Objective? To explore the effect of the mobile-app-based case management on functional rehabilitation among breast cancer patients after operation. Methods? A total of 120 breast cancer patients who had undergone axillary lymph node dissection in a ClassⅢ Grade A hospital in Zhengzhou city from January to December in 2017 were selected by convenient sampling. According to their admission time, 60 in-patients who were admitted between January and June in 2017 were assigned into the control group, and the other 60 in-patients who were admitted between July and December in 2017 were put into the observation group. In the control group, the patients were given by regular functional rehabilitation guidance for the affected limb while in the observation group, the patients were managed by mobile-app-based system besides the regular guidance. For both groups, the follow-up visit lasted for 6 months after surgery. The patients' incidence of edema, upper limbs and shoulder joints' function as well as their quality of life were compared and studied. Results? The incidence of lymphedema at one month and six months after surgery in the observation group were lower than the control group with statistical significance (P＜ 0.05). Six months after surgery, the patients in the observation group were better than the control group in terms of the joint function, quality of life except the emotional condition with statistically significant difference(P＜0.05). Conclusions? The implementation of the mobile-app-based case management for postoperative breast cancer patients can effectively promote the postoperative functional rehabilitation of affected limbs, reduce the occurrence of postoperative lymphedema, and improve their quality of life.

Objective To explore the effect of the rehabilitation self-efficacy of patient with total knee arthroplasty on the first time of ambulation after operation.Methods Totally 110 patients undergoing total knee arthroplasty were recruited,they were investigated with self-designed general information and disease situation questionnaire and recorded the first time of ambulation.The self-efficacy was measured by the Self-Efficacy for Rehabilitation outcome scale(SER).Results The earliest time of ambulation was 7.5 hours after surgery.The latest time of ambulation was 54.0 hours after surgery.The median time of the first ambulation was 46.0 h.The mean score of self-efficacy for rehabilitation therapy exercises was (28.58 ± 9.18) points,and the mean score of self-efficacy in overcoming barriers was (43.07 ± 11.04) points,and the mean score of SER was (71.65 ± 18.47) points.The total score of self-efficacy for rehabilitation therapy exercises,self-efficacy in overcoming barriers,and the score of SER were negatively correlated with the first time of ambulation (r=-0.442,-0.299,-0.399,P＜ 0.01).The self-efficacy of rehabilitation was one of the influencing factors of patient's first time of ambulation(P ＜ 0.05),which explained 9.7％ of total variance of early ambulation of patients with total knee arthroplasty.Conclusions The self-efficacy of rehabilitation after total knee arthroplasty was significantly correlated with the first time of ambulation,and the higher self-efficacy of rehabilitation,the earlier the first time of ambulation.The self-efficacy of rehabilitation was one of the important factors that affect the first time of the patient's ambulation after total knee arthroplasty.

Objective To explore the current situation of stressor,job burnout and anxiety of pediatric nurses of Class Ⅲ Grade A hospitals and to analyze the correlation between stressor and job burnout as well as stressor and anxiety.Methods From January to February 2017,a total of 233 pediatric nurses of 5 Class Ⅲ Grade A hospitals of Beijing were selected by convenience sampling as subjects.All of the pediatric nurses were investigated with the Nurse Job Stressor Scale (NJSS),Maslach Burnout Inventory-Human Services Survey (MBI-HSS),Self-Rating Anxiety Scale (SAS).Results Among 233 pediatric nurses,two dimensions of NJSS with high scores included time allocation and workload (2.69 ± 0.87) as well as patient care(2.54 ± 0.70).Two items of NJSS with high scores contained that the wages and other welfare treatment was low (3.04 ± 0.93) as well as worrying about mistakes and accidents in work (2.97 ± 0.97).The emotion exhaustion dimension of MBI-HSS was with 22.7％ for the severe level.Patients with low scores of sense of personal achievement accounted for 41.2％.The score of SAS was (38.38 ± 7.47) significantly higher than Chinese model (t=17.57,P ＜ 0.01).There were 10.7％ of nurses with the moderate-severe level of anxiety.The correlation analysis among stressor,job burnout and anxiety of pediatric nurses showed that except for time allocation and workload as well as sense of personal achievement,other dimensions of NJSS had positive correlations with dimensions of MBI-HSS and SAS (r=0.169-0.527,P ＜ 0.05).Conclusions Pediatric nurses are with high working pressure.Policy makers and managers should consider characteristics in pediatric nursing,reduce nurses' stressors as well as the level of nurses' job burnout and improve their mental health,so as to ensure the quality of pediatric nursing.

