Predictive value of systemic immunity index for sepsis in low-medium risk community-acquired pneumonia

Objective:To assess the predictive value of systemic immune inflammation index(SII)for sepsis in low-and medium-risk community-acquired pneumonia.Methods:A total of 589 elderly patients with low-and medium-risk community-acquired pneumonia admitted to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University from January 2020 to January 2023 were included as the research subjects,and the general information and laboratory test results of the patients were collected,and the optimal cut-off value of continuous variables for predicting sepsis in elderly patients with low-and medium-risk community-acquired pneumonia was determined by plotting the receiver work characteristic(ROC)curve,which was converted into dichotomous variables and univariate and multivariate logistic Regression analysis of the influencing factors of sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.Based on this,a nomogram model is constructed to predict the risk of sepsis.The differentiation,consistency and accuracy of the model were verified by calibration curve and subject operating characteristic(ROC)curve,and the clinical utility of the model was determined by decision curve analysis.Results:A total of 589 elderly patients with low-and intermediate-risk community-acquired pneumonia were included in this study,of which 96(16.30%)developed sepsis.There were significant differences in age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,PCT,SII and other indexes between sepsis and non-sepsis groups(P<0.05).Logistics regression analysis showed that age,diabetes mellitus and chronic obstructive pulmonary disease,Lac,and SII were independent risk factors for sepsis in elderly patients with low-and medium-risk community-acquired pneumonia.The nomogram prediction model was used to verify the results,and the AUC was 0.826(95%CI:0.780-0.872),and the calibration curve tended to the ideal curve with good accuracy.The decision curve shows that when the threshold of the model is between 0.10~0.78,the model has the advantage of clinical benefit.Conclusion:The nomogram prediction model constructed based on SII to predict sepsis in elderly patients with low-and medium-risk community-acquired pneumonia has good accuracy,which can predict the occurrence of sepsis early,help early identification of high-risk groups and timely intervention,and thus improve the prognosis of patients.

Analysis of Service Marketing Strategies in the Senior Study Travel Tour Market

Senior study travel,as an emerging form of tourism,combines the dual characteristics of educational learning and leisure travel.It not only meets the elderly’s desire for spiritual and cultural life and self-fulfillment but also promotes the construction of a healthy aging society.This study comprehensively uses methods such as literature analysis,interviews,and case studies to analyze the current status and existing problems of the senior study travel market.Based on the 7Ps service marketing model,it explores service marketing strategies for the senior study travel market,aiming to provide reference and guidance for related tourism enterprises to supply more attractive senior study travel services.

Analysis of New Senior English for China Student’s Book 1

This article will firstly discuss the context overview of English teaching and learning in China. Under thiscircumstance, a problematic element will be examined of the New Senior English for China Student’s Book 1 and critical appraisal ofhow this element relates to other elements of curriculum development will be analyzed. The recommended changes and demonstrationmechanisms for evaluating the changes are put forward in the last two parts.

Eigen-Property of Single-j System and Seniority Conservation Condition

In this paper we study the system with three nucleons within a single-j shell, which can be described as the angular momentum coupling of a nucleon pair and the odd nucleon. The overlaps between these non-orthonormal states form a special matrix coincidental with the one obtained by Rowe and Rosensteel. They proposed a proposition related to the eigenvalue problems of that matrix and dimensions of the associated subspaces. We prove their proposition with the help of the symmetric properties of the six-j symbols. We also derive algebraic expressions for eigen energies as well as conditions for conservation of seniority through the decomposition of the angular momentum.

Construction of senior service system in the context of a healthy China

Entering the new era,the healthy senior service cause in China has achieved great development.However,due to regional differences,there are still certain gaps between the actual demands of ageing service in China and the policies on senior service.Besides,there are some other problems to be solved,such as unimplemented associated systems and policies,insufficiency of social awareness and participation,ineffective supply and high vacancy of beds in nursing homes,the shortage and low quality of industry personnel.The development of the healthy endowment service industry needs further follow-up according to the actual situation.To solve the problems of insufficient supply of senior service resources,it is necessary to use social funds to encourage interested and capable social organizations and individuals to participate,and to form a system of senior services with Chinese characteristics with multi-disciplinary cooperation of government,industry,universities and institutes.

