Objective To construct the intervention effect of occupational therapy-based return to family intervention program on improving cognitive function and quality of life in patients with Alzheimer’s disease. Methods Through literature analysis and expert meeting，the return to family intervention program was formed. 68 patients with Alzheimer’s disease in the department of geriatric psychiatry who were admitted for the first time from April 2021 to October 2021 in a tertiary specialized hospital were selected. According to the community where the patients lived，Liangxi district was the study group and Huishan District was the control group，with 34 cases in each group. The study group carried out return to family intervention on the basis of routine nursing，including online communication，offline family visit，nursing clinic and community group activities，for 6 months. The control group received routine psychiatric nursing. The scores of Mini-Mental State Examination，modified Barthel Index Scale and Quality of Life Scale for Alzheimer’s patients were compared before the intervention，3 months and 6 months after the intervention. Results At 3 months and 6 months after the intervention，the scores of Mini-Mental State Examination，modified Barthel Index Scale，and the total score of Quality of Life Scale for patients with Alzheimer’s disease in the study group were higher than those before the intervention and the control group，and the differences were statistically significant（P<0.05）. The compliances of the study group were 64.52% and 90.32% at 3 months and 6 months after intervention，respectively. Conclusion Return to family intervention based on occupational therapy can improve cognitive function，daily living ability and quality of life in patients with Alzheimer’s disease.

Objective To investigate the characteristics of cardiovascular health score trajectories in patients after percutaneous coronary intervention（PCI）. Methods The convenience sampling method was used to recruit 339 acute myocardial infarction patients who underwent PCI for the first time in the cardiology department of a first-class tertiary hospital in Harbin from May to October 2019 with regular follow-up after PCI. We used the group-based trajectory model to identify the heterogeneous trajectory groups of cardiovascular health score based on the baseline,6 months and 12 months follow-up. The Cox proportional risk regression model was used to analyze the effect of trajectory groups and major adverse cardiac events（MACE）. Results 5 cardiovascular health score trajectories were identified as low-increasing group（19.8%）,medium-declining and then increasing group（24.8%）,medium-rapid increasing group（14.4%）,medium-stable group（31.9%）,high-stable group（9.1%）. Cox proportional risk regression model showed that,after adjustment for potential confounding factors（age,sex,high-density lipoprotein cholesterol and alcohol consumption）,the risk of MACE in medium-declining first and then increasing group,medium-rapid increasing group,medium-stable group and high-stable group were 0.498（P=0.033）,0.446（P=0.049）,0.403（P=0.006） and 0.259（P=0.030） times of low-increasing group,respectively. Conclusion Acute myocardial infarction patients after PCI for a year showed various cardiovascular health score trajectories;the improvement and maintainance of a high level of cardiovascular health score were negatively correlated with the risk of MACE. Medical staff can monitor the characteristics of cardiovascular health score changes dynamically,strengthen risk factor management and adopt early intervention methods to improve prognosis.

Objective To investigate the status and influencing factors of dysphagia in elderly patients with chronic obstructive pulmonary disease（COPD）. Methods A total of 1 268 elderly patients with COPD hospitalized in the respiratory department of 13 general hospitals in Ningxia were selected by convenience sampling method from April 2019 to August 2020. Patients were investigated by the general information questionnaire，the Water Swallowing Test，Modified Medical Research Council Dyspnea Scale，Activities of Daily Living，the Geriatric Depression Scale，the Mini Nutritional Assessment-Short Form，COPD Assessment Test Scale，the FRAIL debilitation assessment scale. Logistic regression analysis was performed to analyze the influencing factors of dysphagia in COPD patients with statistically significant variables. Results The incidence of dysphagia in elderly COPD patients was 20.39%. Logistic regression analysis showed that smoking status，tooth loss，feeding attention，feeding position，PaCO₂，dyspnea，nutritional status and COPD severity were the influential factors of dysphagia（P<0.05）. Conclusion The incidence of dysphagia in elderly COPD patients is higher. COPD patients with severe disease，high degree of dyspnea，high PaCO₂，long-term smoking，number of missing teeth≥6，malnutrition，not paying attention to eating，and semi-recumbent position have a higher risk of dysphagia. Clinical medical staff can formulate relevant intervention measures according to the influencing factors to prevent the occurrence of dysphagia.

