Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.

Objective: To explore the feasibility and safety of three dimensional (3D) electro-anatomical mapping system (Carto3) in treating the patients with paroxysmal supra-ventricular tachycardia (PSVT) by radiofrequency catheter ablation (RCFA).
Methods: A total of 180 PSVT patients were divided into 2 groups, n=90 in each group. 3-D group, the patients received RCFA with 3-D reconstructed valve ring model under Carto3 guidance. 2-D group, the patients received RCFA under conventional X-ray guidance. The procedural and X-ray exposure times, rates of success and complications, tachycardia recurrence at 6 months after procedure and the cost were observed and compared between 2 group.
Results: The procedural time was similar between 2 groups, P=0.1403. The patients in 3-D group had the lower X-ray exposure time (2.1 ± 0.7 vs 7.8 ± 3.6) min, particularly in those with right-sided accessory pathway (3.4 ± 0.7 vs 20.2 ± 7.1) min, and dual atrio-ventricular (A-V) nodal pathways (1.1 ± 0.3 vs 5.5 ±1.7) min, all P<0.0001. There was 1 patient in 3-D group without RCFA and all the others were successes. 2-D group had 3 patients with failed RFCA including 2 of right-sided accessory pathway, 1 of dual A-V nodal pathways and received 2nd RCFA under Carto3 guidance. 3-D group had no complication, no recurrence. In 2-D group, 1 patient suffered from complete A-V block (AVB) during ablation and 1-year later, the Holter showed II° to III° AVB;2 patients with recurrence including 1 of dual A-V nodal pathways and had successful 2nd ablation. The cost was higher in 3-D treatment.
Conclusion: RFCA was feasible for treating PSVT patients under Carto3 guidance, which had the higher success rate with lower X-ray exposure and complication.

According to the phenomenon that the curriculum of psychological health education for college students is theoretical,lack of experience and the teaching form is single,this research attempts to private a blended teaching which is based on the small private online course (SPOC) and experiential teaching.The content of mental health is divided into theoretical knowledge and experience knowledge.And the theoretical knowledge is taught through online teaching in the form of massive open online courses (MOOC),while the experiential knowledge is taught by pure experiential teaching in the classroom.The study has summed up 3 stages of learning mode:learning before class,teaching experience and reflection after class.This changes the single classroom theory teaching to students experience learning.Besides,formative evaluation is used as assessment methods,which has enhanced the effectiveness of the course and at the same time,it has also promoted the improvement of teachers' teaching level effectively.

BACKGROUND:In the research on acupuncture treatment for lumbar disc herniation,most acupuncture treatments are performed under CT guidance or without guidance.The precise control of the target site and the effective acupuncture location are not clear. OBJECTIVE:To observe the clinical effects of acupuncture at Jiaji points under ultrasonic guidance in treating lumbar disc herniation. METHODS:A total of 70 cases of lumbar disc herniation,36 males and 34 females aged 18-65 years old,were selected from Chinese PLA General Hospital and Third Affiliated Hospital of Beijing University of Chinese Medicine.They were divided into trial group and control group by random number table method,with 35 cases in each group.The control group received acupuncture at Jiaji points.The trial group received acupuncture at Jiaji points under ultrasonic guidance.The patients were treated once on the day of treatment and 4,7 days after treatment.Visual analog scale score,Oswestry disability index,Japanese Orthopaedic Association score,and MOS 36-Item Short-Form Health Survey(SF-36)were evaluated before and after treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,the visual analog scale scores of both groups were decreased after treatment(P<0.01).Compared with the control group,the visual analog scale scores of the trial group were decreased on days 2,3,6,7 of treatment and 1,2 weeks after the end of treatment(P<0.05,P<0.01).(2)Compared with before treatment,Oswestry disability index after treatment was decreased in both groups(P<0.01).Compared with the control group,Oswestry disability index of the trial group was decreased from days 1 to 7 of treatment and 1,2 weeks after treatment(P<0.01).(3)Compared with before treatment,the Japanese Orthopaedic Association scores of both groups were increased after treatment(P<0.01).Compared with the control group,the Japanese Orthopaedic Association scores of the trial group were increased on days 3,7 of treatment and 1,2 weeks after treatment(P<0.05,P<0.01).(4)Compared with before treatment,SF-36 scores in both groups were increased after treatment(P<0.01).There was no significant difference in SF-36 scores between the two groups after treatment(P>0.05).(5)These results show that acupuncture at Jiaji points has curative effect on lumbar disc herniation,and ultrasonic guidance could improve the clinical curative effect of acupuncture at Jiaji points for lumbar disc herniation.

