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.

Bowel sounds are important acoustic physiological signals that reflect gastrointestinal motility and have significant clinical value in the evaluation of postoperative ileus， intestinal obstruction， and inflammatory bowel diseases. Conventional auscultation is highly subjective and often irreproducible， making continuous and objective monitoring difficult. With advances in microelectronics and signal processing technologies， wearable devices have enabled long-term， dynamic， and noninvasive acquisition of bowel sound signals. Meanwhile， ecological momentary assessment （EMA）， characterized by real-time and repeated data collection of individual behaviors and physiological states in realistic situations， provides a novel methodological framework to overcome the limitations of momentary bowel sound monitoring and to facilitate context-based interpretation. This review systematically summarizes the development of wearable bowel sound monitoring technologies， outlining three stages of the technological evolution stationary acquisition， dedicated portable systems， and wearable long-term monitoring. The clinical application value of bowel sound monitoring in multiple scenarios， including irritable bowel syndrome and inflammatory bowel diseases， is also discussed. Furthermore， the theoretical framework of EMA is introduced for the first time in the field of bowel sound monitoring， and its potential value， application scenarios， and methodological challenges are explored. The integration of wearable technology with the EMA framework may provide a theoretical basis for constructing an，individualized long-term gastrointestinal motility monitoring system with high ecological validity， to optimize postoperative care， improve home management of chronic gastrointestinal diseases， and advance precision health monitoring. Future efforts should focus on key issues such as equipment standardization， clinical validation， and algorithmic interpretability to accelerate progress in this field.

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.

To develop vaccines for the prevention and control of porcine circovirus 2d genotype(PCV2d)and pseudorabies virus(PRV),the PCV2d ORF2 gene was amplified by PCR,and cloned into the BamH Ⅰ site of PRV transfer plasmid pG vector harboring the enhanced green fluorescent protein(EGFP)gene.The resulting recombinant transfer plasmid pG-PCV2d-EGFP was transfect-ed into ST cells infected with the three gene deleted PRV variant strain gE-/g-/TK-PRV NY to generate a recombinant virus rPRV-PCV2d-EGFP+,and then the EGFP gene was knocked out to harvest the rPRV-PCV2d using gene-editing technology termed CRISPR/Cas9 system.The recom-binant virus rPRV-PCV2d had similar genetic stability to the parental PRV as indicated by PCR and one-step growth curve test,and the expression of PCV2d capsid(Cap)protein was validated by Western blot.In animal experiment,higher PCV2-specific ELISA antibodies and detectable PCV2-specific neutralizing antibodies could be elicited in mice immunized with the recombinant vi-rus rPRV-PCV2d compared to commercial PCV2 inactivated vaccine.rPRV-PCV2d significantly re-duced the PCV2d loads in tissues such as the heart,liver and spleen of mice following virulent PCV2d challenge.Moreover,rPRV-PCV2d elicits PRV-specific immune responses in mice and can prevent PRV virulent infection in mice,indicating the recombinant virus rPRV-PCV2d has strong immunogenicity.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

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*

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.