Objective To analyze the effectiveness of a tele-diet combined exercise intervention program in elderly patients with type 2 diabetes mellitus combined with sarcopenia.Methods The selection of 80 cases of elderly patients with type 2 diabetes mellitus combined with sarcopenia was conducted from December 2022 to February 2023 in 2 communities in Urumqi City,and the 2 communities were randomly divided into an experimental group and a control group,with 40 cases in each group.The experimental group carried out the intervention of dietary combined with exercise through tele-technology on the basis of the routine health education,and the control group implemented the routine health education.The scores of somatic functions,muscle strength and quality of life of patients with sarcopenia were compared between the 2 groups before and after the intervention.Results After the intervention,6-meter step speed,5 sit-to-stand tests,grip strength index,and quality of life in the experimental group were better than those in the control group,and the difference was statistically significant(P＜0.05).Conclusion Tele-diet combined with exercise intervention positively affects somatic function,muscle strength,and quality of life in elderly patients with T2DM combined with sarcopenia.

Objective:To explore the risk factors of oral-mucosal pressure injury (OMPI) in patients with tracheal intubation in ICU and to establish a nomogram model.Methods:Using the convenient sampling method, a total of 640 patients with oral tracheal intubation admitted to ICU of the First Affiliated Hospital of Xinjiang Medical University from January to May 2023 were selected as the research objects. They were divided into the occurrence group ( n=286) and the non-occurrence group ( n=354) according to whether OMPI occurred or not. Binomial Logistic regression analysis was used to explore the risk factors for OMPI in patients with tracheal intubation in ICU. A risk nomogram model was created based on independent risk factors, and internal verification was conducted by Bootstrap repeated sampling method. Results:OMPI occurred in 286 of 640 ICU patients with tracheal intubation. Binomial Logistic regression analysis showed that high APACHEⅡ score, modified Beck oral score greater than or equal to 11 points, use of sedative drugs, prone ventilation, long retention time of tracheal catheter, low oxygenation index less than 200 mmHg (1 mmHg=0.133 kPa) and tracheal catheter fixation frequency of 1 time /24 h were the risk factors for OMPI in patients with tracheal intubation in ICU ( P<0.05). A risk nomogram model for OMPI in patients with tracheal intubation in ICU was established based on independent risk factors. The results showed that the predictive performance (area under the receiver operating characteristic curve of subjects was 0.918, 95% confidence interval was 0.897 to 0.938) and calibration (χ 2 value of 4.647, P=0.795) of the risk nomogram model for OMPI in patients with tracheal intubation in ICU were good. When the threshold probability was 0 to 1, the decision curve showed that the model had good clinical effectiveness. Conclusions:The OMPI risk nomogram model of tracheal intubation patients in ICU established in this study has good calibration and differentiation, which can be used as an effective tool for screening high-risk patients.

Objective To probe into the emergency triage efficiency between emergency rapid triage system (ERTS) and emergency severity classification of 4 level. Methods A total of 46965 emergency patients from January to December in 2015 were selected as the research object and utilized a data of patients from the electronic triage system, and triaged the emergency patients by means of ERTS retrospectively. A comparison was performed in patient visits, outcome and hospital rates between ERTS and emergency severity classification of 4 level. Results In both of these triage systems, almost 80％of patients are assigned to the lowest acuity (levelⅢandⅣ). The visits of patients with gradeⅢand grade IV diseases were 71.5％(33580/46965), 50.5％(23717/46965) in ERTS and 12.1％(5683/46965), 35.1％(16485/46965) in emergency severity classification of 4 level respectively. The outcomes of patient under the ERTS were better than emergency severity classification of 4 level at levelⅠandⅡ(χ2=11.79, 1100.62, P<0.05). At levelⅠandⅡ, ERTS in the patient's disease hospital admission rates were 70.5％(311/441), 72.6％(5274/7264), which higher than emergency severity classification of 4 level, 62.5％(371/594), 45.2％(2785/6161), the difference was statistically significant (χ2=7.32, 1043.13, P<0.05). At level Ⅲ and Ⅳ, ERTS in the patient's disease hospital admission rates were 9.6％(3676/38288), 7.9％(77/972) , which lower than emergency severity classification of 4 level, 19.3％(4578/23719) , 9.9％(1632/16491), the difference was statistically significant (χ2=1153.10, 4.05, P<0.05). Conclusions ERTS significantly improves the sensitivity and accuracy of emergency triage compared to emergency severity classification of 4 level. ERTS has obvious significance in the emergency patient distribution, and also has a certain advantage in the patient outcomes and hospitalization rates. It can be used as a auxiliary tool.

