Objective To explore the mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV.Methods 250 children affected by the AIDS/HIV were investigated in the research in a district affected by AIDS/HIV in the Henan province.Self-esteem scale,peer attachment questionnaire and school adjustment questionnaire was adopted in the study.Results ①Self-esteem had a positive significant effect on the school adjustment (β=0.227,P＜0.01).(②)self-esteem had a positive significant effect on the peer attachment (β=0.236,P＜ 0.01).(③When controlled the indirect effect of peer attachment,the effect of the self-esteem on the school adjustment had still been significant (β =0.145,P＜0.05),it proved that the peer attachment played a partly mediation between the relationship of the self-esteem and the school adjustment.Conclusion Self-esteem has a positive significant effect on the school adjustment; and self-esteem can not only affect the school adjustment directly,but also affect the school adjustment through the peer attachment.

Objective To investigate the expression of adiponectin Mrna in adipose tissues of spontaneously hypertensive rats (SHR) and the effects of Fosinopril (Fos) and osartan (Los) on adiponectin Mrna.Methods Twenty 22 - week old male SHR rats were randomly divided into four groups:SHR group,Fos group,and Fus + Los group.Five 22 - week old male WKY rats were used as control.The body weigh,cuff-tail blood pressure,urinary microprotein and urinary N-acetyl-β-D-glucesaminidase were determined.RT-PCR were applied to determine the expression of adiponectin Mrna in adipose tissues.Results At the eighth week,systolic blood pressure of rats in SHR group was significantly higher than those in the other four groups (P＜0.05).The levels of urinary microprotein,urinary NAGase in the WKY group,Fos group,Los group and Fos + Los group were significantly lower than those in SHR group(P＜0.05).RT-PCR analysis revealed that the expression of adiponectin Mrna in SHR group was obviously decreased,compared with WKY goup.Adiponectin Mrna expression in Los group,Fos group and Fos + Los group were increased compared with SHR group(P＜0.05).Conclusions The expression of adiponeetin Mrna is down-regulated in adipose tissues of SHR.After intervention with Fusinopril and Losartan,the adiponectin Mrna expression was up-regulated in adipose tissues of SHR,the levels of urinary microprotein and urinary NAGase were obviously increased in SHR and the levels of urinary microprotein and urinary NAGase were obviously decreased.

Objective To explore the effect of early Chinese medicine intervention on motor function and balance capability of patients with traumatic brain injury (TBI). Methods 55 cases of hospitalized TBI patients were randomly divided into observation group (n=27) and control group (n=28). The control group accepted routine rehabilitation program, while the observation group accepted Chinese medicine therapy in addition for 8 weeks. The motor function and balance capability were tested with Fugl-Meyer Assessment (FMA) and Berg Balance Scale (BBS) respectively before and after treatment. Results The scores of FMA and BBS significantly increased after treatment (P<0.01), and they were higher in the observation group than in the control group (P<0.05). Conclusion Chinese medicine combined with routine rehabilitation program is effective on motor dysfunction after TBI.

Objective To observe the effects of Chinese Traditional Medicine on cognitive functions in the early stage of traumatic braininjury (TBI). Methods 49 inpatients with TBI were divided into treatment group (n=25) and control group (n=24) randomly. The controlgroup accepted routine rehabilitation, while the treatment group accepted Chinese Traditional Medicine in addition. They were assessed withLoewenstein Occupational Therapy Cognitive Assessment (LOTCA) before and after treatment. Results All the scores of LOTCA of treatmentgroup significantly improved after treatment (P<0.01), as well as in control group except "Categories". Most scores of LOTCA improvedmore in the treatment group than in the control group (P<0.05). Conclusion Chinese Traditional Medicine can improve the cognitivefunction after TBI.

