BackgroundThe prevalence of depression is elevated in elderly patients with diabetes， underscoring the critical importance of implementing early psychological intervention to improve their clinical outcomes.However， the cognitive function level of patients may limit the implementation of these intervention methods. While prior research has predominantly focused on interventions such as cognitive behavioral therapy and interpersonal psychotherapy to mitigate the depressive symptoms in this demographic， the exploration of group reminiscence therapy as a therapeutic approach remains underrepresented in the existing literature. ObjectiveTo investigate the effect of group reminiscence therapy on depressive symptoms， cognitive function， and quality of life in elderly patients with diabetes and mild to moderate depression， so as to provide valuable insights for psychological intervention of elderly diabetic patients. MethodsA randomized controlled trial was conducted to recruit 80 elderly diabetic patients with mild to moderate depression attending the endocrine clinic of Northeast International Hospital from June 2022 to December 2023. Subjects were randomly allocated to either the study group or the control group using the random number table method， with 40 cases in each group. Both groups received standard diabetes care and mental health education. Additionally， the study group participated in an 8-week group reminiscence therapy intervention， convening once weekly for 1.5 hours per session. Hamilton Depression Scale-24 item （HAMD-24）， Wisconsin Card Sorting Test （WCST）， Verbal Fluency Test （VFT）， Stroop Color Word Test （SCWT） and Generic Quality of Life Inventory-74 （GQOLI-74） were administered before and after intervention. ResultsAfter intervention， the study group exhibited a significantly lower HAMD-24 score compared with the control group （F=13.908， P<0.01）. The study group also demonstrated better performance in cognitive assessments， as evidenced by increased percentages of correct responses and conceptual-level responses on the WCST， a greater number of correct words on the VFT， and a higher number of accurate responses on the SCWT， all in contrast to the control group （F=14.672， 17.000， 13.309， 21.672， P<0.01）. The study group reported superior quality of life outcomes， with higher total GQOLI-74 scores and significant improvements in the domains of physical function， social function， psychological function， and material life status compared with the control group （F=33.098， 41.224， 16.320， 19.432， P<0.01）. ConclusionGroup reminiscence therapy has the potential to alleviate depressive symptoms， enhance cognitive function and improve quality of life in elderly diabetic patients with mild to moderate depression.

Objective:To explore the protocol for handgrip exercise stress echocardiography by comparing different maximal voluntary contraction（MVC）handgrip groups with bicycle exercise stress.Methods:Forty-one healthy volunteers were enrolled prospectively from June to October 2024 in Tangdu Hospital and utilized a color Doppler echocardiography system，supine cycle ergometer，and handgrip dynamometer to collect echocardiographic data at baseline，during handgrip exercises at 20%（3 min），30%（3 min），and 40%（2 min）of MVC，and spine bicycle exercise stress at peak. Parameters measured included left ventricular ejection fraction（EF），stroke volume（SV），cardiac output（CO），mitral inflow E-wave and A-wave velocities，lateral and septal mitral annular e' velocities，E/A and E/e' ratios，global longitudinal strain（GLS），left atrial reservoir strain（LAS R），conduit strain（LAS CD），and contractile strain（LAS CT）. The non-invasive myocardial work indices were also assessed，including global work index（GWI），global constructive work（GCW），global wasted work（GWW），and global work efficiency（GWE）. Statistical analyses were performed using repeated measures analysis of variance，with corrected paired t-test for comparisons between two exercise stress states. Results:Compared with the baseline state，heart rate，blood pressure，CO、GWI、GCW、GWW and LAS CT gradually increased，while EF、E/A、GLS、GWE、LAS R and LAS CD gradually decreased under 20%，30% and 40% of MVC states. The changes were most obvious at 40% of MVC state，which was selected for the handgrip exercise stress echocardiography protocol.Compared with the peak of bicycle exercise，at 40% of MVC，heart rate was significantly lower［（81.2 ± 9.7）bpm vs.（164.6 ± 11.3）bpm， P<0.05）］，systolic blood pressure was slightly lower［（152.9 ± 13.2）mmHg vs.（165.1 ± 20.4）mmHg， P<0.05］，diastolic blood pressure was higher［（96.0 ± 9.5）mmHg vs.（89.5 ± 10.9）mmHg， P<0.05］，GLS was lower［（19.1 ± 1.5）% vs.（23.5 ± 1.7）%， P<0.05］，GWI was similar［（2 254.2 ± 417.3）mmHg% vs.（2 227.5 ± 389.0）mmHg%， P>0.05］，but GWE was higher［（95.3 ± 2.0）% vs.（93.7 ± 2.0）%， P<0.05］，and LAS R was lower［（39.4 ± 4.2）% vs.（43.9 ± 4.1）%， P<0.05］. Conclusions:The 40% of MVC lasting 2 min can cause the most significant handgrip-related changes in cardiac function and can be used as the standard protocol for handgrip exercise stress echocardiography. Handgrip stress exercise can cause significant changes in cardiac systole，diastole，and work performance，showing different characteristics compared with bicycle exercise stress.

