Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective:To explore the effect of auricular point pressing pill combined with rhubarb acupoint application on intestinal preparation and prevention of adverse events in colonoscopy.Methods:A total of 220 patients who met the inclusion criteria from May 2019 to February 2020 were randomly divided into 4 groups, 55 in each group. The control group was only given compound polyethylene glycol electrolyte powder. The auricular plaster group was combined with auricular point pressing pill on the basis of the control group. The acupoint sticking group was combined with rhubarb acupoint application on the basis of the control group. The combination group was combined with auricular point pressing pill and rhubarb acupoint application on the basis of the control group. The quality of bowel preparation was evaluated by Boston Bowel Preparation Scale(BBPS), and the adverse events such as perianal discomfort, defecation discomfort, abdominal pain and abdominal distension were observed.Results:After treatment, there was significant difference in BBPS score among the four groups ( F=3.038, P=0.030). The BBPS score in the acupoint sticking group (7.45 ± 1.20 vs. 6.78 ± 1.32) and combination group (7.26 ± 1.11 vs. 6.78 ± 1.32) were significantly higher than those in the control group( P<0.05). After treatment, there were significant differences in abdominal pain and abdominal distension scores among the four groups ( F=2.947, 5.879, P=0.034, 0.001). The scores of perianal discomfort (0.07 ± 0.38 vs. 0.44 ± 1.07), defecation discomfort (0.40 ± 0.81 vs. 0.87 ± 1.32) and abdominal pain (0.93 ± 1.32 vs. 1.69 ± 1.61) in the combination group were significantly lower than those in the control group ( P<0.05), and the abdominal distension score (1.05 ± 1.00 vs. 1.64 ± 0.95) in the acupoint sticking was significantly lower than that of the control group ( P<0.05). Conclusion:Auricular combined with rhubarb powder acupoint application can improve the quality of bowel preparation and reduce intestinal adverse reactions. It can be used with polyethylene glycol electrolyte powder for the intestinal preparation process.

Objective:To determine the pathogenic gene mutation in a family with incomplete congenital quiescent night blindness (CSNB) of Schubert-Bornschein type.Methods:A retrospective clinical study. In February 2021, one patient and his parents and elder brother from a Han Chinese incomplete CSNB of Schubert-Bornschein type family diagnosed by clinical and genetic examination at Henan Provincial People's Hospital were included in the study. The patient’s medical history, family history were inquired; best corrected visual acuity (BCVA), color vision, fundus color photography, full-field electroretinogram (ERG), and frequency domain optical coherence tomography (OCT) were examined in detail. Five ml of the subject’s peripheral venous blood was collected and the whole genome DNA was extracted. The genomic DNA of the subject was library constructed, and all-exon probes were polymerized for capture. The suspected pathogenic mutation site was verified by Sanger, and the pathogenicity of the gene mutation site was determined by parallel bioinformatics analysis.Results:The BCVA of both eyes of the proband (Ⅱ2) was 0.4; the color vision test could not recognize the red color. Fundus examination showed no obvious abnormalities. The retina thickness in the macular area of both eyes was slightly thinned. ERG examination of the whole field showed that the amplitude of ERG b wave was significantly reduced under the stimulation of binocular dark adaptation 3.0 and showed a negative waveform. The mother of the proband (Ⅰ2) had normal BCVA, color vision, fundus color photography, and frequency domain OCT examination. The full-field ERG examination showed that the amplitude of each eye reaction was slightly reduced, and the amplitude of the dark adaptation shock potential was significantly reduced. Genetic testing showed that the proband (Ⅱ2) had a c.1761dupC hemizygous mutation in exon 14 of the voltage-dependent calcium channel α1F subunit gene ( CACNA1F gene). The results of protein sequence homology analysis showed that the site was highly conserved in multiple species; the results of bioinformatics analysis showed that the CACNA1F gene c.1761dupC (pY588fs) subsequently had a frameshift mutation and became a stop at position 10. Codons appear translational termination in the conserved regions of the protein. According to the standards and guidelines of the American College of Medical Genetics and Genomics, the mutation was judged to be a possible pathogenic variant. The mother of the proband (Ⅰ2) was a carrier of this site mutation. The clinical and genetic test results of the father and elder brother of the proband were not abnormal. Conclusion:CACNA1F gene c.1761dupC is the pathogenic mutation site of the Schubert-Bornschein type incomplete CSNB family.

Combined radiation-trauma injury is mainly observed in radiation treatment of cancer and radiation injury with traumatic patients. The prominent problem of combined radiation-trauma injury is delayed or prolonged wound healing. The mechanism of the impaired wound healing is complicated, and the current effective treatment method are limited. This paper reviews the mechanism and treatment of this impaired wound healing, including the cellular depletion, stromal cell dysfunction, aberrant collagen deposition, microvascular damage, as well as the targeted therapies for the impaired wound healing such as stem cell repletion, antioxidant therapy, transforming growth factor beta-1 ( TGF-β1 ) modulation, and implantable biomaterials. This paper is designed to provide a reference for further deep research on the mechanism and treatment of radiation-trauma injury.

Energy conservation has become a problem needing to be immediately solved with the extensive con-struction of hospital information system. As a high computing technology, green computing uses resources economically and effectively and is characterized by energy conservation and environment friendship. Its concept and characteristics, and the status quo of hospital information system construction were described. A green computing framework model was established for hospital information system construction, which plays an active role in implementing the idea of green environment protection, low carbon and energy conservation, and sustainable development, thus laying a foundation for studying the mechanisms underlying energy conservation in hospital information system construction and for assessing and optimizing its strategic system.

