Objective:To analyze the current status, hotspots, and trends of community integration (CI) at home and abroad, providing directions for subsequent research.Methods:The China National Knowledge Infrastructure and the Web of Science Core Collection data were used, and CiteSpace software was employed to analyze the publication, countries, disciplines, and keywords of CI.Results:A total of 932 Chinese and 2 319 English hits were included. The publication of CI had shown an increasing trend both domestically and internationally. Sociology and rehabilitation were the main disciplines in CI domestically and internationally, respectively. Domestically, CI research primarily focused on the community integration of migrant workers, floating populations, and accompanying family members. Internationally, the emphasis was on the integration of individuals with disabilities and other special groups. Future research directions in China were likely to focus on group work, the elderly, and relocated populations. Internationally, CI research would continue to concentrate on CI experiences and intervention methods for individuals with disabilities and special populations.Conclusion:CI is increasingly gaining attention both domestically and internationally. However, domestic research remains insufficient and needs to be expanded through more empirical studies in various vertical subfields. Future domestic scholars should continue to focus on CI of the elderly and engage in interdisciplinary research.

Objective:To analyze the current status, hotspots, and trends of community integration (CI) at home and abroad, providing directions for subsequent research.Methods:The China National Knowledge Infrastructure and the Web of Science Core Collection data were used, and CiteSpace software was employed to analyze the publication, countries, disciplines, and keywords of CI.Results:A total of 932 Chinese and 2 319 English hits were included. The publication of CI had shown an increasing trend both domestically and internationally. Sociology and rehabilitation were the main disciplines in CI domestically and internationally, respectively. Domestically, CI research primarily focused on the community integration of migrant workers, floating populations, and accompanying family members. Internationally, the emphasis was on the integration of individuals with disabilities and other special groups. Future research directions in China were likely to focus on group work, the elderly, and relocated populations. Internationally, CI research would continue to concentrate on CI experiences and intervention methods for individuals with disabilities and special populations.Conclusion:CI is increasingly gaining attention both domestically and internationally. However, domestic research remains insufficient and needs to be expanded through more empirical studies in various vertical subfields. Future domestic scholars should continue to focus on CI of the elderly and engage in interdisciplinary research.

Objective:To investigate the influencing factors for gastrointestinal leakage and its occurrence time after minimally invasive radical gastrectomy for gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 3 135 patients with gastric cancer who were admitted to The First Affiliated Hospital of Army Medical University from January 2004 to December 2022 were collected. There were 2 174 males and 961 females, aged (57±11)years. Gastrointestinal leakage occurring within 4 days after surgery was defined as early gastrointestinal leakage, and gastrointestinal leakage occuring more than 4 days after surgery was defined as late gastrointestinal leakage. Measurement data with normal distribution were represented as Mean± SD, and t test was used for comparison between groups. Measurement data with skewed distribution were represented as M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups. Count data were represented as absolute numbers, and chi-square test or Fisher exact pro-bability was used for comparison between groups. Comparison of ordinal data was conducted using the nonparameter rank sum test. Logistic regression model was used for univariate analysis, and Logistic forward stepwise regression model was used for multivariate analysis. Results:(1) Clinico-pathological characteristics of patients with and without postoperative gastrointestinal leakage. Of the 3 135 patients, there were 3 056 patients without gastrointestinal leakage and 79 patients with gastrointestinal leakage after operation, and there were significant differences in age, American Society of Anesthesiologists classification, neoadjuvant chemotherapy, surgical resection range, volume of intraoperative blood loss and surgeon′s experience between them ( P<0.05). (2) Postoperative gastro-intestinal leakage and treatment. Of the 79 patients with postoperative gastrointestinal leakage, there were 36 patients with esophagojejunal anastomotic leakage (2 patients combined with jejunal anastomotic leakage), 29 patients with duodenal stump leakage, 11 patients with gastrojejunal anas-tomotic leakage, 2 patients with esophagogastric anastomotic leakage and 1 patient with gastroduo-denal anastomotic leakage. The same patient could be combined with more than one kind of gastro-intestinal leakage. Thirty-four patients were improved after conservative treatment, 31 patients were improved after puncture drainage or endoscopic interventional therapy, and 14 patients were treated with secondary surgery. Among the patients who underwent secondary surgery, 5 patients died during perioperative period. The time to occurrence of postoperative gastrointestinal leakage of 79 patients was 5(4, 8)days, with the earliest occurrence at 1 day after operation, and the latest occurrence at 16 days after operation. (3) Analysis of influencing factors for the occurrence time of postopera-tive gastrointestinal leakage. Results of multivariate analysis showed that neoadjuvant chemotherapy, total gastrectomy and surgeon′s experience ≤50 patients were independent risk factors for early gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer ( odds ratio=4.262, 2.179, 5.015, 95% confidence interval as 1.386-13.110, 1.026-4.627, 2.378-10.537, P<0.05). Age>60 years, total gastrectomy, volume of intraoperative bleeding loss>200 mL were independent risk factors for late gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer ( odds ratio=3.031, 2.804, 2.223, 95% confidence interval as 1.631-5.631, 1.535-5.122, 1.190-4.151, P<0.05). Conclusions:Most patients with gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer can be cured by non-surgical methods. Neoadjuvant chemo-therapy and surgeon′s experience ≤ 50 patients are independent risk factors for early gastrointes-tinal leakage after minimally invasive radical gastrectomy. Age >60 years and volume of intraopera-tive blood loss >200 mL are independent risk factors for late gastrointestinal leakage after minimally invasive radical gastrectomy. Total gastrectomy is an independent risk factor for both early and late gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer.

