【Objective】 To develop the Visual Cognitive Ability Assessment Scale for Preschool Children and to evaluate its reliability and validity, in order to provide reference for clinical evaluation of visual cognitive ability of preschool children. 【Methods】 1) From November 2021 to February 2022, construct the dimension framework was constructed and the pool of scale items was compiled according to the theory. 2) In March to June 2022, items were screened preliminarily through group discussion and Delphi method. In August 2022, the entries was revised by a pre-survey in a small sample (n=50). 3) Parents of children aged 4 - 7 from 8 kindergartens in 4 main urban areas of Nanjing were investigated by stratified cluster random sampling method in September to December 2022. The valid sample of the first survey (n=344) was analyzed to conduct item analysis and re-test reliability analysis, the valid sample of the second survey (n=695) was tested for reliability and confirmatory factor analysis, then the scale was finally compiled and evaluated. 【Results】 1) The scale contained 19 items in 4 dimensions:visual memory, discerning vision, spatial vision and visual integration. All items passed the project analysis test. 2) The Cronbach′s α coefficient of each dimension ranged from 0.604 to 0.886, and the Cronbach′s α coefficient of the whole scale was 0.917. During the two surveys, the scores of each item were correlated, and the average retest reliability coefficient was 0.601 (P< 0.05). 3) Content validity index (S-CVI) at scale level was 0.91, and item level content validity index (I-CVI) ranged from 0.8 to 1.0. After several rounds of model modification, the confirmatory factor model fit well. 【Conclusion】 The reliability and validity of the Visual Cognitive Ability Assessment Scale for Preschool Children are acceptable and meet the requirements of the scale, which provides a practical tool for clinical screening of visual and cognitive disorders.

Objective:To analysis the effect of health-promoting lifestyle and patient activation on self-management among tumor patients with PICC of the intermission of chemotherapy, so as to provide a basis for the targeted caring intervention programs.Methods:Using cross-sectional survey methods, from January 2021 to December 2022, the tumor patients with PICC of the intermission of chemotherapy of Tianjin Third Central Hosptial were investigated, using the General Demographic Questionnaire, Cancer Patients PICC Self-management Scale, Health Promotion Lifestyle Profile Ⅱ and Patient Activation Measure. Pearson correlation analysis and multiple linear stepwise regression analysis were used to analyze the data, and the structural equation model between related factors were established.Results:A total of 251 patients were collected in the this study, the scores of self-management were (153.12 ± 20.33) points, health-promoting lifestyle were (98.58 ± 16.05) points, and patient activation were (50.52 ± 6.51) points. The dimensions scores and total scores of self-management were positively correlated with the health-promoting lifestyle and patient activation in tumor patients with PICC ( r values were 0.503-0.910, all P<0.01). Multiple linear regression analysis showed that the health-promoting lifestyle and the patient activation were the influencing factors of the patient's self-management ability ( t=2.67, 1365, both P<0.05). Pathway analysis results showed that patient activation played a partially mediating role between health-promoting lifestyle and self-management, the effect value was 0.33 (95% CI 0.301-0.557), accounting for 46.5% of the total effect. Conclusions:Health-promoting lifestyle and the patient activation were the influencing factors of the self-management ability of tumor patients with PICC, patient activation played a partially mediating role between health-promoting lifestyle and self-management.

