Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.

Objective:To improve the clinical ability of interns by establishing the evaluation index system focusing on the training of clinical competence, and to construct the performance incentive mechanism based on the index system.Methods:The subjective evaluation method and expert consultation method were used to construct 5 first-class indexes and 15 second-class indexes. And the indexes and score setting were consulted by experts through questionnaires and in-depth interviews.Results:According to the feedback results of expert consultation, the scores of teaching ward-rounds and small lectures in the index system were need to adjust. At the same time, the minimum graduation standards were set to determine whether to participate in the final examination.Conclusion:The scores of teaching ward-rounds and small lectures have been raised, the scores of case discussion lowered, and the final examination scores are not included in the minimum standards. After the establishment of the initial index system, a series of supporting measures, including two-way selection of tutors, postgraduate reexamination, and other policies, have been carried out for performance incentives. At the same time, new teaching methods, student-oriented teaching activities, and formative evaluation have been adopted to actively improve the clinical competence of interns.

China has a large population with accelerating process of population aging.Elderly patients have universal medical needs such as physical function,psychological needs and social needs.Therefore,it is urgent to have a comprehensive understanding of the health status of the elderly population,in order to develop individualized treatment plans for this special group of patients.Comprehensive geriatric assessment(CGA)as the core skill of geriatric medicine is based on four major aspects,including comprehensive medical assessment,physical function assessment,cognitive and emotional assessment,and social and environmental factors assessment.Several domestic and foreign studies have confirmed that CGA score can be used as an independent prognostic factor in elderly B-cell lymphoma patients receiving immunochemotherapy,and can be used to predict the survival outcome of elderly B-cell lymphoma patients.CGA should be promoted and implemented before immunochemotherapy among elderly patients with B-cell lymphoma in China,in the hope to help with the development of accurate treatment strategies and individualized intervention methods for B-cell lymphoma patients over 60 years old in China.

Objective:To investigate the effects of ear holographic tongbian scraping on the constitution, related symptoms and immune function of the population with Qi-deficiency.Methods:From April 2020 to June 2020, 80 subjects judged as Qi-deficiency by the "Traditional Chinese Medicine constitution test" in Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine were recruited offline and online. They were divided into control group and experimental group by random number table method, with 40 cases in each group. On the basis of online health education, the control group received online health education, while the experimental group was given ear holographic tongbian scraping, once a week, 4 times as a course of treatment, a total of 3 courses. Related symptom scores, Qi-deficiency transformation scores, peripheral blood CD4 + proportion, CD8 + proportion, CD4 +/CD8 + ratio were compared between two groups. Results:Totally 38 cases were included in experimental group and 34 cases in control group. After intervention, symptom scores of fatigue, shortness of breath, easy to catch a cold, laziness to speak, low voice and Qi-deficiency transformation scores were 3.26 ± 0.76, 2.92 ± 0.82, 3.08 ± 0.82, 2.66 ± 0.97, 2.71 ± 0.80, 46.16 ± 17.96 in experimental group and 4.12 ± 0.41, 3.76 ± 0.55, 3.50 ± 0.56, 3.65 ± 0.65, 3.18 ± 0.67, 56.88 ± 10.80 in control group, the differences were statistically significant ( t values were -6.02 - -2.51, all P<0.05). Peripheral blood test results also showed that the proportion of CD8 + was 24.76(19.92, 28.23)% in experimental group and 27.19(24.39, 31.57)% in control group, the difference was statistically significant ( Z=-2.25, P<0.05). Conclusions:Ear holographic tongbian scraping can regulate the Qi-deficiency constitution and improve the immune function of people with Qi-deficiency.

Background and objectivePostoperative radiotherapy (PORT) for thymic tumor is still controversial. The object of the study is to evaluate the role of PORT for stage I/II/III thymic tumor.MethodsThe database of Chinese Al-liance of Research for Thymomas (ChART) was retrieved for patients with stage I/II/III thymic tumor who underwent surgi-cal therapy without neoajuvant therapy between 1994 and 2012. Univariate and multivariate survival analyses were performed. Cox proportional hazard model was used to determine the hazard ratio for death.Results 1,546 stage I/II/III patients were identiifed from ChART database. Among these patients, 649 (41.98%) underwent PORT. PORT was associated with gender, histologic type (World Health Organization, WHO), surgical extent, complete resection, Masaoka stage and adjuvant che-motherapy. The 5-yr and 10-yr overall survival (OS) rates and disease-free survival (DFS) rate for patients underwent surgery followed by PORT were 90% and 80%, 81% and 63%, comparing with 96% and 95%, 92% and 90% for patients underwent surgery alone (P=0.001,P<0.001) respectively. In univariate analysis, age, histologic type (WHO), Masaoka stage, complete-ness of resection, and PORT were associated with OS. Multivariable analysis showed that histologic type (WHO)(P=0.001), Masaoka stage (P=0.029) and completeness of resection (P=0.003) were independently prognostic factors of OS. In univari-ate analysis, gender, myasthenia gravis, histologic type (WHO), Masaoka stage, surgical approach, PORT and completeness of resection were associated with DFS. Multivariable analysis showed that histologic type (WHO) (P<0.001), Masaoka stage (P=0.005) and completeness of resection (P=0.006) were independently prognostic factors of DFS. Subgroup analysis showed that patients with incomplete resection underwent PORT achieved the better OS and DFS (P=0.010, 0.017, respectively). However, patients with complete resection underwent PORT had the worse OS and DFS (P<0.001,P<0.001, respectively). ConclusionThe current retrospective study indicated that PORT atfer incomplete resection could improve OS and DFS for patients with stage I/II/III thymic tumor. But for those atfer complete resection, PORT may not help improve prognosis on the whole.

