Objective To explore the therapeutic effect and influencing factors of individualized exercise under continuous glucose profile in patients with typ 2 diabetes mellitus(T2DM).Methods A total of 110 patients with T2DM who were treated in the Department of Endocrinology of our hospital from December 2021 to July 2022 were randomly divided into conventional group and personalized group,with 55 cases in each group.The conventional group was given routine health exercise guidance,the personalized group was given a personalized exercise program.Repeated measurement analysis of variance was used to evaluate the improvement of blood glucose related indicators in the two groups at 3 and 6 months after intervention.Logistic regression was used to analyze the influencing factors of blood glucose(BG)control after 6 months of intervention.Results After 3 and 6 months of intervention,FBG,2 hBG,hemoglobin A1c(HbA1c),mean blood glucose(MBG)and time above target range(TAR)in the personalized group and conventional group were all lower than those before intervention(P<0.05).Time in range(TIR)of glucose within 24 h was higher than that before intervention(P<0.05).After 3 and 6 months of intervention,FBG,2 hBG,HbA1c,MBG and TAR in the personalized group were lower than those in the conventional group at the same time point(P<0.05),and TIR was higher than that in the conventional group at the same time point(P<0.05).After 6 months of intervention,the BG control rate in the personalized group was higher than that in the conventional group(P<0.05).Logistic regression analysis showed that the DM duration,exercise intervention methods and TIR were the influencing factors of BG control.Conclusions Exercise guidance is an effective intervention method to control diabetes.Compared with conventional exercise guidance,personalized exercise program has a better effect on controlling patients'BG level,and has a better effect on patients with short course of disease.

Objective:To explore the influencing factors of evacuation associated pulmonary edema (WIPE) in patients with mechanical ventilation of cardiogenic respiratory failure, and to build a risk warning model based on independent influencing factors.Methods:A total of 220 patients with cardiogenic respiratory failure who were treated and received mechanical ventilation in Chengbei Campus of Hangzhou First People′s Hospital from April 2021 to December 2023 were retrospectively selected by cross-sectional investigation method, and were divided into WIPE group (34 cases) and non WIPE group (186 cases) according to whether the patients had WIPE or not. Clinical data of the patients were analyzed using the hospital electronic medical record system. The influencing factors of WIPE were determined by univariate analysis and multivariate Logistic regression analysis, and the risk early warning model was constructed based on regression analysis. The corresponding nomogram was drawn by R language software, and the predictive efficiency of the model was tested by receiver operating characteristic curve and calibration curve.Results:WIPE group included 18 males and 16 females, aged (65.12±9.28) years. Non WIPE group included 107 males and 79 females, aged (60.25±8.40) years. Multivariate Logistic regression analysis showed that age ( OR=1.072), smoking history ( OR=3.412), acute physiology and chronic health evaluationⅡ( OR=1.184), cardiac function classification ( OR=4.043), shallow rapid breathing index ( OR=1.100), mechanical ventilation time ( OR=1.540), hypertension ( OR=4.903), left ventricular diastolic dysfunction ( OR=5.151) and chronic obstructive pulmonary disease ( OR= 5.536) were independent influencing factors (all P < 0.05). The area under the curve of the risk early warning model constructed based on the above 9 independent influencing factors was 0.938, and the sensitivity and specificity corresponding to the optimal cutoff value of 0.620 were 0.971 and 0.801, respectively, indicating good differentiation ability. The calibration curve results show that the average absolute error was 0.020, the calibration curve fits the ideal curve, and the model calibration performance was good. Conclusions:WIPE in patients with cardiogenic respiratory failure induced by mechanical ventilation is affected by cardiac function status, mechanical ventilation parameters and other factors. The risk early warning model based on the above 9 independent influencing factors has good predictive efficacy, and can provide reference for clinical prevention of WIPE.

