This article introduces the concept analysis and theoretical basis of family caregiver benefit finding, reviews intervention research on benefit finding of family caregivers in children with autism spectrum disorder, including writing emotional expression, caregiver skill training, peer support intervention, Mind the Gap, acceptance and commitment therapy, parent-child cooperative music therapy, mindfulness yoga intervention, and Satir model intervention. This article also proposes thoughts and prospects for conducting interventions on benefit finding of family caregivers in children with autism spectrum disorder in China.

To analyze the trends in disease burden and risk factors of depression among the elderly population in China from 1990 to 2021, and to provide a theoretical basis for the prevention, treatment, and policy-making of geriatric depression in China.

Objective:To investigate the efficacy of digital reconstruction technology in assisted design of lobulated deep inferior epigastric perforator flap (DIEPF) for surgical reconstruction of large defect in lower extremity.Methods:From January 2017 to January 2022, a study was carried out to retrospectively analyse 8 patients who had massive soft tissue defects in lower extremities were admitted in the Department of Orthopaedic Surgery of the 920 Hospital of Joint Logistic Support Force of Chinese PLA. The size of defects varied from 16.0 cm×12.0 cm-28.0 cm×22.0 cm. CTA scans were performed over abdominal aorta and the arteries of lower extremities. Three-dimensional model of DIEPF and vascular pedicles were reconstructed by Mimics software. According to the shape and size of the wound, targeted perforators were determined on the 3D images, and precisely mapped in a digitised rectangular coordinate system. The lobulated flap was then digitally designed in the 3D coordinate system. Flaps were harvested according to preoperative digital designs for the reconstruction of large defects in the lower extremities. The donor site was sutured directly. The flaps and recovery of lower extremities were observed though postoperative follow-ups and were conducted through visits of outpatient clinics and distance interviews via telephone and WeChat. Recoveries of lower extremities were evaluated using Maryland ankle-foot function scoring system.Results:The 3D reconstructed models of the vessels in donor sites were successfully completed for all patients. The harvests of lobulated DIEPF were successfully guided by the digital designs. Fifteen lobes of lobulated DIEPF survived successfully in all 8 patients. All donor sites were closed in the stage-I. Necrosis occurred at the distal tip of a lobulated flap due to a local venous occlusion, and healed after debridement and re-suture. Four patients received further flap debulking surgery. Time of postoperative follow-ups had ranged 15-27 months, with an average of 20 months. At the last follow-up, all the flaps had satisfactory appearance with linear scars at the donor sites. All fractures were healed. Five patients achieved Maryland's ankle-foot function score in excellent, 2 in good, and 1 was acceptable.Conclusion:Digital reconstruction technology can accurately map the perforators and reasonably assist the design of lobulated flaps. A lobulated DIEPF offers a wider area for flap excision and allows a primary closure of the donor sites. Combination of the 2 advantages of a lobulated DIEPF can be effectively applied in reconstruction of a large-sized defect in lower extremity.

Objective:To adapt the clinical nursing practice guidelines for myeloproliferative neoplasms (MPN) to form high-quality localized evidence, so as to provide a basis for clinical knowledge transformation, and enable clinical practitioners to care for patients based on standards and evidence.Methods:We carried out guideline adaptation registration on the Practice Guideline Registration for Transparency. Guided by the ADAPTE method, evidence was searched and screened from top to bottom based on the "6S evidence pyramid" model. We conducted quality evaluation and content analysis on the included guidelines to extract, organize, and adapt recommendations on MPN clinical nursing practices. The search period was from September 2011 to September 2022.Results:A total of six evidence-based guidelines, six expert consensus guidelines, and four clinical decisions were included. A total of 40 recommendations were extracted, which were adapted into six Level Ⅰthemes for admission assessment, symptom management, risk factor management, medication management, treatment goal management, and follow-up management, as well as 19 Level Ⅱ themes.Conclusions:The guidelines included are of high overall quality, with rich, specific, and highly consistent recommendations, which can provide resource preparation for later evidence conversion. Some content still needs to be supplemented and expanded. It is recommended that scholars in this field develop comprehensive and specific clinical nursing practice guidelines based on clinical needs.

Objective:To explore rational surgical treatment for childhood nail matrix nevi.Methods:A retrospective analysis was conducted on clinical data from 35 children with pathologically confirmed nail matrix nevi, who received surgical treatment in Children′s Hospital of Chongqing Medical University from September 2015 to March 2019. Different surgical approaches were adopted according to the site and width of lesions. For lesions with a width of ≤ 3 mm, the nail bed and nail matrix lesions were directly excised with 1-to-2-mm margins and sutured in 11 cases. For lesions with a width of > 3 mm, one of the following 3 surgical procedures was selected by the children′s parents: (1) shaving of nail bed and nail matrix lesions under a microscope at ×8 magnification (8 cases) ; (2) excision of lesions followed by full-thickness skin grafting on the periosteum of the phalanx (8 cases) ; (3) excision of lesions of the second to fifth fingers followed by transfer of skin flaps from the thenar muscle area and full-thickness skin grafting (5 cases) , or excision of lesions of the thumb followed by abdominal-wall flap transfer (3 cases) . The patients were followed up for 12 months, and clinical efficacy was evaluated.Results:During the follow-up, no recurrence occurred in the 11 cases receiving direct excision and suture, with good appearances and longitudinal linear scars on the nail. Among the 8 cases receiving shaving therapy under a microscope, 4 experienced relapse during the follow-up of 6 - 12 months, and the nail/toenail plates were rough and poor in lustrousness in the other 4 without recurrence. No recurrence was observed in the 8 cases receiving excision of the lesions and full-thickness skin grafting, of whom 1 experienced skin graft necrosis, and skin grafts survived with obvious pigmentation in the other 7 cases. Among cases receiving excision of the lesions combined with transfer of skin flaps from the thenar muscle area or abdominal-wall flap transfer, no recurrence was observed, and all transferred flaps survived; good appearances, nearly normal color and gloss of nails were obtained in the cases after transfer of skin flaps from the thenar muscle area, while the color and gloss of postoperative nails were markedly different from those of normal nails in the cases receiving abdominal-wall flap transfer.Conclusion:For nail matrix nevi with a width of ≤ 3 mm, direct excision and suture with 1-to-2-mm margins are recommended; for those with a width of > 3 mm, excision of lesions combined with full-thickness skin grafting, transfer of skin flaps from the thenar muscle area or abdominal-wall flap transfer is recommended; the shaving procedure under a microscope should be used with caution.

