Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Objective:To explore the effect of CO2 fractional laser combined with glucocorticoid(GC)on T follicular helper cell(Tfh)and B cell subsets in patients with advanced vitiligo(VL).Methods:Patients with advanced VL(128 cases)who were treated in Affiliated Hospital of Hebei University of Engineering from August 2019 to March 2022 were selected as research objects,and divided into group A(64 cases,CO2 fractional laser combined with GC)and group B(64 cases,CO2 fractional laser)according to different treatment methods,clinical efficacy and safety of the two groups were compared.Another healthy subjects(64 cases)were selected as control group.Collected clinical data of the three groups of subjects for comparative analysis.Randomized walking model was used to evaluate the effect of CO2 fractional laser combined with GC on immune function and inflammatory response in patients with advanced VL.Results:Compared with group B,group A had a higher clinical total effective rate(P<0.05)and a lower probability of adverse reactions(P<0.05).After treatment,compared with control group,proportion of Tfh2 and Tfh17 in group A had no significant difference(P>0.05),while proportion of Tfh2 and Tfh17 in group B still had significant difference(P<0.05);compared with group B,proportion of Tfh2 in group A after treatment was higher(P<0.05),while proportion of Tfh17 type was lower(P<0.05).After treat-ment,compared with control group,proportion of memory transformed B cell in group B was still significantly different(P<0.05).After treatment,compared with control group,levels of IgA,IgE and IgM in group B were still significantly different(P<0.05);compared with group B,level of IgM in group A was higher after treatment(P<0.05).After treatment,compared with control group,levels of IL-21 and IL-1β in group B were still significantly different(P<0.05);compared with group B,level of IL-10 in group A after treatment was higher(P<0.05),while levels of IL-21 and IL-1β were lower(P<0.05).Evaluation results of random walking model showed that the improvement of immune function and inflammatory reaction in group A was better than that in group B.Conclusion:CO2 fractional laser combined with GC can improve the immune function and inflammatory reaction of patients with advanced VL better after treatment,and the probability of adverse reactions is lower.

Objective:To explore the effect of CO2 fractional laser combined with glucocorticoid(GC)on T follicular helper cell(Tfh)and B cell subsets in patients with advanced vitiligo(VL).Methods:Patients with advanced VL(128 cases)who were treated in Affiliated Hospital of Hebei University of Engineering from August 2019 to March 2022 were selected as research objects,and divided into group A(64 cases,CO2 fractional laser combined with GC)and group B(64 cases,CO2 fractional laser)according to different treatment methods,clinical efficacy and safety of the two groups were compared.Another healthy subjects(64 cases)were selected as control group.Collected clinical data of the three groups of subjects for comparative analysis.Randomized walking model was used to evaluate the effect of CO2 fractional laser combined with GC on immune function and inflammatory response in patients with advanced VL.Results:Compared with group B,group A had a higher clinical total effective rate(P<0.05)and a lower probability of adverse reactions(P<0.05).After treatment,compared with control group,proportion of Tfh2 and Tfh17 in group A had no significant difference(P>0.05),while proportion of Tfh2 and Tfh17 in group B still had significant difference(P<0.05);compared with group B,proportion of Tfh2 in group A after treatment was higher(P<0.05),while proportion of Tfh17 type was lower(P<0.05).After treat-ment,compared with control group,proportion of memory transformed B cell in group B was still significantly different(P<0.05).After treatment,compared with control group,levels of IgA,IgE and IgM in group B were still significantly different(P<0.05);compared with group B,level of IgM in group A was higher after treatment(P<0.05).After treatment,compared with control group,levels of IL-21 and IL-1β in group B were still significantly different(P<0.05);compared with group B,level of IL-10 in group A after treatment was higher(P<0.05),while levels of IL-21 and IL-1β were lower(P<0.05).Evaluation results of random walking model showed that the improvement of immune function and inflammatory reaction in group A was better than that in group B.Conclusion:CO2 fractional laser combined with GC can improve the immune function and inflammatory reaction of patients with advanced VL better after treatment,and the probability of adverse reactions is lower.