Objective To investigate the incidence rate of sarcopenia and related risk factors in patients with stroke. Methods A retrospective analysis was performed for the patients with stroke who were admitted to the stroke center of a grade A tertiary hospital in Changchun， China， from March 2023 to June 2024. The method of bioelectrical impedance was used to perform body composition analysis for all patients on day（7.0±1.0）after admission， and the incidence rate of stroke-related sarcopenia was analyzed. A binary logistic regression analysis was used to investigate the risk factors for stroke-related sarcopenia. Results A total of 666 patients were included in the study， among whom 150（22.5%） developed sarcopenia （95%CI 0.193‒ 0.257）. Low body mass index， low phase angle， low triglyceride， advanced age， and low Barthel index were risk factors for the early onset of sarcopenia in patients with stroke. Conclusion There is a relatively high incidence rate of sarcopenia in stroke patients， with complex influencing factors. Medical staff should pay more attention to the elderly stroke patients， as well as those patients with emaciation， low phase angle， low triglyceride， and limited activities of daily living. Early nutritional supplementation and functional exercise can help to prevent the onset of stroke-related sarcopenia.
Stroke ; Sarcopenia

Objective To develop the Children's Screen Interaction Quality Questionnaire(CSIQ)suit-able for measuring Chinese children aged 0 to 4 years,and to test its reliability and validity.Methods The purposive sampling method was used,and the guardians of 30 normal children aged 0 to 4 years undergoing physical examinations in the Department of Child Health Care of Guiyang Maternal and Child Health Care Hospital from February to April 2023 were selected as the interview objects.25 initial items were constructed through literature review,semi-structured interviews,and the Delphi expert consultation method.With the convenience sampling method,2 242 guardians of children aged 0 to 4 years old in the small and middle classes of 9 kindergartens in Guiyang City,Zunyi City,and Renhuai City were surveyed for item analysis,exploratory factor analysis,confirmatory factor analysis,and reliability and validity analysis.Results Exploratory factor a-nalysis extracted three factors,namely screen content interaction,reality interaction,and media interaction,with a total of 12 items.The cumulative variance explained rate of the 3-factor model was 69.829％.Confirma-tory factor analysis supported the three-factor model of CSIQ:x2/df=4.424,root mean square error of ap-proximation(RMSEA)=0.066,normed fit index(NFI)=0.955,comparative fit index(CFI)=0.965,incre-mental fit index(IFI)=0.965,Tucker-Lewis index(TLI)=0.955,goodness-of-fit index(GFI)=0.955,and the CSIQ had good convergent validity and discriminant validity.Conclusion The CSIQ has good reliability and validity.

The research literature on the mechanism of Achyranthis Bidentatae Radix and its main components in the treatment of osteoporosis was reviewed. It was found that Achyranthis Bidentatae Radix could promote the osteogenic differentiation of bone marrow mesenchymal stem cells, enhance the activity of osteoblasts, inhibit the activity of osteoclasts, regulate estrogen levels, and achieve the effects of preventing and treating osteoporosis. It mainly regulates Wnt/β-catenin, Notch, PI3K/Akt and other signaling pathways. The mechanism of Achyranthis Bidentatae Radix in the treatment of OP shows the characteristics of multi-component, multi-target and multi-pathway.

