Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.

Fecal incontinence is a very common problem in critically ill and elderly patients and long-term hospitalized bedridden patients, which can easily cause complications such as perianal dermatitis, pressure ulcers and infections, increase patient suffering, and increase medical expenses. Devices that effectively transfer or drain feces are critical to reducing complications after fecal incontinence. This article uses this as a starting point to summarize the main components, current status of use and evaluation indicators of built-in drainage devices at home and abroad, which provides a reference for the development of more scientific and feasible auxiliary tools for fecal incontinence.

Objective To explore the effect of group painting art therapy on social function rehabili-tation and quality of life of chronic schizophrenia patients. Methods Totally 104 inpatients with schizophre-nia were assigned to study group with 53 cases and control group with 51 cases by random number table method. Patients in study group received group painting art therapy intervention,medication and other reha-bilitation activities. While the patients in control group were only given medication and other rehabilitation activities. All patients in both groups received positive and negative symptoms scale(PANSS),schizophrenia quality of life scale(SQLS) and scale of social-skills for psychiatric inpatients(SSPI) before and after the in-tervention. The results were analyzed by independent sample t test. Results Before treatment,there were no significant differences of the total scores and the dimensional subscores of PANSS,SQLS and SSPI between the study group and control group( all P>0. 05). Compared with control group,the difference score between pre-test and post-test of PANSS ((12. 26±6. 87) vs (5. 11±3. 11),t=13. 11,P<0. 01) and negative symp-tom ((-7. 96±5. 44) vs (-2. 82±3. 47),t=-12. 30,P<0. 01),score of SQLS ((27. 45±12. 22) vs (2. 41 ±10. 68),t=-11. 11,P<0. 01) and score of SSPI((-20. 40±8. 10) vs (-0. 94±8. 01),t=12. 31,P<0. 01) in study group changed statistically(all P<0. 01). Conclusion These results suggest that group painting art therapy intervention can improve the negative symptoms,the quality of life and the recovery of social function in patients with chronic schizophrenia.

Objective: To assess the association of single nucleotide polymorphisms (SNPs) CHRNA4 gene with response to selective serotonin re-uptake inhibitors (SSRIs) for the treatment of major depressive disorder (MDD). Methods: For 304 patients receiving drug treatment for major depression, 2 SNPs, namely rs4522666 and rs4603829, of the CHRNA4 gene were determined by matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th and 6th weeks treatment. Results: The frequency of GG genotype/G allele for rs4522666 differed significantly from that of TT and GT genotypes/T allele between responders and non-responders (P =0.015 and P=0.006, respectively). No significant difference was found in genotypic and allelic frequencies of rs4603829 between the two groups (P > 0.05). Conclusion SNPs of the CHRNA4 gene may play an important role in the response to antidepressant drugs among ethnic Han Chinese with MDD.

OBJECTIVETo assess the association of TPH2 gene polymorphisms with the response or remission to selective serotonin reuptake inhibitors (SSRIs) drugs during treatment of major depressive disorder.

METHODSFor 304 patients receiving SSRIs treatment for major depression disorder, 3 single nucleotide polymorphisms (SNPs) (rs1007023, rs1023990 and rs4570625) in the TPH2 gene were genotyped by MALDI-TOF mass spectrometry using a MassArray Analyzer 4 system. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th and 6th week of treatment.

RESULTSThe frequency of GG genotype/G allele for rs4570625 differed significantly with the frequency of TT and GT genotypes/T allele between responders and non-responders (P=0.013 and 0.007, respectively). Genotypic and allelic frequencies of the other polymorphisms did not differ significantly between the two groups (P>0.05). No association of TPH2 gene polymorphism with remission was found with the 3 SNPs.

CONCLUSIONThe polymorphisms of TPH2 gene may play an important role in response to antidepressant drug therapy.

Objective To investigate the effect of cognitive behavior therapy (CBT) on the conversion of individuals with ultra-high-risk (UHR) of schizophrenia,and to find out the related influence factors.Methods Patients were randomly divided into study group (50 cases) and control group (49 cases) by the digital random table method.The study group received cognitive behavioral therapy,and the control group only got follow-up questionnaire.Structured Interview for Prodromal Syndromes (SIPS) was used to evaluate psychosis risk symptoms of each UHR individuals at baseline,3 months,6 months,12 months and 18 months respectively and the effects of CBT on conversion and related influencing factors were analyzed.Results There was no significant difference in the conversion rate (P＞ 0.05) between study group and control group after 3 months,but the conversion rate of study group was significantly lower than the control group after 6 months(6.00％ vs 20.41％,P＜0.05),12 months(10.00％ vs 24.49％,P＜0.05)and 18 months(10.00％ vs 28.57％,P＜0.05).CBT could effectively improve conditions for individuals with positive symptom (study group:5.30±3.62,5.04±3.89,4.38±4.13,5.26±3.65,5.94±4.19,control group:5.59±3.62,6.33±5.29,6.98 ±4.96,7.02±5.02,8.39±6.42,F=4.326,P=0.000) of UHR,but the improvement was not significant for negative individuals (F=1.555,P=0.215).CBT could be effective for disorganized symptom (F=6.901,P =0.010) and general symptom (F=7.752,P=0.006) as well.The poor family relationship was the risk factor of conversion to the schizophrenia (OR=3.411,95％CI=1.016-11.453,P=0.047).Conclusion CBT can effectively reduce the conversion rate of UHR individuals.CBT has a good remission effect on the positive symptoms,disintegrating symptoms and general symptoms of UHR.Family relationship affects prognosis of UHR individuals.

