Objective:To evaluate the effect of continuous theta burst stimulation (cTBS) on postoperative cognitive dysfunction (POCD) in mice and its association with the excitability of parvalbumin (PV) neurons in the medial prefrontal cortex (mPFC).Methods:Twenty-four specific pathogen-free healthy male C57BL/6 mice, aged 8 weeks, weighing 18-24 g, in which adeno-associated virus (AAV) for labeling PV neurons was injected into the mPFC using stereotaxic surgery, were used in this study. Three weeks later, the mice were divided into 3 groups ( n=8 each) using a random number table method: control group (group C), POCD group (group P) and cTBS group. Group C received no treatment. A mouse model of POCD was established by performing tibial fracture surgery under sevoflurane anesthesia and the mice received sham stimulation from postoperative day 0 to day 4 in group P. Group cTBS underwent POCD model establishment and received cTBS stimulation from postoperative day 0 to day 4. Cognitive function was assessed using contextual fear conditioning, Y-maze and novel object recognition tests on postoperative day 5. The spontaneous firing frequency of PV neurons in the mPFC was then measured using ex vivo patch-clamp electrophysiology. Results:The results of contextual fear conditioning test showed that compared to group C, the percentage of freezing time was significantly increased in group P ( P<0.05); compared to group P, the percentage of freezing time was significantly decreased in group cTBS ( P<0.05). The results of Y-maze test showed that compared to group C, the alternation accuracy was significantly decreased in group P ( P<0.05); compared to group P, the alternation accuracy was significantly increased in group cTBS ( P<0.05). The results of novel object recognition test showed that compared to group C, the percentage of time spent exploring the novel object was significantly decreased in group P ( P<0.05); compared to group P, this percentage of time spent exploring the novel object was significantly increased in group cTBS ( P<0.05). The results of ex vivo patch-clamp electrophysiology showed that compared to group C, the spontaneous firing frequency of PV neurons in the mPFC was significantly decreased in group P ( P<0.05); compared to group P, the spontaneous firing frequency of PV neurons in the mPFC was significantly increased in group cTBS ( P<0.05). Conclusions:cTBS can ameliorate POCD in mice, and the mechanism is related to the restoration of excitability of PV neurons in the mPFC.

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot,providing a basis for medical staff to formulate intervention strategies.Methods A convergent mixed study design was used.A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life.During the same period,15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism.Results Quantitative findings:A total of 167 valid questionnaires were retrieved,and the recovery rate of valid questionnaires was 99.4％.the total quality of life score of 167 respondents was(84.22±12.49)scores;the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot(P＜0.05).Qualitative findings:a total of 3 themes were extracted based on the triadic interactive determinism,including subject level,environmental level and behavioural level.Mixed findings:age and amputation affect the physical and mental state of patients and hinders quality of life improvement;limited work and life,and scarce external resources;the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life.Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree,and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients,while also focusing on their individual needs and providing support.

OBJECTIVE T o analyze the current situation and characteristics of hospital-associated infection in a psy-chiatric hospital,providing references for formulation of control measures for hospital-associated infection.METHODS A retrospective analysis was conducted on hospital-associated infection data from Shanghai Mental Health Center between Jan.1,2019,and Oct.31,2024.The infection rates and infection sites across different years,patient populations,and departments were analyzed.RESULTS A total of 47 051 inpatients were investiga-ted,with 1 798 cases of hospital-associated infections,resulting in an infection rate of 3.82％.The highest inci-dence rate was observed in 2020(4.13％).The top three departments with the highest incidence rates were the in-fectious disease department(12.13％),geriatric psychiatry(7.67％),and the Traditional Chinese Medicine De-partment department(4.90％).The primary infection sites were the lower respiratory tract(57.06％),urinary tract(18.24％),skin and soft tissue(14.29％).The incidence rate was higher in males(5.32％)than in females(2.72％)(P＜0.001).Statistically significant differences were found in the incidence rates among different age groups(P＜0.001),with the highest rate observed in patients aged over 90 years(17.11％).The lowest infection rate was found in patients hospitalized for less than 60 days(0.69％),while the highest was in those hospitalized for more than 1 000 days(49.94％).CONCLUSIONS The patients in psychiatric hospitals are susceptible to infec-tions in the respiratory tract,urinary tract,skin and soft tissue.Targeted prevention and control measures can be implemented based on high-risk factors such as age,length of stay,and gender to reduce the occurrence of in-fections.