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Objective:To explore the current status of frailty among elderly inpatients in Zunyi City and analyze its influencing factors.Methods:From October 2022 to March 2023, convenience sampling was used to select elderly patients who were hospitalized and treated at six hospitals, namely the Affiliated Hospital of Zunyi Medical University, the Second Affiliated Hospital of Zunyi Medical University, the First People's Hospital of Zunyi, Guizhou Aerospace Hospital, Zunyi Hospital of Traditional Chinese Medicine, and People's Hospital of Honghuagang District, Zunyi, as the research subject. The study subjects were surveyed using the General Information Questionnaire, Barthel Index, Pittsburgh Sleep Quality Index, Geriatric Depression Scale, and Fatigue, Resistance, Ambulation, Illness, Loss of Weight Scale. Multivariate Logistic regression was used to analyze the influencing factors of frailty in elderly inpatients in Zunyi City.Results:A total of 4 013 questionnaires were distributed and 3 853 valid questionnaires were collected, with an effective response rate of 96.01% (3 853/4 013). The incidence of frailty in elderly inpatients was 15.05% (580/3 853). Multivariate Logistic regression analysis showed that the coexistence of multiple diseases, types of long-term medication, activities of daily living, sleep quality, and depression were the influencing factors for frailty in elderly inpatients ( P<0.05) . Conclusions:The incidence of frailty in elderly inpatients was high. Medical and nursing staff should pay attention to elderly inpatients with the coexistence of multiple diseases, long-term use of multiple medications, decreased activities of daily living, poor sleep quality, and depressive emotions, and develop targeted intervention measures for them.

Objective:To understand the current situation of nurses' willingness to engage in telecare in county-level hospitals in Henan Province and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 1 300 clinical nurses from 6 Class Ⅱ Grade A county-level hospitals in Zhengzhou, Hebi, Zhoukou and other cities in Henan Province were selected as the research objects from August 2022 to January 2023. General Data Questionnaire and Clinical Nurses' Willingness to Engage in Telecare Questionnaire were used to investigate the research objects. Non-parametric test and multiple linear regression were used to analyze the influencing factors of clinical nurses' willingness to engage in telecare.Results:A total of 1 300 questionnaires were sent out in this study, and 1 183 were effectively collected, with an effective recovery rate of 91.00% (1 183/1 300). The total score of Clinical Nurses' Willingness to Engage in Telecare Questionnaire of 1 183 nurses in county-level hospitals was [105.00 (98.00, 112.00) ] points, and all items were scored [3.50 (3.27, 3.73) ]. Multiple linear regression analysis showed that professional title, post, whether they knew about telecare, and the number of times of receiving training on nursing information each year were the influencing factors of nurses' willingness to engage in telecare in county-level hospitals ( P<0.05) . Conclusions:In Henan Province, 1 183 nurses in county-level hospitals have a high willingness to engage in telecare. Relevant departments should further strengthen the publicity of relevant contents of telecare, carry out practical operation training related to nursing information, improve the nursing information ability of nurses in county-level hospitals and strengthen the awareness of health management services, so as to promote the successful implementation of telecare services in rural areas.

