Objective To investigate the relationship between systemic immune-inflammation index (SII)and lower extremity vascular disease in patients with type 2 diabetes mellitus (T2DM).Methods A cross-sectional study was conducted on 390 T2DM patients admitted in our department from January 2013 to January 2024.According to the diagnostic criteria for lower extremity vascular disease in T2DM patients,they were divided into a lower extremity vascular disease group (n=158)and a control group (n=232).General data and results of laboratory tests were compared between the 2 groups.Spearman correlation analysis was used to identify the related factors for lower extremity vascular diseases in T2DM patients.The correlation between SII and lower extremity vascular diseases in T2DM patients was analyzed using the Row Mean Scores and Cochran-Armitage Trend analysis.Multivariate logistic regression analysis was applied to identify the risk factors for lower limb vascular lesions in T2DM patients.Receiver operating characteristic (ROC)curve was plotted to evaluate the diagnostic efficacy of SII for lower extremity vascular disease in the patients.Results Compared with T2DMpatients without lower extremity vascular disease,those with lower extremity vascular disease were older,had higher levels of total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),SII,larger proportion of carotid vascular lesions,and increased proportion of no-taking statins.The lower extremity vascular disease in T2DM patients was positively correlated with SII/100 (r=0.429,P<0.001),age (r=0.517,P<0.001),TC (r=0.161,P=0.001),LDL-C (r=0.117,P=0.021),carotid artery lesions (r=0.101,P=0.047),no-taking statins (r=0.266,P<0.001).Logistic regression analysis showed that SII,age,LDL-C,and no-taking statins were the risk factors for lower extremity vascular lesions in T2DM patients (P<0.01).The area under the curve (AUC)value of SII combined with age,LDL-C,and no-taking statins in predicting lower extremity vascular disease in T2DM patients was 0.896.Conclusion SII is not only a risk factor,but also a simple marker for lower extremity vascular disease in T2DM patients,suggesting that inflammatory response plays an important role in the occurrence and development of lower extremity vascular disease in T2DM.

Objective This study is focused on ultrasound multimodality examination,which refers to the combined use of three ultrasound examination modalities,ultrasound(US),acoustic radiation force impulse(ARFI)imaging,and contrast-enhanced ultrasound(CEUS).The purpose of this study is to analyze the value of applying ultrasound multimodality examination in the differential diagnosis of benign and malignant breast non-mass-like lesions(NMLs).Methods Cases of breast NMLs were analyzed retrospectively,and the nature of all the lesions was verified by pathological examination.Based on the gray-scale ultrasound image characteristics,the cases were classified into types Ⅰto Ⅴ,and type Ⅰ and type Ⅱ were further classified into 4 subtypes,Ⅰa,Ⅰ b,Ⅱ a,and Ⅱ b,according to whether there was also calcification,and the proportion of malignant cases in each subtype was statistically analyzed.Logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS for the diagnosis of malignant cases were established,ROC curves were drawn,the area under the curve(AUC)was calculated,and comparisons were made accordingly.The detection rate of malignant NMLs without calcification(atypical malignant NMLs)by the combination examination of US,ARFI,and CEUS was analyzed.Results A total of 407 cases were included in the study.All subjects were female,aged 22 to 81 years,with the average age being(47.0±1 1.0)years.There were 220 benign cases and 187 malignant cases.Ranked from the highest to the lowest,the malignancy proportion of the different types wasⅠb＞Ⅱb＞Ⅲ＞V＞Ⅰa＞Ⅱa＞Ⅳ.The malignant proportion of the low echo area with calcification was significantly higher than that of the lesions without calcification.The AUC(95％confidence interval[CI])for diagnosing malignant cases with the logistic regression models of US,US+ARFI,US+CEUS,and US+ARFI+CEUS were 0.895(0.862-0.927),0.908(0.878-0.937),0.921(0.893-0.948),and 0.927(0.902-0.952),respectively.Comparison of the AUC of the 4 regression models showed significant differences(P＜0.001).The detection rate of US for NMLs without calcification was 80.7％.When US was used in combination with ARFI and CEUS,86.4％of the malignant NMLs lesions without calcification could be detected if the lesion CEUS score was 4 or 5 points or if shear-wave velocity(SWV)≥4.28 m/s.Conclusion Breast NMLs with calcification show high risks of malignancy,and a pathological examination is always recommended for a conclusive diagnosis.Ultrasound multimodality examination can improve the diagnostic accuracy of breast NML without calcification.

