Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To explore the potential influencing factors of parenteral nutrition-associated cholestasis（PNAC）in extremely premature infants.Methods:A total of 83 cases of extremely premature infants who received parenteral nutrition and developed PNAC admitted to Shanxi Children's Hospital between October 2020 and October 2023 were selected as the case group，while 99 extremely premature infants who received parenteral nutrition but did not develop PNAC during the same period were selected as the control group. Basic information such as gender，gestational age，birth weight，and duration of parenteral nutrition were collected for the extremely premature infants. The health status of the infants at 1 minute and 5 minutes after birth was assessed using the Apgar standardized scoring method. One week after parenteral nutrition,platelet count(PLC)，mean platelet volume(MPV)，and platelet volume distribution width(PDW) were measured. Univariate analysis and non-conditional Logistic regression were used to analyze the potential influencing factors of PNAC in extremely premature infants after parenteral nutrition. Receiver operating characteristic(ROC) curves were plotted to evaluate the performance of the influencing factors and combined predictive factors in predicting PNAC in extremely premature infants receiving parenteral nutrition.Results:The 1-min and 5-min Apgar scores in the case group were lower than those in the control group( P<0.001);the percentages of gestational hypertension in mothers and postnatal infections in children were higher than those in the control group( P<0.05);and the duration of parenteral nutrition was longer than that in the control group( t=4.655, P<0.001), the differences were statistically significant. In the case group, after one week of parenteral nutrition,PLC was lower than that in the control group( t=4.949, P<0.001),MPV was higher than that in the control group( t=12.193, P<0.001), and PDW was higher than that in the control group( t=10.744, P<0.001), the differences were statistically significant.Multifactorial Logistic analysis showed that after adjusting for gender and gestational age，1-minute Apgar score（ OR=0.898），5-minute Apgar score（ OR=0.900），postnatal infection（ OR=1.256），duration of parenteral nutrition（ OR=1.426），one week after parenteral nutrition，PLC（ OR=0.902），MPV（ OR=1.441），and PDW（ OR=1.195）were independent influencing factors for PNAC in extremely premature infants（all P<0.05）. ROC curves showed that each factor and combined predictive factors had certain efficacy in predicting the occurrence of PNAC in extremely premature infants after parenteral nutrition. Conclusion:One-minute Apgar score,5-minute Apgar score，duration of parenteral nutrition，postnatal infection，one week after parenteral nutrition，the PLC,MPV and PDW are independent influencing factors for PNAC in extremely premature infants receiving parenteral nutrition.Each factor predicts the efficacy of parenteral nutrition for PNAC in extremely premature infants, and relevant factors should be controlled in time to reduce the incidence of PNAC in extremely premature infants.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

A case of Sifrim-Hitz-Weiss syndrome(Sifrim-Hitz-Weiss syndrome,SIHIWES)is presented.The patient was a 35-year-old male with cryptorchidism,growth retardation,skeletal malformations,muscular atrophy,a wide forehead,special facial features like square face,small low-set and cup-shaped ears since birth.Whole-exon sequencing identified a heterozygous mutation(NM_001273:c.3047A>G(chr12-6701125)(p.K1016R))in CHD4 gene.The clinical significance of this mutation is currently unknown,and has not been previously reported.In light of the patient's symptoms,the case was diagnosed as Sifrim-Hitz-Weiss syndrome.This case represents the first instance of Sifrim-Hitz-Weiss syndrome in an adult patient in China.

