WeChat-based remote follow-up management alleviates the home care burden and anxiety of parents of premature infants: Randomized controlled study.

OBJECTIVE: The purpose of this study was to explore the effect of WeChat-based remote follow-up management on reducing the home care burden and anxiety of parents of premature infants. METHODS: A randomized controlled study was conducted in our hospital, with 150 premature infants enrolled in this study, each with 75 cases in the intervention group and the control group. WeChat-based remote follow-up management was performed in the intervention group after discharge, while traditional outpatient follow-up management was performed in the control group. Zarit Burden Interview (ZBI) scale as the primary outcome was used to compare the parental care burden between the two groups. RESULTS: At the 1-month follow-up, the ZBI (37.1 ± 8.3 vs. 54.2 ± 10.5 [mean ± SD], mean difference: 17.1, the 95% confidence interval for the mean difference: [14.07, 20.13], P = 0.016), Family Caregiver Task Inventory (FCTI) scale (23.1 ± 5.2 vs. 33.4 ± 6.7 [mean ± SD], mean difference: 10.3, the 95% confidence interval for the mean difference: [8.38, 12.22], P = 0.023), Self-Rating Anxiety Scale (SAS) (49.6 ± 8.5 vs. 60.2 ± 10.8 [mean ± SD], mean difference: 10.6, the 95% confidence interval for the mean difference: [7.49,13.71], P = 0.021) and Self-Rating Depression Scale (SDS) (48.2 ± 9.5 vs. 58.8 ± 11.2 [mean ± SD], mean difference: 10.6, the 95% confidence interval for the mean difference: [7.28, 13.92], P = 0.019) scores of the intervention group were lower than those of the control group, and the lower scores indicate better outcomes. CONCLUSION: WeChat-based remote follow-up management of premature infants after discharge can effectively improve parents' ability to care and their psychological state and reduce burden of care.

[Using Self-Efficacy Theory to Manage Ineffective Airway Clearance in a Client With Advanced Esophageal Cancer].

This nursing experience describes the application of "self-efficacy theory" to a patient with low self-efficacy who was diagnosed with advanced esophageal cancer. The nursing period was from December 3rd, 2020 to December 23rd, 2020. Medical records, interview assessment, and observation showed that the patient had ineffective airway clearance, which caused him to be in and out of the hospital several times, resulting in lower self-efficacy. In addition to applying the "self-efficacy theory", the authors referenced the patient's physiological and affective states, vicarious experiences, and performance experiences and used verbal persuasion techniques to assess the patient for nursing and interventions. During the nursing period, we established a good therapeutic relationship with the patient. We provided him with personalized nursing interventions to improve his physiological and affective states. These interventions included the administration of medication, posture drainage, and sputum percussion. We also sought the help of people who were close to the patient as participants in the medical care process. We improved self-efficacy by means of verbal persuasion through education and mental support; increased vicarious experience through verbal encouragement and sharing the experiences of other patients; and used a comparative approach to enable the patient to observe changes in his physical status over time. The interventions also improved his performance experience. The patient's airway status improved after his self-efficacy had been enhanced. Based on the results, it is hoped that this study will be a helpful reference on the theory of self-efficacy for nursing staff. It is also hoped that the results will better enable nurses to enhance the self-efficacy of patients using different means such as restoring patient confidence and enhancing the patient - the medical team relationship to further enhance the quality of patient care.

Oxalic Acid in Root Exudates Enhances Accumulation of Perfluorooctanoic Acid in Lettuce.

Perfluorooctanoic acid (PFOA) is bioaccumulative in crops. PFOA bioaccumulation potential varies largely among crop varieties. Root exudates are found to be associated with such variations. Concentrations of low-molecular-weight organic acids (LMWOAs) in root exudates from a PFOA-high-accumulation lettuce variety are observed significantly higher than those from PFOA-low-accumulation lettuce variety (p < 0.05). Root exudates and their LMWOAs components exert great influences on the linear sorption-desorption isotherms of PFOA in soils, thus activating PFOA and enhancing its bioavailability. Among root exudate components, oxalic acid is identified to play a key role in activating PFOA uptake, with >80% attribution. Oxalic acid at rhizospheric concentrations (0.02-0.5 mM) can effectively inhibit PFOA sorption to soils by decreasing hydrophobic force, electrostatic attraction, ligand exchange, and cation-bridge effect. Oxalic acid enhances dissolution of metallic ions, iron/aluminum oxides, and organic matters from soils and forms oxalate-metal complexes, based on nuclear magnetic resonance spectra, ultraviolet spectra, and analyses of metal ions, iron/aluminum organometallic complexes, and dissolved organic carbon. The findings not only reveal the activation process of PFOA in soils by root exudates, particularly oxalic acid at rhizospheric concentrations, but also give an insight into the mechanism of enhancing PFOA accumulation in lettuce varieties.

