Objective:To explore the clinical effect of positive reinforcement theory nursing intervention in the rehabilitation treatment of patients with cervical spondylosis and its influence on cervical function and quality of life.Methods:From March 2017 to May 2020, 94 patients who received rehabilitation after anterior cervical decompression surgery were selected as the research samples. They were divided into the control group and the study group by random digits table method with 47 cases in each group. The control group was given routine nursing care, and the study group received positive reinforcement theoretical nursing intervention on the basis of the control group.The nursing effect,cervical vertebra function and quality of life before and after nursing were evaluated by Visual Analogue Scale(VAS), Japanese Orthopaedic Association assesses treatment(JOA) score, SF-36. The nursing satisfaction rate was evaluated by questionnaire.Results:The JOA score, quality of life score and VAS score of the study group before nursing were (7.57 ± 1.35), (56.78 ± 5.62), (6.53 ± 0.34) respectively, while those of the control group were (7.32 ± 1.27), (56.32 ± 5.31), (6.32 ± 0.31) respectively, and there was no significant difference between the two groups ( P > 0.05). The JOA score and quality of life score of the study group after nursing were (15.73 ± 0.33) and (91.67 ± 2.34) respectively, which were higher than those of the control group (12.18 ± 0.46) and (83.43 ± 3.33) respectively. The VAS score of the study group after nursing was (2.33 ± 0.11) and lower than that of the control group (4.53 ± 0.25). The differences were statistically significant ( t values were 3.47, 5.43, 4.67, P< 0.05). Compared with the control group, the nursing satisfaction rate of the study group was higher than that of the control group (85.11%, 40/47 vs. 97.87%,46/47, χ2 value was 4.92, P < 0.05). Conclusions:Positive reinforcement theory nursing intervention can effectively relieve the pain symptoms of patients, improve the cervical function, and effectively improve the quality of life.

Objective:To study the effect of comprehensive nursing combined with cervical spine health care on postoperative psychological status and the prevention of various complications of patients with cervical spine surgery.Methods:A total of 102 patients who underwent cervical spine surgery in Dalian Third People′s Hospital from June 2018 to February 2020 were selected as the research objects. The patients were randomly divided into a control group and an experimental group. The control group was given routine care, and the experimental group was given comprehensive care combined with cervical spine for health care intervention, the main observation indicators included the mental state of the two groups of patients, the incidence of postoperative complications, and the patients' satisfaction with nursing work.Results:After comprehensive nursing combined with cervical health care intervention, the SAS score of the control group was 50.14±3.51 and the SAS score of the experimental group was 30.27±1.12. The SAS score of the control group was significantly higher than that of the experimentalgroup ( t value was 24.134, P< 0.05); the SDS score of the control group was 50.45±1.11, the SDS score of the experimental group was 39.45±2.21, the SDS score of the control group was significantly higher than that of the experimental group ( t value was 20.293, P<0.05), the difference was statistical significance: Compared with the control group (27.45%,14/51), the incidence of postoperative complications (9.80%,5/51) in the experimental group was significantly reduced ( χ2 value was 10.409, P<0.05); the nursing attitude of the patients to nursing staff (91.11± 5.32), nursing quality (90.41±2.30), nursing responsibility (92.82±4.69) in the experimental group were all significantly higher than those of the control group (80.67±3.51, 80.21±4.43, 80.78±4.82), the difference was statistically significant ( t value was 9.151, 14.671, 16.124, P<0.05). Conclusion:Rehabilitation nursing intervention of comprehensive nursing combined with cervical spine health care can improve mental state, reduce incidence of complication and increase satisfaction degree for patients undergoing cervical spondylopathy surgery, which is worthy of further clinical application and promotion.

Objective To observe the effects of the home tele-rehabilitation guidance on activities of daily living and motor function in patients after cerebral infarction. Methods 101 cases with cerebral infarction at recovery stage were divided into control (n=50) and rehabilitation (n=51) group. The rehabilitation group received home tele-rehabilitation guidance. They were assessed with the Barthel index (BI) and the simplified Fugl-Meyer assessment (FMA) before and 3 month after treatment. Results There is no significant difference in both the BI and FMA between these groups before treatment, and the rehabilitation group improved more after treatment (P<0.05). ConclusionHome tele-rehabilitation guidance can facilitate the recovery of activities of daily living and motor function in cerebral infarction patients.

