Clinical practice guidelines represent the best recommendations for patient care. They are developed through systematically reviewing currently available clinical evidence and weighing the relative benefits and risks of various interventions. However, clinical practice guidelines have to go through a long translation cycle from development and revision to clinical promotion and application, facing problems such as scattered distribution, high duplication rate, and low actual utilization. At present, the clinical practice guideline information platform can directly or indirectly solve the problems related to the lengthy revision cycles, decentralized dissemination and limited application of clinical practice guidelines. Therefore, this paper systematically examines different types of clinical practice guideline information platforms and investigates their corresponding challenges and emerging trends in platform design, data integration, and practical implementation, with the aim of clarifying the current status of this field and providing valuable reference for future research on clinical practice guideline information platforms.

This paper elaborated the structural principles,structures and working principles of the A5 type passive training system for hand function through discussed the clinical application of passive training system for hand function in the rehabilitation of patients with stroke.It analyzed a series of occurring common faults during system operation,such as system errors caused by missing components,improper sensitivity settings for spasticity,abnormal connections for equipment,motor failures,jam and pause of robotic hand,and faults of lifting table,and conducted fault analysis for them.After that,this paper proposed corresponding handling strategies and solutions for faults,which included software configuration,calibration and detection of robotic hand sensors,repair of connection fault,and regular maintenance and replacement of system's components.It provided theoretical basis for the maintenance and optimization of the passive training system for hand function.Thus,it can rapid remove troubles,and reduce the equipment's failure rate of passive training system for hand function,and improve the equipment's normal utilization rate,and ensure favorable performance of equipment in long-term use.

Sjogren's syndrome (SS) is a common autoimmune disorder that primarily targets exocrine glands, leading to hallmark manifestations of xerostomia and xerophthalmia, with potential progression to multisystem involvement. The rapid advances in omics technologies-including metabolomics, proteomics, and transcriptomics-have yielded substantial insights into SS pathophysiology. This review consolidates current evidence on omics-derived biomarkers in SS. Studies consistently implicate aberrant glucose metabolism, neutrophil-derived enzyme activity, mitochondrial bioenergetic impairment, ferroptosis, and apoptotic pathways as central to SS development. These findings refine our understanding of disease mechanisms and the heterogeneity of therapeutic responses. Hydroxyproline has emerged as a candidate marker for distinguishing SS from IgG4-related disease, whereas distinct cytokine and chemokine signatures may enable earlier diagnosis. Genomic analyses demonstrate a robust association between expression of the rs11797 locus and SS-related lymphomagenesis, and several genes controlling DNA methylation represent promising therapeutic targets. Collectively, these findings lay the groundwork for personalized risk stratification and intervention in SS. The review concludes by summarizing existing progress and outlining priorities for future omics-based investigations.
Humans ; Sjogren's Syndrome/diagnosis* ; Biomarkers/analysis* ; Metabolomics/methods* ; Proteomics/methods* ; Genomics ; Multiomics

Prone position ventilation (PPV) is an important protective strategy for lung ventilation, widely used in clinical practice, especially since the novel coronavirus infection pandemic. Since PPV is a non-physiological position, improper implementation and management can lead to serious adverse events such as pressure injury, facial edema, unplanned extubation and (or) reintubation, and even asphyxia. At present, preventive and protective strategies are mainly used to manage PPV-related complications in clinical practice. These strategies not only increase the workload of medical staff and the use of consumables, but also increase the medical cost of patients, further burdening patients and their families economically. To overcome the above problems, the medical staff of the department of critical care medicine of Tianjin Third Central Hospital designed a prone position head auxiliary support device and obtained a national utility model patent (patent number: ZL 2022 2 1751906.3). The device consists of annular plate, folding plate, support frame, reflector and wheel bodies. It serves to reduce pressure on the head and facial skin, while also exposing the mouth, nose, eyes, and ears to the hollow position of the annular plate according to the patient's position. At the same time, the patient's face or side skin can be observed through the lower reflector. The height of the annular plate was adjusted by adjusting the support frame, and the head was raised to reduce facial edema. The setting of strip groove, through hole and hook can sort out the facial pipeline, keep the drainage unobstructed, prevent catheter displacement and unplanned extubation, and has certain clinical promotion and practical value.
Humans ; Prone Position ; Equipment Design ; Respiration, Artificial/methods* ; COVID-19 ; Head ; Patient Positioning