Objective:To investigate the correlation between oral cleanliness and secondary Pulmonary infection in patients with severe chronic obstructive pulmonary disease (COPD) in mechanical ventilation, and to investigate the predictive effect of oral cleanliness on the risk of secondary pulmonary infection.Methods:Using the cross-sectional survey method, the purposeful sampling method was adopted to select 216 patients with severe COPD who were hospitalized in Hangzhou First People′s Hospital from June 2020 to December 2023 and received mechanical ventilation. The oral cleanliness index and general clinical data of patients at admission were collected using the hospital electronic medical record system. The independent influencing factors of secondary lung infection were analyzed by univariate analysis and multivariate Logisitic regression. The predictive value of oral cleanliness index on secondary lung infection was analyzed by patient operating characteristic (ROC) curve.Results:216 patients with severe COPD who underwent mechanical ventilation were included.Patients aged 37-84 (66.81 ± 8.98) years were included, including 125 males and 91 females.Among them, 89 cases developed secondary pulmonary infection, with an infection rate of 41.20%.Univariate analysis and multivariate Logistic regression analysis showed that, Beck Oral Rating Scale (BOAS) score ( OR = 1.371), visual simulation score of oral odor ( OR = 1.405), gum index ( OR = 3.508), plaque index ( OR = 14.357), smoking history ( OR = 6.772), duration of disease ( OR = 1.391), COPD assessment test score ( OR = 1.269) and mechanical ventilation time ( OR = 1.302) were independent factors for secondary pulmonary infection (all P<0.05). ROC curve analysis showed that oral cleanliness index combined with infection prediction was effective (the area under the ROC curve was 0.833) . Conclusions:Oral cleanliness was closely related to secondary pulmonary infection in patients with severe COPD with mechanical ventilation. BOAS score, visual simulation score of oral odor, gingival index and plaque index could predict secondary pulmonary infection independently, and combined test could predict secondary pulmonary infection.

Objective To explore the therapeutic effect and influencing factors of individualized exercise under continuous glucose profile in patients with typ 2 diabetes mellitus(T2DM).Methods A total of 110 patients with T2DM who were treated in the Department of Endocrinology of our hospital from December 2021 to July 2022 were randomly divided into conventional group and personalized group,with 55 cases in each group.The conventional group was given routine health exercise guidance,the personalized group was given a personalized exercise program.Repeated measurement analysis of variance was used to evaluate the improvement of blood glucose related indicators in the two groups at 3 and 6 months after intervention.Logistic regression was used to analyze the influencing factors of blood glucose(BG)control after 6 months of intervention.Results After 3 and 6 months of intervention,FBG,2 hBG,hemoglobin A1c(HbA1c),mean blood glucose(MBG)and time above target range(TAR)in the personalized group and conventional group were all lower than those before intervention(P<0.05).Time in range(TIR)of glucose within 24 h was higher than that before intervention(P<0.05).After 3 and 6 months of intervention,FBG,2 hBG,HbA1c,MBG and TAR in the personalized group were lower than those in the conventional group at the same time point(P<0.05),and TIR was higher than that in the conventional group at the same time point(P<0.05).After 6 months of intervention,the BG control rate in the personalized group was higher than that in the conventional group(P<0.05).Logistic regression analysis showed that the DM duration,exercise intervention methods and TIR were the influencing factors of BG control.Conclusions Exercise guidance is an effective intervention method to control diabetes.Compared with conventional exercise guidance,personalized exercise program has a better effect on controlling patients'BG level,and has a better effect on patients with short course of disease.

Objective:To explore the influencing factors of evacuation associated pulmonary edema (WIPE) in patients with mechanical ventilation of cardiogenic respiratory failure, and to build a risk warning model based on independent influencing factors.Methods:A total of 220 patients with cardiogenic respiratory failure who were treated and received mechanical ventilation in Chengbei Campus of Hangzhou First People′s Hospital from April 2021 to December 2023 were retrospectively selected by cross-sectional investigation method, and were divided into WIPE group (34 cases) and non WIPE group (186 cases) according to whether the patients had WIPE or not. Clinical data of the patients were analyzed using the hospital electronic medical record system. The influencing factors of WIPE were determined by univariate analysis and multivariate Logistic regression analysis, and the risk early warning model was constructed based on regression analysis. The corresponding nomogram was drawn by R language software, and the predictive efficiency of the model was tested by receiver operating characteristic curve and calibration curve.Results:WIPE group included 18 males and 16 females, aged (65.12±9.28) years. Non WIPE group included 107 males and 79 females, aged (60.25±8.40) years. Multivariate Logistic regression analysis showed that age ( OR=1.072), smoking history ( OR=3.412), acute physiology and chronic health evaluationⅡ( OR=1.184), cardiac function classification ( OR=4.043), shallow rapid breathing index ( OR=1.100), mechanical ventilation time ( OR=1.540), hypertension ( OR=4.903), left ventricular diastolic dysfunction ( OR=5.151) and chronic obstructive pulmonary disease ( OR= 5.536) were independent influencing factors (all P < 0.05). The area under the curve of the risk early warning model constructed based on the above 9 independent influencing factors was 0.938, and the sensitivity and specificity corresponding to the optimal cutoff value of 0.620 were 0.971 and 0.801, respectively, indicating good differentiation ability. The calibration curve results show that the average absolute error was 0.020, the calibration curve fits the ideal curve, and the model calibration performance was good. Conclusions:WIPE in patients with cardiogenic respiratory failure induced by mechanical ventilation is affected by cardiac function status, mechanical ventilation parameters and other factors. The risk early warning model based on the above 9 independent influencing factors has good predictive efficacy, and can provide reference for clinical prevention of WIPE.