【Objective】 To explore the effect of metaphors based on children′s games on the negative emotion and behavior of children during the recovery period of traumatic brain injury, in order to provide reference for making intervention strategy for these children. 【Methods】 From May 2021 to October 2022, a total of 60 children aged 6-12 years who underwent rehabilitation in the rehabilitation center of the Second Affiliated Hospital of Wenzhou Medical University were selected into this study, and were randomly divided into experimental group and control group, with 30 cases in each group.The control group was given routine nursing, while the experimental group was given metaphorical intervention based on children′s games.The scores of social living ability, abnormal behavior detection rate, depression score, anxiety score and cognitive function were compared between the two groups. 【Results】 The scale score of the two groups was not significantly different before intervention(P>0.05).After intervention, the infant-junior high school students′ social living ability score, Mini-Mental State Examination and the Loewenstein Occupational Therapy Cognitive Assessment score in the experimental group were higher than those in the control group (t=3.175, 5.265, 7.835, P<0.001).The scores of Child Behavior Checklist (CBCL), the children′s depression inventory and the screen for child anxiety related emotional disorders in the experimental group were lower than those in the control group (Z=7.823, t=6.398, 6.248, P<0.001). 【Conclusions】 Metaphorical intervention based on children′s games can reduce the negative emotions of anxiety and depression in children with traumatic brain injury, improve their social life ability, reduce the CBCL score, and improve the cognitive function.

Objective:To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion.Methods:This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age ( M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results:Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95% CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95% CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95% CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95% CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95% CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95% CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95% CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95% CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions:Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.

Objective:To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion.Methods:This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age ( M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results:Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95% CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95% CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95% CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95% CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95% CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95% CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95% CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95% CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions:Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.

