Objective:To explore the effect of diversified nursing rehabilitation exercise in patients with SchatzkerⅡtibial plateau fracture.Methods:From January 2018 to December 2018, a total of 72 patients with Schatzker Ⅱtibial plateau fractures in Wuzhou traditional Chinese medicine hospital were selected by cluster sampling method for study. All patients were treated surgically. 36 of them were included in the control group (routine functional exercise after operation) by random number table method, and the remaining 36 patients were included in the observation group (on the basis of the control group, multiple functional rehabilitation exercise mode was given).The length of hospital stay, knee joint swelling degree and movement angle at different time after operation, preoperative and postoperative Harris Hip Score (HSS) and satisfaction were analyzed.Results:The time of fracture healing and hospitalization in the observation group were (92.58±20.65) d, (8.40±2.32) d, shorter than (108.56±25.38) d, (15.86±2.80) d in the control group ( tvalues were 2.930, 12.309, P<0.05). At 2 weeks and 6 weeks after operation, the swelling degree of knee joint in the observation group was (1.42±0.58) cm and (0.52±0.25) cm, which was less than (1.86±0.62) cm and (0.78±0.34) cm of the control group, respectively, the difference between the two groups was statistically significant ( tvalues were 3.110, 3.697, P<0.05); there was no significant difference in HSS between the two groups ( P>0.05); the score of observation group was (62.36±6.85), (70.32±5.69) points, which was significantly higher than (58.42±6.02), (63.45±6.28) points of control group ( tvalues were 2.592, 4.864, P<0.05); there was no significant difference in HSS score between the two groups 6 months after operation ( P>0.05). The satisfaction of the observation group was 97.22% (35/36), which was higher than 83.33% (30/36) of the control group, and the difference between the two groups was statistically significant ( χ 2value was 3.956, P<0.05). Conclusion:For Schatzker type Ⅱ tibial plateau fracture patients, taking diversified nursing rehabilitation exercise can quickly relieve their limb swelling, promote the recovery of joint function and fracture healing, make them recover as soon as possible, and improve their satisfaction.

Objective To detect the expression of tissue inhibitor of metalloproteinase-4 (TIMP-4) in cutaneous malignant melanoma (CMM) tissue and to assess its relationship with melanoma proliferation,invasion and metastasis.Methods Western blot was conducted to measure the protein expression of TIMP-4 in five fresh lesional and paratumoral tissue specimens of CMM and three fresh tissue specimens of nevi.Immunohistochemistry was carried out to quantify the expression of TIMP-4,Ki-67,matrix metalloproteinase-2 (MMP-2),vascular endothelial growth factor (VEGF) and CD63 in paraffin-embedded tissue samples from 43 cases of CMM and 51 cases of nevi.The degree of malignancy of melanoma was evaluated in these lesions.Results Western blot analysis showed that the expression of TIMP-4 was significantly higher in 4 of 5 CMM tissue specimens than in corresponding paratumoral tissue specimens and nevus tissue specimens.Immunohistochemistry revealed that the expression rate of TIMP-4 was 86.04％ (37/43) in melanoma tissue,compared to 19.6％ (10/51) in nevus tissue (x2 =31.55,P ＜ 0.05).The expression of TIMP-4 increased sequentially from in situ melanoma to invasive and metastatic melanoma (rs =0.309,P ＜ 0.05).As far as CMM was concerned,the TIMP-4 expression was uncorrelated with any of the known prognostic variables including clinical stage,Clark level,Breslow depth,presence of ulcer,and Ki-67 expression (all P ＞ 0.05),but positively correlated with the expressions of VEGF (rs =0.345,P ＜ 0.05) and CD63 (rs =0.555,P ＜ 0.01).The median expression level of TIMP-4 was significantly higher in MMP-2-positive than in MMP-2-negative melanoma tissue samples (3 vs.0,P ＜ 0.01).Conclusions TIMP-4 protein is highly expressed in CMM tissue,which may be closely associated with the initiation and progression of CMM,especially with the metastasis of and angiogenesis in CMM.

Objective To measure the expression of hypoxia-inducible factor (HIF)-1α in acral malignant melanoma (MM) tissue and to investigate its relationship with the stem cell factor (SCF)/c-kit pathway.Methods Immunohistochemical staining was performed to measure the expression of HIF-1α in tissue specimens from lesions of 93 patients with acral MM,21 with non-acral MM,39 with acral melanocytic nevi,and from the normal acral skin of 15 healthy human controls.Meanwhile,the expression of c-kit was detected by immunohistochemical staining in the 93 acral MM tissue specimens.Statistical comparisons were carried out by chi-square test and Mann-Whitney U test.The relationship of HIF-1α expression with c-kit expression as well as tumor progression and staging was assessed by Spearman correlation analysis.Results Immunohistochemistry showed that the expression rate of HIF-1α was 87.10％ (81/93) in acral MM specimens,90.48％ (19/21) in non-acral MM specimens,15.38％ (6/39) in acral melanocytic nevus specimens,but 0 (0/15) in the normal acral skin specimens.The expression of HIF-1α was significantly higher in acral MM lesions than in normal acral skin and acral melanocytic nevus lesions (both P ＜ 0.01),and significantly different between acral MM and non-acral MM lesions (P ＜ 0.01).Moreover,HIF-1α expression was positively correlated with Clark level and Breslow depth of melanoma (rs =0.442,0.368,respectively,both P ＜ 0.01),with the progression of acral MM (from in situ to aggressive and metastatic MM) (rs =0.420,P ＜ 0.01),and with the expression of c-kit (rs =0.307,P ＜ 0.01).Conclusions HIF-1α is highly expressed in acral MM,positively correlated with the staging,progression and aggression of MM,and co-expressed with c-kit in acral MM tissue,suggesting that both HIF-1α and c-kit take part in the pathogenesis of acral MM.