Objective:To explore the current status of decision conflict in breast cancer patients with immediate breast reconstruction, and analysis the relationship with personality traits, which can provides new ideas for understanding decision-making behavior and promotes effective decision-making.Methods:A cross-sectional survey was conducted to select 175 breast cancer patients who met the inclusion and exclusion criteria for immediate breast reconstruction in Cancer Hospital of Tianjin Medical University from May to December 2022 by convenient sampling method. A questionnaire was conducted using the general information questionnaire, Revised NEO Personality Inventory, Decisional Conflict Scale, and the Control Preference Scale. Single factor analysis and multiple linear regression were used to analyze the current situation and influencing factors of decision-making conflict.Results:The 175 patients with immediate breast reconstruction were all female, aged 24-67(45.26 ± 8.01) years. The decision conflict score of 175 breast cancer patients with immediate breast reconstruction was (25.05 ± 7.05), the standardized decision conflict score was (39.14 ± 10.04), the dimension score of factors affecting decision making was(7.18 ± 2.58), the score of decision uncertainty dimension was (7.34 ± 2.28). 37 patients (21.14%) had no decision conflict, 64 patients (36.57%) had moderate decision conflict, and 74 patients (42.29%) had high level decision conflict. The scores of altruism, neuroticism, openness, sociality and moral sense of patients in this survey were (15.16 ± 3.43), (18.14 ± 4.95), (13.71 ± 3.71), (18.12 ± 4.40) and (17.46 ± 4.03) respectively. The decision conflict was negatively correlated with altruism, sociality and moral sense ( r=-0.355, -0.543, -0.331, all P<0.05), and positively correlated with neuroticism( r=0.208, P<0.05). Multivariate regression analysis showed that age, decision type, neuroticism and sociality were the influencing factors of decision conflict ( F=16.39, P<0.05), accounted for 47.1% of the variation. The variance inflation factor of the above variables was less than 10, indicating no collinearity. Conclusions:The decision conflict of breast cancer patients with immediate breast reconstruction needs to be improved urgently. Based on the influencing factors (age, decision-making type and personality traits) of decision conflict, medical staff should implement personalized decision-making aid process to meet decision-making information needs, reduce decision-making conflict and optimize decision-making quality.

Objective:To observe the effects and safety of dienogest on the volume and symptoms of ovarian endometrioma (OMA).Methods:The clinical data of 75 patients with OMA who underwent treatment with dienogest (2 mg/day) at the First Affiliated Hospital of Nanjing Medical University from July 1st 2020 to March 31st 2024 were retrospectively analysed, mainly comparing the changes in the volume of OMA and the visual analogue scale (VAS) scores of endometriosis-related pain before and after the treatment, as well as observing the changes in the blood biological indicators, liver and kidney function, coagulation function and changes in breast.Results:The median cyst volumes of the OMA patients at 3, 6 and 12 months of dienogest treatment were 13.21 cm 3 (volume reduction rate: 36.00%), 8.33 cm 3 (volume reduction rate: 56.00%) and 4.10 cm 3 (volume reduction rate: 77.62%), respectively, which were all significantly decreased from the pre-treatment period (all P<0.05). The VAS scores of pain of the OMA patients at 3, 6 and 12 months of dienogest treatment all were 0 mm. Blood cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA 19-9) levels decreased progressively during treatment (all P<0.05). There were no statistical differences in the coagulation indexes, liver and kidney function indexes of the patients during dienogest treatment compared with those before treatment (all P>0.05). During the follow-up period, there were a few patients with changes in the growth sites or lesion category of the breast nodules, but there were no occurrence of breast cancer or precancerous lesions. Conclusion:Dienogest is effective in reducing OMA volume and alleviating endometriosis-related pain with few adverse effects.

Background Currently,the diagnosis of depressive disorder relies on symptomatology,which is greatly influenced by subjective factors such as clinicians' experience.Finding more accurate and reliable quantitative diagnostic methods is currently an urgent problem.Objective To explore the value of Fisher discriminant function based on inflammatory cytokines in the diagnosis of depressive disorder,so as to provide references for clinical diagnosis.Methods A total of 136 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)criteria,who underwent inpatient treatment at Hebei Mental Health Center from April 2020 to November 2020,were enrolled as study group.67 healthy participants matched for age and gender,was recruited during the same period.Serum levels of inflammatory cytokine were measured using enzyme-linked immunosorbent assay(ELISA).Fisher discriminant model was employed to establish a discriminant function for inflammatory cytokines exhibiting significant statistical differences between study group and control group,which was then validated.Results The levels of pro-inflammatory cytokines interleukin-1β(IL-1β),interleukin-6(IL-6),interferon-γ(INF-γ)and tumor necrosis factor-α(TNF-α)were higher in the study group compared with control group,with statistically significant differences(U=9.115,5.239,4.431,5.428,P<0.01).Conversely,the levels of anti-inflammatory cytokines interleukin-4(IL-4),interleukin-10(IL-10)and interleukin-13(IL-13)were lower in the study group compared with control group,with statistically significant differences(U=7.398,7.331,7.614,P<0.01).The retrospective test in Fisher discriminant function achieved a correct discrimination rate of 89.66%,and the cross validation achieved a correct discrimination rate of 88.67%.Conclusion The Fisher discriminant function developed in this study may serve as a valuable auxiliary method in the diagnosis of depressive disorder.

