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A clinical data, laboratory examination, genetic test results, diagnose and treatment of a patient with 46, XY disorders of sexual development (46, XY DSD) from a family of the Asp-Glu-Ala-His-box helicase 37 ( DHX37) gene mutation were retrospectively analyzed.The child was admitted in the Department of Genetics, Endocrinology and Metabolism, Jiangxi Children′s Hospital in June 2021.The DHX37 gene mutation was confirmed as a new pathogenic gene leading to 46, XY DSD in 2019.It is featured as autosomal dominant inheritance with incomplete externality.Its clinical manifestations are abnormal external genitalia, testicular degeneration insufficiency syndrome and gonadal insufficiency.This patient is the first 46, XY DSD case caused by the heterozygous variation of DHX37 gene c. 2020C>T (p.R674W) in China.This study can provide new ideas for diagnosis and treatment of 46, XY DSD children and reliable genetic evidence for family reproduction.
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A clinical data, laboratory examination, genetic test results, diagnose and treatment of a patient with 46, XY disorders of sexual development (46, XY DSD) from a family of the Asp-Glu-Ala-His-box helicase 37 ( DHX37) gene mutation were retrospectively analyzed.The child was admitted in the Department of Genetics, Endocrinology and Metabolism, Jiangxi Children′s Hospital in June 2021.The DHX37 gene mutation was confirmed as a new pathogenic gene leading to 46, XY DSD in 2019.It is featured as autosomal dominant inheritance with incomplete externality.Its clinical manifestations are abnormal external genitalia, testicular degeneration insufficiency syndrome and gonadal insufficiency.This patient is the first 46, XY DSD case caused by the heterozygous variation of DHX37 gene c. 2020C>T (p.R674W) in China.This study can provide new ideas for diagnosis and treatment of 46, XY DSD children and reliable genetic evidence for family reproduction.
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Objective To investigate the recognition of physicians′ advice about high-alert medications among clinical nurses from grade three and first-class hospitals in Chongqing and to analyse the relevant training requirements. Methods Using a multistage stratified cluster sampling strategy, the physicians′ advice recognition questionnaire of High- alert medications for clinical nurses was administered to 3029 nurses in eight hospitals, to test the nurses′ advice recognition of high-alert medication and collecte training suggestions. Results More than 82.70％(1946/2353) of nurses responded correctly for 8 out of the 12 questions, the accuracy rate of pethidine hydrochloride injection test was 97.11％(2285/2353) and the dopamine hydrochloride injection test was only 28.56％(672/2353). The nurses′ recognition of physicians′ advice of high-alert medications in gender, department, working time and annual income was statistically significant (P<0.10). 81.34％(1914/2353) of the nurses were able to recognize 11 out of the total 24 wrong advices. Pre-job training、theoretical knowledge related to physicians′advice and case-based learning are the best training time, content and form. Conclusions The recognition level of high-alert medications by clinical nurses from grade three and first-class hospitals in Chongqing was not high and the clinical nurses with different gender, department, working time and annual income had different abilities, the targeted training for clinical nurses should be provided.
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Objective To discuss the application form, method and effect of blending learning based on MOOC in Obstetrics and Gynecology Nursing Course, so as to improve learning quality and com-prehensive qualities of students. Methods Randomly selected a nursing undergraduate class as experi-mental group (n=190) and another as control group (n=189);blending learning and traditional teaching model were adopted, respectively. T test and chi-square test were used to compare scores of final exam in two groups, and Rating Scale of Self-directed Learning Competence for Nurses and Scale of Clinical Commu-nication Competence for Nursing Students were used to evaluate two groups before and after the course. Results The average score (76.30±7.08) and excellent rate (35.79％) in the experimental group were higher than those in the control group of (74.78 ±7.18) and 25.93％, with significance differences (P<0.05);Surveys showed that after the course, the autonomous learning ability and the clinical communication ability of students in the experimental group were better than before, and were better than those in the control group. Conclusion Blending learning can be applied to Obstetrics and Gynecology Nursing Course, which can effectively improve learning quality and enhance students' ability of independent study and clinical com-munication, with satisfactory teaching effects to both teachers and students.
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Objective To evaluate the effect of midwives′antenatal clinic service on management of gestational weight and birth outcomes .Methods Totally 420 primiparas who had made registration and regular antenatal examination in a hospital ,were randomly divided into two groups .The women in the control group(n=208) received routine antenatal clinicservice .In addition ,the women in the experimental group(n=212) participated in an individual midwives′antenatal clinic .The primiparas′gestational weight gain and birth outcomes were measured and compared between the two groups .Results The rate of natural birth in the experimen‐tal group was higher than that of the control group .The rate of fetal macrosomia ,episiotomy and labor analgesia were lower than that of the control group(P0 .05) .Conclusion The midwives′antenatal clinic service has good effects on management ofgestational weight gain ,improves birth outcomes and pro‐vides primiparas positive experience of childbirth .
