Objective To develop and test the reliability and validity of the Intrinsic Capacity Assessment Scale for the Older People,so as to provide an effective tool for the assessment of the intrinsic capacity of the aged.Methods Based on the International Classification of Functioning,Disability and Health(ICF)as the theoretical framework,the initial version of The Intrinsic Capacity Assessment Scale for the Older People was developed through literature analysis,Delphi expert consultation and pre-survey.From July to September 2023,650 old people were selected by convenience sampling method to conduct a survey,and 20 old people were surveyed after 2 weeks again to test the reliability and validity of the scale.Results The effective questionnaire recovery rates of the 2 rounds of expert correspondence were 92.3％and 91.7％;the expert authority coefficients were 0.83 and 0.86;the mean importance scores of items were 2.04-3.79 and 3.50-3.82,and the full score ratios were 4.2％-83.3％and 54.6％-86.4％,respectively.The coefficients of variation were 0.11-0.42 and 0.11-0.23,respectively.A total of 5 common factors were extracted from exploratory factor analysis,and the cumulative variance contribution rate was 68.327％.The results of confirmatory factor analysis showed that the fit indexes were x2/df=1.908,RMSEA=0.054,CFI=0.931,IFI=0.932,TLI=0.922,indicating a good fit.The Cronbach's α coefficient of the scale was 0.944;the split half reliability was 0.806;the retest reliability was 0.933.The content validity index of item level was 0.82-1.00,and the content validity index of scale level was 0.91.The Intrinsic Capacity Assessment Scale for the Older People included 35 items in 5 dimensions:movement,vitality,sensation,cognition and psychology.Conclusion The Intrinsic Capacity Assessment Scale for the Older People has good reliability and validity,and it can be used as a reliable tool to evaluate the intrinsic capacity level of the aged.

Objective:To observe the effects of acupuncture at Houxi(SI3)and Huantiao(GB30)on the expression levels of nuclear factor kappa B(NF-κB),inducible nitric oxide synthase(iNOS),and nitric oxide(NO)of NF-κB inflammatory signaling pathway in L5 spinal nerve root of lumbar disc herniation(LDH)model rats and explore the mechanism of acupuncture in LDH treatment.Methods:Forty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into a sham operation group,a model group,acupuncture group 1,and acupuncture group 2,with 10 rats in each group.The non-compression nucleus protrusion model was made by puncturing L4-L5 spinous process space and injecting autologous nucleus suspension.Acupuncture at bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)was carried out in acupuncture group 1,and acupuncture at bilateral Houxi(SI3)and Huantiao(GB30)in acupuncture group 2.All rats were treated with balanced reinforcing and reducing needling manipulations,and the needles were retained for 30 min/time with one episode of needling manipulation every 10 min,once a day,14 times in total.The threshold value of paw withdrawal pain was measured by a thermal stimulation pain instrument;the serum NF-κB,iNOS,and NO levels were measured by enzyme-linked immunosorbent assay.The pathomorphological changes of spinal nerve roots were observed by hematoxylin-eosin(HE)staining;quantitative reverse transcription polymerase chain reaction was used to detect iNOS mRNA expression in spinal nerve roots;the NF-κB and iNOS protein expression in spinal nerve roots was detected by the immunofluorescence method.Results:Compared with the sham operation group,the threshold of paw withdrawal pain in the model group was decreased,and the expression levels of serum NF-κB,iNOS,and NO were increased;HE staining showed many degenerated and dissolved Schwann cells in spinal nerve roots with vacuolar changes;meanwhile,the expression levels of NF-κB and iNOS proteins,and the iNOS mRNA in spinal nerve roots were increased.Compared with the model group,the paw withdrawal pain thresholds in acupuncture group 1 and acupuncture group 2 were increased,and the increase in acupuncture group 2 was greater(P<0.05);the expression levels of serum NF-κB,iNOS,and NO in acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01);the vacuolar changes of spinal nerve roots,and the degeneration and lysis of Schwann cells in acupuncture group 1 and acupuncture group 2 were decreased,which were more obvious in acupuncture group 2;the NF-κB and iNOS protein expression and the iNOS mRNA expression levels in spinal nerve roots of acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01).Conclusion:Acupuncture at Houxi(SI3)and Huantiao(GB30)can improve the morphology of spinal nerve roots,inhibit the NF-κB and iNOS protein expression levels in spinal nerve roots and the serum NO level,and relieve the pain caused by inflammation of spinal nerve roots,which may be one of the mechanisms of acupuncture in LDH treatment.

