Objective:To analyze the influencing factors of low fall alertness in elderly inpatients,construct a risk prediction model and validate it,providing a reference for clinical medical staff to identify elderly inpatients with low fall alertness in the early stage.Methods:A total of 605 elderly inpatients treated in Yijishan Hospital affiliated to Wannan Medical College from Oct 2023 to Mar 2024 were enrolled and randomly divided into the training group(n=423)and validation group(n=182)at a ratio of 7∶3.The patients were evaluated using a general information questionnaire,the Social Frailty Screening Tool(HALFT),the Tilburg Frailty Indicator(TFI),and the Self-Awareness of Falls in Elderly scale(SAFE).Multivariate logistic analysis was used to determine the influencing factors of low fall alertness in elderly inpatients.RStudio was used to construct a risk prediction model of low fall alertness.The discrimination,calibration,and clinical net benefit of the model were verified using the receiver operating characteristic(ROC)curves,calibration plots,and decision curve analysis(DCA).Results:Multivariate logistic analysis showed that the history of falls,monthly income,previous physical activity time,social frailty score and TFI score were independent risk factors for low fall alertness in elderly inpatients.The Hosmer-Lemeshow χ2 test showed that χ2=8.863,P=0.354,indicating good calibration of the prediction model.The area under the ROC curve of the training group and the validation group were 0.860(95%CI:0.815-0.904)and 0.937(95%CI:0.888-0.986),respectively,and the maximum Youden indices of the model was 0.576 and 0.788,respectively,indicating good discrimination of the model.The DCA decision curve showed that the model had good clinical effectiveness.Conclusion:The constructed model has a good prediction effect and can help clinical medical staff quickly and effectively screen out elderly inpatients at risk of low fall alertness.

Objective·To investigate the expression of serpin family E member 1(SERPINE1)in gastric cancer and its potential mechanisms in promoting gastric cancer.Methods·Pan-cancer analysis of SERPINE1 was performed by using the TIMER2.0 online website,and the differences in the expression of SERPINE1 in samples with different tumor stages of gastric cancer were analysed by the clinical data of gastric cancer from The Cancer Genome Atlas(TCGA)database.Survival curves were plotted.Quantitative real-time PCR(qRT-PCR)was used to detect mRNA expression in paired samples of clinical gastric cancer tissues.The small interfering RNA(siRNA)transfection technique was used to knock down the expression of SERPINE1 in MGC-803 and SGC-7901 gastric cancer cell lines,and the migration and invasive abilities of gastric cancer cells were investigated by Transwell and invasion chamber experiments.The effects of SERPINE1 knockdown on the angiogenesis of gastric cancer cells were further explored by the migration assay of human umbilical vein endothelial cells(HUVEC)and tubule formation assay of HUVECs.The Gene Expression Omnibus(GEO)dataset was used for differential gene analysis in high and low expression groups based on the median value of SERPINE1 expression.The differentially expressed genes were further analyzed by Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis and Gene Set Enrichment Analysis(GSEA).qRT-PCR was performed to verify the expression levels of key genes related to epithelial-mesenchymal transition(EMT)and angiogenesis.Results·Bioinformatics analysis showed that SERPINE1 was highly overexpressed in a variety of primary tumour tissues,including gastric cancer.SERPINE1 gene expression increased with increasing tumour stage(P<0.001),and increased expression of SERPINE1 was associated with poor prognosis of gastric cancer(P<0.001).qRT-PCR results showed that SERPINE1 was significantly highly expressed in gastric cancer tissues(P=0.038).After knocking down SERPINE1,gastric cancer cell lines MGC-803 and SGC-7901 cells had decreased migration and invasion(P<0.05).Gastric cancer culture supernatants from the SERPINE1-knockdown gastric cancer cell line reduced angiogenesis in HUVECs(P<0.05).Differential genes in gastric cancer patients in the SERPINE1 high-expression group in the GEO database were enriched in cancer-related pathways such as focal adhesion,extracellular matrix receptor interaction,and angiogenesis-related pathways like angiogenesis and the vascular endothelial growth factor(VEGF)signalling pathway.The expression of SERPINE1 was negatively correlated with cadherin 1(CDH1),and positively correlated with other key genes related to EMT and angiogenesis.Moreover,the expression levels of key genes related to EMT and angiogenesis detected by qRT-PCR in SERPINE1 knockdown gastric cancer cell lines(P<0.05),were consistent with the correlation analysis results mentioned above.Conclusion·SERPINE1 expression is elevated in gastric cancer tissues,which could regulate the expression levels of key genes related to EMT and angiogenesis to promote the migration,invasion and angiogenesis of gastric cancer cells.

