【Objective】 To explore the application value of different language assessment tools in the assessment of language development of 12-month-old high-risk infants, and to screen out simple and valid language assessment tools. 【Methods】 A total of 217 11- to 13-month-old high-risk infants who were followed up at the outpatient service for high-risk infants at the child health clinic of Guiyang Maternal and Child Health Hospital from March 2022 to May 2023 were selected as the study subjects. Their language was evaluated by Early Language Milestone Scale (ELMS), Putonghua Communicative Development Inventory (PCDI) and Ages and Stages Questionnaire-Third Edition (ASQ-3). With Gesell as the gold standard for the assessment of language, the area under receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, Youden index and Kappa value of the three tools were calculated. Spearman correlation analysis was used to analyze the correlation between the different language assessment scales. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to evaluate the three tools. 【Results】 1)Among 217 high-risk infants, 78 preterm infants was the most (35.94%). The rate of delayed language development detected by Gesell, ELMS, PCDI-comprehension, PCDI-expression, ASQ-3 were 5.5%, 7.8%, 36.4%, 30.0% and 11.5%, respectively. 2)ASQ-3 had the strongest correlation with Gesell language region (rs=0.607, P<0.01) and it had the most AUC (AUC=0.812, P<0.05). The consistency between ASQ-3 and Gesell was moderate (Kappa=0.56, P<0.01). ASQ-3 had the highest sensitivity(91.7%), accuracy(93.1%), negative predictive value(99.5%) and Youden index(0.85), and ELMS had the highest specificity(94.6%). 3) Comprehensive evaluation of three tools by the TOPSIS indicated that ASQ-3 was the best, followed by ELMS and PCDI-comprehension was the worse. 【Conclusion】 Among the three assessment tools, ASQ-3 has the highest value in assessing the language development of 11- to 13-month-old high risk infants, and it may be necessary to expand the age range and establish a national norm of ELMS and PCDI in the future.

Objective:To analyze the effect of traditional Chinese medicine fasting therapy on atherogenic index of plasma and metabolic indices in patients with metabolic syndrome.Methods:A case-control study was conducted on 90 patients with metabolic syndrome who were treated at Wenzhou Traditional Chinese Medicine Hospital between June 2021 and June 2023. The patients were divided into two groups with 45 patients in each group using a random number table method. The control group was given a normal diet, while the observation group underwent traditional Chinese medicine fasting therapy. Blood lipid indexes, atherogenic index of plasma, Homeostasis Model Assessment of Insulin Resistance index, anthropometric indices, and oxidative stress response were compared between the two groups.Results:After treatment, the levels of low-density lipoprotein cholesterol, total cholesterol, and triglyceride in the observation group were (2.11 ± 0.26) mmol/L, (4.31 ± 0.26) mmol/L, and (1.39 ± 0.26) mmol/L, respectively. They were significantly lower than those in the control group [(2.95 ± 0.34) mmol/L, (5.24 ± 0.33) mmol/L, (2.68 ± 0.41) mmol/L, t = 13.16, 14.85, 17.82, all P < 0.05]. After treatment, the level of high-density lipoprotein cholesterol was significantly higher in the observation group than in the control group [(1.18 ± 0.09) mmol/L vs. (1.03 ± 0.04) mmol/L, t = 10.21, P < 0.001]. After treatment, atherogenic index of plasma and Homeostasis Model Assessment of Insulin Resistance index in the observation group were (0.10 ± 0.04) and (5.12 ± 0.42), respectively in the observation group. They were significantly lower than those in the control group [(0.28 ± 0.10), (5.80 ± 0.67), t = 11.21, 5.76, both P < 0.001]. After treatment, waist circumference, hip circumference, and visceral adiposity index in the observation group were (91.05 ± 4.26) cm, (98.16 ± 5.06) cm, and (3.94 ± 0.52), respectively. They were significantly lower than those in the control group [(95.55 ± 9.87) cm, (102.64 ± 9.84) cm, (5.66 ± 1.04), t = 2.80, 2.71, 9.92, all P < 0.05). After treatment, the level of superoxide dismutase in the observation group was significantly higher than that in the control group [(101.52 ± 13.52) U/mL vs. (80.01 ± 6.82) U/mL, t = 9.52, P < 0.001]. After treatment, the level of malondialdehyde in the observation group was significantly lower than that in the control group [(4.41±0.35) nmol/L vs. (6.26 ± 0.61) nmol/L, t = 17.64, P < 0.001). Conclusion:Traditional Chinese medicine fasting therapy can effectively reduce the atherogenic index of plasma, blood lipid level, waist circumference, hip circumference, and visceral adiposity index in patients with metabolic syndrome. It also reduces oxidative stress reactions and is highly effective.

