Objective:To explore the effect of spinal interleutkin-33 (IL-33) on radicular pain in rats modeling non-compressive lumbar disc herniation.Methods:A total of 80 male Sprague-Dawley rats were randomly divided into a sham operation group, a model group, a lentivirus negative control group, a low-dose IL-33 recombinant lentivirus group and a high-dose IL-33 group, each of 16. Non-compressive lumbar disc herniation was successfully induced in all except the rats in the sham operation group. Two days later, the model group was injected intrathecally with 10μl of enhanced infection solution. The lentivirus control group received 10μl of negative lentivirus, the low-dose IL-33 recombinant lentivirus group received 5μl of IL-33 recombinant lentivirus and the high-dose IL-33 recombinant lentivirus group received 10μl of IL-33 recombinant lentivirus. The 50% paw withdrawal threshold (50% PWT) was measured one day before the modeling and on the 1 st, 3 rd, 5 th, 7 th, 9 th, 11 th, 13 th, 15 th, 17 th, 19 th, and 21 st day afterward. On the 12 th day the expressions of IL-33 protein and mRNA were evaluated. Results:The average expression of IL-33 protein and mRNA in the model and the lentivirus negative control group increased significantly after the modelling compared with the sham group, while expression in the low- and high-dose IL-33 recombinant lentivirus groups was significantly lower than in the lentivirus negative control group. Compared with one day before the modelling, average 50% PWTs on the affected side decreased significantly in all of the modelling groups. From the 9 th to the 21 st day significantly increased 50% PWTs were observed on the affected side in the low-dose and high-dose IL-33 recombinant lentivirus groups compared with the other two modelling groups. Immunostaining showed significant increase in the expression of IL-33 in the dorsal horn of the spinal cord in the model group, compared with the sham operation group. Significant decrease in the average expression of IL-33 in the spinal dorsal horns was observed in the low-dose and high-dose IL-33 recombinant lentivirus groups. Conclusions:Intervertebral disk herniation may increase the expression of IL-33 in the spinal cord, and may cause radicular pain.

Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.

Objective:To explore the intervention effect of sensorimotor training on cognitive function, balance and fall risk of elderly patients with schizophrenia.Methods:The 60 hospitalized elderly schizophrenic patients in Wuxi Mental Health Center were randomly divided into experimental group and control group from June to September 2021, with 30 cases in each group. The control group implemented traditional exercise on the basis of routine nursing. The experimental group received 8-week and 24 times sensorimotor training on the basis of the routine nursing. The Chinese version of the Mini Mental State Examination (MMSE) was used to assess the cognitive level of patients, the Modified Morse Fall Scale (MMFS) was used to assess the risk of falls, and the Berg Balance Scale (BBS) was used to assess the balance function.Results:After 8 weeks of intervention, the total score of MMSE was (26.72 ± 1.71), higher than the total score of the control group (22.36 ± 1.93), the factor scores of temporal orientation, spatial orientation, recollection, attention and calculation, memory and language ability in the experimental group were (4.90 ± 0.31), (4.72 ± 0.53), (2.86 ± 0.35), (4.66 ± 0.61), (2.83 ± 0.47), (6.76 ± 1.09), higher than scores of the control group (4.36 ± 0.56), (3.93 ± 0.66), (2.57 ± 0.50), (3.64 ± 1.03), (2.18 ± 0.67), (5.68 ± 1.02), and the difference was statistically significant( t values were 2.53-9.06, all P< 0.05). The total score of MMFS in the experimental group was (5.93 ± 1.49), which was lower than that in the control group (8.75 ± 2.30). The difference was statistically significant ( t=-5.51, P<0.01). The total score of BBS in the experimental group was (38.83 ± 1.71), which was higher than that in the control group (30.89 ± 1.93). The difference was statistically significant ( t=16.43, P<0.01). Conclusions:Sensorimotor training can improve the level of balance, cognitive function and reduce the risk of falls in elderly patients with schizophrenia.

