Objective:To evaluate the application of mind mapping in combination with scenario simulation teaching based on symptom management theory (SMT) in geriatric symptom nursing education, and to provide a basis for improving the quality of geriatric symptom nursing education.Methods:A total of 80 nursing students who interned in the Department of Geriatric Medicine of Peking Union Medical College Hospital from August 2022 to April 2023 were included in the study. They were divided into control group and experimental group according to the order of enrollment, with 40 students in each group. The control group employed traditional teaching methods, while the experimental group implemented a method of mind mapping in combination with scenario simulation teaching based on SMT. The general data, training assessment results, and teaching quality satisfaction were compared and analyzed between the two groups. SPSS 22.0 statistical software was used for t-test and chi-square test. Results:There were no significant differences between the two groups in general data such as age, gender, educational background, academic performance, and school of study. The experimental group showed higher scores in geriatric symptom nursing theory assessment [(86.57±8.41) vs. (80.83±9.16), P=0.018] and comprehensive skill assessment [(91.26±7.29) vs. (81.92±8.64), P<0.001], as compared with the control group. The experimental group also showed higher scores in teaching process [(24.52±1.56) vs. (20.18±0.98), P<0.001], teaching methods [(24.49±1.72) vs. (20.65±1.02), P<0.001], teaching effectiveness [(24.35±1.19) vs. (20.01±0.86), P<0.001], teaching content [(24.31±1.83) vs. (20.27±1.21), P<0.001], and overall satisfaction [(97.67±2.80) vs. (81.11±2.53), P<0.001]. Conclusions:The method of mind mapping in combination with scenario simulation teaching based on SMT has a significant positive effect on geriatric symptom nursing education. This method can improve the theoretical and comprehensive skill levels as well as the teaching quality satisfaction of nursing interns.

Objective To investigate the impact of nursing interventions based on Kales conceptual model on agitated behaviours of dementia patients.Methods A total of 80 dementia patients were randomly divided into two groups using a random number table.Patients in the control group(n=40)received routine care,while those in the observation group(n=40)received the nursing interventions based on Kales concept model on top of the routine care.The agitated behaviours and quality of life of the two groups were compared before,2 weeks and 4 weeks after the intervention.Results The repeated measures ANOVA showed statistically significant differences in three time points in terms of the time effect,inter-group effect and interactive effects on the scores of agitations and quality of life(all P<0.05).After the intervention,the score of agitations in the observation group was significantly lower than that of the control group(P<0.05),and the score of quality of life in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The nursing interventions based on Kales conceptual model is effective in reducing agitations of dementia patients and improving the quality of life.

Objective:To explore the professional quality learning needs among nursing students in colleges and universities in China under the background of the five educations.Methods:Convenience sampling was used to select nursing students who interned at Chinese Academy of Medical Sciences & Peking Union Medical College Hospital in 2021 as the research subject. The survey was conducted using a self-made "Professional Quality Learning Needs among Nursing Students in Colleges and Universities ". Multiple linear regression was used to explore the influencing factors of nursing students' professional quality learning needs. A total of 349 questionnaires were distributed, and 348 valid questionnaires were collected, with an effective recovery rate of 99.7%.Results:Among 348 nursing students, the five items with the highest need for professional quality learning were basic nursing skills, correct implementation of nursing procedures, communicating with patients and their families in appropriate ways, understanding of patient safety related concepts and nursing professional knowledge. Academic degree was a factor that affected the professional quality learning needs among nursing students ( P<0.05) . Conclusions:The training of nursing students' professional quality should be need oriented and establish a new era of "five education" concept. It should not only meet job requirements, but also combine students' own characteristics and growth patterns to cultivate nursing talents that meet clinical needs.

