Blood turbidity and collateral disease are closely related to each other as the important component parts of the theoretical system of modern traditional Chinese medicine (TCM). The former focuses on blood and the latter on blood vessels and collaterals. By integrating these two theories, a theoretical basis for TCM syndrome differentiation and treatment of modern diseases can be provided. This article summarizes the correlation of origin, concept, treatment method and representative drugs of two theories, and points out that both blood turbidity and collateral disease prospers and develops through the integration of TCM classical theory and modern medical achievements. Theoretically, blood turbidity is the cause of collateral disease, and collateral disease is the result of aggravated blood turbidity. In many metabolic diseases, blood turbidity and collateral disease actually correspond to the main features of the early and late stages of the same disease, respectively. In treatment, clearing blood turbidity is consistent with dredging collaterals. When clearing blood turbidity, it is necessary to dredge the collaterals, and when dredging the collaterals, it is necessary to clear the blood turbidity. In terms of prescription and medication, Huazhuo Xingxue Decoction is the representative prescription of blood turbidity, which can be combined with Ramulus Cinnamomi, Sichuan lovage rhizome, earthworm, and other dredging collateral drugs. The representative prescription for collateral disease is Tongxinluo Capsule, which can be combined with lotus leaf, Fructus Crataegi, cassia seed, and other turbid-clearing drugs to enhance the curative effect.

Objective:To explore the effect of physical activity trajectories on cognitive function in middle-aged and older adults.Methods:Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, 809 participants aged ≥45 were selected. General data, physical activity levels, and cognitive function were collected. The group-based trajectory model (GBTM) was used to establish the physical activity trajectory model, and multiple linear regression was applied to investigate factors affecting cognitive function in middle-aged and older adults and to analyze the relationship between physical activity trajectories and cognitive function.Results:The cognitive function score for the 809 middle-aged and older adults was (11.71±4.60), and the logarithmic metabolic equivalent of physical activity was (8.38±1.06). Based on GBTM, four physical activity trajectories were identified: stable group, slow-increase group, rapid-decrease group, and stable-decrease group. Multiple linear regression analysis showed that the stable and slow-increase activity trajectories, gender, age, marital status, and retirement status were significant factors influencing cognitive function in middle-aged and older adults ( P<0.01) . Conclusions:Physical activity trajectories are associated with cognitive function in middle-aged and older adults. Maintaining stable or slowly increasing physical activity is beneficial for cognitive health. Nurses should design targeted interventions based on factors influencing cognitive function.

Objective To establish the norm of Sub-Health Measurement Scale for nurses in Shandong Province,so as to provide a basis for understanding the current situation of sub-health and provide a reference for promoting the health of nurses.Methods From December 2020 to February 2023,14,308 nurses from 23 public tertiary hospitals enrolled in the Nurse Health Cohort Study in Shandong Province were selected as participants by convenience sampling.The sub-health status was assessed by the Sub-Health Measurement Scale,and the sub-health norm of nurses was constructed by establishing the mean,percentile and demarcation norm.Results A total of 10669 nurses were included in the analysis.The total score of Sub-Health Measurement Scale of nurses in Shandong Province was(61.13±12.40),and the scores of physiological sub-health sub-scale,psychological sub-health sub-scale and social sub-health sub-scale were(58.35±11.86),(62.56±15.85)and(63.56±16.73),respectively.The mean norm of sub-health assessment scale was established by gender and age.Based on the results of univariate analysis,we selected the characteristics with differences,namely gender,age,marital status,working department,years of working,professional title and employment type to establish a classification norm.P5,P25,P50,P75 and P95 were select to establish percentile norm.Taking(x-s),(x-0.5s),(x+0.5s),(x+s)as the cut-off points,the demarcation norm of the Sub-Health Measurement Scale and sub-scales was established,which was divided into 5 categories,including disease,severe sub-health,moderate sub-health,mild sub-health and healthy states.Conclusion This study established the Sub-Health Measurement Scale norm of nurses,which provided a basis for effectively evaluating and identifying the sub-health status of nurses.

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.

