OBJECTIVES: To investigate the effects of quercetin on cuproptosis and L-type calcium currents in the myocardium of diabetic rats. METHODS: Forty SD rats were randomized into control group and diabetic model groups. The rat models of diabetes mellitus (DM) induced by high-fat and high-sugar diet combined with streptozotocin (STZ) injection were further divided into DM model group, quercetin treatment group, and empagliflozin treatment group (n=10). Blood glucose and body weight were measured every other week, and cardiac function of the rats was evaluated using echocardiography. HE staining, Sirius red staining, and wheat germ agglutinin (WGA) analysis were used to observe the changes in myocardial histomorphology, and serum copper levels and myocardial FDX1 expression were detected. In cultured rat cardiomyocyte H9c2 cells with high-glucose exposure, the effects of quercetin and elesclomol, alone or in combination, on intracellular CK-MB and LDH levels and FDX1 expression were assessed, and the changes in L-type calcium currents were analyzed using patch-clamp technique. RESULTS: The diabetic rats exhibited elevated blood glucose, reduced body weight, impaired left ventricular function, increased serum copper levels and myocardial FDX1 expression, decreased L-type calcium currents, and prolonged action potential duration. Quercetin and empagliflozin treatment significantly lowered blood glucose, improved body weight, and restored cardiac function of the diabetic rats, and compared with empagliflozin, quercetin more effectively reduced serum copper levels, downregulated FDX1 expression, and enhanced myocardial L-type calcium currents in diabetic rats. In H9c2 cells, high glucose exposure significantly increased myocardial expressions of FDX1, CK-MB and LDH, which were effectively lowered by quercetin treatment; Elesclomol further elevated FDX1, CK-MB and LDH levels in the exposed cells, and these changes were not significantly affected by the application of quercetin. CONCLUSIONS Quercetin ameliorates myocardial injury in diabetic rats possibly by suppressing myocardial cuproptosis signaling and restoring L-type calcium channel activity.
Animals ; Quercetin/pharmacology* ; Calcium Channels, L-Type/metabolism* ; Diabetes Mellitus, Experimental/metabolism* ; Rats, Sprague-Dawley ; Rats ; Myocytes, Cardiac/drug effects* ; Myocardium/pathology* ; Male

Objective To investigate the independent influences on the occurrence of ICU Acquired Weakness(ICU-AW)in elderly patients undergoing third-and fourth-level surgeries,to construct a prediction model and draw a column-line diagram,and to internally validate the model.Methods A convenience sampling method was used to select 186 elderly patients undergoing tertiary and quaternary surgeries who were hospitalized in 3 tertiary A hospitals in Beijing from May to December 2022 as the study subjects.Single-factor and multifactor logistic regression were used to analyze the risk factors for ICU-AW in elderly patients undergoing third-and fourth-degree surgeries.A risk prediction model was established and the model was visualized by drawing a column-line diagram,and the receiver operator characteristic curve(ROC)and the Hosmer-Lemeshow tests were applied to verify the predictive effect of the model.Results ICU-AW occurred in 40 of 186 cases in the modeling group,with an incidence rate of 21.5％.The results of univariate analysis showed that the 2 groups of preoperative physiology score and surgical severity score included in the physiology and surgical severity scoring system,age,presence of cardiac disease,hemoglobin(within 24 h of admission to the ICU),blood urea nitrogen(within 24 h of admission to the ICU),blood creatinine(within 24 h of admission to the ICU),presence of braking,mode of establishment of mechanical ventilation,presence of nutritional therapy,number of sedative or analgesic drugs used,whether vasoactive drugs were used,whether diuretics were used,and the level of hemoglobin,blood urea nitrogen and blood creatinine within 24 h after admission to ICU the difference is statistically significant(P＜0.05).The results of multifactorial logistic regression analysis showed that preoperative physiology scores included in the physiology and surgical severity scoring system,the presence of cardiac disease,the presence of braking,the presence of nutritional therapy,and the number of sedative or analgesic medications used were the predictors of the occurrence of ICU-AW in elderly patients undergoing third-and fourth-degree surgeries(OR were 1.364,2.344,5.568,5.823,1.109,all P＜0.05).The above 5 factors were plotted as independent variables in a column-line graph,and the area under the ROC curve of the model was 0.859(95％CI 0.793～0.924),with an optimal critical value of 0.156,a sensitivity of 0.875,a specificity of 0.705,and a Hosmer-Lemeshow goodness-of-fit test of x2=3.906,P=0.865,Brier score of 0.109,and a decision analysis curve indicating that patients could benefit.Conclusion The predictive effect of the constructed model is good,and it can be used as a reference for early and rapid identification of the risk of ICU-AW in elderly patients undergoing third-and fourth-degree surgeries by clinical staff,and timely provision of preventive intervention programs.

