Objective:To analyze the association between continuity of consultation and the management of glycosylated hemoglobin (HbA1c) in diabetes patients contracted by family doctors.Methods:This study was a cross-sectional study. From May 2022 to October 2022, three community health service centers in the urban area of Beijing were selected by convenient sampling. A total of 360 diabetes patients were selected by simple random sampling from the selected centers. Extraction of data from electronic health records were conducted to collect patient characteristics, information on the continuity evaluation indicators for patient visits (usual provider of care, UPC) in 2021 and information of monitoring and control indicators for HbA1c in 2021. The monitoring and control of HbA1c in patients with different continuity of consultations were compared. Chi-square test and logistic regression analysis were used to determine the association between continuity of consultation and HbA1c management (i.e., HbA1c monitoring and control).Results:Of the 360 patients, 167 (46.4%) were male; the age was 68.0 (60.0, 74.0) years and the number of years since diagnosis was 11.0 (7.0, 17.0) years. One hundred and fifty-nine patients (44.1%) had UPC scores below 30%, 101 patients (28.1%) had UPC scores between 30% and 50%, and 100 patients (27.8%) had UPC scores above 50%. The compliance rate for HbA1c monitoring was 66.4% (239/360), and the compliance rate for HbA1c control was 45.8% (165/360). When the UPC score was less than 30%, between 30%-50%, and greater than 50%, the HbA1c monitoring compliance rates were 53.5% (85/159), 73.3% (74/101), and 80.0% (80/100), respectively, and the HbA1c control compliance rates were 37.7% (60/159), 51.5% (52/101), and 53.0% (53/100), respectively, and the differences were statistically significant ( χ2=22.36, 7.57, P<0.05). As the UPC score increased, the likelihood of achieving HbA1c monitoring ( OR=1.020, 95% CI:1.009-1.030 , P<0.001) and control ( OR=1.012, 95% CI:1.003-1.021 ,P=0.008) targets increased. Conclusion:There is an association between the continuity of consultation and the management of HbA1c.

Objective:To investigate the current situation and influencing factors of geriatric nursing competence of nursing students in the later stage of practice, and to provide reference for formulating the reform strategy of geriatric nursing teaching, carrying out nursing education intervention and improving students′ geriatric nursing competence.Methods:From December 2023 to February 2024, 361 students from 6 colleges and universities in Inner Mongolia Autonomous Region were investigated by using the questionnaire of geriatric nursing competence by convenient sampling method.Results:Therefore, 361 nursing students in the late stage of clinical practice who meta the inclusion and exclusion criteria were included, 65 males and 296 females with (21.20 ± 2.02) years. The total score of geriatric nursing competence was (164.47 ± 32.25). Learning motivation ( β=11.09, P<0.05), whether to participate in activities to serve the elderly ( β=10.03, P<0.05), and training level ( β=-4.42, P<0.05) were the influencing factors affecting the elderly care ability of nursing students in the later stage of practice, which explained 12.5% of total variance. Conclusions:The geriatric nursing competence of nursing students in the later stage of practice is generally at a medium level, and the ability of each dimension is not balanced. Nursing educators should enrich the content of geriatric nursing courses, pay attention to the practical activities of the elderly, stimulate students′ learning motivation, and promote the construction of training programs for the geriatric nursing competence of nursing students at different training levels, so as to improve students' geriatric nursing competence.

Objective:To analyze the association between continuity of consultation and the management of glycosylated hemoglobin (HbA1c) in diabetes patients contracted by family doctors.Methods:This study was a cross-sectional study. From May 2022 to October 2022, three community health service centers in the urban area of Beijing were selected by convenient sampling. A total of 360 diabetes patients were selected by simple random sampling from the selected centers. Extraction of data from electronic health records were conducted to collect patient characteristics, information on the continuity evaluation indicators for patient visits (usual provider of care, UPC) in 2021 and information of monitoring and control indicators for HbA1c in 2021. The monitoring and control of HbA1c in patients with different continuity of consultations were compared. Chi-square test and logistic regression analysis were used to determine the association between continuity of consultation and HbA1c management (i.e., HbA1c monitoring and control).Results:Of the 360 patients, 167 (46.4%) were male; the age was 68.0 (60.0, 74.0) years and the number of years since diagnosis was 11.0 (7.0, 17.0) years. One hundred and fifty-nine patients (44.1%) had UPC scores below 30%, 101 patients (28.1%) had UPC scores between 30% and 50%, and 100 patients (27.8%) had UPC scores above 50%. The compliance rate for HbA1c monitoring was 66.4% (239/360), and the compliance rate for HbA1c control was 45.8% (165/360). When the UPC score was less than 30%, between 30%-50%, and greater than 50%, the HbA1c monitoring compliance rates were 53.5% (85/159), 73.3% (74/101), and 80.0% (80/100), respectively, and the HbA1c control compliance rates were 37.7% (60/159), 51.5% (52/101), and 53.0% (53/100), respectively, and the differences were statistically significant ( χ2=22.36, 7.57, P<0.05). As the UPC score increased, the likelihood of achieving HbA1c monitoring ( OR=1.020, 95% CI:1.009-1.030 , P<0.001) and control ( OR=1.012, 95% CI:1.003-1.021 ,P=0.008) targets increased. Conclusion:There is an association between the continuity of consultation and the management of HbA1c.

