Objective To develop the assessment scale of proactive health behavior ability for the disabled elderly in nursing homes and to test its reliability and validity.Methods The first draft of the scale was formed by literature review,qualitative interviews and Delphi method.From December 2023 to March 2024,525 disabled elderly people from 9 nursing homes in Sichuan Province and Chongqing City were selected as the survey subjects,and item analysis and reliability and validity test were carried out on the scale.30 disabled elderly people were re-investigated after 2 weeks to calculate the retest reliability of the scale.Results The scale consisted of 4 dimensions and 27 items.Exploratory factor analysis extracted 4 common factors,with the cumulative vanance contribution rate of 65.992％,and confirmatory factor analysis showed that the modified model fitting index was within acceptable range.The content validity index at item level was 0.917-1.000,and that at scale level was 0.997.The Cronbach's α coefficient,test-retest reliability and split-half reliability of the total scale were 0.944,0.997 and 0.882,respectively.Conclusion The scale has good reliability and validity,and it can be used to evaluate the proactive health behavior ability of the disabled elderly in nursing homes.

Objective This study aims to explore the formation of the dilemma of"giving care"for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi's 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the"giving"care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient"participation"care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to"transformation"of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and ④the decline in"utilization"of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of"giving care"for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of"passive giving care"to"active participation in their health"is an important measure to realize the concept of positive aging and healthy aging.

Objective:To explore the application effect of clinical nursing pathway based on enhanced recovery after surgery (ERAS) concept in perioperative nursing of gastric cancer in the elderly, so as to provide basis for the selection of clinical nursing plan.Methods:A total of 92 patients with gastric cancer who underwent surgical treatment in Hefei Second People′s Hospital from January 2018 to July 2020 were enrolled. They were divided into the observation group and the control group by random number table method, 46 cases in each group. The control group was given routine nursing intervention, while the observation group was given clinical nursing pathway based on ERAS concept for intervention. The postoperative recovery, improvement of nutritional indexes, postoperative complications were compared between the two groups.Results:The first bowel sound time, first exhaust time, first defecation time, leaving bed time, indwelling time of urinary catheter, and postoperative hospitalization time were (18.43 ± 1.80) h, (43.67 ± 8.79) h, (53.06 ± 5.18) h, (22.65 ± 4.95) h, (29.08 ± 2.69) h, (13.93 ± 2.19) d in the observation group, while (22.96 ± 2.24) h, (47.98 ± 8.46) h, (57.97 ± 5.65) h, (31.30 ± 5.73) h, (35.40 ± 3.66) h, (15.48 ± 2.40) d in the control group, there were significant differences between the two groups ( t values were 2.40-10.69, all P<0.05). There was no significant difference in the nutritional indexes before intervention between the two groups( P>0.05). After intervention, the levels of serum total protein, serum albumin and hemoglobin were (64.43 ± 6.22), (35.43 ± 3.07), (125.88 ± 4.75) g/L in the observation group, while (55.97 ± 5.25), (29.96 ± 2.64), (120.05 ± 5.07) g/L in the control group, there were significant differences between the two groups ( t=7.05, 9.16, 5.69, all P<0.05). The incidence of postoperative complications was 4.35%(2/46) in the observation group, 19.57%(9/46) in the control group, there was significant difference between the two groups ( χ2=5.06, P<0.05). Conclusions:The clinical nursing pathway based on ERAS concept can effectively ensure the nutrition needed by patients with gastric cancer during postoperative rehabilitation, accelerate rehabilitation process, and reduce the incidence of postoperative complications.

Objective To explore the correlation factors and clinical significance of lymph node metastasis in right recurrent laryngeal nerve of thyroid papillary carcinoma (PTC).Methods Ninty-eight consecutive patients with PTC who were underwent total thyroidectomy with routine central lymph node dissection in the Second People's Hospital of Hefei from January 2015 to August 2017 were analyzed.The right paratracheal lymph nodes in the central compartment lymph nodes were divided into the level Ⅵ-A (anterior) and level Ⅵ-B (posterior,that was lymph node posterior to recurrent laryngeal nerve) compartments by recurrent laryngeal nerve.The lymph node metastasis of Ⅵ-B area during central compartment lymph node dissection was analyzed.We drew the receiver-operating characteristic curve (ROC) for right neck Ⅵ-A number of lymph node metastasis,and calculated the area under the curve (AUC) and Youden index.Results Among 98 cases,16 cases occurred Ⅵ-B district lymph node metastasis (16.33％).Single factor analysis results showed that lymph node metastasis in Ⅵ-B area of PTC patients were related to the tumor size (x2 =12.864,P ＜0.001),tumor capsular invasion (x2 =16.354,P ＜ 0.001),the right neck Ⅵ-A area lymph node metastasis (x2 =16.065,P ＜ 0.001),tumor number (x2 =15.593,P ＜ 0.001) and neck lymph node metastasis (x2 =21.098,P ＜0.001),but they were not related to the patients' gender,age and lesion location (all P ＞ 0.05).Lymph node metastasis in Ⅵ-B area of PTC patients were related to the number of right neck Ⅵ-A area lymph node metastasis.When the number of right neck Ⅵ-A metastatic lymph nodes was 2.5,the sensitivity and specificity were 70.60％ and 70.00％ respectively,AUC was 0.754,and Youden index was 0.406.Conclusion For patients with PTC,primary tumor diameter ＞ 1 cm,tumor extracapsular invasion,Ⅵ-A area lymph node metastasis,multiple tumor and lateral cervical lymph node metastasis were the predictive factors for the lymph node metastasis in Ⅵ-B area.When the number of right neck Ⅵ-A area metastatic lymph nodes was greater than 3,we should dissect Ⅵ-B area.

