Objective The goal of this study was to investigate the correlation between the level of serum vitamin D and bone metabolism and disease activity in ankylosing spondylitis(AS) patients,and thus to explore the role of vitamin D in bone metabolism in AS patients.Methods The serum levels of BALP,TRACP-5b,25-(OH)D3 and blood lymphocytes VDR of 80 AS patients were measured by enzyme-linked immunosorbent assay (ELISA) and compared with those of the control group.Bone mineral density (BMD)was measured by dual-energy X-ray absorptiometry (DEXA).The ESR and CRP level of AS patients were also measured.The correlation between those parameters was analyzed and evaluated.Patients were divided into normal,insufficient and deficient subgroups according to the serum 25-(OH)D3 levels for further comparison.Indepondent saimple t test,t'test andx2 test were used for statistical analysis.Results The 25-(OH)D3 of AS patients [(11.9±2.7) μg/L] was significantly lower than that of the control groups [(22.3±7.9) μg/L] (P＜0.05),while the serum levels of BALP [(3.9±2.7) μg/L] and TRACP-5b [(46±25) ng/L] of AS patients were significantly higher than those of the control group [(2.4±1.0) μg/L] (P＜0.05).According to linear correlation analysis,25-(OH)D3 was negatively correlated with CRP (r=0.324,P=0.003).The ESR,BALP,TRACP-5b in the deficient subgroup were higher than those in the normal and insufficient subgroups(P＜0.05).Conclusion The plasma 25-(OH)D3 may decrease in AS patients,and this may activate bone metabolism,results in increased morbidity of osteoporo-sis,and negatively affect disease activity.

Objective To evaluate 64-MSCT virtual endoscopy in the examination method,displaying ability and clinical application of colon lesions.Methods Compared the results of 49 cases of patients examined with 64-MSCT with that got from Coloscopy,and statistical analysis was conducted.Results A total of 19 cases of adenocarcinoma and 2 cases of colonic diverticula as well as 44 cases of adenomatous polyp were detected.The display rate of polyps was 100％ in which was larger than 10mm,73％ in which was range of 5 ～ 10mm in size and 50％ in which was smaller than 5mm.Conclusion As an relatively noninvasive examination method,64-MSCT virtual endoscopy is concordant with onventional colonoscopy in the aspect of detectable rate and revealing the lesion morphologic and can be used as an important examination measure in the diagnosis for colonic diseases.

OBJECTIVE To understand the bacterial spectrum distribution of sputum among the lung infection patients in our hospital and their resistance mechanisms for the reasonable clinical application of antibiotics to effectively prevent the occurrence of nosocomial infections. METHODS The pathogens isolated from the sputum of patients were identified with pathogen micro-biochemical identification code and the commonly used antibiotics were detected by drug sensitivity tests. RESULTS From 415 samples of the sputum,537 strains were detected out,from them Gram-positive cocci accounted for 70.8%,Gram-negative bacteria accounted for 28.1%,and Candida albicans accounted for 1.1%;MRSA was in 18 strains and ESBLs 6 strains. CONCLUSIONS It is important to sputum culturing for lung infection patients and determining the pathogen species and in their drug susceptibility results,the in order to rationally use the antibiotics and enhance the effectiveness of treatment.

A method for simultaneous determination of 20 Perfluorinated alkyl substances ( PFAS) in animal liver using QuEChERs and HPLC_MS/MS technique was developed. The samples were extracted with 0. 1%hydrochloric acetonitrile and cleaned up with C18 , N_Propylethylendiamine ( PSA ) and graphitized carbon blacks ( GCB ) . The analytes were separated by a reversed phase C18 column and gradiently eluted with a mixed solution of 5 mmol/L ammonium acetate methanol and 5 mmol/L ammonium acetate. The samples were quantified using isotope internal standard and external standard with the matrix matched standard calibration curve method. Good linearity was obtained for all the 20 PFAS at the concentration of 0. 1-10 μg/L with the linear correlation coefficients more than 0. 9995. The limits of detection (LOD) and the limits of quantification ( LOQ) for PFAS were 0. 05-0. 2 μg/kg and 0. 4-0. 5 μg/kg, respectively. The recoveries at three different concentration levels ( 0 . 5 , 2 and 5 μg/kg ) were in the range of 70 . 3% -108 . 1%. The repeatability expressed as relative standard deviations (RSD) was ranged from 2. 1% to 11. 9% (n=6).

Objective To investigate the changes and significance of Th1/Th2 cytokines in ankylosing spondyhtis (AS).Metbotis Serum and synovial fluid levels of TNF-α,IL.17.IL-10 and IL-4 were detected by en-zyme linked immunosorbent assay(ELISA)in AS cases.Results The serun levels of TNF-α,IL-17 and IL-10 were significantly higher,while the serum level of IL-4 Was significantly lower in AS group than in normal group.The levels of TNF-α.IL-17 and IL-4 in synovial fluid were significantly higher than in serum.Conclusion Disequilibrium exists in Th1/Th2 cytokine network of AS.and there is a strong predominance of Th1.

