Objective:To understand the relationship between pain, negative emotions (anxiety and depression), insomnia and fatigue in patients with rheumatoid arthritis, and explore the multiple mediating effects of negative emotions and insomnia on pain and fatigue.Methods:A total of 240 patients with rheumatoid arthritis were selected from Northern Theater General Hospital from October 2018 to January 2019. The general questionnaire, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire,Visual Analogue Scale,The Hospital Anxiety and Depression Scale and the Asens Insomnia Scale were used to investigate the demographic data, fatigue, pain, anxiety, depression, and insomnia, respectively. SPSS 20.0 was used for correlation analysis, and Mplus 7.0 was used for mediation analysis.Results:The fatigue score of patients with rheumatoid arthritis was (28.88±14.89), which was moderate. The score of Visual Analogue Scale was 4(2-7), the score of insomnia was 7(3-11), the score of anxiety was 5(3-8), the score of depression was 7(4-11). There was a positive correlation between fatigue and pain, negative emotion and insomnia ( r values were 0.432-0.950, P<0.01). Negative emotions and insomnia had a partial mediating effect between pain and fatigue, with mediating effects accounting for 56.44% of the total effect. Conclusions:The fatigue of patients with rheumatoid arthritis is moderate; fatigue is associated with pain, negative emotions, and insomnia; negative emotions and insomnia have multiple mediating effects between pain and fatigue.

Objective To investigate the effects of type 2 diabetes on learning and memory of APP/PS1/Tau triple transgenic (3 × Tg) mice of Alzheimer’s disease, and the protective mechanism of liraglutide (LIR) thereof. Methods One month old C57BL/6 mice were set to be control group (WT). One month old 3×Tg mice were divided into control group (Tg), liraglutide group (Tg+LIR), type 2 diabetes group (Tg+T2DM) and liraglutide treatment group (Tg+T2DM+LIR). The model of T2DM was established by feeding the high fat and sugar fodder, and then injecting streptozotocin (STZ) in mice, making sure the fasting blood glucose was more than 7 mmol/L. Then the subcutaneous injection of LIR was administered for 2 months. The values of body weight and fasting blood glucose were detected at age of 5-month. Morris water maze was applied to evaluate the spatial learning and memory ability. Western blotting assay was used to measure the levels of phosphorylated Tau, neurofilament (NFs) and insulin receptor substrates. ELISA was used to detect the human Aβ42 to evaluate the effect of LIR on-amyloid. Results LIR can reduce body weight and blood glucose, can alleviate spatial learning and memory damaging caused by T2DM, and also can improve phosphorylated Tau levels, NFs and insulin receptor substrates caused by T2DM, and finally can reduce the deposition ofβ-amyloid of 3 × Tg mice. Conclusion T2DM can aggravate symptoms of AD in 3×Tg mice, and LIR has a protective effect on it.

Objective To investigate the clinical significance of detecting cardiac troponin Ⅰ (cTnⅠ) and CK -MB in children with hand-foot-and-mouth disease and myocardial injury.Methods 90 children with hand-foot-and-mouth disease (observation group) were detected the level of serum cTnⅠ and CK-MB.At the same time,40 healthy children were chosen as control group.Results Compared with the control group,the levels of CK-MB and cTnl in observation group were significantly higher than those of the control group (t =8.92,5.46,all P ＜ 0.01),which indicated that children with hand,foot and mouth disease was easier to merge myocardial injury.CK-MB and cTnl levels in high-risk group were significantly higher than those in normal children group (t =9.17,6.13,all P ＜ 0.01),and the levels of CK-MB and cTnl were positively correlated with severe degree (r =0.767,0.683,all P ＜ 0.01).For children with hand,foot and mouth disease merged myocarditis,cTnl diagnostic sensitivity (53.8％) was lower than that of CK-MB diagnostic sensitivity (71.8％),but the specificity was better than that of CK-MB,and the diagnosis of cTnl detection window 2 weeks longer than CK-MB,but after 2 weeks both lose their clinical diagnostic significance.Conclusion Children with hand,foot and mouth disease easily merge myocardial damage,dynamic measuring CK-MB and cTnl levels could help early diagnosis of children with hand,foot and mouth disease whether merged myocardial damage,both applications can also complement each other,more timely and accurate reflection of disease progression and recovery,it is worth promoting.

Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children.Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole,amoxicillin and clarithromycin treatment,and 10 d was 1 treatment course.B group was given probiotic pretreatment,prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.In group C,triple therapy before using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece /time,cold water after meals.The clinical therapeutic effects were recorded.Results The helicobacter pylori clearance rate of group A was 55.00%,that of group B was 86.00%,that in group C was 89.00%,the helico-bacter pylori clearance rate of group B and group C was significantly higher than that in group A,the difference was statistically significant (χ2 =23.103 7,28.670 6,all P <0.05).The treatment effect between group B and group C had no statistically significant difference (χ2 =0.411 4,P >0.05 ).In A group,nausea and vomiting occurred in 5 cases,2 cases of diarrhea,abdominal distension abdominal pain in 4 cases,skin rash in 5 cases.In group B,nausea and vomiting occurred in 2 cases,0 cases of diarrhea,abdominal distension abdominal pain in 1 case,skin rash in 1 case.In group C,nausea and vomiting occurred in 1 case,0 cases of diarrhea,abdominal distension abdominal pain 0 cases,skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A,the difference was statistically significant (χ2 =11.965 8,8.000 0,all P <0.05).The incidence rate of ad-verse reactions between group B and group C had no statistically significant difference (χ2 =0.687 3,P >0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance,reduce the triple therapy drug adverse reactions,it is worthy of popularization and application in clinic.

Objective:Use latent class analysis to classify fatigue symptoms in patients with rheumatoid arthritis, and to explore differences in demographic and disease-related characteristics in different fatigue categories.Methods:Convenient sampling was used to select 250 rheumatoid arthritis patients in Northern Theater General Hospital, and the patients were investigated by a general questionnaire and Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire.Results:The symptoms of fatigue in patients with rheumatoid arthritis were divided into 3 categories ( P<0.05). According to the conditional probability of each category, they were named as no or mild fatigue (62, 25.1%), moderate fatigue (113, 45.7%) and severe fatigue (72, 29.1%). Joint pain and use of biological agents were major factors influencing fatigue( P<0.05). Conclusions:Joint pain and the use of biologics affect fatigue in rheumatoid arthritis patients. It is recommended that health caregivers pay attention to patients with high pain scores and not using biologics, and give corresponding nursing interventions according to the degree of fatigue.

Objective:To explore the mediating effect of perceived organizational support on the relationship between personality traits and perceived self-efficacy of male nurses.Methods:A total of 766 male nurses from 20 level-A general hospitals in Shandong province were selected by convenience sampling method in December 2020. The general status questionnaire, the simplified version of Big Five Personality Inventory, the Perceived Organizational Support Scale and the General Self-efficacy Scale were used to investigate them.Results:The total score and average item score of 766 male nurses' sense of organizational support was 44.05±9.31, 3.38±0.72, and the total score and average item score of general self-efficacy was 26.19±5.65, 2.62±0.57. In 766 male nurses, perceived organizational support had a partial mediating effect on neuroticism and openness, with effect values of 21.71% and 10.19%, respectively. In addition, perceived organizational support had a complete mediating effect on conscientiousness and self-efficacy.Conclusions:The organizational support and self-efficacy of 766 male nurses were above average, and organizational support played a mediating role in the relationship between neuroticism, openness, conscientiousness and general self-efficacy.Nursing managers should give more organizational support to male nurses to change the influence of neuroticism, responsibility, agreeableness and open personality traits on self-efficacy, so as to improve the level of self-efficacy of male nurses.

Objective:To understand the differences between the self-rated quality of life (QOL) and caregiver-rated QOL in elderly patients with Alzheimer's disease, and to provide basis for clinical nursing staff to correctly evaluate their QOL.Methods:From May to August in 2019, a total of 150 pairs of elderly patients with Alzheimer's disease and their main caregivers were selected from Department of Neurology of Shandong Provincial Qianfoshan Hospital and Shandong Provincial Hospital as the subjects by convenient sampling method. A face-to-face survey was conducted with the self-designed general information questionnaire for the elderly and their main caregivers, QOL-Alzheimer's Disease Scale (QOL-AD) , Chinese version of the Disability Assessment for Dementia (CDAD) , Montreal Cognitive Assessment (MoCA) , Short version of Geriatric Depression Scale, Geriatric Depression Scale-15 (GDS-15) , Neuropsychiatric Inventory Questionnaire (NPI-Q) , Zarit Burden Interview (ZBI) .Results:150 valid questionnaires were collected.The total score of QOL-AD was (33.40±2.84) , and the total score of caregiver-rated QOL-AD was (31.45±3.44) , the difference was statistically significant ( P< 0.01) ; Age, education level, types of comorbid diseases, cognitive function, depression and burden of care were the main influencing factors of self-rated quality of life ( P< 0.05) ; the relationship between caregivers and the elderly, education level, self-rated health status, daily living ability, neuropsychiatric symptoms and burden of care were the main influencing factors of self-rated quality of life ( P< 0.05) . Conclusions:There are differences between self-rated QOL and caregiver-rated QOL in the elderly patients with Alzheimer's disease. It is suggested to reduce the differences through improving the accuracy of self-assessment and caregiver assessment, so as to improve QOL of the elderly patients with Alzheimer's disease.