Objective To investigate the tempo?spatial patterns of schistosomiasis in Jiangling County,Hubei Province,so as to identify the risk areas and provide the scientific evidence in following intervention plans for marshland epidemic areas in the stage of transmission control. Methods The schistosomiasis epidemiological data in Jiangling County from 2009 to 2013 to?gether with the related geographical information were collected and analyzed. The tempo?spatial distribution patterns were ana?lyzed by the spatial autocorrelation analysis and spatial clustering analysis. Results The human infection rate was decreased from 2.15%in 2009 to 0.63%in 2013,which was the historically low level. The results of tempo?spatial analysis showed that there were spatial clustering effects in human schistosomiasis infection for each of the years. The values of spatial autocorrelation index Moran’s I were statistically significant. Eighteen and thirty?five clusters were detected by using SatScan and FlexScan soft?ware,respectively. Conclusions From 2009 to 2013,the schistosomiasis endemic situation in Jiangling County presented a decline trend and reached the historical low level. The identified spatial clustering areas should be targeted as the prioritized ar?eas for schistosomiasis control.

Objective To analyze the epidemiological characteristics of the imported malaria cases in 20 counties at the bor?der region of Yunnan Province from 2012 to 2014,so as to provide the evidence?based proof for adjusting the strategies in the elimination stage. Methods The malaria epidemic data of the 20 border counties in Yunnan Province from 2012 to 2014 were collected and analyzed by using Microsoft Excel 2010. Results From 2012 to 2014,a total of 1 558 malaria cases were report?ed in the 20 border counties in Yunnan Province,among which,1 336 were imported cases,accounting for 85.75%(1 336/1 558),and 222 were indigenous cases,accounting for 14.25%(222/1 558). The number of the imported cases in the above years took up 80.00%(544/680),89.10%(425/477)and 91.52%(367/401)of the total reported cases in the whole year,re?spectively. Among all the 1 336 imported cases,1 045(78.22%)were infected with Plasmodium vivax,284(21.26%)were in?fected with P. falciparum,3 were infected with P. malariae,3 were mixed infection and 1 was an unclassified case;2 patients died. And 95.58%of the cases were mainly infected in Myanmar(1 277 cases). Young and middle?aged adult of 20-40 years who worked overseas were the predominant(802 cases,60.03%)and most of the cases occurred from April to June of the year (679 cases,50.82%). Those cases mainly distributed in Tengchong(459 cases),Ruili(366 cases),Yingjiang(191 cases)and Mangshi(78 cases). Conclusions The epidemic situation of imported malaria is serious in the border region of Yunnan Prov?ince. Therefore,the surveillance system of malaria control needs to be well planned and managed to ensure timely case detection and prompt response at the elimination and post?elimination stage.

