Low protein diet combined with α-keto acid improves calcium and phosphorus metabolic disorders and nutritional status in hemodialysis patients: a meta-analysis / 中华临床营养杂志

Objective:To systematically evaluate the effects of low protein diet combined with α-keto acid on calcium and phosphorus metabolism and nutritional status in patients undergoing hemodialysis.Method:Randomized controlled Trials were searched in Cochrane Library, Web of Science, PubMed, Embase, CBM, CNKI, Wanfang and VIP databases from the establishment of respective database until July 2021, and meta-analysis is conducted using RevMan 5.4.Results:A total of 8 studies including 556 patients were selected. Meta-analysis showed that after receiving low protein diet combined with α-keto acid, patients demonstrated significantly reduced blood phosphorus [MD = -0.17, 95% CI (-0.25, -0.7), P < 0.01], calcium- phosphorus product [MD = -6.17, 95% CI (-6.67, -5.58), P < 0.01] and parathyroid hormone levels [MD = -35.36, 95% CI (-40.89, -29.83), P < 0.01]. There was no significant difference in serum calcium [MD = 0.03, 95% CI (-0.00, 0.07), P = 0.08] and serum albumin [MD = 0.41, 95% CI (-0.12, 0.95), P = 0.13]. Conclusion:Low protein diet combined with α-keto acid can reduce the levels of serum phosphorus, calcium-phosphorus product and parathyroid hormone in hemodialysis patients while the effects on serum calcium and serum albumin are undetermined and need further verification.

Correlation between perfusion index and the severity of disease in early neonates / 中国小儿急救医学

Objective:To analyze the role of perfusion index(PI)in assessing the severity of neonatal illnesses.Methods:A total of 502 newborns admitted to the Department of Neonatology within 24 hours of birth at Xinxiang Central Hospital from October 2018 to July 2019 were recruited.Neonatal critical illness score(NCIS)was graded within 24 hours of admission, and newborns were categorized into non-critical(NCIS>90 scores), critical(NCIS 70-90 scores)and extremely critical(NCIS<70 scores). PI was monitored in all newborns within 24 hours of birth in a resting state.A total of 502 PIs were recorded, including 341 cases of non-critical, 110 cases of critical and 51 cases of extremely critical.Results:The medium PI [ M( P25, P75)] of newborns in non-critical, critical and extremely critical groups were 1.80(1.40, 2.60), 0.96(0.74, 1.43)and 0.65(0.41, 1.10), respectively.PI values in extremely critical group was significantly lower than those in critical group and non-critical group( P<0.05). The medium PI [ M( P25, P75)] of full-term newborns, moderate/late preterm newborns and extremely/very preterm newborns were 1.70(1.20, 2.70), 1.60(1.10, 2.30) and 1.35(0.80, 2.30), respectively.PI in full-term newborns was significantly higher than those in moderate/late preterm newborns and extremely/very preterm newborns( P<0.05). PI was moderately positively correlated with NCIS in newborns( r=0.791, P<0.01). The area under the receiver operating characteristic curve of NCIS predicted by PI value was 0.846, and the prediction sensitivity and specificity were 85.0% and 70.8% when PI was 0.56. Conclusion:PI is correlated with NCIS in newborns, which is able to reflect the severity of neonatal illnesses.A low PI indicates severe conditions of neonatal illnesses.