Objective To investigate the Oncomelania hupensis snails spread and its spatio-temporal clustering characteristics in Suzhou City, Jiangsu Province from 2016 to 2023, so as to provide insights into precision control of O. hupensis snails in the City. Methods O. hupensis snail surveillance data in Suzhou City from 2016 to 2023 were collected, and the areas of O. hupensis snail spread and areas of emerging and re-emerging snail habitats were retrieved. The spatial distribution characteristics and clustering types and locations of environments with O. hupensis snail spread were investigated using global and local spatial auto correlation analyses with the software ArcGIS 10.7, and the clustering and cluster areas of O. hupensis snail spread were identified in Suzhou City using spatio-temporal scans with the software SaTScan 10.0.2. Results O. hupensis snail spread covered an area of 677 171 m² in Suzhou City from 2016 to 2023, including 376 230 m² emerging snail habitats and 300 941 m² re-emerging snail habitats. Global spatial autocorrelation analysis showed overall clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023 (Moran’s I = 0.066, P = 0.007), and there were spatial clustering of areas with O. hupensis snail spread in 2019 (Moran’s I = 0.086, P = 0.001) and 2021 (Moran’s I = 0.045, P = 0.003). Local spatial autocorrelation analysis showed clusters of O. hupensis snail spread in Suzhou City from 2016 to 2023, with high-high clusters in Guangfu Township and Dongzhu Street, and the high-high clusters of O. hupensis snail spread were mainly distributed in southwestern Suzhou City. Spatio-temporal scans identified two clusters of areas with O. hupensis snail spread and areas of re-emerging snail habitats in Suzhou City from 2016 to 2023, with large clustering areas found in Guangfu Township, Dongzhu Street, Tong’an Township and Wangting Township [relative risk (RR) = 22.34, log likelihood ratio (LLR) = 163 295.32, P < 0.001] and small clustering areas in Xukou Township, Mudu Township and Xiangshan Street (RR = 2.73, LLR = 921.92, P < 0.001). Conclusions There was spatial clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023. Improved quality of O. hupensis snail control and intensified management of environments at a high risk of O. hupensis snail spread are recommended in Suzhou City.

Objective To understand the current situation of patients with advanced schistosomiasis in Suzhou, and to provide a basis for scientific management, medical assistance, and improvement of patients' quality of life. Methods Questionnaire survey, physical examination and B-ultrasound examination were performed on the registered patients with advanced schistosomiasis. The diagnosis and classification were carried out according to the “Schistosomiasis Control Manual”. The epidemiological and clinical characteristics, disease classification, and medical and financial assistance of all existing patients were analyzed. Results There were 2 420 cases of advanced schistosomiasis in Suzhou. Their distribution was highly correlated with the cumulative area of oncomelania snails and the cumulative number of schistosomiasis patients in each district (county) (r=0.949, P<0.01; r=0.946, P<0.01). There were 845 males and 1 575 females. The highest proportion of male patients was found in Suzhou Industrial Park and the lowest in Kunshan (χ²=26.591, P<0.001). The average age of patients was (76.80±7.55) years old, and the age of female patients were higher that of male patients (F=72.01, P<0.001). The splenomegaly type was the most common (2 165), ascites type was the second (198), colonic proliferative type was the third (55), and pygmy type was the least (2). A total of 895 patients were cured and 1 337 patients were improved, while 188 patients were not cured. The condition of advanced schistosomiasis patients with different clinical types was different (χ² =226.034, P<0.001), and the condition of patients with ascites was the worst. 1 438 patients' labor level was reduced, and 540 patients lost their labor ability, while only 442 patients were normal. Age increase (β=0.012，P<0.001), clinical classification being ascites type (β=0.346，P<0.001) and need for treatment (β=0.298，P<0.001) were risk factors for the loss of labor ability in patients with late schistosomiasis. The stable condition of the disease (β= -0.089，P=0.001) was a protective factor. Conclusion There are a large number of advanced schistosomiasis cases in Suzhou, and the epidemiological characteristics of advanced schistosomiasis patients in different districts (cities) are different. The relief work of advanced schistosomiasis in Suzhou should focus on the historical heavy epidemic areas, strengthen the nursing care of the elderly patients, and pay attention to the quality of life of patients with ascites. It is also important to strengthen the follow-up nursing of patients with splenomegaly to avoid turning into ascites. All districts and counties should be guided by the characteristics of local patients and formulate targeted scientific management methods and rescue policies to improve the quality of life of patients.