Objective:To explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Methods:From February to March 2024, a convenience sampling method was used to select 763 nurses from ClassⅢ Grade A hospitals in Wenzhou as research subjects. Data were collected using a General Information Questionnaire, the Occupational Embeddedness Scale for Nurses (OESN), the Nursing Professional Values Scale-Revised (NPVS-R), the Nurses' Career Planning Questionnaire (NCPQ), and the Career Success Scale for Nurses (CSSN). Pearson correlation analysis was performed to examine the correlations among the scores of OESN, NPVS-R, NCPQ, and CSSN. The AMOS 21.0 software was used to construct a structural equation model to explore the chain mediation role of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness.Results:A total of 763 questionnaires were collected, with 749 valid responses, resulting in an effective recovery rate of 98.17%. The average scores for the 749 nurses were as follows: OESN (60.29±7.65), NPVS-R (108.99±11.82), NCPQ (42.98±4.44), CSSN (73.57±8.34). All four scale scores were positively correlated with each other ( P<0.05). The chain mediation effect of career development planning and career success in the relationship between nurses' professional values and occupational embeddedness was established, with the total indirect effect accounting for 46.04% (0.302/0.656) of the total effect and the chain mediation effect of career development planning and career success accounting for 10.21% (0.067/0.656) . Conclusions:The level of occupational embeddedness among nurses needs further improvement. Nurses' professional values not only directly influence their level of occupational embeddedness but also affect their career development planning, which in turn impacts their career success, ultimately exerting an indirect effect on occupational embeddedness. Nursing managers should strengthen nurses' professional values, assist them in formulating clear career development plans, and provide timely feedback and recognition of career success.

Transcranial alternating current stimulation (tACS) can modulate human neural activity and behavior by inducing local changes in neural oscillatory power and cross-frequency, cross-regional phase synchronization. It has enormous potential for cognitive research and brain condition treatment. Cognitive impairment in the elderly involves dysrhythmic neural activity within and between brain regions. tACS regulates single or nested brain rhythms to induce cell synchronization and desynchronization, enhancing local or distant synchronous activity in the cortical network to improve cognitive function. This review focuses on introducing the possible mechanisms, influencing factors of efficacy, and clinical applications for elderly cognitive impairment, as well as the development prospects of cross-frequency coupling and closed-loop modulation and other paradigms.

Transcranial alternating current stimulation (tACS) can modulate human neural activity and behavior by inducing local changes in neural oscillatory power and cross-frequency, cross-regional phase synchronization. It has enormous potential for cognitive research and brain condition treatment. Cognitive impairment in the elderly involves dysrhythmic neural activity within and between brain regions. tACS regulates single or nested brain rhythms to induce cell synchronization and desynchronization, enhancing local or distant synchronous activity in the cortical network to improve cognitive function. This review focuses on introducing the possible mechanisms, influencing factors of efficacy, and clinical applications for elderly cognitive impairment, as well as the development prospects of cross-frequency coupling and closed-loop modulation and other paradigms.

Objective:To explore the correlation between risk factors of microvascular dysfunction and cognitive impairment in Late-life depression (LLD).Methods:From May 2014 to May 2019, a total of 89 healthy elderly people (normal control group) and 113 patients with LLD (LLD group) were recruited. Patients with LLD were divided into normal cognition group ( n=33) and mild cognitive impairment (MCI) group ( n=80). The related medical history of microvascular dysfunction (e.g. hypertension, type 2 diabetes, coronary heart disease and hyperlipidemia), plasma concentration of homocysteine and C-reactive protein, and MRI features of cerebral small vessel disease (e.g. white matter hyperintensities, enlarged perivascular space and lacunar infarction) were collected or detected. All participants completed the comprehensive neuropsychological assessment on global cognition and other cognitive domains. The differences of microvascular function and cognition among the groups were compared. The correlation between microvascular dysfunction related biomarkers and the cognitive scores was further analyzed. Finally, Logistic regression analysis was used to explore the risk factors affecting cognitive impairment in patients with LLD. Results:The proportion of hypertension and the concentration of homocysteine in LLD with MCI group were significantly higher than those in normal control group and LLD with normal cognition group (χ 2=15.67, P<0.01; F=7.05, P=0.001). Enlarged perivascular space in centrum semiovale in LLD with MCI group was more severe than that in normal control group (χ 2=10.64, P=0.005). Both homocysteine ( r=-0.25, P=0.024) and white matter hyperintensities ( r=-0.33, P=0.017) were negatively correlated with executive function in LLD with MCI group. Hypertension (β=2.34, P=0.005), high levels of homocysteine (β=1.74, P=0.039) and increased EPVS in the semi-oval area (β=1.31, P=0.028) were the independent risk factors for cognitive impairment in patients with LLD. Conclusion:The cognitive impairment of LLD patients may be related to microvascular dysfunction.

