Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at t...Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.展开更多
BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of ...Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of this work was to determine the frequency of mental disorders during the postpartum period at the University Community Health Center of Konobougou in Mali. Methods: This descriptive cross-sectional study took place from March 1 to July 31, 2022, for four months. Results: The study involved 201 immediate postpartum women at the Konobougou Community and University Health Center. The 20-35 age group accounted for 70.00% of the population;the average age was 24 years ± 5.95 years, with a range of 15 to 45 years. Married women made up 96.00% of the sample. The overall frequency of mental disorders was 15.92%. The mental disorders recorded were postpartum depression (5.47%), anxiety disorders (3.98%), postpartum blues (5.47%), and posttraumatic stress disorder (0.50%). Puerperal psychosis was found in 0.50% of the participants. Conclusion: This study revealed a high prevalence of mental disorders among postpartum women in Konobougou, Mali. During postnatal consultations, health workers should prioritize screening for mental health disorders.展开更多
Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the re...Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.Methods:We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province,China.Face-to-face interviews were used to complete a structured questionnaire for all participants.We used the Social Health Scale for the Elderly(SHSE)to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms.Multivariate logistic regression was used to evaluate the asso?ciation between social health status and depressive symptoms.Results:Of the total of 3757 participants included,1887(50.23%)were female,and the mean±standard deviation(SD)age was(70.0±8.3)years.The rate of depressive symptoms was 25.92%.The social health score was higher in non?depressed participants than in depressed participants(raw score 50.7 vs.48.3,P<0.001).Participants with"moderate”or"good”social health had a significantly lower risk of depressive symptoms than those with“poor"social health(odds ratio(OR)=0.55,95%con fide nee interval(Cl):0.46-0.66 for moderate social health;OR=0.45,95%Cl:0.35-0.60 for good social health).The association between social health and depressive symptoms was con sistent across several subgroups.Con clusi ons:Social health is signify cantly inversely associated with depressive symptoms.The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits,but systematic assessment to guide intervention merits further investigation.展开更多
Background Many studies have demonstrated the effectiveness of Screening,Brief Intervention and Referral to Treatment(SBIRT)in addressing substance use problem.However,owing to the shortage of counsellors,it has not b...Background Many studies have demonstrated the effectiveness of Screening,Brief Intervention and Referral to Treatment(SBIRT)in addressing substance use problem.However,owing to the shortage of counsellors,it has not been widely used in China.With the development of smart medicine,we developed a web-based electronic SBIRT(E-SBIRT)program and explored the effectiveness of E-SBIRT in reducing substance use in China.Methods A randomised controlled trial will be conducted in primary healthcare institutions.Four primary healthcare institutions will be selected and randomly divided into an intervention group and a control group(each institution will recruit 60 participants,and in total,240 participants will be recruited).The control group will get a pamphlet of drug abuse prevention,and the intervention group will get the E-SBIRT intervention and the pamphlet.Both groups will receive baseline and follow-up assessment at 1 and 3 months after the intervention.The primary outcome is the change in scores on the Alcohol,Smoking and Substance Use Involvement Screening Test,and the secondary outcomes include changes in motivation,depression,anxiety,positive/negative emotion,self-esteem,addiction knowledge and addiction severity index.Conclusions If the‘E-SBIRT’program is found to be effective,it will be an accessible,affordable and widely implementable intervention to help participants at moderate risk of substance use to reduce their consumption.The potential benefit is to provide early intervention to high-risk patients in time and reduce the harmful consequences to individuals and society.展开更多
Dear Editor,Te Veterans Health Administration(VHA)provides healthcare for over 9 million enrolled veterans with approximately 2.7 million of those residing in rural areas[1].Te MISSION Act of 2018 emphasizes VHA colla...Dear Editor,Te Veterans Health Administration(VHA)provides healthcare for over 9 million enrolled veterans with approximately 2.7 million of those residing in rural areas[1].Te MISSION Act of 2018 emphasizes VHA collaboration with Federally Qualifed Healthcare Centers(FQHC)to serve rural residing veterans and nearly all existing collaborations involve arrangement of payment for community-based care by VHA to FQHCs.Unfortunately,there is a paucity of descriptive clinical data on existing cross-system collaborations which may help characterize these veterans and aid understanding of conditions for which they may receive treatment across systems.Such data has implications for workforce training,development,and resource allocation[2].Te objective of this report is to describe diferent clinical profles between two mutually exclusive samples:veterans engaged in FQHC only use,and VHA-enrolled veterans engaged in dual VHA and FQHC use.展开更多
