Objective: To evaluate the intervention effectiveness of broken window effect combined with narrative nursing on non-suicidal self-injury (NSSI) in adolescents, so as to provide the basis for NSSI prevention in adolescents. Methods: Totally 134 adolescents with NSSI admitted to Mental Health Center of the Affiliated Hospital of Anhui West Health Vocational College from January 2022 to December 2023 were enrolled and randomly assigned into the control and treatment group. All were given narrative nursing and routine care, and the adolescents in the treatment group were given additional intervention based on broken window effect. The effects were evaluated using Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Rating Idea of Suicide Scale (SIOSS), Ottawa Self-injury Inventory-Functions (OSI-F) and Nursing Satisfaction Scale, and the two groups were compared before and after intervention. Results: The treatment and control groups comprised 67 cases each, had a median age of 14.12 (interquartile range, 2.01) years and 14.10 (interquartile range, 1.52) years, included 71.64% and 68.66% girls, and 79.10% and 74.63% junior high school students, respectively. There were no statistically significant differences between the treatment and control groups in terms of gender, age or educational level (all P>0.05). The results of analysis of variance for repeated measures showed that there were interactions between time and group for SDS, HAMD and SIOSS scores (all P<0.05), and the decrease in scores before and after intervention was greater in the treatment group than in the control group. After intervention, the SDS, HAMD, SIOSS score and incidence of suicidal behaviors in the treatment group were all lower than the control group [SDS: (32.54±1.27) vs. (44.25±2.23); HAMD: (10.54±1.83) vs. (18.73±1.89); SIOSS: (10.37±2.20) vs. (15.76±1.62); incidence of suicidal behavior: 14.93% vs. 32.84%; all P<0.05]. The nursing satisfaction rate was significantly higher in the treatment group than in the control group (98.51% vs. 88.06%, P<0.05). Conclusion The broken window effect combined with narrative nursing would improve the depressive symptoms in adolescents with NSSI, and reduce the suicidal ideation and self injury.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

OBJECTIVE: To report on a case with severe hemophilia A (HA) due to a large duplication of F8 gene. METHODS: Inversion detection, Sanger sequencing, and multiplex ligation-dependent probe amplification (MLPA) were used to detect the mutation in the proband and his mother. RESULTS: The patient, a 7-year-old boy, was diagnosed with severe HA at 8 months. No inhibitor was developed over 150 exposure days. Intronic inversion detection and Sanger sequencing have failed to identify pathogenic variants, while MLPA revealed a large duplication [Ex 1_22 dup (2 copies)] in the proband, for which his mother was a carrier [Ex 1_22 dup (3 copies)]. Large duplications of the F8 gene have so far been found in 24 HA patients, all of whom had a severe phenotype, only one had a history of inhibitors. CONCLUSION Large duplications of F8 gene are associated with severe HA. The diagnostic rate for HA may be increased by MLPA.
Child ; Factor VIII/genetics* ; Gene Duplication ; Hemophilia A/genetics* ; Humans ; Introns ; Male ; Mutation ; Phenotype

Objective:To explore the clinical features and managements of novel coronavirus (2019-nCoV) infection after kidney transplantation.Methods:The authors reviewed medical history, laboratory values, imaging studies, treatment options and clinical outcomes of two confirmed hospitalized cases of COVID-19 after kidney transplant in February 2020. Both cases were middle-aged males and confirmed as COVID-19 at 11 or 12 months after transplantation. They both presented initially with moderate-to-low fever, cough and fatigue. Chest computed tomography (CT) hinted at multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary. Both had varying degrees of renal function and cardiac insufficiency.Results:In case 1, the dose of immunosuppressants was tapered while a higher dose of glucocorticoids was prescribed during treatment. In case 2, the dose of immunosuppressants was not tapered and continuous renal replacement therapy (CRRT) performed thrice in the early disease course due to renal insufficiency and hyperkalemia. Both cases received oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy, antibiotics treatment. Both cases were cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 patients after kidney transplantation are not significantly different from those of other people. However, early renal function and heart function abnormalities occur. How to adjust the immunosuppressant in the treatment course of severe COVID-19 after renal transplantation should be further explored.

