Objective To analyze the MTHFR C677T gene polymorphism and homocysteine in women in early pregnancy in Ordos region,to clarify the distribution characteristics of MTHFR C677T gene polymor-phism and the correlation between the two,and to provide genetic basis for scientific guidance on folic acid supplementation during pregnancy and prevention of birth defects.Methods A total of 602 Han women in early pregnancy who were registered and underwent early pregnancy examinations in the gynecology clinic of Ordos Central Hospital from September 2022 to September 2023 were selected as the research subjects.Blood samples were collected from all research objects.MTHFR C677T gene polymorphism was detected by using PCR chip hybridization,and homocysteine level was detected by biochemical enzyme circulation method.Sta-tistical analysis of MTHFR C677T locus genotype and allele frequency,as well as their correlation with homo-cysteine was conducted.Results The detection frequencies of MTHFR C677T gene polymorphism CC,CT,and TT types were 23.6%,47.5%,and 28.9%,respectively.The detection frequencies of alleles C and T were 47.3%and 52.7%,respectively.There were statistically significant differences compared to Han women in Shanghai,Wenzhou,Meishan,Nanning,and other regions(P<0.05),but there was no statistically significant difference compared to Han women in Xi'an(P>0.05).The serum homocysteine level of pregnant women with TT genotype was higher than that of pregnant women with CC and CT genotypes,while the serum ho-mocysteine level of pregnant women with CT genotype was higher than that of pregnant women with CC gen-otype(P<0.05).The CT and TT genotypes of MTHFR C677T were both risk factors for hyperhomocys-teinemia in women in early pregnancy in this region,the risk was 2.80 and 8.07 times higher than that of the CC genotype,respectively,and the differences were statistically significant(P<0.05).Conclusion The distri-bution of MTHFR C677T gene polymorphism Han women in early pregnancy in Ordos region has regional characteristics and is correlated with homocysteine level.Developing personalized folic acid supplementation plans based on different genotypes during pregnancy is of great significance for preventing birth defects.

Patients with type 2 diabetes mellitus (T2DM) typically have a higher risk of cardiovascular diseases, including coronary artery disease (CAD). Currently, the gold standard for diagnosing the severity of coronary artery lesions in T2DM patients is coronary angiography (CAG). This retrospective analysis reviewed data from T2DM patients who underwent CAG at Hengshui People′s Hospital between May 2020 and July 2022. Utilizing multivariate logistic regression analysis, factors associated with the severity of coronary artery stenosis in T2DM patients were identified. Based on these findings, a predictive model was developed to evaluate CAD severity in T2DM patients, incorporating smoking history, elevated triglyceride-glucose (TyG) index, and elevated monocyte to high-density lipoprotein cholesterol ratio (MHR). The combination of the TyG index and MHR model provides insights into coronary artery stenosis severity in T2DM patients, potentially reducing unnecessary invasive CAG procedures.

Objective: To measure the body mass index (BMI) of secondary school students and analyze its association with the physical fitness index, so as to improve the physical health of middle school students. Methods: Using a randomized cluster stratified sampling method, 3 813 secondary school students from six cities (Ganzhou, Ji an, Fuzhou, Nanchang, Shangrao and Jiujiang) in Jiangxi Province, China, were selected in September 2022. Questionnaire survey was administered to obtain basic information and to assess the nutritional status and physical fitness tests were conducted among secondary school students. The study was stratified by gender and age, and the Kruskal Wallis H test was used to compare the differences in the mean values of grip strength, sit-ups, standing long jump performance and strength quality among secondary school students with different BMI levels, while the correlation between BMI and strength quality index was inferred by using curve regression analysis. Results: There was statistical significance in the strength quality index of middle school students with different BMI level ( H=56.79, 8.84, P <0.05). Except 13 years old group, the difference of physical fitness by BMI grade strength quality index of boys in other age groups was statistically significant ( H =22.21, 16.23, 17.98, 18.21, 8.08), while the difference of physical fitness by BMI of girls at 14 years old was statistically significant ( H =9.11)( P <0.05). The curve fitting using regression showed that the physical fitness index and BMI of middle school students (boys and girls) show an inverted U-shaped curve. The physical fitness index was higher in the middle region of BMI ( Z-score) and lower in the two end regions, while showing a decreasing trend from the middle to the two ends. Conclusion An association is found between BMI and physical fitness among secondary school students in Jiangxi Province, and wasting and overweight/obesity are negatively correlated with physical fitness. Greater attention should be paid to the nutritional status of secondary school students to ensure the normal development of physical fitness.

