BackgroundHearing loss can exacerbate cognitive decline; therefore, exploring the mechanisms through which hearing loss affects cognitive function is crucial. The current study aimed to investigate the impact of hearing loss on cognitive function and the mediating role played by self-rated health and depressive anxiety symptoms.MethodsUsing stratified whole-group random sampling, the study employed a cross-sectional design and included 624 participants aged ≥65 years from three communities in Urumqi, China. Cognitive function was assessed using the Mini-Mental State Examination. Hearing function and self-rated health were determined by self-report. The 15-item Geriatric Depression Scale and the 7-item Generalized Anxiety Disorder Scale were used to assess depressive anxiety symptoms. Serial mediation analysis was performed using AMOS 26.0.ResultsHearing loss can not only negatively affect cognitive function in older adults directly (direct effect = −0.106; SE = 0.045; 95% confidence interval (CI): −0.201 to −0.016), but also indirectly affect the relationship between hearing loss and cognitive function through self-rated health and depressive anxiety symptoms. The results of the serial mediation analysis showed that the total indirect effect of self-rated health and depressive anxiety symptoms was −0.115 (95% CI: −0.168 to −0.070), and the total effect of the model was −0.221 (95% CI: −0.307 to −0.132), with the total indirect effect accounting for 52.04% of the total effect of the model.ConclusionOur study discovered that there is a partial mediation of the relationship between hearing loss and cognitive function by self-rated health and depressive anxiety symptoms. It is suggested that by enhancing self-rated health and ensuring good mental health, the decline in cognitive function among older adults with hearing loss can be delayed.

BackgroundIntrinsic capacity (IC) can better reflect the physical functioning of older adults. However, few studies have been able to systematically and thoroughly examine its influencing factors and provide limited evidence for the improvement of intrinsic capacity. The objective of this study was to provide a comprehensive description of the overall decline in intrinsic capacity among older persons in the community. Additionally, the study aimed to analyze the composition of the five domains of reduction, compare the rate of decline among older adults and investigate the factors that influence this decline.MethodsThis was a cross-sectional study conducted in the Chinese community. The self-designed general characteristics questionnaire was created based on the healthy aging framework and a systematic review. Intrinsic capacity was assessed with the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), Community Health Record Management System (CHRMS), Mini Nutritional Assessment Brief Form (MNA-SF), and Short Physical Performance Battery (SPPB). The influencing factors of intrinsic capacity were investigated using stepwise logistic regression.ResultsA total of 968 older adults with a mean age of 71.00 (68.00, 76.75) were examined, and 704 older adults (72.7%) showed a decline in intrinsic capacity. There was a decline in at least one domain in 39.3% of older adults, with reductions in each domain ranging from 5.3% (psychological) to 52.4% (sensory). The study examined the composition of domains that experienced a decline in intrinsic capacity. It was found that a combination of sensory and locomotor domains showed the most significant decrease in 44.5% (n = 106) of individuals who experienced a decline in the two domains. Furthermore, a combination of sensory, cognitive, and locomotor domains exhibited a significant decrease in 51.3% (n = 44) of individuals who experienced a reduction in three domains. Lastly, a combination of sensory, vitality, cognitive, and locomotor domains showed the most significant decline in four domains, accounting for 60.0% (n = 15) of the population. Older adults had a higher risk of intrinsic capacity decline if they were older (95% CI:1.158-2.310), had lower education, lived alone (95% CI: 1.133-3.216), smoked (95% CI: 1.163-3.251), high Charlson Comorbidity Index (95% CI: 1.243-1.807) scores, did not regular exercise (95% CI:1.150-3.084), with lower handgrip strength (95% CI: 0.945-0.982).ConclusionsWe found a relatively high prevalence of intrinsic capacity; more attention should be paid to older adults who are older, less educated, live alone, and have more comorbidities. It is imperative to prioritize a healthy lifestyle among older persons who exhibit smoking habits, lack regular exercise, and possess inadequate handgrip strength.

