Objective To analyze the cognitive function and sleep quality of the elderly in Shanghai community, and explore the related influencing factors. Methods A stratified cluster random sampling method was used to select 8 community health centers in Shanghai for a questionnaire survey, including 3 677 elderly individuals who completed the “Comprehensive Health Status Survey of Elderly Residents in Shanghai” from September 2023 to November 2023. Basic information of the elderly was collected, including age, gender, education level, smoking, drinking, mahjong playing behavior, and exercise habits. The Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality of the elderly, subjective cognitive decline (SCD) self-assessment questionnaire and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function, while the Hamilton Anxiety Scale (HAMA) and patient health questionnaire-9 (PHQ-9) were used to assess anxiety and depression levels, and the mini nutritional assessment (MNA) was used to evaluate nutritional status. According to the MMSE scores, the elderly were divided into three groups: no cognitive impairment (MMSE ≥ 27), mild cognitive impairment (MMSE 21-26), and moderate to severe cognitive impairment (MMSE ≤ 20). The general data, lifestyle habits, and scale scores of the three groups were compared. Ordered logistic regression was used to analyze the influencing factors of sleep quality. Results There were statistically significant differences in age, gender, waist circumference, body mass index (BMI), education level, pet ownership, smoking, drinking, mahjong playing behavior, exercise habits, and scale scores among the three groups (P＜0.05). Logistic regression analysis showed that age, waist circumference, gender, drinking habits, mahjong playing behavior, and chronic comorbidities are influencing factors for the PSQI grading in the elderly (P＜0.05). The MMSE score (OR＝1.037, P＝0.001), SCD score (OR＝1.123, P＜0.001), HAMA score (OR＝1.183, P＜0.001), PHQ-9 score (OR＝1.249, P＜0.001) are positive influencing factors for PSQI grading, while the MNA score is a negative influencing factor (OR＝0.960, P＝0.037). Conclusions Advanced age, female gender, low education level, no pet ownership, no mahjong playing behavior, no exercise habits, and poor sleep quality are risk factors for cognitive impairment in the elderly. Advanced age, female gender, no mahjong playing behavior and poor nutritional status are influencing factors for poor sleep quality in the elderly, and severe comorbidities, anxiety, depression, and subjective decline in cognitive function all affect sleep quality.

Objective:To learn about the levels of 25-hydroxy vitamin D (25-OH VD), TBNK lymphocyte subsets, and cytokines in peripheral blood of patients with brucellosis.Methods:A prospective design was adopted, one hundred patients with brucellosis admitted to the Department of Infectious Diseases, Beidahuang Industry Group General Hospital from May 2024 to February 2025 were selected as the brucellosis group, and one hundred healthy individuals who underwent physical examinations at the hospital during the same period were selected as the control group. The peripheral blood 25-OH VD levels were detected by chemiluminescence method. Further, 100 patients with brucellosis were divided into a brucellosis combined with osteoarthritis group (74 cases) and a brucellosis without osteoarthritis group (26 cases). Flow cytometry was used to detect the counts of peripheral blood TBNK lymphocyte subsets and cytokine levels. Meanwhile, Spearman rank correlation was used to analyze the correlation between peripheral blood 25-OH VD levels and TBNK lymphocyte subsets counts as well as cytokine levels in patients with brucellosis complicated by osteoarthritis.Results:The peripheral blood 25-OH VD level in the brucellosis group [20.31 (15.74, 24.35) ng/ml] was significantly lower than that of the control group [25.18 (21.13, 29.59) ng/ml], and the difference was statistically significant ( Z = - 5.07, P < 0.001). The peripheral blood 25-OH VD level [18.05 (13.79, 23.74) vs 22.43 (19.93, 28.25) ng/ml], CD4 + T cell count [(860 ± 275) vs (1 036 ± 376) cells/μl], and interleukin (IL)-6 levels [4.17 (2.14, 9.41) vs 7.83 (5.97, 11.34) ng/L] in the brucellosis combined with osteoarthritis group were significantly lower than those in the brucellosis without osteoarthritis group ( Z/t = - 2.88, 2.20, - 2.85, P = 0.004, 0.035, 0.004). Correlation analysis showed that the peripheral blood 25-OH VD level in patients with brucellosis complicated by osteoarthritis was positively correlated with the counts of CD45 +, CD3 + T, CD4 + T, CD8 + T, and natural killer cells ( r = 0.31, 0.26, 0.25, 0.25, 0.25, P = 0.007, 0.027, 0.032, 0.031, 0.032), and negatively correlated with IL-17A level ( r = - 0.40, P < 0.001). Conclusion:Patients with brucellosis have insufficient 25-OH VD, and those with osteoarthritis have lower 25-OH VD level, CD4 + T cell count, and IL-6 level than those without osteoarthritis.