Objective:To assess the clinical result of repeated combined detrusor-trigone botulinum toxin A(BTX-A)injection and intermittent catheterization(IC) for male adults with neurogenic detrusor overactivity (NDO) and urinary incontinence(UI) secondary to spinal cord injury(SCI).Methods:From January to August 2021, the data of 43 adult male patients with NDO and UI secondary to SCI who received repeated trigone-including intradetrusor BTX-A injection in Guangdong Provincial Work Injury Rehabilitation Hospital were retrospectively analyzed. The mean age of the patients was (29.1±10.7) years. The mean incontinence specific quality of life (I-QOL) was (39±4.8). The UI episodes was (11.9±2.6), mean voiding volume was (170.7±20.1)ml, mean maximum detrusor pressure at first NDO was (81.4±19.6) cmH 2O and mean volume at first NDO was (169.1±40.0)ml.All patients received trigone-including intradetrusor BTX-A (300 U, 30 sites) injection for four times and IC. Clinical data including I-QOL, bladder diary, video-urodynamic test and adverse events were recorded at baseline and 12 weeks after each injection. Results:Mean interval between four injections were (220.6±27.4), (222.8±24.1) and (224.4±39.0) d ( P=0.13). Compared with baseline data before first injection, mean I-QOL after the first, second, third and fourth injection increased to (54.9±9.1), (56.1±7.9), (61.7±9.1) and (68.8±8.9) (all P<0.001). The number of urinary incontinence cases decreased to 36, 35, 35 and 33 (all P<0.05). The mean urinary incontinence episodes per day decreased to (4.4±0.6), (3.8±0.4), (2.2±0.5) and (2.1±0.3)(all P<0.001). Mean voiding volume increased to (288.3±40.2), (300.0±38.6), (316.9±46.8) and (319.5±36.7) ml (all P<0.001). Mean maximum detrusor pressure at first NDO decreased to (29.4± 11.0), (26.1±8.7), (20.3±5.9) and (18.5±6.0) cmH 2O (all P<0.001) and mean volume at first NDO increased to (270.0±48.7), (284.9±51.3), (287.7±47.9) and (303.0±46.2) ml (all P<0.001), respectively. Compared with four injections, no difference in response was found in the mean I-QOL, the number of urinary incontinence cases, mean urinary incontinence episodes mean voiding volume, mean maximum detrusor pressure at first NDO and mean volume at first NDO (all P>0.05). No de novo VUR occurred and 2 cases of grade Ⅱ VUR at baseline had resolved after the first injection. 9 patients experienced serious gross hematuria within first week after injection, but the urine returned to clear by prolonging the catheter indwelling time or bladder irrigation. 12 patients with active urinary tract infection were treated with indwelling catheter and sensitive antibiotics. Patients continued IC when the symptoms, signs and laboratory examination were normal. Conclusions:Combined detrusor-trigone BTX-A injection and IC could help decrease detrusor pressure, restore some of the lower urinary tract function and improve the quality of life for male patients with NDO and UI secondary to SCI. Repeated injection is as effective and safe as the first injection.

Objective:To explore the type and composition of thalassemia gene variation in children in Ningbo City, and to analyze its correlation with erythrocyte parameters.Methods:From January 2019 to December 2020, 785 children who underwent thalassemia gene testing in Ningbo Women and Children's Hospital were selected as the retrospective research subjects to analyze the type and composition of thalassemia gene variation in local children. A total of 238 thalassemia gene mutation carriers and 100 healthy children (control group) who underwent physical examination during the same period were selected for routine blood test to analyze the correlation between thalassemia gene mutation types and serological indexes.Results:Among the 785 children who underwent thalassemia gene testing, 571 were confirmed as carriers of thalassemia gene mutation, with a detection rate of 72.7%, including 228 cases of α-thalassemia, 337 cases of β-thalassemia, and 6 cases of αβ-complex type thalassemia. It covered 17 variant types and 25 gene combinations. There were significant differences in red blood cell count (RBC), hematokrit (HCT), hemoglobin concentration (Hb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV) and red blood cell distribution width (RDW) between the control, α-thalassemia and β-thalassemia groups ( H/ F = 125.03, 86.24, 141.06, 192.99, 121.46, 198.63, 178.06, P < 0.001). And there were statistically significant differences in HCT, Hb, MCH, MCV and RDW among the four common genotypes (-- SEA/αα, β IVS-Ⅱ-654/β N, β CD41-42/β N and β CD17/β N) in this test ( F = 5.03, 3.34, 6.24, 10.33, 6.83, P < 0.05). Conclusion:The genotypes of children with thalassemia in Ningbo City are diverse, and the erythrocyte parameters are different among different genotypes.

Objective:Based on the previous epidemiological investigation of hyperparathyroxinemia in Urumqi community, a follow-up study was conducted to understand the changes of serum parathyroid hormone (PTH) level and clinical characteristics of residents with PTH.Methods:In the previous study (2013), an epidemiological cross-sectional study of hyperparathyroxinemia was conducted on 1 473 residents of the resident community, and 180 people with hyperparathyroxinemia were found. The serum PTH, parathyroid related laboratory indexes and vitamin D were observed in high PTH population of different genders.Results:According to the inclusion criteria, 159 patients with high PTH were included in the study. The total follow-up rate was 88.3% (159/180), including 24 males (15.09%) and 135 females (84.91%). The serum PTH level in the follow-up population was 68.60 (47.85-98.80)pg/ml, which was significantly different from that in the first visit ( P<0.01). There was no significant difference in serum PTH levels between men and women ( P>0.05). The levels of serum 25(OH)D, calcium, phosphorus, magnesium, creatinine, albumin and alkaline phosphatase in the follow-up population had no significant changes compared with the first visit population (all P>0.05); After stratified by sex, the serum creatinine level of men with high PTH was significantly higher than that of women ( P<0.01), and there was no significant difference in other PTH related laboratory indexes ( P>0.05); Although the vitamin D level was still deficient (<20 ng/ml), the proportion of people with sufficient vitamin D was significantly higher than that at the first visit. Conclusions:25(OH) D deficiency was still common in the follow-up population, but the vitamin D level of the residents with PTH was significantly improved and the serum PTH level was significantly lower than that in the first visit.

