To improve the effectiveness of bedside localization of nasointestinal tube(NIT)and facilitate the placement of nasointestinal tube into jejunum,we established a procedure and composed a teaching verse for bedside placement of nasointestinal tube based on relevant classical literature and our own practices.Verse content:enteral nutrition means a successful strategy to improve the outcome in critically ill patient management,never hesitate to place nasointestinal tubes when necessary.There are several methods to deal with it,but popularizing it remains a long way off.Half-sitting and swallowing into the esophagus,freely withdrawing signifies the stomach cavity.Passing through the pylorus using light tension on the tube in the right lateral decubitus position.Arriving at the jejunum with low resistance in the left lateral decubitus position.What are the signs of intragastric coiling?Tube return out of nose is the initial observation,Failure of air insufflation indicates tube coiling.Dyeing location surpasses imaging.Vacuum test is the most sensitive,Sequential change from acid to base is specific.Methylene blue test is dramatical for localization.Combining three methods is enough to navigate.Abdominal plain film is the goldan standard and can still be used in ultrasonic era.3-D image establishes overall view.CT reveals the tube route exactly.The teaching verse has become a powerful tool for clinical teaching of manual nasointestinal tube placement in a concise and easy-to-remember form.

Objective:To evaluate the data quality of Shenzhen Type 1 Diabetes Alliance (SZT1D), and to provide a basis for evaluation and improvement for the continuous improvement of data quality.Methods:From December 2018 to July 2021, 697 first-visit type 1 diabetes (T1DM) patients (including 501 in Shenzhen and 196 out-of-Shenzhen) and 120 re-visited T1DM patients (including 113 in Shenzhen and 7 out-of-Shenzhen) who were registered by SZT1D in collaborative research platform network of China Type 1 Diabetes Alliance (hereinafter referred to as China T1D). The data quality was evaluated from three dimensions: data completion, accuracy and revisit. The data completion degree was evaluated by the overall data completion degree and the key indicator completion degree; the data accuracy was evaluated by the probability of abnormal blood glucose value; the patient′s return visit was evaluated by the return visit rate.Results:The main characteristics of T1DM in SZT1D were young and middle-aged adults [age: (34.4±17.1)years] with thin body [BMI: (19.80±3.52)kg/m 2)], half of male and female patients [proportion of male: 52.4%(365/697)]; the main types of diagnosis were classical T1DM [65.22%(150/230)] and latent autoimmune diabetes in adults(LADA) [26.08%(60/230)], and the fasting blood glucose (FPG) [(10.93±6.98)mmol/L] and glycosylated hemoglobin (HbA 1c) [(10.63±3.01)%] were high. The average completion rate of the overall data of the first diagnosed patients in SZT1D was only 60% [(62.9±31.5)%]: the number of patients with overall data completion ≥80% in SZT1D was only 50.2%(350/697); the number of patients with overall data completion ≥80% in Shenzhen was less than that outside Shenzhen [44.3%(222/501) vs 65.3%(128/196), P<0.001]. The key indicators with better completion rate of first-visit were disease course [76.2%(531/697)], age of onset [75.8%(528/697)], family history of diabetes [74.9%(522/697)], etc., but none of them had a completion rate of more than 80%, and the diabetes self-management behavior assessment questionnaire and scale score were completely missing; the frequency of daily blood glucose monitoring [46.1%(231/501) vs 64.3%(126/196), P<0.001], current insulin regimen [44.3%(222/501) vs 63.3%(124/196), P<0.001], number of diabetic ketoacidosis (DKA) since the onset of the disease [45.7%(229/501) vs 64.8%(127/196), P<0.001] and the number of symptomatic hypoglycemia in the past 1 month [39.3%(197/501) vs 63.8%(125/196), P<0.001] were higher in Shenzhen than those reported outside Shenzhen. In addition, the probability of abnormal FPG and postprandial glucose (PPG) [5.2%(24/466); 3.8%(19/236)] were low. The revisit rate was not high [17.2%(120/697)], and the revisit rate in Shenzhen was higher than that outside Shenzhen [22.6%(113/501) vs 3.6%(7/196), P<0.001]. The first revisit rate was 16.2%(113/697) and the second revisit rate was seriously insufficient [1.0%(7/697)]. Conclusions:The data quality of T1DM patients recorded by SZT1D needs to be further improved. Improving the information interconnection between China-T1D and SZT1D, employing quality control personnel and building a systematic data quality evaluation analysis and feedback mechanism are methods to promote the comprehensive, accurate and efficient input of T1DM data and continuously improve the evaluation methods to improve the overall data quality.