Mechanism of CD226-dependant NK cell regulation in mouse obesity / 中华微生物学和免疫学杂志

Objective To investigate the effects of CD226 knockout ( KO) on obese mice fed with high fat diet and to analyze the composition of immune cells in CD226KO obese mice for further elucidating the immunological mechanism of CD226 involved in high fat diet-induced obesity. Methods Both wild-type ( WT) and CD226KO mice were randomly divided into two groups, high-fat and normal diet groups, and fed for 14 weeks to establish the type 2 diabetes model. Immune cells in mouse spleen and peripheral blood were analyzed by flow cytometry. In in vitro experiments, NK92-MI cells were infected with pshRNA-CD226 lenti-virus to silence CD226 expression, and then qPCR was performed to detect the expression of Foxp3, TNF-αand IFN-γ at mRNA level. Results In the high-fat diet groups, CD226KO mice had lower blood glucose, serum insulin and HOMA-IR than WT mice, but higher HOMA-IS and HOMA-β. CD226KO could reduce compensatory hyperplasia of islet tissue, and significantly down-regulate the proportion of spleen NK cells in mice. The proportion of CD3-CD49b+CD25+Foxp3+regulatory NK cells (NKreg) increased significantly in CD226KO mice. CD226KO could significantly increase Foxp3 expression in NK92-MI cells and decrease the expression of TNF-α and IFN-γ. Conclusions CD226KO can alleviate insulin resistance, increase the number of islet β-cell and improve islet β-cell function in obese mice. The mechanism might be related to the up-regulation of Foxp3+ NKreg ratio.

An analysis of clinical characteristics and acute treatment of supraventricular tachycardia in children from a multicenter study / 中华儿科杂志

Objective@#The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children.@*Methods@#This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017. The clinical and tachycardia features, response to intravenous antiarrhythmic drug therapy of these children were characterized. Statistical analyses were performed using t test, Mann-Whitney U test, χ2 test and H test.@*Results@#The onset of SVT occurred at any age with a distribution with positive skewness, 57.6% (n=148) children<1 year, 17.5% (n=45) children1~<3 years, 10.5% (n=27) children 3~<6 years and 14.4% (n=37) children ≥ 6 years of age. The percentages of SVT types were 49.4% (n=127) for atrioventricular reentry tachycardia (AVRT), 4.3% (n=11) for atrioventricular nodal reentry tachycardia (AVNRT), 26.8% (n=69) for unclassified paroxysmal SVT and 19.5% (n=50) for atrial tachycardia (AT), respectively. Tachycardia-induced cardionyopathy (TIC) secondary to SVT developed in 30 of 225 (13.3%). Left ventricular ejection fraction (LVEF) of the 27 children attacked by TIC returned to normal after successful control of SVT (41.1%±6.3% vs. 60.3%±9.2%, t=-10.397, P=0.000). Complete termination of SVT by antiarrhythmic drugs was achieved in 164 of 257 (63.8%), partial termination rate was 18.7% (48 of 257) and failure to terminate rate was 17.5% (45 of 257). Propafenone (complete cardioversion in 98 (73.1%) of 134) and amiodarone (complete cardioversion in 23 (76.7%) of 30) showed better efficacy for SVT termination than adenosine (complete cardioversion in 26 (44.1%) 59) (χ2=20.524, P=0.000). Paroxysmal SVT had a higher termination rate on pharmacological therapy than AT (67.1% vs. 50.0%, χ2=6.337, P=0.042). Patients of different age groups had significantly different response to antiarrhythmic therapy (χ2=13.904, P=0.031). Children<1 year of age showed the least response to antiarrhythmic drug therapy with complete termination in 51 (55.4%) of 92. Adverse effects occurred in 9 patients (3.5%): Four patients had severe hypotensive shock using propafenone (n=3) and adenosine (n=1), and 3 patients had sinus arrest using adenosine.@*Conclusion@#Most (57.6%) children with SVT have their first clinical episode within 1 year of age, and AVRT is the most common type. TIC occurs in 13.3% of children with SVT. Intravenous antiarrhythmic drug therapy has a 63.8% complete termination rate for children with SVT and incidence of adverse effects is 3.5%. Propafenone and amiodarone are more effective for SVT termination in children than adenosine. Serious adverse effects may occur when using propafenone.

