ObjectiveTo investigate the effects of Simiaowan on intestinal barrier function and adenosine triphosphate （ATP） binding cassette transporter G2 （ABCG2） expression in hyperuricemic （HUA） rats， and elucidate its therapeutic mechanisms. MethodsForty male Sprague Dawley （SD） rats were randomized into a normal group， a model group， low-dose （282.6 mg·kg^-1） and high-dose （565.2 mg·kg^-1） Simiaowan groups， and a Benzbromarone （4.7 mg·kg^-1） group. The HUA model was established via intraperitoneal injection of potassium oxonate （ip） combined with oral gavage of hypoxanthine （ig） for 14 days. Following modeling， treatments were administered for 14 days. Samples were collected and weighed 4 h after final dosing. Blood uric acid and hepatic function were analyzed. Histopathological changes were evaluated by hematoxylin-eosin （HE） staining， and Chiu's scoring was conducted. Enzyme-linked immunosorbent assay （ELISA） quantified tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， lipopolysaccharide （LPS）， diamine oxidase （DAO）， and D-lactic acid （D-LA） levels. Real-time polymerase chain reaction （Real-time PCR）， Western blot， and immunohistochemistry assessed the expression of Claudin-1， Occludin， occludens-1 （ZO-1）， and ABCG2 mRNAs and proteins. 16S rDNA amplicon sequencing characterized ileal microbiota. ResultsCompared with the normal group， the model group exhibited epithelial shedding in the ileal villus， structural disruption， infiltration of extensive inflammatory cells， and significantly elevated Chiu's scores （P<0.01）. The DAO， TNF-α， IL-6， IL-1β， LPS， and D-LA levels in the ileum were markedly increased （P<0.01）， while mRNA and protein expressions of Claudin 1， Occludin， ZO-1， and ABCG2， as well as positive staining area and proportion， were significantly reduced （P<0.01）. Compared with the model group， the Simiaowan groups at all doses showed improved epithelial damage in the ileal villus， significantly lowered Chiu's scores （P<0.01）， significantly reduced DAO， TNF-α， IL-6， IL-1β， LPS， and D-LA levels in the ileum （P<0.01）， and upregulated mRNA and protein expressions of Claudin 1， Occludin， ZO-1， and ABCG2， as well as positive staining area and proportion （P<0.01）. The 16S rDNA results showed that in the model group， the α-diversity index of the ileal microbiota was increased， and species diversity and richness were enhanced， with microbiota dysfunction observed. The community structure of the gut microbiota was significantly different from that of the normal microbiota. The abundance of probiotics was decreased， and the abundance of pathogenic bacteria was increased， with butyrate-producing bacteria showing a low abundance. In contrast， Simiaowan at all doses reduced species diversity and richness， regulated microbiota dysfunction， and promoted the shift of the structure of the gut microbiota community towards a normal one. This increased the abundance of beneficial bacteria， decreased the abundance of harmful bacteria， and restored the abundance of butyrate-producing bacteria. ConclusionSimiaowan enhances ileal uric acid excretion and further alleviates HUA by modulating the gut microbiota composition to improve the intestinal barrier and upregulate the expression of the urate transporter ABCG2 in HUA rats.

ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.

