Objective To investigate the impacts of individualized and staged exercise rehabilitation on the incidence of complications, self-efficacy, joint function, and quality of life in patients after total hip arthroplasty. Methods A total of 140 patients undergoing total hip arthroplasty were randomly divided into observation group and control group, with 70 patients in each group. The control group received routine rehabilitation nursing, while the observation group received individualized and staged exercise rehabilitation program on the basis of routine rehabilitation nursing, including exercise interventions at preoperative, early postoperative (2 weeks), mid-postoperative (4 weeks), and late postoperative (3 months) stages. The incidence of complications and the scores of self-efficacy, Harris hip function, and the 36-item Short-form Survey (SF-36) before and after intervention were compared between the two groups. Results The total incidence of complications in the observation group was significantly lower than that in the control group (P < 0.05). After the intervention, the scores of the Self-Efficacy Scale, Harris Hip Function Scale, and SF-36 were significantly improved in both groups, and all indicators in the observation group were higher than those in the control group(P < 0.05). Conclusion Individualized and staged exercise rehabilitation has positive impacts on occurrence of complications, self-efficacy, functional recovery, and quality of life in patients after total hip arthroplasty, thereby meeting the individualized needs of patients and optimizing their postoperative recovery outcomes.

Objective:To explore the application of a role transition shock model based on the teach-back technique in knee arthroplasty nursing teaching.Methods:We assigned 50 nursing student interns practicing in the knee arthroplasty team of Orthopedics Department of Nanjing First Hospital between August 2020 and August 2022 into control group ( n=25, traditional teaching) and observation group ( n=25, teach-back-based role transition shock model teaching) according to the order of admission. At the end of internship, the examination scores, the impact of transition shock on comprehensive abilities, and teaching satisfaction of the students were assessed and analyzed using the t test and Fisher's exact test with the use of SPSS 22.0. Results:Compared with the control group, the observation group scored significantly lower in the physical, psychological, knowledge and skills, and sociocultural and developmental dimensions of the transition shock assessment scale ( P<0.05). The observation group showed significantly higher scores of nurse-patient communication, nursing practice, disease observation, health education, humanistic care, team cooperation, clinical thinking, and emergency response than the control group ( P<0.05). The examination results of the observation group were significantly better than those of the control group ( t=12.31, 11.52, P<0.001). The teaching satisfaction rate of the observation group was significantly higher than that of the control group [100.00% (25/25) vs. 68.00% (17/25), χ2=9.52, P=0.002]. Conclusions:The teach-back-based role transition shock model can help alleviate the transition impact faced by nursing student interns when entering clinical practice, and also improve their comprehensive abilities as well as satisfaction with teaching.

Objective:To summary the clinical and electrophysiological characteristics of temporal lobe epilepsy (TLE) originating from the temporal pole (TP), and to conduct brain network analysis based on stereo-electroencephalogram (SEEG) and head positron emission tomography- computed tomography (PET-CT).Methods:A retrospective analysis was conducted on patients with TLE who underwent SEEG implantation from January 1, 2019 to September 1, 2023 in Guangdong Sanjiu Brain Hospital. Based on anatomical-electrical-clinical analysis and SEEG findings, patients with seizures originating from the TP were selected. The clinical data, head magnetic resonance imaging (MRI), PET-CT, scalp electroencephalogram were reviewed, and the seizure-induced network was analyzed based on SEEG and head PET-CT.Results:A total of 108 cases of TLE were analyzed, of whom 13 cases had an epileptogenic zone located at the TP, accounting for 12% (13/108) of all TLE patients. Among them, 8 were males and 5 were females, and age of onset was (11.6±7.8) years. All of them were drug-resistant epilepsy patients, of whom 6 cases had normal cognitive function, 4 had mild cognitive abnormalities, and 3 had severe cognitive decline. A total of 59 seizures were recorded, and the occurrence rate of generalized tonic-clonic seizures (GTCS) was 42% (25/59). Seizure symptoms were classified into 3 types: the first type was hypermotor, seen in 9 patients; the second type was complex motor, seen in 2 patients; and the third type was automotor, seen in 2 patients. Head MRI showed that 9 cases had a blurring of the TP on one side, with or without hippocampal sclerosis; 2 cases had a mass at the TP without hippocampal sclerosis; 2 cases were negative on head MRI. Head PET-CT showed that 13 cases had TP hypometabolism on the lesion side, of whom 11 cases had hypometabolism involving the medial temporal lobe (mTL), posterior orbital gyrus (POG), anterior cingulate gyrus (ACG) and insular lobe at the same time, the other 2 cases combined with ipsilateral hypometabolism of the medial temporal lobe. Pathology showed that 7 cases had microcortical dysplasia of the TP; 3 had focal cortical dysplasia Ⅰ or focal cortical dysplasia Ⅱ; 2 had benign tumors. Scalp electroencephalogram showed that interictal phase was divided into 3 discharge patterns: bilateral temporal regions with prominent lesion side; bilateral anterior regions with prominent lesion side; lesion-side hemisphere with prominent temporal region. Ictal period showed 4 initial patterns: lesion-side hemispheric rhythmic spikes-slow waves or polyspikes-slow waves; lesion-side anterior region rhythmic slow waves; lesion-side anterior region low voltage fast (LVF) activities, and diffuse LVF with prominent lesion-side hemisphere. SEEG showed that 13 patients received electrode implantation with (9±2) electrodes per patient, divided into 3 seizure patterns: type 1: TP?adjacent temporal neocortex?POG, ACG and insula?mTL; type 2: TP?para hippocampal gyrus and the base of temporal lobe?ACG ,POG and insula?mTL; type 3: TP?mTL?insular lobe?POG.Conclusions:TLE originating from the TP is relatively rare, with hypermotor or complex motor as the main manifestations, and automotor being relatively less common, which is more likely to be followed by GTCS. The epileptogenic network analysis displays a tendency to spread from the TP to the frontal and insular lobes, as well as to the mTL, with the former pattern being more common. Common etiologies are cortical dysplasia and benign tumors of the TP without hippocampal sclerosis.