Objective To explore the fear of ulcer recurrence in patients with diabetic foot and analyze its influencing factors,so as to provide strategies for medical staff to implement comprehensive and personalized nursing interventions.Methods From February 2024 to March 2025,convenience sampling was used to select inpatients and outpatients with diabetic foot ulcers from 6 tertiary hospitals in China as the survey subjects.The general information questionnaire,ADL,MNA,PSQI,Diabetic Foot Self-Management Behavior Scale and FOP-Q-SF were used to investigate and analyze the results.Results A total of 191 questionnaires were distributed and 186 valid questionnaires were returned,with an effective recovery rate of 97.38％.The total score of ulcer recurrence fear of diabetic foot patients was(31.78±7.41).Binary Logistic regression analysis showed that nutritional status,sleep quality,duration of diabetes,other chronic diseases,family per capita monthly income and medical insurance were the influencing factors of ulcer recurrence fear in patients with diabetic foot(P＜0.05).Conclusion Patients with diabetic foot have a high level of fear of ulcer recurrence.Nutritional status,sleep quality,duration of diabetes,combined with other chronic diseases,family per capita monthly income,and medical insurance are its influencing factors.Nursing staff should take targeted nursing measures according to its influencing factors to reduce the occurrence of patients' fear of ulcer recurrence.

Objective To understand the economic losses due to healthcare-associated infection(HAI)in patients after Da Vinci robotic thoracic surgery,and provide basis for preventing and controlling HAI after robotic surgery.Methods Patients who underwent Da Vinci robotic surgery from April 2019 to April 2023 were retrospective stu-died.Patients were divided into HAI group and non-HAI group based on the occurrence of postoperative infection.Through 1∶1 propensity score matching(PSM),31 cases were included in each group,economic losses of two groups of patients were compared.Results A total of 921 patients who underwent Da Vinci robotic thoracic surgery were included in the study,51 cases with HAI(HAI group)and 870 without HAI(non-HAI group).After 1∶1 PSM,31 cases were included in each group.Four covariates were compared between two groups of patients before PSM,namely gender,age,comorbidities,and the American Society of Anesthesiologists(ASA)grading,all with statistically significant differences(all P＜0.05).After PSM,distribution of the above covariates reached equilib-rium between the two groups(both P＞0.05).The median total expense for HAI group before PSM during hospi-talization was 88 711.72 Yuan,while 78 509.46 Yuan for the non-HAI group.The direct economic losses caused by HAI after Da Vinci robot surgery was 10 202.26 Yuan,mainly increased by expense of medicine,nursing,laborato-ry diagnosis,etc.Difference in western medicine expense was the highest(8 839.12 Yuan),out of which expense of antimicrobial agents accounted for the highest proportion(73.55％).Difference in daily hospitalization expense between HAI-group and non-HAI group was 502.38 Yuan.Length of hospital stay of patients in HAI group and non-HAI group were(21.59±10.62)and(13.92±9.21)days,respectively,with statistical differences(all P＜0.05).Conclusion The occurrence of HAI in patients undergoing Da Vinci robotic thoracic surgery leads to direct economic losses,with obvious increases in expenses of nursing,laboratory diagnosis,western medicine(mainly an-timicrobial agents).Length of hospital stay of patients also prolongs.

Objective:To deeply understand the real experiences of self-management in home-dwelling elderly patients with diabetic foot, explore the factors associated with management dilemmas, and reveal the diversity of coping strategies based on the theory of planned behavior, so as to provide a reference for development of targeted clinical nursing strategies.Methods:Purposive sampling was used to select 21 elderly patients with diabetic foot who attended the Fourth Medical Center of the Chinese PLA General Hospital from May 2023 to March 2024 for semi-structured interviews. Colaizzi 7-step analysis was used to analyze and refine the themes.Results:After collating, analyzing and summarizing the interview data, 3 themes and 9 sub-themes were extracted, namely, behavioral attitudes (lack of self-management awareness due to insufficient cognition, compromising and avoiding psychology restricting self-management behaviors, negative emotions generating and attacking confidence in self-management), subjective norms (lack of healthcare channels increasing the difficulty of accessing healthcare, increased economic burden delaying disease treatment, and poor treatment experience damaging physical and mental health) and perceived behavioral control (accumulation of knowledge to put into practice, experience of multiple management strategies, seeking external help and support) .Conclusions:The home-dwelling elderly patients with diabetic foot have multiple self-management dilemmas. Nursing staff should emphasize the patient's own and objective dilemmas, provide cognitive intervention strategies, multiple coping support, and long-term professional guidance to improve the patients' self-management ability.