Objective:To observe the dynamic changes of thyroid hormone levels and thyroid autoimmune antibodies in pregnant women in Xinjiang Uygur Autonomous Region during pregnancy, and to investigate the significance of repeated screening of thyroid function in different gestational ages.Methods:A retrospective study was carried out of pregnant women who completed thyroid function screening in Clinic, People's Hospital of Xinjiang Uygur Autonomous Region from January 2015 to December 2017, and the test results of thyroid stimulating hormone (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), thyroid peroxidase antibody (TPOAb), and anti-thyroglobulin antibody (TGAb) were collected and analyzed of their changes during pregnancy. Pregnant women were divided into 2 different gestational age groups by the age limit of 30, the changes of thyroid dysfunction rate with pregnancy were analyzed, and the clinical significance of repeated screening in different pregnancy stages was discussed. Results:Changes of thyroid-related indicators with pregnancy: first, second, and third trimesters were 404,725, and 767 cases, respectively; TSH level in the third trimester (2.76 mU/L) was significantly higher than those in the first and second trimesters (2.55, 2.36 mU/L, P < 0.05), there was no significant difference between the first trimester and the second trimester ( P > 0.05); the FT 4 and FT 3 levels decreased gradually with pregnancy ( P < 0.05); the positive rate of TPOAb was significantly higher in the first and second trimesters than that in the third trimester ( P < 0.05), there was no significant difference between the first trimester and the second trimester ( P > 0.05); the positive rate of TGAb decreased gradually with pregnancy ( P < 0.05). Comparison of abnormal rate of TSH in different gestational ages: the first, second, and third trimesters were 352, 664, 735 cases, respectively; the abnormal rate of TSH in the overall study was statistically significant at different stages of pregnancy (χ 2=31.627, P < 0.05), the first trimester was significantly higher those in the second and third trimesters ( P < 0.05). In pregnant women aged ≥30 years old, the abnormal rate of TSH in the first trimester was significantly higher than those in the second and third trimesters ( P < 0.05); in pregnant women aged < 30 years old, the abnormal rate of TSH in the first trimester was significantly higher than that in the third trimester ( P < 0.05). There were no significant differences in the abnormal rate of TSH in the first, second, and third trimesters between the < 30 years old group and ≥30 years old group ( P > 0.05). Comparison of abnormal rate of FT 4 in different gestational ages: there were no significant differences in the FT 4 abnormal rate among different pregnancy groups in the overall, < 30, ≥30 years old groups (P > 0.05). In early pregnancy, the abnormal rate of FT 4 in the ≥30 years old group was higher than that in the < 30 years old group ( P < 0.05); in second and third trimesters, there were no significant differences between the two age groups ( P > 0.05). Conclusions:Screening for thyroid function in the first trimester of pregnancy is important for women of different ages. Except for women with abnormal thyroid function who have not been treated during the first trimester, the rest may not need to be screened again. Pregnant women aged ≥30 years old may have a higher risk of thyroid dysfunction than those < 30 years old.

Objective To establish a reference range for specific thyroid function during pregnancy and to explore the influencing factors of hypothyroxinemia during pregnancy.Methods A retrospective analysis of 2 996 cases of thyroid function in the pregnant women who were with single pregnancy and without thyroid diseases and family history of those diseases.Results (1) Establish a unified reference range for specific thyroid function during pregnancy;the early,middle,and late trimesters thyrotropin (TSH) ranges were 0.02-6.39,0.16-6.23,0.64-6.59 mU/L,respectively,while free thyroxine (FT4) ranges were 11.32-23.00,9.39-18.92,8.54-16.73 pmol/L respectively.The specific reference ranges of Han and Uygur pregnant women were established separately.There was no difference in the detection rates of various thyroid diseases when using their respective reference ranges and the unified reference range of the hospital (P ＞ 0.05).(2) The detection rate of various thyroid diseases (except subclinical hyperthyroidism) of our subjects with China guideline reference range was significantly higher than the reference range with the hospital (P＜0.05).(3) The detection rates of hypothyroxinemia in all pregnant women with FT4 cut points of P2.5 and P5 were 4.3％ and 7.4％,respectively,of which the Han population was 4.3％ and 7.1％,respectively,and the Uygur population was 4.3％ and 7.9％,respectively.(4) Comparing the mean age,gestational age,median urine iodine,and thyroid antibody positive rate between the hypothyroxinemia group and the control group,only the mean age and gestational age were different (P＜0.05);Logistic binary regression analysis showed that age was the risk factor for hypothyroxinemia during pregnancy (OR =1.035,95％ CI 1.006-1.066,P ＜ 0.05).Conclusions The Han and Uygur pregnant women in this area both can use the thyroid reference range of our hospital during pregnancy.The establishment of thyroid reference range may avoid over-diagnosis of thyroid disease during pregnancy.Age is a possible influencing factor of hypothyroxinemia during pregnancy.

