Objective To investigate the expression of T help cell 1(Th1),T help cell 2(Th2)and related cytokines interleukin 12 (IL -12)and interleukin 4 (IL -4)in the lumbar disc herniation and their clinical significance. Methods 30 postoperative patients with lumbar disc herniation were included as observation group.The control group included 10 patients with lumbar fracture.Flow cytometry was used to distinguish the Th1 and Th2 cells.ELISA was used to measure the expression of interferon γ(IFN -γ),IL -12(the cytokines secreted by Th1 cells)and IL -4 (the cytokine secreted by Th2 cells).RT -PCR was used to detect the mRNA levels of STAT4 and STAT6.Results The distribution of Th1 /Th2 cells was higher in patients with lumbar disc herniation compared to the control group [(6.24 ±2.89)vs (25.12 ±3.20),t =16.26,P <0.05;(2.68 ±0.58)vs (8.16 ±1.20),t =3.84,P <0.05]. The levels of IFN -γand IL -12 in the study group were significantly higher than the control group,the differences were statistically significant[(23.47 ±5.61)vs (7.65 ±3.21),t =8.422,P <0.05;(1.52 ±0.87)vs (5.34 ± 1.39),t =8.135,P <0.05].The level of IL -4 was undetectable in the control group,however,IL -4 expressed in the study group.The expressions of IL -12,IFN -γand IL -4 in the study group were negatively correlated by Spearman correlation analysis (r =-0.57,P <0.05;r =-0.23,P <0.05).In addition,the mRNA level of STAT4 was higher in patients with lumbar disc herniation compared to the control group[(3.21 ±0.49)vs (1.12 ±0.24), t =13.15,P <0.05].Conclusion The expressions of Th1 cells,Th2 cells and related cytokines were participated in the pathogenesis of lumbar disc herniation.

Objective To explore expression of IL -33 and IL -33 mRNA in peripheral blood of patients with ankylosing spondylitis,and analyze the clinical significance,so as to provide scientific reference for the treatment and prognosis of the disease.Methods From February 201 4 to May 201 6,32 patients with ankylosing spondylitis were included as study group,30 healthy persons were selected as control group.Real -time quantitative PCR and enzyme -linked immunosorbent assay were used to detect IL -33 mRNA level in peripheral blood and IL -33 level in plasma of subjects.Results Compared with the control group (1 .23 ±0.58),IL -33 mRNA in peripheral blood of patients in the study group was higher(1 .74 ±0.75),and the difference was statistically significant (t =2.981 , P =0.004).ELISA results showed that IL -33 level in plasma of the study group was higher (227.30 ±45.67)pg/mL than the the control group (1 1 4.70 ±39.58)pg/mL,the difference was statistically significant (t =1 0.344,P <0.01 ).Compared with the control group,the ESR,CRP and PLT of the study group were significantly higher[(47.80 ± 4.73)mm/h,(42.60 ±3.38)mg/L,(329.60 ±48.39)×1 09 /L](t =42.542,54.722,1 4.040,all P <0.01 ).IL -33 in plasma and IL -33 mRNA in peripheral blood of ankylosing spondylitis patients were positively correlated with BASDAI(r =0.472,0.457,all P <0.05),CRP(r =0.71 3,0.687,all P <0.05).Conclusion IL -33 and IL -33 mRNA in patients with ankylosing spondylitis significantly increase,indicates that they should play important role in the occurrence and development of ankylosing spondylitis.

