Abstract Early rehabilitation activity is an important way to improve functional impairment in stroke patients. However, there are no clear standards and opinions on the optimal start time, dosage and frequency of early rehabilitation activity. It is generally believed that early rehabilitation activity should start at 24 to 48 hours after stroke, and individual programs should be developed according to the assessment of stroke type, severity of disease, tolerance degree and other factors. This review searches domestic and international literature related to early rehabilitation activity and summarizes the start time, dose, frequency and content of early rehabilitation activity, as well as the cognition and attitude of medical workers towards it, so as to provide insights into studies and clinical applications of early rehabilitation activity.

Objective To investigate the intra-splenic blood cell count of posthepatitic cirrhotic portal hypertension,and compare it with patients' peripheral blood cell count to explore the role the spleen plays in peripheral cytopenia often seen in posthepatitic cirrhotic portal hypertension.Methods A prospective study was made on 15 cases with post hepatitis B cirrhotic portal hypertension undergoing splenectomy.Intrasplenic blood was sampled from upper pole,hilus (central pole),and lower pole of the spleen respectively for blood cell count.Results were compared with that of preoperative peripheral blood.Results There were significant statistical differences in the WBC count between splenic blood and peripheral blood,(11.20 ± 4.73) × 109/L vs.(4.06 ± 1.75) × 109/L,t =5.05,P ＜ 0.05),and in PLT count,(182.45±66.57) × 109/L vs.(63.54 ±28.40) × 109/L,t =7.285,P ＜0.05.There was no differences in the RBC count,(3.55 ± 0.94) × 1012/L vs.(3.01 ± 0.62) × 1012/L,t =1.874,P ＞ 0.05.Positive correlations were found between splenic PLT count and peripheral PLT count (r =0.610,P ＜0.05).Conclusions In posthepatitic B cirrhotic portal hypertension patients the intra-megalosplenic PLT and WBC count are significantly higher than that in peripheral blood.Megalosplenic PLT count correlates positively with peripheral PLT count.

Objective: To investigate the epidemiologic features of interhospital, intrahospital, interdepartmental and intradepartmental infections of carbapenem-resistant Acinetobacter baumannii (CRAB) isolated from clinical specimens. Methods: From September 2015 to September 2016, 540 non-repetitive strains of Acinetobacter baumannii were clinically isolated from 38 tertiary hospitals in Anhui Province, of which 460 strains were confirmed by antimicrobial resistance surveillance in Anhui Province. Agar plate dilution method was used to determine the MIC of 16 antibiotics and to select 312 CRAB isolates for drug sensitivity test. Pulsed field gel electrophoresis (PFGE) was used to analyze homology of 145 strains. PCR and clonal sequencing were used to determine the corresponding genotypes. Results: All the 312 CRAB strains were multiple antibiotic resistant strains. The drug resistance rates to imipenem and meropenem were 67.9% and 70.6%, respectively. All the 145 strains were divided into 80 different types (PT1-PT80) by PFGE. Only one strain was found in the 60 types and two or more strains were found in the other 20 types. Genotype bla_OXA-51 was detected in 145 strains (100%), genotype bla_OXA-23 was detected in 134 of strains (92.41%), genotype bla_OXA-24 was detected in 1 strain (0.69%), and subtype of bla_IMP-4 was detected in 4 strains (2.76%). Genotype bla_OXA-58, bla_VIM, bla_SIM, bla_NDM and bla_KPC were undetectable. Conclusions Homologous analysis indicates that all 145 strains of CRAB exhibit the interhospital, intrahospital, interdepartmental and intradepartmental transmission. Genotype bla_OXA-51 is the inherent drug resistant associated gene in the chromosome of AB and genotype bla_OXA-23 is the most common carbapenemase gene in Anhui Province and the main genotypes of resistance transmission.

