Indocyanine Green/therapeutic use* ; Photochemotherapy ; Combined Modality Therapy ; Anti-Infective Agents

OBJECTIVES: To provide reference basis for reducing the mortality for children under 5 years old and promote the healthy development, the mortality for children under 5 years old and the main causes for death in Liuyang City from 2013 to 2020 are analyzed. METHODS: The data of 725 cases of death for children under 5 years old in Liuyang City from 2013 to 2020 were collected.The causes and difference of death among the children were analyzed retrospectively by descriptive statistic methods. RESULTS: There were a total of 144 516 live births in Liuyang City from 2013 to 2020. The mortality for children under 5 years old was 5.01‰, for infants was 3.39‰, and for newborns was 1.63‰. The male child mortality was 5.28‰, and the female child mortality rate was 4.72‰, with significant difference (P>0.05). The mortality for children under 5 years old was seasonal fluctuation, without significant difference among seasons (P>0.05). For the past 5 years, the top 3 causes for death among children under 5 years old were preterm birth and low birth weight, congenital heart disease, and pneumonia. Before death, 341 cases (47.04%) were treated in provincial hospitals, 198 cases (27.31%) in county-level hospitals, 56 cases (7.72%) in village-level hospitals, and 130 cases (17.93%) were not treated. CONCLUSIONS The mortality for children under 5 years old in Liuyang City is gradually reduced in the past 5 years. The main causes for death are premature birth and low birth weight, congenital heart disease and pneumonia. We should develop healthy education, improve the rate of prenatal diagnosis, promote the construction of obstetrics and paediatrics, and fundamentally reduce the mortality for children under 5 years old.
Cause of Death ; Child ; Child Mortality ; Child, Preschool ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Male ; Pneumonia/epidemiology* ; Pregnancy ; Premature Birth ; Retrospective Studies

Objective:To explore the cause and treatment of chylothorax after surgery for congenital heart disease(CHD) in newborns.Methods:A retrospective analysis was made to the clinical data of 49 newborns with chylothorax after surgery for CHD within the period from January 2009 to December 2019. These newborns were aged from from 1 day to 28 days with the weight from 2.0 kg to 4.1 kg. The complete transposition of great arteries was performed in 13 cases, coarctation of the aorta/ interruption of the aortic arch in 13 case, right ventricular outflow tract reconstruction/ Blalock-Taussing shunt in 9 cases, total anomalous pulmonary venous connection in 8 cases, ventricular septal defect repair and atrial septal defect repair in 4 cases, ligation of patent ductus arteriosus in 1 case and persisten truncus arteriosus in 1 case. Chylothorax occurred in the right in 19 cases, left side in 20 cases, bilateral in 9 cases and the pericardium in 1 case. The diagnosis was made at the time from 1 day to 22 days after the surgery with an average of 8 days.Results:43 patients were cured(87.75%), 41 cases(83.67%) were cured with diet and support therapy, the course lasted from 4 days to 65 days with an average of 11 days; 1 cases, because of the poor effect of diet and support therapy, was given pleural injection of high-sugar combined with octreotide treatment; 1 case received thoracic duct ligation as the conservative therapy was ineffective; 6 cases of death due to heart failure/ severe pulmonary hypertension after operation, and parents gave up.Conclusion:Individualization conservative therapy is the first choice for chylothorax, while timely surgery can raise the survival rate and save the hospitalization time and the cost.