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Objective:To understand the status of young nurses' turnover intentions in the ClassⅢ Grade A hospitals of our country, and explore its influencing factors from personal factors and organizational factors, and so as to provide a reference for reducing the turnover of young nurses and stabilizing the team of young nurses.Methods:This study is a cross-sectional study. From December 2016 to June 2018, stratified sampling and cluster sampling were used to select young nurses from 10 hospitals in 7 administrative regions of China as the research subject. The Intent to Leave Questionnaire, General Information Questionnaire, Career Growth Scale of Nurses, General Self-Efficacy Scale, Work-Family Support Scale and Organizational Commitment Scale were used to understand young nurses' turnover intentions and organizational factors. Logistic regression was used to explore the influencing factors of turnover intention. A total of 11 466 questionnaires were returned, and 10 781 young nurses were surveyed.Results:Among the 10 781 young nurses in ClassⅢ Grade A hospitals across our country, 3 612 nurses (33.5%, 3612/10 781) had intention to leave, of which 413 nurses (3.8%, 413/10 781) had very strong intention to leave. Logistic regression analysis showed that male ( OR=1.268) , only child ( OR=1.177) , high self-efficacy ( OR=1.671) were risk factors for turnover intention ( P<0.05) , having children ( OR=0.845) , have changed work place ( OR=0.788) , formal authorized strength ( OR=0.852) , higher interest in nursing ( OR=2.161) , high level of career growth ( OR=0.517) , high level of work-family support ( OR=0.523) , and high level of organizational commitment ( OR=0.633) were protective factors for turnover intention ( P<0.05) . Conclusions:The turnover intention of young nurses in ClassⅢ Grade A hospitals across our country is at a high level. Medical institutions need to focus on creating a good environment, providing good work-family support, and increasing nurses' organizational commitment and professional interest, so as to reduce the turnover of young nurses.

Objective:To stablish a transitional nursing model for patients with chronic diseases under the hierarchical diagnosis and treatment system and clarify the structure and functions, so as to provide a chronic disease management model with practical operation, promotion and reference.Methods:In April 2019, a research group was established. Based on a large amount of literature and policy analysis, guided by the three-dimensional quality theory model of structure-process-results, the transitional nursing model was constructed and the index system letter consultation questionnaire was initially prepared. After the preliminary survey, it was revised to form the first-round consultation questionnaire. Delphi method was used to conduct 2 rounds of letter consultation among 19 experts. The positive coefficient of experts, the authoritative coefficient of experts and Kendall 's coordination coefficient were calculated. Analytic hierarchy process (AHP) was used to determine the weight coefficient of each index and quantify the importance degree of the index. Results:The effective recovery rates of the two rounds of letter consultation questionnaires of expert were both 100%. The authoritative coefficients of experts were respectively 0.80 and 0.84, Kendall 's coordination coefficient was 0.137 to 0.253 ( P<0.001) , and the coefficients of variation were all less than 0.25. The index system for the transitional nursing model of patients with chronic diseases finally established included 6 first-level indicators, 38 second-level indicators and 32 third-level indicators of "transitional nursing procedures", and the structural and functional diagram was generated. Conclusions:The established transitional nursing model for patients with chronic diseases is scientifically reliable and comprehensive in content, which has practical significance for promoting the deep integration of mobile Internet and medical and health fields, guiding the subsidence of advantageous resources and promoting the implementation of hierarchical diagnosis and treatment.

Objective To explore the correlation between NLR family pyrin domain containing 3 (NLRP3) and nonalcoholic fatty liver disease (NALFD).Methods A cross-sectional study was conducted in this study.Eighty four cases of health examination personnel in Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital were included in the study randomly,and divided into NAFLD group (27cases) and normal control group (57cases) though liver ultrasound examination.Their general data (sex,height,weight),liver function,blood lipid,and blood glucose were analyzed.The level of NLRP3 in peripheral blood was analyzed by ELISA double antibody sandwich method.The relationship between NLRP3 and NAFLD was analyzed by Logistic regression.Results The prevalence of NAFLD was 32.1 ％ (27/84).The levels of serum cholesterol,triglyceride,low density lipoprotein cholesterol,fasting blood sugar,alanine aminotransferase,creatinine and uric acid in NAFLD group were higher than those in normal control group (all P＜0.01),while the level of serum high density lipoprotein cholesterol was lower than that in normal control group (P=0.023);the concentration of serum NLRP3 in NAFLD group was (5.1±1.8) μg/L,and that in normal control group was (3.9±1.4) μg/L.There was significant difference between the two groups (t =6.221,P =0.016).Logistic regression analysis showed that NLRP3 was a risk factor for NAFLD (OR =1.537,P =0.021).Conclusion The level of NLRP3 is up-regulated in the serum of NAFLD patients,which is related to the occurrence of NAFLD.