Objective:To retrieve, evaluate and summarize the best evidence of exercise reversal intervention in the elderly with cognitive frailty, and to provide evidence for guiding exercise in elderly patients.Methods:This study was a summary of evidence-based nursing evidence. Based on the PIPOST (P: Population; I: Intervention; P: Professional; O: Outcome; S: Setting; T: Type of evidence) mode, the evidence of exercise reversal intervention in the elderly with cognitive frailty in 25 relevant guideline network and association websites, Chinese and foreign language comprehensive databases such as PubMed, CINAHL, Web of Science, Embase, Chinese Biomedical Database, China National Knowledge Internet and others were searched, extracted and integrated. The retrieval time was from January 1, 2013 to February 14, 2022.Results:A total of 22 articles were included, including 3 guidelines, 2 expert consensuses, 1 clinical decision-making, 1 evidence summary, 9 Meta analysis, and 6 randomized controlled trials. Finally, 28 pieces of the best evidence including 7 dimensions were namely formulate principles,overall assessment, exercise mode, exercise intensity, exercise time and frequency, exercise management, health guidance.Conclusions:This study summarized the best evidence of exercise intervention in the elderly with cognitive frailty, which are systematic, comprehensive, rigorous, and reliable. It can provide references for healthcare administrators to dynamically evaluate patients′cognitive frailty status, formulate personalized exercise programs, and standardize exercise guidance for patients, so as to delay or even reverse cognitive frailty.

This article aims to comprehensively review the concept, etiology, classification, classical cortical mapping, assessment, a proposed flowchart for the diagnosis and differential diagnosis, treatment, rehabilitation, mechanisms of development and recovery, prognosis, and influencing factors for post-stroke aphasia(PSA)types in the Chinese language.We emphasize the necessity and significance of neuroimaging assessment of the brain and blood vessels and neuropsychological assessment in the diagnosis and differential diagnosis of PSA in Chinese.We also recommend and encourage the use of the dichotomies of internal vs.external and anterior vs.posterior as a starting point, based on the association of anatomical locations of the brain and blood vessels with brain language areas and language disorders.A classification system of PSA in Chinese developed from this approach in the form of a flowchart is well-suited for guiding the clinical treatment of cerebral stroke.Incorporating the "four elements" , the flowchart enables convenient diagnosis, classification and differential diagnosis of PSA in Chinese and facilitates targeted and personalized rehabilitation planning to benefit the patient.This article introduces the use of memantine, piracetam, donepezil and other drugs for PSA treatment, evaluates clinical trials on memantine conducted in China and abroad and its mechanisms of action for the treatment of PSA, and discusses how rehabilitation therapy achieves therapeutic effects.For the treatment of PSA, clinical research and practice using drugs such as memantine, piracetam and donepezil in combination with non-pharmacotherapy and rehabilitation training should be promoted.

Objective:To explore the current situation of motoric cognitive risk syndrome (MCR) in the community elderly in Taiyuan and analyze its influencing factors.Methods:From January to April 2021, convenience sampling was used to select 500 elderly people from 5 communities in Taiyuan as the research object. The elderly were investigated with the General Information Questionnaire, Mini-Mental State Examination (MMSE) , simplified Geriatric Depression Scale-15 (GDS-15) , Short-Form Mini Nutritional Assessment (MNA-SF) and Lubben Social Network Scale-6 (Lubben-6) , and 4-meter walk test.Results:A total of 500 questionnaires were distributed, and 492 valid questionnaires were recovered, with a valid recovery rate of 98.40%. The prevalence of MCR among 492 community elderly people in Taiyuan was 11.38% (56/492) . Univariate analysis showed that there were statistically significant differences in the incidence of MCR among the community elderly in Taiyuan with different age, education level, obesity, living alone, number of diseases, diabetes, coronary heart disease, stroke, number of medications, chronic pain, nutritional status, depression and social isolation ( P<0.05) . Logistic regression analysis showed that educational level, obesity, diabetes, chronic pain, nutritional status, depression, and social isolation were the influencing factors of MCR in the elderly in Taiyuan ( P<0.05) . Conclusions:The incidence of MCR among the elderly in Taiyuan is high. Individualized interventions should be formulated according to the influencing factors to prevent or delay the occurrence of MCR in the community elderly.

