Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

  Objective  Quantitative imaging evaluation was performed on the liver and spleen system lesions of patients with Gaucher disease after treatment. in order to deepen the understanding of Gaucher disease.  Methods  From August 1999 to August 2018, we registered, examined and treated children with Gaucher disease, and conducted quantitative imaging research on 40 children with Gaucher disease who were intensively followed up in Beijing Children's hospital, Capital Medical University until August 2018. At the same time, 34 normal volunteers were matched. All subjects were scanned with magnetic resonance imaging(MRI). The fat fraction(FF), iron content(R2^*), standard apparent diffusion coefficient(sADC), slow apparent diffusion coefficient(D), fast apparent diffusion coefficient(D^*) and perfusion fraction(f)of the liver and spleen were measured. The quantitative parameter values measured by patients with Gaucher disease and normal subjects were statistically analyzed by independent sample t-tests.  Results  The results showed that there was no significant difference in FF, R2^*, sADC, D, D^*, f of the liver and spleen, and liver elasticity was also within the normal range. However, the volume of liver and spleen in patients was significantly different from that in normal subjects.  Conclusions  After treatment, the volume of the liver and spleen in patients with Gaucher disease is greater than that of normal people, but other quantitative parameters are within the normal range, indicating that long-term enzyme replacement therapy can delay the progress of liver and spleen diseases to a certain extent. Quantitative imaging has a certain value in the evaluation of Gaucher disease.

Objective:To explore the mediating effect of perceived patient safety culture on job burnout and safety behavior among nurses in Emergency Departments of ClassⅢ hospitals.Methods:This study was a cross-sectional study. From February 26 to March 14, 2021, 455 Emergency Department nurses from 39 hospitals in 9 provinces/municipalities were selected as the participants by a combination of purposeful sampling and convenience sampling. 455 Emergency Department nurses was conducted through WeChat using the General Information Questionnaire, Maslach Burnout Inventory (MBI) , Hospital Survey on Patient Safety Culture (HSOPSC) , and the Nurse Safety Behavior Questionnaire (NSBQ) . A total of 428 valid questionnaires were collected, with a valid recovery rate of 94.07%.Results:Among 428 Emergency Department nurses, the scores of job burnout, perceived patient safety culture and nurse safety behavior were 52 (38, 64) , 150 (139, 166) and 54 (49, 58) , respectively. The job burnout score of Emergency Department nurses was negatively correlated with the perceived patient safety culture score ( r=-0.661, P<0.01) and the safety behavior score ( r=-0.513, P<0.01) . There was a positive correlation between the perceived patient safety culture score and the safety behavior score of Emergency Department nurses ( r=0.482, P<0.01) . The perceived patient safety culture of Emergency Department nurses has a mediating effect between their job burnout and safety behavior, accounting for 34.90% of the total effect. Conclusions:Nurses in Emergency Department of Class Ⅲ hospitals have moderate job burnout, and there is room for improvement in their safety behaviors and perceived patient safety culture. In the relationship among the three, perceived patient safety culture has a certain mediating effect between job burnout and safety behavior of nurses. In Emergency Department nursing management, a series of measures can be taken to prevent or reduce the job burnout of nurses, strengthen the construction of patient safety culture and other measures to improve the safety of nursing behavior.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

