OBJECTIVE: To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function. METHODS: A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression. RESULTS: 2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01). CONCLUSION The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans ; Cross-Sectional Studies ; Aged ; Middle Aged ; Nutrition Surveys ; Cognition ; Female ; Male ; Nutritional Status ; Risk Factors ; Geriatric Assessment

Objective This study aims to assess the hazard vulnerability risks in emergency wards to enhance their flexibility and resilience in response to unexpected events.Methods A cross-sectional survey of 73 emergency specialist nurses from 39 hospitals in Zhejiang province was conducted to identify potential threats,assess their probability,and estimate their impact on specific organizations or regions using hazard vulnerability analysis(HVA)based on Kaiser model.The risk values associated with such events were calculated.Results Among the four categories of risk indicators,the highest risk value was attributed to the"system"(37.68％),followed by"staff'(36.53％),"stuff'(29.45％),and"space"(29.25％).The top 10 ranked risk events included exceeding emergency room capacity with patient numbers(52.03％),insufficient staff(47.23％),workplace violence(46.86％),medical litigation(43.64％),accidental removal of high-risk tubes(41.63％),lack of rescue experience or skills(41.51％),specimen errors(40.72％),inadequate experience in observing and handling circulatory support abnormalities(39.22％),information system failures(38.95％),and patient elopement(38.28％).Conclusion Improvements should be made in areas such as leadership planning,system enhancement,communication and collaboration,and adaptability.Emergency ward preparedness and service quality can be further enhanced through measures such as strengthening nurse training and staffing,continuously monitoring item and space-related risks,and implementing bed management and new nurse training programs.

Objective:The regional emergency system needs to maintain normal operation in disasters and sudden public health events, ensuring the timely treatment of critically ill patients, and also bearing the responsibility of ensuring various large-scale sports events. This article explores the practice of the "three-dimensional closed-loop" emergency system in the guarantee of the Hangzhou Asian Games in Wenzhou.Methods:After analyzing and integrating existing medical resources, the First Hospital Affiliated to Wenzhou Medical University conducted a two-year medical emergency exercise in a simulated urban road and natural water environment, and improved and optimized the weak links in the medical security system.Results:The hospital established a "three-dimensional closed-loop" emergency system and completed the medical support tasks for the Asian Games. The "three-dimensional closed-loop" emergency rescue system adopted a three-dimensional management team that combined a decentralized organizational structure and a professional medical team, and also has a land-air-sea emergency rescue team. By combining manpower and information technology, the system could provide "4R" medical services: real-time perception of medical emergencies in venues, rapid assessment of the patient's condition, rapid transfer of patients and rapid deployment of medical forces within the hospital. In addition, closed-loop management of the hospital's diagnosis and treatment process improved patients' satisfaction during the treatment process.Conclusions:The the "three-dimensional closed-loop" emergency system provided a strong guarantee for the successful holding of the Hangzhou Asian Games in Wenzhou and also accumulates experience for future urban emergency rescue.

Objective::Data comparing the outcomes of MiStent (Micell Technologies, Durham, North Carolina, USA) microcrystalline biodegradable polymer (BP) drug-eluting stent (DES) and those of another post-marketing BP-DES, TIVOLI (EssenTech, Beijing, China) are rare. This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent (SES) system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective, single-blinded, multicenter, randomized trial (NCT02448524), which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio. The primary endpoint was a non-inferiority comparison of in-stent late lumen loss (LLL) by quantitative coronary angiography at 9 months. The secondary endpoint was device-related clinical cardiovascular composite events (target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (MI), and clinically driven target lesion revascularization) and 1-year outcomes. Results::A total of 428 patients (216 patients in the MiStent group and 212 patients in the TIVOLI group) were enrolled and included in an intention-to-treat analysis. MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months ((0.23 ± 0.37) mm vs. (0.34 ± 0.48) mm, P for non-inferiority <0.001, P for superiority = 0.02). Although without significant difference, the rate of TLF in MiStent was quantitatively lower than that in TIVOLI (3.70% vs. 6.60%; P = 0.17). Conclusion::Compared with TIVOLI BP-SES, the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.

