Objective: To develop the Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary Schools Students, and to determine its reliability and validity, in order to provide a basis for developing targeted strategies to promote family-school-community cooperation in the area of nutritional education. Methods: Based on overlapping spheres of influence theory, the initial scale was developed through a qualitative and literature review, discussion with Delphi experts and a pilot survey from July 2022 to July 2023. From July to September 2023, a total of 125 primary school parents, 118 primary school teachers and 113 community personnel were selected from six cities in Jiangsu Province by convenient sampling methods, who were investigated to test the reliability and validity of the scale and to develop a formal scale. Results: The final Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School students consisted of 3 dimensions and 19 items. The exploratory analysis extracted three metric factors, with a contribution ratio of 69.07% to the accumulated variance. The mean scale component effectiveness was 0.94, and the coefficient of association between the respective dimensions and the scale ranged from 0.80 to 0.91.The overall Cronbach α coefficient for the scale was 0.95, the folded half reliability was 0.87, and the retest reliability was 0.98. Conclusion The Family-School-Community Cooperation Dilemma Scale for Nutritional Education in Primary School Students has good reliability and validity, and can be used to measure the degree of the family-school-community cooperation dilemma regarding nutritional education in primary school students.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective To analyze the effect of nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model in patients with functional dyspepsia, in order to improve their psychological state and gastrointestinal motility, and provide reference for clinical nursing. Methods A total of 160 functional dyspepsia patients admitted to the First Affiliated Hospital of Xinxiang Medical College from December 2022 to June 2023 were chosen as the study subjects. They were randomly divided into control group and observation group, using a random number table method, with 80 cases in each group. Patients in control group were given routine nursing intervention, and patients in the observation group were treated nursing intervention based on IMB model. The psychological state, gastrointestinal motility andquality of life of the two groups were compared before and after intezrvention. Results After intervention, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in two groups were decreased, and the observation group was lower than that in the control group (P < 0.05). After intervention, the levels of gastrointestinal hormone nitric oxide (NO), serum motilin (MTL) andserum gastrin (GAS) in two groups were improved, and the levels of all indexes in the observation group were better than those in the control group (P < 0.05). After intervention, gastrointestinal quality of life index (GIQLI) of two groups was improved, and the observation group was higher than the control group, the difference was statistically significant (P < 0.05). Conclusion Nursing interventions based on the IMB model are beneficial for alleviating anxiety and depression in patients with functional dyspepsia, effectively enhancing gastrointestinal motility and vitality, and improving their quality of life.

Objective To analyze the influencing factors of self-management ability of coronary heart disease patients after percutaneous coronary intervention (PCI) and construct a nomogram model. Methods A total of 247 CHD patients who underwent PCI were selected as the research subjects, and all of them were evaluated by Coronary Heart Disease Self-management Scale (CSMS). Multivariate Logistic regression analysis was used to screen out the independent influencing factors of self-management ability of CHD patientsafter PCI, and R software was used to construct a nomogram model. The discrimination, calibration, and goodness-of-fit of the nomogram model were evaluated by receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test. Results The average CSMS score of 247 patients was (86.79±9.22), and these patients were divided into low-score group(89 patients) and high-score group (158 patients)based on the critical value of 86.79 points. There were significant differences in age, education level, monthly per capita family income, and self-efficacy between the low-score group and the high-score group (P < 0.05). Multivariate Logistic regression analysis showed that age, education level, monthly per capita family income, and self-efficacy were independent influencing factors of self-management ability of CHD patients after PCI (P < 0.05). The nomogram model constructed based on the four influencing factors found that age >70 years increased the weight by 86.2 points, education level below high school increased the weight by 87.4 points, monthly per capita family income < 3 500 yuan increased the weight by 82.3 points, and low self-efficacy increased the weight by 99.6 points. The results of ROC curve analysis showed that the area under the curve of the nomogram model for predicting self-management ability ofCHD patients after PCI was 0.842 (95%CI, 0.794 to 0.890). The slope of the calibration curve was close to 1, and the results of goodness-of-fit test was as follows: χ²=10.226, P=0.233. Conclusion Age, education level, monthly per capita family income, and self-efficacy are influencing factors of self-management ability of CHD patients after PCI, and the nomogram model constructed based on these factors has high predictive value for self-management ability.