Objective:To understand the current situation of aggression and violence management attitudes of pediatric nurses in Class Ⅲ Grade A hospitals, and analyze its influencing factors.Methods:This research was a survey research. From September to December 2019, convenience sampling was used to select 110 pediatric nurses from three ClassⅢ Grade A hospitals in Wenzhou for investigation with the Management of Aggression and Violence Attitude Scale (MAVAS) and the Self -Transcendence Scale (STS) . A total of 110 questionnaires were distributed and 104 valid questionnaires were collected, with the effective recovery rate of 96.36%. Results:Among 104 pediatric nurses, the total scores of STS and MAVAS were (40.47±9.83) and (57.67±8.24) respectively. Univariate analysis showed that there were statistically significant differences in the MAVAS total score of pediatric nurses with different years of nursing work, whether they participated in relevant training, and whether they experienced violence ( P<0.05) . Regression analysis showed that years of nursing work, whether they experienced violence, and the level of self -transcendence were the influencing factors of pediatric nurses' aggression and violence management attitudes ( P<0.05) . Conclusions:The aggression and violence management attitudes of pediatric nurses in Class Ⅲ Grade A hospitals need to be improved. Years of nursing work, whether they experienced violence and the level of self-transcendence were the main influencing factors. Nursing managers can pay more attention to junior nurses who have not experienced violence so as to improve their aggression and violence management attitudes by improving the self -transcendence of this group.

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0–6 years with ASD in the context of e-health. Methods: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. Results: Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. Conclusion These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0–6 years and their parents.

Purpose/Significance To quantitatively analyze and evaluate 26 health informatization construction policies issued at the national level,so as to provide basis for improving related policies.Method/Process Based on the policy modeling consistency(PMC)index model,a health informatization construction policy evaluation index system is constructed,which includes 9 first-level indicators and 36 second-level indicators.Appling it to the evaluation of various policy texts,and the health informatization construction policies are analyzed in a holistic and concrete way.Result/Conclusion The overall score of the health informatization construction policies is ex-cellent.2 policies are at the perfect level,80.6％of policies are at the excellent level,and there are no bad level policy texts.However,the driving force of the policy and the balance of policy recipients need to be further improved.

Objective:To observe the effect of auricular point press needle on sleep quality of patients with gastric cancer after operation.Methods:From October 2017 to March 2019, a total of 80 patients underwent radical gastrectomy for gastric cancer in the First People's Hospital of Huzhou, Zhejiang Province were selected by using convenience sampling method, and divided into observation group and control group by random number table method, with 40 cases in each group. The control group received routine nursing, while the observation group received auricular point press needle on the basis of routine nursing. Sleep quality was monitored in both groups using sleep monitoring bracelets. In the course of the study, 2 patients in the observation group had surgical complications, and finally 35 patients completed the experiment; 2 patients in the control group had surgical complications, and a total of 33 patients completed the experiment.Results:From the 6th day of intervention (the 4th day after operation) , the sleep duration of the observation group was longer than that of the control group, and the difference was statistically significant ( P<0.05) , the group effect, time effect and interaction effect were statistically significant ( P<0.05) . From the 6th day of intervention (the 4th day after operation) , the proportion of deep sleep of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) , the group effect, time effect and interaction effect were statistically significant ( P<0.05) . Conclusions:Auricular point press needle can effectively improve the sleep quality of patients with gastric cancer after operation.

Purpose: This study aims to comprehensively evaluate the clinical efficacy of chemotherapy or endocrine therapy maintenance in metastatic breast cancer (MBC) patients. Materials and Methods: The meta-analysis of randomized clinical trials (RCTs) and propensity score matching of multicenter cohort study evaluated MBC patients who underwent first-line chemotherapy or endocrine therapy maintenance. This study is registered with PROSPERO: CRD42017071858 and ClinicalTrials.gov: NCT04258163. Results: A total of 2,867 patients from 15 RCTs and 760 patients from multicenter cohort were included. The results from meta-analysis showed that chemotherapy maintenance improved progression-free survival (PFS) (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.54 to 0.73; p < 0.001; moderate-quality evidence) and overall survival (OS) (HR, 0.87; 95% CI 0.78 to 0.97; p=0.016; high-quality evidence) than observation. In the cohort study, for hormone receptor–positive MBC patients, chemotherapy maintenance improved PFS (HR, 0.67; 95% CI, 0.52 to 0.85; p < 0.001) and OS (HR, 0.55; 95% CI 0.42 to 0.73; p < 0.001) compared with observation, and endocrine therapy maintenance also improved PFS (HR, 0.65; 95% CI, 0.53 to 0.80; p < 0.001) and OS (HR, 0.55; 95% CI, 0.44 to 0.69; p < 0.001). There were no differences between chemotherapy and endocrine therapy maintenance in PFS and OS (all p > 0.05). Regardless of the continuum or switch maintenance therapy, showed prolonged survival in MBC patients who were response to first-line treatment. Conclusion This study provided evidences for survival benefits of chemotherapy and endocrine therapy maintenance in MBC patients, and there was no difference efficacy between chemotherapy and endocrine therapy maintenance for hormone receptor–positive patients.