Objective To explore the clinical value of complement 1q(C1q),mannose-binding lectin(MBL)and complement 5a(C5a)in the early diagnosis and disease monitoring of diabetic kidney disease(DKD),as well as their relationship with renal tubular injury.Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study.Patients were divided into the simple diabetes mellitus(SDM)group(n=50)and the DKD group(n=182)based on urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).The DKD group was further divided into the low-risk diabetic nephropathy(LDKD)group(n=90),the moderate-risk diabetic nephropathy(MDKD)group(n=55)and the high-risk diabetic nephropathy(HDKD)group(n=37)according to the risk of chronic kidney disease progression.Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group(NC group).The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe.General biochemical indicators,as well as the levels of C1q,MBL and C5a in each group were detected.Spearman correlation analysis was used to analyze the correlation between C1q,MBL,C5a and glomerular and tubular injury indexes.Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury.Results The levels of systolic blood pressure,diastolic blood pressure,triglycerides(TG),serum creatinine(Scr),uric acid(UA),UACR,NAG/Ucr,C1q,MBL and C5a were higher in the DKD group than those in the SDM group and the NC group.The levels of TC,LDL-C,ApoB and HbA1c were higher than those in the NC group,while the level of HDL-C was lower than that in the NC group.The levels of TC,LDL-C,HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group,while the level of HDL-C was lower than that in the NC group(P＜0.05).Among different progression risk groups of DKD,the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group.The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group,and the level of MBL was higher in the LDKD group than that in the SDM group(P＜0.05).After grouping according to the quartile levels of NAG/Ucr,the levels of TC,ApoB,HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q4 group than those in the Q1 group.The levels of TC,ApoB,Scr,UACR,C1q and C5a were significantly higher than those in the Q2 group,and the levels of UACR and C5a were significantly higher than those in the Q3 group.The levels of HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q3 group than those in the Q1 group.The level of UACR was higher in the Q2 group than that in the Q1 group(all P＜0.05).The Spearman correlation analysis showed that C1q,MBL and C5a were positively correlated with UACR and NAG/Ucr,and negatively correlated with eGFR(all P＜0.05).The ordinal Logistic regression analysis showed that elevated levels of MBL,C5a,NAG/Ucr,Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients.Elevated levels of C5a,HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients.Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury,and C5a is an independent risk factor for DKD progression and tubular injury.MBL can be used to screen for early DKD and is also an independent risk factor for its progression.

Objective:To explore the application effect of BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary) combined with scenario simulation in cultivating the humanistic care ability of undergraduate nursing interns.Methods:Undergraduate nursing students who were interning at the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. The 46 interns from June to December 2023 were set as the control group, and the 46 interns from June to December 2024 were set as the experimental group. The control group adopted the traditional lecture-based teaching method, while the experimental group adopted BOPPPS combined with scenario simulation. Theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of the two groups were compared.Results:After the intervention, the theoretical and practical scores, as well as humanistic care ability, empathy ability, and critical thinking ability scores of the experimental group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:BOPPPS combined with scenario simulation plays a positive role in improving theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of undergraduate nursing interns, and it is worthy of further promotion and application.

Treatment based on meridian differentiation is a characteristic method in clinical acupuncture diagnosis and treatment. Accurately defining and explaining its main content and core concepts is essential for effective clinical guidance. This paper reviews the historical and contemporary understanding, concepts, and primary content of treatment based on meridian differentiation. It proposes a four-step process for clinical application: meridian examination, treatment based on meridian differentiation, acupoint selection, and appropriate treatment methods, with TCM syndrome differentiation applied throughout. Constructing a diagnostic and treatment system which is based on meridian differentiation and suited to clinical acupuncture is significant for enhancing therapeutic efficacy and maximizing the benefits of acupuncture in disease treatment.
Humans ; Meridians ; Acupuncture Therapy/methods* ; Acupuncture Points ; Medicine, Chinese Traditional

On the occasion of the 30th anniversary of Chinese Journal of Modern Nursing, this paper systematically elaborates the development of geriatric nursing as a core discipline in addressing the challenges of aging, from its inception and systematization to innovative development, and analyzes its challenges and prospects. Against the backdrop of China's large aging population and accelerating aging trend, geriatric nursing aims to meet the multi-level health needs of older adults. It has gradually expanded from early focus on disease-centered care to holistic health maintenance, functional promotion, and quality of life improvement for older adults, with the discipline's scope and depth continuously evolving. The discipline development can be divided into three stages: the foundation stage, defined by the initiation of national policies and the establishment of educational systems and teaching materials; the system-building stage, characterized by clearer disciplinary positioning, refined curriculum system, diversified clinical practices, and a robust talent development mechanism; and the innovative development stage, when, driven by policies, technology, and interdisciplinary collaboration, high quality and diversification are emerging. However, geriatric nursing still faces challenges such as insufficient coordination in top-level design, an incomplete theoretical framework, an imbalance between supply and demand for services, and uneven distribution of educational resources. In the future, through policy system optimization, smart health and wellness technology, multidisciplinary integration, education system reform, and deepening scientific research and international cooperation, a modern geriatric nursing discipline system with Chinese characteristics will be established to support healthy aging and the healthy China strategy.

