Objective To determine the expression of Notch pathway receptors (Notch1 and Notch4) and ligands (Jagged1 and Dll4) in cutaneous malignant melanoma (CMM) tissues,and to preliminarily explore the role of the Notch signaling pathway in the pathogenesis of CMM.Methods Immunohistochemical study was performed to determine the expression pattern and intensity of Notch1,Notch4,Jagged1 and Dll4 in 40 paraffin-embedded CMM specimens and 15 paraffin-embedded pigmented nevus specimens.Statistical analysis was carried out by chi-square test and Spearman rank correlation analysis with the SPSS 21.0 software.Results Notchl was detected in 31 (77.5％) of 40 CMM specimens,as well as in 3 of 15 pigmented nevus specimens,and the positive rates significantly differed between the two groups (x2 =15.281,P ＜ 0.001).However,no significant difference in the expression intensity of Notch1 was observed between 18 in situ melanoma tissues and 22 invasive melanoma tissues (x2 =0.631,P =0.427).In addition,the positive rates of Notch4,Jagged1 and Dll4 were also significantly higher in the CMM group than those in the pigmented nevus group (all P ＜ 0.05),and the expression intensity of Notch4,Jagged1 and Dll4 significantly differed between in situ and invasive melanoma tissues (all P ＜ 0.05).In CMM tissues,the expression of Notch1 was positively correlated with that of Jagged1 (rs =0.350,P =0.027) and Dll4 (rs =0.562,P ＜ 0.001),while the expression of Jaggedl was negatively correlated with that of Dl14 (rs =-0.734,P ＜ 0.001).Conclusion Abnormality of the Notch signaling pathway may be involved in the pathogenesis of melanoma,but further researches are still needed to elucidate the detailed mechanism.

The elimination of Oncomelania hupensis snails is important to schistosomiasis control. Recently,the application of molluscicidal organisms is considered as a safe and efficient method for snail elimination. In order to provide scientific evi?dences for effective control of O. hupensis and schistosomiasis,this paper summarizes the researches of molluscicidal microor?ganisms against O. hupensis.

Purpose To study the status of EGFR mutations and the expression of excision repair cross-complementation group 1 ( ER-CC1) and Ki-67 protein in patients with non-small cell lung cancer (NSCLC) and to examine the relationship between their expression and clinicopathologic features. Methods EGFR mutations were analyzed with DNA sequencing, and the expression of ERCC1 and Ki-67 protein was examined by immunohistochemistry EnVision. The relationship of EGFR mutations with the expression of ERCC1and Ki-67 and the clinicopathological features were analyzed. Results EGFR mutations were detected in 143 (143/291, 49. 1%) of the 291 specimens. EGFR mutations were found more frequently in women, non-smokers and adenocarcinoma. The difference of EGFR muta-tion rate between the histological subtypes according to the IASLC/ATS/ERS classification of lung adenocarcinoma was significantly ( P=0. 008). The mean tumor diameter was smaller in patients with EGFR mutations than in those with wild-type EGFR (P=0. 020). EGFR mutations were not related to age, lymph node metastasis. However, EGFR mutations were not related to the expression of ER-CC1 and Ki-67 protein (P>0. 050). Conclusions EGFR mutation is closely linked to several clinicopathological factors, such as gender, differentiation, and histological subtype. There is heterogeneity of EGFR mutation in patients with NSCLC. EGFR mutations were not related to the expression of ERCC1 and Ki-67 protein.