Dynamics, thermodynamics, and mechanism of perfluorooctane sulfonate (PFOS) sorption to various soil particle-size fractions of paddy soil.

Soil is an important sink for perfluorooctane sulfonate (PFOS) that is a typical persistent organic pollutant with high toxicity. Understanding of PFOS sorption to various particle-size fractions of soil provides an insight into the mobility and bioavailability of PFOS in soil. This study evaluated kinetics, isotherms, and mechanisms of PFOS sorption to six soil particle-size fractions of paddy soil at environmentally relevant concentrations (0.01-1 µg/mL). The used soil particle-size fractions included coarse sand (120.4-724.4 mm), fine sand (45.7-316.2 mm), coarse silt (17.3-79.4 mm), fine silt (1.9-39.8 mm), clay (0.5-4.4 mm), and humic acid fractions (8.2-83.7 mm) labeled as F1~F6, respectively. PFOS sorption followed pseudo-second-order kinetics related to film diffusion and intraparticle diffusion, with speed-limiting phase acted by the latter. PFOS sorption isotherm data followed Freundlich model, with generally convex isotherms in larger size fractions (F1~F3) but concave isotherms in smaller size fractions (F4 and F5) and humic acid fraction (F6). Increasing organic matter content, Brunner-Emmet-Teller surface area, and smaller size fractions were conducive to PFOS sorption. Hydrophobic force, divalent metal ion-bridging effect, ligand exchange, hydrogen bonding, and protein-like interaction played roles in PFOS sorption. But hydrophobic force controlled the PFOS sorption, because its relevant organic matter governed the contribution of the soil fractions to the overall PFOS sorption. The larger size fractions dominated the PFOS sorption to the original soil because of their high mass percentages (~80%). This likely caused greater potential risks of PFOS migration into groundwater and bioaccumulation in crops at higher temperatures and ce values, based on their convex isotherms with an exothermic physical process.

Detection of 5 Kinds of Genes Related to Plasmid-Mediated Quinolone Resistance in Four Species of Nonfermenting Bacteria with 2 Drug Resistant Phenotypes.

OBJECTIVE: This study aimed to detect 5 kinds of genes related to plasmid-mediated quinolone resistance in four species of nonfermenting bacteria with 2 drug resistance phenotypes (multidrug resistance and pandrug resistance), which were Acinetobacter baumannii (Ab), Pseudomonas aeruginosa (Pa), Stenotrophomonas maltophilia (Sm), and Elizabethkingia meningoseptica (Em). METHODS: The Phoenix NMIC/ID-109 panel and API 20NE panel were applied to 19 isolated strains, including 6 Ab strains (2 strains with multidrug resistance and 4 strains with pandrug resistance), 6 Pa strains (3 strains with multidrug resistance and 3 strains with pandrug resistance), 4 Sm strains (2 strains with multidrug resistance and 2 strains with pandrug resistance), and 3 Cm strains (2 strains with multidrug resistance and 1 strain with pandrug resistance). After strain identification and drug susceptibility test, PCR was applied to detect 5 genes related to plasmid-mediated quinolone resistance. The genes detected were quinolone resistance A (qnrA), aminoglycoside acetyltransferase ciprofloxacin resistance variant, acc(6')-Ib-cr, and 3 integrons (intI1, intI2, and intI3). The amplified products were analyzed by 1% agarose gel electrophoresis and sequenced. Sequence alignment was carried out using the bioinformatics technique. RESULTS: Of 19 strains tested, 8 strains carried acc(6')-Ib-cr and 6 of them were of pandrug resistance phenotype (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of acc(6')-Ib-cr was 60.0% for strains of pandrug resistance (6/10). Two strains were of multidrug resistance (1 Ab strain and 1 Pa strain), and the carrying rate of acc(6')-Ib-cr was 22.0% (2/9). The carrying rate was significantly different between strains of multidrug resistance and pandrug resistance (P < 0.05). The class 1 integron was detected in 11 strains, among which 6 strains were of pandrug resistance (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of the class 1 integron was 60.0% (6/10). Five strains were of multidrug resistance (3 Pa strains, 1 Ab strain, and 1 Em strain), and the carrying rate was 55.6% (5/9). The carrying rate of the class 1 integron was not significantly different between strains of multidrug resistance and pandrug resistance (P > 0.05). Both acc(6')-Ib-cr and intI1 were detected in 6 strains, which were negative for qnrA, intI2, and intI3. CONCLUSION: Quinolone resistance of isolated strains was related to acc(6')-Ib-cr and intI1 but not to qnrA, intI2, or intI3. The carrying rate of acc(6')-Ib-cr among the strains of pandrug resistance was much higher than that among the strains of multidrug resistance. But, the strains of two drug resistant phenotypes were not significantly different in the carrying rate of intI1. The detection rates of the two genes were high and similar in Ab and Pa strains. 1 Em strain carried the class 1 integron.

