Objective:To understand the current situation and the relevant factors of the intrinsic capacity of the elderly in nursing institutions.Methods:It was a cross-sectional study. From December 2023 to February 2024, a total of 10 elderly people living in 5 institutions in Huaihua City, Hunan Province, 3 institutions in Changsha City, and 2 institutions in Yinchuan City, Ningxia Hui Autonomous Region, were conveniently selected. Relevant clinical data of the participants were collected through questionnaires. The 5 dimensions of motor, psychological, cognitive, vitality, and perceptual were selected to evaluate the intrinsic capacity of the participants, and their total intrinsic capacity scores were calculated by using the Short Physical Performance Battery, Geriatric Depression Scale, Mini-mental State Examination, Short-Form Mini-Nutritionalas Assessment and the Complaints Sensory Functioning, respectively. Multiple linear stepwise regression models were used to analyze the correlates of intrinsic competence in older adults in nursing facilities.Results:Two hundred and seventy institutionalized older adults were included in the analysis, aged (80.9±8.5) years, 117(43.33%) were male, and the length of residence in an institution was 1.50(0.83, 3.00) years.The intrinsic capacity score of the 270 institutionalized older adults was 2.24±0.97, of which 265(98.15%) had declining intrinsic capacity and 5(1.85%) had good intrinsic capacity. The results of multiple linear stepwise regression analysis showed that literacy level, economic source, occupation, frequency of exercise, use of smartphones, use of elderly mobility aids, and whether or not the elderly living in the nursing home received financial support from the state were independently associated with the intrinsic ability of the elderly living in the nursing home (all P<0.05). Conclusions:The overall level of intrinsic capacity of the investigated elderly in nursing homes is low, and literacy level, economic source, occupation, use of smartphones, use of elderly mobility aids, and whether the nursing home receives state financial support are independent correlates of the intrinsic ability of the elderly in nursing homes.

Objective:To explore the characteristics of potential categories of chronic disease co-morbid patients' learned helplessness, and to analyze the differential characteristics of different categories of chronic disease co-morbid patients.Methods:Convenience sampling method was used to select patients with chronic disease co-morbidities who attended The NO.1 People's Hospital of Xiangyang, Hubei University of Medicine, from June to December 2023 as survey respondents. General information questionnaire, Learned Helplessness Scale, Health Questionnaire Somatic Symptom Cluster Scale, Kessler Psychological Distress Scale, and Comprehension Social Support Scale were used for the cross-sectional survey. The potential profile of learned helplessness, and the influencing factors of potential categories of learned helplessness was analyzed.Results:A total of 810 patients with chronic co-morbidities were investigated. There were 453 males and 357 females, aged (65.03±10.89) years old. The learned helplessness of these patients was categorized into three different potential categories, which were named as low-level learned helplessness group, medium-level learned helplessness group, high-level learned helplessness, accounting for 17.5% (142/810), 23.5% (190/810), and 59.0% (478/810), respectively. Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with more severe physical symptoms ( OR=1.456, 1.391, both P<0.01). Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with more severe the psychological distress ( OR=1.359, 1.917, both P<0.01). Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with lower levels of social support ( OR=0.928, 0.874, both P<0.01). Compared with the low-level learned helplessness group, patients with a duration of illness >5 years were used as controls, patients with a duration of illness 2-5 years were more likely to belong to the medium-level learned helplessness group and high-level learned helplessness group ( OR=74.586, 62.620, both P<0.01). Compared with the low-level learned helplessness group, patients with neutral personalities were compared, patients with extroverted personalities had a lower probability of belonging to the medium-level learned helplessness group ( OR=0.105, P<0.05), while patients with introverted personalities had a lower probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group ( OR=0.052, 0.046, both P<0.01). Conclusions:Patients with chronic disease co-morbidities have higher levels of learned helplessness during disease treatment and have more distinctive categorical characteristics. Healthcare professionals should adopt targeted nursing interventions according to different categories of chronic disease co-morbid patients to reduce the level of learned helplessness.

