Objective:To explore the current status of medication adherence to immunosuppressants in lung transplant recipients and to analyze its correlation with medication beliefs and perceived social support.Methods:This was a cross-sectional study. From June 2022 to April 2023, totally 233 lung transplant recipients who were followed up in the Department of Lung Transplantation at China-Japan Friendship Hospital were selected by convenience sampling. The Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS), the Chinese version of the Beliefs about Medicines Questionnaire, and the Perceived Social Support Scale (PSSS) were used for the survey. Multiple linear regression analysis was conducted to explore the correlation between medication adherence to immunosuppressants, medication beliefs, and perceived social support in these lung transplant recipients.Results:A total of 233 questionnaires were distributed, with 213 valid responses received (91.42%). The incidence of non-adherence to immunosuppressants among the 213 transplant recipients was 41.78% (89/213), with the most common issue being not taking medication on time (27.23%, 58/213). Multiple linear regression analysis showed that age and perceived social support were influencing factors of medication adherence ( P<0.05) . Conclusions:The current level of medication adherence to immunosuppressants in lung transplant recipients is relatively poor. Medication adherence is correlated with age and the level of perceived social support. Healthcare providers should pay attention to medication adherence in younger patients and enhance their perceived social support to increase adherence to immunosuppressive medications.

Objective:To analyze the incidence and clinical phenotype of the concomitant extragenital malformations in the patients with female reproductive tract anomalies.Methods:A retrospective study was conducted using clinical data of hospitalized patients diagnosed with uterine, cervical, or vaginal malformations from January 2003 to December 2022 in Peking Union Medical College Hospital. The malformations were classified according to American Society for Reproductive Medicine müllerian anomalies classification 2021, and in each type, the incidence and specific manifestations of concomitant extragnital malformations were analyzed.Results:A total of 444 patients were included. The overall incidence of concomitant extragenital malformations was 43.5% (193/444), including urinary system, skeletal system, and other system malformations. Renal malformations on the obstructed side were present in all patients with oblique vaginal septum syndrome (100.0%, 78/78). The total incidence of concomitant extragnital malformations was as high as 8/11 in uterus didelphys, 43.5% (10/23) in unicornuate uterus, 33.6% (79/235) in Mayer-Rokitansky-Küster-Hauser syndrome, 18.8% (6/32) in septate uterus and 18.5% (12/65) in cervical agenesis. Urinary system malformations (30.6%, 136/444) and skeletal system malformations (13.5%, 60/444) were the most common concomitant malformations in all types, in which, unilateral renal agenesis and scoliosis were the most common.Conclusions:Urinary and skeletal system malformations are important features of female reproductive tract anomalies. Urologic ultrasonography and spinal roentgenogram are recommended for all patients with female reproductive tract anomalies.

Objective To apply the personal digital assistant(PDA)scanning positioning two-dimensional code recognition technology in writing nursing records in patients with acute ischemic stroke treated with intravenous thrombolysis,and to evaluate the application effect.Methods The quasi-experimental design was conducted.The nursing records routinely written by emergency nurses using mobile nursing cart for 58 patients with acute ischemic stroke treated with intravenous thrombolysis admitted to department of emergency of Zhejiang Hospital from September 2021 to February 2022 was taken as the control group,and the nursing records written by emergency nurses using PDA for 51 patients with acute ischemic stroke treated with intravenous thrombolysis from March 2022 to August 2022 through scanning positioning two-dimensional code recognition technology was used as the observation group.The differences of time required for writing nursing records and the incidence of errors in nursing records were compared between the two groups,and the satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was evaluated.Results The time required for writing nursing records in the observation group was significantly shorter than that in the control group[seconds:137(109,192)vs.480(436,604),P<0.05],the incidence of inadequate records of the first course of specialist assessment[3.92％(2/51)vs.20.69％(12/58)],and the incidence of insufficiently detailed records of thrombolytic observations[7.84％(4/51)vs.43.10％(25/58)]were significantly lower than the control group(both P<0.05).The differences between the observation group and the control group were not statistically significant when comparing the incidence of irregularities in thrombolytic drug pump records[0％(0/51)vs.1.72％(1/58)],incidence of irregularities in muscle strength assessment records[1.96％(1/51)vs.5.17％(3/58)],and the occurrence of typos in the nursing records[0％(0/51)vs.3.44％(2/58),all P>0.05].In addition,the overall satisfaction of emergency nurses in the observation group using PDA scanning positioning two-dimensional code to write nursing records was 92.94％(2 844/3 060),and the average score of each item in the synchronous nursing record of the positioning two-dimensional code was>4.5 points,among which the satisfaction score of ease of operation was(4.78±0.50),the acceptance of emergency nurses using PDA scanning positioning two-dimensional code to write nursing records was good,and could meet the clinical needs.Conclusion Using PDA scanning positioning two-dimensional code assists the writing of nursing records in the stroke treatment process,shortens the time required for writing nursing records of emergency nurses,reduces the incidence of errors in nursing records,and improves the quality of nursing records;At the same time,for emergency nurses,it can effectively reduce the burden of writing nursing records and improve their satisfaction with nursing records,which is worthy of clinical promotion.

