Objective To evaluate the effect of PRECEDE-PROCEED model in elder patents with diabetes.Methods 70 elder patients with diabetes were divided into the control group (34 cases)and the intervention group(36 cases) randomly.Routine nursing care was used in the control group,while the PRECEDE-PROCEED model was used in the intervention group in addition.Compared the level of FBG and the 2hPG betweenthe two groups.Results Before and after the intervention,the difference of FBG and 2hPG was not significant between the two groups,P＞ 0.05.Two weeks after the intervention,the incidence rate of hypoglycemia in the intervention group was 8.3％(3/36),which was significant lower than that of in the control group (29.4％,10/34),thex2=5.137,P＜0.05.Conclusion PRECEDE-PROCEED model can be well-applied to decrease hypoglycemia in elder patients with diabetes.

Objective To explore the value of real-time tissue elastography (RTE) with tissue dispersion quantitative analysis technique for assessment of liver fibrosis stage.Methods 51 rats were injected 6％ thioacetamide to induce liver fibrosis model,and 9 rats were injected saline as control group.In modeling 4 weeks,8 weeks,12 weeks respectively,14 rats in group of liver fibrosis model and 3 rats in control group were randomly selected to RTE.All the rats underwent tissue dispersion quantitative analysis,to obtain 12 quantitative parameters of elasticity,which included average relative strain value (MEAN),standard deviation of relative strain value (SD),area ratio of low-strain region (％ AREA),complexity (COMP),kurtosis (KURT),skewness (SKEW),contrast (CONT),entropy (ENT),inverse difference moment (IDM),angular second moment (ASM),correlation (CORR) and liver elasticity index (LF index).Subsequently,rats were sacrificed and their livers were taken for pathology analysis.Liver fibrosis model group was divided into S0,S1,S2,S3,S4 group.The 12 quantitative parameters of elasticity were compared with each group.Results 49 rats were successfully modeled,and 42 rats were analyzed.Except COMP,KURT,CORR,the other quantitative parameters had statistically differences (P ＜ 0.05).The other 9 parameters were correlated with liver fibrosis stage.Among these parameters,MEAN,％ AREA and LF index had higher related coefficient(r =-0.831,0.882,0.866).The ROC curve was made by MEAN,LF index and ％AREA to estimate the fibrosis stage,when S≥S1,S≥S2,S≥S3,S =S4,the areas under the ROCcurve were 0.884,0.925,0.934,0.962 (MEAN);0.917,0.958,0.984,0.962 (％AREA);0.917,0.948,0.966,0.967 (LF index),respectively.Conclusions As a non-invasive examination,RTE dispersion quantitative analysis technology can be used to quantitatively assess liver fibrosis.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.

Objective:To understand application value of pathogen detection in elderly patients with respiratory infection by using multiple RT-PCR to detect 13 common pathogens of respiratory tract infection.Methods:This is a retrospective study, which included 317 elderly patients, aged 60 to 98 years with respiratory symptoms, who visited Geriatrics of the First Hospital of Shijiazhuang between June 2016 and May 2017. Sputum of each patient was collected. After the viral DNA/RNA was extracted, 13 respiratory pathogens were detected by multiplex RT-PCR and capillary electrophoresis. The clinical performance of the assay was evaluated in comparison to direct sequencing and Real-time PCR.Results:Compared with the direct sequencing and Real-time PCR, the accuracy of multiple RT-PCR was 99.93% (95% CI: 99.79%-99.98%), positive predictive value was 99.24% (95% CI: 97.78%-99.74%), negative predictive value was 100% (95% CI: 99.9%-100%), and Cohen’s kappa was 0.9958 (95% CI: 0.9652-1.026). Among the 317 elderly patients, the positive rate of respiratory infection was 75.7% (240/317). The highest was influenza A, 20.2% (64/317), mainly H3N2, 70.3% (45/64), followed by rhinovirus, adenovirus, Mycoplasma pneumoniae and influenza B, with the positive rates 15.5% (49/317), 13.6% (43/317), 11.0% (35/317) and 10.1% (32/317), respectively. In addition, 81 (25.6%) elderly patients were infected with two or more pathogens. Conclusions:Multiple RT-PCR meet the needs of clinical detection of respiratory pathogens and provide information for the prevention and treatment of respiratory system Infection.

