Objective:To explore the application of SPOC+PBL mixed teaching method in Pediatric practice nursing students under the background of Internet.Methods:A total of 100 Pediatric practice nursing students in our hospital from Jan to Dec 2020 were selected as the control group,and the PBL teaching method was adopted.Another 100 Pediatric practice nursing students from Jan 2021 to Dec 2022 were selected as the observation group,and SPOC+PBL mixed teaching method under the background of Internet was adopted.After teaching,the satisfaction with learning outcomes,assessment scores,and critical thinking ability scores were compared between two groups.Result:After teaching,the satisfaction with learning outcomes,assessment scores,and critical thinking ability scores were higher in the observation group than those in the control group(P＜0.01).Conclusion:SPOC+PBL mixed teaching method under the background of Internet can improve learning satisfaction and assessment scores,as well as enhance students'comprehensive professional level.

【Objective】 To investigate the immune status of blood donors in Yangzhou area after SARS-COV-2 vaccinating. 【Methods】 Among 112 voluntary blood donors from August 29 to September 22, 2021, 111 were vaccinated with SARS-COV-2 vaccine.IgM antibody(by enzyme-linked immunocapture method), IgG antibody(by indirect method of combined immunoassay)and IgG antibody titer were detected. 【Results】 A total of 99.11% (111/112 ) voluntary blood donors were vaccinated, two-shot(n=103), one-shot(n=1) and three-shot (n=7) accounting for 91.96%, 0.89% and 6.25%, respectively.Eighty-eight (78.57%) were positive for IgG antibodies, and 14 (12.5%) were positive for IgM antibodies.No statistically significant difference was found in IgG and IgM positive yielding between males and females (P>0.05). The proportion (0.89%, 1/112) of positive IgM in blood donors with blood type A was significantly lower than that of other blood types (P<0.01). The IgG antibody titer of blood donors maintained rather high level within 6 months after vaccinating.47.66% of the donors presented antibody titer more than 160, and 5.60% had IgM antibody been detected within 1 month after vaccinating. 【Conclusion】 At present, the SARS-COV-2 vaccination effect in China is generally good.Since IgG antibodies cannot be detected after 6 months, it is suggested to perform IgG antibody testing for donors who have completed the second dose for more than 6 months.For those IgG antibody negative, booster shots should be conducted.For donors with high IgG antibody titer, their plasma may be considered to replace with COVID-19 convalescent plasma for the treatment of patients with rapid disease progression, or severe/critically ill patients diagnosed with COVID-19, so as to avoid the risk of COVID-19 re-spreading during convalescent plasma collection in blood centers. For blood donors with positive IgM antibodies, it is recommended to follow up the NAT results to minimize the risk of transmission.

This paper summarized the operation cooperation and management of the first case of bilateral lung transplantation assisted with double extracorporeal membrane oxygenation (ECMO) for the recipient with novel coronavirus pneumonia (COVID-19) in the world. The bilateral lung transplantation assisted by double ECMO had been accomplished successfully on a recipient with COVID-19, who was supported by ventilator and ECMO, with other organs function basically normal. The operation took 405 min and went smoothly. The cooperation and management guidelines of the operation room included the following: setting up of COVID-19 emergency operation group quickly; listing and preparing of the detailed operation supplies; transferring of the whole system of lung transplantation operating room in Wuxi People's Hospital to the Wuxi No.5 People's Hospital (isolation hospital); reconstruction of a negative pressure operating room for lung transplantation; formulating and strictly implementing the guidelines and management process for the operation of patient with COVID-19.

The related changes of bone marrow microenvironment (especially mesenchymal stem cells and osteoblasts) would lead to the occurrence of leukemia. Bone morphogenetic protein (BMP) is considered to be the only known morphogenetic factor capable of inducing differentiation of mesenchymal stem cells into osteoblasts, and its role in regulating the occurrence and development of leukemia in the bone marrow microenvironment has been paid more attention. The studies found that acute myeloid leukemia derived-mesenchymal stem cells induced the morphologic transformation and resistance of K562-ADM through BMP. This paper reviews the related research of BMP in order to provide new targets and directions for the research and treatment of leukemia.