Objective To explore the effect of optimizing the treatment process of Mobile Stroke Unit（MSU） on patients with acute ischemic stroke（AIS）. Methods A retrospective analysis was performed on 30 patients with AIS intravenous thrombolysis treated by MSU in our hospital from January to June 2020. Among them,18 patients who received intravenous thrombolysis after MSU process optimization were included in the experimental group,and 12 patients who received intravenous thrombolysis before MSU process optimization in the early operation were included in the control group.The clinical data of the 2 groups was collected,and the nursing efficiency and clinical outcome of the 2 groups were compared. Results In the experimental group,the success rate of the first venous puncture,the time from calling 120 to intravenous thrombolysis,the time from MSU arriving at the scene to intravenous thrombolysis,and the time from onset to intravenous thrombolysis were better than those in the control group,with statistical significance（P<0.05）. There was no significant difference between the time from onset to call 120,the time from call 120 to MSU arrival,the proportion of symptomatic intracranial hemorrhage within 24 h after intravenous thrombolysis,and the ratio of Modified RankinScale（MRS）≤2 at 90 d after thrombolysis（P>0.05）.Conclusion The optimization of the treatment process can effectively shorten the time from onset to intravenous thrombolysis,call 120 to intravenous thrombolysis and the time from MSU to intravenous thrombolysis,and it can also significantly improve the work efficiency of nurses and the quality of patient treatment.

Objective To compare the screening ability of Frailty Phenotype and FRAIL scale for frailty risk in elderly inpatients,and to provide references for clinical selection of appropriate screening tools for frailty.Methods A total of 462 elderly inpatients in a tertiary hospital in Ningxia were selected by convenience sampling method,and the Frailty Index,Frailty Phenotype and FRAIL scale were used to score them. Taking Frailty Index as the diagnostic standard,the predictive value of the 2 scales for frailty risk was compared by the Receiver Operating Characteristic（ROC） and Bayes discriminant analysis.Results The incidences of frailty in elderly hospitalized patients by Frailty Phenotype,FRAIL and Frailty Index were 34.2%,25.1% and 30.5%,respectively. The consistency of the screening results of Frailty Phenotype,FRAIL scale and Frailty Index showed that the Kappa values are 0.511,0.479（P<0.01）.The Frailty Phenotype and FRAIL area under ROC curve are 0.823（95%CI：0.784~0.858） and 0.853（95%CI：0.815~0.885）.The differences are not statistically significant（Z=1.366,P>0.05）.The accuracy of cross-validation in the determination of frailty are 78.6% and 79.0%. The best predictive values are 3 and 2;the sensitivity is 0.709 and 0.837;the specificity is 0.817 and 0.790;the Youden indexes are 0.529 and 0.625;the positive predictive values are 0.697 and 0.702;the negative predictive values are 0.825 and 0.891.Conclusion The ability of Frailty Phenotype and FRAIL scale to screen the frailty risk of elderly inpatients is moderate. FRAIL scale is more effective in predicting the risk of frailty and more convenient to use,and it is more suitable for screening the frailty risk of the elderly inpatients.