Objective: To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction. Methods: Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups. Results: All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group. Conclusions Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.

Objective To study the effects of Puerarin(Pue)on survival rate,expression of GAP-43 and NGF in spinal motoneurons following brachial roots avulsion. Methods From March, 2014 to December, 2015, 192 adult Sprague Dawley rats were divided into four groups: Avulsion, Pue 50 treatment, Pue 100 and Pue 200 groups. The right C5-C7nerve roots were avulsed through the methods of cervical dorsal approach. Puerarin or normal saline was given immediatedly once daily to the rats respectively by the intraperitoneal injection. The rats were killed at 1, 2, 4 and 6 weeks after injury. The paraffin sections of C7 segment were stained with neutral red. Expression of GAP-43 and NGF were detected by Western blot. Results Compared to the avuled group, the motoneuron survival rates of Pue 100 and Pue 200 dose treatment groups increased on the second week and the sixth week(P < 0.05 or P < 0.01), and the Pue 200 dose treatment group increased on the fourth week(P < 0.01).In the anterior horn of all three groups, expression of GAP-43 increased from the 1st week to the 6 week after the operation, and reached the peak at the 4th week, and decreased at the 6th week. Compared to the avuled group, expression of GAP-43 protein increased in the Pue 100 and Pue 200 dose treatment groups at the 1st week and 2nd week,the expression of NGF protein increased in the three Pue treatment groups at four time points(P < 0.05 or P < 0.01). Conclusion Puerarin can improve the survival rates of spinal motoneurons after the brachial plexus root avulsion, and the expression of GAP-43 and NGF increased, suggesting that Puerarin may play an role in the repair of brachial plexus avulsions by promoting the ex-pression of nerve growth factors.

Objective To investigate the level of occupational burnout and mindfulness among undergraduate nursing in-terns, and to analyze their relationship. Methods For convenient sampling, 600 nursing students who belong to 4 colleges and universities of Henan were investigated using the general information questionnaire, the Chinese version of Maslach Burnout Inventory (MBI) and Mindfulness Attention Awareness Scale (MAAS). Results The scores of occupational burnout were as follow: the score of emotional exhaustion was (33.46 ± 9.31) points, the score of depersonalization was (14.26 ± 5.91) points, the score of low personal achievement was (17.58 ± 8.49) points, the score of mindfulness was (57.27 ± 13.41) points. Mindfulness had a significant negative effect on job burnout, emotional exhaustion and low personal achievement. Level of mindfulness, language violence and work overtime in-terns, and possible of clinical nursing work in the future were the main factors influencing job burnout, and three factors could explain 25.4％ of job burnout. Conclusions Mindfulness had a significant negative effect on job burnout. Nursing educators and administrators should improve the level of mindfulness of nursing students to reduce their job burnout.

Objective To investigate the state of the aging perceptions and quality of life in the elderly patients with hypertension in Kaifeng city and their relationship. Methods A total of 156 elderly patients with hypertension in Kaifeng city were investigated by using a general data questionnaire, Chinese version of the Aging Perceptions and SF-36 quality of life assessment scale. Results The scores of the aging perceptions were higher than the median. The score of negative control was the highest with (3.72 ± 0.47) points, and the score of emotion representation was the lowest with (2.59±0.65) points. The scores of physical function, role limitation due to physical health, bodily pain, general health perception, emotional function and mental health of the elderly patients with hypertension were significantly lower than that of normal population (t=-17.074--3.492, P<0.01). Pearson correlation analysis showed that positive control, positive outcome, and recognition were significant positively correlated with quality of life (r=0.221- 0.352, P<0.05); acute/chronic time, emotional representation and negative result were significant negatively correlated with quality of life were presented (r=-0.478--0.310, P<0.01);periodic time was significant negatively correlated with mental health status (r=-0.314, P<0.01). Conclusions There is a significant correlation between the aging perceptions and quality of life in elderly hypertensive patients in Kaifeng city. The quality of life was significantly lower than that of normal population in China, and it was affected by the aging perceptions.

