To analyze the disease burden of hypertension in the elderly population from 1990 to 2021 and to predict future trends in China and globally, thereby providing insights for public health decision-making regarding older adults with hypertension in China.

OBJECTIVE To enhance the training quality of anticoagulation specialty clinical pharmacists， address the resource limitations of a single training base， and promote homogenization of training quality. METHODS A multi-base joint training system for anticoagulation specialty clinical pharmacists in the Beijing area was established. A mixed research method was employed， collecting data through performance comparisons， questionnaires， and qualitative interviews to compare the differences between the joint training model （experimental group， n＝16） and traditional teaching model （the control group， n＝17）. RESULTS The established joint training system encompassed a unified joint training teaching plan， the formation of a joint training teaching team， the establishment of joint theoretical teaching courses， the implementation of joint case discussions and literature presentations， as well as strengthening the assessment throughout the joint training process. Compared to the control group [theoretical assessment of （76.44±3.66） points， case assessment of （84.31±3.27） points]， the experimental group students achieved higher scores in theoretical assessment （[ 79.85±4.64） points] and case assessment （[ 88.70±5.51） points] （P＜0.05）. Through questionnaires and qualitative interviews， the trainees in experimental group were highly satisfied with the joint training model in terms of theoretical learning， communication skills， and teaching interaction. CONCLUSIONS The multi-base collaborative training system for anticoagulation specialty clinical pharmacists can integrate advantageous resources and significantly enhance the training effectiveness of anticoagulation specialty clinical pharmacists， offering value for wider promotion.

Objective To systematically evaluate the effect of speech and language therapies and educational interventions on chil-dren with intellectual and developmental disabilities(IDD). Methods A systematic review was conducted by searching relevant literature in PubMed,PsycINFO,ERIC,Cochrane Library and Web of Science databases,ranging from January,2018 to May,2024. Results A total of eight English articles were included,from six countries including the United States,France,Italy,Nor-way,Poland and New Zealand,involving 610 children with IDD,from journals about speech language pathology,Down syndrome research and speech language hearing research.The publication time was mainly from 2018 to 2023.The age of the subjects was two to twelve years,and the main health conditions included intellectual dis-ability,autism and Down syndrome.The intervention methods included routine speech therapy(individualized therapy and group therapy),augmentative and alternative communication(device-assisted and sign language and picture cards),family-involved language training programs(parent training and family interaction),computer-as-sisted language learning(language learning software and telehealth),and play-based interventions(interactive games and structured games);15 to 150 minutes a time,one to ten times a week,for ten to 144 weeks.The out-comes were reflected in five aspects:increasing the vocabulary in speaking;improving the language comprehen-sion,symbol recognition and vocabulary comprehension;improving both expressive and receptive language skills;improving participation in game diversity and game participation levels,communication,social interaction and interaction skills;and improving overall language and non-verbal communication skills. Conclusion Combining a variety of methods,such as individualized therapy,family participation,technologic assistance and interactive games,speech and language therapies and education are effective on spoken language production,language comprehension,speech production,social interaction and communication skills for children with IDD.

