Objective:To explore the epidemiological characteristics and risk factors of gastroesophageal reflux disease (GERD) in Rongcheng city.Methods:From June to December 2023, 4 421 permanent residents of Rongcheng city were selected as the survey subjects, and an epidemiological investigation of GERD was conducted through a combination of telephone interviews and medical records review.Results:A total of 4 803 permanent residents of Rongcheng city were investigated in this study, and the loss of follow-up rate was 7.95%(382/4 803). The prevalence rate of GERD was 6.11%(270/4 421). Compared with the non-GERD group, patients in the GERD group were older, had a higher body mass index (BMI), had a higher proportion of males, and had a lower proportion of married patients ( P<0.05). The results of single factor analysis showed that gallbladder polyp, enteritis, Helicobacter pylori infection, colon polyp, peptic ulcer, chronic gastritis, coronary heart disease, hypertension, diabetes, pharyngitis, drinking history, smoking history, sleep problems or troubles, and eating fish, shellfish, shrimp and seaweed were the influencing factors of GERD ( P<0.05). Multiple Logistic regression analysis showed that male, gallbladder polyp, enteritis, Helicobacter pylori infection, chronic gastritis, coronary heart disease, hypertension, diabetes, pharyngitis, and sleep problems or troubles were independent risk factors for GERD ( P<0.05), while married and eating fish, shellfish, shrimp and seaweed were protective factors ( P<0.05). The scores of Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Scale (GAD-7) and Health Questionnaire Somatic Symptom Group Scale (PHQ-15) in the GERD group were higher than those in the non-GERD group: 8(5, 12) scores vs. 2(1, 4) scores, 8(5, 11) scores vs. 2(2, 5) scores, 12(8, 16) scores vs. 4(2, 5) scores, there were statistical differences ( P<0.01). The results of Spearman correlation analysis showed that the three mental state scales and GERD scale (GerdQ) scores had positive correlationsrespectively ( r = 0.150, 0.122, 0.153, P<0.05). Conclusions:The etiology and pathogenesis of GERD are related to living habits, basic diseases, mental factors and other factors. In order to reduce the incidence rate of GERD, attention should be paid to the adjustment of personal living habits and eating habits, as well as mental health.

Objective To analyze the expression levels of miR-27a-3p mRNA and Yes-associated protein 1(YAP1)mRNA in breast cancer,and to explore their relationships with clinicopathological features and the survival prognosis of patients.Methods A total of 130 breast cancer patients who underwent mastectomy in our hospital between January 2019 and January 2021 were enrolled.The expression levels of miR-27a-3p and YAP1 mRNA in breast tumor tissues and adjacent normal breast tissues were assessed by qRT-PCR.Furthermore,the relationships between their expression and clinicopathological features,as well as the survival prognosis of patients,were investigated.Results Compared with adjacent normal breast tissues,the expression of miR-27a-3p mRNA in breast tumor tissues was lower(P＜0.05),while that of YAP1 mRNA was higher(P＜0.05).A negative correlation was observed between the expression of miR-27a-3p mRNA and YAP1 mRNA in breast tumor tissues(r=-0.456,P＜0.05).The expression of miR-27a-3p mRNA was correlated with tumor diameter,histological grade,tumor staging by the TNM system,lymph node metastasis,and vascular invasion in patients with breast cancer(P＜0.05).The YAP1 mRNA expression was correlated with histological grade,tumor staging by the TNM system,lymph node metastasis,and vascular invasion(P＜0.05).Kaplan-Meier survival analysis revealed that the 3-year overall survival rate of the miR-27a-3p low-expression group was 71.60％(48/67),which was lower than the 91.50％(54/59)of the miR-27a-3p high-expression group(log-rank x2=8.211,P=0.004).The 3-year overall survival rate of the YAP1 high-expression group was 73.80％(45/61),lower than that of the YAP1 low-expression group(87.70％,57/65)(log-rank x2=4.429,P=0.035).Multivariate regression analysis indicated that lymph node metastasis(hazard ratio[HR]=1.409;95％CI,1.057-1.644;P=0.046),vascular invasion(HR=1.541;95％CI,1.076-1.869;P=0.045),low miR-27a-3p mRNA expression(HR=0.593;95％CI,0.388-0.925;P=0.018),and high YAP1 mRNA expression(HR=0.628;95％CI,0.405-0.912;P=0.022)were relevant factors affecting the 3-year overall survival of patients with breast cancer.Conclusion A significant downregulation of miR-27a-3p mRNA and upregulation of YAP1 mRNA are observed in breast tumor tissues.The low expression of miR-27a-3p mRNA and the high expression of YAP1 mRNA are associated with adverse clinicopathological features and poor survival prognosis,and are risk factors affecting the 3-year overall survival of patients with breast cancer.They show promise as new potential therapeutic targets for breast cancer.

