Objective:To compare the nutritional evaluation methods and to analyze the clinical value of different nutritional evaluation indexes in acute lymphoblastic leukemia (ALL) pediatric patients during the stage of remission induction.Methods:The clinical data of 132 ALL pediatric patients who were diagnosed and treated with remission induction in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University from January 2018 to December 2020 were collected by convenient sampling method. The body composition was measured by direct segmental multifrequency bioelectrical impedance measurement (DSM-BIA), and the height, weight, upper arm circumference and triceps skinfold thickness were also measured. The Screening Tool for the Assessment of Malnutrition in Pediatrics scores were calculated. The serum albumin value and the hemoglobin value were monitored. Using DSM-BIA as the reference standard, the accuracy of different nutritional evaluation indexes was investigated and analyzed.Results:During the stage of remission induction in ALL pediatric patients, there were 69 out of 132 children who had the muscle mass below normal. The muscle mass below normal was detected in 52.3% (69/132). And the upper arm circumference had the highest correlation and the minimal standard error with muscle mass measured by DSM-BIA ( R2=0.520, SE=0.180). Grouped with nutritional status by the upper arm circumference, the children with normal nutritional status had lower incidence of very severe neutropenia 76.8% (24/32) than 92.1% (70/76) with abnormal nutritional status ( χ2=6.14, P=0.013). Conclusions:During the stage of remission induction in ALL pediatric patients, the malnutrition rate is high. The upper arm circumference is a simple index which can accurately reflect the nutritional status of the ALL pediatric patients. It is suggested that the upper arm circumference should be used as the primary screening index of clinical nutrition by clinical nurses.

Objective:To explore the feasibility of quantitative evaluation of extracellular volume (ECV) fraction in acute ST-segment elevation myocardial infarction (STEMI) by dual-layer spectral detector CT.Methods:The clinical and imaging data of 20 patients with STEMI who underwent cardiac contrast-enhanced CT and MRI from January to October 2019 in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.The dual spectral detector was used in the enhanced CT scan of the coronary artery with retrospectively gate and the late iodine enhancement with prospective gate. Conventional image and holographic spectral image were obtained by iterative and spectral reconstruction. The short axis image of the heart matched with MR image was obtained by multiplanar reconstruction. Based on the data of spectral based image, the IDD map was reconstructed for the calculation of myocardial CT-ECV during the late iodine enhancement. ECV of infarcted myocardium, salvageable myocardium and remote myocardium based on CT and MRI were calculated respectively. Bland-Altman consistency test and intra group correlation coefficient analysis (ICC) were used to compare the consistency of two measurements and different methods. The correlation between CT-ECV and MRI-ECV was compared by Spearman method.Results:The CT-ECV values of infarcted, salvageable, and remote myocardium were 51.21 (49.27, 53)%, 38.64 (36.17, 40)%, and 51.21 (49.27, 53)%, respectively. The difference was statistically significant ( H= 43.17, P<0.01). The CT-ECV value of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=-24.60, 35.40, P<0.01), but there was no significant difference between salvageable myocardium and remote myocardium ( Z= 10.80, P=0.15). The T 1 values of infarcted myocardium, salvageable myocardium and remote myocardium were (1 554.85±70.94), (1 443.85±67.28) and (1 307.05±91.73) ms respectively, the difference was statistically significant ( F=51.35, P<0.01). The T 1 value of infarcted myocardium was higher than that of salvageable myocardium and remote myocardium ( t=-5.07, 9.55, P<0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( t=5.38, P<0.01). The MRI-ECV values of infarcted myocardium, salvageable myocardium and remote myocardium were 55.00 (49.27, 57.75)%, 33.50 (29.00, 35.00)%,and 27.00 (26.00, 29.00)%, respectively. The difference was statistically significant ( Z= 47.12, P<0.01). MRI-ECV of infarcted myocardium was significantly higher than that of salvageable myocardium and remote myocardium ( Z=37.45, -20.30, P< 0.01), and salvageable myocardium was significantly higher than that of remote myocardium ( Z = 17.15, P<0.05). The difference between CT-ECV and MRI-ECV measured by two physicians was good. The bias of Bland-Altman analysis was -0.1% (95% CI:-5.5%-5.2%), 0.8% (95% CI:-9.8%-8.2%), and the ICC values were 0.92 and 0.94, respectively. The bias of Bland-Altman analysis in CT-ECV and MRI-ECV consistency test was 4.00% (95% CI:-9.0%-16.9%) and ICC value was 0.88, which had a good correlation ( r=0.75, P=0.001). Conclusions:The iodine density based ECV fromdual-layer spectral detector CT can be used to quantitatively evaluate the changes of extracellular space after acute STEMI, which is helpful to quantitatively evaluate the histological changes after myocardial ischemia.

