Objective: To examine the association between serum vitamin D level and thyroid function indicators among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide the evidence for the prevention and treatment of thyroid function abnormality among elderly patients with T2DM. Methods: Inpatients aged 60 years and older and admitted to the department of endocrinology of Zhejiang Hospital were selected as the study subjects. Gender, age, course of disease and other basic information were collected through questionnaire surveys. The serum 25-hydroxyvitamin D[25-(OH) D], thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) were measured. The correlation between serum vitamin D level and thyroid function indicators in elderly patients with T2DM was evaluated by a multiple linear regression model. Results: A total of 402 elderly patients with T2DM were surveyed, including 210 males (52.24%) and 192 females (47.76%), and had a median age of 70.00 (interquartile range, 12.00) years and a median course of disease of 14.00 (interquartile range, 14.00) years. There were 162 patients with insufficiency of vitamin D (40.30%) and 182 patients with deficiency (45.27%). The levels of TSH and glycated hemoglobin in the vitamin D deficiency group were (2.34±1.66) μIU/mL and (8.83±2.14) %, respectively, which were higher than those in the normal group [(1.74±1.10) μIU/mL and (8.11±1.75) %; P<0.05]. The levels of FT3 and FT3/FT4 in the vitamin D deficiency group were (2.86±0.48) μIU/mL and 2.85±0.71, respectively, which were lower than those in the vitamin D insufficiency group [(3.09±0.47) pg/mL and 3.14±0.81, P<0.05]. Multiple linear regression analysis showed a negative correlation between 25- (OH) D and TSH (β'=-0.159, P=0.001). Conclusion The vitamin D deficiency may be associated with the increase of TSH level among the elderly patients with T2DM.

Objective To evaluate the efficacy and safety of transurethral resection of Prostate(TURP)combined with endocrine therapy in patients with advanced prostate cancer.Methods A retrospective analysis was conducted on 87 cases of late-stage prostate cancer with dysuria admitted between January 2014 and December 2017.We divided them into 2 groups.TURP group(n = 48)received transurethral resection of prostate,followed by regular endocrine therapy.The control group(n = 39)was only given regular endocrine therapy.Comparative analysis of indicators such as prostate-specific antigen before and after treatment,maximum urinary flow rate,residual urine volume,International Prostate Symptom Score(IPSS),and 5-year survival rate was performed between the two groups.Results Three months after TURP surgery,the symptoms of urinary difficulty significantly improved,and various indicators showed significant improvement compared to before the surgery.PSA levels also notably decreased compared to before the surgery.After 3 months of treatment,the TURP group showed significant improvements in IPSS,Qmax,RV,and PSA indicators compared to the control group(P<0.05).Both groups of patients experienced a gradual decrease in PSA levels after receiving standardized treatment.In the first 12 months of treatment,the PSA levels in the TURP group decreased more significantly compared to the control group,but after 12 months of treatment,the comparison difference was not statistically significant in the PSA levels between the two groups(P = 0.056).A 5-year follow-up comparison of the two groups of patients revealed that there was no statistically significant difference in survival(P = 0.734).Conclusion Transurethral resection of Prostate(TURP)combined with regular endocrine therapy can effectively improve the dysuria in prostate cancer patients,improve the quality of life of patients,and will not affect the five-year survival rate.TURP is a safe and effective treatment for advanced prostate cancer.

