Objective: To explore the characteristics of the diversity and composition of oral microbial flora with age, and to provide a reference for understanding the succession of oral microecology at different ages. Methods: Oral rinse 16S rRNA (V4 region) sequencing data from 9 021 participants 14-69 years of age in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Alpha diversity (Observed OTUs, Faith’s PD, Shannon Index), beta diversity (Bray-Curtis and UniFrac), and genus-level composition were examined using weighted generalized linear models (GLMs), including quadratic terms for age and adjusting for key covariates (gender, race/ethnicity, BMI, smoking status, and periodontitis severity). Results: Alpha diversity demonstrated a clear inverted U-shaped trajectory across age, peaking at 25-30 years old and declining thereafter. This trend remained consistent across sex, race, smoking, and periodontal health strata. Beta diversity analyses revealed a modest but steady age-related shift in community structure. Genus-level analyses revealed that Rothia, Prevotella_6, and Lactobacillus increased steadily with age, while Haemophilus, Porphyromonas, and Corynebacterium declined significantly. Notably, potential periodontopathogens, such as Fusobacterium and Treponema_2, peaked in early adulthood before declining with age. Conclusion Age is an important driver of oral microbial succession, and the oral microbiome exhibits dynamic changes across different life stages. Future longitudinal and multi-omic studies are warranted to elucidate the mechanisms underlying these age-related trajectories.

Objective To evaluate the clinical efficacy of a novel sleep-aid decoction in treating elderly insomnia patients with different traditional Chinese medicine (TCM) constitutional types, and its effects on neurotransmitter and inflammatory factor levels. Methods A total of 200 patients with four different TCM constitutions-peaceful, Qi-deficient, Yin-deficient, and Yang-deficient-were recruited. Peripheral blood neurotransmitter and inflammatory factor levels were measured for variations among insomnia patients across different constitutions. These patients were treated using the novel sleep-aid decoction, the effects of which were evaluated based on changes in neurotransmitters and inflammatory factors. Results Compared to the peaceful constitution group, insomnia patients with Qi-deficient, Yin-deficient, and Yang-deficient constitutions exhibited significantly elevated baseline levels of neurotransmitters (5-HT, GABA) and inflammatory factors (IL-6, TNF-α, IL-1β, CRP). Following the treatment, the Qi-deficient and Yin-deficient groups showed a marked increase in 5-HT levels, restored balance of Glu, GABA, and melatonin, and significant reductions in IL-6 and TNF-α levels. The overall effective rate was 83.5%, with optimal efficacy observed in the Qi-deficient (97.72%) and Yin-deficient (95.34%) groups. Conclusion The novel sleep-aid decoction is effective in treating insomnia in elderly patients, with the best results observed in the Qi-deficient and Yin-deficient constitution groups.
Humans ; Sleep Initiation and Maintenance Disorders/blood* ; Aged ; Male ; Female ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Middle Aged ; Tumor Necrosis Factor-alpha/blood* ; Sleep Aids, Pharmaceutical/therapeutic use* ; Anti-Inflammatory Agents/therapeutic use* ; Interleukin-6/blood* ; Interleukin-1beta/blood* ; Neurotransmitter Agents/blood* ; Aged, 80 and over ; C-Reactive Protein/metabolism*

Time perspective therapy can reshape the time perspective of chronic disease patients,improve their psychological state,optimize behavioral patterns,and enhance self-management awareness.This article reviews the concept and theoretical basis of time perspective therapy,assessment methods of time perspective,and influencing factors of time perspective in chronic disease patients,as well as methods and effects of applying time perspective therapy in self-management.Additionally,it analyzes challenges in implementation and proposes practical recommendations,aiming to provide psychological guidance for self-management interventions in chronic disease patients.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.

The Occupational Classification Dictionary of the People's Republic of China (2015 Edition) has added a new occupation type, Medical Nursing Assistants, aiming to meet the strong demand for medical care in the context of the aging population in China.In order to standardize the services of medical nursing assistants for the elderly in home and community settings and contribute to healthy aging, the National Health Commission issued the " Service Standards for Medical Nursing Assistants of Older Adults in Home and Community" ( WS/ T 803—2022) on September 28, 2022.The standards regulate the service processes, service items and requirements, as well as service evaluation and improvement for elderly medical nursing assistants.The interpretation of the standard's formulation background, the compilation process, and the standard's content are as follows.

