Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective:The aim of this study was to explore the associations of muscle size and density with handgrip strength(HGS)and the Timed Up and Go(TUG)test.Methods:Totally 301 participants living in the Xinjiekou community near Beijing Jishuitan Hospital were recruited for CT imaging of the hip and a 1-cm slice of the mid-thigh.The cross-sectional area and density of the gluteus maximus and the mid-thigh muscles were estimated by the Osirix viewer based on CT images.HGS and TUG were also performed in these subjects.Logistic regression analysis was used to evaluate the correlations of muscle density and size with TUG and grip strength.Results:In women, after adjustment for age and BMI, the density of the gluteus maximus was negatively correlated with TUG( P trend=0.0366), while the size of the gluteus maximus and the mid-thigh muscles was not correlated with TUG.In men, the density or size of these muscles was not correlated with TUG.After adjustment for age and BMI, the density of the gluteus maximus was positively correlated with grip strength( P trend=0.0334)and the size of the mid-thigh muscles was also positively correlated with grip strength( P trend=0.0155)in men, but they were not correlated with grip strength in women. Conclusions:There were sex differences in the relationship between muscle size or density and grip strength or timed up and go.The density of the gluteus maximus is associated with muscle strength and physical performance while the size of the mid-thigh muscles is correlated with muscle strength.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective To analyze the prospective coping styles of nurses in operation room of plastic surgery department and its influencing factors. Methods A total of 169 nurses of two tertiary first-class hospitals and two secondary hospitals in Yuncheng city were selected as the research objects by convenient sampling from January 2016 to January 2017, their general data, dispositional hope, occupational expectations, occupational values, occupational maturity and prospective coping styles were analyzed. The influencing factors of prospective coping style were analyzed. Results The quality of hope was (31.78±4.24) points, occupational expectation was (72.41±7.24) points, professional values were (86.63 ± 7.02) points, professional maturity was (94.58 ± 6.25) points, and prospective coping style was (40.64 ± 6.13) points in the nurses in plastic surgery operation room. The results of multivariate linear regression model showed that the longer working time, high professional title, high degree of education, high monthly income, longer working hours in plastic surgery operation room, high hope quality, high career expectation, high occupational values and high career maturity were all the prospective coping styles of nurses in the operation room. Significant factors (P <0.05). Conclusions The nurses in the plastic surgery operation room have a certain prospective coping style, improve the treatment of nurses, set up their active work goals, improve their hope traits, career expectations, occupational values and career maturity, which can significantly enhance the level of prospective coping style.

Objective To assess the clinical diagnostic performance of liver stiffness measurement (LSM) and aspartate transaminase (AST)-to-platelet (PLT) ratio index (APRI) for liver fibrosis in chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) less than or equal to five times of the upper limit of normal (≤5×upper limit of normal [ULN]).Methods FibroScan,blood routine and liver function test were conducted at the day or one day before liver biopsy in 383 CHB patients with ALT≤5 × ULN.The Scheuer scoring system was used for liver histologic assessment.APRI was calculated.Based on the results of liver pathology,the areas under receiver operating characteristic curve (AUC) of LSM and APRI for diagnosis of liver fibrosis stage were compared.Results The median LSM were 5.10 kPa for S0 fibrosis stage,5.20 kPa for S1,6.60 kPa for S2,10.10 kPa for S3,and 18.80 kPa for S4.The median APRI values were 0.36,0.38,0.63,0.61 and 1.27,respectively.The AUC of LSM were 0.817 for ≥S2,0.891 for ≥S3 and 0.913 for ≥S4.And the AUC of APRI were 0.717 for ≥S2,0.711 for ≥S3 and 0.746 for ≥S4.The cut-offs of LSM values were 6.8 kPa for ≥S2,8.7 kPa for ≥S3,and 10.9 kPa for ≥S4.Conclusion LSM can accurately assess the degree of liver fibrosis in CHB patients with ALT ≤5 × ULN,which is superior to APRI in clinical utility.

