Objective To summarize the nursing experience of post-craniotomy patients using continuous intracranial pressure (ICP) monitoring. Methods Fifty post-craniotomy patients using ICP monitoring admitted to the Department of Neurosurgery of the First People's Hospital of Huzhou from March 2015 to March 2016 were enrolled. All patients were given the following nursing measures: maintaining the ICP monitoring device performance efficient and accurate, timely removing the factors associated with the increase of ICP and meanwhile, the dynamic changes of ICP and prognosis were observed. Results Fifty patients in this group all had elevated ICP, and the number of patients with mild, moderate, and severe ICP elevation was 26, 18, and 6 respectively. In this group of patients, 46 cases recovered well, 1 case was in a vegetative state, 2 cases gave up the treatment and 1 case died. None of the 50 patients had any complications and the detachment of tubing. The therapeutic program was adjusted in time based on ICP monitoring results. Conclusion Adopting correct intervention measures can effectively reduce the occurrence of complications, ensure that ICP monitoring can reflect the condition of ICP, and timely discover brain edema or recurrence of intracranial hematoma.

Objective To evaluate the effect of all-inclusive nursing for patients with orthopedic trauma. Methods A total of 142 patients with orthopedic trauma were randomly divided into observation group and control group,the control group underwent routine care,observation group underwent all-inclusive nursing,the nursing results were compared. Results The SDS and SAS scores of the two groups were significantly lower,but the observation group were significant-ly lower than the control group (P<0.05); The nursing satisfaction of observation group was 97.2%,significantly higher than 85.9% of the control group (P<0.05); The functional rehabilitation excellent rate of observation group was 91.5%,significantly higher than 73.2% of the control group(P<0.05);The pain and discomfort score of observation group was significantly lower than the control group,treatment attitudes,mental status,and disease was significantly higher cognitive scores (P<0.05). Conclusion The implementation of all-inclusive nursing for orthopedic trauma pa-tients can improve the physical and mental state,promote functional recovery and improve nursing satisfaction,it should be widely applied.

Objective: To learn the epidemiological characteristics of family clusters of COVID-19 in Henan Province from January 23 to February 22, 2020, so as to provide reference for the prevention and control. Methods: The data of family clusters of COVID-19 in Henan Province from January 23 to February 22 was retrieved from Public Health Emergency Management System, the epidemiological characteristics of time, space, population distribution and clinical feasures were analyzed. Results: By February 22, there were 202 family clusters of COVID-19, with 546 cases reported in Henan Province, including 493 ( 90.29% ) confirmed cases and 53 ( 9.71% ) asymptomatic cases. There were 247 ( 45.24% ) imported cases and 299 ( 54.76% ) local cases. Most of the clusters were reported from January 25 to February 7, with 129 clusters accounting for 63.86% . The cases reported before February 5 were mainly imported ( 153 cases, 57.09% ) , after that local cases were predominant ( 168 cases, 68.29% ) . Eighteen cities in Henan Province all reported family clusters of COVID-19, with Xinyang, Zhengzhou, Nanyang, Zhumadian and Shangqiu as the top five. Most of the confirmed cases ( 430, 87.22% ) were mild. The median and longest incubation period was 8 and 17 days, respectively. The intergenerational distribution was dominated by first-generation and second-generation cases ( 537 cases, 98.35% ) . A total of 5 635 close contacts were tracked down, of whom 262 were secondary cases, with an incidence rate of 4.65%. The first cases of the family clusters were mainly imported from other provinces ( 149 cases, 73.76% ) . Conclusions The family clusters of COVID-19 in Henan Province were concentrated from January 25 to February 7. The source of infection mainly comes from other provinces. Most of the cases are first-and second-generation cases, with longer incubation period. Close contacts have higher incidence rate.