Objective:To evaluate the best preventive measures for hypothermia in patients undergoing hip and knee replacement.Methods:Cochrane Library, PubMed, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP and Chinese biomedical literature database were searched by computer. Randomized controlled trials on hypothermia prevention measures in hip and knee arthroplasty were searched, and back into the literature references, the retrieval time is from database establishment to December 2019; the two researchers independently conducted literature screening, quality evaluation, and data extraction according to the inclusion exclusion criteria, and used Revman5.3 software for meta-analysis of the included literature.Results:A total of 608 patients were included in 11 literatures. The results of Meta-analysis showed that: in terms of core temperature, the main outcome index, the Forced-air Warming System was superior to the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( SMD=0.59, 95% CI 0.27-0.92, P=0.0004); in terms of secondary outcome indexes, the Forced-air Warming System was better than the non-Forced-air Warming measure such as electric blanket, electric heating pad and circulating water mattress ( OR=0.28, 95% CI 0.14-0.58, P=0.0006); in terms of thermal comfort, the Forced-air Warming System had no significant effect ( SMD = 0.21, 95% CI-0.56-0.98, P=0.59). Conclusion:Compared with the Forced-air Warming System, the non-Forced-air Warming measure can effectively maintain the core temperature of patients undergoing hip and knee arthroplasty, reduce the occurrence of postoperative chills, but in the aspect of improve thermal comfort of patients is not obvious. However, due to the number of studies and their statistical heterogeneity, large sample and high-quality studies are needed to verify the results of this study.

Nursing staff plays a crucial role in the end-stage of a patient′s life, and it is inevitable for nursing staff to face and handle problems about death. The ability to cope with death is of vital importance, which can reduce the risk of emotional distress in nurses, and assist nurses to better participate in patients' end-stage care, and improve the quality of care. This paper summarizes the definition, components, theoretical frameworks and models, assessment tools, status quo, influencing factors of the coping with death competence, and propose the corresponding intervention strategy according to the situation of our country, provide references for the future research.

Objective:To evaluate the effect of mobile network platform in out-of-hospital rehabilitation of patients with total knee arthroplasty.Methods:CNKI, Wanfang, VIP, Chinese biomedical literature database, PubMed, Cochrane Library, EMbase and Web of Science database were searched by computer. To collect randomized controlled trials of out-of-hospital rehabilitation management for knee arthroplasty patients using mobile network platform. Two researchers independently screened literature, extracted data and evaluated quality according to inclusion exclusion criteria,and Stata 12.0 software was used for meta-analysis of the required documents.Results:A total of 10 articles were included for meta-analysis. A total of 933 patients were included, 471 in the intervention group and 462 in the control group. Meta-analysis showed that the knee function of patients with total knee arthroplasty managed by mobile network platform were better than those of the control group, and the difference was statistically significant(standardized mean difference( SMD) value was 1.25, 95% confidence interval( CI) 0.84-1.66, P<0.01), but the effect on improving range of motion ( SMD value was 0.29, 95% CI -0.30-0.87, P>0.1) and quality of life( SMD value was 0.90, 95% CI -0.25-2.05, P>0.1) was no difference. Conclusions:There is no obvious effect on the range of motion of the knees and quality of life, while to some extent, the application of mobile network platform in out-hospital rehabilitation management of total knee replacement patients can effectively improve the function of knees. It potentially speed up patients′rehabilitation process.

Objective:To understand the needs of end-stage cancer patients for hospice care, so as to provide a basis for the development of human-centered quality nursing services in hospice care.Methods:13 patients with end-stage cancer in tumor ward were interviewed by personal in-depth interview, and the data were sorted and analyzed by Colaizzi's seven-step analysis method.Results:A total of four themes of hospice care needs of patients with end-stage cancer were extracted. The need to maintain self-subject: the desire to maintain self-efficacy and self-image of dignity in life; the need to relieve the symptoms of self-discomfort. The need to relieve the physical symptoms and psychological discomfort. Meet the needs of self-determination: participate in medical care decisions and choose comfortable social relationships. Express their own emotional needs: the past farewell and remembrance and future wish to achieve the expectationsConclusions:Patients with end-stage cancer have diverse needs for hospice care. In clinical work, medical staff should adhere to the people-oriented concept, explore patients' needs and preferences, and implement individualized quality nursing measures to meet patients' needs for hospice care.

