Gut microbiota,implicated in obesity,insulin resistance,depression,and cardiovascular risk,can be modulated by probiotics to mitigate cardiovascular disease risk.Vascular calcification(VC),a regulated process involving mineral deposits in vessels and valves,is a significant risk factor.Diet profoundly impacts both gut micro-biota and VC,influencing cardiovascular health via microbial metabolites.While the link between gut microbiota and VC is established,the precise dietary effects on vascular health remain unclear.This article reviews mecha-nisms through which dietary patterns shape gut microbiota and metabolites,influence VC and highlights directions for future research on VC diagnosis and treatment.

Coronary heart disease(CHD)is one of the most prevalent cardiovascular diseases in China,with a continuously growing patient population,presenting numerous challenges for personalized and precise treatment.Artificial intelligence(AI),leveraging its advantages in processing and analyzing medical data,integrates clinical information,imaging examinations,and various omics analyses to provide clinicians with accurate diag-nostic and treatment recommendations.AI plays a crucial role in risk prediction,diagnostic optimization,and the development of personalized treatment strategies.This article explores the applications of AI in the diagnosis and treatment of CHD,analyzing its contributions and challenges in risk prediction,diagnostic optimization,and treatment decision-making,while also envisioning its future developmental in the field of cardiovascular medicine.

Objective To construct a patient decision aid(PtDA)for exercise training in pa-tients with chronic obstructive pulmonary disease(COPD)and explore its impacts on decision-making quality of patients' exercise regimens.Methods The development of the PtDA for exercise training in COPD patients was accomplished through literature analysis,the Delphi method,and user surveys,followed by an intervention study.A total of 59 inpatients with COPD were included as study sub-jects.The control group received routine care along with general exercise training guidance,while the intervention group received routine care combined with shared decision-making for exercise training based on the PtDA.The decision conflict and decision preparedness levels of patients in both groups were compared before the intervention and on the day of discharge.The exercise self-efficacy of pa-tients was measured before intervention,on the day of discharge,and 1 month and 3 months after dis-charge.Results The intervention group had significantly lower scores for decision conflict and signif-icantly higher scores for decision preparedness and exercise self-efficacy compared with the control group(P＜0.05).Conclusion The PtDA for exercise training can improve decision conflict and de-cision preparedness in COPD patients,enhance their exercise self-efficacy levels,and provide references for healthcare professionals in improving exercise adherence.

Objective To explore and analyze the characteristics and transmission routes of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains in intensive care unit(ICU).Methods From January to October 2023,17 clinical infection isolates(clinical infection group),5 active screening isolates(active screening group),and 7 envi-ronmental isolates(environmental group)of CRKP in the liver surgery ICU of a hospital were selected and analyzed by whole-genome sequencing.The differences in resistance genes,virulence genes,and sequence typing(ST)were compared,and transmission routes were analyzed based on the phylogenetic tree.Results 29 strains of CRKP car-ried 4-18 resistance genes and 52-98 virulence genes,respectively.There were no statistically significant diffe-rences in genotype distribution of resistance genes,the number of virulence genes,and gene types among three groups of CRKP(all P＞0.05).ST showed that 29 CRKP strains mainly consisted of two categories:ST11 and ST15.Based on the phylogenetic tree constructed from the core genome,there were 7 highly homologous groups of CRKP,among which 4 groups had clear epidemiological associations.Conclusion CRKP in ICU carries more re-sistance and virulence genes,and some strains are highly homologous in ST and phylogenetic tree,which may lead to cross transmission.In the future,prevention and control measures should be strengthened to reduce the trans-mission of CRKP.

Objective To explore and analyze the characteristics and transmission routes of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains in intensive care unit(ICU).Methods From January to October 2023,17 clinical infection isolates(clinical infection group),5 active screening isolates(active screening group),and 7 envi-ronmental isolates(environmental group)of CRKP in the liver surgery ICU of a hospital were selected and analyzed by whole-genome sequencing.The differences in resistance genes,virulence genes,and sequence typing(ST)were compared,and transmission routes were analyzed based on the phylogenetic tree.Results 29 strains of CRKP car-ried 4-18 resistance genes and 52-98 virulence genes,respectively.There were no statistically significant diffe-rences in genotype distribution of resistance genes,the number of virulence genes,and gene types among three groups of CRKP(all P＞0.05).ST showed that 29 CRKP strains mainly consisted of two categories:ST11 and ST15.Based on the phylogenetic tree constructed from the core genome,there were 7 highly homologous groups of CRKP,among which 4 groups had clear epidemiological associations.Conclusion CRKP in ICU carries more re-sistance and virulence genes,and some strains are highly homologous in ST and phylogenetic tree,which may lead to cross transmission.In the future,prevention and control measures should be strengthened to reduce the trans-mission of CRKP.