Objective:To analyze the effect of family involvement in nursing on the recovery effect of children with thrombocytopenic purpura (ITP).Methods:A total of 55 children with ITP in our hospital who were not given family involvement in nursing between January and December 2017 were included in the control group and 63 children with ITP who were given family involvement in nursing between January and December 2018 were included in the observation group. The hospital stay, platelet count (PLT) recovery time, compliance (emotional control, diet, medication), mastery of health knowledge of family members and short-term prognosis were compared between the 2 groups.Results:The recovery time of PLT count (30-50)×10 9/L and (51-100)×10 9/L in the observation group was (1.97±0.56) d, (3.41±0.45) d, which was shorter than those of the control group [(2.79±0.59) d, (4.02±1.22) d] ( t value was 7.739, 3.693, P < 0.05). The scores of emotional control, dietary compliance and medication compliance and total score of compliance of the observation group on the day of discharge were 7.25 ± 1.17 , 8.18 ± 1.19 , 7.47 ± 1.35 , 21.26 ± 4.92, which were higher than those of the control group (5.11 ± 1.34, 5.79 ± 1.25, 4.86 ± 1.75, 15.76 ± 4.34) ( t value was -10.630- -6.397, all P < 0.05). On the day of discharge, the scores of condition monitoring, prevention of complications, dietary guidance, medication guidance, mastery of health knowledge and total score of family members of the observation group were higher than those of the control group ( t value was -7.705-5.949, all P< 0.05). Conclusions:Family involvement in nursing can improve the mastery of health knowledge about ITP of family members and children′s compliance, which is conductive to the recovery of PLT count in children with ITP. It may improve the short-term prognosis.

Objective: To explore the genotype-phenotype correlation among 3 pedigrees affected with congenital aniridia. Methods: Clinical data and genomic DNA were collected and genetic variations were screened by whole-exome sequencing, with an emphasis on PAX6-related genes.Suspected variations were verified by Sanger sequencing and quantitative polymerase chain reaction (PCR). Written informed consent was obtained from the parents of each propositus prior to entering study cohort.This study protocol was approved by Ethic Committee of Henan Eye Hospital (No.HNEECKY-2017(6)). Results: Genetic analysis identified that a nonsense c. 949 C>T variation and an c. 141+ 1 G>T splicing variation of the PAX6 gene in two of the probands, while the remainder has carried a duplication in 11 p13 (chr11: 31531331-31827959) encompassing the PAX6 and ELP4 genes.Phenotype analysis showed that the probands carrying the nonsense and splicing variations had classical features including complete aniridia, macular hypoplasia, microcornea and nystagmus; the proband carrying the 11p13 duplication had microphthalmos, microcornea, macular dysplasia, iris dysgenesis, and nystagmus. Conclusions The 11p13 duplication involving the PAX6 gene may have caused over-expression of PAX6 gene, resulting in severe eye abnormalities including microphthalmos and microcornea, macular dysplasia and nystagmus.The relatively mild iris dysgenesis has distinguishing it from classical aniridia due to PAX6 haploinsufficiency.

Objective To study the clinical value of combined detection of D-dimer,PT,FIB and Cyc-C in the patients with nephrotic syndrome(NS) complicating thromboembolism.Methods Sixty-five patients with clinically diagnosed NS(observation group) in the Huangshi Municipal Central Hospital from April 2013 to March 2016 were selected and divided into the non-thromboembolism group(group A,45 cases) and thromboembolism group(group B,20 cases).Contemporaneous 43 individuals undergoing physical examination served as the control group(group C).The levels of Cys-C and 24 h urine protein were tested by the electrochemical luminescence method;meanwhile PT,FIB and D-dimmer levels were detected by the nephelometry method.Their changes in the patients with NS complicating thromboembolism were observed.Results The levels of Cys-C,24 h urine protein and D-dimer in the observation group were significantly higher than those in the control group (P＜0.01).The difference of PT and FIB levels were not statistically significant(P＞0.05);the D-dimer and Cys-C levels in the observation B group was significantly higher than that in the observation A group(P＜0.05),moreover the D-dimer level was positively correlated with Cys-C.Conclusion D-dimer and Cys-C can be used as the predictive factors of thromboembolism occurrence in NS patients.

Objective To compare the composition of γδ T cells in the peripheral blood of gestational diabetes mellitus(GDM) patients with those of normal pregnant women,so as to explore the association of γδ T cells with the onset and progression of GDM.Methods The peripheral blood mononuclear cells(PBMC) of GDM patients(case group) and normal pregnant women(con-trol group) were separated by Ficoll-Hypaque density gradient centrifugation.γδ T cells were labeled with FITC conjugated anti TCRγδ monoclonal antibody(McAb) and PE conjugated anti-CD3 McAb and analyzed by flow cytometry.Results γδ T cells in GDM patients' peripheral blood were about(6.89 ± 3.22) ％,which was higher than normal control group(4.26 ± 1.64) ％.The percentage of γδ T cells in non-treated GDM group was significantly increased to(8.79 ± 2.33)％,while in treated GDM group,the percentage of γδ T cells was drop to normal(3.76±1.62)％.Conclusion γδ T cells in GDM patients' peripheral blood and CD3+ T Cells were slightly increased.The alteration may be related to the onset of GDM.

