Objective To investigate the correlation between uric acid level and macrovascular disease in type 2 diabetic patients.Methods Sixty type 2 diabetic patients with lower limb atherosclerosis of carotid artery were randomly selected in study group who hospitalized in the First Hospital of Zibo from Mar.to Feb.2012.Sixty type 2 diabetes mellitus(T2DM) without carotid and lower limb athemsclerosis were served as control group.The blood pressure,blood lipid,blood glucose and other biochemical indexes,including blood uric acid,serum insulin (FNS),fasting blood glucose (FPG),apolipoprotein a (LP (a)),apolipoprotein A1,B (APO-A1,APO-B),glycosylated hemoglobin (HbA1c),high density lipoprotein cholesterol (HDL-C),low density lipopmtein cholesterol (LDL-C),triacylglycerol (TG) and total cholesterol (TC) were measured and determined.Results There was no significant difference in terms of blood pressure,blood lipid levels,APO-A1,APO-B,HbA1C,FNS and FPG in study group patiems (P ＞ 0.05).The level LP(a) in study group was (0.4 ± 0.2) g/L,significantly higher than that in control group ((0.2 ± 0.2) g/L; t =3.842,P ＜ 0.01).The blood uric acid level in study group was (362.3 ± 112.8)mmol/L,significantly higher than that of the control group((284.8 ±68.6)mmol/L;t =3.188,P＜0.01).Conclusion Uric acid and LP(a) are involved in the oocurrence and development of athemsclemsis,which is close related to the development of type 2 diabetic macmangiopathy.Therefore,in the process of preventing type 2 diabetes with macroangiopathy,we should pay attention to uric acid and LP (a) of the patient beside effective control of blood glucose,blood pressure,blood lipid level.

OBJECTIVE:To systematically evaluate the effectiveness of probiotics in adjunctive prevention and treatment of chemotherapy-induced diarrhea(CID),and to provide evidence-based reference in the clinic. METHODS:All relevant randomized controlled trials (RCTs) of probiotics in adjunctive prevention and treatment of CID were collected by searching EMBase,Co-chrane library,PubMed,CJFD,VIP,Wanfang databases and CBM. Meta-analysis were performed with Rev Man 5.2 software af-ter data extraction and quality evaluation by Cochrane Hand book 5.0risk-bias assessment tool. RESULTS:10 RCTs were includ-ed,involving 871 patients. The results of Meta-analysis showed that addition of probiotics on the basis of conventional symptomatic therapy significantly reduced the total rate of diarrhea in cancer patients [OR=0.31,95%CI(0.20,0.49),P<0.001] and Ⅲ-Ⅳ diar-rhea rate[OR=0.09,95%CI(0.03,0.24),P<0.001],improved overall response rate [OR=4.16,95%CI(2.40,7.23),P<0.001] and complete remission rate [OR=2.55,95%CI(1.66,3.90),P<0.001],with statistical significance. The probiotics had little effect onⅠ-Ⅱlevel diarrhea rate[OR=0.86,95%CI(0.48,1.56),P=0.62] and partial remission rate[OR=1.00,95%CI(0.67,1.50),P=1.00],with statistical significance. CONCLUSIONS:The use of probiotics before chemotherapy can effectively prevent the occur-rence of severe CID in cancer patients;in the treatment of CID,the combination of probiotics can also improve therapeutic effica-cy of conventional symptomatic treatment.

Objective To explore the nursing of 46 cervical fracture dislocation patients combined with spinal cord injuries.Methods A total of 46 cervical fracture dislocation patients combined with spinal cord injuries treated by rehabilitation were randomly divided into experimental group (n=23) and control group (n=23).The patients in control group were treated with ordinary nursing intervention, while the patients in experimental group were treated with other cares including ache nursing, rehabilitation training and preventing complication on the basis of the control group.After one year, the mean Japanese orthopaedic association score (JOA), Asia classification, complication were observed and recorded.Results After one year of operation, JOA score of the two groups were both improved, and JOA score in experimental group was higher than the control group(P<0.05).After one year, the Asia classifications in the two group were improved than operation before, and it was better in experimental group than that in the control group(P<0.05).The complication rate in experimental group was lower than that in the control group(P<0.05).Conclusion Comprehensive rehabilitation care can decrease complication, accelerate the recovery of spinal function, so it is worthy of promotion in clinic.