Objective:To investigate the association between nonalcoholic fatty liver disease(NAFLD)and mild cognitive impairment(MCI)in the elderly.Methods:Three hundred ninety-two study subjects aged 60 years and above visiting the geriatric department of Peking University People's Hospital for chronic disease management between July 2016 and January 2018 were enrolled, and population-based clinical data of the study subjects were collected.Participants' cognitive function was assessed, and the correlation between NAFLD and MCI was analyzed.Results:The detection rate of MCI in the NAFLD group(n=191)was significantly higher than that in the non-NAFLD group(n=201)[38(19.9%) vs.21(10.4%) χ2=6.837, P=0.009]. Multivariate analysis revealed that NAFLD was closely correlated with and was an independent risk factor for MCI( OR=2.625, 95% CI: 1.250-5.512, P=0.011)after adjusting confounding variables such as age, sex, education level, components of metabolic syndrome, medication, and conditions affecting biochemical and metabolic processes.In addition, the female sex( OR=2.775, 95% CI: 1.363-5.651, P=0.005), unstable carotid plaques( OR=2.736, 95% CI: 1.131-6.620, P=0.026), serum albumin( OR=0.908, 95% CI: 0.840-0.982, P=0.015), fasting serum glucose( OR=1.268, 95% CI: 1.076-1.493, P=0.004), and the serum AST/ALT ratio( OR=2.984, 95% CI: 1.370-6.500, P=0.006)were also independently associated with MCI, of which, the female sex, unstable carotid plaques, increased levels of fasting serum glucose and the AST/ALT ratio were independent risk factors for MCI. Conclusions:NAFLD is associated with and is an independent risk factor for MCI in the elderly.Assessment of cognitive function in elderly patients with NAFLD should be emphasized.

Systemic lupus erythematosus (SLE) is a serious autoimmune disease that affects multiple systems and organs throughout the body. Thrombotic microangiopathy (TMA) is a rare clinical syndrome that can lead to multiple organ dysfunction and even threaten life. Clinically, SLE patients with TMA are relatively rare, especially in children, but the mortality of SLE patients with TMA is significantly increased. The article reports 2 cases of successful remission of SLE complicated with TMA after treatment with eculizumab, and discusses the diagnosis, clinical manifestations and treatment of SLE complicated with TMA in children, so as to provide clinical basis for the diagnosis and treatment of SLE complicated with TMA in children.

Objective:To explore the mediating effect of caring ability of family caregivers on dementia patients′ self-care ability and family caregiver burden.Methods:A total of 113 dementia caregivers of dementia patients recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Mental Health Center from September 2020 to January 2021 were selected, and the Barthel Index, Family Caregiver Task Inventory and Zarit Burden Interview were used to capture their responses on dementia patients′ self-care ability, caring ability, and caregiver burden.Results:The score of self-care ability of dementia patients was (75.19 ± 28.56), and scores of caring ability and care burden of caregivers were 9.00(4.00, 15.00) and (33.78 ± 16.53), respectively. The self-care ability of dementia patients was negatively associated with caring ability and care burden of caregivers ( r=-0.424, -0.420, both P<0.01), and the caring ability and care burden were positively correlated ( r=0.605, P<0.01). The intermediary effect of dementia caregivers' caring ability between patients' self-care ability and caregivers' care burden is significant. The indirect effect was -0.107 and the total effect was -0.187. The indirect effect accounted for 57.22% of the total effect. Conclusions:Caring ability of family caregivers mediates the relationship between self-care ability of dementia patients and caregivers' care burden.The caring ability may be used as an intervening target for future studies.

