Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ²_trend = 708.387, P<0.001). The patients mainly came from referrals, accounting for 71.86%, and the proportion of referrals varied significantly among different years (χ²=355.541, P<0.001). The diagnosis type was mainly pathogenic negative, accounting for 49.12%. The proportion of pathogenic negative had statistically significant difference among different years (χ²=1 354.830, P<0.001). The proportion of patients cured and completed the course of treatment reached 93.98%, with statistically significant differences in the proportions among different years (cured, χ²=1 080.252, P<0.001; completed the treatment course, χ²= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

Objective:To prepare a discharge readiness scale suitable for patients with enterostomy and to test the reliability and validity, so as to provide an effective measurement tool for the assessment of discharge readiness of patients.Methods:On the basis of the existing Chinese version of the discharge readiness scale, items related to enterostomy nursing problems were added to form the scale entry pool, and a draft of the scale was formed by expert consultation. 132 patients with preventive enterostomy admitted to the Affiliated Hospital of Qingdao University were pre-investigated with the original scale to test the reliability and validity.Results:The discharge readiness scale of enterostomy patients contained 18 items. The content validity of the scale was 0.969, and the content validity of each item was 0.824 - 1.000. Four common factors were extracted from the scale, and the cumulative variance contribution rate was 79.503%. Cronbach alpha coefficient of the total scale was 0.923, and each dimension was 0.806 - 0.947.Conclusions:The discharge readiness scale of patients with enterostomy has good reliability and validity, which can be used as an evaluation tool for patients at discharge.

Objective:To compare the effects between improved catheter extubation method and the traditional one on urination pain, urinary retention, first urination time and first urination volume, and to evaluate the advantage of the improved method.Methods:144 patients with indwelling catheters after operation in our department were randomly divided into observation group and control group, with 72 cases in each group. The control group returned to the ward after surgery and began to clamp the urinary tube to train the bladder function, the catheter was removed by traditional method. Observation group: urination reflex was evaluated before extubation, according to more than 250 ml urine in the urine bag. Pumping the saline of the gas bag and injecting back 0.5ml to keep the wall of the bag smooth, eventually the catheter was excreted when urinating. Urethral pain, urinary retention, first micturition time and first micturition volume of two groups were analyzed.Results:Urethral pain, urinary retention, first micturition time in observation group and control group were 1.47±1.48, (20.44±12.98) min, 95.8% (69/72) and 3.11±1.98, (28.03±27.00) min, 83.3% (60/72), respectively, and the difference between the two groups was statistically significant ( t value was -5.644, -2.148, χ2 value was 6.628, all P<0.05). The first micturition volume in observation group and control group were (258.6±41.57) ml and (248.14±48.82) ml, respectively, and there was no significant difference between the two groups ( t value was 1.377, P>0.05). Conclusion:The improved catheter extubation method could significantly reduce the urethral pain, shorten the time of the first urination, and improve the success rate of self-urination, which of clinical promotion.

Objective To explore the effect of social support and coping style on posttraumatic growth of ostomy patients. Methods A total of 237 patients with ostomy from Affiliated Hospital of Qingdao University were investigated using General questionnaire, Perceived Social Support Scale, Medical Coping Modes Questionnaire and Posttraumatic Growth Inventory by cross-sectional survey method from September 2017 to March 2018. The path of social support and coping style on post-traumatic growth was established by correlation analysis and structural equation model. Results The total score of posttraumatic growth in patients with ostomy was (66.76±12.20) points, which was at the upper-middle level. Correlation analysis showed that posttraumatic growth was positively correlated with comprehension of social support (r=0.551, P<0.01), positively correlated with face style (r=0.580, P<0.01), negatively correlated with avoidance style and resignation style (r=-0.334, P<0.01;r=-0.449, P<0.01). Structural equation model showed social support had directly positive effect on posttraumatic growth, path coefficient were 0.44. Face style, avoidance style, and resignation style had a partial mediating effect between social support and posttraumatic growth, and mediation effects account for 20.01％, 5.21％, 9.25％of the total effect, respectively. Conclusions The posttraumatic growth level of patients with ostomy needs to be improved. Medical staff should strengthen social support for patients and guide patients to adopt the positive coping styles, reduce the avoidance and resignation coping styles, and promote patients to get more posttraumatic growth, furthermore, improve their social adaptability and quality of life.