Objective To explore the nursing of 46 cervical fracture dislocation patients combined with spinal cord injuries.Methods A total of 46 cervical fracture dislocation patients combined with spinal cord injuries treated by rehabilitation were randomly divided into experimental group (n=23) and control group (n=23).The patients in control group were treated with ordinary nursing intervention, while the patients in experimental group were treated with other cares including ache nursing, rehabilitation training and preventing complication on the basis of the control group.After one year, the mean Japanese orthopaedic association score (JOA), Asia classification, complication were observed and recorded.Results After one year of operation, JOA score of the two groups were both improved, and JOA score in experimental group was higher than the control group(P<0.05).After one year, the Asia classifications in the two group were improved than operation before, and it was better in experimental group than that in the control group(P<0.05).The complication rate in experimental group was lower than that in the control group(P<0.05).Conclusion Comprehensive rehabilitation care can decrease complication, accelerate the recovery of spinal function, so it is worthy of promotion in clinic.

Objective:To investigate the predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP), cystatin C (CysC) and interleukin-17 (IL-17) in relapse after radiofrequency catheter ablation (RFCA) in elderly patients with persistent atrial fibrillation.Methods:The clinical data of 69 elderly patients with persistent atrial fibrillation underwent RFCA (atrial fibrillation group) in Shanghai Pudong New Area People′s Hospital from January 2020 to December 2021 were retrospectively analyzed. Additionally, 69 healthy subjects underwent physical examinations during the same period were selected as the healthy control group. The levels of serum NT-proBNP, CysC and IL-17 were detected. The relapse after RFCA was recorded. Multivariate Logistic regression was used to analyze the independent risk factors of relapse after RFCA in elderly patients with persistent atrial fibrillation. The values of NT-proBNP, CysC and IL-17 in predicting the relapse after RFCA in elderly patients with persistent atrial fibrillation were evaluated by the receiver operating characteristics (ROC) curve.Results:The serum NT-proBNP, CysC and IL-17 before operation and 7 d after operation in atrial fibrillation group were significantly higher than those in healthy control group: (789.41 ± 89.22) and (358.96 ± 50.24) ng/L vs. (114.38 ± 32.56) ng/L, (1.42 ± 0.30) and (1.20 ± 0.21) mg/L vs. (0.98 ± 0.17) mg/L, (12.48 ± 3.21) and (9.83 ± 2.58) ng/L vs. (7.85 ± 2.13) ng/L, and there were statistical differences ( P<0.05); compared with healthy control group, there were no statistical difference in the indexes 1 and 3 months after operation ( P>0.05). The serum NT-proBNP, CysC and IL-17 7 d, and 1, 3 month after operation in atrial fibrillation group were significantly lower than those before operation, and there were statistical differences ( P<0.05). The 69 patients were followed up for 1 year, with 20 cases experiencing relapse and 49 cases not experiencing relapse. There were no statistical differences in the serum NT-proBNP, CysC and IL-17 before operation and 7 d after operation between relapse patients and non-relapse patients ( P>0.05); the serum NT-proBNP, CysC and IL-17 1 and 3 months after operation in relapse patients were significantly higher than those in non-relapse patients, 1 month after opertion: (132.49 ± 32.84) ng/L vs. (115.56 ± 27.61) ng/L, (1.10 ± 0.15) mg/L vs. (0.99 ± 0.12) mg/L and (8.59 ± 1.76) ng/L vs. (7.65 ± 1.58) ng/L; 3 months after operation: (140.37 ± 32.83) ng/L vs. (119.90 ± 25.44) ng/L, (1.17 ± 0.20) mg/L vs. (1.02 ± 0.15) mg/L and (9.12 ± 2.31) ng/L vs. (7.74 ± 1.80) ng/L, and there were statistical differences ( P<0.05 or<0.01). Multivariate Logistic regression analysis result showed that the serum NT-proBNP, CysC and IL-17 1 and 3 months after operation were the independent risk factors of relapse after RFCA in elderly patients with persistent atrial fibrillation ( P<0.01). ROC curve analysis result showed that the area under curve (AUC) of the serum NT-proBNP, CysC, IL-17 and the combination of three indexes 3 months after operation in predicting the relapse after RFCA in elderly patients with persistent atrial fibrillation were higher than those at 1 month after operation (0.813 vs. 0.783, 0.770 vs. 0.721, 0.725 vs. 0.717 and 0.927 vs. 0.833; P<0.05), the AUC of combination of three indexes 1 and 3 months after operation was significantly higher than that of individual indexes at each time point ( P<0.05). Conclusions:The elevated levels of serum NT-proBNP, CysC and IL-17 after operation in elderly patients with persistent atrial fibrillation are closely related to the relapse after RFCA, and can be used as biochemical indicators to predict recurrence.

