Objective:To explore the psychological experience and demand of parents of children with delayed recovery after congenital heart disease surgery.Methods:This study adopted phenomenological research methods from qualitative research. Using the purposive sampling method, parents of postoperative delayed recovery children with congenital heart disease who met the inclusion criteria were selected as the research objects from October to November 2019 at Fuwai Hospital, Chinese Academy of Medical Sciences. Semi-structured interviews were conducted with the parents of the children, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 13 parents of children with delayed recovery after congenital heart disease surgery were included. According to the interview results, four themes were extracted, which were negative psychological experience of parents of children with delayed recovery, positive psychological experience and expectation change of parents, heavy economic burden of parents and diversified needs of parents.Conclusions:During the delayed recovery period, psychological experience of parents is complex and their needs are diverse. The nursing staff should identify and pay attention to the causes of the negative psychological experience of the parents of the children, timely channel their negative emotions and strengthen the positive psychological experience in many aspects. They can assist parents to seek social help to reduce physical and mental pressure and meet the diverse needs of parents by providing high-quality nursing services and multi-channel information support.

Objective:To explore the effect of cabinet type water curtain exhaust hood applied to small sandblasting machine to prevent and control silicon dust, and put forward a new idea of dust ventilation protection facilities to effectively protect the occupational health of workers.Methods:From August to October 2018, the cabinet type water curtain exhaust hood of sandblasting room in a research institute was selected as the research object, and the methods of occupational health survey, on-site detection and physical simulation of air distribution were used to conduct on-site detection and smoke emission test on the local exhaust facilities, silica dust concentration, control wind speed and air distribution before and after the transformation line analysis and evaluation.Results:The air distribution simulation experiment showed that the air distribution of the cabinet type water curtain exhaust hood was reasonable and could effectively control the whole range of silica dust emission during the cleaning process. After modification, the capture velocity was increased from 0.01 m/s to 0.53 m/s, and the capture velocity was increased by 98.1%. The time weighted average allowable concentration ( CTWA) of silicon dust (total dust) during sand blasting, cabin opening and cleaning was reduced from 7.00 mg/m 3 to 0.50 mg/m 3. The CTWA of silica dust (exhalation dust) was decreased from 3.36 mg/m 3 to 0.27 mg/m 3, and the CTWA dust reduction rates of total dust and respirable dust were 92.9% and 92.0%, respectively. Conclusion:The combination of cabinet type exhaust hood and water curtain dedusting optimizes the combination mode of dust prevention and control. It has the advantages of high efficiency of dedusting and purification, energy saving and environmental protection, and can be popularized and used in enterprises of the same nature.

Objective:To explore the effect of cabinet type water curtain exhaust hood applied to small sandblasting machine to prevent and control silicon dust, and put forward a new idea of dust ventilation protection facilities to effectively protect the occupational health of workers.Methods:From August to October 2018, the cabinet type water curtain exhaust hood of sandblasting room in a research institute was selected as the research object, and the methods of occupational health survey, on-site detection and physical simulation of air distribution were used to conduct on-site detection and smoke emission test on the local exhaust facilities, silica dust concentration, control wind speed and air distribution before and after the transformation line analysis and evaluation.Results:The air distribution simulation experiment showed that the air distribution of the cabinet type water curtain exhaust hood was reasonable and could effectively control the whole range of silica dust emission during the cleaning process. After modification, the capture velocity was increased from 0.01 m/s to 0.53 m/s, and the capture velocity was increased by 98.1%. The time weighted average allowable concentration ( CTWA) of silicon dust (total dust) during sand blasting, cabin opening and cleaning was reduced from 7.00 mg/m 3 to 0.50 mg/m 3. The CTWA of silica dust (exhalation dust) was decreased from 3.36 mg/m 3 to 0.27 mg/m 3, and the CTWA dust reduction rates of total dust and respirable dust were 92.9% and 92.0%, respectively. Conclusion:The combination of cabinet type exhaust hood and water curtain dedusting optimizes the combination mode of dust prevention and control. It has the advantages of high efficiency of dedusting and purification, energy saving and environmental protection, and can be popularized and used in enterprises of the same nature.

