[Objective] To analyse and predict the tendencies of using erythrocyte blood in Changsha based on the autoregressive integrated moving average (ARIMA) model, long short-term memory (LSTM) and ARIMA-LSTM combination model, so as to provide reliable basis for designing a feasible and effective blood inventory management strategy. [Methods] The data of erythrocyte usage from hospitals in Changsha between January 2012 and December 2023 were collected, and ARIMA model, LSTM model and ARIMA-LSTM combination model were established. The actual erythrocyte consumption from January to May 2024 were used to assess and verify the prediction effect of the models. The extrapolation prediction accuracy of the models were tested using two evaluation indicators: mean absolute percentage error (MAPE) and root mean square error (RMSE), and then the prediction performance of the model was compared. [Results] The RMSE of LSTM model, optimal model ARIMA(1,1,1)(1,1,1)12 and ARIMA-LSTM combination model were respectively 5 206.66, 3 096.43 and 2 745.75, and the MAPE were 18.78%,11.54% and 9.76% respectively, which indicated that the ARIMA-LSTM combination model was more accurate than the ARIMA model and LSTM model, and the prediction results was basically consistent with the actual situation. [Conclusion] The ARIMA-LSTM model can better predict the clinical erythrocyte consumption in Changsha in the short term.

Objective:To systematically evaluate the effectiveness of home care services nurse practitioners provide for older adults.Methods:Randomized controlled trials of home care services provided by nurse practitioners were electronically searched in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Biology Medicine disc. The search period was from database establishment to January 30, 2024. Literature was screened according to the inclusion and exclusion criteria. The Cochrane Collaboration risk of bias assessment tool was used to evaluate the methodological quality of the literature, and meta-analysis was performed using Stata 15 software.Results:A total of 19 articles were included, involving 29 217 older adults. Meta-analysis showed that compared with conventional group, older adults who received home care services provided by nurse practitioners had better systolic blood pressure [ WMD=-5.607, 95% CI (-10.692, -0.522), P=0.031], body mass index [ WMD=-2.497, 95% CI (-4.550, -0.444), P=0.017], service satisfaction [ SMD=0.484, 95% CI (0.003, 0.964), P=0.049] and family caregiver burden [ SMD=-0.366, 95% CI (-0.670, -0.062), P=0.018], but higher total monthly medical costs per person [ WMD=105.103, 95% CI (24.932, 185.274), P=0.010]. There were no differences between the two groups regarding unplanned hospitalization rates, emergency room visits, blood glucose levels, lipid levels, mortality, quality of life, and activities of daily living. Conclusions:Home care services provided by nurse practitioners have improved older adults' satisfaction while lowering older adults' systolic blood pressure and body mass index and reducing the burden on family caregivers. However, the total cost of medical care per older adult per month is high. Although subgroup analyses of key indicators were conducted, it was still impossible to clarify the factors that influence the effectiveness of services provided by nurse practitioners.

Objective:To analyze and compare the predictive value of four different intrinsic ability scoring methods for functional impairment in elderly people and to provide scientific evidence for selecting the appropriate scoring method.Methods:Based on data from the China Health and Retirement Longitudinal Study, 1 844 elderly individuals were included and grouped according to their functional status. Univariate analysis and binary Logistic regression were used to construct a basic prediction model for functional impairment in elderly people. On the basis of the basic model, intrinsic ability scores calculated using four different scoring methods were added to construct four extended prediction models. Receiver operating characteristic curves were plotted, and DeLong tests were conducted to compare the area under the curve ( AUC) of the different prediction models. Calibration curves and clinical decision curves were used to evaluate the prediction efficacy of the four intrinsic ability scoring methods for functional impairment in elderly people. Results:The functional impairment incidence in the 1 844 elderly individuals was 22.99% (424/1 844). The AUC of the basic functional impairment prediction model was 65.36%. The extended prediction models based on the Z-score method, dimensional reduction method, direct summation method, and factor analysis method showed improved predictive efficacy, with AUC increasing by 3.87% ( P<0.001), 1.73% ( P=0.007), 3.86% ( P<0.001), and 3.08% ( P<0.001), respectively. The direct summation method and Z-score method showed better predictive efficacy for functional impairment in elderly people, with no statistically significant difference between the two methods ( P>0.05). Calibration and clinical decision curves indicated that all four scoring methods had good calibration ability and clinical utility in predicting functional impairment. Conclusions:All four intrinsic ability scoring methods can improve the predictive efficacy and clinical utility of functional impairment in elderly people to varying degrees. The direct summation method and Z-score method show better predictive efficacy, followed by factor analysis, with the dimensional reduction method showing the lowest efficacy. Due to its simplicity in operation, the direct summation method is suitable for clinical application.

