Objective:To search, evaluate, and summarize the best evidence for difficult peripheral intravenous catheterization in children.Methods:Following the "6S" evidence pyramid model, literature related to the management of difficult peripheral veins in children was searched in both English and Chinese databases including UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, the Joanna Briggs Institute Evidence-Based Health Care Database, PubMed, Medlive, SinoMed, CNKI, and Wanfang Database. The search period was from the establishment of the database to January 2023. Two researchers trained in systematic evidence-based nursing, independently evaluated the quality of included literature and extracted relevant evidence.Results:Five articles were included: two guidelines, two expert consensuses, and one systematic review. 19 best evidence were summarized, covering five aspects: difficult vein quality management, difficult vein assessment, difficult intravenous catheterization site and needle type selection, difficult intravenous catheterization auxiliary methods, and handling of failed difficult intravenous catheterization.Conclusions:This study summarizes the best evidence for difficult peripheral intravenous catheterization in children, demonstrating clinical nursing practicality. It provides evidence-based guidance for pediatric nursing staff performing difficult intravenous catheterization.

OBJECTIVETo assess the value of 15 short tandem repeat (STR) loci selected by an AmpFLSTR Identifilersystem for personal identification and paternity testing among ethnic Hans from Xiamen, Fujian.

METHODSFor 400 unrelated individuals, allelic frequencies for the 15 STR loci from the AmpFLSTR Identifilerkit were determined. Population genetics parameters for forensic usage were calculated.

RESULTSNo deviation of the observed allele frequency from Hardy-Weinberg equilibrium expectations was found by Chi-square test (P>0.05). All of the 15 loci were highly polymorphic. Observed heterozygosity has varied between 0.580 and 0.868. Matching probability was between 0.036 and 0.148. Power of discrimination was between 0.798 and 0.967. Polymorphic information content was between 0.560 and 0.850. And power of exclusion was between 0.268 and 0.730.

CONCLUSIONAll of the 15 loci selected by the AmpFLSTR Identifilersystem are highly polymorphic among ethnic Hans from Xiamen. By determining the alleles and allelic frequencies, data for genetic polymorphisms usable for paternity testing and personal identification for local population were obtained.

Alleles ; Asian Continental Ancestry Group ; genetics ; Chi-Square Distribution ; China ; Forensic Genetics ; methods ; Gene Frequency ; Genetics, Population ; methods ; Genotype ; Humans ; Linkage Disequilibrium ; Microsatellite Repeats ; genetics ; Polymorphism, Genetic

Objective To observe the positional relationship of lumbar nerve roots and its main adjacent structures with CT data, and to conduct 3D construction and measurement,so as to provide anatomical basis for percutaneous lumbar diskectomy(PLD).Methods CT serial tomography dataset of 30 healthy adults' lumbosacral portions were imported into Mimics 17.0 software to segment related structures and obtain the layers of different structures.The structures were 3D reconstructed and virtually demonstrated.The lumbar nerve roots and their main surrounding structures were observed and measured.Results The minimum distances between the lumbar nerve roots and the superior articular processes increased gradually from L3 to L4 intervertebral disc layer to L5 to S1 intervertebral disc layer.The 3D model clearly displayed the morphology and spatial relationship of the lumbar nerve roots and their adjacent structures in lumbosacral portion.The lower the lumbar intervertebral discs were,the thicker they were.The distances from the middle point of the back of lumbar intervertebral disc to the end of the superior spinous process of lumbar vertebra increased at first and decreased then,and the distance in L3 to L4 intervertebral disc layer was the farthest.Conclusion The relationship between lumbar nerve roots and superior articular processes,the intervertebral disc thickness variance and the change of the distances from lumbar intervertebral disc to the end of the superior spinous process have been analyzed in this study,and the clinic basis has been laid for percutaneous lumbar diskectomy.

Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4％),postsurgical epilepsy (10.5％) and hydrocrania (11.6％) in the HBO group were all obviously decreased(47.3％,23.0％,24.3％),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P ＜ 0.05).The incidence of subdural effusion in the HBO group was 32.6％,while that of the routine treatment group was 41.9％,and there was no statistical significance,when comparisons were made between the 2 groups (P ＞ 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.

Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4％),postsurgical epilepsy (10.5％) and hydrocrania (11.6％) in the HBO group were all obviously decreased(47.3％,23.0％,24.3％),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P ＜ 0.05).The incidence of subdural effusion in the HBO group was 32.6％,while that of the routine treatment group was 41.9％,and there was no statistical significance,when comparisons were made between the 2 groups (P ＞ 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.

Mitochondrial quality control is the important mecha-nism that regulates the morphology,quantity and quality of mito-chondrial in cell to maintain cellular homeostasis and thus,cell survival and health.It has been revealed that members of Bcl-2 family are linked to mitochondrial function and integrity.Bcl-2 family proteins are the key regulators of mitochondrial quality control,participating in the signaling pathways regulating the
crosstalk between mitophagy and apoptosis,as well as mitochon-drial fission and fusion.This paper mainly reviews their impact on mitochondrial quality and the major signaling pathways regula-ted by Bcl-2 family proteins.

OBJECTIVETo explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis (AR) treated with warm acupuncture in winter and summer.

METHODSTwo hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupuncture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year. In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. In the western medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session. The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of serum immunoglobulin E (IgE) were compared in the patients' of each group before treatment and in 1 and 2 sessions of treatment.

RESULTSAfter treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment, in the patients of the three groups (all P < 0.05). After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups (all P < 0.05), and the results in the non-summer and winter acupuncture group were better than those in the western medication group (all P < 0.05). After treatment, serum IgE level was lower averagely than that before treatment in the three groups (all P < 0.05). After 2 sessions treatment, the result in the summer and winter acupuncture group was lower than that in the other two groups (both P < 0.05), and the result in the non-summer and winter acupuncture group was lower than that in the western medication group (P < 0.05). After treatment, the total effective rate was 92.3% (72/78) in the summer and winter acupuncture group, better than 80.5% (62/77) in the non-summer and winter acupuncture group and 69.7% (53/76) in the western medication group (both P < 0.05).

CONCLUSIONThe warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; therapy ; Seasons ; Treatment Outcome ; Young Adult

Computational Biology ; Factor VII ; Factor VII Deficiency ; Genetic Testing ; Humans ; Pedigree

Objective To meet the special needs of the department of radiation oncology, a radiation therapy information management system ( RTIMS) has been developed as a secondary database system to supplement the Varian Varis/Aria since 2007. Methods The RTIMS server was used to run a database and web service of Apache + PHP + MySQL. The RTIMS sever's web service could be visited with Internet Explorer (IE) to input, search, count, and print informations from about 30 workstations and 20 personal computers. As some workstations were installed with Windows and IE in English only, some functions had English version. Results In past five years, as the RTIMS was implemented in the department, some further needs were met and more practical functions were developed. And now the RTIMS almost covered the whole workflow of radiation therapy ( RT) . By September 2011 , recorded patients data in the RTIMS is as follows: 3900 patients, 2600 0utpatient RT records, 6800 progress notes, 1900 RT summaries, 6700 charge records, 83000 workload records, 3900 plan application forms, 1600 ICRT records. etc. Conclusions The RTIMS hased on the workflow of RT has been successfully developed and clinically implemented. And it was demonstrated to be user-friendly and was proven to　significantly improve the efficiency of the department. Since it is an in-house developed system, more functions can be added or modified to further enhance its potentials in research and clinical practice.

Objective To evaluate the reliability, validity and feasibility of the Chinese version of SF-36 health survey questionaire in long-term survivors of nasopharyngeal carcinoma (NPC). Methods A total of 85 long-term NPC survivors completed the Chinese version of SF-36 by either telephone or mail survey. Correlation analysis, reliability analysis and factor analysis were performed to evaluate the reliability and validity of the scale. Results The Chinese version of SF-36 was easy to complete. The split-half reliability was 0. 92 and the Cronbach's α coefficient among domains were all above 0. 70, which showed good reliability and discrimination capacity among domains. All the correlation coefficients between each item and its domain achieved or approached 0. 5, which were greater than those between the item and other domains. These results demonstrated that the Chinese version of SF-36 had good content validity and discriminatory validity. Six principal components were extracted from the scale, which could basically represent eight domains. The cumulative variance was 71.4%. Two common factors were extracted from the eight domains, which accounted for 73.3% of the variance. The Chinese version of SF-36 was able to detect differences in the quality of life between NPC patients and healthy populations. Conclusions The Chinese version of SF-36 has good feasibility, reliability and validity in evaluating the quality of life in long-term NPC survivors.