The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Man...The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.展开更多
This article will investigate on the current needs of community service for residents in Tianjin city by providing nursing services at a targeted community.The demands for community nursing services in Tianjin city we...This article will investigate on the current needs of community service for residents in Tianjin city by providing nursing services at a targeted community.The demands for community nursing services in Tianjin city were investigated by sending questionnaire to targeted general residents and communities.As collected from the questionnaire,the most common diseases that were mentioned are hypertension(33.2%),coronary heart disease(27.8%),and diabetes(15.7%).63.0%of the residents have health records and 79.7%of the residents have seen a doctor in community hospitals.As results,the highest demands on general nursing services in the community are a regular physical examination,health consultations,and regular home visits.Moreover,the control and management service demands specifically for chronic diseases are a regular heart rate examination,blood pressure examination,blood sugar examination,drug administration,and a diet management.In conclusion,as the age structure of community is higher,a higher demand is needed in providing health services such as caring for chronic disease patients and geriatric,which is conducive in improving the quality and the satisfactory needs of health services for residents in Tianjin,China.展开更多
Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have fac...Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.展开更多
Objective: to observe the effect and significance of health management in the prevention and treatment of senile chronic diseases in community. Methods: the elderly patients in the railway station community of our cou...Objective: to observe the effect and significance of health management in the prevention and treatment of senile chronic diseases in community. Methods: the elderly patients in the railway station community of our county were included in the management experiment. 82 subjects had chronic diseases. Use the time grouping method to complete the statistics before and after management. In order to obtain the body status of elderly chronic objects in different community areas, and count their chronic disease related health indicators. Results: the health indexes related to chronic diseases after management were higher than those before management. In the comparison of data in different stages, P < 0.05. Conclusion: allowing elderly patients with chronic diseases in the community to receive health management in time can strengthen the prevention and treatment of diseases, promote them to develop good life rules, and has the significance of popularization and implementation.展开更多
Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital...Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.展开更多
This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review...This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review of recent related studies,it analyzes new insights into the etiology and pathogenesis of Alzheimer’s disease within TCM and summarizes novel methods and achievements in the prevention and treatment of the disease using TCM.Based on the TCM principles of“preventive treatment”and holistic health,innovative intervention models with Chinese characteristics,such as the“brain-heart-kidney axis”and“brain-gut connection,”have shown new breakthroughs in improving cognitive function and slowing disease progression.The article also explores the benefits of shifting preventive and therapeutic measures to earlier stages,contributing to the establishment of an integrated community prevention model of“prevention-intervention-rehabilitation.”展开更多
According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderl...According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderly have become a significant concern for society.Common brain diseases among the elderly,including cerebrovascular diseases,genetic factors,or long-term solitary living,can all lead to dementia,with Alzheimer’s disease(AD)being the most common.Early symptoms of AD mainly include memory loss and difficulty concentrating,which are often mistaken for normal aging or stress-related issues and thus overlooked.AD lacks specific biomarkers and effective auxiliary diagnostic methods,making it difficult to accurately diagnose with existing imaging and neuroprotein indicators.Therefore,early detection of AD is very challenging.This article explores community-based early detection and intervention strategies from the perspectives of existing mechanism research,clinical manifestations,modern drug treatments,innovative explorations in traditional medicine,and community-appropriate technologies,aiming to construct an ecological management strategy.展开更多
Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses...Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.展开更多
Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu P...Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.展开更多
Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between J...Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.展开更多
Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile ...Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile based on 1468 blood samples from both human and mouse studies,which include bulk RNA sequencing(RNA-seq),microRNA-seq,and single-cell RNA-seq data.We developed a comprehensive analysis pipeline that conducted over 11 million comparisons and correlations to identify more than 20,000 blood features.With these findings,we established a blood RNA database related to Alzheimer’s disease,RNAs in Blood of AD(RBAD,http://www.bioinform.cn/RBAD/).Using RBAD,we initially validated well-established Alzheimer’s disease-related pathways,including olfactory transduction.We then observed a decrease in both the proportion and functionality of erythroid cells,likely attributed to their elevated CD45 levels and interactions with GZMK^(+)CD8^(+)T cells.Furthermore,we identified 449 blood RNAs linked to patients’overall survival,along with two mRNAs(H4C3 and CTU1)associated with cognitive decline.In summary,RBAD is the first web-based analysis platform dedicated to investigating blood RNA changes in Alzheimer’s disease,and provides valuable insights into potential peripheral biomarkers and pathogenic mechanisms related to Alzheimer’s disease.展开更多
Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled tria...Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.展开更多
Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategie...Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
文摘Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
文摘Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of this work was to determine the frequency of mental disorders during the postpartum period at the University Community Health Center of Konobougou in Mali. Methods: This descriptive cross-sectional study took place from March 1 to July 31, 2022, for four months. Results: The study involved 201 immediate postpartum women at the Konobougou Community and University Health Center. The 20-35 age group accounted for 70.00% of the population;the average age was 24 years ± 5.95 years, with a range of 15 to 45 years. Married women made up 96.00% of the sample. The overall frequency of mental disorders was 15.92%. The mental disorders recorded were postpartum depression (5.47%), anxiety disorders (3.98%), postpartum blues (5.47%), and posttraumatic stress disorder (0.50%). Puerperal psychosis was found in 0.50% of the participants. Conclusion: This study revealed a high prevalence of mental disorders among postpartum women in Konobougou, Mali. During postnatal consultations, health workers should prioritize screening for mental health disorders.
基金Project supported by the Ministry of Science and Technology of the People’s Republic of China(No.2015FY111600)
文摘Objective:Mental disorders of the elderly population in China deserve attention.Social health is significantly associated with depression.This study aimed to evaluate the rate of depressive symptoms and to test the relationships between social health and depressive symptoms among a large sample of community-dwelling elderly adults.Methods:We conducted a cross-sectional study among community-dwelling adults aged 60 years or above in Zhejiang Province,China.Face-to-face interviews were used to complete a structured questionnaire for all participants.We used the Social Health Scale for the Elderly(SHSE)to evaluate social health status and used the short form of the Geriatric Depression Scale to evaluate depressive symptoms.Multivariate logistic regression was used to evaluate the asso?ciation between social health status and depressive symptoms.Results:Of the total of 3757 participants included,1887(50.23%)were female,and the mean±standard deviation(SD)age was(70.0±8.3)years.The rate of depressive symptoms was 25.92%.The social health score was higher in non?depressed participants than in depressed participants(raw score 50.7 vs.48.3,P<0.001).Participants with"moderate”or"good”social health had a significantly lower risk of depressive symptoms than those with“poor"social health(odds ratio(OR)=0.55,95%con fide nee interval(Cl):0.46-0.66 for moderate social health;OR=0.45,95%Cl:0.35-0.60 for good social health).The association between social health and depressive symptoms was con sistent across several subgroups.Con clusi ons:Social health is signify cantly inversely associated with depressive symptoms.The SHSE may serve as an efficient screener to identify those elderly adults with social health deficits,but systematic assessment to guide intervention merits further investigation.
基金This work was supported by the Shanghai Mental Health Center(SMHC)Clinical Research Center Project(CRC2017YB04).