Objective To explore the effects of improved emergency nursing intervention on complications and clinical prognosis of severe patients with craniocerebral injury accompanied by cerebral hernia, and provide evidence for clinical nursing. Methods The patients with severe craniocerebral injury accompanied by cerebral hernia were enrolled in Dongguan People's Hospital from January 2016 to December 2018. According to the admission time, the patients were divided into routine nursing group (Admission from January 2016 to June 2017) and improved emergency nursing methods group (Admission from July 2017 to December 2018). To analyze the effect of two different nursing methods on the prognosis of patients by improving first aid nursing measures and routine nursing. Both groups of patients underwent craniotomy, the conventional nursing group was treated with routine operating room care, the improved emergency nursing methods group was given improved emergency care interventions based on the conventional nursing, the operation preparation time, operation time, intra-operative blood loss and the incidence of postoperative complications, clinical prognosis of the two groups were observed; the self-made questionnaire was used to evaluate the scores of the patient's satisfaction and compliance. Results The operation preparation time, operation time and intra-operative blood loss of the improved emergency nursing methods group (40 cases) were significantly lower than those in the conventional nursing group [40 cases, operation preparation time (minutes): 25.03±5.47 vs. 36.73±5.83, operation time (minutes): 52.56±10.63 vs. 92.10±10.73, intra-operative blood loss (mL): 218.73±20.74 vs. 402.66±23.70, all P < 0.05]; the clinical good prognosis rate, rate of satisfaction to nursing, treatment compliance score of the improved emergency nursing methods group were significantly higher than those of the conventional nursing group [clinical good prognosis rate: 20.0% (8/40) vs. 12.5% (5/40), rate of satisfaction to nursing: 95.0% (38/40) vs. 82.5% (33/40), treatment compliance scores: 95.83±4.09 vs. 81.27±5.04, all P < 0.05]; the complication rate of the improved emergency nursing methods group was significantly lower than that of the conventional nursing group [32.5% (13/40) vs. 55.0% (22/40), P <0.05]. Conclusion The improved emergency nursing intervention can significantly improve the clinical prognosis and reduce the incidence of complications in patients with severe craniocerebral injury accompanied by cerebral hernia, so that the clinical application value is relatively high.

Objective: To explore the difference of personality characteristics of physicians, nurses, medical skills and administrative personnel in a general hospital and its influence on job burnout. Methods: Employee entered the hospital before 2018 were enrolled in the current study and the position was classified as physicians, nurses, medical technician and administrative staff. Minnesota Multiphasic Personality Inventory (MMPI) was completed by the employee at the time of entering the hospital. Status of job burnout was assessed in 2018 using the Maslach Burnout Inventory-General Survey (MBI-GS) . Results: Physicians have a higher rate of paranoia than others (P<0.05) , and administrative staff and medical technician have a slightly higher score than the other two categories of people (P<0.05) , and administrators lie at a higher rate than others (P<0.05) . Further analysis found that personality traits did not have a significant association with job burnout at the time of entry. Conclusion The administrative and medical staff is slightly more irritable, the administrative staff lying slightly higher score, the staff after the entry of job burnout is not affected by the personality characteristics of the onboarding.

To discuss therapeutic effect of intravenous drip of monosialic tetrahexose ganglioside (MTG) combined comprehensive rehabilitation on patients with stroke hemiplegia and its impact on neurologic impairment score (NIS).Methods : A total of 100 patients with stroke hemiplegia treated in our hospital were randomly and e‐qually divided into routine treatment group (received routine comprehensive training treatment including work ther‐apy ,exercise therapy etc .) and combined treatment group (received intravenous drip of MTG based on routine treatment group) ,both groups were continuously treated for four weeks .Limb and neurologic function ,and im‐provement of quality of life (QOL) were compared between two groups .Results : Oneight weeks after treatment , total effective rate of limb function in combined treatment group was significantly higher than that of routine treat‐ment group (94. 0% vs.76. 0%, P＝0.030) ;after one ,four and eight‐week treatment ,along with time went on , there was significant rise in Glasgow coma scale (GCS) score in two groups ,and those of combined treatment group were significantly higher than those of routine treatment group [one week :(8. 56 ± 2. 47) scores vs .(7.24 ± 2.01) scores ,four weeks :(11.26 ± 2.81) scores vs .(9.23 ± 2. 01) scores ,eight weeks :(13.28 ± 3.43) scores vs .(11. 43 ± 2.65) scores] , P＜0. 01 all ;compared with before treatment ,there were significant rise in each dimension score of QOL in two groups after eight‐week treatment ,and each dimension score of combined treatment group was sig‐nificantly higher than that of routine treatment group , P＝0. 001 all.Conclusion : Intravenous drip of MTG com‐bined comprehensive rehabilitation possesses significant therapeutic effect on patients with stroke hemiplegia .It can significantly improve limb and neurologic function state ,improve quality of life in these patients .

