Objective To develop a self-assessment scale for medication literacy in patients with coronary heart disease comorbidity diabetes and to test its reliability and validity.Methods According to medication literacy theory model,the initial scale was formed through literature review,the qualitative interview and expert inquiry.Cognitive interview was used to optimize the expression of item text.421 patients with coronary heart disease comorbidity diabetes in a tertiary hospital in Zhejiang province from November 2022 to April 2023 were selected to investigate the reliability and validity of the scale by convenience sampling.Results The self-assessment scale of drug literacy for coronary heart disease comorbidity diabetes mellitus included 23 items in 5 dimensions including acquisition,understanding,communication,evaluation and calculation.The total Cronbach's α coefficient of the scale was 0.911;the retest reliability was 0.948;the average content validity index was 0.997;the correlation coefficients between each dimension and total score of the scale and the calibration scale ranged from 0.485 to 0.926.The exploratory factor analysis was employed to extract 5 common factors,and the cumulative variance contribution rate was 73.753％.Confirmatory factor analysis showed that the scale factor structure was stable.Conclusion The scale has good reliability and validity,and it can be used as an effective tool to evaluate the self-rated medication literacy level of patients with coronary heart disease comorbidity diabetes.

Peptides are increasingly important resources for biological and therapeutic development, however, their intrinsic susceptibility to proteolytic degradation represents a big hurdle. As a natural agonist for GLP-1R, glucagon-like peptide 1 (GLP-1) is of significant clinical interest for the treatment of type-2 diabetes mellitus, but its in vivo instability and short half-life have largely prevented its therapeutic application. Here, we describe the rational design of a series of α/sulfono-γ-AA peptide hybrid analogues of GLP-1 as the GLP-1R agonists. Certain GLP-1 hybrid analogues exhibited enhanced stability (t _1/2 > 14 days) compared to t _1/2 (<1 day) of GLP-1 in the blood plasma and in vivo. These newly developed peptide hybrids may be viable alternative of semaglutide for type-2 diabetes treatment. Additionally, our findings suggest that sulfono-γ-AA residues could be adopted to substitute canonical amino acids residues to improve the pharmacological activity of peptide-based drugs.

Objective:To develop the supportive care information platform based on full cycle needs of patients and explore the application effect of platform in hemiplegia patients with ischemic stroke.Methods:Based on the supportive care scheme for patients with ischemic stroke in the previous study of the research group, combined with literature review and expert group discussion, the supportive care information platform version 1.0 was developed. After 5 patients with ischemic stroke hemiplegia tried for 3 weeks, it was optimized and upgraded to version 2.0 according to the use experience. From June to December 2020, 64 patients with acute ischemic stroke hemiplegia in the Department of Neurology of the First Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Soochow University hospital were randomly divided into intervention group and control group, 32 cases in each group. Barthel Index and balance ability were compared between the two groups. The control group received supportive care plan, and the intervention group received supportive care information platform.Results:After the intervention, the scores of Barthel index in the intervention group were 85 (75,90), 95 (95,100) at 1 and 3 months of illness, which were significantly higher than 65 (55,75), 75 (70,85) in the control group ( P<0.05). After intervention, the scores of balance ability in intervention group were 37 (28,43), 48 (45,51) at 1 and 3 months after illness, which were significantly higher than 28 (16,36), 31(20,37) in control group ( P<0.05). After the intervention, the scores of stroke related knowledge in the intervention group one day before discharge, one month after illness and three months after illness were 14.97 ± 2.98, 19.00 ± 2.14, 22.81 ± 1.60, which were significantly higher than those in the control group (8.69 ± 1.64), (8.88 ± 1.52), (9.09 ± 1.61) ( t values were 109.37-1 169.84, P<0.05). Conclusions:The application of supportive care information platform can provide targeted nrusing measures for patients at different stages of disease development. The platform has good feasibility, and can significantly improve patients′ Barthel index, balance ability and stroke related knowledge, which shows that the platform has good feasihility and clinical application value.

The development of internet technology provides a new method for management of workplace violence (WPV) in hospitals. This paper reviews the specific application of information technology in hospital workplace violence in the "Internet +" era from three aspects of pre-warning, in-process response and post control and analyzes the shortcomings of application of Internet technology in workplace violence in hospitals, in order to provide reference for further effective prevention of workplace violence in hospitals.

Objective:To explore supportive care needs of patients with stable stroke in the acute phase and provide guidance for effective supportive care through mixed-methods.Methods:A mixed-method study with convergent parallel design was used. A convenient sampling method was used to select neurological inpatients for questionnaire survey. At the same time, a purposive sampling was used to conduct semi-structured interviews with 15 stroke patients.Results:A total of 176 valid questionnaires were collected, and the average score of supportive care needs were 2.17±0.37, The top 3 were disease-related information needs (2.75 ± 0.40), daily life care needs (2.28 ± 0.51), and social support needs (2.26 ± 0.28). Knowing the causes of stroke ranked first in each entry. The theme of qualitative interviews included: assisting daily activities, management of impaired functions, early functional rehabilitation, disease-related knowledge, psychosocial support, and discharge guidance.Conclusions:Stroke patients have rich and high-level supportive care needs, and provide corresponding information needs based on patient needs. Implement early secondary prevention guidance to prevent stroke recurrence; cooperate with multidisciplinary teams to provide early rehabilitation, reduce functional impairment; timely identify negative emotions of patients, and jointly provide family with patients psychological support. Implement a case management model to promote full-course care for stroke patients.

