ObjectiveTo observe the effect of healthy side tilt training on balance function in patients with Pusher syndrome (PS) after stroke. MethodsFrom February, 2021 to November, 2023, 40 patients with PS after stroke in People's Hospital of Bayingolin Mongolian Autonomous Prefecture were selected. They were divided into control group (n = 20) and experimental group (n = 20) in accordance with the order of the patients' admission. The control group received comprehensive training for paralyzed limbs combined with sitting balance training, and the experimental group received comprehensive training for paralyzed limbs combined with healthy side tilt training, for three weeks. They were assessed with Burke Lateropulsion Scale (BLS), Fugl-Meyer Assessment-Balance (FMA-B) and modified Barthel Index (MBI) before and after treatment. ResultsAfter treatment, BLS score significantly decreased in both groups (t > 12.603, P < 0.001), and was lower in the experimental group than in the control group (t = -2.559, P < 0.05). The scores of FMA-B and MBI were significantly increased in both groups (|Z| > 3.941, |t| > 12.082, P < 0.001), and FMA-B score was higher in experimental group than in the control group (Z = -2.538, P < 0.05). ConclusionComprehensive training for paralyzed limbs combined with healthy side tilt training can effectively improve the balance function and postural control of patients with PS after stroke, and improve the activities of daily living.

Objective To study the changes in serum autophagy markers in children with retinopathy of prematurity(ROP)and its clinical value.Methods Premature infants who were screened for ROP in our hospital from January 2020 to December 2022 were selected as the study subjects.Those screened out with ROP at 4-6 weeks of birth were assigned to the ROP group and those without ROP to the control group.The levels of serum autophagy markers LC3-Ⅱ,Beclin-1 and P62 were detected at the 3rd day,1st,2nd and 3rd weeks of birth.The two groups were compared in terms of serum autophagy markers.The diagnostic efficacy of serum autophagy markers on ROP was analyzed.Results There was no significant difference in serum LC3-Ⅱ,Beclin-1 and P62 levels between the ROP group and control group at the 3rd day of birth(P>0.05).At the first,second and third weeks of birth,how-ever,the ROP group showed significantly lower levels of serum LC3-Ⅱ and Beclin-1 but higher level of P62 com-pared to the control group(both P<0.05).The levels of serum LC3-Ⅱ,Beclin-1 and P62 at the first,second and third weeks of birth had diagnostic value for ROP.The children in the ROP group who did not receive mechanical ventilation and oxygen inhalation,and did not develop with sepsis and bronchopulmonary dysplasia showed lower serum LC3-Ⅱ and Beclin-1 levels and higher P62 levels at the first,second and third weeks of birth compared to those without the above-mentioned treatment as well as those complications(all P<0.05).In the ROP group,those with severe ROP showed lower serum LC3-Ⅱ and Beclin-1 levels and higher P62 levels at the 3rd day,and 1st,2nd and 3rd week of birth(all P<0.05).Conclusion The levels of serum autophagy markers in children with ROP show significant changes since the first week of birth,so they have diagnostic efficacy for the diseases.

Objective To evaluate the value of high-energetic virtual monoenergetic imaging(MonoE),bone metal artifact reduction(O-MAR),and their combination based on dual-layer detector spectral computed tomography(DLCT)in removing the artifacts caused by lumbar metal implants.Methods Patients who undergone lumbar implant surgery and performed lumbar examination on DLCT after surgery were prospectively selected.MonoE from 100 to 200 keV with an interval of 20 keV were reconstructed.O-MAR and O-MAR combined with MonoE(O-MAR+MonoE)images were also reconstructed.The differences of objective and subjective image quality among the images were compared.Results There were 45 patients included in the study.With the increasing of keV of MonoE,the attenuation of the tissue with low-and high-density artifact on MonoE and O-MAR+MonoE was increased and decreased,respectively.140 keV MonoE was the best sequence for the artifact reduction and the display of soft tissue.200 keV MonoE and its combination with O-MAR showed the best performance in the display of the interface of metal and bone.However,O-MAR+200 keV MonoE had the lowest noise.Conclusion Compared to O-MAR and O-MAR combined with MonoE,high-energetic MonoE shows a good value in the reduction of metal artifacts caused by the lumbar metal implants.

