Objective: To evaluate the intervention effects of comprehensive nursing combined with rehabilitation intervention among elderly patients with diabetes mellitus in community settings, so as to provide the evidence for optimizing personalized management strategies for elderly diabetes and improving patients' quality of life at primary healthcare institutions. Methods: A stratified random sampling method was used to select patients with diabetes mellitus aged ≥65 years who were under contracted management at Wenhui Subdistrict Community Health Service Center in Gongshu District, Hangzhou City from January 2023 to January 2024. The participants were randomly divided into an intervention group and a control group. The control group received routine community management, while the intervention group received comprehensive nursing combined with rehabilitation intervention in addition to routine management. The intervention period lasted 3 months, with follow-up until 6 months. Demographic information, lower extremity vascular status, and blood pressure levels were collected through Hangzhou Community Health Service Information System. Fasting plasma glucose, 2-hour postprandial blood glucose, and glycated hemoglobin were measured. Quality of life and adherence were assessed using the SF-36 Health Survey Scale and the Community Diabetes Patient Adherence Scale, respectively. Repeated-measures analysis of variance was used to compare differences between the two groups before and after intervention. Results: The intervention group comprised 60 patients, including 32 males and 28 females, and the control group comprised 60 patients, including 30 males and 30 females. No statistically significant differences were found in baseline characteristics between the two groups, including gender, age, duration of diabetes, hypertension comorbidity, glycated hemoglobin, and quality of life scores (all P>0.05). Repeated-measures analysis of variance showed that at 3 months of intervention, there were significant interaction effects between group and time for fasting plasma glucose, 2-hour postprandial blood glucose, and glycated hemoglobin (all P<0.05), with greater reductions in the intervention group than in the control group. At 6 months of follow-up, there were significant interaction effects between group and time for all dimensions of quality of life scores (all P<0.05), with greater increases in the intervention group than in the control group, and scores were higher than those before intervention (all P<0.05). The rates of adherence, improvement in lower extremity vascular lesions, and blood pressure control achievement in the intervention group were higher than in the control group (95.00% vs. 78.33%, 86.67% vs. 51.66%, and 80.00% vs. 58.33%, all P<0.05). Conclusion Comprehensive nursing combined with rehabilitation intervention can improve blood glucose control, enhance quality of life, and increase the improvement of lower extremity vascular lesions rate and the blood pressure control achievement rate in elderly patients with diabetes.

Objective To explore the effect of PCSK9 inhibitor combined with atorvastatin on carotid atherosclerosis and its anti-inflammatory effect in patients with hypertension complicated with type 2 diabetes mellitus.Methods A total of 100 patients with hypertension complicated with type 2 diabetes mellitus who were treated in Nanchang Third Hospital from October 2022 to August 2023 were selected as the research subjects.They were divided into the control group and the study group by the random number table method,with 50 cases in each group.Both groups of patients received conventional antihypertensive,hypoglycemic,and antiplatelet therapy.The control group took 20 mg of atorvastatin calcium tablets orally,once a night.On the basis of the control group,the study group was additionally given 150 mg of evolocumab injection(a PCSK9 inhibitor)by subcutaneous injection,once every two weeks.Both groups of patients were followed up for 24 weeks.The levels of blood lipids,blood glucose,inflammatory cytokines,carotid intima-media thickness(IMT),atherosclerotic plaque score and adverse reactions of the patients in the two groups before and after treatment were detected and compared.Results The levels of TC,TG and LDL-C in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜0.05).The levels of IL-1,IL-6,TNF-α,hs-CRP,as well as the ca-rotid IMT and atherosclerotic plaque score in the study group after treatment were lower than those before treatment and those in the control group at the same period,and the differences were statistically significant(P＜O.05).During the treatment period,there was no significant difference in the occurrence of adverse reac-tions between the two groups(P＞0.05).Conclusion The combination of PCSK9 inhibitor and atorvastatin can effectively regulate the blood lipid levels of patients with hypertension complicated and type 2 diabetes mellitus,alleviate the inflammatory response,and improve the degree of carotid atherosclerosis in these pa-tients.

