ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

Objective To investigate the correlations of serum levels of soluble vascular cell ad-hesion molecule-1(sVCAM-1),homocysteine(Hcy)and D-dimer(D-D)with inner ear microcircu-lation disorders in patients with sudden sensorineural hearing loss.Methods Eighty-four patients with sudden deafness were selected as subjects.Patients were divided into mild(17 cases),moderate(31 cases)and severe(36 cases)groups based on the degree of hearing loss.According to the types of audiogram maps,they were divided into low-frequency group(22 cases),high-frequency group(33 cases)and full-frequency group(29 cases).Forty-two healthy individuals undergoing physical examination during the same period served as healthy group.The levels of sVCAM-1,Hcy as well as D-D and inner ear microcirculation arterial diameters were compared among different audiogram types and degrees of hearing loss.Pearson correlation analysis and linear regression analysis were em-ployed to verify the correlations between the aforementioned serum indicators and arterial diameters in inner ear microcirculation of affected patients.Results Compared with the healthy group,the diameters of the internal auditory artery,basilar artery,and anterior inferior cerebellar artery in the inner ear microcirculation were significantly reduced in the low-frequency type,high-frequency type and full-frequency type groups,with the high-frequency and full-frequency types being significantly smaller than the low-frequency type,and the full-frequency type being significantly smaller than the high-frequency type(P＜0.05).Serum levels of sVCAM-1,Hcy and D-D were significantly higher in the low-frequency type,high-frequency type and full-frequency type groups compared with the healthy group,with the full-frequency type being significantly higher than the low-frequency and high-frequency types(P＜0.05).Serum levels of sVCAM-1,Hcy and D-D were significantly high-er in the mild,moderate and severe groups compared with the healthy group,with the severe group being significantly higher than the mild and moderate groups(P＜0.05).The diameters of the in-ternal auditory artery,basilar artery and anterior inferior cerebellar artery in the inner ear microcir-culation were significantly smaller in the mild,moderate and severe groups compared with the healthy group(P＜0.05).Compared with the mild group,the diameters of the internal auditory ar-tery,basilar artery and anterior inferior cerebellar artery were significantly reduced in the moderate and severe groups,with the severe group being significantly smaller than the moderate group(P＜0.05).Serum levels of sVCAM-1,Hcy and D-D showed negative correlation with the diameters of the internal auditory artery,basilar artery and anterior inferior cerebellar artery(P＜0.05).Arterial di-ameters of the internal auditory artery,basilar artery and anterior inferior cerebellar artery were inde-pendently correlated with serum levels of sVCAM-1,Hcy and D-D(P＜0.05).Conclusion Serum levels of sVCAM-1,Hcy and D-D are closely related to inner ear microcirculation disorders in pa-tients with sudden deafness.As serum levels of sVCAM-1,Hcy and D-D increase,the severity of hearing loss and inner ear microcirculation disorder intensifies.

Objective To compare the clinical efficacy of narrow band imaging(NBI)-guided microscopic CO2 laser surgery and conventional microscopic CO2 laser surgery in treatment of patients with vocal cord atypical hyperplasia.Methods A total of 90 patients with vocal cord atypical hyper-plasia were enrolled as study subjects.Based on different surgical approaches,they were divided into conventional group(43 cases,undergoing conventional microscopic CO2 laser surgery)and NBI-guided group(47 cases,undergoing NBI-guided microscopic CO2 laser surgery).The negative mar-gin rate,complication rate,recurrence rate,and the levels of voice-related parameters(jitter,shim-mer,noise-to-harmonic ratio)and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]before and after surgery were compared between the two groups.Results The negative mar-gin rate of the first-time biopsy after laser surgery in the NBI-guided group was 97.87％,which was higher than 86.05％in the conventional group,with a statistically significant difference(P＜0.05).After surgery,the jitter,shimmer and noise-to-harmonic ratio in both groups were lower than those before surgery,with statistically significant differences(P＜0.05),but there was no statistically sig-nificant difference between the two groups(P＞0.05).After surgery,the levels of CRP and IL-6 in both groups were lower than those before surgery,with statistically significant differences(P＜0.05),but there was no statistically significant difference between the two groups(P＞0.05).The compli-cation rate was 4.26％in the NBI-guided group,and 9.30％in the conventional group,with no statistically significant between-group difference(P＞0.05).During a follow-up of 6 months to 2 years,the recurrence rate in the NBI-guided group was 2.13％and 6.98％in the conventional group,with no statistically significant between-group difference(P＞0.05).Conclusion Com-pared with conventional microscopic CO2 laser surgery,NBI-guided microscopic CO2 laser surgery can more precisely determine the range of the lesion and the surrounding mucosal margins and re-duce the number of intraoperative biopsies in the treatment of vocal cord atypical hyperplasia.How-ever,the two surgical methods have similar impacts on postoperative voice-related parameters,in-flammatory factors,complications and recurrence rates.