OBJECTIVETo investigate the therapeutic effect of facial artery perforator flap for the soft tissue defects at nose, lip and cheek.

METHODSThe facial artery perforator adjacent to the defect was identified by Doppler ultrasonography. The perforator flap was designed according to the defect location, size and shape. The subcutaneous tissue around the perforator was kept as much as possible to protect the venous drainage.

RESULTSFrom Oct. 2012 to Oct.2013, 26 cases were treated with facial artery perforator flaps, with 9 cases of nasal defects, 10 cases of lip defects and 7 cases of buccal defects. The defects size ranged from 1.5 cm x 2.0 cm to 3.0 cm x 3.0 cm and the flaps size ranged from 2.0 cm x 2.5 cm to 3.5 cm x 3. 5 cm. Superficial necrosis(3mm in width) happened at the end of one flap. All the other 25 flaps survived completely. 16 cases were followed up for 3 months to 2 years with no relapse and satisfactory cosmetic and functional results were achieved.

CONCLUSIONSBoth cosmetic and functional effect can be achieved with facial artery perforator flap for defects at nose, lip and cheek.

Arteries ; Cheek ; surgery ; Graft Survival ; Humans ; Lip ; surgery ; Nose ; surgery ; Perforator Flap ; blood supply ; transplantation ; Rhinoplasty ; methods

Background Researches showed that femtosecond laser corneal small incision lenticule extraction (SMILE) was used in the correction of myopia and myopic astigmatism due to its fast recovery,good shortterm efficacy and few complications.However,few research focused on its long-term efficacy.Objective Thisstudy was to evaluate the effectiveness,safety,predictability,stability and complications of SMILE.Methods A serial cases-observational study was carried out under the approval of Ethic Committee of Henan Eye Institute and informed consent of patients.Sixty-seven eyes of 34 patients with myopia and myopic astigmatism were included in Henan Eye Institute from January to June 2013.All the patients received SMILE and followed-up for 2-year duration.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),automatic optometry,intraocular pressure and corneal topography were examined before surgery and 1 day,1 week,1 month,3 months,1 year and 2 years after surgery and calculated the spherical equivalent (SE).The long-term efficacy of SMILE included effective index (preoperative BCVA/postoperative UCVA),safety index (postoperative BCVA/ preoperative BCVA),predictability (linear regression analysis between actual SE and attempted SE) and refractive stability (SE changes at postoperative time points).Results The preoperative BCVA was ≥ 20/20 in 60 eyes with the percentage of 89.55％.UCVA≥ 20/20 were found in 61 eyes and 60 eyes in postoperative 3 months and 2 years respectively (91.04％ and 89.55％).The effective index was 1.038±0.182 and 1.029±0.231 in postoperative 3 months and 2 years respectively,showing an insignificant difference between them (t =0.400,P ＞ 0.05).Compared with the preoperative BCVA,8.96％ (6/67) and 10.45％ (7/67) eyes lost 1 line at 3 months and 2 years after surgery,respectively.The safety indexes were 1.141±0.193 and 1.312±0.242 at 3 months and 2 years after surgery,with no significant difference between them (t =0.414,P＞0.05).A linear correlation was found between actual SE and attempted SE both at postoperative 3 months and 2 years,with the linear regression equations of Y=0.897 1X-0.440 8 (R2 =0.914 2,P＜0.05) and Y =0.893 7X-0.382 3 (R2 =0.915 7,P＜0.05),respectively.The SE was (0.013±0.578),(-0.033±0.489),(-0.106±0.508),(-0.103±0.375),(-0.154±0.518) and (-0.147±0.366)D 1 day,1 week,1 month,3 months,1 year and 2 years after surgery,respectively,and there were no significant difference among different time points (F =0.185,P =0.176).Eighteen in the 67 eyes occurred opaque bubble layer after surgery.Diffuse lamellar keratitis appeared in 6 eyes and punctate keratitis was in 2 eyes.These complications were cured 1 month after administration of drugs.Conclusions SMILE is good in effectiveness,safety,predictability and refreactive stability and has fewer complications during 2-year following-up.