Objective:To investigate the current situation and influencing factors of geriatric nursing competence of nursing students in the later stage of practice, and to provide reference for formulating the reform strategy of geriatric nursing teaching, carrying out nursing education intervention and improving students′ geriatric nursing competence.Methods:From December 2023 to February 2024, 361 students from 6 colleges and universities in Inner Mongolia Autonomous Region were investigated by using the questionnaire of geriatric nursing competence by convenient sampling method.Results:Therefore, 361 nursing students in the late stage of clinical practice who meta the inclusion and exclusion criteria were included, 65 males and 296 females with (21.20 ± 2.02) years. The total score of geriatric nursing competence was (164.47 ± 32.25). Learning motivation ( β=11.09, P<0.05), whether to participate in activities to serve the elderly ( β=10.03, P<0.05), and training level ( β=-4.42, P<0.05) were the influencing factors affecting the elderly care ability of nursing students in the later stage of practice, which explained 12.5% of total variance. Conclusions:The geriatric nursing competence of nursing students in the later stage of practice is generally at a medium level, and the ability of each dimension is not balanced. Nursing educators should enrich the content of geriatric nursing courses, pay attention to the practical activities of the elderly, stimulate students′ learning motivation, and promote the construction of training programs for the geriatric nursing competence of nursing students at different training levels, so as to improve students' geriatric nursing competence.

Objective:To investigate the status quo of potentially inappropriate medication (PIM) among elderly hypertensive patients in community general practice clinic and related influencing factors.Methods:A total of 767 prescriptions for elderly hypertensive patients in a community health service center in Beijing from October 2020 to August 2021 were reviewed. The prevalence of PIM was assessed based on the criteria of potentially inappropriate medications for older adults in China(2017). Logistic regression analysis was employed to analyze the influencing factors for PIM. Results:The survey showed that 198 elderly patients had PIM with 244 person-doses. The top three drugs with high rate of PIM were benzodiazepine-estazolam (64 person-doses), clopidogrel (53 person-doses) and insulin (35 person-doses). Univariate analysis showed that PIM was significantly associated with types of medication;and underlying diseases hypertension with hyperlipidemia, coronary heart disease, type 2 diabetes, osteoarthritis, upper respiratory tract infection and insomnia (χ 2=82.58, 13.65, 17.74, 7.52, 10.34, 68.19,respectively,all P<0.05). Multivariate logistic regression analysis showed that the types of medication, hypertension complicated with upper respiratory tract infection, and insomnia were independent influencing factors for PIM ( OR=1.55, 2.47, 9.05; P<0.05). Conclusion:The study shows that PIM is more common in elderly hypertensive patients in community general practice clinics,which is associated with types of medication, hypertension complicated with upper respiratory tract infection and insomnia. It is suggested that general practitioner working in community clinics should be aware of PIM, minimize the number of prescription drugs, and choose new drugs or non-drug treatments to reduce the occurrence of PIM.

OBJECTIVE: To analyze the pathogenic variant of preaxial polydactyly in a Chinese Han pedigree and identify the cause of polydactyly. METHODS: The peripheral blood DNA of the proband and her parents was extracted. The polydactyly-related genes were detected by trio whole exome sequencing, and the suspected pathogenic gene was screened out. Sanger sequencing was applied to other members of the pedigree. RESULTS: The results of gene sequencing showed that the LMBR1 gene had a heterozygous variant of c.423+4909(IVS5)C>T in 6 patients of the pedigree. The same variant was not detected in family members with normal phenotype. Based on the ACMG guidelines, c.423+4909(IVS5)C>T of the LMBR1 gene was predicted to be pathogenic (PM1+PM2+PP1-S(PS)+PP4+PP5). CONCLUSION The heterozygous C>T variant at position 4909 of intron 5 of the LMBR1 gene probably underlies the disease in this pedigree.
China ; Female ; Humans ; Mutation ; Pedigree ; Polydactyly/genetics* ; Thumb ; Whole Exome Sequencing

