Objective:To investigate dietary patterns of individuals aged ≥50 in Shanghai and analyze their association with frailty.Methods:Using data from the third wave of the Study on Global Ageing and Adult Health in Shanghai conducted between 2018 and 2019. We collected the frequency and average intake of food by the food frequency questionnaire. Factor analysis was used to extract dietary patterns, and a frailty index was constructed using the ratio of the cumulative total score of health deficits to 35 health-related variables considered. We used an ordinal multinomial logistic regression model to analyze the association between dietary patterns and frailty.Results:A total of 3 274 participants aged (67.9±9.2) years were included in the study, including 1 971 (60.2%) men and 1 303 (39.8%) women. We extracted four dietary patterns: high-protein-nuts pattern, potato-bean-vegetable-fruit pattern, poultry-meat pattern, and high-oil-salt pattern. After adjusting for confounding factors, the logistic regression analysis showed that compared with the high-oil-salt pattern, the high-protein-nuts pattern was negatively associated with the risk of higher frailty ( OR=0.743, 95% CI: 0.580-0.951). We did not find an association between dietary patterns and frailty between the different gender groups. In the age group 50-64, the high-protein-nuts and potato-bean-vegetable-fruit patterns were negatively correlated with a higher degree of frailty than the high-oil-salt pattern. In the low-level physical activity group, the high-protein-nuts pattern was negatively correlated with a higher degree of frailty than the high-oil-salt pattern ( OR=0.509, 95% CI: 0.361-0.720). However, we found no significant effect of the high-protein nuts pattern, potato-bean-vegetable-fruit pattern, and poultry-meat pattern on the risk of higher frailty compared to the high-oil-salt pattern in the moderate to high level of physical activity group. Conclusions:Compared to the high-oil-salt pattern, dietary patterns with a higher intake of high-protein nuts, potatoes, legumes, and fruits and vegetables might be associated with a lower risk of higher frailty in residents aged 50-64 years of age than with a high oil and salt pattern. At the same time, it may have a more significant protective effect in people with lower physical activity levels. It is suggested that a diet rich in high-protein foods, nuts, potatoes, beans, vegetables, and fruits may help reduce and delay the risk of frailty.

Objective:To understand the association between vitamin D level and grip strength in people aged ≥50 years in Shanghai.Methods:Data were obtained from the WHO's Study on Global Ageing and Adult Health in Shanghai during 2018-2019. Logistic regression model was used to analyze the association between vitamin D level and grip strength, and a stratified analysis was conducted for different gender, age and dairy product intake groups. Restricted cubic spline was used to evaluate the dose-response association between vitamin D level and low grip strength.Results:A total of 4 391 participants were included in the study, including 2 054 men (46.8%), with an average age of (67.02±8.81) years. And 1 421 individuals (32.4%) had low grip strength; 1 533 individuals (34.9%) had vitamin D deficiency, and 401 individuals (9.1%) had vitamin D deficiency. After adjusted for confounding factors, the logistic regression results analysis showed that individuals with vitamin D deficiency had a higher risk for low grip strength ( OR=1.41, 95% CI: 1.09-1.83). In men, after adjusting for confounding factors, vitamin D deficiency was positively associated with the risk for low grip strength ( OR=1.67, 95% CI: 1.12-2.50), but there was no significant association between vitamin D level and grip strength in women ( OR=1.30, 95% CI: 0.97-1.74). In age group 60-69 years and ≥80 years, there was significant association between vitamin D deficiency and low grip strength after adjusting for confounding factors ( OR=1.57, 95% CI: 1.05-2.35; OR=2.40, 95% CI: 1.08-5.31). In people who had daily intake of dairy product <250 ml, there was positive association between vitamin D deficiency and low grip strength, but there was no significant association in people who had daily dairy product ≥250 ml after adjusting for confounding factors. The restrictive cubic spline demonstrated that risk of low grip strength might decreased with the increase of vitamin D levels, however, the difference was not significant ( P>0.05). Conclusions:This study demonstrated that there is association between vitamin D level and grip strength. People with vitamin D deficiency have higher risk for low grip strength.

ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables. ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）. ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.

Objective: To study the protective effect of melatonin (MT) against lead-induced neurotoxicity. Methods: PC12 cells were divided in four groups (control, 25 μmol/L PbAc, 50 μmol/L MT and 25 μmol/L PbAc+50 μmol/L MT) . After treatment, cell viability was detected by cell counting kit-8 (CCK-8) assay and cytotoxicity LDH assay were used to evaluate cell damage rate. The expression of Cleaved-Caspase-3 and cytochrome C (cyto C) was detected by immunofluorescence (IF) . ROS levels were measured by DCFH method. GSH contents and SOD activities were detected after whole cell protein was extracted. Results: Compared with control group, 25 μmol/L PbAc caused significantly decreased cell viability, GSH contents and SOD activities, while increased cell damage rate and ROS level significantly (P<0.05) . 25 μmol/L PbAc could also increase the protein level of cleaved-caspase-3 and cyto C in cytoplasm. Compared with 25 μmol/L PbAc group, 50 μmol/L MT+25 μmol/L PbAc caused significantly increased cell viability, GSH contents and SOD activities, while decreased cell damage rate and ROS level significantly (P<0.05) . Compared with 25 μmol/L PbAc group, 50 μmol/L MT+25 μmol/L PbAc decreased the protein level of cleaved-caspase-3 and cyto C. Conclusion Melatonin could attenuate PbAc-induced oxidative stress and cell death and promote cell survival.