Objective:To investigate the activation of peripheral basophils from patients with rheumatoid arthritis ( RA) and its mechanisms. Methods:The activation markers including CD203c and the proportion of IL-4 positive rate of peripheral basophils from RA patients and healthy controls were detected by flow cytometry. Serum levels of IgE in RA patients and healthy controls were detected by electrochemilu minescence immunoassay. Basophils were negatively isolated and co-cultured with or without purified IgE,anti-IgE as positive control,then,the expression of CD203c and propotion of IL-4 positive basophils were detected by flow cytometry. Results:The expression of CD203c and IL-4 positive rate of basophils from RA patients were higher than that of healthy controls (P<0. 05). Serum levels of IgE in RA were higher than that of healthy controls (P<0. 05). After co-cultured with isolated IgE from RA patients,basophils negatively isolated from healthy controls were activated,and higher expression of CD203c and proportion of IL-4 (P<0.05). Conclusion:Basophil activation is related with development of RA,and its activation is mainly mediated by IgE. Targeting basophil and its activation pathway would be expected to provide new strategies for the treatment of RA.

Vasculogenic mimicry (VM) is a brand-new tumor vascular pattern with the ability to form vessellike networks without participation of endothelial cells and independent on angiogenesis.It can provide adequate blood supply for tumor growth.The formation of VM involves multiple molecule mechanisms and signal pathways,including cancer stem cell and epithelial-mesenchymal transition.As a unique blood-supply pattern,VM is associated with cancer invasion,metastasis and poor prognosis.Because of its important role in cancer progression,VM will become a new target for therapy of cancers.

OBJECTIVETo study the changes in quantitative kinetic parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during radiotherapy and their value for efficacy evaluation in patients with nasopharyngeal carcinoma (NPC).

METHODSTwenty-four patients with NPC that had been pathologically confirmed as poorly differentiated squamous cell carcinoma underwent conventional MRI and DCE-MRI scans 1-2 days before radiotherapy (Pre-RT), during radiotherapy (RT 50 Gy), and upon completion of radiotherapy (RT 70 Gy). Based on the two-compartment model and using the arterial input function deconvolution technique, we calculated the quantitative kinetic parameters of DCE-MRI (K(trans), kep, and Ve) of the tumor tissues, examined the correlation between the tumor regression rate (RS0-50) and the parameters on Pre-RT and RT 50 Gy, and compared the parameters for RT 70 Gy among the groups with different prognosis.

RESULTSThe K(trans) value of the tumor tissue decreased after radiotherapy and showed a significant difference between Pre-RT and RT 70 Gy, but not between Pre-RT and RT 50 Gy. The kep value decreased and Ve value increased after radiotherapy. The tumor regression rate was found to be positively correlated with the K(trans) value for Pre-RT (P=0.005) but negatively with the K(trans) value for RT 50 Gy (P=0.001). During the follow-up for 3 years, 5 patients died and 3 patients had distant metastases. No statistical differences in K(trans), kep, or Ve were found between the groups with different prognosis.

CONCLUSIONSThe kinetic parameters in DCE-MRI, which vary significantly during radiotherapy, allow monitoring of tumor angiogenesis and vascular permeability and quantitative assessment of treatment efficacy for NPC. K(trans) value for Pre-RT and RT 50 Gy can serve as an indicator for early efficacy assessment of radiotherapy and for treatment adjustment, but its relation with the long-term outcomes awaits further study.