Objective:To evaluate the systemic involvement, outcome and other disease characteristics of children with systemic lupus erythematosus (cSLE), and to explore the prognostic factors.Methods:cSLE treated in Beijing Children′s Hospital, Capital Medical University from January 1, 2016 to December 31, 2017 were enrolled in this study.Medical records including clinical manifestations and evaluation of affected systems, autoantibodies, treatment adjustment, and follow-up were collected and analyzed retrospectively.SPSS 21.0 was used for statistical analysis and mapping.The prognostic factors were studied by the Cox proportional risk regression model.Results:A total of 210 children were included, including 37 males and 173 females, with a male to female ratio of 1.0∶4.7.The average age of onset was (121.39±30.44) months.There were 167 (79.5%) patients with skin and mucous membrane damage, 137(65.2%) patients with blood system damage, 129(61.4%) patients with digestive system damage, 123(58.6%) patients with kidney damage, 119(56.7%) patients with skeletal and musculoskeletal system damage, 71(33.8%) patients with nervous system damage, 68(32.4%) patients with heart damage, and 60(28.6%) patients with respiratory system damage.The 90.95%(191/210) of the children enrolled presented moderate or high disease activity at the first visit.The effective rate was 76.92% (150/195) after 1-month follow-up and 96.95% (159/164) after 1-year follow-up.A high level of compliment C 3 was a protective factor for disease remission.The glucocorticoid level was declined to 5 mg or less in 42 children, and the median time was 40.5 (36.0, 42.0) months.Young onset age and no renal damage were protective factors for glucocorticoid reduction. Conclusions:cSLE tends to occur in female children with multiple involved systems and severe conditions.After reasonable treatment and follow-up, the disease can be alleviated or improved in one year.A high level of complement C 3 at the beginning of disease is conducive to rapid remission of the disease, and the young age of onset and no renal damage is conducive to rapid glucocorticoid reduction.

Objective:To detect the genotype of carbapenase and investigate the drug sensibility of Ceftazidime-avibactam (CAZ/AVI) on carbapenem-resistant Enterobacteriaceae (CRE), and to provide evidence for rational use of antibacterial drugs in clinical practice. Methods:A total of 179 strains of CRE were isolated from clinical specimens of patients treated in Linyi People′s Hospital from January 2019 to December 2020. mCIM/eCIM test and GeneXpert were used to detect the genotype of carbapenemases. The drug sensibility of CAZ/AVI was detected by K-B test.Results:One hundred and seventy-four out of 179 strains of CRE were positive upon to mCIM test (97.2%), 147strains were positive upon to eCIM test (84.5%). There were 27 serine carbapenemase (15.5%) and 147 metallo-β-lactamase (84.5%). The results of Fluorescent quantitative PCR rapid detection system developed by Saipei GeneXpert were consistent with the results detected by mCIM/eCIM. In the drug sensitivity test, 58 out of 174 mCIM positive strains were sensitive to CAZ (33.3%), of which the sensitivity of 27 strains producing serine carbapenemase was 96.3% (26/27) and all 147 strains producing metallo-β-lactamase were drug-resistant to CAZ/AVI.Conclusions:The carbapenase genotype of CRE in Linyi region is mainly metal β-lactamase. The CRE producing serine carbapenemase is highly sensitive to CAZ/AVI. It is helpful to guide the rational clinical use of the CAZ/AVI according to the detection results of CRE with or without carbapenemase production capacities.

Objective:To demonstrate the clinical significance of group A streptococcal infection (GAS) in patients with enthesitis related arthritis (ERA).Methods:A retrospective study was conducted on ERA (136) and PolyRF-/Oligo juvenile idiopathic arthritis (JIA) (272) patients in Beijing Children's Hospital from 2016 to 2018. Anti-streptococcal hemolysin "O" (ASO) was tested and documented in all patients. The infection rate of GAS was compared between patients with ERA and PolyRF-/Oligo JIA. Patients with ERA were divided to two groups according to the result of ASO (ASO positive and ASO negative). All the clinical data were documented and compared within the two groups. The statistical methods used mainly include t test, rank sum test, chi-square test, and Spearman correlation analysis.Results:The GAS infection rate of patients with ERA was higher than patients with PolyRF-/Oligo JIA (17.6% vs 9.5%, χ2=5.52, P=0.019). In ERA patients, clinical data were analyzed, and a statistical significant difference was observed in the presence of human leukocyte antigen (HLA)-B27 between ASO positive and ASO negative group [75.0%(18/24) vs 49.1%(55/112), χ2=5.329, P=0.021]. Statistical differences were found in Patrick's sign positive rate between the two groups [100%(24/24) vs 67.0%(75/112), χ2=10.61, P=0.001]. There was statistically significant difference between the two groups regarding the radiogr-aphic grading at the sacroiliac joint. More patients with positive ASO had grade Ⅲ damage at the sacroiliac joint compare to patients with negative ASO [68.2%(15/22) vs 28.4%(29/102), χ2=12.49, P<0.001]. The logarithmic of the ASO was slightly correlated with the radiographic grade of sacroiliac joint ( r=0.26, P=0.005). Conclusion:Patients with ERA are prone to be infected by GAS. It's probably related to HLA-B27 postivity for antigen presentation. Patients who were infected by GAS fre-quently have sacroiliac joint involvement, and tend to be more sever. This indicates that GAS may play an important role in the pathogenesis of sacroiliac joint destruction.

