Severe asthma is a chronic inflammatory disease that is not sensitive to glucocorticoid treatment.In the pathogenesis of severe asthma,T helper cell 17(Th 17)and interleukin 17(IL-17)play an important role,mainly by aggregating the infiltration of neutrophil to aggravate the severity of asthma.Methyl-CpG-binding protein 2(MBD2)plays an important role in the differentiation of Th 17 cells from naive CD4+T cells,positively regulate Th17 differentiation and IL-17 expression.MBD2 binds to the CpG islands in the promoter region of interferon regu-latory factor 4(IRF4),suppressor of cytokine signaling 3(S0CS3),hypoxia-inducible factor-1α(HIF-1α)and misshapen like kinase 1(MINK1),which leads to methylation,regulates the differentiation of Th 17 cells,and par-ticipates in the pathogenesis of severe asthma.

Objective:To explore the effect of nursing intervention based on the integrated theory of health behavior change on the compliance of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with continuous positive airway pressure (CPAP) treatment.Methods:From February 2023 to January 2024, convenience sampling was used to select 98 patients with moderate to severe OSAHS from the Sleep Center of Affiliated Wuxi Fifth Hospital of Jiangnan University as participants. Patients were divided into a control group and an experimental group based on their enrollment time, with 49 cases in each group. Control group received routine nursing, while experimental group was treated with nursing intervention based on the integrated theory of health behavior change. The compliance with CPAP was compared between two groups after three months of intervention, and the subjective daytime drowsiness, self-efficacy, social support, and quality of life were compared between the two groups before and after intervention.Results:After intervention, the compliance with CPAP in experimental group was higher than that in control group, and daytime sleepiness, self-efficacy, social support, and quality of life scores in experimental group were all better than those in control group, with statistical differences ( P<0.05) . Conclusions:Nursing intervention based on the integrated theory of health behavior change can increase compliance of OSAHS patients with CPAP, alleviate daytime sleepiness, enhance self-efficacy and social support, and improve quality of life.

Objective:To describe disability rates of dementia in community residents aged 65 years and over in China,and explore related risk factors of disability.Methods:This study conducted an in-depth data analysis of the China Mental Health Survey.World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)was used to assess dementia disability,Community Screening Interview for Dementia(CSID)and Geriatric Mental Status Examination(GMS)were used for dementia screening and diagnosing.Univariate analysis was used to calcu-late the weighted disability rates of dementia in population and in patients,and their population distribution.Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity.Results:The weighted disability rate of dementia was 2.1％in population,and 38.6％in pa-tients.The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia.Female,older age,lower education level,lower economic status,and lower cognitive test scores in CSID had higher disability rates of dementia in population.Female and urban resident had higher disability rates of dementia in patients.Multiple linear regression showed economic status(β=0.11),gender(β=0.11),age(β=0.10),and treatment in the last 12 months(β=-0.20)were statistically associated with WHODAS 2.0 scores.Multiple logistic regression showed female(OR=2.81)and treatment in the last 12 months(OR=2.38)were statistically associated with disability.Conclusions:Persons with low economic status,female and elderly peo-ple are the high-risk groups for dementia disability.It should be paid attention to prevent dementia and its conse-quential disabilities.

Objective:To explore the age of onset and consultation, the main clinical manifestations, common types of combined malformations, the relationship of endometriosis, surgical prognosis and different types of proportion of adolescent female reproductive system dysplasia.Methods:The medical records of 356 patients (aged 10-19) with female reproductive system dysplasia in Women′s Hospital, School of Medicine, Zhejiang University from January 2003 to August 2018 were collected and retrospectively analyzed.Results:(1) Among the 356 adolescent dysplasia patients, uterine dysplasia (23.6%, 84/356), oblique vaginal septum syndrome (OVSS; 22.5%, 80/356) and vaginal dysplasia (21.6%, 77/356) were the most frequent ones, followed by multi-sectional dysplasia (16.0%, 57/356), other types of developmental abnormalities like external genitaliaand urogenital fistula (13.5%, 48/356) and Mayer-Rokitansky-Küster-Hauser syndrome (MRKH syndrome; 2.8%, 10/356). (2) There were significant differences between the median age of onset and the age of consultation of patients with OVSS and other types of abnormalities except hymen atresia (both P<0.05). In contrast, there were no significant differences between the age of onset and the age of consultation of the patients of uterine dysplasia, vaginal dysplasia, hymen atresia, MRKH syndrome and multi-sectional dysplasia (all P>0.05). (3) The clinical manifestations were lack of specificity, and mainly abnormal finding was lower abdominal pain. (4) After admission, the majority of patients underwent comprehensive cardiopulmonary examination (71.3%, 254/356) and urinary system examination (63.5%, 226/356). Only 18.3% (65/356) of patients had completed abdominal organ examination, and 5.9% (21/356) skeletal system examination. About other systemic malformations, urological malformations were the most common (27.5%, 98/356), followed by anorectal malformation (0.6%, 2/356), heart malformations (0.3%, 1/356), and spinal malformations (0.3%, 1/356). 46.4% (84/181) of the surgical patients were diagnosed with combined endometriosis. Patients with obstructive genital tract malformations were more likely to combine with endometriosis than non-obstructive ones [50.3% (74/147) vs 29.4% (10/34); P<0.05]. However, there was no significant difference between the severity of endometriosis of those two kinds ( P>0.05). (5) Totally 308 patients were followed up successfully with a median of 25.0 years old, and 20 cases were treated again; 12.0% (37/308) of them were suffering from menstrual disorder and 33.1% (102/308) of them with dysmenorrhea. Totally 130 patients had sexually active reported no sexual problems. Conclusions:Uterine dysplasia, OVSS and vaginal dysplasia are the most common syndromes in adolescent female reproductive system dysplasia along with frequent cases of coexisting urinary malformations and increasing risks of endometriosis. Meanwhile, the lack of specificity of clinical manifestations might delay the timely diagnosis and treatment after the onset of symptoms. Nonetheless, most patients could achieve good surgical outcomes.

