Objective:To explore the association of gait speed and cognitive function of the community-dwelling elderly.Methods:From March to December 2021, a total of 1 172 Xinxiang community-dwelling elderly people were investigated by general information questionnaire, mini-mental state examination(MMSE), patient health questionnaire depression scale and 4.6 m gait test. The elderly were divided into five groups based on the quintile grouping of gait speed values, with Q1 group (≤0.76 m/s), Q2 group (0.77-0.88 m/s), Q3 group (0.89-0.98 m/s), Q4 group (0.99-1.11 m/s) and Q5 group (≥1.12 m/s). SPSS 25.0 statistical software was used for descriptive statistics, and binary Logistic regression was used to analyze the influence of gait speed and depression on cognitive impairment of the elderly.Results:The gait speed of community-dwelling elderly people was (0.92±0.22) m/s. The scores of MMSE in Q1-Q5 groups were (24.72±3.67), (26.63±2.90), (26.58±2.66), (27.01±2.45) and (27.18±2.35), respectively, and the cognitive function was significantly different among the five gait speed groups( F=27.92, P<0.05). The results of binary Logistics regression showed that compared with Q1 group, the OR value (95% CI) of cognitive impairment in Q2-Q5 group were 0.475 (0.253-0.893), 0.426 (0.219-0.828), 0.421(0.212-0.826) and 0.371(0.179-0.766), respectively, which indicated that fast walking speed was a protective factor for cognitive function. Old age ( OR=1.096, 95% CI=1.053-1.140) and depression ( OR=14.441, 95% CI=12.670-19.829) were risk factors of cognitive impairment. Conclusion:The gait speed is associated with cognitive function among community-dwelling elderly people, and faster gait speed is a protective factor for cognitive function.

Objective:To assess a value of dual energy index(DEI)and effective atomic number(Zeff)of dual-energy computed tomography(DECT)combined with slope of energy spectrum curve in identifying the component of urinary tract stones.Methods:The clinical and DECT imaging data of 111 patients with urinary tract stones who admitted to Nantong Haimen People's Hospital from October 2019 to October 2022 were selected,and the diameters of the urinary tract stones of all patients were<5 mm.The components of outside body stones of all patients were analyzed by infrared spectrum.The accuracy,sensitivity and specificity of the DEI,Zeff,slope of energy spectrum curve and the combination of the them were respectively calculated in identifying the components of urinary tract stones.Results:In 111 patients,the patients with calcium oxalate stones were 75(67.57%),and ones with hydroxyapatite were 15 cases(13.51%),and ones with uric acid stones were 21 cases(18.92%),and there were no other type of stone included cysteine.The differences of CT values(F=487.691,P<0.001),DEI values(F=395.553,P<0.001),Zeff values(F=818.689,P<0.001)and the slopes of energy spectrum curves(H=19.615,P<0.001)were statistically significant among the three types of stones.The overall accuracies of DEI,Zeff and slope of energy spectrum curve were 87.39%(97/111),84.68%%(94/111)and 81.98%(91/111)in identifying the components of urinary tract stone.The range of diagnostic accuracies of DEI,Zeff and the slope of energy spectrum curve was between 80%and 100%for calcium oxalate stones,hydroxyapatite and uric acid stones.The overall accuracy of DEI,Zeff combined with slope of energy spectrum curve was 94.59%(105/111)in identifying the components of urinary tract stones.The diagnostic accuracies of DEI,Zeff combined with slope of energy spectrum curve were respectively 94.59%,94.59 and 100%for calcium oxalate stones,hydroxyapatite and uric acid stones.Conclusion:Compared with the single indicator of DECT,the DEI and Zeff combined with the slope of the energy spectrum curve showed better diagnostic accuracy in identifying the components urinary track stones.

Objective:To establish a core competence evaluation index system for thoracic specialist nurses.Methods:From April to September 2022, based on the iceberg model of post competence, the primary evaluation index system of core competence of thoracic specialist nurses was developed through literature review and semi-structured interview. The core competence evaluation index system for thoracic specialist nurses was determined through three rounds of letter consultation with 20 experts by Delphi method.Results:The effective recovery rates of the three rounds of expert inquiry questionnaires were 100.0% (20/20), 95.0% (19/20) and 100.0% (19/19), respectively. The expert authority coefficients were 0.925, 0.958 and 0.968, and the Kendall's concordance coefficients were 0.270, 0.235 and 0.184, respectively ( P<0.01). Finally, a core competency evaluation index system for thoracic specialist nurses was formed, including 6 first level indicators, 18 second level indicators and 68 third level indicators. Conclusions:The core competency evaluation index system for thoracic specialist nurses constructed based on post competence in this study is certain scientific, reliable and practical, which can provide a basis for the training and assessment of thoracic specialist nurses.