Objective:To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) for Trousseau’s syndrome (TS) in patients with acute multiple cerebral infarctions (AMCI).Methods:The patients with AMCI in Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from July 2013 to March 2022 were retrospectively enrolled. The demographic and baseline clinical data of patients with TS and those without TS were compared. Multivariate logistic regression analysis was used to determine the independent influencing factors of TS-AMCI, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR for TS-AMCI. Results:A total of 59 patients with AMCI were enrolled, including 43 males and 16 females, aged 64.9±14.0 years. There were 16 patients in the TS-AMCI group and 43 in the non-TS-AMCI group. The proportions of patients with diabetes mellitus, hypertension and previous stroke or transient ischemic attack in the TS-AMCI group were significantly lower than those in the non-TS-AMCI group (all P<0.05), while the proportion of patients with ischemic heart disease were significantly higher than that in the non-TS-AMCI group ( P<0.05). The proportion of patients with bilateral infarction in the TS-AMCI group was significantly higher than that in the non-TS-AMCI group ( P<0.001). The D-dimer, NLR, white blood cell count, neutrophil count, monocyte count, percentage of neutrophils, total cholesterol and low-density lipoprotein cholesterol in the TS-AMCI group were significantly higher than those in the non-TS-AMCI group (all P<0.001), while the lymphocyte count, lymphocyte percentage, red blood cell count, hemoglobin and hematocrit were significantly lower than those in the non-TS-AMCI group (all P<0.001). Multivariate logistic regression analysis showed that high NLR was an independent predictor of TS-AMCI (odds ratio [ OR] 2.897, 95% confidence interval [ CI] 1.270-6.527; P=0.011), while high hemoglobin was independently negatively correlated with TS-AMCI ( OR 0.839, 95% CI 0.723-0.975; P=0.022). ROC curve analysis showed that the area under the curve of NLR for predicting TS-AMCI was 0.929 (95% CI 0.831-0.979; P<0.001). When the NLR cutoff value was 4.01, the corresponding Youden index was 0.744. At this time, the sensitivity and specificity were 100% and 74.42% respectively. Conclusion:NLR has high predictive value for TS-AMCI.

Objective:To investigate the evaluation value of one-stop whole-brain dynamic volume CT angiography and CT perfusion imaging (CTA-CTP) in the cynomolgus monkeys models of middle cerebral artery occlusion (MCAO).Methods:Ten adult cynomolgus monkeys were selected and examined by head and neck CTA-CTP and craniocerebral MRI to rule out craniocerebral space-occupying lesions or cerebrovascular malformation. Under guidance of digital substraction angiography (DSA), the right femoral artery was dissected and monkey autologous thrombosis was injected into the right middle cerebral artery (MCA) through microcatheter to prepare MCAO models. Whole brain DSA was performed intraoperatively to observe whether the model was successfully prepared, and head and neck CTA-CTP was performed 24 h and 7 d after modeling to determine the locations and brain blood flow changes of ischemic lesions. The monkeys were sacrificed 8 d after modeling, and the brain tissues were stained with 2,3,5-triphenyltetrazolium chloride (TTC).Results:Among the 10 cynomolgus monkeys, one was excluded because of preoperative cerebrovascular malformation, and one died of cerebral hernia caused by cerebral hemorrhage during the experiment. The remaining 8 MCAO models were successfully prepared. Intraoperative DSA orthography showed unclear M1 segment and distal branch of MCA. Brain CT scan 24 h and 7 d after modeling showed obvious cerebral ischemic lesions in the right MCA blood supply area, and the infarct extent 7 d after surgery was more obvious than that 24 h after surgery. CTA examination showed obvious blood flow interruption imaging in the in M1 segment of MCA on the right side, the distal vessels were not clearly displayed and the distal branches of the infarct side 7 d after surgery were obvious decreased as compared with those 24 h after surgery. CTP scan showed that the cerebral blood volume of the right cerebrum was obviously reduced as compared with that of the left cerebrum, which was consistent with the blood supply area of MCA; and the infarct cores and penumbra areas 7 d after surgery were obvious increased as compared with those 24 h after surgery. TTC staining showed that the ischemic lesions of the brain tissue on the slices were gray and involved multiple layers, and the range was roughly consistent with the infarction sites shown by DSA and CT imaging.Conclusion:One-stop whole brain dynamic volume CTA-CTP has good evaluation value in imaging findings in MCAO animal models.