Gender differences in clinical characteristics of patients with non-cystic fibrosis bronchiectasis in different age groups in northern China.

INTRODUCTION: Patient gender has clinical and prognostic implications in non-cystic fibrosis bronchiectasis, yet the potential effect of gender on clinical characteristics of patients with non-cystic fibrosis bronchiectasis is still unclear. OBJECTIVES: This study aimed to investigate the gender differences in clinical characteristics of patients with bronchiectasis in different age groups in northern China. METHODS: A total of 777 patients diagnosed with bronchiectasis were retrospectively included in Beijing Chaoyang Hospital and divided into two groups by gender: the male group and the female group. Each group was then subdivided into two according to their age (≤65 and >65 years). Gender differences in clinical characteristics were compared in all patients with bronchiectasis in the two age groups, respectively. RESULTS: A total of 777 bronchiectasis patients were included. Of these patients, the prevalence of female non-smokers was substantially higher than that of male non-smokers (94.0% vs. 36.8%). There were gender differences in etiology of bronchiectasis, with more post-measles and connective tissue disease in females (p = 0.006 and 0.002 separately) and more chronic obstructive pulmonary disease (COPD) in males (p < 0.001). The male group had a significantly higher C-reactive protein (CRP) on admission (p = 0.03). Female patients showed a higher forced expiratory volume in 1 s as percentage of predicted volume (FEV1%pred) and forced vital capacity rate of 1 s (FEV1/FVC) (p < 0.001), lower partial pressure of carbon dioxide (PaCO2 ) (p = 0.04) and hospital costs (p = 0.02) than males, and a higher prevalence of infection with Pseudomonas aeruginosa in >65-year-old group (p = 0.019). CONCLUSIONS: There were many differences between male and female patients in smoking status, etiology, lung function, blood gas analysis, and hospital costs in all patients or different age groups.

The design and application of an intensive care unit point-of-care nursing handover checklist based on the situation, background, assessment, and recommendation technique.

Objective: This study aims to analyze the effect of using an intensive care unit point-of-care nursing handover checklist based on the situation, background, assessment, and recommendation (SBAR) communication technique. Methods: An intensive care unit point-of-care nursing handover checklist was designed based on the SBAR technique, and standard point-of-care nursing handover procedures and effect assessment indicators were established to compare the occurrence of adverse handover events and nursing risks with those previously observed. Results: Before and after the application of the intensive care unit point-of-care SBAR checklist, the occurrence of missed items during the handover was 7.26 and 2.02%, inadequate preparation for handover was 28.33 and 5%, and nursing risks were 5 and 1.67%, respectively. Conclusion: Based on the SBAR technique, the application of an intensive care unit point-of-care nursing checklist reduced the occurrence of adverse handover events and nursing risks.

Improved cathodic oxygen reduction and bioelectricity generation of electrochemical reactor based on reduced graphene oxide decorated with titanium-based composites.

