Many studies have shown that diabetes mellitus is associated with vascular cognitive impairment (including vascular dementia),mild cognitive impairment,and Alzheimer's disease.Its pathophysiological mechanism is very complex,involving in vascular mechanisms and including non-vascular mechanisms of hyperglycemia,hypoglycemia,and insulin resistance.

Breast Neoplasms ; etiology ; Female ; Humans ; Integrins ; physiology

Objective:To investigate the prognostic value of platelet volume indices (PVIs), neutrophil/lymphocyte ratio (NLR) and the combination of these parameters for the neurological function of acute ischemic stroke (AIS) patients after intravenous thrombolysis.Methods:From January 2016 to January 2019, the data of 147 AIS patients with intravenous thrombolysis in the Emergency Department of Peking University People's Hospital who met the diagnostic criteria of AIS were retrospectively analyzed. The patients were divided into two groups according to modified rank in scale (MRS) score: MRS≤2 and MRS≥3. The general information, past medical history and laboratory examination results of each group were compared. Logistic regression analysis was used to analyze the risk factors of poor prognosis of neurological function in AIS patients with thrombolysis.Results:NLR ( OR=1.045, 95% CI: 1.032-2.350, P=0.032), mean platelet volume (MPV) ( OR=4.212, 95% CI:1.074-16.513, P=0.039), MPV×NLR/PLT ( OR=5.711, 95% CI: 1.342-24.298, P=0.018), platelet distribution width (PDW) ( OR=1.015, 95% CI: 1.001-2.372, P=0.032), and NIHSS score ( OR=1.266, 95% CI: 1.111-1.443, P<0.01) were related with poor prognosis neurological function of AIS patients with intravenous thrombolysis. Conclusions:MPV, NLR, MPV×NLR/PLT PDW and NIHSS scores are the risk factors for poor prognosis of neurological function in AIS patients with thrombolysis. MPV×NLR/PLT can predict the neurological severity of AIS after 3 months.

Objective To investigate the status of undergraduates′ sub-health and explore the relationship between personality traits and sub-health and the mediating role of self-harmony. Methods A total of 196 undergraduate nursing students in Tianjin University of Traditional Chinese Medicine were investigated by Sub-health Self-rating Scale (SSS), Self Consistency and Congruence Scale (SCCS) and Eysenck Personality Questionnaire Short Scale. Results The the total scores of the undergraduate nursing students′personality traits, self-harmony and sub-health were 22.71±4.90, 102.74±14.41, 182.54± 31.76. The neuroticism and extroversion of personality traits were significantly correlated with self-harmony and sub-health (P<0.01). Neuroticism had a significant prediction on self-harmony (β=0.37, P<0.01) and sub-health (β=-0.64, P<0.01), after controlling self-harmony, the prediction on sub-health was reduced, but still significant (β=-0.56, P<0.01);extroversion had a significant prediction on self-harmony (β=-0.27, P<0.01) and sub-health (β=0.54, P<0.01), after controlling self-harmony, the prediction on sub-health was reduced, but still significant (β=0.46, P < 0.01). Conclusions The sub-health status of undergraduate nursing students was not optimistic. Nursing students′ personality traits of psychoticism, extroversion, which directly impact on the health status, and through self-harmony indirectly affect their health level, self-harmony played a intermediary role between personality traits and sub-health.

OBJECTIVE:To investigate clinical efficacy and adverse reactions(ADRs)of 4 kinds of the second-generation anti-psychotic drugs in the treatment of acute phase of schizophrenia. METHODS:159 patients with schizophrenia were randomly divid-ed into risperidone group(40 cases),olanzapine group(40 cases),aripiprazole group(39 cases)and ziprasidone group(40 cas-es). All groups were given routine dosage of relevant medicine by routine usage for 6 weeks. Mental status of patients were mea-sured by PANSS before treatment and after 2,4 and 6 weeks of treatment. At the same time,blood glucose,blood lipid,prolac-tion and other metabolic and biological indicators were all detected. RSESE,BARS and UKU were adopted to evaluate ADR. RE-SULTS:A total of 100 patients completed the study. Compared with aripiprazole group and ziprasidone group,risperidone and olan-zapine inhibited symptom more rapidly,with statistical significance (P<0.05). After treatment,body mass index and abdominal circumference of olanzapine group were significantly higher than those of other 3 groups,with statistical significance (P<0.05). Low density lipoprotein of olanzapine group was increased significantly,there was statistical significance compared to ziprasidone group and aripiprazole group(P<0.05). Prolactin level of risperidone group was significantly higher than those of other 3 groups, while that of aripiprazole group was significantly lower than those of other 3 groups,with statistical significance(P<0.05). ADRs of 4 drugs were mild or moderate,most of whom could be alleviated by symptomatic treatment. CONCLUSIONS:In the treatment of acute phase schizophrenia,4 drugs of the second-generation have similar curative effect in symptoms control,among which ris-peridone and olanzapine inhibit positive symptom more rapidly while more ADRs that related to lipid and glucose metabolism and prolactin also show. Aripiprazole and ziprasidone induce less ADRs relatively,and patients show better tolerability. Physicians should consider all kinds of factors in drugs selection,and make individualized treatment plan.

Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.

Objective:To investigate the occurrence of carotid artery abnormalities in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients and the related risk factors affecting the occurrence of carotid artery abnormalities.Methods:A total of 169 regular follow-up outpatients with HIV/AIDS from April 2003 to December 2019 in Peking Union Medical College Hospital, whose carotid artery ultrasound examination were performed from July 2015 to December 2019 were included. The patients were divided into young (≤44 years old), middle-aged and elderly (≥45 years old) according to their ages, and the physical examination data of the included patients were collected.The statistical methods were logistic regression analysis and single sample t test. Results:Among the 169 HIV/AIDS patients, 40(23.7%) had abnormal carotid artery and 129(76.3%) had no abnormal carotid artery. Middle-aged and elderly people (odds ratio ( OR)=3.85, 95%confidence interval (95% CI) 1.54-9.65, P<0.01), hypertension ( OR=6.24, 95% CI 1.95-20.00, P<0.01), hyperlipidemia ( OR=2.44, 95% CI 1.00-5.93, P<0.05), and elevated human leucocyte antigen (HLA)-DR + CD8 + /CD8 + ( OR=1.03, 95% CI 1.01-1.06, P<0.05) were the risk factors for carotid artery abnormality. The common carotid artery inner medium film thickness (IMT) of patients in HIV/AIDS group Ⅰ (20 to 30 years old), group Ⅱ (31 to 40 years old), group Ⅲ (41 to 50 years old) were (0.061 0±0.001 2), (0.062 9±0.001 4) and (0.065 6±0.002 6) cm, respectively, which were thicker than the control groups ((0.051±0.003), (0.056±0.004) and (0.063±0.002) cm, respectively). The differences were all statistically significant ( t=5.119, 4.775 and 1.739, respectively, all P<0.05). The common carotid artery IMT of patients in HIV/AIDS group A (30 to 44 years old) and group B (45 to 59 years old) were (0.062 6±0.001 1) and (0.072 3±0.003 4) cm, respectively, which were thicker than the control groups ((0.052±0.011) and (0.064±0.015) cm, respectively), the differences were both statistically significant ( t=9.520 and 3.012, respectively, both P<0.01). Conclusion:Younger HIV-positive people have a higher probability of abnormal carotid arteries and may be at greater risk of cardiovascular disease than HIV-negative people of the same age, suggesting that HIV-positive people, especially young people, should be examined early with ultrasound of the neck arteries to detect abnormalities and intervene as soon as possible.