Primary immune thrombocytopenia ( ITP) is an organ-specific autoimmune hemorrhagic disease. The etiology of ITP is still unclear, but loss of immune tolerance to platelet surface antigens is con-sidered as a fundamental cause of ITP. Therapeutic strategies that prevent the activation and proliferation of autoreactive cells have been suggested, which includes clearance of autoreactive cells ( apoptosis) , receptor editing, induction of anergy and extrinsic cellular suppression. Failure at any of these steps may lead to the production of autoantibodies against platelet and megakaryocyte glycoproteins. An improved understanding of the mechanisms for autoantibody production will provide theoretical basis for optimal diagnosis and treatment of ITP.

Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF).Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation.Mean age was 38.7 years (range, 18-72 years).Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative B(o)hler angle, width of postoperative calcaneus, and time to surgery after injury.Clinical result was evaluated and compared within each group.Results Mean duration of follow-up was 18.3 months (range, 14-26 months).The clinical results were excellent for 67 feet (74％), good for 12 feet (13％), fair for 7 feet (8％) and poor for 5 feet (5％), which yielded 87％ good to excellent results.Good to excellent results in Sanders Ⅱ , Ⅲ and Ⅳ groups reached 94％, 85％ and 53％ respectively, in quality of fracture reduction ≤ 2 mm and ＞ 2 mm groups reached 93％ and 30％ respectively, in postoperative B(o)hler angle ＜ 15° and ≥15° groups reached 33％ and 90％ respectively;in broadening of postoperative calcaneus ＜ 1 cm and ≥ 1 cm groups reached 92％ and 17％ respectively, in time to surgery after injury ≤14 days and ＞ 14 days groups reached 91％ and 43％ respectively, in age ≤60 years old and ＞ 60 years old groups reached 85％ and 88％ respectively.Except for the age group, the clinical result differed significantly within group (P ＜ 0.05).Conclusions Fracture type, reduction quality, postoperative B(o)hler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture.Thereupon the unfavorable influences should be avoided to improve the operative results.

3' Untranslated Regions ; Animals ; Biomarkers ; metabolism ; Cell Proliferation ; Cell Survival ; Embryonic Stem Cells ; cytology ; metabolism ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; Mice ; Swine ; Transcription Factors ; genetics ; metabolism

The chemical constituents from Aconitum richardsonianum var.pseudosessiliflorum were investigated.The roots of this plant were extracted three times with 90％ EtOH at the room temperature.The ethanol extracts were combined and concentrated under reduced pressure to yield residue,which was suspended in water and successively partitioned with chloroform.The chloroform extraction was isolated and purified by silica gel and Sephadex LH-20 column chromatography. Six compounds were isolated and elucidated as delelatine (1), isodelpheline (2),3-acetylaconitine (3),isoatisine (4),nordhagenine A (5) and yunaconitine (6).Compounds 1 - 5 were obtained from Aconitum Brunneum for the first time.Compound (1) showed significant cytotoxic activities (IC50 =4.36 tμM) against the human tumor cell line P388.

The chemical constituents from Aconitum richardsonianum var.pseudosessiliflorum were investigated.The roots of this plant were extracted three times with 90% EtOH at the room temperature.The ethanol extracts were combined and concentrated under reduced pressure to yield residue,which was suspended in water and successively partitioned with chloroform.The chloroform extraction was isolated and purified by silica gel and Sephadex LH-20 column chromatography.Six compounds were isolated and elucidated as delelatine（1）,isodelpheline（2）,3-acetylaconitine（3）,isoatisine（4）,nordhagenine A（5）and yunaconitine（6）.Compounds 1-5 were obtained from Aconitum Brunneum for the first time.Compound（1）showed significant cytotoxic activities（IC50=4.36 μM）against the human tumor cell line P388.