Objective:To investigate the value of CT radiomic model based on analysis of primary gastric cancer and the adipose tissue outside the gastric wall beside cancer in differentiating stage T1-2 from stage T3-4 gastric cancer.Methods:This study was a case-control study. Totally 465 patients with gastric cancer treated in Affiliated People′s Hospital of Jiangsu University from December 2011 to December 2019 were retrospectively collected. According to postoperative pathology, they were divided into 2 groups, one with 150 cases of T1-2 tumors and another with 315 cases of T3-4 tumors. The cases were divided into a training set (326 cases) and a test set (139 cases) by stratified sampling method at 7∶3. There were 104 cases of T1-2 stage and 222 cases of T3-4 stage in the training set, 46 cases of T1-2 stage and 93 cases of T3-4 stage in the test set. The axial CT images in the venous phase during one week before surgery were selected to delineate the region of interest (ROI) at the primary lesion and the extramural gastric adipose tissue adjacent to the cancer areas. The radiomic features of the ROIs were extracted by Pyradiomics software. The least absolute shrinkage and selection operator was used to screen features related to T stage to establish the radiomic models of primary gastric cancer and the adipose tissue outside the gastric wall beside cancer. Independent sample t test or χ2 test were used to compare the differences in clinical features between T1-2 and T3-4 patients in the training set, and the features with statistical significance were combined to establish a clinical model. Two radiomic signatures and clinical features were combined to construct a clinical-radiomics model and generate a nomogram. The area under the receiver operating characteristic curve (AUC) was used to evaluate the efficacy of each model in differentiating stage T1-2 from stage T3-4 gastric cancer. The calibration curve was used to evaluate the consistency between the T stage predicted by the nomogram and the actual T stage of gastric cancer. And the decision curve analysis was used to evaluate the clinical net benefit of treatment guided by the nomogram and by the clinical model. Results:There were significant differences in CT-T stage and CT-N stage between T1-2 and T3-4 patients in the training set ( χ2=10.59, 15.92, P=0.014, 0.001) and the clinical model was established. After screening and dimensionality reduction, the 5 features from primary gastric cancer and the 6 features from the adipose tissue outside the gastric wall beside cancer established the radiomic models respectively. In the training set and the test set, the AUC values of the primary gastric cancer radiomic model were 0.864 (95% CI 0.820-0.908) and 0.836 (95% CI 0.762-0.910), and the adipose tissue outside the gastric wall beside cancer radiomic model were 0.782 (95% CI 0.731-0.833) and 0.784 (95% CI 0.702-0.866). The AUC values of the clinical model were 0.761 (95% CI 0.705-0.817) and 0.758 (95% CI 0.671-0.845), and the nomogram were 0.876 (95% CI 0.835-0.917) and 0.851 (95% CI 0.781-0.921). The calibration curve reflected that there was a high consistency between the T stage predicted by the nomogram and the actual T stage in the training set ( χ2=1.70, P=0.989). And the decision curve showed that at the risk threshold 0.01-0.74, a higher clinical net benefit could be obtained by using a nomogram to guide treatment. Conclusions:The CT radiomics features of primary gastric cancer lesions and the adipose tissue outside the gastric wall beside cancer can effectively distinguish T1-2 from T3-4 gastric cancer, and the combination of CT radiomic features and clinical features can further improve the prediction accuracy.

Working memory training,as a low-cost and efficient computerized cognitive training,can improve the cognitive function and behavioral decision-making of chronic disease patients,enhance their self-management awareness and ability,and demonstrate good application prospects in chronic disease management.This article reviewed the origin and development of working memory training,its application in chronic disease management,effectiveness evaluation,application challenges,and suggestions,providing references for improving the quality of chronic disease management.