ObjectiveTo investigate the mechanism by which Simiao Wan improve intestinal uric acid excretion in hyperuricemic （HUA） rats by inhibiting ferroptosis via the solute carrier family 7 member 11/glutathione peroxidase 4 （SLC7A11/GPX4） signaling pathway. MethodsForty-eight male SD rats were randomly assigned to a normal group， a model group， a low-dose Simiao Wan group （282.6 mg·kg^-1）， a high-dose Simiao Wan group （565.2 mg·kg^-1）， an etoricoxib group （5.4 mg·kg^-1）， and a ferroptosis inhibitor （Fer-1） group （2 mg·kg^-1）. Except for the normal group， rats in all other groups were intraperitoneally injected with potassium oxonate （100 mg·kg^-1） combined with intragastric administration of hypoxanthine （500 mg·kg^-1） to establish the HUA rat model. After 21 days， rats in each administration group received the corresponding dose of drug by gavage， rats in the Fer-1 group received intraperitoneal injection of Fer-1， and rats in the normal and model groups were given an equal volume of normal saline by gavage. After sampling， serum levels of uric acid （SUA）， creatinine （Cr）， and blood urea nitrogen （BUN） were measured using biochemical assays. The content of ferrous ion （Fe²⁺）， reduced glutathione （GSH）， and malondialdehyde （MDA）， as well as superoxide dismutase （SOD） activity in ileal tissues were determined. Hematoxylin and eosin （HE） staining was performed to observe the histopathological changes in the ileum， and transmission electron microscopy was used to observe mitochondrial alterations in the ileal tissue. Immunohistochemistry （IHC） and Western blot were used to detect the protein expression levels of GPX4， ferritin heavy chain 1 （FTH1）， acyl-CoA synthetase long-chain family member 4 （ACSL4）， SLC7A11， and ATP-binding cassette transporter G2 （ABCG2） in ileal tissue. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to determine the mRNA expression of GPX4， FTH1， ACSL4， SLC7A11， and ABCG2 in the ileal tissue. ResultsCompared with the normal group， the model group exhibited significantly elevated serum UA， Cr， and BUN levels （P<0.01）， significantly increased content of MDA and Fe²⁺ in ileal tissue， and significantly decreased GSH content and SOD activity （P<0.01）. HE staining showed extensive shedding of the ileal villous epithelium， disrupted and disorganized villous structure， and incomplete local tissue architecture. Transmission electron microscopy revealed reduced mitochondrial volume， decreased or even vanished cristae， indicating ultrastructural features characteristic of ferroptosis. Molecular and immunohistochemical results demonstrated that the protein and mRNA expression levels of GPX4， FTH1， SLC7A11， and ABCG2 were significantly downregulated， whereas those of ACSL4 were significantly upregulated （P<0.05， P<0.01）. Compared with the model group， after intervention with Simiao Wan， the serum UA， Cr， and BUN levels significantly decreased in all dose groups （P<0.05，P<0.01）， the MDA and Fe²⁺ content in ileal tissues were significantly reduced （P<0.01）， and the GSH content and SOD activity significantly increased （P<0.01）. HE staining showed that the shedding of ileal villous epithelium was markedly alleviated， the villous structure became relatively intact and regularly arranged， and local tissue damage was obviously improved. Transmission electron microscopy showed attenuated mitochondrial damage， improvement in mitochondrial shrinkage， and partial restoration of mitochondrial cristae. Molecular and immunohistochemical results showed that Simiao Wan upregulated GPX4， FTH1， SLC7A11， and ABCG2， and downregulated ACSL4 in a dose-dependent manner. In the high‑dose group， all indices improved significantly （P<0.05，P<0.01）， whereas in the low‑dose group， only improving trends were observed for FTH1， SLC7A11 mRNA， and ABCG2 protein. ConclusionSimiao Wan may inhibit ferroptosis of ileal epithelial cells by regulating the SLC7A11/GPX4 signaling pathway， and upregulate the expression of the uric acid transporter ABCG2， thereby promoting intestinal uric acid excretion and improving HUA.

Objective: To examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

Objective To observe the value of cervical lymph node ultrasound network model based on deep learning(DL)for diagnosing cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Methods Totally 444 PTC patients with suspected cervical lymph node enlargement on ultrasonography were retrospectively enrolled and divided into metastasis group(n=253)and non-metastasis group(n=191)based on fine needle aspiration pathology and thyroglobulin detection.And 1 754 cervical lymph node ultrasonic images were divided into training set(n=1 404),validation set(n=175)and test set(n=175)at the ratio of 8∶1∶1.Ultrasonic features of cervical lymph nodes were extracted,then ultrasound network model was established using DL,and the diagnostic efficacy of this model for diagnosing lymph node metastasis was analyzed.Results The sensitivity,specificity,accuracy and area under the curve of ultrasound network model for diagnosing cervical lymph node metastasis of PTC was 93.06％,97.05％,95.04％and 0.858 in validation set,which was 86.14％,78.67％,88.49％and 0.828 in test set,respectively.Conclusion Cervical lymph node ultrasound network model based on DL was helpful for diagnosing cervical lymph node metastasis of PTC.

