Objective To investigate the present situation of diabetic foot knowledge among nurses in Changzhi of Shanxi Province. Methods Adopting convenience sampling,100 nurses were recruited from 3 secondary hospital in Changzhi of Shanxi Province and evaluated by the questionnaire making by author. Results The average level of DF among nurses was unsatisfied. There are significant deference between who experiencing continuing education and not. Conclusions The present situation of diabetic foot knowledge among nurses in rural areas in China which should arouse more attention from management of nurse in rural area. Continuing education and professional training education should be carried out for nurses in rural area who also should develop their ability to read article,and Cognition of prevention and health education.

1.2 ng/ml on the third day as a threshold,the sensitivity,and specificity in predicting the prognosis of VAP were 81.0%,and 87.5%,respectively. CONCLUSIONS The results suggested that serum PCT be important for the diagnosis of VAP.PCT concentration over 1.2 ng/ml as a threshold is more sensitive and specific to distinguishing different outcomes.And the sensitivity and specificity of PCT are better than that of IL-6,IL-8.

Twenty-three patients with pain from osteoporotic vertebral fractures,aged 65-90 yr,weighing 51-78 kg,received an image intensifier-assisted nerve-root block with a 6-8 ml mixture of 0.5 ％ lidocaine,mecobalamine 0.5 mg and betamethasone sodium phosphate injection 5.26 mg in a prone or lateral position.The VAS scores before operation,at 0,1 week,1 and 3 months after operation were 8.6 ± 0.9,1.5 ± 0.7,2.8 ± 0.9,1.6 ± 0.5 and 2.5 ± 0.7,respectively.VAS scores were significantly lower at each time pint after operation than before operation (P ＜ 0.05).According to modified MacNab standard,the effectiveness of treatment was rated as excellent/good in 87％ of the patients.No complication such as bleeding,hematoma,infection,pneumothorax,hemopneumothorax,headache was found during or after operation.Selective nerve-root block is effective in the treatment of pain resulting from osteoporotic vertebral fractures in patients.

Through to the new reform under the background of hosting the analysis of the hospital management , put forward according to the construction of talent as the breakthrough point , the two-way referral system , focus on building characteristic specialized platform , stick to the quality construction , carrying out medical core system vig-orously and also carrying out fine management , set up the mechanism of medical quality long -term improvement , constantly improving the quality of connotation construction level , lay a foundation for hosting the hospital sustain-able development .

Objective　To confirm previous effort to identify type 2 diabetes susceptibility genes in a Northern Chinese population by conducting a new genome scan with both an increased number of type 2 diabetes families and a new set of microsatellite markers within the previously localized regions. Methods　A genome scan method was applied. After multiplexed PCR, electrophoreses, genescan and genotyping analysis, we obtained size information for all loci , and then a further study was done by both parametric and non-parametric linkage analysis to investigate the P values and Z values of these loci. Results　We surveyed 34 microsatellite markers which distributed within 5 regions along chromosome 1, and a total of 12?000 genotypes were screened. Evidence of linkage with diabetes was identified for 8 of the 34 loci. All P values of the 8 loci were lower than 0.05, and the highest Z value was 2.17. A very interesting finding is that all 5 markers at the p- terminal 1p36.3-1p36.23 region, spanning a long range of 16.9?cM, were identified to have a low P value of less than 0.05, which suggests that this region may contain multiple susceptibility genes. Regions 4 and 5 also confirmed the previous findings, and we narrowed these two regions to a 2.7?cM and 2.5?cM regions, respectively. Conclusions　We further confirmed the results gained in the previous genome-wide scan using an increased number of NIDDM families and a new set of microsatellite markers lying within the initially localized regions. The fact that all 5 loci at the p- terminal region displayed a low P value of less than 0.05 suggests that more than 1 susceptibility gene may reside in this region.

Objective To systematically review the clinical efficacy of paroxetine plus olanzapine versus paroxetine alone among depression complicated with sleep disorder patients in China.Methods PubMed,Embase,Cochrane Library,CINAHL,SinoMed,CNKI,VIP,WanFang Data databases,SUMsearch and Google search engine were electronically searched to collect randomized controlled trials(RCTs)of paroxetine plus olanzapine versus paroxetine in the treatment of depression complicated with sleep disorder Chinese patients from inception to April 3,2023.Two researchers independently screened the literature,extracted data and evaluated the risk of bias of the included studies,and the Meta-analysis was then performed by using RevMan 5.3 software.Results A total of 70 RCTs involving 5 683 patients were included.The results of Meta-analysis showed that:(1)the total effective rate in experimental group was significantly higher than that of the control group(OR=5.98,95％CI 4.51 to 7.94,P＜0.001);(2)Pittsburgh sleep quality index scores after treatment in the first month(MD=-2.81,95％CI-3.24 to-2.38,P＜0.001),in 2 months(MD=-2.41,95％CI-3.13 to-1.70,P＜0.001),in 3 months(MD=-2.80,95％CI-3.18 to-2.42,P＜0.001)and in 6 months(MD=-1.65,95％CI-1.83 to-1.48,P＜0.001)in experimental group were significantly lower than the control group;(3)Hamilton depression scale scores after treatment in the first month(MD=-5.79,95％CI-6.63 to-4.95,P＜0.001),in 2 months(MD=-4.33,95％CI-5.45 to-3.21,P＜0.001),in 3 months(MD=-3.76,95％CI-4.17 to-3.34,P＜0.001)and in 6 months(MD=-3.38,95％CI-3.60 to-3.15,P＜0.001)in experimental group were significantly lower than the control group;(4)Hamilton anxiety scale scores in experimental group were significantly lower than the control group(MD=-3.47,95％CI-3.78 to-3.16,P＜0.001).Conclusion Current evidence shows that,compared with the paroxetine alone in the treatment of depression complicated with sleep disorder patients in China,paroxetine plus olanzapine can effectively increase patients'total effective rate of clinical treatment,improve the sleep quality and depression symptoms in 1 month,2 months,3 months and 6 months after treatment,and also reduce patients'anxiety.Due to limited quality and quantity of the included studies,more high-quality studies are required to verify above conclusions.

Patients with non-small cell lung cancer (NSCLC) are treated in a variety of ways. In addition to radiotherapy, chemotherapy and targeted therapy, breakthroughs have been made in immune checkpoint inhibitors, in particular, programmed cell death 1 (PD-1) and its ligand (PD-L1) inhibitors have achieved survival benefits for NSCLC patients, and some of them have been approved as first-line drugs by the US Food and Drug Administration. Currently, commonly used PD-L1 inhibitors are atezolizumab, durvalumab and avelumab. Combination therapies include combination with chemotherapy, anti-vascular endothelial growth factor drugs, molecular targeted therapy and immunotherapy.

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

Humans ; Cardiovascular Diseases ; Risk Factors ; Myocardial Infarction/complications* ; Coronary Disease/etiology* ; Heart Disease Risk Factors