Objective:This study focuses on Na +-taurocholate cotransporting polypeptide (NTCP) deficiency to analyze and investigate the value of the serum bile acid profile for facilitating the diagnosis and differential diagnosis. Methods:Clinical data of 66 patients with cholestatic liver diseases (CLDs) diagnosed and treated in the Department of Pediatrics of the First Affiliated Hospital of Jinan University from early April 2015 to the end of December 2021 were collected, including 32 cases of NTCP deficiency (16 adults and 16 children), 16 cases of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD), 8 cases of Alagille syndrome, and 10 cases of biliary atresia. At the same time, adult and pediatric healthy control groups (15 cases each) were established. The serum bile acid components of the study subjects were qualitatively and quantitatively analyzed by ultra-high performance liquid chromatography-tandem mass spectrometry. The data were plotted and compared using statistical SPSS 19.0 and GraphPad Prism 5.0 software. The clinical and bile acid profiles of children with NTCP deficiency and corresponding healthy controls, as well as differences between NTCP deficiency and other CLDs, were compared using statistical methods such as t-tests, Wilcoxon rank sum tests, and Kruskal-Wallis H tests.Results:Compared with the healthy control, the levels of total conjugated bile acids, total primary bile acids, total secondary bile acids, glycocholic acid, taurocholic acid, and glycochenodeoxycholic acid were increased in NTCP deficiency patients ( P < 0.05). Compared with adults with NTCP deficiency, the levels of total conjugated bile acids and total primary bile acids were significantly increased in children with NTCP deficiency ( P < 0.05). The serum levels of taurochenodeoxycholic acid, glycolithocholate, taurohyocholate, and tauro-α-muricholic acid were significantly increased in children with NTCP deficiency, but the bile acid levels such as glycodeoxycholic acid, glycolithocholate, and lithocholic acid were decreased ( P < 0.05). The serum levels of secondary bile acids such as lithocholic acid, deoxycholic acid, and hyodeoxycholic acid were significantly higher in children with NTCP deficiency than those in other CLD groups such as NICCD, Alagille syndrome, and biliary atresia ( P < 0.05). Total primary bile acids/total secondary bile acids, total conjugated bile acids/total unconjugated bile acids, taurocholic acid, serum taurodeoxycholic acid, and glycodeoxycholic acid effectively distinguished children with NTCP deficiency from other non-NTCP deficiency CLDs. Conclusion:This study confirms that serum bile acid profile analysis has an important reference value for facilitating the diagnosis and differential diagnosis of NTCP deficiency. Furthermore, it deepens the scientific understanding of the changing characteristics of serum bile acid profiles in patients with CLDs such as NTCP deficiency, provides a metabolomic basis for in-depth understanding of its pathogenesis, and provides clues and ideas for subsequent in-depth research.

Acute intermittent porphyria(AIP) is a rare inherited metabolic disease that can cause severe and fatal acute attacks. This article shares the treatment and management of a severe AIP patient. It is proposed that (1) avoiding incentives is essential; (2) emotional problems easily overlooked should be paid attention; (3) long-term follow-up and patient education can improve the prognosis. The patient underwent renal biopsy during the remission period. We found a red-brown-yellow-white refractive index crystal under a polarized light microscope that had not been reported in the previous literature, which was speculated to be a porphyrin crystal.

Objective:To discuss the clinical features, diagnosis and treatment of linear scleroderma (LS).Methods:A case of LS diagnosed in the Second Hospital of Shandong University in October 20, 2020, was reported and the clinical features and pathological documentation of the disease reported in the literature were reviewed.Results:A 24-year-old woman presented cicatricial alopecia on the left frontoparietal area and facial atrophy for about 10 years. Two years before, she began to suffer ptosis and neurological complaints. Clinical features of different stages of the disease are presented. All 15 patients reported in the literature were analyzed, with a median of 22 years and a male to female ratio of 9∶6. There were 4 cases of linear scleroderma with ipsilateral drooping eyelids and lateral contraction, 3 cases of linear scleroderma with demyelinating lesions, combined with lateral contraction, 3 cases of linear scleroderma combined with lateral atrophy, and 1 case of linear scleroderma with ipsilateral facial spasm. Two cases were with the chest sclerosing spot. Two cases of linear scleroderma were with epileptic seizure and white matter demyelination lesion. Six cases were treated with hormone, 2 cases were treated with methotrexate. One case was treated with both hormone and methotrexate. One case was treated with botulinum toxin. Three cases were treated with surgical correction of eyelid ptosis. One case was treated with ultraviolet A1 radiation phototherapy and 1 case was treated with vitamin therapy.Conclusions:Patients with scleroderma may have ipsilateral facial atrophy, blepharoptosis and facial spasm. Some patients involving the nervous system may have epilepsy and myelitis. And demyelinating lesions can be seen in magnetic resonance imaging. Localized scleroderma may develop into systemic scleroderma. Therefore, it is recommended to combine immunosuppressants as soon as possible to control the development of the disease if necessary.

Based on the International Federation of Nursing Anesthetists (IFNA) education and training base, our hospital has built a training base for anesthesia specialized nurses in Nanjing from the following aspects: the application for training base of anesthesia specialized nurses, the qualification and examination of students' and teachers' qualification, the settings of training curriculum, the examination contents and methods, and the evaluation of post-training effect. This article summarizes the construction experience of this base, therefore, providing support and standard for the training of anesthesia specialized nurses.