Objective::Data comparing the outcomes of MiStent (Micell Technologies, Durham, North Carolina, USA) microcrystalline biodegradable polymer (BP) drug-eluting stent (DES) and those of another post-marketing BP-DES, TIVOLI (EssenTech, Beijing, China) are rare. This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent (SES) system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective, single-blinded, multicenter, randomized trial (NCT02448524), which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio. The primary endpoint was a non-inferiority comparison of in-stent late lumen loss (LLL) by quantitative coronary angiography at 9 months. The secondary endpoint was device-related clinical cardiovascular composite events (target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (MI), and clinically driven target lesion revascularization) and 1-year outcomes. Results::A total of 428 patients (216 patients in the MiStent group and 212 patients in the TIVOLI group) were enrolled and included in an intention-to-treat analysis. MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months ((0.23 ± 0.37) mm vs. (0.34 ± 0.48) mm, P for non-inferiority <0.001, P for superiority = 0.02). Although without significant difference, the rate of TLF in MiStent was quantitatively lower than that in TIVOLI (3.70% vs. 6.60%; P = 0.17). Conclusion::Compared with TIVOLI BP-SES, the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.

Objective:To explore the influencing factors of severity of upper gastrointestinal bleeding (UGIB) and to establish the early warning evaluation model in the form of line chart, so as to provide a feasible basis for emergency nurses' triage.Methods:A total of 680 UGIB patients admitted to the Emergency Department of the First Affiliated Hospital of Wenzhou Medical University from January 2019 to January 2020 were retrospectively analyzed. They were divided into a modeling group ( n=510) and a validation group ( n=170) by random number table method, and were divided into a high-risk group and a low-risk group according to the expert Consensus on Emergency Diagnosis and Treatment Procedures for Acute Upper Gastrointestinal Bleeding in 2020. The differences of various indicators between groups were compared, the factors affecting the severity of the disease were analyzed by Logistic regression, and the nomogram was drawn and validated. Results:Multivariate logistic regression analysis showed that hematemesis ( OR=3.875, 95% CI: 2.212-6.79), diabetes ( OR=2.64, 95% CI: 1.184-5.883), syncope ( OR=10.57, 95% CI: 3.675-30.403), heart rate ( OR=3.262, 95% CI: 1.753-6.068), red blood cell distribution width ( OR=3.904, 95% CI: 2.176-7.007), prothrombin time ( OR=3.665, 95% CI: 1.625-8.269), lactic acid ( OR=3.498, 95% CI: 1.926-6.354) and hemoglobin ( OR=4.984, 95% CI: 2.78-8.938) were the influencing factors of the severity of UGIB patients ( P < 0.05). The nomogram model showed good consistency and differentiation (C-index=0.903, 95% CI: 0.875-0.931), and was verified internally (C-index=0.895) and Hosmer-Lemeshow goodness-of-fit test ( P=0.7936). Externally verified C-index was 0.899 (95% CI: 0.846-0.952). The calibration curve prompt warning evaluation model had good stability and the prediction efficiency was better than the modified early warning score ( P < 0.05). Conclusions:The early warning evaluation model has a reliable predictive value, which can provide a reference for emergency medical staff to screen high-risk patients and formulate targeted nursing interventions.

Objective To study the hypoglycemic effect of Polygonatum sibiricum polysaccharides on type 2 diabetic mice and its effects on intestinal flora and pathological structure of small intestine. Methods Fifty male mice were used, except 10 were fed normally, the others were fed with high-fat and high-sugar diet for 6 weeks, and then injected with streptozotocin intraperitoneally to make type 2 diabetes mice model. After successful modeling, they were randomly divided into model group and Polygonatum sibiricum polysaccharides (500, 250, 125 mg/kg) group and the model group mice were given normal saline. The changes of bodyweight and blood glucose of mice in each group were recorded. After 4 weeks, feces were collected and sequenced by a 16S rRNA high-throughput sequencing, and the pathological changes of small intestine were observed by HE staining. Results In diabetic mice, the weight decreased. After given Polygonatum sibiricum polysaccharides, the weight of mice increased by 14.24%,11.97% and 8.78%, and the blood glucose decreased by 26.6%, 22.3% and 13.3%, respectively after high, medium and low doses of Polygonatum sibiricum polysaccharides were administered. In addition, the pathological disorder and swelling of intestinal histopathology were improved. There were significant differences in intestinal microorganisms between the model group and the Polygonatum sibiricum polysaccharides. Verrucomicrobiae in the model group increased significantly, while the microorganism abundance of Firmicutes and Bacteroidetes in the healthy group and Polygonatum sibiricum polysaccharides group was higher. Conclusion Polygonatum sibiricum polysaccharides has a significant hypoglycemic effect on diabetic mice and a certain protective effect on their intestines, the mechanism may be achieved by increasing the richness of beneficial bacteria and improving the immune function of mice, it’s in a certain dose-effect relationship, and its immune function needs further study.

