Objective:To investigate the effects of backward walking observational training combined with Soundsory cognitive training based on PASS (P: planning; A: attention; S: simultaneous; S:successive) theory on cognitive function, balance function and self-efficacy in elderly patients with post-stroke mild cognitive impairment (MCI).Methods:A randomized controlled trial was conducted. Elderly patients with post-stroke MCI admitted to the Department of Neurology, Affiliated Hospital of Jiangnan University from December 2022 to November 2023 were selected as the study objects by convenience sampling method. The patients were divided into control group and observation group by random number table. The patients in the control group implemented routine care and rehabilitation training, while the observation group were implemented backward walking observational training combined with Soundsory cognitive training based on the PASS theory. The Montreal Cognitive Assessment (MoCA), the Brunel Balance, and the Stroke Self-Efficacy Questionnaire (SSEQ) were used to evaluate the intervention effect before intervention, 2 weeks and 4 weeks of intervention, respectively.Results:A total of 116 elderly patients with post-stroke MCI were included, comprising 58 patients in the observation group (32 males and 26 females), aged (73.47 ± 7.10) years, and 58 patients in the control group (33 males and 25 females), aged (72.72 ± 8.37) years. Before intervention, there were no significant differences in the total scores of MoCA, SSEQ and Brunel Balance Scale between the 2 groups (all P>0.05). At 2 and 4 weeks of intervention, the total score of MoCA in the observation group were (20.10 ± 2.73), (22.98 ± 2.98) points, which were higher than those of the control group (18.24 ± 2.84), (20.47 ± 3.29) points, the differences were statistically significant ( t=3.61, 4.32, both P<0.05). The total score of SSEQ in the observation group were (49.97 ± 7.73), (54.98 ± 7.88) points, which were higher than those in the control group (46.50 ± 8.69), (51.59 ± 6.10) points, the differences were statistically significant ( t=2.27, 2.60, both P<0.05). At 4 weeks of intervention, the Brunel Balance Scale score in the observation group was 11(9, 11) points, which was higher than 10(8, 11) points in the control group, the difference was statistically significant ( Z=-2.00, P<0.05). Conclusions:Backward walking observational training combined with Soundsory cognitive training based on PASS theory can effectively improve cognitive and balance functions, and enhance self-efficacy in elderly patients with post-stroke MCI.

Objective:To investigate the effects of backward walking observational training combined with Soundsory cognitive training based on PASS (P: planning; A: attention; S: simultaneous; S:successive) theory on cognitive function, balance function and self-efficacy in elderly patients with post-stroke mild cognitive impairment (MCI).Methods:A randomized controlled trial was conducted. Elderly patients with post-stroke MCI admitted to the Department of Neurology, Affiliated Hospital of Jiangnan University from December 2022 to November 2023 were selected as the study objects by convenience sampling method. The patients were divided into control group and observation group by random number table. The patients in the control group implemented routine care and rehabilitation training, while the observation group were implemented backward walking observational training combined with Soundsory cognitive training based on the PASS theory. The Montreal Cognitive Assessment (MoCA), the Brunel Balance, and the Stroke Self-Efficacy Questionnaire (SSEQ) were used to evaluate the intervention effect before intervention, 2 weeks and 4 weeks of intervention, respectively.Results:A total of 116 elderly patients with post-stroke MCI were included, comprising 58 patients in the observation group (32 males and 26 females), aged (73.47 ± 7.10) years, and 58 patients in the control group (33 males and 25 females), aged (72.72 ± 8.37) years. Before intervention, there were no significant differences in the total scores of MoCA, SSEQ and Brunel Balance Scale between the 2 groups (all P>0.05). At 2 and 4 weeks of intervention, the total score of MoCA in the observation group were (20.10 ± 2.73), (22.98 ± 2.98) points, which were higher than those of the control group (18.24 ± 2.84), (20.47 ± 3.29) points, the differences were statistically significant ( t=3.61, 4.32, both P<0.05). The total score of SSEQ in the observation group were (49.97 ± 7.73), (54.98 ± 7.88) points, which were higher than those in the control group (46.50 ± 8.69), (51.59 ± 6.10) points, the differences were statistically significant ( t=2.27, 2.60, both P<0.05). At 4 weeks of intervention, the Brunel Balance Scale score in the observation group was 11(9, 11) points, which was higher than 10(8, 11) points in the control group, the difference was statistically significant ( Z=-2.00, P<0.05). Conclusions:Backward walking observational training combined with Soundsory cognitive training based on PASS theory can effectively improve cognitive and balance functions, and enhance self-efficacy in elderly patients with post-stroke MCI.