Objective To evaluate the effect of Notch 1 signaling pathway on the differentiation and function of Th17 cells in peripheral blood of patients with psoriasis.Methods Peripheral blood samples were obtained from 35 patients with psoriasis and 32 healthy controls.Flow cytometry was performed to determine the proportion of Th17 cells in CD4+ T cells in peripheral blood mononuclear cells (PBMCs),real-time RT-PCR to measure the mRNA expression of retinoic acid receptor-related orphan receptor γt (RORγt),interleukin (IL)-17,Notch 1 and hairy-and-enhancer-of-split-1 (Hes-1),and enzymelinked immunosorbent assay (ELISA) to detect levels of IL-17 in the serum and culture supernatant of PBMCs stimulated with phorbol ester,calcium ionophore and brefeldin A.The correlation of Notch 1 mRNA expression with psoriasis area and severity index (PASI) was analyzed,so were its correlation with the proportion of Th17 cells,mRNA expression of RORγt,and mRNA and protein expression of IL-17.PBMCs isolated from the patients with psoriasis were divided into 5 groups to be treated with γ-secretase inhibitor N-[N-(3,5-difluorophenacetyl)-1-alanyl]-S-phenylglycine t-butyl ester (DAPT) at different concentrations of 0(control group),2.5,5.0,10.0 and 20.0μmol/L,respectively,so as to evaluate the effects of blocking the Notch1 signaling pathway by DAPT on the proportion of Th17 cells in PBMCs,levels of RORγt and IL-17.Results Compared with the healthy controls,patients with psoriasis showed a significant increase in the proportion of Th17 cells in CD4+ T cells in PBMCs (2.863％ ± 0.969％ vs.0.604％ ± 0.124％,P ＜ 0.01),mRNA expression of RORγt (5.255 ± 0.998 vs.1.530-± 0.485,P ＜ 0.01),Notch1 (6.743 ± 1.756 vs.1.731 ± 0.456,P ＜ 0.01),Hes-1 (6.384 ± 1.665 vs.1.627 ± 0.485,P ＜ 0.01) and IL-17 (6.944 ± 1.626 vs.1.698 ± 0.329,P ＜ 0.01),and serum level of IL-17 ([36.444 ± 5.936] ng/L vs.[11.762 ± 2.260] ng/L,P ＜ 0.01).Among the patients with psoriasis,the mRNA expression of Notch1 was positively correlated with PASI scores,proportion of Th17 cells,mRNA expression of RORγt and IL-17,and serum level of IL-17 (r =0.584,0.544,0.518,0.549 and 0.511,respectively,all P ＜ 0.05).There were significant differences in the proportion of Th17 cells,mRNA expression of RORγt and IL-17,and level of IL-17 in the culture supematant among the control group,2.5-,5.0-,10.0-and 20.0-μmol/L DAPT groups (F =79.527,82.239,78.086 and 80.558,respectively,all P ＜ 0.01).The above indices were significantly lower in the 2.5-,5.0-,10.0-and 20.0-μmol/L DAPT groups than in the control group (all P ＜ 0.05),and decreased along with the increase of DAPT concentrations.Conclusion Notch1 signaling pathway can promote the differentiation of Th17 cells and the expression of RORγt,IL-17 and Hes-1 in the peripheral blood of patients with psoriasis.

Objective To explore the effects of mirror therapy combined with Tongdu Xingshen acupuncture on the upper extremity function of stroke survivors.Methods Sixty stroke survivors were randomly divided into a mirror group (n =20),an acupuncture group (n =20) and a combined group (n =20).In addition to routine rehabilitation treatment,those in each group received mirror therapy,acupuncture or both for 4 weeks.Before the treatment and after 2 and 4 weeks of treatment,all of the patients were assessed using the Fugl-Meyer motor function assessment (FMA),Brunnstrom upper limb and hand staging (BSULH),the Barthel Index (BI) and in terms of the active range of motion in the wrist contralateral to their hemiplegia (AROM).The combined group was also evaluated using functional magnetic resonance imaging (fMRI) before treatment and after the 4 weeks.Results After 2 and 4 weeks of the treatment,the average BI,AROM,FMA and BSULH results had improved significantly compared with before the treatment.The improvements in the combined group were significantly greater than in the other groups after 2 and 4 weeks.The fMRI demonstrated that there were high-intensity signals in the primary motor area,the premotor area and the supplementary motor area on the affected side after 4 weeks of treatment.Conclusions Mirror therapy combined with Tungdu Xingshen acupuncture can improve the functional performance of the upper extremities of stroke survivors.