Objective:To investigate the imaging characteristics of clear cell acanthoma (CCA) by dermoscopy and reflectance confocal microscopy (RCM) .Methods:A retrospective analysis was conducted on 12 patients diagnosed with CCA through histopathological examination at the Department of Dermatology, Wuhan No.1 Hospital, from 2020 to 2024. Dermoscopic and RCM features of these cases were summarized.Results:Among the 12 CCA patients, 3 were males and 9 were females, and they were aged 50.08 ± 10.43 years. Clinically, CCA lesions were typically presented as red or brown papules or nodules with well-defined borders, ranging in diameter from 3 mm to 2 cm. Histopathological examination showed that the tumor manifested as psoriasiform or papillary hyperplasia with a thickened spinous layer and a distinct boundary surrounded by the normal skin; proliferating cells were larger with lightly stained cytoplasm; neutrophil infiltration was observed in the epidermis, and vascular dilation was observed in the dermal papillae and superficial dermis; periodic acid-Schiff staining revealed abundant glycogen in the cells. In 10 patients examined by dermoscopy, dotted, globular, or glomerular vessels were arranged in a beaded pattern in all the 10 patients, and collar-like scales were seen at the edges of the lesions in 6 patients. In 6 patients examined by RCM, RCM images all revealed epidermal hyperplasia, thickened spinous layers, large keratinocytes with enlarged nuclei and abundant cytoplasm that blended in with the intercellular demarcations, disordered honeycomb structure of the epidermis, and dilation and up-thrust of blood vessels in the dermal papillae and superficial dermis; segmented cell infiltration was observed in the epidermis of 4 patients. As measured, the longest diameters of cells in the upper part of the CCA spinous layer ranged from 30.25 μm to 35.13 μm; the longest diameters of spinous layer cells at the CCA follicles (19.39 ± 2.93 μm) were significantly lower than those of the surrounding spinous layer cells (30.95 ± 5.66 μm, t = 5.73, P < 0.001) . Conclusions:CCA presents a distinctive vascular pattern on dermoscopy, and the majority of histological features can be visualized by RCM. Dermoscopy and RCM can be relatively reliable auxiliary diagnostic methods for CCA.

Diabetic foot is one of the most common and serious chronic complications in diabetic patients.With the advancement of digital healthcare,digital therapy has been gradually implemented and promoted among diabetic foot patients as an emerging tool with the advantages of safety,efficiency,and intelligence that can make up for the shortcomings of traditional diabetic foot risk assessment,health education,and self-management.This study provides an overview of digital therapeutics,summarizes its application in patients with diabetic foot,and proposes relevant recommendations,aiming to provide a reference for improving the quality of life and satisfaction of patients with diabetic foot and reducing the recurrence of diabetic foot.

Objective To explore the predictive value of electroencephalograph(EEG)quantitative parameters combined with serum microRNAs(miR)-146a-5p in cognitive dysfunction in patients with Alzheimer's disease(AD).Methods A total of 96 AD patients diagnosed in Shaoxing Seventh People's Hospital from March 2022 to May 2024 were selected to assess whether the patients had cognitive impairment according to the Montreal cognitive scale(MoCA)score,and 40 patients with cognitive impairment were set as occurrence group(MoCA score＜26points).A total of 56 patients with normal cognitive function were set as non-developing group(MoCA score ≥ 26points).Quantitative electroencephalography(EEG)parameters and serum miR-146a-5p were compared between the two groups.The risk factors of cognitive dysfunction in AD patients were analyzed by Logistic regression,and receiver operating characteristic curve was used to predict efficacy of EEG quantitative parameters and serum miR-146a-5p on cognitive dysfunction in AD patients.Results The δ frequency band,θ frequency band,and serum miR-146a-5p levels were lower in occurrence group than those in non occurrence group,while β frequency band and α frequency band were higher in occurrence group than in those non occurrence group(P＜0.05).δ frequency band,θ frequency band,miR-146a-5p,age,and years of education were risk factors for cognitive dysfunction in AD patients(P＜0.05).The area under the curve(AUC)of predicting cognitive impairment in AD patients using the combination of δ frequency band,θ frequency band,βfrequency band,α frequency band,and miR-146a-5p was 0.908.The sensitivity of predicting cognitive impairment in AD patients using the combination of delta frequency band,δ frequency band,β frequency band,α frequency band,and miR-146a-5p was higher than that of individual detection(P＜0.05).Conclusion The decrease in δ frequency band,θ frequency band,serum miR-146a-5p,and the increase in β frequency band and α frequency are closely related to the occurrence of cognitive dysfunction in AD patients.Combined detection of EEG of electroencephalogram and serum miR-146a-5p can improve the predictive efficiency of cognitive dysfunction.

This study summarized the nursing experience of midline catheter insertion in 12 patients with a body mass index≥50,providing clinical references.Key nursing interventions included:pre-insertion patient positioning was adjusted to semi-Fowler's or sitting position based on respiratory status.The puncture sites were chosen at the middle or distal third of the upper arm with elbow flexion.The widened tourniquets and extended-length needles/catheter sheaths were used according to vascular depth and puncture angle.The modified pre-insertion length measurement and real-time ultrasound-guided vascular puncture were applied.The catheter with crisscross elastic bandage was secured post-insertion.All 12 patients successfully underwent catheterization,with devices removed after completing intravenous therapy and blood sampling.

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.