Objective To explore the effects of different serum potassium levels on the 28-day prognosis of elderly patients with sepsis. Methods A retrospective analysis was conducted on the clinical data and laboratory indicators within 24 hours after the diagnosis in 204 elderly patients with sepsis admitted to the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University from January 2018 to January 2022. According to the potassium concentrations in the blood of the patients within 24 hours after admission to intensive care unit (ICU), the patients were divided into the hyperkalemia group (K^＋≥5.3 mmol/L), normokalemia group (K^＋ 3.5–＜5.3 mmol/L), and hypokalemia group (K^＋＜3.5 mmol/L). According to 28-day outcomes, the patients were divided into the death group and survival group. The acute physiological and chronic health evaluation (APACHE) Ⅱ score, sequential organ failure assessment (SOFA) score and laboratory indicators were analyzed. Multivariate logistic regression analysis was used to analyze the risk factors for 28-day mortality in elderly patients with sepsis. Results Compared with the normokalemia group (n＝99), patients in both the hyperkalemia (n＝61) and hypokalemia (n＝44) groups had significantly higher levels of C-reactive protein (CRP) and procalcitonin (PCT), longer duration of mechanical ventilation, longer length of hospital stay and ICU stay, and higher mortality (P ＜ 0.05). The death group (n＝49) had significantly higher APACHE Ⅱ score, SOFA score, white blood cell (WBC) counts, CRP level, and PCT level than the survival group (n＝155, P＜0.05). Multivariate logistic regression analysis showed that increased or decreased serum potassium level, higher SOFA score, and increased WBC counts were independent risk factors for 28-day mortality in elderly patients with sepsis (P＜0.05). Quadratic fitted curve showed a U-shaped association between serum potassium levels and 28-day mortality risk in elderly patients with sepsis, with the lowest mortality risk observed within the intermediate (normal) range, and both hypokalemia and hyperkalemia were associated with an increased mortality risk (P＝0.182). Conclusion Both increased and decreased serum potassium levels are independent risk factors for 28-day mortality in elderly patients with sepsis, which should be given particular attention in clinical management.

Objective:To review the application of internet cognitive behavioral therapy (CBT) in perinatal women with negative emotions, point out the limitations of existing studies, and put forward development suggestions for future research.Methods:Using the Scope review guide published by Joanna Briggs Institute as the methodological framework, eight Chinese and English databases including China National Knowledge Infrastructure (CNKI), Wanfang, PubMed and Web of Science were searched until July 1, 2024, and the literatures were collected and analyzed.Results:A total of 18 literatures were included. The interventionists of internet cognitive behavioral therapy were mostly psychologists; the intervention methods were mostly in the form of partial participation of therapists, and the intervention platforms were mostly websites. The intervention content was centered on mental health education, emotional monitoring, cognitive reconstruction, behavioral activation training, and problem solving. There were 15 studies that demonstrated that internet cognitive behavioral therapy was effective, and three studies showed that internet cognitive behavioral therapy was not effective in improving negative emotions in perinatal women, but perinatal women responded to treatment.Conclusions:The Internet cognitive behavioral therapy can effectively improve the negative emotions of perinatal pregnant women, but the long-term effect is not clear. Future studies can expand the sample size and follow up the effect for a long time.

