“Integrated elderly care and medical services” is a new model of elderly care that relies on medical care as a guarantee， rehabilitation as a support， and combines ongoing medical treatment with nurturing， offering comprehensive therapy. This new type of elderly care model also poses new job requirements for elderly care workers. However， there is currently a large shortage of elderly care workers， along with prevalent issues such as low professional quality， low education level， and an older average age. The main reasons for this situation are low welfare benefits， low social status， and an incomplete promotion system in the industry， resulting in low social recognition of the industry， a shortage of employees， and a high number of resignations. Based on this， it is suggested to expand the number of the elderly care team and enhance the quality of the elderly care team by improving the career development system， increasing salary and welfare benefits， and expanding social recognition.

To investigate the expression and distribution of follicular dendritic cell(FDC)and follic-ular helper T cells(Tfh)in mouse spleen and lymph nodes induced by foot-and-mouth virus-like particles(FMDV-VLPs),the recombinant pCMV-HA-HBcAg-VP1-VP4 plasmid was transfected into CHO-K1 cells to prepare FMDV-VLPs,and the recombinant FMDV VP1-VP4 protein was expressed and purified through a prokaryotic expression system.BALB/c mice were subcutaneous-ly immunized with FMDV-VLPs(VLP group)and recombinant FMDV VP1-VP4 protein(VP1-VP4 group),and PBS control group(PBS group)was set up.At 21 d post primary immunization(dpi),booster immunization was carried out.Spleen,shoulder lymph nodes,and submandibular lymph nodes were collected at 7,28,42,72 and 102 dpi,and frozen sections were prepared.Immu-nohistochemical staining was used to observe the expression and distribution of FDC and Tfh.The results showed that the number of FDC and Tfh cells in the VLP group in the spleen and lymph nodes showed a gradual increase from 7 to 42 dpi,and gradually decreased to non-immune levels starting from 72 dpi.The results indicate that FMDV-VLPs can induce the formation of GC in the spleen and lymph nodes,and the number of FDC and Tfh cells in GC can last for at least 42 d.This study provides a theoretical basis for the study of the immune memory response mechanism of B cells induced by FMDV virus-like particles.

Objective:To explore the impact of childhood trauma on drug relapse tendency, as well as the mediating role of post-traumatic stress disorder (PTSD).Methods:From March to May 2017, a total of 403 compulsory drug rehabilitation personnel were selected for a cross-sectional study and then were investigated by the general demography scale, drug relapse risk scale, childhood trauma questionnaire (CTQ), and PTSD checklist for DSM-5(PCL-5).SPSS 27.0 software and PROCESS 4.1 macro program were used for correlation analysis, regression analysis and Bootstrap-based mediation analysis.Results:The scores of negative emotions subscale of drug relapse risk scale, emotional abuse and emotional neglect subscales of CTQ had no significant gender differences(all P>0.05).There were gender differences in relapse tendency, childhood trauma, and PTSD total scores as well as other dimensions ( t/ Z=2.08-4.67, all P<0.05).There were pairwise positive correlations among the total score of the drug relapse risk scale(31.68±9.79), CTQ(39.90±12.13), and PCL-5(11(3, 24)) for compulsory isolation and rehabilitation personnel ( r=0.28, 0.36, 0.37, P<0.05).After controlling for gender, childhood trauma could significantly and positively predict drug relapse tendency( β=0.34, t=7.24, P<0.01), and PTSD played a mediating role between childhood trauma and drug relapse tendency, with the indirect effect of 0.11(95% CI=0.06-0.16). Conclusion:Childhood trauma can affect drug relapse tendency directly, and indirectly through PTSD.

Objective:To explore the impact of childhood trauma on drug relapse tendency, as well as the mediating role of post-traumatic stress disorder (PTSD).Methods:From March to May 2017, a total of 403 compulsory drug rehabilitation personnel were selected for a cross-sectional study and then were investigated by the general demography scale, drug relapse risk scale, childhood trauma questionnaire (CTQ), and PTSD checklist for DSM-5(PCL-5).SPSS 27.0 software and PROCESS 4.1 macro program were used for correlation analysis, regression analysis and Bootstrap-based mediation analysis.Results:The scores of negative emotions subscale of drug relapse risk scale, emotional abuse and emotional neglect subscales of CTQ had no significant gender differences(all P>0.05).There were gender differences in relapse tendency, childhood trauma, and PTSD total scores as well as other dimensions ( t/ Z=2.08-4.67, all P<0.05).There were pairwise positive correlations among the total score of the drug relapse risk scale(31.68±9.79), CTQ(39.90±12.13), and PCL-5(11(3, 24)) for compulsory isolation and rehabilitation personnel ( r=0.28, 0.36, 0.37, P<0.05).After controlling for gender, childhood trauma could significantly and positively predict drug relapse tendency( β=0.34, t=7.24, P<0.01), and PTSD played a mediating role between childhood trauma and drug relapse tendency, with the indirect effect of 0.11(95% CI=0.06-0.16). Conclusion:Childhood trauma can affect drug relapse tendency directly, and indirectly through PTSD.

