BACKGROUND AND OBJECTIVES:The dietary inflammatory potential, assessed by the Dietary Inflammatory Index (DII), may influence ischemic stroke (IS) risk, but evidence from high-incidence regions in China remains limited. This study aimed to investigate the associations among dietary patterns, the DII, and IS in Eastern China. METHODS AND STUDY DESIGN:In a hospital-based case-control study in Zhejiang, China, 223 IS patients and 510 age- and sex-matched controls completed a validated food frequency questionnaire. DII scores were calculated, and dietary patterns were derived using factor analysis. Multivariate logistic regression models were used to calculate odds ratios and 95% confidence intervals (CIs). RESULTS:A "Jiangnan red-sauce and heavy oil" pattern, characterized by high intake of refined grains, salted vegetables, processed meats, and fats, was associated with higher DII scores and an increased IS risk (OR = 1.85; 95% CI: 1.74-2.51; top versus bottom tertile). Conversely, a "Traditional Chinese" pattern, rich in whole grains, vegetables, fruits, and legumes, was correlated with lower DII scores and a potentially reduced IS risk (OR = 0.85; 95% CI: 0.76-0.94). CONCLUSIONS:The findings suggest that pro-inflammatory diets were associated with a high likelihood of IS, while anti-inflammatory patterns, such as the Traditional Chinese diet, may be protective. The findings may also provide insights for dietary prevention strategies in the high-risk populations, pending confirmation from prospective studies.

Objectives: The aim was to develop and validate the Communities Geriatric Mild Cognitive Impairment Risk Calculator (CGMCI-Risk), aiding community healthcare workers in the early identification of individuals at high risk of mild cognitive impairment (MCI). Methods: Based on nationally representative community survey data, backward stepwise regression was employed to screen the variables, and logistic regression was utilized to construct the CGMCI-Risk. Internal validation was conducted using bootstrap resampling, while external validation was performed using temporal validation. The area under the receiver operating characteristic curve (AUROC), calibration curve, and decision curve analysis (DCA) were employed to evaluate the CGMCI-Risk in terms of discrimination, calibration, and net benefit, respectively. Results: The CGMCI-Risk model included variables such as age, educational level, sex, exercise, garden work, TV watching or radio listening, Instrumental Activity of Daily Living (IADL), hearing, and masticatory function. The AUROC was 0.781 (95% CI = 0.766 to 0.796). The calibration curve showed strong agreement, and the DCA suggested substantial clinical utility. In external validation, the CGMCI-Risk model maintained a similar performance with an AUROC of 0.782 (95% CI = 0.763 to 0.801). Conclusions: CGMCI-Risk is an effective tool for assessing cognitive function risk within the community. It uses readily predictor variables, allowing community healthcare workers to identify the risk of MCI in older adults over a three-year span.

Objective The aim of this study was to investigate the possible causal relationship between COVID-19 and the risk of pre-eclampsia/eclampsia using a Mendelian randomized (MR) design.Methods We estimated their genetic correlations and then performed two-sample Mendelian randomization analyses using pooled statistics from the COVID-19 susceptibility/hospitalization genome-wide association study and the pre-eclampsia/eclampsia datasets. The main analyses were performed using the inverse variance weighting method, supplemented by the weighted median method and the MR-Egger method.Results We identified a significant and positive genetic correlation between COVID-19 susceptibility and pre-eclampsia/eclampsia [OR = 1.23 (1.01-1.51), p = 0.043]. Meanwhile, hospitalization of COVID-19 was significantly associated with a higher risk of pre-eclampsia/eclampsia [OR = 1.15 (1.02-1.30), p = 0.024]. Consistently, hospitalization of COVID-19 were nominally associated with higher risk of pre-eclampsia [OR = 1.14, (1.01-1.30), p = 0.040]. The results were robust under all sensitivity analyses.Conclusion These results suggest that COVID-19 may increase the risk of pre-eclampsia/eclampsia. Future development of preventive or therapeutic interventions should emphasize this to mitigate the complications of COVID-19.