Objective To explore the chain mediating effect of mastery and self-efficacy between optimism and resilience of breast cancer patients.Methods Totally 262 breast cancer patients were investigated with general information questionnaire,resilience scale (RS-14),mastery scale for Chinese version (MSC),general self-efficacy scale (GSES) and revised life orientation test (LOT-R).Causual steps and Bootstrap method were used to test the chain mediating effect of mastery and self-efficacy between optimism and resilience.Results The media score of the participants was 18 for optimism,and the average score of the participants was 27.1±4.6 for mastery,26.0±5.9 for self-efficacy,76.6± 13.9 for resilience.There existed a significant difference in RS-14 scores among the patients with different family relationships,family income,and form of payment (all P＜0.05).Correlation analysis showed that optimism,mastery,self-efficacy,and resilience were positively correlated with each other(r=0.57-0.74,all P＜ 0.01).Mediation modeling analysis showed that optimism had a direct effect on resilience.The effect value was 0.361,and the effect was 49.7％.Mastery and self-efficacy mediation effect value were 0.123 and 0.162,and the mediation effect were 16.9％ and 22.3％.While chain mediating effect of mastery-self-effcacy was also significant,and the mediation effect value was 0.081 and the mediation effect was 11.1％.Conclusion Optimism influences breast cancer patients' resilience,not only through the direct path,but also through the indirect path of mastery and self-efficacy,as well as the chain mediating path between these two variables.

Objective:To investigate the molecular mechanism of excessive iodine induced experimental autoimmune thyroiditis (EAT) in mice.Methods:Sixty female non-obese diabetic (NOD) mice were selected and divided into 5 groups according to body weight [(25 ± 3) g] via the random number table method, with 12 mice in each group: control group (group A), 10-fold high iodine group (group B), 100-fold high iodine group (group C), 1 000-fold high iodine group (group D) and 1 000-fold high iodine combined with polyinosinic acid-polycytidylic acid [Poly (I:C)] group (group E). The experiment period was 16 weeks. Mice in each group drank purified water with sodium iodine (NaI) content of 0.000, 0.005, 0.050, 0.500 and 0.500 mg/L, respectively; mice in group E were intraperitoneally injected with Poly (I:C) at week 7 and week 15, respectively. At the end of the 16th week, mice were dissected and blood samples and thyroid tissue were taken. The levels of serum thyroid function indexes [thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), and thyroid peroxidase antibody (TPOAb)] were detected by enzyme-linked immunosorbent assay (ELISA); the pathological changes of thyroid tissue were observed after hematoxylin-eosin (HE) staining; differentially expressed genes in thyroid tissue were detected by RNA-sequencing (RNA-seq), and analyzed by KEGG pathway; mRNA and protein levels of p38, intercellular adhesion molecule-1 (ICAM-1) and chemokine 10 (CXCL10) in thyroid tissue were detected by real-time fluorescence quantitative PCR (qPCR) and Western blotting, respectively. Results:There were statistically significant differences in serum levels of TSH (ng/ml: 6.53 ± 0.86, 6.61 ± 0.82, 7.68 ± 0.55, 7.93 ± 0.60, 8.73 ± 1.60), FT 3 (pg/ml: 59.35 ± 10.16, 53.73 ± 10.96, 46.19 ± 8.03, 41.01 ± 8.67, 34.21 ± 11.75), FT 4 (pg/ml: 136.74 ± 10.06, 124.33 ± 14.34, 101.80 ± 6.78, 91.37 ± 6.75, 73.29 ± 17.31), and TPOAb (U/ml: 130.81 ± 24.53, 145.47 ± 28.89, 166.52 ± 41.59, 199.78 ± 42.19, 201.99 ± 44.03) among the 5 groups of mice ( F = 4.77, 4.96, 23.12, 3.68, P < 0.05). Compared with group A, the serum TSH levels of mice in groups C, D and E were higher, the levels of FT 3 and FT 4 in groups B, C, D and E were lower, and the levels of TPOAb in groups D and E were higher, and the differences were statistically significant ( P < 0.05). HE staining showed that the thyroid follicle lesion in groups D and E was serious, and the EAT phenotype appeared in both groups. The differentially expressed genes were analyzed by KEGG pathway. Compared with group A, 8 metabolic pathways related to thyroid autoimmunity and inflammation were found in groups B, C, D and E. Further analysis found that 3 genes appeared in multiple pathways, namely p38, ICAM-1 and CXCL10. There were significant differences in the mRNA levels of p38, ICAM-1 and CXCL10 in thyroid tissue of the 5 groups of mice ( F = 14.77, 12.76, 16.39, P < 0.05); compared with group A, the mRNA levels of p38 in groups B, C, D and E were higher, and the mRNA levels of ICAM-1 and CXCL10 in groups C, D and E were higher ( P < 0.05). There were significant differences in the protein levels of p38, ICAM-1 and CXCL10 in thyroid tissue of the 5 groups of mice ( F = 7.97, 73.86, 18.02, P < 0.05); compared with group A, the protein levels of ICAM-1 and CXCL10 in groups B, C, D and E were higher ( P < 0.05). Conclusion:Excessive iodine promotes the occurrence and development of EAT in mice by up-regulating the expressions of p38 and ICAM-1 genes that are closely related to thyroid autoimmune and inflammatory responses.