To implement the Opinions of the State Council of the Central Committee of the Communist Party of China on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine， delve into the diseases specifically responding to traditional Chinese medicine （TCM）， and serve the building of advantageous specialties， clinical talent cultivation， national research layout， and academic innovation， the Chinese Association of Chinese Medicine sponsored the salons in multiple fields to discuss the diseases specifically responding to TCM. On August 26， 2023， the 25^th salon on the diseases specifically responding to TCM was held in Shanghai. In view of the advantages of TCM and integrated traditional Chinese and Western medicine in the diagnosis and treatment of psoriasis， Chinese and western medicine experts and interdisciplinary researchers carried out extensive and in-depth discussions and formed specific suggestions and consensus on the diagnosis and treatment of psoriasis with TCM and integrated traditional Chinese and Western medicine. However， there was still a lack of detailed research path. Under the guidance of the Chinese Association of Chinese Medicine， this paper analyzes the problems in the diagnosis and treatment of psoriasis from the occurrence and development of psoriasis. According to the advantages and characteristics of TCM and integrated traditional Chinese and Western medicine in the diagnosis and treatment of psoriasis， this paper puts forward the main points of research layout for psoriasis from the three aspects of psoriasis diagnosis and treatment， comorbidity prevention， and chronic disease management as follows： ① optimization of the syndrome differentiation system for psoriasis， ② optimization of assessment indicators for psoriasis， ③ recurrence mechanisms of psoriasis， ④ construction and research of TCM prevention and treatment of psoriasis recurrence， ⑤ construction of the comorbidity spectrum and TCM theoretical system of psoriasis， ⑥ comorbidity mechanisms of psoriasis. Furthermore， this article proposed the research layout and directions， expected goals and values， and funding priorities. Therefore， on the basis of the series of salons about psoriasis as a disease specifically responding to TCM， this article puts forward the research paradigm of psoriasis， aiming to facilitate the high-quality development of TCM and provide reference for the national research layout， the research and development of new TCM preparations， the selection of research topics， and the formulation of guidelines and consensus.

OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

Objective:To investigate the relationship between circular RNA (circRNA) circ-DCAF7 and the survival of prostate cancer patients, as well as the effects and potential mechanisms of circ-DCAF7 on proliferation and migration of prostate cancer cells in vitro.Methods:The expression and survival data of circ-DCAF7 gene were obtained from 151 prostate cancer patients using the PROGgeneV2 online platform. Patients were divided into circ-DCAF7 high and low expression groups based on the median expression level of circ-DCAF7 gene, and the difference in overall survival between the two groups was compared. Real-time fluorescence quantitative polymerase chain reaction (qPCR) was used to detect the expression of circ-DCAF7 at transcription level in human prostate cancer cell lines 22Rv1, VCaP, PC-3, DU-145, LNCaP, and human normal prostate epithelial cell line RWPE-1. The control plasmid (carrying irrelevant control sequences) and the plasmid carrying circ-DCAF7 sequences were transfected into VCaP cells using liposome reagents, respectively, and referred to as the control group and circ-DCAF7 group. The proliferation and migration abilities of two groups of VCaP cells were detected by plate clone formation assay and cell scratch assay, respectively; using CircInteractome online software, specific binding sites were predicted between circ-DCAF7 and miRNA-18a-5p (miR-18a-5p) sequences, and validated using dual luciferase reporter gene assay; qPCR was used to detect the expression of miR-18a-5p at transcription level in VCaP cells of control group and circ-DCAF7 group; Western blotting was used to detect the expression levels of AKT signaling pathway factors p-AKT, p-mTOR, HIF-1α, and c-myc proteins in two groups of VCaP cells.Results:Analysis using the PROGgeneV2 online tool showed that the overall survival of prostate cancer patients in the circ-DCAF7 high expression group was better than that in the circ-DCAF7 low expression group, and the difference was statistically significant ( P < 0.001). Compared with the normal prostate epithelial cell line RWPE-1, the relative expression of circ-DCAF7 at transcription level in all prostate cancer cell lines was lower, and the differences were statistically significant (all P < 0.05). Among them, the expression level of circ-DCAF7 in VCaP cells was the lowest ( P < 0.001). The relative expression of circ-DCAF7 at transcription level in VCaP cells in the circ-DCAF7 group was higher than that in the control group (9.88±1.58 vs. 1.04±0.39), and the difference was statistically significant ( t = 5.42, P = 0.002). The number of VCaP cell clone formation in the circ-DCAF7 group was less than that in the control group (35±12 vs. 116±11), and the difference was statistically significant ( t = 4.96, P = 0.003). The 25-hour scratch healing rate of VCaP cells in the circ-DCAF7 group was lower than that in the control group [(16±3)% vs. (52±6)%], and the difference was statistically significant ( t = 5.37, P = 0.002). The dual luciferase reporter gene assay showed that compared with VCaP cells co-transfected with miR-18a-5p unrelated control and carrying wild-type circ-DCAF7 sequence plasmid, the relative luciferase activity of VCaP cells co-transfected with miR-18a-5p and carrying wild-type circ-DCAF7 sequence plasmid was lower, and the difference was statistically significant ( t = 7.31, P < 0.001). The relative expression of miR-18a-5p at transcription level in VCaP cells in the circ-DCAF7 group was lower than that in the control group (0.99±0.15 vs. 7.55±1.12), and the difference was statistically significant ( t = 5.83, P = 0.001). Western blotting analysis showed that the expression levels of p-AKT, p-mTOR, HIF-1α, and c-myc proteins of the AKT signaling pathway in VCAP cells of the circ-DCAF7 group were lower than those in the control group. Conclusions:The low expression level of circRNA circ-DCAF7 may be associated with poor prognosis of prostate cancer patients; upregulation of circ-DCAF7 level in prostate cancer cells may inhibit cell proliferation and migration by regulating the miR-18a-5p/AKT signaling pathway.

