Objective:To explore the effect of nursing intervention based on protection motivation theory on medication compliance and quality of life in elderly patients with Parkinson′s disease.Methods:From August 2017 to August 2018, 60 elderly patients with Parkinson′s disease were selected. The patients were randomly divided into the control group ( n = 30) and the intervention group ( n = 30). In the control group, the routine nursing model was adopted, and the intervention group accepted the nursing intervention based on the protection motivation theory. Two groups of patients were investigated by using medication compliance scale and the 39-item Parkinson′s Disease Questionnaire. Results:Three months after the intervention, 86.67%(26/30) of the patients in the intervention group and 33.33%(10/30) of the patients in the control group had good compliance with the drug, and the difference between the two groups was statistically significant ( χ2 value was 17.778, P < 0.05). The total scores of quality of life and scores of physical activity, daily life behavior, mental health, humiliation, social support, cognition, communication and physical discomfort in the intervention group were 26.20±3.12, 4.00±0.76, 4.87±1.19, 2.33±0.72, 1.93±0.17, 2.80±0.86, 4.40±1.12, 2.27±0.80, 3.27±1.10, the scores in the control group were 39.20±2.88, 7.40±1.12, 7.13±0.83, 3.80±0.68, 2.87±0.64, 4.27±0.96, 5.20±0.68, 3.73±0.70, 5.07±0.80, the difference between the two groups was statistically significant ( t value was -2.366-11.849, P <0.05). Conclusion:Nursing intervention based on the protection motivation theory can improve the compliance of elderly patients with Parkinson's disease and their quality of life.

Objective: To explore the effect of nutritional support based on clinical nursing pathway on nutritional status and quality of life among elderly inpatients with Alzheimer disease (AD). Methods: A total of 101 elderly inpatients with AD who met the criteria of the protocol were consecutively enrolled and randomly divided to study group receiving nutritional support based on clinical nursing pathway for two months (n=51) and control group receiving routine nutritional management for 2 months (n=50). Nutritional risk and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and Quality of Life-Alzheimer's Disease Scale (QOL-AD) respectively before and after nutritional support. Results: Baseline data were comparable between the two groups (all P>0.05). After 2-month nutritional support, compared to the control, the incidence of nutritional risk (36.0% vs 17.6%, P=0.037) and undernutrition (26.0% vs 9.8%, P=0.033) decreased significantly in study group. The score of quality of life in study group were significant higher than that of control group (35.73±5.85 vs 30.76±6.14, P=0.023). Conclusion The nutritional support based on clinical nursing pathway is helpful to improve the nutritional status and quality of life in elderly hospitalized patients with AD.

Objective To evaluate the effectiveness of family-centered educational intervention on fall prevention knowledge and attitude,compliance and fall incidence of elderly inpatients. Methods A total of 300 elderly inpatients were selected in a first-class grade A hospital in Beijing and divided into the experiment group and the control group equally.The intervention group was given family-centered educational intervention for 6 months,while the control group was given conventional treatment and care in ward.The knowledge and attitude,compliance and the incidence of falls of elderly inpatients were evaluated at discharge and 3 months,6 months after discharge. Results The knowledge and attitude, compliance of elderly inpatients in the intervention group were significantly better than that in the control group (P<0.05).The incidence of falls in the intervention group was significantly lower than that in the control group at discharge and 3 months,6 months after discharge (P<0.05). Conclusions The family-centered educational intervention can enhance the fall prevention knowledge, attitude and compliance of elderly inpatients effectively and reduce the incidence rate of falls.The long-term effect is relatively obvious.

