BackgroundPerceived discrimination has been identified as a main risk factor for depression in maintenance hemodialysis patients. Chronic Illness Rejection and Discrimination Scale （CIRDS） is a measure for assessing perceived discrimination in individuals with chronic disease. However， the Chinese version of CIRDS for maintenance hemodialysis patients has not yet been established. ObjectiveTo translate CIRDS into Chinese version and evaluate its reliability and validity in maintenance hemodialysis patients， so as to provide an effective tool for assessing the perceived discrimination among maintenance hemodialysis patients. MethodsThe Brislin's model for translation， back-translation， cross-cultural adaptation and pre-experimentation was utilized to develop a Chinese version of CIRDS. A coherent of 250 maintenance hemodialysis patients attending Taihe Hospital Affiliated to Hubei Medical College， from July to October 2023 were selected as the research subjects. The formal scale was refined by employing item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated using content validity and construct validity. The reliability of the scale was evaluated using Cronbach's α coefficient， test-retest reliability and split-half reliability. ResultsThe Chinese version of CIRDS consisted of 11 items， including 2 factors （perceived discrimination and perceived rejection）. The scale-level content validity index （S-CVI） value was 0.898 and the item-level content validity index （I-CVI） values ranged from 0.875 to 1.000. Two common factors were extracted by exploratory factor analysis and explained 65.41% of the total variance. Confirmatory factor analysis also indicated that the model provided a good fit for the data. The Cronbach's α coefficient of the scale was 0.910， with Cronbach's α coefficients of 0.835 and 0.912 for the perceived discrimination and perceived rejection， respectively. The split-half reliability of the scale was 0.803， and the test-retest reliability was 0.920. ConclusionThe Chinese version of CIRDS has excellent reliability and validity， which can be used to evaluate the perceived discrimination in maintenance hemodialysis patients.

Objective:Based on the specific cleavage and non-specific "trans-cleavage" activities of the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein(CRISPR/Cas13), we established a visually amplification-free rapid detection technique of 2019-nCoV nucleic acid. This technique is easily processed with a low detection limit and good specificity.Methods:According to the 2019-nCoV gene sequence, specific CRISPR RNAs were screened and designed by bioinformatics analysis, and then synthesized as universal signal-strained RNA transcription targets in vitro to establish and optimize the reaction system. Moreover, the 2019-nCoV pseudoviral nucleic acid was used as a standard substance to evaluate the detection limit. A total of 65 positive samples were collected from various 2019-nCoV variants, while 48 negative samples included other clinically common respiratory pathogens, such as influenza A virus, influenza B virus, human parainfluenza virus, Klebsiella pneumonia, etc. All samples were tested by quantitative PCR (qPCR), digital PCR, and the method established in this study. The sensitivity and specificity of the newly established method were analyzed and evaluated. Results:With the newly established technique, the detection time for 2019-nCoV nucleic acid could be minimized to 6 minutes. In addition, the detection limit was 14 copies/μl when assisted by the displaying instrument, whereas it increased to 28 copies/μl with the naked eye. This technique had a sensitivity and specificity of 98.5% (66/67) and 100% (46/46) respectively, showing no statistically significant difference compared to the gold standard qPCR( P=1). Conclusions:This study has successfully established a CRISPR/Cas13a-based visually rapid detection technique for 2019-nCoV nucleic acid. This technique offers the advantages of a simple process, convenient operation, low environmental operating requirements, a detection limit close to qPCR, and a strong potential for on-site testing applications.