The specific forms and contents of narrative nursing clinical practice were analyzed. On the basis of a brief review of the concept and origin of narrative nursing and the significance of it, this paper focuses on the field, methods, forms and evaluation methods of clinical practice of narrative nursing. The study found that through the literature review, the value of narrative medicine has been fully affirmed, but how to implement theory to a real clinical nursing practice environment has not yet been reported more. Therefore, exploring the narrative nursing in the clinical workplace, rich forms, contents and methods of clinical practice can provide new methods and new ideas for nursing humanistic care and clinical practice, and has certain social significance, academic significance, individual significance and application prospect.

The status quo of American informatics nurses investigated 4 times by US HIMSS from 2004 to 2014 was analyzed.The following characteristics of American informatics nurses were summarized in terms of their educa-tion level, income, qualification authentication, occupation satisfaction, work experience and duties, including high education level and interdisciplinary background, high income and occupation satisfaction, necessary clinical background, and systematic professional development, which may provide reference for nursing staff in China to have a better understanding of informatics nurse.

Objective To develop secondary nursing discipline system based on the situation of China and the international trends of nursing education,which would be applied as the theoretical guideline for the construction of nursing system in China.Methods An indicator system of entry criteria of secondary nursing discipline was formed by examining the current situation of nursing knowledge body and organizational system in domestic and foreign countries through bibliometric and content analysis,were further supported in the panel meeting.Then the secondary nursing discipline system were constructed according to the entry criteria.Results Knowledge innovation,knowledge dissemination,personnel training and social needs of health were found to be the first indicators of the entry criteria,including 14 secondary indicators,10 secondary nursing disciplines were proposed.Conclusions The secondary nursing discipline system is in line with current situation of nursing at home and abroad,and would be gradually refined with the de velopment of nursing discipline.

Objective To analys hyperinsulinemia in Bartter syndrome. Methods Twenty-three cases of Bartter syndrome [age (27 ±9) years;fasting serum potassium(2. 8 ±0. 5)mmol/L], 20 patients of aldosterone-producing adenoma [APA, age (45 ± 11 ) years, fasting serum potassium ( 3.0 ± 0. 4 ) mmol/L], 20 patients of idiopathic hyperaldosteronism [IHA, age (51 ± 11 ) years, fasting serum potassium (3.4 ±0. 2)mmol/L] were diagnosed in Peking Union Medical College Hospital from September 2003 to May 2008. All patients underwent 3-hours oral glucose tolerance test(3hOGTT), postural stimulation test and calculated HOMA-insulin resistance ( HOMA-IR ) and HOMA-insulin sensitivity ( HOMA-IS ) by Homeostasis model.Results The insulin area under curve-(229.0±162.4)mIU·L-1·h] was singnificantly higher than APA group [(227.7±158.6)mIU·-1·h].But HOMA-IR in Bartter group were similar to APA group( 1.96 ± 1.14 vs 1.41 ± 0. 91 ), and HOMA-IR in APA group was lower than IHA group ( 1.96 ± 1.14 vs 2.40 ± 1.60, P ＜ 0. 05 ). There was no deference in HOMA-IS among three groups,but APA group had lower level. In all three groups, the peak of insulin secretion was delayed. Conclusion Bartter syndrome patients commonly present with hyperinsulinemia.

To guarantee the basic quality of nursing service, many countries have carried out the licensure examinations for registered nurses, which are used not only to evaluate the quality of nursing education but also to guide the development of education. This paper reviewed the process of the establishment of the systems, and outlined the features of the examinations in content design, organization and implementation, improvement and development trends in both China and America in order to improve ours.

Objective To study the impact of head nurses'support on the creation of encouraging management atmosphere.Methods We randomly selected 120 clinical nurses from the Sir Run Run Shaw hospital.Then we adopted head nurses'support questionnaires,nurses'stressor questionnaires and career satisfaction questionnaires and drew argumentation of our hypothesis by introducing double-factor theory.Results The management atmosphere was only inferior to the workload among all of the stressor resources.The supportive behaviors of head nurses were positively related to the career satisfaction of nurses and the encouraging management atmosphere.Conclusion Head nurses'could relieve nurses'working pressure and unsatisfactory attitude toward work by using supportive management style.In this way they could increase encouraging factors in the management and facilitated the creation of encouraging management atmosphere and improvement of effective management.