Objective:To analyze the influencing factors of low fall alertness in elderly inpatients,construct a risk prediction model and validate it,providing a reference for clinical medical staff to identify elderly inpatients with low fall alertness in the early stage.Methods:A total of 605 elderly inpatients treated in Yijishan Hospital affiliated to Wannan Medical College from Oct 2023 to Mar 2024 were enrolled and randomly divided into the training group(n=423)and validation group(n=182)at a ratio of 7∶3.The patients were evaluated using a general information questionnaire,the Social Frailty Screening Tool(HALFT),the Tilburg Frailty Indicator(TFI),and the Self-Awareness of Falls in Elderly scale(SAFE).Multivariate logistic analysis was used to determine the influencing factors of low fall alertness in elderly inpatients.RStudio was used to construct a risk prediction model of low fall alertness.The discrimination,calibration,and clinical net benefit of the model were verified using the receiver operating characteristic(ROC)curves,calibration plots,and decision curve analysis(DCA).Results:Multivariate logistic analysis showed that the history of falls,monthly income,previous physical activity time,social frailty score and TFI score were independent risk factors for low fall alertness in elderly inpatients.The Hosmer-Lemeshow χ2 test showed that χ2=8.863,P=0.354,indicating good calibration of the prediction model.The area under the ROC curve of the training group and the validation group were 0.860(95%CI:0.815-0.904)and 0.937(95%CI:0.888-0.986),respectively,and the maximum Youden indices of the model was 0.576 and 0.788,respectively,indicating good discrimination of the model.The DCA decision curve showed that the model had good clinical effectiveness.Conclusion:The constructed model has a good prediction effect and can help clinical medical staff quickly and effectively screen out elderly inpatients at risk of low fall alertness.

Objective·To investigate the expression of serpin family E member 1(SERPINE1)in gastric cancer and its potential mechanisms in promoting gastric cancer.Methods·Pan-cancer analysis of SERPINE1 was performed by using the TIMER2.0 online website,and the differences in the expression of SERPINE1 in samples with different tumor stages of gastric cancer were analysed by the clinical data of gastric cancer from The Cancer Genome Atlas(TCGA)database.Survival curves were plotted.Quantitative real-time PCR(qRT-PCR)was used to detect mRNA expression in paired samples of clinical gastric cancer tissues.The small interfering RNA(siRNA)transfection technique was used to knock down the expression of SERPINE1 in MGC-803 and SGC-7901 gastric cancer cell lines,and the migration and invasive abilities of gastric cancer cells were investigated by Transwell and invasion chamber experiments.The effects of SERPINE1 knockdown on the angiogenesis of gastric cancer cells were further explored by the migration assay of human umbilical vein endothelial cells(HUVEC)and tubule formation assay of HUVECs.The Gene Expression Omnibus(GEO)dataset was used for differential gene analysis in high and low expression groups based on the median value of SERPINE1 expression.The differentially expressed genes were further analyzed by Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis and Gene Set Enrichment Analysis(GSEA).qRT-PCR was performed to verify the expression levels of key genes related to epithelial-mesenchymal transition(EMT)and angiogenesis.Results·Bioinformatics analysis showed that SERPINE1 was highly overexpressed in a variety of primary tumour tissues,including gastric cancer.SERPINE1 gene expression increased with increasing tumour stage(P<0.001),and increased expression of SERPINE1 was associated with poor prognosis of gastric cancer(P<0.001).qRT-PCR results showed that SERPINE1 was significantly highly expressed in gastric cancer tissues(P=0.038).After knocking down SERPINE1,gastric cancer cell lines MGC-803 and SGC-7901 cells had decreased migration and invasion(P<0.05).Gastric cancer culture supernatants from the SERPINE1-knockdown gastric cancer cell line reduced angiogenesis in HUVECs(P<0.05).Differential genes in gastric cancer patients in the SERPINE1 high-expression group in the GEO database were enriched in cancer-related pathways such as focal adhesion,extracellular matrix receptor interaction,and angiogenesis-related pathways like angiogenesis and the vascular endothelial growth factor(VEGF)signalling pathway.The expression of SERPINE1 was negatively correlated with cadherin 1(CDH1),and positively correlated with other key genes related to EMT and angiogenesis.Moreover,the expression levels of key genes related to EMT and angiogenesis detected by qRT-PCR in SERPINE1 knockdown gastric cancer cell lines(P<0.05),were consistent with the correlation analysis results mentioned above.Conclusion·SERPINE1 expression is elevated in gastric cancer tissues,which could regulate the expression levels of key genes related to EMT and angiogenesis to promote the migration,invasion and angiogenesis of gastric cancer cells.

Objective:To investigate the intervention effect of binary coping strategy based on systemic interaction model on the postoperative survival quality of patients with oral cancer.Methods:A total of 99 patients with oral cancer admitted to the Department of Oral and Maxillofacial Surgery of a tertiary hospital from Jun 2021 to Jun 2022 was selected.They were randomly divided into the control group(50 cases)and the observation group(49 cases)with random number table method.The control group received routine nursing for oral cancer.On this basis,the observation group also received the binary coping strategy based on the systemic interaction model.The scores of UW-QOL quality of life scale and binary coping scale were compared between the two groups before surgery,at the 3rd and 9th weeks after surgery.Results:The UW-QOL scores of both groups at the 3rd and 9th weeks after surgery were lower than those at admission,and the UW-QOL score in the control group was lower than that in the observation group(P＜0.05).At the 3rd week after surgery,the score of coping with the partner in the observation group was higher than that in the control group(P＜0.05).At the 9th week after surgery,the total score,negative coping,stress communication,coping together,and supportive coping scores in the observation group were higher than those in the control group(P＜0.05).Repeated measures analysis of variance showed that there was an interaction between time and group for the total score of binary coping scale(P＜0.05).And there was a significant main effect of time and group on the total score of binary coping scale(P＜0.05).Conclusions:The quality of life of patients with oral cancer is poor.The binary coping strategy based on the systemic interaction model can improve the quality of life of patients,enhance the intimacy of patients with their partners,and contribute to the disease recovery of patients with oral cancer.