Objective:Currently,traditional cervical cancer screening methods,such as high-risk human papillomavirus testing and liquid based cytology(LBC),still possess limitations.This study aims to identify new diagnostic biomarkers to achieve the goal of"precision screening"via exploring the clinical value of DNA methylation[ΔCtP:paired box gene 1(PAX1)and ΔCtJ:junctional adhesion molecule 3(JAM3)]detection in cervical exfoliated cells for the diagnosis of high-grade cervical lesions. Methods:A total of 136 patients who underwent gynecological examinations in the vaginal room of the Department of Gynecology at the Third Xiangya Hospital of Central South University from June 2021 to June 2022 were retrospectively studied.Among them,122 patients had non-high-grade cervical lesions,and 14 patients had high-grade cervical lesions.The variables included general information(age,body mass index,and menopause status),LBC,high-risk human papillomavirus,cervical tissue pathology,vaginal examination results,and the ΔCt values of JAM3 and PAX1 gene methylation.Logistic regression analysis was used to identify the factors affecting the diagnosis of high-grade cervical lesions,followed by correlation analysis and construction of a conditional inference tree model. Results:Logistic regression analysis showed that the methylation ΔCt values of PAX1 and JAM3 genes and LBC detection results were statistically significant between the high-grade cervical lesions group and the non-high-grade cervical lesions group(all P<0.05).Correlation analysis revealed a negative correlation between cervical pathological changes and ΔCtP(r=-0.36,P<0.001),ΔCtJ(r=-0.448,P<0.001),LBC(r=-0.305,P<0.001),or bacterial diversity(r=-0.183,P=0.037).The conditional inference tree showed that when ΔCtJ>10.13,all of patients had non-high-grade cervical lesions,while ΔCtP>6.22,the number of non-high-grade lesions accounted for 97.5%(117/120),and high-grade lesions accounted for only 2.5%(3/120).When ΔCtJ>8.61 and LBC were atypical squamous cell of undetermined significance or negative for intraepithelial lesions or malignancy(NILM),105(99.1%)patients were non-high-grade cervical lesions,only 1(0.9%)patient was high-grade lesion.When the results of LBC were high-grade lesions,only 9 patients'histopathological examination was the high-grade lesions and 3 non-high-grade lesions.When LBC indicated low-grade lesions,atypical squamous cell of undetermined significance,no intraepithelial lesions,and ΔCtP>6.22,117(97.5%)of patients'histopathological examination was the non-high-grade lesions. Conclusion:The JAM3/PAX1 gene methylation test can be used independently for the stratified diagnosis of high-grade/non-high-grade cervical lesions in women with high-risk human papillomavirus infection,independent of the cytological results of cervical excision.The JAM3/PAX1 gene methylation test can also be used in combination with LBC to make up for the shortcomings of low sensitivity of LBC.In addition,the application of methylation kit in large-scale cervical cancer screening in the future will be good to the detection of more patients with high-grade cervical lesions,and achieve early screening and early treatment for cervical lesions/cancer.

Objective:To explore the application value of conventional ultrasound(US) in detecting occult bleeding lesions in joints of patients with hemophilia.Methods:Twenty-seven children with severe hemophilia A who received factor Ⅷ prophylactic treatment from March 2017 to April 2018 in Nanfang Hospital, Southern Medical University were enrolled. Clinical data were collected from routine practice accompanied with US examination, hemophilia joint health score (HJHS) 2.1 assessment and the history of hemarthrosis of both ankles, elbows and knees at baseline and at 1 year follow-up.Results:A total of 157 joints of 27 patients were followed up for one year. During the treatments, 74 joints were found without history of hemarthrosis, among which the total US score of 14(14/74, 18.9%) joints increased, and HJHS 2.1 score of 11(11/74, 14.9%) joints developed. There was no significant change in the HJHS 2.1 score of 108 joints, among which 25 joints (25/108, 23.1%) had an increase in the total US score.However, there was no significant change in the total US score for 93 joints, of which 9(9/93, 9.7%) had an increase in HJHS 2.1 score.Conclusions:US examination can sensitively detect hemophilia arthropathy in joints without history of hemarthrosis and without obvious progression of arthropathy by HJHS 2.1 examination, and provide clinicians with more accurate joint information.

