ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.

A chemical investigation of secondary metabolites (SMs) from Aspergillus nidulans resulted in the identification of five novel dioxopiperazine (DKP)-diphenyl ether hybrids, designated as diphenylemestrins A-E (1-5). These compounds 1-5 represent the first known dimers combining DKP and diphenyl ether structures, with compound 4 featuring an uncommon dibenzofuran as the diphenyl ether component. The structural elucidation and determination of absolute stereochemistry were accomplished through spectroscopic analysis and electronic circular dichroism (ECD) calculations. Notably, diphenylemestrin C (3) exhibited moderate cytostatic activity against NB4 cells, with a half maximal inhibitory concentration (IC₅₀) value of 21.99 μmol·L^-1, and induced apoptosis at higher concentrations.
Aspergillus nidulans/metabolism* ; Diketopiperazines/pharmacology* ; Molecular Structure ; Phenyl Ethers/pharmacology* ; Humans ; Apoptosis/drug effects* ; Cell Line, Tumor

Objective:To explore the impact of body constitutional metabolic phenotype on the outcomes of hypertensive intracerebral hemorrhage (HICH) patients one year after onset.Methods:This study retrospectively studied the clinical data of 467 HICH patients admitted to the First People's Hospital of Lianyungang City from May 2021 to May 2023. Based on telephone follow-up after one year, the patients were categorized into two groups: a good outcome group (287 cases) and a poor outcome group (180 cases). According to the patients' body mass index (BMI) and metabolic status, the population was divided into six phenotypes: metabolically healthy with normal weight (MH-NW), metabolically healthy with overweight (MH-OW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MU-NW), metabolically unhealthy with overweight (MU-OW), and metabolically unhealthy with obesity (MUO). The baseline data of the two groups were compared between two groups. The influencing factors of adverse outcomes in patients with HICH one year after onset were analyzed. Quantitative data that conforms to normal distribution were represented by xˉ±s, and independent sample t-test was used for comparison between two groups; The measurement data of skewed distribution was represented by M ( Q1, Q3), and Mann Whitney U test was used for comparison between the two groups; Count data was presented as an example (%), and comparison between groups was conducted using the χ2 test. Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in HICH patients one year after onset. Results:BMI, high density lipoprotein cholesterol(HDL-C) levels and baseline Glasgow coma score(GCS) score in the poor outcome group were lower than those in the good outcome group [23.8 (22.4, 26.1) kg/m 2 vs. 25.0 (22.5, 27.4) kg/m 2, Z=-2.31, P=0.021; 1.1 (1.0,1.4) mmol/L vs. 1.3 (1.0,1.6) mmol/L, Z=-4.18, P<0.001; 14 (13,15) score vs. 10 (7,13) score, Z=-10.20, P<0.001]. The incidence of hemorrhage into the ventricle, cerebral hernia, pulmonary infection and hydrocephalus [43.3%(78/180) vs. 23.7% (68/287). 5.6%(10/180) vs. 0.7% (2/287), 48.9%(88/180) vs. 6.6% (19/287), 5.0%(9/180) vs. 1.4% (4/287), χ2=19.86, P<0.001, χ2=10.43, P<0.001, χ2=111.90, P<0.001, χ2=5.32, P=0.021], proportion of surgical removal of hematoma [41.1%(74/180) vs. 19.5% (56/287), χ2=25.69, P<0.001], systolic blood pressure [158 (141,173) mmHg vs. 152 (138,169) mmHg, Z=-2.18, P=0.029] and fasting blood glucose [6.9 (5.7,8.2) mmol/L vs. 6.3 (5.4,7.8) mmol/L, Z=-2.08, P=0.038] were higher than those in good outcome group. The metabolic phenotypes in the poor conversion group were as follows: 41 cases (22.8%) of MH-NW, 23 cases (12.8%) of MH-OW, 9 cases (5.0%) of MHO, 54 cases (30.0%) of MU-NW, 33 cases (18.3%) of MU-OW, and 20 cases (11.1%) of MUO. Conversely, the metabolic phenotypes in the good conversion group were as follows: 67 cases (23.3%) of MH-NW, 77 cases (26.8%) of MH-OW, 31 cases (10.8%) of MHO, 40 cases (13.9%) of MU-NW, 46 cases (16.0%) of MU-OW, and 26 cases (9.1%) of MUO. Regarding metabolic types, the poor conversion group comprised 73 healthy cases (40.6%) and 107 unhealthy cases (59.4%), whereas the good conversion group had 177 healthy cases (61.7%) and 110 unhealthy cases (38.3%). In terms of body mass, the poor conversion group included 94 cases (52.2%) of normal weight, 57 cases (31.7%) of overweight, and 29 cases (16.1%) of obesity. Conversely, the good conversion group had 108 cases (37.6%) of normal weight, 122 cases (42.5%) of overweight, and 57 cases (19.9%) of obesity.There were statistically significant differences in the composition ratios of physical metabolic phenotype, metabolic type, and xBMI type between the two groups of patients ( χ2=29.56, P<0.001, χ2=19.83, P<0.001, χ2=9.68, P=0.008). Multivariate Logistic regression analysis showed that after adjusting for other risk factors related to the prognosis of HICH, HDL-C ( OR=0.30, 95% CI: 0.12-0.75, P=0.010), admission GCS score ( OR=0.71, 95% CI:0.64-0.79, P<0.001), MH-OW ( OR=0.38, 95% CI: 0.17-0.82, P=0.013) and MHO ( OR=0.30, 95% CI:0.09-0.99, P=0.048) were all protective factors for adverse outcomes in patients with HICH 1 year after the onset of the disease, and hemorrhage into the ventricle ( OR=2.46, 95% CI:1.41-4.32, P=0.002) and pulmonary infection ( OR=9.13, 95% CI: 4.78- 17.44, P<0.001) were risk factors for adverse outcomes. Conclusions:MH-OW and MHO are beneficial to the prognosis of HICH patients 1 year after the onset of HICH. The secondary prevention of HICH patients should pay attention to the BMI level and comprehensive metabolic status of the patients.