Objective To explore the diagnostic value of Young's modulus obtained by real-time shear wave elastography (SWE) for liver fibrosis in autoimmune hepatitis (AIH) patients. Methods A total of 75 AIH patients in the First Affiliated Hospital of Zhengzhou University from January 2013 to April 2022 were retrospectively enrolled. Scheuer scoring system was used to evaluate degrees of liver fibrosis (S0-S4). By using pathological examination of liver tissues as the golden standard, the receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was used to evaluate the diagnostic value of SWE for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3), and liver cirrhosis (S4), respectively. Independent sample t test was used for comparison of continuous data with normal distribution between the two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and Bonferroni method was used for further comparison between two groups. The Spearman correlation coefficient was used for correlation analysis. The logistic regression analysis was used to predict the impact factors in diagnosis accuracy. Results The Young's modulus measured by SWE was statistically significant different among various fibrosis groups ( H =35.186, P < 0.001) although there was no statistical significance in patients' age and platelet, alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and glutamyl transpeptidase levels (all P > 0.05). The Young's modulus measurement was positively correlated with liver fibrosis ( r =0.675, P < 0.05). The AUCs of SWE in the diagnosis of≥S2, ≥S3, and S4 were 0.839, 0.820 and 0.898, respectively and the corresponding optimum cut-off values were 9.2, 10.9, and 14.4 kPa, respectively. The overall concordance rate of the liver Young' s modulus measurements vs . fibrosis stages was 57.33%. Moreover, the alkaline phosphatase level was an independent predictor for diagnostic accuracy of SWE for stage 0-1 fibrosis ( OR =1.009, 95% CI : 1.001-1.018, P =0.029). Conclusion The SWE possessed a diagnosis value for the significant fibrosis (≥S2), advanced liver fibrosis (≥S3) and liver cirrhosis (S4), although there was a low overall concordance rate in the liver Young's modulus measurements obtained using SWE vs. fibrosis stages.

Objective:To construct an evaluation index system for quality of use of insulin pumps in hospitals, in order to provide a reference for evaluating quality of use of insulin pumps in hospitals in clinical work.Methods:Based on the three-dimensional quality evaluation model of "structure-process-result", the first draft was determined through literature review and group discussion from January to February 2022. Using the Delphi expert correspondence method, 26 experts from 13 provinces/municipalities in China were consulted in two rounds to determine the quality evaluation index system for the use of insulin pumps in the hospital.Results:The recovery rate of the two rounds of expert questionnaire was 100%, and the expert authority coefficient was 0.971. The mean value of the second round of index importance assignment was 4.500-5.000 and the coefficient of variation was 0-0.22. The final construction of quality evaluation index system of insulin pump use in the hospital included 3 first-level indicators, 15 second-level indicators and 37 third-level indicators.Conclusions:The constructed quality evaluation index system of insulin pump use in the hospital is scientific, reasonable and practical, which has guiding significance for evaluating the quality of insulin pump use in the hospital.

Objective:To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) .Methods:Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days (UAS7) and chronic urticaria quality of life (CU-Q2oL) score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results:All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point (complete control) in 93.3% of the patients, 1-6 points (favorable control) in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients (65%) achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed.Conclusion:Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.

The construction of nursing clinical teaching base in traditional Chinese medicine (TCM) universities is an extremely important link in nursing education of TCM universities. Building a clinical base with high performance, high quality and high satisfaction has also become an important goal for the development of the nursing discipline of TCM universities. This article reviews and analyzes the current situation of the construction of the nursing clinical teaching base of TCM universities, aiming at providing ideas and plans for the construction of nursing clinical teaching base of TCM universities, so as to improve the quality of clinical teaching and the teaching level of the TCM nursing clinical teaching base.

In order to enable the teachers of professional basic courses to play a role adequately in teaching and educating students, the elements of humanistic quality education are excavated from Histology and Embryology chapters and integrated with professional basic knowledges. The effects of teaching are tested through students' writing experience, teachers' interview and national peer review. The results show that students have received the education of gratitude, dedication and responsibility, meanwhile their enthusiasm for learning has been significantly improved. Teachers believe that teaching and learning has achieved self-education at the same time. The national colleagues agree that it's feasible to integrate humanistic quality education into the teaching process of professional basic courses, and the better teaching effect is also be achieved.