Objective:To explore the clinical efficacy of ultrasound-indicated cervical cerclage in twin pregnancies.Methods:This retrospective cohort study included 96 asymptomatic twin pregnancies with cervix length (CL)≤2.5 cm at 16-27 +6 weeks indicated by transvaginal ultrasound from January 2013 to May 2022 in Fujian Maternity and Child Health Hospital. They received either cervical cerclage (cerclage group, n=45) or conservative treatment (conservative group, n=51). The subgroup analysis was further performed after stratifying the subjects into the CL≤1.0 cm subgroup, the CL>1.0-≤1.5 cm subgroup, and the CL>1.5 cm subgroup. Two independent samples t-test, Mann-Whitney U test, and Chi-square test were used to compare the differences in the pregnancy and perinatal outcomes between different groups. Multivariate logistic regression was used to analyze the impact of cervical cerclage on pregnancy outcomes of women with different CLs. Results:The average gestational age at delivery and the prolonged gestation were significantly greater in the cerclage group than those in the conservative group [35.9 (34.9-37.0) weeks vs 34.9 (29.1-36.1) weeks; 10.7 (9.6-13.1) weeks vs 8.7 (4.8-11.0) weeks, Z=－2.59 and -3.63, both P<0.05]. The incidences of preterm birth before 34 weeks and 28 weeks, chorioamnionitis, and preterm premature rupture of membrane were lower in the cerclage group than those in the conservative group [17.8% (8/45) vs 45.1% (23/51), χ2=8.16; 2.2% (1/45) vs 15.7% (8/51), Fisher' exact test; 8.9% (4/45) vs 25.5% (13/51), χ2=4.52; 15.6% (7/45) vs 33.3% (17/51), χ2=4.03; all P<0.05]. There were no statistically significant differences in the proportion of postpartum hemorrhage and live births between the two groups (both P>0.05). In the women with CL≤1.0 cm, the cerclage group had a greater gestational age at delivery [36.0 (34.8-37.3) weeks vs 34.9 (28.6-35.4) weeks, Z=－2.61, P=0.009], greater prolonged gestation [12.3 (9.7-13.9) weeks vs 7.3 (3.4-9.1) weeks, Z=－3.34, P=0.001], higher birthweight [2 430.0 (2 173.8-2 646.3) g vs 1 900.0 (1 372.5-2 435.0) g, Z=－3.06, P=0.002], lower incidence of adverse neonatal outcomes [16.7% (6/36) vs 36.7% (11/30), χ2=4.22, P=0.048] compared with the conservative group. Multivariate Logistic regression analysis showed that cerclage reduced the risks of preterm birth before 34 and 32 weeks [ aOR (95% CI)=0.083 (0.009-0.790) and 0.092 (0.009-0.939), both P<0.05]. However, cerclage did not reduce the risk of preterm birth in women with CL>1.5 cm or CL>1.0-≤1.5 cm (both P>0.05). Conclusion:Ultrasound- indicated cervical cerclage can reduce the risk of preterm birth before 34 and 32 weeks, prolong pregnancy, and improve perinatal outcomes in asymptomatic twin pregnancies with CL≤1.0 cm.

Objective:To evaluate the correlation between anti-C1q antibody and disease activity and cellular immune function in patients with systemic lupus erythematosus (SLE).Methods:The clinical data and test indexes of 134 patients with SLE and 90 healthy people who were admitted to Henan Provincial People′s Hospital from June 2017 to February 2018 were collected. The level of anti-C1q antibody was measured by enzyme-linked immunosorbent assay (ELISA), and lymphocyte subsets were measured by flow cytometry. According to the score of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K, SLE patients were divided into active and inactive groups, and SLE patients were divided into LN group and non-LN group according to the presence or absence of kidney involvement. The levels of anti-C1q antibodies and lymphocyte subsets were compared among the three groups, and correlations between anti-C1q antibodies and disease activity and lymphocytes were analyzed. The predictive value of anti-C1q antibodies and anti double stranded DNA (dsDNA) antibodies for SLE disease activity was evaluated.Results:The anti-C1q antibody level, percentage of T cells and Ts cells in SLE group were higher than those in control group, while the percentage of Th cells, percentage of NK cells, T cell count, Th cell count, B cell count and NK cell count in SLE group were lower than those in control group (all P<0.05); The anti-C1q antibody level in the active group was higher than that in the inactive group, and the counts of T cells, Ts cells, Th cells, B cells and NK cells were lower than those in the inactive group (all P<0.05); The anti-C1q antibody level in LN group was higher than that in non-LN group, and the T cell count, Ts cell count, Th cell count, B cell count, NK cell count were lower than that in non-LN group, with statistically significant difference (all P<0.05). Correlation analysis showed that age, hemoglobin (HB), C3, C4, T cell count, Th cell count, B cell count and NK cell count were negatively correlated with anti-C1q antibody, while SLEDAI-2K, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and anti-dsDNA antibody were positively correlated with anti-C1q antibody (all P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of anti-C1q antibody alone in predicting SLE disease activity was 0.702, with a sensitivity of 0.547 and a specificity of 0.827. The combination of anti-C1q and anti ds-DNA antibodies resulted in an AUC of 0.761, a sensitivity of 0.756, and a specificity of 0.691. The combined detection value of the two antibodies predicting SLE disease activity was better than the single detection. Conclusions:Anti-C1q antibody is closely related to disease activity and cellular immune dysfunction, and has certain predictive value in SLE disease activity.