Objective To assess the predictive value of serum uric acid levels to the incident nonalcoholic fatty liver disease(NAFLD)in a cohort of healthy population. Methods A prospective cohort study of NAFLD incidence was conducted in Xinjiang province, from 2012 to 2014. A cohort study was performed on 2 207 subjects with no evidence of fatty liver disease by liver ultrasound and with no major risk factors for liver disease at baseline. All participants were interviewed to carry out the epidemiological questionnaire survey, physical examination, abdominal ultrasonography, as well as blood biochemistry measurements. The hazard ratios of NAFLD were compared among groups with different uric acid levels. All subjects were classified according to serum uric acid (within normal range grouped by quartile: Q1-Q4 group; above the normal range: Q5 group). Results NAFLD was newly diagnosed in 13.72% subjects within the 3-year period. The incidence of NAFLD was increased with elevated serum uric acid quartiles(P<0.01). In multivariate logistic regression, after adjustment for gender, age, race, metabolic syndrome and its components, OR for incident fatty liver in Q2 to Q5 of serum uric acid concentration as compared to Q1 were 2.509, 3.172, 3.392, and 4.041 respectively. Conclusion Elevated serum uric acid concentrations may predict NAFLD in the subjects for a regular health checkup.

Objective To investigate the status quo of wander behavior among inpatients with senile dementia and discuss relevant risk factors.Methods Totally 84 inpatients with senile dementia from the Department of Geriatrics of Shanghai Mental Health Center were selected, evaluated with Revised-Algase Wandering Scale (RAWS), Mini Mental State Examination (MMSE) and Narcissistic Personality Inventory (NPI), and divided into a wandering group (69 patients) and a non-wandering group (15 patients). The risk factors related to wander behavior were analyzed.Results The incidence of wander behavior among the inpatients with senile dementia was 82.1%, with spatial disorientation as the main form in RAWS factor analysis; The MMSE score of the patients in the wandering group was (2.58±5.65), lower than that of the patients in the non-wandering group, and their NPI score was (17.88±7.93), higher than that of the patients in the non-wandering group (t=2.89, 2.21;P<0.05). According to the Logistic Stepwise Multiple Regression, wander was closely related to severity of dementia, mental and behavior disorder and NPI apatheia.Conclusions Wander behavior is widely found among patients with senile dementia and brings great difficulty to their caregivers. Therefore, studies on their causes play a practical part in improving the treatment, nursing and family care for patients with senile dementia and preventing them from getting lost, felling down and being injured.

ObjectiveTo analyze the correlation between serum 25-hydroxyvitamin D level and nonalcoholic fatty liver disease (NAFLD), and to provide a clinical basis for the prevention and treatment of NAFLD. MethodsFrom March to October, 2014, 200 Uyghur patients and 200 Han patients with NAFLD in our hospital were enrolled into NAFLD group, while an equal number of healthy Uyghurs and Hans were used as controls. For all subjects, questionnaire survey, physical examination, abdominal ultrasound examination, and blood biochemical examination were performed, and serum 25-hydroxyvitamin D level was determined using enzyme-linked immunosorbent assay. The relationship between 25-hydroxyvitamin D and NAFLD was analyzed by Spearman correlation analysis and multivariate logistic regression analysis. ResultsSerum 25-hydroxyvitamin D levels in the NAFLD group were significantly lower than those in the control group for both Uyghurs and Hans (P＜0.05), and serum 25-hydroxyvitamin D level was negatively correlated with NAFLD (rHan=-0.212, rUyghur=-0.220, P＜0.01). The results of multivariate logistic regression analysis showed that the rising serum 25-hydroxyvitamin D level was a protective factor for NAFLD (ORHan=0.894, PHan=0.015; ORUyghur=0.897, PUyghur=0.025). ConclusionSerum 25-hydroxyvitamin D level is closely associated with NAFLD in Uyghurs and Hans.

Objective To explore the key elements and key assessment point of ICU specific nurses training base for long term effects evaluation. Methods Under the fundamental of literature review and the long-term demand survey of ICU specific nurses training, the preliminary evaluation index system drew up to form the first round of expert questionnaire. Delphi method was applied to consult 10 experts. Results The long-term effects evaluation content of ICU specific nurses training base included: current situation of training base, present training teachers situation, training organization and implementation, training result evaluation, tracking evaluation after training, retraining demands and implementation of 6 first-level indexes, 14 secondary indexes and 42 tertiary indexes. Conclusions The construction of evaluation index system further develops specific indexes and provides the basis for related research.

