Objective:To analyze ultrasonographic manifestations and genetic etiology of nine fetuses with 7q11.23 duplication syndrome.Methods:Ultrasonographic finding, pregnancy outcome and follow-up of nine fetuses detected at the Prenatal Diagnosis Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to December 2021 were retrospectively analyzed.Results:The fetuses were found to harbor a duplication in the 7q11.23 region by chromosomal microarray analysis (CMA). Among these, five had shown ventriculomegaly, including four syndromic and one non-syndromic. For the remainders, one had ventricular septal defect and mild tricuspid regurgitation, one had echogenic intracardiac focus, whilst another two were normal. Five couples had accepted parental verification, and the results confirmed that the 7q11.23 duplication carried by their fetuses were de novo in origin. Following genetic counseling, seven couples had opted to terminate their pregnancies. Two fetuses were delivered at full term, and follow-up had found no abnormalities. Conclusion:Prenatal ultrasonographic manifestations of fetuses with 7q11.23 duplication syndrome are variable. CMA can provide assistance for their diagnosis and genetic counseling.

Objective:To explore the process and content of family management of asthma children and their caregivers, so as to provide basis for improving the health outcomes of asthma children.Methods:This study is qualitative research. From March to April 2022, 26 children and 26 main caregivers from the Asthma Clinic of the Children's Hospital affiliated to the Capital Institute of Pediatrics were selected by objective sampling for semi-structured interviews. QSR Nvivo 12 software and subject analysis method were used to analyze the data.Results:A total of 4 themes and 13 sub-themes were extracted, including the content on family management of asthma children (inducement prevention, drug management, disease monitoring), the family management style of asthma children (disease management concept, asthma management expectation, disease management life routine, disease essence understanding, disease management difficulty), and the family factors affecting the transition of family management of asthma children to self-management (promoting transition factors, obstructing transition factors), psychosocial state (numbness, optimism and stigma) .Conclusions:The family management of asthma children needs the intervention and support of professional nursing staff to improve the family management and the health outcomes of asthma children.

Objective:To investigate the current status of primiparas′ postpartum fatigue and paternal involvement, and to explore the relationship between primiparas′ postpartum fatigue and paternal involvement, and to provide reference basis for developing targeted intervention measures to alleviate postpartum fatigue of primiparas.Methods:A cross-sectional survey was conducted on 347 primiparas from Affiliated Hospital of Yangzhou University, Yangzhou Maternal and Child Health Care Hospital from September to December 2020 by convenience sampling. The survey instruments included the general information questionnaire, the Parenting Alliance Inventory (PAI), and the Postpartum Fatigue Scale (PFS).Results:The total score of PAI was (86.51 ± 12.07) points, and the level of paternal involvement was high. The total score of PFS was (16.68 ± 4.12) points. 95.97% (333/347) of primiparas had varying degrees of postpartum fatigue. There was a significant negative correlation between paternal involvement and primiparas′ postpartum fatigue ( r=-0.327, P<0.01). The results of multiple stratified regression analysis showed that paternal involvement was included in the influencing factor model of primiparas′ postpartum fatigue, which could independently explain 9.7% variation of primiparas′ postpartum fatigue. Conclusions:The higher level of paternal involvement could predict the lower level of primiparas′ postpartum fatigue. Medical staff should pay attention to the participation level of the spouses of primiparas in childcare, and improve the participation level of the spouses of primiparas in scientific ways to alleviate the postpartum fatigue of primiparas.

Objective:To investigate the safety and consistency of domestic inhaled allergen extracts in the diagnosis of allergic diseases in children.Methods:Nine thousand five hundred and sixty-three children diagnosed with allergic diseases from September 2018 to June 2020 in Children′s Hospital Affiliated to Capital Institute of Pedia-trics were selected in this study, and all of them were subjected to skin prick test(SPT), and 415 of them were subjected to serum specific IgE (sIgE) test at the same time.The adverse events during SPT were recorded and the consistency of the results between SPT and sIgE test was analyzed.Results:There were 14 cases with adverse events in 9 563 patients, and the overall incidence was 0.15%.The incidence of adverse events was 0.07% (2/2 581 cases) in the 1-5 years old group, 0.19% (12/6 197 cases) in the 6-11 years old and 0 in the 12-17 years old group.The severity of all these events was grade Ⅰ.Out of the 14 cases with adverse events, only 1 case was considered to be related to allergen preparations, with the incidence being 0.01% (1/9 563 cases). The Kappa index showed that the results of dermatophagoides pteronyssinus, dermatophagoides farinae, alternaria and artemisia measured by SPT and sIgE were almost the same.There was high consistency between tree pollens and ragweed ( P<0.01), and moderate consistency between aspergillus fumigatus ( P<0.01). When the results of sIgE were used as the diagnostic criteria, the Youden index for the results of SPT ranged from 0.76 to 0.89, with aspergillus fumigatus (0.76) and tree pollens mixture (0.79) as the lowest.The positive likelihood ratio for most of the inhaled allergens was more than 10 except for tree pollens mixture (7.12) and dermatophagoides farinae (9.10). The negative likelihood ratio for most of the inhaled allergens was less than or equal to 0.1 except for aspergillus fumigatus (0.19). Conclusions:The domestic inhaled allergen extracts had high safety in the clinical application of SPT, and their results of SPT had good consistency with those of serum sIgE, which was conducive to the diagnosis and evaluation of allergic diseases in children.

