Objective:To explore the real-life experiences of patients six months after laparoscopic sleeve gastrectomy (LSG), aiming to provide a reference for developing intervention plans.Methods:This was a descriptive phenomenological study. Purposeful sampling and maximum variation sampling were used to select 24 patients who underwent LSG at the Affiliated Hospital of Zunyi Medical University from February to August 2023. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was applied to inductively extract and refine the themes.Results:A total of six main themes and ten sub-themes were identified through analysis. The main themes were: desires to improve postoperative physical symptoms (gastrointestinal symptoms, hair loss, neurological symptoms, and general symptoms) ; perception of subjective emotions (anxiety, regret, fear, and confidence) ; decreased social adaptability (decline in work ability, impaired social skills) ; general low compliance; desire for professional guidance; and postoperative benefit finding.Conclusions:Six months after LSG, patients primarily experienced physical symptom disturbances, poor psychological states, decreased social adaptability, low compliance, and a desire for professional guidance. However, they also recognized various benefits of the surgery. Healthcare providers should strengthen dynamic symptom assessments and management, guide patients psychologically, enhance social support, and actively improve follow-up and continuous care to help patients improve self-coping abilities and weight loss outcomes.

Objective:To explore the real-life experiences of patients six months after laparoscopic sleeve gastrectomy (LSG), aiming to provide a reference for developing intervention plans.Methods:This was a descriptive phenomenological study. Purposeful sampling and maximum variation sampling were used to select 24 patients who underwent LSG at the Affiliated Hospital of Zunyi Medical University from February to August 2023. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was applied to inductively extract and refine the themes.Results:A total of six main themes and ten sub-themes were identified through analysis. The main themes were: desires to improve postoperative physical symptoms (gastrointestinal symptoms, hair loss, neurological symptoms, and general symptoms) ; perception of subjective emotions (anxiety, regret, fear, and confidence) ; decreased social adaptability (decline in work ability, impaired social skills) ; general low compliance; desire for professional guidance; and postoperative benefit finding.Conclusions:Six months after LSG, patients primarily experienced physical symptom disturbances, poor psychological states, decreased social adaptability, low compliance, and a desire for professional guidance. However, they also recognized various benefits of the surgery. Healthcare providers should strengthen dynamic symptom assessments and management, guide patients psychologically, enhance social support, and actively improve follow-up and continuous care to help patients improve self-coping abilities and weight loss outcomes.

Laparoscopic sleeve gastrectomy, as the significantly effective weight loss surgery currently recognized, is widely used at home and abroad, and the quality of life of postoperative patients also receives widespread attention. At present, domestic researchers often use universal scales to evaluate the quality of life of postoperative patients, but such scales cannot truly reflect the quality of life of postoperative patients. This paper reviews the universal and specific assessment tools for quality of life in patients after laparoscopic sleeve gastrectomy, elaborates on the advantages and disadvantages of each tool, compares and analyzes the specific assessment tools, and proposes the shortcomings of the specific assessment tools and future research directions. The aim is to provide a reference for selecting and developing suitable assessment tools for the quality of life of patients after laparoscopic sleeve gastrectomy in China.

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery(BS).Methods 8 databases,including PubMed,PsycInfo,and Embase and Clinic Trials,were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep.2022.Independent quality evaluation was conducted by 2 researchers,and Meta-analysis was performed by the RevMan5.3 software.Results Totally 23 RCTs were included.The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44,95％CI(-0.78,-0.09),P=0.010;MD=-5.88,95％CI(-8.65,-3.11),P＜0.001],promote better quality of life[SMD=0.30,95％CI(0.02,0.59),P=0.040]and physical mobility,alleviates anxiety and depression[SMD=-0.37,95％CI(-0.67,-0.08),P=0.010;SMD=-0.59,95％CI(-0.84,-0.33),P＜0.001].However,the effect on improving eating disorders[MD=-0.01,95％CI(-0.19,0.18),P=0.950]is not significant,and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group.Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients,improve the quality of life and increase physical activity of patients.However,the effect of intervention on eating disorder and weight change is still unclear.More high-quality clinical studies need to be carried out for further verification.