[Abstract] Objective: To investigate the expression level of lncRNA (long non-coding RNA) SNHG1 in endometrial cancer tissues, and to analyze its mechanism of action as well as its clinical significance. Methods: NCBI-GEO and TCGA database were used to analyze the expression level of SNHG1 in endometrial cancer. A total of 53 cases of endometrial cancer tissue samples and 41 cases of normal endometrial tissue samples were collected from January 2016 to March 2019 at Zhongxin Ecocity Hospital of Tianjin Medical University; in addition, endometrial cancer cell lines Ishikawa and HEC-1A as well as normal endometrial ESC cells were also collected for this study. qPCR was used to detect the expression level of SNHG1 in tissues and cells, and its correlation with the clinical characteristics of patients were statistically analyzed. The effect of SNHG1 on cell proliferation and apoptosis of HEC-1A cells was measured by MTT assay and Annexin V/PI double staining Flow cytometry, respectively. The migration and invasion of HEC-1A cells were measured by Transwell assay. StarBase was used to predict the regulatory relationship between SNHG1 and RELA, which was then verified by qPCR and Western blotting. Dual fluorescent reporter gene system and qPCR were adopted to identify the influence of SNHG1 on NF-κB pathway. Results: The expression of SNHG1 was significantly up-regulated in endometrial cancer tissues compared with normal endometrial tissues (P<0.01), and its expression was related to tumor size, TNM staging, histological grade and lymph node metastasis (all P<0.05). The expression level of SNHG1 in Ishikawa and HEC-1A cells was significantly higher than that in ESC cells (all P<0.01). Overexpression of SNHG1 notably promoted the proliferation, migration and invasion and inhibited cell apoptosis of HEC-1A cells. By promoting the expression of RELA, SNHG1 activated the NF-κB pathway and promoted the expressions of downstream gene IL-6 and CCL19 (all P<0.01). Conclusion: Up-regulated SNHG1 in endometrial cancer functions as an oncogene by activating the NF-κB pathway through promoting the RELA expression.

Objective To explore the application value of retrobulbar nerve block combined with general anesthesia in the penetrating keratoplasty (PKP). Methods A total of 100 recipients undergoing PKP from January 2017 to January 2019 were recruited in this study. All recipients were divided into the observation group (n=50) and control group (n=50) by random number table method. In the control group, patients received laryngeal mask airway under general anesthesia, and in the observation group, patients received laryngeal mask airway under general anesthesia combined with retrobulbar nerve block. Hemodynamic changes of the PKP recipients before and after operation were observed in two groups. The dosage of analgesic drugs and the incidence of complications were observed in two groups. The degree of pain at postoperative 2-, 6- and 24-h was evaluated by visual analogue scale (VAS) in two groups. The awakening situation of the recipients in two groups was observed. The levels of inflammatory cytokines at 1 d before and after operation were statistically compared in two groups. Results The average arterial pressure and heart rate at intraoperative 15 min and after the surgery in the observation group were significantly higher than those in the control group (both P < 0.05). In the observation group, the dosage of remifentanil and propofol were (1.0±0.4) mg and (299±40) mg, significantly lower than (1.3±0.6) mg and (365±42) mg in the control group (both P < 0.05). The incidence of complications did not significantly differ between two groups (P > 0.05). In the observation group, the VAS scores at 2-, 6- and 12-h after operation were remarkably lower than those in the control group (all P < 0.01). The respiratory recovery time, eye opening time, directional force recovery time and extubation time of the recipients in the observation group were significantly shorter than those in the control group (all P < 0.05). The expression levels of including interleukin (IL)-1, IL-6 and tumor necrosis factor-α (TNF-α) at postoperative 1 d in the observation group were considerably lower than those in the control group (all P < 0.05). Conclusions Retrobulbar nerve block combined with general anesthesia can maintain hemodynamic stability during PKP, reduce the dosage of remifentanil and propofol and alleviate the degree of postoperative pain and inflammatory responses of the recipients.

A motion unit for sucking robot with a stable motion, convenient operation and process simulation is introduced. The key parameters and process data of the sucking operation were obtained from the clinical work, which provided the basis for the design of the sucking robot motion unit. According to the points of sucking action, robotic thumb, forefinger and metacarpophalangeal joints were used to grip the suction tube, and the servo and arm structure were used to simulate the motion of the wrist and elbow to complete the rotation and push of the sputum suction tube. The feasibility is verified through the advanced sputum suction training model. The movement unit is stable in movement, and can smoothly complete the clamping, feeding, back off protection and rotating tube removal of the sputum suction tube, so as to achieve effective sputum suction.
Catheterization ; Intubation, Intratracheal ; Robotics ; Suction