Objective:To explore the clinical significance of the MYCN gene, PHOX2B gene and plasma cell-free DNA (cfDNA) in risk stratification and predicting the prognosis of high-risk neuroblastoma (NB). Methods:This was a prospective study involving 94 high-risk NB children admitted to Beijing Children′s Hospital, Capital Medical University from August 2017 to December 2018.Relative levels of MYCN and PHOX2B and cfDNA at diagnosis, and 4 and 6 cycles of chemotherapy were detected, and their differences were compared by the Chi- square test.Kaplan-Meier survival analysis was performed to explore their prognostic potential in high-risk NB. Results:Among the 94 high-risk NB children, 14 cases (14.9%) had MYCN amplification, 76 cases (80.8%) had positive expression of PHOX2B and 56 cases (59.6%) had cfDNA level higher than 100 μg/L.The proportion of high lactate dehydrogenase (LDH, ≥1 500 U/L) level in the MYCN gene amplification group (6/14 cases) was higher than that in the normal group (9/80 cases) ( P=0.009). The proportion of multi-site metastasis (54/76 cases) and high neuron specific enolase (NSE) level (NSE≥370 μg/L, 37/76 cases) in PHOX2B positive group were significantly higher than those in the negative group (5/14 cases, 2/14 cases) ( P=0.015, 0.020). The proportion of high LDH and high NSE in high cfDNA concentration (≥229.6 μg/L)group (13/37 cases, 28/37 cases) were significantly higher than those in low cfDNA concentration group (2/48 cases, 10/48 cases) (all P<0.001). With the decreased tumor burden during the treatment, the copy number of PHOX2B gene and cfDNA level were significantly lower than those at the initial diagnosis [0 (0-719.6) copies vs.1 723.5 (0-186 000.0) copies; 19.0 (1.1-225.5) μg/L vs.200.6 (8.0-5 247.4) μg/L, all P<0.001]. The 2-year event-free survival (EFS) rate of the MYCN gene amplification group was significantly lower than that of the normal group[(33.3±13.1)% vs.(58.5±7.1)%, P=0.020]. The 2-year EFS rate of PHOX2B positive group was significantly lower than that of the negative group[(47.9±7.1)% vs.(79.1±11.1)%, P=0.043]. EFS rate in high cfDNA concentration group was significantly lower than that in cfDNA low concentration group[(38.6±9.8)% vs.( 71.7±8.2)%, P=0.001]. After 6 cycles of chemotherapy, EFS rate in the PHOX2B positive group was significantly lower than that in the negative group [(16.7±14.4)% vs.( 60.6±6.6)%, P=0.014]; which was significantly lower in the Metaiodobenzylguanidine (MIBG) positive group than that of the negative group[(35.2±11.7)% vs.(65.8±7.1)%, P=0.037]. The MYCN gene and cfDNA concentration were not correlated with the prognosis of high-risk NB.Survival analysis of the combination of PHOX2B and MYCN gene ( PHOX2B+ /MIBG + , PHOX2B+ or MIBG + , PHOX2B-/MIBG -) showed a significant difference in the survival among three groups[0 vs.(53.6±1.2)% vs.(65.5±7.4)%, P=0.003]. Conclusions:The MYCN and PHOX2B gene and cfDNA concentration are of significance in risk stratification and predicting the prognosis of high-risk NB.Compared with the MYCN gene and cfDNA concentration, the PHOX2B gene is more suitable for monitoring the curative effect of chemotherapy on high-risk NB.A combined analysis of PHOX2B gene and MIBG before treatment can be more accurate in evaluating the treatment effect and residual lesions.

Objective:To investigate the current situation of moisture-associated skin damage (MASD) in patients with permanent colostomy, and analyze its influencing factors.Methods:From January 2019 to January 2020, 115 patients received permanent colostomy in Henan Provincial People's Hospital were selected by convenience sampling method as the research objects. The patients were investigated by the self-designed General Information Questionnaire and Disease Factor Questionnaire.Results:Finally, 107 patients with permanent colostomy were included, and the incidence of MASD was 39.25% (42/107) . One-way analysis of variance showed that age, body mass index, stoma site, stoma height, excrement characteristics, defecation regularity, chassis leakage times were the influencing factors for the incidence of MASD in patients with permanent colostomy ( P<0.05) . Conclusions:The incidence of MASD in patients with permanent colostomy is high. Age, stoma site, stoma height, defecation and so on are the influencing factors of MASD in patients with permanent colostomy. Medical and nursing staff can formulate targeted preventive measures according to the influencing factors to reduce the incidence of MASD.

