Objective:To explore the application effect of a multidisciplinary full-process chain nursing program based on the online-to-offline (OTO) model for patients with Parkinson′s disease and providing theoretical basis for medical staff to guide patients' rehabilitation.Methods:A randomized controlled trial was conducted, and 80 patients with Parkinson′s disease who visited the Neurology Department of Qilu Hospital, Shandong University (Qingdao) from January to December 2023 were selected using convenience sampling. Patients were divided into an intervention group and a control group using random number table method, with 40 patients in each group. The control group received routine nursing interventions, while the intervention group received a multidisciplinary full-process chain nursing program based on the OTO model in addition to routine care. The quality of life, rehabilitation training outcomes, psychological status, and nursing satisfaction of the two groups were compared.Results:In the intervention group, there were 23 males and 17 females, with an age of (65.46 ± 3.04) years; in the control group, there were 24 males and 16 females, with an age of (65.02 ± 3.42) years. After intervention, the scores for quality of life, rehabilitation training outcomes, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale in the intervention group were (163.57 ± 18.56), (44.18 ± 4.57), (6.27 ± 1.05) and (6.18 ± 1.05) respectively, while those in the control group were (139.42 ± 14.26), (37.54 ± 4.80), (11.53 ± 2.24) and (10.48 ± 2.22) respectively. There were statistically significant differences between the two groups ( t values were from 6.34 to 13.45, all P<0.05). Patient satisfaction was 97.50% (39/40) in the intervention group and 77.50% (31/40) in the control group, with a statistically significant difference ( χ2=7.31, P<0.05). Conclusions:Implementing a multidisciplinary full-process chain nursing program based on the OTO model for patients with Parkinson′s disease yields significant rehabilitation effects, improves negative emotions and quality of life, and is worthy of promotion in clinical practice.

Objective:To explore the application effect of a multidisciplinary full-process chain nursing program based on the online-to-offline (OTO) model for patients with Parkinson′s disease and providing theoretical basis for medical staff to guide patients' rehabilitation.Methods:A randomized controlled trial was conducted, and 80 patients with Parkinson′s disease who visited the Neurology Department of Qilu Hospital, Shandong University (Qingdao) from January to December 2023 were selected using convenience sampling. Patients were divided into an intervention group and a control group using random number table method, with 40 patients in each group. The control group received routine nursing interventions, while the intervention group received a multidisciplinary full-process chain nursing program based on the OTO model in addition to routine care. The quality of life, rehabilitation training outcomes, psychological status, and nursing satisfaction of the two groups were compared.Results:In the intervention group, there were 23 males and 17 females, with an age of (65.46 ± 3.04) years; in the control group, there were 24 males and 16 females, with an age of (65.02 ± 3.42) years. After intervention, the scores for quality of life, rehabilitation training outcomes, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale in the intervention group were (163.57 ± 18.56), (44.18 ± 4.57), (6.27 ± 1.05) and (6.18 ± 1.05) respectively, while those in the control group were (139.42 ± 14.26), (37.54 ± 4.80), (11.53 ± 2.24) and (10.48 ± 2.22) respectively. There were statistically significant differences between the two groups ( t values were from 6.34 to 13.45, all P<0.05). Patient satisfaction was 97.50% (39/40) in the intervention group and 77.50% (31/40) in the control group, with a statistically significant difference ( χ2=7.31, P<0.05). Conclusions:Implementing a multidisciplinary full-process chain nursing program based on the OTO model for patients with Parkinson′s disease yields significant rehabilitation effects, improves negative emotions and quality of life, and is worthy of promotion in clinical practice.

Objective To analyze the trajectory categories of fatigue development in middle-aged and elderly stroke patients and explore its influencing factors. Methods A convenient sampling method was used to select 230 middle-aged and elderly stroke patients in the Luzhou People's Hospital from January 2021 to January 2023 as the research subjects. A self-compiled general information-questionnaire, the Fatigue Severity Scale (FSS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI) were used to investigate the sociodemographic and clinical data, fatigue, sleep quality, and depression status of patients at 2 days after admission and 3 and 6 months after discharge. The latent growth curve model was used to fit the categories and trajectories of fatigue development, and the unordered multinomial Logistic regression model was used to analyze the influencing factors of trajectory categories of fatigue development. Results The fatigue development trajectory of middle-aged and elderly stroke patients showed three potential categories, namely the low-level fatigue stability group (33.04%), the medium-level fatigue rapid aggravation group (42.17%), and the high-level fatigue slow aggravation group (24.79%). The results of unordered multinomial Logistic regression analysis showed that age, marital status, education level, disease severity, the Activity of Daily Living (ADL) score, PSQI score, and BDI score were the influencing factors of fatigue development trajectory in middle-aged and elderly stroke patients (all P < 0.05). Conclusion The fatigue development trajectory of middle-aged and elderly stroke patients is heterogeneous. Nurses should understand the evolution characteristics of fatigue in different patients and implement targeted management measures according to patients'symptoms to improve their health outcomes.