Objective To explore the risk factors and incidence of epiretinal membrane(ERM)formation following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD),and to construct a risk prediction model to facilitate screening of high-risk populations and prevent ERM formation.Methods RRD patients who underwent SB in the Second Affiliated Hospital of Harbin Medical University between February 2022 and April 2024 were included in the study.The pa-tients were divided into occurrence and non-occurrence groups according to whether they developed ERM.Patient data were analyzed,and univariate Cox regression analysis was performed to select variables,which were then incorporated into the multivariate Cox regression model for the identification of risk factors for ERM formation after SB in RRD patients.A predictive model for ERM risk in RRD patients was constructed based on this data,and nomograms,receiver operating characteristic(ROC)curves,and calibration curves were drawn to evaluate and validate the diagnostic performance of the model.Results A total of 126 RRD patients(126 eyes)who underwent SB were included.There were 27 cases develo-ping ERM(occurrence group)and 99 not developing ERM(non-occurrence group),with an ERM incidence of 21.4％.Multivariate Cox regression analysis revealed that a history of diabetes mellitus[Hazard ratio(HR)=3.52,95％CI:1.37-9.02,P=0.009],preoperative proliferative vitreoretinopathy(PVR)(HR=13.00,95％CI:5.18-32.63,P＜0.001),and ≥4 retinal holes(HR=2.33,95％CI:1.04-5.23,P=0.041)were independent influence factors for ERM formation in RRD patients.ROC curve analysis showed that the area under the curve(AUC)was 0.840(95％CI:0.740-0.940)at 30 days and 0.904(95％CI:0.834-0.975)at 90 days.Conclusion A history of diabetes mellitus,preoperative PVR,and ≥4 retinal holes are factors influencing the development of ERM after SB in RRD patients.It is verified that the risk prediction model constructed based on these factors can accurately predict the risk of ERM formation within 6 months in RRD patients.