Objective:To explore the epidemiological characteristics and risk factors of gastroesophageal reflux disease (GERD) in Rongcheng city.Methods:From June to December 2023, 4 421 permanent residents of Rongcheng city were selected as the survey subjects, and an epidemiological investigation of GERD was conducted through a combination of telephone interviews and medical records review.Results:A total of 4 803 permanent residents of Rongcheng city were investigated in this study, and the loss of follow-up rate was 7.95%(382/4 803). The prevalence rate of GERD was 6.11%(270/4 421). Compared with the non-GERD group, patients in the GERD group were older, had a higher body mass index (BMI), had a higher proportion of males, and had a lower proportion of married patients ( P<0.05). The results of single factor analysis showed that gallbladder polyp, enteritis, Helicobacter pylori infection, colon polyp, peptic ulcer, chronic gastritis, coronary heart disease, hypertension, diabetes, pharyngitis, drinking history, smoking history, sleep problems or troubles, and eating fish, shellfish, shrimp and seaweed were the influencing factors of GERD ( P<0.05). Multiple Logistic regression analysis showed that male, gallbladder polyp, enteritis, Helicobacter pylori infection, chronic gastritis, coronary heart disease, hypertension, diabetes, pharyngitis, and sleep problems or troubles were independent risk factors for GERD ( P<0.05), while married and eating fish, shellfish, shrimp and seaweed were protective factors ( P<0.05). The scores of Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Scale (GAD-7) and Health Questionnaire Somatic Symptom Group Scale (PHQ-15) in the GERD group were higher than those in the non-GERD group: 8(5, 12) scores vs. 2(1, 4) scores, 8(5, 11) scores vs. 2(2, 5) scores, 12(8, 16) scores vs. 4(2, 5) scores, there were statistical differences ( P<0.01). The results of Spearman correlation analysis showed that the three mental state scales and GERD scale (GerdQ) scores had positive correlationsrespectively ( r = 0.150, 0.122, 0.153, P<0.05). Conclusions:The etiology and pathogenesis of GERD are related to living habits, basic diseases, mental factors and other factors. In order to reduce the incidence rate of GERD, attention should be paid to the adjustment of personal living habits and eating habits, as well as mental health.

Objective:To explore the impact of self-disclosure on demoralization syndrome in patients with permanent enterostomy for colorectal cancer, so as to provide reference for clinical nursing interventions for those patients.Methods:From January to May 2023, convenience sampling was used to select 207 patients with permanent enterostomy for colocrctal cancer of the Wound Ostomy Clinic of Laoshan Campus of the Affiliated Hospital of Qingdao University as the research subjects. A survey was conducted on patients using the General Information Questionnaire, Distress Disclosure Index, Social Support Rating Scale, and the Demoralization Scale Mandarin Version.Results:Among 207 patients with permanent enterostomy for colorectal cancer, the scores of self-disclosure, social support, and demoralization syndrome were 35.00 (26.00, 47.00) , 32.00 (26.00, 39.00) , and 35.00 (23.00, 47.00) , respectively. A total of 128 patients (61.8%) were in moderate demoralization, and 37 patients (17.9%) were in severe demoralization. Multiple linear regression analysis showed that place of residence, self-care of stoma, self-disclosure, and social support were the influencing factors for demoralization syndrome in patients with permanent enterostomy for colorectal cancer ( P<0.05) . Conclusions:Patients with permanent enterostomy for colorectal cancer have a high overall score of demoralization syndrome, and a high proportion of patients with moderate to severe demoralization. Medical and nursing staff should focus on patients in remote rural areas and those with poor self-care abilities to stomas, develop targeted intervention measures to improve patients' negative emotions, enhance their self-disclosure, and pay attention to strengthening social support to relieve their demoralization syndrome, thereby improving their quality of life.