Objective:To investigate the influencing factors for gastrointestinal leakage and its occurrence time after minimally invasive radical gastrectomy for gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 3 135 patients with gastric cancer who were admitted to The First Affiliated Hospital of Army Medical University from January 2004 to December 2022 were collected. There were 2 174 males and 961 females, aged (57±11)years. Gastrointestinal leakage occurring within 4 days after surgery was defined as early gastrointestinal leakage, and gastrointestinal leakage occuring more than 4 days after surgery was defined as late gastrointestinal leakage. Measurement data with normal distribution were represented as Mean± SD, and t test was used for comparison between groups. Measurement data with skewed distribution were represented as M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups. Count data were represented as absolute numbers, and chi-square test or Fisher exact pro-bability was used for comparison between groups. Comparison of ordinal data was conducted using the nonparameter rank sum test. Logistic regression model was used for univariate analysis, and Logistic forward stepwise regression model was used for multivariate analysis. Results:(1) Clinico-pathological characteristics of patients with and without postoperative gastrointestinal leakage. Of the 3 135 patients, there were 3 056 patients without gastrointestinal leakage and 79 patients with gastrointestinal leakage after operation, and there were significant differences in age, American Society of Anesthesiologists classification, neoadjuvant chemotherapy, surgical resection range, volume of intraoperative blood loss and surgeon′s experience between them ( P<0.05). (2) Postoperative gastro-intestinal leakage and treatment. Of the 79 patients with postoperative gastrointestinal leakage, there were 36 patients with esophagojejunal anastomotic leakage (2 patients combined with jejunal anastomotic leakage), 29 patients with duodenal stump leakage, 11 patients with gastrojejunal anas-tomotic leakage, 2 patients with esophagogastric anastomotic leakage and 1 patient with gastroduo-denal anastomotic leakage. The same patient could be combined with more than one kind of gastro-intestinal leakage. Thirty-four patients were improved after conservative treatment, 31 patients were improved after puncture drainage or endoscopic interventional therapy, and 14 patients were treated with secondary surgery. Among the patients who underwent secondary surgery, 5 patients died during perioperative period. The time to occurrence of postoperative gastrointestinal leakage of 79 patients was 5(4, 8)days, with the earliest occurrence at 1 day after operation, and the latest occurrence at 16 days after operation. (3) Analysis of influencing factors for the occurrence time of postopera-tive gastrointestinal leakage. Results of multivariate analysis showed that neoadjuvant chemotherapy, total gastrectomy and surgeon′s experience ≤50 patients were independent risk factors for early gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer ( odds ratio=4.262, 2.179, 5.015, 95% confidence interval as 1.386-13.110, 1.026-4.627, 2.378-10.537, P<0.05). Age>60 years, total gastrectomy, volume of intraoperative bleeding loss>200 mL were independent risk factors for late gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer ( odds ratio=3.031, 2.804, 2.223, 95% confidence interval as 1.631-5.631, 1.535-5.122, 1.190-4.151, P<0.05). Conclusions:Most patients with gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer can be cured by non-surgical methods. Neoadjuvant chemo-therapy and surgeon′s experience ≤ 50 patients are independent risk factors for early gastrointes-tinal leakage after minimally invasive radical gastrectomy. Age >60 years and volume of intraopera-tive blood loss >200 mL are independent risk factors for late gastrointestinal leakage after minimally invasive radical gastrectomy. Total gastrectomy is an independent risk factor for both early and late gastrointestinal leakage after minimally invasive radical gastrectomy for gastric cancer.

Objective:To investigate the short-term outcomes of totally robotic surgical system and robotic surgical system assisted radical gastrectomy for gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 290 patients who under-went robotic surgical system radical gastrectomy for gastric cancer in the First Affiliated Hospital of Army Medical University from January 2018 to November 2021 were collected. There were 208 males and 82 females, aged 58 (range, 24?84)years. Of the 290 patients, 125 patients undergoing totally robotic surgical system radical gastrectomy combined with reconstruction of digestive tract were divided into the totally robot group, and 165 patients undergoing robotic surgical system radical gastrectomy combined with a small midline incision-assisted reconstruction of digestive tract were divided into the robotic-assisted group. Observation indicators: (1) surgical and postoperative situations; (2) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was conducted using the non-parameter rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations. The operation time, volume of intraoperative blood loss, length of incision, duration of postoperative analgesic using, time to postoperative gastric tube removal, time to postoperative initial water intake, time to postoperative first anal flatus, duration of post-operative hospital stay were (246±43)minutes, (104±51)mL, 4(range, 3?6)cm, (2.2±0.5)days, 36(range, 10?112)hours, 62(range, 32?205)hours, 63(range, 18?138)hours, 8(range, 6?50)days in patients of the totally robot group, versus (296±59)minutes, (143±87)mL, 6(range, 3?13)cm, (3.6±0.7)days, 42(range, 12?262)hours, 90(range, 18?262)hours, 80(range, 16?295)hours, 9(range, 6?63)days in patients of the robotic-assisted group, showing significant differences in the above indicators between the two groups ( t=8.04, 4.42, Z=?13.98, t=18.46, Z=?5.47, ?5.87, ?6.14, ?4.04, P<0.05). (2) Post-operative complications. Cases with systemic related complications and cases with pulmonary infection were 7 and 4 in patients of the totally robot group, versus 31 and 16 in patients of the robotic-assisted group, showing significant differences in the above indicators between the two groups ( χ2=10.86, 4.68, P<0.05). Further analysis showed that there were significant differences in age ≥60 years, body mass index ≥25 kg/m 2, tumor diameter ≥3 cm, TNM staging as stage Ⅲ of cases with postoperative complications between the totally robot group and the robotic-assisted group ( odds ratio=0.44, 0.17, 0.40, 0.31, 95 confidence interval as 0.20?1.00, 0.03?0.88, 0.18?0.89, 0.11?0.84, P<0.05). Conclusion:Totally robotic surgical system radical gastrectomy for gastric cancer is safe and feasible with advantages of minimal trauma and quick recovery, especially for patients as age ≥60 years, body mass index ≥25 kg/cm 2, tumor diameter ≥3 cm and TNM stage Ⅲ in complication controlling.