Antibodies, Neutralizing/immunology* ; Antibodies, Viral/immunology* ; COVID-19/virology* ; COVID-19 Vaccines/immunology* ; Humans ; SARS-CoV-2/pathogenicity* ; Spike Glycoprotein, Coronavirus/immunology* ; Vaccines, Inactivated/immunology*

Objective:Intensive physicians have relatively insufficient knowledge and experience in treating patients with decompensated schistosomiasis cirrhosis (DSC) admitted in intensive care unit (ICU), but are relatively familiar with patients with decompensated alcoholic cirrhosis (DAC). For this purpose, the clinical characteristics and prognosis of these patients were compared and analyzed.Methods:A retrospective analysis was performed from January 2013 to May 2019 in our hospital and Quzhou People’s hospital. The demographic data, laboratory examination, liver function, Child-Pugh classification, complications of cirrhosis, ultrasonic imaging gastroscopy manifestations were recorded and analyzed. In addition, the treatments and prognosis were also compared.Results:A total of 30 patients (12 males and 18 females) with DSC (aged 57-88) and 31 patients with DAC (aged 41-75) were collected. Compared with patients with DAC, DSC patients were more likely to have coronary heart disease, lower proportion of hyponatremia and lower need of ventilator support. Although the incidences of jaundice and hepatic encephalopathy were significantly reduced ( P<0.05), but parameters of liver function and coagulation were no significant differences in both groups ( P>0.05). B-mode ultrasound of liver in patients with DSC displayed more proportion of patchy and diffuse echo changes and liver volume reduction ( P<0.05), whereas the manifestations of gastroscope in both groups were similar. No significant difference in main treatment measures like uses of somatostatin and three-chamber and two-capsule tube was observed. After treatment, the stop time of gastrointestinal bleeding was similar between groups of DAC and DSC [1.25 (0.5-4.125) days vs. 1.75 (1-2.375) days] ( P>0.05). In addition, the length of ICU stay in DAC group was similar to DSC group [(4.96±3.58) days vs. (3.82±1.99) days], so did the 28-day mortality [14.29% (2/14) vs. 18.18% (2/11)] (both P>0.05). Conclusions:In genenal, patients with decompensated schistosomiasis cirrhosis have the similar clinical characteristics, major biochemical indicators and accessory examination results like ultrasound and gastroscopic examinations to patients with decompensated alcoholic cirrhosis. After timely treatments, both of these patients could achieve a good prognosis.

Purpose: This study aimed to utilize concept analysis to obtain a better understanding of the concept of “continuity of care” in chronic diseases. Methods: The concept of continuity of care was analyzed using the Walker and Avant method. Covering literature in English from 1930 to 2018, the data sources included CINAHL Complete, Academic Search Complete, MEDLINE, PsyARTICLES, Health Source: Nursing/ Academic Edition, Google Scholar, Science Direct, and the Cochrane Library. Results: A comprehensive definition of concept of continuity of care was developed based on a systematic search and synthesis. The key defining attributes were identified as (a) care over time, (b) the relationship between an individual patient and a care team, (c) information transfer, (d) coordination, and (e) meeting changing needs.The antecedents of continuity of care were having a chronic disease, inexperienced with disease management, a poorly coordinated healthcare system, and medical care limitations. The consequences of continuity of care were decreasing hospital admissions, reducing costs, reducing emergency room visits, improving the quality of life, improving patient satisfaction, and delivering good healthcare. Conclusion The thorough concept analysis provides insight into the nature of “continuity of care” in chronic diseases and also helps ground the concept in healthcare.

Objective This study aimed to evaluate the impact of Intensive Care Unit (ICU)admission on patients with malignant liver tumors after elective major hepatectomy,and to analyze the relevant factors relating to ICU admission.Method 1 044 liver cancer patients who underwent elective hepatectomy were included into this study.Using the length of extubation time (＞ 5 h) and/or treatment time (＞ 24 h) in ICU,the patients were divided into the ICU group and the general group.The age,gender,underlying disease and operative time,intraoperative blood loss,blood transfusion,as well as postoperative complications,mortality,hospital stay and hospitalization costs were compared between the two groups.The relative factors of the ICU group were evaluated using univariate and multivariate analysis.Results Compared to the general group,the mean age (57.4 ± 3.7 vs.53.2 ± 3.2),and the proportions of patients with associated lung diseases (33.7％ vs.10.0％),chronic kidney diseases (9.6％ vs 2.0％),anemia (50.6％ vs.5.3％),as well as the amounts of intraoperative blood loss (816 ml vs.635 ml) and blood transfusion (4.3 U vs.1.4 U) in the ICU group were significantly higher.The differences were significant (P ＜0.05).Furthermore,the ICU group of patients had a significantly longer hospital stay (21.6 days vs.10.1 days,P ＜ 0.05) and more hospital costs (76 751 yuan vs.42 069 yuan,P ＜ 0.05).Multivariate analysis showed that age,blood loss and transfusion were associated with ICU admission.Conclusions It is not necessary to admit every patient with malignant liver tumors to ICU after elective major hepatectomy.ICU admission resulted in prolonged hospital stay and elevated hospital costs.Age (OR =1.077,95％ CI:1.030 ～ 1.127),amount of blood loss (OR =3.211,95％ CI:1.038 ～ 9.929) and blood transfusion (OR =1.330,95％ CI:1.113 ～ 1.589) were associated with ICU admission.There are still many potentially influencing factors which need further studies to determine.