Objective:To explore the protocol for handgrip exercise stress echocardiography by comparing different maximal voluntary contraction（MVC）handgrip groups with bicycle exercise stress.Methods:Forty-one healthy volunteers were enrolled prospectively from June to October 2024 in Tangdu Hospital and utilized a color Doppler echocardiography system，supine cycle ergometer，and handgrip dynamometer to collect echocardiographic data at baseline，during handgrip exercises at 20%（3 min），30%（3 min），and 40%（2 min）of MVC，and spine bicycle exercise stress at peak. Parameters measured included left ventricular ejection fraction（EF），stroke volume（SV），cardiac output（CO），mitral inflow E-wave and A-wave velocities，lateral and septal mitral annular e' velocities，E/A and E/e' ratios，global longitudinal strain（GLS），left atrial reservoir strain（LAS R），conduit strain（LAS CD），and contractile strain（LAS CT）. The non-invasive myocardial work indices were also assessed，including global work index（GWI），global constructive work（GCW），global wasted work（GWW），and global work efficiency（GWE）. Statistical analyses were performed using repeated measures analysis of variance，with corrected paired t-test for comparisons between two exercise stress states. Results:Compared with the baseline state，heart rate，blood pressure，CO、GWI、GCW、GWW and LAS CT gradually increased，while EF、E/A、GLS、GWE、LAS R and LAS CD gradually decreased under 20%，30% and 40% of MVC states. The changes were most obvious at 40% of MVC state，which was selected for the handgrip exercise stress echocardiography protocol.Compared with the peak of bicycle exercise，at 40% of MVC，heart rate was significantly lower［（81.2 ± 9.7）bpm vs.（164.6 ± 11.3）bpm， P<0.05）］，systolic blood pressure was slightly lower［（152.9 ± 13.2）mmHg vs.（165.1 ± 20.4）mmHg， P<0.05］，diastolic blood pressure was higher［（96.0 ± 9.5）mmHg vs.（89.5 ± 10.9）mmHg， P<0.05］，GLS was lower［（19.1 ± 1.5）% vs.（23.5 ± 1.7）%， P<0.05］，GWI was similar［（2 254.2 ± 417.3）mmHg% vs.（2 227.5 ± 389.0）mmHg%， P>0.05］，but GWE was higher［（95.3 ± 2.0）% vs.（93.7 ± 2.0）%， P<0.05］，and LAS R was lower［（39.4 ± 4.2）% vs.（43.9 ± 4.1）%， P<0.05］. Conclusions:The 40% of MVC lasting 2 min can cause the most significant handgrip-related changes in cardiac function and can be used as the standard protocol for handgrip exercise stress echocardiography. Handgrip stress exercise can cause significant changes in cardiac systole，diastole，and work performance，showing different characteristics compared with bicycle exercise stress.

