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Objective:To explore the experience and true feeling of home care aides during nighttime caring at the first beginning stage of this program, find the difficulty of it and provide constructive suggestions for improvement.Methods:Semi-structed interviews were used to collect the data of 16 home care aides who were taking part in nighttime caring. Colaizzi phenomenological analysis was used to process and analyze the data.Results:Three themes were extracted by classifying and analyzing the details of the interview: the service content of nighttime care was easy, but had many constraint conditions; the caregivers had diversified emotional experience during nighttime care; the elderly would like to enjoy nighttime care, but they were unwilling to pay by themselves.Conclusions:Nighttime caring project deepens the service content of home-based care. But the nighttime care project needs to be standardized. We should establish risk prevention measures to guarantee the benefit and security of both home caregivers and care-receivers, changing the opinions of consumption among the elderly, increasing the amount of subsidy to enlarge the expansion of nighttime care and improve the equality of this caring program.
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@#Objective To explore the relationship between metformin use and the risk and prognosis of esophageal cancer in patients with diabetes. Methods The PubMed, Web of Science, EMbase, VIP, WanFang and CNKI databases were searched by computer to identify relevant studies from inception to August 21, 2021. Newcastle-Ottawa scale (NOS) was used to evaluate research quality. The STATA 12.0 software was used to conduct the statistical analysis. Results A total of 14 studies involving 5 605 218 participants were included finally. NOS of all researches were≥6 points. The pooled results indicated that metformin use could decrease the risk of esophageal cancer in diabetics (OR=0.84, 95%CI 0.71-1.00, P=0.045), and could also prolong the overall survival of diabetics with esophageal cancer (HR=0.89, 95%CI 0.80-0.99, P=0.025). Conclusion Metformin use can not only decrease the risk of esophageal cancer in patients with diabetes, but also improve the prognosis of diabetics with esophageal cancer significantly. However, more prospective high-quality studies are still needed to verify the conclusion.
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Objective:On the basis of introducing and piloting long-term care insurance services and providing home care for older adults with disabilities in Suzhou, this paper aims to explore the working experience of home caregivers in the caring environment, understand their difficulties and issues, explore their true feelings and the relevant causes, and to draw lessons from their experience, providing constructive suggestions for the establishment of caregivers as well as policy recommendations for the government.Methods:The qualitative research method was used to collect the field experience data of 9 home caregivers in the caring environemnt through observation and semi-structured interview. Colaizzi phenomenological analysis was used to process and analyze the data.Result:1. Heavy workload and lack of incentive mechanism; 2. Care experience is diverse, with a sense of achievement and happiness, but lack of family′s trust and identification; 3. Professional trainings and peer support are needed.Conclusion:1. Improving the working environment of caregivers and reducing the burden of care; 2.Improve the employment treatment of home care workers, and actively improve the relevant incentive mechanism;3. Paying attention to the emotional experience of caregivers and helping them adapt to their role; 4.Standardize professional knowledge and skills training, provide risk assessment tools, and improve the quality of care.
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@#Objective To explore the correlation of preoperative D-dimer (DD) level with prognosis in Chinese esophageal cancer patients. Methods PubMed, EMbase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang, SinoMed databases were searched to identify potential studies which assessed prognostic value of preoperative DD level in Chinese esophageal cancer patients from the establishment date of each database to March 20, 2019. The Stata 12.0 software was applied to conduct the meta-analysis and the hazard ratio (HR) with 95% confidence interval (CI) was combined to evaluate the relation between preoperative DD level and survival of Chinese esophageal cancer patients. Results A total of 5 studies involving 1 277 patients were included. The quality score of each study was ≥6 points. The results showed that the elevated preoperative DD level was significantly associated with poor overall survival (OS, HR=1.49, 95%CI 1.05-2.10, P=0.025) and cancer-specific survival (CSS, HR=1.83, 95%CI 1.39-2.42, P<0.001). However, no significant relation of preoperative DD with disease-free survival (DFS) was observed (HR=1.55, 95%CI 0.89-2.70, P=0.125). Conclusion High preoperative DD level may be an independent prognostic factor for Chinese patients with esophageal cancer. More prospective studies with bigger sample sizes are still needed to verify our results.