Objective:To investigate the risk factors of lower extremity deep venous thrombosis (LEDVT) in patients with sepsis during hospitalization in intensive care unit (ICU), and to construct a nomogram prediction model of LEDVT in sepsis patients in the ICU based on the critical care scores combined with inflammatory markers, and to validate its effectiveness in early prediction.Methods:726 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2015 to December 2021 were retrospectively included as the training set to construct the prediction model. In addition, 213 sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from January 2022 to June 2023 were retrospectively included as the validation set to verify the performance of the prediction model. Clinical data of patients were collected, such as demographic information, vital signs at the time of admission to the ICU, underlying diseases, past history, various types of scores within 24 hours of admission to the ICU, the first laboratory indexes of admission to the ICU, lower extremity venous ultrasound results, treatment, and prognostic indexes. Lasso regression analysis was used to screen the influencing factors for the occurrence of LEDVT in sepsis patients, and the results of Logistic regression analysis were synthesized to construct a nomogram model. The nomogram model was evaluated by receiver operator characteristic curve (ROC curve), calibration curve, clinical impact curve (CIC) and decision curve analysis (DCA).Results:The incidence of LEDVT after ICU admission was 21.5% (156/726) in the training set of sepsis patients and 21.6% (46/213) in the validation set of sepsis patients. The baseline data of patients in both training and validation sets were comparable. Lasso regression analysis showed that seven independent variables were screened from 67 parameters to be associated with the occurrence of LEDVT in patients with sepsis. Logistic regression analysis showed that the age [odds ratio ( OR) = 1.03, 95% confidence interval (95% CI) was 1.01 to 1.04, P < 0.001], body mass index (BMI: OR = 1.05, 95% CI was 1.01 to 1.09, P = 0.009), venous thromboembolism (VTE) score ( OR = 1.20, 95% CI was 1.11 to 1.29, P < 0.001), activated partial thromboplastin time (APTT: OR = 0.98, 95% CI was 0.97 to 0.99, P = 0.009), D-dimer ( OR = 1.03, 95% CI was 1.01 to 1.04, P < 0.001), skin or soft-tissue infection ( OR = 2.53, 95% CI was 1.29 to 4.98, P = 0.007), and femoral venous cannulation ( OR = 3.72, 95% CI was 2.50 to 5.54, P < 0.001) were the independent influences on the occurrence of LEDVT in patients with sepsis. The nomogram model was constructed by combining the above variables, and the ROC curve analysis showed that the area under the curve (AUC) of the nomogram model for predicting the occurrence of LEDVT in patients with sepsis was 0.793 (95% CI was 0.746 to 0.841), and the AUC in the validation set was 0.844 (95% CI was 0.786 to 0.901). The calibration curve showed that its predicted probability was in good agreement with the actual probabilities were in good agreement, and both CIC and DCA curves suggested a favorable net clinical benefit. Conclusion:The nomogram model based on the critical illness scores combined with inflammatory markers can be used for early prediction of LEDVT in ICU sepsis patients, which helps clinicians to identify the risk factors for LEDVT in sepsis patients earlier, so as to achieve early treatment.

Objective:To develop the Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers, so as to provide a measurement tool for investigating the current situation of knowledge, attitude, and practice of full-time caregivers in preventing falls in elderly inpatients.Methods:A test version of the scale was formed through literature review, expert consultation, and pre investigation. From January to April 2022, convenience sampling was used to select 312 full-time caregivers from 5 accompanying companies in 6 ClassⅢ Grade A hospitals in Qingdao as the research subject, to test the reliability and validity, and to revise the final scale. A total of 312 questionnaires were distributed, and 300 valid questionnaires were collected, with an effective response rate of 96.154% (300/312) .Results:The Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers had a total of 35 items, including 3 dimensions, including 11 items in the knowledge dimension, 10 items in the attitude dimension, and 14 items in the practice dimension. The total Cronbach's α coefficient of the scale was 0.926, with Cronbach's α coefficients of 0.914 to 0.944 for each dimension, 0.998 for test-retest reliability coefficient, and 0.681 for split half reliability coefficient of the scale. The content validity index of the scale level was 0.984, and the cumulative variance contribution rate was 59.688%.Conclusions:The reliability and validity of the Elderly Inpatient Falls Prevention Knowledge, Attitude and Practice Scale for Full-time Caregivers are good, and can be used as a tool to evaluate the full-time caregiver knowledge, attitude and practice for preventing falls in elderly inpatients.

Objective:To translate the English version of the Modified Atrial Fibrillation Information Overload Scale into Chinese,and to preliminarily test its reliability and validity.Methods:According to the Brislin translation model,the English version of the Modified Atrial Fibrillation Information Overload Scale was translated into Chinese, and then was back-translated and modified for cultural adaptation followed by the guidelines. From December 2021 to May 2022,200 patients with atrial fibrillation in the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital Affiliated to Qingdao University were included by a convenience sampling method for a questionnaire survey, in order to evaluate its reliability and validity.Results:The Chinese version of the Modified Information Atrial Fibrillation Overload Scale contained 8 items. The Cronbach α coefficient of the Chinese version of the Modified Atrial Fibrillation Information Overload Scale was 0.884. The test-retest reliability was 0.653. The split-half reliability was 0.794. The scale-content validity index was 0.98, and the item-content validity index ranged from 0.83 to 1.00. Confirmatory factor analysis showed that the two-factor model fitted well, χ2/ df was 3.958, root mean square error was 0.026, comparative fit index was 0.936, goodness of fit index was 0.918, normal of fit index was 0.917, Tucker-Lewis index was 0.900, root mean square error of approximation was 0.08. Conclusions:The Chinese version of the Modified Atrial Fibrillation Information Overload Scale has good reliability and validity. It provides a reliable research tool for the patients to measure information overload in China, and provides a basis for health education for medical staff.

