The nursing care of a case of Sheehan syndrome with infection and combined with diabetic ketoacidosis was summarized.To improve prognosis of the disease and guarantee patient's safety,key points of nursing care are as following:sufficient early liquid resuscitation and target-oriented management of blood glucose to correct internal environment disorder;dynamic monitoring of condition,implementing hormone replacement therapy by stages to prevent pituitary crises;to measure the mental state and implement cluster intervention measures to prevent infection worsening;regular follow-up and disease education to improve patients'disease self-management ability.After positive treatment and careful nursing care,no serious complications occurred,blood glucose was controlled well,and the case was in stable conditions and was discharged.

Objective:To investigate the impact of the progesterone concentration on human chorionic gonadotropin (hCG) trigger day in fresh cycles versus thawed transfer cycles (the freeze-all strategy) with an antagonist protocol, and to compare the differences in clinical outcomes.Methods:This retrospective cohort study included a total of 2 165 cycles conducted at Henan Provincial People′s Hospital with cleavage-stage embryo (at least one top-quality) transfer between January 2017 and December 2023, with serum progesterone levels on hCG trigger day all≤6.34 nmol/L (i.e. 2 ng/ml). Multivariate logsitic regression analysis and curve fitting were performed based on different serum progesterone levels on hCG trigger day [≤3.17 nmol/L (i.e. 1 ng/ml) or 1-2 ng/ml].Results:Multivariate regression analysis, by using cycle type (either fresh or frozen-thawed cycle) as the exposure variable, showed that the clinical pregnancy rate (≤1 ng/ml: OR=0.93, 95% CI: 0.75-1.14; 1-2 ng/ml: OR=1.05, 95% CI: 0.58-1.87) and live birth rate (≤1 ng/ml: OR=0.90, 95% CI: 0.71-1.13; 1-2 ng/ml: OR=1.53, 95% CI: 0.79-3.00) had no statistically significant differences in group of progesterone concentration ≤1 ng/ml or in group of 1-2 ng/ml. Using serum progesterone levels on hCG trigger day as a continuous variable for curve fitting analysis, the clinical pregnancy rate in fresh or thawed cycles showed no significant changes with increasing progesterone levels. Conclusions:In the antagonist protocol with cleavage-stage embryo transfer (at least one top-quality), when the serum progesterone level on hCG day is ≤2 ng/ml, there are no significant differences in clinical outcomes between thawed cycles and fresh cycles, including clinical pregnancy rate and live birth rate. Transferred in fresh cycles or choosing the freeze-all strategy could be selected based on the actual situation of the patients.

Objective This study systematically evaluated the clinical efficacy of Shangke Jiegu tablet in the treatment of fracture,and explored the mechanism of action of Shangke Jiegu tablet and the compatibility of each efficacy group from the"Disease-Symptom-Formula"perspective.Methods Clinical research literatures on the use of Shangke Jiegu tablet for fracture intervention were retrieved from Chinese databases(CNKI,Wanfang Database,VIP database)and English databases(PubMed,Cochrane Library,EMbase),covering the period from the inception of the databases to January 2024.Risk assessment tools were used to evaluate the literature's quality,and the data were extracted and analyzed using Stata 16.0 software.Gene sets associated with fracture symptoms were identified through the TCMIP platform(version 2.0).Differential gene expression related to fractures was obtained from the GEO database.Chemical composition and candidate target profiles of the 12 herbs in Shangke Jiegu tablets were collected from TCMIP v 2.0.An interaction network between fracture-related genes and drug candidate targets was established,and core network targets were screened based on topological features,with functional enrichment analysis performed.Results A total of 14 articles were incorporated into the Meta-analysis,encompassing a total sample size of 1 293 cases,indicating an overall response rate of Shangke Jiegu tablets in fracture therapy(RR=1.24,95%CI:1.18-1.31,P<0.001).The"Disease-Symptom-Formula"association network analysis indicated that the pathways related to the putative targets of Shangke Jiegu tablet were primarily involved in bone healing,nerve and blood system regulation,and immune-inflammation regulation.Different efficacy groups within the prescriptions showed varying emphases on these roles.Conclusions Shangke Jiegu tablet may facilitate fracture healing by regulating blood and nervous systems,correcting immune-inflammatory imbalances,and maintaining bone and energy metabolism.The comprehensive effects include the dissipation of blood stasis,the promotion of blood circulation,the alleviation of swelling and pain,the regeneration of muscles and bones,and the clearance of heat and detoxification.These findings support the clinical advantages and positioning of Shangke Jiegu tablet.

The observation and nursing care of a case of fulminant type 1 diabetes mellitus related to immune checkpoint inhibitor were summarized.To improve prognosis of the disease and guarantee patients'safety,key points of nursing are as following:sufficient early liquid resuscitation to improve renal perfusion;dynamic monitoring and summary of blood glucose changes,implementing a target-oriented blood glucose management program;providing nutritional support;regularly follow-up and health education.After positive rescue and careful nursing,no serious complications occurred;blood glucose was controlled well;nutritional status was improved;the patient was in stable conditions and was discharged.Telephone follow-up of the patient for 3 months showed stable blood glucose and good condition.

Elder financial exploitation is an important subtype of elder abuse, which has become a global social problem. Financial exploitation of the elderly will not only damage their physical and mental health, reduce the quality of life, but also bring huge financial losses to society. The research on the elder financial exploitation in foreign countries started earlier, while the research on the elder financial exploitation in China is still in its infancy. Therefore, this paper summarizes the concept, theoretical framework, current situation and countermeasures of elder financial exploitation, with a view to providing reference for the study of elder financial exploitation in China.