To further improve the post competency of application-oriented medical students, the university medical simulation center, clinical teaching base, and off-campus social practice base were linked to establish a platform. Four key points were used to explore a new training model of "one body and four bases" for application-oriented medical students. This includes problem-oriented theoretical teaching to improve the professional knowledge of medical students, hands-on practice-oriented experimental teaching to improve the clinical skills, "strengthening clinical thinking training"-oriented practice in the base to enhance clinical awareness and cultivate clinical habits, and "cultivating humanistic literacy"-oriented off-campus social practice base to improve the humanistic sentiment and professional spirit of medical students. This teaching mode lays a foundation for training high-quality application-oriented medical talents with solid knowledge and skills and comprehensive development of ability and literacy, and provides a reference for teaching and research in similar colleges and universities.

Objective:To explore the mediating effect of illness acceptance between self-compassion and rehabilitation motivation in stroke patients with partial disability.Methods:By convenience sampling method, stroke patients who attended the neurology outpatient clinic of Xinxiang Central Hospital from February to December 2024 were selected as the research subjects. The General Information Questionnaire, Self-Compassion Scale (SCS), Chinese version of Acceptance of Illness Scale (AIS-CHI), and Stroke Rehabilitation Motivation Scale (SRMS) were used for the survey. Pearson correlation analysis was applied to analyze the relationships among self-compassion, illness acceptance, and rehabilitation motivation. AMOS 21.0 software was used to establish a structural equation model and verify the mediating effect.Results:A total of 300 questionnaires were distributed, and 289 valid ones were recovered, with an effective recovery rate of 96.33%. Among the 289 stroke patients with partial disability, the total score of SCS was (65.73±5.50), the total score of AIS-CHI was (17.46±5.62), and the total score of SRMS was (77.18±10.97). Pairwise positive correlations were found between self-compassion, illness acceptance, and rehabilitation motivation (all P<0.05). Self-compassion had a direct positive effect on rehabilitation motivation ( β=0.328, P<0.01) and a direct positive effect on illness acceptance ( β=0.439, P<0.01). Illness acceptance played a partial mediating role between self-compassion and rehabilitation motivation, and the mediating effect accounted for 31.38% of the total effect (0.150/0.478) . Conclusions:The levels of self-compassion, illness acceptance, and rehabilitation motivation in stroke patients with partial disability need to be further improved. Illness acceptance exerts a partial mediating effect between self-compassion and rehabilitation motivation. Clinically, the rehabilitation motivation of patients can be enhanced by improving their levels of self-compassion and illness acceptance.

Objective:To investigate the operation opportunity for vascular rings in infants and assess the impact of prenatal and postnatal integrated management strategies on treatment outcomes.Methods:A retrospective analysis was conducted on the clinical data of 75 infants with vascular rings who underwent surgical treatment at the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2023. Among them, 54 were males and 21 were females, with a median age at surgery of 1.7 (0.7-6.9) months and a median weight of 5.3 (3.5-8.0) kg. Vascular rings malformation was diagnosed by real-time three-dimensional color doppler echocardiography during pregnancy in 51 cases. Preoperatively, 28 cases presented with respiratory or digestive system-related symptoms, and 26 cases had a history of hospitalization due to related symptoms. All patients underwent preoperative cardiac CTA+ CTVE and three-dimensional reconstruction examinations, and 56 cases showed varying degrees of airway compression and stenosis on imaging. Among them, 10 patients presented with preoperative stridor and respiratory distress; fiberoptic bronchoscopy performed after anesthesia induction confirmed significant tracheal compression/stenosis. One patient was ventilator-dependent preoperatively, and bronchoscopy revealed main bronchomalacia. The cohort included: Complete vascular rings (62 cases of double aortic arch, 10 cases of right aortic arch with aberrant left subclavian artery and left-sided ductus arteriosus/ligamentum) and incomplete vascular rings (3 cases of pulmonary artery sling). Additionally, 5 cases had associated Kommerell’s diverticulum, and 12 had intracardiac malformation. All patients successfully completed surgery, and those with intracardiac malformation underwent extracorporeal circulation and primary radical surgery concurrently. Based on prenatal diagnosis and implementation of prenatal and postnatal integrated management, patients were divided into an observation group (prenatal and postnatal integrated management group) and a control group (postnatally diagnosed group). The perioperative data of the two groups were compared to analyze the surgical outcomes and the advantages of prenatal and postnatal integrated treatment.Results:All 75 patients successfully completed surgery. Preoperatively, 56 cases (74.66%) presented with varying degrees of tracheal stenosis. Except for 1 case that died after abandoning treatment and 1 case that underwent tracheal surgery due to repeated failed ventilator weaning, all other patients were successfully discharged from the hospital. The overall mortality rate was 1.33%, and the rate of tracheal surgery was 1.35%. The age and weight at surgery in the observation group were lower than those in the control group ( P<0.05), and the proportion of preoperative hospitalization history was lower in the observation group ( P<0.05). No significant differences were observed between the two groups in terms of tracheal compression and stenosis, postoperative monitoring time, operation time, ventilator time, and risk of postoperative complications ( P>0.05). Conclusion:Tracheal stenosis is a common complication in children with vascular rings. Early surgical intervention is recommended for complete vascular rings and pulmonary artery slings (as an incomplete ring). Timely prenatal diagnosis of vascular ring anomalies combined with the implementation of an integrated prenatal-postnatal management strategy can significantly reduce the risk of preoperative hospitalization due to related symptoms and may lower the risk of subsequent tracheal surgery, potentially improving long-term prognosis.

