Objective:To evaluate the clinical effects of problem solving therapy on the elderly patients with depression by Meta-analysis.Methods:Randomized controlled trials articles regarding the effects of problem solving therapy on the elderly patients with depression were searched from the database of PubMed, EMbase, Medline, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database and Wanfang Data electronically. SMD was used as the post merger response, and its 95% CI was calculated. Results:Ten articles were recruited and a total of 1 005 patients were included, 501 patients in the intervention group and 504 patients in the control group. Meta-analysis showed that problem solving therapy was significantly better than the control group in the treatment of depressive symptoms in the elderly patients with depression ( SMD =-0.64, 95% CI -0.98 - -0.31, P<0.05); during the follow-up within 3 months and 6 months after the intervention, the improvement of depression in the intervention group was better than that in the control group ( SMD=-0.62, 95% CI -1.00 - -0.25, P<0.05) and ( SMD =-0.79, 95% CI -1.03 - -0.55, P<0.05), respectively. Compared with the control group, the intervention group had an effect on the improvement of dysfunction ( SMD=-1.28, 95% CI -2.22 - -0.35, P<0.05). Conclusions:Problem solving therapy can improve the depressive symptoms of the elderly patients with depression and the clinical effect remains stable for a certain period of time; problem solving therapy has an improvement effect on the dysfunction of the elderly patients with depression.

Objective:To explore the effect of serum lactic acid (Lac) level on acute kidney injury (AKI) in patients with sepsis and whether Lac level affects the in-hospital mortality of patients with sepsis-associated AKI.Methods:A retrospective cohort study was conducted. Clinical data of patients with sepsis admitted to the internal intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from March 2014 to June 2019 and the ICU of the Second Affiliated Hospital of Guangxi Medical University from January 2017 to June 2020 were collected. According to the first quartile of Lac within 24 hours of admission to ICU, the patients were divided into Lac ≤ 1.4 mmol/L group (group Q1), Lac 1.5-2.4 mmol/L group (group Q2), Lac 2.5-4.0 mmol/L group (group Q3), and Lac ≥ 4.1 mmol/L group (group Q4). The incidence of sepsis-associated AKI after admission to ICU and hospital mortality were compared among four groups. The effect of elevated Lac on the incidence and mortality of sepsis-associated AKI was investigated by binary Logistic regression analysis. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of Lac on the incidence and mortality of sepsis-associated AKI, and the cut-off value was obtained to analyze the incidence and death risk of sepsis-associated AKI at different Lac levels. Results:A total of 655 sepsis patients were enrolled, of which 330 patients (50.4%) developed AKI and 325 patients (49.6%) did not. Among 330 patients with sepsis-associated AKI, 134 (40.6%) died and 196 (59.4%) survived. With the increase of Lac level, the incidence of sepsis-associated AKI increased gradually (34.5%, 41.0%, 58.4%, 66.3%, respectively, in group Q1- Q4), meanwhile, the in-hospital mortality also increased gradually (23.4%, 29.2%, 33.1%, 43.4%, respectively, in group Q1- Q4), the differences were statistically significant (both P < 0.01). Compared with the non-AKI group, the Lac level in the AKI group was significantly increased [mmol/L: 3.08 (1.84, 5.70) vs. 1.91 (1.20, 3.10), P < 0.01]. After adjustment for factors such as gender (male), site of infection (abdominal cavity), vasoactive drugs, basal mechanical ventilation, mean arterial pressure (MAP), basal renal insufficiency, uric acid, procalcitonin (PCT), platelet count (PLT), basal serum creatinine (SCr) and basal estimated glomerular filtration rate (eGFR), and other influencing factors, multivariate Logistic regression analysis showed that elevated Lac was an independent risk factor for sepsis-associated AKI [odds ratio ( OR) = 1.096, 95% confidence interval (95% CI) was 1.022-1.175, P = 0.010]. Compared with the survival group, the Lac level in the death group was significantly increased [mmol/L: 3.55 (2.00, 6.76) vs. 3.00 (1.70, 4.50), P < 0.01]. After adjusting for age, diabetes, vasoactive drugs, basal eGFR, and other factors, multivariate Logistic regression analysis suggested that increased Lac was an independent risk factor for in-hospital mortality in sepsis-associated AKI patients ( OR = 1.074, 95% CI was 1.004-1.149, P = 0.037). ROC curve analysis showed that the area under the ROC curve (AUC) of Lac for predicting the incidence and mortality of sepsis-associated AKI was 0.653 (95% CI was 0.611-0.694) and 0.593 (95% CI was 0.530-0.656, both P < 0.01), respectively, and the cut-off values were 2.75 mmol/L (sensitivity was 57.8%, specificity was 69.2%) and 5.95 mmol/L (sensitivity was 56.7%, specificity was 83.7%). When the Lac ≥ 2.75 mmol/L, the risk of sepsis-associated AKI was 2.772 times higher than that of < 2.75 mmol/L ( OR = 2.772, 95% CI was 1.754-4.380, P < 0.001). When the Lac ≥ 5.95 mmol/L, the patients with sepsis-associated AKI had a 2.511 times higher risk of in-hospital death than those with Lac < 5.95 mmol/L ( OR = 2.511, 95% CI was 1.378-4.574, P = 0.003). Conclusions:Elevated Lac level is an independent risk factor for the incidence and mortality of sepsis-associated AKI. When Lac ≥ 2.75 mmol/L, the risk of AKI in patients with sepsis increased by 1.772 times; when Lac ≥ 5.95 mmol/L, the risk of in-hospital death in patients with sepsis related AKI increased by 1.511 times.