文摘Background Many studies have demonstrated the effectiveness of Screening,Brief Intervention and Referral to Treatment(SBIRT)in addressing substance use problem.However,owing to the shortage of counsellors,it has not been widely used in China.With the development of smart medicine,we developed a web-based electronic SBIRT(E-SBIRT)program and explored the effectiveness of E-SBIRT in reducing substance use in China.Methods A randomised controlled trial will be conducted in primary healthcare institutions.Four primary healthcare institutions will be selected and randomly divided into an intervention group and a control group(each institution will recruit 60 participants,and in total,240 participants will be recruited).The control group will get a pamphlet of drug abuse prevention,and the intervention group will get the E-SBIRT intervention and the pamphlet.Both groups will receive baseline and follow-up assessment at 1 and 3 months after the intervention.The primary outcome is the change in scores on the Alcohol,Smoking and Substance Use Involvement Screening Test,and the secondary outcomes include changes in motivation,depression,anxiety,positive/negative emotion,self-esteem,addiction knowledge and addiction severity index.Conclusions If the‘E-SBIRT’program is found to be effective,it will be an accessible,affordable and widely implementable intervention to help participants at moderate risk of substance use to reduce their consumption.The potential benefit is to provide early intervention to high-risk patients in time and reduce the harmful consequences to individuals and society.
基金supported in part by an award from the VHA Office of Rural Health,Veterans Rural Health Resource CenterDIowa City(VRHRC-IC),Iowa City VA Health Care System,Iowa City,IA(Award#7345)。
文摘Dear Editor,Te Veterans Health Administration(VHA)provides healthcare for over 9 million enrolled veterans with approximately 2.7 million of those residing in rural areas[1].Te MISSION Act of 2018 emphasizes VHA collaboration with Federally Qualifed Healthcare Centers(FQHC)to serve rural residing veterans and nearly all existing collaborations involve arrangement of payment for community-based care by VHA to FQHCs.Unfortunately,there is a paucity of descriptive clinical data on existing cross-system collaborations which may help characterize these veterans and aid understanding of conditions for which they may receive treatment across systems.Such data has implications for workforce training,development,and resource allocation[2].Te objective of this report is to describe diferent clinical profles between two mutually exclusive samples:veterans engaged in FQHC only use,and VHA-enrolled veterans engaged in dual VHA and FQHC use.
文摘The emergence of the Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) pneumonia, also referred to as COVID-19 in New York City in March 2020, has put an overwhelming strain on the healthcare system in the city. Many local hospitals have reported a surge of cases, with most cases presenting with severe respiratory complications. We aim to present a comprehensive surge filter protocol for outpatient programs to mitigate the surge of cases admitted in the emergency rooms and intensive care units (ICUs) of local hospitals in our community. Our surge filter protocol was developed based on a detailed review of how South Korea and Spain mounted their outpatient surge responses. Our preliminary findings revealed that our Four-Ts approach (<em>i.e.</em>, Test, Treat, Track, and Teach) has resulted in none of our patients reaching a clinical requirement for inpatient care.
基金Tianjin 2018 Philosophy and Social Science Planning Project(No.TJGL18-044)1The Natural Science Foundation of Tianjin(No.18JCQNJC11500)。
文摘This article will investigate on the current needs of community service for residents in Tianjin city by providing nursing services at a targeted community.The demands for community nursing services in Tianjin city were investigated by sending questionnaire to targeted general residents and communities.As collected from the questionnaire,the most common diseases that were mentioned are hypertension(33.2%),coronary heart disease(27.8%),and diabetes(15.7%).63.0%of the residents have health records and 79.7%of the residents have seen a doctor in community hospitals.As results,the highest demands on general nursing services in the community are a regular physical examination,health consultations,and regular home visits.Moreover,the control and management service demands specifically for chronic diseases are a regular heart rate examination,blood pressure examination,blood sugar examination,drug administration,and a diet management.In conclusion,as the age structure of community is higher,a higher demand is needed in providing health services such as caring for chronic disease patients and geriatric,which is conducive in improving the quality and the satisfactory needs of health services for residents in Tianjin,China.