Objective:To investigate the clinical applicability of the four-grade grading(G4) advocated by the academy in recent years compared with the guideline-recommended three-grade grading(G3) in functional tricuspid regurgitation (FTR).Methods:A total of 137 consecutive patients were prospectively included from outpatient and inpatient clinics at Tangdu Hospital, Air Force Medical University from May to December 2023. All patients underwent echocardiography and were graded for regurgitation based on the 2017 American Society of Echocardiography Valve Evaluation Guidelines as the reference standard. The patients with regurgitation were grouped according to the G3 based on the guidelines and the G4 advocated by the academic community in recent years, respectively. The consistency of the regurgitation grading between multi-indicators and single-indicators was analyzed using the Kappa test for both G3 and G4. The quantitative regurgitation relevant parameters were analyzed using ROC curves to evaluate the diagnostic efficacies for G4, including the vena contracta width (VCW), the area of the color flow jet (A Jet), and the radius of the PISA (R PISA). Results:The results of consistency analysis showed that the consistency of regurgitation volume (RVol) was significantly higher in the G4 multi-indicators comprehensive assessment versus the single-indicators assessment compared with the G3, with a Kappa value of 0.84 vs. 0.30. The consistency of effective regurgitant orifice area (EROA) and VCW remained unchanged, with a Kappa value of 0.76 vs. 0.89, 0.51 vs. 0.66. ROC curve analysis showed that for the G4, the area under the curve (AUC) for moderate regurgitation were 0.854, 0.993, and 0.894, respectively, while for moderate-severe regurgitation, these values were 0.899, 0.979, and 0.917, respectively.Conclusions:For FTR, the G4 currently advocated by the academic community has better consistency between single-indicators and comprehensive indicators grading than the G3 based on the guideline, which is clinically applicable; A Jet, R PISA, and VCW can be supplemented to the G4, which helps to improve the quantitative assessment system.

Objective:To explore the suitable prostate cancer screening mode under the medical community for primary hospitals.Methods:From April 2021 to April 2022, a total of 16007 male population ≥50 years from 9 branches of the medical community of the second hospital of Yinzhou participated in this study. They were divided into four groups according to age with group 1 of 50-59 years old, group 2 of 60-69 years old, group 3 of 70-79 years old, and group 4 of 80 years old and above. Serum tPSA was added to the routine physical examination, and the screening positive patients were referred to the referral hospital for further diagnosis and treatment under the mode of medical community. We proposed multi-parametric MRI (mpMRI) for those with serum PSA ≥4 ng/ml and suspicious lesions should be scored according to PI-RADS V2. The ultrasound-guided transperineal targeted prostate biopsy was performed for those with PI-RADS ≥3 and those with PI-RADS < 3 but tPSA ≥10 ng/ml. The tPSA follow-up examinations were performed every 6 months for tPSA < 10 ng/ml and PI-RADS < 3 points and once a year for tPSA < 4 ng/ml.Results:Among the 16 007 male population ≥50 years, 2 007(12.54%) were found serum PSA ≥4 ng/ml, and 634(31.59%)were referred to the referral hospital through the medical community system. Combining tPSA and mpMRI, 271 patients underwent ultrasound-guided transperineal targeted prostate biopsy. Among them, 162 were finally diagnosed with PCa, with a biopsy positive rate of 59.78%. The detection rate of PCa in all the subjects was 1.01%. According to the pathological grade, 5(3.08%) were in ISUP group 1, 95(58.64%) in ISUP group 2-3, and 62(38.27%) in ISUP group 4-5. There were 102(62.96%), 39(24.07%) and 21(12.96%) with localized, locally advanced or metastatic PCa, respectively. The levels of tPSA in the four groups were (1.13±1.44)ng/ml, (1.77±3.45)ng/ml, (3.27±17.58)ng/ml, and (4.26±11.48)ng/ml, respectively, with statistically significant differences ( P<0.01). The positive number of biopsy in each group was 1 case(0.06%), 56 cases(0.79%), 81 cases(1.36%) and 24 cases(1.82%) respectively, with statistically significant differences ( P<0.01). The number of ISUP 4-5 grades in each group was 0, 17(30.35%), 29(35.80%), and 16(66.67%) respectively, with statistically significant differences ( P<0.01). Conclusions:Based on the medical community system, according to the tPSA screening results of the primary hospitals, it is feasible and effective to refer suspicious patients to the referral hospitals for mpMRI examination, and screen prostate cancer by ultrasound-guided transperineal prostate fusion biopsy.

