Objective To explore the application effect of multi-component home-based exercise in elderly patients with osteoporosis and frailty.Methods A total of 52 elderly patients with osteoporosis and frailty were recruited from the osteoporosis clinic of a tertiary hospital in Nanjing,Jiangsu Province from March to August 2022 using the convenience sampling method.Subjects were randomly divided into an experimental group and a control group with 26 cases in each group by the random number table.The experimental group was given the home-based exercise program,while the control group maintained the daily lifestyle.Short Physical Performance Battery(SPPB),grip strength,Frail Scale and Chinese Osteoporosis-targeted Quality of Life Questionnaire(COQOL)of the 2 groups were compared at 12 weeks and 24 weeks,and bone mineral density(BMD)was analyzed after 24-week intervention.Results The scores in the experimental group had significant statistical differences in SPPB,grip strength,Frail Scale and COQOL compared with those in the control group after 12-week and 24-week intervention(P＜0.05).The BMD of total hip of the experimental group was significantly higher than it in the control group(P＜0.05).Conclusion The home-based exercise program can help the elderly with osteoporosis and frailty to improve the physical function and upper body strength,improve the frailty state,and enhance the quality of life,and it may be one of the effective intervention methods to prevent and reverse the frailty state of osteoporosis patients.

Blood glucose fluctuation is gradually becoming an important evaluation index of blood glucose control. Long-term blood glucose fluctuation, which reflects the long-term stability of blood glucose, plays an important role in the long-term outcome of diabetes. Excessive long-term blood glucose fluctuation not only increases the risk of cardiovascular disease, ischemic stroke and accelerates the occurrence and progression of diabetic nephropathy, but also acts as an independent predictor of diabetic retinopathy, peripheral neuropathy and mortality. In the course of diabetes treatment, maintaining long-term stability of blood glucose is the key to avoid adverse outcomes.

Objective:To construct an evaluation index system for quality of use of insulin pumps in hospitals, in order to provide a reference for evaluating quality of use of insulin pumps in hospitals in clinical work.Methods:Based on the three-dimensional quality evaluation model of "structure-process-result", the first draft was determined through literature review and group discussion from January to February 2022. Using the Delphi expert correspondence method, 26 experts from 13 provinces/municipalities in China were consulted in two rounds to determine the quality evaluation index system for the use of insulin pumps in the hospital.Results:The recovery rate of the two rounds of expert questionnaire was 100%, and the expert authority coefficient was 0.971. The mean value of the second round of index importance assignment was 4.500-5.000 and the coefficient of variation was 0-0.22. The final construction of quality evaluation index system of insulin pump use in the hospital included 3 first-level indicators, 15 second-level indicators and 37 third-level indicators.Conclusions:The constructed quality evaluation index system of insulin pump use in the hospital is scientific, reasonable and practical, which has guiding significance for evaluating the quality of insulin pump use in the hospital.

Objective:To evaluate the association of HbA 1C level and variability with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. Methods:A total of 527 elderly type 2 diabetic patients with baseline estimated glomerular filtration rate(eGFR)≥60 mL·min -1·(1.73 m 2) -1 at the diabetes center of a tertiary hospital in Jiangsu province were included and followed up. The mean value and the variability of HbA 1C, including standard deviation(HbA 1C-SD), variation coefficient(HbA 1C-CV), and adjusted standard deviation(Adj-HbA 1C-SD) were calculated. According to the annual decreased rate of eGFR, the patients were divided into △eGFR>5% group and △eGFR≤5% group. Cox proportional risk regression model was used to evaluate the relationship between HbA 1C variability and the risk of decreased glomerular filtration rate. Results:With a mean follow-up time of 19 months, there were 176 patients whose △eGFR>5%. Compared with △eGFR≤5% group, the HbA 1C-mean and HbA 1C variability were significantly higher in △eGFR>5% group( P<0.05). Cox regression analysis showed that HbA 1C-mean, HbA 1C-SD, HbA 1C-CV, and Adj-HbA 1C-SD were significantly correlated with decreased glomerular filtration rate. After adjustment for age, gender, HbA 1C-mean, and other factors, only Adj-HbA 1C-SD was correlated with renal insufficiency [ HR=3.32(1.68-6.57)]. Conclusions:HbA 1C variability is independently associated with annual decline in glomerular filtration rate in elderly patients with type 2 diabetes. The Adj-HbA 1C-SD is the most sensitive indicator in predicting decreased glomerular filtration rate.

Objective:To understand the status quo of self-stigma of diabetic patients in college students and analyze its influencing factors.Methods:This study was a cross-sectional study, and the convenient sampling was conducted online and offline from July 2017 to June 2020. College students with diabetes who were treated in outpatient or inpatient Departments of Endocrinology and Metabolism in 5 Class Ⅲ Grade A hospitals were selected as the research objects, and similar patients who followed 2 diabetes public accounts were selected as online supplements. General information questionnaire and China-Self Stigma Scale (C-SSS) were used for questionnaire surveys. Data were statistically processed by t-test, analysis of variance and multiple linear regression analysis. A total of 200 questionnaires were distributed, and 189 valid questionnaires were recovered, with an effective recovery rate of 94.50%. The self-stigma of 80.42% of college students with diabetes mellitus was at a medium-to-high level. The total average score of C-SSS was (2.34±0.49) , of which the mean scores of cognitive dimension, emotional dimension and behavioral dimension were respectively (2.33±0.50) , (2.41±0.57) and (2.19±0.64) . The results of univariate analysis showed that there were statistically significant differences in the stigma scores of diabetic patients with different genders, family locations, parental physical conditions, diabetes types, family history, diabetes complications and insulin treatment or not ( P<0.05) . The results of multiple linear regression analysis showed that gender and type of diabetes were factors affecting the self-stigma level of college students with diabetes mellitus ( P<0.05) . Conclusions:The level of self-stigma in college students with diabetes mellitus is generally high. Hospitals, schools and families should strengthen cooperation and pay attention to these with high level of self-stigma. Meanwhile, early prevention and control should be targeted through dynamic tracking, psychological counseling and other interventions.