Objective To investigate the predictive value of acute physiology and chronic health score ( APCHE Ⅱ) scoring system on the patients with acute coronary syndrome ( ACS) , and to demonstrate whether the predictive value combined with TIMI risk score impact on prognosis. Methods We calculated APACHEⅡ, TIMI risk score and total score of these two for 198 patients with acute coronary syndrome ( ACS) in CCU, and compared the discriminative power of the three scores by the area under the receiver operating characteristic curve ( AUROCC ) . Results The APACHEⅡscores of survival group ( 9. 42 ± 3. 38 ) and death group (14. 77 ± 3. 27) were statistically significant (t= -8. 018,P<0. 01). The survival groups of TIMI risk score was (3.48±0.96), while the score of death group (5.57 ±0.68), (t = -11.383,P<0.01). For ST segment elevation myocardial infarction group, the score of APACHEⅡwas ( 10. 33 ± 3. 86 ) and predicted mortality 11. 61% (13/112) and actually mortality 18. 75% (21/112) (χ2 =15. 998,P <0. 01); in non-ST segment elevation myocardial infarction group, the score of APACHEⅡwas ( 10. 10 ± 4. 14 ) and predicted mortality 11. 63% (10/86) and actually mortality 10. 47% (9/86) (χ2 =79. 330,P>0. 05);for the total ACS, the score of APACHEⅡwas (10. 23 ± 3. 86) and predicted mortality 11. 62% (23/198) and actually mortality 15. 15%(30/198) (χ2 =29. 892,P<0. 01). The ROC curve area of 3 score methods had been compared and found out TIMI had the biggest ROC curve area and the best predicted livability and mortality. Conclusions APACHEⅡscore can not predict mortality satisfactorily in patients with ACS well, and the method of APACHEⅡcombined with TIMI risk score is not better than TIMI risk score showed in the study. The TIMI risk score is a quick, convenient and effective method to evaluate patients with ACS.

BACKGROUNDProstate specific membrane antigen (PSMA) can facilitate the growth, migration, and invasion of the LNCaP prostate cancer cell lines, but the underlying molecular mechanisms have not yet been clearly defined. Here, we investigated whether PSMA serves as a novel regulator of the phosphatidylinositol 3-kinase (PI3K)/Akt signaling by employing PSMA knockdown model and PI3K pharmacological inhibitor (LY294002) in LNCaP prostate cancer cells.

METHODSPSMA knockdown had been stably established by transfecting with lentivirus-mediated siRNA in our previous study. Then, LNCaP cells were divided into interference, non-interference, and blank groups. We first testified the efficacy of PSMA knockdown in our LNCaP cell line. Then, we compared the expression of PSMA and total/activated Akt by Western blotting in the above three groups with or without LY294002 treatment. Furthermore, immunocytochemistry was performed to confirm the changes of activated Akt (p-Akt, Ser473) in groups. Besides, cell proliferation, migration, and cell cycle were measured by CCK-8 assay, Transwell analysis, and Flow cytometry respectively.

RESULTSAfter PSMA knockdown, the level of p-Akt (Ser473) but not of total-Akt (Akt1/2) was significantly decreased when compared with the non-interference and blank groups. However, LY294002 administration significantly reduced the expression of p-Akt (Ser473) in all the three groups. The results of immunocytochemistry further confirmed that PSMA knockdown or LY294002 treatment was associated with p-Akt (Ser473) down-regulation. Decrease of cell proliferation, migration, and survival were also observed upon PSMA knockdown and LY294002 treatment.

CONCLUSIONSTaken together, our results reveal that PI3K/Akt signaling pathway inhibition may serve as a novel molecular mechanism in LNCaP prostate cancer cells of PSMA knockdown and suggest that Akt (Ser473) may play a critical role as a downstream signaling target effector of PSMA in this cellular model.

Antigens, Surface ; genetics ; metabolism ; Cell Line, Tumor ; Glutamate Carboxypeptidase II ; genetics ; metabolism ; Humans ; Male ; Phosphatidylinositol 3-Kinases ; metabolism ; Prostatic Neoplasms ; enzymology ; genetics ; therapy ; Proto-Oncogene Proteins c-akt ; metabolism ; RNA Interference ; Signal Transduction ; genetics ; physiology

Objective To verify the efficiency of a new laparoscopic urethrovesical anastomosis training model by comparing it with the chicken skin model. Methods Chicken posterior trunks and porcine colons were used to construct the training model. The posterior trunk of a chicken was used to simulate a human pelvis, and a 3-mm cloacal stump was used to simulate a human urethral stump. A 15-cm segment of porcine colon with a 1-cm orifice was used to simulate a human bladder or neobladder. An imitation urethrovesical anastomosis was performed with laparoscopic instruments in a laparoscopic training box. Forty trainees with no laparoscopic experience were randomized into 2 groups.The trainees in group A (n=20) practiced using this new model for 8 h, while those in group B (n=20) practiced using the chicken skin model for 8 h. The trainees' skills were assessed using the porcine model before and after training. Results Compared with the chicken skin model, this new training model more accurately resembled the structure and characteristic of human pelvis, urethral stump, and bladder (neobladder). After the training sessions, both groups improved in anastomosis time [GroupA: (64±11)min vs. (123±20)min, P＜0.05; Group B: (77±12)min vs. (121±17)min, P＜0.05] and quality (Group A: 8.8± 1.0 vs. 3.8 ± 1.2, P＜0. 05 ; Group B: 7.7 ± 0.9 vs.3. 7± 1.1, P＜0. 05). Compared with trainees in group B, trainees in group A required less time and achieved a higher quality score (P＜0.05). Conclusions This new training model can help urologic surgeons to reduce learning curve of this technique and improve their suturing skills. It is an effective,convenient training model for laparoscopic urethrovesical anastomosis.