Objective:To explore the effect of external application of Traditional Chinese Medicine on preventing peripherally inserted central catheter (PICC) associated phlebitis in tumor patients by network Meta-analysis.Methods:Randomized controlled trials on the prevention of PICC associated phlebitis in tumor patients with external application of Traditional Chinese Medicine were searched in PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, WanFang Database, and China Biomedical Medicine disc. The search period was from the establishment of the database to July 1, 2022. Stata 17.0 software was used for network Meta-analysis.Results:A total of 15 articles were included, including 1 160 patients and 13 types of Traditional Chinese Medicine. Probability ranking according to the surface under the cumulative ranking curve showed that the top four traditional Chinese medicines in terms of effectiveness in preventing PICC associated phlebitis in tumor patients were Rhizoma Corydalis Mixture, Liuhe Dan, Qingfu Ointment, and Ruhuangbing Ointment.Conclusions:The external application of Rhizoma Corydalis Mixture, Liuhe Dan, Qingfu Ointment, and Ruhuangbing Ointment can effectively prevent the occurrence of PICC associated phlebitis in tumor patients. Although Rhizoma Corydalis Mixture has the best effect in preventing phlebitis, due to the limited sample size involved in the analysis and insufficient accuracy of the combined effects, its effectiveness in preventing phlebitis can be further verified in the future.

Objective:To explore the influencing factors and effectiveness of community follow-up in patients with cardiac implantable electronic device (CIED) implantation.Method:A total of 132 patients who received CIED implantation in the Department of Cardiology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine from February 2021 to February 2022 were enrolled in this prospective cohort study. Among them 33 patients were followed up in community health service centers associated with Tongren Hospital (community follow-up group) and 99 matched patients were followed up in the CIED outpatient clinic of the hospital (outpatient follow-up group) with a ratio of 1∶3. The clinical data of the selected patients were collected through a questionnaire survey; the follow-up data were extracted through the CarelinkExpress electronic follow-up platform and the CIED outpatient information system of Tongren Hospital. Adjustment of the treatment protocol or CIED parameters at follow-up, and the referral from the community health service centers were defined as visit with-an-action (VWA). The endpoint of follow-up was the occurrence of major adverse events. The multivariate logistic regression model was used to analyze the factors influencing patient selection for community follow-up.Results:The univariate analysis showed that the frequency of visits to community health service centers and the service contracting rate in community follow-up group were higher than those of outpatient follow-up group ( P<0.05). The multivariate logistic regression analysis showed that the contracted community physician service was an independent influencing factor of patient choosing community follow-up ( OR=2.143, 95% CI: 1.103-4.166, P=0.025). A total of 469 visits of followed up occurred in 132 patients, including 45 community visits and 424 outpatient visits. VWA accounted for 22.2% (10/45) in the community follow-up group, and 17.2% (73/424) in the outpatient follow-up group ( P>0.05). There was no significant difference in the safety and effectiveness indicators (VWA, major adverse events, and unplanned follow-up) between the two groups ( P>0.05). More patients in the community follow-up group walked to the hospital than the outpatient follow-up group ( P<0.05);and the main transportation for the later was by bus or taxi(42(42.4%)or 41(41.4%)). The average waiting time in the community follow-up group was significantly shorter than that in outpatient follow-up group ( P<0.05). The total time required for a single follow-up in the community follow-up group was 50.0 (45.0, 59.5) minutes, which was significantly shorter than that in the routine outpatient follow-up group (107.0 (90.0, 135.0) minutes, P<0.05). Conclusions:The contracting with community physicians is an independent influencing factor for CIED implanted patients to choose community follow-up. The safety and effectiveness of community follow-up are comparable to routine outpatient follow-up, and community follow-up is more convenient.

ObjectiveTo analyze the research hotspots and development trends of postpartum rehabilitation at home and abroad in the past ten years. MethodsCiteSpace 6.2.R2 was used to analyze the co-occurrence, cluster, and bursting of keywords of the relevant literature in the field of postpartum rehabilitation in CNKI and Web of Science (WOS) in the past ten years. ResultsTotally, 2 686 Chinese papaers were included in CNKI and 1 247 English papers were included in WOS. Both databases showed an increasing trend in the number of publications related to the field of postpartum rehabilitation, but the overall number of publications in CNKI grew faster and the total number of publications was more than that in WOS. For CNKI, there were 455 nodes, 1 102 links, with a density of 0.010 7; nine clusters were obtained; the bursting keywords showed that the diseases of concern shifted from breast distension and pain to pelvic floor diseases, and the hot spots of treatment methods shifted from Chinese medicine to electrical stimulation, biofeedback, and then pelvic floor training. For WOS, there were 463 nodes, 1 633 connected lines, with a density of 0.015 3; 14 clusters were obtained; the bursting keywords showed that the disease hotspots of concern shifted from anal prolapse and postpartum hemorrhage to organ prolapse, the hotspots of treatment methods shifted from analgesia to exercise, and the focus of research methods shifted from trial to qualitative research and meta-analysis. ConclusionDomestic postpartum rehabilitation started later than foreign countries. Although certain research results have been achieved, there is still a certain gap compared with the development of foreign postpartum rehabilitation.

