Objective To explore the application of nurse-performed point-of-care ultrasound in abdominal distension of ICU patients with enteral nutrition.Methods Purposive sampling method was used to select 108 patients with enteral nutrition abdominal distension admitted to the ICU of a tertiary A general hospital in Hefei City from January to December 2022,and they were divided into an experimental group and a control group according to random number table method.The experimental group used bedside ultrasound to evaluate the stomach,intestine and abdominal cavity of patients with abdominal distension,and implemented targeted treatment measures according to the evaluation results.The control group was given corresponding treatment measures according to the abdominal sight,touch,tapping,listening and traditional syringe withdrawal method.Intra-abdominal pressure,abdominal circumference,feeding compliance rate and feeding interruption rate,ICU stay time and mechanical ventilation time were compared at the 1st,3rd and 5th day.Results 11 cases dropped out of the study due to transfer,automatic discharge,death,etc.,and 97 cases were included 51 cases in the experimental group and 46 cases in the control group.Repeated measurement ANOVA showed that intra-abdominal pressure and abdominal circumference time in the 2 groups had interaction with each other(F=41.724,P＜0.001;F=17.762,P＜0.001).Generalised estimating equations showed that there was only a between-group effect for the rates of feeding compliance and feeding disruption in 2 groups(Wald y2=18.033,P＜0.001;Wald x2=6.567,P＜0.001).Simple effect analysis showed that on the 3rd and 5th day after intervention.The experimental group had lower abdominal depression and the feeding interruption rate was lower than the control group(P＜0.05).On the 5th day after interven-tion,the abdominal circumference of the experimental group was lower than that of the control group,the feeding compliance rate was higher than that of control group(P＜0.05).After intervention,in the experimental group,the mechanical ventilation time was shorter than that of the control group(P＜0.05).There was no significant difference in ICU stay time between the 2 groups(P=0.095).Conclusion The application of nurse-performed point-of-care ultrasound in the management of abdominal distension in patients with enteral nutrition in ICU is feasible and scientific,which is helpful for the management of patients with enteral nutrition abdominal distension in ICU,reducing internal abdominal pressure,shortening mechanical ventilation time,and avoiding the occurrence of feeding intolerance.

Objective To investigate the features of autonomic nervous function symptoms in patients with different motor subtypes of Parkinson disease(PD)and the impact of autonomic dysfunction on quality of life in patients with different motor subtypes of PD.Methods Basic information was recorded for all patients enrolled in this study,including the scores of both motor and non-motor symptoms.The patients were divided into different subtypes based on tremor-dominant(TD)and postural instability and gait difficulty(PIGD)scores.Motor and non-motor symptoms,especially autonomic symptoms,were compared between the patients with TD subtype and those with PIGD subtype,and the association between autonomic dysfunction and quality of life was analyzed for patients with different motor subtypes.Results There were 105 patients(57.7%)in the TD group and 63(34.6%)in the PIGD group.There were no significant differences between the TD group and the PIGD group in age,sex,lifestyle,course of disease,levodopa equivalent dose,and disease severity,and there were also no significant differences between the two groups in the scores of anxiety,depression,apathy,cognition,and constipation,the reduction in systolic blood pressure(SBP)in standing and supine positions,and the incidence rate of orthostatic hypotension before and after medication.The PIGD group had a significantly higher total score of autonomic nervous function than the TD group,with a median of 24 and 19,respectively.The median of quality of life score was 66 points in the PIGD group and 46 points in the TD group,suggesting that the PIGD group had a poorer quality of life than the TD group.Quality of life was positively correlated with autonomic nervous function symptoms in the PD patients in both the PIGD group(R2=0.209,P=0.000)and the TD group(R2=0.166,P=0.000).In the TD group,quality of life was correlated with constipation(r=0.313,P=0.002)and the maximum difference in SBP in standing and supine positions before Madopar administration(r=0.252,P=0.009).Conclusion PD patients with PIGD subtype tend to have more severe symptoms of autonomic dysfunction and a lower quality of life than those with TD subtype.PD patients with both TD and PIGD subtypes tend to have a worse quality of life due to severe autonomic dysfunction,and the quality of life of patients with TD subtype is also correlated with constipation and the maximal difference in SBP in standing and supine positions before Madopar administration.

This paper discusses the application of MRN combined with 3D printing in SNM in neurogenic bladder patients with special comorbidities. In this study, 21 cases of neurogenic bladder patients with special comorbidities involved, including 14 cases into the control group and 7 cases in the experimental group. Traditional X-ray guidance was used in the control group, while the MRN combined with 3D printing navigation template positioning was used in the experimental group. Compared with those in the control group, the X-ray fluoroscopy, number of punctures, puncture time, intraoperative adjustment and testing time were significantly decreased in the experimental group. The difference of implantable pulse generator implantation rates between the two groups was statistically significant.

