Objective To investigate the knowledge and attitude of clinical nurses on Panvascular Disease(PVD)care in Zhejiang Province,and to analyze the influencing factors,so as to provide references for constructing a systematic PVD training program.Methods The convenient sampling method was used to investigate 454 nurses from 36 general hospitals in 11 prefectures and cities in Zhejiang Province in June 2024 with a self-designed questionnaire on general information and a questionnaire on PVD nursing knowledge and attitude questionnaire,and multiple stepwise linear regression was used to analyze the impact factors.Results 452 valid questionnaires were collected and the valid recovery rate was 99.56％.Nurses scored(8.57±2.02)in knowledge dimension,(60.82±6.45)in attitude dimension.The results of multiple stepwise linear regression analysis showed that hospital grade was the factor influencing the score of nurses'knowledge towards PVD nursing in Zhejiang Province(P＜0.05).Hospital grade,whether they had received systematic knowledge training related to PVD were the factors influencing the score of nurses'attitude towards PVD nursing(P＜0.05).Conclusion Nurses in Zhejiang Province are positive about PVD nursing,but their knowledge level needs to be improved.Nursing managers should pay full attention to the training intention of clinical nurses,establish a PVD knowledge training system,and strengthen the theoretical and practical training of clinical nurses on PVD nursing,so as to promote the development of PVD nursing work.

The " no-accompany" service is an important measure to meet the patients′ needs for comprehensive, continuous, and high-quality diversified care and to enhance their medical experience. Starting in March 2024, the Second Affiliated Hospital of Zhejiang University School of Medicine launched a pilot " no-accompany" service in the breast surgery and dermatology wards. The hospital established a working team led by the nursing department and involving multiple administrative departments such as the medical affairs department, medical insurance office, and logistics management department. And the hospital has successfully advanced the implementation of the " no-accompany" ward program by establishing a multi-department collaborative management mechanism, standardizing the management of medical caregivers, developing a tiered fee scheme for the " no-accompany" service, and improving relevant service measures. The acceptance of the " no-accompany" service by patients increased from (3.93±0.83) in the second quarter of 2024 to (4.69±0.59) in the fourth quarter, and overall satisfaction rose from (4.18±0.73) to (4.50±0.54) (all P<0.001). The job competency of medical caregivers also improved significantly from (64.80±3.49) before starting work in March 2024 to (94.00±2.40) in the fourth quarter ( P<0.001). These findings provide a reference for the implementation of " no-accompany" services in public hospitals.

Objective To explore the relationship between the influencing factors for high risk foot(HDF)and the controlling nutritional status(CONUT)score in patients with type 2 diabetes mellitus(T2DM)at different ages.Methods A total of 1314 patients with T2DM hospitalized in the Department of Endocrinology of our hospital from January 2022 to January 2024 were enrolled.According to age and the international working group on diabetic foot risk classification system,they were divided into the elderly low-risk(ELR)group with age≥65 years old and grade 0(n=294),the elderly high-risk(EHR)group with aged≥65 years and grade 1～3(n=138);non-elderly low-risk(NELR)group with age<65 years and grade 0(n=636),and non-elderly high-risk group(NEHR)with the age<65 years and grade 1～3(n=246).The general data,biochemical indexes and CONUT scores of patients with different ages and different risk levels were compared among the groups.Spearman correlation analysis was used to analyze the correlation between HDF grade and CONUT score in different age groups,and Logistic regression analysis was used to analyze the influencing factors for high-risk foot in T2DM patients of different ages.Results The age,DM duration,smoking,hemoglobin A1c(HbA1c),and CONUT score were higher in the EHR group than in the ELR group(P<0.05),while the hemoglobin and albumin(ALB)were lower in the EHR group than in the ELR group(P<0.05).The DM duration,smoking,FPG and HbA1c were higher in the NEHR group than in the NELR group(P<0.05),while ALB was lower than that in the NELR group(P<0.05).Spearman correlation analysis showed that the risk level of HDF in patients aged≥65 years was positively correlated with the CONUT score(r=0.301,P<0.001),while in patients aged<65 years,the risk level of HDF was not correlated with the CONUT score(r=0.055,P=0.102).Logistic regression analysis showed that age(OR 1.714,95%CI 1.420～2.067),DM duration(OR 1.062,95%CI 1.001～1.126),smoking(OR 3.986,95%CI 1.469～10.814),HbA1c(OR 1.246,95%CI 1.008～1.541),and CONUT score(OR 1.550,95%CI 1.051～2.286)were the influencing factors for the occurrence of HDF in T2DM patients aged≥65 years.DM duration(OR 1.051,95%CI 1.023～1.080),HbA1c(OR 1.141,95%CI 1.052～1.238)and FPG(OR 1.071,95%CI 1.019～1.125)were influencing factors for the occurrence of HDF in T2DM patients aged<65 years.Conclusions DM duration,HbA1c,etc.are the influencing factors for HDF in patients with T2DM,while the CONUT score is the influencing factor for the occurrence of HDF only in T2DM patients aged≥65 years.