总结 1 例抗CASPR2 抗体脑炎并发阵发性交感神经过度兴奋综合征和呼吸衰竭患者的护理经验.护理要点包括:阵发性交感神经过度兴奋综合征的双轨制识别及分层式干预,加强呼吸衰竭的病情预警与多团队的急救护理,实施序贯式营养支持,促进综合性康复护理.患者住院 28d,经治疗和护理,病情好转,转康复科行康复治疗后顺利出院.

目的 总结帕金森患者睡眠障碍评估与护理干预的最佳证据,帮助帕金森病患者改善睡眠障碍,为临床护理工作提供参考.方法 系统检索国内外数据及相关网站中关于帕金森病患者睡眠障碍的所有证据,检索文献类型包括指南、专家共识、临床决策、证据总结、系统评价及最新的基础研究.检索时限为建库至2022年11月.由2名研究者对纳入文献的质量进行评价,对符合标准的文献进行资料提取与证据汇总.结果 共纳入10篇文献,包括临床决策3篇、指南2篇、系统评价3篇、专家共识2篇.总结了包括睡眠障碍筛查与评估、护理干预、教育和支持系统4个类别的23条证据.结论 该研究全面、科学地总结了帕金森病患者睡眠障碍评估与护理干预的最佳证据,可为临床医护人员提供循证依据,从而以科学的方法管理帕金森病患者的睡眠障碍,提高患者的生活质量.

总结1例佩里综合征患者的护理经验.护理重点为:做好有创呼吸机及无创呼吸机的序贯治疗管理;给予针对性心理护理;做好低体质量营养管理以及出院指导与随访.患者住院23 d后,携带无创呼吸机顺利出院;随访3个月,未发生严重的呼吸衰竭事件,恢复较好.

目的 观察多专科护理专家联合查房在慢性病护理中的应用效果.方法 组建多专科护理专家团队库,慢性病相关护理单元针对科室慢性病同时合并多种疾病/问题的患者提出联合查房申请,邀请相关专科护理专家进行联合查房评估并讨论,为临床一线护士提供护理决策和技术支持.结果 多专科护理专家联合查房16次,解决针对护理质量和疾病护理的相关问题各31条(分别占46.27％),护理流程和制度相关问题5条(占7.46％);改善了相关护理敏感指标;联合查房后,临床护士专业自我效能感量表的护理实践情况维度高于联合查房前,比较差异有统计学意义(P<0.05).结论 多专科护理专家联合查房在慢性病护理中起到积极作用,提升了护理质量,增强了临床护士的专业自我效能感.

Aim: To analyse the application status of nursing assessment terminology for neurological conditions and determine whether the International Classification of Functioning, Disability, and Health (ICF) covers nursing assessment. Design: A multi-centre cross-sectional study. Methods: Four researchers extracted all nursing problems from the patients of three different hospitals and formed a pool of nursing terminology from the electronic nursing records, self-reports, family reports, medical examinations, and clinical records for all patients. The ICF Linking Rules were then used to map the nursing assessment terminology of neurological conditions with the ICF. Results: Though 37.5% of nursing assessment terms were closely related to neurological diseases, this does not appear in the existing electronic nursing assessment records. The unrecorded rate of 9 (16.1%) terms ranged from 40%-50%, while the unrecorded rate of 8 (14.3%) terms was more than 80%. Overall, 96.4% of nursing assessment terms could be described by the corresponding categories of the ICF, with 37 (66.1%) of the "same" concepts, 9 (16.1%) "similar" concepts, 6 (10.7%) "narrower" concepts (the nursing assessment terms were more specific than the ICF categories), and 2 (3.6%) "broader" concepts (the nursing assessment were less specific than the ICF categories).

目的 观察社区-医院一体化医学营养方式早期干预血糖异常孕妇的成效.方法 对在某社区卫生服务中心门诊常规产检的210例有妊娠期糖尿病高危因素的血糖异常孕妇,实施社区-医院一体化医学营养方式早期干预,观察干预前后的膳食营养素指标和血糖指标变化.结果 干预后孕妇每日饮食摄入的能量、碳水化合物及其供能比、脂肪及其供能比较干预前低,而蛋白质及其供能比较干预前增高.餐后1 h血糖、餐后2 h血糖值随干预时间延长而呈下降态势(P<0.05);空腹、餐后1 h、餐后2 h血糖值与干预时间呈负相关关系.结论 社区-医院一体化医学营养方式早期干预血糖异常孕妇效果较好.