Objective:To carry out high-risk foot examination and grading combined with two examination methods for inpatients with type 2 diabetes, and explore the influencing factors of the occurrence and development of high-risk foot, and investigate their foot care behavior status.Methods:From July 2021 to January 2022, 409 patients with diabetes who were admitted to the Department of Endocrinology, Department of Geriatrics, Department of Cardiology, Urology Surgery and Department of Ophthalmology of Xuanwu Hospital of Capital Medical University were selected as research subjects by convenience sampling. The General Information Questionnaire, Standardized Process of At-risk Foot Screening and Stratification for Diabetic Patients, InIow's Screening for the High-Risk Diabetic Foot: A 60-Second Tool, and Foot Care Behavior Questionnaire for Diabetic Patients. Single factor analysis and Logistic regression analysis were used to explore the factors influencing the occurrence and development of high-risk foot in type 2 diabetes patients. A total of 409 questionnaires were distributed, and 392 valid questionnaires were collected, with an effective response rate of 95.8% (392/409) .Results:Among 392 patients, the detection rate of high-risk diabetic foot (HRDF) was 76.3% (299/392), and the proportion of high-risk foot grade 2 was the largest (193). Age ( OR=1.042, P<0.01) and years of hypertension ( OR=1.030, P<0.05) were independent influencing factors for the occurrence of HRDF, with statistically significant differences. Taking the high risk foot grade 3 as a reference, cerebrovascular disease [ OR=16.408, 95% CI (1.323, 203.417) ], diabetes course [ OR=1.066, 95% CI (1.008, 1.128) ], education level in middle school [ OR=0.180, 95% CI (0.056, 0.581) ], education level in primary school and below [ OR=0.126, 95% CI (0.019, 0.841) ] were independent influencing factors for the progress of high risk foot. The foot care behavior of high-risk foot patients with high risk levels was not superior to that of patients with low risk levels. Conclusions:The combination of the two screening methods can meet the examination needs of clinical and nursing medical staff for inpatients with type 2 diabetes. Emphasizing the influencing factors of HRDF occurrence and development can provide reference for early identification of high-risk foot.

Objective:To investigate risk factors for cognitive decline in elderly hospitalised hypertensive patients, develop a risk prediction model and validate it.Methods:By the convenient sampling method, a total of 379 elderly hypertensive patients admitted to Department of Cardiology, Department of Geriatrics (General) and Department of Endocrinology in Xuanwu Hospital of Capital Medical University from April to October 2022 were selected as the study objects. Binomial Logistic regression analysis was used to explore the risk factors of cognitive frailty in elderly hospitalized hypertensive patients and establish a prediction model. Receiver operating characteristic curve (ROC) and Hosmer-Lemeshow goodness of fit test were used to evaluate the prediction effect and calibration degree of the model, and Bootstrap method was used for internal verification.Results:Among 379 elderly hospitalized hypertensive patients, 145 (38.3%) had cognitive frailty. Binomial Logistic regression analysis showed that age, education level, drinking history, daily exercise, use of angiotensin receptor antagonists, Barthel index and nutritional status were the influential factors for cognitive frailty in elderly hospitalized hypertensive patients ( P< 0.05). The area under ROC curve of the prediction model was 0.770 (95% CI: 0.721-0.819, P< 0.001), the sensitivity was 0.607, the specificity was 0.838, and the maximum approximate entry index was 0.445. Hosmer Lemeshow goodness of fit test χ 2=3.581, P=0.893. Internal validation was conducted using the Bootstrap method to resample 1 000 times, and the results showed that the average area under the ROC curve of the prediction model was 0.737 (0.687-0.788) . Conclusions:The risk prediction model for cognitive decline in elderly hospitalized hypertensive patients can predict the risk of cognitive frailty in elderly hospitalized hypertensive patients, which can provide references for medical staff to develop corresponding intervention measures.

This article briefly introduces the roles and characteristics of nurse practitioners abroad and reviews their role and influence in primary health care and puts forward some thoughts on the training of nurse practitioners in China, in order to provide a reference for the training of nurse practitioners in China.

Objective To establish mild cognitive dysfunction (MCI) models in elderly rats,and to investigate the pathophysiological features.Methods Totally 40 SD rats (14 to 18-month-old) were randomly divided into 2 groups:the model group (n=20) and the sham operation group (n=20).Bilateral carotid artery stenosis was prepared in the model group while bilateral carotid artery was seperated with no bilateral narrowing in the sham operation group.30 days after the operation,Morris water maze test was performed,pathomorphological and electron microscopic observations of the cerebral tissue were examined and the expression of G protein-coupled receptor kinase 2(GRK2) in hippocampus tissue w detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blottin.Results The mortality in model group was only 10％.Pathological morphology and ultrastructure showed that hippocampal tissue structure was almost normal in sham operated group,but in model group group,hippocampal CA1 pyramidal cells were in ischemic demyelination,arranged loose,and part of the cells showed nucleus pyknosis,deeply stained; there was no obvious infarct in white matter,part of the white matter fiher hecame thinner and disorder,nucleolus became smaller and steped aside,cytoplasmic electron density increased,lipofuscin appeared occasionally.Rough endoplasmic reticulum and Golgi were expanded,cytosolic free ribosomes increased,part of mitochondria became swelled,vacuolated.Morris water maze test results showed that the average escape latency in model group was longer than in sham group (P＜0.05).In spatial probe test,the average time of crossing the first original platform in model rats was significantly longer than the sham operated group [(36.80±7.68) s vs.(20.87±6.16)s,P＜0.05].The average number of crossing the original platform in 60 seconds in model group was significantly less than in sham group(1.43±0.51 vs.3.10±1.45,P＜0.05).The expressiones of GRK2 mRNA and protein in the hippocampus were significantly increased in model group rats than in sham group (P＜0.05).Conclusions The model of severe CCA stenosis in elderly rats can be applied for MCI animal models with good stability and repeatability.Compared with sham group,the cells morphology and ultrastructure in model group appeare more obvious pathological changes and mild impairments in cognitive function.GRK2 may play an important role in the development of MCI.