Urinary tract infection (UTI) is one of the most common infectious diseases. It has the characteristics of high recurrence rate and prolonged course. At present, the problem of antibiotic resistance is becoming more and more serious, the incidence of adverse reactions is high, and the disadvantages of long-term administration appear, which brings severe challenges to the treatment of recurrent urinary tract infection. The prevention and treatment of UTI recurrence has become the focus of research. Recurrent urinary tract infection is related to the immune regulation mechanism of the body. Administration of immune regulation can provide new ideas for prevention and treatment. The vaccine based on immune regulation to prevent rUTI has made some progress. It can not only reduce the frequency of recurrences, but also decrease related symptoms. At the same time, the vaccine has good tolerance, high safety and good application prospect. This paper aims to summarize the progress of immune regulation and immune vaccines in vivo and clinical research.

Objective:To explore the mediating effects of self-efficacy between leadership empowerment behavior and neglect of care among senior care workers.Methods:In this cross-sectional study, from July to September 2020, totally 423 senior care workers from 50 nursing institutions for the aged in Jining, Jiaozuo, and Shijiazhuang were selected by convenient sampling and investigated with the General Information Questionnaire, Leadership Empowerment Behavior Scale, Self-Efficacy Scale, and Nursing Caregiver Negligence Assessment Scale. Pearson's correlation analysis was used to analyze the correlation of each variable, and bootstrapping was employed to test the mediating effect.Results:In this study, 423 questionnaires were distributed and 386 valid questionnaires were recovered. The total score of leadership empowerment behavior of 386 care workers was (47.93±7.51) ; the total score of self-efficacy was (28.65±5.92) ; the total score of neglecting care was (73.04±8.80) . The leadership empowerment behavior, self-efficacy, and neglect of care in the senior care workers were positively correlated ( P<0.01) . Self-efficacy played a partial mediating role between leadership empowerment and neglect of care, and the mediating effect accounted for 19.73%. Conclusions:The neglect of care in the senior care workers is at a low level, and self-efficacy plays a partial mediating role between leadership empowerment and neglect of care. Leaders of nursing institutions for the aged should improve their level of empowerment behaviors and strengthen the self-efficacy of senior care workers, so as to reduce the neglect of care among senior care workers.

With the accelerated aging of the global population, the problem of elder abuse has become increasingly prominent, among which mental abuse is the type with the highest incidence. Mental abuse seriously damages the mental health of the elderly, increases their risk of illness and suicide, and reduces the quality of life of the elderly. This article combs the relevant research on mental abuse of the elderly at home and abroad in detail, introduces the definition, assessment tools and the current situation of mental abuse, and summarizes the corresponding influencing factors from the three levels of the elderly, caregivers and society, and aims at providing a basis for further research on the intervention of mental abuse of the elderly and the prevention of the occurrence of mental abuse.

Panic disorder (PD) is an acute paroxysmal anxiety disorder with poorly understood pathophysiology. The dorsal periaqueductal gray (dPAG) is involved in the genesis of PD. However, the downstream neurofunctional changes of the dPAG during panic attacks have yet to be evaluated in vivo. In this study, optogenetic stimulation to the dPAG was performed to induce panic-like behaviors, and in vivo positron emission tomography (PET) imaging with F-flurodeoxyglucose (F-FDG) was conducted to evaluate neurofunctional changes before and after the optogenetic stimulation. Compared with the baseline, post-optogenetic stimulation PET imaging demonstrated that the glucose metabolism significantly increased (P < 0.001) in dPAG, the cuneiform nucleus, the cerebellar lobule, the cingulate cortex, the alveus of the hippocampus, the primary visual cortex, the septohypothalamic nucleus, and the retrosplenial granular cortex but significantly decreased (P < 0.001) in the basal ganglia, the frontal cortex, the forceps minor corpus callosum, the primary somatosensory cortex, the primary motor cortex, the secondary visual cortex, and the dorsal lateral geniculate nucleus. Taken together, these data indicated that in vivo PET imaging can successfully detect downstream neurofunctional changes involved in the panic attacks after optogenetic stimulation to the dPAG.

Objective To explore the effects of long-term low-protein intake on nonspecific inflammatory responses in the liver and T lymphocytes in the spleen in middle-aged and older mice and underlying mechanisms.Methods Fourteen month-old female KM(Kunming)mice were randomly divided into the control group,the low-protein group,the high-protein group and the high-protein + rapamycin group.Additionally,Two month-old female KM mice served as the adult group and were fed regular chow.Animals in the high-protein + rapamycin group received injections of rapamycin intraperitoneally once every two days.Animals were sacrificed at the end of 3 months.Liver histology slices were prepared for the examination of pathological changes and detection of the expression of CD68 and mTOR(the mechanistic target of rapamycin).Spleen lymphocyte suspensions were prepared to count the percentages of CD4+ T and CD8+ T cells.Results Compared with the control group,the low-protein group and the high-protein-+-rapamycin group in histology slides showed regularly arranged hepatocytes,no obvious sinus hepaticus expansion and only mild time-related changes.Moreover,compared with the control group,the low-protein and high-protein + rapamycin groups were associated with increased percentages of CD4+T and CD8 + T cells in the spleen(all P＜ 0.05)and decreased expression of CD68 in the liver(P＜0.05),though the levels of mTOR were similar among the groups.Conclusions Long-term low-protein intake has beneficial effects in mitigating the reduction of T lymphocytes in the spleen and slowing age-related structural and nonspecific inflammatory changes in the liver,possibly through downregulation of the expression of the mTOR protein.