Objectives:To investigate the predictive value of epicardial fat volume(EFV)and atrioventricular groove fat thickness(AVGT)—morphological biomarkers of epicardial adipose tissue—for major adverse cardiovascular events(MACE)in patients with dilated cardiomyopathy(DCM).Methods:This study enrolled 216 DCM patients.EFV and AVGT were obtained from cardiac magnetic resonance imaging(CMR).Patients were divided into event-free group(n=142)and event group(n=74)based on MACE occurrence during follow-up.Receiver operating characteristic(ROC)curve analysis was used to determine optimal cutoff values.Survival differences were assessed using Kaplan-Meier analysis,Cox proportional hazards regression analysis was used to identify independent risk factors,and restricted cubic spline(RCS)models were used to evaluate dose-response relationships.Results:AVGT and EFV were significantly higher in the event group than in event-free group(both P<0.05).ROC analysis identified optimal MACE-predicting cutoffs as follows:AVGT≥7.74 mm(area under the curve[AUC]=0.57)and EFV≥78.6 ml(AUC=0.62).Kaplan-Meier analysis revealed significantly lower MACE-free survival rates in patients with AVGT≥7.74 mm and EFV≥78.6 ml(both P<0.05).Cox regression analysis confirmed that AVGT(HR=2.18,95%CI:1.34-3.54)and EFV(HR=1.81,95%CI:1.11-2.96)were independent MACE risk factors(both P<0.05)in this patient cohort.RCS models demonstrated the significant linear associations between EFV/AVGT and MACE risk(bothoverall P<0.05).Conclusions:EFV and AVGT,the non-invasive imaging biomarkers quantifying and characterizing fat distribution,are independently correlated with elevated MACE risk in DCM patients.These metrics serve as potential prognostic indicators,enriching risk stratification indicators for early identification of high-risk patients and guiding personalized medication strategies.

To prepare monoclonal antibody to the N protein of porcine reproductive and respiratory syndrome virus(PRRSV),BALB/c mice were immunized with the purified N protein of the PRRSV-2 strain expressed by prokaryotic expression system.Mouse splenocytes were fused with myeloma cells using hybridoma technique,hybridoma cells were identified by indirect ELISA method and indirect immunofluorescence assay(IFA),and positive hybridoma cells were screened for subclones using the limited dilution method.The results showed that a monoclonal antibody cell line 4A7 was successfully obtained,and the results of Western blot and IFA indicated that the monoclonal antibody could accurately recognize the N proteins of type 1 and type 2 PRRSV.Mean-while,the N protein gene was truncated and expressed by prokaryotic expression system,and the amino acid sequence of the B-cell antigenic epitope recognized by 4A7 was screened as 51EKPHF55 using Western blot.Comparison of epitope amino acids in the N protein gene sequences of different strains revealed that the antigenic epitope 51EKPHF55 recognized by the monoclonal antibody 4A7 has no amino acid difference in the sequences of three subtypes among the PRRSV-1 strains and nine lineages among the PRRSV-2 strains,indicating a high degree of conservation.The results of the study provide a foundation the development of PRRSV diagnostic kits and novel vaccines.