Objective To develop the assessment scale of proactive health behavior ability for the disabled elderly in nursing homes and to test its reliability and validity.Methods The first draft of the scale was formed by literature review,qualitative interviews and Delphi method.From December 2023 to March 2024,525 disabled elderly people from 9 nursing homes in Sichuan Province and Chongqing City were selected as the survey subjects,and item analysis and reliability and validity test were carried out on the scale.30 disabled elderly people were re-investigated after 2 weeks to calculate the retest reliability of the scale.Results The scale consisted of 4 dimensions and 27 items.Exploratory factor analysis extracted 4 common factors,with the cumulative vanance contribution rate of 65.992％,and confirmatory factor analysis showed that the modified model fitting index was within acceptable range.The content validity index at item level was 0.917-1.000,and that at scale level was 0.997.The Cronbach's α coefficient,test-retest reliability and split-half reliability of the total scale were 0.944,0.997 and 0.882,respectively.Conclusion The scale has good reliability and validity,and it can be used to evaluate the proactive health behavior ability of the disabled elderly in nursing homes.

Objective:To investigate the spectrum and antimicrobial resistance of major pathogens causing nosocomial infections in China during 2020-2021.Methods:A total of 1 311 non-duplicated nosocomial pathogens causing bloodstream infections (BSI, n=670), hospital-acquired pneumonia (HAP, n=394) and intra-abdominal infections (IAI, n=297) were collected from 10 teaching hospitals across China. The minimum inhibitory concentrations (MICs) of clinical common strains were determined using agar dilution or broth microdilution method. Interpretation of reults followed the CLSI M100-Ed33 criteria, with data analysis conducted using WHONET-5.6 software. The Chi-square test was used to compare rates. Results:The most prevalent pathogens causing BSI were Escherichia coli (21.2%, 142/670), Klebsiella pneumoniae (14.9%, 100/670) and Staphylococcus aureus (11.5%, 77/670); the most prevalent pathogens causing HAP were K. pneumoniae (27.7%, 109/394), Acinetobacter baumanii (22.1%, 87/394) and Pseudomonas aeruginosa (18.3%, 72/394). IN IAI, E. coli (24.3%, 60/247), Enterococcus faecium and K. pneumoniae (both 14.6%, 36/247) were dominated. All S. aureus strains were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. Rates of methicillin-resistant S. aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) were 36.5% (42/115) and 74.5% (38/51), respectively. The rate of vancomycin-resistant E. faecium and E. faecalis was 3.3% (3/90) and 1.9% (1/53), respectively. The prevalence of extended-spectrum β-lactamase (ESBL) was 23.7% (58/245) in K. pneumonia and 60.5% (130/215) in E. coli.The rate of carbapenem-resistant K. pneumonia and E. coli was 29.8% (73/245) and 4.2% (9/215), respectively; the percentage of tigecycline-resistant K. pneumonia and E. coli was 1.6% (4/245) and 0, respectively; the rate of colistin-resistant K. pneumonia and E. coli was 1.6% (4/245) and 2.8% (6/215), respectively; the percentage of ceftazidime/avibactam-resistant K. pneumonia and E. coli was 2.0% (5/245) and 2.3% (5/215), respectively. The rate of carbapenem-resistant A. baumanii and P. aeruginosa was 76.7% (125/163) and 28.4% (33/116), respectively. A. baumanii showed low susceptibility to most antimicrobial agents except colistin (98.8%, 161/163) and tigecycline (89.6%, 146/163). Colistin, amikacin and ceftazidime/avibactam demonstrated high antibacterial activity against P. aeruginosa with susceptility rates of 99.1% (115/116), 94.0% (109/116) and 83.6% (97/116), respectively. Conclusions:The major pathogens of nosocomial infections were K. pneumonia, E. coli, A. baumanii, P. aeruginosa and S. aureus. Nosocomial Gram-negative pathogens exhibited high susceptibilities to tigecycline, colistin and ceftazidime/avibactam. Antimicrobial resistance in A. baumannii remains a significant challenge. The increasing prevalence of carbapenem-resistant Enterobacterales underscores the urgency of antibiotics rational applications and hospital infection controls.