Based on the theory of "Johari Window", this study introduced how to stimulate information content obtained in doctor-patient communication and how to apply the comprehensive geriatric assessment creatively from the four modules of open area, blind area, hidden area and unknown area in the model. It helped students to gain the trust and cooperation of patients, rapidly narrow down the blind area, hidden area and unknown area, guide patients to actively extend the open area, improve the teaching quality of doctor-patient communication in a scientific way.

As a new type of functional wound dressing, conductive hydrogel, shows broad prospects of application in the field of wound repair due to its suitable electrical conductivity, good moisture retention, excellent biocompatibility, and biological effects such as mediating cell migration and proliferation, and promoting angiogenesis and collagen deposition. Combined with the clinical electrical stimulation therapy, the conductive hydrogel primarily showed curative effects of promoting granulation tissue formation, re-epithelialization, and wound healing, providing a new treatment idea for the repair of diabetic wounds. This review summarized the research advances of electronic conductive hydrogels and ionic conductive hydrogels in recent years based on different conductive mechanisms. Meanwhile, the applications of conductive hydrogel in the diabetic wound repair were specifically introduced, and the future development of conductive hydrogel wound dressing was prospected.

Objective To explore the MRI features of acute optic neuritis with positive aquaporin?4 (AQP4) antibodies and myelin oligodendrocyte glycoprotein (MOG) antibodies during the first attack. Methods Eighty five patients (105 affected nerves) with first?episode AQP4?seropositive optic neuritis (AQP4?ON; n=58; 64 affected nerves) and MOG?seropositive optic neuritis (MOG?ON; n=27; 41 affected nerves) diagnosed by our hospital Neuro?ophthalmology Department between April 2014 and December 2017 were retrospectively analyzed. Double seronegative patients or double seropositive patients were not included. All patients underwent orbital conventional MRI; 29 patients also underwent RESOLVE?DWI and 55 underwent brain T2 fluid?attenuated inversion recovery (T2FLAIR). Theclinical features (age, gender, disease duration) and MRI features (T2WI, bilateral involvement, the degree and extent of enhancement, the extent of involvement, the affected segment and ADC values of nerve; demyelinating lesions of brain) were analyzed by 2 doctors. The qualitative parameters were compared with χ2 test or Fisher exact test and the quantitative parameters were compared with two independent sample t test (normal distribution) or the Mann?Whitney U test (skewed distribution). The Kappa test was used to test the consistency of the qualitative characteristics of the images evaluated by the 2 doctors. The interclass correlation coefficient (ICC) was used to test the consistency of the ADC obtained by the 2 doctors. Results There were no significant differences in the distributions of age and disease duration between 2 groups (t=1.911, Z=-1.054, P>0.05). AQP4?ON had a higher female proportion (χ2=13.911, P<0.05) and showed mainly unilateral involvement. MOG?ON more commonly showed bilateral involvement (χ2=17.640, P<0.05), but there were no significant differences in the demyelinating lesions of brain (χ2=0.000)and the presence/absence of optic tract involvement (both P>0.05). There was a higher probability of optic nerve swelling, long segmental lesions and optic nerve head involvement in MOG?ON(χ2=16.845, 13.525, 13.264, P<0.05). Moreover, the rate of obvious enhancement and the involvement of optic chiasm was higher in AQP4?ON(χ2=7.152, 5.088, P<0.05). RESOLVE?DWI showed the ADC values of the AQP4?ON were significantly lower than those of MOG?ON (t=-3.300, P<0.05). The qualitative features of image evaluated by the 2 doctors were consistent well (Kappa=0.712-0.932, P<0.001).The ADC values obtained by the 2 doctors were consistent well (ICC=0.942, P<0.001).Conclusions For the first?episode acute optic neuritis, AQP4?ON hasobvious female predilection and the trend of unilateral involvement and obvious enhancement, while MOG?ON isoften involved bilaterally with longitudinally extensive lesions. The ADC values of the AQP4?ON are significantly lower than those of MOG?ON and AQP4?ON are more vulnerable to involve the optic chiasm. Conventional MRI and RESOLVE?DWI are helpful for differentiating AQP4?ON from MOG?ON during the early stage of the disease course.