Objective To investigate the fertility history and demand for reproductive health services of new residents in Shanghai. Methods A questionnaire survey was conducted among 1 358 new residents in 36 survey sites in 7 districts of Shanghai from July to September 2020. The content includes fertility history， induced abortion history， demand for reproductive health-related services， awareness rate of the Shanghai Family Planning Association and service access rate， etc. Results Among the new residents themselves and their spouses/sexual partners， 31.3% （374/1 194） had been pregnant once and 33.6% （401/1 194） had been pregnant twice； 46.3% （533/1 194）had one child and 29.7% （355/1 194）had two children. The difference of number of births among new residents with different residence time， those who did or did not possess permanent residency or residence permits， and those from different sources （urban or rural） was statistically significant （ χ ²=158.664， 50.263， 16.011， 114.419， all P <0.001）. Among the new residents themselves and their spouses / sexual partners， the proportion of induced abortion of more than once was 36.1%. The difference of the number of abortions of new residents with or without permanent residency was statistically significant （ χ ²=19.389， P <0.001）. The awareness rate of new residents of the harm of induced abortion to health was 92.1% （1 100/1 194）； There were significant differences in the scientific knowledge of harm of induced abortion to health among new residents with different local residence time and those with or without a residence permit （ χ ²=36.590， 20.926， both P <0.001）. The awareness rate of the Family Planning Association was 82.6% （986/1 194）， and the service access rate was 51.3% （613/1 194）. Permanent residency and residence permits are the main factors that affect the service accessibility of the Shanghai Family Planning Association. 44.8% （535/1 194） of new residents hope to receive reproductive health services in their place of residence， and they are most concerned about knowledge on good prenatal and postnatal care. Conclusion We should further publicize the "three-child" fertility policy， advocate a friendly fertility culture， and provide new residents with people-centered and accurate reproductive health services adapted to their needs through multi-sectoral cooperation， so as to improve their reproductive health level.

Objective:To build a hospital bed resource allocation model, for the reference of public hospitals in optimizing their bed resource allocation.Methods:Based on ReLU activation function, a hospital bed resource allocation model was constructed by combining DRG and public hospital performance appraisal requirements, including discharge person times, average length of stay, hospital bed utilization rate, proportion of surgery, proportion of fourth level surgery, case mix index, average bed day income and other indicators. When the existing number of hospital beds available was greater than the number of hospital beds allocated for the first time, a secondary allocation should be made. A tertiary general hospital was taken as an example for a model analysis.Results:As found in the model analysis, among the 2 729 beds of the hospital in the first allocation, 110 beds were left available for secondary allocation. The results of bed allocation of 40 inpatient departments in the hospital were as follows: 15 departments need more beds, 3 departments need more beds and shorter length of stay, 2 departments need no change, 1 department needs shorter length of stay, 4 departments need less beds, and 15 departments need less beds and shorter length of stay.Conclusions:The bed resource allocation model enriches the connotation of indicators, reflects the specialty characteristics. These indicators can be flexibly adjusted in combination with hospital development planning and budget management, hence conducive to refined management of hospital bed resources in public hospitals.

Objective:To discuss the method and strategy of selecting reviewers for nursing journals.Methods:Through the review practice of different review conclusions, this paper analyzed the reasons for the differences in review conclusions.Results:The methods and suggestions for selecting reviewers included more detailed research direction of reviewers and more comprehensive distribution of research direction; complementary "academic school" and "clinical school" in the same research direction; certain reserved candidates in hot research areas; full consideration of the energy and time of reviewers who hold concurrent administrative positions.Conclusion:The selection of reviewers of nursing journals should follow the characteristics of disciplines and fully consider the distribution of reviewers with different characteristics, so as to make the review process more professional and reliable.

Objective:To explore the methods to improve the ability of editors of nursing journals to recognize new clinical nursing techniques and methods.Methods:Aanalyzed the difficulties in the recognition of new nursing technology innovation points, and summarized the methods of improving the recognition ability of nursing journal editors.Results:It was difficult to identify the new technology of nursing that the presentation of innovation points was inappropriate, inaccurate and there were differences in the definition and application of new technology and new method in different levels of medical units. To improve the identification ability of new technology innovation, nursing editors must fully understand the new information and development trend of specialized field industry and specialized technology, and the application of clinical nursing technology in different levels of medical units.Conclusion:The editors of nursing journals should strive to overcome the difficulties in the identification of new nursing technology in the paper, improve the innovative appreciation ability of the paper, and assist the authors to enhance the innovative value of the paper.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

With high accuracy and precision,next generation sequencing (NGS) has provided a powerful tool for clinical testing of genetic diseases.To follow a standardized experimental procedure is the prerequisite to obtain stable,reliable,and effective NGS data for the assistance of diagnosis and/or screening of genetic diseases.At a conference of genetic testing industry held in Shanghai,May 2019,physicians engaged in the diagnosis and treatment of genetic diseases,experts engaged in clinical laboratory testing of genetic diseases and experts from third-party genetic testing companies have fully discussed the standardization of NGS procedures for the testing of genetic diseases.Experts from different backgrounds have provided opinions for the operation and implementation of NGS testing procedures including sample collection,reception,preservation,library construction,sequencing and data quality control.Based on the discussion,a consensus on the standardization of the testing procedures in NGS laboratories is developed with the aim to standardize NGS testing and accelerate implementation of NGS in clinical settings across China.