Objective:To investigate the relationship of plasma residual cholesterol (RC), atherogenic index (AI), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (THR) and low-density lipoprotein cholesterol (LDL-C) to HDL-C ratio (LHR) with mild cognitive impairment(MCI) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).Methods:This was a cross-sectional study. A total of 318 T2DM patients aged 50-80 years admitted to the general practice ward of Tiantan Hospital from October 2023 to May 2024 were enrolled. The relevant clinical data were collected, including patient basic information, glycated hemoglobin, lipid test results, and cognitive level was evaluated using the Mini-Mental State Examination (MMSE) form. According to MMSE scores, the patients were divided into the MCI group ( n=102) and the normal cognitive (NC) group ( n=216). Results:Compared with the NC group, patients in MCI group had a older age, longer diabetes duration, lower education level, higher HbA1c, and higher plasma TG levels ( P<0.05). The levels of RC, AI, LHR, and THR in the MCI group were significantly higher than those in the NC group ( P<0.001). Multivariate logistic regression analysis showed that RC ( OR=1.981, P=0.045), AI ( OR=1.657, P=0.043), LHR ( OR=4.360, P=0.001), and THR ( OR=2.908, P=0.002) were independently associated with mild cognitive impairment in T2DM patients. Age-stratified analysis revealed that among T2DM patients aged 60 to 69 years, all four plasma lipid parameters were associated with the risk of MCI in T2DM patients ( P<0.05). Conclusion:Plasma levels of RC, AI, LHR and THR are significantly associated with MCI in middle-aged and elderly T2DM patients, while LHR and THR have a closer association with MCI.

Objective:To investigate the relationship of plasma residual cholesterol (RC), atherogenic index (AI), triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (THR) and low-density lipoprotein cholesterol (LDL-C) to HDL-C ratio (LHR) with mild cognitive impairment(MCI) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).Methods:This was a cross-sectional study. A total of 318 T2DM patients aged 50-80 years admitted to the general practice ward of Tiantan Hospital from October 2023 to May 2024 were enrolled. The relevant clinical data were collected, including patient basic information, glycated hemoglobin, lipid test results, and cognitive level was evaluated using the Mini-Mental State Examination (MMSE) form. According to MMSE scores, the patients were divided into the MCI group ( n=102) and the normal cognitive (NC) group ( n=216). Results:Compared with the NC group, patients in MCI group had a older age, longer diabetes duration, lower education level, higher HbA1c, and higher plasma TG levels ( P<0.05). The levels of RC, AI, LHR, and THR in the MCI group were significantly higher than those in the NC group ( P<0.001). Multivariate logistic regression analysis showed that RC ( OR=1.981, P=0.045), AI ( OR=1.657, P=0.043), LHR ( OR=4.360, P=0.001), and THR ( OR=2.908, P=0.002) were independently associated with mild cognitive impairment in T2DM patients. Age-stratified analysis revealed that among T2DM patients aged 60 to 69 years, all four plasma lipid parameters were associated with the risk of MCI in T2DM patients ( P<0.05). Conclusion:Plasma levels of RC, AI, LHR and THR are significantly associated with MCI in middle-aged and elderly T2DM patients, while LHR and THR have a closer association with MCI.

Objective:To study the quality and stability of commercial ready-to-use tryptone soya agar(TSA)after storing at 2-25 ℃ for different storage duration under dark condition in order to discuss a determination method of validity period for medium.Methods:Three consecutive batches of ready-to-use TSA medium from two manufac-turers were selected and stored at 2-25 ℃ under dark conditions for 30,90 and 180 days,respectively.The appearance,pH,medium suitability and sterility of the medium were tested.Results:The results of appearance,pH,suitability and sterility of TSA medium from two manufacturers for each batch under different storage duration all met the requirements of the Chinese Pharmacopoeia 2020 Volume IV on the quality control of medium.Conclusion:The TSA medium from two manufacturers all met the requirements when stored for 180 days at 2-25 ℃ under dark condition,indicating that the validity period of TSA medium from two manufacturers can reach 180 days.

