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Objective:To investigate the trend of posttraumatic stress disorder (PTSD) in the mothers of preterm infants within 6 months and analyze the related factors.Methods:There were 171 mothers of premature infants selected by convenience sampling method who received outpatient follow-up from Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University from July 2018 to November 2019. The mothers were evaluated by post-traumatic stress disorder questionnaire from corrected age 1 month to 6 months of preterm infants, and the general data, maternal anxiety and family management were investigated as well. Linear regression analysis was used to determine the influencing factors of post-traumatic stress disorder for preterm infants within corrected 6 months.Results:The incidence of posttraumatic stress disorder in mothers of premature infants was significantly higher than the domestic norm. The incidence was 35.09%(60/171) in 1 month and the highest score was 4.80 ± 2.09, and then gradually decreased to 12.06%(17/141) in 6 months, with an average score of 3.41 ± 1.82. The results of linear regression analysis showed that the birth weight of preterm infants, hospital stay and the age of the mother, the maternal anxiety score, the Family Management Measure score, re-hospitalization after discharge were the influencing factors of the maternal PTSD score ( t values were -247 - 3.08, all P<0.05). Conclusions:The incidence of post-traumatic stress disorder in mothers of preterm infants within 6 months is higher. Although the incidence gradually decreases over time, it is still significantly higher than the average level, which deserves clinical attention. The mothers of premature infants with low birth weight, long hospital stay and young mothers should be alert to the occurrence of PTSD. During the hospitalization of premature infants, family participatory nursing should be provided as much as possible to improve mothers′ confidence in caring. Alleviating mother′s anxiety, maintaining good family relationship, improving family management ability and providing continuous nursing service after discharge are beneficial to prevent mother from having post-traumatic stress disorder.
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Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and has relatively high incidence and mortality rates. Abnormal modification of N6-methyladenosine (m6A) may promote the development and progression of HCC. This article describes the structure and function of m6A and summarizes the mechanism of action of methylase complexes which decide the function of m6A in HCC, including methyltransferases (writers), demethylases (erasers), and m6A-binding proteins (readers). It is pointed out that more in-depth studies are needed to clarify the diverse and specific role of methylase complexes in HCC, so as to help them become the new targets for the prevention and treatment of HCC in the future.
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Objective:To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU).Methods:A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression.Results:The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age ( β=-0.484, P<0.01), time of breast milk feeding through mouth ( β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease ( β=0.587, P=0.050), maternal anxiety ( β=0.206, P<0.01), depression ( β=0.727, P<0.01) and interaction between maternal anxiety and depression ( β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation. Conclusions:Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.
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Objective@#To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU).@*Methods@#A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression.@*Results@#The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age (β=-0.484, P<0.01), time of breast milk feeding through mouth (β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease (β=0.587, P=0.050), maternal anxiety (β=0.206, P<0.01), depression (β=0.727, P<0.01) and interaction between maternal anxiety and depression (β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation.@*Conclusions@#Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.
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Endoscopic retrograde cholangiopancreatography (ERCP)has become an important method for the diagnosis and treatment of cholangio -pancreatic duct diseases.Post -ERCP pancreatitis (PEP)is the most common complication and its incidence has increased up to 40% in recent years.The prevention of PEP has always been a hot topic in clinical research.This article reviews the research advances in the pharmacological prevention of PEP and points out that controlled clinical trials with a large sample size are still needed to investigate the effect of preventive drugs,and further studies should focus on optimal medication time,route of administration,and dose.In addition,de-mographic features of populations from different countries and different age groups should be taken into consideration.
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Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.
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ObjectiveTo find out the risk factors and the incidence of lithiasis. MethodsA questionnaire was formulated by the National Biliary Surgical Group. It was sent to the medical staff of all levels of hospitals in the Zunyi Region, Guizhou to fill in on surgically proven cases of cholelithiasis. The clinical data were collected and analyzed using SPSS 13.0. ResultFor lithiasis, the gender ratio was 1∶ 1.78; the peak age was 41-year and 51-year respectively. The proportion of cholecystolithiasis (n =4456 ; 86.76 ％) and choledocholithiasis (n =554;10.79 ％ ) was comparatively higher than in other regions in China. ConclusionsThe commonest type of lithiasis in Zunyi was cholecystolithiasis. There was an increasing tendency for lithiasis to develop in young people. Lithiasis was closely associated with factors such as gender, food and occupation.
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The purpose of this study was to explore the role of epithelial-mesenchymal transition in the pathogenesis of hepatolithiasis. Thirty-one patients with primary hepatolithiasis were enrolled in this study. Expressions of E-cadherin, alpha-catenin, alpha-SMA, vimentin, S100A4, TGF-beta1 and P-smad2/3 in hepatolithiasis bile duct epithelial cells were examined by immunohistochemistry staining. The results showed that the expressions of the epithelial markers E-cadherin and alpha-catenin were frequently lost in hepatolithiasis (32.3% and 25.9% of cases, respectively), while the mesenchymal markers vimentin, alpha-SMA and S100A4 were found to be present in hepatolithiasis (35.5%, 29.0%, and 32.3% of cases, respectively). The increased mesenchymal marker expression was correlated with decreased epithelial marker expression. The expressions of TGF-beta1 and P-smad2/3 in hepatolithiasis were correlated with the expression of S100A4. These data indicate that TGF-beta1-mediated epithelial-mesenchymal transition might be involved in the formation of hepatolithiasis.