Objective To investigate the temporal and spatial distribution of Schistosoma infection of population and its risk factors in Eastern Dongting Lake area in 2012 and 2014,so as to provide the reference for formulating effective intervention mea-sures. Methods Junshan District was selected as a study field in Eastern Dongting Lake area. The method of spatial autocorre-lation analysis was applied to analyze the change of spatial distribution of Schistosoma infection in Junshan District in 2012 and 2014. The spatial regression model was fitted to detect the risk factors for human infection. Results The livestock infection rate in 2013 was lower than that in 2011. The average infection rate of schistosome was reduced to 0.55%in 2014. The spatial auto-correlation existed on the distribution of schistosomiasis in Junshan District in both 2012 and 2014 and 4 high incidence villages were identified. The results of the spatial error model showed that the prevalence of human infection was positively correlated with the infection rate of the livestock and the area of the susceptible environment in 2012. The spatial lag model showed that the prevalence of human schistosomiasis was positively correlated with the area of the susceptible environment ,but not with the in-fection rate of livestock. Conclusion The measures involving grazing prohibition and phasing out cattle and sheep are remark-ably effective and should continue on the basis of the current spatial distribution of schistosomiasis in this area.

Objective:To evaluate the effect of exercise on the sleep quality of elderly persons experiencing a sleep disorder so as to provide an evidentiary basis for future studies.Methods:Reports of randomized and controlled trials of the effects of exercise on sleep quality among elderly persons with sleep disorders were extracted from the Cochrane library, PubMed, EMbase, the Web of Science, CNKI and other databases. Reports from the database′s inception to August 28, 2019 were retrieved. All were screened applying inclusion and exclusion criteria, and their methodological quality was evaluated using the Cochrane bias risk tool. The combined effect was analyzed using version 5.0 of the ReMan software.Results:Nine reports covering 928 patients were identified. Meta-analysis showed that compared with the control group, exercise could significantly improve the overall sleep quality of elderly patients with sleep disorders in terms of sleep score, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, degree of sleep disturbance, sleep medication use, and daytime functioning.Conclusion:Exercise can improve the overall sleep quality of patients with a sleep disorder, shortening the sleep latency, improving sleep efficiency, reducing the use of sleep drugs, and improving their daytime functioning. However, it has less effect on subjective evaluations of sleep quality and sleep disorder.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective:To explore the influencing factors of 31-day unplanned readmission in obstetrics.Methods:The medical records and relevant clinical data of 29 public hospitals in a province in 2017 were collected to construct a two-level logistic regression model on the influencing factors of 31-day unplanned readmission.Results:In 2017, there were 71 330 obstetric patients discharged from 29 public hospitals, 690 of whom were unplanned readmitted in 31 days, accounting for 0.97%. The type of medical insurance payment, number of previous hospitalization, condition of previous hospitalization, age, history of cesarean section, pregnancy complications and complications during delivery were all the factors influencing the 31-day unplanned readmission of obstetrics.Conclusions:The condition of 31-day unplanned readmission could be influenced by the factors of sociology, previous visit and clinical. These factors should be considered reasonably in the evaluation and management of obstetric quality.

Objective:Through the analysis of intelligent nursing patents, to provide reference for clinical nurses to understand the development trend of intelligent nursing patents and carry out related inventions.Methods:The website of China Intellectual Property Office and CNKI were searched with the keywords of " intelligence" , " intellectualization" and " artificial intelligence" , " nursing" and " nurse" from the establishment of the database to December 31, 2020. Information of the patent application time, application area, patent type, main classification number and other patent information were analyzed.Results:Until 2020, China applied for 4 128 patents related to intelligent nursing, among which invention patents were the most, and appearance patents were the least; before 2006, intelligent nursing patents were in the early stage of development, from 2006 to 2014, it showed a slow increasing trend, since 2015, it entered the stage of rapid growth; the regions with the largest number of applications were Shandong, Jiangsu, Guangdong, Shanghai and Zhejiang; IPC of A61, G06, H04, G16 and A47 accounted for the largest proportion, and showing an upward trend as a whole, but different technical fields show different growth rates; intelligent nursing was the most popular. The number of applications for beds and related ancillary products was the largest, followed by intelligent nursing monitoring equipment.Conclusions:It is suggested that to improve the patent incentive mechanisms, encourage nurses to solve clinical problems from an intelligent perspective, and actively promote the transformation of intelligent nursing patents.

