Objective To investigate the detection rate of non-alcoholic fatty liver disease (NAFLD) and influencing factors in the elderly population undergoing physical examination in Nanjing. Methods People who participated in the elderly physical examination in Nanjing from 2018 to 2023 were selected as the study subjects according to the inclusion and exclusion criteria. Basic information and physical examination results were collected. The t-test and Chi-square test were used to compare the detection status of NAFLD in different characteristic populations, and multivariate logistic regression model was used to analyze influencing factors of NAFLD. Results A total of 41 066 people were included in the study, with a detection rate of 39.55%. The detection rate in males (24.12%) was significantly lower than that in females (49.75%) (χ² = 2702.442, P<0.001). Trend χ² test results showed that the detection rate of NAFLD increased gradually with BMI (χ²_trend = 4084.414, P_trend < 0.001). Multivariate logistic regression analysis showed that female (OR = 3.055, 95% CI : 2.911-3.206), primary school or below (OR = 1.075, 95% CI : 1.009-1.146), unmarried (OR = 1.107, 95% CI : 1.039-1.179), BMI (18.5kg/m²-23.9 kg/m²: OR = 4.876, 95% CI :3.340-7.119; 24.0 kg/m²-27.9 kg/m²: OR = 15.324, 95% CI : 10.503-22.358; ≥28.0 kg/m²: OR = 37.433, 95% CI : 25.591-54.753), hypertension (OR = 1.095, 95% CI : 1.040-1.153), diabetes mellitus (OR = 1.317, 95% CI :1.250-1.387), and dyslipidemia (OR = 1.574, 95% CI : 1.501-1.652) were risk factors for NAFLD (all P<0.05). Conclusion The detection rate of NAFLD in the elderly population undergoing physical examinations in Nanjing is relatively high. Women, unmarried people, people with low education, overweight and obesity, and people with hypertension, diabetes, and dyslipidemia are the high-risk groups.

Patients with sudden deafness encounter greater psychological challenges and communication barriers after experiencing sudden hearing loss， and traditional medical models often fail to adequately address their unique needs. This paper analyzed the current situation of emotional and behavioral changes in patients with sudden deafness， and the gap between their expectations and the reality of medical care. From the perspective of narrative medicine， the theory and characteristics of the reconstruction of the doctor-patient relationships in patients with sudden deafness were explored. The results showed that narrative medicine can enhance patients’ emotional resonance and understanding， improve the efficiency and quality of doctor-patient communication， promote the formulation of personalized treatment plans， and enhance treatment adherence and satisfaction. Based on these results， strategies and pathways for the reconstruction of doctor-patient relationships for patients with sudden deafness were proposed， including building empathetic bridges and tapping into mechanisms of emotional resonance within narrative medicine； optimizing communication strategies and promoting the application of narrative techniques in doctor-patient dialogues； connecting narrative pathways and advocating the exploration of stories and strategies in personalized treatments； as well as facilitating treatment adherence and making full use of the psychodynamic effects of narrative medicine. Narrative medicine， as a patient-centered medical practice， can effectively promote the reconstruction of doctor-patient relationships， enhance treatment effectiveness， and offer a more humane treatment experience for patients.

BACKGROUND:Protein is one of the essential nutrients for the human body and is a key component of human cell tissue.Protein supplementation can promote the synthesis of myofibrillar protein and play a key role in strength training.However,the interaction mechanism and signaling pathway between protein and exercise are still unclear.OBJECTIVE:To explore the mechanism of interaction between exercise and protein,and to optimize the benefits of protein supplementation on exercise performance.METHODS:Using"sports,proteins,amino acids,polypeptide,interaction mechanisms,signaling pathway"as Chinese and English search terms,we searched WanFang Data,CNKI,VIP,and PubMed databases respectively.Articles were screened according to the inclusion criteria,and finally 73 articles were included in the review.RESULTS AND CONCLUSION:Current research on protein supplementation promoting exercise performance mainly focuses on promoting muscle growth,endurance improvement,and body recovery through protein supplementation,but there are differences in the existing experimental results.The interaction mechanism between protein molecules and proteins in the body is not yet clear.The research on the interaction mechanism between exercise and peptides is still in its infancy.Exercise can stimulate the full absorption of external protein intake,which can affect the mechanism of protein molecules in the body.Supplementing peptide nutrition can more accurately affect the body's state,thus better eliminating the phenomena of"sub-health"and"modern diseases."Therefore,studying the interaction mechanism between exercise and proteins is particularly important,delving into the specific mechanisms by which amino acids act on the body,and further exploring the interaction mechanism between exercise and peptides.