Objective To investigate the value of micro-course in colostomy patients in self-care. Methods A total of 120 patients with colostomy patients were divided into the intervention group and the control group with 60 cases each according to the first time in the hospital bed and odd number. The intervention group was given micro-course in colostomy patients discharge health education. The control group was taken the traditional health education missionary single conduct health education of discharged. The self-efficacy (divided stoma care effectiveness and social effectiveness of two dimensions and six separate entries, score 28-140 points. Using five no confidencethere a little confidence some of confidencequite confident or very confident scoring 1-5 points) and stoma care skills (including two parts, a total of 18 entries, each entry method using Likert scale of 51-5 points representing very unskilledsomewhat skilledordinary skillskilled and very skilled, score 18-90 points, higher scores indicate better skills) of patients after 3 months of discharge between the two groups were compared and evaluated. Results After 3 months of discharge, the self- efficacy scores of the intervention group were evaluated with respect to stoma care, social performance, diet choice, confidence in sex life, confidence in sexual life, confidence in physical activity, confidence in vitality and confidence in self-care (53.17±3.54), (38.62±5.25), (3.45 ± 1.06), (2.43 ± 1.06), (2.22 ± 0.86), (2.88 ± 0.94), (3.52 ± 0.89), (3.88 ± 0.64) points, respectively, compared with the control group (50.45 ± 4.79), (35.33 ± 3.42), (3.03±1.15), (1.77±0.81), (1.78±0.72), (2.47±0.96), (3.02±0.70), (3.40±0.81) points, there were significant differences (t=-4.366--2.076, all P<0.05) . According to the comparison of stoma nursing skills, the score of stoma care and the related knowledge of stoma care were (36.33±4.21), (37.13±3.85) points in the intervention group, and (34.22±3.87), (31.32±4.95) points in the control group, and there were statistically significant difference (t=-3.140,-7.741, P < 0.05). Conclusions Colostomy patients discharged from hospital health education classes in the use of micro-course, can effectively improve patients' self-efficacy and ostomy care capacity, enhance the quality of life.

Objective To investigate the influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair.Methods A total of 35 patients with acute Achilles tendon rupture were treated with early low frequency training after anchors repair,including 28 males and 7 females.Aged 18 to 37 years, mean 26 years old.Duration 2h to 5d from injury to therapy.All patients palpated the discontinuity of Achilles tendon, limitative activity of ankle plantar flexion,Thompson test was positive,and MRI examination was taken.Results 35 patients were followed up for 12 to 18 months,with an average follow -up of 14.5 months.According to the Amer-Lindholm score,excellent in 30 cases,good in 5 cases,the good rate was 100%.All the wounds were healed, without infection,dehiscence,sural nerve injury and re -rupture occurred.Conclusion Early low frequency training after anchors repair for acute Achilles tendon rupture is safe and reliable,patients can receive a better functional outcome.

Objective To evaluate the effect of greater trochanteric transfer for the treatment of coxa brevis in children and adolescents.Methods From August 2005 to January 2011,twenty patients (22 hips)with coxa brevis underwent greater trochanteric transfer.Among them 18 patients (20 hips) were available for evaluation,including 4 boys and 14 girls,with an average age of 11.4 years (range,7.5-15.0 years) at operation.Five cases (6 hips) were caused by Perthes disease,and 13 cases (14 hips) were caused by developmental dysplasia of hip.Four patients (4 hips) had undergone greater trochanteric epiphyseodesis ever before.All patients were fixed with tension screw after the deformity was corrected during the operation.After operation,the human plaster spica was used for 6 weeks in all patients.Results All patients were followed up for 14 to 79 months (average,31 months).At the last follow-up,fatigue or pain in the hips disappeared or improved in 13 patients.Sixteen patients had limping and positive Trendelenburg sign preoperatively,at the last follow-up 9 patients got improvement.Twelve patients (13 hips) had limitation of abduction of the hip,the average range of abduction was 25.38°±1.20°,which was improved to 45.38°±1.05° at the last follow-up.The average articulotrochanteric distance and ratio of the distance from the greater trochanter tip to femoral head center and the radius of the femoral head at the last follow-up was (17.47+3.14)mm and 2.10±0.21,respectively,there were statistical differences compared with those before operation [(-2.89±4.62) mm and 1.59±0.22,respectiovely].The average leg-length discrepancy at the last follow-up was (0.78t±0.26) cm,which had on statistical differences compared with that [(0.83 ±0.33) cm]before operation.Conclusion Greater trochanteric transfer for the treatment of coxa brevis in children and adolescents could improve the clinical symptom,recover the normal anatomy of the proximal femoral,restore the hip biomechanics environment,but could uot improve the leg-length discrepancy.

