With the acceleration of population aging in China,the management of elderly patients with diabetes has become a critical issue in the field of public health.By integrating international evidence-based medical research data with the specific conditions of China,the 2024 edition of Guideline for the management of diabetes mellitus in the elderly in China proposes individualized diagnosis and treatment strategies for elderly patients with diabetes.This article gives a systematic interpretation of the guideline from a nursing perspective,with a focus on the core contents closely associated with nursing practice,and it also elaborates on the implications for nursing work,summarizes and analyzes the challenges in the management of elderly patients with diabetes,and proposes corresponding strategies,in order to provide a theoretical basis and practical guidance for implementing nursing management of elderly patients with diabetes among clinical nurses.

Objective:Through the meta-analysis of activation likelihood estimation (ALE), the functional magnetic resonance imaging research evidence of acupuncture in the treatment of depression was systematically integrated to analyze the effect of acupuncture on brain activity in patients with depression and systematically reveal its potential neural mechanism.Methods:The literatures which used functional magnetic resonance imaging to explore brain image changes of patients with depression after receiving acupuncture intervention were retrieved from CNKI, VIP database, Wanfang database, PubMed, Embase, EBSCO host MEDLINE and Web of Science database. The retrieval time is from the establishment of the database to March 2025. Data processing was performed using the ALE method by the Ginger ALE 2.3 software. The coordinates of the subjects included in the study were extracted, and the brain regions with abnormal spontaneous brain activity in patients with depression were integrated and analyzed.Results:A total of 28 articles involving 770 subjects were included. Depressed patients receiving acupuncture exhibited increased brain activity in the bilateral medial frontal gyrus and bilateral anterior cingulate cortex. Exploratory analysis revealed that depressed patients receiving acupuncture exhibited reduced activation in the left posterior cerebellar lobe (MNI: x, y, z = -6, -68, -21; x, y, z = -9, -81, -9) compared to healthy controls (voxel sum=5 824 mm 3,P<0.05). Conclusion:Patients with depression who received acupuncture intervention exhibited relatively consistent activation in brain regions compared to depressed patients who did not receive acupuncture and healthy individuals. Compared to healthy individuals, patients with depression who received acupuncture showed reduced activation in the left posterior cerebellum. It is suggested that acupuncture intervention may play a therapeutic role by regulating the functional state of emotion-related brain regions and brain networks.

Objective:Through the meta-analysis of activation likelihood estimation (ALE), the functional magnetic resonance imaging research evidence of acupuncture in the treatment of depression was systematically integrated to analyze the effect of acupuncture on brain activity in patients with depression and systematically reveal its potential neural mechanism.Methods:The literatures which used functional magnetic resonance imaging to explore brain image changes of patients with depression after receiving acupuncture intervention were retrieved from CNKI, VIP database, Wanfang database, PubMed, Embase, EBSCO host MEDLINE and Web of Science database. The retrieval time is from the establishment of the database to March 2025. Data processing was performed using the ALE method by the Ginger ALE 2.3 software. The coordinates of the subjects included in the study were extracted, and the brain regions with abnormal spontaneous brain activity in patients with depression were integrated and analyzed.Results:A total of 28 articles involving 770 subjects were included. Depressed patients receiving acupuncture exhibited increased brain activity in the bilateral medial frontal gyrus and bilateral anterior cingulate cortex. Exploratory analysis revealed that depressed patients receiving acupuncture exhibited reduced activation in the left posterior cerebellar lobe (MNI: x, y, z = -6, -68, -21; x, y, z = -9, -81, -9) compared to healthy controls (voxel sum=5 824 mm 3,P<0.05). Conclusion:Patients with depression who received acupuncture intervention exhibited relatively consistent activation in brain regions compared to depressed patients who did not receive acupuncture and healthy individuals. Compared to healthy individuals, patients with depression who received acupuncture showed reduced activation in the left posterior cerebellum. It is suggested that acupuncture intervention may play a therapeutic role by regulating the functional state of emotion-related brain regions and brain networks.