Coping style is a cognitive or behavioral strategy taken by individuals in the face of stress. Positive coping style is of great significance for improving the physical and mental outcomes of elderly patients with urinary incontinence. Accurate assessment of coping styles for the elderly patients with urinary incontinence can provide reference for the subsequent development of intervention measures. The existing coping style assessment tools for elderly incontinence at home and abroad include specific scale of incontinence, relevant psychological assessment scale, and universal scale. In a word, the progress in the studies on relevant assessment tools is slow, and it mainly focuses on the assessment of female population. The assessment content is relatively single and lacks of pertinence and systematization. In the future, a comprehensive scale with strong adaptability should be developed based on the characteristics of elderly incontinence patients in China.
Adaptation, Psychological ; Aged ; China ; Female ; Humans ; Urinary Incontinence

Objective: To investigate the prevalence and associated factors of eczema in children in order provide reference for the prevention and treatment of eczema. Methods: Two primary schools in a district of Shenyang were randomly selected to conduct a questionnaire survey on 2 240 students in May 2017. Children with eczema need to be diagnosed by a doctor. Results: There were 838 cases of eczema with a reported rate of 37.4%, 38.7% in boys and 36.1% in girls. The age of 6 to 12 months was the peak period of first eczema in children, and the proportion of eczema within 1 year was up to about 70%. Children who have had eczema in the past were now more likely to catch a cold, and the reported rates of allergic rhinitis, asthma and food allergies were also significantly higher. The Logistic regression analysis showed that the mother was unhappy during pregnancy(OR=1.32,95%CI=1.03-1.69), the parents were more educated (OR=1.60, 95%CI=1.19-2.16), and the parents were allergic (OR=1.58,95%CI=1.07-2.33；OR=1.41, 95%CI=1.02-1.94), family history of diabetes(OR=1.95, 95%CI=1.41-2.68), and cesarean(OR=1.33, 95%CI=1.07-1.65) were risk factors of eczema in children. Conclusion The incidence of children eczema is affected by maternal mood during pregnancy, family factors and delivery mode. It is of practical significance to prevent children eczema in early development for reducing the incidence of other allergic diseases in the future.

Objective:To investigate the effect of hyperuricemia on acute kidney injury in sepsis patients.Methods:It is a retrospective cohort study of 459 adult sepsis patients who were admitted to the Department of Intensive Care Unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from March 2014 to June 2019, and the Second Affiliated Hospital of Guangxi Medical University from January 2017 to June 2019. The patients were divided into the hyperuricemia group and the non-hyperuricemia group according to the first serum uric acid level within 24 h after ICU admission, and the incidence of AKI within 7 days after ICU admission was compared between the two groups. The effect of hyperuricemia on sepsis-associated AKI was analyzed by univariate analysis and binary logistic regression analysis.Results:Among the 459 sepsis patients, 81 patients (17.6%) had hyperuricemia, and 127 patients (27.7%) had AKI. The incidence of AKI in the hyperuricemia group and the non-hyperuricemia group were 60.5% (49/81) and 20.6% (78/378), respectively, which showed significantly statistical difference ( χ2=52.954, P<0.01). After adjusting for gender, associated diseases (diabetes, coronary heart disease), sequential organ failure score (SOFA) on the day of ICU admission, the use of diuretics within one week before and after ICU admission, invasive mechanical ventilation, basal renal function, lactic acid, and procalcitonin, binary logistic regression analysis showed that hyperuricemia was an independent risk factor for AKI in sepsis patients ( OR=5.091, 95% CI: 2.768-9.362, P<0.01); For every 1 mg/dL increase in serum uric acid in sepsis patients, the risk of developing AKI increased by 28.4% ( OR=1.284, 95% CI: 1.165-1.414, P<0.01). Conclusions:AKI is a common complication in sepsis patients admitted to ICU, and hyperuricemia is an independent risk factor for AKI in sepsis patients.

