Objective:To conduct a multi-center cross-sectional study of elderly patients with cognitive impairment based on real-world data; To analyze the clinical characteristics and core medication law of the disease population.Methods:The medical records of elderly patients diagnosed with cognitive impairment from January 1, 2016 to December 31, 2024 were retrieved from Chinese Evidence-based TCM Database. Excel 2010 software was used to collect general information, TCM syndrome elements and syndrome types, use frequency of Chinese materia medica, property, taste, meridian tropism, efficacy classification and other information, using PivotTable to establish Chinese materia medica matrix. IBM SPSS Modeler 18.0 software was used to display the frequency of co-occurrence among high-frequency Chinese materia medica, and the association rules were analyzed based on the Apriori algorithm. R language 4.4.1 was used for clustering analysis on Chinese materia medica and the cluster pedigree and correlation heat map were drawn.Results:A total of 1 194 elderly patients with cognitive impairment were enrolled, with a mean age of (79.51±7.65) years, and the highest frequency of comorbidities was hypertension (891 cases, 74.62%); AD was the most frequent diagnosis of cognitive impairment (367 times, 30.74%). The proportion of mild cognitive impairment in the low value group of Systemic Immune Inflammation Index (SII) was relatively high, and the high value group of SII was mainly vascular dementia and AD. Wind-phlegm blocking syndrome (106 times, 13.73%) topped the list; phlegm was the most frequent element of pathogenicity (353 times, 45.73%), and meridians and collaterals (194 times, 25.13%). Totally 328 prescriptions were included, involving 308 kinds of Chinese materia medica. The total recorded frequency of Chinese materia medica was 5 665, with tonifying herbs constituting the most frequently used category, accounting for 1 633 times; the medicinal property of drugs for treating elderly patients with cognitive disorders was mostly warm (103 times, 33.44%), the taste was mostly bitter (141 times, 45.78%), and attributed to the liver meridian (145 times, 47.08%); among the two and three association rules, the drug pairs with the highest confidence were Gastrodiae Rhizoma→Uncariae Ramulus cum Uncis (97.22%) and Hyperici Perforati Herba→Acanthopanacis Senticosi Radix et Rhizoma seu Caulis+Alpiniae Oxyphyllae Fructus (97.06%); five medicinal combinations were obtained by high frequency drug clustering analysis.Conclusions:Elderly patients with cognitive impairment are mainly diagnosed with AD. There may be a potential correlation between SII level and the progression of cognitive impairment. The drugs are used to tonify the kidney and replenish essence, detoxify and unblock collaterals, replenish qi and activate blood circulation, and awaken the brain and open the orifices. Shengmai Decoction, Renshen Yangrong Decoction and other TCM classic prescriptions can be used in clinic.

Objective:To investigate the current status of career success of ICU nurses and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 178 ICU nurses from 7 Class Ⅲ Grade A hospitals in Guangzhou, Guangdong Province from April to May 2021 were selected as the research objects. General questionnaire and Chinese version of Career Success Scale were used to conduct the survey through the questionnaire network platform.Results:A total of 178 electronic questionnaires were filled in and 167 valid electronic questionnaires were recovered. The total score of career success of ICU nurses was (35.68±6.07). Multiple linear regression analysis showed that gender of ICU nurses, whether they had regular specialized skills training, and the cooperative relationship of doctors and nurses in departments were the influencing factors of career success scores of nurses ( P<0.05) . Conclusions:The career success level of ICU nurses needs to be improved. It is recommended that nursing managers should clarify the career development path of nurses, broaden the career development space of nurses and enhance their professional autonomy and work enthusiasm.

Objective To evaluate the efficacy of one stage anterior debridement combined with posterior pedicle screw fixation in the treatment of cervical intervertebral space infection.Methods From June 2010 to June 2016,28 cases were fixed by anterior debridement combined with the posterior vertebral pedicle screws for the cervical intervertebral space infection,19 males and 9 females.The average age was 45-74 years (58±14.5 years old).21 cases (75％) were spontaneous infection,of which 6 cases were diabetes mellitus,15 cases were over 60 years old.The remaining 7 cases (25％) were intervertebral space infection after radiofrequency ablation of the cervical spine.All patients were excluded from tuberculosis and Brucella infection.All patients underwent hematological examination,with emphasis on WBC,ESP and CRP.All patients received JOA score before operation,applied antibiotic according to blood culture and drug sensitive test.All patients underwent one stage anterior debridement combined with posterior pedicle screw fixation,and the operative time and bleeding volume were recorded.After the operation,intravenous antibiotic therapy was continued,and the application of antibiotics was guided according to the results of ESP and CRP,and the time for the application of antibiotics was recorded.Follow up was performed at 3 months,6 months and 1 years after operation respectively.The JOA score and postoperative cervical lordosis Cobb angle were recorded.Results All operations were successfully completed in this group.The operation time was 130-225 min,with an average of 145.5±12.7 min.The intraoperative blood loss was 40-100 ml,with an average of 67±35.2 ml.The incision was healed in one stage.The time of application of antibiotics in 28 patients was 21-87 days,with an average of 30.8±8.7 days.The longest application time of antibiotics was 87 days,and no relapse was found during follow-up.The postoperative JOA score increased from 11.3± 1.2 to three months 14.9 ± 1.96 postoperatively and 6 months 15.1 ± 1.55 and 1 years 16.5±0.48 after operation.The JOA score was significantly higher than that before operation.No significant loss and change of the Cobb angle in the cervical spine surgery were found.All cases had good bone graft fusion at 1 years.Conclusion One stage anterior debridement combined with posterior pedicle screw fixation is a safe and effective method for the treatment of cervical vertebra instability and nerve function injury caused by cervical intervertebral space infection.It provides a new way for the treatment of cervical intervertebral space infection.