Objective:To observe the changes of lactate clearance rate (LCR) and serum polyligandosan-1 (SDC-1) in patients with septic shock complicated with acute respiratory distress syndrome (ARDS) and to evaluate its prognostic value.Methods:Patients with septic shock and ARDS who were admitted to the Respiratory Intensive Care Unit (RICU) of Zhengzhou Central Hospital Affiliated to Zhengzhou University from February 2021 to April 2022 were selected as subjects. The patients were divided into the survival group and death group according to their 28-day survival status. General clinical data and related indicators of patients in the two groups were collected and compared. The related factors influencing the 28-day death of patients with septic shock and ARDS were screened, and receiver operating characteristic (ROC) curve was drawn to evaluate the individual and combined forecast value of LCR and SDC-1 for the prognosis of patients with septic shock and ARDS.Results:Compared with the survival group, sequential organ failure score (SOFA) and acute physiology and chronic health status score Ⅱ(APACHE Ⅱ) at admission to RICU, the levels of 24 h Lac, 6 h SDC-1, 24 h SDC-1 and 72 h SDC-1 in the death group increased significantly (all P< 0.05), and the levels of 6 h LCR, 24 h LCR, 6 h OI, 24 h OI and 72 h OI significantly decreased (all P<0.05). Spearman correlation analysis showed that SDC-1 at 6 h, 24 h and 72 h was significantly negatively correlated with OI at corresponding time points (all P<0.05), and LCR at 6 h and 24 h was significantly positively correlated with OI at corresponding time points (all P<0.05). Multivariate Logistic regression analysis showed that SOFA score, 24 h LCR, 24 h SDC-1 and 72 h SDC-1 were the risk factors of 28-d death in patients with septic shock and ARDS (all P<0.05). The areas under ROC curve of each related factor were SOFA score, 24 h LCR, 24 h SDC-1 and 72 h SDC-1, which could predict the prognosis (all P<0.05). 24 h LCR combined with 24 h SDC-1 had the maximum area under the curve (AUC=0.805, 95% CI: 0.691-0.920, with a sensitivity of 75.0% and a specificity of 74.4%). Conclusions:24 h LCR, 24 h SDC-1 and 72 h SDC-1 are the risk factors of the 28-day death of patients with septic shock and ARDS. 24 h LCR combined with 24 h SDC-1 can improve the test efficiency compared with the single indicator.

Objective To explore the negative psychological experience of nursing students during clinical practice in NICU .Methods The qualitative phenomenological research method was adopted in this study.Semi-structured in-depth interviews were conducted with twelve nursing students during practice in NICU.Data were analyzed by content analysis .Results Four themes were extracted , including high tension , exhaustion of body and mind , lack of confidence , and sense of worthlessness .Conclusions The head nurse and the clinical teachers should pay attention to the negative psychological experience of nursing students during clinical practice in NICU , make a scientific and reasonable practice teaching program , take effective measures , and help them to complete the task of practice better in NICU .

Objective To investigate the application and effect of pediatric nursing cooperated with obstetrical nursing on breast-feeding effect of ICU preterm children. Methods Totally 126 cases of premature children hospitalized in our hospital NICU form January 2015 to December 2015 as the research object. Cases from January to June were selected as the control group ( n=65) , cases from July to December were selected as the intervention group ( n=61) . In the control group, routine post-natal nursing was performed respectively in obstetric and pediatrics. In the intervention group, pediatric nursing cooperated with obstetrical nursing was performed.Results Exclusive breast-feeding rate of 1 week in the intervention group was higher than the control group;mixed feeding rate and artificial feeding rate were lower than the control group. Feeding mode in two groups was significantly different (χ2 =7. 025, P=0. 006 ); breast-feeding day for the first feeding in the intervention group was significantly earlier than the control group (χ2=2.365, P=0.020) . The degree of breast-feeding in 1 week was higher than the control group (χ2=5.628, P=0.021;t=5.158, P<0.001);the degree of breast-feeding in 2 weeks was higher than the control group (χ2=6.852, P=0.009;t=6.542, P<0.001); the exclusive breastfeeding rate during hospitalization was higher than the control group (χ2=7.852, P<0.001). The rate of weight gain in the intervention group was significantly higher than the control group (t=4.526, P=0.003) , hospital stay shortened compared with the control group ( t=3.524, P=0.009) , the incidence of sepsis was significantly lower than the control group (χ2 = 4. 159, P= 0. 042 ) . Conclusions Pediatric nursing cooperated with obstetrical nursing can effectively improve the breast-feeding level and exclusive breast-feeding rate of NICU preterm children, promote neonatal weight gain, shorten hospital stays and reduce the incidence of sepsis.