Objective:To investigate the characteristics of lymphocyte subsets in peripheral blood of patients with immunoglobulin G4-related disease (IgG4-RD) and the correlation between T helper 17 cell (Th17)/regulatory T cells (Treg) cell imbalance and cytokines.Methods:A total of 31 patients with IgG4-RD who were admitted to the Rheumatology and Immunology Department of the Second Hospital of Shanxi Medical University from January 2016 to June 2020 were included. We collected their clinical and laboratory data, and selected 30 age and sex matched healthy people as the control group. Flow cytometry was used to detect the percentage and absolute number of lymphocyte subsets [T, B, natural killer cell (NK), CD4 +T, CD8 +T] and CD4 +T subsets [Th1, Th2, Th17, CD4 +CD25 +forkhead box protein 3 (Foxp3) +Treg] in peripheral blood of IgG4-RD patients and healthy controls. The serum interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor (TNF)-α and interferon (IFN)-γ levels in the IgG4-RD patients were measured by cytometric bead array (CBA). Correlation between Th17/Treg ratio and disease-related indicators was also analyzed. We used χ2 test, Mann-Whitney U test and Spearman correlation analysis for statistical analysis. Results:① The percentage of CD4 +T cells in the peripheral blood of IgG4-RD patients was higher than that of healthy controls [45.00%(33.97%, 51.48%) vs 39.36%(33.78%, 43.30%), Z=-2.142, P<0.05]. ② The percentage and absolute number of Th17 cells was increased in IgG4-RD patients [1.13%(0.70%, 1.55%) vs 0.77%(0.43%, 1.07%), Z=-2.229, P<0.05; 7.90(5.20, 12.23) cells/μl vs 5.60(3.12, 8.47) cells/μl, Z=-2.568, P<0.05], while the percentage of Treg cells was decreased [3.37%(2.82%, 5.65%) vs 4.96%(4.18%, 6.34%), Z=-2.986, P<0.01]. But the number of Treg cells showed no difference between the two groups. ③ Th17/Treg ratio was significantly increased in IgG4-RD patients [0.29(0.16, 0.46) vs 0.15(0.08, 0.23), Z=-3.119, P<0.01], and it was positively correlated with IgG4-RD response index score ( r=0.491, P<0.01). ④ Serum IL-6 [13.72(9.29, 26.06) pg/ml vs 2.23(1.94, 3.10) pg/ml, Z=-4.815, P<0.01], IL-10 [5.46(4.28, 15.38) pg/ml vs 1.81(1.59, 2.02) pg/ml, Z=-5.298, P<0.01], TNF-α [4.25(1.47, 7.26) pg/ml vs 1.15(1.05, 1.45) pg/ml, Z=-3.146, P<0.01] and IFN-γ [3.89(1.76, 6.61) pg/ml vs 1.41(1.24, 1.65) pg/ml, Z=-3.172, P<0.01] in IgG4-RD group were significantly higher than those in healthy control group. Moreover, Th17/Treg ratio was negatively correlated with IL-2 level ( r=-0.554, P<0.05). Conclusion:Th17/Treg disorder exists in IgG4-RD patients, and it is related to disease activity, indicating that Th17/Treg imbalance may be an important mechanism in IgG4-RD. IL-2 plays an important role in regulating Th17/Treg balance and may be a potential immunotherapy target in future.

Objective:To explore the effect of three-dimensional (3D) printing technology combined with case-based learning (CBL) teaching method in clinical nursing teaching of adolescent idiopathic scoliosis.Methods:The convenience sampling was used to select 48 nursing students who had clinical practice in the Orthopedic Spine Ward of the Fourth Medical Center of Chinese People's Liberation Army General Hospital from January to November 2020 as the control group. A total of 50 nursing students in the same ward were selected as the experimental group from December 2020 to October 2021. The control group adopted the unified and standardized traditional teaching method of the Nursing Department, and the experimental group applied 3D printing technology combined with CBL teaching method on the basis of traditional teaching. After the internship, the two groups of intern nursing students were evaluated on their graduation examination results, teaching satisfaction and learning interest, and the knowledge assessment was carried out six months later.Results:The scores of the students in the experimental group in the academic theory, operation examination, teaching satisfaction and learning interest, as well as the scores of the related knowledge after half a year were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The combination of 3D printing technology and CBL teaching method can help intern nursing students understand and master relevant teaching content, improve learning interest and teaching satisfaction, and help form long-term memory in the clinical nursing teaching practice of adolescent idiopathic scoliosis.

Objective To study the prevalence of hyperuricemia and its risk factors in elderly people of Yiyang District,Hunan Province,China.Methods A total of 1363 elderly people undergoing physical examination in our hospital were divided into hyperuricemia group (n=245) and control group (n=1118).Their general clinical data were recorded and compared.The risk factors for hyperuricemia were analyzed.Results The age was significantly older,number of males was significantly larger,the serum TG,LDL-C,urea,UA levels and body height,BMI,SBP were significantly higher while the serum TC and HDL-C levels and Cr clearance rate were significantly lower in hyperuricemia group than in control group (P＜0.05,P＜0.01).Pearson correlation analysis showed that serum UA level was positively related with age,serum TG and urea level,BMI,SBP and DBP,but negatively related with Cr clearance rate and serum TC,LDL-C,HDL-C levels (P＜ 0.01).Binary logistic regression analysis showed that age,male gender,hyperlipidemia,and obesity were the independent risk factors for hyperuricemia after adjustment of age (OR=1.857,95 ％ CI:1.302-2.649,P=0.001;OR=1.866,95％CI:1.363-2.555,P=0.000;OR=2.214,95％ CI:1.716-2.856,P=0.000).However,serum HDL-C level and Cr clearance rate were the protective factors for hyperuricemia (OR =0.388,95 ％ CI:0.242-0.623,P =0.000;OR =0.948,95％CI:0.937-0.959,P=0.000).Conclusion The prevalence of hyperuricemia is rather high in elderly people of Yiyang Distric,Hunan Province,China,suggesting that the lifestyle of elderly people should be improved and hyperuricemia should be treated with appropriate drugs.