Objective:To explore the characteristics of potential categories of chronic disease co-morbid patients' learned helplessness, and to analyze the differential characteristics of different categories of chronic disease co-morbid patients.Methods:Convenience sampling method was used to select patients with chronic disease co-morbidities who attended The NO.1 People's Hospital of Xiangyang, Hubei University of Medicine, from June to December 2023 as survey respondents. General information questionnaire, Learned Helplessness Scale, Health Questionnaire Somatic Symptom Cluster Scale, Kessler Psychological Distress Scale, and Comprehension Social Support Scale were used for the cross-sectional survey. The potential profile of learned helplessness, and the influencing factors of potential categories of learned helplessness was analyzed.Results:A total of 810 patients with chronic co-morbidities were investigated. There were 453 males and 357 females, aged (65.03±10.89) years old. The learned helplessness of these patients was categorized into three different potential categories, which were named as low-level learned helplessness group, medium-level learned helplessness group, high-level learned helplessness, accounting for 17.5% (142/810), 23.5% (190/810), and 59.0% (478/810), respectively. Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with more severe physical symptoms ( OR=1.456, 1.391, both P<0.01). Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with more severe the psychological distress ( OR=1.359, 1.917, both P<0.01). Compared with the low-level learned helplessness group, the probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group was higher for patients with chronic co-morbidities with lower levels of social support ( OR=0.928, 0.874, both P<0.01). Compared with the low-level learned helplessness group, patients with a duration of illness >5 years were used as controls, patients with a duration of illness 2-5 years were more likely to belong to the medium-level learned helplessness group and high-level learned helplessness group ( OR=74.586, 62.620, both P<0.01). Compared with the low-level learned helplessness group, patients with neutral personalities were compared, patients with extroverted personalities had a lower probability of belonging to the medium-level learned helplessness group ( OR=0.105, P<0.05), while patients with introverted personalities had a lower probability of belonging to the medium-level learned helplessness group and high-level learned helplessness group ( OR=0.052, 0.046, both P<0.01). Conclusions:Patients with chronic disease co-morbidities have higher levels of learned helplessness during disease treatment and have more distinctive categorical characteristics. Healthcare professionals should adopt targeted nursing interventions according to different categories of chronic disease co-morbid patients to reduce the level of learned helplessness.

Objective:To understand the current situation and the relevant factors of the intrinsic capacity of the elderly in nursing institutions.Methods:It was a cross-sectional study. From December 2023 to February 2024, a total of 10 elderly people living in 5 institutions in Huaihua City, Hunan Province, 3 institutions in Changsha City, and 2 institutions in Yinchuan City, Ningxia Hui Autonomous Region, were conveniently selected. Relevant clinical data of the participants were collected through questionnaires. The 5 dimensions of motor, psychological, cognitive, vitality, and perceptual were selected to evaluate the intrinsic capacity of the participants, and their total intrinsic capacity scores were calculated by using the Short Physical Performance Battery, Geriatric Depression Scale, Mini-mental State Examination, Short-Form Mini-Nutritionalas Assessment and the Complaints Sensory Functioning, respectively. Multiple linear stepwise regression models were used to analyze the correlates of intrinsic competence in older adults in nursing facilities.Results:Two hundred and seventy institutionalized older adults were included in the analysis, aged (80.9±8.5) years, 117(43.33%) were male, and the length of residence in an institution was 1.50(0.83, 3.00) years.The intrinsic capacity score of the 270 institutionalized older adults was 2.24±0.97, of which 265(98.15%) had declining intrinsic capacity and 5(1.85%) had good intrinsic capacity. The results of multiple linear stepwise regression analysis showed that literacy level, economic source, occupation, frequency of exercise, use of smartphones, use of elderly mobility aids, and whether or not the elderly living in the nursing home received financial support from the state were independently associated with the intrinsic ability of the elderly living in the nursing home (all P<0.05). Conclusions:The overall level of intrinsic capacity of the investigated elderly in nursing homes is low, and literacy level, economic source, occupation, use of smartphones, use of elderly mobility aids, and whether the nursing home receives state financial support are independent correlates of the intrinsic ability of the elderly in nursing homes.

Objective To comprehend the present condition of sustaining within familial pulmonary rehabilitation for COPD patients,alongside exploring the factors that impact this continuity.Methods A convenience sampling method was used to select 392 COPD patients from outpatient clinics of 2 tertiary-level A hospitals and 1 community health service center in Huaihua in Hunan Province from December 2023 to February 2024 as survey respondents.Patients were surveyed using the general information questionnaire,the COPD Assessment Test,the Modified Medical Research Council Dyspnea Scale,the Exercise Benefits/Barriers Scale,and the Brief 2-Way Social Support Scale.Results We sent out 392 questionnaires and collected 362 valid ones,with an effective response rate of 92.47％.The percentage of COPD patients who never performed home pulmonary rehabilitation was 56.08％,and the maintenance time of health behaviors in home pulmonary rehabilitation was 17.40％for 1-3 months,7.18％for 4-6 months,4.70％for 7-12 months,and 14.64％for more than 1 year.The results of multiple linear regression analysis showed that exercise place,pulmonary rehabilitation health education,exercise habits before having COPD,perceived level of exercise behavior,and two-way social support were influential factors affecting the maintenance of health behaviors in pulmonary rehabilitation in the families of COPD patients,which explained 38.5％of the variability.Conclusion Patients with COPD have a low level of maintenance of health behaviors in home pulmonary rehabilitation,and health education on exercise rehabilitation for COPD patients and caregivers should be strengthened to enhance patients'level of exercise perception and ability to utilize social support.