Objective? To construct a risk assessment scale for patients with acute myocardial infarction (AMI) and reperfusion arrhythmia after percutaneous coronary intervention (PCI) by Delphi expert consultation at home and abroad. Methods? From 1st January 2017 to 31st December 2017, we preliminarily drew up risk factors related to patients with AMI and reperfusion arrhythmia after PCI by retrieving and analyzing the heart surgery related risk assessment scale at home and abroad; and we confirmed the weight of risk factors by two rounds of expert consultation on scientific nature, suitability and operability of risk factors with the method of Delphi method and the expert evaluation method. Results? The recovery rates of questionnaire were 90% and 95% respectively in two rounds of expert consultation, and the authority coefficient was 0.89 and 0.93. The risk assessment scale constructed for patients with AMI and reperfusion arrhythmia after PCI included 3 first-level risk factors, 13 second-level risk factors. Among weight of risk factors by two rounds of expert consultation, the variation coefficients were all less than 0.2, and the coordination coefficient ranged from 0.20 to 0.34. Conclusions? All the experts participating in the investigation are positive with the high consistency of expert opinion, good coordination, professional representativeness and high authority. The constructed risk assessment scale can effectively assess the risk of AMI patients after PCI, reduce the processing time of reperfusion arrhythmia, enhance the ability of nurses to predict the reperfusion arrhythmia of those patients so as to early decrease the incidence of reperfusion risk.

Objective: To analyze the influence of malnutrition in the elderly patients with acute coronary syndrome on related factors and short-term prognosis. Methods: 415 elderly patients with acute coronary syndrome were selected.Comprehensive geriatric assessment was used to investigate the risk of acute coronary syndrome by examining coexisting diseases and using the NRS2000 score.The mortality and emergency visits were followed up. Results: The patients were divided into two groups according to NRS2000 score: malnutrition group (n=179) and non-malnutrition group (n=236). (1) In malnutrition group, the proportions of female, over 85 years old, more than 3 kinds of coexisting diseases were 47.5%(85/179), 11.7%(21/179), 62.6%(112/179), respectively, which were higher than those of the non-malnutrition group[36.9%(87/236), 4.7%(11/236), 41.9%(99/236)](χ²=4.732, 7.152, 17.318, all P<0.05). (2) In malnutrition group, the incidence rates of geriatric syndromes such as uracratia, falls, visual disorder, hearing disorder, constipation, sleep disorders, oral problems were 47.5%(85/179), 30.2%(54/179), 40.2%(72/179), 41.9%(75/179), 54.7%(98/179), 52.0%(93/179), 76.5%(137/179), respectively, which were higher than those of the non-malnutrition group[31.4%(74/236), 14%(33/236), 29.2% (69/236), 29.7% (70/236), 30.5%(72/236), 36.0%(85/236), 53.0%(125/236)](χ²=11.206, 16.092, 5.477, 6.707, 24.732, 10.577, 24.297, all P<0.05). (3) In malnutrition group, the incidence rates of coexisting chronic diseases such as hypertension, chronic obstructive pulmonary disease, heart failure, severe renal insufficiency, cerebrovascular disease, dementia, anemia, osteoporosis were 77.1%(138/179), 16.2% (29/179), 22.9%(41/179), 17.9%(32/179), 46.9%(84/179), 6.7%(12/179), 27.4%(49/179), 26.8%(48/179), respectively, which were higher than those of the non-malnutrition group[61.9%(146/236), 7.6%(18/236), 14.4%(34/236), 7.2%(17/236), 32.2%(76/236), 1.3%(3/236), 13.1%(31/236), 17.4%(41/236)](χ²=10.931, 7.451, 4.965, 11.137, 9.315, 8.624, 13.262, 5.388, all P<0.05). (4)Cox regression analysis showed that malnutrition risk score was the independent risk predictor for all-cause mortality (HR=0.034, 95% CI: 0.072-0.904) and emergency department visits (HR=0.328, 95% CI: 0.197-0.548) in elderly patients with acute coronary syndrome. Conclusion Comprehensive geriatric assessment and nutritional assessment are useful to evaluate the clinical features of acute coronary syndrome in elderly patients.Malnutrition risk score is an independent predictor of all-cause mortality and emergency treatment in elderly patients with acute coronary syndrome.