Objective:To investigate the influences of minimally invasive hematoma removal assisted by stereotaxis technique and conservative treatment in clinical prognoses of patients with small/medium intracerebral hematoma in the basal ganglia.Methods:Sixty-four patients with spontaneous basal ganglia cerebral hemorrhage, admitted to our hospital from March 2020 to March 2021, were enrolled in our study; these patients were randomly divided into surgical group (accepted minimally invasive hematoma removal assisted by stereotaxis technique, n=33) and conservative treatment group ( n=31). The baseline general data and 6 months follow-up data of patients from the 2 groups were compared. The Glasgow outcome scale (GOS) scores, modified Barthel index (MBI), modified Rankin scale (mRS) scores and complications were compared 7 d, 1 month and 6 months after surgery. Results:There were no significant differences in gender, age, and amount of bleeding between the 2 groups ( P>0.05). On the 7 th d of surgery, there were no significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P>0.05). One month after surgery, there were statistically significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P<0.05); the good prognosis rate in the surgical group was 78.79% (26/33), and that in the conservative treatment group was 25.81%(8/31), with significant difference ( P<0.05). Six months after surgery, there were significant differences in GOS scores, MBI, and mRS scores between the 2 groups ( P<0.05); the good prognosis rate in the surgical group was 95.7% (29/33), and that in the conservative treatment group was 32.3% (10/31), with significant difference ( P<0.05). The incidence of complications in the surgical group and conservative treatment group was 6.06% and 29.03%, respectively, with significant difference ( P<0.05). Conclusion:Minimally invasive hematoma removal assisted by stereotaxis technique is more conducive to the repair of nerve function in patients with moderate to small cerebral hemorrhage in the basal ganglia than conservative treatment.

Objective:To construct an evaluation index system of nursing counterpart support by ClassⅢ Grade A hospitals for country hospitals so as to provide a ruler for evaluating the quality of nursing counterpart support and provide a reference for sounding the long-term mechanism of counterpart support.Methods:This study combed the counterpart support policy document of China from 2009 to 2018 to refine nursing work assignment and goals, collected index pool by carrying out expert interview and searching literature. Expert meeting was used to sort out the items of index pool. After that, this study designed the inquiry questionnaire, implemented pilot survey and two rounds of expert consultation for 20 experts with Delphi method to determine the index system. Analytic hierarchy process was used to build judgment matrix so as to confirm the index weight.Results:Among two rounds of expert consultation, the recovery rates of questionnaire were all 100%; the expert authority coefficients were 0.817 and 0.838; the coordination coefficients were 0.117 and 0.247. The final evaluation index system of nursing counterpart support by ClassⅢ Grade A hospitals for country hospitals included three first-level indexes, hospital organizational leadership, accredited personnel management and synthetic evaluation, as well as 7 second-level indexes and 48 third-level indexes.Conclusions:This index system could be a tool for evaluating the nursing counterpart support.

Objective To investigate the clinical and genetic features of juvenile-onset Huntington disease (HD).Methods The clinical data of members from one juvenile-onset HD family,admitted to our hospital in February 2015,were collected,and the family pedigree tree was drawn.Peripheral venous blood of volunteers of this family was extracted to pursue IT15 genetic test.Results The pedigree tree indicated that HD was autosomal dominant inheritance.There were 3 patients in this family,2 of them died,and 2 were juvenile-onset HD.Clinical manifestations of these patients were characterized by dystonia,dysarthria,ataxia and cognitive dysfunction.Among 7 participants who pursued genetic test,4 were normal,and 3 carried expanded alleles,whose cytosine-adenine-guanine trinucleotide (CAG) repeat number was 59,60,and 57,respectively.Conclusions (1) The clinical manifestations of juvenile-onset HD are characterized by dystonia,dysarthria,ataxia and cognitive dysfunction;juvenile-onset HD has rapid progression.(2) The phenomenon called "anticipation" is found in this family.

Objective To introduce the application of grafting mechanism on a classⅢ grade A hospital's nursing counterpart support to county-level hospitals in Shanxi Province, and to summarize its effects and existing problems, so as to promote nursing counterpart support work and provide reference for the increase of the efficiency of counterpart support. Methods From 2014 to 2016, grafting mechanism was carried out in 23 county-level hospitals nursing counterpart supported by a classⅢ grade A hospital of Shanxi Province through 4 segments: field investigation, content selection, cultural integration and guided implementation. The evaluation of various mechanisms before and after grafting and the nurse satisfaction, patient satisfaction, high quality nursing service, as well as key discipline construction were statistically analyzed in 23 count-level hospitals. Results 100% of the 23 county-level hospitals applied grafting mechanism. A total of 20 nursing mechanism were grafted, focusing on 7 personnel systems, 3 performance management systems and 10 nursing quality management systems. The evaluation level of various mechanisms was significantly improved in the county-level hospitals after mechanism grafting. Nurse satisfaction increased from (87.6±15.2) to (89.7±16.8);patient satisfaction increased from (92.3±17.5) to (94.1±18.1); and high quality nursing service score increased from (73.5±12.9) to (75.8±14.0), and the differences were statistically significant (t=5.725, 4.042, 6.493;P< 0.01). A total of 5 of the county-level hospitals were approved provincial key discipline construction projects. Conclusions The mechanism of grafting plays a significant role in nursing counterpart support activities. Its theories and practice are worth of promoting.