Objective To investigate diabetes specialist nurse training mode and clinical practice conditions in Shandong Province,explore the main factors influencing clinical practice of diabetes specialist nurses,gradually improve diabetes specialist nurses training and application.Methods A total of 232 nurses with diabetes specialist nurses certificates in Shandong Province were carried out with the questionnaire about geneal information,training model,clinical practice conditions by convenient sampling method.Results Diabetes specialist nurse training mode in Shandong Province had achieved remarkable results.The total scores of practical skills were (54.64 ± 9.46),in which the scores of clinical nursing dimension were (12.99 ± 2.90),at top level.By using multivariate linear regression analysis,achiuement in scientific research,assessment form of clinical nursing and sources of training teachers were the ninfluential factors of clinical practice of diabetes specialist nurses.Conclusions It would play a positive stimulating effect in bringing diabetes nurse specialist into full play if we gave diabetes specialist nurse systematic and standardized training,a good learning and communication platform,and effective support system.

Objective:To investigate the effect of doctor-nurse-patient collaborative nursing mode on long-term self-management ability and cardiovascular events of patients after percutaneous coronary intervention (PCI).Methods:Totally 160 patients who received PCI from the department of cardiology of the First Affiliated Hospital of Chengdu Medical College were randomly assigned to control group ( n=80) and experimental group ( n=80). The traditional nursing model was adopted in the control group. However, the nursing mode of doctor-nurse-patient collaborative was adopted in experimental group. The self-management ability and cardiovascular events in patients after PCI at 6 months and 12 months in two groups were both measured by chronic disease management software, self-behavioral management scale, Minnesota Living Scale, self-made medical care work assessment scale and self-made satisfaction questionnaire. Results:The rates of adverse habits management, symptom management, emotional cognition, emergency management, disease knowledge management, general life management, and therapy compliance management in the experimental groups, 6 months after operation, were 96.3%(77/80), 73.8%(59/80), 80.0%(64/80), 91.3%(73/80), 85.0%(68/80), 81.3%(65/80), respectively. In the control group, the above indexes were 85.0%(68/80), 56.3%(45/80), 62.5%(50/80), 75%(60/80), 75%(60/80), 65%(52/80). The difference between the two groups was statistically significant ( χ 2 value was 5.375-7.530, P<0.05). In the experimental group, 12 months after PCI, the rates of the above indexes were 91.3%(73/80), 78.8%(63/80), 82.5%(66/80), 93.8% (75/80), 87.5%(70/80), 86.3%(69/80), 93.8%(75/80). While, the ratios in the control group were 77.5%(62/80), 52.5%(42/80), 66.3%(53/80), 78.8%(63/80), 66.3%(53/80), 65.0%(52/80), 75.0%(60/80), there was significantly difference between two groups ( χ 2 value was 5.542-12.218, P<0.05). Furthermore, there were 12 and 38 cases of cardiovascular events at 6 months and 12 months after operation, and 28 and 60 cases in the control group, respectively. Meanwhile, the number of re-hospitalizations events in experimental group were 13, and 27 in the control group, after 12 months operation, there was significantly difference between two groups( χ 2 value was 8.533,12.745, 6.533, P<0.05). The quality of life scores and medical work quality score in the experimental group in different months were 31.26±8.39 (6 months), 26.39±4.76 (12 months), 77.44±8.21 (6 months) and 71.50±5.73(12 months), respectively. However, the scores in the control group were 40.51±8.38, 35.39±4.89, 65.90±5.62, 63.55±5.62, there was significant difference between two groups ( t value was -10.373-11.804, P<0.01). And the overall satisfaction of patients in the experimental group [96.3%(77/80)] was significantly higher than the control group [85.0% (68/80)]. The difference between the two groups was statistically significant ( χ 2 value was 5.959, P<0.05). Conclusion:The doctor-nurse-patient collaborative nursing mode can improve the long-term self-management ability, reduce the occurrence of cardiovascular events and the number of re-hospitalizations in patients after PCI, and improve the quality of life and satisfaction of patients.

OBJECTIVE: To explore the pathogenesis of two siblings (including a fetus) from a pedigree affected with Joubert syndrome. METHODS: Peripheral blood samples of the proband and his parents as well as amniotic fluid and abortion tissues of the fetus were collected. Part of the samples were used for the extraction of DNA, and whole exome sequencing (WES) was carried out to screen potential variants in the proband and his parents. Suspected variants were subjected to bioinformatics analysis with consideration of the clinical phenotype, and were verified by Sanger sequencing of the proband, fetus and their parents.The remainders were used for the extraction of RNA, and the mechanism of splicing variant was validated by reverse transcription-PCR (RT-PCR). RESULTS: WES showed that both patients have carried c.175C>T (p.R59X) and c.553+1G>A compound heterozygous variants of the TMEM237 gene. Among these, c.175C>T was a nonsense mutation inherited from the asymptomatic mother, while c.553+1G>A was an alternative splicing mutation inherited from the asymptomatic father. RT-PCR showed that this variant has resulted in aberrant splicing by exon skipping. CONCLUSION The compound heterozygous variants of the TMEM237 gene probably underlay the etiology of Joubert syndrome in this pedigree. Above finding has enriched the phenotype and variant spectrum of the TMEM237 gene, and facilitated genetic counseling and prenatal diagnosis for the family.
Abnormalities, Multiple/genetics* ; Cerebellum/abnormalities* ; Eye Abnormalities ; Female ; Genotype ; Humans ; Kidney Diseases, Cystic ; Mutation ; Pedigree ; Phenotype ; Pregnancy ; Retina/abnormalities*