Objective:To explore the potential influencing factors of parenteral nutrition-associated cholestasis（PNAC）in extremely premature infants.Methods:A total of 83 cases of extremely premature infants who received parenteral nutrition and developed PNAC admitted to Shanxi Children's Hospital between October 2020 and October 2023 were selected as the case group，while 99 extremely premature infants who received parenteral nutrition but did not develop PNAC during the same period were selected as the control group. Basic information such as gender，gestational age，birth weight，and duration of parenteral nutrition were collected for the extremely premature infants. The health status of the infants at 1 minute and 5 minutes after birth was assessed using the Apgar standardized scoring method. One week after parenteral nutrition,platelet count(PLC)，mean platelet volume(MPV)，and platelet volume distribution width(PDW) were measured. Univariate analysis and non-conditional Logistic regression were used to analyze the potential influencing factors of PNAC in extremely premature infants after parenteral nutrition. Receiver operating characteristic(ROC) curves were plotted to evaluate the performance of the influencing factors and combined predictive factors in predicting PNAC in extremely premature infants receiving parenteral nutrition.Results:The 1-min and 5-min Apgar scores in the case group were lower than those in the control group( P<0.001);the percentages of gestational hypertension in mothers and postnatal infections in children were higher than those in the control group( P<0.05);and the duration of parenteral nutrition was longer than that in the control group( t=4.655, P<0.001), the differences were statistically significant. In the case group, after one week of parenteral nutrition,PLC was lower than that in the control group( t=4.949, P<0.001),MPV was higher than that in the control group( t=12.193, P<0.001), and PDW was higher than that in the control group( t=10.744, P<0.001), the differences were statistically significant.Multifactorial Logistic analysis showed that after adjusting for gender and gestational age，1-minute Apgar score（ OR=0.898），5-minute Apgar score（ OR=0.900），postnatal infection（ OR=1.256），duration of parenteral nutrition（ OR=1.426），one week after parenteral nutrition，PLC（ OR=0.902），MPV（ OR=1.441），and PDW（ OR=1.195）were independent influencing factors for PNAC in extremely premature infants（all P<0.05）. ROC curves showed that each factor and combined predictive factors had certain efficacy in predicting the occurrence of PNAC in extremely premature infants after parenteral nutrition. Conclusion:One-minute Apgar score,5-minute Apgar score，duration of parenteral nutrition，postnatal infection，one week after parenteral nutrition，the PLC,MPV and PDW are independent influencing factors for PNAC in extremely premature infants receiving parenteral nutrition.Each factor predicts the efficacy of parenteral nutrition for PNAC in extremely premature infants, and relevant factors should be controlled in time to reduce the incidence of PNAC in extremely premature infants.

Objective To investigate the quality of life of acute coronary syndrome patients(ACS)preoperatively to 6 months postoperatively percutaneous coronary intervention(PCI)and analyze its changing trend and influencing factors so as to provide reference for the improvement of ACS patients after PCI and direct for patient health management.Methods The patients with ACS were investigated for their sociodemographic characteristics,disease data,behavior and lifestyle and quality of life with the Seattle Angina Scale(SAQ)of PCI before PCI,1 month,3 months and 6 months after the surgery by means of medical records,face-to-face or telephone follow-up.Results A total of 235 ACS patients were surveyed before PCI,and 213(90.6％)of them who were successfully followed up to 6 months after PCI were included in this study,with a mean age of(62.67±9.18)years,and 76.1％being male.The results of the generalized estimation equation analysis showed that all the scores of the five dimensions of SAQ before PCI to 6 months after surgery,i.e.,physical limitation(Wald x2=83.118,P＜0.001),angina stabilizaton stability(Wald x2=289.369,P＜0.001),angina frequency(Wald x2=219.458,P＜0.001),treatment satisfaction(Wald x2=159.055,P＜0.001),and disease perception(Wald x2=130.839,P＜0.001)increased overall(all P＜0.001).However,the scores of physical limitation,angina stability and disease perception were only moderate at 6 months after surgery.The results of generalized linear model analysis showed that the factors affecting the quality of life before PCI to 6 months after PCI were gender,educational level,type of ACS,time to diagnosis,in-stent restenosis(ISR),tobacco smoking,and alcohol drinking.Conclusion The quality of life of the ACS patients gradually improved at 6 months after PCI,but the improvement effect of physical activity,angina stability and cognitive level was not ideal.Being female,low-level education,unstable angina,onset to diagnosis time 6 months or longer,occurrence of ISR,and postoperative tobacco smoking and alcohol drinking made patients have relatively low quality of life;therefore,more attention and guidance should be given to this group of population.