Objective:To explore the application and effect of autologous cartilage in rhinoplasty for patients with traumatic hernia and nasal dysfunction.Methods:From January 2017 to April 2019,30 patients with nasal trauma admitted to Department of Otorhinolaryngology Head and Neck Surgery, Daping Hospital, Army Medical University were treated for 6 days to 14 years. All patients were accompanied by different degrees of nasal deformity and nasal ventilatory disorders. They were classified into three categories: light, medium and heavy. All of them were open at the same time. Rhinoplasty and nasal septum deviation correction. For mild to moderate nasal deformity and nasal ventilatory disorders, ear cartilage was used to modify the tip of the nose and strengthen the nasal septal cartilage support to modify the deformity of the nasal back. For severe nasal deformity and nasal ventilatory disorders, we engraved the costal cartilage into a "Y" shaped monolithic stent or flank costal cartilage to form a 2+1 or 4+1 stent, and the costal cartilage stent and the septal cartilage tail end were sutured. Reshape the nasal septum frame support and the nasal column to avoid collapse of the nose.Results:Three patients had a septal hematoma after operation and recovered normally after cleansing. All patients were followed up for 2 months to 2 years, and no complications such as nasal septum perforation and nasal bridge collapse occurred. The postoperative cure rate was 60.0% (18/30). All patients had a grade I nasal drop after surgery, and the effective rate was 100% (30/30). The patient′s preoperative measurement deviation was (6.85±2.43) mm, the postoperative measurement deviation was (2.4±1.58) mm, the preoperative nasal appearance VAS score was (1.93±1.31), and the postoperative nasal appearance VAS score was (6.60±1.16), the difference in facial appearance deviation and VAS score before and after surgery was statistically significant ( P<0.05). All patients had improved nasal ventilation after operation. The preoperative nasal ventilation VAS score was (1.97±1.07), the postoperative nasal ventilation VAS score was (6.53±1.04), and the difference between preoperative and postoperative nasal ventilation VAS scores was statistically significant ( P<0.05). Conclusions:Autologous cartilage is effective in rhinoplasty in patients with traumatic nasal contraction and nasal dysfunction. One stage open rhinoplasty and nasal septum deviation surgery are performed to shorten the treatment time and improve the nasal appearance and nasal ventilation function. The patients got satisfaction.

Objective To explore the relationship between basic motor skills and social interaction ability in school-age children with moderate autism,and the mediating role of executive function and the realization path.Methods A cross-sectional design was used to investigate 117 school-age children with autism from Sep.to Dec.2020.The level of basic motor skills was assessed by the test of gross motor development(TGMD),the impairment of executive function was assessed by the behavior rating inventory of executive function(BRIEF),and the social disorder was assessed by the social responsive scale-second edition(SRS-2).Pearson correlation analysis was used to explore the interrelationship,and structural equation modeling was applied to explore the path relationship.Results There was a significant negative correlation between the level of basic motor skills and SRS-2 scores(r=-0.312,P＜0.001).There were significant negative correlations between the level of basic motor skills and the BRIEF scores of inhibition(r=-0.336,P＜0.001),switching(r=-0.325,P＜0.001),affective control(r=-0.338,P＜0.001),task initiation(r=-0.240,P=0.009),working memory(r=-0.278,P=0.002),and planning(r=-0.224,P=0.015).The SRS-2 score was positively correlated with the BRIEF scores of inhibition(r=0.378,P＜0.001),switching(r=0.299,P=0.001),affective control(r=0.417,P＜0.001),task initiation(r=0.246,P=0.007),working memory(r=0.409,P＜0.001),and monitoring(r=0.258,P=0.005).Executive function played a complete intermediary role between basic motor skills and social interaction ability(B=-1.912,95％confidence interval:-3.116 to-1.069).Conclusion In school-age children with moderate autism,executive function and social interaction ability change positively with the level of basic motor skills.Basic motor skills can affect social interaction ability through the mediating role of executive function,and inhibition and affective control are important pathways to achieve this.