Objective:To investigate the effect of prolonged negative pressure drainage time after parotidectomy and analyze its relationship with the incidence of postoperative salivary fistula.Methods:The clinical data of 94 patients with benign parotid gland tumors who received treatment in the Department of Otolaryngology-Head and Neck Surgery of The First Affiliated Hospital of Xiamen University from July 2021 to June 2022 were retrospectively analyzed. These patients were divided into an observation group and a control group ( n = 47 per group). In the observation group, the negative pressure drainage tube was removed after 1 week of simple negative pressure drainage, while in the control group, conventional local bandaging of the parotid gland was performed for 2 weeks, and negative pressure drainage was given for 2-3 days. Postoperative drainage volume, pain degree, and the incidence of salivary fistula were recorded for each group. Results:The total drainage volume in the observation group was (77.93 ± 23.83) mL, which was significantly greater than (47.06 ± 24.71) mL in the control group ( t = 6.17, P < 0.001). The Visual Analogue Scale score in the observation group was (3.021 ± 1.07) points, which was significantly lower than (7.53 ± 1.27) points in the control group ( t = 18.63, P < 0.001). The incidence of postoperative salivary fistula in the observation group was 2.1% (1/47), which was significantly lower than 17.0% (8/47) in the control group ( χ2 = 4.42, P = 0.035). Conclusion:Simple prolongation of negative pressure drainage time can achieve full drainage, improve the quality of life of patients after parotidectomy and reduce the occurrence of postoperative salivary fistula, which is worthy of clinical promotion.

Objective To evaluate the guidelines for prevention of catheter-associated urinary tract infections so as to provide important bases to formulate the program of standardized nursing care related to clinical urinary catheter and quality improvements of guideline implementation .Methods Databases and guidelines network at home and abroad were searched to collect guidelines or guidance .And then, guidelines or guidance were included according to the inclusion and exclusion criterion .Besides, we descriptively analyzed the names, years of publication, institution of publication, formulation methods, reference number of guidelines and so on.Moreover, methodological quality of included guidelines was assessed according to the Appraisal of Guidelines Research and Evaluation Ⅱ ( AGREE Ⅱ) .Results A total of five guidelines were included involving one in Chinese and four in English .Quality evaluation results illustrated that the score of clarity of five guidelines was the highest ( average of 72%) , and the next was independence ( 64%) , purpose and scope (62%), rigor ( 53%), applicability ( 46%) along with the lowest ( stakeholder involvement , 44%). Moreover, three reviewers all agreed that Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009 published by Centers for Disease Control and Prevention in 2010 should be recommended to use and three guidelines could be used after being revised .Conclusions The guidelines for prevention of catheter-associated urinary tract infections are of uneven quality .Besides, how to determine and select guideline in clinical implementation should be based the evaluation results of methodological quality , clinical environment , status and so on.

【Objective】 To develop an assay to determine β-lactam antibiotics using microcolumn gels and to study the β-lactam antibiotics present in the blood of patients and their clinical significances. 【Methods】 446 patients with a history of taking β-lactam antibiotics from January 2019 to June 2019 were randomly selected from Trauma Emergency Center, Department of Arthrosis, Department of Spine and Department of Bone Oncology of our hospital, and 4 mL(per capita) venous blood was collected. Irregular antibody screening, anti-globulin detection and drug antibody determination were performed by microcolumn gel method. The data of gender, age, disease, blood transfusion history and medication were collected. The test results and clinical data were retrospective analyzed. 【Results】 The yielding rate of antibody was 0.45%(2/446) in patients with a history of taking β -lactam antibiotics. 16.38%(73/446) of the samples were positive in direct antiglobulin test, and 64.38%(47/73) of them did not agglutinate with RBCs treated with drugs. The yielding rate of specific antibodies against drug was 4.93%(22/446), and the titer ranged from 2 to 128(8). 1 case of auto-IgM antibody, 1 case of blood group related antibody and 2 cases of non-specific protein adsorption were detected. The yielding rate of drug antibody in patients with blood transfusion history reached to 12.10 %(22/124), so it was also high in patients with bone tumor. 【Conclusion】 Direct antiglobulin assay is helpful for the detection of β-lactam antibodies. The negative results of antibody screening cannot completely exclude the presence of drug antibodies. The yielding rate of drug antibody can be greatly improved by specific drug antibody detection, and it was higher in transfused patients relative to non-transfused one.