To provide basis for prevention and treatment by analyzing the clinical features, emotional and cognitive states and their correlations of idiopathic tinnitus. Cross-sectional study was used. Thirty-six right, 44 left, and 46 bilateral idiopathic tinnitus patients diagnosed in Beijing Tongren Hospital were prospectively enrolled from October, 2020 to February, 2022. The clinical data was recorded and the THI, DBI, STAI, and MoCA were evaluated. The clinical features and the incidence of severe tinnitus, hearing lose, anxiety, and cognitive impairment were compared by one-way ANOVA, Kruskal-Wallis H, and chi-square test. The correlation between tinnitus or hearing and emotional and cognitive states were evaluated by multivariable correlation analysis. There was no significant difference in age, BMI, years of education, tinnitus duration, and the incidence of hearing loss among groups ( F=0.730, P=0.484; F=1.535, P=0.219; F=1.506, P=0.226;χ2=4.242, P=0.120;χ2=6.672, P=0.083). In right, left, and bilateral tinnitus patients, the number of severe tinnitus was 12, 7, and 20 cases and the incidence was 33.3%, 15.9%, and 43.5%; the number of depression was 13, 14, and 26 cases and incidence was 36.1%, 31.8%, and 53.5%; the number of trait anxiety was 3, 2, and 10 cases and the incidence was 8.3%, 4.5%, and 21.7%. Compared with left tinnitus patients, the incidence of severe tinnitus, depression, and trait anxiety was higher in bilateral tinnitus patients (χ2=8.139, P=0.004;χ2=5.558, P=0.018;χ2=5.753, P=0.007). The incidence of state anxiety and cognitive impairment were no significant difference among groups (χ2=0.142, P=0.931;χ2=1.338, P=0.512). The overall incidence of state anxiety and cognitive impairment were 16.7%(21/126) and 37.3%(47/126) respectively. There was positive correlation between THI score and BDI, S-AI, and T-AI scores ( r=0.529, P=0.001; r=0.649, P<0.001; r=0.483, P=0.003) and negative correlation between THI and MoCA scores ( r=-0.364, P=0.029) in right tinnitus group. The positive correlation was found between THI score and BDI, S-AI, and T-AI scores in left tinnitus group ( r=0.508, P<0.001; r=0.506, P<0.001; r=0.357, P=0.017). The positive correlation between THI score and BDI, S-AI, and T-AI scores ( r=0.753, P<0.001; r=0.527, P<0.001; r=0.536, P<0.001) and the positive correlation between tinnitus duration and MoCA score( r=0.334, P=0.023) were also found in bilateral tinnitus group.

To provide basis for prevention and treatment by analyzing the clinical features, emotional and cognitive states and their correlations of idiopathic tinnitus. Cross-sectional study was used. Thirty-six right, 44 left, and 46 bilateral idiopathic tinnitus patients diagnosed in Beijing Tongren Hospital were prospectively enrolled from October, 2020 to February, 2022. The clinical data was recorded and the THI, DBI, STAI, and MoCA were evaluated. The clinical features and the incidence of severe tinnitus, hearing lose, anxiety, and cognitive impairment were compared by one-way ANOVA, Kruskal-Wallis H, and chi-square test. The correlation between tinnitus or hearing and emotional and cognitive states were evaluated by multivariable correlation analysis. There was no significant difference in age, BMI, years of education, tinnitus duration, and the incidence of hearing loss among groups ( F=0.730, P=0.484; F=1.535, P=0.219; F=1.506, P=0.226;χ2=4.242, P=0.120;χ2=6.672, P=0.083). In right, left, and bilateral tinnitus patients, the number of severe tinnitus was 12, 7, and 20 cases and the incidence was 33.3%, 15.9%, and 43.5%; the number of depression was 13, 14, and 26 cases and incidence was 36.1%, 31.8%, and 53.5%; the number of trait anxiety was 3, 2, and 10 cases and the incidence was 8.3%, 4.5%, and 21.7%. Compared with left tinnitus patients, the incidence of severe tinnitus, depression, and trait anxiety was higher in bilateral tinnitus patients (χ2=8.139, P=0.004;χ2=5.558, P=0.018;χ2=5.753, P=0.007). The incidence of state anxiety and cognitive impairment were no significant difference among groups (χ2=0.142, P=0.931;χ2=1.338, P=0.512). The overall incidence of state anxiety and cognitive impairment were 16.7%(21/126) and 37.3%(47/126) respectively. There was positive correlation between THI score and BDI, S-AI, and T-AI scores ( r=0.529, P=0.001; r=0.649, P<0.001; r=0.483, P=0.003) and negative correlation between THI and MoCA scores ( r=-0.364, P=0.029) in right tinnitus group. The positive correlation was found between THI score and BDI, S-AI, and T-AI scores in left tinnitus group ( r=0.508, P<0.001; r=0.506, P<0.001; r=0.357, P=0.017). The positive correlation between THI score and BDI, S-AI, and T-AI scores ( r=0.753, P<0.001; r=0.527, P<0.001; r=0.536, P<0.001) and the positive correlation between tinnitus duration and MoCA score( r=0.334, P=0.023) were also found in bilateral tinnitus group.