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Objective To investigate the current status and existing problems in the implementation of stroke care continuity in China, and to collect relevant suggestions for solving these problems. Methods Focus group interviews were used, to survey thirty-six nursing managers and senior nurses in neurology departments or rehabilitation programs in 24 cities of 13 provinces. The interview team members presided over the meetings, with full-time staff taking notes and recordings, and the results of the interviews were summarized and organized in a timely manner after the interview. Results At present, most of the general hospitals surveyed are doing their best to continue supporting nursing care for patients discharged from hospitals in different forms following their rescue of the acute phase. However, they are faced with such challenges as insufficient nursing manpower, and discontinuity between different medical institutions, which result in oversimplified nursing care and fragmented care. Conclusions Stroke nursing practitioners are working on continuous nursing care, with quite some challenges as well. Nursing care continuity is an important step towards establishing and improving a scientific and rational grading nursing care system.
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We hereby reported the prenatal diagnosis of a case of fetal Emanuel syndrome. At 12+3 gestational weeks, ultrasound examination suggested that the fetal nuchal translucency thickness was 3.3 mm. At 24+2gestational weeks, the fetus was found with growth restriction, lateral ventriculomegaly (14 mm), broadened posterior cranial fossa (13 mm), right multicystic dysplastic kidney and doubled left renal pelvis by ultrasound. Karyotyping of both the fetus and the parents was performed using G banding, and showed that the fetus was 47, XX, +mar, the father was normal, while the mother was 46, XX, t(11;22)(q23;q11.2). Single-nucleotide polymorphism-array of the fetal cells in amniotic fluid suggested that the fetus had a partial duplication of chromosomes 22 and 11 at 22q11.1-q11.21 and 11q23.3-q25 and carried a marker chromosome +der(22)t(11;22) (q23.3;q11.21), based on which the fetus was eventually diagnosed as Emanuel syndrome. The pregnancy was terminated after genetic consultation.
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<p><b>OBJECTIVE</b>To assess the value of combined chromosomal karyotyping and BACs-on-Beads(BoBs) assay for the prenatal diagnosis of high risk gravida from Ningbo.</p><p><b>METHODS</b>For 2779 women, results of conventional karyotyping analysis and BoBs assay were compared.</p><p><b>RESULTS</b>For common aneuploidies involving chromosomes 13, 18, 21, X and Y, the two methods have yielded a concordance rate of 98.78%. Eight cases detected with microduplication by BoBs were missed by karyotyping analysis. On the other hand, 17 structural chromosomal abnormalities, 10 chimeras and 1 triploidy detected by karyotyping analysis were missed by BoBs.</p><p><b>CONCLUSION</b>The BoBs technology has featured high throughput and rapidity, and can detect 9 microdeletion syndromes, which can improve the quality of prenatal diagnosis and provide an ideal complementary for conventional chromosomal karyotyping.</p>
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Adult , Female , Humans , Pregnancy , Chromosome Aberrations , Chromosome Deletion , Chromosomes, Artificial, Bacterial , Genetics , Karyotyping , Methods , Prenatal Diagnosis , MethodsABSTRACT
Objective To explore the effect of extracurricular activities based on specialist nursing clinic. Methods Thirty-four undergraduate nursing students of grade 2013 in the Capital Medical University were enrolled in the study. After learning of nursing theories for senile dementia, the extracurricular activities based onspecialist nursing clinicwere carried out. Before and after the second class activities, the caring ability inventory scale and self scale-rating for self-directed learning (SRSSDL) were used to assess 34 students. Result After the activities, students' caring ability and self-directed learning ability were statistically significantly improved (P<0.01). Conclusion The extracurricular activities based onspecialist nursing cliniccan stimulate the learning interest of nursing students and improve their self-directed learning ability and humanistic care ability.
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Objective To investigate the effects of growth-discordant twin pregnancies on neonatal thyroid stimulating hormone (TSH) level and congenital hypothyroidism (CH).Methods A total of 3 444 live-birth twin neonates born between January 1,2012 and December 30,2014 in Ningbo City were enrolled.Blood samples via heel puncture were collected and tested.Incidence of CH in singleton and twin neonates was compared.Deviation of birth weight larger than 25％ in twin neonates was set as the criteria for discordant growth.TSH and 17 α-hydroxylase levels in CH twins and normal twins,with or without discordant growth,were compared.Chi-square and non-parametric statistics were performed for data analysis.Results The incidence of CH in twin neonates was 0.56％ (19/3 444),higher than that in singleton neonates [0.09％ (203/225 712),x2=76.225,P＜0.01].Among nineteen CH twins,CH occurred in both twins in eight cases (four twins) and in one of the twins in eleven cases.The gestational age at birth in the eight CH twins were less than 37 weeks,with four males and four females;five were low birth weight infants;one twin were dichorionic,and three twins were monochorionic.In the eleven cases of CH occurring in one of the twins,the gestational age was less than 37 weeks in nine cases,eight were low birth weight infants,six were male and five female;seven were monochorionic and four were dichoronic twins.Five cases of temporary hypothyroidism were all low birth weight infants among the growth-discordant twins.CH cases in growth-discordant group had lower birth weight than their normal twins [M(P25-P75),2 100 (1 800-2 600) vs 2 770 (2 530-2 960) g,Z=4.369],and a higher TSH level [15.4 (11.8-18.5) vs 6.4 (4.8-7.9) mU/L,Z=6.339] (both P＜0.05).In normal twins with or without discordant growth,the neonates with a lower birth weight had a higher TSH level [3.6(2.5-4.7) vs 2.4(1.8-2.9) mU/L,Z=0.962] in weight consistent group,compared with 6.0(4.4-7.8) vs 3.4(1.9-4.1) mU/L in weight inconsistent group (Z=4.369),both P＜0.05.Conclusions In the growth-discordant twins,neonates with a lower birth weight have a higher TSH level and a higher risk of temporary hypothyroidism.
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Objective To evaluate the possibility of elevating the age line for pregnant women with advanced age to conducted amniocentesis .Methods A retrospective cohort study was performed .The information of 5 176 advanced age pregnant women in July 2003 to August 2015 from Ningbo Women and Children Hospital were collected and analyzed .Grouped the patients by age , using chi-square analysis , comparing the difference of abnormal rate of target chromosomes (13, 18, 21) and sex chromosomes (X and Y) between the adjacent two age groups .Results Total of 15 408 cases were screened.Among these, 262 cases were diagnosed with abnormal chromosome .The positive rate was 1.70%.Total of 5 176 advanced age pregnant women were included , 82 women were found with abnormal target chromosomes (13, 18, 21) and sex chromosome.The positive rate was 1.58%(82/5 176).For age groups, the positive rates were 0.95%(11/1 156), 0.94%(9/954), 0.87%(10/1 144), 2.16%(14/648), 2.16%(10/464), 2.51%(10/399) and 4.38%(18/411) respectively.Chi-square analysis results showed that the positive rate between group of 37 and 38 was significant difference (chi-square value of 5.181,P value of 0.023).There were no significant differences among all remained groups ( chi-square value: <0.001, 0.028, <0.001, 0.117, 2.129 respectively, P value: 0.985, 0.868, 0.995, 0.733, 0.145 respectively ) .Conclusion It is worthwhile to elevate the age of pregnant women up to 38 years old as the age line for the indications of amniotic fluid chromosome analysis .