Objective:To explore the relationship between AluYb8 insertion in the MUTYH gene and the risk of decreased left ventricular diastolic function in the elderly.Methods:In the retrospective analysis, 498 elderly patients with decreased left ventricular diastolic function(the disease group)and 155 people without left ventricular diastolic function(the control group)were recruited.Polymerase chain reaction was employed to analyze the genotype distribution of AluYb8 insertion in MUTYH gene.Cardiac function was measured by high-resolution color Doppler ultrasound.Results:The frequencies of the A/A, A/P and P/P genotypes were 30.1%(150/498), 48.4%(241/498)and 21.5%(107/498)in patients with decreased left ventricular diastolic function, and 27.7%(43/155), 54.8%(85/155)and 17.5%(27/155)in the control group, respectively.There were no significant differences in genotype( χ2=2.162, P=0.339)and allele frequency( χ2=1.342, P=0.794)between the two groups.Further analysis after stratification revealed that there were statistically significant differences in genotype( χ2=7.173, P=0.028)and allele frequency( χ2=8.352, P=0.015). Multivariate Logistic regression analysis showed that, in elderly patients with diabetes, P-allele carriers had a higher risk of decreased left ventricular diastolic function than non-carriers( OR=3.450, 95% CI: 1.148-10.372, P=0.027). Conclusions:AluYb8 insertion in the MUTYH gene may be associated with the risk of decreased left ventricular diastolic function in the elderly with diabetes.

Objective:To explore the association between non-thyroid illness syndrome(NTIS)and pre-sarcopenia in the elderly.Methods:In the retrospective study, a total of 219 patients aged 60-85 years in Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University from April 2018 to March 2021, included 60 patients with NTIS and 159 patients without NTIS.Clinical data, laboratory results and body composition data were collected.Pre-sarcopenia was diagnosed based on human composition determination data and diagnostic criteria of pre-sarcopenia.Logistic regression analysis, Pearson's correlation analysis and the area under receiver operator characteristic curve(ROC)were used to explore the correlation between serum thyroid hormone levels and diagnostic data level of pre-sarcopenia.Results:Of 54 pre-sarcopenia patients, 30.3%(36/119)were male, 18.0%(18/100)were female with statistically significantly differences( P<0.01). Mean age was higher in both male and female patients in the NTIS group than in the non-NTIS group( P<0.01). The body mass index, levels of triiodothyronine(T3), free triiodothyronine(FT3), hemoglobin, and albumin were lower in NTIS group than in non-NTIS group( P<0.05). The prevalence of presarcopenia in female patients was higher in the NTIS group than in the non-NTIS group[42.9%(10/17) vs.10.6%(8/83), χ2=9.564, P<0.01]. Multivariate logistic regression analysis showed that the risk of pre-morbidity of sarcopenia was significantly higher in NTIS patients than in non-NTIS patients.FT3 was positively correlated with skeletal muscle mass index, fat-free body weight, and phase angle, and negatively correlated with visceral fat area( r=-0.17, P<0.05). While, free thyroxine(FT4)was negatively correlated with skeletal muscle mass index( r=-0.21), fat-free body weight( r=-0.16)and phase Angle( r=-0.2, P<0.01 or P<0.05), and was positively correlated with body fat percentage and visceral fat area( r=0.20 and 0.22, respectively, P<0.01). The use of area under ROC curve(AUC)of FT3 predicting sarcopenia stage showed that the AUC was 0.768(95% CI: 0.691~0.844). Conclusions:In elderly patients, NTIS is correlated with the pre-sarcopenia in the elderly, and FT3 and FT4 are related to muscle mass.The low level of FT3 can predict the pre-validation of pre-sarcopenia.

The involvement of parents in nursing is a new nursing model that promotes the recovery of children and increases parental satisfaction. It has the advantages of optimizing medical resources and promoting doctor-patient harmony. Now it is been widely introduced in the nursing of neonatal intensive care units. However, there are huge differences in the implementation of the involvement of parents in nursing, and there is also a lack of evaluation tools for such involvement. This article reviews the theoretical basis and significance, implementation path and effect evaluation of the involvement of parents in nursing at home and abroad, in order to provide a reference for the construction of local involvement programs of parents in nursing in neonatal intensive care units.

Objective To investigate the state of chronic low-grade inflammation in healthy elderly adults and its related factors.Methods A total of 762 healthy people aged 30-99 years were retrospectively analyzed and assigned into 2 groups:the young group(30-59 years old,n=272)and the elderly group(60-99 years old,n=490).Patients in the elder group were subgrouped into 2 groups:the 60 to 79-year-old group(n=288)and the 80 to 99-year-old group(n=202).The differences in levels of tumor necrosis factor(TNFa) and hypersensitive C-reactive protein (hsCRP) were compared between groups.Correlations of TNFα or hsCRP levels with age,body mass index(BMI)and metabolic indexes were analyzed.Results The levels of TNFα and hsCRP were higher in elderly male group than in the young male group[(16.03±2.32) ×1015 mol/L vs.(15.28±2.63) × 10-15 mol/L,(1.30±1.01mg/L) vs.(0.79±0.61) mg/L,P=0.019 and 0.048],while there was no obvious difference between the 60 to 79-year-old male group and the 80 to 99-year-old male group(P =0.957 and 0.937).TNFα and hsCRP levels were higher in the elderly female group than in the young female group[(15.76 ±2.66) × 10-15 mol/L vs.(14.43 ± 3.18) × 1015 mol/L,(1.30 ± 0.81) mg/L vs.(0.75 ± 0.74) mg/L,P =0.006 and 0.001],and no difference were observed between the 60 to 79-year-old female group and the 80 to 99-year-old female group(P=0.282 and 0.389).Spearman's rank correlation coefficient analysis showed that TNFα level was positively associated with age,total protein,albumin,totalcholesterol,glomerular filtration rate,uric acid (P ＜ 0.05) in man and positively associated with age,triacylglycerol and fasting blood glucose in woman,while hsCRP level was positively associated with age,body mass index,total-cholesterol and negatively associated with total bilirubin,direct bilirubin and indirect bilirubin(P ＜0.05)in man and was positively associated with age,alkaline phosphatase,triacylglycerol and fasting blood glucose and negatively associated with GFR(P ＜0.05)in woman.Conclusions Healthy elderly people are often in a state of chronic low-grade inflammation,which is closely related to several metabolic parameters.