Multicenter investigation of the correlation between supraventricular tachycardia and tachycardia-induced cardiomyopathy in children / 中华儿科杂志

Objective@#This study aimed to investigate the correlation between supraventricular tachycardia (SVT) and tachycardia-induced cardiomyopathy(TIC) in children and assess the risk factors for the development of TIC.@*Method@#One hundred and eighty-three patients were recruited in four hospitals of Beijing diagnosed as SVT were divided into two groups depending on whether or not complicated with TIC. The age, gender, tachycardia type, ventricular rate during tachycardia, frequency of tachycardia episodes and duration of tachycardia were compared between the two groups and risk factors associated with TIC were analyzed. Statistical analyses were performed using t test, Mann-Whitney U and χ2 test.@*Result@#Totally 183 patients were included in this study (paroxysmal supraventricular tachycardia, PSVT, n=149; atrial tachycardia, AT, n=34). The incidence of TIC was 13.1%. There was significant difference regarding the incidence of TIC between children with AT and children with PSVT (26.5% vs. 10.1%, χ2=6.537, P=0.011). The percentage of AT in patients with TIC was significantly higher than patients without TIC (37.5% vs. 15.7%, χ2=6.537, P=0.011). Patients with TIC had a higher frequency of tachycardia episodes(2.5(1.0-4.8) beats/year vs 4.0(1.0-10.0) beats/year, Z=-2.223, P=0.026)and longer duration of tachycardia(11.0(1.1-36.0) h vs 2.5(1.0-12.0) h, Z=-2.154, P=0.031)compared with patients without TIC. Multivariate predictors of TIC was longer duration of tachycardia (OR=2.041, P=0.028).@*Conclusion@#TIC occurs in 13.1% of children with SVT. The incidence of TIC in children with AT is higher than in children with PSVT. Risk factor for the development of TIC is longer duration of tachycardia.

Clinical analysis of three cases with infant botulism and review of literature / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics and diagnosis of three cases with infant botulism.</p><p><b>METHOD</b>Clinical data of three clinically diagnosed cases with infant botulism in May 2015 in Peking University First Hospital were retrospectively analyzed. Literature search at databases of PubMed, Wanfang, China National Knowledge Infrastructure and VIP with the key words"infant AND botulism". The date of literature retrieval was from the database founding to November 2015. The characteristics of infant botulism were summarized through review of literature.</p><p><b>RESULT</b>Three patients were infants of 4-8 months of age, and all had acute onsets of anorexia and poor response. All of them had normal psychomotor development previously, and without clear history of exposure to poisons. The main findings on physical examination were reduced muscle strength and hypotonia, dullness or disappeared pupillary light reflex, reduced facial expression, weak crying and dysphagia. Unexpectedly their states of consciousness were relatively normal. Finally, through identification and PCR genotyping of bacteria in stool, 2 cases were confirmed as Clostridium (C.) botulinum type B infection. Totally 446 reports were retrieved from foreign language literature and 52 reports from Chinese literature. More than 3,000 cases of infant botulism cases were reported in the world. Rare cases were reported in China and only 1 case was reported in 2000.</p><p><b>CONCLUSION</b>Most cases of infant botulism had no clear exposure history. The main clinical manifestations are hypotonia, cranial nerve paralysis, flaccid paralysis, but different patients may have different presentations. Detection of C. Botulinum and its toxin in stool can help to confirm the diagnosis. Infant botulism is relatively rare in China, which may be related to the insufficient understanding and inspection level of the disease. It might be underestimated in China.</p>

Non-invasive cardiac output measurement in children using bioreactance:a comparison with echocar-diography / 中国小儿急救医学