Objective? To investigate the depression of community elderly patients with mild cognitive impairment (MCI) and to analyze its influencing factors so as to provide a basis for relieving the depression and delaying the conversion of MCI among elderly patients to dementia. Methods? From December 2016 to March 2018, we selected 1 093 community elderly people (≥60 years old) complained of cognition hypofunction by convenience sampling. All of the aged were investigated with the general information questionnaire, Peking Union Medical College Hospital Version of Montreal Cognitive Assessment (MoCA-P) and Activities of Daily Living (ADL). Outpatient doctors of neurology department at a ClassⅢ Grade A hospital in Beijing provided clinical diagnosis for elderly patients with primary screening of MCI. The Geriatric Depression Scale-30 (GDS-30) was used to assess depression of MCI patients. SPSS 21.0 was used to the date entry and statistical analysis, and multiple Logistic regression was used to analyze the influencing factors of depression. Results? A total of 271 community elderly people were diagnosed as MCI. After excluding 30 depression assessment questionnaires with glaring holes and regularity, a total of 241 valid questionnaires were collected finally with 88.93% for the effective rate. Among 241 community elderly patients with MCI, 71 cases of them were with depression and the incidence was 29.46%; the score of depression was (15.99±4.31);a total of 59 cases (83.10%) of them had the moderate depression and 12 cases (16.90%) had severe depression. Multiple Logistic regression analysis showed that the risk factors of depression included insomnia (OR=2.09), negative emotions such as anxiety or agitation (OR=6.25), recent major events (OR=3.93) and poor ADL (OR=1.45), the protective factors of depression included ages of over 80 years (OR=0.29) compared with the ages from 60 to 65 years among elderly MCI patients. Conclusions? The incidence of elderly MCI patients with depression is high. Based on comprehensive evaluation for elderly MCI patients, nurses should pay attention to their depression emotions and help patients to improve sleep and ADL, and help them positively deal with negative influences brought by major events.

Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.

Objective:To predict the status of microvascular invasion (MVI) in intrahepatic cholangiocarcinoma (ICC) patients preoperatively based on the radiomics analysis of contrast-enhanced CT to provide imaging evidence for early identification of patients at high risk of recurrence.Methods:Clinical data of 40 ICC patients who underwent radical hepatectomy at Nanjing Drum Tower Hospital from January 2021 to May 2024 were retrospectively collected. Patients were divided into the MVI group ( n=8) and the non-MVI group ( n=32) according to the MVI status of the postoperative pathology report. Whether there were differences in each pathological index between the groups and the efficacy of radiomics analysis of contrast-enhanced CT for the preoperative prediction of MVI were analyzed. The regions of interest (ROI) were outlined on the arterial and venous phase images using the 3D Slicer software. Then, radiomics features were extracted from each ROI based on Python. Finally, the LASSO regression and glm function were used to screen radiomics features and establish a prediction model based on the R language. The established predictive model′s diagnostic efficacy, calibration, and net clinical benefit were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Count data were expressed as frequency and compared using the chi-square test. Results:Patients in the MVI group had more poorly differentiated tumors and a significantly higher proportion of lymph node metastases ( P<0.05). The established radiomics prediction model included six features, 1 first-order statistical feature and 5 gray texture features. The area under the ROC curve was 0.87, the sensitivity was 75.0%, and the specificity was 90.6%. The calibration curve showed good agreement between the predicted MVI and actual MVI status, and the decision curve demonstrated that the model could provide a large net clinical benefit. Conclusion:Radiomics analysis of contrast-enhanced CT can identify the MVI status of ICC patients preoperatively and aid in clinical decision-making, providing vital evidence for individualized and precise treatment of ICC.

Objective:To investigate the relationship between single nucleotide polymorphism (SNPs) of Zeste homolog enhancer 2 (EZH2) gene and the risk of breast cancer.Methods:Recruiting 1 039 breast cancer patients and 1 040 controls at 22 referral hospitals nationwide in China, the genotype distribution of 3 SNPs loci of EZH2 genes was observed to detect the correlation between different genotypes and the risk of breast cancer genotypes EZH2 expression in breast cancer tissues and its correlation with patient prognosis were analyzed using breast cancer data from the database.Results:EZH2 rs6464926 CC genotype was compared with TT genotype (TT vs. CC: OR=1.362, 95% CI: 1.063-1.746, P=0.015) and dominant model (TC+TT vs .CC: OR=1.22, 95% CI: 1.004-1.483, P=0.045) .In women with BMI ≥24 kg/m 2, the TC genotype ( P=0.050), TT genotype ( P=0.025) and dominant model (TC+TT, P=0.021) of rs6464926 locus were significantly different from CC genotype in cancer risk. rs6464926 was correlated with EZH2 gene expression ( P=6.89E-47). EZH2 gene is highly expressed in breast cancer tissues, and patients with high expression were associated with shorter OS ( HR=1.27, P=0.013), DMFS ( HR=1.37, P<0.01), and RFS ( HR=1.44, P<0.01). Conclusions:The polymorphism rs6464926 of EZH2 gene is associated with breast cancer susceptibility in Chinese women. rs6464926 might regulate breast cancer risk and prognosis by changing EZH2 expression.