Objective:To investigate the efficacy of magnesium sulfate plus aspirin in the treatment of pregnancy-induced hypertension and its effect on placental hypoxia-induced factor-1α (HIF-1α) levels.Methods:This is a case-control study. The clinical data were collected from 96 patients with gestational hypertension who were admitted to Jiaxing Maternity and Child Health Care Hospital between January 2019 and January 2023. These patients were divided into a control group and a study group, with 48 patients in each group, according to different treatment methods. The control group received magnesium sulfate treatment, whereas the study group was treated with magnesium sulfate combined with aspirin. Both groups were treated for 14 days. The clinical efficacy of the two groups was compared. Pre- and post-treatment blood pressure, placental HIF-1α levels, and endothelin levels were compared between the two groups. The incidence of adverse reactions and adverse pregnancy outcomes were also compared between the two groups.Results:The response rate in the study group was significantly higher compared with that in the control group, with 93.8% (45/48) versus 79.2% (38/48), respectively ( χ2 = 4.36, P < 0.05). Following treatment, both diastolic and systolic blood pressure levels in the study group were significantly lower than those in the control group ( t = 5.70, 7.33, both P < 0.05). Placental HIF-1α and endothelin levels in the study group were (41.03 ± 6.95) μg/L and (93.37 ± 8.29) ng/L, respectively, which were significantly lower than those in the control group [(82.97 ± 8.86) μg/L, (124.96 ± 9.32) ng/L, t = 17.55, 25.80, both P < 0.001]. The incidences of adverse reactions and unfavorable pregnancy outcomes in the study group were 12.5% (6/48) and 10.4% (5/48), respectively. These were significantly lower compared with those in the control group, which were 31.3% (15/48) and 27.1% (13/48), respectively ( χ2 = 4.94, 4.38, both P < 0.05). Conclusion:Magnesium sulfate combined with aspirin is highly effective in treating pregnancy-induced hypertension. This combined therapy can effectively lower patients' diastolic and systolic blood pressures, as well as placental HIF-1α and endothelin levels. It can obviously reduce the incidences of adverse reactions and unfavorable pregnancy outcomes.

Objective:To analyze the risk factors for surgical site infections（SSI）in liver transplant recipients.Methods:Relevant studies on the risk factors for SSI in liver transplant recipients were searched in PubMed，Web of Science，EMbase，The Cochrane Library，CNKI，Wanfang，Vep，and the Chinese Biomedical Literature Database from inception to July 10，2023. The literature quality was assessed，and meta-analysis was performed using RevMan 5.4 and Stata 16 software.Results:A total of 10 studies involving 3 113 adult liver transplant recipients were included，and 723 cases of SSI were reported. Meta-analysis revealed that Roux-en-Y biliary reconstruction（ OR=2.60，95% CI 1.45-4.65），bile leakage（ OR=17.22，95% CI 8.48-34.96），repeat surgery（ OR=7.22，95% CI 4.25-12.26），re-transplantation（ OR=13.88，95% CI 7.71-24.97），prolonged surgical duration（ MD=0.52，95% CI 0.19-0.84），dialysis（ OR=3.44，95% CI 2.41-4.91），and extended hospital stay（ MD=11.42，95% CI 5.73-17.12）were independent risk factors for SSI in liver transplant recipients. Conclusion:The identified risk factors for SSI in liver transplant recipients include Roux-en-Y biliary reconstruction，bile leakage，repeat surgery，re-transplantation，prolonged surgical duration，dialysis，and extended hospital stay. Clinicians should enhance the assessment of these factors and take effective intervention to improve clinical outcomes for liver transplant recipients.

Objective:To construct an evaluation index system of nursing counterpart support by ClassⅢ Grade A hospitals for country hospitals so as to provide a ruler for evaluating the quality of nursing counterpart support and provide a reference for sounding the long-term mechanism of counterpart support.Methods:This study combed the counterpart support policy document of China from 2009 to 2018 to refine nursing work assignment and goals, collected index pool by carrying out expert interview and searching literature. Expert meeting was used to sort out the items of index pool. After that, this study designed the inquiry questionnaire, implemented pilot survey and two rounds of expert consultation for 20 experts with Delphi method to determine the index system. Analytic hierarchy process was used to build judgment matrix so as to confirm the index weight.Results:Among two rounds of expert consultation, the recovery rates of questionnaire were all 100%; the expert authority coefficients were 0.817 and 0.838; the coordination coefficients were 0.117 and 0.247. The final evaluation index system of nursing counterpart support by ClassⅢ Grade A hospitals for country hospitals included three first-level indexes, hospital organizational leadership, accredited personnel management and synthetic evaluation, as well as 7 second-level indexes and 48 third-level indexes.Conclusions:This index system could be a tool for evaluating the nursing counterpart support.