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in adults with type 2 diabetes (T2D). The aim of this study was to determine the CV risk in Chinese patients with T2D based on the 2019 European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and CV diseases. METHODS: A total of 25,411 patients with T2D, who participated in the study of China Cardiometabolic Registries 3B study, were included in our analysis. We assessed the proportions of patients in each CV risk category according to 2019 ESC/EASD guidelines. RESULTS: Based on the 2019 ESC/EASD guidelines, 16,663 (65.6%), 1895 (7.5%), and 152 (0.6%) of patients were included in "very high risk," "high risk," and "moderate risk" categories, respectively. The proportions of patients in each category varied based on age, sex, body mass index, and duration. While 58.7% (9786/16,663) of elderly patients were classified to "very high risk" group, 89.6% (3732/4165) of patients with obesity were divided into "very high risk" group. Almost all patients with a duration of diabetes >10 years had "very high risk" or "high risk." However, 6701 (26.4%) of Chinese T2D patients, who had shorter duration, and one or two risk factors, could not be included in any category (the "unclear risk" category). CONCLUSIONS In China, most patients with T2D have "very high" or "high" CV risk based on 2019 ESC/EASD guidelines. However, the risk of patients in "unclear risk" group needs to be further classified.
Adult ; Aged ; Cardiovascular Diseases/epidemiology* ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Heart Disease Risk Factors ; Humans ; Risk Factors

OBJECTIVE: To detect genetic variant in a sib-pair with Finnish type congenital nephrotic syndrome (CNF). METHODS: Clinical data of the sib-pair was reviewed. Coding regions of the NPHS1 gene was analyzed for the sib-pair and both parents. RESULTS: The sister and brother respectively developed severe proteinuria 1 month and 28 days after birth, in addition with low serum albumin, hypercholesterolemia and severe edema, which were suggestive of CNF. Genetic testing identified that the sib-pair has both carried two heterozygous variants of NPHS1 gene, namely c.2605G>C (p.P869>A) and c.-61G>A, for which their father and mother were heterozygous carriers. CONCLUSION The c.2605G>C (p.869P>A) and c.-61G>A variants of the NHPS1 gene probably underlay the CNF in both sibs. The c.2605G>C(p.869P>A) was unreported previously.
Adult ; Female ; Humans ; Infant, Newborn ; Male ; Membrane Proteins/genetics* ; Mutation ; Nephrotic Syndrome/genetics* ; Siblings

Objective To investigate the number and activation status of circulating mucosal associated invariant T (MAIT) cells in patients with sepsis.Methods Flow cytometric method was used to determine the number and percentage of MAIT cells and their expression of activation molecule CD69.Results The circulating MAIT cells dropped significantly at early stage of sepsis in septic patients.The MAIT cells in the sepsis group continued to express high levels of CD69 on day 1 and day 3 after admission to ICU.Conclusions Remarkable decrease of circulating MAIT cells may portend the possibility of sepsis in patients with severe infection.

Objective To discuss the value of high frequency ultrasound for the evaluation of subclinical rheumatoid arthritis.Methods Forty-four rheumatoid arthritis patientswho reached disease activity score (DAS28) clinical remis-sion were included.Ultrasound assess were carried out in all 68 joints,including bilateral temporomandibular joints,sternoclavicular joint,acromioclavicular joint,shoulder joint,elbow joint,wrist joint,1-5 metacarpophalangeal joints and the interphalangeal joint of the thumb,the 2-5 proximal interphalangeal joints,the 2-5 distal interphalangeal joints,hip,knee joint,ankle joint,tarsus joint,the 1-5 metatarsophalangeal joint,1-5 toeinterphalangeal joints.Analysis for the correlation between PD,GS score and gender,age,course of disease and clinical disease activity index were conducted.The pain visual analogue scale (VAS),time of morning stiffness,swollen joint count (SJC) and tender joint count (TJC),health assessment questionnaire (HAQ) score,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) and rheumatoid factor (RF),anti cyclic citrullinated peptide (anti CCP) antibody,simplified disease activity index (SDAI),DAS28-CRP,DAS28-ESR were compared.Using Pearson and Spearman to analyze ultrasonic joint synovitis index score and clinical indexes,Student's t-test was employed to assess the significance of difference between two independent sample.Results Twenty-six patients reached/European League against Rheumatism (ACR/EULAR) 2011 remission,19 patients achieved ACR remission,and 3 patients achieved ultrasound remission.There was correlation between GS score and the course of disease and the number of swollen joints (r=0.602,0.470,P＜0.01).There was a positive correlation between ultrasound PD score and the patient's pain score,the total score of patients,ACR/EULAR2011,DAS28-ESR,DAS28-CRP (r=0.323,0.337,0.329,0.360,0.343,P＜0.05).The ultrasound PD score also had a positive correlation with CRP,ESR,time of morning stiffness (r=0.474,0.490,0.415,P＜0.01).Conclusion The subclinical arthrosynovitis can be detected by high frequency ultrasound in most rheumatoid arthritis patients at clinical remission.The PD ultrasound has advantage in evaluating RA activity over GS ultrasound.