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Objective To explore hereditary phenomenon in the process of pregnancy and childbirth .Methods Pregnancy and delivery data of pregnant women and their mothers conformed to the standard was collected from January 2013 to December 2013 for correlation analysis .Results An association existed between pregnant women and their mothers in gestational age ,weight gain during pregnancy ,child′s birth weight ,duration of labor ,delayed pregnancy experience .Conclusion Hereditary exists in the process of pregnancy and childbirth .
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Objective:To study the effect and underlying mechanism of sulfur-fumigation and water-soaking on total ash of Di-oscoreae Rhizoma, find the key factor( s) affecting the total ash of Dioscoreae Rhizoma, and explore the rationality of ash limits of Di-oscoreae Rhizoma described in Chinese Pharmacopoeia. Methods:Dioscoreae Rhizoma was respectively dealt with sulfur-fumigation and water-soaking. The changes in total ash content of Dioscoreae Rhizoma was detected by the ash determination methods for total ash and SO2 described in the pharmacopoeia, and then the ash content change of inorganic salts was used to study the mechanism. Results:Sulfur-fumigation could slightly reduce the total ash content of Dioscoreae Rhizoma, while significantly reduce the ash content of calcium oxalate and calcium sulfate with the reduction degree of 7. 20% and 9. 90%, respectively. Calcium phosphate and calcium chloride were slightly affected by sulfur-fumigation, and the results indicated that the effect of sulfur-fumigation on ash content was mainly real-ized by increasing the decomposition rate of calcium oxalate and calcium sulfate. Water-soaking could decline the ash content of Di-oscoreae Rhizoma, and the phenomenon was common in the rhizome medicinal materials. The influence of water-soaking on total ash was more significant than that of sulfur fumigation. Conclusion:Sulfur-fumigation can reduce the total ash content of Dioscoreae Rhizo-ma by increasing the decomposition rate of calcium oxalate and calcium sulfate, however, the effect is mild and the process isn't the key influencing factor in the total ash content of Dioscoreae Rhizoma. During the preparation of Dioscoreae Rhizoma medicinal slices, water-soaking can cause the great loss of water-soluble mineral salts, such as Cl-, C2 O4 2-, NO3 - and SO4 2-, which leads to the reduction of total ash content, therefore, water-soaking is the key influencing factor in the total ash content of Dioscoreae Rhizoma.
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Objective To explore the methods and results of the application of formative assessment in gynecology and obstetrics nursing teaching.Methods In the gynecology and obstetrics nursing teaching practice,556 undergraduate students in Grade 2011 were set as experimental group while 339 students in Grade 2010 as control group.Based on the teaching syllabus,in the experimental group,traditional lecture and bilingual teaching method were applied in theory courses and PBL or PBL combined with Scene simulation were applied in practice lessons.And after the teaching,formative assessment was applied in the experimental group,which included setting up small study groups and learning files,giving evaluation to students' participation in class activities,written assignments,operation exams,attendance to classes and their in-class test results.In the evaluation of a student,the results of formative assessment took a proportion of 50％ and the final exam result took the other half.While in the control group,traditional summative assessment was applied,namely,results of the final exams were the terminal results of students.Results Gynecology and obstetrics nursing got the first prize in the Final-term Assessment of Teaching Efficiency of the Nursing School.When comparing the results of the final exam of the students in the experimental group and the control group,there was statistically difference(P=0.000),and 86％ of the students in the experimental group were in favor of formative assessment.Conclusion When applied in gynecology and obstetrics nursing teaching in undergraduate students,formative assessment can help teachers adjust teaching methods to improve the effectiveness of teaching; it can also make students more motivated in learning and help students form good learning habits and improve their learning strategies,which can improve students' comprehensive quality.
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Objective To study the responsibilities of nurses at different levels in providing clini cal care for patients in wards.Methods On the basis of conducting hierarchical management on nurses,the tasks of nurses in providing patients in wards with clinical care were summed up by means of data analysis and field observation.According to the tasks,a questionnaire about the responsibilities of nurses at all levels was designed.The 132 nurses from a Grade-3 Class-A general hospital in Chongqing Municipality who were responsible for providing clinical cares for patients in wards completed these questionnaires.Results Nurses in charge of providing clinical care for patients in wards usually undertook 11 tasks which could be divided into four aspects,which were,clinical nursing,nursing management,teaching on nursing and research into nursing.Based on the 11 tasks,44 responsibilities these nurses shouldered were defined,which included 4 responsibilities for N0-level nurses,6 for N1-level nurses,10 for N2-level nurses,11 for N3-level nurses,8 for N4-level nurses and 5 for N5-level nurses.Conclusions By defining in a scientific and systematic way the responsibilities and tasks of nurses at different levels in providing clinical cares for patients in wards,the research offered clinical nurses clear guidance on their work,and provided basis for the hospital's decision on clinical nurses,such as the personnel allocation,performance assessment and training; it could also help promote the position management on the work of nurses in China.