Objective:To explore the clinical utility of liquid chromatography tandem mass spectrometry forprimary aldosteronism screening.Methods:From January to October 2019, 413 inpatients diagnosed hypertension from Fuwai Hospital of Chinese Academy of Medical Sciences were enrolled, including 60 Primary aldosteronism(PA)patients and 353 primary hypertension patients. The plasma aldosterone concentration (PAC) and renin concentration (DRC) were measured after 2 h of standing. The 24 h urine samples were collected for measurement of aldosterone using LC-MS/MS. The performance of urine aldosterone and urine aldosterone/renin ratio (UADRR) in PA screening was evaluated by ROC, and compared with PAC/DRC ratio (ADRR). Meanwhile, the efficiency of urine aldosterone in elderly patients or patients with low blood potassium or 24 h urine sodium over 200 mmol was investigated.Results:Area under the curve (AUC)of urine aldosterone was 0.725 (95 %CI 0.679-0.767), and the best cut-off was 7.13 μg/24 h, which was lower than AUC of ADRR (0.958, 95 %CI 0.934-0.975). The AUC of UADRR was 0.947 (95 %CI 0.920-0.966), the best cut-off was 1.11 (μg/24 h)/(μIU/ml), the sensitivity and specificity were 91.7% and 89.0%, respectively. There is no significant differences found with ADRR. In patients with 24 h urine sodium over 200 mmol, AUC of aldosterone was 0.834 (95 %CI 0.730-0.910) and the best cut-off was 9.31 μg/24 h. The sensitivity and specificity were 90.9% and 68.7%, respectively. For the elderly patients over 60 years old, the AUC of urinary aldosterone was 0.860 (95 %CI 0.770-0.925), and the best cut-off was 6.91 μg/24 h. The sensitivity and specificity were 84.6% and 81.3%, respectively. When admission blood potassium was less than 3.50 mmol/L, AUC of urinary aldosterone was 0.822 (95 %CI 0.684-0.917), and the best cut-off was 10.63 μg/24 h. The sensitivity and specificity were 85.7% and 66.7%, respectively. Conclusion:The detection of aldosterone in urine by LC-MS/MS can provide clinical information for PA screening, and the screening performance is better in patients with 24-hour urine sodium over 200 mmol, elderly patients or patients with low blood potassium. If combined with renin, screening efficiency was the same as that in ADRR.

Objective:To understand the cognition of experiencers and witnesses on workplace violence (WPV) in nurses and to analyze the differences among them so as to provide a theoretical basis for formulating intervention.Methods:From February to May 2018, totals of 26 nurses, experiencers and witnesses of WPV, at a hospital in Suzhou were selected as subjects by purposive sampling to carry out semi-structured interview with the method of descriptive qualitative study. Content analysis was used to the data.Results:Under different perspectives, the differences of nurses' cognition on WPV included three aspects involving subject responsibility attribution, pre-recognition in advance and organizational support of WPV. Experiencers thought that patients had great responsibilities on violence, WPV was difficult to identify, lack of organizational support. Witnesses showed that nurses and patients matched each other in responsibilities, WPV could be identified in advance, the ways of organizational support needed diversification.Conclusions:Under different perspectives, there are differences in nurses' cognition on WPV. Hospital managers should strengthen the building of security, and improve nurses' violence identification and coping capacity to reduce the incidence of hospital violent incidents.

Stroke is the world＇s second most dead disease and the leading cause of death in China. Its incidence, disability, recurrence rate, and high mortality rate, which seriously endangers the quality of life and life safety of residents. Continuing nursing can improve the health outcomes of stroke patients and reduce the rate of readmission. This article discusses the dynamic changes of continuing nursing needs of stroke patients from health education, life care, rehabilitation nursing, psychosocial support, etc., and analyzes the influencing factors of continuing nursing needs in terms of the general situation of patients, family society and health status, and provides a basis for future targeted hospital-community-family continuing nursing interventions.

? This paper reviewed the application status of the common deep vein thrombosis (DVT) risk assessment tools for stroke patients to explore the advantages and disadvantages of every tool so as to provide a basis for selecting the best assessment tools for early DVT in stroke patients.