Objective:To investigate the efficacy and safety of transperitoneal robot-assisted nephroureterectomy (RANU) with a single body position and original ports for upper urinary tract urothelial carcinoma(UTUC).Methods:Clinical data of 21 patients from March 2018 to November 2019 in the First Affiliated Hospital of Zhengzhou University was retrospectively analyzed, including 14 males and 7 females. The age was (63.8±11.4) years and the BMI was (23.6±2.5) kg/m 2.Of the 21 localized UTUC patients, 8 pelvic tumors, 3 middle ureter tumors, 10 lower ureter tumors; 11 on the left, 10 on the right; 20 of 21 tumors (95.2%) were high risk. Surgery was done by the same urologist. Under general anesthesia, the patients were in 75 ° healthy side lying position and overall 15 ° head down and foot high position. Improved layout of ports: camera port C was located at two fingers lateral to the umbilicus, 2 cm below the umbilicus; robotic arm port 1 and 2 were respectively located at pararestus line, close to costal margin and 2 cm below the midpoint between C and the affected iliac crest. Assistant port 1 and 2 were respectively located at 2 cm above the umbilicus and 4 cm below the umbilicus. The right cases need an additional assistant port under the xiphoid to provoke the liver. Hem-o-lok cliped the ureter distal to the tumor and the affected kidney was radically removed. Under the principle of tumor free, the ureter and the surrounding bladder wall within 1 cm were excised and the bladder was sutured. Lymphadenectomy was performed when the kidney and ureter were dissociated. Results:All 21 procedures were successful without open surgery or position change and intraoperative complications. No patients required a blood transfusion. The operation time was (205.2±57.3) min. The median intraoperative blood loss was 50 ml (20-120 ml). The median drainage tube indwelling time was 4d(3-7 d) and the median urinary catheter indwelling time was 7 d(5-8 d), the median postoperative hospital stay was 7 d(6-12 d).7 cases(33.3%)of Clavien-Dindo grade Ⅰ complications after surgery and they all relieved after giving symptomatic treatment. All postoperative pathology showed UTUC and negative resection margins. The median follow-up time was 12 months (4-22 months), 1 patient died of an accident 7 months after surgery and 3 patients had recurrence at 6, 8, and 10 months after surgery, survival at the last follow-up after treatment.Conclusions:The transperitoneal RANU with a single body position and original ports is safe and effective. The operation time is saved, the incidence of intraoperative and postoperative complications is low, the postoperative patients recover quickly.Short-term follow-up results prompt low recurrence rate and good tumor control effect.

BACKGROUND:Stem cel transplantation has gained considerable support recently. It provides new opportunities for treating diabetic neurogenic bladder. OBJECTIVE:To summarize the research progress in bone marrow mesenchymal stem cel s (BMSCs)transplantation in the treatment of diabetic neurogenic bladder. METHODS:The first author retrieved Sciencedirect, PubMed, Embase, Wangfang and CNKI databases, for relevant articles of BMSCs transplantation in the treatment of diabetic neurogenic bladder, published from 2000 to 2016. The key words were“bone marrow mesenchymal stem cel s, diabetic neurogenic bladder, differentiation, transplantation”in Chinese and English, respectively. RESULTS AND CONCLUSION:In patients with diabetic neurogenic bladder, the transplantation of BMSCs may provide safer and longer-lasting outcomes by repairing the damaged bladder and urethra. And it can produce various bioactive substances, which wil have nutritional paracrine effects on the bladder microenvironment, including anti-inflammation, promoting cel proliferation and improving cel survival. On the one hand, the BMSCs have the ability to migrate to the injury site via the blood circulation. On the other hand, BMSCs can produce various growth factors, as wel as the cytokines that can inhibit the inflammatory response. While the current clinical studies are lacking, its efficacy and safety needs further verification.