Objective To investigate the relationship between serum homocysteine (Hcy) level and heart rate variability (HRV) in patients with acute cerebral infarction.Methods A retrospective study was conducted in 76 elderly patients with acute cerebral infarction in the Second Affiliated Hospital of Nanjing Medical University from January 2015 to December 2016,and the patients were monitored by 24 hours electrocardiogram within three months.According to age and Hcy level,the patients were divided into three groups:normal Hcy low age group (5-15μmol/L,60-80 years old),high Hcy low age group (＞ 15μmol/L,60-80 years old),high Hcy high age group (＞15μmol/L,≥80 years old).The correlation between Hcy and HRV was analyzed.Results The standard deviation of the normal-to-normal RR intervals (SDNN),the mean standard deviation of 5-minute RR intervals means (SDANN),the root mean square of successive differences in RR intervals (RMSSD),adjacent RR intervals greater than 50 ms (PNN50) in the high Hcy low age group were (108.75 ±34.18)ms,(97.63 ±31.34) ms,(22.04 ±6.97) ms,(3.78 ± 4.07) ％,respectively,which in the high Hcy high age group were (81.43 ± 27.68) ms,(71.46 ±25.45) ms,(23.82 ± 7.59) ms,(3.95 ± 3.56) ％,respectively,which were significantly lower than those in the normal Hey low agc group[(127.21 ± 22.21) ms,(114.75 ± 23.55) ms,(29.17 ± 9.71) ms,(7.68 ± 6.17) ％](t =2.219,2.140,2.920,2.585,t =6.502,6.328,2.227,2.722,all P ＜ 0.05).The levels of SDNN and SDANN in the high Hcy low age group were lower than those in the high Hcy low age group (t =3.185,3.322,all P ＜ 0.05).The low frequency (LF) and high frequency (HF) values in the high Hcy low age group were (11.86 ± 5.39) ms,(8.47 ± 3.25) ms,respectively,which in the high Hcy high age group were (9.29 ± 4.98) ms,(71.46 ± 25.45) ms,respectively,which were lower than those in the normal Hcy low age group[(15.15 ±4.56) ms,(11.36 ±4.36) ms] (t =2.281,2.612,t =4.392,2.900,all P ＜ 0.05).The LF/HF value of high Hcy high age group (1.09 ± 0.3) was lower than (1.42 ± 0.36) in normal Hcy low age group and (1.41 ± 0.40) in the high Hcy low age group (t =3.569,3.339,all P ＜ 0.05).Logistic regression analysis showed that SDNN,SDANN,RMSSD,nocturnal HF and nocturnal LF/HF were correlated with hyperhomocysteinemia (r =-0.037,-0.132,-0.087,-0.468,-3.746,all P ＜ 0.05).Conclusion Hyperhomocysteinemia with acute cerebral infarction in elderly patients is more likely to have cardiac autonomic nerve dysfunction.And clinically we should strengthen HRV detection of elderly patients with acute cerebral infarction and hyperhomocysteinemia.