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Objective To analyze the influence of validating the parental origin to the interpretation of clinical pathogenicity of total 54 copy number variations(CNV)with different clinical significance in 46 patients undergo chromosomal microarray analysis(CMA).Methods A retrospective study.This study enrolled 46 patients conducted in Department of Pediatric Endocrinology and Genetics of Shanghai Xinhua Hospital during the period of August 2014 to December 2015,involving 54 different CNVs detected by CMA.The parental origin of CNVs was examined by CMA or quantitative real-time polymerase chain reaction.Results Totally 54 different CNVs were found in 46 patients by CMA.Seventeen out of the 54 CNVs were pathogenic variations.After validating the parental origin,14 CNVs were proved de novo mutation,while 3 CNVs have maternal origin including 1q21.1 deletion syndrome,Xq27.3q28 and Xq22.1q22.3 duplications which inherited from maternal X chromosome.CNVs of 1q21.1 deletion syndrome often inherited from parents,and no phenotype appears on mother which may be due to the deactivation mechanism of duplications on mother′s X chromosome.Therefore,these 17 pathogenic variations were still considered to be clinical pathogenic significance after validating the parental origin.Ten out of 54 CNVs were variants of uncertain significance-likely pathogenic.After parental original validation,3 CNVs were proved de novo mutation considering likely pathogenic significance,while 7 CNVs have parental origin still judged to be unknown clinical pathogenicity.Twenty-seven out of 54 CNVs were variants of uncertain significance.After validating the parental origin,only 1 CNV was proved de novo mutation considering likely pathogenic significance,while all the others had parental origin considered to be variations likely benign.Conclusion CNVs reported as likely pathogenic should be validated the parental origin in order to further study their clinical pathogenicity,while variants of uncertain significance can preliminary clear its nature by validating parental origin.
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Copy number variations in the human genome,one of the causes of complex diseases and genetic diseases,can lead to genomic disorders.As these diseases are difficult to diagnose,it is significantly meaningful to conduct genetic researches and molecular diagnosis.Chromosomal microarray can be used to detect copy number variations on a genome-wide scale.With the advantage of high throughput and resolution,chromosomal microarray is perceived as an important means of identifying copy number variations in genomic disorders.As technology advancements of chromosomal microarray and accumulations of clinical experiences,chromosomal microarray has played a significant role in etiological diagnosis of multiple malformations,mental retardation and autism.
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Objective To investigate the relationship of single nucleotide polymorphism (SNP) on FTO gene rs9939609 with metabolism index and obesity in children. Methods One hundred and fifty-three children (age 7-11 year) were recruited in this study, 102 of them were obese and 51 of them were overweight. One hundred and sixty children with normal body weight were recruited as control. Height, weight and biochemical indicator of liver function were measured. PCR and direct sequence were applied to detect the polymorphism of rs9939609, and the frequency of the allele was calculated. Results TT or TA/AA genotype frequency on FTOgene rs9939609 was significantly different among overweight group, obesity group and normal con-trol group (χ2=23.01, P<0.001);TA/AA genotype frequency in overweight and obesity group was significant higher than that in the control group(P<0.014). The frequencies of T and A allele in overweight group, obesity group and control group was 96.25%and 3.75%, 85.29%and 14.71%, 85.78%and 14.22%respectively. There was significant difference of allelic frequency among overweight group, obesity group and control group (χ2=21.72, P<0.001). The frequency of A allele in overweight and obe-sity group was higher than that in control group (P'<0.014). Subjects with TA/AA allele had significantly higher BMI compared with subjects with TT allele. Conclusions rs9939609 of FTO gene is associated with obesity in children, and allele A on this spot may raise BMI and leads to overweight and obesity.
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At present, the training pattern in the higher-education institutions of traditional Chinese medicine (TCM) is still characterized as a trilogy of basic medical theory courses, clinical medical courses and graduation clinic practice, which results in the slow-cultivation of the TCM talent, and brings into the severe problems of theory being divorced from practice and bad social adaptability in the graduates. Under this situation, it is imperative to reform the traditional training patterns and to advocate innovation in the education. It is suggested that creative teachers, students' creative study and a democratic, harmonious, relaxing and easy study atmosphere are helpful to the cultivation of TCM talents. Therefore, a student-orientating training pattern of classroom-teaching synchronized with the clinic practice, emphasizing clinic practice, and aiming to improve the scientific research ability is advocated in higher-education of TCM. This is expected to provide some thoughts for the development of TCM higher education in the new era.
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Objective To prevent data transfer or loss in application development when dealing with data exchange between Oracle database with different server's character set.Methods Environment variable is set to update Oracle client's character set so as to solve data transfer or loss caused by character set transformation.Results It was the environment variable not the register list that was reset,so Oracle databases with different server's character set were not connected at the same time.Conclusion An adaptive method for different server's character set is given to solve this problem.
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The authors first describe their preparation for and implementation of the assessment of candidates to be fostered as leaders in various fields of learning, viz. selecting assessment methods, identifying an assessment index system, and specifying the index weight and ways to keep the score and implement the assessment. Then they give an account of the assessment results. Finally they analyze the clinical abilities and research capacities examined in the assessment and sum up their practical experience as: ①emphasis by the leading group on the creation of the right environment and mechanism for the growth of leaders in various fields of learning; ②transformation of concepts regarding the use of personnel; ③specification of the function of the assessment; ④identification of strengthened assessment as the key to guaranteeing the quality in fostering leaders in various fields of learning.