Objective:To investigate the age-specific distribution characteristics of plantar pressure parameters in healthy children aged 3-12 years.Methods:This cross-sectional study retrieved data from the hospital information system in January 2025 for 272 children aged 3-12 years who underwent physical examinations and voluntarily completed plantar pressure analysis at Beijing Children′s Hospital, Capital Medical University, from July 2022 to December 2024. Demographic and clinical data, including anthropometric measurements (height and weight), flatfoot diagnosis and plantar pressure parameters (maximum pressure, time to maximum force, and contact time percentage in bilateral forefoot, midfoot, and hindfoot) were recorded. Participants were categorized into 3 age groups (3-6 years, 7-9 years, and 10-12 years) and were grouped by gender as well. Intergroup comparisons used one-way ANOVA or least-significant difference test or χ2 tests. Spearman′s rank correlation assessed the relationship between flatfoot prevalence and age. Results:Among 272 children (143 boys, 129 girls), age groups comprised 3-6 years (118 children, 64 boys and 54 girls), 7-9 years (96 children, 49 boys and 47 girls), and 10-12 years (58 children, 30 boys and 28 girls). Flatfoot prevalence was higher in boys than in that of girls (41.3% (59/143) vs. 28.7% (37/129), χ2=4.70, P=0.030), and negatively correlated with age ( r=-0.21, P<0.001). There all had statistically differences in the maximum pressure values of the bilateral forefoot and hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). The maximum pressure values of bilateral midfoot in the group of aged 10-12 years were all higher than those of the other two groups (all P<0.001). There had no statistically differences in the time maximum force value of the bilateral forefoot among the 3 age groups (all P>0.05). The time maximum force values of bilateral midfoot in the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). There all had statistically differences in the time maximum force value of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There all had statistically differences in the contact time percentage values of the bilateral forefoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all the lowest, and those of the group of aged 10-12 years were all the highest (all P<0.05). There had no statistically differences in the contact time percentage values of the bilateral midfoot among the 3 age groups (all P>0.05). There all had statistically differences in the contact time percentage values of the bilateral hindfoot among the 3 age groups (all P<0.001), and after pairwise comparison, those of the group of aged 3-6 years were all lower than those of the other two groups (all P<0.05). Conclusion:Plantar pressure parameters exhibit distinct age-related patterns, reflecting the development of gait patterns and foot arch formation, which will be useful for monitoring physical growth and sports rehabilitation.