Objective:To explores the relationship between self-efficacy and marital adjustment in infertile couples based on Actor-Partner Interdependence Model (APIM) .Methods:This study was a cross-sectional survey. A total of 310 infertile couples who underwent in vitro fertilization-embryo transfer cycle treatment in Reproductive Center of Peking University Third Hospital from January to April 2022 were selected as the research objects by the convenient sampling method. General Self-Efficacy Scale and Locke-Wallace Marital Adjustment Test were used to investigate. The relationship between self-efficacy and marital adjustment of infertile couples was analyzed by Pearson correlation analysis and APIM. A total of 310 groups of questionnaires were distributed (1 group was 1 couple) , and 293 groups of effective questionnaires were collected, with an effective recovery rate of 94.5%. Results:The self-efficacy scores of infertile couples were (25.08±5.54) for wives and (27.08±5.35) for husbands, and the self-efficacy scores of wives were lower than those of husbands ( P<0.01) . In the score of marital adjustment, the wives scored (109.39±23.13) and the husbands scored (111.99±20.87) . The APIM analysis results show that in terms of subjective effects, the self-efficacy of both infertile couples could affect their own marital adjustment (β=0.166, 0.408; P<0.01) . In terms of object effects, the husbands' self-efficacy could affect the wives' marital adjustment (β=0.117, P<0.05) . Conclusions:The self-efficacy of infertile couples undergoing in vitro fertilization-embryo transfer cycle treatment is at the middle level, and the marriage adjustment is generally good. The self-efficacy of couples is closely related to their own marital adjustment, and the self-efficacy of husbands can also positively affect the wifes' marital adjustment. In clinical work, infertile couples should be regarded as a whole, focusing on the binary interaction between both parties, and developing targeted measures to help infertile couples improve their self-efficacy, thereby improving marital adjustment, improving health outcomes, and stabilizing family relationships.

Objective:To explore the effect of the wearable low-level light therapy (LLLT) device on joint pain and knee function in community patients with knee osteoarthritis.Methods:From September 2021 to February 2022, the convenience sampling was used to select 57 middle-aged and elderly patients with knee osteoarthritis who met the inclusion criteria from 8 communities in Shijiazhuang as the study subject. The patients were randomly divided into intervention group ( n=27) and placebo group ( n=30) based on the community. The intervention group used wearable LLLT device to treat bilateral knee joints, while the placebo group wore the same phototherapy device, with the same frequency and duration as the intervention group, but did not turn on the light source. The patients were investigated with the Graphical Knee Osteoarthritis Patient Self-assessment Questionnaire and knee function test, and the joint pain and knee function of the two groups of patients during the study period were compared. Results:A total of 45 patients with knee osteoarthritis in the community completed the study, including 21 in the intervention group and 24 in the placebo group. The results of the Graphical Knee Osteoarthritis Patient Self-assessment Questionnaire showed that the total pain score of the intervention group were lower than that of the placebo group at the third and eighth weeks, with statistically significant differences ( P<0.01). At the eighth week, the scores of knee rest pain, starting pain and joint chills in the intervention group were significantly lower than those in the placebo group, and the differences were statistically significant ( P<0.01). The score of exercise pain in the third and eighth weeks showed a lower trend than that in the placebo group (0.01< P<0.05). There was no statistical difference in knee function test results between the two groups at the beginning of intervention and at the third week ( P>0.05) . Conclusions:Wearable LLLT devices can relieve the joint pain in patients with knee osteoarthritis in the community, but no significant improvement was found in knee function. The effect of wearable LLLT devices still needs to be further verified by multi-center, large sample and long-term follow-up study.

【Objective】 To conduct serological and molecular study of D^el type in RhD-negative donor population in Zhongshan area, so as to improve the diagnosis of D^el type. 【Methods】 A total of 102 initially RhD-negative samples, collected from December 2017 to February 2019, were classified by RHCE and PCR-SSP genotyping. And 95 cases of truly negative RhD were confirmed by IAT, 28 cases of D^el type were identified by absorption and elution test. The phenotype and genotyping characteristics of D^el type in Zhongshan area were summarized based on domestic data of relative literature. 【Results】 Among 102 initially RhD-negative samples by serological test, 95 were truely RhD-negative, 28 were DELRHD 1227A without any other D^el allele. Among them, RHCE antigen type were Ccee in 20(71.4%) cases, CCee in 8(28.6%), with no difference in comparison with other regions in China. The frequency of D^el in RhD-negative blood donors was 29.5% (28/95), with difference between Shanghai, Taiwan, and Fuzhou, but no difference between Nanchang, Zhejiang, and Wuhan. 【Conclusion】 The study showed that the D^el phenotype was closely related to Ce haplotype, and has no difference with other regions in China. The frequency of D^el type in RhD negative donors was 29.5%, with regional differences. RHD1227A was the main allele of D^el.

