Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective:To integrate qualitative research on the experience of type 2 diabetes patients using self-management APP, so as to provide evidence support for the design and promotion of highly accepted diabetes self-management APP.Methods:This study is a Meta-synthesis. Qualitative research on experience of type 2 diabetes patients using self-management APP was retrieved through computer in China National Knowledge Infrastructure (CNKI) , WanFang, VIP, China Biology Medicine disc Literature Database, PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Ovid (LWW Journals) , Scopus Chinese and English databases. The retrieval time limit was from the establishment of the database to April 30, 2022. According to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, the methodology of the included article was evaluated, and the included article was integrated with the method of pooled Meta-synthesis.Results:A total of 11 articles were included, 48 research findings were extracted and summarized into 3 integration results and 14 new categories. The integration results included that self-management APP promoted patients to form continuous self-management behavior and improved physical and mental health, obstacle factors that affected patients' use of APP, and patients' suggestions for improving the function of APP.Conclusions:Patients feel the benefits of self-management APP, such as correct understanding of diabetes, disease control, and improvement of psychological status. When developing relevant APP, we should pay attention to the change of patient behavior, design the APP function based on user needs, conduct cultural adjustment, improve training and technical support, and improve its acceptance and promotion.

Objective:To systematically review the risk prediction models for hypoglycemia in diabetic patients.Methods:The literatures published up to March 25, 2022 was retrieved from PubMed, Embase, Web of Science, Cochrane Library, CINAHL, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP and SinoMed. Two researchers independently screened the literatures, extracted information, and applied the PROBAST tool to evaluate the quality of the included models.Results:A total of 11 literatures and 13 models were included. The area under the receiver operating characteristic curve or C statistic of all models was 0.666-0.890, with a high risk of bias and a low risk of applicability, and the most included predictors were chronic kidney disease and age. The main reason for the bias in the model were insufficient number of events in the dependent variable, improper handling of continuous variables, and screening of predictors by single factor analysis. Conclusions:The existing hypoglycemia risk prediction models for diabetic patients are still in the development stage, and medical and nursing staff can choose the existing hypoglycemia models according to the results of this systematic review and clinical practice. In the future, we should improve the existing models based on tools or carry out large-sample, multi-center, prospective cohort studies, and build a high-quality hypoglycemia risk prediction model for diabetic patients that is more suitable for China based on more comprehensive and accurate statistical methods and clinical data.

Objective:To investigate the predictive value of serum D-dimer combined with myocardial injury markers on admission for early identification of high-risk patients with acute myocarditis.Methods:Patients hospitalized for acute myocarditis in China-Japan Friendship Hospital were retrospectively enrolled from 2010 to 2021. Patients were divided into the high D-dimer level group and low D-dimer level group according to the median value of D-dimer measured by immunoturbidimetry within 24 h of admission. In-hospital adverse events were defined as death, cardiogenic shock, malignant ventricular arrhythmia and new-onset heart failure. Multivariate logistic analysis was used to explore the independent predictors of in-hospital adverse events, and receiver operating characteristic curve was used to evaluate the predictive value.Results:A total of 106 patients were analyzed, including 52 high level D-dimer patients and 54 low level D-dimer patients, with an average age of (36±16) years, and 62.3% were male. Compared with the low D-dimer level group, patients in the high D-dimer level group had lower mean systolic blood pressure [(114±21) mmHg vs. (121±14) mmHg] and diastolic blood pressure [(71±13) mmHg vs. (76±10) mmHg], higher heart rate [(97±26) beats/min vs. (79±15) beats/min], higher C-reactive protein levels [6.82 (1.61, 20.05) mg/dL vs. 1.30 (0.13, 8.93) mg/dL] and creatinine levels [86.95 (67.63, 117.83) μmol/L vs. 68.80 (60.18, 81.93) μmol/L] on admission. The proportion of patients having QRS interval >120 ms on electrocardiogram was higher in high D-dimer level group (25.0% vs. 7.4%). There was no significant difference in patients with positive myocardial injury biomarkers between the two groups. The incidence of in-hospital adverse events was higher in the high D-dimer level group (67.3% vs. 22.2%, P<0.001). Multivariate logistic analysis showed that serum D-dimer levels and elevated myocardial injury markers on admission were independently associated with in-hospital adverse events. The area under the curve (AUC) of elevated serum D-dimer level on admission for predicting in-hospital adverse events was 0.781 (95% CI: 0.690-0.873), the sensitivity was 74.5%, and the specificity was 71.2%. When combined with positive cardiac biomarkers, the AUC was 0.831 (95% CI: 0.752-0.910) with a sensitivity of 80.9% and a specificity of 78.0%. Conclusions:Elevated D-dimer level on admission can predict the risk of in-hospital adverse events in patients with acute myocarditis. The combination of cardiac injury biomarkers can improve the predictive value.