Objective To compare the differences in the practical operation of exercise therapy courses for rehabilitation major students between workshop teaching method and traditional teaching method, and to explore the teaching model and process of workshop teaching method. Methods We im-plemented traditional teaching method in 94 rehabilitation major students in grade 2012 from Xuzhou Medical University, while 96 students in grade 2013 were taught by workshop method, which is based on specific cases, combined with multi-angle evaluation methods and various treatment protocols, with the opti-mal therapeutic method carried out after learning different practical operations and comparing their indica-tions. Then we conducted course satisfaction survey and skills operation evaluation on students from both grades after the course, and the t test was performed with the use of SPSS 19.0. Results The survey showed that the satisfaction score was significantly higher in grade 2013 students with workshop teaching method (79.07±10.49), compared with that in grade 2012 students with traditional teaching method (72.59±13.56), and the difference was statistically significant (P<0.05); as for the skills operation evaluation, the average score was significantly higher in students from 2013 grade (95.04±2.98), compared with that in students from 2012 grade (92.33±1.97), and the difference was statistically significant (P<0.05). Conclusions The work-shop teaching method can significantly improve students' satisfaction for the practical course of exercise therapy while improving their operation abilities.

Objective To observe the damage effect of borneol on rabbit corneal epithelial cells. Methods After the treatment with borneol at 100, 200, 400 μg·mL-1 respectively, the viability of rabbit corneal epithelial cells was determined by methyl thiazolyl tetrazolium ( MTT) assay, cell apoptosis was determined by flow cytometry with Annexin V- fluorescein isothiocyanate/propidium iodide ( FITC/PI) staining, and Caspase-3 mRNA expression was detected with real-time reverse transcription polymerase chain reaction ( RT-PCR) . Results Borneol at the concentrations of 100, 200, 400 μg·mL-1 inhibited the activity of rabbit corneal epithelial cells. Compared with the normal control group, borneol increased the rate of apoptosis, and enhanced the Caspase-3 mRNA expression in rabbit corneal epithelial cells ( P<0.05 or P<0.01) . Conclusion Borneol can inhibit the proliferation of rabbit corneal epithelial cells, induce cell apoptosis through enhancing the expression of apoptosis-related gene Caspase-3 mRNA.

Objective:To conduct a systematic study of the immunologic response of rats to transplanted glutaraldehyde ( GA)-treated porcine blood vessels in vivo.Methods: The experiment was divided into two groups:fresh group and glutaraldehyde-treated group.Twenty cases of fresh and glutaraldehyde-treated porcine pulmonary arteries were subcutaneously embedded in rats.We compared the changes using HE staining and immunohistochemistry.Results:HE staining showed that there were stronger expression on day 12 and day 30 in the fresh group than that in the glutaraldehyde group.There were similar results in morphology in CD68,C3,IgG.The results of integral optical density ( IOD) in immunohistochemistry showed that IOD started rising from day 4 and got the peak on day 12 or day 30 and or fell on day 60.Conclusion: Innate immunity played an important role in the research on xenogenic immunological rejection mechanism.The immunogenicity of glutaraldehyde-treated xenogenic blood vessels is lower than that in fresh blood vessels.However there is still immunogenicity in glutaraldehyde-treated xenogenic blood vessels.We will explore better ways to obviously weaken the rejection.

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Objective:To detect the existence of IFNGR in the stellate ganglion in female goats .Methods:The stellate ganglia were taken from female goats .The expression of IFNGR was detected by PCR method and immunohistochemical SP staining .Results:The results showed that:IFNGR immunoreactive substances were distributed in neurons , supporting cells and passing fiber , and mainly in the cytomembrane and nuclei of neurons .The relative expression of IFNGR was very significantly higher than that of non-neuronal cells (P<0.01).The sequence of IFNGR1 gene amplified by PCR method contained 376 bp, and IFNGR1 gene of goats exhibited the highest homology with sheep(98%),followed by cattle(97%).Conclusion:The results suggested that the IFNGR in the Stellate Gan-glion of female goats mainly expressed and located in sympathetic postganglionic neurons which were provided with the conditions for the role of IFN-γ, which implied that the Stellate Ganglion may act as the critical point to concert the immune regulation of IFN -γand neu-roregulation of autonomic nerve on cardiovascular system .