Objective This study aimed to examine the risk factors and prognostic factors of brucellar spondylitis for early prevention and treatment of the disease,and improving the outcomes of patients.Methods A retrospective case-control study was conducted on the patients with brucellosis who were hospitalized in the Third Hospital of Hebei Medical University from June 2020 to June 2022.Patients were assigned to brucellosis without spondylitis group or brucellar spondylitis group according to the presence of spondylitis.The patients in brucellar spondylitis group were followed for 1 year.Then they were stratified into a subgroup of good or poor prognosis according to clinical outcomes.The dataset for the demographic and clinical variables of patients were analyzed using SPSS 26.0 software.Results A total of 300 patients with brucellosis were enrolled,including 113 cases of brucellosis without spondylitis and 187 cases of brucellar spondylitis.Multivariate analysis showed that age,time from onset to diagnosis,low back pain,and erythrocyte sedimentation rate were independent risk factors for brucellar spondylitis(P＜0.05).Of the 154 cases of brucellar spondylitis with known outcomes,121 cases showed good prognosis and 33 cases had poor prognosis.COX regression analysis showed that the time from onset to diagnosis,diabetes mellitus,paravertebral abscess,and neurological impairment were independent risk factors for poor prognosis in patients with brucellar spondylitis(P＜0.05).Conclusions Old age,prolonged time from onset to diagnosis,low back pain,and increased erythrocyte sedimentation rate are independent risk factors for spondylitis in patients with brucellosis.Prolonged time from onset to diagnosis,diabetes mellitus,paravertebral abscess,and neurological impairment are independent risk factors for poor prognosis of brucellar spondylitis.

Objective:To retrieve, evaluate, and summarize evidence on the nonpharmacological management of chemotherapy-induced peripheral neuropathy (CIPN) to provide an evidence-based basis for the clinical nursing of patients undergoing cancer chemotherapy.Methods:In accordance with the "6S" model of evidence-based search resources, guidelines, evidence summaries, clinical decisions, expert consensus, and systematic reviews on the nonpharmacological management of CIPN were systematically searched on domestic and international websites or databases. The search period was from January 1, 2019 to December 31, 2023.Results:A total of 19 papers were included, including one evidence summary, one guideline, six expert consensus, and 11 systematic reviews. Forty pieces of best evidence in five aspects of assessment/screening, prevention, intervention, clinical management, and health education were summarized.Conclusions:The 40 best evidence for nonpharmacological management of CIPN summarized can be used to prevent or reduce CIPN in cancer patients. Clinical medical and nursing staff should select evidence entries as appropriate for different clinical situations, taking into account the patient's own condition and the feasibility and appropriateness of evidence implementation.

Specialist nurses assume an important role in clinical practice, teaching and research, and even in the development of the nursing discipline. Their professionalism is critical to improving the quality of nursing, enhancing the practice experience, and promoting organizational progress. This article reviews the current status, influencing factors, and measurement tools of professionalism among specialist nurses, with the aim of informing subsequent studies and intervention programs by nursing administrators.

Objective:To systematically retrieve, evaluate, extract, and integrate the best evidence on sleep disordered breathing (SDB) assessment and intervention in stroke patients to inform clinical practice.Methods:Based on the "6S" evidence model, the literature on SDB assessment and intervention in stroke patients was searched top-down on clinical decision-making websites, guideline websites, professional association websites, and databases. The search period was from the establishment of the database to September 1, 2024. The evidence-based team was formed to select the corresponding tool for quality assessment based on the type of literature. The evidence was also summarized using the Joanna Briggs Institute Center for Evidence-Based Health Care quality level of evidence and grade of recommendation.Results:A total of twenty papers were included, including six expert consensus, six guidelines, four clinical decision-making, two evidence summaries, and two systematic reviews. Eighteen pieces of evidence were summarized around four aspects of assessment, treatment, adherence, and health education.Conclusions:The assessment and intervention of SDB in stroke patients is multifaceted. It is recommended that healthcare professionals dynamically observe the actual condition of patients when applying the evidence to scientifically assess and manage SDB in stroke patients.