Background Gestational diabetes mellitus (GDM) is very commonly-seen in clinical settings, and GDM patients may have higher levels of anxiety. It's necessary to evaluate the anxiety level and potentially influencing factors in patients with GDM, to provide insights for the management of anxiety of GDM patients. Methods Patients with GDM treated in our hospital from May, 2018 to May, 2020 were included. We evaluated the characteristics of patients and the scores of pregnancy-related anxiety scale for anxiety level, vulnerable personality style questionnaire (VPSQ) for personality, general self-efficacy scale (GSES) for self-efficacy, social support rating scale (SSRS) for social support level. Logistic regression analyses were conducted to identify the potential influencing factors of anxiety in GDM patients. Results A total of 386 GDM patients were included, the incidence of anxiety in patients with GDM was 59.07%. Anxiety was positively correlated with the susceptible personality (r = 0.604, p = 0.023), and it was negatively correlated with self-efficacy and social support (r = -0.586 and -0.598 respectively, all p < 0.05). The education level, monthly income, abnormal pregnancy (miscarriage, premature rupture of membranes) and cesarean section history and first pregnancy were the independent influencing factors for the anxiety in the patients with GDM (all p < 0.05). Conclusions The anxiety of GDM patients is very common, early care and interventions are warranted for those patients with abnormal pregnancy and cesarean section history, first pregnancy, lower education level, and less monthly income.

Background: Although several neuropsychiatric symptoms (NPSs) have been demonstrated to have value in the prediction of the progression of mild cognitive impairment (MCI) to dementia, these symptoms are less studied for the prediction of the transition from normal cognition (NC) to MCI. Methods: Prospective cohort studies were included if they reported on at least one NPS at baseline and had MCI as the outcome. Results: We obtained 13 cohort studies with a total population of 33,066. Depression was the most common neuropsychiatric symptom and could significantly predict transition to MCI (RR = 1.49, 95% CI: 1.13-1.86). However, depression was more capable of predicting amnestic MCI (RR = 1.43, 95% CI: 1.04-1.83) than nonaMCI (RR= 0.96, 95% CI 95% CI: 0.60-1.33). Subgroup analysis suggested that the association between depression and MCI changed with depression severity, depression criteria, apolipoprotein-E-adjusted status, age, the percentage of females, and follow-up times, but some data were too sparse for a reliable estimate. Regarding other NPSs, there were insufficient data to assess their effect on the development of MCI. However, apathy, anxiety, sleep disturbances, irritability, and agitation might be risk factors for the prediction of NC-MCI transition with strong predictive value. Conclusions: Depression was associated with an approximately 1.5-fold sincreased risk of the progression to MCI in the population with normal cognition. Other NPSs with underlying predictive value deserve more attention.

ObjectiveTo systematic analyze the intervention effects of early ambulation on ICU acquired weakness(ICU-AW) in ICU patients. MethodsThe Cochrane Library, PubMed, EMBASE, MEDLINE, CBM, CNKI and Wanfang database were searched via computer for randomized controlled trials on early ambulation to prevent ICU-AW in ICU patients from the data base establishment date to February 10th, 2019.After screening literature, extracting data and evaluating the quality of literature, Meta-analysis was carried out with RevMan 5.3 software. ResultsFinally, 11 randomized controlled trials were included. Meta-analysis results showed that the incidence of ICU-AW was RR=0.52, 95%CI was (0.41, 0.66); muscle strength (MRC-score) WMD=8.08, 95%CI was (6.27, 9.81); Barthel index WMD=18.24, 95%CI was (7.27, 29.2); mechanical ventilation time was WMD=-1.29, 95%CI was (-1.96, -0.61); ICU hospitalization time was MD=-1.81, 95%CI was (-2.78,-0.84); total hospitalization time WMD=-3.39, 95%CI (-5.91, -0.88). ConclusionsBased on the present evidence, early ambulation can reduce the incidence of ICU-AW, improve the activity of daily life ability of patients,shorten the duration of mechanical ventilation, length of stay in ICU and hospital, which is worthy of clinical application.