Veterinary Immunology is a science that studies organization structure and biological function of animal immune system.It is a subject with strong theory and application,which is a very important basic course in undergraduate education of veteri-nary medicine.With rapid development of modern science and technology,people have a deeper understanding of immunology,and traditional teaching content and teaching mode can no longer meet teaching needs of modern veterinary undergraduates.This paper briefly analyzes problems existing in current teaching process of Veterinary Immunology,and puts forward relevant suggestions for teaching reform,aiming at improving teaching quality of undergraduate Veterinary Immunology and shouldering important mission of cultivating innovative veterinary talents for socialist modernization of our country.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective:To explore the latent categories and influencing factors of health activation among community-dwelling older adults with chronic diseases.Methods:Older patients with chronic diseases attending three community health centers in Hefei City from August to December 2023 were selected for the study using the convenience sampling method. The survey utilized the General Information Questionnaire, Consumer Health Activation Index, Chinese version of the Life-Space Assessment, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Mplus 8.3 software was applied for latent profile analysis to examine patients' health activation, and unordered multicategory Logistic regression was used to explore the factors influencing different categories of health activation.Results:A total of 382 questionnaires were distributed, and 368 valid questionnaires were recovered, with a valid recovery rate of 96.34%. Three latent categories of health activation existed in community-dwelling older adults with chronic diseases, which were named as low health activation-high efficiency-coping inability group (16.85%, 62/368) , medium health activation group (27.99%, 103/368) , and high activation perception-action group (55.16%, 203/368) . Multicategory logistic regression analysis indicated that place of residence, age, self-rated health status, life space, social support, and active coping strategies were significant factors influencing the health activation of different latent categories of community-dwelling older adults with chronic diseases (all P<0.05) . Conclusions:The health activation of community-dwelling older adults with chronic diseases can be classified into three latent categories. Primary healthcare providers should identify the characteristics of patients in different categories and implement targeted nursing interventions to enhance their health activation levels.

Objective To investigate the correlation between cognitive function and medication compliance in patients with type 2 diabetes mellitus(T2DM).Methods Patients with T2DM who were admitted to the Department of Endocrinology,Drum Tower Hospital,Nanjing University School of Medicine from July 2023 to December 2023 were selected.The clinical data and laboratory results of the patients were collected.The medication compliance of the patients was evaluated by Adherence to Refills and Medications Scales(ARMS).And the overall cognitive function and independent cognitive domain tests were performed.According to the diagnostic criteria of mild cognitive impairment(MCI),patients were divided into normal cognitive group and MCI group.Linear regression analysis was used to evaluate the correlation between cognitive function and medication compliance in T2DM patients.Multivariate logistic regression analysis was used to explore the relationship between cognitive dysfunction and poor medication compliance in T2DM patients.Results A total of 216 patients with T2DM were enrolled,including 113 patients with normal cognitive function and 103 patients with MCI.The ARMS score(16.4±4.1 vs.15.1±2.8)and the rate of poor medication compliance(54.4%vs.31.0%)in the MCI group were higher than those in the normal cognitive group(all P<0.05).After adjusting for gender,age,years of education and glycosylated hemoglobin,ARMS scores were significantly negatively correlated with immediate memory,attention and delayed memory scores(all P<0.05).Multivariate logistic regression analysis showed that patients with MCI had a higher risk of poor medication adherence[OR=2.645,95%CI=(1.414,4.946),P<0.001].Conclusions Poor cognitive function,especially memory and concentration,is associated with reduced medication compliance in patients with T2DM.Patients with memory and attention problems should be given appropriate medication advice to improve their compliance in clinical practice.