OBJECTIVE: To study the value of ADRB2, GLCCI1, FCER2 gene detection in individualized medication of children with refractory asthma.METHODS: Clinical pharmacists participated in therapy for 2 cases of refractory asthma, and comprehensively analyzed risk factors as its pathogenic factors (allergens and pathogens of respiratory infections), lung function indexes and family history. It was suggested to conduct anti-asthmatic drugs gene [p2-adrenergic receptor (ADRB2), glucocorticoid induced transcriptional 1 gene (GLCCI1), low affinity IgE receptor (FCER2)] testing. According to detection results, the suggestions were put forward such as increasing the dose of Glucocorticoid for inhalation, stopping β2 receptor agonist, additionally using anticholinergic drug. RESULTS: The clinical physicians adopted the suggestions of clinical pharmacists. After optimizing refractory asthma therapy plan according to the results of gene testing and clinical factors, 2 patients were stable and the number of seizures decreased significanthy. CONCLUSIONS: Gene test can provide evidence for the formulation of individualized therapy in asthma children.

Objective To identify the efficacy and safety of implant vagus nerve stimulation (IVNS) for intractable epilepsy.Methods Eligible patients with intractable epilepsy during 2012-2015 were enrolled,and the information of preoperative evaluation was collected as baseline.During IVNS therapy,the process of seizures,the epileptic discharges of electroencephalogram (EEG),the complications and the changes of antiepileptic drugs or device parameters were recorded.The responder rate,the mean seizure reduction and the change of epileptic discharges were chosen as the indictors.Results Efficacy analyses were done in 33 patients,and the average age of these patients was 17.79 years.Seizure control improved over time with mean seizure reduction of 11.9％,17.3％,35.5％,38.1％,45.4％ and 50.0％,and responder rates of 18.2％(6/33),27.3％(9/33),41.4％(12/29),38.5％(10/26),7/18,and 10/17 at 1,3,6,12,24,36 months of IVNS therapy,respectively.In addition,the mean epileptic discharge reduction in EEG was 0.4％ and 13.0％,while the rate of patients who had epileptic discharge reduction of ≥50％ was 15.3％ and 23.1％ at 6,12 months of IVNS therapy,respectively.Conclusions IVNS is effective and safe.Furthermore,the efficacy of IVNS is time-dependent.

Objectives To investigate whether the presence of metabolic syndrome (MS) modifies overall survival and cardiovascular (CV) outcomes among patients undergoing long-term peritoneal dialysis (PD) and to explore suitable diagnostic criterion for PD patients.Methods A total of 258 patients on PD in Peking University Third Hospital between October 2008 and March 2009 were enrolled and followed until June 2017.According to the diagnostic criteria of WHO,IDF and ATP Ⅲ,the patients were divided into MS group and non-MS group.The median following time was 51.9 (26.8,97.9) months.Overall survival and cardiovascular death were analyzed by the Kaplan-Meier method.The analyses were also done among non-diabetic PD patients.The influence of MS and its components on outcomes was analyzed by Cox regression models.Results Among 258 PD patients,106(41.1％) fulfilled the WHO criteria,121(46.9％) the IDF criteria,and 167(64.7％) the ATP criteria.139 cases were dead,among which 50(36.0％) cases were caused by CV diseases.The patients with MS had worse outcomes than those without MS by WHO and IDF criteria (cumulative survival rates of WHO criteria:21.3％ vs 44.8％,P ＜ 0.01;cumulative surviva rats of IDF criteria:23.3％ vs 45.7％,P ＜ 0.01).It was the same even in non-diabetic PD patients.The patients with MS had more CV death than those without MS by WHO and IDF criteria (both P ＜ 0.05).Among non-diabetic PD patients,the results remained the same only by IDF criteria (P ＜ 0.05).By ATP criteria,above analyses showed no difference.By multivariate Cox regression analysis,MS and serum albumin (all P ＜ 0.01) were independently associated with increased risk for overall and cardiovascular survival.Among MS components,waist girth,low-density lipoprotein cholesterol (LDL-C) levels and blood sugar (all P ＜ 0.01) were significant risk factors for adverse survival outcomes.Conclusions In patients undergoing PD,both overall survival and cardiovascular survival were worse in patients with MS than those without MS.Waist girth,blood sugar and serum LDL-C were the main risk factors.For PD patients the IDF criterion for MS was recommended.