The influence of mild perioperative hypothermia on the immune function and incidence of postoperative wound infections has been suggested, but the specific mechanism is unclear. This study aimed to analyze the body temperature, immune function, and wound infection rates in patients receiving open surgery for gastric cancer. Body temperature was controlled in each patient using one of four different methods: wrapping limbs, head and neck; insulated blankets; warming infusion fluids and insulated blankets; and warming fluids without insulated blankets. One hundred patients were randomly divided into four groups of 25 patients each, and every group received a different intraoperative treatment for maintaining normal body temperature. Nasopharyngeal and rectal temperatures, transforming growth factor beta (TGF-β), interleukin 10 (IL-10) levels, and cluster of differentiation (CD)3+T and CD4+/CD25+ regulatory T cell (Treg) counts were measured before surgery and at 2 and 4 hours postoperatively. Patients were evaluated at one week after surgery for signs of infection. Intraoperative body temperature and measures of immune function varied significantly between the four groups, with the largest temperature changes observed in the group in which only the limbs were wrapped in cotton pads to control the body temperature. The lowest temperature change (i.e., close to normal temperature) and cytokine response after surgery were observed in the group in which infusion fluids and transfused blood (if needed) were heated to 37℃, peritoneal irrigation fluid was heated to 37℃, and an insulation blanket was heated to 39℃ and placed under the patient. No intergroup differences were found in the infection rates at one week after surgery. In conclusion, body temperature variation during surgery affects the immune function of patients, and maintaining body temperature close to normal results in the least variation of immune function.

目的了解基层医院手术患者不同时段手术切口感染状况,为手术科室及医院感染管理部门预防手术切口感染提供依据。方法采用前瞻性调查方法,随访监测患者住院期间、出院后至手术后30d的切口感染状况。结果患者术后手术切口总感染率为3.28%,显著高于住院期间感染率(1.95%,P<0.01)。不同切口类型、科室、年龄、性别及季节切口感染率比较,差异有统计学意义(均P<0.05);其中Ⅱ类切口、普外科和妇科手术后、36～45岁和≥65岁的患者手术切口感染率较高。结论医护人员及医院感染监测者应严格按照《医院感染诊断标准(试行)》进行切口感染监测;同时,应加强Ⅱ类切口、中老年患者及普外科、妇科手术患者的切口管理,尤其加强出院后患者的切口管理,以降低手术切口感染率。

目的通过对50例皮瓣移植术患者的术后护理,研究转移皮瓣术后护理规范以及术后观察的要点及重点。方法对2008年4月～2010年4月在我科行皮瓣移植术患者50例进行统计分析,总结术后的护理和观察要点。结果本组患者术后皮瓣一期愈合率82.2%,成活率93.3%。皮瓣愈合时间12～25天,平均17天。结论对转移皮瓣患者制订有效的护理程序以及规范的观察项目,可有效化解术后皮瓣成活过程中出现的问题,通过发现问题并及时处理可使转移皮瓣顺利成活,减少皮瓣坏死风险,使患者早日康复。

目的探讨新护士岗前培训的模式和效果。方法对116名新护士每周集中授课2次,连续3个月,分别进行医院概况与护理现状、护理文书书写等12项专题的岗前培训。结果新护士认为护理文书的书写及常见护理表格介绍,法律、法规及常见护理纠纷内容的培训、突发公共卫生事件的应急预案、医院概况与护理现状、临床基本操作技能培训较为重要。48.28%新护士认为3个月的培训时间过长,可集中在1个月完成;培训后新护士的理论知识(除职业防护及护士礼仪外)与操作技能水平显著提高(P<0.05,P<0.01)。结论根据新护士的培训需求,建立适宜的岗前培训模式,可促进新护士尽快适应临床工作。