Objective:To investigate the regulating molecules and acting mechanism of TAB182 in HR pathway.Methods:TAB182 in human breast cancer MCF-7 cells was knocked down by shRNA strategy, the TAB182 knockdown MCF-7 as the TAB182 knockdown group, and the MCF-7 cell using the shRNA negative control as the TAB182 negative control group. RNA sequencing and qRT-PCR were performed to screen and verify the differentially expressed genes of HR pathway related to TAB182 depression. Western blot was used to detect protein expression. Immunofluorescence staining of nuclear RAD51 and BrdU was used to check the 3′ ssDNA formation by the end resection. The cell cycle arrest and apoptosis were measured by flow cytometry. Cloning formation assay was used to evaluate the sensitivity TAB182-knockdown cells to radiation.Results:Both quantitative RNA sequencing and qRT-PCR assays showed that TAB182-knockdown significantly decreased the mRNA expression of RPA2( t=17.97, P<0.05). Compared with the TAB182 negative control group, the protein level of RPA2, the number of RAD51 foci, and the 3′ ssDNA-binding nuclear protein marker BrdU in TAB182-knockdown cells were significantly reduced. At 4, 8, and 12 h after actinomycin D treatment, the attenuation of RPA2 mRNA in the TAB182-knockdown cells was accelerated ( t=5.37, 3.79, 3.69, P<0.05). Compared with the TAB182 negative control group, the radiosensitivity and radiation-induced apoptosis in the TAB182-knockdown group were increased ( t=3.48, 11.05, P<0.05), and at 24 h after irradiation, the cell cycle block time was prolonged ( t=8.40, P<0.01). Conclusions:TAB182 plays a role in maintaining RPA2 mRNA stability, thereby promoting HR repair. TAB182 knockdown cells are highly sensitive to ionizing radiation.

Objective:To investigate disease benefit finding of primary caregivers of children with cerebral palsy, in order to provide reference for clinical diagnosis, treatment and nursing of children with cerebral palsy.Methods:Using the phenomenological method of qualitative research, a total of 12 primary caregivers of children with cerebral palsy were selected from the outpatient and inpatient wards of Department of Child Rehabilitation in the Second Affiliated Hospital of Wenzhou Medical University/Yuying Children's Hospital from October 2020 to February 2021 by the purposive sampling method. Semi-structured interviews were conducted to understand the feelings of the primary caregivers when their children were diagnosed with cerebral palsy, how their thoughts changed during care and what coping methods they adopted. Colaizzi 7-step content analysis was used to analyze the collected text data.Results:The disease benefit finding of primary caregivers of children with cerebral palsy was mainly reflected in self-growth (cultivating healthy behaviors, learning to face and accept reality and enhancing emotional regulation), positive prospects for future life (cherishing the present and re-planning life, looking at things from a positive perspective, strengthening beliefs and regaining hope), improvement of interpersonal relationships (closer husband and wife relationship, more harmonious relationship between family members, feeling the care of medical staff and support and understanding from peers) and diversified social support (crowdfunding platforms provided by social welfare projects, government subsidy) .Conclusions:The disease benefit finding of primary caregivers of children with cerebral palsy is mainly manifested in four aspects, including self-growth, changes in life attitudes, improvement of interpersonal relationships and social support. Medical staff can carry out psychological interventions for the main caregivers of children with cerebral palsy from the above four aspects, relieve their negative emotions, improve their psychological adjustment capabilities and enhance their disease benefit finding.