Objective? To develop the Traditional Chinese Medicine (TCM) nursing skill training program for community nurses and to evaluate its effects based on Kirkpatrick Model. Methods? Totally 83 community nurses from 2 districts of Hangzhou between April and August 2017 were selected using convenient sampling and divided into the control group (n=42) and the observation group (n=41). Community nurses in the control group received conventional training, while community nurses received TCM nursing skill training, and its effects were evaluated in terms of reaction, learning, behavior and result layers based on Kirkpatrick Model. Results? There was no statistically significant difference in general information and student analysis data between the two groups (P＞0.05). The attendance rates of both groups were above 85% after the training, and the total satisfaction, theoretical performance of TCM and skill examination of the observation group scored (95.05±5.32), (79.90± 6.03) and (88.52±2.47), respectively. The scores of self-evaluated behavior and others-evaluated behavior were (44.75±3.58) and (40.15±2.85); and patients＇ satisfaction score was (95.35±3.61), higher than that of the control group (P＜0.05), which was (91.95±4.56). The number of TCM nursing items launched in the departments to which the two groups belonged to was 3.(5 3.00, 4.75) and [3(?2, 4);(P＞0.05)]. Conclusions? The TCM nursing skill training program can benefit community nurses in terms of reaction, learning, behavior and result layers, which is worth promoting in clinical practice.

Objective:To investigate the prevalence of depression symptoms in residents, and to analyze the demographic characteristics, training status and psychological influencing factors in order to provide the evidence for the mental health management and intervention of residents in China at current stage.Methods:A total of 1 050 participants from eight different training centers in Shenyang, Dalian, Jinzhou and Fushun of Liaoning Province were investigated by Pittsburgh sleep quality index, International physical activity questionnaire, Survey of perceived organizational support, Psychological capital questionnaire and Minnesota satisfaction questionnaire, which covered questions including social demographic information, training information, sleep status, physical activity, organization support, psychological capital, job satisfaction and depressive symptoms of residents. SPSS 22.0 were used to carry out statistical analysis such as logistic regression.Results:A total of 962 valid questionnaires were collected and the results showed that 44.59% (429/962) of residents had depressive symptoms. High training grade ( ORPGY-3=1.775, P=0.006) and poor quality of sleep ( OR=1.662, P<0.001) were risk factors of depressive symptoms, whereas psychological capital ( OR=0.962, P<0.001) and job satisfaction ( OR=0.972, P=0.001) were protective factors of depressive symptoms. Conclusion:The prevalence of depressive symptoms is high in residents. Training grade, sleep quality, psychological capital and job satisfaction are closely associated with the high prevalence of depressive symptoms, which should be paid more attention to.

Objective:To analyze the correlation between serum glycated hemoglobin (HbA 1c), γ-glutamyltranspeptidase(γ-GT) and intercellular adhesion factor-1 (ICAM-1) levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular disease. Methods:In this retrospective cohort study, 158 elderly patients who underwent examination and were diagnosed with hyperlipidemia complicated with cardiovascular disease at Beijing Anzhen Hospital Affiliated with Capital Medical University from January to December 2022 were selected as study subjects. The simple mental state scale (MMSE) was assessed in the subjects in combination with the subject′s level of education. Illiteracy≤17 points, primary school≤20 points, middle school and above≤24 points were classified as cognitive impairment group (67 cases), the rest were were classified into the non-cognitive impairment group (91 cases); and another 50 healthy elderly people who received physical examination in the same period were selected as the control group. The blood samples in the three groups were extracted to measure serum HbA 1c, γ-GT and ICAM-1. The correlation between HbA 1c, γ-GT and ICAM-1 levels with cognitive impairment were analyzed. Results:The serum levels of HbA 1c, γ-GT and ICAM-1 in the cognitive impairment group were all significantly higher than those in the non-cognitive impairment group and the control group [5.41%±1.04% vs 4.82%±0.95%, 4.39%±0.86%; (52.01±10.96) vs (41.28±9.23), (25.03±7.17) U/L; (336.61±85.36) vs (286.93±72.53), (143.52±64.20) g/ml], and the MMSE score was significantly lower [(20.19±2.85) vs (25.30±1.24), (27.14±1.56) points] (all P<0.05). Serum levels of HbA 1c, γ-GT and ICAM-1 were all significantly negatively correlated with MMSE score ( r=-0.512, -0.498, -0.563) (all P<0.05). The areas under the receiver operating characteristic curves (AUCs) for serum HbA 1c, γ-GT, and ICAM-1 levels in the assessment of cognitive dysfunction were 0.657, 0.816, and 0.691, respectively (all P<0.05). The optimal cut-off values were 5.115%, 47.65 U/L, and 304.58 g/ml, respectively. Conclusion:Serum HbA 1c, γ-GT and ICAM-1 levels in elderly patients with hyperlipidemia complicated with cardiovascular disease are negatively correlated with cognitive impairment, and have certain value for the evaluation and early diagnosis of cognitive impairment.

Based on the survey on Anhui indigenous medicine and the protection for the traditional Chinese medicine knowledge, we made an analysis and summary for the survey result of Anhui indigenous and special acupuncture techniques in terms of area distribution, types, diseases of treatment, etc. The result shows that though acupuncture and moxibustion are widely applied for all kinds of diseases in most areas of Anhui grassroots regions, they mainly concentrat in major cities like Hefei, Wuhu, Anqing, etc. The techniques are mainly used in orthopedics department and neurology department. They have weighted too much on needling skills, but moxibustion and other special techniques are not paid attention to. We propose that special acupuncture-moxibustion techniques should be promoted, and the relevant training for grassroots medical workers should be developed so as to further enhance their ability to serve grassroots people as well as inherit and innovate the techniques.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.