Construction of nursing quality evaluation criteria for orthopaedic trauma specialty / 中国实用护理杂志

Objective:To establish the evaluation criteria for the quality of nursing care in orthopaedic trauma specialties, and to provide a basis for scientific evaluation of the quality of nursing care in orthopaedic trauma specialties.Methods:From February to October 2023, John Hopkinson evidence-based method was used to synthesize the evidence, clinical investigation and semi-structured interview were used to draw up the "quality standard of nursing care in orthopaedic trauma specialty", and two rounds of Delphi method of expert inquiry were used to screen, demonstrate and calibrate the evaluation standard of nursing quality in orthopaedic trauma specialty.Results:The questionnaire recovery rate of 2 rounds of expert consultation was 100.00%, the coefficient of familiarity and authority of 2 rounds of expert consultation were 0.92 and 0.93. Through 2 rounds of expert letter consultation, the quality evaluation criteria of orthopaedic trauma specialist care were established, including 3 first-level indicators (structural quality, process quality and outcome quality), 22 second-level indicators and 85 third-level indicators.Conclusions:The process of constructing the evaluation standard of nursing quality in orthopaedic trauma specialty is scientific and reliable, which can provide standard guidance for clinical practice and is conducive to the development of specialized nursing.

Role of echocardiography in assessing copy number variation in fetal congenital heart disease / 中华围产医学杂志

Objective:This study examines the application of echocardiography in the prenatal diagnosis of copy number variation (CNV) associated with fetal congenital heart disease (CHD).Methods:A retrospective analysis was conducted on 447 singleton pregnancies from Quanzhou Maternal and Child Care Hospital (Quanzhou Children's Hospital) from January 2019 to August 2022. These individuals underwent echocardiographic assessments suggestive of fetal CHD and subsequently received invasive prenatal diagnoses. Comprehensive karyotype analysis and chromosome microarray analysis (CMA) were performed for each case. The discrepancies in the chromosomal abnormality detection were analyzed between the results produced by CMA and karyotype analysis. Furthermore, differences in the detection of pathogenic copy number variation (pCNV) between the two methods in CHD cases with diverse cardiac phenotypes, including the presence or absence of extracardiac structural malformations, the type, and quantity of cardiac structural anomalies, were explored. Statistical analysis was conducted using the Chi-square test. Results:Compared with conventional karyotype analysis, CMA demonstrated a higher detection rate of fetal chromosomal abnormalities [10.5% (47/447) vs. 20.6% (92/447), χ 2=161.56, P<0.001]. In terms of distinct cardiac phenotypes, CHD cases with extracardiac structural anomalies displayed an escalated pCNV detection rate in comparison to isolated CHD cases [11.4% (45/394) vs. 32.1% (17/53), χ 2=16.68, P<0.001]. Within the cardiac structural anomaly subgroups, increased pCNV detection rates were observed in the septal defect subgroup, conotruncal malformation subgroup, and left ventricular malformation subgroup [18.4%(29/158), 25.9%(7/27), and 25.0%(7/28) vs. 7.6%(16/210); χ 2=9.15, 9.68, and 8.55, respectively, all P<0.05]. The CMA-identified pCNV correlated with CHD included 22q11.2 deletions/duplications in eight cases, 4p16.3 deletions in two cases, 11q23.3 microduplications in two cases, 1q21.1 microdeletions/microduplications in two cases, 4q28.3 microduplications in one case, and 10p15.3 microdeletions in one case. Conclusions:CMA technology exhibited an enhanced ability to detect pCNV in fetuses with CHD. Echocardiography can guide targeted CMA screening, thereby facilitating prenatal genetic assessment of CHD.

