Objective To investigate the effect of the revision of Chinese Versions of Reading the Mind in the Eyes Test(RME) on the diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's dementia (AD).Methods We compared performance on the cognitive test battery between 96 patients with MCI and 55 patients with AD and 95 control individuals.Neuropsychological tests, encompassing RME-T, Mini Mental State Examination (MMSE) and Auditory Verbal Learning Test (AVLT), were conducted on 96 patients with MCI, 55 patients with AD and 95 healthy control individuals.Completion rate of RME-T in the normal group and the total scores and each item score of RME-T were analyzed, and the feature between RME-T and RME-S (RME-short) was compared.Results The total score of RME-T was (23.7±4.7) in normal group, (19.9 ± 4.9) in MCI group,and (19.9±7.5) in AD group.There were significant differences in the total score of RME-T among the three groups (t=13.9, P＜0.01).The differences in the total score of RME-T between normal group and AD group, between normal group and MCI group were also significant (both P＜0.01).RME-S was composed of 20 items after rejecting 16 items of RME T whose project completion rate was lower than 50％ in the normal group and in which there was no significant difference among normal, MCI and AD groups.The correlations between the total score of RME-T and 3 item scores of RME-T were not significant (P＞0.05).However, the total score of RME-S was highly correlated with each item score of RME-S (P＜0.01).The total score of RME-T and RME S were highly correlated with each total score of the cognitive test battery (P＜0.01).With the normal and MCI groups, normal and AD groups as the subjects, the receiver operating characteristic (ROC) curve analysis found that AUC(RME-S) was＞ AUC(RME-T) in normal and AD groups (P＜0.01), whereas, AUC(RME-S) was＜AUC(RME-T) in normal and MCI groups (P＞0.05).Conclusions RME has good reliability and validity, and RME-S is better than RME-T in internal consistency, which is more suitable for identifying mild cognitive impairment and Alzheimer's disease in Chinese population, and it is worthy of further popularization and application.

Nutrition Risk Screening 2002 (NRS 2002) was developed on the basis of 128 randomized controlled clinical studies by a group of experts led by Kondrup from the European Society for Parenteral and Enteral Nutrition (ESPEN).As the first evidence-based nutritional screening tool worldwide,NRS 2002 has been recommended for nutritional risk assessment of hospitalized patients in Europe for the addition of disease metabolism and its simplicity.In this article,we reviewed the increasing applications of NRS 2002 in China,pointed out the existing problems and made several suggestions on improvement for popularization and standardization of its clinical use.

Objective To determine prevalence of dementia in diabetics and non-diabetics, and in different age and gender groups. Methods A case-control study was conducted among participants aged 50 and over in Jing' an temple community in Shanghai. Subjects in diabetics group were matched to non-diabetics groups for age and sex with 1:1 matching. Personal information and case history were collected through questionnaire. The subjects were screened for dementia using the Mini Mental State Examination (MMSE). Subjects that screened positively (indicated by an MMSE score below 19, 21 and 24 among those with illiteracy, elementary school and above junior middle school education, respectively) were subsequently examined by a series of neuropsychological tests. Based on all available information, a diagnosis of dementia was defined according to the Diagnostic and Statistical Manual of Mental Disorders ( DSM )-Ⅳ criteria Results Prevalence of dementia of 4. 75% (23/484, 95% CI: 3. 03%-7.04%) in diabetics was higher than that of 2. 24% (11/490,95% CI: 1.13% -3.98%) in non-diabetics (X~2 = 4.54, P=0.03).Prevalence of dementia among diabetics in age groups of 60-69, 70-79 and 80 and above was 1.94% (2/103), 4. 43 % (9/203) and 14.12% (12/85, trend X~2 =18.04, P <0.01), and in non-diabetics was 1.43% (2/140), 2. 86% (6/210) and 5.00% (3/60, trend X~2 = 4.58, P=0.03), respectively.Prevalence of dementia among female and male in diabetics was 6.55% (19/299) and 2.06% (4/194) (X~2 = 5.18, P = 0.02), respectively, and in non-diabetics was 3.01% (9/299) and 1.05% (2/191).Conclusions Prevalence of dementia is significantly higher in diabetics than in non-diabetics, higher in women than men, and increases as age rises.