Objective: To study the effects of altitude exposure and altitude exposure on mental health of Tibetan cadres. Methods: 105 cadres in Tibet were selected as the research objects. Among them, 74 cadres in Shannan and Lhasa of Tibet (average altitude 3 680 m), 31 in Shigaze and Ali (above 3 800 m) and 14 in Ali (above 4 300 m) were selected. Using Symptom Checklist 90 (SCL-90), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Ascension Insomnia Scale (AIS), 105 Tibetan aid cadres were tested by SAS, SDS, AIS and SCL-90 one week after entering Tibet and one week before leaving the plateau. The scores were collected and the mental health and sleep status of Tibetan aid workers were measured. Results: The number of positive items of SCL-90 of 105 Tibetan cadres increased from (13.21±9.05) one week after entering Tibet to (38.35±18.84) one week before leaving Tibet. SAS, SDS and AIS also increased from (25.49±5.19), (26.41±5.15), (5.16±3.54) points one week after entering Tibet to (36.78±7.53), (41.42±9.15), (8.71±4.64) points one week before leaving Tibet. The difference was significant in the last week (Z = 8.420, 8.689, 6.277, P<0.01). The correlation analysis between SCL-90 and SAS, SDS and AIS showed that SCL-90 was positively correlated with SAS, SDS and AIS scores (r = 0.651, 0.616, 0.356, P<0.01). Different altitudes have an effect on the mental health of Tibetan aid cadres. The paranoid item scores of Tibetan aid cadres with altitude>4 300 m in SCL-90 were (1.68 ± 0.50) points, which were higher than those of Tibetan aid cadres with altitude<4 300 m (1.24±0.28) points and (1.40± 0.38) points. The difference was statistically significant (F=5.255, P=0.007); The SDS scores of Tibetan aid cadres with altitude>4 300 m were (46.64 ± 7.24) points, which were higher than those of Tibetan aid cadres with altitude<4 300 m (40.76 ± 8.99) points and (40.58 ± 8.28) points. The difference was statistically significant (F=3.223, P=0.044). Conclusion Exposure to high altitude affects the mental health of cadres assisting Tibet to varying degrees. The mental health of cadres assisting Tibet deserves attention.

Objective To explore the effect of electroacupuncture (EA) at tusanli (ST36) on regulation of stress response under different doses of etomidate anesthesia in rats.Methods Sixty male Sprague-Dawley rats, weighing 280-310 g, were randomly divided into control group (group C), model group (group M), etomidate 60 mg/kg group (group E1), etomidate 30 mg/kg group (group E2), etomidate 60 mg/kg combined with EA group (group EA1) and etomidate 30 mg/kg combined with EA group (group EA2), n=10 in each group.All groups received inferior caudal trunk transection at the level between sacral spinal nerve 3 and 4 (S3, S4) to prepare acute stress response model except group C.Group M received no others treatment.The rats in group E1, group EA1, group E2 and group EA2 were intraperitoneally injected with 60, 60, 30 and 30 mg/kg etomidate, respectively.Group EA1 and group EA2 received EA ST36.The points were stimulated at a frequency of 2/100 Hz with 1 mA output and a dilatational wave, which lasted for 30 min.ACTH and Cor levels were measured by ELISA.The c-fos protein expression in hypothalamic tissue was examined by Western blot.Results Compared with group C, ACTH and Cor levels, and hypothalamic expression of c-fos protein in group M were significantly increased (P<0.05).Compared with group M, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein in groups E1, E2, EA1 and EA2 were significantly decreased (P<0.05).Compared with group E1, serum ACTH and Cor levels, and hypothalamic expression of c-fos protein were significantly higher in groups E2 and EA1 (P<0.05).Compared with group E2, serum ACTH level and hypothalamic expression of c-fos protein were significantly lower in group EA2 (P<0.05).Conclusion EA at ST36 regulating stress response under etomidate anesthesia in rats is effective and two-way, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in hypothalamus.