To investigate the expression and distribution of follicular dendritic cell(FDC)and follic-ular helper T cells(Tfh)in mouse spleen and lymph nodes induced by foot-and-mouth virus-like particles(FMDV-VLPs),the recombinant pCMV-HA-HBcAg-VP1-VP4 plasmid was transfected into CHO-K1 cells to prepare FMDV-VLPs,and the recombinant FMDV VP1-VP4 protein was expressed and purified through a prokaryotic expression system.BALB/c mice were subcutaneous-ly immunized with FMDV-VLPs(VLP group)and recombinant FMDV VP1-VP4 protein(VP1-VP4 group),and PBS control group(PBS group)was set up.At 21 d post primary immunization(dpi),booster immunization was carried out.Spleen,shoulder lymph nodes,and submandibular lymph nodes were collected at 7,28,42,72 and 102 dpi,and frozen sections were prepared.Immu-nohistochemical staining was used to observe the expression and distribution of FDC and Tfh.The results showed that the number of FDC and Tfh cells in the VLP group in the spleen and lymph nodes showed a gradual increase from 7 to 42 dpi,and gradually decreased to non-immune levels starting from 72 dpi.The results indicate that FMDV-VLPs can induce the formation of GC in the spleen and lymph nodes,and the number of FDC and Tfh cells in GC can last for at least 42 d.This study provides a theoretical basis for the study of the immune memory response mechanism of B cells induced by FMDV virus-like particles.

Objective:To summarize the best evidence for the use of ankle pump exercises in preventing perioperative lower limb deep vein thrombosis (DVT) in patients undergoing joint replacement surgery and to evaluate its clinical application.Methods:This study utilized an evidence-based continuous quality improvement model. A systematic search was conducted for relevant clinical practice guidelines, expert consensus, systematic reviews, and randomized controlled trials (RCTs) from both domestic and international sources. The best evidence was evaluated and summarized, and audit indicators were developed for baseline assessments. Facilitating and hindering factors were analyzed based on the baseline results. From December 2022 to April 2023, the evidence was applied in the Department of Orthopedics at Henan Provincial People's Hospital. The pre-evidence group for baseline assessments included 36 joint replacement patients and 18 nurses from the orthopedic unit between December 2022 and January 2023, while the post-evidence group included 36 joint replacement patients and the same 18 nurses between March and April 2023. The knowledge level of nurses, the effectiveness of ankle pump exercises, the execution rate, and patient compliance were compared before and after evidence-based practice.Results:A total of 12 articles were included in the study, comprising one clinical practice guideline, five expert consensus papers, one systematic review, and five RCTs. Ten best practices were summarized in terms of applicable populations, exercise assessment, exercise positions, timing, methods, frequency, and patient education. After implementing evidence-based practice, the knowledge scores of nurses on ankle pump exercises significantly improved from (70.56±9.98) to (82.78±8.26) ( P<0.01). The compliance rates of audit items 2, 3, 4, 5, and 6 among nurses increased from 0, 22.2%, 0, 27.8%, and 11.1% respectively, to 94.4%, 94.4%, 83.3%, 100.0%, and 100.0% respectively ( P<0.01). On the patient side, the compliance rates for audit items 7 and 8 increased from 5.6% and 0 to 86.1% and 94.4%, respectively ( P<0.01) . Conclusions:Implementing evidence-based ankle pump exercises to prevent DVT in joint replacement patients can significantly improve nurses' knowledge of evidence-based practice, standardize the practice of ankle pump exercises, and explore balanced educational strategies that enhance patient compliance, ensuring clinical practices are evidence-based.

Objective:To construct a core muscle strength training plan for patients with lumbar degenerative diseases based on the concept of pre-rehabilitation, and provide a theoretical basis for core muscle strength training for patients with lumbar degenerative diseases.Methods:From January 2022 to June 2023 based on literature search and group discussion, develop a primary item pool for core muscle strength training plan for patients with lumbar degenerative diseases under the concept of pre-rehabilitation. Through two rounds of Delphi expert consultation, revise and establish the core muscle strength training plan for patients with lumbar degenerative diseases under the concept of pre-rehabilitation.Results:A total of 15 experts were consulted by letter, including 3 males and 12 females, aged 35-58 (41.38 ± 5.44) years old. The positive coefficients of two rounds of correspondence with experts were 1.00 and 0.93, the expert judgment coefficients were 0.78 and 0.90, the familiarity coefficients were 0.84 and 0.92, and the authority coefficients were 0.81 and 0.91. The Kendall coordination coefficients of two rounds of inquiry had statistical significance in terms of indicator rationality (0.378, 0.384), indicator importance (0.283, 0.291), and indicator operability (0.263, 0.375) (all P<0.05). The constructed perioperative nursing quality sensitive indicator system for minimally invasive spinal surgery patients included 3 primary indicators, 9 secondary indicators, and 17 tertiary indicators. Conclusions:The core muscle strength training plan for patients with lumbar degenerative diseases based on the concept of pre- rehabilitation is scientific, reliable, practical, and feasible, and can provide a theoretical basis for core muscle strength training for patients with lumbar degenerative diseases.