OBJECTIVE: To assess the value of single sperm sequencing in preimplantation genetic testing for monogenic disease (PGT-M). METHODS: A Chinese couple with two children whom had died of Spinal muscular atrophy (SMA) and attended the Jiangxi Provincial Maternal and Child Health Care Hospital in June 2020 was selected as the subject. Eleven single sperm samples were isolated by mechanical immobilization and subjected to whole genome amplification. Real-time PCR and Sanger sequencing were used to detect the SMN1 variants in the single sperm samples. Genomic DNA of the wife, her parents and the husband, as well as one single sperm sample harboring the SMN1 variant and two single sperm samples without the variant were used for the linkage analysis. Targeted capture and high-throughput sequencing were carried out to test 100 single nucleotide polymorphisms distributed within 2 Mb up- and downstream the variant site. The haplotypes linked with the SMN1 variants were determined by linkage analysis. Blastocyst embryos were harvested after fertilizing by intracytoplasmic sperm injection. Cells from the trophoblasts of each embryo were biopsied and subjected to whole genome amplification and targeted capture and high-throughput sequencing to determine their carrier status. Chromosomal aneuploidy of wild-type embryos was excluded. An euploid embryo of high quality was transferred. Amniotic fluid sample was taken at 18 weeks of gestation to confirm the status of the fetus. RESULTS: Genetic testing showed that the couple both had deletion of exons 7 ~ 8 of the SMN1 gene. The wife has inherited the deletion from her father, while the husband was de novo. The haplotypes of the husband were successfully constructed by single sperm sequencing. Preimplantation genetic testing has indicated that 5 embryos had harbored the heterozygous variant, 4 embryos were of the wild type, among which 3 were euploid. Prenatal diagnosis during the second trimester of pregnancy has confirmed that the fetus did not carry the deletion. CONCLUSION By single sperm sequencing and PGT-M, the birth of further affected child has been successfully avoided.
Humans ; Pregnancy ; Female ; Child ; Male ; Preimplantation Diagnosis ; East Asian People ; Semen ; Genetic Testing ; Muscular Atrophy, Spinal/genetics* ; Aneuploidy ; Blastocyst/pathology* ; High-Throughput Nucleotide Sequencing ; Spermatozoa

Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.

Objective: To observe the clinical effects of recombinant human growth hormone (rhGH) on children with severe burn. Methods: Clinical data of 94 children with severe burn, hospitalized in our burn unit from April 2012 to December 2016, conforming to the study criteria, were retrospectively analyzed. According to the use of rhGH, children were divided into rhGH group (n=50) and control group (n=44). Children in control group received conventional treatment, while children in rhGH group received both conventional and rhGH treatment. The rhGH treatment was started 3 to 5 days post injury in dosage of 0.2-0.4 U·kg^-1·d^-1, by way of subcutaneous injection, and the course of treatment was (11±5) d. The plasma albumin and prealbumin levels, heart rate, alanine aminotransferase (ALT), and serum creatinine level in 2 weeks post injury, times of skin grafting operation, hospitalization time, total hospitalization treatment cost, and sepsis and death of children were compared between the 2 groups. Data were processed with independent sample t test, Mann-Whitney U test, and Fisher′s exact test. Results: (1) In 2 weeks post injury, the plasma albumin level [(36±4) g/L] and prealbumin level [(94±34) g/L] of children in rhGH group were significantly higher than those in control group [(33±4) and (73±20) g/L, t=3.666, 3.401, P<0.05]. (2) In 2 weeks post injury, the heart rate of children in rhGH group was (123±11) times per minute, which was slower than (130±14) times per minute of children in control group (t=2.839, P<0.05). There was no significant difference in ALT level of children between the 2 groups (Z=0.868, P>0.05). The blood creatinine levels of children in the 2 groups were within normal range. (3) The times of skin grafting operation of children in rhGH group was 0.3±0.5, which was significantly less than 0.5±0.6 in control group (Z=2.234, P<0.05). The hospitalization time of children in rhGH group was (22±8) days, which was shorter than (28±10) days in control group (t=2.837, P<0.05). The total hospitalization treatment cost of children in rhGH group was (41±15) thousand yuan, which was significantly less than (53±25) thousand yuan in control group (t=2.878, P<0.05). (4) There were 2 cases of sepsis in control group and 1 case of sepsis in rhGH group, with no significant difference between the 2 groups (P>0.05). No children died in the 2 groups. Conclusions rhGH treatment of children with severe burn can correct post-injury hypoproteinemia, improve cardiac function, reduce the times of skin grafting operation and hospitalization treatment cost, shorten hospitalization time, with no significant effect on kidney and liver function, sepsis, and death.

