ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

Objective To investigate the influence of combination of oxycodone-acetaminophen and local radiotherapy on serum cytokines in elderly patients with malignant tumor bone metastasis and cancer pain.Methods Eighty elderly patients with malignant tumor bone metastasis and cancer pain admitted to Huainan Xinhua Medical Group Xinhua Hospital from January 2020 to April 2024 were divided into control group(40 cases)and observa-tion group(40 cases)according to the order of admission.The control group received codeine combined with local radiotherapy,whereas the observation group was treated with oxycodone-acetaminophen combined with local radio-therapy.Pain relief(assessed using visual analogue scale(VAS)),daily fulminant pain occurrence frequency and occurrence of adverse reactions during treatment as well as serum cytokines[substance P(SP),prostaglandinE2(PGE2),interleukin-6(IL-6)],sleep quality(assessed using Pittsburgh sleep quality index(PSQI))and quality of life[assessed using functional assessment of cancer therapy-general(FACT-G)]before and after treatment were compared between the two groups..Results The pain relief effect in the observation group was better(P<0.05),and the daily occurrence frequency of fulminant pain was less than that in the control group(P<0.05).After treat-ment,serum levels of SP,PGE2 and IL-6 in the observation group were lower compared to those in the control group(P<0.05).The total incidence rate of bone-related events during treatment was not significantly different between the two groups(P>0.05),and the total incidence rate of adverse reactions was lower in the observation group compared to those in the control group(P<0.05).The PSQI score in the observation group after treatment was lower(P<0.05)while the scores of physiology and emotion of FACT-G were higher compared to those in the control group(P<0.05).Conclusion Oxycodone-acetaminophen combined with local radiotherapy can down-regulate the levels of serum SP,PGE2 and IL-6,relieve the pain,and improve the sleep quality and quality of life in elderly patients with malignant tumor bone metastasis complicated with cancer pain.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Objective:To analyze the effect of nucleotide sequence variants in the 5′ untranslated region (5′UTR) of Helicobacter pylori (Hp) cagA on mRNA secondary structure, as well as its regulatory role in cytotoxin-associated gene A (CagA) protein expression and bacterial virulence. Methods:The upstream nucleotide sequence of cagA was amplified by polymerase chain reaction (PCR) from 37 Hp strains, and the PCR products were sequenced. MEGA 5.0 software and RNAfold prediction software were used to analyze the nucleotide sequence variants of cagA 5′UTR and the changes in mRNA secondary structure of this region, respectively. Western blot was used to detect the expression level of CagA protein in Hp strains, and the regulatory effect of cagA 5′UTR variants on the difference in CagA protein expression was analyzed. An Hp-infected AGS cell model was established to evaluate bacterial adhesion rate; quantitative PCR (qPCR) was used to analyze the mRNA transcription levels of interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α); enzyme-linked immunosorbent assay (ELISA) was used to detect the secretion levels of IL-8 and TNF-α proteins. Results:Nucleotide sequence alignment of cagA 5′UTR from 37 Hp strains showed that sequence differences were mainly concentrated in the -53motif, -10motif, + 34motif, and + 86motif regions. mRNA secondary structure prediction analysis revealed three types based on the StemB stem-loop structure: type Ⅰ (no StemB stem-loop), type ⅡA (StemB stem-loop with 3-4 base partial pairing), and type ⅡB (StemB stem-loop with 5 base full pairing). Western blot analysis showed that the CagA protein expression level was the highest in type Ⅰ Hp strains (1.72±0.29) and the lowest in type ⅡB strains (0.81±0.26), with a statistically significant difference between the two types ( P=0.030). The adhesion rate of type Ⅰ Hp strains to AGS cells was (52.90±11.17)%, which was higher than that of type Ⅱ strains [(21.27±6.16)%]. qPCR results showed that the mRNA transcription levels of IL-8 and TNF-α in AGS cells induced by type Ⅰ Hp strains were higher than those induced by type Ⅱ strains (140.23±24.47 vs 76.16±8.76, P=0.069; 55.20±9.04 vs 21.26±6.16, P=0.036). ELISA analysis further indicated that the secretion levels of IL-8 and TNF-α proteins in AGS cells induced by type Ⅰ Hp strains were also higher than those induced by type Ⅱ strains [(344.66±62.62)pg/ml vs (302.13±66.27)pg/ml, P=0.665; (131.04±4.94)pg/ml vs (79.17±11.32)pg/ml, P=0.014]. Conclusions:The cagA 5′UTR region of Hp strains exhibits significant nucleotide sequence variants. Hp strains with no StemB stem-loop (type Ⅰ) in the mRNA secondary structure show significantly increased CagA protein expression and higher bacterial pathogenic potential.