Objective:To build a competency index system for "double-qualified" nursing teachers in application-oriented universities.Methods:The overall research period was from September 2020 to February 2021. The literature research and behavioral event interview were used to initially form the competency index system for "double-qualified" nursing teachers in application-oriented universities. A total of 20 nursing experts from Qiqihar Medical University and its three affiliated hospitals were selected by convenience sampling. Delphi expert consultation was used to conduct two rounds of consultations.Results:Among two rounds of consultations, the effective response rates of the questionnaires were all 100%, and the expert authority coefficients were 0.815 and 0.845, and the Kendall harmony coefficients were 0.236 and 0.243, respectively. The final form of the competency index system for "double-qualified" nursing teachers in application-oriented universities included 5 dimensions and 23 items.Conclusions:The competency index system for "double-qualified" nursing teachers in application-oriented universities has clear indicators, which can be used as a quantitative reference basis for university and hospital education, and manager training, assessment as well as evaluation of nursing teachers.

Clinical scales and external devices are two important ways to quantify the severity of motor symptoms for Parkinson′s disease (PD). As one representative of scales, the Unified Parkinson′s Disease Rating Scale is considered the "gold standard" in the comprehensive assessment of PD. External devices are divided into electrophysiological and mechanical devices based on the type of sensors. Both sides can monitor the PD motor symptoms objectively. Currently, numerous and ununified parameters of devices make the clinical quantification of PD symptoms still rely on scales. This article reviewed the progress on quantitative assessments of motor symptoms for Parkinson′s disease.

Oral medicine and deep brain stimulation are two main treatments for Parkinson′s disease (PD). But their long-term efficacies are decreasing, which limit the choice of patients in advanced stage. As a special way of sensory intervention, rhythmic cueing can improve gait parameters, reduce freezing of gait severity and improve gait-related mobility by activating the motor pathway directly, repairing internal clock, promoting internal dopamine release and improving cognitive function to maintain gait stability. Rhythmic auditory and visual cueing has a potential in PD treatment.

Maple syrup disease (MSUD) is a rare autosomal recessive disorder caused primarily by mutations of branched-chain keto acid dehydrogenase complex (BCKDC). BCKDC includes at least four pathogenic genes of BCKDHA, BCKDHB, DLD and DBT. The clinical manifestations of MSUD are complex, and the main symptoms at the early stage include difficulty in feeding, drowsiness, change in muscle tone and special urine flavor of maple syrup. As the disease progresses, convulsion, hypoglycemia, coma and systemic failure may occur. MSUD is easily missed or misdiagnosed during the neonatal period. This paper provides a review for recent progress made in research on MSUD including etiology, physiopathology, clinical manifestation, auxiliary examination and treatment, with a particular emphasis on genetic testing and treatment.
3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide) ; genetics ; Humans ; Maple Syrup Urine Disease ; diagnosis ; genetics ; therapy ; Mutation

Objective: To investigate the expression of gamma-aminobutyric acid type A receptor beta3 subunit (GABRB3) on cleft palate in C57BL/6J mice induced by 2,3,7,8-tetrachlorodibenzo- p-dioxin (TCDD). Methods: Sixty C57BL/6J pregnant mice on gestation day (GD) 10.5 were divided into two groups: one group was administered through gastric tubes one dose of 28 μg/kg TCDD (experimental group) and the other group was administered through gastric tubes one dose of 5.6 ml/kg corn oil (control group). Embryos were removed by cesarean section from pregnant mice during the palatal formation stage (GD 13.5-17.5) and the palatal tissue studied in morphological and histological observation. The relative mRNA and protein expression of GABRB3 was measured by real-time quantitative PCR and Western blotting. Localization of GABRB3 protein was measured by immunohistochemistry or immunofluorescence. Results: The incidence of cleft palate at GD17.5 was 100% in experimental group and there was no cleft palate occurred in the control group (0); elevation of palatine processes in experimental group was completed on GD15.5 which was clearly delayed by a day compared with that in control group. On GD14.5-GD17.5, the mRNA expression (0.561±0.073, 0.728±0.104, 0.782±0.137, 0.686±0.145) and protein expression (0.288±0.013, 0.404±0.017, 0.399±0.012, 0.307±0.010) in the experimental group were significantly lower than the control group mRNA expression (0.818±0.088, 0.865±0.086, 1.021±0.054, 1.163±0.179) and protein expression (0.481±0.017, 0.456±0.009, 0.474±0.016, 0.529±0.015)(P<0.05). Immunohistochemistry and immunofluorescence showed that GABRB3 was mainly expressed in the mesenchymal cells and medial edge epithelium. Conclusions TCDD delayed palatal shelf elevation and eventually led to cleft palate may be associated with a decrease in GABRB3. GABRB3 may play an important role in the elevation and fusion phases of the palate development.