Objective To investigate the effects of extended care on the treatment compliance and the quality of life on discharged elderly patients with chronic heart failure. Methods One hundred and eight patients were randomly assigned to the experimental group and the control group with 54 patients in each, the experimental group received extended care for 1 year, including regular telephone and visit follow-up, supporting medical care, diet care, rehabilitation exercises and supervision of self-care. The control group underwent routine health education before discharge. Medical compliance and self-management ability were compared three months, six months and 1 year after discharge, evaluation score of life quality were also compared at discharge and one year after discharge between the two groups. Results There were no significant differences in medication, diet and regular follow-up visits between the two groups. However, the patients in the experimental group showed better compliance than the control group in the self-testing of urine, body weight,and recording of symptoms, body signs and required exercises. Additionally, the patients in the experimental group had higher scores than the control group in the daily life-skills, happiness and the quality of life. Conclusions The extended care significantly improved the treatment compliance and the quality of life in the elderly patients with chronic heart failure.

Objective:To investigate the clinical efficacy of electrical stimulation, biofeedback, and radiofrequency therapy in combination for the treatment of pelvic floor dysfunction.Methods:A total of 144 patients with pelvic floor dysfunction who received treatment in Lianyungang Maternal and Child Health Hospital from June 2020 to June 2022 were included in this prospective randomized controlled study. They were randomly assigned to undergo electrical stimulation combined with biofeedback (electrical stimulation group, n = 48), treatment with a novel radiofrequency technique (radiofrequency therapy group, n = 48), or electrical stimulation, biofeedback, and treatment with a novel radiofrequency technique (combined group, n = 48). Pelvic floor dysfunction, stress urinary incontinence, and pelvic floor myofascial pain were compared among the three groups. Pelvic organ prolapse quantification was compared among the three groups before and after treatment. Quality of life was evaluated. Results:The effective rates of treatment against pelvic floor dysfunction, stress urinary incontinence, and pelvic floor myofascial pain in the combined group were 95.83% (46/48), 97.92% (47/48), and 93.75% (45/48), respectively, which were significantly higher than 79.17% (38/48), 79.17% (38/48), 77.08% (37/48) in the radiofrequency group, and 75.00% (36/48), 77.08% (37/48), 72.92% (35/48) in the electrical stimulation group ( χ2 = 8.40, 9.77, 7.66, all P < 0.05). After treatment, the severity of pelvic organ prolapse in the combined group was significantly milder than that in the novel radiofrequency technique group and electrical stimulation group (both P < 0.05). The scores of the pelvic floor dysfunction questionnaire and urinary incontinence questionnaire in the combined group were significantly lower than those in the radiofrequency therapy group and the electrical stimulation group (both P < 0.05). Conclusion:Electrical stimulation, biofeedback, and radiofrequency therapy in combination can greatly strengthen the muscle strength of the pelvic floor, relieve urinary incontinence, reduce pelvic floor myofascial pain, and improve the quality of life of patients with pelvic floor dysfunction.

Objective:To observe the effects of epidural labor analgesia during latency period on factors related to labor process.Methods:A total of 120 single fetus cephalic presentation primiparas,aged from 22 to 35,were enrolled and randomly divided into group undergoing epidural labor analgesia during latency period (group Q),group undergoing epidural labor anal-gesia during active period (group H),and control group without epidural labor analgesia (group C).Duration of each labor pe-riod,pain score and amount of bleed were compared among the groups.Venous blood was collected for determination of inter-leukin (IL-6,IL-8)and tumor necrosis factor-α(TNF-α)levels before latent phase of labor or before starting infusion of oxyto-cin (time 1),2 h after delivery (time 2)and 24 h after delivery (time 3).Results:The second stage of labor in group Q or group H was longer than that in group C and the difference was statistically significant(P <0.05).However,there was no sta-tistical significance regarding other stages of labor among the three groups (P >0.05).There was no statistical significance re-garding IL-6,IL-8 and TNF-αlevels among the three groups at each of the 3 time points above (P >0.05).Conclusions:Epi-dural labor analgesia during latency period or active period could prolong the second stage of labor to different degree,but it had little effect on the entire labor process.Epidural labor analgesia had no significant effect on serum cytokines related to the birth process.Changing the time point of epidural labor analgesia from active period to latency period could improve maternal com-fort,so that it is worthy of clinical application.

Objective:To analyze and compare the practical value of serum cystatin C(Scys C)and serum creatinine(SCr)in the assessment of kidney function in older adults.Methods:A retrospective, cross-sectional study was performed in 2 450 participants who were divided into a non-elderly group(<65 years)and an elderly group(≥65 years).Glomerular filtration rate(GFR), Scys C and SCr were measured by 99mTc-DTPA clearance, particle-enhanced immunoturbidimetry and an oxidase method, respectively.The χ2 test was used to compare increases in percentage of Scys C and SCr at the same GFR level.The screening value of Scys C and SCr for GFR<60 ml·min -1·1.73m -2was evaluated by the area under curve(AUC)of the receiver operating characteristic(ROC)curve.Values of 95% reference ranges were established for Scys C and SCr at different GFR levels. Results:The proportions of the general population with increased Scys C were 82.74%(556/672)and 94.74%(90/95), respectively, for GFR levels between 30~59 ml·min -1·1.73m -2and <30 ml·min -1·1.73m -2, while only 38.24%(257/672)and 75.79%(72/95)had elevated SCr levels( χ2=278.328, 13.571, both P<0.001).For the above GFR intervals, the proportions of older adults with increased Scys C were 84.81%(240/283)and 100.00%(43/43)respectively, and the proportions for non-elderly adults with increased Scys C were 81.23%(316/389)and 90.38%(47/52)( χ2=1.463, 4.364, P=0.226, 0.037), respectively.The screening value of Scys C for GFR<60 ml·min -1·1.73m -2was slightly better than SCr in terms of sensitivity, specificity and the Youden index.However, the sensitivity and specificity of Scys C in older adults were 76.4% and 75.7%, respectively, both lower than 78.7% and 84.0% in non-older adults.The variability of Scys C increased progressively with age.The reference range for Scys C was higher in older adults than in non-older adults at the same GFR level. Conclusions:When screening for GFR<60 ml·min -1·1.73m -2, the sensitivity and specificity of Scys C are slightly better than those of SCr, but are lower in older adults than in non-older adults.Scys C levels are higher and more variable in older adults.Using Scys C to assess GFR may lead to over-diagnosis of chronic kidney disease in older adults.

Objective:To explore the effect of health education based on the forgetting curve in maintenance hemodialysis patients.Methods:A total of 84 patients undergoing maintenance hemodialysis in the First Affiliated Hospital of Nanjing Medical University from March 2017 to March 2020 were enrolled and divided into in the observation group (43 cases) and in the control group (41 cases) using the random number table. The control group received conventional health education, and the observation group conducted health education based on the forgetting curve. Six months after intervention, disease cognition level, self-management ability, quality of life of the two groups were compared.Results:Six months after intervention, disease cognition level, self-management ability, quality of life scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on the forgetting curve can help maintenance hemodialysis patients enhance the awareness of diseases, promote the development of self-management ability, and improve their quality of life.