Objective:To study the efficacy of different systemic chemotherapy regimens as first-line and second-line therapy and to determine the prognostic factors for patients with advanced biliary tract cancer.Methods:The clinical data of patients with advanced biliary tract cancer who underwent systemic chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2018 were studied. The efficacy of chemotherapy on objective response rate (ORR) and disease control rate (DCR) were evaluated. Potential prognostic factors for survival were studied using the Cox proportional hazards models.Results:Of 151 patients enrolled into this study, there were 75 males and 76 females, with ages ranging from 31 to 77 years (median 58 years). Two treatment protocols were used: (1) 104 patients received a gemcitabine-based regimen (combined with platinums or fluorouracils) or a combination of platinums and fluorouracils, while (2) 47 patients received a combination of albumin-bound paclitaxel and S-1. The corresponding ORR for each group were 15.4%(16/104) and 27.6%(13/47), respectively, and the DCR were 65.4%(68/104) and 72.3%(34/47), respectively. Of 58 evaluable patients who received chemotherapy as a second-line therapy, 31 patients received the regimen containing gemcitabine, platinums or fluorouracils with an ORR of 3.2% (1/31) and a DCR of 35.5%(11/31); a total of 18 patients received the taxanes-based regimen with an ORR of 11.1%(2/18) and a DCR of 38.9%(7/18); 9 patients received the irinotecan-based regimen with an ORR of 22.2%(2/9) and a DCR of 44.4%(4/9). Univariate analysis showed positive liver metastasis and elevated carbohydrate antigen (CA)19-9 level to be significantly correlated with worse survival outcomes ( HR=1.540, 95% CI: 1.019-2.328, P=0.040 and HR=1.892, 95% CI: 1.123-3.188, P=0.017). Conclusion:For patients with advanced biliary tract cancer, in addition to the conventional regimens containing gemcitabine, platinums and fluorouracils, the combination of albumin-bound paclitaxel and S-1 was shown to be an effective chemotherapeutic regimen for these patients. Second-line chemotherapy was insufficient and ineffective, and an irinotecan-based regimen deserves to be further investigated. Liver metastasis and elevated CA19-9 level were worse prognosis after chemotherapy for patients with advanced biliary tract cancer.

Objective:To understand the present situation of self-acceptance of elderly in nursing home and explore its influencing factors, so as to provide basis for improving self-acceptance level of elderly in nursing home.Methods:Totally 415 elderly people in 3 Medical and nursing homes in Fuyang city of Anhui province were selected by Self-Acceptance Scale, and influencing factors were analyzed.Results:The total score of Self-Acceptance Scale of the elderly in nursing home was (44.11±7.25) points, the score rate was 67.86% (44.11/65), in the middle level; the results of multiple linear stepwise regression showed that the relationship with children, hobbies, number of children, length of stay in nursing home, frequency of visits and age were the main influencing factors ( F value was 48.228, P<0.001). Conclusion:The self-acceptance of the elderly in nursing home is in the middle level. The nursing home or social should pay attention to the higher age group and the newly admitted elderly in nursing home, give such people timely psychological guidance, help them to plan their later life, cultivate their interests and hobbies through recreational activities, and take corresponding measures to harmonize their relationship with their children in order to improve their self-acceptance level and promote mental health.

Objective To evaluate the clinical value of maternal serum 25(OH)D level and bilateral uterine artery S/D mean in early prediction of pre-eclampsia(PE). Methods Sixty normal pregnancy women(normal group),40 mild preeclampsia women(MPE group)and 60 severe preeclampsia women(SPE group)who were examined in Changzhou First People′s Hospital and Changzhou Maternal and Child Health Care Hospital between January 2016 and June 2018 were included. The mean value of S/D of bilateral uterine artery was measured from 15th to 20th weeks in all the 3 groups,and serum 25(OH)D level of the mother was measured at 24th week. Meanwhile, the ROC curves of S/D mean value,serum 25(OH)D level and combined detection were drawn to compare the area under each curve(AUC),and the diagnostic efficiency of S/D mean value,serum 25(OH)D level and combined detection PE were also calculated. Results The incidence of adverse pregnancy outcome in SPE group was significantly higher than that in MPE group,and that in MPE group was significantly higher than that in normal group(P < 0.05). The mean value of S/D of bilateral uterine artery in SPE group was(4.09 ± 0.62),which was higher than that in MPE group(3.26 + 0.55)and in normal group(2.62 ± 0.51),while the mean value of S/D in MPE group was significantly higher than that in normal group and the difference was statistically significant(P < 0.05). The level of serum 25(OH)D in SPE group was(32.44 ± 5.84),which was significantly lower than that in MPE group(37.15 ± 5.90)and in normal group(42.57 ± 7.44),while the serum 25(OH)D level in MPE group was significantly lower than that in normal group,and the difference was statistically significant(P < 0.05). The mean value of S/D of bilateral uterine artery in the pre-eclampsia group was negatively correlated with 25(OH)D level(r = -0.66,P < 0.01). The area under the ROC curve separately detected by S/D mean value and 25(OH)D level was 0.787 and 0.719 respectively,both of which were lower than that by jointly detection(0.908)and the difference was statistically significant(P < 0.001). Conclusion Both the mean S/D value of bilateral uterine arteries and serum 25(OH)D level can be used for the diagnosis and monitoring of pre-eclampsia,and the diagnostic efficacy of the combined detection is superior to that of single detection.