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Home-based hospice care for the elderly is an important medical service model aimed at providing comprehensive medical and social support for the elderly. However, due to the special needs and difficulties in nursing of the elderly, a single medical service model often fails to meet their needs. Therefore, establishing a collaborative medical and social worker intervention model for elderly home care and shared care has become an important research direction. This article aims to investigate the sharing model of medical and social workers participating in home-based hospice care under the background of population aging, explore a home-based hospice care model suitable for China's elderly care system, standardize and guide the participation of medical and social workers in home-based shared care, leverage the intervention role of social workers, and meet the needs of patients at home. (老年人居家安宁疗护是一种重要的医疗服务模式, 由于老年人的特殊性和照护难度, 单一的医疗服务模式往往难以满足老年人的需求。因此, 建立医务社工联动介入老年居家安宁疗护共照护理模式成为了一个重要的研究方向。本研究探讨老龄化趋势下医务社工联动参与居家安宁疗护的共照模式, 旨在探索适合我国养老体系下的居家安宁疗护模式, 规范化指引医务社工参与居家共照工作, 发挥社工介入作用, 为老年人提供全面的医疗和社会支持。)

Objective To investigate the effect of narrative nursing combined with Traditional Chinese Medicine foot soaking and auricular acupoint pressing in the treatment of post-stroke sleep disorder. Methods From June 2022 to December 2022, 80 patients with sleep disorder after stroke admitted to the Rehabilitation Department of Beijing Longfu Hospital were selected and randomly divided into a control group and a study group, with 40 patients in each group. Patients in the control group received routine nursing intervention, and those in the study group were given narrative nursing combined with Traditional Chinese Medicine foot soaking and auricular acupoint pressing in addition to the routine nursing. Pittsburgh Sleep Quality Index(PSQI) scale was used to measure patient’s sleep quality. Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were performed to evaluate the patient’s anxiety and depression level. Results The PSQI score was decreased in both two groups after intervention, and PSQI score in the study group was lower than that in the control group (P＜0. 01). The HAMA and HAMD scores were decreased in both two groups after intervention, and HAMA and HAMD scores in the study group were lower than that in the control group (P＜0. 01). Conclusion The narrative nursing combined with Traditional Chinese Medicine foot soaking and auricular acupoint pressing can effectively improve the sleep quality of stroke patients with sleep disorder. (目的 探讨叙事护理联合中药泡足和耳穴贴压治疗脑卒中后睡眠障碍的效果。方法 2022年6月—12月, 选取北京市隆福医院康复科收治的脑卒中后睡眠障碍患者80例, 采用随机数字表法分为对照组和研究组, 各40例。对照组患者将接受常规护理干预, 研究组在对照组的基础上接受叙事护理联合中药泡足和耳穴贴压治疗, 采用匹兹堡睡眠质量指数(PSQI)评价患者睡眠质量, 采用汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分评估患者焦虑和抑郁程度。结果 干预后, 两组PSQI量表总分较干预前下降, 且研究组PSQI量表总分低于对照组, 差异有统计学意义(P＜0. 01)。干预后, 两组HAMA和HAMD量表总分较干预前下降, 且研究组HAMA和HAMD量表总分低于对照组, 差异有统计学意义(P＜0. 01)。结论 叙事护理联合中药泡足和耳穴贴压能有效改善脑卒中后睡眠障碍患者的睡眠质量和负性情绪。)

SUMMARY: The target of rapamycin (TOR) kinase serves as a central regulator that integrates nutrient and energy signals to orchestrate cellular and organismal physiology in both animals and plants. Despite significant advancements having been made in understanding the molecular and cellular functions of plant TOR kinases, the upstream regulators that modulate TOR activity are not yet fully elucidated. In animals, the translationally controlled tumor protein (TCTP) is recognized as a key player in TOR signaling. This study reveals that two TCTP isoforms from Cucumis sativus, when introduced into Arabidopsis, are instrumental in balancing growth and defense mechanisms against the fungal pathogen Golovinomyces cichoracearum. We hypothesize that plant TCTPs act as upstream regulators of TOR in response to powdery mildew caused by Podosphaera xanthii in Cucumis. Our research further uncovers a stable interaction between CsTCTP and a small GTPase, CsRab11A. Transient transformation assays indicate that CsRab11A is involved in the defense against P. xanthii and promotes the activation of TOR signaling through CsTCTP. Moreover, our findings demonstrate that the critical role of TOR in plant disease resistance is contingent upon its regulated activity; pretreatment with a TOR inhibitor (AZD‐8055) enhances cucumber plant resistance to P. xanthii, while pretreatment with a TOR activator (MHY‐1485) increases susceptibility. These results suggest a sophisticated adaptive response mechanism in which upstream regulators, CsTCTP and CsRab11A, coordinate to modulate TOR function in response to P. xanthii, highlighting a novel aspect of plant–pathogen interactions. Significance Statement: Target of rapamycin (TOR) signaling pathway serves as a central integrator of diverse nutrient, energy, hormone, and environmental signals, playing a pivotal role in the precise regulation of cellular and organismal physiology. In this study, we reveal a novel mechanism involving the TCTP‐Rab11A module, which significantly contributes to plant stress responses by positively regulating the TOR signaling pathway. This discovery not only enhances our understanding of the complex regulatory networks in plants but also provides potential targets for improving plant resistance to biotic and abiotic stresses. [ABSTRACT FROM AUTHOR]