Objective To describe the adequate feeding of early enteral nutrition in critical patients with cancer, and explore its influencing factors. Methods A retrospective analysis study was performed and 161 patients were involved. Results Nearly 57.14%patients got adequate feeding. The independent risk factors included complications (P < 0.05,OR=2.312,OR 95%CI 1.078-4.958), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores (P < 0.05,OR=1.111,OR 95%CI 1.017-1.214) and hypoalbuminemia (P<0.05,OR=2.252,OR 95%CI 1.036-4.892) , and the protective factor was previous enteral nutrition experience (P<0.01,OR=0.123,OR 95%CI 0.021-0.494). Patients who got adequate feeding showed more increase in albumin levels, more decrease in APACHEⅡscores and shorter ICU stays. Conclusions Part of patients got inadequate feeding, due to comprehensive effects of many factors. And adequate feeding may be beneficial to the increase of albumin levels, also helps patients rehabilitate early and shorten the ICU stays.

The major clinical risk of atherosclerosis (AS) lesion is instability and vulnerability of plaque.Intraplaque vasa vasorum (VV) has structure defects with the characteristics of immature,irregular,fragile,and prone to extravasation and intraplaque hemorrhage due to the compromised structural integrity.It stimulates inflammatory reaction and provides channel for hemocyte and blood soluble composition entering into the plaque.Intraplaque VV can promote AS plaque formation and is closely related to the intraplaque hemorrhage,plaque rupture and occurrence of clinical cardiovascular events.In-depth study of VV function and key signaling pathways related to AS pathological process are promising to fundamentally prevent vulnerable plaque development,unstable plaque rupture and its complications.This article summarized the effect and mechanism of VV in pathological process of AS and related treatment,in order to provide theoretical basis for stabilization of AS vulnerable plaque.

This study was aimed to observe the effect of Si-Miao Yong-An (SMYA) decoction intervention in atherosclerosis (AS) vulnerable plaque,and to further explore the action mechanism from the entry point of vasa vasorum (VV) neovascularization.Male ApoE-/-mice were randomly divided into the model group,simvastatin group and SMYA group.High-fat diet added 1.1％ L-methionine was fed for 8 weeks to establish the AS vulnerable plaque model.The C57BL/6 mice were used as control.After 8 weeks' continuous medication,mice were sacrificed.HE staining were used to observe the pathological changes of mice aorta;immunohistochemical staining was used to observe the VV density in AS plaque and aortic adventitia;macrophage infiltration in plaque was also detected;the blood-lipid changes of TC,TG,LDL-C and HDL-C were detected;western blot was used to detect essential proteins of HIF-1α-Apelin/APJ signal pathway.The results showed that SMYA decoction decreased the plaque area and the ratio of plaque area and lumen area,increased the minimum thickness of fibrous cap,which significantly improved the pathological feature of aortic plaque in mice.The function of increasing the minimum thickness of fibrous cap was obviously superior to simvastatin.SMYA decoction effectively suppressed the VV neovascularization and decreased the macrophage content.SMYA decoction effectively decreased the serum level of TC,TG and LDL-C;however,it had no effect on HDL-C.SMYA decoction decreased the protein expression of HIF-1α.Its function was obviously superior to simvastatin.SMYA decoction can down-regulate the protein expressions of Apelin,APJ,Phospho-MEK1/2 (Ser217/221),Phospho-p44/42 MAPK (Erk1/2) (Thr202/Tyr204) and Phospho-p70 S6 Kinase (Thr421/Ser424).It was concluded that SMYA decoction regulated the HIF-1α-Apelin/APJ signal pathway,suppressed VV neovascularization and stabilized AS vulnerable plaque.

Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

Objectives To explore the decade-feature of military personnel' s psychosomatic health and Its Influence factors.Methods By random cluster sampling,a total of 11362 military personnel ( including army,navy and air-force) were tested by Chinese Psychosomatic Health Scale (CPSHS) from 80' ( n=1100),90' ( n=8000),2000' ( n =2262)then employing SPSS statistic 17.0 program for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.Results The factor of eye-ear( 80s' ( 1.17 ± 1.68),90s'( 1.19 ± 1.64 ),2000s' ( 1.12 ± 1.48 ) ) had no significant difference in three decades (P ＞ 0.05 ) ; military personnel' s respiratory system,cardiovascular system,alimentary system,bone-muscle,skin,reproductive-endocrine system,nervous system,anxiety,depression,psychotic traits,family history,mental heath,physical health,and total psychosomatic health psychosomatic health had significant differences in the three decades (P＜ 0.05 ～0.01 ).The stepwise regression analysis revealed that decade,length of military service,urban-rural,marital state had significant effect on total psychosomatic health( decade:t =- 12.452,length of military service:t =-0.024,urban-rural:t=-0.066,marital status:t=0.119,P＜0.012 ～0.000).Conclusions The level of military personnel's psychosomatic health is improved from 80' s,90' s of last century to the year of 2000; the influenced factors of military personnels' psychosomatic health are including decade,length of military service,rural-urban,and marital status.

ObjectiveTo explore the decade-feature of military personnel' mental maladjustment and its influenced factors.MethodsBy random cluster sampling,a total of 10883 military personnel( including army,navy and air-force) were tested by military mental maladjustment scale (MMMS) in three decades (80s' 90s',2000),then employing SPSS 17.0 for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.ResultsThe single scores for behavioral disorders( (2.79 ±2.96),(3.42 ± 2.98 ) vs (2.85± 2.93 ) ),affective disorders ( ( 1.50 ± 1.47 ),( 1.76 ± 1.50 ) vs ( 1.51 ± 1.47 ) ),interpersonal relationship( ( 1.78 ± 1.93 ),( 2.44 ± 2.14) vs (2.30 ± 2.18 ) ),environmental adjustment( (0.63 ± 0.94 ),( 0.89 ± 1.02 )vs ( 1.02 ± 1.18) ),and total score ( ( 6.71 ± 6.01 ),( 8.50 ± 6.20) vs ( 7.69 ± 6.89 ) ) had significant differences in the three decades (P ＜ 0.01 ).The changing disposition of behavior,emotion,interpersonal relationship and total mental maladjustment seemed as reversed V in three decades,but environmental adjustment revealed linear increase; stepwise regression analysis revealed that total scores of mental maladjustment had significant decadeeffect after introducing other four independent variables( t =5.96,P =0.000 ) ; the educational level,urban-rural also had significant influence on military mental maladjustment( t =- 3.15,- 9.02,P =0.002 ～ 0.000 ).ConclusionThe mental maladjustment of military personnel reveale a decreasing disposition from 80s',90s' of last century to the year of 2000 ; the influencing factors are decade,educational level and rural-urban.

To investigate the value of apoptosis of the allo-antigen specific T cells induced by Fas/FasL pathway in preventing graft-versus-host disease (GVHD), the CD34+ cells transfected with FasL or not, used as stimulus cells, were mixed with allo-antigen specific T lymphocytes in presence or absence of IFN-gamma and IL-2. After 5 days, apoptosis of T cells was detected by TdT nick end mediated dUTP labeling (TUNEL) and flow cytometry (FCM). The affects of these two cytokines on CD34+ cells in the graft were also compared. The ratio of apoptosis of T cells was 12.1+/-1.5% when CD34+ cells transfected with FasL was used as stimulus cells, much higher than that of CD34+ cells non-transfected (3.2+/-1.1%, P<0.01). And in presence of IFN-gamma or IL-2, the ratio reached 20.1+/-2.3%, 17.6+/-1.3% respectively (P<0.01). However, IFN-gamma up-regulated Fas expression of CD34+ cells and increased the sensibility of CD34+ cells to soluble FasL (sFasL); IL-2 showed no such effect. It is possible to induce apoptosis of the allo-antigen specific T cells of grafts activated by allo-antigen by exogenous Fas ligand expressed on recipient cells and this might provide a new approach for preventing GVHD and IL-2 may be more suitable for clinical application.
Antigens, CD34 ; biosynthesis ; immunology ; Apoptosis ; Cytotoxicity, Immunologic ; DNA, Complementary ; genetics ; Fas Ligand Protein ; Graft vs Host Disease ; prevention & control ; Interferon-gamma ; biosynthesis ; immunology ; Interleukin-2 ; biosynthesis ; immunology ; Membrane Glycoproteins ; biosynthesis ; immunology ; T-Lymphocytes ; cytology ; physiology ; fas Receptor ; biosynthesis ; immunology