Objective To investigate the status of community type 2 diabetic patients with peripheral arterial disease,analyze the influencing factors and put forward nursing countermeasures.Methods 210 type 2 diabetic patients living in a community in Shanghai were enrolled in the investigation.ABI and arterial peak velocity were measured using Doppler blood flow detector,symptoms and signs of foot were assessed and related laboratory examinations,including HbA1c,HDL-C,LDL-C were tested.Results There were 49 cases of ABI ＜ 0.9.The proportion of abnormal color of foot skin,edema,abnormal pulsation of dorsal artery of foot and sense of coldness in group of ABI ＜ 0.9 were larger than group of ABI≥0.9.There was no statistical significance between the two groups in the pain at rest and intermittent claudication.Logistic stepwise regression analysis showed that age and LDL-C not up to the standard were risk factors of PAD and the peak of foot dorsal artery flow was a protective factor of PAD.Conclusions It's important to early screen for PAD and to adopt corresponding nursing measures on the basis of treatment.We hope to further prevent the development of PAD and effectively prevent diabetic foot.

Objective To investigate the insulin injection-related knowledge of the registered nurses in first-class general hospitals in Shanghai and look into its influence factors. Methods Totally 331 nurses in the hospitals were enrolled in this study. Univariate and multivariate stepwise regression were used to analyze the factors which influenced the insulin injection-related . Results The aggregate score of insulin injection-related knowledge was 54.20 ± 7.64, and the score index was 67.75%. Multiple linear regression analysis showed that such factors as professional title and nursing experience and training in the endocrinology department were the main factors of insulin injection-related knowledge (all P<0.05). Conclusion We should enhance the training to promote the injection skills so that they can assist the patients to effectively control blood sugar and improve the quality of life.

Objective To investigate the status of risk population of diabetic foot in community and analyze the influencing factors.Methods 210 diabetes patients living in a community in Shanghai were enrolled,acoording to Gavin's weighted integral method with risk factors of diabetic foot,Doppler blood flow detector,Semmes Weistein 5.07 (10 g) nylon monofilament and 128Hz tuning fork were used to screen for the risk population of diabetic foot.Results Risk population of diabetic foot were 174 patients (82.9％),wherein the low risk group were 112 patients (53.4％),in the middle and high risk group were 62 people (29.5％).In addition to the Gavin's diabetic foot risk factors,different ages,cultural degrees,the values of FBG,PBG and HbAlc would also affect the risk level of diabetic foot.While the values of FBG,PBG and HbAlc of diabetes patients in the moderate and high risk group were significantly higher than those in the normal group.Conclusions We should make early screening for risk factors of diabetic foot and strengthen health education and management in order to effectively prevent diabetic foot.

Objective To investigate the applicability of Bakes Caregiving Outcom Scale(BCOS) in the study of primary family caregivers'burden of stroke survivors. Methods The BCOS was used to inves-tigate the 180 primary family caregivers of stroke survivors.The applicability of BCOS was evaluated by in-ternal consistency,construct validity and criterion-related validity. Results The correlation coefficient be-tween the items and the total BCOS score was 0.408～0.725 (P ＜ 0.01 ).The total Cronbach's α was 0.877.Factor analysis used for examining the construct validity showed that 3 components were extracted and their accumulated contribution rate reached 60.93%.Factor loading of each item ranged from 0.510 to 0.875.The criterion-related validity was - 0.461 by using self-rated burden as a criterion(P ＜ 0.01 ). Conclusions BCOS is applicable in the evaluation of the primary family caregivers' burden of stroke survivors.

