The influence path of stigma on the time of healthcare-seeking decision in caregivers of elderly patients with dementia and humanistic care strategies / 中国实用护理杂志

Objective:To clarify the influence and influence paths of stigma on the time of the healthcare-seeking decision in caregivers of elderly patients with dementia, and to provide a theoretical basis for the construction of corresponding humanistic care strategies.Methods:A total of 176 caregivers of elderly patients with dementia who visited the Affiliated Hospital of Xuzhou Medical University and Xuzhou Oriental People ′s Hospital from February 2021 to February 2022 were selected as the study subjects. The General Information Questionnaire, self-designed Scale of Stigma for Caregivers of Senile dementia patients, Multidimensional Scale of Perceived Social Support, self-designed Elderly Dementia Caregivers′ Perceived Barriers Scale for Healthcare-seeking Decision, and self-designed Scale of the Intention to Seek Healthcare for caregivers of senile dementia patients were used in the survey. AMOS 20.0 was used to establish a structural equation model for path analysis. Results:The higher the stigma of caregivers, the longer the time of the healthcare-seeking decision ( β=0.05, P<0.05). Social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare were the mediating variables of caregivers ′ stigma affecting the time of the healthcare-seeking decision, with a total effect of -0.04, 0.14, and 0.36, respectively, and all P<0.05. Conclusions:The stigma in caregivers of senile dementia patients is an important factor affecting the time of the healthcare-seeking decision. By improving mediating factors including social support, perceived barriers to the healthcare-seeking decision, and the intention to seek healthcare, the implementations of targeted humanistic care strategies are expected to help shorten the time of the healthcare-seeking decision.

Cytochrome P450 oxidoreductase deficiency in an infant / 中华围产医学杂志

This study reported the diagnosis and treatment of cytochrome P450 oxidoreductase deficiency (PORD) in a male infant. The patient was admitted to Children's Hospital Affiliated to Shandong University at the age of 38 days due to nasal obstruction and feeding difficulties presented at 10 d after birth, as well as less weight gain. Physical examination showed craniosynostoses, hand and foot deformities, and normal external genitalia. Laboratory examination revealed mildly elevated serum adrenocorticotrophic hormone and decreased level of baseline cortisol. A homozygous mutation of c.1370G>A(p.R457H) in POR gene was detected by whole-exome sequencing, which confirmed the diagnosis of PORD. Skeletal deformities complicated by external genital malformations and/or adrenocortical hormone abnormalities are important diagnostic indicators for PORD.

Development and optimization of perfusion process for mammalian cell culture / 生物工程学报

In recent years, the demand of biologics has increased rapidly. Cell culture process with perfusion mode has become more and more popular due to its high productivity, good quality and high efficiency. In this paper, the unique operation and the details of process optimization for perfusion culture mode are discussed by comparing with traditional batch culture process. Meanwhile, the progress and strategies in the development and optimization of perfusion culture process in recent years are summarized to provide reference for the future development of mammalian cell perfusion culture technology.

A multicenter, randomized, open and positive parallel controlled clinical study of clotrimazole vaginal expansion suppository and vaginal tablet in the treatment of mild and moderate vulvovaginal candidiasis / 中华妇产科杂志

Objective:Using clotrimazole vaginal tablet as a positive control, to evaluate the results of clotrimazole vaginal expansion suppository in the treatment of mild and moderate vulvovaginal candidiasis in terms of efficacy, patient satisfaction, side effects, and recurrence rate.Methods:This study was jointly conducted by 5 hospitals from August 2017 to October 2018, patients with mild and moderate vulvovaginal candidiasis confirmed by fungal culture and symptoms scores were selected. They were randomized to experimental group and control group as 1∶1 ratio. In the experimental group ( n=105), the subjects applied clotrimazole vaginal expansion suppository (150 mg) daily at night for 7 days. In the control group ( n=106), the subjects used a single dose of clotrimazole vaginal tablet (500 mg). Follow-ups were performed at (8±3) and (30±5) days after the discontinuation of the drugs, respectively. The difference in clinical symptoms and signs scores was used to evaluate the improvement of clinical symptoms, and the patient′s satisfaction and side effects were recorded. Results:At the first follow-up, the experimental group and control group were followed up by fungal culture on the cure rate [66.7% (70/105) versus 63.2% (67/106), P>0.05] and total effective rate [98.1% (103/105) versus 99.1% (105/106), P>0.05], the differences were not statistically significant. At the second follow-up, the recurrence rates of the experimental group and the control group were 5.7% (4/70) and 14.9% (10/67), respectively, with no significant difference ( P>0.05). In the evaluation of patient satisfaction, the leakage of the drug in the experimental group was significantly better than that in the control group ( P<0.01). The side effects mainly included vaginal stimulation, itching and burning sensation, and there was no statistical difference between the two groups ( χ2=1.070, P=0.586). Conclusions:In the treatment of mild and moderate vulvovaginal candidiasis, clotrimazole vaginal expansion suppository is no less effective than clotrimazole vaginal tablet, and there is no significant difference in the recurrence rate between the two. In terms of patient satisfaction, clotrimazole vaginal expansion suppository is superior to clotrimazole vaginal tablet.