Objective:To explore the mediating effect of illness acceptance between self-compassion and rehabilitation motivation in stroke patients with partial disability.Methods:By convenience sampling method, stroke patients who attended the neurology outpatient clinic of Xinxiang Central Hospital from February to December 2024 were selected as the research subjects. The General Information Questionnaire, Self-Compassion Scale (SCS), Chinese version of Acceptance of Illness Scale (AIS-CHI), and Stroke Rehabilitation Motivation Scale (SRMS) were used for the survey. Pearson correlation analysis was applied to analyze the relationships among self-compassion, illness acceptance, and rehabilitation motivation. AMOS 21.0 software was used to establish a structural equation model and verify the mediating effect.Results:A total of 300 questionnaires were distributed, and 289 valid ones were recovered, with an effective recovery rate of 96.33%. Among the 289 stroke patients with partial disability, the total score of SCS was (65.73±5.50), the total score of AIS-CHI was (17.46±5.62), and the total score of SRMS was (77.18±10.97). Pairwise positive correlations were found between self-compassion, illness acceptance, and rehabilitation motivation (all P<0.05). Self-compassion had a direct positive effect on rehabilitation motivation ( β=0.328, P<0.01) and a direct positive effect on illness acceptance ( β=0.439, P<0.01). Illness acceptance played a partial mediating role between self-compassion and rehabilitation motivation, and the mediating effect accounted for 31.38% of the total effect (0.150/0.478) . Conclusions:The levels of self-compassion, illness acceptance, and rehabilitation motivation in stroke patients with partial disability need to be further improved. Illness acceptance exerts a partial mediating effect between self-compassion and rehabilitation motivation. Clinically, the rehabilitation motivation of patients can be enhanced by improving their levels of self-compassion and illness acceptance.

Objective To construction and investigate the application effect of auricular acupressure technology in patients with cough with different syndrome types.Methods From December 2022 to March 2023,the Delphi method was used to consult experts to form a technical scheme for auricular pressure in patients with cough with different syndrome types in the early and middle stages.122 patients with stage Ⅰ and stage Ⅱ lung cancer cough from the oncology department of 3 tertiary hospitals of Traditional Chinese Medicine in Beijing between July 2023 to January 2024 were randomly divided into an experimental group(61 cases)and a control group(61 cases).The experimental group referred to the constructed auricular acupressure technique program to identify and take acupoints,and the control group used the original auricular acupressure program for 7 d of continuous intervention.The changes in the scores of the Visual Analog Scale(VAS)and the scores of The MD Anderson Symptom Inventory for lung cancer(MDASI-LC)were observed in the 2 groups before and after the intervention.Results The final scheme included 3 first-level items,12 second-level items,and 14 third-level items.The 2 rounds of expert authority coefficients were 0.88,indicating a high degree of authority,and the Kendall harmony coefficients of the 2 rounds of correspondence were 0.170 and 0.130(P＜0.001),respectively,and the results tended to be consistent.A total of 122 patients completed the study.After intervention,the VAS score of cough severity in the experimental group was 3.0(2.0,3.0)points,which was lower than 3.0(3.0,4.0)points in the control group.The MDASI-LC score of the experimental group was 17.0(9.5,31.5)points,which was lower than 28.0(15.5,47.5)points in the control group,and the difference was statistically significant(P＜0.05).Conclusion The constructed auricular acupressure technique program has certain scientificity,and it can effectively relieve cough symptoms of stage Ⅰ～Ⅱ lung cancer patients,and the severity of symptom clusters has been improved,which provides the basis for TCM nursing intervention in cough symptoms of lung cancer patients.

As another major measure to accelerate the pace of medical and health system reform and benefit people's health,"one hospital with multiple campuses"has important practical significance for building a high-quality and efficient medical and health service system.How to achieve standardized,high-quality and sustainable multi hospital development,collaborative governance is the key.Based on the perspective of collaborative governance,through the analysis of the difficulties in the construction of"one hospital with multiple campuses",it is found that the positioning of"one hospital with multiple campuses"remains to be clarified,the cost-benefit balance is under pressure,and the collaborative management efficiency is insufficient.It is proposed that the party's leadership should be strengthened,the government's leading responsibility should be implemented,the institutional setting should be strictly standardized,the development scale should be reasonably controlled,the functional positioning objectives should be clear,the dislocation collaborative development should be promoted,the unified operation system should be improved,the management efficiency level should be improved,the talent recruitment mechanism should be optimized,the training and development system and the quality control system should be improved,the medical homogeneous development should be promoted,and the"three relationships"should be comprehensively grasped.