Objective To observe the effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis. Methods 90 patients with rheumatoid arthritis in our hospital were randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with infliximab and methotrexate. The patients in the observation group were treated with tocilizumab and methotrexate. The patients in the two groups were both treated for 6 months. The clinical efficacy of the two groups was compared after treatment. Before and after treatment, the serum levels of immunoglobulin, Th-1 and Treg of patients in two groups were measured. Results The results showed that after treatment, the situation of morning stiffness, joint pressure pain and joint swelling of the patients in the two groups were improved, and the improvement of morning stiffness, joint pressure pain and joint swelling in the observation group was greater (P<0.05). The levels of IgG and Th1 cells in the serum of patients in the two groups significantly decreased, and the levels of IgG and Th1 cells in the serum of the patients in the observation group were significantly lower than that of the control group (P<0.05). The serum level of Treg cells in the serum of patients in the two groups increased significantly, and the level of Treg in the serum of patients in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Topazumab could effectively improve the clinical symptoms of patients with rheumatoid arthritis, and improve the immune dysfunction of the patients with better clinical efficacy.

Objective To explore the effect of nurse-led intensive nutritional intervention on nutritional risk,undernutrition and quality of life in hospitalized Alzheimer disease (AD) patients.Methods A total of 170 hospitalized AD patients who met the criteria of the protocol were enrolled and divided randomly into two groups as study group (n=86) and control group (n=84).The two groups received nurse-led intensive nutritional intervention and routine nutritional management respectively for six weeks.Nutritional risk,undernutrition and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and quality of life-Alzheimer disease scale before and after the nutritional intervention.Results There was no significant difference in baseline data between the two groups.The suitable rate of NRS 2002 was 100％.After a 6-week intervention,the prevalence of nutritional risk (41.9％ vs.70.9％,P＜0.001) and undernutrition (17.4％ vs.30.2％,P =0.049) decreased significantly in study group.The prevalence of nutritional risk was significantly lower in study group than in control group (41.9％ vs.64.3％,P=0.003).The score of quality of life in study group significantly increased (34.12±5.91 vs.31.56±6.80,P=0.028) after the intervention,and was significantly higher than that of the control group (34.12±5.91 vs.31.63± 6.22,P=0.030).Conclusion The application of nurse-led intensive nutritional intervention can help to improve the nutritional status and quality of life in hospitalized AD patients.

Objective To investigate the correlation between nutritional status in elderly patients with Alzheimer disease (AD) and self-efficacy of their caregivers.Methods Ninety-two elderly patients with AD and 92 their caregivers were enrolled from a Peking Union Medical College in Beijing from March to October 2017,who were evaluated by the mini nutritional assessment short form (MNA-SF) and the general self-efficacy scale (GSES) respectively for the nutritional status of the AD patients and the self-efficacy of their caregivers,and the correlation between them was analyzed.Results The average MNA-SF score of the AD patients was 7.8± 2.5.The incidence of malnutrition risk and malnutrition were 34.8％ and 27.2％ respectively.The MNA-SF score of the AD patients decreased (F =4.589,P =0.009),and the incidence of malnutrition risk (x2 =7.319,P =0.026) and malnutrition (x2 =7.080,P =0.032) increased significantly with the aggravation of AD.The average self-efficacy score of the caregivers was 2.20±0.45.With the aggravation of AD,the GSES score of the caregivers decreased significantly (F=3.122,P=0.016).There was a positive correlation between the nutritional status of the AD patients and the self-efficacy of their caregivers (r =0.254,P =0.022).Conclusion The nutritional status in elderly patients with AD is positively correlated with the self-efficacy of their caregivers,that is,the higher GSES score of the caregiver is,the better nutritional status of the AD patient has.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.

Objective To investigate the impact of nursing interventions based on Kales conceptual model on agitated behaviours of dementia patients.Methods A total of 80 dementia patients were randomly divided into two groups using a random number table.Patients in the control group(n=40)received routine care,while those in the observation group(n=40)received the nursing interventions based on Kales concept model on top of the routine care.The agitated behaviours and quality of life of the two groups were compared before,2 weeks and 4 weeks after the intervention.Results The repeated measures ANOVA showed statistically significant differences in three time points in terms of the time effect,inter-group effect and interactive effects on the scores of agitations and quality of life(all P<0.05).After the intervention,the score of agitations in the observation group was significantly lower than that of the control group(P<0.05),and the score of quality of life in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The nursing interventions based on Kales conceptual model is effective in reducing agitations of dementia patients and improving the quality of life.