Objective:To investigate the effects of 4-hydroxy-2, 2, 6, 6-tetramethylpiperidine (Tempol) on the expressions of hypoxia inducible factor-1 α (HIF-1α)/vascular endothelial growth factor (VEGF) and lung development in premature neonatal rats under intermittent hypoxia (achieved by supplying a low concentration of oxygen).Methods:The intermittent hypoxia model was established.Caesarean section of rats was performed at 21 days of gestation when the fetal rats were estimated to be in labor.A total of 192 premature neonatal rats survived and were randomly divided into 6 groups according to random number table method: air control+ saline group, air control+ Tempol group, constant oxygen + saline group, constant oxygen + Tempol group, intermittent hypoxia + saline group, and intermittent hypoxia + Tempol group, 32 rats in each group.On the 7 th, 14 th and 21 st day of birth, the lung tissues of 8 neonatal preterm rats in each group were taken.Malondialdehyde (MDA) and total antioxidant capacity (TAOC) were detected by chemical analysis.The mRNA and protein levels of HIF-1α and VEGF were detected by real-time fluorescence quantitative PCR (qPCR) and immunohistochemistry, respectively.Another 8 neonatal rats in each group were taken for pulmonary function test on the 21 st day after birth. One- way ANOVA and SNK- q test were used for comparison among and between groups, respectively. Results:Compared with the constant oxygen + saline group, the intermittent hypoxia + saline group showed mild pulmonary septal thickening, increased MDA, decreased TAOC, elevated mRNA and protein expression levels of VEGF and HIF-1 α, and decreased lung function indexes.The differences were statistically significant (all P<0.05). Compared with the corresponding saline group, the intermittent hypoxia + Tempol group had decreased MDA and increased TAOC, and the differences were statistically significant at 14 d[MDA(3.09±0.45) nmol/(mg·pr) vs.4.02±0.30) nmol/(mg·pr), TAOC(3.13±0.31) U/(mg·pr) vs.(2.44±0.22) U/(mg·pr)]and 21 d[MDA(2.87±0.43) nmol/(mg·pr) vs.(4.47±0.56) nmol/(mg·pr), TAOC(3.47±0.35) U/(mg·pr) vs.(2.31±0.32) U/(mg·pr)] (all P<0.05). Compared with the corresponding saline group, the mRNA and protein expression of HIF-1 α and VEGF decreased in the intermittent hypoxia+ Tempol group, and the decrease in the mRNA expression of HIF-1 α was statistically significant at 14 d (2.11±0.60 vs.2.88±0.59) (all P<0.05). Lung function indexes, including tidal volume[(0.41 ± 0.01) mL vs.(0.36±0.02) mL], minute respiratory ventilation[(35.48 ± 2.95) mL vs.(30.62±2.27) mL], maximum expiratory flow[(2.19 ± 0.19) mL/s vs.(1.51±0.19) mL/s]and dynamic lung compliance[(2.65 ± 0.40) mL/cmH 2O vs.(1.83±0.34) mL/cmH 2O, 1 cmH 2O=0.098 kPa]increased (all P<0.05). Conclusions:Tempol can alleviate the lung injury induced by intermittent hypoxia under the intervention of a low concentration of oxygen to premature newborn rats and improve their lung function.

Objective: To investigate the interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age. Methods: Stratified multistage random sampling method was used to choose samples from 30 districts and counties of Shaanxi province. Information on childbearing-age women with their children between January 2010 and November 2013 was retrospectively collected through face-to-face questionnaire survey. The childbearing-aged women were in pregnancy or having had definite outcomes of pregnancy. Enumeration data were described by percentage, and measurement data were described by Mean±SD, and χ² test was used to compare the rates. Unconditional logistic regression analysis was performed to estimate the interaction between pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age, and by using small for gestational age as dependent variables, pregnancy-induced hypertension and history of preterm birth as independent variables. Confounding factors were under control. Firstly, the association between pregnancy-induced hypertension and small for gestational age has been analyzed in primiparas, secondly, interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age has been analyzed in multiparas. Results: A total of 25 751 women of childbearing age and their children were recruited. 60.55% (15 592/25 751) were primiparas, 39.45% (10 159/25 751) were multiparas, the rate of history of preterm birth was 1.89% (192/10 159) for multiparas. The incidence rates of pregnancy-induced hypertension and small for gestational age were 1.55% and 15.49% in pregnant woman (400/25 751) and their newborns (3 990/25 751). Unconditioned logistic regression analysis showed that compared with woman without pregnancy-induced hypertension, primiparas with pregnancy-induced hypertension had increased risk of small for gestational age (OR=1.43, 95%CI: 1.02-2.00, P=0.041). Regarding multiparas, the main effect of pregnancy-induced hypertension had a positive correlation with small for gestational age (OR=1.34, 95%CI: 0.91-1.96), but there was no statistical significance (P=0.138). The main effect of history of preterm birth was positively correlated with small for gestational age (OR=1.61, 95%CI: 1.13-2.31, P=0.009). The interaction term "pregnancy-induced hypertension×history of preterm birth" was positively associated with risk of small for gestational age (OR=5.93, 95%CI: 1.19-29.61, P=0.030). Conclusions Pregnancy-induced hypertension was associated with increased risk for small for gestational age in both primiparas and multiparas, and history of preterm birth further increased risk for small for gestational age in pregnant women with pregnancy-induced hypertension, indicating that there was multiplication interaction between pregnancy-induced hypertension and history of preterm birth.

This paper tries to introduce the relevant concepts and status quo of standardized training for clinical nurses, relevant standardized training research and the main forms of assessment at home and abroad, discuss the effects achieved through standardized training, analyze existing problems, propose relevant countermeasures, and look forward to future development so as to provide a reference for establishing a unified standardized training model for clinical nurses.