总结4例颈动脉支架成形术后发生脑高灌注综合征患者的护理经验.护理要点包括:密切监测神经系统相关症状,严格控制血压,做好早期癫痫发作的护理,以及相关的基础护理和加强偏瘫肢体的康复锻炼.4例患者经治疗和护理恢复良好,顺利出院.

Aims/Introduction To explore the association between lactation and type 2 diabetes incidence in women with prior gestational diabetes. Materials and Methods We searched PubMed, Embase and the Cochrane Library for cohort studies published through 12 June 2017 that evaluated the effect of lactation on the development of type 2 diabetes in women with prior gestational diabetes. A random effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs). Results A total of 13 cohort studies were included in the meta-analysis. The pooled result suggested that compared with no lactation, lactation was significantly associated with a lower risk of type 2 diabetes (RR 0.66, 95% CI 0.48-0.90, I-2 = 72.8%, P < 0.001). This relationship was prominent in a study carried out in the USA (RR 0.66, 95% CI 0.43-0.99), regardless of study design (prospective design RR 0.56, 95% CI 0.41-0.76; retrospective design RR 0.63, 95% CI 0.40-0.99), smaller sample size (RR 0.52, 95% CI 0.30-0.92, P = 0.024) and follow-up duration >1 years (RR 0.75, 95% CI 0.56-1.00), and the study used adjusted data (RR 0.69, 95% CI 0.50-0.94). Finally, by pooling data from three studies, we failed to show that compared with no lactation, long-term lactation (>1 to 3 months postpartum) was associated with the type 2 diabetes risk (RR 0.69, 95% CI 0.41-1.17). Conclusions The present meta-analysis showed that lactation was associated with a lower risk of type 2 diabetes in women with prior gestational diabetes. Furthermore, no significant relationship between long-term lactation and type 2 diabetes risk was detected. The impact of long-term lactation and the risk of type 2 diabetes should be verified in further large-scale studies.

Objective To apply daily goal health education in the inpatients with stroke,to observe the influence on cognitive attitude to the disease and treatment compliance of patients.Methods A total of 133 cases of inpatients with ischemic stroke were included,which were divided into experimental group (n=67) and control group (n=66),experimental group conducted with daily goal health education mode,while the control group with conventional health education mode.Cognitive attitude to the disease and treatment compliance were all compared in patients when discharged.Results After health education in two ways,scores of disease treatment attitude and social participation attitude of the experimental group [(12.15±2.61) points and (5.70±1.60) points] was higher than the control group [(11.33±1.91) points and (5.02±1.49) points],the difference was statistically significant (t=2.059,2.561,P＜0.05),treatment compliance was higher than control group (x2=6.130-7.063,P＜0.05).Conclusions Daily goal health education can significandy improve the cognitive attitude and the treatment compliance of patients with stoke,which is a good health education mode to the inpatients with stroke.

目的 探讨抗凝剂皮下注射护理规范及其效果评价.方法 运用循证方法得出证据形成建议,制订抗凝剂皮下注射标准、用药规范、定位卡和宣教卡,规范护理,并对护理人员进行培训,设计患者资料表、患者问卷和护士问卷对患者和护士进行调查,并用抗凝剂皮下注射不良反应率、患者对抗凝剂皮下注射知识的知晓率和护士对抗凝剂皮下注射规范护理的掌握率进行效果评价.结果 措施实施后抗凝剂皮下注射不良反应率明显下降,患者知晓率明显提高,护士掌握率明显高于培训前,差异有统计学意义(P＜0.05或P＜0.01).结论 应用循证实践规范抗凝剂皮下注射护理,可改善护理质量,保证药物疗效,促进医疗安全.

Objective To discuss the practice of nursing management model of stroke unit based upon the international standards implemented in the neurological unit.Methods The experiences of the stroke unit management were summarized and applied to instruct the clinical practice.Results After the implementation,the average hospitalization days,the proportion of drugs,medical cost,and mortality rate decreased.The satisfactory degree of patients with the stroke unit increased.Conclusions The nursing management model of stroke unit not only improved the quality of nursing service to stroke patients,but also decreases the mortality and disability rate,shortened the length of hospital stay,and enhanced the satisfaction degree of patients and their family members.