OBJECTIVE To observe the isolation rates and drug resistance rates of Acinetobacter baumannii strains isolated from intensive care unit(ICU)patients in 8 consecutive years so as to provide bases for reasonable clinical application of antibiotics and control of infections.METHODS The isolation rates and specimens from which the A.baumannii and carbapenem-resistant A.baumannii(CRAB)strains were isolated from ICU patients of the First People's Hospital of Changzhou between 2017 and 2024 were retrospectively analyzed.The trends of the drug resistance rates were observed.RESULTS Totally 2078(18.03％)strains of A.baumannii were isolated from the ICU patients from 2017 to 2024,and there was no significant difference in the changing trend among the years(x2=-1.573,P=0.116).Among the A.baumannii strains that were isolated from 2017 to 2024,58.08％were isolated from sputum,and 24.25％from lavage fluid specimens;the percentage of sputum specimens showed a downward trend in the 8 years(x2=-8.257,P＜0.001),while the percentage of lavage fluid speci-mens showed an upward trend(x2=12.964,P＜0.001).The isolation rate of the CRAB strains was 91.48％in 2017,92.61％in 2018,92.56％in 2019,82.53％in 2020,52.44％in 2021,showing a down-ward trend,and it began to rise in 2022-2024,there was significant difference(x2=-2.277,P=0.012).The isolation rates of the CRAB strains from both sputum and lavage fluid specimens showed downward trends and then upward trends(all P＜0.05).The drug resistance rates of the A.baumannii strains to piperacillin and minocycline showed slow upward trends,while the drug resistance rates to gentamicin and tigecycline showed downward trends,and there were significant differences(P＜0.05).The drug resistance rates of the A.bau-mannii strains to imipenem and meropenem remained more than 90％.CONCLUSIONS Acinetobacter spp is the major pathogen causing the hospital-acquired infection.The isolation rate of CRAB strains shows a downward trend then a upward trend in recent two years.It is necessary for the hospital to standardize the submission of spu-tum specimens and increase the aseptic submission.The A.baumannii strains show high drug resistance rates to the commonly used antibiotics.Polymyxin B,tigecycline and minocycline are the major antibiotics for treatment of CRAB infection.

Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot,providing a basis for medical staff to formulate intervention strategies.Methods A convergent mixed study design was used.A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life.During the same period,15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism.Results Quantitative findings:A total of 167 valid questionnaires were retrieved,and the recovery rate of valid questionnaires was 99.4％.the total quality of life score of 167 respondents was(84.22±12.49)scores;the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot(P＜0.05).Qualitative findings:a total of 3 themes were extracted based on the triadic interactive determinism,including subject level,environmental level and behavioural level.Mixed findings:age and amputation affect the physical and mental state of patients and hinders quality of life improvement;limited work and life,and scarce external resources;the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life.Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree,and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients,while also focusing on their individual needs and providing support.

Objective To understand the economic losses due to healthcare-associated infection(HAI)in patients after Da Vinci robotic thoracic surgery,and provide basis for preventing and controlling HAI after robotic surgery.Methods Patients who underwent Da Vinci robotic surgery from April 2019 to April 2023 were retrospective stu-died.Patients were divided into HAI group and non-HAI group based on the occurrence of postoperative infection.Through 1∶1 propensity score matching(PSM),31 cases were included in each group,economic losses of two groups of patients were compared.Results A total of 921 patients who underwent Da Vinci robotic thoracic surgery were included in the study,51 cases with HAI(HAI group)and 870 without HAI(non-HAI group).After 1∶1 PSM,31 cases were included in each group.Four covariates were compared between two groups of patients before PSM,namely gender,age,comorbidities,and the American Society of Anesthesiologists(ASA)grading,all with statistically significant differences(all P＜0.05).After PSM,distribution of the above covariates reached equilib-rium between the two groups(both P＞0.05).The median total expense for HAI group before PSM during hospi-talization was 88 711.72 Yuan,while 78 509.46 Yuan for the non-HAI group.The direct economic losses caused by HAI after Da Vinci robot surgery was 10 202.26 Yuan,mainly increased by expense of medicine,nursing,laborato-ry diagnosis,etc.Difference in western medicine expense was the highest(8 839.12 Yuan),out of which expense of antimicrobial agents accounted for the highest proportion(73.55％).Difference in daily hospitalization expense between HAI-group and non-HAI group was 502.38 Yuan.Length of hospital stay of patients in HAI group and non-HAI group were(21.59±10.62)and(13.92±9.21)days,respectively,with statistical differences(all P＜0.05).Conclusion The occurrence of HAI in patients undergoing Da Vinci robotic thoracic surgery leads to direct economic losses,with obvious increases in expenses of nursing,laboratory diagnosis,western medicine(mainly an-timicrobial agents).Length of hospital stay of patients also prolongs.