BACKGROUND:Cobalt chloride (CoCl2) may promote the proliferation of human umbilical cord-derived mesenchymal stem cels (hUC-MSCs) in a time- and concentration-dependent manner, and meanwhile, CoCl2 can regulate the expression of genes and proteins in hUC-MSCs. OBJECTIVE:To explore the effects of CoCl2 induced-hypoxia on the proliferation of hUC-MSCs and gene and protein expressions in hUC-MSCs, thereby establishing an effective method for MSCs culture and amplificationin vitro. METHODS: hUC-MSCs were extracted using tissue explant method. Under hypoxia conditions induced by CoCl2 (0, 100, 150, 200, 250 μmol/L) for different periods (0, 1, 2, 3, 4 days), flow cytometry was used to identify cel surface-associated antigens; cel counting kit-8 was used to detect cel proliferation; RT-PCR was used to determine levels of hypoxia inducible factor-1α, inducible nitric oxide synthase, stromal cel-derived factor-1, interleukin-6, transforming growth factor-β mRNA; western blot assay was used to detect protein expression of hypoxia inducible factor-1α. RESULTS AND CONCLUSION:The cels were positive for CD29, CD73, CD90, CD105, while negative for CD31, CD14, CD34, CD45, CD11b, HLA-DR. Moreover, the antigen expression was not affected by CoCl2 induced-hypoxia. CoCl2 induced-chemical hypoxia could promote the proliferation of hUC-MSCs in a time- and concentration-dependent manner. RT-PCR results showed thatunder hypoxia, hypoxia inducible factor 1α, inducible nitric oxide synthase and stromal cel-derived factor-1 mRNA expressions were significantly up-regulated, but interleukin-6 and transforming growth factor-β mRNA expressions were down-regulated significantly (P < 0.05). Additionaly, the protein expression of hypoxia inducible factor 1α was increased under hypoxia conditions. These findings indicate that CoCl2 induced-hypoxia environment may promote the proliferation of hUC-MSCs and the optimal concentration of CoCl2 is 200μmol/L. However, a higher concentration of CoCl2 (≥ 250μmol/L) inhibits the proliferation of hUC-MSCs, and the mechanism may be related to the increase of hypoxia inducible factor-1α at protein and mRNA levels.

The concept and significance of readiness for hospital discharge, measuring tools, application status, shortcomings and prospects of readiness for hospital discharge among patients with chronic diseases were reviewed in this article, with attempts to draw more attention to the readiness for hospital discharge among patients with chronic diseases in clinical practice and provide theoretical basis for forming the intervention plan suitable for China.

Objective To systematically evaluate the risk prediction models of diabetic foot infections,and to ex-plore its implications for clinical nursing care.Methods Relevant studies in the databases of CNKI,VIP,Wanfang,CBM,CINAHL,PubMed,Web of Science,Cochrane Library,Embase,ProQuest,and Ovid were searched for the time-frame of database construction to December 2023.Literature was screened independently by 2 investigators and the area under the model curve(AUC)and its 95％confidence interval(CI),calibration method and predictors were ex-tracted,and the quality of the model was evaluated using the Predictive Modeling Study Risk of Bias Assessment Tool.Meta-analysis of the predictive value of model predictors was performed using RevMan 5.4 software.Results 7 studies were included,containing 8 risk prediction models,all of which reported the AUC(0.748-0.922),and 6 models underwent model calibration.The overall fit of the included studies was good,among which l model was low fit,and all 7 studies were at high risk of bias,mainly focusing on predictors and analysis.Meta-analysis showed that the area under the curve of the combined models was 0.831(95％CI:0.780～0.883);the disease duration(OR=2.460,95％CI:1.850～3.270),vascular disease(OR=3.110,95％CI:1.070～9.000),and neuropathy(OR=3.550,95％CI:1.920～6.560)were effective predictors of diabetic foot infection.Conclusion The current diabetic foot infection risk prediction model is still in the developmental stage,and further optimization and external validation of the ex-isting model is recommended for the future.