Objective To investigate the value of measurement of cardiac output in children by bio-reactance versus echocardiography.Methods Pediatric patients admitted in pediatric department of Peking University First Hospital from September to December 2012 who needed hemodynamic monitoring were enrolled prospectively.Cardiac index(CI)and stroke volume(SV)were measured by echocardiography and non-invasive cardiac output measurement(NICOM)and compared by Spearman correlation and Bland-Alt-man analysis.Results Thirty patients were included.The median age was 7.25 years.CI[M(P5 ,P95 )] measured by NICOM and echocardiography were correlated significantly[3.42(2.28,4.92)L /(min?m2 ) vs.3.51 (2.94,4.85 )L/(min?m2 ),R =0.385,P =0.035 ].Bland-Altman analysis revealed a bias of-0.22 L/(min?m2 )(P =0.051 ),limits of agreement of -1.40 to 0.95 L/(min?m2 ).SV[M(P5 ,P95 )] measured by NICOM and echocardiography were correlated more significantly [36.3 (12.6,87.8 )ml vs.39.4(14.7,86.9)ml,R =0.768,P ﹤0.001 ].Bland-Altman analysis revealed a bias of -3.1 ml(P =0.176),limits of agreement of -27.4 to 21.2 ml.Conclusion There is no significant difference between NICOM and echocardiography for the measurement of CI and SV in pediatric patients.Further validation studies need to be conducted before routine clinical use.

Learning and memory abilities between BALB/c and C57BL/6 mice after voluntary movement / 中国组织工程研究

BACKGROUND: BALB/c and C57BL/6 mice are two inbred strains, but after voluntary movement, there is no report on how to scientifical y reasonably select behavioral experiment methods and indicators and to evaluate the learning and memory abilities of mice. OBJECTIVE: To analyze and compare the behavioral indicators between BALB/c and C57BL/6 mice fol owing voluntary wheel running, to explore the effect of exercise on learning and memory, and to provide a reference for selecting reasonable behavioral indicators. METHODS: 2.5-month-old BALB/c and C57BL/6 mice were randomly divided into control and voluntary wheel running groups. Independent running wheel movement of mice was recorded with VitalView system. 4 weeks later, newborn neurons were labeled via DCX immunofluorescence. Spatial learning, memory and exploration abilities were compared through new arm test, new object recognition test and Morris water maze test. RESULTS AND CONCLUSION: (1) The mean spontaneous activity of BALB/c mice daily was 2.56 fold of that of C57BL/6 mice during wheel running (P < 0.001). (2) Hippocampal DCX-positive cel s in exercised BALB/c and C57BL/6 mice were more than those in control group. (3) Meantime, exhibited by higher frequencies to explore new arm or object, and longer time and distance of moving around them, the learning and exploring capability was improved after exercising (P < 0.001), especial y in BALB/c mice. (4) Wheel running C57BL/6 mice exhibited progressed spatial learning and memory abilities compared with control mice in Morris water maze test, characterized by decreased latency to target, elevated target crossings and longer time or distance in quadrant zone (P < 0.05). However, there was no significant difference between wheel running and control BALB/c mice. Taken these data together, voluntary wheel running contributed to hippocampal neurogenesis of BALB/c and C57BL/6 mice, accompanied by the change of learning and memory capability, which could be detected properly via both new arm test and new object recognition test, but for Morris water maze test, C57BL/6 mice might be superior to BALB/c mice.

Analysis of clinical features of 6 patients with infantile type glycogen storage disease type II / 中华儿科杂志