Objective: To investigate the refractive status of children and adolescents aged 4-18 years in Chengdu, and to analyze the epidemiological characteristics of refractive parameters. Methods: A cross sectional survey was conducted among 82 024 children and adolescents aged 4-18 years in Gaoxin District of Chengdu from August to September 2021. The prevalence of screening myopia, low vision rate, high myopia rate, refractive status and axial development were analyzed. Results: The prevalence of screening myopia in students aged 4-18 years was 40.42%(33 158/82 024). Low myopia was 24.51%(20 108/82 024), moderate myopia was 13.05%(10 703/82 024) and high myopia was 2.86%(2 347/82 024). The prevalence of screening myopia was 1.81% (233/12 848) in kindergarten, 34.44%(17 095/49 644) in primary school, 79.73%(9 738/12 214) in junior high school and 83.25% (6 092/7 318) in senior high school. The rate of visual impairment increased by year from the age of 4, and the rate of myopia increased most rapidly from 6 to 15 years old, the prevalenct of high myopia was compared between adjacent age groups: there were statistical differences between 9-15 years old were more likely to be nearsighted than boys( P <0.035 7). Significant differences in screening myopia between 5- and 7-17 year old groups,and in boys and girls.The median total diopter was 0.40 D at the age of 4 and developed to -2.90 D at the age of 18 . The diopter of girls aged 8-15 years was higher than that of boys, and there was statistical significance( Z=-2.53, -4.09, -5.67, -8.64, -5.56, -4.97, -2.52, -2.14, P <0.05). The axial length gradually increased with age, with the mean value of (22.31±0.59) mm at 4 years old and (24.91±1.00) mm at 18 years old. The mean corneal curvature did not change with age (43.19±1.47)D. Conclusion 6-15 years old is a especially critical period for myopia development. More efforts need to be taken to decrease the prevalence of myopia before 6 years old. Prevention of the development of high myopia should start before the age of 10. The prevalence of myopia in girls is higher than that in boys, more prevention and control of myopia should focus on girls.

ObjectiveTo explore the effects of continuous nursing care based on theory of goal attainment on self-health management ability and quality of life in patients with stroke. MethodsTotally 126 patients with stroke treated in a ClassⅢ Grade A hospital in Anhui Province from December 2017 to December 2018 were selected using convenient sampling and stratified into treatment (n=64) and control (n=62) groups. Patients in the control group received conventional nursing care, while patients in the treatment group received continuous care based on the theory of goal attainment. Self-Health Management Scale for Patients with Chronic Diseases (SHMSPCD) and Quality of Life Inventory (QLI) were used to assess the effects before and after intervention. ResultsBoth the total self-health management ability and quality of life scores of the treatment group were higher than those of the control group 1, 3 and 6 month after intervention, and there were statistically significant differences between the two groups (P＜0.05). ConclusionsContinuous nursing care based on the theory of goal attainment can improve the self-health management ability and quality of life of the patients with stroke.

Objective To compare the characteristics of the tremor of multiple system atrophy Parkinsonism type (MSA-P) with Parkinson's disease (PD), and improvement after acute levodopa challenge test. Methods From Match to September 2017, 70 patients with PD and 23 patients with probable MSA-P were included. All the patients were required of rest or postural tremor in at least one extremity or head, and accepted acute levodopa challenge test and analysis for dominant tremor frequency, amplitude and rhythm under resting state, posturing and holding 1000 g state, respectively.Results The score of Unified Parkinson Diease Rating Scale Part III was higher in MSA-P patients than in PD patients (t=-2.098, P<0.05), with less improvement after acute levodopa challenge test (Z=-9.446, P<0.01), while the tremor score and improvement were not significantly different between two groups (P>0.05). There were more frequence with non-alternating or synchronic tremor rhythm (χ2=8.756, P<0.01) and small irregular tremor in rest tremor (χ2=4.788, P<0.05) in MSA-P patients than in PD patients, as well as the high frequency tremor (>6 Hz) in postural tremor (χ2=11.312, P<0.01). The frequency of rest tremor was higher in MSA-P patients than in PD patients (t=-2.119, P<0.05), as well as the frequency of postural tremor with 1000 g (t=-2.274, P<0.05). Both PD and MSA-P patients showed, the lower frequency the postural tremor was, the higher the tremor scores were. There were 25% PD patients with head tremor, while none in MSA-P patients. Tremor score improved more than 30% after acute levodopa challenge test in 22.7% MSA-P patients, but none improved in UPDRS score. The frequence of tremor score improvement was more in female MSA-P patients than in males (P<0.05).Conclusion The features of the tremor are similar in PD and MSA-P, with some differences that MSA-P tend to higher frequency in rest or postural tremor, more non-alternating or synchronic tremor rhythm in rest tremor, and fewer has tremor besides limbs. Some MSA-P patients improve after acute levodopa challenge test, and women may improve more than men.