Clinical analysis of 86 cases of acute fatty liver of pregnancy / 中华妇产科杂志

Objective: To investigate the clinical characteristics and maternal and fetal prognosis of pregnant women with acute fatty liver of pregnancy (AFLP). Methods: The clinical data of 86 AFLP pregnant women admitted to the Third Affiliated Hospital of Guangzhou Medical University from September 2017 to August 2022 were collected, and their general data, clinical characteristics, laboratory tests and maternal and fetal outcomes were retrospectively analyzed. Results: (1) General information: the age of the 86 pregnant women with AFLP was (30.8±5.4) years, and the body mass index was (21.0±2.5) kg/m2. There were 50 primiparas (58.1%, 50/86) and 36 multiparas (41.9%, 36/86). There were 64 singleton pregnancies (74.4%, 64/86) and 22 twin pregnancies (25.6%, 22/86). (2) Clinical characteristics: the main complaints of AFLP pregnant women were gastrointestinal symptoms, including epigastric pain (68.6%, 59/86), nausea (47.7%, 41/86), anorexia (46.5%, 40/86), vomiting (39.5%, 34/86). The main non-gastrointestinal symptoms were jaundice of skin and/or scleral (54.7%, 47/86), edema (38.4%, 33/86), fatigue (19.8%, 17/86), bleeding tendency (16.3%, 14/86), polydipsia or polyuria (14.0%, 12/86), skin itching (8.1%, 7/86), and 17.4% (15/86) AFLP pregnant women had no obvious symptoms. (3) Laboratory tests: the incidence of liver and kidney dysfunction and abnormal coagulation function in AFLP pregnant women was high, and the levels of blood ammonia, lactate dehydrogenase and lactic acid were increased, and the levels of hemoglobin, platelet and albumin decreased. However, only 24 cases (27.9%, 24/86) of AFLP pregnant women showed fatty liver by imageology examination. (4) Pregnancy outcomes: ① AFLP pregnant women had a high incidence of pregnancy complications, mainly including renal insufficiency (95.3%, 82/86), preterm birth (46.5%, 40/86), hypertensive disorders in pregnancy (30.2%, 26/86), gestational diabetes mellitus (36.0%, 31/86), fetal distress (24.4%, 21/86), pulmonary infection (23.3%, 20/86), disseminated intravascular coagulation (16.3%, 14/86), multiple organ dysfunction syndrome (16.3%, 14/86), hepatic encephalopathy (9.3%, 8/86), and intrauterine fetal death (2.3%, 2/86). ② Treatment and outcome of AFLP pregnant women: the intensive care unit transfer rate of AFLP pregnant women was 66.3% (57/86). 82 cases were improved and discharged after treatment, 2 cases were transferred to other hospitals for follow-up treatment, and 2 cases (2.3%, 2/86) died. ③ Neonatal outcomes: except for 2 cases of intrauterine death, a total of 106 neonates were delivered, including 39 cases (36.8%, 39/106) of neonatal asphyxia, 63 cases (59.4%, 63/106) of neonatal intensive care unit admission, and 3 cases (2.8%, 3/106) of neonatal death. Conclusions: AFLP is a severe obstetric complication, which is harmful to mother and fetus. In the process of clinical diagnosis and treatment, attention should be paid to the clinical manifestations and laboratory tests of pregnant women, early diagnosis and active treatment, so as to improve maternal and fetal outcomes.

Changes of environmental and personal hygiene in rural schools of Henan and Sichuan from 2016 to 2018 / 中国学校卫生

Objective@#To investigate the changes of environmental sanitation, health knowledge and behavior of students and diarrhea in rural schools in Henan and Sichuan Provinces from 2016 to 2018, and to provide data for improving environmental sanitation, health literacy, as well as reducing diarrhea and other infectious diseases among rural students.@*Methods@#Based on the "Community Approach to Total Sanitation (CATS)", a total of 13 rural primary schools were selected in 2016 and 2018 respectively, including 8 in Henan and 5 in Sichuan. One class of fourth grade students was selected from each school. Totally 450 students were surveyed in 2016 and 2018, respectively. The drinking water, environmental hygiene, students personal hygiene and behavior, and the incidence of diarrhea in recent 3 months were investigated by interview, observation, inquiry and questionnaire.@*Results@#Between 2016 and 2018, the number of schools providing safe drinking water for students increased from 6 to 8, the number of schools with proper hand washing facilities increased from 9 to 12, the number of schools with hand washing facilities equipped with soap or hand sanitizer increased from 2 to 9, and the number of schools with sanitary toilet type increased from 9 to 12. The awareness rate of students total health knowledge increased from 58.74% (793/1 350) to 64.96% (877/1 350), the formation rate of students total health behavior increased from 67.78% (1 220/1 800) to 75.28 % (1 355/1 800), the proportion of diarrhea in recent 3 months decreased from 36.89% (166/450) to 21.11% (95/450), the differences were statistically significant( χ 2=11.08, 24.86, 27.20, P <0.05).@*Conclusion@#The basic environmental sanitation facilities of rural schools in Henan and Sichuan has improved substantially, together with increased students health knowledge and hygiene behavior, and decreased incidence of students diarrhea.