Active Transport, Cell Nucleus ; Animals ; Cell Nucleus ; metabolism ; Forkhead Box Protein O3 ; metabolism ; Mice ; Mice, Knockout ; Muscle, Skeletal ; metabolism ; pathology ; Muscular Atrophy ; metabolism ; pathology ; Protein-Serine-Threonine Kinases ; deficiency ; metabolism

OBJECTIVETo identify secondary mutations associated with deafness in a Chinese family affected with deafness.

METHODSThe family has been subjected to clinical and molecular analyses, in addition with measurement of reactive oxygen species and doubling time after establishment of immortalized lymphocyte cell lines.

RESULTSThe results showed that the hearing loss level and audiometric configuration were discrepant among the family members with maternally transmitted hearing loss. The penetrance of hearing loss in this family was respectively 66.7% and 44.4% when aminoglycoside-induced hearing loss was included or excluded. Analysis of whole mitochondrial genome has found 33 variants as previously reported polymorphisms, except for a 12s rRNA A1555G mutation and a tRNA(Thr)T15943C mutation. Haplotype evolutionary tree has verified that this family belonged to East-Asian haplogroup F. 15943 position was located on the T-stem of the tRNA(Thr), which has destroyed the extremely conserved T-A base pair when T changed to C at this position. However, functional experiments indicated that the population doubling time in special galactose and glucose were longer, whilst the level of reactive oxygen species has increased. Compared with the control cell line groups and a family only carrying the 12s rRNA A1555G mutation, all of the three groups belonged to the same haplogroup.

CONCLUSIONMitochondrial tRNA(Thr)T15943C mutation may act as a potential modifying factor and interact with 12s rRNA A1555G mutation, and thereby enhance the penetrance and expression of deafness.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Child, Preschool ; China ; DNA, Mitochondrial ; genetics ; Deafness ; genetics ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Pedigree ; Phenotype ; Point Mutation ; RNA, Ribosomal ; genetics ; RNA, Transfer, Thr ; genetics ; Young Adult

Asian Continental Ancestry Group ; Hearing Loss ; genetics ; Humans ; Mutation ; genetics ; Pedigree ; RNA, Ribosomal ; genetics

Objective To explore the effect of acupuncture treatment combined with specific nursing intervention on the intestinal function recovery in the gastrointestinal tumor patients after operation .Methods Eighty patients with gastrointestinal tumor were divided into the control group and the intervention group according to the random number table , each with 40 cases.The control group including the patients and their family received the routine education of perioperative nursing the day before surgery , and also received the acupuncture treatment including bilateral acupuncture point injection of vitamin B 1 at Zusanli ( 100 mg/d ) and bilateral electro-acupuncture at Zusanli and Neiting twice daily after the operation .The intervention group received the specific nursing intervention on the basis of control group .The times of first anal exhaust , bowel movement and removal of nasogastric tube , and the incidence rate of abdominal distention were compared between two groups . Results The times of first anal exhaust , bowel movement and removal of nasogastric tube were respectively (47.90 ±6.16),(58.90 ±10.68),(24.52 ±8.45) h in the intervention group, and were shorter than (52.62 ± 9.46),(65.46 ±13.56),(31.38 ±9.50) h in the control group, and the differences were statistically significant (t=2.64,2.40,3.41, respectively;P<0.05).The incidence rate of abdominal distention was 5%in the intervention group , and was lower than 20.0% in the control group , and the difference was statistically significant (χ2 =4.11,P <0.05).Conclusions The acupuncture treatment combine with specific nursing intervention can effectively promote the intestinal function recovery in the gastrointestinal tumor patients after operation.

BACKGROUND: The degradable poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) has superior mechanical property and biocompatibility.OBJECTIVE: To elucidate the intravascular biocompatibility of PHBHHx in vivo.METHODS: We developed hybrid materials based on decellularized xenogenic vascular scaffolds that were coated with PHBHHx and implanted it into the abdominal aorta of New Zealand rabbits. The decellularized xenogenic pulmonary artery patch without PHBHHx coating served as the control. The implanted patches were determined for the histology, immunofluorescence staining, scanning electron microscopy and calcium contents at 1, 4 and 12 weeks after the surgery.RESULTS AND CONCLUSION: Hybrid patches exhibited smooth lumen surface without thrombus, the intimal hyperplasia was mild and recellularization was complete; immunofluorescence staining showed that the endothelial cells in the neointima were positive for CD31, with continuous single-layer arrangement, interstitial cells were positive for smooth muscle actin; the calcium content in hybrid patches was obviously lower than that in uncoated patches. PHBHHx shows a remarkable intravascular biocompatibility in vivo and is believed as an ideal candidate for lumen coating of cardiovascular tissue engineering.