The National Medical Insurance Administration launched a national pilot project based on diagnosis-related group (DRG) payment across the country in 2019. It optimizes and reuses limited resources from a clinical perspective, controls hospitalization expenses and medical costs, and reduces average hospital stays based on DRG payment. This article expounds the concept and application of DRG payment, from the perspective of clinical nursing, expounds the research progress of DRG payment at home and abroad, attempts to analyze the relationship between DRG payment and nursing, and further proposes the impact on the development of clinical nursing.

Objective:To investigate the influences of age-adjusted Charlson comorbidity index (ACCI) on prognosis of patients undergoing laparoscopic radical gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 242 gastric cancer patients who underwent laparoscopic radical gastrectomy in 19 hospitals of the Chinese Laparoscopic Gastrointestinal Surgery Study Group-04 study, including 54 patients in Fujian Medical University Union Hospital, 32 patients in the First Hospital of Putian City, 32 patients in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 31 patients in Zhangzhou Affiliated Hospital of Fujian Medical University, 17 patients in Nanfang Hospital of Southern Medical University, 11 patients in the First Affiliated Hospital with Nanjing Medical University, 8 patients in Qinghai University Affiliated Hospital, 8 patients in Meizhou People′s Hospital, 7 patients in Fujian Provincial Hospital, 6 patients in Zhongshan Hospital of Fudan University, 6 patients in Longyan First Hospital, 5 patients in the First Affiliated Hospital of Xinjiang Medical University, 5 patients in the First Hospital Affiliated to Army Medical University, 4 patients in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, 4 patients in West China Hospital of Sichuan University, 4 patients in Beijing University Cancer Hospital, 3 patients in the First Affiliated Hospital of Xiamen University, 3 patients in Guangdong Provincial People′s Hospital, 2 patients in the First Affiliated Hospital of Xi′an Jiaotong University, from September 2016 to October 2017 were collected. There were 193 males and 49 females, aged 62(range, 23?74)years. Observation indicators: (1) age distribution, comorbidities and ACCI status of patients; (2) the grouping of ACCI and comparison of clinicopathological characteristics of patients in each group; (3) incidence of postoperative early complications and analysis of factors affecting postoperative early complications; (4) follow-up; (5) analysis of factors affecting the 3-year recurrence-free survival rate of patients. Follow-up was conducted using outpatient examination or telephone interview to detect postoperative survival of patients up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the nonparametric rank sum test. The X-Tile software (version 3.6.1) was used to analyze the best ACCI grouping threshold. The Kaplan-Meier method was used to calculate survival rates and draw survival curves. The Log-Rank test was used for survival analysis. The Logistic regression model was used to analyze the factors affecting postoperative early complications. The COX proportional hazard model was used for univariate and multivariate analyses of factors affecting the 3-year recurrence-free survival rate of patients. Multivariate analysis used stepwise regression to include variables with P<0.05 in univariate analysis and variables clinically closely related to prognosis. Results:(1) Age distribution, comor-bidities and ACCI status of patients. Of the 242 patients, there were 28 cases with age <50 years, 68 cases with age of 50 to 59 years, 113 cases with age of 60 to 69 years, 33 cases with age of 70 to 79 years. There was 1 patient combined with mild liver disease, 1 patient combined with diabetes of end-organ damage, 2 patients combined with peripheral