Objective To explore the interactive effect of vitamin D and triglyceride(TG)/high-density lipoprotein cholesterol(HDL-C)on the time to achieve glycemic control in hospitalized patients with type 2 diabetes mellitus(T2DM).Methods A retrospective cohort study was conducted on 82 T2DM patients admitted to Henan Hongli Hospital from March 2021 to December 2023.Patients were categorized into two groups based on the time it took for their blood glucose to reach target levels during their hospitalization:the≤7 d group and the>7 d group.The baseline data,vitamin D levels,and TG/HDL-C ratios of both groups were compared.The relationship between vitamin D,TG/HDL-C levels,and the time it took for blood glucose to reach target levels was analyzed.Further-more,the TG/HDL-C levels of patients with varying vitamin D levels were compared,and the relative risk(RR)and receiver operating characteristic(ROC)curve were used to analyze the interactive effect and predictive value of vitamin D and TG/HDL-C levels on the time it took for hospitalized T2DM patients to achieve target blood glucose levels.Results The hospitalization duration of the group with a duration of>7 days was longer than that of the group with a duration of≤7 days.The fasting blood glucose,glycosylated hemoglobin,and TG/HDL-c levels were higher in the former group,while the vitamin D level was lower.The proportion of patients with vitamin D deficiency and severe deficiency was higher in the former group compared to the latter group(P<0.05).Pearson correlation analysis revealed that vitamin D level was negatively correlated with the time to achieve glycemic control(r=-0.733,P<0.001),while TG/HDL-C level was positively correlated with the time to achieve glycemic control(r=0.830,P<0.001).After adjustment,logistic regression analysis indicated that vitamin D(95%CI:0.482～0.694)and TG/HDL-C level(95%CI:1.053～1.392)remained independent factors influencing the time to achieve glycemic control in hospitalized T2DM patients(P<0.05).Patients with insufficient,deficient,and severely defi-cient vitamin D had higher TG/HDL-C levels compared to those with sufficient vitamin D(P<0.05).The relative risk(RR)of patients with vitamin D deficiency and elevated TG/HDL-C coexisting resulting in a hospitalization duration of>7 days for T2DM patients was 15.867,indicating a synergistic effect.The area under the receiver operating characteristic(AUC)curve for predicting the time to achieve glycemic control in hospitalized T2DM patients using a combination of vitamin D and TG/HDL-C was 0.929,which was greater than that of vitamin D and TG/HDL-C alone(Z=3.849,3.526,P<0.05).Conclusion The vitamin D and TG/HDL-C levels in hospitalized T2DM patients are closely related to the time of reaching glycemic targets.The simultaneous exposure of both factors can affect the time of achieving glycemic targets,and the combined prediction of vitamin D and TG/HDL-C has good reference value for predicting the time of achieving glycemic targets in hospitalized T2DM patients.

Objective:To explore the relationship between stress coping styles and disability levels in patients with spinal cord injury (SCI) .Methods:Totally 300 SCI patients who were hospitalized in the Spinal Surgery Department of three Class Ⅲ Grade A hospitals in Anhui Province from March 2021 to February 2022 were selected by convenience sampling. Data were collected using a general information questionnaire, the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ), and the WHO Disability Assessment Schedule (WHODAS 2.0). Spearman correlation analysis was used to examine the relationship between stress coping styles and disability levels, and multiple linear regression analysis was employed to identify factors influencing disability levels in these patients.Results:A total of 300 questionnaires were distributed, with 269 valid responses received, yielding an effective response rate of 89.67% (269/300). The total score of WHODAS 2.0 for the 269 patients was [91.00 (72.50, 104.00) ], with an item mean score of [2.53 (2.01, 2.89) ], and an average score rate of 59.86%, indicating a moderate to high level of disability. The average score rate for positive stress coping (facing, seeking support, rationalization) was 67.30%, while for negative stress coping (rejection and denial, fantasy, dependency and compromise), it was 64.48%. Negative stress coping was positively correlated with disability levels ( P<0.05), while positive stress coping was negatively correlated with disability levels ( P<0.05). Multiple linear regression analysis showed that occupation, American Spinal Injury Association classification, facing, rejection and denial, and dependency and compromise were factors influencing disability levels in SCI patients ( P<0.05), explaining 50.4% of the total variance in disability levels. Conclusions:The disability level of SCI patients is moderate to high, and stress coping style is an influencing factor. Healthcare professionals should help patients avoid controllable stressors, cultivate effective stress coping strategies, prevent helplessness, to shorten the time window for disability development, and improve patients' quality of life.

