radiotherapy at the irradiation dose of 60～70Gy.Acute radiation pneumonitis occurred in 24 patients with 11 Grade Ⅰ,7 Grade Ⅱ,3 Grade Ⅲ,3 Grade Ⅳ.There were no significant difference between the pre-irradiation and the three months after irradiation for FVC (P＞0.05).But there were significant different between pre-irradiation and three months after irradiation for FEV1.0 and DLCO (P＜0.05).V20,V30 and MLD were observed in patients treated with high radiation pneumonitis.ConclusionsThere were close relationships among pulmonary function,DVH and radiation pneumonitis in patients with non-small cell lung cancer.