Objective To explore the development trajectory of rehabilitation exercise adherence and its potential classes predictors in stroke patients. Methods By the convenience sampling method，252 stroke patients who were hospitalized in 2 tertiary hospitals in Daqing from September 2020 to May 2021 were selected.The general situation questionnaire，questionnaire of exercise adherence for stroke patients，the brief illness perception questionnaire，Herth hope index，and hospital anxiety and depression scale were used to collect the baseline data of patients，and the rehabilitation exercise adherence was assessed at 6，14 and 24 weeks after stroke. Latent growth mixed model was used to identify the development trajectory of rehabilitation exercise adherence among stroke patients，and multivariate logistic regression analysis was used to explore the predictors of different latent trajectories classes. Results A total of 4 developmental trajectories of rehabilitation exercise adherence among stroke patients were identified：low adherence-improvement group（7.5%），sustained moderate adherence group（21.4%），moderate adhere-nce-decline group（46.5%）and low adherence-decline group（24.6%）. Multivariate Logistic regression analysis showed that stroke type，number of stroke attacks，baseline hope，anxiety and depression levels were independent predictors of different developmental trajectory of rehabilitation exercise adherence among stroke patients（P<0.05）. Conclusion There is significant group heterogeneity in the developmental trajectory of rehabilitation exercise adherence in stroke patients within 24 weeks of onset. Only a small number of patients’ adherence continued to be at a high level or improved from a low level，and about 1/4 of the patients continued to be at a low level and tending to decline. Medical staff should identify patients in the low adherence-decline group early on the basis of predictive factors，and implement targeted，specific and efficient adherence interventions to improve the development trend of adherence.

Objective To investigate the optimal starting time，safety and effectiveness of shoulder and neck functional rehabilitation exercise for patients undergoing gassless transaxillary endoscopic thyroidectomy（GTET）. Methods 175 patients who underwent GTET were selected by convenient sampling，with 121 patients in 2 test groups（61 patients in the test group 1 and 60 patients in the test group 2） and 54 patients in a control group. The starting time of postoperative shoulder and neck rehabilitation training in the control group，test group 1 and test group 2 were postoperative 7 days，postoperative 48 hours and 2 hours after general anesthesia wakening，respectively. The analysis among 3 groups included the amount of drainage（ml），the retention time of drainage tube （h），the postoperative hospital stay（d），the cases of bleeding，the pain score of incision（neck and armpit） at postoperative day 1 and day 3，the range of shoulder and neck movement and the quality of life. Results There was no statistically significant difference in term of drainage amount，retention time of drainage tube，bleeding cases，hospital stay and pain in neck and incisions at postoperative day 1 and day 3 among the 3 groups（P>0.05）. The motion range of cervical extension，lateral cervical flexion，cervical rotation，shoulder abduction，shoulder adduction，shoulder flexion and shoulder extension among different groups were statistically significant 1 month after surgery（P<0.001）. In term of quality of life（QOL），there were statistically significant differences in aspects of stiffness，pain，numbness of the neck or shoulder，and the impact on leisure and entertainment（P<0.05）. Conclusion Starting shoulder neck rehabilitation exercise 2 hours after awake under anesthesia in patients undergoing GTET would not cause bleeding and affect the comfort，and could safely and effectively improve the early QOL of patients in the early postoperative period.

Objective To explore the effect of cognition-early warning intervention on the cognitive behavior of patients with delayed treatment of diabetes in rural areas,in order to improve their treatment compliance. Methods Rural patients with delayed treatment of diabetes in Datong District,Daqing City,in Heilongjiang Province and Luannan County,Tangshan City,in Hebei Province were conveniently selected as the research subjects from October 2019 to January 2020. According to the random number table method,6 villages were divided into an experimental group and a control group,with 63 cases in each group. The experimental group was given the cognition-early warning intervention for 2 weeks,and the control group was given routine health education. The general demographic data of patients with delayed treatment of diabetes in rural areas were obtained through a general data questionnaire;the cognitive behavior scale of delayed treatment of diabetes in rural areas,medication compliance questionnaire and diabetes management self-efficacy scale were used to evaluate the cognitive behavior,medication compliance and self-efficacy scores of subjects before and after intervention;fasting glucose results were collected by venous blood collection. Results A total of 60 samples were included in the experimental group and the control group respectively. Before intervention,general demographic data,cognitive scores,medication compliance scores and diabetes management self-efficacy scores were comparable between the 2 groups. After intervention,the cognitive behavioral scores and medication compliance scores of the experimental group were higher than these of the control group and these before intervention,and the difference was statistically significant（P<0.05）. The scores of diabetes management self-efficacy in experimental group were higher than these of the control group,with statistical significance（P<0.05）. The self-efficacy score of diabetes management in experimental group was slightly higher than before intervention. Fasting blood glucose level in the experimental group was better than in the control group after intervention,with statistical significance（P<0.05）. Conclusion Cognition-early warning intervention can improve the cognitive and behavioral level of patients with delayed treatment of diabetes in rural areas,and contribute to the standardized treatment of patients with delayed treatment of diabetes in rural areas.

Objective To explore the feasibility of oral glucose intake before surgery in thyroid cancer patients with diabetes for the purpose of decreasing complications and increasing comfort. Methods Between January 2017 and July 2018,98 patients with thyroid cancer and diabetes were selected as the experimental group,and were further randomly divided into two subgroups：experimental group 1 and experimental group 2. Fifty-two patients diagnosed between January 2016 and December 2016 were selected as the control group. Experimental group 1 received preoperative warm water intake,experimental group 2 had preoperative oral 5% glucose intake,and the control group was traditionally abstinent from food and water before surgery. Blood glucose,C reactive protein,throat pain,incision infection,incision healing,indwelling time of plasma drainage tube,thirsty score among three groups were compared. Results For blood glucose,there was significant difference between experimental group 1 and 2（P<0.001）,and there were no differences for the rest. For C reactive protein,there were significant differences among three groups（P<0.05）,a significant difference was found between the control group and experimental group 1 and 2（P<0.05）. For throat pain,there were significant differences between the control group and experimental group 1 and 2,but no significant difference was found between experimental group 1 and 2（P>0.05）. For complications,there were significant differences among three groups in delayed incision healing and thirst（P<0.05）,and no significant difference was found in incision infection（P>0.05）. Conclusion Preoperative oral 5% glucose intake doesn’t increase postoperative blood glucose level among thyroid cancer patients with diabetes,relieves throat pain and thirst,reduces postoperative stress,decreases chances of delayed incision healing.