Objective:To systematically evaluate the effectiveness of home care services nurse practitioners provide for older adults.Methods:Randomized controlled trials of home care services provided by nurse practitioners were electronically searched in PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Biology Medicine disc. The search period was from database establishment to January 30, 2024. Literature was screened according to the inclusion and exclusion criteria. The Cochrane Collaboration risk of bias assessment tool was used to evaluate the methodological quality of the literature, and meta-analysis was performed using Stata 15 software.Results:A total of 19 articles were included, involving 29 217 older adults. Meta-analysis showed that compared with conventional group, older adults who received home care services provided by nurse practitioners had better systolic blood pressure [ WMD=-5.607, 95% CI (-10.692, -0.522), P=0.031], body mass index [ WMD=-2.497, 95% CI (-4.550, -0.444), P=0.017], service satisfaction [ SMD=0.484, 95% CI (0.003, 0.964), P=0.049] and family caregiver burden [ SMD=-0.366, 95% CI (-0.670, -0.062), P=0.018], but higher total monthly medical costs per person [ WMD=105.103, 95% CI (24.932, 185.274), P=0.010]. There were no differences between the two groups regarding unplanned hospitalization rates, emergency room visits, blood glucose levels, lipid levels, mortality, quality of life, and activities of daily living. Conclusions:Home care services provided by nurse practitioners have improved older adults' satisfaction while lowering older adults' systolic blood pressure and body mass index and reducing the burden on family caregivers. However, the total cost of medical care per older adult per month is high. Although subgroup analyses of key indicators were conducted, it was still impossible to clarify the factors that influence the effectiveness of services provided by nurse practitioners.

Objective:To analyze and compare the predictive value of four different intrinsic ability scoring methods for functional impairment in elderly people and to provide scientific evidence for selecting the appropriate scoring method.Methods:Based on data from the China Health and Retirement Longitudinal Study, 1 844 elderly individuals were included and grouped according to their functional status. Univariate analysis and binary Logistic regression were used to construct a basic prediction model for functional impairment in elderly people. On the basis of the basic model, intrinsic ability scores calculated using four different scoring methods were added to construct four extended prediction models. Receiver operating characteristic curves were plotted, and DeLong tests were conducted to compare the area under the curve ( AUC) of the different prediction models. Calibration curves and clinical decision curves were used to evaluate the prediction efficacy of the four intrinsic ability scoring methods for functional impairment in elderly people. Results:The functional impairment incidence in the 1 844 elderly individuals was 22.99% (424/1 844). The AUC of the basic functional impairment prediction model was 65.36%. The extended prediction models based on the Z-score method, dimensional reduction method, direct summation method, and factor analysis method showed improved predictive efficacy, with AUC increasing by 3.87% ( P<0.001), 1.73% ( P=0.007), 3.86% ( P<0.001), and 3.08% ( P<0.001), respectively. The direct summation method and Z-score method showed better predictive efficacy for functional impairment in elderly people, with no statistically significant difference between the two methods ( P>0.05). Calibration and clinical decision curves indicated that all four scoring methods had good calibration ability and clinical utility in predicting functional impairment. Conclusions:All four intrinsic ability scoring methods can improve the predictive efficacy and clinical utility of functional impairment in elderly people to varying degrees. The direct summation method and Z-score method show better predictive efficacy, followed by factor analysis, with the dimensional reduction method showing the lowest efficacy. Due to its simplicity in operation, the direct summation method is suitable for clinical application.

Objective To explore the clinical features and risk factors of post-concussion syndrome (PCS) in patients after mild traumatic brain injury (mTBI).Methods Two hundred and seventy-six patients with mTBI,admitted to our hospital from December 2016 to June 2018,were chosen in our study;114 patients (41.30％) developed PCS.The epidemiological data,causes and sites of brain injury,clinical symptoms,and duration and time of PCS occurrence were investigated.Multivariate Logistic regression was used to analyze the risk factors of PCS in patients with mTBI.Results The most common syndromes of PCS were headache (89.13％),amnesia (63.77％),dizziness (63.04％) and nausea (57.61％).The incidence rate of PCS was 51.75％ in the first month of injury and decreased with time.Multifactor Logistic regression analysis showed that student (P=0.041,OR=0.36,95％ CI:0.14-0.95),electric bicycle accidents (P=0.043,OR=0.54,95％CI:0.30-0.98),and occipital injury (P=0.022,OR=0.28,95％CI:0.09-0.83) were independent risk factors of PCS of mTBI patients.Conclusion Patients with mTBI,especially those who are students,victims of electric bicycle accidents and victims of occipital injury,should be highly alert to the occurrence of PCS,and need reasonable rest,symptomatic treatments and memory training or other rehabilitation treatments within one month of injury,in order to prevent the development of PCS.