Glucagon-like peptide-1 receptor agonists （GLP-1RAs） have been widely used in diabetes and obese people in recent years， and they have also caused a series of adverse reactions， the most important of which is digestive system-related adverse reactions. The adverse reactions of the digestive system associated with GLP-1RAs involve the gastrointestinal， pancreatic， and biliary tracts； among them， nausea， vomiting， constipation， and diarrhea are the most common adverse reactions， which are the main reasons for drug withdrawal. The incidence of pancreatic and biliary system diseases is low， but there is no research evidence to exclude their association with GLP-1RAs. Tirzepatide appears on the market relatively late， and its safety still lacks sufficient real-world data. Medical staff should adopt active dietary guidance strategies for patients and strengthen medication education to help patients actively prevent and scientifically respond to adverse reactions in the digestive system.

Immune checkpoint inhibitors(ICIs)are an emerging tumor treatment approach following traditional surgery,chemoradiotherapy and targeted therapy.They have proven to be effective in a variety of cancers.However,they may induce immune-related adverse events(irAEs)during treatment,which may affect patients'quality of life and lead to treatment interruption or cessation.The key to preventing irAEs is early evaluation and identification of medical staff.Therefore,this article reviews the clinical manifestations and influencing factors of irAEs to help the early identification of high-risk groups and provide reference for clinical nursing work.

OBJECTIVE To evaluate the correlation between 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants. METHODS PubMed，Embase，Cochrane Library ，CNKI，Wanfang database ，CBM and VIP database were searched for domestic and foreign literatures on the correlation between 5-HTR1A gene C- 1019G polymorphism and antidepressant efficacy. The retrieval time limit was from the inception to February 2022. According to different outcome measures of drug response，Stata 14.0 and RevMan 5.4 software were used for meta-analysis of efficacy group and remission group ，respectively. RESULTS A total of 18 literature were included. The combined results showed that among recessive gene model in valid group ， the correlation of 5-HTR1A gene C- 1019G polymorphism with the efficacy of antidepressants had statistically significance in Asian population（GG vs. CG+CC ，OR＝0.751，95％CI＝0.585-0.964，P＝0.024）. There was statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in China （GG vs. CG+CC ，OR＝0.677，95％CI＝ 0.508-0.901，P＝0.007）. There was no statistical significance in the correlation of 5-HTR1A gene C- 1019G polymorphism and the efficacy of antidepressants in remission group （P＞0.05）. CONCLUSIONS In the effective group ，5-HTR1A gene C- 1019G polymorphism is correlated with the efficacy of antidepressants in the Asian population and the Chinese population ；while in the remission group ，it is not proved that this polymorphism is correlated with the efficacy of antidepressants.

Objective:To study the expression of Proline rich protein11 (PRR11) in breast cancer and its relationship with clinical biological behavior, prognosis and survival.Methods:A prospective analysis method was used to select 80 patients with breast cancer from Jan. 2018 to Jan. 2019. Immunohistochemical S-P method was used to detect the expression of PRR11 in cancer tissues. Patients with positive expression of PRR11 were set as the study group ( n=47) and the patients with negative expression of PRR11 were set as the control group ( n=33) . All patients were followed up for 3 years to analyze and compare the survival rates of patients with positive and negative expression of PRR11. The relationship between PRR11 expression and clinical biological behavior, prognosis and survival was analyzed by Cox risk ratio review model. Results:80 patients were followed up for 3 years. It was found that the prognosis of patients with negative PRR11 expression was significantly better than that of patients with positive PRR11 expression ( χ2=5.75, P<0.001) . Chi square test was used to analyze the correlation between the expression of PRR11 and tumor size, TNM stage, lymph node metastasis, distant metastasis, histological grade, Ki67 expression and hormone receptor status ( P<0.05) . The expression of PRR11 in breast cancer tissues with larger tumors, distant metastasis and later staging was relatively high ( P<0.05) . Univariate Cox regression analysis showed that histological grade, TNM stage and PRR11 were independent risk factors affecting the prognosis of breast cancer patients ( P<0.001) . The AUC of prognosis prediction in patients with breast cancer was 0.812, and the 95% CI was 0.635-0.796. When PRR11 expression was positive, the sensitivity was 81.47%, and the specificity was 85.57%. Conclusions:The expression of PRR11 is relatively high in the late stage breast cancer tissue. The expression of PRR11 is closely related to the clinical biological behavior of breast cancer size, TNM stage and lymph node metastasis. The survival rate of patients with high PRR11 expression is low, and the positive expression of PRR11 is an independent risk factor affecting the prognosis of breast cancer patients. PRR11 detection has preferable clinical application value in predicting the prognosis of breast cancer.