[Objective]To summarize the famous traditional Chinese medicine(TCM)doctor Professor JIN Yabei's clinical experience in treating slowing height growth in adolescents with QI Yong's Navel Acupuncture.[Methods]Through clinical follow-up,sorting,reviewing and analyzing the medical records of Professor JIN in the diagnosis and treatment of slowing height growth in adolescents with Navel Acupuncture,the clinical experience of Professor JIN was summarized and presented from several aspects such as etiology and pathogenesis,syndrome differentiation and treatment,and characteristics of acupoint use,and two test cases were attached.[Results]Professor JIN believes that the intrinsic core pathogenesis of this disease is"spleen can't govern transportation and the weakness in five Zang-organs",which is closely related to"the weakness of kidney and the lacking origin of bone marrow""liver fails to govern free flow of Qi and liver insulting spleen".Patients are divided into two types:spleen and kidney deficiency syndrome and liver stagnation and spleen deficiency syndrome.Spleen and kidney deficiency syndrome usually uses QI Yong's Navel Acupuncture with"Zhen,Xun,Li and Kun",while liver stagnation and spleen deficiency syndrome takes"rising four needles on the left side".In the course of treatment,Professor JIN keeps close tabs on the adjustment of emotions,and adjusts the acupuncture prescription flexibly according to the syndromes.In the cases cited,the spleen and kidney deficiency syndrome was treated with invigorating Qi and strengthening the spleen,tonifying the kidney and nurturing vital Qi,to balance negative emotions,supplemented by soothing the liver,expulsing pathogen and stemming desertion.After the pathogens were gone,it was changed to"rising four needles on the left side"to help the Yang Qi rise and make the height growth.The patient with liver stagnation and spleen deficiency syndrome,which was caused by great pressure on study,liver failing to govern free flow of Qi and liver insulting spleen,was treated by"rising four needles on the left side"to disperse stagnated liver Qi to relieve depression and raise Yang Qi,supplemented by promoting the lung and regulating Qi,and finally the five Zang-organs were harmonized and the height grew by itself.[Conclusion]Professor JIN treats slowing height growth in adolescents with QI Yong's Navel Acupuncture,keeping rigorously differentiation of the two syndromes and treatment.She focuses on patients'psychological states and keeps close tabs on the adjustment of emotions.With distinctive clinical characteristics and remarkable treatment effects,her clinical experience is worth promoting and learning.

End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.

Objective:To explore the obstacle factors and promoting factors of exercise guidance and implementation after breast cancer surgery, so as to provide reference and basis for the formulation of exercise program after breast cancer patients.Methods:Using the objective sampling method, a total of 10 medical staff and 10 patients with breast cancer after operation from the breast surgery department of the Seven People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine hospital in Shanghai were selected as research objects from July to September 2022. A semi-structured interview was conducted. The interview outline was developed based on the knowledge transformation framework, and the results were analyzed by the content analysis method.Results:The study extracted three levels of influencing factors. The system level included caregiver workload, educational materials, norms and responsibilities and trust in evidence-based evidence. The practitioner level included the level of exercise knowledge, the concern about patient compliance and the emphasis on exercise. The patient level included sports knowledge level, personality and interest, venous line, adverse reaction of treatment, psychological state, weather environment, attention to health and concern of family members.Conclusions:The medical staff need to consider the postoperative exercise guidance for breast cancer patients from the department, themselves and patients, and should fully consider the patients' conditions and subjective experience to improve the patients' exercise compliance.