Objective:To explore the application effect of Jiankuai psychosomatic active therapy in the elderly perioperative patients.Methods:From March 2018 to December 2019, 387 elderly patients in the urology department of the First People′s Hospital of Lianyungang City, Jiangsu Province were selected. According to the patients in two medical groups in the same ward, 193 patients in one medical group were divided into the experimental group and 194 patients in two medical groups as the control group. The experimental group was intervened by routine perioperative nursing combined with simple and fast psychosomatic active therapy, while the control group was only intervened by routine perioperative nursing. Self rating Anxiety Scale (SAS), Rosenberg Self-confidence Scale and General Self-efficacy Scale (GSEs) were used as the evaluation indexes before and after the implementation of the two groups.Results:The SAS score of the experimental group was 31.13 ± 3.64 and that of the control group was 48.45 ± 7.72 on the 7th day after operation. The difference between the two groups was statistically significant ( t value was 16.36, P < 0.05). The effective rate of self-confidence was 98.4% (190/193) and 94.8% (183/193) in the experimental group and 86.6% (168/194) and 85.1% (165/194) in the control group on the first day and the seventh day after operation, respectively. The difference between the two groups was statistically significant ( Z values were - 3.27 and 14.66, all P < 0.05). The GSEs score of the patients in the experimental group was 26.79 ± 2.17 and that of the control group was 16.86 ± 1.90. The difference between the two groups was statistically significant ( t value was 10.19, P < 0.05). Conclusions:The application of Jiankuai psychosomatic active therapy can effectively reduce the tension and anxiety of the elderly patients during the perioperative period, increase their self-confidence and self-efficacy, effectively improve the communication efficiency between doctors and patients, and promote rehabilitation.

Objective:To explore the effect of adult growth hormone deficiency on cognitive function in adults.Methods:A total of 19 hypophyseal or craniopharyngioma patients who underwent surgical treatment and were diagnosed with adult growth hormone deficiency in Department of Endocrinolog, the Second Affiliated Hospital, School of Medicine, Zhejiang University from June 2017 to June 2018 were selected as the case group, and 19 normal people were included as the control group. All the members were assessed with the cognitive function scale and brain functional magnetic resonance examination, data between the groups were analyzed.Results:The body weight within a year of case group was significantly increased than that of the control group( P=0.017). Compared with the control group, the case group was relatively inattentive and had decreased memory(Time of stroop color words test-a, test-c, and trail-making test-A, P values were 0.009, 0.018, 0.020 respectively; Auditory word learning test N6, P=0.008). The executive function and language ability of the case group were weakened compared with the control group(Raven′s matrices score E1-E12, P=0.022; Time cost and the number of arrivals in 1 min of connection test B, P values were 0.023, 0.004; Symbol digit modalities test, P=0.037; The number of words spoken in 46-60 s and total number in 0-60 s of the case group was less than the control, P values were 0.030, 0.006). The general mental state of the case group was worse than the control group( P=0.018). The accuracy of the 2-back task of the case group was significantly lower and the activation signal of the left frontal lobe in the case group was significantly weaker( P<0.005). Conclusions:Adult growth hormone deficiency may increase obesity risk and have a detrimental influence on patients′ overall mental health, resulting in varying degrees of cognitive impairment. Working memory impairments associated with adult growth hormone deficiency may be a result of decreased frontal lobe brain activity.

