Objective:To investigate the characteristics of cognitive frailty and its influencing factors in older patients with chronic heart failure.Methods:In this cross-sectional study, 300 older patients hospitalized for chronic heart failure in a tertiary hospital in Shandong Province between September 2021 and September 2022 were selected.A general information questionnaire, the mini-nutritional assessment scale-short form(MNA-SF), the athens insomnia scale(AIS), the ulca loneliness scale, the geriatric depression scale-5 item version(GDS-5), and the social support rating scale(SSRS)were used for assessment and influencing factors were identified by univariate and Logistic regression analysis.Results:Among 300 older patients with chronic heart failure, the prevalence of cognitive frailty was 75.3%(226 cases). Logistic regression analysis showed that age between 70-79 years( OR=0.543, 95% CI: 0.299-0.987), education level( OR=3.644, 95% CI: 1.780-7.461), weekly intellectual activity( OR=2.168, 95% CI: 1.082-4.334)and loneliness( OR=1.101, 95% CI: 1.032-1.175)were factors influencing cognitive frailty in older patients with chronic heart failure. Conclusions:The prevalence of cognitive frailty in older patients with chronic heart failure is high, and age, education level, weekly intellectual activity and loneliness are influencing factors, with education level having the greatest impact on older patients with chronic heart failure.

Objective:To explore the mediating roles of family resilience and perceived social support between fear of progression and quality of life in patients with adult pulmonary hypertension, so as to provide guidance for grassroots medical staff to deeply understand and improve the long-term quality of life of adult pulmonary hypertension patients.Methods:Using a convenience sampling method, 219 adult pulmonary hypertension patients who attended Qilu Hospital, Shandong University from July 2021 to February 2022 were selected for a cross-sectional study using the World Health Organization Quality of Life Questionnaire Abbreviated Version (WHOQOL-BREF), Perceived Social Support Scale (PSSS), Shortened Chinese version of the Family Resilience Assessment Scale (FRAS-C) and Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for investigation. A structural equation model was established to evaluate the mediating effect of family resilience and perceived social support on fear of progression and quality of life.Results:The scores of WHOQOL-BREF, PSSS, FRAS-C, and FoP-Q-SF were (45.85 ± 10.22), 66(56, 75), 94(89, 97) and 39(32, 46) points in adult pulmonary hypertension patients. The total scores of WHOQOL-BREF were negatively correlated with FoP-Q-SF ( r = -0.63, P<0.01), and positively correlated with FRAS-C and PSSS ( r=0.54, 0.46, both P<0.01). Family resilience played a partial mediating role between fear of progression and quality of life, accounting for 13.43% of the total effect. Family resilience and perceived social support played a chain mediating role between fear of progression and quality of life, accounting for 2.71% of the total effect. Conclusions:Family resilience-perceived social support play mediating roles between fear of progression and quality of life, healthcare workers can alleviate fear of progression and improve quality of life by promoting the levels of family resilience and perceived social support of adult pulmonary hypertension parents.

Objective To investigate the effects of a multi-component exercise nursing intervention on frailty,activities of daily living and quality of life in elderly patients with chronic heart failure.Methods Through literature analysis and expert meeting,the multi-component exercise nursing intervention program was formed.A total of 71 elderly patients with chronic heart failure who admitted from January 2022 to September 2022 in a tertiary A hospital in Shandong Province were randomly divided into an intervention group(35 cases)and a control group(36 cases).The control group received usual care,while the intervention group received an additional multi-component exercise nursing training.2 groups were evaluated by Tilburg frailty indicator scale,modified Barthel index scale and 12-item short form health survey scale before the intervention,4 weeks and 12 weeks after the intervention.Results A total of 62 patients(31 in the experimental group and 31 in the control group)completed the study.Generalized estimation equation results showed that the inter-group effect,time effect and interaction effect of frailty,activities of daily living and quality of life in the 2 groups were statistically significant(P＜0.05).At 4 weeks and 12 weeks after the intervention,the Tilburg Frailty Indicator scale scores in the intervention group were lower than that in the control group(P＜0.05),and the scores of the modified Barthel index scale and 12-item short form health survey scale were significantly higher than those in the control group(P＜0.05).Conclusion The multi-component exercise nursing intervention can effectively improve frailty,activities of daily living and quality of life in elderly patients with chronic heart failure.

Objective:To evaluate nutritional status in elderly patients with chronic heart failure and to investigate its association with unplanned readmission.Methods:From July 2020 to August 2021, 220 elderly patients hospitalized for chronic heart failure in Qilu Hospital of Shandong University were enrolled in a prospective cohort study. Basic information, laboratory tests and other data of the patients were collected. Nutritional status of the patients was assessed by geriatric nutritional risk index and the patients were divided into groups. Data were analyzed by R4.1.1 and SPSS26.0, survival curves were drawn by Kaplan-Meier method, and the relationship between nutritional status and unplanned readmission in elderly patients with chronic heart failure was analyzed by univariate and multivariate Cox regression.Results:Among 220 elderly patients with chronic heart failure, 59.5%(131/220) were in normal nutrition. There were 40.5%(89/220) in the malnutrition, including 26.8%(59/220) in the mild malnutrition and 13.6%(30/220) in the moderate and severe malnutrition. During the follow-up period of 3 months, 25.9% (57/220) had unplanned readmission. Kaplan-Meier survival curve showed that the incidence of unplanned readmissions was higher in the moderate and severe malnutrition than in the normal and mild malnutrition, and the difference among them was statistically significant ( P<0.05). Multivariate Cox regression analysis showed that moderate and severe malnutrition was an independent predictor of unplanned readmission in elderly patients with chronic heart failure ( HR=2.064, 95% CI 1.029-4.138, P<0.05). Conclusions:The prevalence of malnutrition in elderly patients with chronic heart failure is high. Moderate and severe malnutrition is an independent predictor of unplanned readmission in elderly patients with chronic heart failure. The geriatric nutritional risk index is an effective screening tool and can provide a reference for clinical evaluation of nutritional risk in patients.