Objective:To investigate the correlation between oral cleanliness and secondary Pulmonary infection in patients with severe chronic obstructive pulmonary disease (COPD) in mechanical ventilation, and to investigate the predictive effect of oral cleanliness on the risk of secondary pulmonary infection.Methods:Using the cross-sectional survey method, the purposeful sampling method was adopted to select 216 patients with severe COPD who were hospitalized in Hangzhou First People′s Hospital from June 2020 to December 2023 and received mechanical ventilation. The oral cleanliness index and general clinical data of patients at admission were collected using the hospital electronic medical record system. The independent influencing factors of secondary lung infection were analyzed by univariate analysis and multivariate Logisitic regression. The predictive value of oral cleanliness index on secondary lung infection was analyzed by patient operating characteristic (ROC) curve.Results:216 patients with severe COPD who underwent mechanical ventilation were included.Patients aged 37-84 (66.81 ± 8.98) years were included, including 125 males and 91 females.Among them, 89 cases developed secondary pulmonary infection, with an infection rate of 41.20%.Univariate analysis and multivariate Logistic regression analysis showed that, Beck Oral Rating Scale (BOAS) score ( OR = 1.371), visual simulation score of oral odor ( OR = 1.405), gum index ( OR = 3.508), plaque index ( OR = 14.357), smoking history ( OR = 6.772), duration of disease ( OR = 1.391), COPD assessment test score ( OR = 1.269) and mechanical ventilation time ( OR = 1.302) were independent factors for secondary pulmonary infection (all P<0.05). ROC curve analysis showed that oral cleanliness index combined with infection prediction was effective (the area under the ROC curve was 0.833) . Conclusions:Oral cleanliness was closely related to secondary pulmonary infection in patients with severe COPD with mechanical ventilation. BOAS score, visual simulation score of oral odor, gingival index and plaque index could predict secondary pulmonary infection independently, and combined test could predict secondary pulmonary infection.

Objective To construct a risk prediction model of post-traumatic stress disorder(PTSD)after hypertensive intracerebral hemorrhage in elderly patients and analyze the correla-tion of PTSD with rs806377 polymorphism of cannabinoid receptor 1(CNR1)gene.Methods A total of 215 elderly patients with hypertensive cerebral hemorrhage admitted to the Department of Neurology of Geriatric Hospital of Hainan and Department of Neurosurgery of the First Affiliated Hospital of Hainan Medical University from January 2020 to August 2022 were enrolled in this study.According to the results of PTSD scale(scoring＞50 or 0～50)after surgical treatment,they were divided into PTSD group(43 cases)and non-PTSD group(172 cases).The rs806377 polymorphism of CNR1 gene was detected in both groups by gene sequencing.Univariate and mul-tivariate logistic regression analyses were used to analyze the susceptibility to PTSD among the elderly after hypertensive intracerebral hemorrhage.Another 103 elderly patients with hyperten-sive intracerebral hemorrhage during the same period were also subjected and served as verifica-tion set.A prediction model was constructed.Results There were significant differences in age,family annual income,blood loss amount,psychological resilience score and social support score between the PTSD group and non-PTSD group(P＜0.05,P＜0.01).The PTSD group had obvi-ously larger proportion of TT genotype carriers and higher T allele frequency than the non-PTSD group(P＜0.05,P＜0.01).Logistic regression analysis showed that age(OR=2.020,95％CI:1.115-3.658),family annual income(OR=1.799,95％CI:1.232-2.626),blood loss(OR=1.507,95％CI:1.243-1.826),psychological resilience score(OR=2.059,95％CI:1.068-3.969),social support score(OR=1.664,95％CI:1.122-2.467),rs806377 TT genotype(OR=1.861,95％CI:1.485-2.331)and rs806377 T allele(OR=3.777,95％CI:2.049-6.962)were the influencing fac-tors of postoperative PTSD in these patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the sensitivity was 69.57％,the specificity was 71.25％,and the AUC value was 0.762(95％CI:0.708-0.813)in the verification group,indicating a certain accuracy of our model.Conclusion CNR1 gene rs806377 locus polymorphism is an influencing factor for PTSD susceptibility,and rs806377 TT genotype and rs806377 T allele can predict PTSD in elderly patients after hyperten-sive intracerebral hemorrhage.