基金Supported by Post-Subsidy Funds from the National Clinical Research Center,Ministry of Science and Technology of China,No.303-01-001-0272-08Beijing Municipal Administration of Hospitals Incubating Program,No.PX2022032Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI),No.JYY2023-13.
文摘Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.
文摘Objective: to observe the effect and significance of health management in the prevention and treatment of senile chronic diseases in community. Methods: the elderly patients in the railway station community of our county were included in the management experiment. 82 subjects had chronic diseases. Use the time grouping method to complete the statistics before and after management. In order to obtain the body status of elderly chronic objects in different community areas, and count their chronic disease related health indicators. Results: the health indexes related to chronic diseases after management were higher than those before management. In the comparison of data in different stages, P < 0.05. Conclusion: allowing elderly patients with chronic diseases in the community to receive health management in time can strengthen the prevention and treatment of diseases, promote them to develop good life rules, and has the significance of popularization and implementation.
文摘Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.
基金Shanghai Pudong New District“National Traditional Chinese Medicine Development Comprehensive Reform Experimental Zone”Construction Project(Project No.:PDZY-2024-1003)Shanghai Pudong New District“National Traditional Chinese Medicine Heritage and Innovation Experimental Zone”Project(Project No.:PDZY-2025-0804)。
文摘This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review of recent related studies,it analyzes new insights into the etiology and pathogenesis of Alzheimer’s disease within TCM and summarizes novel methods and achievements in the prevention and treatment of the disease using TCM.Based on the TCM principles of“preventive treatment”and holistic health,innovative intervention models with Chinese characteristics,such as the“brain-heart-kidney axis”and“brain-gut connection,”have shown new breakthroughs in improving cognitive function and slowing disease progression.The article also explores the benefits of shifting preventive and therapeutic measures to earlier stages,contributing to the establishment of an integrated community prevention model of“prevention-intervention-rehabilitation.”
基金Pudong New District“National Comprehensive Reform Experimental Zone for Traditional Chinese Medicine Development”Construction Project(Project No.:PDZY-2024-1003)。
文摘According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderly have become a significant concern for society.Common brain diseases among the elderly,including cerebrovascular diseases,genetic factors,or long-term solitary living,can all lead to dementia,with Alzheimer’s disease(AD)being the most common.Early symptoms of AD mainly include memory loss and difficulty concentrating,which are often mistaken for normal aging or stress-related issues and thus overlooked.AD lacks specific biomarkers and effective auxiliary diagnostic methods,making it difficult to accurately diagnose with existing imaging and neuroprotein indicators.Therefore,early detection of AD is very challenging.This article explores community-based early detection and intervention strategies from the perspectives of existing mechanism research,clinical manifestations,modern drug treatments,innovative explorations in traditional medicine,and community-appropriate technologies,aiming to construct an ecological management strategy.
基金supported by the“Climbing Plan”for Outstanding Young Teachers at Shanghai University of Medicine&Health Sciences(A3-0200-21-311008)Ministry of Education of Humanities and Social Science Project(23YJC630002).
文摘Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.
基金supported by the National Natural Science Foundation of China[grant number 71804064].
文摘Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.
文摘Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.
基金supported by Research and Innovation Foundation of Wuhan Asia General Hospital,No.2022KYCX1-B10(to FH)the Natural ScienceFoundation of Hubei Province,No.2023AFB550(to FH)+2 种基金the National Natural Science Foundation of China,Nos.32400554(to FH),82371444(to YZ)theGuiding Project of the Scientific Research Program of the Department of Education of Hubei Province,No.B2021016(to FH)the Natural Science Foundationof Hubei Province,No.2024AFB853(to QW).