<p><b>OBJECTIVE</b>To summarize clinical features and diagnosis of Chinese infantile patients with glycogen storage disease type II (GSD II).</p><p><b>METHOD</b>Six infant patients with GSD II diagnosed from January 2012 to June 2014 in the Department of Pediatrics, Peking University First Hospital were enrolled into this study. Clinical information of the 6 patients, including clinical manifestation, blood biochemistry, chest X-ray, echocardiogram, electrocardiogram, acid alpha-glucosidase (GAA) activity and GAA gene mutation analysis by direct sequencing of polymerase chain reaction (PCR) product were reviewed.</p><p><b>RESULT</b>Of the 6 patients, five were female and one was male, five of whom were classic infantile type while the other one was atypical. The age of onset ranged from birth to 3-month-old. All patients had varying degrees of generalized muscle weakness, hypotonia and development retardation or retrogression. Other common findings were feeding difficulties in two patients, tongue weakness in two patients, respiratory distress in four patients, macroglossia in one patient, and hepatomegaly in two patients. Left ventricular hypertrophy and cardiomegaly were obvious in all the six patients. All six patients were found to have a enlarged heart in physical examination, and three patients who underwent a chest X-ray examination had an enlarged heart shadow. Four patients who had an echocardiography were found to have myocardial hypertrophy. The electrocardiogram in three patients showed short PR intervals and high voltage. The creatine kinase (CK) levels were three to seven times elevated. The mildest elevated CK was 441 IU/L, and the highest CK level was 1 238 U/L. Assay of GAA enzyme activity in whole blood showed significantly reduced activity (1.3 nmol/ (spot·d) to 2 nmol/(spot·d)) in the patients tested. Gene sequencing in 4 patients showed 8 pathogenic mutations, including 6 missense mutations, one nonsense mutation and one frameshift mutation. The missense mutations were c.998C > A (p.Thr333Lys), c.1280T > C (p.Met427Thr), c.1760T > C (p.Leu587Pro), c.1924G > T (p.Val642Phe), c.2012T > A (p.Met671Lys) and c.2105G > A (p.Arg702His). The nonsense mutation was c2662G > T (p.Glu888X), and the frameshift mutation was c2812_2813delTG (p.Cys938fs). The 5 classic infantile patients died at the age of 7 to 22 months. The atypical infantile patient was 2 years and five months old according to our latest follow up.</p><p><b>CONCLUSION</b>Infantile GSD II had similar motor manifestations and cardiac involvements, blood biochemical test, imaging findings, enzyme assays, though there were slight differences. The probability of GSD II should be taken into consideration if an infant has both muscular disease and cardiac involvement.</p>

A signal center follow-up study on the treatment of postural tachycardia syndrome in children / 中华实用儿科临床杂志

Objective To compare the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts,Metoprolol plus oral rehydration salts and simple oral rehydration salts on children with postural tachycardia syn-drome(POTS). Methods One hundred and ninety - two children with POTS were divided into Midodrine hydrochlo-ride plus oral rehydration salts group(84 cases),Metoprolol plus oral rehydration salts group(54 cases)and oral rehy-dration salts group(54 cases). The patients were followed up at the outpatient department after 3 - months treatment. Short - term effect was analyzed by reevaluating the symptom scores,repeating upright test and studying the side effects of the drugs. All the children were followed - up by telephone,mainly investigating on the syndrome recurrence and symptom - free survival by Kaplan - Meier analysis. The follow - up time was 3 to 122(42. 7 ± 24. 3)months. Results Short - term effect showed that the symptom scores were decreased after treatment(t = 21. 536,P ﹤ 0. 001). Head -up test showed that delta heart rate was decreased. The effective rates in the Midodrine hydrochloride plus oral rehydra-tion salts group and the Metoprolol plus oral rehydration salts group were significantly higher than those of the simple oral rehydration salts group(χ2 = 10. 905,P = 0. 004). But no statistical difference was found between the Midodrine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group(χ2 = 0. 042,P =0. 837). Long - term effect by Kaplan - Meier curve showed that the therapeutic effect of Midodrine hydrochloride plus oral rehydration salts group was significantly higher than any of the other two groups(χ2 = 13. 299,P ﹤ 0. 01),but no statistical difference was found between the Metoprolol plus oral rehydration salts group and the simple oral rehydration salts group(χ2 = 0. 150,P = 0. 699). Conclusions In terms of the short - term result,the effective rates in the Mido-drine hydrochloride plus oral rehydration salts group and the Metoprolol plus oral rehydration salts group were signifi-cantly higher than those of the simple oral rehydration salts group. The therapeutic effect of the Midodrine hydrochloride plus oral rehydration salts was superior to that of the Metoprolol plus oral rehydration salts and the simple oral rehydra-tion salts for POTS children by the long - term follow - up study.