Objective To research the correlation of single nucleotide polymorphisms(SNPs) of Plasmacytomas Variant Translocation Gene(PVT1) and diabetes nephropathy.Methods To assay PVT1 SNPs (rs10808565,rs13447075,rs2648862,rs2720709,rs2648875) in two groups individuals with diabetes nephropathy and diabetes by MassARRAY system.Then analysis the results by statistical methods to evaluate the relationship between PVT1 SNPs and diabetes nephropathy.Results The distributions of SNPs of PVT1 (rs10808565,rs13447075,rs2648862,rs2720709,rs2648875) were all under the Hard-Weinberg equilibrium in two groups.Difference in PVT1 rs2648875 between two groups was statistically significant(P<0.05);and there were no significant differences in the others SNPs (rs10808565,rs13447075,rs2648862,rs2720709) between two groups.Conclusion PVT1 rs2648875 may contribute to the susceptibility of DN in chinese people and the others PVT1 SNPs (rs10808565,rs13447075,rs2648862,rs2720709) may not be Chinese susceptibility gene in DN.

Despite the deepening of research on breast cancer,improving of treatment techniques,there are still many patients will appear local-regional recurrence after surgery.For patients with local recurrence after radical mastectomy,according to whether the postoperative radiotherapy performed,prognosis and treatment protocols are absolutely different.As for patients with local recurrence after breast-conserving surgery,more and more studies have shown that lumpectomy (secondary breast conserving surgery) combined with brachytherapy can achieve a similar effect with radical surgery in recent years,so it is a worth considering treatment protocol.

Objective To investigate the impact of lack of progesterone receptor ( PR) expression on the prognosis of patients with operable ER ( estrogen receptor)?positive invasive breast cancer. Methods We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+/PR+ and ER+/PR? invasive breast cancer. Results Among the 318 patients, there were 219 PR?positive and 99 PR?negative cases. The 5?year overall survival ( OS ) rate was 92. 5%, and the 5?year disease?free survival ( DFS) rate was 87. 2% in the 318 ER?positive patients. Among them, the 5?year OS rates were significantly different between the PR?positive group (94.6%) and PR?negative group (87.8%, P=0.020), and the 5?year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019).Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS ( P<0.05 for all) . Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER?positive breast cancer patients ( P<0. 05 for all ) . Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stageⅠ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR?negative disease had poorer DFS and OS than PR?positive patients ( P<0.05 for both) . Conclusions Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER?positive invasive breast cancer, especially in patients with a large tumor (>2 cm) , advanced clinical stage ( StageⅡ or Ⅲ) or in premenopausal status.

Objective To investigate the impact of lack of progesterone receptor ( PR) expression on the prognosis of patients with operable ER ( estrogen receptor)?positive invasive breast cancer. Methods We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+/PR+ and ER+/PR? invasive breast cancer. Results Among the 318 patients, there were 219 PR?positive and 99 PR?negative cases. The 5?year overall survival ( OS ) rate was 92. 5%, and the 5?year disease?free survival ( DFS) rate was 87. 2% in the 318 ER?positive patients. Among them, the 5?year OS rates were significantly different between the PR?positive group (94.6%) and PR?negative group (87.8%, P=0.020), and the 5?year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019).Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS ( P<0.05 for all) . Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER?positive breast cancer patients ( P<0. 05 for all ) . Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stageⅠ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR?negative disease had poorer DFS and OS than PR?positive patients ( P<0.05 for both) . Conclusions Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER?positive invasive breast cancer, especially in patients with a large tumor (>2 cm) , advanced clinical stage ( StageⅡ or Ⅲ) or in premenopausal status.