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This paper aimed to describe the concept of the cancerous person's supportive care needs and the current situation of the study on this issue abroad so that we can analyze the factors which influence the needs,and we also try to elaborate the shortcomings and study expectation on cancerous person's sup portive care study.
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Children short stature is pediatric endocrine disease.It has now been confirmed that short stature homeobox gene(SHOX gene)deletion and mutation are the molecular genetic basis of children Leri-Weill syndrome,Turner syndrome,idiopathic short stature and other short stature phenotype.SHOX gene defect has obvious heterogeneity in clinical phenotype.Early detection of SHOX gene defects provides important reference value and guiding significance for short stature diagnosis and treatment.
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Sulfur , a major component of gunpowder , has been widely used in the engineering and military in-dustries since ancient times . In fact , the application of sulfur in traditional Chinese medicine ( TCM ) has a long history , which indicated the uniqueness of TCM theory and practice . Besides , sulfur has played an impor-tant role for the development of TCM in the history . In order to scientifically analyze the role of sulfur in TCM , this paper focused on the application and evolution of sulfur in the development process of TCM , which aimed to provide a reference for the study of the value and role of sulfur in TCM .
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Objective To explore the effects of low-concentration heparin sodium (LCHS) on preventing thrombophlebitis in patients with peripherally inserted central catheter (PICC). Methods Totally 287 patients who received PICC from 2007 to 2009 in our department were divided into LCHS group ( n = 128 ), in which the patients had no coagulation disorders or other blood diseases and the used drugs were compatible with heparin sodium, and control group ( n = 159). In the LCHS group, LCHS ( 10 U/ml) was used for irrigation and sealing of the catheter with positive pressure. In the control group, 0. 9% normal saline was used for the same procedures. Changes of the clinical manifestations of phlebitis and the values of plasma fibrinogen in both two groups were observed.Results In LCHS group, 21 patients had obvious clinical manifestations of phlebitis, among whom 8 patients met the diagnostic criteria of thrombophlebitis. On the contrary, in control group, 38 patients had obvious clinical manifestations of phlebitis ( P ＜ 0. 05 ), among whom 31 patients met the diagnostic criteria of thrombophlebitis ( P ＜0. 001 ). The changes of plasma fibrinogen were also significantly different between these two groups ( P ＜ 0. 001 ).Conclusion LCHS can prevent thrombophlebitis in patients with PICC who have no coagulation disorder or other blood diseases and the used drugs are compatible with heparin sodium.
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Objective To study characteristic findings and the diagnostic value of MRI in pituitary stalk interruption syndrome (PSIS). Methods Twenty-one patients with PSIS were included. Small field of view (FOV) MR1 scanning and clinic hormone detection were performed in all patients. Moreover, fluid attenuated inversion recovery (FLAIR)T,1 WI with fat-suppression sequence was performed in 8 cases. The appearance on FLAIR T1 WI and T2 WI were recorded. The shape of pituitary stalk and antehypophysis, and the signal intensity of posthypophysis were analyzed simultaneously. Results Growth hormone deficiency (GHD) was confirmed by clinic hormone detection in all 21 cases. The level of basal GH varied from 0. 03 μg,/L to 1.50 μg/L. The peak value under GH provocation was from 0. 13 μg/L to 4. 14 μg/L, and the GH was absolute default in all patients. Seventeen cases of them were combined pituitary hormone deficiency (CPHD), and 4 cases were isolated growth hormone deficiency (IGHD). The height of antepituitary was in the range from 1 mm to 3 mm, and the average value was (1.9±1.2) mm. Pituitary stalk was absent in 18 cases and showed as linear and discontinuous stalk in the other 3 cases. The high signal intensity was invisible in normal position in all cases, the high signal intensity spot in the region of infundibular recess of the third ventricle was shown in 19 cases, while it could not be found anywhere in 2 patients with diabetes insipidus. Conclusion PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.
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OBJECTIVE:To discuss ward drug control to ensure safe.METHODS:We analyzed retrospectively the application of 5S theory in ward drug control.RESULTS & CONCLUSION:By this drug control mode,drugs were classified according to varieties,usage,frequency of use etc,drug control quality and work efficiency were enhanced,patients' needs could be satisfies and staff' s professional quality was enhanced.