The application of laparoscopic resection of colorectal cancer in elderly patients / 中国基层医药

Objective To explore the application effect of laparoscopic resection of colorectal cancer in elderly patients.Methods 220 patients with colorectal cancer were selected and divided into the study group and the control group,ll0 cases in each group.The patients of the control group were treated with abdominal surgery.The patients of the study group were given laparoscopic surgery.The operative time,blood loss,anal exhaust time,postoperative hospital stay,and postoperative complications,pull tube time of the two groups were compared.Results The operative time of the study group was (245.4 ± 23.2) min,which was significantly longer than (214.8 ± 25.1) min of the control group(t =8.759,P =0.026) ; The blood loss,anal exhaust time,postoperative hospital stay,time to pull the tube of the study group were (175.3 ± 18.4)mL,(2.1 ±0.5)d,(13.2 ±0.1)d and (1.2 ±0.3) d,respectively,which were significantly better than those of the control group(t =9.041,9.757,8.969,8.704,P =0.025,0.023,0.027,0.028) ;The incidence rate of complication of the study group was 14.5％,which was significantly lower than 24.5％ of the control group(x2 =11.704,P =0.019).Conclusion Laparoscopic resection of colorectal cancer had better effect,and it can lower blood loss,shorter hospital stays,and has fewer complications.

ExPression of PeriPheral blood heat shock Protein-90 in Patients with hyPertensive disorders comPlicating Pregnancy / 中国综合临床

Objective ThrouGh the detection of heat shock protein 90(HSP90)Gene expression in the peripheral blood in in patients with hypertensive disorders complicatinG preGnancy( HDCP ),to understand its role in the pathophysioloGy of HDCP. Methods The expression of HSP90 was observed in Groups of normal preGnant women,Gestational hypertension patients,mild preeclampsia patients,severe preeclampsia patients by ELISA. Results The expression of HSP90 in peripheral blood of Gestational hypertension Group,mild preeclampsia Group,severe preeclampsia Group were siGnificantly hiGher than normal preGnant Group( P<0. 0l ) . Conclusion HSP90 may have close relationship with the onset and development of HDCP. It can predict HDCP by detectinG the level of HSP90 in peripheral blood.

Analysis of factors affecting the neonatal birth weight / 临床儿科杂志

Objectives To investigate factors affecting neonate birth weight. Methods Random cluster sampling method was adopted to investigate the physical development of 5539 single live newborns in Beijing, Harbin, Changsha, and Guang-zhou. Single factor analysis and logistic regression analysis were used to find the factors influencing neonate birth weight. Re-sults Single factor analysis showed that neonatal sex, gestational age, maternal age, maternal pre-pregnancy BMI, gestational weight gain, mother's education and occupation have effects on neonatal birth weight. Risk factors for macrosomia, including male fetus, maternal age≥25 years before pregnancy, maternal pre-pregnancy BMI≥24 kg/m2, gestational weight gain greater than 12.5 kg, and preterm delivery and maternal pre-pregnant BMI<18.5 kg/m2 are the risk factors of low birth weight. Conclu-sions Premature, excessive weight gain during pregnancy, high or low maternal pre-pregnancy BMI are main factors that caused abnormal body mass in neonates.

Expression of placenta heat shock protein-90 in patients with hypertensive disorders complicating pregnancy / 中国综合临床

Objective To detect heat shock protein 90 (HSP90) expression in the placenta in pregnancy induced hypertension in order to understand its role in the pathophysiology of hypertensive disorders comphcating pregnancy (HDCP).Methods The gene and protein expression of HSP90 in the placenta of normal pregnant women,gestational hypertension patients,mild preeclampsia patients,severe preeclampsia patients,by RT-PCR and Western blotting.Results The gene and protein expression of HSP90 in placenta of gestational hypertension group,mild preeclampsia group,severe preeclampsia group were significantly higher than that of normal pregnant group (P ＜ 0.01),and it showed the increased progressively with the increasing of disease stage.Conclusion HSP90 may be involved in the onset and development of HDCP.Monitoring HSP90 concentration in the placenta which is the initial theoretical basis for the target as HSP90 for the treatment of HDCP.