Objective: To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention. Methods: A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively. Results: Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P<0.05). Before intervention, the scores of Barthel index, upper limb motor function, lower limb motor function were (33.15±7.08), (22.88±4.42), (15.31±3.38) in the observation group, and (33.40±3.78), (22.26±5.03), (16.04±3.30) in the control group, however, those index mentioned above were (47.96±8.45). There was no significant difference in Barthel index, motor function scores between two groups pre-intervention (P>0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05). Conclusion Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention.

Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.

Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.

Objective: To investigate the principles of diagnosis and treatment of breast cancer during pregnancy. Methods: Clinical data of patients with breast cancer during pregnancy admitted to Obstetrics and Gynecology Hospital of Fudan University between January 2012 to July 2017 were analyzed retrospectively. A total of 17 patients were diagnosed with breast cancer in pregnancy, the median age was 32 years (range from 25 to 45 years old), pathological staging revealed 2 patient with stage 0, 1 with stage Ⅱa, 7 with stage Ⅱb, 1 with stage Ⅲa, 2 with stage Ⅲc, 4 with stage Ⅳ. Results: Thirteen patients received surgical treatment in pregnancy, the gestational age at surgery was (27.7±4.6) weeks; 2 patients with ductal carcinoma in situ received mastectomy, 11 patients with breast cancer underwent modified radical mastectomy. In patients undergoing surgery during pregnancy, no prophylactic contractions were used in 4 patients who had been treated earlier, there were 2 patients with frequent contractions within 24 hours after operation in these patients. Follow-up 9 patients were given oral nifedipine to prevent contractions, no obvious contractions occurred after the operation. Seven patients received chemotherapy during pregnancy; the chemotherapy of 4 cases of triple negative breast cancer was weekly paclitaxel sequential epirubicin and cyclophosphamide, the chemotherapy of the other three patients was docetaxel sequential epirubicin and cyclophosphamide. Fifteen patients underwent cesarean section to terminate pregnancy, 2 patients underwent spontaneous labor. The gestational age of birth was (36.9 ±1.3) weeks. Less than 35 weeks of termination of pregnancy occurred in one patient, the fetus was delivered to the neonatal intensive care unit due to neonatal respiratory distress syndrome, and suffered from congenital dysaudia. The prognosis of the other 16 survived infants was good. The median follow-up time was 10 months (range from 4 to 27) months, in 13 patients of stage 0 to Ⅲc, one patient were diagnosed with bone metastasis at 12 months after surgery, the remaining 12 patients had no disease progression, the progression free survival rate was 12/13, the overall survival rate was 13/13. Among the 4 patients with stage Ⅳ, one died in 7 months after delivery, one had new liver metastasis in 8 months after delivery. The remaining 2 patients were in stable condition. Conclusions Breast cancer in pregnancy can be treated effectively, multidisciplinary cooperation and detailed assessment of maternal-fetal risks and benefits are necessary. Chemotherapy during pregnancy is safe for maternal-fetal, but it needed a large sample of clinical studies and long-term follow-up. The neonatal outcome was associated with gestational age, and therefore premature delivery was avoided as much as possible during treatment.

Objective To evaluate the effect of individualized food composition table on serum phosphorus management for patients undergoing peritoneal dialysis(PD). Methods A total of 83 patients who were treated with PD for over 3 months with serum phosphorus greater than 1.78 mmol/L were included from March to May 2016 in PD Center of the Second Hospital of Hebei Medical University by convenient sampling. They received dietary guidance with individualized food composition table and stable phosphorus binding agent. After 6 months, level of serum phosphorus, biochemical indicators and other PD indicators before and after the intervention were compared. Results After 6 months of diet intervention, the patients' serum phosphorus achieved rate was 71%. Serum phosphorus, potassium, parathyroid hormone decreased, and hemoglobin, serum albumin increased (P<0.05). For the PD indicators, blood pressure control was improved (P<0.05), and the rest of the indicators had no difference compared with those before intervention (P>0.05). Conclusions Dietary intervention based on individual food composition table can effectively reduce the serum phosphorus levels in patients with PD,and improve the nutritional status and simplify education working process of the PD center diet as well.