Objective: To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI. Methods: A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale. Results: Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05). Conclusion The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Objective:To explore the risk factors of poor renal prognosis in patients with coronary artery bypass surgery (CABG)-associated acute kidney injury (AKI), and establish a preliminary clinical risk prediction model for chronic kidney disease (CKD) progression in CABG-associated AKI patients, and evaluate its predictive efficacy.Methods:It was a retrospective, observational cohort study. The study subjects were patients who underwent CABG at Central China Fuwai Hospital from January 1, 2018 to December 31, 2020, with a baseline estimated glomerular filtration rate (eGFR)>60 ml·min -1·(1.73 m 2) -1 and postoperative complication of AKI. The patients were followed up for 90 days after discharge from hospital. The endpoint event was defined as progression to CKD after 90 days of the occurrence of CABG-associated AKI. The patients were divided into CKD group and non-CKD group based on whether they experienced endpoint events. The baseline clinical data were compared between the two groups. The logistic regression model was used to analyze the risk factors of endpoint event. The receiver-operating characteristic curve was drawn to evaluate the performance of the clinical risk prediction model for predicting poor renal prognosis in CABG-associated AKI patients. Results:A total of 124 CABG-associated AKI patients were enrolled in the study, including 95 males and 29 females, aged (62.57±9.61) years old. Thirty-eight patients (30.8%) progressed to new-onset CKD 90 days after CABG-associated AKI. Compared with non-CKD group, CKD group had lower preoperative hemoglobin ( t=2.778, P=0.006) and baseline eGFR ( t=3.603, P<0.001), higher proportion of women ( χ2=10.714, P=0.001), and higher preoperative blood NT-proBNP ( Z=-2.150, P=0.030) and discharged serum creatinine ( Z=-5.290, P<0.001). The multivariate logistic regression analysis results revealed that female ( OR=5.179, 95% CI 1.535-17.477, P=0.008), high preoperative blood NT-proBNP ( OR=1.049, 95% CI 1.004-1.095, P=0.032), low baseline eGFR ( OR=0.928, 95% CI 0.889-0.968, P=0.001), and high serum creatinine at discharge ( OR=1.019, 95% CI 1.009-1.029, P<0.001) were independent influencing factors of CABG-associated AKI to CKD. The clinical risk prediction model including female, preoperative blood NT-proBNP, preoperative baseline eGFR, and serum creatinine at discharge produced a moderate performance for predicting CABG-associated AKI to CKD ( AUC=0.872, 95% CI 0.806-0.939, P<0.001). Conclusion:Patients with CABG-associated AKI are at high risks for new-onset CKD. Female, preoperative high NT-proBNP, preoperative low baseline eGFR and high serum creatinine at discharge can help identify patients with a high risk of CABG-associated AKI to CKD.

Objective:To explore the correlation between the length of peripherally inserted central catheter (PICC) through upper and lower extremities of premature infants and their body parameters, and to deduce the formula of the different length of PICC of premature infants, so as to improve the accuracy of the tip of PICC in premature infants.Methods:This study was a retrospective case series study.From January 2016 to September 2021, 758 premature infants with PICC hospitalized in Neonatal Intensive Care Unit (NICU) of Shanghai Children's Hospital were selected retrospectively by convenience sampling. We recorded the sex, gestational age, catheterization age, catheterization vessel location, birth length, length on the day of catheterization, birth weight and weight on the day of catheterization of premature infants. Pearson correlation analysis and simple linear regression were used to find the most relevant body parameters, and formula fitting was carried out to derive the optimal length of PICC for premature infants.Results:In 652 premature infants (86.02%, 652/758) , the PICC was placed in the lower limb vein, and the proportion of great saphenous vein was the highest, accounting for 41.42% (314/758) . Simple linear regression showed that the weight and length had the highest correlation with the optimal length of PICC in the superficial veins of the upper and lower extremities. The formula for the length of PICC with the puncture points of median vein, basilic vein, axillary vein, great saphenous vein, small saphenous vein, popliteal vein and femoral vein was derived.Conclusions:The formula derived from the weight and length of premature infants can provide a reference for clinical measurement of PICC length of premature infants.