Objective To observe the effects of tocilizumab on the efficacy, immunoglobulin and helper T cells in patients with rheumatoid arthritis. Methods 90 patients with rheumatoid arthritis in our hospital were randomly divided into control group and observation group, 45 cases in each group. The patients in the control group were treated with infliximab and methotrexate. The patients in the observation group were treated with tocilizumab and methotrexate. The patients in the two groups were both treated for 6 months. The clinical efficacy of the two groups was compared after treatment. Before and after treatment, the serum levels of immunoglobulin, Th-1 and Treg of patients in two groups were measured. Results The results showed that after treatment, the situation of morning stiffness, joint pressure pain and joint swelling of the patients in the two groups were improved, and the improvement of morning stiffness, joint pressure pain and joint swelling in the observation group was greater (P<0.05). The levels of IgG and Th1 cells in the serum of patients in the two groups significantly decreased, and the levels of IgG and Th1 cells in the serum of the patients in the observation group were significantly lower than that of the control group (P<0.05). The serum level of Treg cells in the serum of patients in the two groups increased significantly, and the level of Treg in the serum of patients in the observation group was significantly higher than that in the control group (P<0.05). Conclusion Topazumab could effectively improve the clinical symptoms of patients with rheumatoid arthritis, and improve the immune dysfunction of the patients with better clinical efficacy.

Objective:To explore the effect of nursing intervention based on protection motivation theory on medication compliance and quality of life in elderly patients with Parkinson′s disease.Methods:From August 2017 to August 2018, 60 elderly patients with Parkinson′s disease were selected. The patients were randomly divided into the control group ( n = 30) and the intervention group ( n = 30). In the control group, the routine nursing model was adopted, and the intervention group accepted the nursing intervention based on the protection motivation theory. Two groups of patients were investigated by using medication compliance scale and the 39-item Parkinson′s Disease Questionnaire. Results:Three months after the intervention, 86.67%(26/30) of the patients in the intervention group and 33.33%(10/30) of the patients in the control group had good compliance with the drug, and the difference between the two groups was statistically significant ( χ2 value was 17.778, P < 0.05). The total scores of quality of life and scores of physical activity, daily life behavior, mental health, humiliation, social support, cognition, communication and physical discomfort in the intervention group were 26.20±3.12, 4.00±0.76, 4.87±1.19, 2.33±0.72, 1.93±0.17, 2.80±0.86, 4.40±1.12, 2.27±0.80, 3.27±1.10, the scores in the control group were 39.20±2.88, 7.40±1.12, 7.13±0.83, 3.80±0.68, 2.87±0.64, 4.27±0.96, 5.20±0.68, 3.73±0.70, 5.07±0.80, the difference between the two groups was statistically significant ( t value was -2.366-11.849, P <0.05). Conclusion:Nursing intervention based on the protection motivation theory can improve the compliance of elderly patients with Parkinson's disease and their quality of life.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.

Objective: To explore the effect of nutritional support based on clinical nursing pathway on nutritional status and quality of life among elderly inpatients with Alzheimer disease (AD). Methods: A total of 101 elderly inpatients with AD who met the criteria of the protocol were consecutively enrolled and randomly divided to study group receiving nutritional support based on clinical nursing pathway for two months (n=51) and control group receiving routine nutritional management for 2 months (n=50). Nutritional risk and quality of life were measured by nutritional risk screening 2002 (NRS 2002) and Quality of Life-Alzheimer's Disease Scale (QOL-AD) respectively before and after nutritional support. Results: Baseline data were comparable between the two groups (all P>0.05). After 2-month nutritional support, compared to the control, the incidence of nutritional risk (36.0% vs 17.6%, P=0.037) and undernutrition (26.0% vs 9.8%, P=0.033) decreased significantly in study group. The score of quality of life in study group were significant higher than that of control group (35.73±5.85 vs 30.76±6.14, P=0.023). Conclusion The nutritional support based on clinical nursing pathway is helpful to improve the nutritional status and quality of life in elderly hospitalized patients with AD.

Objective To evaluate the effectiveness of family-centered educational intervention on fall prevention knowledge and attitude,compliance and fall incidence of elderly inpatients. Methods A total of 300 elderly inpatients were selected in a first-class grade A hospital in Beijing and divided into the experiment group and the control group equally.The intervention group was given family-centered educational intervention for 6 months,while the control group was given conventional treatment and care in ward.The knowledge and attitude,compliance and the incidence of falls of elderly inpatients were evaluated at discharge and 3 months,6 months after discharge. Results The knowledge and attitude, compliance of elderly inpatients in the intervention group were significantly better than that in the control group (P<0.05).The incidence of falls in the intervention group was significantly lower than that in the control group at discharge and 3 months,6 months after discharge (P<0.05). Conclusions The family-centered educational intervention can enhance the fall prevention knowledge, attitude and compliance of elderly inpatients effectively and reduce the incidence rate of falls.The long-term effect is relatively obvious.