Objective To investigate nurses' presenteeism and job stressors, and explore the correlation between them. Methods From January to May in 2017, a total of 380 nurses were investigated in one classⅢ grade A hospital in He'nan and totally 349 valid questionnaires were included. Presenteeism Questionnaire and Nurses Job Stressors Scale were used to investigate nurses' presenteeism and job stressors. SPSS 21.0 statistical package was used to organize and analyze the data. Independent sample t-test and ANOVA, Pearson correlation analysis and multivariate linear regression analysis were used. Results For the 349 nurses, the score of presenteeism was(3.25±0.73) points. Presenteeism behavior score of married nurses was higher than that of the unmarried nurses; presenteeism behavior scores of different titles were different (t=2.655, F=2.830;P<0.05). The score of job stressors was (2.50±0.49) points, which belonged to the medium level. Correlation analysis showed that work environment, interpersonal management had no correlation with presenteeism behavior(P> 0.05) and the other relations between the two variables was positive (P< 0.05). Patient care, time allocation and workload, nursing profession and work had predictive effect on presenteeism behavior (P< 0.05). Conclusions The stressors of nurses in this study are at medium level. The stressors of nurses affect their presenteeism. Nursing managers should take measures to prevent and interfere with the stressors of nurses,reduce the frequency of nurses' presenteeism, promote their physical and mental health and improve the quality of nursing.

Objective To explore the necessity and training needs of nursing students before nurse qualification examination.MethodsTotally 200 undergraduates and college nursing students who graduated in 2016 were investigated during March to April 2016 by using stratified random sampling method. The questionnaire survey was applied to investigate the necessity,needs,and demand degree of training before examination.Results The scores of training necessity were (4.492±0.726) for undergraduates and (4.634±0.653) for college students (P>0.05). Both undergraduates and college nursing students had high training needs,which related to the circulatory system,respiratory system,digestive system,pregnancy, childbirth,and puerperal diseases (P>0.05). But college students were less desired to have nursing training of traditional Chinese medicine compared with undergraduates [(3.909±0.913) vs. (4.299±0.675);P<0.05]. Furthermore,142 (71%) participants preferred to have training on weekends;186 (93%) participants advised to combine teaching with exercise;92 (46%) participants recommended to invite both their own teachers and professors from other schools;88 (44%) participants thought that it was reasonable to remain two review weeks between the training and the exam.ConclusionsThe training before nurse qualification examination is necessary for nursing students. Students' knowledge level and course content should be paid attention to since only reasonable and effective training can help to improve their examination pass rate.

Objective To know the psychological experience and the demand for psychological health services of secondary vocational nursing students, and explore the measures of improving their psychological health and provide psychological health services and strategies. Methods Phenomenological methods of qualitative research was used in this study, and nine secondary vocational nursing students were selected and investigated by in-depth personal interview. The data were analyzed by the thematic framework. Results Four themes were extracted from the data analysis: suffering from multiple pressures, common bad behaviors, weak psychological support system, look forward to psychological health services. Conclusions Secondary vocational nursing students have many psychological and behavioral problems. Families, schools and the society should work together to provide personalized and modern mental health services for them and reduce the psychological and behavioral problems.

Objective To explore the effect of cognitive thinking rehabilitation nursing on the delayed encephalopathy after acute CO intoxication .Methods From October 2012 to May 2013 , totals of 37 cases with delayed encephalopathy after acute CO intoxication were selected as study group , and others 33 cases during November 2013 and May 2014 were recruited as control group .Study group received the rehabilitation nursing of cognitive thinking on the basis of routine nursing , while control group received the routine nursing only .Then, the clinical effect of two groups were observed .Results After the intervention , the scores of MMSE , HDS and ADL in study group were (16.87 ±3.95),(18.90 ±3.65) and (42.12 ±10.21),that respectively higher than before the intervention (25.04 ±2.00),(26.04 ±1.71) and (86.12 ±8.93),and the differences were statistically significant (P<0.05).In control group, scores of MMSE [(21.05 ±1.75) vs (16.86 ±3.92)], HDS[(20.97 ±1.65) vs (18.06 ±3.70)] and ADL[(65.52 ±10.38) vs (43.01 ±11.23)] after the intervention were higher than that before , and the differences were statistically significant (P<0.05).After the intervention , the scores of MMSE , HDS and ADL in study group were significantly higher than that in control group (t=3.449,6.747,4.758,respectively;P<0.05),and the nursing satisfaction of patients in study group was significantly higher than that in control group (97.30% vs 87.88%;χ2 =2.333, P <0.05). Conclusions Strengthen the rehabilitation nursing intervention of cognitive thinking can improve cognitive and self-care abilities of patients with delayed encephalopathy after acute CO intoxication , and improve patients ’ satisfaction,which is worthy of clinical popularization and application .