Objective:To retrospectively analyze the prevalence and genotype distribution of human papillomavirus (HPV) among women in mainland China from the introduction of cervical cancer vaccine to its marketing in China, so as to provide data for comparing HPV prevalence after the application and gradual promotion of HPV vaccine.Methods:Related articles published during 2006 to 2016 were retrieved from PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang databases. Data about HPV infection in women receiving physical examination or routine cervical cancer screening and female outpatients were collected and analyzed.Result:A total of 270 articles were retrieved, in which the sampled women were aged from 13 to 90 years old. Seventy-two articles were about HPV infection in women screened for cervical cancer with a sample size of 580 308 people. The overall results showed that during the 11 years, the five most common high-risk HPV genotypes were HPV52, 16, 58, 68 and 18, and the common low-risk HPV genotypes were HPV81, 43 and 6. The distribution of HPV genotypes varied in different regions, but HPV16, 52 and 58 were always the predominant genotypes. Among the 270 collected articles, 200 analyzed HPV infection in female outpatients with a total of 675 035 cases. The results showed that the top five high-risk HPV genotypes with high prevalence were HPV16, 52, 58, 18 and 33, and the common low-risk types were HPV6, 11 and 81. The analysis of HPV infection rate in seven geographical regions indicated that, although the distribution of the commonly circulating high-risk HPV genotypes varied in different regions, HPV16, 52 and 58 remained the predominant genotypes.Conclusions:The present study showed that the prevalence and genotype distribution of HPV infection varied by region, but HPV16, 52 and 58 were always the most common high-risk genotypes and HPV6 was the predominant low-risk genotype in both women screened for cervical cancer and female outpatients. Besides that, the infections of other high-risk genotypes, such as HPV53 and 68, should also be of concern.

Objective:To investigate the relationship between serum matrix metalloproteinase-9 (MMP-9) level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods:A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group, and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group. The clinical data and biochemical indicators of the two groups were collected. Serum MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA). According to susceptibility weighted imaging (SWI), CMBs patients were divided into grade 1 group ( n=24), grade 2 group ( n=19) and grade 3 group ( n=17), and according to the micro analytical rating scale (MARS), the CMBs patients were divided into the lobar group ( n=19), the deep or infratentorial group ( n=17) and the mixed group ( n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed. SPSS 19.0 software was used for data statistical analysis.One-way ANOVA, t-test and rank sum test were used for comparison. Logistic regression analysis was used to analyze the influencing factors. Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis. Results:The level of MMP-9 in CMBs group was significantly higher than that in control group (208.13(142.25, 285.88) μg/L, 149.50(93.40, 186.51)μg/L), and the difference was statistically significant ( P<0.05). Serum MMP-9 level was a risk factor of CMBs ( β=1.322, OR=3.750, 95% CI=2.038-7.997, P=0.002). The difference of level of MMP-9 in different severity of CMBs was statistically significant (147.55(109.25, 266.47)μg/L, 242.12(147.55, 288.80)μg/L, 270.42(203.43, 364.27)μg/L, P=0.017). Serum MMP-9 level was positively correlated with the number of CMBs ( r=0.371, P=0.003). The difference of MMP-9 level of CMBs in different locations were statistically significant (249.77(158.43, 338.46)μg/L, 188.83(138.52, 243.15)μg/L, 210.65(144.25, 255.78)μg/L, P=0.013). The increased serum MMP-9 level was a risk factor for CMBs( β=0.401, OR=1.122, 95% CI=1.004-1.204, P=0.036). Conclusion:The increased level of serum MMP-9 may be a risk factor of CMBs, especially for CMBs in cerebral lobesand, and the level of MMP-9 is positively correlated with the severity of CMBs.