Endothelial progenitor cells (EPCs) are progenitor cells possessing vasculogenic potential.The main function of EPCs is to play a role by paracrine angiogenic factors and neuroprotective factors.EPCs also have the ability to differentiate into endothelial cells and integrate themselves into newly formed capillaries.Therefore, EPCs play an important role in vascular repair and neuroprotection.The research on surface markers and functions of EPCs is the basis of EPCs research.A series of clinical trials, animal and cell experiments show that EPCs transplantation and joint transplantation of EPCs and other cells can promote vascular repair and improve retinal function with good safety.EPCs are expected to be an effective treatment for diabetic retinopathy (DR). DR is now defined as a refractory eye disease with retinal neurovascular unit (NVU) injury associated with systemic metabolism anbormality.Change in EPCs count and damage of EPCs function are involved in the occurrence and development of DR.Ophthalmologists should pay attention to the early managing approach of EPCs.Current treatment strategies include transplantation of EPCs, joint transplantation of EPCs with other cells, and regulation of endogenous EPCs.The unique biological characteristics of EPCs provide many possibilities in repairing retinal NVU injury and DR prevention and treatment.This article introduces the latest research progress of EPCs for DR from five aspects including the origin of EPCs, physiological and pathological state, function, treatment strategy and clinical application.At the same time, the existing problems and technical bottlenecks will also be discussed.

Objective:To evaluate the status quo of humanistic care of clinical nursing staff, and analyze its influencing factors to provide theoretical basis for improving the humanistic care ability of clinical nursing.Methods:The self-compiled questionnaire on the knowledge, attitude and practice of humanistic care of clinical nursing staff was adopted in June to July 2019 to select 2 136 nurses from five first-class tertiary general hospitals in Shandong province by random sampling method for the status survey.Results:The total score of humanistic care knowledge and practice of clinical nurses was 259.54±33.55, and the standard score was 82.39±10.65. Single factor analysis showed that the total score of humanistic care knowledge, credit and practice was statistically significant for clinical nurses with different gender, age, fertility status, relationship with parents, employment reasons, initial education background, department, working years, professional title, position, employment mode and night shift frequency ( t value was -2.604, F values were 2.667-23.692, all P < 0.01). Pearson correlation showed that in the pairwise correlation analysis of knowledge, belief/attitude and behavior dimension, there was positive correlation and the correlation coefficient ( r values were 0.638, 0.431, 0.560, all P < 0.01). Multiple stepwise regression analysis showed that: the influencing factors of knowledge, attitude and practice total score of clinical nursing staff on humanistic care were the relationship between the parents, employment way, night shift frequency, fertility status, and the employment reason, the initial degree, department, position ( β values were -0.132-0.126, all P < 0.05). Conclusions:The current situation of humanistic care knowledge and practice of clinical nursing staff is in the middle level. Relationship with parents, position, night shift frequency, fertility status, employment reasons, initial education background, department, and employment mode are the factors that affect the current situation of humanistic care, knowledge, attitude and practice of clinical nurses. Therefore, medical institutions should adopt targeted and focused training methods and intervention measures to improve the level of nursing staff′s knowledge, faith and practice from the aspects of different influencing factors of clinical nursing staff′s humanistic care.

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objective:To construct a knowledge, attitude and practice evaluation system of nursing humanistic care, and to provide reference for improving nursing humanistic construction.Methods:Based on literature analysis, the draft evaluation system was sorted out, and two rounds of Delphi expert consultation were conducted on 28 experts, and the items were modified according to the consultation opinions.Results:The enthusiasm coefficients of the two rounds of consultation were 100% and 96.4%, the authority coefficients were 0.888 and 0.870, and the coordination coefficients were 0.342 and 0.467, respectively, which were statistically significant ( P<0.05) . The final evaluation system of humanistic care for clinical nursing staff includes 3 first-level indicators and 63 second-level indicators. Conclusion:The humanistic care evaluation system constructed in this study is scientific and practical and can be used as a scientific evaluation tool for the humanistic care ability of clinical nurses.

Objective:To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload.Methods:From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis.Results:The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R2=0.08) . Conclusion:Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objective:To construct a knowledge, attitude and practice evaluation system of nursing humanistic care, and to provide reference for improving nursing humanistic construction.Methods:Based on literature analysis, the draft evaluation system was sorted out, and two rounds of Delphi expert consultation were conducted on 28 experts, and the items were modified according to the consultation opinions.Results:The enthusiasm coefficients of the two rounds of consultation were 100% and 96.4%, the authority coefficients were 0.888 and 0.870, and the coordination coefficients were 0.342 and 0.467, respectively, which were statistically significant ( P<0.05) . The final evaluation system of humanistic care for clinical nursing staff includes 3 first-level indicators and 63 second-level indicators. Conclusion:The humanistic care evaluation system constructed in this study is scientific and practical and can be used as a scientific evaluation tool for the humanistic care ability of clinical nurses.