Objective:To investigate the effect of oxytocin on neonatal instinctive behavior expression and breast-feeding.Methods:A total of 71 pairs of parturient women and their newborns who delivered in the delivery room of the Affiliated Hospital of Weifang Medical College from February to May 2021 were selected. According to whether oxytocin induced labor, they were divided into the oxytocin group and the control group. Widstr?m nine stages was used to observe and record neonatal behavior. Breastfeeding was followed up 3 days and 3 months after delivery.Results:Totally 35 pairs in each group were included. In the oxytocin group, the occurrence time of neonatal head or head turning, hand in mouth, body moving to nipple, lips touching areola, licking nipple, nipple and effective sucking were (18.2 ± 5.4), (27.8 ± 8.3), (31.0 ± 10.1), (44.3 ± 14.5), (47.2 ± 15.6), (49.4 ± 16.3), (48.3 ± 13.6) min, which were significantly later than those in the control group (15.3 ± 5.3), (21.0 ± 8.1), (24.3 ± 9.0), (34.0 ± 11.4), (37.2 ± 11.9), (38.6 ± 11.8), (39.6 ± 8.7) min. The difference was statistically significant ( t values ranged from -3.10 to -2.17, P<0.05). The duration of neonatal awakening, activity, crawling and familiarity in the oxytocin group were (6.9 ± 3.2), (18.9 ± 9.3), (13.6 ± 7.9), (9.2 ± 5.1) min, which were significantly longer than those in the control group (5.1 ± 2.8), (12.3 ± 7.1), (10.3 ± 5.3), (6.7 ± 4.3) min; sucking stage duration in the oxytocin group was (35.1 ± 7.2) min, which was significantly shorter than that in the control group (39.6 ± 7.1) min; all the differences were statistically significant ( t values ranged from -3.25 to 2.28, P<0.05). The times of exclusive breast-feeding in the oxytocin group were (2.8 ± 3.1), (4.5 ± 3.3), (6.9 ± 3.0) at 24, 48 and 72 h postnatal, and the exclusive breastfeeding rate at 3 months after birth was 77.1%(27/35), which were significantly lower than those (7.6 ± 3.6), (8.9 ± 2.7), (10.3 ± 2.0) and 82.9%(29/35) in the control group, the differences were statistically significant ( t=6.05, 6.11, 5.48, χ2=0.36, P<0.05). Conclusions:The use of oxytocin during labor may affect the expression of neonatal lactation behavior and negatively affect the breastfeeding.

【Objective】 To analyze the prevalence of anemia in preschool children in Bincheng District of Binzhou city and its influencing factors, so as to provide reference for formulating new measures to prevent anemia in children. 【Methods】 The health examination results of 10 674 children aged 3~6 from multiple kindergartens in Bincheng District in 2020 were collected, and anemia prevalence was investigated by analyzing the blood routine indicators. 【Results】 The incidence of anemia in 10 674 children was 1.95%, with 1.86%(100/5 375)in boys and 2.04%(108/5 299)in girls(P>0.05), with 3.06%(44/1 439)vs 2.93%(43/1 468), 1.79%(37/2 071)vs 2.04%(43/2 107)and 1.02%(19/1 865)vs1.28%(22/1 724)in boys and girls aged 3, 4 and 5, respectively. No significant difference was noticed in anemia incidence between boys and girls in each age group(P>0.05), while significant difference laid between boys and girls among different age groups(P<0.05). The degree of anemia was mainly mild in both boys and girls, accounting for 98.6%(205/208)of the total anemia. The median Hb of preschool children in Bincheng District was 125 g/L(boys 125 g/L vs girls 124 g/L). The median Hb of 5-year-old boys was 126 g/ L, which was higher than 125 g/L of 5-year-old girls. The Hb values of boys and girls were different by age groups, with statistical significance(P<0.05). 【Conclusion】 The anemia prevalence in children in Bincheng District decreased gradually with the increase of age. The general survey of anemia in children with younger age is an important step for early detection and early intervention.

Na?ve CD4 + T cells differentiate into a variety of T helper (Th) subsets that secrete various cytokines to exert biological effects. Th22 cells, a novel identified CD4 + T cell subset, are distinct from Th1, Th2 and Th17 cell subsets. Th22 cells express chemokine receptors CCR4, CCR6 and CCR10, and secrete multiple cytokines such as IL-22, IL-13 and TNF-α, but not IL-17, IL-4 IFN-γ; and IL-22 is considered as major effector cytokine of Th22. The understanding on functions and differentiation mechanisms of Th22 cells have been constantly improved, and Th22 cells play important roles in human common viral infections. The article reviews the current advances about the characteristics, function, differentiation of Th22 cells, the roles of Th22 cells and the key molecules in several human common viral infections, which would provide novel immune strategies for the prevention and treatment of human viral infection.