Objective To investigate the application and effects of the continuous improvement measures on pressure ulcer management .Methods Many methods were used such as collecting and analyzing the data of pressure ulcer status , conducting and applying corresponding improvement measures , optimizing nursing process , and analyzing the effect .Results With the continuous improvement measures , the assessment of hospital-acquired pressure ulcer was increased from 82.6% to 98.0%.The incidence of hospital-acquired pressure ulcer was decreased from 21.93% to 14.58%, and the difference was statistically significant (χ2 =5.44,P<0.05).Conclusions Studying the important factors of pressure ulcer problem , and optimizing nursing process could improve the incidence of hospital-acquired pressure ulcer .

Objective To analysis the causes and preventive measures of acquired pressure ulcers in hospitalized patients, and to provide evidences and references for strengthening hospital management of pressure ulcers.Methods We took a retrospective study to collect relevant information of 201 patients with hospital-acquired pressure ulcers from January 2012 to December 2014, and conducted a descriptive statistical analysis on the cause of the developed, high-risk departments and high-risk areas, then came up with preventive suggestions.Results The high incidence of 201 hospital-acquired pressure ulcers was oncology department, which accounted for 33.83%;the most common part was the sacrococcygeal region, which accounted for 59.2%;stage II was the most common stage of pressure ulcer, which accounted for 76. 12%; 64. 67% of the pressure ulcers happens within the first two weeks in hospital. Braden scoring less than 12 points that accounted for 58. 21%;anemia accounted for 72. 14%; hypoalbuminemia accounted for 75. 62%; forced postures caused by pain or hydrothorax and ascite accounted for 26.87%; medical equipment pressure accounted for 10.95%. The use of vacuum pad accounted for 87.56%;turning over once every 2 hours accounted for 41.79%. Skin nursing according to the guide accounted for 62. 19%; nutritional support through the mouth or vein accounted for 38.81%. Reporting to the nursing department timely after the occurrence accounted for 95.52%; found in ward rounds accounted for 1.99%; reported by patients or their families accounted for 1.49%; failure to report and found in the medical records accounted for 1.00%,the patient or family members to report accounted for 1.49%. Conclusions Cancer patients are high-risk groups of nosocomial pressure ulcers. The sacrococcygeal region is the high-risk area;stage II is the most common stage, and most of them happens within the first 2 weeks in hospital. Main reasons are hypoalbuminemia, anemia, forced postures, unable to turn over periodically, and the preventive care implementation is not enough. For cancer patients, preventive care is recommended, especially those patients with cancer pain, malnutrition and forced postures.

Objective To investigate the methods and effect of specialized and standardized training, and provide evidence for the revision of the standardized training program.Methods Cluster sampling method was used to recruit all the psychiatric nurses who started their career in 2013 by“needs-based and tutorial manner”cultivating model. These nurses received a three-year standardized training. Competency inventory for registered nurse(CIRN)were used to evaluate the effect of the training program before and after the intervention. Results After three-year standardized training,the total score of CIRN was improved from(114.34±17.12) points to(147.37±14.87)points(t=-21.176,P<0.01). The dimension score of critical thinking/scientific research,clinical care,leadership ability,interpersonal relationship,legal/ethical practice,professional development and education/consultation were respectively(22.60±5.38),(17.46±3.49),(29.09±2.79), (23.69±3.00),(24.29±3.75),(12.74±2.65),(17.51±4.27)after the training,and they were all higher than (14.09±5.14),(10.11±3.21),(27.80±3.54),(22.29±3.03),(23.17±3.670),(8.54±4.50),(8.34±2.81) before the training(t=-13.896,-15.960,-3.277,-3.790,-3.545,-7.727,-14.192;P<0.01).Conclusions “Needs-based,tutorial manner”standardized training model has a positive effect on improving the core competence of new mental health nurses.