Objective:To develop the Health Promotion Behavior Intention Questionnaire for enterostomy patients and test its reliability and validity.Method:Based on the theory of planned behavior, the first draft of the questionnaire was formed through literature review, group discussion, correspondence with Delphi experts and pre-test. The convenient sampling method was used to select 419 patients with enterostomy who visited Stoma Outpatient Department of the Affiliated Hospital of Qingdao University from December 2020 to June 2021 to conduct a questionnaire survey. Item analysis and reliability and validity tests were carried out on the questionnaires.Results:The Health Promotion Behavior Intention Questionnaire for enterostomy patients included 15 items. Exploratory factor analysis extracted four common factors, namely, attitude, subjective norm, perceived behavioral control and behavioral intention. The cumulative variance contribution rate was 83.166%. The content validity index of item level was 0.875-1.000 and the content validity index of questionnaire level was 0.983. The Cronbach's α coefficient of the total questionnaire was 0.921 and the retest reliability coefficient was 0.848.Conclusions:The Health Promotion Behavior Intention Questionnaire for enterostomy patients has good reliability and validity and it can be used as a tool to evaluate the health promotion behavior intention of patients with enterostomy.

Objective:To understand the status of self-transcendence, social support and stoma psychosocial adaptation in patients with enterostomy, and to analyze the correlation among the three.Methods:This study was a cross-sectional study. From July to November 2021, convenience sampling was used to select 210 patients with enterostomy who visited the Wound and Stoma Outpatient Clinic in Laoshan Campus, the Affiliated Hospital of Qingdao University as the research object. The General Information Questionnaire, Self-transcendence Scale (STS) , Social Support Rating Scale (SSRS) and Ostomy Adjustment Inventory-20 (OAI-20) were used to investigate the patients. Pearson correlation was used to test the correlation among variables, and multiple linear regression was used to explore the influencing factors of self-transcendence. A total of 210 questionnaires were distributed, and 196 effective questionnaires were recovered, with an effective recovery rate of 93.33% (196/210) .Results:Among 196 patients with enterostomy, the STS score was (36.48±11.84) . Pearson correlation analysis showed that the self-transcendence in colostomy patients was positively correlated with social support and stoma psychosocial adaptation ( r=0.712, 0.855; P<0.01) . Multiple linear regression analysis showed that educational level, stoma self-care, social support and stoma psychosocial adaptation were the main influencing factors of self-transcendence in patients with enterostomy ( P<0.05) . Conclusions:The self-transcendence of patients with enterostomy needs to be improved, and the self-transcendence is related to social support and stoma psychosocial adaptation. Medical and nursing staff should take targeted measures to improve the social support and social adaptation of patients with enterostomy, thereby improving the self-transcendence and the quality of life of patients.

Objective:To explore the relationships among perceived social constraints, social participation, as well as anxiety and depression in first stroke patients, and to further analyze the mediating effect of social participation on these variables.Methods:A total of 216 first stroke patients in the Department of Neurology of Affiliated Hospital of Qingdao University from April to December 2020 were recruited by convenience sampling and investigated by general information questionnaire, Social Constraints Scale (SCS), Chinese version of Impact on Participation and Autonomy Questionaire (IPA-C) and Hospital Anxiety and Depression Scale (HADS).Results:The total score of SCS, IPA-C, depression and anxiety were 33.49 ± 6.81, 43.42 ± 9.62, 8.05 ± 4.15 and 8.61 ± 2.59. Social constraints were positively correlated with social participation as well as anxiety ( r=0.644, 0.383, both P<0.05). Social constraints were positively correlated with social participation as well as depression ( r=0.482, 0.371, both P<0.05). The quality of social participation partially mediated the relationship between social constraints and anxiety (intermediary effect was 0.119), and also partially mediated the relationship between social constraints and depression (intermediary effect was 0.270). Conclusions:First stroke patients experience high level of social constraints, low quality of social participation and severe anxiety and depression. Social constraints can affect anxiety and depression through social participation. Medical staff should build a good environment to meet the needs of stroke patients of social participation, help patients to establish a correct psychological coping style, reduce patients' avoidance of social participation due to perceived constraints and exclusion, and thus promote the mental health of patients.