Objective:To investigate associations between cardiac biomarkers with stroke severity and short-term outcome in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the Affiliated Hospital of Qingdao University from June 2018 to February 2024 whose etiological classification was large artery atherosclerosis (LAA), small vessel occlusion (SVO) or cardioembolism (CE) were included retrospectively. According to the National Institutes of Health Stroke Scale score at admission, patients were divided into mild stroke group (≤8) and moderate to severe stroke group (>8). According to the modified Rankin Scale score at discharge, patients were divided into good outcome group (≤2) and poor outcome group (>2). Multivariate logistic regression analysis was used to determine the independent correlation between cardiac biomarkers and short-term outcome. The predictive value of cardiac biomarkers for poor outcome in patients with AIS and different stroke etiology subtypes were evaluated using receiver operating characteristic (ROC) curves. Results:A total of 2 151 patients with AIS were enrolled, including 1 256 males (58.4%), aged 67.40±11.34 years. 1 079 patents were LAA type (50.2%), 679 were SVO type (31.6%), and 393 were CE type (18.3%); 1 223 were mild stroke (56.86%) and 928 (43.14%) were moderate to severe stroke; 1 357 patients (63.09%) had good short-term outcome, and 794 (36.91%) had poor short-term outcome. Multivariate logistic regression analysis showed that N-terminal pro-B type natriuretic peptide (NT-proBNP), NT-proBNP/creatine kinase (CK) isoenzyme MB (CK-MB) ratio, and CK-MB/CK ratio were independent risk factors for poor short-term outcome. ROC curve analysis shows that the CK-MB/CK ratio had a higher predictive value for short-term poor outcome in patients with AIS (the area under the curve, 0.859, 95% confidence interval 0.839-0.879). Various cardiac biomarkers had a higher predictive value for short-term outcome of CE type and LAA type, but the predictive value for short-term outcome of SVO type was lower. Conclusions:Cardiac biomarkers are associated with the severity and poor outcome of AIS. NT-proBNP/CK-MB and CK-MB/CK ratios have higher predictive value for short-term poor outcome of AIS, especially in patients with CE type.

Objective:To analyze the distribution of ages at the interhospital transfer of outborn very preterm infants in China and to compare their perinatal characteristics and outcomes at discharge and neonatal intensive care unit (NICU) treatment.Methods:A total of 3 405 outborn very premature infants with a gestational age of 24-31 +6 weeks who were transferred to the NICUs of the Chinese Neonatal Network (CHNN) in 2019 were included in this retrospective study. According to the age at transfer, they were divided into three groups: early transfer (≤1 d), delayed transfer (>1-7 d) and late transfer (>7 d) groups. Analysis of variance, t-test, Chi-square test (Bonferroni correction), Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare the general clinical condition, treatment, and outcomes at discharge among the three groups. Results:The median gestational age was 29.7 weeks (28.3-31.0 weeks) and the average birth weight was (1 321.0 ± 316.5) g for these 3 405 infants. There were 2 031 patients (59.6%) in the early transfer group, 406 (11.9%) in the delayed transfer group and 968 (28.4%) in the late transfer group. Infants who received continuous positive airway pressure ventilation and tracheal intubation in the delivery room accounted for 8.4% (237/2 806) and 32.9% (924/2 805), respectively. A total of 62.7% (1 569/2 504) of the mothers received antenatal glucocorticoid therapy and the ratio in the early transfer group was 68.7% (1 121/1 631), which was higher than that in the delayed transfer group [56.1% (152/271), χ2=16.78, P<0.017] and the late transfer group [49.2% (296/602), χ2=72.56, P<0.017]. The total mortality rate of very premature infants was 12.7% (431/3 405), and the mortality rates in the early, delayed and late transfer groups were 12.4% (252/2 031), 16.3% (66/406) and 11.7% (113/968), respectively ( χ2=5.72, P=0.057). The incidences of severe intraventricular hemorrhage, late-onset sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge were all higher in the delayed and late transfer groups than in the early transfer group, respectively. The incidences of retinopathy of prematurity, retinopathy of prematurity requiring treatment and bronchopulmonary dysplasia at the corrected gestational age of 36 weeks or discharge in the late transfer group were significantly higher than that in the delayed transfer group (Bonferroni correction, all P<0.017). In the late transfer group, the median age of very premature infants at discharge was 66.0 d (51.0-86.0 d), and the corrected gestational age at discharge was 38.9 weeks (37.1-41.2 weeks), and both were greater than those in the early transfer [48.0 d (37.0-64.0 d), Z=260.83; 36.9 weeks (35.7-38.3 weeks), Z=294.32] and delayed transfer groups [52.0 d (41.0-64.0 d), Z=81.49; 37.4 weeks (36.1-38.7 weeks), Z=75.97] (all P<0.017). Conclusions:Many very premature infants need to be transferred to higher-level hospitals after birth. The later the very premature infants are transferred, the higher the incidence of complications will be. It is suggested that intrauterine or early postnatal transport may improve the prognosis of very premature infants.