【Objective】 To explore the dynamic change of depression in diabetic patients so as to provide evidence for early detection and warning of psychological problems in diabetic patients. 【Methods】 Based on the data from the China Health and Retirement Longitudinal Study （CHARLS）， the propensity score matching method was used to eliminate confounding factors in the study. The linear growth model， the nonlinear quadratic growth model， and the growth model without defined curve type were fitted respectively. According to the fitting indices of the models， the optimal solution of the growth function was determined to explore the changes of depression development in the diabetic patients. 【Results】 A total of 5 711 cases （5 380 cases in the non-diabetic group and 331 cases in the diabetic group） were included in the study. After propensity score matching， 1 621 cases （1 291 cases in the non-diabetic group and 330 cases in the diabetic group） were included and all confounding factors were balanced between the two groups. By fitting three growth curve models with latent variables， the results showed that the model without defined curve type was better than the other two models. The mean depression score for initial status in the non-diabetic and diabetic groups was 9.640 and 10.097， respectively， with significant inter-individual differences. During the follow-up period， the depression status of both groups showed a trend of decrease first and then increase， but the depression score was always lower in the non-diabetic group than in the diabetic group. At the same time， there was no individual difference in the rate of change between the two groups， and there was no statistical difference between the initial depression score and the subsequent slope of change. 【Conclusion】 Exploring the change track of depression status over time in diabetic patients， understanding the individual psychological change trend and further explaining the differences between individuals are of great significance for intervention on psychological status at different stages.

Objective To evaluate prospectively the side effects and tolerance of docetaxel with concurrent late-course hyperfractionated radiotherapy after breast-conserving surgery for stage T1-T2 breast cancer, and to assess the value of this treatment in shortening the treatment time and reducing the economic burden among patients. Methods A total of 20 patients with T1-T2 breast cancer were recruited after they underwent breast-conserving surgery. The acute radiation response classification, treatment completion rate, disease-free survival, hospital stays, and treatment costs were observed. Radiotherapy for all patients was started before the last single-agent docetaxel chemotherapy. Results The completion rate of treatment and the good rate of cosmetic effect reached 100%. The main adverse reactions were hematological toxicity (leukopenia) and skin reactions, which were tolerated. The median follow-up time was 30.1 months, and the follow-up rate was 100%. The average total treatment time of this hyperfractionated radiotherapy with concurrent docetaxel was four weeks, and the total hospitalization cost savings was approximately 10, 000 yuan. The 21-month disease-free survival rate was 100%. Conclusion Stage T1-T2 breast cancer can tolerate hyperfractionated radiotherapy with concurrent chemotherapy after a breast-conserving operation. The procedure results in good local control and satisfactory cosmetic effects, with high health and economic value.

Objective:To explore the intervention effect of different modes of ankle pump exercise on femoral vein peripherally inserted central catheter (PICC) catheter-related thrombosis in patients with lung cancer.Methods:Using the convenient sampling method, 96 cases of lung cancer patients with femoral vein PICC catheterization admitted to Xiangya Hospital of Central South University from January 2019 to October 2020 were set as the control group and 97 cases of lung cancer patients with femoral vein PICC cannula from October 2020 to October 2021 were set as the observation group. They adopted the comfort angle ankle pump exercise and the maximum angle ankle pump exercise mode, respectively. The differences in the incidence of catheter-related thrombosis, the incidence of unplanned extubation, fatigue score and catheter indwelling time were compared between the two groups.Results:The incidence of catheter-related thrombosis and unplanned extubation in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The fatigue score and catheter indwelling time of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The maximum angle ankle pump motion mode can reduce the incidence of catheter-related thrombosis and unplanned extubation of femoral vein PICC catheterization in patients with lung cancer and improve the catheter indwelling time, but it is easy to cause patient fatigue, so clinical promotion and use should consider the patients' tolerance.

Objective:To investigate the effects of cone beam computed tomography measurement of maxillary anterior teeth on implant success and patient satisfaction of maxillary anterior teeth.Methods:120 patients who underwent maxillary anterior teeth implantation in Hangzhou Dental Hospital from October 2017 to October 2019 were included in this study. They were randomly assigned to receive either conventional maxillary anterior teeth implantation (control group, n = 60) or cone beam computed tomography measurement of maxillary anterior teeth and maxillary anterior teeth implantation (study group, n = 60). The implant success rate was compared between the two groups. Alveolar bone thickness and ISQ value immediately, 3 and 12 months after implantation as well as patient satisfaction were compared between the two groups. Results:Implant success rate in the observation group was significantly higher than that in the control group [96.67% (58/60) vs. 85.00% (51/60), χ2 = 4.904, P < 0.05]. In the observation group, alveolar bone thickness at 3 and 12 months after implantation was (1.53 ± 0.05) mm and (1.78 ± 0.12) mm, respectively, which was significantly higher than that in the control group [(1.46 ± 0.04) mm, (1.64 ± 0.10) mm, t = 9.839, 8.066, both P < 0.001]. In the observation group, ISQ value at 3 and 12 months after implantation was (76.83 ± 5.49) and (82.91 ± 4.85), respectively, which was significantly higher than that in the control group [(67.81 ± 4.61), (74.18 ± 5.21), t = 11.324, 11.038, both P < 0.001). Total satisfaction rate in the observation group was significantly higher than that in the control group [95.00% (57/60) vs. 81.67% (49/60), χ2 = 5.175, P < 0.05]. Conclusion:Cone beam computed tomography measurement of maxillary anterior teeth can help increase implant success rate and patient satisfaction.