Objective? To expLore the effects of wound therapists invoLved in heaLth education for pressure uLcer prevention on the behavior of primary caregivers of high-risk popuLations with pressure uLcers in the community. Methods? TotaLLy 112 primary caregivers of high-risk popuLations with pressure uLcers from 2 communities near China-Japan Union HospitaL of JiLin University were seLected in September 2017 using convenient sampLing, who received a 3-month heaLth education for pressure uLcer prevention which invoLved wound therapists. HeaLth Information Seeking Behavior (HISB) and Caregiver Behavior ScaLe (CBS) were used to evaLuate the primary caregivers' initiative to Learn heaLth behaviors and their nursing behaviors for pressure uLcers at admission and 3 months post intervention. ResuLts? After 3 months, the subjects' score of HISB and CBS were higher than that before the intervention (P＜ 0.01). ConcLusions? HeaLth education for pressure uLcer prevention which invoLves wound therapists heLps to enhance the initiative to Learn heaLth behaviors in on the primary caregivers of high-risk popuLations with pressure uLcers in the community, improve their nursing behaviors for pressure uLcers, and reduce the incidence rate of pressure uLcers in high-risk popuLations in the community.

Objective To explore the effect of extracurricular activities based on specialist nursing clinic. Methods Thirty-four undergraduate nursing students of grade 2013 in the Capital Medical University were enrolled in the study. After learning of nursing theories for senile dementia, the extracurricular activities based onspecialist nursing clinicwere carried out. Before and after the second class activities, the caring ability inventory scale and self scale-rating for self-directed learning (SRSSDL) were used to assess 34 students. Result After the activities, students' caring ability and self-directed learning ability were statistically significantly improved (P<0.01). Conclusion The extracurricular activities based onspecialist nursing cliniccan stimulate the learning interest of nursing students and improve their self-directed learning ability and humanistic care ability.

Objective To evaluate the effect of early non-liquid diet for patients with mild acute pancreatitis by using Meta-analysis. Methods The randomized controlled trials(RCT) on early non-liquid diet intake for patients with mild acute pancreatitis were collected by computer searching the database of China National Knowledge Infrastructure(CNKI),Wanfang Periodical Database,CBM,Elsevier Scien Direct, cochrane library and PubMed from inception to February 2017, and analyzed by RevMan 5.2 software. Results Five RCTs were included in the study.The Results of Meta-analysis revealed that both the length of hospitalization after eating [MD=-1.48,95%CI-2.50~-0.47, P=0.004] and the total length of hospitalization[MD=-1.99,95%CI-(0.99-2.99),P=0.0001]in liquid diet group were less than that of non-liquid diet group,and the differences were statistically significant.There was no significant difference in the rate of the pain recurrence[RR=1.21,95%CI 0.77-1.91,P=0.40]and the rate of the elimination of oral feeding[RR=1.02,95%CI 0.45-2.30,P=0.96]because of pain,nausea or vomiting after refeeding,although all that rate in non-liquid diet was not lower than that of liquid diet group. Conclusions compared with liquid diet,early non-liquid diet intake for mild acute pancreatitis can shorten their hospitalization time, and it cannot be concluded that the non-liquid diet will increase the pain recurrence rate, and most patients have a better tolerance to non-liquid diet,and non-liquid diet can promote rehabilitation.

Objective To set up an objective criterion for BI-RADS assessment.Methods The breast sonograms of 1 938 female cases were retrospectively studied which had been confirmed by pathology from January to September 2011 and 2012 January.1 660 cases during 2011 were model cases,and the importance of each single feature in distinguishing between benign and malignant was obtained with Chi square and OR value.A detailed criterion of BI-RADS assessment category was set up based on US-BI-RADS.Results Eighteen of 24 lexicons were statistically significant distinguished between benign and malignant breast masses(P ＜ 0.05).The lexicons were divided into major suspicious signs,middle ones and minor ones assigned 3 points,2 points and 1 point,and a scoring model was established as follows:Score =3 * (X1 + X2 + … + X6) + 2 * (X7 + X8 + … + X12) + (X9 + X10 + … + X18).Based on BI-RADS,the positive predictive value of model cases was 1.5％,6.9％,22.1％,62.5％,96.1％ followed by category 3,4A,4B,4C and 5,and it was 1.4％,3.4％,21.1％,69.4％,92.7％ in test cases.Conclusions The scoring model could be useful for BI-RADS final assessment more objectively,and could make it more convenient to predict the risk of breast cancer.