Objective To explore the clinical value of complement 1q(C1q),mannose-binding lectin(MBL)and complement 5a(C5a)in the early diagnosis and disease monitoring of diabetic kidney disease(DKD),as well as their relationship with renal tubular injury.Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study.Patients were divided into the simple diabetes mellitus(SDM)group(n=50)and the DKD group(n=182)based on urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).The DKD group was further divided into the low-risk diabetic nephropathy(LDKD)group(n=90),the moderate-risk diabetic nephropathy(MDKD)group(n=55)and the high-risk diabetic nephropathy(HDKD)group(n=37)according to the risk of chronic kidney disease progression.Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group(NC group).The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe.General biochemical indicators,as well as the levels of C1q,MBL and C5a in each group were detected.Spearman correlation analysis was used to analyze the correlation between C1q,MBL,C5a and glomerular and tubular injury indexes.Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury.Results The levels of systolic blood pressure,diastolic blood pressure,triglycerides(TG),serum creatinine(Scr),uric acid(UA),UACR,NAG/Ucr,C1q,MBL and C5a were higher in the DKD group than those in the SDM group and the NC group.The levels of TC,LDL-C,ApoB and HbA1c were higher than those in the NC group,while the level of HDL-C was lower than that in the NC group.The levels of TC,LDL-C,HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group,while the level of HDL-C was lower than that in the NC group(P＜0.05).Among different progression risk groups of DKD,the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group.The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group,and the level of MBL was higher in the LDKD group than that in the SDM group(P＜0.05).After grouping according to the quartile levels of NAG/Ucr,the levels of TC,ApoB,HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q4 group than those in the Q1 group.The levels of TC,ApoB,Scr,UACR,C1q and C5a were significantly higher than those in the Q2 group,and the levels of UACR and C5a were significantly higher than those in the Q3 group.The levels of HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q3 group than those in the Q1 group.The level of UACR was higher in the Q2 group than that in the Q1 group(all P＜0.05).The Spearman correlation analysis showed that C1q,MBL and C5a were positively correlated with UACR and NAG/Ucr,and negatively correlated with eGFR(all P＜0.05).The ordinal Logistic regression analysis showed that elevated levels of MBL,C5a,NAG/Ucr,Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients.Elevated levels of C5a,HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients.Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury,and C5a is an independent risk factor for DKD progression and tubular injury.MBL can be used to screen for early DKD and is also an independent risk factor for its progression.

Objective:To explore the application effect of BOPPPS (Bridge-in, Objectives, Pre-assessment, Participatory learning, Post-assessment, and Summary) combined with scenario simulation in cultivating the humanistic care ability of undergraduate nursing interns.Methods:Undergraduate nursing students who were interning at the First Affiliated Hospital of Zhengzhou University were selected by convenience sampling. The 46 interns from June to December 2023 were set as the control group, and the 46 interns from June to December 2024 were set as the experimental group. The control group adopted the traditional lecture-based teaching method, while the experimental group adopted BOPPPS combined with scenario simulation. Theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of the two groups were compared.Results:After the intervention, the theoretical and practical scores, as well as humanistic care ability, empathy ability, and critical thinking ability scores of the experimental group were all higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:BOPPPS combined with scenario simulation plays a positive role in improving theoretical and practical scores, humanistic care ability, empathy ability, and critical thinking ability of undergraduate nursing interns, and it is worthy of further promotion and application.

On the occasion of the 30th anniversary of Chinese Journal of Modern Nursing, this paper systematically elaborates the development of geriatric nursing as a core discipline in addressing the challenges of aging, from its inception and systematization to innovative development, and analyzes its challenges and prospects. Against the backdrop of China's large aging population and accelerating aging trend, geriatric nursing aims to meet the multi-level health needs of older adults. It has gradually expanded from early focus on disease-centered care to holistic health maintenance, functional promotion, and quality of life improvement for older adults, with the discipline's scope and depth continuously evolving. The discipline development can be divided into three stages: the foundation stage, defined by the initiation of national policies and the establishment of educational systems and teaching materials; the system-building stage, characterized by clearer disciplinary positioning, refined curriculum system, diversified clinical practices, and a robust talent development mechanism; and the innovative development stage, when, driven by policies, technology, and interdisciplinary collaboration, high quality and diversification are emerging. However, geriatric nursing still faces challenges such as insufficient coordination in top-level design, an incomplete theoretical framework, an imbalance between supply and demand for services, and uneven distribution of educational resources. In the future, through policy system optimization, smart health and wellness technology, multidisciplinary integration, education system reform, and deepening scientific research and international cooperation, a modern geriatric nursing discipline system with Chinese characteristics will be established to support healthy aging and the healthy China strategy.