Objective:To systematically evaluate the risk prediction model of ICU-acquired dysphagia in critically ill patients, and to provide a reference basis for medical practitioners to select or develop suitable risk assessment tools.Methods:Cross-sectional studies, case-control studies, and cohort studies of ICU-acquired dysphagia risk prediction models were searched in eight databases, including Wanfang database, China Biomedical Literature Database, VIP database, China National Knowledge Infrastructure, PubMed, Embase, CINAHL, and the Cochrane Library in both English and Chinese, and the search timeframe was from the construction of the database to July 5th, 2023. and the search was limited to Chinese and English. Literature was independently screened and data were extracted by 2 investigators, and the risk of bias assessment tool for predictive modeling studies was applied to analyze the risk of bias and applicability of the included literature.Results:A total of 8 high-quality papers were included, including 8 predictive models of risk of ICU-acquired dysphagia. The area under the subject operating characteristic curve for the models ranged from 0.750 to 0.980, with 6 models reporting calibration and 2 models having a Hosmer-Lemeshow test P>0.05, indicating good agreement. 2 models were externally validated. Independent predictors reported repeatedly for multivariate models were age ≥ 65 years, chronic lung disease, cerebrovascular disease, comorbid arrhythmias, use of sedative medications and duration of use, Acute Physiology and Chronic Health Evaluation Ⅱ score ≥ 15, presence of a nasogastric tube, duration of indwelling gastric tube ≥ 72 h, and duration of endotracheal intubation ≥ 72 h. Smaller sample sizes (outcome events), insufficient attention to missing data, variable screening processes irrationality, and model overfitting increased the risk of model bias. Conclusions:The included models showed overall good discrimination and applicability, but their risk of bias was high, and external validation was carried out in only a very few studies. Future studies should refer to transparent reports of multivariate predictive models to develop, update, and validate the models to obtain high-quality predictive models of the risk of ICU-acquired dysphagia, which can provide a reference basis for the development of relevant preventive strategies.

Objective:To test the reliability and validity of the Chinese version of the Demoralization Scale-Ⅱ (DS-Ⅱ) in maintenance hemodialysis (MHD) patients.Methods:This was a cross-sectional study. From October 2021 to February 2022, 989 patients who received MHD in 16 hospitals in Xiangyang City, Hubei Province, were selected by convenience sampling as the study subject. The patients were investigated with the General Information Questionnaire, DS-Ⅱ, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) . The correlation coefficient and critical ratio were used for project analysis. The reliability of the total scale and sub-scale were tested by Cronbach 's α coefficient, split half reliability coefficient, retest reliability coefficient. The exploratory factor analysis was used to determine item pool dimension and scale structure, and the confirmatory factor analysis was used to test the structural validity of the scale. We tested the correlation among the scores of SAS, SDS and Chinese version of DS-Ⅱ. A total of 989 questionnaires were distributed, and 920 valid questionnaires were recovered, with a valid recovery rate of 93.02% (920/989) . Results:The correlation coefficient among each item score and the total score of the scale was 0.679 to 0.777 ( P<0.05) . The critical ratio of each item in high score group and low score group was 21.637 to 30.719 ( P<0.05) . The total content validity coefficient of the scale was 0.984, and the content validity coefficient of each item was 0.875 to 1.000. Two common factors were extracted after exploratory factor analysis, and the cumulative variance contribution rate was 59.844%. The confirmatory factor analysis showed that the model fitted well, and the correlation coefficients among items and dimensions were 0.687 to 0.803. The total score of DS-Ⅱ and each factor score were positively correlated with scores of SAS and SDS ( P<0.05) . Cronbach 's α coefficient of the total scale was 0.944, and the split half reliability Guttman 's coefficient was 0.884, and the retest reliability coefficient was 0.909. Conclusions:The Chinese version of DS-Ⅱ has good reliability and validity in MHD patients.