OBJECTIVETo explore the anesthetic effects of repeated administration of propofol combined with vitamin C in mice.

METHODSForty mice were subjected to daily intraperitoneal injections of 80 mg/kg propofol (P80 group), 70 mg/kg propofol and 50 mg/kg vitamin C (P70+Vc50 group), 55 mg/kg propofol and 100 mg/kg vitamin C (P55+Vc100 group), or 50 mg/kg propofol and 200 mg/kg vitamin C (P50+Vc200 group) for 6 consecutive days, and the anesthesia induction time and anesthesia duration were recorded.

RESULTSCompared with the P80 group, the mice in P55 + Vc100 group and P50 + Vc200 group showed significantly shorter anesthesia duration on the first 3 days (P<0.05). In all the groups, anesthesia duration was significantly shortened in the following days compared with that on day 1 (P<0.01); anesthesia duration was shorter on day 3 than on day 2 in P50 + Vc200 group (P<0.01), and was shorter on days 4, 5, and 6 than on day 2 in all the groups (P<0.01). In all the groups, the rate of loss of righting reflex (LORR) decreased gradually with time in a similar pattern.

CONCLUSIONVitamin C can reduce the dose of propofol without obviously affecting the anesthetic effect to reduce the incidence of drug tolerance and potential dose-related side effects of propofol.

Anesthesia ; Anesthesia Recovery Period ; Anesthetics, Intravenous ; administration & dosage ; pharmacology ; Animals ; Ascorbic Acid ; administration & dosage ; pharmacology ; Drug Tolerance ; Mice ; Propofol ; administration & dosage ; pharmacology

Objective To explore the anesthetic effects of repeated administration of propofol combined with vitamin C in mice. Methods Forty mice were subjected to daily intraperitoneal injections of 80 mg/kg propofol (P80 group), 70 mg/kg propofol and 50 mg/kg vitamin C (P70+Vc50 group), 55 mg/kg propofol and 100 mg/kg vitamin C (P55+Vc100 group), or 50 mg/kg propofol and 200 mg/kg vitamin C (P50+Vc200 group) for 6 consecutive days, and the anesthesia induction time and anesthesia duration were recorded. Results Compared with the P80 group, the mice in P55 + Vc100 group and P50 + Vc200 group showed significantly shorter anesthesia duration on the first 3 days (P<0.05). In all the groups, anesthesia duration was significantly shortened in the following days compared with that on day 1 (P<0.01);anesthesia duration was shorter on day 3 than on day 2 in P50+Vc200 group (P<0.01), and was shorter on days 4, 5, and 6 than on day 2 in all the groups (P<0.01). In all the groups, the rate of loss of righting reflex (LORR) decreased gradually with time in a similar pattern. Conclusions Vitamin C can reduce the dose of propofol without obviously affecting the anesthetic effect to reduce the incidence of drug tolerance and potential dose-related side effects of propofol.

Objective To explore the anesthetic effects of repeated administration of propofol combined with vitamin C in mice. Methods Forty mice were subjected to daily intraperitoneal injections of 80 mg/kg propofol (P80 group), 70 mg/kg propofol and 50 mg/kg vitamin C (P70+Vc50 group), 55 mg/kg propofol and 100 mg/kg vitamin C (P55+Vc100 group), or 50 mg/kg propofol and 200 mg/kg vitamin C (P50+Vc200 group) for 6 consecutive days, and the anesthesia induction time and anesthesia duration were recorded. Results Compared with the P80 group, the mice in P55 + Vc100 group and P50 + Vc200 group showed significantly shorter anesthesia duration on the first 3 days (P<0.05). In all the groups, anesthesia duration was significantly shortened in the following days compared with that on day 1 (P<0.01);anesthesia duration was shorter on day 3 than on day 2 in P50+Vc200 group (P<0.01), and was shorter on days 4, 5, and 6 than on day 2 in all the groups (P<0.01). In all the groups, the rate of loss of righting reflex (LORR) decreased gradually with time in a similar pattern. Conclusions Vitamin C can reduce the dose of propofol without obviously affecting the anesthetic effect to reduce the incidence of drug tolerance and potential dose-related side effects of propofol.