Clinical and genetic analysis of a neonate with Cornelia de Lange syndrome 5 caused by HDAC8 gene mutation / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic cause of a neonate with congenital dysplasia, growth retardation through clinical evaluation, laboratory tests and next generation sequencing (NGS).@*METHODS@#Peripheral blood samples were obtained from the child and his parents. Whole genomic DNA was extracted and subjected to NGS. Suspected mutation was predicted by bioinformatic tools and validated by Sanger sequencing.@*RESULTS@#The child was found to carry a c.556G>A (p.E186K) mutation of the HDAC8 gene on the X chromosome, which was predicted to be pathogenic by Bioinformatic analysis.@*CONCLUSION@#The patient was diagnosed as Cornelia de Lange syndrome 5 caused by the c.556G>A mutation of the HDAC8 gene.

Clinical Study on Acupuncture Treatment of Insomnia Based on Data Mining in Recent 30 Years / 世界科学技术-中医药现代化

To explore the rule of acupuncture and moxibustion in treating insomnia, and to use the Ancient and ModernMedical Cloud Platform (V1.4), a data mining technology, as a basis for interdisciplinary research ideas to providereference for clinical. Searching for acupuncture therapy insomnia clinical research literature in the past 30 years (January 1, 1987-December 31, 2017 in Chinese Knowledge Resource Base (CNKI), Chinese Science and TechnologyJournal Database (Chongqing Weipu), Chinese Academic Journal Database (Wanfang Data), and China BiomedicalDocumentation Database (CBM) for) by computer, using Excel to establish a database and enter the Ancient and ModernMedical Case Cloud Platform (V1.4), data mining methods such as frequency analysis, association rule analysis, hole pairanalysis, community analysis, and complex network analysis are used to analyze the data from the perspectives of singlehole frequency, cave Association, core prescriptions, and clinical syndrome differentiation prescriptions. The data arevisually displayed using novel and colorful charts to enhance visibility. After screening, a total of 191 articles wereincluded in the literature, involving a total of 149 acupoints and a total of 2139 points. Among them, the top fiveacupoints in the point frequency were Sanyinjiao (143 times), Shenmen (139 times), Baihui (120 times), Neiguan (115 times), and Taichong (107 times) . The first five points are Shenmen-Sanyinjiao (120 times), Neiguan-Sanyinjiao (98 times), Neiguan-Shenmen (96 times), Baihuo-Sanyinjiao (96 times), Baihui-Shenmen (91 times) and so on. The maincore prescriptions are Sanyinjiao, Shenmen, Baihui, Neiguan, Taichong, Xinshu, Taixi, Zusanli, Si shencong, Pi shu, andAn mian. The secondary core prescriptions are Fenglong, Shen shu, Yin tang, Gan shu, Dan shu, Fengchi, Zhong wan, Shenting, Zhaohai, Da ling, and others. Using the Ancient and Modern Medical Cloud Platform (V1.4) to analyze thedata, the clinical study of acupuncture and moxibustion for insomnia is illustrated with charts, thus visibility is enhanced, and it is easier to understand. It can guide clinical practice, but remember to consider specific clinical conditions.