A kind of reduced graphene oxide decorated with titanium-based (RGO/TiO2) composites are successfully synthesized and employed in this current study as a novel nonprecious metal catalyst for enhancing bioelectricity generation and cathodic oxygen reduction reaction (ORR) in single chamber microbial fuel cells (MFCs). Compared with commercial Pt/C, RGO/TiO2 shows obviously enhanced oxygen reduction reaction activity due to the appropriately-permeated, large electrochemical active area, enough exposure of electrocatalytic active sites of RGO/TiO2. The air-cathode MFC with RGO/TiO2-1 cathode achieves 1786.7 mW m-3 of power density, 86.7% ±â€¯1.2% of COD removal and 31.6% ±â€¯1.1% of CE, which are higher than commercial Pt/C. Moreover, RGO/TiO2-1 cathode exhibits high-effective electrocatalytic activity, and the power density of RGO/TiO2-1 can keep a stable level and only has a minor decline (5.35%) during 30-cycles operation. These results indicate that RGO/TiO2-1 is a potential cathode catalyst, markedly enhancing cathode ORR, wastewater treatment efficiency, and bioelectricity generation of MFC.

Prevalent phthalates in air-soil-vegetable systems of plastic greenhouses in a subtropical city and health risk assessments.

Wide use of plastic greenhouses for vegetable production increases human exposure to phthalate (PAEs) through vegetable intake. However, little information is available about distribution of PAEs in air-soil-vegetable systems of plastic greenhouses and PAE estrogenic effects. This study was designed to investigate PAE distributions and corresponding health risk in plastic greenhouses in Guangzhou, a subtropical city in South China. PAEs were prevalent in plastic greenhouses, with sum concentrations of 16 PAE compounds (∑16PAEs) up to 5.76 mg/kg in soils, 5.27 mg/kg in vegetables and 4393 ng/m3 in air. Di (2-ethylhexyl) phthalate, di-isobutyl phthalate, and dibutyl phthalate were predominant compounds. Average concentrations and bioconcentration factor of ∑16PAEs and the predominant PAE compounds in vegetables of greenhouses were higher than those of open fields. Plastic greenhouses exhibited significantly higher air PAE levels than those of open fields due to higher indoor temperature, which enhanced PAE accumulation by vegetables. Both carcinogenic and non-carcinogenic risks of PAEs via dietary and non-dietary exposures for farmers decreased with an order of vegetable > air > soil. Consumption of vegetables from greenhouses resulted in significantly higher estrogenic effects compared to those from open field cultivation. This study emphasizes highly potential health risks of PAEs in air-soil-vegetable systems of plastic greenhouses.

Antiretroviral Long-Term Efficacy and Resistance of Lopinavir/Ritonavir Plus Lamivudine in HIV-1-Infected Treatment-Naïve Patients (ALTERLL): 144-Week Results of a Randomized, Open-Label, Non-Inferiority Study From Guangdong, China.

Dual therapy with lopinavir/ritonavir (LPV/r) plus lamivudine (3TC) has been demonstrated to be non-inferior to the triple drug regimen including LPV/r plus two nucleoside reverse transcriptase inhibitors (NRTIs) in 48-week studies. However, little is known about the long-term efficacy and drug resistance of this simplified strategy. A randomized, controlled, open-label, non-inferiority trial (ALTERLL) was conducted to assess the efficacy, drug resistance, and safety of dual therapy with LPV/r plus 3TC (DT group), compared with the first-line triple-therapy regimen containing tenofovir (TDF), 3TC plus efavirenz (EFV) (TT group) in antiretroviral therapy (ART)-naïve HIV-1-infected adults in Guangdong, China. The primary endpoint was the proportion of patients with plasma HIV-1 RNA < 50 copies/ml at week 144. Between March 1 and December 31, 2015, a total of 196 patients (from 274 patients screened) were included and randomly assigned to either the DT group (n = 99) or the TT group (n = 97). In the primary intention-to-treat (ITT) analysis at week 144, 95 patients (96%) in the DT group and 93 patients (95.9%) in the TT group achieved virological inhibition with plasma HIV-1 RNA <50 copies/ml (difference: 0.1%; 95% CI, -4.6-4.7%), meeting the criteria for non-inferiority. The DT group did not show significant differences in the mean increase in CD4+ cell count (247.0 vs. 204.5 cells/mm3; p = 0.074) or the CD4/CD8 ratio (0.47 vs. 0.49; p = 0.947) from baseline, or the inflammatory biomarker levels through week 144 compared with the TT group. For the subgroup analysis, baseline high viremia (HIV-1 RNA > 100,000 copies/ml) and genotype BC did not affect the primary endpoint or the mean increase in CD4+ cell count or CD4/CD8 ratio from baseline at week 144. However, in patients with genotype AE, the DT group showed a higher mean increase in CD4+ cell count from baseline through 144 weeks than the TT group (308.7 vs. 209.4 cells/mm3; p = 0.038). No secondary HIV resistance was observed in either group. Moreover, no severe adverse event (SAE) or death was observed in any group. Nonetheless, more patients in the TT group (6.1%) discontinued the assigned regimen than those in the DT group (1%) due to adverse events. Dual therapy with LPV/r plus 3TC manifests long-term non-inferior therapeutic efficacy, low drug resistance, good safety, and tolerability compared with the first-line triple-therapy regimen in Guangdong, China, indicating dual therapy is a viable alternative in resource-limited areas. Clinical Trial Registration: [http://www.chictr.org.cn], identifier [ChiCTR1900024611].