A Digital Filtering Method for Eliminating DC Offset in Ambulatory ECG Signals / 中国医疗器械杂志

The amplifier is easy to saturation because of polarization voltage in ambulatory ECG acquisition. The traditional way is using analog high-pass filter to eliminate, but the output tends to have a residue. If upgrading high-pass filter cutoff frequency, it will lead to low frequency distortion of ECG signals. In this paper, a Savitzky-Golay (SG) smoothing filter has been designed by combining the single edge point and the polynomial order , which can fit the polarization voltage components of ECG signals, filter useful components and get drift-free ECG signals by using the subtraction algorithm. The results of ECG filtering experiment verify the feasibility of the SG smoothing filter, and show the filtered ECG signal without any losses of useful components.

Protective effect of ulinastatin on intestinal barrier function of septic rats / 中华临床感染病杂志

Objective To observe the protective effect of ulinastatin (UTI) on the intestinal barrier function of septic rats.Methods Septic rat model was established using Sprague-Dawley rats by cecal ligation and puncture (CLP) method.Thirty Sprague-Dawley rats were randomly divided into 3 groups (n =10 for each grop) : sham group, septic group and UTI group.All rats received intraperitoneal injections of 0.9％ saline (10 mL/kg) after and 8 h after surgery.In UTI group, UTI (10 × 104 U/kg in 10 mL/kg saline) was injected after and 8 h after surgery.Collect blood samples after 0, 8, 12 h after surgery to examine levels of procalcitonin (PCT), intestinal fatty acid binding protein (iFABP) and diamine oxidase (DAO) by enzyme-linked immunosorbent assay (ELISA) method.Rats were killed 12 h after surgery to collect intestine tissue samples.Pathological changes of intestine were observed under microscopy, and the expression of tight junction protein-1 (ZO-1) and occludin were analyzed by Western blot.Results In sham group, the mucosa structure was complete and the shape was normal, and villi stood neatly.In septic group, intestinal was expanded, intertinal mucosal was atrophic, villi were scanty.An inflammatory infiltrate with numerous nuetrophils was found in the mucosal.In UTI group, the level of severity was relatively slight.The relative optical density of Western blot images were decreased on ZO-1 and occludin in CLP and UTI groups, and decreased more in CLP group (F =43.15 and 52.23, P ＜ 0.05).At 0h after surgery, the plasma values of PCT, iFABP and DAO were similar in three groups (F =11.17, 22.45 and 13.58, P ＞ 0.05).At 8h and 12h after surgery, values of PCT, iFABP and DAO in septic and UTI groups were much higher than those in the sham group, and those in UTI group were also significantly higher than those in septic group (F8h=85.26, 44.59 and 101.47, F12h =59.44, 49.26 and 69.57, all P＜0.05).PCT, iFABP and DAO levels were first increased and then fell down in sham group, those in septic group were keeping increasing, and those in UTI group were first increased and then kept stable.Conclusion UTI shows protective effect to intestinal barrier function in rats with sepsis.

Reaffirmation and classifcation of the areas with highwater iodine and the endemíc areas of íodine excess goiter in Jiansu Provice / 中国地方病学杂志

Objective To affirm and calssify the arsas with high water iodine and the endemic areas of indline excess goiter in Jiangsu Privince accirding to mational standard.Methods A cross section survey was condueted in 2005 at township level in Fenxian,Tongshan,Suining,Pizhou counties in Xuzhou municipal and Chuzhou district in Huai'an municipal in Jiangsu Province One sample of dringing well water from five directions in the five villages located dircetions of every township namely east west south north and central.was tested for its water iodine concentration.If the sample number sas less than 5 in one village,then all the well water would be tested Endemic stutas of iodine excess goiter was investigated in those townships whose menian water iodine comcentration was between 150 to 300 μg/L Then status was affirmed and reclassifed according.to National Criteria GB/T 19280-2003 Results In all 158 tawnships from the 6 counties the median of water iodine concentration in 79 townships were over 150 μg/L with 32 townships in the range of 150 to 300μg/L In those 32 townships 9 met the criteria of area of high water iodine 23 accorded with that of encemic areas of iosine excess goiter 16 had stopped the supply of non-iodzed salt in advace,but 16 newly detected areas were still served with iodized salt Four were 300 μg/L Conctusions Iodized salt intervention should be stopped in all townships with the problems of high water iodine and the endmic areas of iodine excess goter in order to prevent the possible hazards due to double intade.