Objective To assess left ventricular synchronicity in patients with metabolic syndrome(MS)by tissue Doppler imaging.Methods Twenty-two patients with MS and left ventricular hypertrophy(LVH)(MS-LVH group),69 patients with MS and non-LVH(MS-NLVH group)and 33 healthy subjects(control group) were included.Left ventricular(LV)systolic and diastolic synchronicity were determined by measuring the maximal difference in time to peak myocardial systolic contraction(Ts-diff)and time to peak myocardial early diastolic relaxation(Te-diff),and the standard deviation of time to peak myocardial systolic contraction(Ts-SD)and early diastolic relaxation(Te-SD)with 6 basal and 6 middle LV segments.Results Compared with control group,patients with MS in MS-NLVH and MS-LVH group showed significantly prolonged Ts-diff,Ts-SD,Te-diff and Te-SD.Furthermore,Te-diff and Te-SD were much more prolonged in MS-LVH group than in MS-NLVH group.Conclusions Patients with MS have impaired L V systolic and diastolic synchronicity.LVH impacts the LV diastolic synchronicity much more obviously than systolic synchronicity in the patients with MS and LVH.

Objective To observe the effect of Proanthocyanidin on motor after spinal cord injury (SCI) in rats. Methods 36 healthy adult SD rats were divided into groups A, B and C (n=12), and SCI was induced with Allen's mode (250 g·mm) on T9. Proanthocyanidin 40 mg/kg was injected intraperitoneally for group A, methylprednisolone (MP) 30 mg/kg for group B and the same volume of saline for group C 30 min after SCI. 1 d, 3 d and 7 d after operation, all the rats were assessed with Basso-Beattie-Bresnahan (BBB) scale and slanting board test, and their serumal malondialdehyde (MDA) and superoxide dismutase (SOD) were detected. Results The scores of BBB and the slanting board test imporoved more in group A and group B than in group C (P<0.05). The SOD increased and MDA decreased in groups A and B significantly 1 d and 3 d after operation compared with those of group C (P<0.05), and only in group A 7 d after operation (P<0.05). Conclusion Proanthocyanidin may inhibit the lipid peroxidation and promote the recovery of motor after spinal cord injury in rats.

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.

Objective To investigate the status quo of cancer-related fatigue(CRF)in patients with advanced malignant tumours during anti-tumour treatment,and explore the influencing factors so as to provide a reference for nursing intervention.Methods Between January and August 2022,a total of 279 patients with advanced malignant tumours who received anti-tumour therapies in the Department of Oncology of a general hospital in Beijing were selected as study subjects using convenience sampling method.General data questionnaire,cancer fatigue scale,chemotherapy-related gastrointestinal symptoms inventory,and nutritional risk screening 2002 were used for the investigation.Logistic regression analysis was conducted to determine the influencing factors of cancer-related fatigue.Results Toally 279 patients finished the study.A total of 204(73.12%)patients had cancer-related fatigue.Binary logistic regression analysis showed that BMI,education,monthly family income and diabetes were the influencing factors in cancer-related fatigue(all P<0.05).Conclusions The incidence of cancer-related fatigue is high in patients with advanced malignant tumours during anti-tumour therapy.Low BMI,poor education,low monthly family income and diabetes are the risk factors in cancer-related fatigue.Targeted interventions should be implemented based on the risk factors so as to reduce the incidence of cancer-related fatigue.

Objective:To systematically evaluate the real breastfeeding experience in professional women.Methods:Qualitative studies on breastfeeding experience and needs in professional women which were published up to August 20, 2020 were retrieved from English databases such as PubMed, Medline, The Cochrane Library, Embase, Web of Science, Ovid, CINAHL, Joanna Briggs Institute Library, Chinese databases such as CNKI, Wanfang, VIP, SinoMed, and grey literature databases like ProQuest. After literature screening and evaluation, a collection integration method was used to integrate the results.Results:A total of 12 studies were included, and 57 complete research results were extracted, which were summarized into 8 new categories integrated into 3 new results: working mothers benefited from breastfeeding but also had negative experience due to returning to work; their breastfeeding was affected by multiple promotion and obstacles after returning to work; and they dealt with breastfeeding challenges after returning to work through self-management.Conclusions:We should actively pay attention to the breastfeeding experience of professional women, improve the support for breastfeeding of working mothers, and help them improve their self-management ability, in order to promote their breastfeeding behavior after returning to work.