Objective:To explore the effects of teamwork strategy in cardiac rehabilitation exercise therapy for elderly patients with myocardial infarction.Methods:From November 2017 to May 2019, we selected elderly patients with myocardial infarction at Shulan (Hangzhou) Hospital as the study objects by convenience sampling. All patients were divided into control group ( n=58) and observation group ( n=60) . Control group implemented the routine nursing. On the basis of routine nursing, observation group carried out the cardiac rehabilitation exercise therapy by applying the teamwork strategy. We compared the exercise compliance and activities of daily living (ADL) of patients between two groups. Results:The exercise compliance of patients in observation group was higher than that in control group with a statistical difference ( P<0.01) . At discharge, the score of Barthel index of patients in observation group was higher than that in control group also with a statistical difference ( P<0.01) . Conclusions:Teamwork strategy helps to improve the exercise compliance and ADL in elderly patients with myocardial infarction.

Objective: To investigate the level of foot care behaviors of in patients with type 2 diabetes mellitus in Jinshan District of Shanghai, analyze the influential factors, and provide information for the intervention study. Methods: With convenient sampling method, a questionnaire survey was conducted with a sample of 110 inpatients with type 2 diabetes mellitus from Jinshan District of Shanghai. The investigation contents included patients′ demographic data, foot care knowledge and behaviors. The investigation tools were the questionnaire of diabetes general information, the questionnaire of foot care knowledge, and the questionnaire of foot care behaviors. Survey tools included general information questionnaire, foot care knowledge scale for diabetic patients and Nottingham Foot Care Assessment Scale in Chinese version. Independent-samples t test and oneway ANOVA were used in univariate analyses, whereas multiple stepwise linear regression was used in multivariate analyses. And Pearson correlation analysis was used to measure correlation between variables. Results: The scores of foot care behaviors were statistically significant in the group comparison of sex and glycosylated hemoglobin(t=-2.142, F=3.071, P<0.05). The patients′score of foot care behaviors was (45.31±7.74) scores. 50.9 percent (54/106) patients′scores were less than 45. And the score of foot care knowledge was (16.10±4.18) scores, which was in the medium level. The foot care behaviors level was lower in the patients whose foot care knowledge was poorer (t=-5.591, P<0.01). Foot care knowledge, glycosylated hemoglobin level and gender were the main influencing factors on foot care behaviors of type 2 diabetic patients (R²=0.221, F=9.664, P=0.000). Pearson analysis demonstrated that there was a positive correlation between knowledge score, glycosylated hemoglobin level and behavior score (r=0.377, 0.207, P<0.05). Conclusions The status of foot care knowledge and behaviors of type 2 diabetic patients are not optimistic in Jinshan District of Shanghai. It′s very important to strengthen the education and management on diabetic patients′foot care knowledge and behaviors, especially in male patients. Meanwhile, the patients whose glycosylated hemoglobin are well controlled should not be ignored.

Objective To introduce the application of grafting mechanism on a classⅢ grade A hospital's nursing counterpart support to county-level hospitals in Shanxi Province, and to summarize its effects and existing problems, so as to promote nursing counterpart support work and provide reference for the increase of the efficiency of counterpart support. Methods From 2014 to 2016, grafting mechanism was carried out in 23 county-level hospitals nursing counterpart supported by a classⅢ grade A hospital of Shanxi Province through 4 segments: field investigation, content selection, cultural integration and guided implementation. The evaluation of various mechanisms before and after grafting and the nurse satisfaction, patient satisfaction, high quality nursing service, as well as key discipline construction were statistically analyzed in 23 count-level hospitals. Results 100% of the 23 county-level hospitals applied grafting mechanism. A total of 20 nursing mechanism were grafted, focusing on 7 personnel systems, 3 performance management systems and 10 nursing quality management systems. The evaluation level of various mechanisms was significantly improved in the county-level hospitals after mechanism grafting. Nurse satisfaction increased from (87.6±15.2) to (89.7±16.8);patient satisfaction increased from (92.3±17.5) to (94.1±18.1); and high quality nursing service score increased from (73.5±12.9) to (75.8±14.0), and the differences were statistically significant (t=5.725, 4.042, 6.493;P< 0.01). A total of 5 of the county-level hospitals were approved provincial key discipline construction projects. Conclusions The mechanism of grafting plays a significant role in nursing counterpart support activities. Its theories and practice are worth of promoting.