False decrease of high-sensitivity cardiac troponin T assay in pneumatic tube system samples.

BACKGROUND: The pneumatic tube system (PTS) is widely established in clinical laboratories. We aimed to evaluate the impacts of PTS on high-sensitivity cardiac troponin T (hs-cTnT) assays. METHODS: The hemolysis distribution of hs-cTnT PTS specimens from emergency department (ED) were determined by hemolysis index (HI). Grouped samples from 15 healthy volunteers were delivered to the laboratory via manual delivery (MD) or PTS. Interference studies were conducted to access the influence of different hemolysis degrees on hs-cTnT assays. RESULTS: 7.26% PTS specimens from ED were hemolyzed in clinic. Compared with MD samples, we found highly elevated free plasma hemoglobin (Hb) in PTS samples. Hs-cTnT was interfered negatively with free Hb (R = -0.625, P < .001), and it was also validated in interference studies (R ≥ -0.820, all P ≤ .001). Clinically significant bias occurred in each hs-cTnT concentration at 100 mg/dl free Hb (Bias≥ - 13.85%, all P < .05). Moreover, bias of hs-cTnT assays at 50 mg/dl free Hb was approaching 10%, especially at 30 ng/l hs-cTnT concentration (Bias: -11.72%, P < .001). CONCLUSIONS: PTS could increase the frequency of specimen hemolysis which might cause false decrease in hs-cTnT assays. Hence, clinicians should be aware of the increased measurement bias in hs-cTnT from hemolyzed PTS samples with free Hb ≥50 mg/dl.

Isolation and identification of Sclerotinia stem rot causal pathogen in Arabidopsis thaliana.

A new stem rot disease is found to occur naturally on Arabidopsis plants in greenhouses of Fuzhou, China. In order to identify its pathogen, we conducted a series of fungal isolation and purification, plant reinoculation, and ascus and ascospore induction from the sclerotia. The isolate caused typical water-soaked lesions after reinoculation and produced sclerotia both on Arabidopsis plants and culture medium plates, and the sclerotia could be induced to produce discal apothecia and 8 binucleate ascospores per ascus. These disease symptom and fungal morphology data revealed that the fungus Sclerotinia sclerotiorum (Lib.) de Bary was the pathogen for Arabidopsis stem rot. To confirm this, we further amplified its large subunit ribosomal DNA (LSU rDNA) by polymerase chain reaction (PCR), and compared the sequence with the known LSU rDNA sequences in GenBank. The results show that the sequence shares the highest identities with the LSU rDNAs of different S. sclerotiorum strains. Taking all these data together, we concluded that the fungus that caused the Arabidopsis stem rot is S. sclerotiorum (Lib.) de Bary. This is the first report that Arabidopsis is naturally infected by S. sclerotiorum.

High uric acid (UA) downregulates bone alkaline phosphatase (BALP) expression through inhibition of its promoter activity.