Objective To investigate the role of protein O-linked mannose β1,2-N-acetylglucosaminyltransferase 1 (POMGnT1) in the pathogenic process of Alzheimer's disease (AD).Methods The expression of POMGnT1 gene was examined in AD model cells (N2a/amyloid-precursor protein (APP) 695swe,n=3) and N2a/wt cells (n=3) using real-time PCR and Western blotting.This expression was also examined in AD model mice (APP/PS1,n=3) and wild-type mice (n=3) using immunofluorescence staining.Amyloid β-protein (Aβ) were examined in POMGnT1-gene-knockout mice (n=3) and wild-type mice (n=3) using immunochemistRy.Results The expression of POMGnT1 gene decreased in mRNA and protein levels in N2a/APP695swe cells compared to N2a/wt cells (mRNA:0.80±0.02 vs 1.00,t=10.52,P＜0.01;protein:0.50±0.02 vs 1.31±0.04,t=18.64,P＜0.01).Immunofluorescence results showed the reduced expression of POMGnT1 protein in neurons of APP/PS1 mice.Immunochemistry results showed more Aβ deposits in POMGnT1-gene-knockout mice (2 months old:0.358±0.014 vs 0.048±0.001,t=22.58,P＜0.01;1 year old:0.266±0.004 vs 0.229±0.003,t=7.771,P=0.002).Conclusion These findings suggest POMGnT1 gene may play an important role in the pathogenic process of AD.

Wnt7a is a secreted glycoprotein in the Wnt signaling family. It is located on chromosome 3p25 and is easy dele-ted. It is mainly expressed in placenta,kidney,testis,uterus,fetal lung and brain,and participates in human embryonic development and cell differentiation. More and more studies have found that Wnt7a is also expressed and plays an important role in many tumor cells. As a new tumor target of therapy or an important factor in the tumor growth pathway,Wnt7a has begun to attract the attention of many scientists.

Objective To observe the effects of chemotherapy on nutritional status and quality of life in elderly patients aged 60 years and over with stage Ⅲ or Ⅳ non-small-cell lung cancer,who were unable to undergo molecular-targeted drug therapy according to genetic testing.Methods A total of 100 elderly patients with stage Ⅲ or Ⅳ non-small cell lung cancer were randomized into an observation group(n=50)and a control group(n=50).Patients in the observation group were treated with GP regimen(gemcitabine+ cisplatin),while patients in the control group were treated with TP regimen(paclitaxel+cisplatin).The scores of nutritionally relevant indicators and quality of life were compared between the two groups.Results After chemotherapy,the body weight,body mass index,plasma total protein,plasma albumin,and triglyceride concentrations were significantly lower in the GP regimen group than in the TP regimen group(P＜0.0001,P =0.0027,P =0.0305,P＜0.0001,P＜ 0.0001,respectively).The overall health status score,physical function,role function,and emotional function scores were higher in the GP group than in the TP group(P =0.0017,0.0044,0.0064,0.006,respectively) after chemotherapy.The scores of shortness of breath,insomnia,loss of appetite,constipation,and diarrhea were significantly lower in the GP group than in the TP group(P =0.0067,P ＜0.0001,P =0.0026,P =0.0066,P =0.0023).The clinical effective rate was significantly higher in GP regimen than in TP regimen(56.0％ vs 30.0％,x2 =6.90,P=0.009).The incidence of grade Ⅰ adverse reactions was higher in the observation group (54.0％,27/50 cases),and the incidences of grade Ⅱ,Ⅲ and Ⅳ adverse reactions were higher in the control group(36.0％,18/50 cases;24.0％,12/50 cases;and 24.0％,12/50 cases,respectively) (x2 =16.40,P =0.001).Conclusions The TP chemotherapy is more beneficial to patients' nutrition,while the GP chemotherapy can achieve both higher clinical efficacy and better quality of life.

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.

Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment.However,because of the lack of knowledge on traditional Chinese patent medicines,many Western physicians,who are accountable for the majority of clinical prescriptions for such medicine,are confused with the use of traditional Chinese patent medicines.Therefore,the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines.In this paper,Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment.First,115 stroke patients from three hospitals are recruited in the cross-sectional survey.Simultaneously,traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient.Second,particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment.Moreover,these particular indicators can be easily obtained by Western physicians and are feasible for widespread clinical application in the future.Third,the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking.Experimental results reveal that traditional Chinese patent medicines can be differentiated.Moreover,the proposed model can obtain high accuracy of aid decision.

Objective:To discuss the composition and connotation of practical training objectives for nurses specialized in intravenous therapy, and provide guidance and reference for standardizing the practical training of nurses specialized in intravenous therapy.Methods:In this phenomenological analysis in qualitative research, 13 intravenous treatment and nursing experts from Shandong, Zhejiang, Sichuan, and Shaanxi provinces were selected from May to July 2021 for semi-structured interviews. Colaizzi's 7-step method and Nvivo 12.0 were used to organize data and analyze and refine themes.Results:Three themes and 12 subthemes were extracted for the practical training of intravenous therapy nurses, including knowledge objectives, ability objectives, and well-rounded objectives.Conclusions:Attention should be paid to the setting of clinical professional knowledge, skills and comprehensive quality goals for nurses specialized in intravenous therapy, so as to improve the pertinence and timeliness of training, promote the quality of training and the professional development of specialized training for intravenous therapy.