Objective:To explore home maintenance acceptance of family members of elderly discharged patients with peripherally inserted central catheter (PICC) catheter and to analyze its influencing factors.Methods:From January to November 2019, a total of 143 family members of elderly patients who were given PICC in three ClassⅢ Grade A hospitals in Wenzhou and discharged with catheter were selected as research objects. A questionnaire survey was conducted on 143 family members of elderly discharged patients with PICC catheter using a general information questionnaire, Catheter Maintenance Related Cognitive Questionnaire and Barthel Index Rating Scale (BI) . A total of 143 questionnaires were distributed in this study and a total of 143 valid questionnaires were recovered. The effective recovery rate was 100%.Results:The acceptance rate of home maintenance of 143 family members of elderly discharged patients with PICC catheter was 60.14% (86/143) . Single factor analysis showed that home maintenance acceptance score of family members of elderly discharged patients with PICC catheter had statistically significant differences in working status of family members, ADL score of patients, whether they stayed in bed, whether the catheter maintenance in the residence was convenient, whether they were confident in catheter observation and treatment and whether they were worried about the effect of home maintenance ( P<0.05) . Multivariate logistic regression analysis showed that the convenience of catheter maintenance in the residence, self-care ability of patients and whether they were worried about the maintenance effect were the influencing factors of the home maintenance acceptance of family members of elderly discharged patients with PICC catheter ( P<0.05) . Conclusions:The family maintenance acceptance of elderly discharged patients with PICC catheter is at a medium level. It is necessary to strengthen the maintenance knowledge education and operation skills training of family members with inconvenient catheter maintenance in residence and poor self-care ability of patients and help them to improve the maintenance effect so as to better carry out home maintenance.

Objective To investigate the ADC value and intravoxel incoherent motion (IVIM) parameters to predict the early response to chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods Twenty-six patients with pathologically confirmed NSCLC in our hospital from June 2015 to January 2017 were prospectively studied. MR routine scan, DWI and IVIM scans were performed before and at the end of the first cycle of chemotherapy. The ADC value, pure diffusion parameter (D), perfusion parameter (D*) and perfusion fraction (f) before and after chemotherapy were recorded respectively, and the maximum diameter of tumor (MDMRI) was measured on T2WI. The effective group and the ineffective group were divided according to RECIST 1.1. Intra- and interobserver reproducibility were assessed with intraclass correlation coefficient (ICC). The differences of the parameters and their change rate were compared pre-and posttreatment, in the effective and the ineffective groups by using t test. Receiver operating characteristic (ROC) curves were generated to explore the optimal parameters and thresholds for early prediction of the efficacy of chemotherapy. Z test was used to compare the differences in the areas under the ROC curves. Results The repeatability of D*was relatively poor (ICC 0.507-0.716). The ADC and D values of the effective group before chemotherapy were (1.28±0.21)×10-3 and (1.05±0.14)×10-3mm2/s, respectively, and those of the ineffective group were (1.55 ± 0.25) × 10-3 and (1.29 ± 0.18) × 10-3mm2/s, respectively. The differences between two groups were statistically significant (t=-2.989, -3.755, respectively, P all<0.05). While there was no significant difference in f between the effective and ineffective groups before chemotherapy (t=-1.034, P=0.312). The ADC, D and f values of the effective group before chemotherapy were lower than those after chemotherapy, and the differences were statistically significant (t=-3.969,-5.617 and-2.876, respectively, P all<0.05). While there was no significant difference in ADC and D values in ineffective group (t=-0.737, -0.866, P>0.05, respectively). The difference of f was statistically significant (t=-2.731, P<0.05).ΔADC％,ΔD％andΔMDMRI％in effective group were (23.90 ± 22.28)％, (32.58 ± 20.63)％ and (18.77 ± 10.36)％, respectively, and those in ineffective group were (1.19 ± 11.35)％, (6.22 ± 21.63)％ and (9.35 ± 8.26)％, respectively. The differences between two groups were statistically significant (t=3.393, 3.154 and 2.487, respectively, P all<0.05). There was no significant difference inΔf％between two groups (t=1.346, P=0.191). ROC curve analysis showed that the area under curve (AUC) of preADC, preD, ΔADC％, ΔD％ and ΔMDMRI％ was 0.788, 0.848, 0.800, 0.830 and 0.727, respectively. When setting the preD=1.20×10-3 mm2/s as the boundary under the largest AUC, however, there was no significant differences in AUC compared with preADC, ΔADC％, ΔD％ and ΔMDMRI％ (Z=1.336, 0.363, 0.136, 1.395, P>0.05). Conclusion The ADC value, D value before chemotherapy and the early change rate after chemotherapy can better predict the early response of chemotherapy in NSCLC patients.