Objective To compare the characteristics of tremor and non-motor symptoms in patients with essential tremor (ET) and patients with Parkinson's disease developed from essential tremor (ET-PD). Methods From March, 2016 to August, 2017, 30 ET patients and 17 ET-PD patients were investigated with the general questionnaire, Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and were measured with transcranial sonography and the frequency, amplitude and contraction patterns of resting and postural tremors. Results Compared with the ET patients, there were more patients reported olfactory dysfunction and rapid eye movement behavior disorder (RBD) in ET-PD patients (χ2>4.656, P<0.05). Meanwhile, the area of hyperechogenicity in substantia nigra was greater (t=2.164, P<0.05), the incidence of lower limb tremor and mandibular tremor was more (χ2>8.745, P<0.01), the frequency of rest and postural tremor in the head and upper limbs was less (t>2.082, P<0.05). The rest and postural tremors in the upper limbs were mainly synchronous in ET patients, whereas it was alternating in ET-PD patients (χ2>3.943, P<0.05). Conclusion Some differences of non-motor symptoms and tremor are found in patients with ET-PD and ET. When ET patients suffer from hyposmia, RBD, or the site, frequency and contraction patterns of tremor changes, they may develop to PD.

Objective To report a novel case of hereditary spastic paraparesis type 11 (SPG11) first presenting as juvenile Parkinsonism. Methods A 27 years old man first attack at 13 years old was reviewed. Results Parkinsonism-like features, such as tremor, rigidity, bradykinesia and gradually difficulty walking, were complained, and responded to dopaminergic therapy. MRI showed thin corpus callosum and hyper-intense T2WI lesions in periventricular regions. His nerve conduction velocity was normal. Genetic analysis detected two novel mutations, named c.5867-1G>C and c.3687-2A>G, in spastic paraplegia gene 11, which came from his father and mother separately. Conclusion Parkinsonism may be the inaugural presentation of SPG11, and a genetic test may be needed for the child with juvenile Parkinsonism.

Objective To study the changes of neutrophil surface molecule CD64 and inflammatory factor levels in patients with burn infection. Methods 46 cases of patients with burn infection who were treated in the department of burn in our hospital between March 2010 and October 2015 were selected as the observation group. Meanwhile, 46 cases of healthy people who underwent physical examination in our hospital during the same period were included in the control group. The levels of neutrophil surface molecule CD64, C-reactive protein (CRP), white blood cell count (WBC) and inflammatory factor [interleukin IL-6 (IL-6), interleukin (IL-8), tumor necro-sis factor (TNF-α) in the two groups of subjects were determined by flow cytometry and were compared. Results In the observation group, the levels of CD64, CRP, WBC and inflammatory factors were significantly higher than those in the control group (P < 0.05). Conclusion The levels of CD64, CRP, WBC and inflammatory factors in patients with burn infection are significantly higher than those in healthy people , which indicates that neutrophil surface molecule CD64, inflammatory factors and burn infection are closely correlated.

Objective To investigate the clinical manifestations and MR imaging features of olivopontocerebellar atrophy(OPCA).Methods The clinical data and MR findings of 8 patients with OPCA (OPCA group) were retrospectively analyzed,and 75 cases of healthy physical examination people were chosen as control group (they were divided into 21-30 years group,31-40 years group,41-50 years group,51-60 years group,61-70 years group,and 15 cases in each group),all subjects under went pons measurement.Results All 8 patients with OPCA were sporadic cases.The cerebellar symptom,autonomic symptoms and extrapyramidal symptoms were common manifestations.The head MR imaging of OPCA presented with cerebellum and brain stem atrophy,cross sign was the characteristic appearance.Vertical diameter and anteroposterior diameter of the pons in OPCA group patients was (20.63 ± 2.16) and (16.74 ±4.37) mm,compared with control group [(27.14 ±1.73) and (22.28 ± 1.49) mm],there was significant difference (P ＜ 0.01).In control group,vertical diameter and anteroposterior diameter of the pons maximum in 21-30 years group and 31-40 years group,increased with age,the value had been reduced,but there was no significant difference (P ＞ 0.05).Conclusion MR is the first choice for the diagnosis of OPCA,combine with clinical manifestations may improve the diagnostic accuracy.