Objective:To analyze the influencing factors on the therapeutic effect of glucocorticoid impact in the treatment of active thyroid-related eye diseases.Methods:A total of 106 patients with thyroid-related eye disease admitted to Lishui People's Hospital from December 2020 to January 2024 were retrospectively selected, all of whom were treated with glucocorticoid impact therapy. According to the efficacy, they were divided into poor efficacy group (34 cases) and good efficacy group (72 cases), and relevant clinical data of the two groups were compared. Single factor and multiple factor Logistic regression were used to analyze the risk factors affecting the curative effect.Results:The proportion of smoking history in the poor efficacy group was higher than that in the good efficacy group:73.53% (25/34) vs. 29.17% (21/72), there was statistical difference ( χ2 = 18.50, P<0.01). The thyroid stimulating hormone (TSH) and lymphocyte (LYM) in the poor efficacy group were lower than those in the good efficacy group: (0.08 ± 0.02) mU/L vs. (0.10 ± 0.02) mU/L, 0.175 ± 0.028 vs. 0.192 ± 0.031;the free triiodothyronine (FT 3), free thyroxine (FT 4), tumor necrosis factor - α (TNF- α), interleukin (IL) -6, IL-8, neutrophil-to-lymphocyte ratio (NLR), degree of proptosis, and clinical activity score (CAS) were higher than those in the good efficacy group: (5.28 ± 1.21) pmol/L vs. (4.73 ± 1.03) pmol/L, (15.52 ± 2.35) pmol/L vs. (14.28 ± 2.31) pmol/L, (11.82 ± 2.11) ng/L vs. (10.05 ± 2.04) ng/L, (2.12 ± 0.21) ng/L vs. (1.96 ± 0.18) ng/L, (38.56 ± 4.35) ng/L vs. (35.46 ± 4.21) ng/L, 2.52 ± 0.41 vs. 1.67 ± 0.37, (17.42 ± 2.44) mm vs. (15.32 ± 2.27) mm, (4.34 ± 0.65) scores vs. (3.98 ± 0.63) scores, there were statistical differences ( P<0.05). Multiple Logistic regression analysis showed that smoking history, TSH, FT 3, FT 4, TNF-ɑ, IL-6, IL-8, LYM, NLR, exophthalmia and CAS score were all included in the regression equation, and they were all influential factors affecting the efficacy of glucocorticoid shock therapy for thyroid-related eye diseases ( P<0.05). Conclusions:In active thyroid-related eye disease patients receiving glucocorticoid impact therapy, the efficacy may be affected by many factors, and comprehensive intervention should be implemented according to the actual situation to further improve the efficacy.