The rapid development of digital intelligence technologies is providing a powerful boost to the high-quality development of the healthcare system.Considering the current state of our healthcare services and guided by General Secretary Xi Jinping's insights on new quality productive forces and the directives from Third Plenary Session of Communist Party of China's 20th Central Committee,the high-quality development of the healthcare service system should focus on digital intelligence technologies such as cloud computing,big data,privacy computing,blockchain,Internet of Things(IoT),mobile computing,and AI.The key measures should include the optimization of production factors,services,and governance.Emphasis should be placed on enhancing the efficient and intensive development of the development model,ensuring the high-quality and continuous integration of the supply model,and transitioning to scientific and modern management methods.Herein,we analyzed the"factor optimization—service optimization—governance optimization"development mechanism driven by digital intelligence and proposed corresponding implementation pathways,intending to provide references for establishing a high-quality and efficient healthcare service system with Chinese characteristics.

Objective To analyze oxidative stress status and its correlation with urinary albumin creatinine ratio (UACR) and urinary β₂ microglobulin (Uβ₂-MG) in patients with diabetic nephropathy (DN), and to provide a theoretical basis for clinical evaluation of oxidative stress status in DN patients. Methods A total of 382 DN patients admitted to our hospital from January 2020 to December 2021 were selected. According to the 24h urinary microalbumin excretion rate (24h UAER), the patients were divided into mild renal injury group (20µg/min <24h UAER<200µg/min, n=233) and severe renal injury group (24h UAER≥200µg/min, n=149). Oxidative stress indicators as well as UACR and Uβ2-MG levels in all subjects were determined. Spearman correlation was used to analyze the correlation between oxidative stress status and the levels of UACR and Uβ2-MG in DN patients. The combined ROC curve of UACR and Uβ2-MG was used to predict the efficacy of oxidative stress status in DN patients. Results The level of SOD in the severe renal injury group was significantly lower than that in the mild renal injury group (P<0.05). The serum MDA level in the severe renal injury group was significantly higher than that in the mild renal injury group (P<0.05). The levels of UACR and Uβ2-MG in the severe renal injury group were significantly higher than those in the mild renal injury group (P<0.05). Spearman correlation analysis showed that SOD level was positively correlated with UACR and Uβ₂-MG levels in DN patients (r=-0.462, 0.413, P<0.05). The serum MDA level was negatively correlated with UACR and Uβ₂-MG levels in DN patients (r=-0.438, -0.459, P<0.05). The ROC curve analysis showed that the combined AUC of UACR and Uβ₂-MG to predict the oxidative stress status of DN patients was 0.689, the sensitivity was 79.84%, and the specificity was 83.45%. Conclusion Oxidative stress in DN patients can accelerate the pathological progression of nephropathy. The oxidative stress status is closely related to the levels of UACR and Uβ₂-MG, which can be used to judge the oxidative stress of the body and prevent the pathological progression of nephropathy in DN patients.