Algorithms ; Capillary Permeability ; Carcinoma ; Carcinoma, Squamous Cell ; diagnosis ; Humans ; Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms ; blood supply ; radiotherapy ; Neovascularization, Pathologic ; Prognosis ; Treatment Outcome

Objective To study the changes in quantitative kinetic parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during radiotherapy and their value for efficacy evaluation in patients with nasopharyngeal carcinoma (NPC). Methods Twenty-four patients with NPC that had been pathologically confirmed as poorly differentiated squamous cell carcinoma underwent conventional MRI and DCE-MRI scans 1-2 days before radiotherapy (Pre-RT), during radiotherapy (RT 50 Gy), and upon completion of radiotherapy (RT 70 Gy). Based on the two-compartment model and using the arterial input function deconvolution technique, we calculated the quantitative kinetic parameters of DCE-MRI (Ktrans, kep, and Ve) of the tumor tissues, examined the correlation between the tumor regression rate (RS0-50) and the parameters on Pre-RT and RT 50 Gy, and compared the parameters for RT 70 Gy among the groups with different prognosis. Results The Ktrans value of the tumor tissue decreased after radiotherapy and showed a significant difference between Pre-RT and RT 70 Gy, but not between Pre-RT and RT 50 Gy. The kep value decreased and Ve value increased after radiotherapy. The tumor regression rate was found to be positively correlated with the Ktrans value for Pre-RT (P=0.005) but negatively with the Ktrans value for RT 50 Gy (P=0.001). During the follow-up for 3 years, 5 patients died and 3 patients had distant metastases. No statistical differences in Ktrans, kep, or Ve were found between the groups with different prognosis. Conclusions The kinetic parameters in DCE-MRI, which vary significantly during radiotherapy, allow monitoring of tumor angiogenesis and vascular permeability and quantitative assessment of treatment efficacy for NPC. Ktrans value for Pre-RT and RT 50 Gy can serve as an indicator for early efficacy assessment of radiotherapy and for treatment adjustment, but its relation with the long-term outcomes awaits further study.

Objective To study the changes in quantitative kinetic parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during radiotherapy and their value for efficacy evaluation in patients with nasopharyngeal carcinoma (NPC). Methods Twenty-four patients with NPC that had been pathologically confirmed as poorly differentiated squamous cell carcinoma underwent conventional MRI and DCE-MRI scans 1-2 days before radiotherapy (Pre-RT), during radiotherapy (RT 50 Gy), and upon completion of radiotherapy (RT 70 Gy). Based on the two-compartment model and using the arterial input function deconvolution technique, we calculated the quantitative kinetic parameters of DCE-MRI (Ktrans, kep, and Ve) of the tumor tissues, examined the correlation between the tumor regression rate (RS0-50) and the parameters on Pre-RT and RT 50 Gy, and compared the parameters for RT 70 Gy among the groups with different prognosis. Results The Ktrans value of the tumor tissue decreased after radiotherapy and showed a significant difference between Pre-RT and RT 70 Gy, but not between Pre-RT and RT 50 Gy. The kep value decreased and Ve value increased after radiotherapy. The tumor regression rate was found to be positively correlated with the Ktrans value for Pre-RT (P=0.005) but negatively with the Ktrans value for RT 50 Gy (P=0.001). During the follow-up for 3 years, 5 patients died and 3 patients had distant metastases. No statistical differences in Ktrans, kep, or Ve were found between the groups with different prognosis. Conclusions The kinetic parameters in DCE-MRI, which vary significantly during radiotherapy, allow monitoring of tumor angiogenesis and vascular permeability and quantitative assessment of treatment efficacy for NPC. Ktrans value for Pre-RT and RT 50 Gy can serve as an indicator for early efficacy assessment of radiotherapy and for treatment adjustment, but its relation with the long-term outcomes awaits further study.

Objective To explore effects of non-nutritive sucking ( NNS) on various aspects of neonates.Methods 58 cases refusing oral feeding were selected from June 2012 to June 2013 in our hospital with no significant differences in weight, gastrointestinal function and sleep (p>0.05).The specimen was randomly divided into the experimental group and the control group.The experimental group was given with NNS.Weight gain, quiet time to fall asleep, sleep time and gastro-intestinal disorders were observed and recorded in both two groups.One month later, the data recorded from both two groups were processed and analyzed statistically.Results The weight gain in the experimental group was significantly higher than that in the control group (p>0.05).The quiet time to fall asleep in the experimental group was shorter than that in the con-trol group (p>0.05).The sleep time in the experimental group was longer than that in the control group (p>0.05).The incidence of gastrointestinal disorders in the experimental group was significantly lower than that in the control group ( p >0.05).Conclusion Non-nutritive sucking in neonates can accelerate weight gain, improve sleep quality and reduce the in-cidence of gastrointestinal disorders to promote the growth and development of newborns to some extent .