Three hundred patients aged≥60 year, who visited general practice clinic of Zhangjiakou Mingdebei Community Health Service Center or Beijing Fatou Community Health Service Center from March to May 2019, were randomly selected as study subjects. The prevalence of senile prutitus (SP) was calculated; the awareness, treatment and clinical characteristics of SP were surveyed with questionnaire. The degree of skin pruritus was compared among SP patients with different characteristics in the community, and the factors influencing pruritus of SP patients were analyzed. The results revealed that the prevalence of SP in elderly patients visiting community general practice clinic was 33.30% (198/600), the SP awareness rate was 29.29% (58/198), and the SP treatment rate was 23.23% (46/198). Frequent bath taken (>3 times/week, χ 2=9.129), long bathing time (>1 h/time, χ 2=12.742), regular use of alkaline detergents (χ 2=8.695), irregular life (χ 2 =14.819), spicy food (χ 2=9.852), not using moisturizer for skin care (χ 2=6.614), frequent drinking strong tea (χ 2=6.258), frequent drinking coffee (χ 2=6.513), poor sleep quality (χ 2=12.364) and irritability temperament (χ 2=23.120) were significantly associated with pruritus in elderly patients. (all P<0.05).The study indicates that the elderly patients in the community have a high incidence of SP, low awareness and low treatment rates. It is necessary to strengthen the health education, improve life style and live habits to reduce the incidence of SP in the community.

Objective:To summarize and analyze the results of chromosome karyotype in children with neuroblastoma (NB) with bone marrow metastasis at first diagnosis, and to discuss the clinical significance.Methods:G-banding was applied to the analysis of chromosome karyotype of patients who were regularly treated in the Hematological and Oncology Center in Beijing Children′s Hospital from January 2015 to December 2017, and all the patients were followed up until December 31, 2018.Their clinical features and prognosis were analyzed.Results:(1) There were 120 cases with bone marrow metastasis, including 74 boys and 46 girls, and 98 cases (81.7%) were ≥ 18 months.Among 60 cases with normal chromosome, 56 cases (93.3%) were in International Neuroblastoma Staging System(INSS)-Ⅳ phase, and 4 cases in INSS-Ⅳs phase; there were 2 low-risk (LR) cases, 9 intermediate-risk (MR) cases, and 49 high-risk (HR) cases (81.7%); 7 cases had MYCN gene amplifications.All 60 patients with chromosome abnormalities were in INSS-Ⅳ phase; there was 1 case in MR and 59 cases (98.3%) in HR; 14 cases had MYCN gene amplifications.(2) Among 60 children (50%) with chromosome abnormalities, 4 children had number abnormalities, 14 children had structural abnormalities, and 42 children had both number and structural chromosome abnormalities.Chromosome 21, 10, 11 deletions were the most common in number abnormalities; structural abnormalities involving 11q, 1p, 3p segments had a high incidence.(3) Seventeen cases of children with normal chromosome had tumor progression or recurrence during the 4 to 44-month follow-up period, and 31 cases of children with chromosome abnormalities had tumor progression or recurrence during the 2 to 42-month follow-up period.The 3-year overall survival rate and event-free survival rate of all children were 60.0% and 48.4%, respectively; children in the normal chromosome group had a 3-year overall survival rate of 74.2% and an event-free survival rate of 65.7%; the 3-year overall survival rate and event-free survival rate of children with chromosome abnormalities were 47.5% and 24.9%, respectively.Most children suffering from tumor progression or recurrence had chromosome 10 deletion, and abnormal structure of 11q, 1p, 2p segments. Conclusion:The chromosomal abnormality rate of Nb children's tumor cells is high, but the repetition rate is low, and the individual difference is obvious.The deletion of chromosome 10, abnormal regional structure of 11q, 1p and 2p segments may be poor prognostic factors for NB.Chromosome karyotype analysis of bone marrow samples is feasible, which can provide a basis for more accurate risk stratification and treatment.