Incidence of extrauterine growth retardation and associated factors in very low birth weight preterm infants / 中华围产医学杂志

Objective To assess the incidence of extrauterine growth retardation (EUGR) in very low birth weight (VLBW) preterm infants and to evaluate the effects of nutritional support and morbidities on EUGR.Methods Data of VLBW preterm infants ＜ 34 weeks of gestation admitted to the Neonatal Intensive Care Unit (NICU) of the First Affiliated Hospital of Sun Yat-Sen University between January 1,2005 and December 31,2010 were reviewed.Those VLBW preterm infants were divided into the EUGR group (n=67) and the non-EUGR group (n=40).Perinatal data,growth data,nutritional information and morbidities were compared between the two groups.The incidence of EUGR in VLBW preterm infants was assessed and the associated risk factors were analyzed.Independent samples t,Chi-square and rank sum tests and Logistic regression analysis were used for statistical analyses.Results A total of 107 VLBW infants survived to discharge.The average gestational age in the EUGR group was much lower than that in the non-EUGR group [(30.0±2.1) weeks vs (30.9 ± 1.1) weeks,t=2.904,P=0.002].However,the incidences of small for gestational age (SGA) and maternal hypertension in the EUGR group was higher than that in the non-EUGR group [SGA:53.7％ (36/67) vs 15.0％ (6/40),x2=15.575,P ＜ 0.01; maternal hypertension:40.3％ (27/67) vs 20.0％ (8/40),x2=4.689,P=0.030].Standard deviation score (SDS) of birth weight and weight at discharge in the EUGR group was lower than that in the non-EUGR group [SDS of birth weight:(--1.9±0.8) vs (--1.1±0.7),t=5.418; weight at discharge:-2.6 (-3.0--2.0) vs-0.5 (-0.9--0.1),U=30.271; both P ＜ 0.01].The velocity of weight gain in the EUGR group was lower than that in the non-EUGR group [(12.0±4.4) g/(kg · d) vs (16.1±4.0) g/(kg · d),t=1.879,P=0.036],while the maximum percentage of weight loss and the age at maximum weight loss in the EUGR group was higher than that in the non-EUGR group [percentage of weight loss:(13.2± 1.7)％ vs (9.0± 1.6)％,t=12.832,P ＜ 0.01; age:(13.4±3.5) vs (10.9±4.3) d,t=3.113,P=0.001].The time to achieve full enteral feeds,3 g/(kg · d) protein and 120 kcal/(kg · d) calories intake were longer in than the EUGR group [(39.7 ± 8.2) vs (30.8±6.1) d,t=6.293,P=0.007; (21.4±5.8) vs (17.5±1.3) d,t=4.286,P=0.002; (28.4±6.0) vs (20.3±5.4) d,t=7.198,P=0.015; 1 kcal=4.184 k J].The cumulative caloric deficit and cumulative protein deficit in the first two weeks of life in the EUGR group were significantly higher than those in the non-EUGR group [(600.9±49.3) vs (536.4 ± 55.2) kcal/kg,t=6.082,P ＜ 0.01; (17.4 ± 0.8) vs (12.4 ± 0.8) g/kg,t=31.279,P=0.003,respectively].The incidences of late-onset infection and bronchopulmonary dysplasia (BPD) in the EUGR group was significantly higher than that in the non-EUGR group [77.6％ (52/67) vs 40.0％ (16/40),x2=15.300,P ＜ 0.01;38.8％ (26/67) vs 17.5％ (7/40),x2=5.330,P=0.040,respectively].The length of oxygen therapy and mechanical ventilation in the EUGR group were significantly longer than that in the non-EUGR group [(44.5 ±4.5) vs (32.5± 1.5) d,t=20.042,P=0.030; 9.5(6.5-44.0) d vs 6.2(5.0-35.5) d,U=19.195,P=0.004,respectively].Logistic regression analysis showed that SGA,gestational age,BPD,late-onset infection,time to achieve full enteral feeds and 3 g/(kg · d) protein intake and the cumulative caloric deficit in the first two weeks after birth were the independent risk factors for EUGR (all P ＜ 0.05).Conclusions EUGR remains a serious issue in VLBW preterm infants,especially SGA,in the NICU.An early aggressive nutritional strategy,prevention of BPD and infection,and improvement of perinatal care may facilitate a reduction in the occurrence of EUGR.