OBJECTIVE:To establish a method for simultaneous determination of tanshinol,caffeic acid,rosmarinic,salviano-lic acid B,salvianolic acid A,tanshinoneⅠ,cryptotanshinone,tanshinone ⅡA and ursolic acid in Compound xueshuantong cap-sules. METHODS:UPLC-MS/MS method was adopted. The determination was performed on ACQUITY UPLC? BEH C18 column with mobile phase consisted of acetonitrile-0.1%formic acid(gradient elution)at the flow rate of 0.2 mL/min. The column tempera-ture was 40 ℃,and the temperature of injector was 10 ℃. Analysis time was 7 min,and sample size was 5 μL. The electrospray ionization source(ESI)was used;ion source temperature was 150℃;capillary voltage was 3.5 kV;cone flow was 50 L/h;desol-vation temperature was 350 ℃;desolvation gas flow was 650 L/h;nebuliser pressure was 7 × 105 Pa;ion monitoring and multiple reaction monitoring (MRM) was performed. RESULTS:The linear ranges of tanshinol,caffeic acid,rosmarinic,salvianolic acid B,salvianolic acid A,tanshinoneⅠ,cryptotanshinone,tanshinone ⅡA and ursolic acid were 10.0-100.0 μg/mL (r=0.9998), 0.1-1.0 μg/mL(r=0.9998),4.0-40.0 μg/mL(r=0.9999),10.0-100.0 μg/mL(r=0.9999),15.0-150.0 μg/mL(r=0.9997), 8.0-80.0 μg/mL(r=0.9998),10.0-100.0 μg/mL(r=0.9997),50.0-500.0 μg/mL(r=0.9997)and 6.0-60.0 μg/mL(r=0.9998), respectively. The limits of quantitation were 40.0,9.6,38.0,88.0,130.0,39.0,4.4,3.2 and 10.0 ng/mL,separately. The limits of detection were 12.0,3.0,11.0,26.0,39.0,12.0,1.3,1.0 and 3.0 ng/mL,respectively. RSDs of precision,stability and repro-ducibility tests were all lower than 3%. The recoveries were 97.34%-103.20%(RSD=2.19%,n=6),97.22%-102.39%(RSD=2.03%,n=6),98.51%-101.70%(RSD=1.32%,n=6),97.86%-102.49%(RSD=2.09%,n=6),96.75%-103.12%(RSD=2.36%,n=6),98.43%-101.65%(RSD=1.25%,n=6), 97.59%-101.50%(RSD=1.50%,n=6), 96.45%-102.88%(RSD=2.58%,n=6),97.02%-103.11%(RSD=2.38%,n=6),separately. CONCLUSIONS:The method is simple and accurate,and can be used for simultaneous determination of 9 components in Compound xueshuantong capsules.

Objective To investigate the sleep quality of pacemaker implanted patients,to analyze the relationships among neuroticism,positive psychological capital and sleep quality,and to examine the potential mediating effect of positive psychological capital on the relationship between neuroticism and sleep quality. Methods Using convenience sampling, a total of 178 pacemaker implanted patients were interviewed and analyzed in two tertiary hospitals of Shandong province. They were assessed with Big Five Inventory,The Positive Psycap Questionnaireand Pittsburgh Sleep Quality Indexfor the evaluation of neuroticism,positive psychological capital and sleep quality.The Process macro was used to test the mediating effect. Results The mean score of PSQI in patients with pacemaker implantation was (8.48± 4.50), and 71.3％of them had sleep problems.The scores of neuroticism had positively correlated with the PSQI scores(r=0.31, P<0.01), the scores of positive psychological capital had negatively correlated with the PSQI scores(r=- 0.39, P<0.01).The confidence interval from Bootstrap output indicated positive psychological capital played a mediating role between neuroticism and sleep quality (95％CI:0.06-0.23), mediation effect was 0.14, the percentage of mediation effect in total effect was 43.75％. Conclusions The relation of positive psychological capital to neuroticism and sleep quality among pacemaker implanted patients are intimate.Positive psychological capital could mediate the relationship between neuroticism and sleep quality. It is suggested that nurses can improve the patient′s sleep by enhancing the intervention of positive psychological capital according to the personality characteristics of patients.

Objective To investigate oral feeding progression and its influencing factors in very-low-birth-weight infants. Methods Investigation was conducted among 114 infants with the Gestational age≤30 weeks,birth weight≤1 500 g using very low birth weight infants clinical information questionnaire and oral feeding survey. Results The very low birth weight infants started enteral nutrition(20.61±4.67) h after admission, achieved a total enteral nutrition (41.47 ± 15.53) days after birth with the correct gestational age was (34.35 ± 2.76) weeks. The infants started oral feeding (41.47 ± 15.53) days after birth with the correct gestational age(34.58±1.98)weeks.The infants achieved full oral feeding(55.19±16.30) days after birth with the correct gestational age(36.40 ±1.99)weeks.Single factor and multiple regression analysis showed that birth weight,gestational age,BPD were significant factors of oral feeding progression. Conclusions The smaller gestational age, birth weight, the longer duration the infants reach the oral feeding milestones, Infants with BPD have obvious oral feeding progression. The medical staffs should learn that the very low birth weight have oral feeding difficulties and thus take positive and effective measures to promote the advancement of oral feeding.