Objective To investigate the influence of health education with nursing program in the hepatocellular carcinoma patients undergoing first transcatheter arterial chemoembolization (TACE).Methods A total of 100 patients diagnosed with liver cancer and underwent first TACE were randomly divided into the control group and the experimental group , with 50 cases in each group .The patients in the control group received routine nursing and were given the necessary explanations and comfort , and the patients in the experimental group received targeted health education with nursing program on the basis of routine nursing .The health knowledge understanding level was observed in the two groups .Self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS ) were used to evaluate the psychological status of patients .Results Before the implementation of health education , fourteen patients understood about health knowledge and 36 patients understood less in the experimental group , while 16 patients and 34 patients in the control group , respectively, and the difference was not statistically significant (χ2 =0.190, P>0.05).After the implementation of health education , totals of 44 patients understood about health knowledge and six patients understood less in the experimental group , while 31 patients and 19 patients in the control group , respectively , and the difference was statistically significant (χ2 =9.013, P<0.05).Before the implementation of health education , there was no statistically significant difference between the two groups on the score of SAS and SDS (P>0.05).After the implementation of health education , the score of SAS and SDS was respectively (45.40 ±9.62) and (38.80 ± 8.01) in the experimental group, and (50.36 ±10.64) and (43.08 ±10.81) in the control group, respectively, and the difference was statistically significant (t=-2.445, -2.250, respectively; P<0.05). Conclusions The application of health education with nursing program can improve the health knowledge of patients, relieve patients anxiety and depression , as well as improve their negative emotion .

Laiminin,which has been found 15 isoforms up to today,is a kind of noncollagen glycoprotein of extracellular matrix.However,the functions of laminin varis from each other,which mainly takes participation in the process of the cell adherence,migration,differentiation,growth,cell signaling and tissue repair in vivo.In recent years,some scholars have found that laminin plays an important role in angiogenesis.The purpose of this article is to summarize the role of laminin in angiogensis and sum up the current research progress.

OBJECTIVETo construct the eukaryotic expression vector, encoding major histocompatibility complex class I-related chain A gene (MICA), for the further research of transfecting Tca8113-Tb cell line(a metastatic cell line of brain metastasis from human tongue cancer Tca8113 cells in nude mouse), and to establish a stable MICA overexpression oral squamous cell line.

METHODScDNA of MICA gene from pCMV-SPORT6-MICA was amplified by PCR, and subcloned into eukaryotic expression vector pEGFP-N1 marked with green fluorescent protein (GFP). The recombinant plasmid was sequenced and transfected into Tca8113-Tb cell line by lipofectamine 2000. After screen culture by G418, stable tranfected Tca8113-Tb cell line was established using definite dilution method. The expressions of GFP protein was viewed directly with fluorescence microscopy and the overexpression of MICA was identified by RT-PCR, real time PCR and immunocytochemistry.

RESULTSThe MICA gene was amplified by PCR and then cloned into the vector, whose sequence was identical to that in the GenBank. The transfected cells showed the expression of GFP. And the overexpression of MICA gene in transfected cells was detected by RT-PCR, real time PCR and immunocytochemistry.

CONCLUSIONThe recombinant eukaryotic expression vector pEGFP-N1-MICA has been constructed successfully and stably expressed in Tca8113-Tb cell line, providing a foundation for further studies on the function of MICA in vitro.