Objective:To investigate the expressions of micro RNA-26a (miR-26a) and toll-like receptor (TLR) in peripheral blood mononuclear cells (PBMCs) of patients with psoriasis vulgaris (PV), and to analyze their relationships with disease activity.Methods:Total 200 PV patients treated in our hospital from June 2016 to June 2018 were selected as the study group. According to Psoriasis Area and Severity Index (PASI) score, the PV patients were divided into 71 cases in mild group, 84 cases in moderate group, 45 cases in severe group, at the same time, 100 healthy people in the physical examination center were selected as the control group. The mRNA levels of TLR2 and TLR4 in PBMCs were detected by fluorescence quantitative polymerase chain reaction (PCR); serum C-reactive protein (CRP) level was detected by immunoturbidimetry; Pearson correlation was used to analyze the relationships between the expressions of miR-26a, TLR2 and TLR4 with the activity of PV (PASI score and CRP level).Results:There was no significant difference in sex, age, body mass index (BMI) and course of disease among PV patients of different grades in the study group ( P>0.05); the mRNA expression levels of miR-26a, TLR2 and TLR4 in PBMCs of the study group were significantly higher than those of the control group ( P<0.05); the PASI score, serum CRP level, miR-26a, TLR2 and TLR4 mRNA expression levels in severe PV group were significantly higher than those in mild group and moderate group ( P<0.05), and the above indexe in the moderate group were significantly higher than those in mild group ( P<0.05); the PASI score and serum CRP level of PV patients were positively correlated with miR-26a, TLR2 and TLR4 mRNA expression levels ( P<0.01). Conclusions:The mRNA expression levels of miR-26a, TLR2 and TLR4 in PBMCs of PV patients are increased and positively correlated with PASI score and CRP level, which can reflect the activity of PV disease.

Objective:To study the clinical characteristics and compliance of early-onset gout patients by case-control analysis.Methods:A total of 111 early-onset patients (onset age ≤35 years old) were included as Group A, and 111 non-early-onset patients (onset age >35 years old) with matched disease durationwere included as Group B. The differences ofclinical characteristics, causes of acute gout attack, dairy diet habits, compliance, and misunderstanding of the disease were compared.Results:Compared with the non-early-onsetgoutpatients, the early-onset patients had a higher proportion of obesity (63 cases vs 28 cases), family history (36 cases vs 20 cases) and tophus (39 cases vs 23 cases) and higher level of VAS scores (8.5±1.3 vs 7.6±1.7; χ2=22.988, P<0.01; χ2=5.749, P=0.016; χ2=5.729, P=0.017; t=4.639, P<0.01), lowerproportionof the first metatarsophalangeal joint involvement as the initial joint involvement (45.9%, 51 cases vs 59.4%, 66 cases; χ2=4.066, P=0.044), higher proportion of the ankle involvement as the initial joint involvement (34.2%, 38 cases vs 21.6%, 24 cases; χ2=4.386, P=0.036), higher proportion of alcohol drinkers and high fructose drinkers, which was more likely to relate to alcohol intake, strenuous exercise and high fructose intakeas trigger of the flare ( χ2=6.513, P=0.011; χ2=7.126, P=0.008; χ2=1.978, P=0.160), while the proportion of regular exercisers and on diet in the family was lower ( χ2=22.887, P<0.01; t=-4.917, P<0.01). The proportion of poor diet and medication compliance in Group A was higher than that in Group B(57.7%, 64 cases vs 38.7%, 43 cases; χ2=5.207, P=0.022; χ2=5.867, P=0.015). As for the reason for poor treatment compliance, early-onset gout patients were more worry about the side-effects of drugs than non-early onset patients ( χ2=4.190, P=0.041). There was no significant difference between the two groups in the main misunderstanding of gout. Conclusion:Although early onset gout patients are young, their condition is more serious, and compliance is poorer, this group of patients should be highly valued in clinical diagnosis and treatment.