Objective·To retrieve and evaluate evidence related to weight management during endocrine therapy for prostate cancer patients,and summarize the best evidence available.Methods·The PIPOST model was adopted to construct evidence-based questions.Following the"6S"model of evidence resources,a systematic computer-based search was conducted to retrieve relevant evidence on weight management during prostate cancer endocrine therapy from various databases and websites,including Guidelines International Network,BMJ Best Practice,UpToDate,JBI Evidence-Based Healthcare Center Database,American Guidelines Network,Medlive,Cochrane Library,PubMed,CINAHL,Web of Science,Embase,CNKI,Chinese Biomedical Literature Database,Wanfang Database,and VIP Database,as well as the websites of the American Urological Association,European Urological Association,and Urological Branch of Chinese Medical Association.The evidence retrieved included guidelines,clinical decisions,recommended practices,expert consensuses,evidence summaries,systematic reviews,and original studies.The search period spanned from database establishment to December 2023.Two researchers independently evaluated the quality of the included literature.The included articles were read one by one and summarized according to themes.Priority was given to high-level,high-quality,and newly published authoritative literature during evidence screening and extraction.The included and extracted evidence was uniformly classified into levels 1?5 according to the JBI evidence pre-classification and evidence recommendation level system,and the evidence recommendations were divided into strongly recommended(Grade A)and weakly recommended(Grade B).Results·A total of 12 articles were retrieved,consisting of 4 guidelines,3 expert consensuses,2 evidence summaries,2 randomized controlled trials,and 1 quasi-experimental study.All 12 articles were rated as high quality and were included.The best evidence was summarized into 8 aspects:weight management assessment and monitoring,multidisciplinary collaboration,personalized support,family involvement strategies,nutrition management strategies,exercise management strategies,health education,and follow-up management.Conclusion·The best evidence for weight management during endocrine therapy for prostate cancer is summarized into eight aspects.In clinical application,specific clinical situations and patient characteristics should also be considered to improve the effectiveness of clinical interventions and the quality of care.

Burn is a common trauma,and debridement is an important step in the treatment of burn.Traditional surgical debridement is the standard of care,but it can lead to additional trauma,infection and other complications,with a low compliance.Enzymatic debridement,a new debridement strategy,can promote wound healing,reduce infection,inhibit scar formation,avoid secondary damage,greatly relieve pain,and shorten wound healing time.This paper comprehensively compares enzymatic debridement versus traditional surgical debridement in the management of burn injuries,and reviews the advantages and latest advancements of enzymatic debridement in burn management.

Objective To investigate the correlation between cognitive function and medication compliance in patients with type 2 diabetes mellitus(T2DM).Methods Patients with T2DM who were admitted to the Department of Endocrinology,Drum Tower Hospital,Nanjing University School of Medicine from July 2023 to December 2023 were selected.The clinical data and laboratory results of the patients were collected.The medication compliance of the patients was evaluated by Adherence to Refills and Medications Scales(ARMS).And the overall cognitive function and independent cognitive domain tests were performed.According to the diagnostic criteria of mild cognitive impairment(MCI),patients were divided into normal cognitive group and MCI group.Linear regression analysis was used to evaluate the correlation between cognitive function and medication compliance in T2DM patients.Multivariate logistic regression analysis was used to explore the relationship between cognitive dysfunction and poor medication compliance in T2DM patients.Results A total of 216 patients with T2DM were enrolled,including 113 patients with normal cognitive function and 103 patients with MCI.The ARMS score(16.4±4.1 vs.15.1±2.8)and the rate of poor medication compliance(54.4%vs.31.0%)in the MCI group were higher than those in the normal cognitive group(all P<0.05).After adjusting for gender,age,years of education and glycosylated hemoglobin,ARMS scores were significantly negatively correlated with immediate memory,attention and delayed memory scores(all P<0.05).Multivariate logistic regression analysis showed that patients with MCI had a higher risk of poor medication adherence[OR=2.645,95%CI=(1.414,4.946),P<0.001].Conclusions Poor cognitive function,especially memory and concentration,is associated with reduced medication compliance in patients with T2DM.Patients with memory and attention problems should be given appropriate medication advice to improve their compliance in clinical practice.

Veterinary Immunology is a science that studies organization structure and biological function of animal immune system.It is a subject with strong theory and application,which is a very important basic course in undergraduate education of veteri-nary medicine.With rapid development of modern science and technology,people have a deeper understanding of immunology,and traditional teaching content and teaching mode can no longer meet teaching needs of modern veterinary undergraduates.This paper briefly analyzes problems existing in current teaching process of Veterinary Immunology,and puts forward relevant suggestions for teaching reform,aiming at improving teaching quality of undergraduate Veterinary Immunology and shouldering important mission of cultivating innovative veterinary talents for socialist modernization of our country.