BACKGROUND:Protein is one of the essential nutrients for the human body and is a key component of human cell tissue.Protein supplementation can promote the synthesis of myofibrillar protein and play a key role in strength training.However,the interaction mechanism and signaling pathway between protein and exercise are still unclear.OBJECTIVE:To explore the mechanism of interaction between exercise and protein,and to optimize the benefits of protein supplementation on exercise performance.METHODS:Using"sports,proteins,amino acids,polypeptide,interaction mechanisms,signaling pathway"as Chinese and English search terms,we searched WanFang Data,CNKI,VIP,and PubMed databases respectively.Articles were screened according to the inclusion criteria,and finally 73 articles were included in the review.RESULTS AND CONCLUSION:Current research on protein supplementation promoting exercise performance mainly focuses on promoting muscle growth,endurance improvement,and body recovery through protein supplementation,but there are differences in the existing experimental results.The interaction mechanism between protein molecules and proteins in the body is not yet clear.The research on the interaction mechanism between exercise and peptides is still in its infancy.Exercise can stimulate the full absorption of external protein intake,which can affect the mechanism of protein molecules in the body.Supplementing peptide nutrition can more accurately affect the body's state,thus better eliminating the phenomena of"sub-health"and"modern diseases."Therefore,studying the interaction mechanism between exercise and proteins is particularly important,delving into the specific mechanisms by which amino acids act on the body,and further exploring the interaction mechanism between exercise and peptides.

Objective:To explore the correlation between fasting plasma glucose (FPG) trajectory and new-onset chronic kidney disease (CKD) in elderly population (≥65 years old) in Nanjing.Methods:The study cohort was composed of 14 763 subjects who met the inclusion criteria in the population in elderly health examination in Nanjing. Based on the FPG levels detected in health examination from 2018 to 2021 (logarithm was used for normal distribution), three different FPG trajectory groups were determined using the SAS Proc Traj program, i.e. low-stable group, medium-stable group, and high-stable group. The incidence of CKD in 2022 was analyzed, and log-rank test was performed to compare the differences of cumulative incidence of new-onset CKD among different trajectory groups. Cox proportional hazards regression model was used to analyze the correlation between different FPG trajectories and new-onset CKD.Results:The mean follow-up time was (416.09±81.96) days. The follow-up time of the 500 th day was selected to analyze the cumulative incidence rate of CKD in different FPG trajectory groups, and the cumulative incidence rate of CKD in the low-stable group, the medium-stable group, and the high-stable group of FPG increased with elevated trajectory, which was 15.3%, 21.8%, and 29.3%, respectively (log-rank test χ2=151.16, P<0.001). Cox proportional hazards regression model analysis showed that compared with the low-stable group, the medium-stable group and the high-stable group were all at risk for new-onset CKD. After adjusting for multiple confounding factors, the analysis by Cox proportional hazards regression model 4 indicated that the risk for CKD in medium-stable and high-stable groups were still 1.676 (95% CI: 1.462-1.921) times and 2.007 (95% CI: 1.562-2.579) times higher than that in low-stable group. Conclusions:Elevated FPG change trajectory level is a risk factor for new-onset CKD, and persistently high level of FPG increase the risk for CKD. FPG should be monitored in elderly population by follow up, and individualized prevention and control measures for CKD should be developed for different trajectory groups.

Objective This paper aims to address the challenges of hospital equipment management by implementing the life cycle management system in the medical laboratories of public hospitals.Methods Based on the three principles of standard-ization,refinement,and dynamism,this paper conducted data tracking and managed equipment analysis with specifications dur-ing the processes of planning,discussion,procurement,acceptance,operation,maintenance,performance evaluation,scrap-ping,and updating.Results After implementing life cycle management,the average risk level significantly decreased compared to pre-implementation(P＜0.05).Budget implementation efficiency increased by 14.53％from 2019 to 2023.The investment payback period was controlled within 2 years.Conclusion The application of the life cycle management system to equipment management in medical laboratories of public hospitals is of great significance for the high-quality development of hospitals.