Study on the neonatal conditions in four cities of China in 2012 / 临床儿科杂志

Objective To understand the birth conditions of newborns in four cities of China and its trend. Methods The physical development data of single live newborns in 4 cities of Beijing, Harbin, Changsha and Guangzhou were investi-gated by random cluster sampling method, and was compared with the national neonatal growth standard developed from the investigation in 15 cities from 1986 to 1987. Results The study investigated a total of 5 539 newborns:1 412 in Beijing, 1 410 in Harbin, 1 274 in Changsha and 1 443 in Guangzhou. Except for the head circumference of male newborns, the weight, height and head circumference of full-term newborns in four cities in 2012 were all more than the national neonatal growth standard of 1986-1987 (P<0.05). Compared with the data obtained from 1986-1987, the sex ratio and the prevalence of macrosomia and premature were higher, but the rates of post-term delivery and low birth weight were lower (P<0.01). Conclusions The new-borns in four cities of China are in good condition during recent 25 years. More attention should be paid to improve the birth sex ratio and to decrease rates of macrosomia and premature.

'Four modernizations' teaching in physiology course for vocational nursing students / 中华医学教育探索杂志

To improve the vocational nursing students' interest in learning physiology,‘four modernizations' teaching method was preliminarily explored in physiology teaching practice.‘Four modernizations' referred to the teaching by using multimedia.Using this method,we can simplify complex issues,inspire students' curiosity and thirst for knowledge,combine with real life,make abstract problem specific,mobilize students' initiative,contact with clinical practice,visualize theoretical issues,strengthen the importance and understanding and make moderate expansion so that professional skills and practicality of nursing can be emphasized.

'Four modernizations' teaching in physiology course for vocational nursing students / 中华医学教育探索杂志

To improve the vocational nursing students' interest in learning physiology,‘four modernizations' teaching method was preliminarily explored in physiology teaching practice.‘Four modernizations' referred to the teaching by using multimedia.Using this method,we can simplify complex issues,inspire students' curiosity and thirst for knowledge,combine with real life,make abstract problem specific,mobilize students' initiative,contact with clinical practice,visualize theoretical issues,strengthen the importance and understanding and make moderate expansion so that professional skills and practicality of nursing can be emphasized.

Reliability and validity of the sleep apnea knowledge questionnaire / 中国实用护理杂志

Objective To study the reliability and validity of the Chinese version of AKT(the Apnea Knowledge Test).Methods The AKT was tested in a sample of 91 middle aged and elderly patients with obstructive sleep apnea and hypopnea syndrome and the AKT was retested in 30 of them after 1 month.Results Cronbach's alpha reliability coefficient was 0.76.Retest correlation coefficient was 0.96.There was significant difference between test and retest.Item analysis indicated that there was significant difference in most items between higher scores group and lower one except the fourth item.Conclusions AKT has satisfying reliability and validity which is suitable for evaluation of sleep apnea knowledge.

Artificial preparation, indoor passage, and nature breed of Oncomelania hupensis infected with Schistosoma Japonicum / 中南大学学报(医学版)