1,25(OH) 2 vitamin D 3 is the most effective status of vitamin D in the body.It will play a biological active role when it combines with the receptor of vitamin D. It is common in the chronic kidney disease patients who are lack of vitamin D. The research finds that among the chronic kidney disease patients, in addition to the classic role of vitamin D in regulating calcium and phosphorus metabolism, it can also protect the kidney and delay the progress of chronic kidney disease by blocking the renin-angiotensin system, inhibiting inflammation, reducing podocyte damage and delaying renal fibrosis, etc.This article summarizes the protection mechanism of Vitamin D in the chronic kidney diseases.

Objective:To investigate the incidence of asthma and the characteristics of acute attacks in children aged 3-14 in different administrative areas of Wuxi, and to analyze the correlation of asthma with the outdoor environmental factors.Methods:A total of 10 175 children aged 3-14 were randomly selected from 5 different administrative regions in Wuxi City, Jiangsu Province for childhood asthma epidemiological survey from January to December in 2017.Results:The complete questionnaires were collected from 8 318 children with a response rate of 81.70%.There were 6 734 valid questionnaires.Asthma occurred to 259 children, and the prevalence rate was 3.84%.The prevalence of asthma in male and female children was 4.89% (163 cases) and 2.82% (96 cases), respectively.The ratio of male patients to female patients was 1.70∶1.00, and the difference was significant ( χ2=19.72, P<0.01). Children were most prone to suffer from asthma attacks at the turn of seasons (87/259 cases, 33.59%). The frequency of asthma was the lowest from June to August (9/259 cases, 3.47%). Among 244 cases attacked by acute asthma, the prevailing time period of acute attacks was irregular in 88 patients (36.07%), bedtime in 64 cases (26.23%). In different regions of the city, the lowest prevalence rate of asthma was found in Binhu District (50/1 830 cases, 2.73%), the highest prevalence rate of asthma was found in Xinwu District (71/1 502 cases, 4.72%), the difference between the highest and lowest prevalence rates of asthma was significant ( χ2=13.19, P<0.05). In terms of the air quality in different admi-nistrative regions of Wuxi, the nitrogen dioxide (NO 2) concentration, the carbon monoxide (CO) concentration, PM 10 and PM 2.5 in Binhu District were lower than other 4 regions.In different seasons in Wuxi city, the sulfur dioxide(SO 2) concentration, the NO 2 concentration, the CO concentration, PM 10 and PM 2.5 from June to August were significantly lower than those in other months.The prevalence of asthma in children in different administrative districts of Wuxi was weakly positively correlated with the SO 2 concentration, the NO 2 concentration and PM 10 ( r=0.10, P<0.01; r=0.22, P<0.01; r=0.06, P<0.01, respectively). The prevalence of asthma was weakly negatively associated with the ozone(O 3) concentration ( r=-0.06, P<0.01). Acute asthma attacks were weakly positively correlated with the SO 2 concentration ( r=0.22, P<0.01), the NO 2 concentration ( r=0.28, P<0.01), the CO concentration ( r=0.23, P<0.01), PM 10 ( r=0.18, P<0.01) and PM 2.5 ( r=0.18, P<0.01), and weakly negatively correlated with the O 3 concentration ( r=-0.40, P<0.01). Conclusions:The prevalence of asthma in Wuxi is higher in boys than in girls, and the frequency of asthma attacks is related to the season.The SO 2, NO 2, CO, PM 10, PM 2.5 and O 3 concentration affect the prevalence and acute attacks of asthma.

Objective: To explore the reliability and validity of the Chinese Pediatric Quality of Life Inventory（PedsQL）in influenza children. Methods: From January 2017 to February 2018,we selected laboratory-diagnosed influenza cases and healthy children according to age and gender ratio by stratified random sampling and systematic sampling method. We employed Chinese version of PedsQL 4.0 to investigate their quality of life,used Cronbach's α to evaluate the reliability,and used Pearson correlation coefficient, t-test,confirmatory factor analysis（CFA）and ROC curve to evaluate the validity. Results: Totally 300 influenza cases and 300 healthy children were surveyed,with 294（98.00%）and 295（98.33%）valid questionnaires recovered. The general Cronbach's α was 0.89,and the Cronbach's α of each dimension ranged from 0.79 to 0.84. The Pearson correlation coefficients between the items and their belonged dimension ranged from 0.537 to 0.755,between the items and other dimension ranged from 0.203 to 0.384. The CFA resulted in RMSEA of 0.06,GFI of 0.88,AGFI of 0.90,CFI of 0.91 and NFI of 0.89. The scores in total and in all the dimensions in influenza cases were significantly different with those in healthy children（P<0.05）. Taking the scores in influenza cases as a golden standard,the area under the ROC curve was 0. 985（P<0.05）,the sensitivity was 0.92,and the specificity was 0.95. When the limit score was 82.18,the Youden index was the largest. Conclusion The Chinese version of PedsQL4.0 has good reliability and validity, which can be applied to quality of life assessment in children.