Objective To explore the risk factors and incidence of epiretinal membrane(ERM)formation following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD),and to construct a risk prediction model to facilitate screening of high-risk populations and prevent ERM formation.Methods RRD patients who underwent SB in the Second Affiliated Hospital of Harbin Medical University between February 2022 and April 2024 were included in the study.The pa-tients were divided into occurrence and non-occurrence groups according to whether they developed ERM.Patient data were analyzed,and univariate Cox regression analysis was performed to select variables,which were then incorporated into the multivariate Cox regression model for the identification of risk factors for ERM formation after SB in RRD patients.A predictive model for ERM risk in RRD patients was constructed based on this data,and nomograms,receiver operating characteristic(ROC)curves,and calibration curves were drawn to evaluate and validate the diagnostic performance of the model.Results A total of 126 RRD patients(126 eyes)who underwent SB were included.There were 27 cases develo-ping ERM(occurrence group)and 99 not developing ERM(non-occurrence group),with an ERM incidence of 21.4％.Multivariate Cox regression analysis revealed that a history of diabetes mellitus[Hazard ratio(HR)=3.52,95％CI:1.37-9.02,P=0.009],preoperative proliferative vitreoretinopathy(PVR)(HR=13.00,95％CI:5.18-32.63,P＜0.001),and ≥4 retinal holes(HR=2.33,95％CI:1.04-5.23,P=0.041)were independent influence factors for ERM formation in RRD patients.ROC curve analysis showed that the area under the curve(AUC)was 0.840(95％CI:0.740-0.940)at 30 days and 0.904(95％CI:0.834-0.975)at 90 days.Conclusion A history of diabetes mellitus,preoperative PVR,and ≥4 retinal holes are factors influencing the development of ERM after SB in RRD patients.It is verified that the risk prediction model constructed based on these factors can accurately predict the risk of ERM formation within 6 months in RRD patients.

Objective:To sinicize the Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care (OCBS-MPPRBC) to test its reliability and validity, and to provide an evaluation tool for evaluating the degree of compulsive behaviors of postpartum mothers regarding baby care.Methods:Following the principles of Brislin translation, back translation and cross-cultural adaptation, the Chinese version of OCBS-MPPRBC was formed. A convenient sampling method was used to investigate 360 women in Mianyang Central Hospital from November 2023 to February 2024, and to test the reliability and validity of the Chinese version OCBS-MPPRBC. The critical ratio method and the total correlation analysis method were used for item analysis, the reliability test was based on Cronbach α coefficient and half-reliability method, and the content validity index, exploratory factor analysis, confirmatory factor analysis and aggregate validity were used for validity test. Results:A total of 352 women aged 21-41 (31.55 ± 3.17) years who met the exclusion criteria were included. The Chinese version of OCBS-MPPRBC contained 9 items, and 2 common factors were extracted by exploratory factor analysis, and the cumulative total variance contribution rate was 65.523%. The content validity index of the scale level was 0.89, the content validity index of each item level was 0.86-1.00, and the Cronbach α coefficient of the total scale was 0.844, and the half-folded reliability was 0.759. The results of confirmatory factor analysis showed that the fitting index of the Chinese version of the OCBS-MPPRBC model was better. Conclusions:The Chinese version of the OCBS-MPPRBC scale has good reliability and validity, and has good operability, which can be used to evaluate the degree of compulsive behavior of postpartum mothers about baby care in China.

Objective:To summarize the risk factors for and outcomes of financial toxicity in heart failure patients, to identify populations at risk for financial toxicity and the consequent health impacts, so as to provide evidence for subsequent intervention study.Methods:Relevant studies on economic toxicity factors and outcomes of patients with heart failure were searched from China National Knowledge Infrastructure, China Biomedical Literature Database, VIP database, Wanfang Database, PubMed, Embase, CINAHL, Web of Science and Scopus. The search period was from establish to August 23, 2024. The included literatures were screened and summarized.Results:A total of 5 955 articles were retrieved, including 9 studies from 6 countries. The risk factors included socioeconomic, demographic, disease and treatment, psychological and cognitive factors. The outcomes caused by economic toxicity include physical changes, psychological changes, behavioral responses and clinical outcomes.Conclusions:The influencing factors of economic toxicity in patients with heart failure are complex, and there are many adverse outcomes. Therefore, it is necessary to develop specific assessment tools and construct intervention strategies based on multiple levels and perspectives, in order to reduce economic toxicity and adverse effects in patients with heart failure.