Objective:To explore the correlation between risk factors of microvascular dysfunction and cognitive impairment in Late-life depression (LLD).Methods:From May 2014 to May 2019, a total of 89 healthy elderly people (normal control group) and 113 patients with LLD (LLD group) were recruited. Patients with LLD were divided into normal cognition group ( n=33) and mild cognitive impairment (MCI) group ( n=80). The related medical history of microvascular dysfunction (e.g. hypertension, type 2 diabetes, coronary heart disease and hyperlipidemia), plasma concentration of homocysteine and C-reactive protein, and MRI features of cerebral small vessel disease (e.g. white matter hyperintensities, enlarged perivascular space and lacunar infarction) were collected or detected. All participants completed the comprehensive neuropsychological assessment on global cognition and other cognitive domains. The differences of microvascular function and cognition among the groups were compared. The correlation between microvascular dysfunction related biomarkers and the cognitive scores was further analyzed. Finally, Logistic regression analysis was used to explore the risk factors affecting cognitive impairment in patients with LLD. Results:The proportion of hypertension and the concentration of homocysteine in LLD with MCI group were significantly higher than those in normal control group and LLD with normal cognition group (χ 2=15.67, P<0.01; F=7.05, P=0.001). Enlarged perivascular space in centrum semiovale in LLD with MCI group was more severe than that in normal control group (χ 2=10.64, P=0.005). Both homocysteine ( r=-0.25, P=0.024) and white matter hyperintensities ( r=-0.33, P=0.017) were negatively correlated with executive function in LLD with MCI group. Hypertension (β=2.34, P=0.005), high levels of homocysteine (β=1.74, P=0.039) and increased EPVS in the semi-oval area (β=1.31, P=0.028) were the independent risk factors for cognitive impairment in patients with LLD. Conclusion:The cognitive impairment of LLD patients may be related to microvascular dysfunction.

Objective To investigate regional spontaneous brain activity in mild cognition impairment (MCI) patients with amnesic (aMCI) and non-amnesic (naMCI).Methods Twenty-five aMCI patients,21 naMCI patients and 15 normal controls (NC) underwent resting-state functional magnetic resonance imaging.The regional homogeneity (ReHo) map of the whole brain was obtained by calculating the similarity of each voxel with its nearest 26 voxel time series.The differences of ReHo map across the whole brain among three groups were compared.Results In aMCI group,ReHo values were lower in right frontal lobe and higher in left middle temporal gyrus and left cerebellum compared with NC (P＜0.05,Alphasim correction).In naMCI group,ReHo values were higher in anterior cingulate cortex and right middle frontal gyrus and lower in right parahippocampa gyrus,right middle temporal gyrus as well as right precuneus compared with NC (P＜0.05,Alphasim correction).Compared with naMCI,the ReHo values were significantly higher in left prefrontal gyrus,left middle temporal gyrus and lower in right cerebellum (P＜0.05,Alphasim correction).Conclusion There are differences in spontaneous brain activity of left prefrontal gyrus,left middle temporal gyrus and right cerebellum between aMCI and naMCI,which may be used to differentiate brain function between aMCI and naMCI patients.