Objective:To evaluate the 3-year survival outcomes and late injury between the self-designed patent single-channel applicator, which was modified from the traditional tandem applicator and wrapped with a oval-shield alloy around the source channel and standard Fletcher-type applicator in the high-dose-rate brachytherapy for cervical cancer.Methods:Patients initially diagnosed with cervical cancer in the Affiliated Hospital of Southwest Medical University from December 2011 to April 2017 were enrolled and randomly assigned into the external beam radiotherapy (EBRT)+ single-channel intracavitary applicator group (the patent single-channel group) and EBRT+ the Fletcher applicator group. The whole pelvis irradiation was delivered with 6-MV photons via a four-field box variant or anterior and posterior parallel fields. Five to six fractions of intracavitary brachytherapy were performed at a dose of 7 Gy at point A once a week after 30 Gy (Equivalent Dose in 2 Gy at point A: 80-90 Gy). Chemotherapy was given with intravenous injection of cisplatin at a dose of 40 mg/m 2 once weekly during EBRT. Clinical efficacy and safety were evaluated after corresponding treatment. Results:In total, 150 eligible cases were assigned into the Fletcher applicator group and 149 cases into the patent single-channel group. Up to December 2020, all patients had been followed up for 3 years, and the median duration of follow-up was 61 months. In the Fletcher group, the 3-year overall survival, progression-free survival and locoregional failure-free survival was 76.3%, 78.1% and 75.4%, and 83.8%, 80.3% and 85.5% in the single-channel group, respectively. In the Fletcher group, the cumulative rate of grade 3-4 late rectal complications was 3.3% and 6.7% in the single-channel group ( P=0.122). The cumulative rate of grade 3-4 bladder complications was 1.3% in the Fletcher group and 0.7% in the single-channel group ( P=1.000). Conclusion:The self-designed patent single-channel intracavitary applicator yields equivalent long-term clinical efficacy and safety to the standard Fletcher-type three-channel applicator in the HDR brachytherapy for uterine cervical cancer.

Objective: To evaluate whether the self-designed single-channel intracavitary applicator yields equivalent clinical efficacy and safety to the standard Fletcher-type three-channel applicator in the high-dose-rate (HDR) brachytherapy for uterine cervical cancer. Methods: From December 2011 to April 2017, patients initially diagnosed with cervical cancer were randomly assigned into the external beam radiotherapy (EBRT)+ single-channel intracavitary applicator group (the patent single-channel group) and EBRT+ the Fletcher applicator group. Whole pelvis irradiation was delivered with 6-MV photons via a four-field box variant or anterior and posterior parallel fields. Five to six fractions of intracavitary brachytherapy were performed at a dose of 7 Gy at point A once a week after 30 Gy (BED at point A: 80-90 Gy). Chemotherapy was given with intravenous injection of cisplatin at a dose of 40 mg/m² once weekly during EBRT.Clinical efficacy and safety were evaluated after the treatment. Results: In total, 150 eligible cases were assigned into the Fletcher applicator group and 149 cases into the patent single-channel group. The short-term clinical efficacy and acute toxicity did not significantly differ between two groups. The response rate was 94.0% in the Fletcher group, and 94.7% in the patent single-channel group. In the Fletcher applicator group, 76(50.7%) patients developed ≥ grade 3 hematologic toxicity and 61(40.9%) in the patent group (P=0.195). Conclusions: The self-designed patent single-channel intracavitary applicator yields equivalent clinical efficacy and safety (acute toxicity) to the standard Fletcher-type three-channel applicator in the HDR brachytherapy for uterine cervical cancer. Clincal Trial Registration Chinese Clinical Trial Registry (ChiCTR-TRC-12002321).

Objective: To determine the spatiotemporal distribution of Schistosoma (S.) japonicum infections in humans, livestock, and Oncomelania (O.) hupensis across the endemic foci of China. Methods: Based on multi-stage continuous downscaling of sentinel monitoring, county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019. The data included S. japonicum infections in humans, livestock, and O. hupensis. The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model, with a standard deviational ellipse (SDE) tool, which determined the central tendency and dispersion in the spatial distribution of schistosomiasis. Further, more spatiotemporal clusters of S. japonicum infections in humans, livestock, and O. hupensis were evaluated by the Poisson model. Results: The prevalence of S. japonicum human infections decreased from 2.06% to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019, with a reduction from 9.42% to zero for the prevalence of S. japonicum infections in livestock, and from 0.26% to zero for the prevalence of S. japonicum infections in O. hupensis. Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan, Hubei, Jiangxi, and Anhui, as well as in the Poyang and Dongting Lake regions. Poisson model revealed 11 clusters of S. japonicum human infections, six clusters of S. japonicum infections in livestock, and nine clusters of S. japonicum infections in O. hupensis. The clusters of human infection were highly consistent with clusters of S. japonicum infections in livestock and O. hupensis. They were in the 5 provinces of Hunan, Hubei, Jiangxi, Anhui, and Jiangsu, as well as along the middle and lower reaches of the Yangtze River. Humans, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the north of the Hunan Province, south of the Hubei Province, north of the Jiangxi Province, and southwestern portion of Anhui Province. In the 2 mountainous provinces of Sichuan and Yunnan, human, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the northwestern portion of the Yunnan Province, the Daliangshan area in the south of Sichuan Province, and the hilly regions in the middle of Sichuan Province. Conclusions: A remarkable decline in the disease prevalence of S. japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019. However, there remains a long-term risk of transmission in local areas, with the highest-risk areas primarily in Poyang Lake and Dongting Lake regions, requiring to focus on vigilance against the rebound of the epidemic. Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection, wild animal infection, and O. hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.