Objective To explore the relationship between the influencing factors for high risk foot(HDF)and the controlling nutritional status(CONUT)score in patients with type 2 diabetes mellitus(T2DM)at different ages.Methods A total of 1314 patients with T2DM hospitalized in the Department of Endocrinology of our hospital from January 2022 to January 2024 were enrolled.According to age and the international working group on diabetic foot risk classification system,they were divided into the elderly low-risk(ELR)group with age≥65 years old and grade 0(n=294),the elderly high-risk(EHR)group with aged≥65 years and grade 1～3(n=138);non-elderly low-risk(NELR)group with age<65 years and grade 0(n=636),and non-elderly high-risk group(NEHR)with the age<65 years and grade 1～3(n=246).The general data,biochemical indexes and CONUT scores of patients with different ages and different risk levels were compared among the groups.Spearman correlation analysis was used to analyze the correlation between HDF grade and CONUT score in different age groups,and Logistic regression analysis was used to analyze the influencing factors for high-risk foot in T2DM patients of different ages.Results The age,DM duration,smoking,hemoglobin A1c(HbA1c),and CONUT score were higher in the EHR group than in the ELR group(P<0.05),while the hemoglobin and albumin(ALB)were lower in the EHR group than in the ELR group(P<0.05).The DM duration,smoking,FPG and HbA1c were higher in the NEHR group than in the NELR group(P<0.05),while ALB was lower than that in the NELR group(P<0.05).Spearman correlation analysis showed that the risk level of HDF in patients aged≥65 years was positively correlated with the CONUT score(r=0.301,P<0.001),while in patients aged<65 years,the risk level of HDF was not correlated with the CONUT score(r=0.055,P=0.102).Logistic regression analysis showed that age(OR 1.714,95%CI 1.420～2.067),DM duration(OR 1.062,95%CI 1.001～1.126),smoking(OR 3.986,95%CI 1.469～10.814),HbA1c(OR 1.246,95%CI 1.008～1.541),and CONUT score(OR 1.550,95%CI 1.051～2.286)were the influencing factors for the occurrence of HDF in T2DM patients aged≥65 years.DM duration(OR 1.051,95%CI 1.023～1.080),HbA1c(OR 1.141,95%CI 1.052～1.238)and FPG(OR 1.071,95%CI 1.019～1.125)were influencing factors for the occurrence of HDF in T2DM patients aged<65 years.Conclusions DM duration,HbA1c,etc.are the influencing factors for HDF in patients with T2DM,while the CONUT score is the influencing factor for the occurrence of HDF only in T2DM patients aged≥65 years.

Objective:To analyze the influencing factors on the therapeutic effect of glucocorticoid impact in the treatment of active thyroid-related eye diseases.Methods:A total of 106 patients with thyroid-related eye disease admitted to Lishui People's Hospital from December 2020 to January 2024 were retrospectively selected, all of whom were treated with glucocorticoid impact therapy. According to the efficacy, they were divided into poor efficacy group (34 cases) and good efficacy group (72 cases), and relevant clinical data of the two groups were compared. Single factor and multiple factor Logistic regression were used to analyze the risk factors affecting the curative effect.Results:The proportion of smoking history in the poor efficacy group was higher than that in the good efficacy group:73.53% (25/34) vs. 29.17% (21/72), there was statistical difference ( χ2 = 18.50, P<0.01). The thyroid stimulating hormone (TSH) and lymphocyte (LYM) in the poor efficacy group were lower than those in the good efficacy group: (0.08 ± 0.02) mU/L vs. (0.10 ± 0.02) mU/L, 0.175 ± 0.028 vs. 0.192 ± 0.031;the free triiodothyronine (FT 3), free thyroxine (FT 4), tumor necrosis factor - α (TNF- α), interleukin (IL) -6, IL-8, neutrophil-to-lymphocyte ratio (NLR), degree of proptosis, and clinical activity score (CAS) were higher than those in the good efficacy group: (5.28 ± 1.21) pmol/L vs. (4.73 ± 1.03) pmol/L, (15.52 ± 2.35) pmol/L vs. (14.28 ± 2.31) pmol/L, (11.82 ± 2.11) ng/L vs. (10.05 ± 2.04) ng/L, (2.12 ± 0.21) ng/L vs. (1.96 ± 0.18) ng/L, (38.56 ± 4.35) ng/L vs. (35.46 ± 4.21) ng/L, 2.52 ± 0.41 vs. 1.67 ± 0.37, (17.42 ± 2.44) mm vs. (15.32 ± 2.27) mm, (4.34 ± 0.65) scores vs. (3.98 ± 0.63) scores, there were statistical differences ( P<0.05). Multiple Logistic regression analysis showed that smoking history, TSH, FT 3, FT 4, TNF-ɑ, IL-6, IL-8, LYM, NLR, exophthalmia and CAS score were all included in the regression equation, and they were all influential factors affecting the efficacy of glucocorticoid shock therapy for thyroid-related eye diseases ( P<0.05). Conclusions:In active thyroid-related eye disease patients receiving glucocorticoid impact therapy, the efficacy may be affected by many factors, and comprehensive intervention should be implemented according to the actual situation to further improve the efficacy.

