ObjectiveToinvestigatethecorrelationsofmethylenetetrahydrofolatereductase(MTHFR) gene C677T polymorphism w ith ischemic stroke and hyperuricemia in Chinese Han population in Shandong, China.Methods The patients w ith acute ischemic stroke and age-and sex-matched controls in Chinese Han population in Shandong, China w ere enrol ed. Polymerase chain reaction amplification and microarray hybridization w ere used to detect the MTHFR gene C677T polymorphism, and the serum uric acid concentration w as measured. Results A total of 145 patients w ith acute ischemic stroke and 145 age-and sex-matched controls in Chinese Han population in Shandong, China were enroled. The proportion of diabetes ( 26.90%vs. 6.89%; χ2 = 20.653, P< 0.001 ) and fasting blood glucose ( 5.56 ± 1.57 mmol/L vs.5.01 ±1.11 mmol/L;t= -3.390, P=0.001), homocysteine (median, interquartile range:18.2[16.30-22.55 μmol/L] vs.15.20[12.10-17.85 μmol/L]; Z= -6.323, P<0.001), and uric acid (43.0[361.60-490.45 μmol/L] vs.285.9[267.00-346.25 μmol/L]; Z= -10.360, P<0.001) levels in the ischemia stroke group w ere significantly higher than those in the control group. The distribution frequencies of TT genotype (42.07%vs.15.17%; χ2 =25.673, P<0.001) and T alele (58.28%vs. 34.48%; χ2 =33.008, P<0.001) in the ischemia stroke group w ere significantly higher than those in the control group. Multivariate logistic regression analysis showed that the uric acid (odds ratio [OR] 1.018, 95%confidence interval [ CI] 1.013-1.024; P<0.001), TT genotype ( vs.CT genotype OR 6.774, 95%CI 1.779-25.507; P=0.005), hypertension ( OR 1.919, 95%CI 1.013-3.636; P=0.045), and homocysteine (OR 1.153, 95%CI 1.059-1.258;P=0.001) w ere the independent risk factors for ischemic stroke. The ischemic stroke group w as combined w ith the control group, a total of 101 patients had hyperuricemia, and 189 had normal uric acid. The proportion in patients w ith diabetes ( 32.67%vs. 11.64%; χ2 = 23.749, P< 0.001), as wel as total cholesterol ( 5.67 ±1.56 mmol/L vs.5.10 ± 1.33 mmol/L; t= -3.255, P< 0.001 ) and homocysteine ( 19.50[17.10-24.70 μmol/L] vs. 15.40[12.60-18.05 μmol/L ]; Z= -7.236, P< 0.001 ) levels in the hyperuricemia group w ere significantly higher than those in the normal uric acid group. The distribution frequencies of the TT genotype (55.45%vs.13.76%;χ2 =56.409, P<0.001) and T alele (71.9%vs.32.54%;χ2 =79.561, P<0.001) w ere significantly higher than those in the normal uric acid group. Multivariate logistic regression analysis show ed that the TT genotype ( vs.CC genotype, OR 6.434, 95%CI 2.334-17.736; P<0.001 ), CT genotype ( vs.CC genotype, OR 2.234, 95%CI 1.019-4.898; P= 0.045 ), homocysteine ( OR1.081, 95%CI 1.010-1.157;P=0.024), and total cholesterin ( OR 1.363, 95%CI 1.123-1.653;P=0.002) w ere the independent risk factors for high hyperuricemia. Conclusions MTHFR gene C677T TT genotype and serum uric acid level are the independent risk factors for ischemic stroke in Chinese Han population in Shandong, China. MTHFR gene C677T TT genotype is also an independent risk factor for hyperuricemia in this population. Adjusting dietary habit may have a positive significance for the prevention of ischemic stroke in Chinese Han population in Shandong, China.

Objective To investigate the symptom clusters of gastric cancer patients before chemotherapy,so as to provide a theoretical basis for the development of targeted management strategies.Methods A total of 228 gastric cancer patients who were treated in the General Surgery Department and Oncology Department of the Second Affiliated Hospital of Zhengzhou University from September 2016 to August 2017 were selected as the survey subjects by convenience sampling method.A cross-sectional survey was used to conduct a questionnaire survey.The Chinese Version Memorial Symptom Assessment Scale(MSAS)was used to evaluate the patients' symptoms before chemotherapy.Correspondence analysis was used to extract symptom clusters.Results A total of 228 questionnaires were distributed,and 224 were effective.The effective recovery rate was 98.2％.Before chemotherapy,the 5 most prevalent symptoms of gastric cancer patients were weight loss(97.8％),dry mouth(95.1％),pain(90.6％),sweating(84.4％)and lack of vitality/fatigue(79.5％).The top 5 symptoms of severity were lack of vitality/fatigue,difficult to focus,body swelling/bloating,swelling of the arms or legs and anxiety.Using the correspondence analysis to get 5 symptom clusters,the 5 symptom clusters were the energy deficiency symptom cluster,digestive tract symptom cluster,physical and mental symptom cluster,surgical related symptom cluster and neurological symptom cluster.The Cronbach's α coefficient was 0.95,0.89,0.92,0.93 and 0.87 respectively.Conclusions This study clarified the pre-chemotherapy symptom clusters of gastric cancer patients,and provided a scientific basis for exploring practical and effective methods of symptom management.At the same time,this research can also provide reference for the applicationof correspondence analysis method in the study of cancer symptom clusters.

Objective:To explore the current situation of evidence-based practice competence of nurses with master's degree at Class Ⅲ hospitals in Henan Province and its influencing factors so as to provide a reference for managers to formulate the targeted continuing education plan.Methods:From March 2019 to April 2019, we selected 133 nurses with master's degree of 6 ClassⅢ hospitals in Zhengzhou City of Henan Province as subjects by purposive sampling. All of nurses were investigated with the Chinese version of Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) and the Barriers to Research Utilization Scale. Multiple linear regression was used to analyze the influencing factors.Results:Among 133 nurses with master's degree, the total scores of the EBP-COQ and the Barriers to Research Utilization Scale were (98.57±11.01) and (79.66±20.46) respectively. Multiple linear regression analysis showed that the influencing factors of evidence-based practice competence of nurses with master's degree included the working lives, positional titles, attending evidence-based nursing training, awareness to evidence-based practice, accessibility of research funding and resource conditions of evidence-based nursing ( P<0.05) . Conclusions:Nurses with master's degree in Henan Province have the intermediate level of evidence-based practice competence and positive attitudes to evidence-based practice, but their evidence-based knowledge and skills need to be improved. Nursing managers should pay more attention to evidence-based practice competence training of nurses with master's degree, provide many supportive resources and environments, promote evidence-based practice skills training so as to boost the development of specialist nursing practice.