vascular diseases, 2 patients combined with peptic ulcer, 6 patients combined with congestive heart failure, 8 patients combined with chronic pulmonary diseases, 9 patients with diabetes without end-organ damage. The ACCI of 242 patients was 2 (range, 0-4). (2) The grouping of ACCI and comparison of clinicopathological characteristics of patients in each group. Results of X-Tile software analysis showed that ACCI=3 was the best grouping threshold. Of the 242 patients, 194 cases with ACCI <3 were set as the low ACCI group and 48 cases with ACCI ≥3 were set as the high ACCI group, respectively. Age, body mass index, cases with preoperative comorbidities, cases of American Society of Anesthesiologists classification as stage Ⅰ, stage Ⅱ, stage Ⅲ, tumor diameter, cases with tumor histological type as signet ring cell or poorly differentiated adenocarcinoma and cases with tumor type as moderately or well differentiated adenocarcinoma, cases with tumor pathological T staging as stage T1, stage T2, stage T3, stage T4, chemotherapy cycles were (58±9)years, (22.6±2.9)kg/m 2, 31, 106, 85, 3, (4.0±1.9)cm, 104, 90, 16, 29, 72, 77, 6(4,6) in the low ACCI group, versus (70±4) years, (21.7±2.7)kg/m 2, 23, 14, 33, 1, (5.4±3.1)cm, 36, 12, 3, 4, 13, 28, 4(2,5) in the high ACCI group, showing significant differences in the above indicators between the two groups ( t=-14.37, 1.98, χ2=22.64, Z=-3.11, t=-2.91, χ2=7.22, Z=-2.21, -3.61, P<0.05). (3) Incidence of postoperative early complications and analysis of factors affecting postoperative early complications. Of the 242 patients, 33 cases had postoperative early complications, including 20 cases with local complications and 16 cases with systemic complica-tions. Some patients had multiple complications at the same time. Of the 20 patients with local complications, 12 cases had abdominal infection, 7 cases had anastomotic leakage, 2 cases had incision infection, 2 cases had abdominal hemorrhage, 2 cases had anastomotic hemorrhage and 1 case had lymphatic leakage. Of the 16 patients with systemic complications, 11 cases had pulmonary infection, 2 cases had arrhythmias, 2 cases had sepsis, 1 case had liver failure, 1 case had renal failure, 1 case had pulmonary embolism, 1 case had deep vein thrombosis, 1 case had urinary infection and 1 case had urine retention. Of the 33 cases with postoperative early complications, there were 3 cases with grade Ⅰ complications, 22 cases with grade Ⅱ complications, 5 cases with grade Ⅲa complications, 2 cases with grade Ⅲb complications and 1 case with grade Ⅳ complica-tions of Clavien-Dindo classification. Cases with postoperative early complications, cases with local complications, cases with systemic complications were 22, 13, 9 in the low ACCI group, versus 11, 7, 7 in the high ACCI group, respectively. There were significant differences in cases with postoperative early complications and cases with systemic complications between the two groups ( χ2=4.38, 4.66, P<0.05), and there was no significant difference in cases with local complications between the two groups ( χ2=2.20, P>0.05). Results of Logistic regression analysis showed that ACCI was a related factor for postoperative early complications of gastric cancer patients undergoing laparoscopic radical gastrectomy [ odds ratio=2.32, 95% confidence interval ( CI) as 1.04-5.21, P<0.05]. (4) Follow-up. All the 242 patients were followed up for 36(range,1?46)months. During the follow-up, 53 patients died and 13 patients survived with tumor. The 3-year recurrence-free survival rate of the 242 patients was 73.5%. The follow-up time, cases died and cases survived with tumor during follow-up, the 3-year recurrence-free survival rate were 36(range, 2-46)months, 29, 10, 80.0% for the low ACCI group, versus 35(range, 1-42)months, 24, 3, 47.4% for the high ACCI group. There was a significant difference in the 3-year recurrence-free survival rate between the two groups ( χ2=30.49, P<0.05). (5) Analysis of factors affecting the 3-year recurrence-free survival rate of patients. Results of univariate analysis showed that preoperative comorbidities, ACCI, tumor diameter, histological type, vascular invasion, lymphatic invasion, neural invasion, tumor pathological TNM staging, postoperative early complications were related factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy [ hazard ratio ( HR)=2.52, 3.64, 2.62, 0.47, 2.87, 1.90, 1.86, 21.77, 1.97, 95% CI as 1.52-4.17, 2.22-5.95, 1.54-4.46, 0.27-0.80, 1.76-4.70, 1.15-3.12, 1.10-3.14, 3.01-157.52, 1.11-3.50, P<0.05]. Results of multivariate analysis showed that ACCI, tumor pathological TNM staging, adjuvant chemotherapy were indepen-dent influencing factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy ( HR=3.65, 11.00, 40.66, 0.39, 95% CI as 2.21-6.02, 1.40-86.73, 5.41-305.69, 0.22-0.68, P<0.05). Conclusions:ACCI is a related factor for post-operative early complications of gastric cancer patients undergoing laparos-copic radical gastrectomy. ACCI, tumor pathological TNM staging, adjuvant chemotherapy are indepen-dent influencing factors for postoperative 3-year recurrence-free survival rate of gastric cancer patients undergoing laparoscopic radical gastrectomy.

OBJECTIVES: To examine the changes of coenzyme Q10 (CoQ10) and β-galactosyl transferase specific chaperone 1 (C1GALT1C1) in brain of rats with ischemic injury at different time points and to explore the protective mechanism of ultrashort wave (USW) on ischemic brain injury. METHODS: Fifty SD rats were randomly divided into 5 groups (=10 per group): a sham group (control group) and 4 experimental group (ischemia for 2 h). The 4 experimental groups were set as a model 1 d group, a USW 1 d group, a model 3 d group and a USW 3 d group, respectively. Five rats were randomly selected for 2,3,5-triphenyltetrazoliumchloride (TTC) staining in each experimental group, and the remaining 5 rats were subjected to Western blotting and real-time PCR. The percentage of cerebral infarction volume and the relative expression level of CoQ10 and C1GALT1C1 in the brain were examined and compared. RESULTS: The infarct volume percentage after TTC staining was zero in the sham group. With the progress of disease and USW therapy, the infarct volume percentage was decreased in the experimental groups (all <0.05); Western blotting and real-time PCR showed that the relative expression level of CoQ10 in the sham group was the highest, while in the experimental groups, the content of CoQ10 showed a upward trend with the extension of disease and USW therapy, with significant difference (all <0.05). The relative expression level of C1GALT1C1 in the sham group was the lowest, but in the experimental groups, they showed a downward trend with the extension of disease and USW therapy, with significant difference (all <0.05). CONCLUSIONS Non-caloric USW therapy may upregulate the expression of CoQ10 to suppress the expression of C1GALT1C1 in rats, leading to alleviating cerebral ischemic reperfusion injury.
Animals ; Brain ; Brain Ischemia ; Molecular Chaperones ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; Ubiquinone ; analogs & derivatives

In the middle of December in 2019, a pneumonia outbreak caused by a new coronavirus, 2019 novel coronavirus (2019-nCoV), emerged in the populations in Wuhan city of China. The epidemic spreads rapidly and has been disseminated throughout the country and to 13 other counties in Asia, Europe, Oceania and North America. To accurately and deeply understand the biological characteristics, epidemiological features and pathogenicity of 2019-nCoV and related immunological characteristics, microbiological examinations and public protection measure, this study reviewed 2019-nCoV and 2019-nCoV pneumonia based on the newest relevant literatures and the newest version of National Diagnosis and Treatment Scheme of 2019-nCoV pneumonia.

