Objective:To develop the Peripherally Inserted Central Catheter (PICC) Nursing Knowledge, Attitude and Practice Scale for Primary Caregivers of Patients with PICC, and to test its reliability and validity.Methods:Taking the theory of knowledge, attitude and practice as the basic framework, the item pool was initially constructed through literature review, group discussion, and semi-structured interviews from March to April 2021. From May to July 2021, the initial scale was formed through Delphi expert consultation, and the items of the scale were pre-tested and adjusted through cognitive interviews. From June to October 2021, convenience sampling was used to select the primary caregivers of 450 patients with PICC in a cancer hospital in Hunan Province for a formal survey to test the reliability and validity of the scale.Results:The formal scale consisted of 53 items in 3 dimensions, including 19 items in the knowledge dimension, 8 items in the attitude dimension, and 26 items in the practice dimension. The Cronbach's α coefficients of each dimension and the total scale were 0.949, 0.962, 0.972, and 0.981, respectively, and the test-retest reliability coefficients of each dimension and the total scale were 0.951, 0.935, 0.972, and 0.967, respectively. The split-half reliability coefficients of each dimension and the total scale were 0.889, 0.954, 0.889, and 0.882, respectively. The content validity index of the item ranged from 0.82 to 1.00.Conclusions:The reliability and validity of the PICC Nursing Knowledge, Attitude and Practice Scale for Primary Caregivers of Patients with PICC is good, and it can be used as a tool to evaluate the PICC nursing knowledge, attitude, and practice of primary caregivers of patients with PICC.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Birth Weight ; China ; Female ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male

Objective To explore the relationship between the level of plasma homocysteine(HCY)and intima-media thickness(IMT)with incipient cerebral infarction.Methods According to the clinical diagnostic criteria,112 patients with incipient cerebral infarction were randomly selected as the cerebral infarction group,and 102 healthy people were randomly selected as the control group.All carotid arteries of both groups were checked by carotid artery ultrasound and IMT was tested.The levels of plasma HCY and plasma folate as well as vitamin B12 were measured in both groups by chemiluminescence immunoassay.Results The plasma HCY level in the cerebral infarction group [(24.89 ± 1.96) μmol/L] was significantly higher than (8.58 ± 2.34) μmol/L in the control group (P ＜ 0.01).The levels of plasma folate [(4.79 ± 2.35) μg/L] and vitamin B12 [(228.67 ± 114.75) ng/L] in the cerebral infarction group were significantly lower than [(8.65 ± 2.64) μg/L and (320.53 ± 154.78) ng/L] of the control group (P ＜ 0.01).The IMT of the cerebral infarction group [respectively the left common carotid artery fork (1.12 ± 0.25) mm,the right common carotid artery fork(1.09 ± 0.28) mm,the left internal carotid artery(1.18 ± 0.23) mm,the right internal carotid artery(1.03 ± 0.24)mm] were obviously higher than those of the control group[respectively the left common carotid artery fork (0.65 ± 0.18) mm,the right common carotid artery fork (0.61 ± 0.24) mm,the left internal carotid artery(0.58 ±0.22)mm,the right internal carotid artery(0.61 ±0.19)mm] (P ＜0.05).Significant positive correlation between IMT and HCY was found in patients with cerebral infarction(r =0.834,P ＜ 0.01),but no corre lation was found in the control group(r =0.081,P ＞ 0.05).Conclusion The increase of plasma HCY and the thickening of IMT are closely related with incipient cerebral infarction.Examination of plasma HCY and IMT has important clinical significance for the secondary prevention of incipient cerebral infarction.

Objective To explore the clinical effect of restructuring human brain natriuretic peptide in treatment of heart failure associated with severe acute myocarditis.Methods Fifty cases of heart failure associated with severe acute myocarditis were divided into experimental group and control group according random number table method,each group 25 cases.The patients in control group were given conventional treatment,and the patients in experimental group were given restructuring human brain natriuretic peptide on the basis of conventional treatment.The clinical effects of two groups were observed.Results The level of N terminal brain natriuretic peptide,left ventricular ejection fraction,urine volume,creatinine in two groups had no significant difference before treatment (P ＞ 0.05).After treatment,these index in experimental group were better than those in control group [(7 785 ± 432) ng/L vs.(10 022 ± 447) ng/L,(45.28 ± 2.67)％ vs.(41.34 ±3.11)％,(1 833 ±49) ml/24 h vs.(1 456 ±47) ml/24 h,(109.34 ± 10.77) μmol/L vs.(125.44 ± 11.00) μ mol/L] (P ＜ 0.05).The rate of clinical symptoms improving in experimental group was significantly higher than that in control group [71.4％ (55/77) vs.26.0％ (20/77)] (P ＜0.01).Conclusion Restructuring human brain natriuretic peptide with conventional treatment can effectively improve heart failure associated with severe clinical symptoms of acute myocarditis,improve the clinical therapeutic effect.