Objective:To explore the mediating effect of self-efficacy between personality traits and learning engagement in nursing undergraduates.Methods:In December 2020, 2 170 4-year nursing undergraduates from 6 full-time universities in Shandong Province were selected as the research subject by convenience sampling. The Chinese Big Five Personality Inventory-15 (CBF-PI-15) , the Work Engagement Scale, and the General Self-Efficacy Scale (GSES) were used to conduct a cross-sectional survey. AMOS 17.0 was used to establish the structural equation model.Results:Among 2 170 undergraduate nursing students, the average scores of 5 dimension items of CBF-PI-15 in descending order were agreeableness (3.63±0.87) , sense of responsibility (3.24±0.84) , extroversion (2.58±0.68) , openness (2.56±1.00) , and neuroticism (1.76±1.19) . The total scores of 2 170 nursing undergraduates on the Work Engagement Scale and the GSES were (67.24±11.34) and (29.64±5.47) respectively. The self-efficacy of nursing undergraduates had a partial mediating effect between neuroticism, sense of responsibility, openness personality traits and learning engagement, and the effect values were 42.64%, 30.21%, and 48.67%, respectively.Conclusions:The learning engagement of nursing undergraduates is at the upper middle level. Nursing educators can change the influence of neuroticism, sense of responsibility, and openness personality traits on learning engagement by improving the self-efficacy of nursing students, thereby increasing the level of learning engagement of nursing undergraduates.

Objective:To explore effects of the total number of night shifts on BMI of medical workers in recent 5 years.Methods:This study was a cross-sectional study. Using the convenient sampling method, data of medical workers in Affiliated Hospital of Jining Medical University were collected from January 2016 to December 2020. The medical examination data of medical workers were obtained from the electronic information system of medical examination center, and the number of night shift and basic information of medical workers are extracted from the human resource management department. The covariates in this study included categorical variables and continuous variables. Categorical variables included gender, job title and job type. Continuous variables included age, working years, systolic blood pressure, diastolic blood pressure, white blood cells, red blood cells, hemoglobin, average hemoglobin volume, platelets, ALT, total bilirubin, total protein, albumin, urea, creatinine, uric acid, triacylglycerol, Total cholesterol, HDL-C, LDL-C and glucose. The relationship between the number of night shift and BMI was processed by generalized addition model and smoothing curve fitting.Results:Finally, a total of 908 medical workers were selected for data analysis. The average number of night shifts for 908 medical workers in 5 years was (339.0±30.8) , and the average BMI was (22.88±2.08) kg/m 2. After adjusting for confounding factors, the number of night shift showed a non-linear relationship with BMI, and the number of inflection points was 634. On the left of the inflection point, there was no significant relationship between the number of night shifts and BMI ( P=0.829) . The relationship between the two on the right side of the inflection point was significant, the effect size and 95% confidence interval were 0.02 and 0.01-0.03, respectively. Conclusions:BMI value of medical workers increases significantly with the increase of night shift number when the number of night shift is more than 634 in recent 5 years. Hospital managers can calculate and plan the number of night shifts per year to reduce the effect of night shifts on the health of medical workers.

Objective To study the medication law of postoperative treatment of colorectal cancer by national TCM doctor Professor Piao Bingkui.Methods Professor Piao Bingkui's electronic medical records and paper medical records of colorectal cancer postoperative patients at Guang'anmen Hospital,China Academy of Chinese Medical Sciences and Beijing Yiqingtang Chinese Medicine Clinic were collected and organized from their outpatients from January 1st,2002 to February 28th,2022.R4.2.1 was used to study the prescriptions,including high-frequency drugs,drug types,properties of Chinese materia medica,yin yang and five elements and dosage of drugs,as well as the law of multi-drug association in postoperative patients with colorectal cancer.Results Totally 642 colorectal postoperative cancer patients were included,involving 2 226 prescriptions,180 kinds of Chinese materia medica,and a total frequency of 39 988 times.The high-frequency drugs were Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,etc.The main drugs in terms of efficacy were tonics for tonifying deficiency,disinfectants,etc.;the main properties were warm and neutral,the main tastes were sweet,pungent and bitter,and the main meridians were spleen meridians and stomach meridians.Ascending medicines were often used,and the drug were basically non-toxic.The frequency of using yang tonifying medicine was high,and the five elements were commonly used as local medicines;the dosage was mostly 10,15 and 20 g.The complex network analysis and clustering analysis of the association between multiple drugs found that Professor Piao Bingkui's basic prescription for treating colorectal cancer included Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,salt Alpiniae Oxyphyllae Fructus,Citri Reticulatae Pericarpium,Smilacis Glabrae Rhizoma,Pseudostellariae Radix,and fried Atractylodis Macrocephalae Rhizoma with wheat bran.Conclusion In the treatment of colorectal cancer,Professor Piao Bingkui focuses on reinforcing the healthy qi,nourishing spleen and stomach function,combined with detoxication method and clearing heat,expelling phlegm and dampness,guiding stagnation and dispelling stasis methods,making syndrome differentiation as well as tonifying and benefiting qi,regulating qi movement,so as to realize the"treating middle-energizer as balance"and achieve mild level when treating colorectal cancer.