Objective: To investigate the effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women who took their first antenatal care and willing to undergo their prenatal care and delivery in Ma 'anshan Maternity and Child Care Centers were recruited in the cohort study. Excluding subjects without weight data before delivery (n=54), pregnancy termination (n=162), twins live births (n=39), without fetal birth weight data (n=7), 3 212 maternal-singleton pairs were enrolled for the final data analysis. Demographic information of pregnant woman, pregnancy history, disease history, height and weight were collected. In the 24^th-28^th, 32^nd-36^th gestational week and childbirth, three follow-up visits were undertaken to collect data of pregnancy weight, pregnancy vomiting, gestational hypertension, gestational diabetes mellitus, newborn gender and birth weight. χ² test was used to compare the detection rate of fetal growth restriction in different groups. Multivariate unconditional logistic regression model and spreadsheet were used to analyze the independent and interaction effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Results: The incidence of fetal growth restriction was 9.7%(311/3 212). The incidence of fetal growth restriction in pre-pregnancy underweight group was 14.9% (90/603), higher than that in normal pre-pregnancy weight group (8.7% (194/2 226)) (χ²=24.37, P<0.001). The incidence of fetal growth restriction in inadequate increase of gestational weight group was 17.9% (50/279), higher than the appropriate increase of weight group (11.8% (110/932)) (χ²=36.89, P<0.001). Multivariate unconditional logistic regression analysis showed that compared with normal pre-pregnancy weight group, pre-pregnancy underweightwas a risk factor for fetal growth restriction, with RR (95%CI) at 1.76 (1.34-2.32); Compared with the appropriate increase of gestational weight group, inadequate weight increase during pregnancy was a risk factor for fetal growth restriction, with the RR (95%CI) at 1.70 (1.17-2.48). No additive model interaction [relative excess risk of interaction, attributable proportions of interaction, the synergy index and their 95%CI were 0.75 (-2.14-3.63), 0.21 (-0.43-0.86) and 1.43 (0.45-4.53), respectively] or multiplication model interaction (RR (95%CI): 1.00 (0.44-2.29)) existed between pre-pregnancy underweight and inadequate increase of gestational weight on fetal growth restriction. Conclusion Pre-pregnancy underweight and inadequate increase of gestational weight would increase the risk of fetal growth restriction without interaction.

AIM: Cystostomy is the traditionary method for detecting urodynamic indexes in mice, which de-stroys the continuity of the bladder, and there are significant differences between this method and the clinically used trans-urethral method.This study aims to develop an appropriate urethral catheter to investigate the advantages and application val-ue of transurethral method for urodynamic test.METHODS:A pediatric intravenous catheter was used for urethral catheter-ization on 8 female mice, and linked to connect the catheter to baroreceptor and micropump.The epidural catheter was also used as manometry tube.RESULTS:Using this method, the following urodynamic indicators has been successfully cap-tured:basal bladder pressure (BBP), bladder leak point pressure (BLPP), maximum voiding pressure (MVP), maxi-mum bladder capacity ( MBC ) , post-void residual urine volume ( PVR ) , voiding volume ( VV ) , efficiency of voiding ( EV) and bladder compliance ( BC) .CONCLUSION:This is the first successful simulation used in human body to a-chieve mouse urodynamic testing through the urethra catheter, which avoids the impact of cystostomy on urodynamics in mice, and the mice are able to keep long-term survival after tests for the follow-up molecular and genetic experiments.

Objective To explore the relation between coping style and critical thinking among nursing students in order to provide the powerful evidence for instructing nursing students to take the correct coping style so as to improve their critical thinking .Methods Sixty-three nursing students in Grade 2010 in School of Nursing, Jilin University were surveyed by critical thinking disposition inventory ( CTDI-CV) and simple coping style questionnaire (SCSQ).Results The average score of CTDI-CV was (278.35 ±33.14) in the nursing students, and the percent of students with less than 280 was 58.73%, and the percent of students with 280 to 350 was 36.51%, and the percent of students with more than 350 was 4.76%.The score of positive coping styles in the nursing students was (1.86 ±0.626), and was higher than that of the national norm , and the difference was not statistically significant (t =0.207,P>0.05).The score of negative coping styles in the nursing students was (1.18 ±0.566), and was lower than that of the national norm , and the difference was statistically significant (t=-5.745,P <0.01).Nursing undergraduates positive coping style was positively correlated with CTDI-CV scores ( P<0.05), negative coping styles and negatively correlated with CTDI-CV scores (P<0.01).Negative coping style and the critical mind all dimensions are in different degree of negative correlation, positive coping styles and open mind , systematic ability, self-confidence were positively correlated (P<0.01).Conclusions Developing positive coping styles in the nursing students can improve their critical thinking .