Objective: Schizophrenia (SCZ) is a severe psychiatric disorder with unknown etiology and lacking specific biomarkers. Herein, we aimed to explore plasma biomarkers relevant to SCZ using targeted metabolomics. Methods: Sixty drug-naïve SCZ patients and 36 healthy controls were recruited. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. We analyzed the levels of 271 metabolites in plasma samples from all subjects using targeted metabolomics, and identified metabolites that differed significantly between the two groups. Then we evaluated the diagnostic power of the metabolites based on receiver operating characteristic curves, and explored metabolites associated with the psychotic symptoms in SCZ patients. Results: Twenty-six metabolites showed significant differences between SCZ patients and healthy controls. Among them, 12 metabolites were phosphatidylcholines and cortisol, ceramide (d18:1/22:0), acetylcarnitine, and γ-aminobutyric acid, which could significantly distinguish SCZ from healthy controls with the area under the curve (AUC) above 0.7. Further, a panel consisting of the above 4 metabolites had an excellent performance with an AUC of 0.867. In SCZ patients, phosphatidylcholines were positively related with positive symptoms, and cholic acid was positively associated with negative symptoms. Conclusion Our study provides insights into the metabolite alterations associated with SCZ and potential biomarkers for its diagnosis and symptom severity assessment.

Objective:To examine characteristics and risk factors of the blood lipid trajectories among HIV-infected patients treated with antiviral therapy (ART).Methods:Based on the retrospective cohort study design, sociodemographic characteristics and baseline laboratory indicators of HIV-infected patients receiving ART from January 2004 to April 2021 in Taizhou, Zhejiang province. The blood lipid trajectories of the subjects was described and classified using the latent class mixed model (LCMM). Multivariate logistic regression was used to determine the risk factors of blood lipid trajectories. The data were analysized by R 3.5.0. software with lcmm package.Results:Among 2 079 HIV-infected patients, the median age ( Q1, Q3) was 31 (43, 55) years, and the majority were being male (78.1%, 1 623/2 079) and married (58.7%, 1 221/2 079). BMI ≥24.0 kg/m 2 accounted for 18.9% (393/2 079). Heterosexual transmission accounted for 67.7% (1 407/2 079). Three different blood lipid trajectories were classified: inverted U-shaped (2.3%, 48/2 079), progressive (31.3%, 650/2 079), and general trajectory (U-shaped) (66.4%, 1 381/2 079). The inverted U-shaped and progressive trajectory are identified as dangerous trajectories (33.6%). Multivariate logistic regression analysis indicated that compared with 3TC-TDF-EFV antiviral treatment regimen, baseline TC level <5.2 mmol/L, baseline TG level <1.7 mmol/L, BMI 18.5-23.9 kg/m 2, baseline CD4 +T lymphocytes (CD4) counts <200 cells/μl, antiviral treatment time <5 years,those who had been using 3TC-AZT-EFV antiviral therapy regimen (a OR=1.99,95% CI:1.44-2.77) and those who switched to LPV/r antiviral therapy regimen (a OR=3.17, 95% CI: 2.00-5.01), baseline TC levels were 5.2-6.1 mmol/L (a OR=2.55, 95% CI: 1.92-3.39) and ≥6.2 mmol/L (a OR=5.89,95% CI:3.76-9.25), and baseline TG levels were 1.7-2.2 mmol/L (a OR=2.00, 95% CI: 1.53-2.62) and ≥2.3 mmol/L (a OR=6.51,95% CI:4.97-8.54), respectively, BMI ≥24.0 kg/m 2 (a OR=1.44, 95% CI: 1.11-1.88) were more likely to show the dangerous trajectories. BMI <18.5 kg/m 2 (a OR=0.55, 95% CI: 0.35-0.86), baseline CD4 counts level was 200-349 cells/μl (a OR=0.67, 95% CI: 0.52-0.87) and baseline CD4 ≥350 cells/μl (a OR=0.71, 95% CI: 0.54-0.94). The duration of antiviral therapy was 5-9 years (a OR=0.74, 95% CI: 0.56-0.99), and ≥10 years (a OR=0.53, 95% CI: 0.22-0.67) were less likely to show the dangerous trajectories. Conclusions:HIV-infected patients showed a dangerous trajectory of blood lipids after ART, which was significantly associated with the use of specific antiviral drugs such as AZT and LPV/r, treatment duration, baseline CD4, TC, TG levels and BMI. It is recommended to strengthen blood lipid monitoring and targeted intervention measure when HIV infected persons start antiviral treatment.