Objective To observe the effect of Baduanjin on mild cognitive impairment (MCI). Methods From January to June, 2016, 60 patients with MCI in community were randomly divided into control group (n=30) and training group (n=30). The training group accepted training of Baduanjin for six months, and the control group accepted no intervention. They were assessed with Montreal Cognitive Assessment (MoCA) before and after intervention; while the blood lipid, and serum interleukin-6 (IL-6), acetylcholine (Ach), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected. Results The total score, and scores of visual space and executive function, abstract and delayed memory of MoCA were more in the training group than in the control group after intervention (t>3.576, P<0.01), while the level of total cholesterol, IL-6 and MDA decreased (t>2.744, P<0.05), and the level of high density lipoprotein cholesterol, Ach and SOD increased (t>2.922, P<0.01). Conclusion Baduanjin can improve the cognitive function in MCI patients, as well as reducing blood fat, oxidation and inflammation. There may be some relationship between them.

Objective To investigate clinical and hematological features of myeloid neoplasms with eosinophilia and abnormal PDGFRA/B and the effect of imatinib. Methods The data of three eosinophilia patients with abnormal PDGFRA/B fusion gene in Changhai Hospital, the Second Military Medical University and 22 Chinese cases reported in Chinese medical journals were analyzed. Thirty-one cases of idiopathic hypereosinophilic syndrome from Changhai Hospital, the Second Military Medical University were used as the controls. Results Compared with idiopathic hypereosinophilic syndrome, no differences were found in age, percentage of bone marrow eosinophils and counts of platelets in peripheral blood in myeloid neoplasms with eosinophilia and abnormal PDGFRA/B (all P ＞0.05), but statistical differences were found in gender (χ2＝5.080, P ＝ 0.016), peripheral blood white blood cell count (t ＝ 4.908, P ＝ 0.001), eosinophilic granulocyte absolute value (χ2＝ 17.230, P ＝ 0.001) and hemoglobin concentration (t ＝ 2.770, P ＝ 0.013). The median follow-up time was 17 months (3-108 months) in 24 myeloid neoplasms patients with eosinophilia and abnormal PDGFRA/B from Chinese report. Complete hematopoietic remission (CHR) rate was 91.7 % (22/24) after the treatment of imatinib. The total complete molecular remission (CMR) rate was 75.0 % (18/24). The median time of remission was 3 months (1-8 months). CMR in patients with PDGFRA and with PDGFRB was 76.5 % (13/17) and 85.7 % (6/7), respectively. Only one patient (4.2 %) died of disease relapse. Conclusion Imatinib has a favorable effect on myeloid neoplasms with eosinophilia and abnormal PDGFRA/B featured by distinct hematologic and clinical manifestations.

Objective To investigate iodine nutrition status in healthy adults in Xinjiang Urumqi city and their relationship to ethnicity, gender and age. Method A cross-sectional survey was performed in 2 100 residents of Xinjiang Urumqi 2 communities in May 2013, of which 1 835 healthy adults aged 18-84 years, mean age 46.3 ± 14.2 years were enrolled. Urine iodine with arsenic-cerium catalytic spectrophotometry and salt iodine and water iodine of the residents were measured. Result The water iodine content was 3.14 μg/L, salt iodine was 27.75 mg/kg, 1 835 urine samples were collected, the urinary iodine median(MUI) was133.4 μg/L, iodine deficiency accounted for 32.37% (595 cases), iodine sufficient 42.94% (788 cases), iodine super-sufficient 14.44%(265 cases), iodine excess 10.19%(187 cases). The urine iodine level in Han ethnic group was higher than those in Uygur adults, no significant difference was observed between men and women (P>0.05). Urinary iodine levels among different age groups had no statistical difference, but in the older groups the level was lower than that in young or middle age adults. The urinary iodine level decreased gradually with the age increasing. Conclusion There was a sufficient pattern of iodine nutrition levels in healthy adults in Xinjiang Urumqi; there was a correlation between the level of iodine nutrition and the ethnicity but not with gender;iodine nutrition level in older age group was lower than those in younger age groups. Monitoring the urinary iodine continually and decreasing iodine intake may be necessary for part of iodine excess population.