Objective:To develop a health behavior guidance program for stroke rehabilitation patients based on the adaptive leadership framework (ALF) .Methods:Relevant stroke health behavior guidelines were systematically retrieved, screened, included, and recommendations extracted from domestic and international websites. The initial draft of the health behavior guidance program for stroke rehabilitation patients was developed in light of the ALF. From January to March 2022, the draft was refined through two rounds of Delphi expert consultation, resulting in the finalized health behavior guidance program.Results:A total of 10 guidelines were included, and 73 guideline recommendations were extracted. These recommendations were categorized into six dimensions and 25 specific items. In both rounds of expert consultation, 15 questionnaires were distributed and all were returned, yielding an effective recovery rate of 100.00%, with an expert authority coefficient greater than 0.8. Based on expert feedback and group discussions, the final program included eight dimensions and 31 items, adding sleep management and regular health consultations to the original six dimensions.Conclusions:The health behavior guidance program for stroke rehabilitation patients, based on the ALF, introduces a new perspective on nursing by reasonably dividing adaptive and technical problems. This approach aligns with clinical practice in China, providing scientific and practical value for promoting health behaviors and offering a new perspective for health education in stroke patients.

This paper deeply studied the definition and characteristics of clinical research programs. On such basis, the researchers utilized theoretical and comparative studies in combination of practical studies, to probe deeply into both the operating procedures and management documents of the clinical research management council.These efforts contributed to constructing a systematic, overall and feasible management system,for reference of building such a council by medical institutions.

Objective: To observe the parameters of the results of suppression head impulse paradigm (SHIMP) in healthy adults, and to provide reference for evaluating vestibular oculomotor reflex function in patients with peripheral vertigo. Methods: Fifty healthy adults, 22 males and 28 females, aged from 23-65 years, with an average age of (38.5±11.6) years, were recruited from January to March 2018. Parameters provided by the video head pulse software included the gains, the latency and the peak velocity of saccades, and comparison was made with head impulse paradigm (HIMP). Results: All subjects were elicited anti-compensatory saccades in SHIMP. The normal values of left and right gains were 1.02 and 1.10 in HIMP, and 0.93 and 1.01 in SHIMP respectively. The left and right saccades latency were (201.1± 50.8)ms and (187.0± 42.9)ms, and the peak saccadic velocity were (302.7±58.5)°/s and (291.5±46.5)°/s in SHIMP; there were small but significant difference between two sides about gains in HIMP and SHIMP, as well as latency in SHIMP(P<0.05); there were small but significant difference between HIMP and SHIMP about gains in ipsilateral(P<0.01); there were no significant difference between two sides about peak saccadic velocity in SHIMP(P>0.05). Conclusions SHIMP can be used for the examination of vestibular oculomotor reflex function in adult population. It is easy to be operated and is convenient for clinical application. Combined with head pulse test, the function of the semicircular canal can be evaluated together.

Objective To explore the application and nursing care of patients with severe burn patients with scar skin treated by ultrasound-guided PICC catheter placement. Methods Twelve patients with burn area of more than 95% were treated with intravenous catheter placement of PICC under the condition of scar hyperplasia skin with the help of ecg. Results Ten patients in elbow basilic vein catheterization by PICC disposable puncture, 1 cases of catheter in the right upper arm of the basilic vein into vascular sheath scar after guidewire dilating the skin in place leading to vascular sheath damaged anterior guidewire failed in bending catheter, to your left arm to venous catheter success, 1 cases of catheter for initial puncture puncture into the insufficient experience in successful puncture needle when the guide wire back because of scar skin relaxation will not needle guide wire fixing the wire with a lead to two times of puncture, 12 cases of catheter tip position by X-ray showed in the superior vena cava under 1/3, indwelling time ranged from-11 months of March, in the retention period without related complications. Conclusions It is feasible and advantageous for the application of PICC catheter in the treatment of severe burn patients with scar skin.