Objective To explore the consistency between the Chinese Version of Stressors in Nursing Students (SINS-CHI) and the Student Nurse Stress Index Scale (SNSI-CHI) in assessing the pressure of undergraduate nursing students.Methods A total of 960 nursing undergraduates from three universities in Henan province were randomly selected.SINS-CHI and SNSI-CHI were applied to all subjects and SPSS 21.0 was used to analyze the validity and reliability.Results The total score of SINS-CHI was (112.73± 26.07).The Cronbach's α was 0.926,the Guttman's partial reliability coefficient was 0.893,the test-retest reliability was 0.820,the content validity index (CVI) was 0.890,the sensitivity was 70.0％,and the specificity was 62.3％.The Yoden index was 0.323 and the area under the ROC curve was 0.710.The total score of SNSI-CHI was (58.71± 14.18).The Cronbach's α was 0.893,Guttman split-half reliability coefficient was 0.829,test-retest reliability was 0.966,CVI was 0.954,sensitivity was 71.4％,specificity was 63.6％.The Yoden index was 0.350 and the area under the ROC curve was 0.714.Conclusion The consistency of SINS-CHI and SNSI-CHI is good.

Objective To test the reliability and validity of the Chinese Version of the Student Nurse Stress Index Scale ( SNSI-CHI ) among Chinese nursing students. Methods A random sampling method was used to collect 1100 nursing students who were from two medical universities of Henan Province, China,and SPSS 17. 0 and AMOS 17. 0 software were used. Results The average total score of SNSI-CHI was 58. 46±13. 90. The Cronbach's α was 0. 886,the test-retest intra-class correlation coefficient( ICC) of SNSI-CHI was 0. 996 (95％CI:0. 992-1. 000,P<0. 01). The item-to-total correlations ranged from 0. 351 to 0. 664 ( all P<0. 01) . The content validity index( CVI) was 0. 954. The result of exploratory factor analysis ( EFA) was that three factors together explained 75. 013％ of the total variances,and the confirmatory factory analysis( CFA) also indicated a good fit (χ2/df=1. 347,GFI=0. 956,AGFI=0. 945,RMR=0. 032,RMSEA= 0. 025, NFI=0. 974, IFI=0. 993, TLI=0. 992, CFI=0. 993 ) . Criterion-related validity was between 0. 330 and 0. 903 ( all P<0. 01) . Conclusion The SNSI-CHI is proved to be reliable and valid in China, and it can be used to measure the stress of Chinese nursing students.