Objective To evaluate the effect of self-management education based on nurse-leading on the quality of life in patients with chronic heart failure (CHF).Methods Eighty patients with CHF in a tertiary hospital were enrolled in this study,and were divided into the intervention group and the control group randomly,with 40 cases in each group. Patients in the control group received conventional health education, while patients in the intervention group received the self-management education based on nurse-leading. The score of self-management behavior and the quality of life in two groups were evaluated and compared after six months.Results After six months,the score of self-management in the intervention group was (70.83±12.02), and was significantly higher than that in the control group (55.58±6.46) (t=9.675,P<0.05). The score of total quality of life and self-management in the intervention group was significantly higher than that in the control group (P<0.05).Conclusions Self-management education based on nurse-leading can improve the self-management and the quality of life of patients with CHF.

Objective To analyze the effects of early cluster rehabilitation nursing on bladder function, psychological status and quality of life in patients with neurogenic bladder after spinal cord injury.Methods A total of 64 cases with neurogenic bladder after spinal cord injury were selected in our hospital and were divided into routine group and experimental group, with 32 cases in each group, receiving routine nursing care and early cluster rehabilitation nursing intervention, respectively.The changes of bladder function, psychological status and quality of life were compared between the two groups after 1 month of treatment.Results After 1 month of treatment, the residual urine volume and bladder capacity in the two groups were better than treatment before (P<0.05), and those levels in the experimental group were superior to the control group (P<0.05);The scores of anxiety and depression in the two group were lower than treatment before (P<0.05), and those scores after the treatment in the experimental group were lower than that in the routine group (P<0.05);The scores of quality of life in the two groups were higher than treatment before (P<0.05), and those scores in the experimental group after treatment were higher than in the routine group (P<0.05).Conclusion Early cluster rehabilitation nursing intervention can improve the bladder function in patients with neurogenic bladder after spinal cord injury, which can relieve their anxiety, depression and other negative motions, so it is helpful to improve their quality of life.

Objective To analyze the effects of early cluster rehabilitation nursing on bladder function, psychological status and quality of life in patients with neurogenic bladder after spinal cord injury.Methods A total of 64 cases with neurogenic bladder after spinal cord injury were selected in our hospital and were divided into routine group and experimental group, with 32 cases in each group, receiving routine nursing care and early cluster rehabilitation nursing intervention, respectively.The changes of bladder function, psychological status and quality of life were compared between the two groups after 1 month of treatment.Results After 1 month of treatment, the residual urine volume and bladder capacity in the two groups were better than treatment before (P<0.05), and those levels in the experimental group were superior to the control group (P<0.05);The scores of anxiety and depression in the two group were lower than treatment before (P<0.05), and those scores after the treatment in the experimental group were lower than that in the routine group (P<0.05);The scores of quality of life in the two groups were higher than treatment before (P<0.05), and those scores in the experimental group after treatment were higher than in the routine group (P<0.05).Conclusion Early cluster rehabilitation nursing intervention can improve the bladder function in patients with neurogenic bladder after spinal cord injury, which can relieve their anxiety, depression and other negative motions, so it is helpful to improve their quality of life.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