Objective:To explore the characteristics and differences of oxygenated hemoglobin responses in different brain regions in adolescent depressive disorder patients and healthy adolescents during speech fluency task based on functional near-infrared spectroscopy imaging.Methods:From March 2021 to June 2021, twenty-nine adolescents with depression(depressed group) and 26 healthy adolescents(normal group) were enrolled. The severity of depression was assessed by Hamilton depression scale, and the speech fluency task was performed by functional near-infrared spectroscopy brain imaging, and the relative concentrations of oxyhemoglobin in the prefrontal and bilateral temporal lobes were measured.SPSS 26.0 statistical software was used for data analysis, chi-square test was used for gender count data. The t-test was used for comparison of two groups. The measurement data that did not conform to normal distribution were compared between the two groups by Mann-Whitney U test. Results:In the speech fluency task, there was no significant difference in the concentration of oxygenated hemoglobin in prefrontal and left temporal between the depressed group and the normal group (both P>0.05); the oxygenated hemoglobin concentration in the right temporal lobe(-9.179(-22.231, 4.789)) of depressed group was significantly lower than that of the normal group (12.754(-9.438, 35.008)), and the difference was statistically significant ( U=538.00, P<0.05). The oxygenated hemoglobin concentration in right temporal lobe of depressed group had no correlation with the score of Hamilton depression rating scale ( r=0.092, P>0.05). Conclusion:The right temporal lobe function of adolescent depression patients is lower than that of healthy controls during speech fluency tasks, which provides a basis for study of the relationship between depression and some cognitive sensitivity impairment and the function of right temporal lobe.

Objective:To explore the effects of Williams life skills training on the coping style of parents of systemic lupus erythematosus (SLE) children.Methods:From March to December 2017, we selected 73 parents of 73 SLE children hospitalized in the Pediatric Ward of a Class Ⅲ Grade A hospital in Beijing as the research object by convenience sampling. All parents were randomly divided into intervention group ( n=37) and control group ( n=36) . During the hospitalization of the child, control group provided the SLE general knowledge, medication knowledge, daily care, attentions and other health education for the child's parents and answered questions raised by the child's parents at any time. On this basis, intervention group received the Williams life skills training (WLST) for 4 times, and the follow-up was carried out by WeChat or phone every week after discharge of children. The coping styles of two groups were evaluated with the Simple Ways of Coping Questionnaires before intervention, before discharge, one month and three months after intervention. Results:There were no statistical differences in the scores of positive coping subscale and negative coping subscale of the child's parents between two groups before intervention ( P>0.05) . At each time point after intervention, the score of positive coping subscale of intervention group was higher than that of control group, and the score of negative coping subscale was lower than that of control group with statistical differences ( P<0.01) . Conclusions:WLST can enhance the positive coping of parents of children with SLE, weaken their negative coping and effectively improve their coping styles.

Objective:To explore the effects of individualized psychological nursing in Operating Room in patients undergoing combined spinal and epidural anesthesia for hip replacement.Methods:Total of 95 patients undergoing combined spinal and epidural anesthesia for hip replacement at Henan Provincial People's Hospital from July 2019 to September 2020 were selected by convenient sampling. 47 patients treated from July 2019 to February 2020 were included into the control group which received routine Operating Room nursing, while 48 patients treated between February and September 2020 were included into the observation group which received individualized psychological nursing in operating rooms based on the care provided to the control group. The bad mental state, degree of fear, and degree of surgical cooperation were compared between the two groups of patients before and after operation.Results:After operation, the Depression Anxiety Stress Scale-21 scores and the degree of fear were lower in the observation group than in the control group, and the differences were statistically significant ( P<0.05) ; the observation group had higher cooperation in the operation than the control group, and there was statistically significant difference ( P<0.05) . Conclusions:The use of individualized psychological nursing in Operating Room in patients undergoing combined spinal and epidural anesthesia for hip replacement can effectively reduce the surgical pressure of the patient, relieve their anxiety, depression, fear, and improve their surgical cooperation.