ObjectiveTo analyze the epidemic characteristics of foodborne disease outbreaks in Mengla County， Yunnan Province， so as to provide basis for formulating corresponding prevention and control measures. MethodsThe data of foodborne disease outbreaks in Mengla County， Yunnan Province from 2017 to 2021 in the national "foodborne disease outbreak monitoring system" were collected. The time， population， region， place， pathogenic factors and inducing links of the events were statistically analyzed. ResultsFrom 2017 to 2021， a total of 68 incidents were reported， including 526 cases and 5 deaths. The total incidence rate was 23.40% and the case fatality rate was 0.95%. The peak period was from May to July， with the largest number of reported events in July. The reporting areas were mainly Mengla Town （35.29%）， Guanlei Town （11.76%） and Mengpeng Town （10.29%）. The main place of the incident was family （76.47%）. The main pathogenic factors were plant toxins （79.41%）， mainly through the ingestion of wild mushrooms （68.52%）， improper processing of green beans （12.96%） and aconitum （9.26%）. ConclusionAccording to the epidemiological characteristics of Mengla County， we should focus on the public education of health knowledge in key areas and places， especially on the identification of wild mushrooms， to prevent accidental eating. At the same time， we should strengthen the monitoring and risk assessment of foodborne diseases， find potential risks as soon as possible， issue early warning and forecast in time， and constantly improve the clinical treatment ability of poisoned patients.

Objective To understand the clinical features of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) complicated by cytomegalovirus (CMV)viremia.Methods The clinical data of 249 cases of HIV/AIDS patients hospitalized in Beijing Ditan Hospital from Oct 2008 to Nov 2009 were analyzed retrospectively,in which 43 HIV/AIDS patients were diagnosed with CMV viremia.The symptoms and signs,cerebrospinal fluid (CSF)tests,and pathological detections by bronchoscope,gastroscope and fibercoloscope were collected.The database was set up using Excel software.The association between cellular immunity and CMV DNA level was determined by SPSS12.0 software.Results Forty-three patients (17.3%)were diagnosed with CMV viremia by positive results of CMV pp65 antigen and CMV DNA tests; 14 patients manifested retinal bleeding or infiltration and 4 patients displayed retinal fibrosis; 1 patient was diagnosed with CMV pneumonitis by pathological results of bronchoalveolar lavage fluid.Low level of CD4+ T lymphocytes and CMV DNA levels were positively correlated.Conclusions CMV pp65 antigen and CMV DNA should be detected in HIV/AIDS patients with CD4+ T lymphocytes less than 100 × 106/L and anti-CMV treatment should be given according to the results.Ophthalmologic examination and bronchoalveolar lavage fluid pathological detection are effective methods in diagnose of CMV retinitis and pneumonitis.

Objective This study aimed to investigate the incidence and the cause for duodenalbiliary reflux and reflux cholangitis after metallic stent placement in distal common bile duct Methods After percutaneous transhepatic bile duct puncture and biliary outside drainage was performed, 16 cases with malignant distal biliary stricture underwent metallic stent placement in distal common bile duct Before stent placement, the routine laboratory studies including leukocyte, neutrophil percentage and the levels of total bilirubin and direct bilirubin in blood were performed for all patients. Two to five days [ an average of (3.3 ±0. 9) days ] after stent implantation, the above indexes were tested again, and 1 ml of water containing 185 MBq of 99Tcm-DTPA was given orally before extubation, then 99Tcm radioactivity in the bile was detected 2 hours later. For the measurement data obtained from the experiment, t test or Wilcoxon signed rank test was adopted to compare them, and P ＜ 0. 05 was considered to be statistically different Results In 14 cases, radioactivity was successfully detected in the bile 2-5 days after stent implantation. Twelve of them was detected to have radioactivity in the bile 2 hours before extubation with duodenal-biliary reflux. The technetium count in the bile accounted for 1.82% of the total intake dose. There was no radioactivity in the bile in 2 cases. In 14 patients, there were no symptoms of cholangitis such as high fever, chills, increased jaundice, and so on after stent implantation. The mean of white blood cell count was (7.59 t2. 62) × 109/L, and the median of neutrophil percentage was 0. 74. Compared with those before stent implantation, the difference did not reach statistical significance ( t = 0. 423, Z = 1. 036, P ＞ 0. 05 ).After stent implantation, the median of total bilirubin and direct bilirubin were significantly lower, which were 92. 2 and 74. 3 μmol/L. Compared with those before stenting,the difference was statistically significant (Z= -3. 170, -3. 170, P ＜0.05). Conclusions There is a high incidence of duodenal-biliary reflux after stent implantation in distal common bile duct in the early stage. However, there is no simultaneous cholangitis caused by duodenal-biliary reflux.

Objective To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis.Methods Sixteen cases with bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed.According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents.Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments.The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments.The patients were followed up within 2 years.Results The PTBD was successfully performed in 16 cases.Permanent external drainage, temporary internal drainage and implantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively.TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2±80.5) μmol/L averagely from (261.9±77.2)μmol/L before the treatments.All the patients died before the end of followed-up.The average survival time was 204 days (30 to 391 d)and the median survival time was 200 days.Bleeding and infection were the main complications, which could be controlled successfully by routine treatments.Conclusion With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis.

OBJECTIVE To investigate the relation of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) expression with cervical lymph metastases in papillary thyroid carcinoma. METHODS The expression of COX-2 and VEGF in 79 specimens of papillary thyroid carcinoma were evaluated with SP immunohistochemical methods. In all the 79 cases, there were 46 cases with cervical lymph node metastases and 33 cases without cervical lymph node metastasis. RESULTS The positive expression rates of COX-2 and VEGF in the cases with cervical metastases were 81.6 % and 86.8 % respectively, and in the cases without cervical lymph metastases were 54.5 % and 66.7 % respectively. There was a significant difference in the positive expression rates of COX-2 and VEGF between two groups (P