Objective To investigate the nutritional risk of elderly patients with cardiac dysfunction by nutritional risk screening(NRS2002),and to explore the effectiveness of individualized nutritional intervention. Methods A total of 127 elderly patients with cardiac dysfunction in the Department of Cardiovascular Medicine in Ningbo First Hospital from January to November 2016 were screened for the nutritional risk using NRS2002. A number of 56 patients who may have nutritional risk were randomly divided into the control and observation groups,28 cases respectively. Patients in the control group were given routine nursing,while patients in the observation group received individualized nutritional interventions. Complications including lung congestion and pulmonary infection as well as heart function of patients at the admission and at 2 weeks after the intervention were compared between the two groups. Results There were 56 cases with nutritional risk who had scores more than 3 points among 127 elderly patients with cardiac dysfunction,with a nutritional risk rate of 44.1%. The differences of nutritional risk scores in patients with different heart function classification were statistically significant(P < 0.05). After the intervention,the incidences of complications including alveolar effusion,pleural effusion and pulmonary infection in the observation group were significantly lower than those in the control group(χ2=4.909,4.595,3.903;P<0.05);LVEF and BNP of patients in the observation group were(51.00±2.71)% and(420.68±143.71)pg/ml respectively,which were higher than those in the control group,with statistically significant differences between the two groups(P < 0.05). Conclusions Elderly patients with cardiac dysfunction have high nutritional risk. The individual nutritional intervention is effective on patients with nutritional risk,can improve their cardio-pulmonary function and promote their rehabilitation.

Objective To discuss the application of day surgery management mode in patients with cardiovascular interventional treatment, evaluate the safety of day surgery and its effects on the average in-hospital days and expenses. Methods A total of 1 578 patients who received cardiovascular interventional therapy in the Department of Cardiology in Ningbo First Hospital from January 2015 to December 2016 were included in the study. They were randomly divided into the observation group and the control group, 789 cases respectively. Patients in the control group received normal in-hospital operation mode, while patients in the observation group used day surgery mode. The safety, complications, average in-hospital days and expenses were compared between two groups. Results The average in-hospital days and expenses were 1 d and 3 083 Yuan in the observation group; in the control group, average in-hospital days and expenses were (5.34±0.73) d and (3 713.70±21.06) Yuan, which were significantly higher than those in the observation group (P<0.05). There were 5 cases of bleeding in the puncture site of the radial artery, 9 cases of forearm hematoma, and 1 case of Iodine allergic reaction with a complication incidence of 1.9% in the control group. In the observation group, there were 3 cases of bleeding in the puncture site of the radial artery, 6 cases of forearm hematoma, and 2 cases of Iodine allergic reaction with a complication incidence of 1.4%. No significant difference in the complications of patients was observed between two groups (P>0.05). Conclusions The day surgery mode of patients with cardiovascular interventional treatment, which can ensure the therapeutic effect and the safety of patients, is feasible and can reduce the average in-hospital days and expenses.

Objective? To explore the effects of symposium involving patients and their family members on health education in patients with acute myocardial infarction after percutaneous transluminal coronary intervention (PCI). Methods? Totally 86 patients with acute myocardial infarction receiving PCI in Ningbo First Hospital from January 2017 to June 2018 were selected continuously and divided into the control group (n=43) and the observation group (n=43). Patients in the control group received conventional health education which combined oral education and education manuals, while patients in the observation group symposium-based health education which involved both patients and their family members on the basis of conventional education after PCI. Both groups received health education for 4 weeks. Health knowledge about acute myocardial infarction, rehabilitation initiative, postoperative complication and satisfaction with overall nursing were compared between the two groups before and after intervention. Results? The health-related knowledge of the patients with acute myocardial infarction in the observation group 4 weeks after intervention scored (94.3±4.0), higher than that of the control group, which was (78.4±5.1), and there was statistically significant difference (t=8.285, P＜ 0.05). The scores of five dimensions of rehabilitation initiative (coordination with therapy, compliance, needs for rehabilitation, emotions post frustration and encouragement from family members and nurses) of the observation group were higher than those of the control group (t=4.726, 5.114, 3.975, 7.116, 5.893; P＜0.05). The incidence rate of postoperative complication in the observation group was 9.30%, lower than that of the control group, which was 30.23%, and there was statistically significant difference (χ2=5.939, P＜0.05). The nursing satisfaction of the observation group was 96.73%, higher than that of the control group, which was 83.78%, and there was statistically significant difference (χ2=4.904, P＜0.05). Conclusions? The symposium involving patients and their family members for patients with acute myocardial infarction after PCI can improve the patients' disease-related knowledge, satisfaction with overall nursing and rehabilitation initiative, and reduce the postoperative complications effectively.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.