Responsibility Distribution Between the Government and Society in Guaranteeing Basic Senior Care Services

The 20th National Congress of the Communist Party of China put forward the task to ensure all elderly people enjoy basic senior care services.In an aging society,basic senior care services are key to protecting the basic human rights of the elderly.The government-society partnership is an ideal model to guarantee basic senior care services.In terms of responsibility distribution,the government and social organizations should follow the principle of subsidiarity.On the one hand,social organizations undertake the responsibility to provide basic senior care services under public constraints with regard to service prices,service content,and service targets;On the other hand,the government is the responsible guarantor for minimum senior care services and the prevention of risks.The government’s responsibility of guaranteeing minimum senior care services lies in the government taking over relevant projects after the occurrence of risks.Constrained by the principle of subsidiarity,the government’s responsibility for risk prevention shifts from ex-ante prevention to interim and ex-post prevention.Emphasis should be placed on the principle of the government and society assuming shared responsibilities for risk prevention and achieving risk prevention through government spending.

智慧养老数据资源治理体系研究:基于活动理论视角

智慧养老产业市场规模不断扩大,产生了一系列有价值的数据资源,但全国智慧养老数据资源共享程度低、不成体系,呈现出不集成、不统一和不均衡的“三不”问题,导致数据资源价值难以充分发挥,阻碍了各养老服务主体的合作和效益提升,也影响了老年人对养老服务的满意度,因而亟须建立和完善智慧养老数据资源治理体系。尤其是对于治理过程中各个要素如何协同、面向具体场景的治理活动如何展开等难题,利用规范分析方法,基于活动理论提出智慧养老领域数据资源治理体系的整体框架,对其中的治理主体、客体、共同体、规则、工具和分工六大要素展开详细分析,并基于康复场景构建老年人康复活动中的数据资源治理流程。提出基于本体模型并包含“元数据—主数据—参考数据”三个层次的数据资源分类体系,发现智慧养老数据资源的治理模式将经历从无中心引导型的分布式治理到单中心集聚型的集中式治理,再到多中心孤岛型的分布集中式治理,最后形成多中心合作型的网络式治理,在不同阶段可相应构建督促机制、注册机制、协商机制、权责机制、激励机制、监管机制等治理机制。

早期中国嫡庶之分与宗法制度形成--基于王国维《殷周制度论》的哲学反思

王国维《殷周制度论》指出,立子立嫡之制是周人对殷商“兄终弟及”王位继承制度的突破和创新。天子在众多公子中选拔接班人,难免任意性、随机性,容易导致祸乱事变。周政的特点是让政治道德化,让道德政治化,使血亲社会化,使社会宗法化。血缘关系是生来如此而并非后天人力所为。把血缘关系上升到一种天定法则的高度予以确认,等于在为“亲亲”之制建构可靠根基。以嫡系长房、长孙为大宗,血缘正统可靠,是“百世不迁之宗”,秉承先祖恩德最隆最多;而以庶子系统、旁支所出为小宗,是先祖余泽播撒。“五世而迁之宗”要求小宗超过五世则剔出丧服范围。“大宗维翰”而具有核心地位,“宗子维城”则能够起到拱卫、守护作用。对别子小宗和别子大宗强调尊过去的祖,无疑是变相要求他们尊现在的王。依据亲亲尊尊法则所建构出的宗法社会,以一种向内挖掘亲和力而不是向外诉诸神力的形上方式,来实现一种具有儒家鲜明特色的王道普遍性。

“一老一小”服务体系协同发展的理论逻辑、现实基础及发展路径

我国家庭正面临着照料人力减少和照料成本增加的双重现实困境,以社区为基础的“在地化”弹性服务既是家庭照料面临的共同刚需,也是“一老一小”服务体系协同发展的需方基础。“一老一小”服务体系建设是促进家庭和谐和国家人口安全的共同目标和服务资源可共享的“供方”协同发展前提。当前我国“一老一小”服务体系协同发展面临着多部门协同机制基本建成但有待落实、资源相对失衡且各自独立发展、“在地化”服务供给与利用双低的局面。应从全生命周期、全人群和全家庭的视角,推动不同政策主体形成合力,完善以家庭需求为中心的协同机制、打造代际共融型“在地化”服务示范样本、建立社区智慧家庭协同服务平台、营造协同发展的“家庭友好型”社会支持性环境和加强“一老一小”家庭问题的调查与研究,以实现“一老一小”服务体系协同的高质量发展。

师徒制对缓解高职院校高年资教师职业倦怠的影响机制研究

高年资教师是我国高职院校教师队伍的中流砥柱,然而“躺平(职业倦怠)”亦成为阻碍其进一步推动我国高等职业教育事业高质量发展的重要因素。本研究基于社会交换理论,以我国高职院校99对高年资教师与青年教师为对象,展开了为期5天的调查研究。结果发现:(1)师徒制存在“师—徒”间的双向增益机制;(2)师徒制能够通过知识重组路径抑制高年资教师职业倦怠的滋生,同时,指导成效是干预这一效果的重要边界条件。在此基础上,本研究通过组态分析提出了“专业资本导向型”与“心理资本导向型”两种基于师徒制的高年资教师职业倦怠应对方案,进而建议相关院校加大对师徒制的资源投入力度,赋予该制度一定的灵活性,以期从根源上解决高年资教师的职业倦怠问题。