Objective:To explore the application value of enhanced recovery after surgery (ERAS) nursing in the prevention of lower extremity deep vein thrombosis (LDVT) of elderly patients with hip arthroplasty (HA) .Methods:A total of 105 elderly HA patients in Henan Provincial People's Hospital (Zhengzhou University People's Hospital) from February 2019 to August 2020 were selected by the convenient sampling method. Patients were divided into the control group (52 cases) and the observation group (53 cases) by the random number table method. The control group received routine nursing intervention, while the observation group received ERAS nursing intervention on this basis. The coagulation function [thrombin time (TT) , D-dimer, activated partial thromboplastin time (APTT) ] before operation and 3 days after operation, and incidences of LDVT, lower extremity swelling and lower extremity skin color change within 6 months were compared between two groups.Results:Three days after operation, TT and APTT levels in the observation group were higher than those in the control group, while D-dimer levels were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Within 6 months, the incidences of LDVT, lower limb skin color change and lower limb swelling in the observation group were respectively 1.89%, 5.66% and 3.77%, which were lower than 15.38%, 19.23% and 17.31% in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Applying ERAS nursing to elderly HA patients can regulate the coagulation function of patients and reduce the risk of LDVT and related symptoms.

Objective To explore the association of nocturnal serum cortisol levels with diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus. Methods Serum cortisol levels of 316 overweight or obese type 2 diabetic patients were tested at midnight by the method of chemiluminescence. Diabetic microvascular complications were compared among various groups according to nocturnal serum cortisol levels. All the patients with nocturnal serum cortisol level > 50 nmol/L were asked to undergo overnight low-dose dexamethasone suppression test to rule out the possibility of subclincal Cushing's syndrome. The incidences of diabetic nephropathy ( DN ) , diabetic retinopathy ( DR ) , and diabetic peripheral neuropathy ( DPN ) were examined in all the patients. Results (1)The incidence of DN was gradually increased from 13.3％to 27.7％and 44.2％in patients with low, medium, and high cortisol level groups, showing a statistical difference among 3 groups ( P<0.05) . The incidences of DR in medium and high cortisol level groups were higher than that in low cortisol level group (40.6％and 47.7％vs 22.7％, both P<0.01). The incidence of DPN in high cortisol level group was higher as compared with low cortisol level group (60.5％ vs 38.7％, P<0.01). (2) Nocturnal serum cortisol level in patients with diabetic microvascular complications was higher than that in patients without complications [ (136.87 ± 105.78 vs 97.55 ± 93.48) nmol/L, P<0.01]. Nocturnal serum cortisol level in patients with multiple diabetic microvascular complications was higher than that in patients with single diabetic microvascular complication [ (151.66±114.54vs117.69±90.26)nmol/L,P<0.05].(3)Singlefactorlogisticregressionanalysisshowedthat higher nocturnal serum cortisol level was a risk factor for diabetic microvascular complications in addition to female, age, longer diabetic duration, higher fasting plasma glucose ( FPG ) . Multivariate logistic regression analysis showed that higher nocturnal serum cortisol level was still a risk factor for diabetic microvascular complications after adjusted by diabetic duration, FPG, HbA1C, and the use of insulin (P=0.013). Conclusion Nocturnal serum cortisol level seems to be a risk factor for diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus.

Objective: To explore HIV-1 drug resistance and influencing factors among people living with HIV/AIDS before antiretroviral therapy in Liangshan Yi Autonomous Prefecture (Liangshan). Methods: Between January 1 and June 30, in both 2017 and 2018, a cross-sectional survey was conducted in Liangshan HIV-1 pol sequences were gathered and analyzed according to WHO Guidelines on HIV drug resistance surveillance of 2014. Both HyPhy 2.2.4 and Cytoscape 3.6.1 software were used to analyze the drug resistant strains of HIV-1 transmission network. Results: A total of 464 people living with HIV/AIDS was recruited. The proportion of HIV-1 CRF07_BC subtype was 88.6% (411/464), with HIV-1 drug resistance rate was 9.9% (46/464). The HIV-1 drug resistance rates of non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors(NRTI) and protease inhibitors (PI) were 6.7% (31/464), 1.9% (9/464) and 0.4% (2/464) respectively. New recombinant strains of HIV-1 URF_01BC subtype was independently clustered according to the drug resistant mutation sites. Results from the multivariate logistic analysis showed that injected drug users group had higher risk on HIV-1 drug resistance (aOR=3.03, 95%CI:1.40-6.54) than heterosexual group among people living with HIV/AIDS. Conclusions HIV-1 drug resistance rate had already been in a high level before antiretroviral therapy was in place. The newly identified recombinant strains of HIV-1 URF_01BC subtype were independently clustered according to the drug resistant mutation sites. It was necessary to strengthen the prevention of the HIV-1 drug resistant strains transmission.