Objective:To investigate the protective effect of fibroblast growth factor 10 (FGF10) on neuronal injury and its potential molecular mechanism.Methods:Cortical neurons were dissected from brain tissues of newborn SD rats and seeded on Poly-L-Lysine coated plates. These neurons were then divided into control group, myelin group and myelin+FGF10 group; after 4 h of culture, neurons in the myelin group were added with a certain content of myelin solution (final concentration: 10 μg/mL), while neurons in the myelin+FGF10 group were added with myelin and FGF10 solution (final concentration: 4.3 nmol/L). One week after culturing, the neuronal apoptosis was detected by TUNEL and flow cytometry; neuronal survival was evaluated by live/dead assay and CCK-8 assay; expressions of apoptosis-related proteins, microtubule related proteins and RAS homologous gene family member A (Rho A)/Rho a-related protein kinase (ROCK) signaling pathway related proteins were detected by Western blotting and immunofluorescent double-label staining.Results:Compared with the control group, the myelin group had significantly increased neuronal apoptosis rate by TUNEL, early neuronal apoptosis rate by flow cytometry, activated cysteine proteinase-3 (caspase-3) protein expression and neuronal mortality rate by live/dead assay, and significantly decreased Bcl-2/Bax value, neuronal survival rate by CCK-8 method, value of acetylated tubulin/Tyr-tubulin (Ace/Tyr-tubulin), Tau protein expression and Ace/Tyr-tubulin fluorescent intensity ratio, and statistically increased Rho A and ROCK protein expressions and Rho A fluorescent intensity ( P<0.05). Compared with the myelin group, the myelin+FGF10 group had significantly decreased neuronal apoptosis rate by TUNEL, early neuronal apoptosis rate by flow cytometry and activated caspase-3 protein expression, significantly increased Bcl-2/Bax value, neuronal survival rate by CCK-8 method, Ace/Tyr-tubulin value, Tau protein expression and Ace/Tyr-tubulin fluorescent intensity ratio, and statistically decreased Rho A and ROCK protein expressions and Rho A fluorescent intensity ( P<0.05). Conclusion:FGF10 maintains microtubule stability in neurons likely through inhibiting Rho A/ROCK axis to antagonize myelin-induced apoptosis and improve the neuronal survival.

Objective:To carry out evidence-based nursing practice of nutritional management of patients in the perioperative period of hepatobiliary surgery, formulate review indicators based on the best evidence, analyze obstacles, and provide reference for the application of evidence in clinical practice.Methods:According to the "6S" evidence model, the search was conducted on Cochrane Library, Joanna Briggs Institute evidence-based Health Care Center Database, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, the British Journal of Medicine, PubMed, SinoMed, CNKI and Wanfang Database from the date of database construction to September 30, 2021. Through systematic search, evaluation and summary of evidence, the evidence-based nursing review plan for perioperative patients in hepatobiliary surgery was determined and the status review was conducted. Influencing factors were analyzed, and action strategies were formulated.Results:A total of 14 pieces of best evidence were included in this study, and 16 review indicators were formulated, of which the implementation rate of one indicator was 85%, and the implementation rate of the other indicators was 0-55%. The main obstacles include the following: the lack of relevant knowledge at the medical and nursing level; the resistance of medical staff caused by the increasing clinical work, the lack of systems, procedures, quantitative tools, and instruments and equipment; insufficient leadership, etc.Conclusions:There is a big gap between evidence-based nursing evidence and clinical practice. It should be combined with the judgment of clinical professionals and the results of the baseline review to analyze the obstacles and formulate action strategies to promote the effective transformation of evidence.

Objective:To explore the effect of early activity based on action research method in severely ill children.Methods:From February 2020 to January 2022, 101 children with severe illness admitted to the Henan Provincial People's Hospital were selected as the study subjects by convenient sampling. The 51 children with severe illness included from February 2020 to January 2021 were set as the control group, and the 50 children with severe illness included from February 2021 to January 2022 were set as the experimental group. The children in the control group were treated with routine rehabilitation in the Pediatric Intensive Care Unit (PICU) , and the experimental group was treated with early activity based on action research method on the basis of the control group. Before and after the intervention, the effect was evaluated by the Medical Research Council Scale (MRC) , the Intensive Care Unit Mobility Scale (IMS) , the length of stay in PICU and hospitalization time, and the incidence of ICU-acquired weakness (ICU-AW) when transferring out of PICU.Results:When transferring out of PICU, the MRC muscle strength score of children in the experimental group was higher than that in the control group, and the incidence of ICU-AW was lower than that in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the IMS score of children in the experimental group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . The length of stay in PICU and hospitalization time of children in the experimental group were shorter than those in the control group with statistical differences ( P<0.05) . Conclusions:Early activity based on action research method can effectively prevent the occurrence of ICU-AW in severely ill children, improve the activity of children, and shorten the hospitalization time, which is worthy of clinical promotion and application.