Objective: To explore the effects of microRNA-34a on regulating silent information regulator 1 (SIRT1) and influence of SIRT1 on myocardial damage of rats with severe burns at early stage. Methods: (1) Twenty-four Sprague-Dawley (SD) rats were divided into sham injury (SI) group, simple burns (SB) group and SIRT1 agonist (SA) group according to the random number table (the same grouping method below), with 8 rats in each group. Rats in groups SB and SA were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burns) on the back, and rats in group SI were sham injuried on the back. Immediately after injury, rats in groups SI and SB were intraperitoneally injected with normal saline of 50 mL/kg, and rats in group SA were intraperitoneally injected with normal saline of 50 mL/kg and 1 mg/mL resveratrol of 50 mg/kg. At 6 h post injury, abdominal aortic blood was collected to make serum and myocardial tissue of rats was collected. (2) Myocardial cells of twelve neonatal SD rats were collected and divided into microRNA-34a mimic control (MMC) group, microRNA-34a mimic (MM) group, microRNA-34a inhibitor control (MIC) group, and microRNA-34a inhibitor (MI) group, which were respectively transfected with gene sequences of mimic control, mimic, inhibitor control, and inhibitor of microRNA-34a. The microRNA-34a expression level and protein expression level of SIRT1 in myocardial cells were respectively detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blotting. Another batch of myocardial cells were divided into microRNA-34a inhibitor control+ burn serum (MCB) group, microRNA-34a inhibitor+ burn serum (MB) group, and microRNA-34a inhibitor+ burn serum + EX527 (MBE) group. Myocardial cells in group MCB were transfected with gene sequence of inhibitor control, and myocardial cells in the later groups were transfected with gene sequence of inhibitor of microRNA-34a. After transfection of 48 h, myocardial cells in group MBE were cultured in Dulbecco′s modified Eagle′s medium (DMEM) solution for 6 hours, with serum in group SB of volume fraction of 10% and final amount-of-substance concentration of 1 mol/L, and myocardial cells in the other 2 groups were cultured in DMEM solution with serum from rats of group SB of volume fraction of 10%. The protein expression levels of myocardial cells of SIRT1, cleaved-caspase-3, and Bax were detected by Western blotting. (3) Myocardial tissue from (1) was collected to detect expression levels of microRNA-34a and mRNA of SIRT1 in groups SI and SB by real-time fluorescence quantitative RT-PCR. Morphology of myocardial tissue of rats in groups SI, SB, and SA was observed with biological image navigator. The mRNA expression levels of interleukin 1β (IL-1β) and tumor necrosis factor (TNF-α) of rats in groups SI, SB, and SA were detected by real-time fluorescence quantitative RT-PCR. The expression levels of cleaved-caspase-3, and Bax of myocardial tissue of rats in groups SI, SB, and SA were detected by Western blotting. Data were processed with one-way analysis of variance and least-significant difference test. Results: (1) After transfection of 48 h, the expression level of microRNA-34a of myocardial cells in group MM was 4.67±0.92, significantly higher than 1.03±0.04 in group MMC (P<0.01); the protein expression level of SIRT1 of myocardial cells in group MM was 0.35±0.06, significantly lower than 1.12±0.11 in group MMC (P<0.01). After transfection of 48 h, the expression level of microRNA-34a of myocardial cells in group MI was 0.26±0.07, significantly lower than 1.33±0.07 in group MIC (P<0.01); the protein expression level of SIRT1 of myocardial cells in group MIC was 1.12±0.16, significantly lower than 1.74±0.34 in group MI (P<0.01). At 6 h after culture, compared with those in group MCB, the SIRT1 protein expression level of myocardial cells in group MB was significantly increased (P<0.05), while cleaved-caspase-3 and Bax protein expression levels of myocardial cells in group MB were significantly decreased (P<0.05). Compared with those in group MB, the SIRT1 protein expression level of myocardial cells in group MBE was with no significantly statistical difference (P>0.05), and cleaved-caspase-3 and Bax protein expression levels were significantly increased (P<0.05). (2) At 6 h post injury, compared with that in group SI, the microRNA-34a expression level of myocardial tissue in group SB was significantly increased (P<0.01), and the mRNA expression level of SIRT1 of myocardial tissue in group SB was significantly decreased (P<0.01). At 6 h post injury, myocardial cells in group SI arranged neatly with normal nucleus and no inflammatory cells infiltration; myocardial cells in group SB arranged disorderly, with no abnormal nucleus, and obvious inflammatory cells infiltration; myocardial cells in group SA arranged neatly, with normal nucleus and little inflammatory cells infiltration. At 6 h post injury, compared with those in group SB, the mRNA expression levels of IL-1β and TNF-α, and the protein expression levels of cleaved-caspase-3 and Bax of myocardial tissue in groups SI and SA were significantly decreased (P<0.01). Conclusions The microRNA-34a expression level of myocardial tissue of rats with severe burns at early stage increases, which decreases the expression level of SIRT1, and increases the expression levels of IL-1β, TNF-α, cleaved-caspase-3 and Bax, leading to obvious myocardial damage. Activation of SIRT1 can alleviate myocardial damage of rats with severe burns at early stage through decreasing expression levels of IL-1β, TNF-α, cleaved-caspase-3, and Bax.