Objective:To explore the clinical value of syndecan-1 (SDC1), asymmetric dimethylarginine (ADMA) assessment in the early diagnosis and course monitoring of patients with type 2 diabetic kidney disease (DKD).Methods:This is a cross-sectional study. A total of 232 patients with type 2 diabetes admitted to the Department of Endocrinology of Kailuan General Hospital from December 2020 to December 2021 were included. The general biochemical indexes, SDC1 and ADMA were detected. According to urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), patients were divided into simple diabetes group (50 cases) and DKD group (182 cases). According to the risk of progression of DKD, the DKD group was further divided into low-progression diabetic nephropathy (LDKD) subgroup (90 cases), medium-progression diabetic nephropathy(MDKD)subgroup (55 cases), and high-progression diabetic nephropathy(HDKD) subgroup (37 cases). Forty healthy people undergoing physical examination during the same period in our hospital were selected as the healthy control group. According to the quartile value of N-acetyl-β-D-glucosaminase/urinary creatinine (NAG/Ucr), the DKD group was divided into Q1- Q4 subgroups, with 45, 45, 46 and 46 cases, respectively. Spearman correlation was used to analyze the correlation between SDC1, ADMA and glomerular and renal tubule injury indexes in DKD patients. Multifactor ordered Logistic regression was used to analyze the influencing factors of the progression risk of DKD and renal tubular injury. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of SDC1 and ADMA for DKD. Results:The levels of systolic blood pressure, diastolic blood pressure, triglyceride (TG), serum creatinine (Scr), uric acid (UA), NAG/Ucr, SDC1 and ADMA in DKD group were higher than those in SDM group and healthy control group (all P<0.05). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and hemoglobin A1c (HbA 1c) in DKD group were higher than those in healthy control group, and the level of high density lipoprotein cholesterol (HDL-C) was lower than that in healthy control group (all P<0.05). The SDC1 level in HDKD subgroup was higher than that in SDM group and LDKD subgroup, and the ADMA level was higher than that in SDM group and lower than that in LDKD subgroup (all P<0.05). SDC1 level in MDKD subgroup was higher than that in SDM group and LDKD subgroup, ADMA level was higher than that in SDM group, but lower than that in LDKD subgroup (all P<0.05).The levels of SDC1 and ADMA in LDKD subgroup were higher than those in SDM group (all P<0.05). The levels of TC, AporB, HbA 1c, Scr, UACR and SDC1 in NAG/Ucr Q4 subgroup were higher than those in Q1 subgroup, the levels of Scr, UACR and SDC1 were higher than those in Q2 subgroup, and the levels of HbA 1c, Scr, UACR and SDC1 in Q3 subgroup were higher than those in Q1 subgroup (all P<0.05). Spearman correlation analysis showed that SDC1 was positively correlated with UACR, NAG/Ucr ( r=0.757, 0.566, all P<0.05),and was negatively correlated with eGFR ( r=-0.337, P<0.05). ADMA was positively correlated with UACR, NAG/Ucr ( r=0.197, 0.142, all P<0.05). Multifactor ordered Logistic regression analysis showed that SDC1, NAG/Ucr and Scr were the independent influencing factors of progression risk in DKD patients ( OR=2.043, 1.067, 1.047, 0.660, 1.394, all P<0.05), while SDC1, HbA 1c and ACR were the independent influencing factors of renal tubule injury in DKD patients ( OR=1.177, 1.193, 1.002,all P<0.05). ROC curve showed that the area under the curve (AUC) of SDC1 for DKD diagnosis was 0.979, the sensitivity was 92.31%, and the specificity was 92.22%, while the AUC of ADMA for DKD diagnosis was 0.745, the sensitivity was 81.32%, and the specificity was 60.00%. The AUC, sensitivity and specificity of the combined diagnosis of DKD were 0.981, 90.66% and 95.66%. Conclusions:SDC1 is an independent risk factor of DKD progression and tubular injury in DKD patients, which can be used to diagnose early DKD and monitor the progression of DKD. ADMA is suitable for early screening of DKD.

Objective:To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children.Methods:Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index.Results:The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m2 and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters.Conclusion:There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.

Objective:To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children.Methods:Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index.Results:The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m2 and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters.Conclusion:There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.