Objective To observe the curative effect of nursing intervention in the treatment of children with bronchial pneumonia and its effects on pulmonary function.Methods 100 children with bronchial pneumonia were selected as the research subjects,they were randomly divided into control group (50 cases) and observation group (50 cases) according to the digital table.The control group received routine nursing,the observation group received high quality nursing.The pulmonary function indicators (FVC,FEV1,PEF),the adverse reactions and the clinical curative effect were observed in the two groups after treatment.Results After treatment,the FVC,FEV1,PEF of the observation group were (3.96 ± 0.80) L,(3.15 ± 0.80) L,(6.32 ± 2.01) L/s,respectively,which were better than those of the control group [(2.85 ±0.91)L,(2.43 ±0.63)L,(4.90 ± 1.35)L/s] (t =6.478,P=0.000;t =5.000,P =0.000;t =4.147,P =0.000).The incidence rate of adverse reactions of the observation group was 14.00％ (7/50),which was lower than 38.00％ (19/50) of the control group (x2 =7.484,P =0.006).The total effective rate of the observation group was 98.00％ (49/50),which was higher than 80.00％ (40/50) of the control group (x2 =8.274,P =0.004).Conclusion To give children symptomatic treatment of infantile bronchial pneumonia at the same time,take the high quality nursing intervention can effectively improve lung function in children,reduce the incidence of complications,it is conducive to prognosis and can improve the therapeutic efficacy.

Objective To investigate the status quo of emergency nurses′ future work self and occupational coping self-efficacy (OCSE),and analyze the correlation between them,so as to offer references for improving the quality of emergency nursing.Methods Totally 192 emergency nurses from four tertiary hospitals in Wenzhou were selected by convenience sampling method. In April 2016,they were investigated with future work self clarity scale and OCSE scale for nurses (OSCE-N). Finally,the correlation between them were explored in accordance with Pearson correlation analysis.Results The emergency nurses′ scores for future work self and OCSE were [(19.22±4.39),(33.05±6.82)];their future work self and OCSE were positively correlated with occupational burden and relational difficulties (r=0.311,0.349,0.287;P<0.05).Conclusions The higher of emergency nurses′ future work self is,the higher of their OCSE.

Objective To investigate effects of disease cognitive education and behavior intervention on acute testicular torsion of adolescents. Methods A total of 100 cases with acute adolescent testicular torsion were randomly divided into observation group and control group, and 50 cases in each group. The patients in control group received conventional health education, while patients in observation group were administrated cognitive psychology education and behavioral intervention. We scored health education on testicular torsion knowledge by applying self-made cognitive questionnaire, and then compared the differences of adverse events and compliance of health education between two groups. Results The scores of health education and health compliance on adolescent testicular torsion disease were (95. 65 ± 10. 35) and (80. 30 ± 16. 30) in observation group, while they were (58.15 ±16.85) and (73. 70 ± 17. 20) in control group (t =20. 386, 4. 184; P <0. 05). There was no postoperative incision infection and testicular atrophy in observation group. However, there was 15 incision infection and 10 testicular atrophy in control group (χ2 =14. 326, 10. 358; P<0. 05). Conclusions Public education on testicular torsion knowledge can contribute adolescent patients to be aware of the dangers of testicular torsion, give importance to treatment timing, and increase the rate of early diagnosis and treatment.