This paper summarized the clinical experience of hospice care in a patient with end-stage gastrointestinal stromal tumor. The concept, knowledge and skills of hospice care were used to nurse a patient with gastrointestinal stromal tumor in the terminal stage, to help the patient to control symptoms, to provide comfortable care, to solve physical problems and to provide psychological support, spiritual care was provided through dignity therapy and meaning therapy; the patient's right to decision-making was respected, and pre-medical care plans were discussed and family members were instructed to participate effectively in the care. (本文总结1例胃肠道间质瘤终末期患者安宁疗护的临床经验。 运用安宁疗护的理念、知识和技能, 对1例胃肠道间质瘤终末期患者进行护理, 帮助患者症状控制, 提供舒适照护, 解决躯体问题, 提供心理支持; 评估灵性需求, 采取尊严疗法和意义疗法, 提供灵性照护; 尊重患者的自主决策权, 谈论预先医疗照护计划, 指导家属有效参与护理。)

Cellulose nanocrystals (CNCs) can self‐assemble in an aqueous solution to form a chiral nematic liquid crystal structure, which is maintained in the subsequent solid iridescent film and presents a unique structural color. In this study, in order to explore the effect of ultrasound on the optical properties of CNC, CNC films with a chiral nematic helix structure and different structural colors were prepared by ultrasonic‐assisted dispersion and natural static evaporation. Results showed that prolonging the ultrasonic duration significantly increased layer pitches and red‐shifted the color of CNC films, likely due to increased steric hindrance and a larger electric double layer. On this basis, CNC/1,3‐butylene glycol (BG) composite films were prepared with uniform and structural color. Results showed that BG was incorporated into CNCs most likely through hydrogen bonds. Moreover, the presence of BG increased the layer pitches and red‐shifted the structural color of CNC/BG composite films, which indicates that structural color of the film has a good stability response to humidity. On the whole, our work provides a new point of view in understanding the role of ultrasound and small‐molecule additives in the preparation of CNC‐based films. [ABSTRACT FROM AUTHOR]

This article presents an analysis of the determinants of Chinese commercial banks' income diversification decisions. Using a panel dataset comprising 88 Chinese domestic banks from 2003 to 2010, we find that bank diversification reflects a variety of managerial abilities: insolvency risks, cost, capital position, asset scale and ownership structure. A larger ratio of banking assets to gross domestic product and lower interest spread lead to a higher level of diversification. Moreover, national banks and regional banks have different strategic responses to the macroeconomic, and indeed, regulatory environment. Resisting shocks from the banking sector and the macro economy, and supplementing liquidity shortages from intermediation business seem to be the driving forces of national banks to operate in non-banking sectors. [ABSTRACT FROM AUTHOR]

To investigate the stability characteristic of hypersonic flow under the action of a freestream pulse wave, a high-order finite difference method was employed to do direction numerical simulation (DNS) of hypersonic unsteady flow over an 8° half-wedge-angle blunt wedge with freestream slow acoustic wave. The evolution of disturbance wave modes in the boundary layer under a pulse wave and a continuous wave are compared, and the wall temperature effect on the hypersonic boundary layer stability for a pulse wave disturbance is discussed. Results show that, both for a pulse wave and a continuous wave in freestream, the disturbance waves inside the nose boundary layer are mainly a fundamental mode; the Fourier amplitude of pressure disturbance mode in the boundary layer for a pulse wave is far less than that for a continuous wave, and the band frequency of the former is wider than that of the latter. All disturbance modes decay rapidly along the streamwise in the nose boundary layer. In the non-nose boundary layer, the dominant mode is transferred from fundamental mode into second harmonic. The transformation of dominant mode for a pulse wave appears much earlier than that for a continuous wave. Different frequency disturbance modes present different changes along streamline in the boundary layer, and the frequency band narrows around the second harmonic mode along the streamwise. Keen competition and the transformation of energy exist among different modes in the boundary layer. Wall temperature modifies the stability characteristic of the hypersonic boundary layer, which presents little effect on the development of fundamental modes and cooling wall could accelerates the growth of the high frequency mode as well as the dominant mode transformation. [ABSTRACT FROM AUTHOR]