Objective To explore changes of urine transferrin (TFR),micro albumin (mALb),β2 microspheres protein (MG),α1MG and N-acetylβ-D amino group (NAG) in children with kidney injury induced by cytomegalovirus (CMV) infec?tion, and the outcome after treatment. Methods Fifty children with CMV infection were used as case group, and 35 chil?dren of convalescence stage of upper respiratory tract infection were used as control group. The serum levels of creatinine (Scr), blood urea nitrogen (BUN),β2MG, liver function, CMV-IgM, CMV-PCR and brainstem auditory (BAEP), head CT and urine routine test, urine TFR, mALb,β2MG,α2MG and NAG were detected. The sputum CMV-PCR was detected if childrencombined with CMV pneumonia. Ganciclovir (5mg/kg) was given to two groups, 1/12 h i.v. for 14 d. The urine TFR,mALb,β2MG, α2MG and NAG were detected again after treatment. Results There were no significant differences in the urine mALb and TFR between the two groups. The urine levels ofα1MG, NAG andβ2MG were higher in case group than those of control group. The urine levels ofα1MG, NAG andβ2MG were decreased after 2-week treatment in case group. There were no significant differences in urine mALb and TFR before and after treatment. Conclusion The combined detection ofβ2MG,α1MG and NAG can predict CMV kidney damage in children at a early stage.

Objective To investigate clinical outcome of laparoendoscopic single-site compared with traditional three-port in treatment of ovarian cystectomy.Method From February 2012 to June 2013,54 patients with ovarian cyst were randomized to the single-site group (n =24) or the three-port group (n =30) in Peking Union Medical College Hospital.The outcome of laparoscopic single-site and three-port ovarian cystectomy were evaluated.Operation time,blood loss,surgical complications,postoperative pain score,postoperative analgesic requirements,length of hospital stay,cosmetic satisfaction score,postoperative recovery and total cost were compared between both groups.Results No difference was found in blood loss,length of hospital stay,complications and total cost between the two groups(P ＞ 0.05).Operation time was (31-± 10) minute in three-port group and (40 ± 19) minute in single-site group.Visual analogue pain score was 5.6 ± 1.7 in three-port group and 2.7 ± 1.4 in single-site group,cosmetic satisfaction score was 92.5 ± 2.5 in three-port group and 97.4 ± 1.5 in single-site group.Those clinical parameter reached statistical difference (all P ＜ 0.05).Conclusion Laparoendoscopic single site surgery approach is feasible and safe to treat benign ovarian cyst disease.And it offers decreased pain and offer improved cosmesis.

Objective To explore the operation skills of laparoendoscopic single site surgery ( LESS) of total hysterectomy , to expand the application of LESS in the field of in gynecologic surgery . Methods A total of 23 cases of total hysterectomy were completed under laparoendoscopic single site surgery in Peking Union Medical College Hospital from January 2012 to August 2013, applying with combination of the traditional laparoscopic and special LESS apparatuses , intelligent electronic coagulation and excision device and the self-fixed absorbable sutures ( V-LOC).The datas of the patients during the operations and the follow-up were recorded and analyzed Results Twenty-three cases LESS-TH are accomplished.The weight of uterus was (230+38) g.The operation time was (73+22) minutes, with the intraoperative blood loss (99 ±53) ml.The postoperative intestinal function recovery time was (13 +4) hours, and postoperative hospitalized time was ( 1.8 ±0.6 ) days, with the postoperative pain visual analogue scale 3.9 ±1.6.There were no complications reported during intraoperative and postoperative time.All of our patients was finished the follow-up from 14 d to 2 months.As usual, vaginal discharge is normal, wound healed well, most of the wounds healing (19/23) hidden in umbillicus, no obvious scar, vaginal stub wound healed well Conclusions ( 1 ) LESS can accomplish total hysterectomy of uterus of gestational age less than 8 weeks safely and effectively .( 2 ) Combination of traditional laparoscopic and special LESS appatatuses , the use of intelligent energy devices and V-LOC to suture vaginal stub could make the total hysterectomy by LESS much easier and safer .