Objective:To evaluate the hemodynamic changes and short-term (one year) outcomes after superficial temporal artery(STA)-middle cerebral artery (MCA) bypass by vascular ultrasonography.Methods:Operation group included a total of 41 hemispheres of 38 patients who underwent STA-MCA bypass for severe stenosis or occlusion of MCA or severe stenosis or occlusion of internal carotid artery(ICA), or Moyamoya disease at Xuanwu Hospital between August 2017 and June 2020. The following examinations were performed in all patients: cranial MRI, CT perfusion imaging, and cerebral angiography. All of the patients were retrospectively followed up for one year postsurgery. Normal group included a total of 40 hemispheres of 20 healthy people who had been examined by vascular ultrasonography of carotid artery and intracranial artery. Inner diameter, peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), resistance index (RI), pulsatility index (PI) and flow of STA, PSV, EDV, MV, PI, RI of external carotid artery (ECA) and PSV, EDV, MV, PI, RI of MCA at 1 week, 6 months and 12 months after STA-MCA bypass of operation group were compared with normal group.Results:①Inner diameter, PSV, MV and flow of STA were increased significantly in operation group at 1 week, 6 and 12 months than normal group (all P<0.05). The flow of STA was decreased significantly from 1 week to 12 months after operation (all P<0.05), but Inner diameter, PSV and MV were only decreased gradually from 1 week to 12 months after operation (all P>0.05). ②STA/ECA PI and RI decreased significantly after operation compared with normal group (all P<0.01). Conclusions:Vascular ultrasonography is a non-invasive examination which can objectively evaluate the extracranial and intracranial hemodynamic changes after STA-MCA bypass, and provide reference effectiveness of the operation. The flow of STA has decreased gradually from 1 week to 12 months after operation to achieve the homeostasis, but it is still higher than normal.STA/ECA PI and RI can be a steady indirect pointer to show the fluency of bypass.

This article is a summary of the Second China Breast Milk Science Conference, which was held in Beijing from August 5 to 7, 2022, with the theme of "Data sharing, method sharing and science sharing". The purpose of the conference is to summarize the latest progress in breast milk research, identify the unresolved issues, and jointly discuss the direction of future breast milk research. Firstly, we summarize the contents and purpose of breast milk scientific research and prospect of breast milk science. The second part focuses on the research status of breast milk composition and its health effects, and puts forward the future research direction. The third section focuses on the health effects of breastfeeding and scientific support and key aspects of breastfeeding promotion actions. The fourth part elaborates the specific methods of current scientific research of breast milk and emphasize the importance of method standardization and the idea of future methodological research. The fifth part consists of the strategy of feeding infants with medical conditions and ways to better promote the growth and development of these infants. The last part introduces the innovation, deficiencies, and future research directions of infant formula production technology in China. This conference demonstrate the importance of multidisciplinary communication, discussions and collaborations in clinical medicine, nutrition, perinatal health, food science, and policy-making in the scientific research of breast milk, and provides guidance for future multidisciplinary research on the physiology of lactation, the composition of breast milk, breastfeeding, and infants and young children nutrition.

Objective: Saposhnikoviae Radix (Fangfeng in Chinese), the roots of Saposhnikovia divaricata, lacks commodity specification and grade standardization in the current market. This study investigated the existing specifications and grades of Saposhnikoviae Radix to provide a standardized scientific reference for its market use. Methods: Based on a textual research of Chinese herbal medicine from the Han Dynasty to the present, medicinal materials of different specifications and grades obtained from Saposhnikoviae Radix in the main producing areas of China were collected and the markets for these materials were investigated. Field investigations were performed in the major producing areas such as Northeast China, Hebei Province, and Inner Mongolia. Four major Chinese herbal medicine markets in China were investigated. Sensory indices were used to categorize the two specifications (wild and cultivated) according to the shape, color, texture, and cross-section. High-performance liquid chromatography was performed to determine the active components. Vernier calipers and measuring tape were used to measure the diameter and length, respectively, of 41 samples. Using Excel and the R Language software, cluster analysis and descriptive statistical analysis were performed to assist in the application of new specifications and grades based on physical characteristics, pharmacological activity, and chemical composition. Results: The two specifications (wild and cultivated) of Saposhnikoviae Radix were divided into three grades each based on the length and diameter. Prim-O-glucosylcimifugin, 5-O-methylvisamminoside, and the length of Saposhnikoviae Radix can be used as a basis for classifying the commodity specifications and grades. The specifications and grade standards of Saposhnikoviae Radix were established based on the following eight aspects: shape, surface characteristics, texture, cross section, taste, prim-O-glucosylcimifugin content, 5-O-methylvisamminoside content and length. Conclusion: The formulation of this standard stipulates the commodity specification level of Saposhnikoviae Radix. It is also suitable for the evaluation of commodity specifications in the process of production, circulation and use of Saposhnikoviae Radix.