Objective: To explore the factors affecting the prevalence of HIV-associated neurocognitive disorders (HAND) among HIV/AIDS patients, so as to provide insights into developing HAND prevention measures. Methods: HIV/AIDS patients aged 18 years and above in the Infection Department of Nanjing Second Hospital were selected.Demographic data, treatment regimen and blood biochemical indicators were collected. Depression was evaluated using Patient Health Questionnaire Depression Scale, frailty was evaluated using Chinese version of Tilburg Frailty Indicator, and HAND was evaluated by Montreal Cognitive Assessment Scale. Factors affecting HAND were analyzed using a multivariable logistic regression model. Results: Totally 440 questionnaires were allocated and 426 valid questionnaires were recovered, with an effective rate of 96.82%. The median age of patients investigated was 33.00 (interquartile range, 10.00) year. There were 407 males, accounting for 95.54%; 232 patients with bachelor degree or above, accounting for 54.46%; 171 patients with HAND, accounting for 40.14%. Multivariable logistic regression analysis showed that educational level (bachelor degree or above, OR=0.291, 95%CI: 0.157-0.541), depression (OR=2.499, 95%CI: 1.530-4.083), frailty (OR=2.121, 95%CI: 1.307-3.441) and treatment regimen including efavirenz (OR=2.223, 95%CI: 1.367-3.615) were the influencing factors for HAND among HIV/AIDS patients. Conclusion Educational level, depression, frailty and use of efavirenz may be associated with HAND risk.

Objective: To explore the application of asymmetrical sculpture in the ear reconstruction with autologous cartilage through comparing the difference of the balanced sculpture and asymmetrical sculpture. Methods: We used the method of retrospective survey and classified the patients who had undergone ear reconstruction because of microtia into two groups. Group A included the patients who had undergone operation with the application of balanced sculpture method. Group B included the patients who had undergone operation with the application of unsymmetrical sculpture method. We picked out 35 patients containing 19 patients of group A and 16 patients of group B according to our grouping criteria and exclusion criteria. The number of cases with complications was recorded, such as collapse of framework, exposure of cartilage, necrosis of skin flap and reconstructed ear infection. The clinical outcomes of two methods in refining the delicate structures of the reconstructed ear were evaluated (that is the definition, shape, size, color and projection). The time for sculpture was compared. Then we analysed the results and evaluated the effectiveness, safety and feasibility of asymmetrical sculpture′s application in the ear reconstruction. Results: Group A had 2 cases which suffered skin flap necrosis. One of them had cartilage exposure and then had secondary infection leading to local cartilage necrosis and absorption, but after active treatment and local skin flap transplantation it was cured. Group B had no skin flap necrosis, cartilage extrusion, framework deformation and distortion, framework collapse and necrosis or absorption. Group B had a higher score in definition, shape, size, color and projection, and the difference was significant in definition, shape, color and projection. In our clinical practice, the sculpture time in both group was similarly about 40 minutes after the surgery operator had skillfully mastered both techniques. Conclusions Both methods are safe and feasible. The method of asymmetrical sculpture does not require additional operative time, and the method of asymmetrical sculpture is a better one compared with the method of balanced sculpture in refining the reconstructed ear.

OBJECTIVE:To develop a method for rapid determination of moisture and salidroside in Rhodiolae crenulatae.METHODS:The content of moisture was determined by the methods of oven drying (as reference value);the content of salidroside was determined by HPLC (as reference value).Near infrared spectroscopy (NIR) combined with partial least squares (PLS) algorithm were adopted to establish quantitative model for the contents of moisture and salidroside.According to reference value,83 samples were collected for preprocessing spectra by Savitsky Golay with second derivative and Norris Derivative with first derivative.The optimal spectrum range of moisture and salidroside were 7 343.60-6 865.34,5 183.72-4 890.59 cm-1 and 7 050.47-4 327.48 cm-1,respectively.RESULTS:The content determination methodology of salidroside was in line with the requirement.The correlation coefficients of calibration for moisture and salidroside were 0.968 9 and 0.920 3,and the root mean square errors of calibration were 0.273 0 and 0.085 0,respectively.The correlation coefficients of predication were 0.977 1 and 0.930 0,and the root mean square errors of prediction were 0.222 0 and 0.075 5,respectively.CONCLUSIONS:The method is proved to be simple,rapid,non-destructive and accurate,which can be used for the rapid determination of moisture and salidroside in R.crenulatae.