Objective To develop an intelligent recognition model based on deep learning algorithms of unmanned aerial vehicle (UAV) images, and to preliminarily explore the value of this model for remote identification, monitoring and management of cattle, a source of Schistosoma japonicum infection. Methods Oncomelania hupensis snail-infested marshlands around the Poyang Lake area were selected as the study area. Image datasets of the study area were captured by aerial photography with UAV and subjected to augmentation. Cattle in the sample database were annotated with the annotation software VGG Image Annotator to create the morphological recognition labels for cattle. A model was created for intelligent recognition of livestock based on deep learning-based Mask R-convolutional neural network (CNN) algorithms. The performance of the model for cattle recognition was evaluated with accuracy, precision, recall, F1 score and mean precision. Results A total of 200 original UAV images were obtained, and 410 images were yielded following data augmentation. A total of 2 860 training samples of cattle recognition were labeled. The created deep learning-based Mask R-CNN model converged following 200 iterations, with an accuracy of 88.01%, precision of 92.33%, recall of 94.06%, F1 score of 93.19%, and mean precision of 92.27%, and the model was effective to detect and segment the morphological features of cattle. Conclusion The deep learning-based Mask R-CNN model is highly accurate for recognition of cattle based on UAV images, which is feasible for remote intelligent recognition, monitoring, and management of the source of S. japonicum infection.

BACKGROUND: Breast cancer patients who are positive for hormone receptor typically exhibit a favorable prognosis. It is controversial whether chemotherapy is necessary for them after surgery. Our study aimed to establish a multigene model to predict the relapse of hormone receptor-positive early-stage Chinese breast cancer after surgery and direct individualized application of chemotherapy in breast cancer patients after surgery. METHODS: In this study, differentially expressed genes (DEGs) were identified between relapse and nonrelapse breast cancer groups based on RNA sequencing. Gene set enrichment analysis (GSEA) was performed to identify potential relapse-relevant pathways. CIBERSORT and Microenvironment Cell Populations-counter algorithms were used to analyze immune infiltration. The least absolute shrinkage and selection operator (LASSO) regression, log-rank tests, and multiple Cox regression were performed to identify prognostic signatures. A predictive model was developed and validated based on Kaplan-Meier analysis, receiver operating characteristic curve (ROC). RESULTS: A total of 234 out of 487 patients were enrolled in this study, and 1588 DEGs were identified between the relapse and nonrelapse groups. GSEA results showed that immune-related pathways were enriched in the nonrelapse group, whereas cell cycle- and metabolism-relevant pathways were enriched in the relapse group. A predictive model was developed using three genes ( CKMT1B , SMR3B , and OR11M1P ) generated from the LASSO regression. The model stratified breast cancer patients into high- and low-risk subgroups with significantly different prognostic statuses, and our model was independent of other clinical factors. Time-dependent ROC showed high predictive performance of the model. CONCLUSIONS A multigene model was established from RNA-sequencing data to direct risk classification and predict relapse of hormone receptor-positive breast cancer in Chinese patients. Utilization of the model could provide individualized evaluation of chemotherapy after surgery for breast cancer patients.
Humans ; Female ; Breast Neoplasms/genetics* ; East Asian People ; Neoplasm Recurrence, Local/genetics* ; Breast ; Algorithms ; Chronic Disease ; Prognosis ; Tumor Microenvironment