Objective To investigate the application and effect of pediatric nursing cooperated with obstetrical nursing on breast-feeding effect of ICU preterm children. Methods Totally 126 cases of premature children hospitalized in our hospital NICU form January 2015 to December 2015 as the research object. Cases from January to June were selected as the control group ( n=65) , cases from July to December were selected as the intervention group ( n=61) . In the control group, routine post-natal nursing was performed respectively in obstetric and pediatrics. In the intervention group, pediatric nursing cooperated with obstetrical nursing was performed.Results Exclusive breast-feeding rate of 1 week in the intervention group was higher than the control group;mixed feeding rate and artificial feeding rate were lower than the control group. Feeding mode in two groups was significantly different (χ2 =7. 025, P=0. 006 ); breast-feeding day for the first feeding in the intervention group was significantly earlier than the control group (χ2=2.365, P=0.020) . The degree of breast-feeding in 1 week was higher than the control group (χ2=5.628, P=0.021;t=5.158, P<0.001);the degree of breast-feeding in 2 weeks was higher than the control group (χ2=6.852, P=0.009;t=6.542, P<0.001); the exclusive breastfeeding rate during hospitalization was higher than the control group (χ2=7.852, P<0.001). The rate of weight gain in the intervention group was significantly higher than the control group (t=4.526, P=0.003) , hospital stay shortened compared with the control group ( t=3.524, P=0.009) , the incidence of sepsis was significantly lower than the control group (χ2 = 4. 159, P= 0. 042 ) . Conclusions Pediatric nursing cooperated with obstetrical nursing can effectively improve the breast-feeding level and exclusive breast-feeding rate of NICU preterm children, promote neonatal weight gain, shorten hospital stays and reduce the incidence of sepsis.

Objective To investigate the effect of an ACE inhibitor ,perindopril ,on the expression of SR‐A in renal tubuloint‐erstitium of diabetic rats .Methods Diabetes was induced in male Sprague‐Dawley rats by injection with streptozotocin .The rats were then randomly divided into 3 groups:normal control group;untreated diabetes mellitus group and diabetes mellitus group trea‐ted with perindopril .After a 24‐week treatment ,tubulointerstitial injury index was assessed with Masson′s trichrome sections .The expression of SR‐A mRNA was detected by RT‐PCR and the expression of SR‐A protein in renal tubulointerstitium was detected by immunohistochemistry .Results The tubulointerstitial injury index ,the expression of SR‐A mRNA were significantly higher in the diabetes group than those in normal control group .Perindopril treatment not only attenuated the tubulointerstitial injury ,but also reduced the overexpression of SR‐A mRNA in diabetic rats .The expression of SR‐A protein was most obvious in renal tubulointer‐stitium in diabetic rats ,which was obviously attenuated by perindopril treatment(P<0 .05) .Conclusion The findings of the this study indicate that perindopril may have renoprotective effects on diabetic nephropathy via inhibiting the expression of SR‐A in re‐nal tubulointerstitium .

Objective To evaluate the clinical effect of Wy 10 whitening combined with enamel microabrasion on bleaching dental fluorosis.Methods Forty patients with dental fluorosis were in-cluded and divided into two groups (20 each):group A was treated with Wy 10 whitening and enamel microabrasion,and group B only with Wy 10 whitening.Efficacy was measured according to the Vita classical shade guide before and after treatment.Sensitivity between groups was also tested.Results The effective rate of group A was significantly higher than that of group B (x2 =5.096,P＜0.05).The sensitive rates were 20.0％ (4/20) and 15.0％ (3/20) in group A and group B,respectively.No significant difference was found between the two groups in sensitivity (P＞0.05).Conclusions Wy 10 whitening combined with enamel microabrasion is an effective and safe method for bleaching dental fluorosis.

OBJECTIVETo investigate the effect of different length and diameters on the stability of mini implant and to select optimal length and diameter using continuous variation of parameters.

METHODSTo perform 3-dimensional finite element analysis, finite element models of a maxilla, and mini implants with length of 6-12 mm and diameters of 1.2-2.0 mm were generated. Load of two different forces were applied to the head of mini implant. One type was horizontal force (HF), the other was composite force (CF). The maximum equivalent stress (Max EQV) in maxilla and the maximum displacement (Max DM) of mini implant were evaluated.

RESULTSThe Max EQV in maxilla and Max DM of mini implant decreased as length and diameter increased. When length was more than 9 mm, the evaluation indexes were small and had a less change. Datas indicated that diameter played a more important role in reducing target, and was a more effective parameter in reducing Max EQV when CF was loaded.

CONCLUSIONFrom biomechanical point of view, the choice of the length should not be more than 9 mm. When CF is loaded using the mini implant, diameter exceeding 1.2 mm are optimal design for mini implant.

Objective To explore the negative psychological experience of nursing students during clinical practice in NICU .Methods The qualitative phenomenological research method was adopted in this study.Semi-structured in-depth interviews were conducted with twelve nursing students during practice in NICU.Data were analyzed by content analysis .Results Four themes were extracted , including high tension , exhaustion of body and mind , lack of confidence , and sense of worthlessness .Conclusions The head nurse and the clinical teachers should pay attention to the negative psychological experience of nursing students during clinical practice in NICU , make a scientific and reasonable practice teaching program , take effective measures , and help them to complete the task of practice better in NICU .