Objective:To explore the effect of nursing intervention based on the health action process approach (HAPA) theory on follow-up compliance and blood glucose management of patients with diabetes retinopathy (DR) .Methods:From October 2022 to May 2023, 102 DR patients who visited the Diabetes Fundus Clinic of Shanxi Eye Hospital were selected by convenience sampling as participants. A total of 51 patients who visited from October 2022 to January 2023 were selected as control group, and 51 patients who visited from February to May 2023 were selected as observation group. Control group received routine nursing, while observation group received nursing intervention based on HAPA theory on this basis. The follow-up compliance, Chinese version of the Compliance with Annual Diabetic Eye Exams Survey (CADEES-C) score, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) were compared between the two groups.Results:The compliance of DR patients in observation group after six months of follow-up was higher than that in control group, and the difference was statistically significant ( P<0.05). After six months, the CADEES-C dimension scores and total score of DR patients in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). FBG and 2hPG of DR patients in observation group were lower than those in control group after three and six months, and the differences were statistically significant ( P<0.05). After six months of intervention, there was no statistically significant difference in HbA1c between observation group and control group ( P>0.05) . Conclusions:Nursing interventions based on HAPA theory can effectively improve the follow-up compliance of DR patients, enhance their health beliefs during follow-up, and improve their blood glucose.

Objective:To explore the characteristics and categories of self-management behavior of patients with diabetic retinopathy (DR) and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 200 patients who visited Diabetes Fundus Department of Shanxi Eye Hospital from October 2021 to June 2022 were selected as the research objects. The General Information Questionnaire, General Self-Efficacy Scale, Social Support Rating Scale, Chinese version of Mishel Uncertainty in Illness Scale-Adult and Diabetes Retinopathy Self-management Scale were used to investigate. Cluster analysis method was used to classify subgroups, and univariate analysis and ordered Logistic regression analysis were used to identify the influencing factors.Results:A total of 200 questionnaires were sent out in this survey, and 195 valid questionnaires were finally recovered, with an effective recovery rate of 97.5%. The self-management behaviors of DR Patients were divided into three categories, such as active practice type (19.5%, 38/195) , passive obedience type (33.8%, 66/195) and passive inaction type (46.7%, 91/195) . Logistic regression analysis showed that the duration of diabetes, degree of DR, self-efficacy, social support and disease uncertainty were the influencing factors of patients' self-management behavior ( P<0.05) . Conclusions:The self-management behavior of diabetic retinopathy patients is heterogeneous, which can be divided into three categories, such as active practice type, passive obedience type and passive inaction type. There are differences in the characteristics of patients in different categories. Clinical medical staffs should take targeted intervention measures according to different patient types to improve the self-management ability of patients.

Objective:To comprehensively search, analyze and integrate the best evidence on environmental factors for the prevention and management of myopia in children and adolescents, to provide reference for the formulation of scientific and complete myopia prevention and management programs.Methods:A comprehensive search about evidence on environmental factors prevention and management of myopia in children and adolescents was conducted in following databases: UpToDate, BMJ Best Practice, Cochrane Library, JBI Evidence-Based Health Care Center Database, Chinese Medical Ace Base, China Association of Chinese Medicine, Chinese Medical Association, American Academy of Ophthalmology, International Myopia Society, European Society of Ophthalmology, International Agency for the Prevention of Blindness, Brien Holden Vision Research Center, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, etc. Research types included guidelines, expert consensus, systematic review/Meta-analysis, evidence summary, best clinical practice.Results:A total of 23 articles were included, including 6 guidelines, 3 expert consensus articles and 14 systematic reviews. Evidence summarized 27 items from the following 4 aspects: prevention and management purpose, risk assessment, environmental prevention and management measures and health education.Conclusions:This study summarized the best evidence on environmental factors to prevent and manage myopia in children and adolescents. When the evidence is applied, appropriate environmental prevention and management measures should be selected to prevent and control the onset and progression of myopia in children and adolescents, based on the actual situation, to promote evidence-based practice.

The incidence rate of the adenomyosis complicated with infertility in women has gradually increased. For these patients, the current clinical challenge is to alleviate symptoms and promote fertility. In this case, multi-disciplinary treatment is the development direction of adenomyosis complicated with infertility. We emphasize individual comprehensive treatment for these women. Drug therapy, which can control the focus, maintain the integrity of the uterus, relieve symptoms and protect fertility, has its unique advantages in various treatment methods. This paper discusses the pharmacological methods of infertile patients with adenomyosis.

The incidence rate of the adenomyosis complicated with infertility in women has gradually increased. For these patients, the current clinical challenge is to alleviate symptoms and promote fertility. In this case, multi-disciplinary treatment is the development direction of adenomyosis complicated with infertility. We emphasize individual comprehensive treatment for these women. Drug therapy, which can control the focus, maintain the integrity of the uterus, relieve symptoms and protect fertility, has its unique advantages in various treatment methods. This paper discusses the pharmacological methods of infertile patients with adenomyosis.