Objective:To explore the effect of interactive self-management education model in the self-management behavior of outpatients with type 2 diabetes (T2DM) .Methods:Convenience sampling method was used to select 98 patients with T2DM who were treated in the Outpatient Department of Heping Hospital Affiliated to Changzhi Medical College from March 2018 to March 2019 as the research objects. Patients were randomly divided into control group and observation group by lottery, with 49 cases in each group. On the basis of hypoglycemic and basic disease treatment, control group carried out the conventional self-management education model, and observation group implemented the interactive self-management education model. We compared the score of Summary of Diabetes Self-Care Activities (SDSCA) , fasting blood glucose (FBG) , 2-hour postprandial blood glucose (2 hPBG) , glycosylated hemoglobin (HbA1c) between the two groups of patients before and after intervention, as well as compliance after intervention to understand the self-management behavior, blood glucose control and compliance of patients.Results:After intervention, except for the smoking dimension, the scores of all dimensions of SDSCA in observation group were higher than those of control group, and the differences were statistically significant ( P<0.05) . After intervention, FBG, 2 hPBG and HbA1c of observation group were (5.11±0.62) mmol/L, (6.83±0.59) mmol/L and (4.62±0.34) % respectively, which were lower than those of control group [ (7.28±0.73) mmol/L, (8.41±0.72) mmol/L, (7.23±0.35) %], the differences were statistically significant ( t=15.860, 11.881, 37.442; P<0.05) . After intervention, there was a statistically significant difference in the compliance of the two groups of patients ( Z=7.170, P<0.05) . Conclusions:The interactive self-management education model can improve the self-management ability of patients with T2DM and effectively control the blood glucose of patients, which is worthy of clinical promotion.

Objective:To summarize the nursing experience of a patient with multiple renal transplants with high sensitization and severe obstructive sleep apnea hypopnea syndrome.Methods:A phased care intervention was implemented through multidisciplinary joint treatment.Results:The transplanted renal function of the patient recovered well, the concentration of immunopreparations was stable, and the patient was cured and discharged after 30 days of hospitalizationConclusion:Preoperative accurate antibody screening and effective desensitization therapy are the prerequisites for successful operation. Postoperative sleep apnea, rejection and observation and nursing of immunosuppressive drugs are implemented. Personalized rehabilitation guidance and psychological care are implemented throughout the whole process. Strengthening missions and attaching importance to continuous care have effectively protected patients' safety.

Objective:To investigate the relationship between serum matrix metalloproteinase-9(MMP-9) level and vascular cognitive impairment with no dementia (VCIND) in patients with cerebral small vessel diseases (CSVD).Methods:A total of 374 patients with CSVD treated in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2020 were collected and 150 healthy subjects in the same period were used as general data of the control group. All subjects were detected for serum MMP-9 level using enzyme linked immunosorbent assay and received cognitive function scoring using Montreal cognitive assessment (MoCA). The 374 patients with CSVD were divided into the Group A(186 cases with vascular cognitive impairment with no dementia) and the Group B(188 cases without cognitive impairment). The general data, serum MMP-9 level and cognitive function score were compared among the three groups and the correlation between MMP-9 level and cognitive function was analyzed.Results:The MMP-9 levels of Groups A and B ( (335.10±105.10)μg/L, (261.62±80.32)μg/L) were higher than those of the control group ( (168.23±48.85)μg/L), and the MMP-9 level of Group A was higher than that of Group B ( P<0.05). The MoCA scores of Groups A and B ( (18.45±5.24), (28.31±1.52) ) were lower than those of the control group (29.49±0.90), and the MoCA scores of Group A were lower than those of Group B ( P<0.05). The serum MMP-9 level, a risk factor for VCIND in patients with CSVD ( β=1.505, OR=1.323, 95% CI=1.149-1.527, P<0.05), was negatively correlated with total score of MoCA scale, visual-spatial and executive function, naming, language, abstract thinking, delayed recall, and directive force factor score ( r=-0.299, r=-0.155, r=-0.383, r=-0.358, r=-0.192, r=-0.259, r=-0.246 respectively, all P<0.05). Conclusion:The increased level of MMP-9 may be a risk factor of VCIND in CSVD patients, and it is closely related to cognitive impairment.