新制度主义视域下高中走班制困境及其优化路径

走班制作为一种新的教学模式,可以有效推进我国素质教育的落实,贯彻“以人为本”的教育理念,满足学生学习和成长的个性化需求。然而,当前走班制在推行中仍然存在一些困境。基于新制度主义规制性、规范性、文化—认知性三种要素,从规章制度、教师道德、教师文化3个角度对走班制进行研究发现:当前走班制存在缺乏相应规章制度的指导和约束、教师道德上陷入困境与冲突、教师文化上反思与批判的意识薄弱3个问题。为此,应建立科学合理的规章制度,促使教师适应教育情景的转变,构建良好的教师文化氛围,这不仅能为选课走班制度的调整指明方向,也有助于新高考改革的现代转型。

全身免疫炎症指数对低中危社区获得性肺炎发生脓毒症的预测价值

目的:评估全身免疫炎症指数(systemic immune inflammation index,SII)对低中危社区获得性肺炎发生脓毒症的预测价值。方法:纳入2020年1月~2023年1月海南医学院第二附属医院急诊科收治的589例低中危社区获得性肺炎老年患者为研究对象,收集患者一般资料、实验室检测结果,通过绘制受试者工作特征(ROC)曲线确定连续变量预测低中危社区获得性肺炎老年患者并发脓毒症的最佳界值,转化为二分类变量,采用单因素和多因素Logistic回归分析低中危社区获得性肺炎老年患者发生脓毒症的影响因素。并以此构建预测脓毒症发生风险的列线图模型。分别通过校准曲线和ROC曲线验证模型的区分度、一致性和准确性,并采用决策曲线分析法确定模型的临床实用性。结果:本研究共纳入589例低中危社区获得性肺炎老年患者,其中发生脓毒症者96例(16.30%)。脓毒症组和非脓毒症组的年龄、合并糖尿病及慢性阻塞性肺疾病、Lac、PCT、SII等指标的差异有统计学意义(P<0.05)。Logistics回归分析显示:年龄、合并糖尿病及慢性阻塞性肺疾病、Lac、SII为低中危社区获得性肺炎老年患者发生脓毒症的独立危险因素。使用列线图预测模型进行验证,结果显示AUC为0.826(95%CI:0.780~0.872),校准曲线趋于理想曲线,具有较好的准确性。决策曲线表明,该模型的阈值在0.10~0.78之间时,该模型有临床获益优势。结论:基于SII构建的预测低中危社区获得性肺炎老年患者发生脓毒症的列线图预测模型具有较好的准确性,可以早期预测脓毒症的发生,有助于早期识别高危人群和及时干预,从而改善患者预后。

Higher intakes of lysine,threonine and valine are inversely associated with non-alcoholic fatty liver disease risk:a community-based case-control study in the Chinese elderly

The associations of individual amino acid with non-alcoholic fatty liver disease(NAFLD)risk remained unclear.The present study aimed to investigate the associations between the two in the Chinese elderly.Methods:A community-based health check-up program was conducted in Qingdao,China.NAFLD was diagnosed by ultrasonography accompanied by epidemiological investigation.The dietary intakes of amino acids were investigated with 3-day,24-h dietary records and calculated by Nutrition Calculator software.Restricted cubic spline model was used to evaluate a nonlinear relationship between amino acid intake and NAFLD risk.Results:400 NAFLD subjects were identified,and 400 participants were randomly selected as controls and matched by gender and age(±3 years)Dose-response analysis showed that 1000 mg increment of aromatic amino acids(AAAs)was associated with reduced 16%risk of NAFLD.Dietary increments of 750 mg/d threonine,950 mg/d valine,or 1700 mg/d lysine were associated with a 20%reduction in the NAFLD risk(all P for linearity<0.05).Conclusion:The present study demonstrated that the dietary increases in milk,eggs and deep-sea fish,which are rich in the amino acids,might contribute to protecting against NAFLD in the elderly.