Objective To investigate the functional disability of lumbar disc herniation (LDH) patients and to analyze influencing factors.Methods A total of 260 LDH patients treated in the 2nd Affiliated Hospital of Wenzhou Medical University from November 2015 to April 2016, were selected by convenience sampling method and evaluated by Oswestry low back pain-disability index-Chinese vision (ODI-C) about their functional disability, with the results analyzed by single factor analysis, Pearson correlation and hierarchical regression analysis.Results 216 valid questionnaires were regained, which showed that ODI-C scores of all the 216 LDH patients were (26.00±11.83) points. It was shown in single factor analysis that age, course of disease and surgery influenced the patients′ functional disability. It was shown in Pearson correlation analysis that interference of the pain degree or the pain, on the patients′ life was positively correlated with the patients ODI-C score, and so was their condition of depression (r=0.765, 0.725, 0.708;P<0.05). It was shown in regression analysis that, after control of demographic variables, interference of the pain degree or the pain, on the patients′ life, and the condition of depression, were independent influencing factors of functional disability of LDH patients, which accounted for 39.7% of the amount of variability.Conclusions Functional disability is common in LDH patients, which can be reduced by relieving their pain and depression.

Objective To investigate the characteristics of cognitive impairment and psychotic symptoms in general paresis of insane (GPI) before and after penicillin therapy, and explore factors that may predict the clinical outcomes. Methods Thirty patients with GPI were recruited. All GPI patients underwent a comprehensive neuropsychological assessment before receiving penicillin therapy, and returned for follow-up visits after 7 months. The severity of dementia was determined by Clinical Dementia Rating Scale (CDR), cognitive functions were assessed by Mini Mental State Examination (MMSE) and Alzheimer 's Disease Assessment Scale-cognitive subscale (ADAS-Cog), ability of daily living was assessed by Instrumental Activities of Daily Living Scale (IALD) and Physical Self maintenance Scale(PSMS), behavioral and psychological symptoms were assessed by Neuropsychiatric Inventory (NPI). Aqueous crystalline penicillin G 24 million units per day was administered as continuous infusion for 14 days, followed by benzathine penicillin 2.4 million units IM once per week for 3 weeks. Patients returned for follow-up visits after 7 months. Clinical outcomes were determined by the improvement of neuropsychological test scores at the end of the treatment. Grouped by CDR scores, changes in neuropsychological tests scores among different GPI groups were used to explore the correlation between severity of dementia and clinical outcomes. Univariate analysis and multivariate linear regression analysis were used to identify factors that may predict the clinical outcomes. Results (1)After penicillin therapy, GPI patients' MMSE scores(14.4± 6.9 vs.17.1 ± 9.1)and IADL scores(4.0(2.0, 5.0)vs.6.0(2.0, 7.3))both improved significantly(t=5.820, Z=3.710, P<0.01),while in ADAS-Cog, only factor scores of attention(1.5(0.7, 3.0)vs.1.5(0, 2.3))reduced significantly(Z=- 2.680, P<0.01). NPI's total scores(46.0 ± 27.1 vs.17.6 ± 15.4)and subscores of hallucination, delusion, agitation, depression, euphoria, disinhibition and irritability reduced significantly (Z=-4.940,-2.381,-2.504,-3.095,-2.492,-3.097,-2.527,-3.715, all P<0.05).(2) Grouped by the CDR scores, MMSE scores and IADL scores in very mild GPI group with CDR=0.5 improved significantly. In mild GPI group with CDR=1, significant changes were also found in all neuropsychological tests scores(MMSE,t=5.409, P<0.01), total scores of ADAS-Cog (Z=-2.366,P<0.05), IADL (Z=2.546, P<0.05), total scores of NPI (Z=-3.558,P<0.01), but except for PSMS. In moderate to severe GPI group with CDR>1,significant change was found only in total scores of NPI (t=-3.772,P<0.05). (3) Univariate analysis and multivariate linear regression analysis showed that improvement of MMSE scores after the treatment was significantly correlated with IADL scores and MMSE scores at baseline(β=0.541,P=0.004;β=0.364,P=0.044). Conclusions After penicillin treatment, GPI patients may improve in both cognitive function and psychotic symptoms but not in all the domains. Symptoms of anxiety, sleep/nigh-time behavior change, and apathy, as well as moderate to severe GPI patients may not benefit much from the treatment.