Objective To observe the clinical effect of cardiopulmonary resuscitation (CPR) in the treatment of cardiac arrest. Methods A retrospective analysis was coducted, 137 patients with cardiac arrest admitted to Department of Emergency of Fuyang People's Hospital from January 2017 to December 2018 were enrolled, emergency rescue with CPR machine. There were 116 cases of CPR in emergency room, including 44 cases of cardiac arrest before hospital and 72 cases of cardiac arrest in hospital. There were CPR was 21 cases of CPR in EICU. The difference of return of spontaneous circulation (ROSC) rate and rescue time between Emergency Room and Emergency Intensive Care Unit (EICU) and ROSC rate in patients with cardiac arrest before and after emergency rescue room were compared. Results There were 45 cases of ROSC in 137 patients, the success rate of rescue was 32.85%, rescue time was 30.00 (20.00-40.00) minutes, and the maximum duration of times was 180 minutes. The ROSC rate of EICU was significantly higher than that of emergency room [66.67% (14/21) vs. 26.72% (31/116), P < 0.05], and the rescue time was significantly shorter than that of emergency room [minutes: 25.00 (10.00-30.00) vs. 30.00 (25.00-40.00), P < 0.05]. The ROSC rate of patients with cardiac arrest in emergency room was significantly higher than that before hospitalization [33.33% (24/72) vs. 15.91% (7/44), P < 0.05], there was no significant difference in rescue time between patients with cardiac arrest in emergency room and that before hospitalization [minutes: 30.00 (20.00-40.00) vs. 30.00 (26.25-40.00), P > 0.05]. Conclusions The function of CPR provides high quality extrathoracic compression, which effectively saves the labor cost of cardiac compression, especially in the case of shortage of medical and nursing staff. In the face of patients who need continuous CPR for a long time, it is a feasible choice to use CPR machine instead of unarmed CPR, which is worth popularizing in clinic.

Objective To compare the radiographic and clinical outcomes of uniaxial and polyaxial locking plates used in the treatment of Sanders types Ⅳ intra-articular calcaneal fractures. Methods A retrospective comparative study was performed on the 72 patients with Sanders types Ⅳintra-articular calcaneal fractures who had been treated by uniaxial locking plates (A group, 38 cases) or polyaxial locking plates (B group, 34 cases) between January 2012 and December 2016. Operation time, intraoperative bleeding, union time, radiological and functional outcomes and functions by the Maryland foot score were compared between the two groups. Results There were no significant differences between the two groups in operation time, intraoperative bleeding, or union time (P>0.05). The patients in A group were followed up for (23.2 ± 5.4) months, and those in B group were followed up for (22.5 ± 4.9) months. All the patients obtained bony union. B group displayed significantly better Bohler angles [(31.6 ± 4.5)° vs. (27.6 ± 6.1)°, (30.7 ± 4.2)° vs.(27.0 ± 5.4)°] and Gissane angles [(109.2 ± 10.8)° vs. (96.8 ± 9.5)°, (107.3 ± 10.1)° vs. (95.4 ± 10.2)°] at 3 and 12 months after operation , compared with A group (P<0.05). Evaluated by the Maryland foot score, the excellent and good rate for the B group was 91.2％(31/34) , which was insignificantly higher than that for the A group (84.2％, 32/38) (P > 0.05). Conclusions Both uniaxial locking and polyaxial locking plates can lead to satisfactory therapeutic outcomes for Sanders types Ⅳ intra-articular calcaneal fractures, but polyaxial locking plates may be superior in stability and functional recovery.