Objective To analyze the clinical value of anterior decompression and fusion with internal fixation and simple decompression in the treatment of cervical vertebral multilevel degeneration.Methods Selected 40 patients with cervical degenerative changes in our hospital from 2012 to 2014,and 20 patients of them underwent anterior decompression and fusion with internal fixation while the other 20 cases took simple decompression.All the patients were well followed up,and the clinical therapeutic effect of the two groups were compared and analyzed.Results After operation,the VAS score and JOA score showed that the scores of the patients underwent anterior decompression and fusion with internal fixation were significandy improved compared with the simple decompression group,and the difference was statistically significant(P ＜ 0.05).Compared with the simple decompression group,the cervical curvature and the curvature of the surgerysection in the anterior decompression and fusion with internal fixation group were significantly improved,especially in the first year after surgery (P ＜ 0.05).The cervical spine joint activity of the two group were improved in the first year after surgery,and the difference was significant (P ＜ 0.05),but there was no significant difference in the degree of cervical joint activity at the last follow-up(P ＞ 0.05).The anterior decompression and fusion with internal fixation is better than simple decompression in the degree of cervical joint activity with statistical significance (P ＜ 0.05).Conclusion The clinical effect of anterior decompression and fusion with internal fixation in treatment of multiple segment degeneration of cervical spine is better than that of simple decompression,it can meet the clinical requirements of biomechanics.

Objective To develop and validate the Knowledge-Attitude-Practice Scale for Prevention of Occupational Low Back Pain for Nurses (hereinafter referred to as KAP). Methods Based on the knowledge, attitudes and practice theory, a list of 48 potential items were developed by reviewing literatures related to the prevention of occupational low back pain in nurses. The Delphi expert consultation method was used to conduct two rounds of consultation on the items, and the KAP (draft) with 31 items was formed. A total of 269 nurses in a hospital in Guangdong Province were selected as study subjects by convenience sampling method and investigated with the KAP (draft). The list was selected and its validity tested using SPSS 25.0 software. Results The authority degrees of two rounds of expert consultation were 0.919 and 0.922. All of the recovery rates of valid questionnaires were >80.0%, with the coefficients of variation ranged from 0.07 to 0.40 and 0.05 to 0.28. The Kendall's concordance coefficients were 0.198 and 0.274, respectively (all P<0.05). After item selection, five items were removed, resulting in the KAP with 28-item including three dimensions： knowledge, attitude and behavior. The scale-level content validity index/average was 0.976, and the item-level content validity index ranged from 0.833 to 1.000, as assessed by experts. The scale demonstrated 100.0% for convergent and discriminative validity of the three dimensions. The exploratory factor analysis revealed three factors with a cumulative variance contribution rate of 51.0%. Cronbach's alpha coefficients for the overall scale and knowledge, attitude, and behavior dimensions were 0.880, 0.878, 0.895, and 0.877, respectively. Split-half reliability coefficients were 0.922, 0.863, 0.852, and 0.820, respectively. Conclusion The KAP shows good reliability and validity and can be used to assess knowledge, attitude and practice levels related to occupational low back pain prevention among nurses.

Objective:To explore the effects of father-feeding attitudes on feeding status in preterm infants at discharge, and the role of father support breastfeeding self-efficacy, in order to provide a certain reference and basis for the intervention to improve the breastfeeding rate of premature infants.Methods:This was a cross-sectional study. A total of 402 premature infants' fathers were selected from 3 ClassⅢ Grade A hospitals from Zhejiang Province by convenience sampling method from July to November 2020. The basic data questionnaire, Iowa Infant Feeding Attitude Scale and Father Support Breastfeeding Self-Efficacy Scale-Short Form were used in the investigation. A total of 402 questionnaires were distributed, and 376 valid questionnaires were recovered. The recovery rate of effective questionnaires was 93.5%.Results:The score of father-feeding attitude of the 376 premature infants' fathers was (49.80±9.26) , and the score of support breastfeeding self-efficacy was (43.23±8.52) . Father's self-efficacy of breastfeeding support played a mediating role between feeding attitude and feeding status of premature infants at discharge, and the mediating effect accounted for 33.3% of the total effect.Conclusions:The father's feeding attitude can affect the feeding status of premature infants at discharge by influencing their self-efficacy of supporting breastfeeding. Medical staff should help premature fathers pay attention to breastfeeding, adopt practical and diverse health education methods to help premature fathers gradually master specific support behaviors and enhance their self-efficacy in supporting breastfeeding, and ultimately improve the rate of breastfeeding in premature infants.