Objective To investigate six yearsˊ outcome of children with asthma. Methods Children with asthma diagnosed in the epidemiological survey of childhood asthma in urban area of Beijing in 2010 were selected in this study. The field follow-up was conducted in 2016(6 years later)to obtain information about asthma attack,di-sease control,medication usage,and comorbidities of allergic diseases. The skin prick test,lung function and exhaled ni-tric oxide were performed during field follow - up stage. Results Sixty - four children,aged 7 - 19 years old [(13. 59 ± 3. 48)years old],completed the field follow-up survey. Among 35. 9%(23/64 cases)children,the asth-ma symptoms still persisted within 2 years(without remission),while 64. 1%(41/64 cases)children had no symp-toms within 2 years and above(remission). The course of children without remission(9. 0 years)was significantly lon-ger than that of children with remission(5. 5 years),and there was statistical significance(z＝ -3. 775,P<0. 001). Among the children without remission,the number of uncontrolled children in the last month accounted for 13. 0%(3/23 cases),partially controlled for 17. 4%(4/23 cases),and under controlled for 69. 6%(16/23 cases). The majority of unrelieved children were treated with intermittent control drug[43. 5%(10/23 cases)υs. 12. 2%(5/41 cases), χ2 ＝8. 036,P<0. 01]. A total of 47. 8%(11/23 cases)of children without remission were completely unaffected by physical activity,while 92. 7%(38/41 cases)of children with clinical remission were completely unaffected by physi-cal activity(χ2 ＝14. 117,P<0. 001). The proportion of children without remission with eczema and atopic dermatitis lasting longer than 6 years old was 56. 5%(13/23 cases),which was significantly higher than that of children with re-mission[29. 3%(12/41 cases),χ2 ＝4. 598,P<0. 05]. In 2010 and 2016,there were 46 children with allergen re-sults. Compared with 2010,the proportion of animal fur and pollen allergy increased in 2016[19. 6%(9/46 cases)υs. 52. 2%(24/46 cases),36. 9%(17/46 cases)υs. 67. 4%(31/46 cases)],and there were statistical significances (χ2 ＝10. 632,8. 538,all P<0. 01). In 2016,the number and degree of total allergens in the clinical unrelieved chil-dren were higher than that in the relieved children. Further analysis showed that the unrelieved children had higher cigarette allergy positivity(21. 7% υs. 2. 5%,χ2 ＝4. 239,P<0. 05). There was no significant difference in lung func-tion and exhaling nitric oxide between the clinical unrelieved children and the relieved children. Conclusions Six years later,the proportion of animal fur and pollen allergy increased in children with asthma. Compared with children with remission,the children without remission had more treatment with intermittent control drug,with higher proportion of eczema and atopic dermatitis over six years old,and higher percentage of cigarette allergy positivity.

BACKGROUND: Recent studies have shown that induced pluripotent stem cells (iPSCs) could be differentiated into mesenchymal stem cells (MSCs) with notable advantages over iPSCs per se. In order to promote the application of iPSC-MSCs for osteoregenerative medicine, the present study aimed to assess the ability of murine iPSC-MSCs to differentiate into osteoblast phenotype. METHODS: Osteogenic differentiation medium, blending mouse osteoblast-conditioned medium (CM) with basic medium (BM) at ratio 3:7, 5:5 and 7:3, were administered to iPSC-MSCs, respectively. After 14 days, differentiation was evaluated by lineage-specific morphology, histological stain, quantitative reverse transcription-polymerase chain reaction and immunostaining. RESULTS: The osteogenesis-related genes, alp, runx2, col1 and ocn expressions suggest that culture medium consisting of CM:BM at the ratio of 3:7 enhanced the osteogenic differentiation more than other concentrations that were tested. In addition, the alkaline phosphatase activity and osteogenic marker Runx2 expression demonstrate that the combination of CM and BM significantly enhanced the osteogenic differentiation of iPSC-MSCs. CONCLUSION: In summary, this study has shown that osteoblast-derived CM can dramatically enhance osteogenic differentiation of iPSC-MSCs toward osteoblasts. Results from this work will contribute to optimize the osteogenic induction conditions of iPSC-MSCs and will assist in the potential application of iPSC-MSCs for bone tissue engineering.
Alkaline Phosphatase ; Animals ; Bone and Bones ; Culture Media, Conditioned ; Induced Pluripotent Stem Cells ; Mesenchymal Stromal Cells ; Mice ; Osteoblasts ; Phenotype