Objective To investigate clinical effect of fluvastatin in the treatment of early diabetic nephropa-thy,to provide a reference for clinical treatment.Methods 90 patients with diabetic nephropathy were selected,the patients were divided into observation group(50 cases)and control group(40 cases).Conventional hypoglycemic ther-apy used in the control group,and valsartan treatment also used.The observation group received fluvastatin on the basis of treatment of control group.The efficacy,urinary albumin excretion rate,inflammatory markers,serum creatinine and other indicators and adverse reactions were compared.Results The effective rate of the observation group was 90.00%,which was significantly higher than 75.00% of the control group,the difference was statistically significant (χ2 =4.325,P <0.05).After treatment,the BUN,UAER,TC,TG,LDL of the observation group were (6.54 ± 1.24)mmol/L,(40.43 ±4.21)μg/min,(3.81 ±0.47)mmol/L,(2.51 ±0.34)mmol/L,(2.41 ±0.64)mmol/L, the improvement was better than the control group,the differences were statistically significant (t =5.547,5.225, 5.457,4.957,5.339,all P <0.05).After treatment,the CRP,IL -6,IL -18,TNF -αin the observation group and control group were significantly improved compared with before treatment,the differences were statistically significant (P <0.05 ).After treatment,the CRP,IL -6,IL -18,TNF -αlevels of the observation group were (4.14 ± 0.87)mg/L,(88.17 ±8.54)pg/mL,(139.64 ±9.48)ng/L,(40.17 ±5.22)ng/L,the improvement was better than the control group,the differences were statistically significant (t =6.914,6.357,5.847,7.054,all P <0.05 ). Conclusion Fluvastatin in the treatment of early diabetic nephropathy has good effect,which will help to improve inflammatory cytokines and proteinuria and protect renal function,it is worthy of clinical application.

Objective:To systematically integrate qualitative studies of impediments to help-seeking behavior in victims of elder abuse.Methods:A computer search of PubMed, the Cochrane Library, Web of Science, PsyINFO, Scopus, China Biology Medicine disc, China Knowledge Network, Vipshop, and Wanfang was conducted to collect qualitative studies on help-seeking in abused older adults, with search time from establishment of the database to February 2022. The literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care quality assessment criteria, and the results were integrated using the Meta integration method.Results:A total of 9 papers were included, 32 results were extracted and grouped into 9 categories, and 3 integrated results were synthesized including the role of personal factors, the influence of cultural values, and the lack of effective support networks.Conclusions:Seeking help after elder abuse is a complex process influenced by a variety of personal, social and cultural factors. Awareness of seeking help after abuse should be raised, attention should be paid to the physical and mental health of the elderly, and professional assistance and counseling services should be provided.

Objective:To investigate the spiritual health status of nurses in elderly care institutions, analyze the potential categories of spiritual health of nurses in elderly care institutions and explore the influencing factors of different categories.Methods:This study was a cross-sectional survey. From April to July 2022, 352 nurses from 15 elder care institutions in Shandong province were selected to conduct a questionnaire survey on demographic characteristics and spiritual health. Potential profile analysis was used to identify different spiritual health categories, and one-way ANOVA and ordered logistic regression were used to test the differences in population characteristics.Results:There were group heterogeneity in the spiritual health of nurses in elderly care institutions, which were divided into "high level stable type" (34.66%), "medium level type" (44.89%) and "low self transcendence type" (20.45%). Ordered logistic regression showed that age ( OR = 1.054, OR 95% CI: 1.031-1.078, P<0.01), self-assessment health ( OR = 3.034, OR 95% CI: 1.478-6.221, P<0.01), and spiritual learning and training experience ( OR = 2.221, OR 95% CI: 1.370-3.600, P<0.01) were protective factors of spiritual health. Single parent families ( OR = 0.018, OR 95% CI: 0.002-0.197, P<0.01) and working 12 to 16 hours a day ( OR = 0.029, 95% CI: 0.009-0.091, P<0.01), working more than 16 hours a day ( OR = 0.046, 95% CI: 0.018-0.119, P<0.01) were risk factors for spiritual health. Conclusions:There are three potential categories of nurses′ spiritual health in the elderly care institutions, and different categories of nurses have different characteristics. Institutional managers should carry out targeted interventions according to different characteristics to improve their spiritual health.