Objective To investigate the characteristics of cognitive impairment and psychotic symptoms in general paresis of insane (GPI) before and after penicillin therapy, and explore factors that may predict the clinical outcomes. Methods Thirty patients with GPI were recruited. All GPI patients underwent a comprehensive neuropsychological assessment before receiving penicillin therapy, and returned for follow-up visits after 7 months. The severity of dementia was determined by Clinical Dementia Rating Scale (CDR), cognitive functions were assessed by Mini Mental State Examination (MMSE) and Alzheimer 's Disease Assessment Scale-cognitive subscale (ADAS-Cog), ability of daily living was assessed by Instrumental Activities of Daily Living Scale (IALD) and Physical Self maintenance Scale(PSMS), behavioral and psychological symptoms were assessed by Neuropsychiatric Inventory (NPI). Aqueous crystalline penicillin G 24 million units per day was administered as continuous infusion for 14 days, followed by benzathine penicillin 2.4 million units IM once per week for 3 weeks. Patients returned for follow-up visits after 7 months. Clinical outcomes were determined by the improvement of neuropsychological test scores at the end of the treatment. Grouped by CDR scores, changes in neuropsychological tests scores among different GPI groups were used to explore the correlation between severity of dementia and clinical outcomes. Univariate analysis and multivariate linear regression analysis were used to identify factors that may predict the clinical outcomes. Results (1)After penicillin therapy, GPI patients' MMSE scores(14.4± 6.9 vs.17.1 ± 9.1)and IADL scores(4.0(2.0, 5.0)vs.6.0(2.0, 7.3))both improved significantly(t=5.820, Z=3.710, P<0.01),while in ADAS-Cog, only factor scores of attention(1.5(0.7, 3.0)vs.1.5(0, 2.3))reduced significantly(Z=- 2.680, P<0.01). NPI's total scores(46.0 ± 27.1 vs.17.6 ± 15.4)and subscores of hallucination, delusion, agitation, depression, euphoria, disinhibition and irritability reduced significantly (Z=-4.940,-2.381,-2.504,-3.095,-2.492,-3.097,-2.527,-3.715, all P<0.05).(2) Grouped by the CDR scores, MMSE scores and IADL scores in very mild GPI group with CDR=0.5 improved significantly. In mild GPI group with CDR=1, significant changes were also found in all neuropsychological tests scores(MMSE,t=5.409, P<0.01), total scores of ADAS-Cog (Z=-2.366,P<0.05), IADL (Z=2.546, P<0.05), total scores of NPI (Z=-3.558,P<0.01), but except for PSMS. In moderate to severe GPI group with CDR>1,significant change was found only in total scores of NPI (t=-3.772,P<0.05). (3) Univariate analysis and multivariate linear regression analysis showed that improvement of MMSE scores after the treatment was significantly correlated with IADL scores and MMSE scores at baseline(β=0.541,P=0.004;β=0.364,P=0.044). Conclusions After penicillin treatment, GPI patients may improve in both cognitive function and psychotic symptoms but not in all the domains. Symptoms of anxiety, sleep/nigh-time behavior change, and apathy, as well as moderate to severe GPI patients may not benefit much from the treatment.

Objective To investigate the cognitive characteristics and vascular risk factor between early onset de?pression and late onset depression in late life depression and provide a clue to elucidate the cause of cognitive impairment in late life depression. Method Fifty-six late life depression patients were recruited in our hospital, including 29 early on?set depression patients and 27 late onset depression patients. 25 controls were recruited from Guangzhou community. Cog?nitive evaluation were conducted in all the patients and controls, including MMSE, memory, attention, language, visuospa?tial abilities,executive function and Framingham vascular risk assessment, and analyze the cognitive and vascular risk be?tween the patients. Result There were statistically significant differences in overall cognitive assessment MMSE(24.8 ± 2.9,22.8±3.5,P=0.030), symbol digit modalities test(SDMT)(29.8±10.5, 22.9±11.8, P=0.028), clock drawing test(CDT) (3.6 ± 0.8, 2.9 ± 1.3, P=0.006) and trail making test(TMT) (60.4 ± 20.6, 74.7 ± 28.8, P=0.027) between late onset depression and early onset depression. In addition, the score of vascular risk assessment was significant between late onset depression and early onset depression(14.6±2.7,12.3±2.2,P=0.001). Conclusion Compare with early onset depression, late onset de?pression has much severe cognitive impairments and increased vascular risk factors.