Frailty syndrome, caused by degenerative changes in the body and the body vulnerability due to a variety of chronic diseases, is associated with adverse outcomes, such as fall, disability and mortality. With the development of antiretroviral therapy, the average life span of HIV/AIDS patients is extended, the number of elderly living with HIV/AIDS has increased, resulting the increase of the incidence of frailty syndrome in this population. The incidence of frailty syndrome in the elderly is associated with HIV infection and adverse reaction of antiretroviral therapy. Early assessment and intervention of frailty syndrome in elderly HIV/AIDS patients can reduce adverse clinical events and improve the quality of life.

Objective:To explore the gap between the clinical nursing status and practice guidelines of elderly functional constipation, propose corresponding action strategies, and provide reference for the clinical transformation of the guidelines.Methods:From July to October 2019, totally 330 clinical nurses and nursing managers of elderly patients with functional constipation admitted into the general hospitals, hospitals of traditional Chinese medicine, and hospitals of traditional Chinese medicine and western medicine in Beijing were selected by convenient sampling and investigated with self-made questionnaires. The standard and algorithm of recommendations were formulated, and Excel software was used to calculate the compliance rate, partial compliance rate, and non-compliant rate of recommendations. A total of 330 questionnaires were distributed in this study, and 330 questionnaires were recovered, with a recovery rate of 100.0% (330/330) . After excluding invalid questionnaires such as items with missing values greater than 10% and all items having the same answers, there were 317 valid questionnaires, with an effective rate of 96.1% (317/330) .Results:Among the recommendations of the 12 guidelines, the 3 items with the highest compliance rate were health education related to toileting patterns, health education related to activities and sports, satisfaction and effect evaluation, while the 4 items with the highest non-compliance rates were building interdisciplinary teams, comprehensive education and program promotion, health assessment, and physical examination of medication history. There was a statistically significant difference in the clinical practice status between nurses who had and had not received relevant training ( P<0.01) . Conclusions:Most nurses can provide comprehensive care for elderly patients with functional constipation, but there is a big gap between the practice and the guidelines. Measures such as strengthening nurse training and talent training and standardizing the nursing process of constipation can help promote the clinical translation of evidence.

Due to the overwhelming percentage of poorly water-soluble drugs, pharmaceutical industry is in urgent need of efficient approaches for solubilization and permeability improvement. Salts consisting of lipophilic fatty acid anions and hydrophilic choline cations are found to be surface active and able to form ionic co-aggregates (ICAs) in water. Choline oleate-based ICAs significantly enhance oral absorption of paclitaxel (PTX) as compared with cremophor EL-based micelles (MCs). Aggregation-caused quenching probes enable tracking of intact ICAs in in vivo transport and cellular interaction. Prolonged intestinal retention of ICAs than MCs implies stronger solubilizing capability in vivo. Ex vivo imaging of major organs and intestinal tracts suggests transepithelial transport of intact ICAs. Cellular studies support the enhanced absorption of PTX and transmembrane transport of intact ICAs. In conclusion, ICAs, consisting of lipophilic ions and hydrophilic counter-ions, are of great potential in delivery of poorly water-soluble drugs by enhancing solubility and permeability.