ObjectiveTo develop the comprehensive geriatric assessment (CGA) nursing information management system and to explore its application value. MethodsCGA and mobile nursing information system were combined to design and develop the CGA nursing information management system. Totally 196 geriatric inpatients admitted in Geriatric Hospital of Nanjing Medical University from April 1st to June 30th, 2018 were selected using convenient sampling. These geriatric patients were managed by the well-trained nursing staff using the system, including CGA at admission and before discharge and continuous CGA. The changes of CGA at admission and discharge were used to assess the clinical application value of the CGA nursing information management system. ResultsThe consistency rate of the implementation of CGA nursing intervention with CGA nursing norms was 67%-91%. The geriatric patients' pain scores at discharge decreased compared with those at admission(P＜0.01), but there was no statistically significant difference in malnutrition risk, pressure ulcer, fall and ADL scores (P＞ 0.05). ConclusionsThe CGA nursing information management system is conductive to the implementation of CGA clinically, the monitoring of the effects of CGA nursing intervention, and the nursing quality control by nursing managers, which is worth promoting clinically and in communities.

Objective To investigate the effect of home diabetes care platform based on internet and family fixed partner on the continuous care of diabetes patients outside the hospital.Methods A total of 150 out-patients with diabetes were collected from June 2016 to November 2016,divided into family fixed partner group(group A),smart phone APP home diabetes care platform group(group B),family fixed partner combination with smart phone APP home diabetes care platform group(group C)with 50 cases each by random digits table method.The three groups received the same health education during their stay in hospital,patients in group A and group C were required to have family fixed partners,patients in group B and group C were required to receive the home diabetes care platform for smart phones APP after they left the hospital,the intervention time was six months,and the indexes of blood glucose metabolism,self-management ability of diabetes were assessed at the end of six months after intervention and before intervention.Results Fasting blood glucose and postprandial blood glucose and glycosylated hemoglobin values of the three groups after intervention were lower than those before intervention.The postprandial blood glucose and glycosylated hemoglobin values was(9.96±4.23)mmol/L,(7.16±1.47)%in group C,(13.78±3.34),(11.46±4.85)mmol/L and(8.46±2.21)%,(8.07±2.45)%in group A and B,the difference was significant(F=10.57,3.92,P＜0.05).The scores of self-management ability of diabetes of the three groups after intervention were all higher than those before intervention.The score of self-management ability of diabetes of item 1-6 was(6.45±1.65),(4.87±2.23),(6.17±2.12),(5.24±1.65),(4.67±2.13),(6.27±2.02)points in group C,(5.78±1.96),(3.63±2.14),(5.25±2.34),(4.12±1.97),(3.65±1.34),(5.26±2.21)points in group B,(5.04±1.78),(3.37±1.64),(4.63±1.87),(4.03±2.17),(3.32±1.74),(5.30±1.97)points in group A,the difference was statistically significant(F=3.82-7.94,P＜0.05).Conclusions Home diabetes care platform based on internet,combined with family fixed partner education,are more conductive to patient blood sugar control,and enhance self-management ability and account ability.

Objective To evaluate the impact of community-aged care program (CACP) on cognitive function and fall risk among elderly adults.Methods A total of 91 elderly were included in Senior Apartment of Jiangxi province by cluster sampling and they were divided into the control group and the CACP group. Health assessment and functional screening were conducted before intervention and nine months after intervention. Results Before intervention, there were no difference between two groups in aspects of general social demo-graphic data, clinical characteristics, cognitive function, depression, fall risk, daily life activities ability and quality of life(P>0.05). After intervention, indictors of health assessment of CACP group were superior to those of the control group (P>0.05).Conclusions CACP intervention could improve cognitive function effectively and reduce fall risk for the elderly.

This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Objective To evaluate the raliability and validity of walking impairment questionnaire applied to assess the walking ability of patients with type 2 diabetes. Methods One hundred and twenty-six patients with type 2 diabetes were selected. WIQ, SF-36 and 6-minute walk test were used to collect da-ta that was conducted for reliability analysis, correlation analysis and independent-samples t test to evaluate the reliability and validity. Results The internal consistency determined by Cronhach's α was 0.867 for the total WIQ score. Significnat correlations were found between WIQ and 6MWD, also between WIQ and physical domains of SF-36. compared with patients over seventy-one years old, the score of WIQ including the distance, speed, stair climbing and total score is significantly higher than that in patients aged seventy-one or less than seventy-one years old. Conclusions The Chinese version of WIQ is a simple, valid and reliable, clinically relevant tool to assess the walking ability of patients with type 2 diabetes.