Objective To investigate the role of IFN-γ and FOXP3 expression in subpopulation distribution and functions of tumor-infiltrating lymphocytes (TILs) in the microenvironment of renal cell cancer.Methods 30 renal cell cancer tissue samples were freshly collected from the laparoscopic radical nephrectomy in the first hospital of Jiaxing.After frozen sectioning,immunofluorescent staining was conducted to detect the infiltrating CD4 positive and CDs positive cells,and the expression of FOXP3 and IFN-γ as well.In addition,TILs were isolated from the tumor tissues by density-gradient centrifugation.TILs from tumor center or tumor invasive edge were purified independently and measured for the mRNA levels of FOXP3 and IFN-γ by qRT (quantitative reverse transcription)-PCR.Results Tumor-infiltrating CD4+ and CD8+ T cells were concentrated in the invasive edge of renal cell cancer tissues.The expression of FOXP3 was found to be inversely related to that of IFN-γ from the immunofluorescent staining.The relative FOXP3 mRNA levels for the TILs from tumor center and invasive edge were 64.6 ± 9.4 and 36.2 ± 1.8,respectively,with significant difference(P ＜0.05).The relative IFN-γ mRNA levels were 631.8 ± 151.4 and 1 726.0 ± 344.1 (P ＜ 0.05).The trend of relative expression of FOXP3 was reversed in terms of IFN-γ.Conclusions The study on the renal cell cancer tissue samples suggested that the tumor-specific cytotoxic immune cells relatively concentrated in the tumor invasive edge.

Objective To study the therapeutic effect of anti-CD80 bivalent antibody on mouse lu-pus nephritis and to explore the possible molecular mechanism. Methods A mouse model of lupus nephritis was established through intraperitoneal injection of 0. 5 ml of pristine in female C57BL/6J mice. Appearance of urinary protein and significantly increased levels of peripheral antinuclear antibody ( ANA) and anti-doub-le-stranded DNA ( anti-dsDNA) antibody in the fourth month after injection indicated that the mouse model was established successfully. Then the mice were divided into two groups including anti-CD80 bivalent anti-body intervention group (injected with 200μg of anti-CD80 bivalent antibody at day 1, 3, 5, 8 and 15, fol-lowed by three times of injection with an interval of one month) and model group ( injected with the same protein using the same strategy). A normal control group was set up accordingly. Albustix test paper was used to monitor the dynamic changes in mouse urinary protein. Flow cytometry was used to analyze the acti-vation of immune-related cells in spleen. Levels of autoantibodies ( ANA and anti-dsDNA) and levels of IFN-γ and IL-4 in serum were detected by indirect immunofluorescence assay. Renal tissue samples were an-alyzed with hematoxylin and eosin ( HE) staining and immunocomplex ( IC) assay. Results Urinary pro-tein level of the anti-CD80 bivalent antibody intervention group was significantly lower than that of the model group (P<0. 05). Activated macrophages, dendritic cells, neutrophils and B cells in spleen tissues of the anti-CD80 bivalent antibody intervention group were significantly less than those of the model group ( P<0. 05), and the numbers of CD4+ and CD154+ T cells were significantly less than those of the model group (P<0. 05). Positive rates and titers of ANA and dsDNA in serum samples of the intervention group were lower than those of the model group (P<0. 05). Levels of IFN-γand IL-4 in serum samples of the interven-tion group were decreased as compared with those of the model group (P<0. 05). HE staining and immuno-fluorescence assay showed that glomerular inflammatory injury and necrosis were alleviated and kidney im-mune complex deposition was reduced after anti-CD80 bivalent antibody intervention. Conclusion Anti-CD80 bivalent antibody specifically binds to the CD80 molecule on antigen presenting cell surface, blocks the CD80/CD28 co-stimulatory signaling pathway and down-regulates the body′s immune response, which al-leviates and reverses the lupus-like nephritis-induced pathological damages in mice.

Objective To explore the effects of providing quality nurse′s resources to the grassroots hospitals (county level) on psychological empowerment of nurses.Methods A total of 123 nurses from some county hospital were investigated by convenience sampling method from October 2014 to June 2016 using general data questionnaire and Psychological Empowerment Scale before and after the training of empowerment,and the Results were compared between before and after.Results Before training,in the control group and the experimental group,the total scores of psychological empowerment were (14.92±1.24) and (14.84±1.64)(t=0.107,P>0.05). After training, in the control group and the experimental group, the total scores of psychological empowerment were (14.74±1.31) and (16.44±1.68)(t= 2.312,P<0.05).Conclusions Providing quality nurse's resources to the grassroots hospitals (county level) can help to improve nurse′s psychological empowerment.

The literature analysis method is applied to summarize the research findings and proposals for hospital counterpart support work, and then we put forward its insufficient and advice, so as to provide reference for perfecting the construction of counterpart support mechanism, promoting further study.