Vasovagal syncope(VVS), the most common type of syncope in children, is a functional cardiovascular disease that rarely threatens life, but repeated syncope episodes seriously affect children′s learning and daily life, and some children even appear accidental physical injury, which has gradually become a hot topic of research at home and abroad.According to the positive reaction type of VVS in the head-up tilt test, the children can be further divided into vascular inhibitory type, cardiac inhibitory type and mixed type, in which the mixed type and vascular inhibitory type are main.This article mainly reviews the progress of diagnosis and treatment of VVS in children in recent years, in order to provide reference for clinical diagnosis and treatment.

Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

Cognitive impairment secondary to cardiovascular disease is a common complication in the elderly population， which seriously threatens the health of patients and affects the long-term quality of life. Cardiovascular diseases can lead to vascular endothelial injury， cerebral hypoperfusion， and brain lesions， and then cause cognitive impairment. Cardiovascular risk factors also increase the risk of secondary cognitive impairment in patients. It is particularly important to seek for early diagnosis and traditional Chinese medicine （TCM） and western medicine prevention and treatment. Based on the "holistic concept"， TCM puts forward the theory of "the connection of heart and brain". The heart and brain are connected and both are in charge of mental activities. Heart injury affects the brain， resulting in abnormal consciousness， which is considered to be the pathogenesis of cognitive impairment secondary to cardiovascular disease in TCM. Later generations of doctors propose the theory of "simultaneous treatment of the heart and the brain" on the basis of "treating different diseases with the same treatment" and "the connection of heart and brain". The theory contains two meanings. One is that different diseases can be treated by the same method because of the same etiology and pathogenesis. The other is the coexistence of different diseases and the treatment should be targeted to the same risk factors. This paper systematically discussed the TCM pathogenesis of cognitive impairment secondary to cardiovascular disease and the prevention and treatment strategy of "simultaneous treatment of the heart and the brain". In this paper， the deficiency of qi and blood was the foundation， and the interaction of blood stasis and poison and the obstruction of the pulse and the loss of the body were the key factors. Activating blood， detoxifying arteries， and connecting the orifices were the main treatment method for the disease. This paper is expected to enrich the connotation of "simultaneous treatment of the heart and the brain"， and provide new ideas for the prevention and treatment of cognitive impairment secondary to the cardiovascular disease with TCM.

Objective To investigate the effect of self efficacy and coronary heart disease knowledge on health literacy of young and middle-aged patients with coronary heart disease.Methods Investigation was conducted among 500 patients using general questionnaire,chronic health literacy scale,self-efficacy scale and coronary heart disease knowledge questionnaire.Results The score of health literacy for young and middle-aged patients was (97.76± 15.45),and 57％ of the patients had good health literacy.Self-efficacy and coronary heart disease knowledge were positively correlated with health literacy (r=0.301,r=0.309;P＜ 0.05).Multiple regression analysis showed that self-efficacy (β=0.210),coronary heart disease knowledge (β=0.226) were significant factors of health literacy(both P＜0.01).Conclusion The self-efficacy and coronary heart disease knowledge have impact on the health literacy.The more self-efficacy and coronary heart disease knowledge,the higher health literacy.

Objective To understand and compare the proportion of neural stem cells (NSCs) in the whole brain and cerebral cortex of mice at different embryonic days, and provide quantitative data for the later optimization of NSCs isolation and culture.Methods The whole brains (at embryonic 12.5, 14, 16 and 18 days) and cerebral cortex (at embryonic14, 16 and 18 days) were isolated and digested into single cell suspension, and were adherently cultured for 3-4 h.Immunofluorescence staining of Nestin, a NSCs specific marker, was used to statistically analyze the proportion of NSCs in each group.Expression of Nestin mRNA in the cerebral cortex of mice at E12.5, E14, E16, and E18 was detected by real-time fluorescence quantitative PCR.Results The result of immunofluorescence assay showed that there were Nestin-positive cells in the whole brain and cerebral cortex of mice at different embryonic days.In the whole brain,the proportion of NSCs was highest at E12.5 (53.42±1.57%) and lowest at E18(25.96±1.31%), and the proportions at E14 and E16 were placed in the middle among the groups.In the cerebral cortex, the highest proportion of NSCs was at E14 (33.65±0.29%), and the lowest at E18(25.29±0.28%), and the middle at E16 (26.82±0.30%).The result of real-time PCR showed that when the mRNA expression of Nestin in the cerebral cortex was set to 1, the relative mRNA expression of Nestin was 0.83±0.04 at E14, 0.77±0.05 at E16, and 0.44 ±0.05 at E18.Thus, the mRNA expression level of Nestin in the mouse cerebral cortex was gradually decreasing with the increase of embryonic days.Conclusions During the brain development, the proportion of NSCs is gradually decreasing in the whole brain and cerebral cortex of mice with the increase of embryonic days.