The distribution of journals, cooperated papers, authors and their affiliated institutions, fund-supported papers, and subjects in 305 papers published in 17 core journals of stomatology since their establishment with their citation frequencies ≤40 were analyzed in an attempt to provide reference for the editorial departments of journals in their topic selection , manuscripts review and solicitation .

Objective To explore the efficacy of comprehensive community-based rehabilitation on chronic schizophrenia and assess in the view of health economy. Methods 80 chronic schizophrenic patients accepted comprehensive community-based rehabilitation for 1 year and were followed up for 1 year. Other 80 chronic schizophrenics were as the controls. They were observed with outcome and the cost. Resultsn The social function, compliance, stability rate, burden on family caregiver, satisfaction of living, psychiatric symptoms, hospitalization were all better in the rehabilitation group than in the control group (P<0.01), and the total cost in the 2 years was less, especially that on hospitalization,maintenance treatment, work loss of caregivers, public prevention (P<0.01). Conclusion Comprehensive community-based rehabilitation can improve the outcome of chronic schizophrenics with less cost.

OBJECTIVETo investigate the effect of polyethylene oxide (PEO) on renal blood flow and its renoprotective effect in rabbits with endotoxin sepsis.

METHODSTwenty normal New Zealand white rabbits were randomly divided into normal saline (NS) group and PEO group (n=10), and endotoxin shock was induced by an intravenous injection of 0.6 mg/kg lipopolysaccharide. Resuscitation was performed when the blood pressure of the rabbits showed a 30% decline, using NS (in NS group) or the mixture of equal volumes of NS and 20 ng/g PEO (in PEO group) perfused at the rate of 5 ml/kg per hour. Before and during shock and at 1 h after resuscitation, the renal hemodynamics was monitored by ultrasound and the venous blood was extracted to examine the renal functions. The heart rate and arterial blood pressure were monitored throughout the experiment.

RESULTSThe rabbits in both groups showed a significantly lower renal artery blood flow velocity during the shock (P<0.05) with significantly increased pulsatility index (PI) and resistance index (RI) compared with those before the shock. One hour after resuscitation, the blood flow velocity in the renal arteries at all levels and the tertiary veins were reduced in NS group without obvious reduction of the PI and RI; in PEO group, the blood flow velocities in the renal arteries increased significantly compared to those before shock (P<0.05), and the PI and RI of the tertiary arteries were significantly lower than those in NS group (P<0.05). In both groups, BUN and Cr increased during endotoxin shock stage, and 1 h after resuscitation, PEO group showed significantly lower BUN and Cr levels than NS group (P<0.05).

CONCLUSIONA small dose of PEO can significantly promote renal perfusion in rabbits with septic shock, thus offering renoprotective effect against early damage in septicopyemia and septic shock.

Animals ; Hemodynamics ; Polyethylene Glycols ; pharmacology ; therapeutic use ; Rabbits ; Renal Circulation ; Shock, Septic ; drug therapy ; physiopathology

BACKGROUND:Transgenosis of basic fibroblast growth factor (bFGF) gene has been successfully performed into the muscle satellite cells of rat extraocular muscles in the previous study of the research group, proving that bFGF could express in the myoblasts of extraocular muscles, also promote cell proliferation and differentiation.OBJECTIVE: To further investigate the methods for regulating the expression of the bFGF in myoblasts following transfection. METHODS: Target gene bFGF was connected with inducing expression vector pcDNA4/T0/myc-His?A, followed by masculine clone sequencing identified by colony PCR and enzyme digestion, EcoR I and Hind III restriction enzyme digestion, as well as Xho I single enzyme verification. C2C12 myoblasts antibiotics sensitivity was screened and finally defined. By use of lipofection transfection technology, cell lines where C2C12 stably expressed pcDNA6/TR were estabolishd and then identified by Western blot. The pcDNA4/TO/myc-His?A-bFGF was transfected into pcDNA6/TR- C2C12 cells. The bFGF expression and secretion in C2C12 cells following tetracycline-induced pcDNA4/TO/myc-His?A-bFGF transfection were determined by immunofluorescence and Western blot, the controls were established.RESULTS AND CONCLUSION: ① The conjunction between the bFGF and inducing expression vector pcDNA4/TO/myc-His?A was proved successfully by sequencing comparison, double digestion and single digestion. ②The minimal lethal concentration of blasticidin to C2C12 cells was 10 mg/L, while that of zeocin was 750 mg/L. ③ The pcDNA6/TR-C2C12 cell lines were established correctly. ④ The myoblasts treated by tetracycline and transfected with pcDNA4/TO/myc-His?A-bFGF were positive for gene expression, those untreated exhibited a negativity; bFGF protein could be produced in myoblasts treated by tetracycline and transfected with pcDNA4/TO/myc-His?A-bFGF, the production reached a peak at 24 hours, while those untreated can not produce bFGF protein. Results suggest that the bFGF expression in the myoblasts can be controlled by tetracycline inhibition and regulatory systems.