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 develop a curriculum integration attitude assessment scale for students in nursing school of China and to test its reliability and validity.Methods:The first draft of scale was developed with the methods of literature review and Delphi technique. From June to November 2018, we selected 575 interns from three nursing schools undergoing curriculum integration in Heilongjiang Province as respondents by convenience sampling. The reliability and validity of this scale were tested.Results:The curriculum integration attitude assessment scale for nursing students included three dimensions and 20 items. The content validity index of the total scale was 0.943 and that of items ranged from 0.8 to 1.0. Exploratory factor analysis extracted three factors including value tendency, participation tendency and emotional tendency with 77.602% for the cumulative variance contribution.The Cronbach's α coefficient of the total scale was 0.928 and that of dimensions ranged from 0.942 to 0.954; the Spearman-Brown coefficient of the total scale was 0.879 and that of dimensions ranged from 0.921 to 0.933; the test-retest reliability coefficient of the total scale was 0.789 and that of dimensions ranged from 0.549 to 0.779.Conclusions:The curriculum integration attitude assessment scale for nursing students has high reliability and validity which can be used to assess nursing students' attitude with curriculum integration so as to provide a scientific basis for further optimize curriculum system and a reference for similar teaching assessment.

Individual differences of P300 potentials lead to that a large amount of training data must be collected to construct pattern recognition models in P300-based brain-computer interface system, which may cause subjects' fatigue and degrade the system performance. TrAdaBoost is a method that transfers the knowledge from source area to target area, which improves learning effect in the target area. Our research purposed a TrAdaBoost-based linear discriminant analysis and a TrAdaBoost-based support vector machine to recognize the P300 potentials across multiple subjects. This method first trains two kinds of classifiers separately by using the data deriving from a small amount of data from same subject and a large amount of data from different subjects. Then it combines all the classifiers with different weights. Compared with traditional training methods that use only a small amount of data from same subject or mixed different subjects' data to directly train, our algorithm improved the accuracies by 19.56% and 22.25% respectively, and improved the information transfer rate of 14.69 bits/min and 15.76 bits/min respectively. The results indicate that the TrAdaBoost-based method has the potential to enhance the generalization ability of brain-computer interface on the individual differences.
Algorithms ; Brain-Computer Interfaces ; Discriminant Analysis ; Electroencephalography ; Event-Related Potentials, P300 ; Humans ; Support Vector Machine

Objective: To evaluate the change of tooth root volume and length after rapid maxillary expansion by CBCT three dimensional reconstruction method. Methods: 33 patients underwent rapid maxillary expansion were examined by CBCT before and after treatment. The CBCT images of the first,second premolars and the first molars were segmented and reconstructed by Mimics image processing software for the analysis of the changes of root volume and length. All data were analyzed by SPSS software statistically. Results: After maxillary expansion,all root volumes were reduced(P ＜ 0. 05),more reduction was observed in anchorage teeth than in non-anchorage teeth(P ＜ 0. 05). The length of most teeth roots was not decreased(P＞ 0. 05) except the buccal and distal roots of the first molars(P ＜ 0. 05). Conclusion: Rapid maxillary expansion may result in root resorption and this resorption is mainly based on the volume decrease.

Objective:To evaluate the effects of maxillary protraction with or without rapid maxillary expansion in the treatment of Class Ⅲ malocclusion by Meta-Analysis.Methods:The randomized controlled trail,quasi-randomized controlled trail and the clinical controlled trail about the treatment of Class Ⅲ malocclusion by protraction with or without expansion were searched in the database of Cochrane Library,Embase,PubMed,Medline,CBM,Wan Fang,CNKI,VIP.2 authors qualified and extracted the data independently.Then the Meta-analysis was performed by using the RevMan 5.3 software.Results:7 studies with 228 cases were included,114 cases were treated by maxillary protraction with expansion and the other 114 cases by maxillary protraction without expansion.The Meta-analysis showed that:there was no significant difference in SNA,SNB,ANB and SN-PP except ANS-Me,U1-NA,SN-MP.A favorable improvement of the sagittal relationship between maxillary and mandibular was observed by using protraction whether with expansion or not.The expansion did not shorten the course of treatment,but it lowered the inclination of upper incisors,resulting in more clockwise rotation of mandibular plane and increase of the facial vertical dimension.Conclusion:Maxillary protraction with rapid maxillary expansion can be used in the treatment of class Ⅲ malocclusion with incisor labioclination.

Objective:To study the dental and skeletal changes after orthodontic treatment for malocclusion patients with rapid maxil-lary and mandibular expansion companied with fixed appliance.Methods:36 patients underwent the treatment with rapid maxillary and mandibular expansion companied with straight wire appliance.Pre-and post-treatment dental casts and lateral cephalometric radiographs were measured and compared.Results:After treatment,the maxillary and mandibular arch width perimeters increased(P <0.05).The anterior arch depths decreased(P <0.05).No significant differences were found in vertical skeletal variables(P >0.05).U1-SN and U1-NA decreased,L1-MP and L1-NB increased(P <0.05).Conclusion:Dental crowding can be solved effectively and occlusion re-lationship can be kept well with rapid maxillary and mandibular expansion companied with straight wire appliance without influence on the vertical skeletal relationship.