Objective:To explore the application of PDCA (plan, do, check, act) cycle theory in the teaching of eight-year clinical medical students for the course of Laboratory Diagnostics.Methods:From September 2021 to November 2022, the students majoring in clinical medicine of eight-year system who were studying the course of Laboratory Diagnostics at Peking Union Medical College were selected as the research objects. The teaching reform of the course of Laboratory Diagnostics was carried out according to the four stages of PDCA cycle theory, and the teaching effect was evaluated by the final examination results and questionnaire survey scores of the students.Results:The score of theoretical examination of eight-year students in 2018 was (86.7±4.68) points, which was higher than that of students in 2017 [(83.3±3.89) points], and the difference was statistically significant ( P<0.05). The questionnaire survey results of the two groups of students showed that the rating of experimental course was higher than that of theoretical course ( P<0.05). After the teaching reform based on PDCA cycle theory, the questionnaire survey scores of theoretical course [(3.83±0.25) points vs (2.94±0.28) points] and experimental course [(4.13±0.09) points vs (3.32±0.12) points] in students of 2018 were higher than those of 2017 (all P<0.001). Conclusion:PDCA cycle theory provides new methods and ideas for teaching management, which helps to improve the performance of clinical medical students of eight-year system and their recognition of the course.

Review the literature on the economic evaluation of PCV-10, PCV-13 and PPSV-23 for providing references for decision-making and research in China. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology, modeling and the results were extracted. The 14 studies adopted Markov model, 2 studies adopted decision tree model and 1 study adopted probabilistic model. The cost including vaccine price and administration costs, direct medical expenses and indirect lost. All the 17 studies use QALY as the outcome, some studies also use LYG as the outcome. 9 of 13 studies (69.2%) involving people over the age of 50 concluded that pneumococcal vaccination was cost-effective. To provide effective references for decision-makers, China should collect the relevant epidemiological parameters, vaccine effect of pneumococcal disease in the Chinese population and carry out the economic evaluation of pneumococcal vaccination.

Review the literature on the economic evaluation of PCV-10, PCV-13 and PPSV-23 for providing references for decision-making and research in China. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology, modeling and the results were extracted. The 14 studies adopted Markov model, 2 studies adopted decision tree model and 1 study adopted probabilistic model. The cost including vaccine price and administration costs, direct medical expenses and indirect lost. All the 17 studies use QALY as the outcome, some studies also use LYG as the outcome. 9 of 13 studies (69.2%) involving people over the age of 50 concluded that pneumococcal vaccination was cost-effective. To provide effective references for decision-makers, China should collect the relevant epidemiological parameters, vaccine effect of pneumococcal disease in the Chinese population and carry out the economic evaluation of pneumococcal vaccination.

Rift Valley fever (RVF) is an acute, febrile zoonotic disease that is caused by the RVF virus (RVFV). RVF is mainly prevalent on the Arabian Peninsula, the African continent, and several islands in the Indian Ocean near southeast Africa. RVFV has been classified by the World Organisation for Animal Health (OIE) as a category A pathogen. To avoid biological safety concerns associated with use of the pathogen in RVFV neutralization assays, the present study investigated and established an RVFV pseudovirus-based neutralization assay. This study used the human immunodeficiency virus (HIV) lentiviral packaging system and RVFV structural proteins to successfully construct RVFV pseudoviruses. Electron microscopy observation and western blotting indicated that the size, structure, and shape of the packaged pseudoviruses were notably similar to those of HIV lentiviral vectors. Infection inhibition assay results showed that an antibody against RVFV inhibited the infective ability of the RVFV pseudoviruses, and an antibody neutralization assay for RVFV detection was then established. This study has successfully established a neutralization assay based on RVFV pseudoviruses and demonstrated that this method can be used to effectively evaluate antibody neutralization.
Africa ; Animals ; Blotting, Western ; HIV ; Indian Ocean ; Islands ; Methods ; Microscopy, Electron ; Product Packaging ; Rift Valley fever virus ; Rift Valley Fever ; Zoonoses