Objective To explore the effects of project management to reduce the rate of physical restraint for psychiatric inpatients.Methods From October 2014 to December 2015, 160 nurses was selected for the study in the hospital by whole group sampling method. Through the perfect system, processes and guide construction for physical restraint, as well as more training, implement and supervision, we observed the rate, duration and frequency of physical restraint, the achieved rate of physical restraint nursing quality and the adverse event incidences before (October to December in 2014) and after (October to December in 2015) project management.Results After the project management, the restraint rate was 53.42%, the duration of restraint (4.07±0.50)h, and the restraint's times for patients (2.35±1.25), which were all lower than that before the intervention (P<0.01). The qualified restraint rate increased from 83% to 93% (P<0.01); but the rate of adverse event had no statistical significance (P>0.05).Conclusions Project management not only provides advanced management methods for nurse administrators, but also reduces the rate of physical restraint for psychiatric inpatients, and improves the quality of physical restraint nursing.

Objective To explore the application effects of quality control circle (QCC)on reducing the peculiar smell in Psychiatry Ward for vagrant patients.Methods Quality control circle named “Improving the peculiar smell in Psychiatry Ward for vagrant patients”was established to investigate the current situation. The study investigated 35 patients who were hospitalized in April 201 4 and 20 nurses before the QCC.They also investigated 42 patients who were hospitalized in October 201 4 and 20 nurses after the QCC.The peculiar smell level and nurses′satisfaction were compared before and after the QCC,which included the analysis of the source of peculiar smell and the implementation of the related interventions.Results After the QCC,the feeling score of peculiar smell reduced from 6.78 to 1 .82 and the satisfaction level of nurses and patients were significantly improved (P <0.05 ).Conclusions The QCC can significantly reduce the peculiar smell of the Psychiatry Ward and improve the nursing quality and patients′satisfaction.

ObjectiveTo investigate the effect of individual donation-nucleic acid amplification test (ID-NAT) and minipool of 16 donations-NAT (P16-NAT) on the results of NAT of blood donors.Methods From February 2009 to June 2009,samples randomly collected from voluntary blood donors in Beijing were tested individually or in pooling of 16 donations by the PROCLEIX ULTRIO assay.For ID-NAT reactive samples with HBsAg,anti-HCV,or anti-HIV serologically unqualified,ID-NAT repeat reactive samples with serologically qualified,and P16-NAT reactive and followed resolution ID-NAT reactive samples,were performed for further discriminatory assays for HIV-1,samples and followed resolution ID-NAT reactive samples,were performed for further discriminatory assays for HBV,HCV and HIV-1discriminatory reagents.Samples which were HBV NAT + alone with serologically qualified were further quantified and confirmed of HBV DNA by Roche HBV quantitative PCR,analyzed by HBV serology and were diluted to simulate if they could be detected in P16-NAT.Results ( 1 ) Among 7613 samples tested by ID-NAT,26 were NAT positive,i.e.the ID-NAT positive rate was 0.34％ ( 26/7613 ). ( 2 ) Among 1004 P16 samples from 16 064 blood donations,27 were NAT positive,i.e.the P16-NAT positive rate was 0.17％ (27/16 064).(3)In serological qualified donations,ID-NAT yield rate (1 in 826,9/7438 ) was much higher than P16-NAT ( 1 in 7875,2/15 750) (x2 =11.880,P ＜ 0.05 ).All these 9 ID-NAT positive and 2 P16-NAT positive donations were discriminated as HBV NAT positive.There were no HCV NAT yield or HIV NAT yield samples. (4) Dilution assay showed only 2 of the 9 (22.22％ ) ID-NAT HBV yields were detected by P16-NAT.(5)Eight ID-NAT and 2 P16-NAT positive samples were quantified for HBV DNA and confirmed as HBV NAT yield,although the virus loads were very low:2 samples had HBV viral loads of 15 IU/ml and 472 IU/ml,6 samples ＜ 12 IU/ml,and 2 could not be detected in the original samples while had ＜ 12 IU/ml and 14.3 IU/ml in the 10 times concentrated samples.(6)Among 11 HBV NAT yield cases,3 (27.3％ ) were possible HBV window-period donors with all HBV seromarkers negative,the other 8 (72.7％ ) had occult HBV infections with anti-HBc or anti-HBe positive,however anti-HBc IgM negative.(7) The rate of initial P16-NAT reactive pools needed to be further tested by ID-NAT was 2.49％(25/1004).Initial P16-NAT reactive pools which caused by serologically qualified donations was 0.20％(2/1004).ConclusionsHBV NAT yield cases are detected at a higher frequency with ID-NAT than P16-NAT.In order to avoid samples with low viral loads would be undetected,NAT assay with high sensitivity should be selected and tested in minimized minipool donations or even with individual donation.

To establish an analytical method for tongue image acquisition under natural daylight based on L*a*b* error correction, and to observe the classification rules of tongue color using color error correction.

Objective This study aimed to explore issues about dysandia female during pregnancy,peripartum and contraception and to supply reference for their reproductive health improvement. Methods Purposive sampling strategy was used. With the aid of an interview guide, 12 dysaudia women who met inclu-sion and exclusion criteria were invited to be interviewed. Interviews were recorded, validated and then ana-lyzed. Results Four themes were generated, limited knowledge, passive information acquisition, total depen-dence on family and reluctant to talk about contraception. Total dependence on family was noticeable during pregnancy and peripartum. Though little was known about health protection related to pregnancy, peripartum and contraception, participants were passive at seeking for relevant information. Conclusions Deaf women may experience more threats to reproductive health in relation to pregnancy, peripartum and contraception that they require more guidance and assistance.