Bedridden patients with cardiopulmonary diseases,elderly long-term bedridden patients,and certain postoperative patients require elevation of their lower limbs to a position above the heart.Traditionally,this is achieved by placing items such as clothing,blankets,or soft objects like leg pads under the lower limb as cushions.However,this method can lead to uneven force distribution on the patient's legs,potentially causing vascular compression and discomfort.To address these issues,the medical staff of department of brain surgery of the Second People's Hospital of Tongxiang City had developed a multi-functional foot pad device incorporating height adjustment,pressure dispersion,and heating functions,based on biomechanical principles.This device has been granted a National Utility Model Patent of China(patent number:ZL 2021 2 3217248.8).The device consists of a cushion plate,a backing plate,a raised block,a rotating shaft,a fixed shaft,a support frame,a chute,a footrest,a gaiter strap,a connecting belt,an extension plate,a drive motor,and a power cord.It allows for angular adjustments ranging from 15°-45° through the use of a rotating backing plate and a chute-supported frame.The arc-shaped footrest,designed ergonomically,and an intelligent temperature control system enable precise adaptation to individual anatomical characteristics.The usage procedure involves placing the adjustable foot pad on a flat bed,positioning the patient's leg in the footrest,securing it with the gaiter strap,adjusting it to a comfortable height,activating the intelligent temperature control system for heating,and promoting limb blood circulation.This device offers an innovative solution for preventing lower extremity deep vein thrombosis(LE-DVT)by employing a multi-dimensional intervention strategy that combines mechanical prevention with physical therapy effects.The adjustable heating foot pad is easy to operate,provides comfort and convenience,and reduces complications such as LE-DVT formation,thereby alleviating the economic burden on patients,enhancing quality of life,and increasing patient and family satisfaction.It is highly suitable for clinical application.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Objective:To explore the correlation between nurses' electronic health literacy and their health education competence.Methods:A convenience sampling method was used to select nurses from 24 secondary and tertiary hospitals in Jincheng for the study from July to August 2022. The Mobile-e Health Literacy Scale and the Nurse Health Education Competence Self-assessment Scale were used to survey the subjects. Pearson correlation analysis was performed to analyze the correlation between nurses' electronic health literacy and their health education competence. Canonical correlation analysis was employed to build a standardized canonical correlation model, conduct canonical structure analysis, and canonical redundancy analysis to explore the relationship between electronic health literacy and health education competence in nurses.Results:A total of 705 questionnaires were distributed, 74 were excluded due to short response times (<120 seconds), regular responses, or incorrect fillings, leaving 631 valid questionnaires, with an effective response rate of 89.5%. The total score of the Mobile-e Health Literacy Scale for 631 nurses was (50.40±8.75), with scores of (12.69±2.41) for self-perception, (21.35±3.70) for information acquisition, and (16.36±3.29) for interaction judgment. The total score for the Nurse Health Education Competence Self-assessment Scale was (366.32±57.51), with subscale scores of (29.71±4.77) for knowledge and experience, (95.65±14.20) for comprehensive quality, and (240.97±40.85) for skills and abilities. The total score of electronic health literacy and the scores of each dimension were positively correlated with the scores of each subscale of health education competence ( P<0.01). Canonical correlation analysis identified three pairs of canonical variables, with correlation coefficients of 0.750, 0.279, and 0.067 for the first, second, and third pairs, respectively. The correlation coefficients of the first and second pairs were statistically significant ( P<0.01). Nurses' electronic health literacy was primarily determined by interaction judgment ( r=-0.982), while health education competence was primarily determined by skills and abilities ( r=-0.995) . Conclusions:There is a positive correlation between nurses' electronic health literacy and health education competence. Enhancing nurses' electronic health literacy is of significant importance for improving their health education competence.

Strengthening ideological and political work is crucial for promoting the high-quality development of public hospitals.From the perspective of the 5W theory of communication,this paper deconstructs and analyzes the five key elements within the ideological and political work of public hospitals:the communicator,the message,the channel,the audience,and the effect.It identifies existing challenges,including the multiple roles of communicators,a disconnect between message content and context,the overwhelming volume of information through numerous channels,the heightened subjective consciousness of the audi-ence,and a lack of feedback mechanisms for assessing effectiveness.The causes of these challenges are analyzed.Corresponding strategies are proposed,such as introducing multi-agent collaboration,strengthening the integration of Party building with profes-sional services,consolidating platform development,enhancing emotional communication,and establishing feedback agendas.These measures aim to improve the effectiveness and pertinence of ideological and political education in public hospitals,thereby advancing their high-quality development.

Objective To explore the effect of external attentional focus strategy on walking function after stroke.Methods From July to December 2024,40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group(n=20)and experimental group(n=20).Both groups underwent conventional rehabilitation.On this basis,the control group received conventional walking training,while the experimental group received walk-ing training based on external attentional focus strategy,for three weeks.Before and after training,they were as-sessed with Gait Watch 3D gait analysis,Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results After training,the step speed,step frequency,walking cycle,time of TUGT,and the scores of BBS and FMA-LE improved in both groups(|t|>3.098,P<0.01),and the step speed,step frequency,walking cycle and the score of FMA-LE improved more in the experimental group than in the control group(|t|>2.572,P<0.05).Conclusion External attentional focus strategy can improve the walking function of patients with stroke.