Value of combining targeted emergency nursing with psychological nursing in children with febrile convulsions

BACKGROUND Febrile convulsions are a common pediatric emergency that imposes significant psychological stress on children and their families.Targeted emergency care and psychological nursing are widely applied in clinical practice,but their value and impact on the management of pediatric febrile convulsions are unclear.AIM To determine the impact of targeted emergency nursing combined with psychological nursing on satisfaction in children with febrile convulsions.METHODS Data from 111 children with febrile convulsions who received treatment at Nantong Maternal and Child Health Care Hospital between June 2021 and October 2022 were analyzed.The control group consisted of 44 children who received conventional nursing care and the research group consisted of 67 children who received targeted emergency and psychological nursing.The time to fever resolution,time to resolution of convulsions,length of hospital stays,Pittsburgh Sleep Quality Index,patient compliance,nursing satisfaction of the parents,occurrence of complications during the nursing process,and parental anxiety and depression were compared between the control and research groups.Parental anxiety and depression were assessed using the Hamilton Rating Scale for Depression(HAMD)and the Hamilton Rating Scale for Anxiety(HAMA).RESULTS The fever resolution,convulsion disappearance,and hospitalization times were longer in the control group compared with the research group(P<0.0001).The time to falling asleep,sleep time,sleep quality,sleep disturbance,sleep efficiency,and daytime status scores were significantly better in the research group compared with the control group(P<0.0001).The HAMD and HAMA scores for parents of children in the research group were lower than the scores in the control group after nursing(P<0.05).Compliance with treatment of children in the research group was higher than in the control group(P<0.05).Parental satisfaction with nursing in the research group was higher than in the control group(P<0.05).The total complication rate of children in the control group was higher than in the research group(P<0.05).CONCLUSION Combining psychological nursing with targeted emergency nursing improved the satisfaction of children’s families and compliance with treatment and promoted early recovery of clinical symptoms and improvement of sleep quality.

Impact of enteral nutrition on energy metabolism in patients with Crohn's disease

AIM: To investigate the impact of enteral nutrition(EN) on the body composition and metabolism in patientswith Crohn's disease(CD). METHODS: Sixty-one patients diagnosed with CD were enrolled in this study. They were given only EN(enteral nutritional suspension, TPF, non-elemental diet) support for 4 wk, without any treatment with corticosteroids, immunosuppressive drugs, infliximab or by surgical operation. Body composition statistics such as weight, body mass index, skeletal muscle mass(SMM), fat mass, protein mass and inflammation indexes such as C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and CD activity index(CDAI) were recorded before and after EN support. RESULTS: The 61 patients were divided into three groups according to CDAI before and after EN support: A(active phase into remission via EN, n = 21), B(remained in active phase before and after EN, n = 19) and C(in remission before and after EN, n = 21). Patients in group A had a significant increase in SMM(22.11 ± 4.77 kg vs 23.23 ± 4.49 kg, P = 0.044), protein mass(8.01 ± 1.57 kg vs 8.44 ± 1.45 kg, P = 0.019) and decrease in resting energy expenditure(REE) per kilogram(27.42 ± 5.01 kcal/kg per day vs 22.62 ± 5.45 kcal/kg per day, P < 0.05). There was no significant difference between predicted and measured REE in active CD patients according to the HarrisBenedict equation. There was no linear correlation between the measured REE and CRP, ESR or CDAI in active CD patients. CONCLUSION: EN could decrease the hypermetabolism in active CD patients by reducing the inflammatory response.

Score model for predicting acute-on-chronic liver failure risk in chronic hepatitis B