Objective: To evaluate the ergonomic load of clinical nursing procedures and to provide evidence for the prevention and management of work-related musculoskeletal disorders (WMSDs) in nurses. Methods: Based on the nursing unit characteristics and the common departments involving patient-turning procedures, 552 nurses were selected from 6 clinical departments from July to September, 2016. The ergonomic load of four types of patient-turning procedures, i.e., turning the patient’s body, changing the bed linen of in-bed patients, moving patients, and chest physiotherapy, was evaluated by the on-site inspectors and self-evaluated by the operators using the Quick Exposure Check. The exposure value, exposure level, and exposure rate of WMSDs were assessed based on the procedure-related physical loads on the back, shoulders/arms, wrists/hands and neck, as well as the loads from work rhythm and work pressure. Results: All surveyed subjects were females who were aged mostly between 26-30 years (49.46%) , with a mean age of 29.66±5.28 years. These nurses were mainly from the Department of Infection (28.99%) and Spine Surgery (21.56%) . There were significant differences in the back, shoulders/arms, neck, work rhythm, and work pressure scores between different nursing procedures (F=16.613, 5.884, 3.431, 3.222, and 5.085, respectively; P<0.05) . Patient-turning nursing procedures resulted in high to intermediate physical load in nurses. Procedures with high to low level of WMSDs exposure were patient turning (72.69%) , bed linen changing (67.15%) , patient transfer (65.82%) , and chest physiotherapy (58.34%) . In particular, patient turning was considered as very high-risk procedure, whereas others were considered as high-risk procedures. Conclusion Patient-turning nursing procedures result in high ergonomic load in the operators. Therefore, more focus should be placed on the ergonomics of the caretakers and nurses.

Objective: To investigate the correlation between work-related musculoskeletal disorders (WMSDs) and work ability (WA) among nurses in Xinjiang. Methods: A total of 1 873 nursing staff in the Departments of Internal Medicine, Surgery, Emergency and ICU Department, Operating Room and Supply Room of 6 Grade 3 General Hospitals in Xinjiang Beijiang Region were randomly selected by means of random sampling, and revised Nordic National Musculoskeletal Disorders Standard Questionnaire and Work Ability Index Scale were used to evaluate the status of nursing WMSDs and WA. Results: (1) The symptom incidence of work-related musculoskeletal disorders among nursing staff in the past year was 77.42%; The highest symptom incidence in all parts of the body was waist, neck, shoulder and back, and the symptom incidence was 63.59%, 59.80%, 47.78% and 37.32%, respectively; (2) The total score of nursing staff's work ability was (35.91±5.143) ; The proportion of "poor" , "middle" , "good" and "excellent" were 5.23%, 47.41%, 41.43% and 5.93% respectively; (3) The total working capacity of the sick group was (35.11±5.044) , The working ability of the non-diseased group was (38.64±4.507) , The difference between the two groups was statistically significant (t=13.773, P<0.01) ; There was a significant difference in the level of work ability between the two groups (z=-12.335, P<0.01) ; The working ability of "poor" and medium in the injury group was significantly higher than that of the non injury group, while the working ability was "better" and "excellent" than that of the non injury group; (4) The working ability of nursing staff of different age in WMSDs injury group was lower than that in non injury group, the difference was statistically significant (P<0.01) ; There was a negative correlation between the working ability of the injury group and the length of service, that is, with the increase of the length of service, the working ability index decreased (P<0.01) ; There was a positive correlation between the working ability of the non injury group and the length of service, that is, with the increase of the length of service, the work ability index increased gradually, but the correlation was not statistically significant (r=0.063, P=0.195) ; (5) The working ability of nursing staff of different departments in WMSDs injury group was lower than that in non injury group, the difference was statistically significant (P<0.01) . (6) Multiple linear regression analysis showed that the factors influencing the working ability of nursing staff were: past medical history, WMSDs disease, length of service and night shift frequency; Conclusion The symptom incidence of WMSDs was high among nurses; Work Ability at a moderate level; work-related musculoskeletal disorders is associated with reduced ability of nursing staff; work-related musculoskeletal disorders are associated with reduced working capacity of nursing staff.