Bone metastases often occur in prostate cancers, lung cancers and breast cancers. Bone alkaline phosphatase (BALP) is one of the most commonly used serological markers for clinical evaluation of bone metabolism. Here, we reported that high concentrations of uric acid (UA) caused decrease of BALP levels and revealed that the effect of high concentrations of UA on the BALP expression was through inhibition of its promoter activity. Our results suggested physicians to think about serum UA status of patients with advanced cancer to avoid misdiagnosis when BALP was used to diagnose or assess the extent of bone metastases.

Proliferation PET image to characterize pathological spatial features in patients with non-small cell lung cancer: a pilot study.

PURPOSE: (18)F-FLT-PET imaging was proposed as a tool for measuring in vivo tumor cell proliferation and detecting sub-volumes to propose escalation in radiotherapy. The aim of this study was to validate whether high FLT uptake areas in (18)F-FLT PET/CT are coincident with tumor cell proliferation distribution indicated by Ki-67 staining in non-small cell lung cancer, thus provide theoretical support for the application of dose painting guided by (18)F-FLT PET/CT. MATERIALS AND METHODS: Twelve treatment naive patients with biopsy proven NSCLC underwent (18)F-FLT PET/CT scans followed by lobectomy were enrolled. The surgical specimen was dissected into 4-7 µm sections at approximately 4-mm intervals. The best slice was sort out to complete Ki-67 staining. Maximum Ki-67 labelling Index and SUVmax of the corresponding PET image was calculated. The correlation between Ki-67 Labelling Index and SUVmax of FLT was determined using Spearman Correlation analysis. High uptake areas and high proliferating areas were delineated on the two images, respectively, and their location was compared. RESULTS: The maximal SUV was 3.26 ± 0.97 (1.96-5.05), maximal Ki-67 labeling index was 49% ± 27.56% (5%-90%). Statistical analysis didn't reveal a significant correlation between them (r = -0.157, P = 0.627, > 0.05). 9 patients can contour high proliferating area on Ki-67 staining slice, and eight can contour the high uptake areas. In 4 patients, we can observe a generally close distribution of high uptake areas and high proliferating areas, in one patient, both the uptake level and proliferation status was low, while the others didn't not find a significant co-localization. CONCLUSION: Noninvasive (18)F-FLT PET assessing the proliferative status may be a valuable aid to guide dose painting in NSCLC, but it needs to be confirmed further.

A facile one-pot reduction method for the preparation of a SnO/SnO2/GNS composite for high performance lithium ion batteries.

A SnO/SnO2/GNS composite with controlled oxidation states and composition has been prepared through simple one-pot reduction of an EG suspension of SnCl2 and graphene oxide. The as-prepared composite was characterized by XRD, FT-IR, XPS, SEM, TEM and BET. SnO and SnO2 nanoparticles are uniformly distributed on the surface of the graphene. Taking advantage of the high electron conductivity of graphene and the large theoretical capacity of SnO, this SnO/SnO2/GNS composite exhibits high charge/discharge capacity, good cycling stability and good rate capability. A specific discharge capacity of approximately 464.2 mA h g(-1) is retained after being charged/discharged at a current density of 1000 mA g(-1) for 30 cycles.

[Effect of monoclonal antibodies against LI-cadherin on the proliferation of human hepatocellular carcinoma cells].

OBJECTIVE: To obtain monoclonal antibodies (mAb) against LI-cadherin and investigate their effects on the proliferation of human hepatocellular carcinoma cells. METHODS: Balb/c mice were immunized with recombinant LI-cadherin, and hybridoma cell lines secreting monoclonal antibodies against LI-cadherin were established with routine cell fusion and subcloning approach. The specificity of these mAbs was determined by enzyme-linked immunosorbent assay (ELISA) and Western blotting. The effect of the mAbs obtained on the growth of HepG2 cells was assessed using inverted microscope and MTT assay. RESULTS: Two hybridoma cell lines (F001 and F002) stably secreting specific mAbs were obtained. Western blot analysis showed that the two antibodies specifically recognized LI-cadherin antigen derived from human eucaryotic cells or tissue. Treatment of the HepG2 cells with the mAbs resulted in reduced viable cell number and changes in the cell morphologies, and the two mAbs inhibited the proliferation of HepG2 cells in a concentration-dependent manner (P<0.05). CONCLUSION: The two specific mAbs obtained can inhibit the proliferation of HepG2 cells in vitro, which facilitates further study of the relationship between LI-cadherin and tumors.