Objective To observe the effects of rosuvastatin on the homocysteine (Hcy)-induced expression of matrix metalloproteinase 2 (MMP 2) and cell migration in rat vascular smooth muscle cells (VSMCs), and to explore the possible mechanism of Hcy-induced atherosclerosis and the role of statins in reversing atherosclerosis. Methods In one cell culture plate, the cultured rat VSMCs were incubated with different concentrations of Hcy (0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L) in vitro for 24 h, 48 h and 72 h. And in another cell culture plate, the different concentrations of rosuvastatin (10-9, 10-8, 10-7, 10-6, 10-5 mol/L and 0 mol/L) were added to the cultured rat VSMCs (while the concentration of Hcy was 1000 μmol/L). The MMP 2 expression and enzyme activity were determined by gelatin zymography and Western blotting. The effects of Hcy and rosuvastatin on cell migration and invasiveness of VSMCs were observed. Results Hcy (50-5000 μmol/L) increased the protein expression, and Hcy (50-1000 μmol/L) increased enzyme activity of MMP 2 significantly. But Hcy (5000 μmol/L) inhibited activity of MMP 2 (F=9.31, 6.44 and 5.97, all P＜0.05). Rosuvastatin (10-9-10-5 mol/L) inhibited Hcy-induced expression and enzyme activity increasing of MMP 2. The counts of cell migration of VSMCs were 18.32±2.17, 32.68±4.34, 44.75±4.08, 61.39±5.21, 79.74±5.54 and 90.78±5.83, while the concentration of Hcy was 0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L respectively (F=5.31, P＜0.05). The counts of cell migration of VSMCs were 79.74±5.54, 62.53±6.41, 48.37±5.66, 31.41±4.79, 19.27±3.62 and 11.17±2.33, while the concentration of rosuvastatin was 10-9, 10-8, 10-7, 10-6 and 10-5 mol/L respectively (F=4.99, P＜0.05). Rosuvastatin could decrease the stimulation of Hcy-induced migration of VSMCs. Conclusions Hcy can influence the MMP 2 protein expression/activity in VSMCs, and rosuvastatin can inhibit augmentation of Hcy-induced MMP 2 expression/activity and migration of VSMCs. It may be one of the multiple-effects of rosuvastatin reducing atherosclerosis.

Objective To investigate the possibility and utility of metformin alone or in combination with fosinopril to reduce blood pressure in patients with essential hypertension.Met hods A total of 140 cases of non-diabetic essential hypertension with hyperinsulinemia were recruited and randomly assigned to two groups: a group of 68 treated with metformin 500 mg tid and a group of 72 treated with fosinopril 10 mg qd.The duration of the treatment was 8 weeks.Combination therapy with the two drugs was used after 4 weeks of treatment if needed.If the target goals of systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg =0.133 kPa) and /or diastolic blood pressure (DBP) <90 mm Hg were not attained 4 weeks, combination therapy with two drugs was used in either group in the next 4 weeks.The changes of blood pressure and insulin sensitivity of the two groups were observed before and after treatment.Results (1) After 4 weeks of treatment, SBP in metformin group and fosinopril group decreased by ( 13.0 ± 1.2) mm Hg and (15.4 ± 1.4) mm Hg, and DBP decreased by (9.0 ± 1.0) mm Hg and ( 10.4 ± 1.1 ) mm Hg respectively.After 8 weeks of treatment, SBP in metformin group and fosinopril group decreased by (17.8 ± 1.5) mm Hg and (20.9 ± 1.5) mm Hg, and DBP decreased by (13.2 ±0.9) mm Hg and (15.3 ± 1.1) mm Hg respectively.There was no significant difference in the decline of blood pressure between the two groups (P >0.05).The rates of combination therapy were both 54% in the two groups.(2) Fasting insulin as well as 30 min and 120 min insulin levels after oral glucose tolerance test and insulin area under the curve in the metformin group were significantly reduced after 4 and 8 weeks of treatment as compared with those of baseline(P < 0.05 and P < 0.01 ) .In the fosinopril group, however, they decreased only after 8 weeks treatment (P < 0.05).The insulin action index in the metformin group was higher than that in the fosinopril group after 4 weeks of treatment (P <0.05) ,but there was no significant difference between the two groups after 8 weeks of treatment (P > 0.05).Conclusion Metformin and fosinopril have similar antihypertensive effect and a good synergy in essential hypertension with hyperinsulinemia.