Objective:To evaluate the application of mind mapping in combination with scenario simulation teaching based on symptom management theory (SMT) in geriatric symptom nursing education, and to provide a basis for improving the quality of geriatric symptom nursing education.Methods:A total of 80 nursing students who interned in the Department of Geriatric Medicine of Peking Union Medical College Hospital from August 2022 to April 2023 were included in the study. They were divided into control group and experimental group according to the order of enrollment, with 40 students in each group. The control group employed traditional teaching methods, while the experimental group implemented a method of mind mapping in combination with scenario simulation teaching based on SMT. The general data, training assessment results, and teaching quality satisfaction were compared and analyzed between the two groups. SPSS 22.0 statistical software was used for t-test and chi-square test. Results:There were no significant differences between the two groups in general data such as age, gender, educational background, academic performance, and school of study. The experimental group showed higher scores in geriatric symptom nursing theory assessment [(86.57±8.41) vs. (80.83±9.16), P=0.018] and comprehensive skill assessment [(91.26±7.29) vs. (81.92±8.64), P<0.001], as compared with the control group. The experimental group also showed higher scores in teaching process [(24.52±1.56) vs. (20.18±0.98), P<0.001], teaching methods [(24.49±1.72) vs. (20.65±1.02), P<0.001], teaching effectiveness [(24.35±1.19) vs. (20.01±0.86), P<0.001], teaching content [(24.31±1.83) vs. (20.27±1.21), P<0.001], and overall satisfaction [(97.67±2.80) vs. (81.11±2.53), P<0.001]. Conclusions:The method of mind mapping in combination with scenario simulation teaching based on SMT has a significant positive effect on geriatric symptom nursing education. This method can improve the theoretical and comprehensive skill levels as well as the teaching quality satisfaction of nursing interns.

Objective:To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) for Trousseau’s syndrome (TS) in patients with acute multiple cerebral infarctions (AMCI).Methods:The patients with AMCI in Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from July 2013 to March 2022 were retrospectively enrolled. The demographic and baseline clinical data of patients with TS and those without TS were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of TS-AMCI, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR for TS-AMCI. Results:A total of 59 patients with AMCI were enrolled, including 43 males and 16 females, aged 64.9±14.0 years. There were 16 patients in the TS-AMCI group and 43 in the non-TS-AMCI group. The proportions of patients with diabetes mellitus, hypertension and previous stroke or transient ischemic attack in the TS-AMCI group were significantly lower than those in the non-TS-AMCI group (all P<0.05), while the proportion of patients with ischemic heart disease were significantly higher than that in the non-TS-AMCI group ( P<0.05). The proportion of patients with bilateral infarction in the TS-AMCI group was significantly higher than that in the non-TS-AMCI group ( P<0.001). The D-dimer, NLR, white blood cell count, neutrophil count, monocyte count, percentage of neutrophils, total cholesterol and low-density lipoprotein cholesterol in the TS-AMCI group were significantly higher than those in the non-TS-AMCI group (all P<0.001), while the lymphocyte count, lymphocyte percentage, red blood cell count, hemoglobin and hematocrit were significantly lower than those in the non-TS-AMCI group (all P<0.001). Multivariate logistic regression analysis showed that high NLR was an independent predictor of TS-AMCI (odds ratio [ OR] 2.897, 95% confidence interval [ CI] 1.270-6.527; P=0.011), while high hemoglobin was independently negatively correlated with TS-AMCI ( OR 0.839, 95% CI 0.723-0.975; P=0.022). ROC curve analysis showed that the area under the curve of NLR for predicting TS-AMCI was 0.929 (95% CI 0.831-0.979; P<0.001). When the NLR cutoff value was 4.01, the corresponding Youden index was 0.744. At this time, the sensitivity and specificity were 100% and 74.42% respectively. Conclusion:NLR has high predictive value for TS-AMCI.