Objective To construct an intelligent information management system of donor human milk bank,to establish a management information platform connecting of human milk donors,managers and recipients,to standardize and optimize the process,and to explore suitable human milk bank management methods suitable for China's national conditions. Methods From October 2017 to November 2019,the information management system of human milk bank was constructed including the following 5 functional modules,namely importing donor information,inputting milk information,managing donors' milk in and out,tracking adverse events,statistical analysis. The staff efficiency,the number of error events and breastfeeding rates were compared between July to August 2019 before the system application and October to December 2019 after the system application. Results Before and after the application of the management system of the donor human milk bank,the average operation time of the donor milk input for storage was reduced from 8min/portion to 2min/portion,and the average operation time of the donor milk out from the storage was reduced from 5min/portion to 1min/portion. The daily calculation of milk consumption by the staff was also changed from 1h daily to be automatically generated by the system. The backtracking time of milk source information was changed from 1.5h/person before application to automatic system correlation. The incidence of adverse events due to mis-delivery or near shelf life of donor milk decreased from 3 cases before application to 0 after application. The breastfeeding rate before and after system application increased from 65.11% to 69.74%,and the difference was statistically significant（χ ²=12.55,P<0.001）. Conclusion The intelligent information management system of human milk bank can help health care professionals to optimize the operation process,ensure the safety of donor human milk breastfeeding,and improve the breastfeeding rate in neonatal intensive care unit.

Objective To retrieve the relevant evidence for the assessment and management of volume load in maintenance hemodialysis （MHD） patients,and to summarize the best evidence,so as to provide evidence-based bases for medical staff to evaluate the volume load of MHD patients. Methods The guideline database and comprehensive database were searched,including WHO Guidelines,NICE,GIN,AHRQ,SIGN,Cochrane Library,BMJ Best Practice,UpToDate,Yimaitong,PubMed,Web of Science,Embase,CINAHL,CNKI,Wanfang,Med Online,CMJD. All the evidence were searched on assessment of volume load in MHD patients,including guidelines,evidence summaries,best practice,systematic evaluations,meta analysis and original research. The retrieval time was from January 2015 to December 2020. The literature was screened and evaluated,in order to summarize the best evidence. Results 11 articles were finally included,including 8 guidelines and 3 systematic reviews（including meta-analysis）. 19 pieces of best evidence were summarized in 7 aspects including volume load assessment methods,dry weight assessment and optimization,blood pressure control and drug use,sodium intake and elimination,diet assessment and fluid restriction,dialysis frequency and time,and the use of bio-impedance equipment. Conclusion In the assessment of volume load in MHD patients,a multidisciplinary assessment method of shared decision making is practical. In clinical practice,medical staff should select the best evidence based on specific clinical situations and patient wishes. In order to improve the accuracy of the assessment of volume load in MHD patients,a scientific,effective,and easy-to-use comprehensive assessment method and capacity management measure is meant to be further studied.

Objective This study aimed to translate the Psychological Adaptation Scale（PAS） into Chinese and explore the psychometric qualities of the Chinese translation of the Psychological Adaptation Scale（C-PAS）. Methods The PAS was translated and culturally adjusted into Chinese in strict accordance with the Brislin translation model. The reliability and validity of the C-PAS were tested through a survey of 221 caregivers of children with cancer by convenience sampling from October 2019 to December 2019. Results There were 20 items in C-PAS,including 4 dimensions of coping efficacy（4 items）,self-esteem（6 items）,social integration（5 items）,and spiritual well-being（5 items）. In exploratory factor analysis,the cumulative variance contribution rate of 4 common factors was 55.996%. Cronbach’s alpha coefficient for the overall scale was 0.900;the split half reliability coefficient was 0.792;the test-retest reliability coefficient was 0.876. Conclusion The Chinese version of PAS has been proved to be reliable and valid which can be used to evaluate the psychological adaptation level of caregivers of children with cancer in China.

Objective To compare the effects of dual-task training and single-task training on gait and balance performance in healthy older adults.Methods Electronic databases including Cochrane Library,Medline,EMBASE,Web of Science,PubMed,Ovid,CINAHL（EBSCO） and China National Knowledge Internet were searched. Randomized controlled trails that assess the effects of dual-task training and single-task training in healthy older adults were included. Meta-analysis was conducted using Revman 5.3.Results Totally 18 studies with a population of 775 were reviewed and pooled for meta-analysis. Dual-task training was superior to single-task training in improving gait speed and step length（P<0.05）,the effects of dual-task training and single-task training were equal in the improvement of balance performance（P>0.05）.Conclusion Compared with the traditional single-task training,the dual-task training can better improve the gait speed and step length of the elderly. The effects of dual-task training on the balance performance needs further discussion.