Objective To investigate the knowledge and attitude of clinical nurses on Panvascular Disease(PVD)care in Zhejiang Province,and to analyze the influencing factors,so as to provide references for constructing a systematic PVD training program.Methods The convenient sampling method was used to investigate 454 nurses from 36 general hospitals in 11 prefectures and cities in Zhejiang Province in June 2024 with a self-designed questionnaire on general information and a questionnaire on PVD nursing knowledge and attitude questionnaire,and multiple stepwise linear regression was used to analyze the impact factors.Results 452 valid questionnaires were collected and the valid recovery rate was 99.56％.Nurses scored(8.57±2.02)in knowledge dimension,(60.82±6.45)in attitude dimension.The results of multiple stepwise linear regression analysis showed that hospital grade was the factor influencing the score of nurses'knowledge towards PVD nursing in Zhejiang Province(P＜0.05).Hospital grade,whether they had received systematic knowledge training related to PVD were the factors influencing the score of nurses'attitude towards PVD nursing(P＜0.05).Conclusion Nurses in Zhejiang Province are positive about PVD nursing,but their knowledge level needs to be improved.Nursing managers should pay full attention to the training intention of clinical nurses,establish a PVD knowledge training system,and strengthen the theoretical and practical training of clinical nurses on PVD nursing,so as to promote the development of PVD nursing work.

The " no-accompany" service is an important measure to meet the patients′ needs for comprehensive, continuous, and high-quality diversified care and to enhance their medical experience. Starting in March 2024, the Second Affiliated Hospital of Zhejiang University School of Medicine launched a pilot " no-accompany" service in the breast surgery and dermatology wards. The hospital established a working team led by the nursing department and involving multiple administrative departments such as the medical affairs department, medical insurance office, and logistics management department. And the hospital has successfully advanced the implementation of the " no-accompany" ward program by establishing a multi-department collaborative management mechanism, standardizing the management of medical caregivers, developing a tiered fee scheme for the " no-accompany" service, and improving relevant service measures. The acceptance of the " no-accompany" service by patients increased from (3.93±0.83) in the second quarter of 2024 to (4.69±0.59) in the fourth quarter, and overall satisfaction rose from (4.18±0.73) to (4.50±0.54) (all P<0.001). The job competency of medical caregivers also improved significantly from (64.80±3.49) before starting work in March 2024 to (94.00±2.40) in the fourth quarter ( P<0.001). These findings provide a reference for the implementation of " no-accompany" services in public hospitals.

Objective In this study,Knoevenagel derivatives of curcumin were synthesized,and their oil-water partition coefficient were determined.Our aim is to provide an experimental basis for further development of curcumin derivatives.Methods Two Knoevenagel derivatives of curcumin,including 4-(thiophen-2-ylidene)curcumin(3a)and 4-(pyridine-4-ylidene)curcumin(3b),were obtained by using the methylene group of curcumin as the modification site and purified by column chromatography.The structures of these derivatives were confirmed by nuclear magnetic resonance spectroscopy(NMR),infrared(IR)and high-resolution liquid mass spectrometry(HRLC-MS).The oil-water partition coefficient of the derivatives in n-octanol aqueous solution was determined by quantitative analysis using HPLC.Results Knoevenagel derivatives of curcumin were successfully synthesis.The oil-water partition coefficients(lgPap)of curcumin derivatives 3a and 3b are 0.96 and 0.82,respectively.Compared with the oil-water partition coefficient of curcumin(lgPap=3.85),it suggested that curcumin derivatives showed better water solubility than curcumin.Conclusion Compared to the curcumin prototype,Knoevenagel derivatives of curcumin increased water solubility and improved bioavailability.Thus,it may provide experimental basis for introducing heteroarylene moiety of the methylene position of curcumin to enhance pharmacological activity.

Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.