Objective:To evaluate and rank the effects of different non-pharmaceutical interventions on the management of blood glucose in children and adolescents with type 1 diabetes by Bayesian network Meta-analysis.Methods:Computer search for PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China Biomedical Literature Database, China Knowledge Network, Wangfang Data and VIP Database, China and the United States Clinical Registration Center, the search time limit is from the establishment of each database to December 2020. Use WinBUGS, GeMTC, Stata software for blood glucose management data analysis.Results:Finally, 37 articles were included, with a total of 4 188 cases, involving 14 non-pharmaceutical intervention programs. The results of the network Meta-analysis showed that when different non-pharmacological interventions were used, the effectiveness of blood glucose management in children and adolescents with type 1 diabetes was ranked as follows: peer support education first, cognitive behavioral therapy second, advanced diabetes education third, family support intervention fourth, self guided intervention (GSD-Y) fifth, case training sixth, positive psychological intervention seventh, mobile phone based remote intervention eighth, diabetes education ninth, supportive consultation tenth, network based remote intervention eleventh position, multi-system therapy multi system therapy twelfth, conventional nursing thirteenth, motivational interview fourteenth.Conclusions:The available evidence shows that peer support education and cognitive behavioral therapy show certain advantages in blood glucose management in children and adolescents with type 1 diabetes, while motivational interviews perform the worst. Future research will further consider other potential benefits of non-pharmacological interventions, such as emotional health and diabetes self-management behavior.

Objective To gain an in-depth understanding of the authentic experiences of impaired dignity among patients in the recovery phase of severe bums,thereby informing the development of targeted dignity intervention plans by clinical medical staff.Methods By purposive sampling,the study included 16 patients in the recovery phase of severe burns,admitted to the Burn and Plastic Surgery Rehabilitation Department of a tertiary hospital in Guangzhou between December 2023 and January 2024.Face-to-face,semi-structured in-depth interviews were conducted,and the themes were analyzed,summarized,and distilled by the Colaizzi 7-step analysis method.Results 3 themes were identified,including impairment of physical dignity(physical disfigurement,change in appearance,and limitations in autonomous activities),psychological dignity conflicts(negative emotional disturbances and positive adjustment for adaptation)and the aspiration for social dignity(desire for family understanding,social support,and the hope to return to a normal life).Conclusion Clinical nurses should value the dignity experience of patients in the recovery phase of severe burns and establish patient-dignity-centered intervention plans to facilitate their dignified and high-quality recovery to a normal life.

Objective:To explore the occurrence time and risk factors of deep vein thrombosis (DVT) in patients with acute cerebral infarction, so as to guide clinical prevention and treatment.Methods:1 129 patients with acute cerebral infarction treated in Beijing Tiantan Hospital from May 2014 to May 2016 were selected as the research objects. According to whether DVT occurred, the patients were divided into DVT group ( n=22) and non DVT group ( n=1 107); The information was analyzed retrospectively and the occurrence time of DVT was counted. The independent risk factors of acute cerebral infarction complicated with DVT were analyzed by univariate and multivariate logistic regression. Results:The time of DVT in patients with acute cerebral infarction was 10.5 (4-14) days. Univariate analysis showed that there were significant differences in age, gender, atrial fibrillation, smoking, drinking, chronic obstructive pulmonary disease, peripheral artery disease, renal failure, anticoagulants, BMI, white blood cell, blood glucose at admission and length of stay between the DVT group and the non DVT group ( P<0.05). Multiple factors further confirmed that renal failure [odds ratio ( OR)=57.421; 95% confidence interval ( CI), 5.792-569.314)] and length of hospital stay ( OR=1.148; 95% CI: 1.071-1.232) were independent risk factors for DVT. Conclusions:The median time of DVT in patients with acute cerebral infarction was 10.5 days. Renal failure and hospital stay were independent influencing factors of DVT in patients with acute cerebral infarction. This is helpful to determine the best prevention and treatment duration of DVT in patients with acute cerebral infarction, make rational use of medical resources and formulate personalized prevention and treatment strategies.

Objective:To assess global myocardial work in non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) patients with no obvious regional wall motion abnormalities and preserved left ventricular ejection fraction (LVEF) by noninvasive left ventricular (LV) pressure-strain loops, and to explore its diagnostic value in patients with NSTE-ACS.Methods:A total of 169 NSTE-ACS patients with normal wall motion abnormalities and LVEF (>55%) were recruited in Beijing Chao Yang Hospital, Capital Medical University from June to December 2019. The patients were divided into two groups according to the degree of coronary stenosis, including severe coronary artery stenosis group ( n=121), and no severe stenosis group ( n=48). The patients of severe coronary artery stenosis group were further subdivided into single-vessel severe stenosis group ( n=52) and multi-vessel severe stenosis group ( n=69). Global longitudinal strain (GLS) analysis was performed by speckle tracking echocardiography before coronary angiography. Brachial cuff systolic pressure was used as left ventricular pressure to construct a non-invasive left ventricular pressure-strain loop. Global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW) and global myocardial work efficiency (GWE) was computed by LV pressure-strain loops with a proprietary algorithm between groups. ROC curve analysis was used to determine the optimal cutoff value of the parameters to detect severe coronary artery stenosis. Independent factors affecting left ventricular myocardial function were assessed by Logistic regression analysis. Results:GLS, GWI, GCW and GWE were significantly reduced, and GWW was increased in severe coronary artery stenosis group than in no severe stenosis group(all P<0.05). GLS was significantly reduced in multi-vessel severe stenosis group ( P<0.05) but not in single-vessel severe stenosis group ( P=0.32). GWE was an independent factor affecting myocardial function in severe coronary artery stenosis group, GWE<96% had a area under the curve (AUC)=0.83 (74% for sensitivity, 81% for specificity) to identify severe coronary artery stenosis, and was superior to GLS (AUC=0.66, P<0.05) and GWI (AUC=0.70, P<0.05). Conclusions:In NSTE-ACS patients with severe coronary artery stenosis, no obvious regional wall motion abnormalities and preserved LVEF, LV global myocardial function is impaired based on noninvasive pressure-strain loops, GWI, GCW, and GWE are reduced, and GWW is increased, and GWE is a more sensitive index than GLS and GWI to predict severe coronary artery stenosis in NSTE-ACS patients.