OBJECTIVE:To establish a method for the content determination of polymer in cefatrizine propylene glycol. METHODS:High performance sephadex gel chromatography was performed on the column of Sephadex G-10 with mobile phase A of 0.01 mol/L phosphate buffer [0.01 mol/L Disodium hydrogen phosphate solution-0.01 mol/L Sodium dihydrogen phosphate solution (61∶39,V/V)](pH7.0)and mobile phase B of water at a flow rate of 1.0 ml/min,the detection wavelength was 254 nm,column temperature was 30℃,and volume injection was 200μl. RESULTS:The linear range of polymer was 2.07-103.30 mg/ml(r=0.999 4);the limit of quantitation of 10.4 ng,limit of detection was 4.1 ng;RSDs of precision and reprodicibility tests were lower than 3%. CONCLUSIONS:The method is specific with high sensitivity and good reproducibility,and can be used for the content determination of polymer in active pharmacentical ingredient cefatrizine propylene glycol.

Objective To evaluate the expression of transient receptor potential melastatin 7(TRPM7)in cholangiocarcinoma and its correlation with prognosis.Methods The expressions of TRPM7 were detected by SP immunohistochemical in 49 cases of cholangiocarcinoma,7 cases of benign bile duct lesions and 36 cases of adjacent histologically noncancerous bile duct tissues,and to analysis its relationship with the clinical pathological characteristics of cholangiocarcinoma.Results The positive expression rate of TRPM7 in cholangiocarcinoma was 77.6%(38/49),which was higher than that in benign bile duct lesions(0,0/7)and adjacent his-tologically noncancerous bile duct tissues(2.8%,1/36),the difference was statistically significant(P <0.05).The positive expres-sion of TRPM7 in cholangiocarcinoma was correlated with the TNM stage of tumor,lymph node metastasis and organ metastasis (P <0.05),but not related to patients′age,gender,site,differentiation and hepatitis(P >0.05).Kaplan-Meier analysis showed that increased expression of TRPM7 was associated with shorted overall survival (P <0.05).Cox regression analysis showed that the expression level of TRPM7 was significantly associated with prognosis and an independent risk factor for prognosis(P <0.05 ). Conclusion TRPM7 plays an important role in the tumorigenesis progression,invasion,and metastasis of cholangiocarcinoma,and is an important factor for prognosis in patients with cholangiocarcinoma.

Age impact in mouse model of secondary hepatic alveolar echinococcus was investigated in this research . Twenty-nine 8-week-old ,twenty-five 18-week-old and twenty-five 28-week-old female mice were anesthetized with 20% ure-thane by intraperitoneal injection and then transhepatically injected by Echinococcus multilocularis (E .m) tissue suspension through skin incision and abdominal muscle to liver in all three groups to establish mouse model of secondary hepatic alveolar e-chinococcus .Results showed that the survival rates for the three groups of mice were 62 .1% ,84% and 68% ,respectively (P>0 .05) .The E .m infection rates in liver were 72 .2% ,71 .4% and 76 .5% ,respectively (P>0 .05) .The diameter of E .m cysts in liver were 0 .915 ± 0 .103 cm ,1 .247 ± 0 .112 cm and 1 .215 ± 0 .197 cm ,respectively (P>0 .05) .The mass of E .m cysts in liver were 0 .332 ± 0 .035 g ,0 .532 ± 0 .155 g and 0 .382 ± 0 .085 g ,respectively (P> 0 .05) .HE stain showed no difference in pathology .Results indicated that the establishment of secondary hepatic alveolar echinococcus model by using transhepatic injection through skin incision and abdominal muscle of 18-week-old mice was capable of simplifying operation and improving the survival rate of the mice .

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.