Xerostomia, as a common symptom in surgical patients, is mainly caused by factors such as strict food and liquid fasting, body change in metabolism and secretion function during the operation period, and decrease of patients' comfort during perioperative period. In this paper, Chinese and foreign researches on current status, influencing factors, assessment methods and mechanisms of secondary xerostomia during perioperative period were reviewed, and current nursing interventions were described, so as to arouse attention of medical staff to the symptom of xerostomia in surgical patients and to provide references for conducting quality nursing.

Objective To compare three rat models of acute stress response and to explore an ideal experimental rat model for research of acute stress response .Methods A total of 40 clean grade male SD rats were randomly ( by random number ) divided into 4 groups ( n=10 each ):Normal group ( group I ) , caudal trunk transection group ( group II), burn group (group III), and amputation group (group IV).The group I received no special treatment , the group II received inferior caudal trunk transection at the level between sacral spinal nerve 3 and 4 (S3, S4), the group III was inflicted with 30%total body surface area ( TBSA) grade 3 burn on the back , and the group IV had an amputation of the left lower limb as severe traumatic stress .Rats in each group were killed at 30 minutes after treatment and blood samples were collected for measuring serum adrenocorticotropic hormone (ACTH) and corticosterone (CORT) levels by ELISA. The c-fos protein expression in hypothalamic tissue was examined by immunohistochemistry .Results Compared with the group I, serum ACTH and CORT levels , and hypothalamic expression of c-fos protein in the group II , III, IV were significantly increased ( P <0.05 ) .Compared with the group III , serum ACTH and CORT levels , and hypothalamic expression of c-fos protein were significantly higher in the group II and IV ( P <0.05 ) , while there was no significant difference between the group II and IV (P>0.05).Conclusions The preparation of acute stress response model induced by inferior caudal trunk transection has simple operation steps and produces a traumatic injury to a similar degree , and quite well reflects the acute stress response in humans caused by sudden accident .Therefore it is a quite good method to establish acute stress response and deserves further investigation .

Objective To investigate the factors affecting non-neoplasma touch technology operation by operation room nurses for malignant tumor patients.Methods The qualitative methods was used in the study to interview 15 operation room nurses phenomenologically using semi-structured interviews.Colaizzi principles were used for data analysis and summarization of themes.Result The themes brought out from the data included lack of knowledge of no-neoplasma touch technology operation,huge workload,less importance attached to the management,over-consideration of medical costs.Conclusions It is a need to improve the level of knowledge of operating room nurses on non-neoplasma technology operations.The importance should be attached to management of the technology operation.The training on the operation should be strengthened so as to improve their operation of the technology.

Objective There is a lack objective methods for the diagnosis of postoperative cognitive dysfunction (POCD).This study aimed to investigate the influence of propofol or etomidate anes-thesia on the postoperative cognitive function and serum S 100βprotein level in infants . Methods This study included 100 hernia infants aged 1-3 years treated by laparoscopic herniorrhaphy under propofol (n=50) or etomidate anesthesia (n=50).At 1 day before and 3 days after surgery, we assessed the cognitive function of the patients using Bayley Scales of Infant and Toddler Development ( BSID-Ⅲ) and further divided each group into a POCD and a non-POCD sub-group based on the results of diagnosis made according to the Z-scores.Using ELISA, we measured the levels of the serum S100βpro-tein in the iliac venous blood drawn preoperatively ( T0 ) and before PACU ( T1 ) and compared them between the POCD and non-POCD groups. Results At 3 days after operation, POCD was observed in 10 cases (20.0%) in the propofol group and 9 cases (18.0%) in the etomidate group, with no statistically significant differences between the two (P>0.05).The level of the serum S100βprotein was markedly elevated in both the propofol and etomidate groups at T 1 as compared with that at T0(P<0.05), and so was it in the POCD in comparison with that in the non-POCD group (P<0.05), with no statistically significant differences between the two groups at T1(P>0.05).A significant correlation was found between the postoperative S 100βlevel and POCD at 3 days after surgery in both the propofol (r=0.842, P=0.001) and the etomidate group (r=0.821, P=0.001). Conclusion Propofol and etomidate anes-thesia can induce different degrees of postoperative decline of cognitive function in 1-3 years old infants .The post-anesthesia elevation of the serum S100βprotein level is positively correlated with early postoperative POCD and indicates various degrees of brain damage .