This paper reported a case of fetal congenital chloride diarrhea (CCD) indicated by prenatal ultrasound and confirmed by whole-exome sequencing. At 26 weeks and two days of gestation, a routine prenatal ultrasound revealed fetal bowel dilation and numerous floating echogenic particles in the amniotic fluid, suggesting the possibility of CCD. Multiple follow-up ultrasounds in late pregnancy showed persistent bowel dilation, polyhydramnios with numerous floating echogenic particles, and fetal development larger than the gestational age. Whole-exome sequencing and Sanger validation revealed two compound heterozygous mutations in the fetal SLC26A3 gene: c.2006C>A (p.S669*) inherited from the mother and c.1355T>A (p.L452Q) inherited from the father, leading to a diagnosis of CCD. Postnatally, the infant exhibited persistent watery diarrhea. Based on prenatal ultrasound and diagnostic results, the infant was immediately given intravenous and oral electrolyte supplementation after birth, preventing severe electrolyte imbalance. As of June 2024, the infant was five months old, with follow-up showing good growth and development.

This paper reported a case of fetal congenital chloride diarrhea (CCD) indicated by prenatal ultrasound and confirmed by whole-exome sequencing. At 26 weeks and two days of gestation, a routine prenatal ultrasound revealed fetal bowel dilation and numerous floating echogenic particles in the amniotic fluid, suggesting the possibility of CCD. Multiple follow-up ultrasounds in late pregnancy showed persistent bowel dilation, polyhydramnios with numerous floating echogenic particles, and fetal development larger than the gestational age. Whole-exome sequencing and Sanger validation revealed two compound heterozygous mutations in the fetal SLC26A3 gene: c.2006C>A (p.S669*) inherited from the mother and c.1355T>A (p.L452Q) inherited from the father, leading to a diagnosis of CCD. Postnatally, the infant exhibited persistent watery diarrhea. Based on prenatal ultrasound and diagnostic results, the infant was immediately given intravenous and oral electrolyte supplementation after birth, preventing severe electrolyte imbalance. As of June 2024, the infant was five months old, with follow-up showing good growth and development.

Hydroxychloroquine retinopathy is an ocular lesions that develops following long-term or excessive use of hydroxychloroquine. The early clinical presentation of this lesion is nonspecific and is often detected when severe central vision impairment occurs in late stage. It currently mainly includes hydroxychloroquine binding to melanin, inducing degeneration of the retinal pigment epithelium, increasing the pH of lysosomes in the retinal pigment epithelium and interfering with the visual cycle. In recent years, with the development of retinal imaging technology and the in-depth study of hydroxychloroquine retinopathy, characteristic fundus structural changes such as retinal and choroidal thickness and blood vessels may occur in the early stage. This not only provides an important basis for the early diagnosis of hydroxychloroquine retinopathy, but also provides important clues for investigating its pathogenesis. Clinicians' proficiency in relevant fundus changes and pathogenesis will facilitate early diagnosis and treatment, while also minimizing irreversible central vision impairment in patients.

Objective:To explore the effects of problem-solving therapy on breastfeeding self-efficacy and psychological status among primiparas, to provide basis for improving the breastfeeding of primipara.Methods:A total of 102 primiparas were divided into experimental group and control group by random number table method, each group contained 51 cases. Finally, 47 cases in the experimental group and 49 cases in the control group completed the study. The control group received routine nursing, while primiparas in the experimental group carried out problem-solving therapy. Before and after 6-week intervention, the effects was assessed by Breastfeeding Self-Efficacy Scale (BSES), Edinburgh Postnatal Depression Scale (EPDS) and General Well-being Schedule (GWB), respectively.Results:After intervention, the scores of primapara feedig cognition, feeding feeling, feeding skills and BSES total scores were (21.13±2.97) points, (65.47±6.63) points, (31.94±2.59) points, (118.53±8.47) points in the experimental group, significantly higher than (19.43±3.28) points, (61.76±5.20) points, (30.53±2.01) points, (111.71±6.11) points in the control group ( t values were 2.658-4.507, P<0.01); the scores of EPDS were (6.04±1.49) points in the experimental group, significantly lower than (6.92±2.08) points in the control group; the scores of life satisfaction and interest, depression and pleasure, energy, relaxation and tension in General Well-Being (GWB) and total scores were (7.51±1.71) points, (20.19±2.47) points, (21.68±2.32) points, (17.06±2.74) points, (90.45±4.96) points in the experimental group, significanlty higher than (6.41±1.82) points, (18.71±2.98) points, (20.57±1.87) points, (15.78±1.79) points, (84.61±5.26) points in the control group, the difference was statistically significant ( t values were 2.380-5.587, P<0.05 or 0.01). Conclusion:Problem-solving therapy can improve breastfeeding self-efficacy and alleviate postnatal depression as well as enhance subjective well-being of primipara women.