Objective:To analyze the diagnostic value of bedside capsule endoscopy in patients with acute or severe gastrointestinal bleeding.Methods:Clinical data from patients who underwent bedside capsule endoscopy due to acute or severe suspected gastrointestinal bleeding in Nanfang Hospital, Southern Medical University from June 2018 to September 2021 were analyzed retrospectively. The efficacy of capsule endoscopy in detecting upper gastrointestinal tract and small intestinal bleeding was evaluated.Results:A total of 74 patients underwent bedside capsule endoscopy for suspected acute or severe gastrointestinal bleeding. Five patients were excluded due to failure of examination due to retention of capsule endoscope in the gastric lumen, and 69 were included in the study, of whom 54 patients with a definitive diagnosis of gastrointestinal hemorrhage. The positive detection rate of the capsule endoscopy was 83.33% (45/54), including 17 cases of ulcer, 5 cases of erosion, 5 cases of vascular malformation, 4 protrusion mass, 4 diverticulum, 5 obscure gastrointestinal bleeding, 1 stenosis , 1 active mucosal blood exudation, 1 gastric retention, 1 mucosal swelling, and 1 mucosal wrinkle change. The sensitivity and specificity of capsule endoscopy in the diagnosis of upper gastrointestinal bleeding were 92.31% (12/13) and 75.00% (3/4) respectively. The sensitivity and specificity of capsule endoscopy for diagnosing small intestinal bleeding were 80.49% (33/41) and 90.91% (10/11) respectively.Conclusion:Bedside capsule endoscopy demonstrates high sensitivity and specificity in the diagnosis of gastrointestinal bleeding, showing potential advantages in bedside applications for acute and severe gastrointestinal bleeding.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective To investigate changes in gut microbiota during diabetic nephropathy(DN)pro-gression using 16S rDNA sequencing technology.Methods A total of 90 male SD rats were randomly divided into a normal control group(n=10,no modeling,regular feeding)and a model group(diabetes model).The diabetes model was established by a single intraperitoneal injection of streptozotocin(STZ)at 60 mg/kg,with regular feeding.According to the feeding time after modeling,the rats were divided into 2-week,4-week,8-week,and 12-week model groups(fed for 2,4,8,and 12 weeks after model establishment),with 20 rats in each group.Blood urea nitrogen(BUN)was measured using the urease method,serum creatinine(Scr)was deter-mined by the picric acid method,and ELISA was used to detect urinary kidney injury molecule-1(KIM-1)and neutrophil gelatinase-associated lipocalin(NGAL)levels.HE,PAS,and Masson staining were used to observe renal tissue pathological changes.Gut microbiota was collected from the rats,and 16S rDNA gene sequencing was used to analyze the gut microbiota to understand changes in the gut microbiota.Results Compared with the normal control group,the levels of KIM-1 and NGAL in urine of rats in all model groups were significantly increased(P<0.05).Pathological staining results showed that,compared with the normal control group,rats in all model groups exhibited diffuse thickening of the glomerular basement membrane and pathological chan-ges such as local necrosis and vacuolar degeneration in renal tubular epithelial cells.16S rDNA sequencing re-sults indicated that the abundance and structure of intestinal microbiota in rats of all model groups changed.Compared with the normal control group,in the 8-week and 12-week model groups,the relative abundance of Bacteroides and Akkermansia decreased,while the relative abundance of Roseburia,Alloprevotella,Prevotel-laceae-Ga6A1,and Ruminococcaceae UCG-005 increased.Compared with the normal control group,in the 12-week model group,the abundance of Akkermansia decreased and that of Prevotellaceae-NK3B31 increased.Conclusion The abundance and structure of gut microbial community in DN rats under conventional feeding at different time points change significantly,further confirming the"gut-kidney axis"theory.

Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease, and extracranial-intracranial revascularization is the most commonly treatment for MMD. With the continuous development of imaging techniques, the perioperative monitoring methods for MMD patients have gradually become more diverse. However, Doppler ultrasound still holds an important position due to its convenience and non-invasiveness. This article reviews the role of Doppler ultrasound in the perioperative assessment of patients with MMD.

Objective:To explore the relief effect and mechanism of electroacupuncture in rats with knee osteoarthritis (KOA) based on the NF-κB/NLRP3 signaling pathway.Methods:SD rats were divided into a blank control group, a model group, an electroacupuncture group, and an electroacupuncture+PMA group using a random number table method, with 10 rats in each group. Except for the blank control group, all other groups were used to prepare KOA models. After successful modeling, rats in the electroacupuncture group and electroacupuncture+PMA group were subjected to electroacupuncture stimulation on both sides of the "Yanglingquan"(GB34), "Neixiyan"(EX LE4), and "Waixiyan"(EX-LE5); the electroacupuncture+PMA group received intraperitoneal injection of 5 mg/kg PMA once a day for 11 consecutive days of intervention; the blank control group and model group did not receive any intervention. Thermal foot contraction latency (TWL) and mechanical foot contraction threshold (MWT) were detected. HE staining was used to observe the inflammation and damage of synovial tissue and knee articular cartilage tissue. ELISA was used to detect the levels of calcitonin gene-related peptide (CGRP), pain mediator substance P (SP) and IL-6 in serum. The expressions of CGRP, iNOS proteins in dorsal root ganglion were detected by immunofluorescence assay. The expressions of CGRP, iNOS, p-p65/p65, NLRP3, Caspase-1, ASC proteins in dorsal root ganglia were detected by Western blot.Results:Compared with the model group, the TWL and MWT of the rats in the electroacupuncture group (3, 6, 9 and 11 days) significantly increased ( P<0.05), the pathological damage of synovial tissue and knee articular cartilage tissue were reduced, serum CGRP, SP, IL-6 levels significantly decreased ( P<0.05), and the expressions of CGRP, iNOS, p-p65/p65, NLRP3, Caspase-1, ASC proteins in dorsal root ganglion significantly decreased ( P<0.05); PMA significantly inhibited the effect of electrolysis on KOA rats ( P<0.05). Conclusion:Electroacupuncture can alleviate pain symptoms in KOA rats, and the mechanism may be related to the inhibition of the activation of NF-κB/NLRP3 signaling pathway.