Objective:To determine the effect of Notch1 signaling pathway on the differentiation and function of Th17 cells in murine psoriasis model.Methods: BALB/c mice were randomly divided into psoriasis model group and control group.Murine psoriasis model was established by topical 5% imiquimod application in combination with intraperitoneal injection of α-2b interferon.The CD4+ T lymphocytes were isolated by magnetic activated cell sorter (MACS).Flow cytometric analysis (FCM) was performed to detect the percentage of Th17 cells.Real-time RT-PCR was employed to measure the mRNA levels of RORγt,IL-17A,Notch1 and Hes-1.The CD4+ T lymphocytes were then divided into γ-secretase inhibitor DAPT groups and control group,and the expression differences of Notch1 signaling molecule and its target gene Hes-1 mRNA levels,Th17 cell percentage,RORγt and IL-17A mRNA levels,and IL-17A concentrations in cell-free supernatant were detected.Results: The expression levels of Th17 cell percentage and RORγt,IL-17A,Notch1 and Hes-1 mRNA in CD4+ T lymphocytes of murine psoriasis model were significantly higher than control mouse[(2.97±0.86)% vs.(0.65±0.11)%,t=15.083;(5.75±0.61) vs.(1.57±0.43),t=21.630;(7.83±0.97) vs.(1.63±0.31),t=25.348;(7.10±1.37) vs.(1.47±0.34),t=17.386;(7.30±1.15) vs.(1.67±0.48),t=18.840,respectively,all P<0.01].Compared with control group,Th17 cell percentage,mRNA expression levels of Notch1,Hes-1,RORγt and IL-17A,and IL-17A concentrations in cell-free supernatant from cultured CD4+ T lymphocytes of murine psoriasis model were dramatically decreased in DAPT treated groups in a dose-dependent way (F=74.368,89.719,126.572,94.558,124.323 and 123.231 respectively,all P<0.01).Conclusion: Notch1 signaling pathway can regulate the differentiation and function of Th17 cells in murine psoriasis model,and may have potential value for the target immunotherapy of psoriasis.

This paper summarized the characteristics, rehabilitation needs, and situation and problems of stroke dysfunction in China. Approaches and methods of family rehabilitation were also discussed.

Objective To investigate the protective effect of somatostatin (SS)combined with growth hormone (GH) in treatment of intestinal mucosal barrier injury in rabbits with severe acute pancreatitis (SAP), as well as its clinical significance. Methods Seventy-two rabbits were equally assigned into model group (SAP group), SS treated group (SS group) and SS combined with GH treated group (SS + GH group). SAP models were induced by retro-injection of 5% sodium taurocholate into the pancreatic duct. After modeling, all rabbits were given 5 % glucose saline daily.The rabbits in SS group and SS+GH group were continuously Given SS (3.5μg·kg-1·h-1)for 48 hours. Besides, the rabbits in SS+GH group were subcutaneously injected with 0.15 IU/kg of GH at the 1st and the 24th hours after modeling. The levels of serum amylase, serum tumor necrosis factor-α (TNF-α) and plasma diamine oxidase were measured at the 6th, 12th, 24th and 48th hours after modeling. The pathological changes of pancreatic tissue and ileal mucosa were observed. Survival rate was calculated. Data were analyzed using SPSS 16.0 software. The univariate analysis was used to compare the difference among groups. Results In SS+GH group, the levels of serum TNF-α and plasma diamine oxidase were (2. 43 ± 0. 14) pg/ml and (4. 61 ± 0. 45) U/L at the 24th hour respectively, and were (2.08±0.23) pg/ml and (3.75±0.47) U/L at the 48th hour, respectively,which were lower than those in SAP group and SS group [(2.80 0.30) pg/ml and (8.74 ± 1.77)U/L, respectively, at the 24th hour; (2. 45±0.12) pg/ml and (5. 02±0.95) U/L, respectively, at the 48th hour)]with significant difference (P＜0.05). The inflammation in pancreas and ileal mucosa was alleviated, and the integrity of bowel mucosa was improved. Survival rate of SS+GH group was significantly higher than SAP group and SS group. There was no significant difference in level of serum amylase between SS+GH group and SS group. Conclusion The combination of SS with GH may enhance the function of intestinal mucosa barrier and improve the prognosis of SAP in rabbits.

Objective To study the feasibility and security about misoprostol combined with fentanyl and propofol applied in visualization of artificial abortion.Methods 1270 cases of pregnant women who requested termination of pregnancy and voluntarily accepted abortion were selected.In the observe group,634 cases of pregnant women received oral misoprostol about 600 mg 90 minutes before surgery.After anesthetized by fentanyl and propofol,painless artificial abortion using visual abortion instrument was carried out.In the control group,636 cases of pregnant women anesthetized by fentanyl and propofol via the venous were carried out artificial abortion.The degree of cervical relaxation,loss of blood,total dose of propofol,surgical time,recovery time,the incidence of abortion complications and so on were observed.Results In the observation group and the control group,the average dosage of propofol are( 14.15 ± 2.37) ml and (16.90 ± 4.52) ml respectively;The average time required for surgery are ( 146.1 ± 38.2) s and ( 199.7 ± 37.3 ) s respectively;the average time required for awakening are ( 6.01 ± 1.90 ) min and ( 8.81 ± 2.02 )in;In the observation group,there are 405 ( 63.9% ) cases of cervical laxity markedly,in the control group,including 145 ( 22.8% ) cases of cervical laxity markedly,there is statistical significance ( P ＜ 0.05 ) between the observation group and the control group.There are no abortion syndrome in both groups.Conclusion Misoprostol combined with fentanyl and propofol was the first choice for painless artificial abortion using ultrasound visualization.