Objective:To establish an in vivo infection model of West Nile virus (WNV) pseudovirus and evaluate the neutralizing activity of antibody WNV-XH1.Methods:A stable cell line that can package the WNV pseudovirus was established in the early stage to prepare the pseudovirus supernatant. The supernatant was concentrated and infected BHK21 cells to detect the titer of the pseudovirus. After intraperitoneal injection of the pseudovirus into C57BL/J mice, bioluminescence imaging was performed to observe the infection status of the pseudovirus in the mice. After simultaneous infection, blood was collected and ELISA was used to detect NS1 levels in mouse serum. The in vivo functional activity of antibody WNV-XH1 was evaluated using the established mouse infection model.Results:Fluorescence was detected in C57BL/J mice infected with WNV pseudovirus, and the NS1 levels in the peripheral blood serum of mice infected with pseudovirus were significantly higher than those of non infected mice (1.453±0.09vs0.305±0.018). After intravenous administration of WNV-XH1 antibody before the attack, the fluorescence signal in the mice decreased and the serum NS1 level decreased (0.384±0.015).Conclusions:A successful in vivo infection model of WNV pseudovirus was established, and it was confirmed that the antibody WNV-XH1 had a protective effect against WNV pseudovirus infection in vivo.

Objective:To explore the effect of feedback health education combined with positive psychological suggestion on the rehabilitation of patients undergoing artificial total knee arthroplasty.Methods:From August 2020 to July 2021, the convenient sampling method was used to select 126 patients with artificial total knee arthroplasty admitted to the Orthopedic Department of Henan Provincial People's Hospital. They were randomly divided into the control group and the observation group in a 1∶1 ratio using a random number table method. The control group received routine health education combined with positive psychological suggestion, while the observation group received feedback based health education combined with positive psychological suggestion intervention. The level of knowledge, attitude and practice, scores on the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale (VAS), American Knee Society (AKS) score, knee swelling rate and nursing satisfaction were compared between two groups of patients.Results:The knowledge, attitude and practice scores of the two groups at discharge were higher than those at admission ( P<0.05), and the knowledge, attitude and practice scores of the observation group were higher than those of the control group at discharge ( P<0.05). The SAS and SDS scores of the observation group were lower than those of the control group before and on the third day after surgery ( P<0.05). The VAS of the observation group on the first day and 2 weeks after surgery were lower than those of the control group ( P<0.05), while AKS was higher than that of the control group ( P<0.05). The postoperative swelling rates in the observation group were lower than those in the control group at 1 week and 3 months after surgery ( P<0.05). The nursing satisfaction scores of the observation group in terms of health education, service attitude, department environment, psychological intervention, and nursing outcomes were higher than those of the control group ( P<0.05) . Conclusions:Feedback health education combined with positive psychological cues can improve the knowledge, attitude and practice levels of patients undergoing artificial total knee arthroplasty, reduce anxiety and depression, and improve rehabilitation effectiveness and nursing satisfaction.

Objective:Compared to imprecisely repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC), this study aimed to explore whether localizing the DLPFC precisely or targeting on the right orbital frontal cortex (rOFC) can improve the rTMS efficacy for the treatment of depressive disorder.Methods:From January 2018 to March 2021, this study recruited patients who met the DSM-Ⅳ diagnostic criteria for depressive disorder in Shanghai Mental Health Center. Nineteen patients were located in the imprecise DLPFC group, 19 patients in the precise DLPFC group, and 14 patients in the rOFC group. All patients were assessed by the 17-item Hamilton Depression Scale (HAMD 17) and Hamilton Anxiety Scale (HAMA) at baseline and after 10-session rTMS treatments. The primary outcome of this study was the HAMD 17 response rate, and the second outcome included the reduction score and reduction ratio of the HAMD 17/HAMA. Results:At baseline, there was no significant group difference in HAMD 17 or HAMA scores among the three groups. After the rTMS treatment, the HAMD 17 response rate was significantly different among the three groups (χ2=6.86, P=0.032). The HAMD 17 response rate in the precise DLPFC group (74%) was significantly higher than that in the imprecise DLPFC group (32%, χ2=6.76, P=0.011), but was comparable with that in the rOFC group (57%, χ2=2.16, P=0.133). HAMD 17 response rate did not significantly differ between the precise DLPFC group and the rOFC group (χ2=0.99, P=0.266). The HAMD 17 reduction score tended to be significantly different among the three groups ( F=2.95, P=0.062), with the precise DLPFC group presented the highest HAMD 17 reduction score. There were no significantly differences in the reduction score of HAMD and the reduction ratio of HAMA and HAMD 17 among the three groups. Conclusions:Precisely localizing the DLPFC target may be helpful to improve the rTMS efficacy for the treatment of depressive disorder, while rOFC may be a candidate target for rTMS treatment of the depressive disorder.