Objective To prepare the Elderly Functional Constipation(FC) Health Education Scale, and verify its reliability and validity. Methods The Elderly FC Health Education Scale was prepared by qualitative interviews, literature review, and Delphi method. The elderly patients who were over 60 years old and at Chinese PLA 181st Hospital were recruited by the purposive sampling method from January 2013 to August 2015.The diagnostic criteria of RomanⅢwas used to diagnose FC, the data of preliminary investigation and large sample test was used to form the formal scale, and its reliability and validity were further verified. Results The Elderly FC Health Education Scale was compiled with 6 dimensions and 28 items, and the Cronbach alpha coefficient which was the internal consistency reliability of the 6 factor was 0.965; the correlation coefficient analysis of equality reliability Kendall tau-b rank and various index variables score were positive correlation significantly. Both item level content validity index and scale level content validity index of the content validity were as a result of 1. The structure validity of the cumulated variance contribution ratio of the 6 factors were 60.15%. All factor loading coefficients between the items were more than 0.5, which indicated the fitting was good. Conclusions The reliability and validity of the Elderly FC Health Education Scale are good, and the scale may be used as a tool to prevent the elderly FC health education, and also be applied to the elderly FC patients in self-management and continue nursing after leaving hospital.

ObjectiveTo establish a method for measuring exhaled nitric oxide (eNO)concentrations in neonates with and without hypoxemic respiratory failure ( HRF), and to investigate the relationship between eNO and respiratory parameters in neonates with HRF. Methods Twenty-two newborn infants with HRF and 26 control neonates were included within the first 24 hours of postnatal life.Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation ( SpO2 ), inspired fraction of oxygen ( FiO2 ) and other parameters.Wilcoxon Mann-Whitney U tests were used to compare eNO, SpO2/FiO2 and eNO/ ( SpO2/FiO2 × 100) in two groups. Pearson's correlation analyses were used to determine the relationships between eNO levels and indices of hypoxemic respiratory failure. ResultsDuring the first two days of postnatal life, eNO values of HRF neonates were higher than those of the control neonates[day 1,(7. 9 ± 3.2 )× 10-9 vs. (5.8 ±1.8)×10-9, P＜0.05;day2, (8.8±3.2)×10-9vs. (6.0±2.4)×10-9, P＜0. 05], butthere were no significant differences in the following days. With SpO2/FiO2 increasing, difference of eNO values between the HRF and non-HRF controls became narrowed, but there was still two fold difference of eNO/(SpO2/FiO2 × 100) on day 5-7. ConclusionsA method for measuring eNO was established and there was difference in neonates with and without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF.

Objective To discuss the responsibility and quality requirement of head nurses in nursing quality improvement in obstetrical and gynecological department.Methods The responsibility of head nurses in nursing quality improvement in obstetrical and gynecological department were investigated by carrying out surveys in patients of obstetrical and gynecological department.Results The quality of head nurses needed improvement and their responsibility required definitude,thus the satisfaction degree of patients and nursing quality can be improved.Conclusions Through this research,we find that the head nurses not only need good quality,but also should be given definite responsibility and certain service,supervising and management power,if so,they can fully exert their role in nursing work.

Objective To investigate the effects of rehabilitation intervening in different stage on activities of daily living of old stroke patients. Methods 74 old cases were divided into 3 group according to the time from onset of stroke to rehabilitation intervention: group A (＜3 months), group B (3～6 months), and group C (>6 months). They were treated with routine rehabilitation for 2 months and assessed with Barthel Index before and after rehabilitation. Results All the patients improved their ADL significantly after rehabilitation (P=0.000), and those in group A improved more than in group C (P<0.05). There was no significant difference between group A and B, and group B and C (P>0.05). Conclusion The rehabilitation can effectively improve the ADL of old stroke patients. The early the rehabilitation intervenes, the better the ADL is.