ObjectiveTo observe the effect of Simiaowan on the intestinal ATP-binding cassette superfamily G （White） member 2 （ABCG2） expression and the intestinal uric acid excretion in hyperuricemia rats. MethodA total of 48 SD male rats were randomized into the normal， model， benzbromarone （4.7 mg·kg^-1）， and high-， medium-， low-dose Simiaowan groups （2 260.6， 1 130.3， 565.2 mg·kg^-1， respectively）， with 8 rats in each group. Potassium oxonate and hypoxanthine was employed to induce hyperuricemia in rats （21 days）. On the 8^th day， administration began （once a day for 14 days）. Rats were killed on the 21^st day， and serum uric acid， serum creatinine， blood urea nitrogen， and intestinal uric acid were detected. The protein expression of ABCG2 in the small intestine was detected by Western blot. The ABCG2 protein expression and localization in intestinal tissues were determined by immunohistochemistry. The ABCG2 mRNA expression in small intestine was measured by quantitative real-time PCR. ResultThe levels of serum uric acid， serum creatinine， and blood urea nitrogen in the model group were higher than those in the normal group （P<0.01）. Low level of serum uric acid in the three Simiaowan groups and benzbromarone group （P<0.01）， high level of intestinal uric acid in medium-dose and low-dose Simiaowan groups （P<0.05， P<0.01）， high level of serum creatinine in benzbromarone group （P<0.01）， and low level of blood urea nitrogen in low-dose Simiaowan group （P<0.05） were observed as compared with those in the model group. Serum uric acid showed insignificant difference between the low-dose Simiaowan group and benzbromarone group. The expression of ABCG2 protein in the model group was lower than that in the normal group （P<0.05）. The expression of ABCG2 protein in the medium-dose and low-dose Simiaowan groups （P<0.05， P<0.01）， the high-dose Simiaowan group， and benzbromarone group increased as compared with that in the model group. ABCG2 mRNA expression was insignificantly different between the model group and the normal group， while the expression in the medium-dose and low-dose Simiaowan groups was higher than that in the model group （P<0.05）. ABCG2 protein was mainly distributed in intestinal villi， and ABCG2 protein expression demonstrated no significant difference between the model group and the normal group. The ABCG2 protein expression in the three Simiaowan groups increased as compared with that in the model group （P<0.05）. ConclusionSimiaowan can significantly reduce the serum uric acid level in hyperuricemia rats. Particularly， the low-dose Simiaowan shows similar efficacy to benzbromarone in lowering uric acid and protects renal function. The mechanism is the likelihood that it up-regulates intestinal ABCG2 expression to promote intestinal excretion of uric acid.

【Objective】 To explore the application of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) in the genotyping of difficult blood typing samples, and to provide evidence for clinical blood transfusion. 【Methods】 Three ambiguous blood group samples, submitted to Shanghai Blood Center by Shanghai regional hospitals, were studied, of which Sample1 included the proband and his parents. Serological methods were used to perform blood group typing, direct antibody test, unexpected antibody screening and identification test. Blood group genotyping was performed by using the MALDI-TOF MS detection systeme stablished in our laboratory. Sanger sequencing was used to confirm gene mutation sites, and serological or flow methods were used to verify specific samples′ phenotype. 【Results】 Serological results indicated the existence of antibodies against high frequency antigens in sample 1 (including proband and her mother), 2 and 3. The genotyping results of MALDI-TOF MS showed that the proband of sample 1 was Di(a+ b+ ), her father was Di(a-b+ ), her mother was Di(a+ b-), sample 2 was p, and sample 3 was Jr(a-). Sequencing results of three samples were consistent with mass spectrometry typing results. Serological results showed that sample 2 had a p phenotype. The flow cytometry results suggested that sample 3 had a Jr(a-) phenotype. 【Conclusion】 For the first time, we applied MALDI-TOF MS technology to blood type genotyping of ambiguous clinical samples in China. Compared with other genotyping methods such as PCR-SSP, MALDI-TOF MS has the advantages of rapid detection, high throughput and high specificity, which would contribute to identification of difficult blood typing samples in the future, as well as rare blood group screening.