ObjectiveTo explore the role of peripheral blood intermediate monocytes in the pathogenesis of preeclampsia.MethodsFifty-two patients with established preeclampsia in Binhai County People's Hospital from October 2014 to October 2015, 42 healthy pregnant women and 42 healthy non-pregnant women were enrolled in this study. The percentage of intermediate monocyte subsets, ratio of positive cells and mean fluorescence intensity (MFI) of Toll-like receptor (TLR) 2, TLR4, CD64, and triggering receptor expressed on myeloid cell-1(TREM-1), and MFI of intracellular tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 were evaluated by flow cytometry. The concentrations of IL-6, IL-8, IL-1β, IL-12P70 and TNF-α in serum were analyzed using Luminex liquid phase chip technology. Independent two samplest-test, analysis of variance, Mann-WhitneyU test, Kruskal-Wallis test and Pearson correlation analysis were used for statistical analysis.ResultsPercentage of intermediate monocytes was higher in preeclampsia patients [10.4%(5.3%-19.9%)]than in healthy pregnant women [6.6%(4.9%-7.8%)], and both were higher than in non-pregnant women [3.8%(2.4%-5.0)%](allP<0.05). The ratio of TLR4 and CD64 positive intermediate monocytes [(60.1±12.5)%vs (24.9±8.8)%; (85.3±5.4)% vs (67.4±7.5)%](t were 15.416 and 13.437, bothP<0.05), and MFI of TLR4 (50.3±10.2 vs 26.8±8.6), TREM-1(35.6±4.1 vs 28.6±4.7) and CD64 (39.8±5.2 vs 28.9±4.8) (t were 11.898, 7.707 and 10.454, allP<0.05) were higher in preeclampsia patients than in healthy pregnant women. MFI of intracellular IL-6 (32.3±4.7 vs 28.6±3.5) and TNF-α (44.6±6.3 vs 36.7±8.3) in intermediate monocytes of preeclampsia patients was also significantly higher than that of healthy pregnant women (t were 4.239 and 5.245, bothP<0.05). Serum concentrations of IL-6, IL-8 and TNF-α were higher in preeclamptic patients than in healthy pregnant women and non-pregnant women (allP<0.05). Furthermore, a positive correlation was found between the percentage of intermediate monocytes and the serum levels of IL-6 and TNF-α in preeclamptic patients (r were 0.397 and 0.347, bothP<0.05).ConclusionsMonocyte subpopulations from preeclamptic patients are abnormally skewed toward intermediate monocytes which have high expressions of TLR4, TREM-1 and CD64, and secret more proinflammatory cytokines such as IL-6 and TNF-α. Therefore, intermediate monocytes are specifically altered in preeclamptic patients and may play a role in the pathophysiology of preeclampsia.

Objective To explore the recognition degree of resource based relative value scales (RBRVS) among the head nurses of different clinical departments and provide references for the hospitals to gradually adjust and improve the RBRVS performance allocation program. Method Toally 13 clinical head nurses were recruited and in-depth interviews were phenomenologically conducted. The acquired data were analyzed. Results Six themes were extracted: RBRVS's reflection of the value of nursing operation, avoidance of nonstandard registering and charging, differences in performance distribution across clinical departments, unreasonable allocation between internal medical and surgical departments, small numbers of chargeable nursing items, larger coefficient gap between doctors and nurses and inaccuracy in data collection. Conclusions RBRVS for performance evaluation is concerned about the work strength and technical difficulty, but less attention to quality problems is attached. In implementation, we should reasonably treat differences between the clinical departments, setting up reasonable gap coefficient and increasing their enthusiasm. Moreover, as the direct leaders of nursing teams, the nursing management should master the principles of RBRVS and improve the management ability of head nurses.

ObjectiveTo explore the relationship between the status of vitamin A and the level of AntiHBs in infants.Methods One hundred and ninty eight infants met the criteria were recruited into an investigation through local vaccination service.Two milliter venous blood was drawn from each studied child,and the infants' feeding information of successive 72 hours was collected through the 24-hour dietary recall method and 2-day diet records method.The nutrients intakes were analyzed with a NCCW software for calculation.The concentration of serum vitamin A and Anti-HBs was analyzed by HPLC and ECLIA,respectively.The logarithm of anti-HBs concentrations was compared among sub-clinical vitamin A deficiency (87 cases ),suspicious subclinical vitamin A deficient group (51 cases )and normal group (60 cases )and the relationship between the logarithm of anti-HBs concentrations and vitamin A were analyzed.ResultsThere were only 19.7％ of children whose average daily intake of vitamin A reached the 80％ of recommended nutrient intakes(RNI).The incidence rate of vitamin A malnutrition was 67.2％.The serum Anti-HBs GMC was 402.8 U/L The positive rate was 98.0％.There were significant differences on Anti-HBs Ig GMC between Sub-clinical vitamin A deficiency (SVAD) group,suspicious SVAD group and normal group( F =15.88,P ＜ 0.001 ).The correlation coefficient between the level of serum vitamin A and Anti-HBs lg GMC was 0.441 ( P =0.01 ).ConclusionThe results show that the level of serum vitamin A may have influence on the maintenance of an effective anti-HBs level against hepatitis B virus.