A Brief Introduction to Sichuan Academy of Social Sciences

Sichuan Academy of Social Sciences is the think tank for the People’s Government of Sichuan Province and the Sichuan Provincial Committee of the CPC,with full financial backing of the Party and the government.The Academy consists of 16 institutes,1 graduate school,10 departments of scientific research management services.At the end of 2023 the staff numbered 459.Among the scientific research personnel,79 employees have senior professional titles,and 147 employees have associate senior professional titles;31 employees are experts entitled to special allowances of the State Council,33 employees are provincial academic and technical leaders,20 employees are experts with outstanding contributions at provincial level;and 184 employees have doctorate degrees.

专业群导师学长制工作室集群运行机制探索与实践

职业教育提质培优行动计划明确提出了发展高职教育是优化高等教育结构的重要方式,建设高水平专业群是扎实推进中国特色专科高职学校高质量发展的抓手,数字媒体技术专业群以在线教育领域为服务核心,围绕在线教育产业技术链的职业岗位建设工作室集群,形成“导师学长工作室制”专创融合人才培养模式,探索校企协同“2334”导师学长制工作室运行模式,设计校企协同“三师五环、项目驱动”教学模式,提升了专业群的建设水平。

Investigation on the Characteristics of the Senior Citizens' Activities in the Parks and Greenbelts——A Case Study of Nanjing City

From the perspective of senior citizens,questionnaire survey and field investigation were carried on and analyzed in three parks in Nanjing City.The results showed that outdoor activities are the principal ways for the senior citizens to spend their time,the parks near home is their prior choice,and the radiation range of the park and greenbelt mostly is no more than 2 km;most of the senior citizens come to parks on foot and the parks are always within 30 minutes walking distance;the senior citizens always have fixed partners and groups for their exercise-dominant activities.

Frailty in People Living with Human Immunodeficiency Virus Aged 50 Years and Older: Prevalence and Predictors

Introduction: Life expectancy improvement for people living with Human Immunodeficiency Virus (HIV) is coming up against the problems associated with aging and chronic diseases. Frailty is a concern affecting a growing number of patients, particularly the elderly in this population. Our study aimed to determine the prevalence of frailty and its predictors on people living with HIV aged 50 years and older followed at the Outpatient Treatment Clinic (CTA) in Dakar. Methodology: We conducted a cross-sectional study of descriptive and analytic purposes ranging from November 2022 to August 2023, in CTA, Dakar (Senegal). We included people living with HIV aged 50 years and older under antiretroviral therapy for at least 6 months (≥6 months). Frailty was considered according to Fried criteria with a score ≥3. To identify the predictors of frailty, we performed a multivariate logistic regression analysis using STATA software version 18. Results: We included 199 patients. The median age at the moment of the study was 58 years old [50 - 91] with a sex ratio (M/F) of 0.58. The most representative age group was that of [50 - 59] years (59.3%). HIV-1 profile was most common in 89.45%. The median duration under antiretroviral therapy was 180 months [6 - 284] and 94% of patients received a Tenofovir Disoproxil Fumarate (TDF)-containing regimen with 43% of them for at least 10 years. Viral load was undetectable (≤40 copies/ml) in 98% of cases. WHO Stage III was more common at inclusion and 55.78% had nadir TCD4+ Lymphocyte counts Conclusion: Our study confirms the high prevalence of frailty among older people living with HIV. Its prevention should consider the management of comorbidities and the implementation of non-pharmacological interventions such as nutrition.

A Tale of the CPC's Foreign Relations(Excerpt from the Introduction of A Tale of Two Continents)

In 2017,China time and again captured the attention of the world.On January 17,President Xi Jinping delivered a keynote speech at Davos entitled Jointly Shoulder Responsibility of Our Times,Promote Global Growth at the opening session of the World Economic Forum Annual Meeting.Then,on May 14-15,the Belt and Road Forum for International Cooperation was convened in Bejing,attended by more than 1,500 delegates,including 29 heads of state or government,more than 70 chiefs or their deputies of international Organisations,and senior representatives from more than 110 countries.

Short Video Craze at a Nursing Home

Short videos shot at a nursing home in the northern Chinese city of Tianjin are aimed at enriching the inner world of its elderly residents and maintaining their optimistic life view.Agroup of senior citizens face the camera and deliver lines from a scripted sketch ending with the homespun homily,“There are some parents who always compare their children with other people’s children,but they never think to compare themselves with other parents.”The occasional bloopers of these senior players make fellow actors fall about laughing.But rather than reproving them,the director joins in the merriment.This is not a stage rehearsal or movie set scenario,but a video shooting taking place at a nursing home in the northern Chinese city of Tianjin.Since last April,Jingya Nursing Home,in an effort to enrich the lives of its elderly residents,has taken the new approach of shooting short videos.These have since attracted nearly a million followers and scored over six million likes on Douyin,the Chinese version of TikTok.