Objective To investigate the association of nitric oxide(NO)/endothelin-1(ET-1)ratio and low-density lipoprotein(LDL)/apolipoprotein B(ApoB)ratio with early neurological deterioration(END)after acute ischemic stroke(AIS).Methods A retrospective analysis was performed for the clinical data of 108 AIS patients who were admit-ted to Mianyang Hospital Affiliated to University of Electronic Science and Technology School of Medicine&Mianyang Central Hospital from March 2021 to March 2023,and the incidence rate of END within 24 hours after disease onset was analyzed.Laboratory data were collected to calculate NO/ET-1 ratio and LDL/ApoB ratio.A binary logistic regression analysis was used to analyze the influencing factors for END after AIS,and the receiver operating characteristic(ROC)curve was used to investigate the value of NO/ET-1 ratio and LDL/ApoB ratio in identifying END after AIS.Results END was observed in 23 patients,and the END group had significantly lower NO/ET-1 ratio and LDL/ApoB ratio than the non-END group(P<0.05).High NHISS score on admission and diabetes were risk factors for END after AIS(P<0.05),while NO/ET-1 ratio and LDL/ApoB ratio were protective factors(P<0.05).NO/ET-1 ratio and LDL/ApoB ratio had and area under the ROC curve(AUC)of 0.737 and 0.753,respectively,in predicting END after AIS,and NO/ET-1 ratio com-bined with LDL/ApoB ratio had an AUC of 0.900 in predicting END after AIS,suggesting that NO/ET-1 ratio combined with LDL/ApoB ratio had a significantly higher AUC than NO/ET-1 ratio or LDL/ApoB ratio alone(P<0.05).Conclusion The reductions in NO/ET-1 ratio and LDL/ApoB ratio in AIS patients are associated with the onset of END,and the combination of NO/ET-1 ratio and LDL/ApoB ratio has a higher value in predicting END after AIS.

Objective:To explore the path of standardized training and quality supervision for geriatric nursing assistants basing on the three-way linkage of "hospital, government and market".Methods:From January 2019 to December 2020, we conducted standardized training and management for geriatric nursing assistants in 24 nursing institutions for the aged in Mianyang, Sichuan Province in batches. Through the three-way linkage of "hospital, government and market", the whole-process management mode of "standardized training of geriatric nursing assistants, one-to-many tracking service for three months after the training, and service quality supervision of nursing institutions for the aged" has been established. The theoretical and operational achievements of nursing staff before and after training, the service quality of nursing home and the incidence of adverse events before and after the implementation of the project were observed and compared.Results:From 2019 to 2020, a total of 224 geriatric nursing assistants were trained in five sessions. There were statistical differences in the theoretical and operational scores before and after the training ( t=-72.494, -26.150; P<0.01) . 13 nursing institutions participating in the training in 2019 were selected to compare the service quality before and after the project implementation, the difference was statistically significant ( t=-14.575, P<0.01) , and the incidence of nursing adverse events decreased (χ 2=-7.913, P<0.01) . Conclusions:The mode of geriatric nursing assistants training and quality supervision based on the three-way linkage of "hospital, government, market" is conducive to giving full play to the administrative function of the government and the professional function of the hospital, effectively integrating resources and improving the quality of geriatric nursing service in the region.