AIM: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure(ACLF) in chronic hepatitis B(CHB) patients.METHODS: This was a retrospective study of 1457 patients hospitalized for CHB between October 2008 and October 2013 at the Beijing Ditan Hospital, Capital Medical University, China. The patients were divided into two groups: severe acute exacerbation(SAE) group(n = 382) and non-SAE group(n = 1075). The SAE group was classified as the high-risk group based on the higher incidence of ACLF in this group than in the non-SAE group(13.6% vs 0.4%). Two-thirds of SAE patients were randomly assigned to risk-model derivation and the other one-third to model validation. Univariate risk factors associated with the outcome were entered into a multivariate logistic regression model for screening independent risk factors. Each variable was assigned an integer value based on the regression coefficients, and the final score was the sum of these values in the derivation set. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve and the Hosmer-Lemeshow test. RESULTS: The risk prediction scoring model includedthe following four factors: age ≥ 40 years, total bilirubin ≥ 171 μmol/L, prothrombin activity 40%-60%, and hepatitis B virus DNA > 107 copies/m L. The sum risk score ranged from 0 to 7; 0-3 identified patients with lower risk of ACLF, whereas 4-7 identified patients with higher risk. The Kaplan-Meier analysis showed the cumulative risk for ACLF and ACLF-related death in the two risk groups(0-3 and 4-7 scores) of the primary cohort over 56 d, and log-rank test revealed a significant difference(2.0% vs 33.8% and 0.8% vs 9.4%, respectively; both P < 0.0001). In the derivation and validation data sets, the model had good discrimination(C index = 0.857, 95% confidence interval: 0.800-0.913 and C index = 0.889, 95% confidence interval: 0.820-0.957, respectively) and calibration demonstrated by the Hosmer-Lemeshow test(χ2 = 4.516, P = 0.808 and χ2 = 1.959, P = 0.923, respectively).CONCLUSION: Using the scoring model, clinicians can easily identify patients(total score ≥ 4) at high risk of ACLF and ACLF-related death early during SAE.

Wavelet denoising and nonlinear analysis of solids concentration signal in circulating fluidized bed riser

Particles,particle aggregates,and reactor walls complicate the dynamic microstructures of circulating fluidized beds(CFBs).Using local solids concentration data from a 10-m-high and 76.2-mm-inner-diameter riser with FCC(Fluid Catalytic Cracking)particles(dp=67μm,ρp=1500 kg/m^3),this paper presents an improved denoising process for use before nonlinear chaos analysis.Using the soft-threshold denoising method in the wavelet domain with experimental empty bed signals as base data to estimate the denoising threshold,an efficient denoising algorithm was proposed and used for the dynamic signals in CFBs.Analysis shows that for the local solids concentration time series,high-frequency fluctuations may be one of the system properties,while noise interference can also make a low-frequency contribution.An exact denoising method is needed in such cases.The correlation dimension and Kolmogorov entropy were calculated using denoised data and the results showed that the particle behavior in the CFB is highly complex.Generally,two correlation dimensions coexist in a low-flux CFB.The first correlation dimension is low and corresponds to small-scale fluctuations that reveal a high-frequency pseudo-periodic movement,but the second correlation dimension is high and corresponds to large-scale fluctuations that indicate multi-frequency movements,including particle aggregation and breakage.At the same axial level,the first correlation dimensions change slightly with radial position,and the main tendency is high at the center but slightly lower near the wall.However,the second correlation dimensions show large changes along the radial direction,are again high in the core region,and after r/R≥0.6(r as radial position,R as radius of the riser),the dimensions clearly drop down.This indicates that the particle behavior is more complex and has higher degrees of freedom at the center,but clusters near the wall are restrained to some degree because of wall effects.

Three CNGC Family Members, CNGC5, CNGC6, and CNGC9, Are Required for Constitutive Growth of Arabidopsis Root Hairs as Ca2+-Permeable Channels

The genetic identities of Ca2+ channels in root hair (RH) tips essential for constitutive RH growth have remained elusive for decades. Here, we report the identification and characterization of three cyclicnucleotide-gated channel (CNGC) family members, CNGC5, CNGC6, and CNGC9, as Ca2+ channels essential for constitutive RH growth in Arabidopsis. We found that the cngc5-1cngc6-2cngc9-1 triple mutant(designated shrh1) showed significantly shorter and branching RH phenotypes as compared with thewild type. The defective RH growth phenotype of shrh1 could be rescued by either the expression ofCNGC5, CNGC6, or CNGC9 single gene or by the supply of high external Ca2+, but could not be rescuedby external K+ supply. Cytosolic Ca2+ imaging and patch-clamp data in HEK293T cells showed that thesethree CNGCs all function as Ca2+-permeable channels. Cytosolic Ca2+ imaging in growing RHs furthershowed that the Ca2+ gradients and their oscillation in RH tips were dramatically attenuated in shrh1compared with those in the wild type. Phenotypic analysis revealed that these three CNGCs are Ca2+ channels essential for constitutive RH growth, with different roles in RHs from the conditional player CNGC14.Moreover, we found that these three CNGCs are involved in auxin signaling in RHs. Taken together, ourstudy identified CNGC5, CNGC6, and CNGC9 as three key Ca2+ channels essential for constitutive RHgrowth and auxin signaling in Arabidopsis.