Objective To investigate the diagnostic efficacy of the nomogram model based on Chinese thyroid ima-ging reporting and data system(C-TIRADS)combined with shear wave elastography(SWE)and clinically inde-pendent risk factors for category IV thyroid nodules.Methods 2D-ultrasound images and SWE images of 256 pa-tients(269 nodules)with category IV thyroid nodules were analyzed.The sensitivity,specificity,and accuracy of the diagnosis by C-TIRADS and SWE were calculated using pathological findings as the gold standard.Receiver op-erating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was obtained.Independent risk factors for thyroid nodules were screened by univariate and multifactorial logistic regression analyses,a risk model was developed and a nomogram model was plotted,and a calibration curve analysis was used to assess the accuracy of prediction.ROC of the nomogram model was plotted,and the diagnostic efficacy of C-TIRADS,SWE and nomogram model based on independent risk factors was compared according to the AUC in category IV thyroid nodules.Results The sensitivity,specificity,and accuracy of C-TIRADS for differentiating malignant and benign nodules was 0.921,0.724 and 0.844 respectively,the AUC was equal to 0.822 with a 95%confidence interval(95%CI)of 0.775-0.870.The sensitivity,specificity and accuracy of SWE were 0.701,0.981,0.814 respec-tively,and the AUC was 0.833(95%CI:0.795-0.872).Multifactorial logistic regression analysis suggested that C-TIRADS classification,mean value of elasticity(E-mean)age and aspect ratio were independent risk factors for identifying benign and malignant thyroid nodules.The sensitivity,specificity and accuracy of the nomogram model established based on the above four factors were 0.957,0.943 and 0.959,the AUC was 0.963(95%CI:0.943-0.984),which showed a diagnostic efficacy superior to that of C-TIRADS or SWE alone.Conclusion The nomogram model,constructed based on C-TIRADS,SWE and clinically independent risk factors,can improve the efficacy in diagnosing category IV thyroid nodules,with a better clinical application value.

Objective To construct a telemedicine-based home care system of palliative care for end-of-life cancer patients,and to evaluate its application effect.Methods The construction of the system was based on the literature research,interview results of the patients and their caregivers,and expert group meeting discussions.From May to August 2023,a total of 88 patients,who were about to be discharged from the palliative care ward of a cancer hospital in Hunan Province,were selected as the study subjects using a convenient sampling method,and then they were divided into an experimental group and a control group according to the order of admission.The experimental group was given home care services based on the system,while the control group was given routine discharge guidance and follow-up visits.The duration of the intervention was 8 weeks.The Chinese version of the Edmonton Symptom Assessment Scale and the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 palliative were used to evaluate the symptom burden and quality of life between 2 groups before and after intervention;the Telemedicine Satisfaction Questionnaire was used to evaluate the care satisfaction of the experimental group.Results The system of patient side includes 8 main features,namely personal health record establishment,doctor-patient communication,palliative care knowledge library,medication assistance,smart reporting and monitoring,intelligent Q&A,intelligent follow-up,and intelligent forms.The healthcare professional side includes 7 main functions,namely workbench,case management,follow-up management,warning reminder,popularization push,statistical analysis and user management.A total of 67 patients completed the intervention,with 33 in the experimental group and 34 in the control group.The symptom burden of the experimental group was lower than that of the control group(P＜0.05);the quality of life in the experimental group was better than that in the control group(P＜0.05);the score of care satisfaction was(59.00±6.66),which indicated a high level of satisfaction.Conclusion The system can reduce the symptom burden and improve the quality of life of end-of-life cancer patients with good practicality