Objective To prepare the infected Oncomelania hupensis by artificial method for the research on the activity, vaccine, and genetic variation of Schistosoma Japonicum (S. Japonicum).Methods The mature eggs of S. Japonicum were collected by Nylon silk method and the miracidia were incubated under appropriate conditions. Negative snails were infected with miracidia in different proportion by means of individual or collective infection to seek the best method and proportion of infection between miracidia and snails. Infected snails were divided into 12 groups in total. Ⅰ-Ⅵ groups were for individual infection and Ⅶ-Ⅻ groups were for collective infection. There were 200 snails in each group. The infection ratios between snails and miracidia in Group Ⅰ-Ⅵ or screened, numbered, and reared singly. The amount of cercariae was calculated once every 10 days until the infected snails died. Then cercariae shedding quantity, infection quantity, and mortality of infected snails in every group were compared to find the best infection method and the best infection proportion between miracidia and snails. The cercariae were collected from the first generation of infected snails and were used to infect experimental animals. The mature eggs of S. Japonicum were saved from the infected experimental animals and incubated to get miracidia. The snails were artificially infected by miracidium to get the second generation of infected snails. The developmental rates of adult worms, the egg density in fecal and liver were compared between artificially and naturally infected snails. Results In individual infection GroupⅠ-Ⅵ,the average infection value of snails were 0±0,22.7±4.2,31.7±4.5,53.0±5.3,39.3±5.9,32.7±4.7,the average fatality of snails were 21.7±3.1,25.0±3.6,31.3±4.9,44.7±6.5,78.3±9.5,89.7±13.6, and the average value of cercariae shedding from infected snails were 0.0±0.0,308.0±96.6,428.1±146.2,527.0±171.1,571.4±148.9,602.9±356.3, respectively. In collective infection Group Ⅶ-Ⅻ,the average infection value of snails were 0±0,12.3±2.5,18.7±4.7,28.3±4.2,33.3±4.7,29.3±5.5,and the average fatality of snails were 22.7±3.8,23.7±4.5,28.3±5.5,47.0±9.5,75.7±8.5,86.3±12.2, and the average value of cercariae shedding from infected snails were 0±0,244.5±57.3,292.3±74.8,347.1±100.8,477.2±142.1,447.3±161.4, respectively. The second generation of artificially infected snails was obtained successfully. The average infection rate and fatality rate for the second generation of artificially infected snails were 24.65% and 24.50%, both of which were not obviously different from that of the first generation of artificially infected snails (P>0.05). In the animal experiment, the worm growth rate for the naturally infected snails, the first or second generation of artificially infected snails were 68.50%,73.50% or 71.00%. There was no obvious difference among them (P>0.05). The fecal (or liver) eggs per gram for the naturally infected snails, the first or the second generation of artificially infected snails were 1 503±269,1 683±233, or 1 541±117 (or 6 641±1 819,6 272±1 419, or 7 263±1 643). There was no significant difference among the 3 groups (P>0.05). Conclusion Infected snails can be obtained through the artificial method by using S. Japonicum miracidia to infect snails. Individual infection has the advantage over collective infection. The optimal proportion of infection between first and the second generation of artificially infected snails in the average of cercariae shedding, infection, and fatality average of snails. There was no significant difference between artificially and naturally infected snails in the developmental rate of adult worms, fecal and liver eggs per gram.

Clinical analysis of 129 infertility patients with both fallopian tubes unobstructed and cavitas pelvis fluidify / 中国医师进修杂志

Objective To evaluate the relationship between cavitas pelvis fluidify and infertility.Methods The clinical data of 129 infertility patients which ultrasound hint cavitas pelvis fluidify but hysterosalpingography hint both fallopian tubes to be unobstructed were analyzed retrospectively. The patients were divided into two groups, after 3 months cure with traditional Chinese medicine, the cavitas pelvis fluidify of 86 cases were obsolescent as group Ⅰ , the cavitas pelvis fluidify of 43 cases were no obsolescent as group Ⅱ. Compared their pregnancy rates. Results The pregnancy rate of group Ⅰ was 30.23%(26/86),group Ⅱ was 6.98%(3/43 ), there was significant deviation between the two groups (P < 0.05 ). Eighty-seven patients who were no pregnant were diagnosed laparoscopy, there were 55 cases with endometriosis (EMS), 25 cases with cavitas pelvis accretion, 1 case with tuberculosis of peritoneum, 6 cases with carmoisine cavitas pelvis fluidify without other abnormal. Thirty-one of these patients were pregnant through in vitro fertilization and embryo transfer. Conclusion Cavitas pelvis fluidify is very important in clinic, search for the cause of a disease and cure actively is needed, so that they can cure utility.