文摘Alzheimer’s disease-associated transcriptomic landscapes have been defined in brain tissue.However,changes in blood RNA and their clinical relevance remain poorly understood.In this study,we developed an RNA profile based on 1468 blood samples from both human and mouse studies,which include bulk RNA sequencing(RNA-seq),microRNA-seq,and single-cell RNA-seq data.We developed a comprehensive analysis pipeline that conducted over 11 million comparisons and correlations to identify more than 20,000 blood features.With these findings,we established a blood RNA database related to Alzheimer’s disease,RNAs in Blood of AD(RBAD,http://www.bioinform.cn/RBAD/).Using RBAD,we initially validated well-established Alzheimer’s disease-related pathways,including olfactory transduction.We then observed a decrease in both the proportion and functionality of erythroid cells,likely attributed to their elevated CD45 levels and interactions with GZMK^(+)CD8^(+)T cells.Furthermore,we identified 449 blood RNAs linked to patients’overall survival,along with two mRNAs(H4C3 and CTU1)associated with cognitive decline.In summary,RBAD is the first web-based analysis platform dedicated to investigating blood RNA changes in Alzheimer’s disease,and provides valuable insights into potential peripheral biomarkers and pathogenic mechanisms related to Alzheimer’s disease.
基金supported by grants from the National Institute of Biomedical Imaging and Bioengineering(NIBIB)of the National Institutes of Health(NIH)under award numbers R01-EB001659(2003-2013)and R01-EB017205(2014-2018)approved by the Institutional Review Boards of Beth Israel Deaconess Medical Center(Boston,MA)and the Massachusetts Institute of Technology(Cambridge,MA).
文摘Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.
基金funding from the China National Key Research and Development Program(No.2023YFC3603104)the National Natural Science Foundation of China(Nos.82472243 and 82272180)+6 种基金the Fundamental Research Funds for the Central Universities(No.226-2025-00024)the Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China(No.LHDMD24H150001)the Key Research&Development Project of Zhejiang Province(No.2024C03240)a collaborative scientific project co-established by the Science and Technology Department of the National Administration of Traditional Chinese Medicine and the Zhejiang Provincial Administration of Traditional Chinese Medicine(No.GZY-ZJ-KJ-24082)he General Health Science and Technology Program of Zhejiang Province(No.2024KY1099)the Project of Zhejiang University Longquan Innovation Center(No.ZJDXLQCXZCJBGS2024016)Wu Jieping Medical Foundation Special Research Grant(No.320.6750.2024-23-07).
文摘Objective:Sepsis exhibits remarkable heterogeneity in disease progression trajectories,and accurate identificationof distinct trajectory-based phenotypes is critical for implementing personalized therapeutic strategies and prognostic assessment.However,trajectory clustering analysis of time-series clinical data poses substantial methodological challenges for researchers.This study provides a comprehensive tutorial framework demonstrating six trajectory modeling approaches integrated with proteomic analysis to guide researchers in identifying sepsis subtypes after laparoscopic surgery.Methods:This study employs simulated longitudinal data from 300 septic patients after laparoscopic surgery to demonstrate six trajectory modeling methods(group-based trajectory modeling,latent growth mixture modeling,latent transition analysis,time-varying effect modeling,K-means for longitudinal data,agglomerative hierarchical clustering)for identifying associations between predefinedsequential organ failure assessment trajectories and 25 proteomic biomarkers.Clustering performance was evaluated via multiple metrics,and a biomarker discovery pipeline integrating principal component analysis,random forests,feature selection,and receiver operating characteristic analysis was developed.Results:The six methods demonstrated varying performance in identifying trajectory structures,with each approach exhibiting distinct analytical characteristics.The performance metrics revealed differences across methods,which may inform context-specificmethod selection and interpretation strategies.Conclusion:This study illustrates practical implementations of trajectory modeling approaches under controlled conditions,facilitating informed method selection for clinical researchers.The inclusion of complete R code and integrated proteomics workflows offers a reproducible analytical framework connecting temporal pattern recognition to biomarker discovery.Beyond sepsis,this pipeline-oriented approach may be adapted to diverse clinical scenarios requiring longitudinal disease characterization and precision medicine applications.The comparative analysis reveals that each method has distinct strengths,providing a practical guide for clinical researchers in selecting appropriate methods based on their specificstudy goals and data characteristics.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