Objective:To evaluate the accuracy of two-dimensional ultrasound(2D-US), three-dimensional volume ultrasound (3D-US) and ultrasound strain elastography (USE) in the measurement of preoperative tumor size of breast cancer and its influencing factors.Methods:A total of 101 patients with breast cancer in Nanfang Hospital of Southern Medical University from April to November 2016 were recruited in this study. The maximum diameter of the lesion was examined by 2D-US 3D-US and USE before core needle biopsy or surgery biopsy. The Bland-Altman analysis and intraclass correlation coefficient (ICC) were used to analyze the consistency between the ultrasonic technique measurements and the pathological measurements of postoperative lesion. Chi-square test or Fisher exact test was used to analyze whether the accuracy of three imaging techniques was affected by different clinical pathologic factors and imaging characteristics.Results:3D-US showed better agreement with histology than 2D-US and USE, with a higher ICC (ICC 3D-US=0.90>ICC 2D-US=0.81>ICC SUE=0.78) and low variation. In 3D-US, the accuracy rate of the age >40 years old group was higher than ≤40 years old group. In 2D-US, the measurement accuracy of invasive ductal carcinoma (IDC) without intraductal carcinoma in situ (DCIS) group was higher than DCIS with DCIS group, non-microcalcifications group was more accurate than microcalcifications group. The long diameter of lesion ≤2 cm group was more accurate than >2 cm group, IDC group was more accurate than invasive lobular carcinoma(ILC) group. In USE, the measurement accuracy of IDC without DCIS group was higher than DCIS with DCIS group, non-microcalcifications group was more accurate than microcalcifications group. All the differences mentioned above were statistically significant(all P<0.05). Conclusions:For accurate measurement of the size of breast cancer lesions, 3D-US is the best, which is least affected by clinicopathological factors and imaging features, followed by 2D-US and USE. This has certain significance for clinically determining the extent of breast cancer lesions.

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.

Objective:Through analysis of the development status of pediatric and the problems faced by pediatric young scientists, combined with the situation of research management, this paper puts forward some suggestions.Methods:Collect the identified problems of pediatric development, summarize the common ones and propose methodological strategies for scientific research management.Results:The development of pediatrics faces problems such as insufficient resources, unreasonable resource allocation and talents shortage.Conclusions:It is recommended to support the development of pediatric according to optimize the scientific research management model, establish a reasonable evaluation and incentive mechanism, establish a pediatric talent training model and team, improve the pediatric research level, and obtain policy support for salary, talent introduction and training, promotion of professional titles, research resources and so on.

Objective:To translate the Spirituality and Spiritual Care Rating Scale (SSCRS) into Chinese and test its reliability and validity.Methods:After obtaining authorization from the original author, we carried out translation, back translation and cross-cultural adaptation based on the Brislin principle, and formed the Chinese version of the SSCRS. From April to June 2019, we conducted the questionnaire survey among 189 nurses at a Class Ⅲ Grade A hospital in Shiyan by convenience sampling to evaluate the reliability and validity of the Chinese version of SSCRS.Results:The Chinese version of SSCRS had 17 items. Exploratory factor analysis extracted a total of 4 common factors, with a cumulative contribution rate of 62.83%. The Cronbach's α coefficient of the entire scale was 0.840, the split-half reliability was 0.842, and the test-retest reliability was 0.860. The scale-level content validity index of all items was 0.91, and the item-level content validity index of each item ranged from 0.81 to 1.00.Conclusions:The Chinese version of SSCRS has a good reliability and validity, which can be used as an effective tool to evaluate nurses' cognition of spirituality and spiritual care in China.

Objective To investigate the clinical effect of pernasal heated humidified high flow oxygen therapy (HFNC) on treating children with severe pneumonia.Methods For the children with severe pneumonia by treatment of HFNC in PICU in 2016,the changes of respiratory rate,heart rate,p(O2) and p(CO2) after one hour of HFNC and intubation rate,time of oxygen therapy and curative rate were analyzed.Results The HFNC was able to alleviate the respiratory rate,heart rate and increased p (O2) significantly (P ＜ 0.05),and for children with severe pneumonia complicated with type Ⅱ respiratory failure,the HFNC also can reduced p (CO2) significantly (P ＜ 0.05).There was no significant difference of intubation rate between children with type Ⅰ and Ⅱ respiratory failure,but both were significantly higher than children without respiratory failure (P ＜ 0.05).The mean oxygen therapy time of children with type Ⅱ respiratory failure was 7.38 d,which was significantly longer than 5.45 d of children with type Ⅰ respiratory failure and 4.45 d of children without respiratory failure (P ＜ 0.05).The curative rate was 100％.Conclusion HFNC can effectively relieve the respiratory rate,heart rate and hypoxemia in children with severe pneumonia.It can also significantly reduce p(CO2) in children with type Ⅱ respiratory failure.