Objective To approach the therapeutic effect of modified Linggui Zhugan decoction for treatment of patients with type Ⅱ cardiorenal syndrome (CRS).Methods Thirty patients with CRS admitted to Affiliated Hospital of Tianjin Institute of Chinese Medicine were selected. By a random number table and double-blind method, they were divided into two groups: treatment and control groups, 15 cases in each group. The patients in both groups were treated with conventional western medicine, and those in the treatment group were additionally given traditional Chinese medicine (TCM) modified Linggui Zhugan decoction (including the following ingredients: Poria 30 g, Cinnamomi Cortex 10 g, Atractylodis Macrocephalae Rhizoma 15 g, Glycyrrhizae Radix et Rhizoma Preparata cum Melle 10 g, Morindae Officinalis Radix 15 g, Arecae Pericarpium 30 g, Astragali Radix 30 g, Zingiberis Rhizoma 10 g, Descurainiae Semen 15 g), one dose daily for consecutive 30 days. Before and after treatment the changes in levels of B-type natriuretic peptide (BNP), serum creatinine (SCr), blood urea nitrogen (BUN), amount of urine, clinical efficacy and TCM syndrome score efficacy were observed in two groups.Results After treatment, the levels of BNP, SCr, and BUN were significantly decreased, while urine volume was obviously increased compared with those before treatment in the two groups, and the degrees of changes in the treatment group were superior to those in control group [BNP (ng/L): 297.3±75.1 vs. 344.2±56.3, SCr (μmol/L): 139.7±62.1 vs. 154.4±39.7, BUN (mmol/L): 10.1±6.4 vs. 13.2±8.7, urine volume (mL/d): 847.2±32.7 vs. 786.4±13.6, allP < 0.05]. The total effective rates of patients and TCM syndrome scores in treatment group were significantly higher than those in control group [both 86.7% (13/15) vs. 66.7% (10/15), bothP < 0.05]. Conclusions Modified Linggui Zhugan decoction can alleviate the symptoms of yang deficiency of heart and kidney and heart failure due to the attack of heart by retained fluid, and can also ameliorate the complicated renal function impairment; the therapeutic effect of integrative traditional Chinese and western medicine for treatment of patients with type Ⅱ CRS is superior to that of conventional western medicine treatment.

Objective To investigate the genetic relation between Cryptococcus neoformans var.the clinical strains in MLMT - 13 genotype and the environmental strains in MLMT - 36 genotype. Methods Multilocus microsatellite typing (MLMT) method was applied for the genotype analysis in our study.Through this method, we recognized two genotypes that distinguish a majority of clinical and environmental strains. In order to compare virulence between the two types, we chose to infect BALB/c mice (6 weeks,female) with 9 MLMT-13 strains and 10 MLMT-36 strains intravenously. Results Forty( 17 clinical and 23 environmental isolates) were analyzed. Of 17 clinical strains, 9 belonged to a major type of MLMT-13 (52.9%). They were mainly isolated from clinical specimens. About 43.5% of strains from the environment belong to a major type of MLMT-36, which are indigenous to environments and which were not isolated from clinical samples. The mortality rate and pathological changes of the above mice were observed during two months after injection. The results showed that the mortality rate of mice infected with MLMT-13 strains was 100%, while the mortality rate with MLMT-36 strains was 7. 5%. The pathological sections showed that lesions of MLMT-13 infected mice appeared in the brain, lungs, liver and kidneys, while the lesions of MLMT-36 infected mice only appeared in the brain. Most brains of MLMT-13 infected mice were distorted,and both the number and size of lesions in such brains were much larger than those of MLMT-36 infected mice. Conclusion Our study illustrated the virulent difference between MLMT-13 and MLMT-36, which are isolated from patients and environment respectively. The results inferred that some genetic changes, such ss microsatellite repeats, might occur between environmental and clinical isolates through their environmental adaptation progress.

Objective In order to know the influence of psychological nursing intervention on rehabilitation of children with primary nocturnal ensuresis. Methods Divided 112 children with primary nocturnal ensuresis into the research group (40 cases) and the control group (72 cases). Routine treatment and nursing cares were used in the control group, while the psychological nursing was used in the research group in addition. Compared the treatment effect betweent the two groups. Results The efficient rate in the research group was 90.0%, which higher than that of in the control group significantly. Conclusions Psychological nursing intervention can effective promote the rehabilitation for children with primary nocturnal ensuresis.