OBJECTIVE: To explore the genetic basis for a Chinese patient with amyotrophic lateral sclerosis (ALS). METHODS: Peripheral blood samples were collected from the patient and his parents for the extraction of genomic DNA. Genetic variant was identified by whole exome sequencing. Candidate variant was verified by Sanger sequencing of his parents and healthy controls. RESULTS: The patient was found to harbor a heterozygous c.420C>G (p.Asn140Lys) variant of the SOD1 gene. The same variant was not detected in his parents and 100 healthy controls. The variant has not been included in HGMD, dbSNP and other databases. CONCLUSION The c.420C>G variant of the SOD1 gene may underlie the ALS in this patient. Above finding has enriched the spectrum of SOD1 gene variants.
Amyotrophic Lateral Sclerosis/genetics* ; China ; Heterozygote ; Humans ; Superoxide Dismutase-1/genetics* ; Whole Exome Sequencing

OBJECTIVE: To detect the mutation site in a pedigree affected with autosomal dominant polycystic kidney disease (ADPKD) and verify its impact on the protein function. METHODS: Peripheral blood samples were collected from the proband and his pedigree members for the extraction of genomic DNA. Mutational analysis was performed on the proband through whole-exome sequencing. Suspected variant was verified by Sanger sequencing. A series of molecular methods including PCR amplification, restriction enzyme digestion, ligation and transformation were also used to construct wild-type and mutant eukaryotic expression vectors of the PKD2 gene, which were transfected into HEK293T and HeLa cells for the observation of protein expression and cell localization. RESULTS: The proband was found to harbor a c.2051dupA (p. Tyr684Ter) frame shift mutation of the PKD2 gene, which caused repeat of the 2051st nucleotide of its cDNA sequence and a truncated protein. Immunofluorescence experiment showed that the localization of the mutant protein within the cell was altered compared with the wild-type, which may be due to deletion of the C-terminus of the PKD2 gene. CONCLUSION The c.2051dupA (p. Tyr684Ter) mutation of the PKD2 gene probably underlay the pathogenesis of ADPKD in this pedigree.
DNA Mutational Analysis ; Female ; Frameshift Mutation ; HEK293 Cells ; HeLa Cells ; Humans ; Male ; Pedigree ; Polycystic Kidney, Autosomal Dominant/physiopathology* ; Protein Kinases/genetics* ; Protein Transport/genetics* ; Whole Exome Sequencing

Ossifying fibroma (OF) and fibrous dysplasia (FD) are two fibro-osseous lesions with overlapping clinicopathological features, making diagnosis challenging. In this study, we applied a whole-genome shallow sequencing approach to facilitate differential diagnosis via precise profiling of copy number alterations (CNAs) using minute amounts of DNA extracted from morphologically correlated microdissected tissue samples. Freshly frozen tissue specimens from OF (n = 29) and FD (n = 28) patients were obtained for analysis. Lesion fibrous tissues and surrounding normal tissues were obtained by laser capture microdissection (LCM), with ~30-50 cells (5 000-10 000 µm
DNA Copy Number Variations ; Diagnosis, Differential ; Fibroma, Ossifying/genetics* ; Fibrous Dysplasia of Bone/genetics* ; Galactosyltransferases ; Humans ; Jaw ; Neoplasm Recurrence, Local ; Nuclear Proteins

Objective:To optimize the extraction process of the water extract of Zhenwutang and study on the preparation of gran -ule of Zhenwu decoction to provide reference for the development and utilization of Zhenwutang granule .Methods: Heating refluxing was used, and the effects of the ratio of solid to liquid , extraction time and times were investigated by orthogonal test .As the synthetic indices of evaluation , the yield of extraction and the contents of paeoniflorin and benzoylmesaconine measured by HPLC were deter -mined to confirm the optimal water extraction process of Zhenwutang granule .Besides, granularity pass rate, moisture, loss on drying, solubility and angle of repose of the granule were regarded as the indices to evaluate the best ratio of the excipients in the preparation of the granule by single factor test.Results:Paeoniflorin and benzoyl mesaconitine had good linearity within the range of 5.45-32.70μg (r=0.9996) and 3.24-16.80 μg(r=0.9997), respectively.The average recovery was 99.62％ (RSD =1.34％ , n=6) and 1017.2 ％(RSD=1.74％, n=6), respectively.The optimum extraction process was as follows :the ratio of solid to liquid was 1:12 with twice refluxing extraction ( 2h for each time) .The optimum granule forming process was as follows:the pharmaceutical excipients were a mixture of dextrin and soluble starch with the best ratio of 1:3. The granularity pass rate , moisture, loss on drying, solubility and angle of repose of the granule was94 .12％ ,4.87 ％, 0.93％,89 .23％ and 36.18°, respectively.Conclusion:The optimized re-fluxing extraction process is stable , reliable and feasible , and the prepared granule is in good formability and melting .