Objective:To explore the status of "socialized hospitalization" of chronic obstructive pulmonary disease (COPD) patients and its influencing factors, and propose constructive coping strategies.Methods:From June 2018 to June 2020, convenience sampling was used to select 256 COPD patients admitted to Hangzhou First People's Hospital as the research object. The self-designed Socialized Hospitalization Status and Influencing Factors Questionnaire was used to investigate patients. Single factor analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of the "socialized hospitalization" of COPD patients.Results:Among 256 COPD patients, 239 effective samples were finally obtained, and 61 cases (25.52%) were "socialized hospitalization". The hospitalization time of patients with "socialized hospitalization" was longer than those with non-"socialized hospitalization", and the difference was statistically significant ( t=16.510, P<0.01) . Hospitalization expenses were higher than those with non-"socialized hospitalization", and the difference was statistically significant ( t=17.820, P<0.01) . The results of single factor analysis showed that there were statistically significant differences in the age, course of illness, type of medical insurance, hospital admission method, hospital-acquired infection, mental status score, dyspnea score, and basic life activity ability in patients with "socialized hospitalization" and non-"socialized hospitalization" ( P<0.05) . The results of multivariate Logistic regression analysis showed that the patient's age, type of medical insurance, hospital admission method, hospital-acquired infection, mental status, dyspnea, and basic life activity ability were the influencing factors of COPD patients' "socialized hospitalization", and the difference was statistically significant ( P<0.05) . Conclusions:Various physiological and pathological conditions and family conditions are the influencing factors of "socialized hospitalization" in COPD patients. The allocation of medical resources should be balanced, the nursing system should be perfected, and the technical level and quality of medical and nursing staff should be improved to ease the pressure of "socialized hospitalization".

Objective To investigate the fatigue in patients with type 2 diabetes mellitus (T2DM),and analyze its related factors.Methods A total of 211 patients with type 2 diabetes were investigated with Chinese version of Multidimensional Fatigue Inventory-20 (MFI-20),Medical Outcomes Study Health Status Short Form-Vitality (SF-36-VT) and demographic survey questionnaire.T test,one-way AVOVA and multiple linear regression analysis were used to analyze the data.Results The fatigue incidence of 211cases of patients with type 2 diabetes was 63.5％ (134/211),the mean score of MFI-20 was 54.10±15.63,and women's score (57.89±15.32) was significantly higher than that of men (51.54±15.37)(t=2.949,P ＜ 0.01).Physical fatigue got the highest score of the three dimensions in MFI-20,which was 2.99±1.03,the mental fatigue scored 2.67±0.82.Multiple linear regression analysis showed that fatigue was related to the sports,2hPBG,rest situation,cerebrovascular complications and the number of complications,which could totally explain 30.7％ of the variance.Conclusions More attention should be paid to fatigue of T2DM patients.Effective interventions should be carried out to relieve the fatigue status of T2DM patients and improve their self-management ability and quality of life.

OBJECTIVE:To observe clinical efficacy of urinary kallidinogenase in the treatment of acute cerebral watershed in-farct (WSI). METHODS:128 patients with WSI were randomly divided into control group and treatment group,each of the 64 cases. Control group was given Shuxuening 15 ml added into 0.9% Sodium chloride 250 ml,ivgtt,qd;treatment group received urinary kallidinogenase 0.15 PNA added into 0.9% Sodium chloride 100 ml,ivgtt,qd. Both groups were treated for consecutive 14 days. Neurologic impairment score(NIHSS)and clinical efficacy were observed in 2 groups before treatment and 3,7 and 14 days after treatment. The blood specimens were collected after 7 and 14 days treatment,to determine serum levels of TCC. RESULTS:After treatment,NIHSS and total effective rate of treatment group were significantly higher than those of control group,with statis-tical significance(P<0.01). There was no statistical significance in TCC between 2 groups before treatment(P>0.05);7 days af-ter treatment,TCC level of 2 groups increased significantly,to 14 days,and a declive;the treatment group was higher than the control group,with statistical significance (P<0.05). CONCLUSIONS:Urinary kallidinogenase can improve clinical efficacy of WSI significantly,and promote neurologic impairment symptom and TCC levels.