Objective:To establish the post competency evaluation index system for extracorporeal membrane oxygenation (ECMO) nurses.Methods:Based on semi-structured interviews, a preliminary post competency evaluation index system for ECMO nurses was developed. From May to June 2022, the Delphi method was used to conduct two rounds of consultation with 19 experts in critical illness field from 15 ClassⅢGrade A hospitals in 6 provinces and municipalities across the country to determine the evaluation index system. The analytic hierarchy process was used to determine the weights and consistency coefficients of indexes at all levels. The positivity of experts was expressed by the effective response rate of the questionnaire, the coordination degree of expert opinions was expressed by Kendall's W and coefficient of variation, the authority of experts was expressed by the authority coefficient of experts, and the concentration of expert opinion was expressed by the mean importance assignment and the perfect score rate. Results:In two rounds of expert consultations, the effective response rates of the questionnaires well all 100.00% (19/19), with expert authority coefficients of 0.834 and 0.879. The Kendall's W for the overall indicator in the second round of expert correspondence was 0.281 ( P<0.01), and the coefficient of variation of the indicators at all levels was 0.05 to 0.17. In the second round of consultation, the mean importance scores assigned to indicators at all levels was 4.05 to 4.95, with a perfect score of 21.05% to 94.74%. The final constructed post competency evaluation index system for ECMO nurses included 4 first-level indicators, 28 second-level indicators, and 59 third-level indicators. Conclusions:The post competency evaluation index system for ECMO nurses is scientific, reliable, and reasonable, which can provide reference for optimizing the ECMO nurse training system and improving evaluation standards.

Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

This paper reviews the research status of the training and certification of extracorporeal membrane oxygenation nurses at home and abroad and their job competencies, and analyzes its limitations, so as to provide a reference for the training of extracorporeal membrane oxygenation nurses in my country.

Mammalian carboxylesterases (CEs) are key enzymes from the serine hydrolase superfamily. In the human body, two predominant carboxylesterases (CES1 and CES2) have been identified and extensively studied over the past decade. These two enzymes play crucial roles in the metabolism of a wide variety of endogenous esters, ester-containing drugs and environmental toxicants. The key roles of CES in both human health and xenobiotic metabolism arouse great interest in the discovery of potent CES modulators to regulate endobiotic metabolism or to improve the efficacy of ester drugs. This review covers the structural and catalytic features of CES, tissue distributions, biological functions, genetic polymorphisms, substrate specificities and inhibitor properties of CES1 and CES2, as well as the significance and recent progress on the discovery of CES modulators. The information presented here will help pharmacologists explore the relevance of CES to human diseases or to assign the contribution of certain CES in xenobiotic metabolism. It will also facilitate medicinal chemistry efforts to design prodrugs activated by a given CES isoform, or to develop potent and selective modulators of CES for potential biomedical applications.

Objective To perform a questionnaire survey on patients with cerebrovascular disease, so as to find problems in the fall-preventing education and provide scientific evidence for health education improvement. Methods From October 2015 to December 2016, a self-designed "Let's mitigate falling danger"questionnaire was applied to investigate a total of 193 patients with cerebrovascular disease from geriatric department, neurology department and neurosurgical department, and analyzed the resules. Results The average score of the 193 patients was (25.05±4.63). The three items with lowest score were "Using fall-leading drugs" (1.30±0.86), "Getting-up behavior" (1.32±0.88) and "Feeling embarrassed seeking help"(1.35±0.64) in the questionnaire. Besides, the fall-preventing score were different in patients with different gender, education level, diagnosis, history of fall and whether received fall-preventing education or not, and the differences were statistical significant (t=2.013, 11.638, 10.750, 5.238, 2.147;P< 0.05). Generalized linear regression analysis showed that receiving fall health education, gender, education level and disease type were the influencing factors of fall prevention cognition in patients with cerebrovascular disease (P< 0.05). Conclusions Cerebrovascular patients are lack of awareness of fall risks in hospital. The nursing management should take risk control on these patients. The responsible nurse should choose personalized education mode and content according to relevant awareness deficits.