Objective:To explore the application effects of application of rehabilitation care decision-making scheme based on case management model in severe burn patients.Methods:The study was a non-randomized historical control study. Thirty patients who met the inclusion criteria and received routine rehabilitation nursing in the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as the hospital) from April 2021 to March 2022 were included in routine rehabilitation nursing group (26 males and 4 females, aged 48.50 (31.75, 56.25) years), and 30 patients who met the inclusion criteria and received case management rehabilitation nursing in the hospital from April 2022 to March 2023 were included in case management rehabilitation nursing group (22 males and 8 females, aged 46.00 (36.75, 55.25) years). The length of intensive care unit (ICU) stay, total hospitalization day, and total hospitalization cost of the patients in two groups were recorded. At admission, convalescence, discharge, and 6 months after injury, the patients' life quality was evaluated by the concise burn specific health scale, the sleep quality was evaluated by the Pittsburgh sleep quality index, and the functional independence was evaluated by the functional independence rating scale. At convalescence, discharge, and 6 months after injury, the patients' scar status was evaluated by the Vancouver scar scale. At 6 months after injury, a third-party satisfaction questionnaire was used to investigate the efficacy satisfaction of patients.Results:The length of ICU stay and total hospitalization day of patients in case management rehabilitation nursing group were both significantly shorter than those in routine rehabilitation nursing group (with Z values of -1.97 and -1.99, respectively, P<0.05), and the total hospitalization cost was less than that in routine rehabilitation nursing group ( Z=-1.99, P<0.05). At discharge and 6 months after injury, the life quality scores of patients in case management rehabilitation nursing group were significantly higher than those in routine rehabilitation nursing group (with t values of -3.19 and -4.43, respectively, P<0.05), while the sleep quality scores were significantly lower than those in routine rehabilitation nursing group (with Z values of -2.18 and -3.33, respectively, P<0.05). There were no statistically significant differences in cognitive function scores of functional independence of patients between the 2 groups at admission, convalescence, discharge, and 6 months after injury ( P>0.05). The exercise function scores and total scores of functional independence of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly higher than those in routine rehabilitation nursing group (with Z values of -4.37, -2.73, -4.10, -4.37, -2.64, and -4.06, respectively, P<0.05). The scar pigmentation scores of patients in case management rehabilitation nursing group at 6 months after injury were significantly lower than those in routine rehabilitation nursing group ( Z=-2.05, P<0.05), and the scar vascularity scores of patients in case management rehabilitation nursing group at discharge and 6 months after injury in case management rehabilitation nursing group were significantly lower than those in routine rehabilitation nursing group (with Z values of -3.16 and -2.07, respectively, P<0.05). The scar pliability scores (with Z values of -3.16, -2.45, and -4.38, respectively, P<0.05), thickness scores (with Z values of -2.56, -2.35, and -4.70, respectively, P<0.05), and total scores (with Z values of -3.77, -3.04, and -3.13, respectively, P<0.05) of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly lower than those in routine rehabilitation nursing group. At 6 months after injury, the efficacy satisfaction scores of patients in case management rehabilitation nursing group were 4.00 (3.00, 4.25), which were significantly higher than 3.00 (2.00, 4.00) in routine rehabilitation nursing group ( Z=-2.72, P<0.05). Conclusions:The implementation of rehabilitation care decision-making scheme based on case management model can optimize the cost efficiency, improve the effectiveness of clinical treatment, and enhance the life quality and satisfaction of the curative effect of severe burn patients.