Colorectal cancer （CRC） is one of the refractory malignant tumors of the digestive system worldwide. With limitations， the available clinical therapies are usually suspended or show unsatisfactory effect. Therefore， it is urgent to find and develop new candidate drugs specifically targeting the cancer with ideal efficacy， low toxicity， and low cost， and the solutions can be found in traditional Chinese medicine （TCM） which has a long history. In TCM， sovereign， ministry， assistant， and guiding medicinals are selected based on the syndrome differentiation， and it has shown remarkable efficacy on CRC in recent years. In particular， Chinese medicinal compounds and monomers from Chinese medicinals which have been applied in clinical settings are advantageous in the treatment of CRCs， as they improve the quality of life， alleviate clinical symptoms and toxic and side effects of chemotherapy， and prolong the survival of patients. Therefore， we retrieved the English and Chinese articles with "CRC"， "TCM"， "compound" and "monomer" as keywords， and summarized the progress in the treatment of CRC with Chinese medicinal compounds and monomers from Chinese medicinals from four aspects of "replenishing Qi and invigorating spleen"， "clearing heat and removing toxin"， "nourishing liver and kidney"， and "tonifying Qi and nourishing blood". However， Chinese medicine features multiple components， multiple targets， and multiple pathways， and in-depth research should be carried out on the application of Chinese medicinal compounds and monomers from Chinese medicinals in the treatment of CRC， in an attempt to minimize the pain and side effects and maximize the therapeutic effect. This study is expected to provide new insight into the treatment of CRC and a reference for further research on the efficacy and mechanism of Chinese medicine.

Objective:To investigate the role of serum hepatitis B virus RNA (HBV RNA) in predicting HBeAg serological conversion in children with chronic hepatitis B.Methods:175 children aged 1~17 years with chronic hepatitis B who received interferon α (IFNα) for 48 weeks were selected. Patients were divided into HBeAg seroconversion and non-conversion based on whether HBeAg seroconversion occurred at 48 weeks of treatment.T-test and Mann-Whitney U test were used to compare between groups; chisquare test or Fisher exact probability method was used to compare the frequency between groups of classified variables; and Pearson correlation was used to analyze the correlation between indicators. Univariate and multivariate logistic regression analyses were used to identify influencing factors associated with HBeAg serological conversion. The predictive effect of HBV RNA, HBV DNA, and HBsAg on HBeAg serological conversion was compared and analyzed by the receiver operating characteristic curve (ROC).Results:The seroconversion rate of HBeAg at 48 weeks was 36.0% (63/175). The reduction in HBVRNA levels from baseline to the 12th, 24th, 36th, and 48th weeks of antiviral therapy was significantly greater in the HBeAg serological conversion group than that in the non-conversion group, and the difference was statistically significant between the two groups (P < 0.05). Univariate and multivariate regression analyses showed that age and a decline in HBV RNA levels at week 12 were independent predictors of HBeAg serological conversion. The area under the ROC curve (AUROC) of HBV RNA decline at week 12 was 0.677(95% CI∶0.549-0.806, P = 0.012), which was significantly better than the same period of AUROC of HBV DNA (0.657, 95% CI∶0.527-0.788, P = 0.025) and HBsAg (0.660, 95% CI∶0.526-0.795, P = 0.023) decline. HBV RNA levels decreased (>1.385 log10 copies/ml) at week 12, with a positive predictive value of 53.2%, a negative predictive value of 72.2%, a sensitivity of 77.4%, and a specificity of 57.9% for HBeAg seroconversion. Conclusion:HBV RNA level lowering during the 12th week of antiviral therapy can serve as an early predictor marker for HBeAg serological conversion in children with chronic hepatitis B.

Objective? To construct the "Internet +" based health management model for physical examination population. Methods? From September 2016 to September 2017, we constructed the primary"Internet +" health management model by literature review. Two rounds of consultation with 25 experts were carried out with the Delphi method to construct the "Internet +" health management model for physical examination population. Results? Among two rounds of consultation, the recovery rate of questionnaire was all 100%. The expert authority coefficient (Cr) was 0.87. The final "Internet +" health management model included 3 first-level indicators, 7 second-level indicators and 26 third-level indicators. Conclusions? The "Internet +"based health management model is reliable which can be intervention for health management model of physical examination population.