Objective To explore the the characteristics of non-motor symptoms of essential tremor(ET).Methods Totally 50 ET patients and 45 age-gender-matched healthy volunteers,admitted in Department of Neurology,The Second Affiliated Hospital of Zhejiang University School of Medicine from May 2015 to April 2016,were included.Clinical data and tremor analyses under different postures were obtained.The non-motor symptoms were evaluated using the Pittsburgh Sleep Quality Index(PSQI),Hamilton anxiety scale(HAMA),Hamilton's Depression Scale(HAMD),and the MOS item short from health survey (SF-36).Cognitive functions were evaluated by the Minimental state examination(MMSE).Results ET group had lower MMSE total score of (25.81 ±2.75 vs.28.16 ± 1.71),increased rate of dyssomnia (62.0％ vs.15.6％) and higher PQSI score (6.42±2.71 vs.3.84±2.13)compared with the control group(all P＜0.05).Moreover,more patients in the ET group had moderate and severe anxiety(60.0 ％ vs.37.8 ％),moderate and severe depression (34.0％ vs.15.6％)than the control group(both P ＜ 0.05).Anxiety and depression had effects on physical and mental health and were also related to the quality of life.Conclusions Non-motor symptoms,such as mild cognitive deficits,depression,anxiety and dyssomnia are common in ET patients.Furthermore,depression and anxiety have negative effects on physical and mental health.

Objective To develop tailored scientific research evaluation indexes for medical personnel with different characteristics in the third grade hospital.Methods 40 experts in clinical medicine were interviewed and 2/3 frequency of their opinions were collected,working plan was developed based on such findings.Results Developed a clear orientation to update the scientific research evaluation system for promotion with consideration of different characteristics of various groups,including young people with high medical trainings,general medical staff,skilled clinicians and full-time researchers.Conclusions The system promoted the development of both individual career and hospital.

Objective To investigate the changes in cognitive function in patients with early Parkinson's disease (PD) in a 5-year follow-up.Methods A total of 181 PD and 173 normal participants were recruited between January 2009 and January 2012 at the Department of Neurology,the Second Hospital of Jiaxing City.Regression analysis was used to evaluate the risk factors of cognitive impairment,and changes in subdomains of the Montreal Cognitive Assessment (MoCA) were compared annually with baseline data.Results Baseline clinical data were similar between the two groups.The level of cognitive impairment was positively correlated to the age of onset and the Hamilton Anxiety Scale (H AMD) (t =3.326,P＜ 0.05;t =5.211,P＜0.01),and negatively correlated to education level (t=-2.505,P＜0.05).There were no statistical differences in the first (26.5 ± 2.6),second (26.3±3.2) and third year (25.9±2.9) in the total scores of MoCA,which significantly increased in the forth (24.4 ± 2.3,P＜0.05) and fifth (24.1 ± 1.2,P＜0.05) year compared with baseline levels (26.7±2.9).However,in the control group,differences between any two years in total scores were not statistically significant (all P＞0.05).Seven subdomains of MoCA were attenuated,and four of them were significant different between the groups,including delayed recall,attention,abstraction task and orientation after the forth year of follow-up (all P ＜ 0.05).Meanwhile,visuospatial execution capacity was attenuated before the third year,and then rose markedly (P＜0.05).In the control group,the between-year differences of seven subdomains were not statistically significant (all P＞0.05).Conclusions Cognitive function of PD patients decreases significantly in some domains,such as delayed recall,attention,abstraction task and orientation after a five-year followup.

Objective To analyze the clinical features of Parkinson's disease (PD) combined with chronic pain in the elderly.Methods A total of 366 idiopathic PD patients experiencing pain were enrolled and divided into two groups:the elderly group (n=289) and the young group (n=77).Rating scales including Visual Analogue Scale (VAS),Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn Yahr (H-Y) Scale,Self-rating Anxiety Scale (SAS),Self rating Depression Scale (SDS) and Brief Pain Inventory (BPI) were evaluated.Results Compared with the young group,the elderly group had evidently higher scores of UPDRSⅡ,Ⅱ,Ⅳ,H-Y Scale,VAS as well as five sub-items of BPI including daily living,working,sleeping,walking ability and social communication [(13.7±5.3) vs.(12.3±6.3),(27.3±12.9)vs.(23.3±9.6),(2.3±2.2)vs.(1.7±1.3),(2.4± 1.0)vs.(2.1±0.9),(63.3±25.6)vs.(56.6±25.0),(5.3±2.7)vs.(4.6±2.7),(5.9±3.2)vs.(5.1±2.8),(6.3±2.5)vs.(5.6±2.6),(4.7±3.1)vs.(3.8±2.0),(3.2±2.1)vs.(2.6±2.5),t=1.976,2.539,2.287,2.381,2.050,2.021,1.997,2.165,2.420,2.134,respectively,all P＜0.05].No significant differences were found in SAS,SDS or other sub-items of BPI such as life pleasure and mood scores between the two groups (all P＞0.05).Compared with the young group,patients in the elderly group had a higher ratio of two or more pain types associated with PD[41.2％ (119/299)vs.23.4％ (18/77),x2=8.190,P＜0.05],but a lower ratio of pain-related treatment [29.76％ (86/299)vs.51.95％ (40/77),x2=13.260,P＜0.05].Conclusions Pain in elderlyPD patients is more severe,shows more diverse types,and significantly aftects the quality of life.Enhanced intervention is needed.