Objective To investigate the influencing factors of disease progression and prognosis in patients with large artery atherosclerotic(LAA)cerebral infarction and analyze the value of plasma cyclin-dependent kinase 9(CDK9)level in the diagnosis and treatment of LAA cerebral infarction.Methods Patients with acute cerebral infarction admitted to the Department of Neurology of the Affili-ated Hospital of Yangzhou University between March 1,2022,and November 20,2023,were select-ed.According to the diagnostic criteria,98 patients with acute LAA(LAA group)and 33 patients with acute small artery occlusion(SAO)cerebral infarction(SAO group)were selected.Additionally,40 healthy individuals matched for age and gender from the Health Examination Center were included as control group.Based on whether the condition of LAA cerebral infarction patients progressing,they were divided into progressive cerebral infarction(PCI)group(39 patients)and the non-pro-gressive cerebral infarction(NPCI)group(59 patients).During the 3-month follow-up period,6 patients from the 98 LAA cerebral infarction patients were lost.According to the modified Rankin Scale(mRS)score at 90 days of follow-up,patients were divided into good prognosis group(mRS score≤2,59 patients)and poor prognosis group(mRS score＞2,33 patients).Fasting lipid in-dices[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),glucose(GLU),glycated hemoglobin(HbA1c),and homocysteine(Hey)]were collected on the second day after admission.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of neurological impairment in cerebral infarction patients.Enzyme-linked immunosorbent assay(ELISA)was used to measure plasma CDK9 levels in different groups;factors influencing disease progression in patients with acute LAA cerebral infarction were explored;and receiver operating characteristic curves were plotted to evalu-ate the predictive value of CDK9 in patients with acute LAA cerebral infarction.Results Compared with the control group,the LAA group had lower HDL-C level and higher CDK9 level(P＜0.05).The LAA group had a higher proportion of diabetes history,larger infarction volume,higher NIHSS score at admission,and higher CDK9 level compared with the SAO group(P＜0.05).Binary Logistic regression analysis showed that diabetes history and plasma CDK9 levels were influencing factors for LAA cerebral infarction.There were statistically significant differences in the proportion of diabetes history,HbA1c,random GLU,and CDK9 levels between the NPCI and PCI groups(P＜0.05).Diabetes history and plasma CDK9 levels were influencing factors for disease progression in patients with acute LAA cerebral infarction.The area under the ROC curve for CDK9 in predicting acute LAA cerebral infarction was 0.854 5(95％CI,0.794 1 to 0.9148).When the CDK9 level was 602.1 ng/L,the Youden index was maximum(0.604),with a corresponding sensitivity of 0.849 and specificity of 0.755.The NIHSS score,infarction volume,and plasma CDK9 level were higher in the poor prognosis group compared with the good prognosis group(P＜0.01).Correlation analysis showed a positive correlation between mRS scores and CDK9 levels(r=0.485,P＜0.01).Conclusion Plasma CDK9 levels are significantly elevated,and is an influencing factor.It is positively correlated with disease progression and poor prognosis in acute cerebral infarction and has certain predictive value for the progression of LAA cerebral infarction.

Objective To explore the application effect of the dual-track nursing intervention model in the treatment process of children with lobar pneumonia.Methods A total of 186 children with lobar pneumonia were selected and randomly divided into control group and intervention group u-sing a double-blind method,with 93 cases in each group.The control group received conventional nursing intervention,while the intervention group implemented the dual-track nursing intervention model on the basis of conventional nursing.This model included the establishment and training of nurs-ing teams,personalized nursing plans,health education,and psychological support.Outside the hos-pital,it emphasized family support,regular follow-up guidance,and community-based collaborative ed-ucation.Both groups received a 3-week intervention.The improvement times of clinical symptoms,hos-pital stay,pulmonary function indicators before and after nursing,treatment compliance,and family members' satisfaction with nursing were compared and analyzed between the two groups.Results The fever resolution time[(3.89±0.96)d],cough relief time[(6.21±1.34)d],disappearance time of pulmonary rales[(7.89±1.56)d],and hospital stay duration[(9.45±1.89)d]in the intervention group were all shorter than those in the control group[(5.23±1.14),(7.45±1.67),(9.32±2.01),and(11.28±2.35)d,respectively],with statistically significant differences(P＜0.05).After nursing,the forced expiratory volume in one second(FEV1)[(1.51±0.22)L],forced vital capacity(FVC)[(1.75±0.25)L],and FEV1/FVC[(94.12±5.65)％]in the intervention group were all higher than those in the control group[(1.42±0.15)L,(1.66±0.22)L,and(85.73±8.41)％,respectively],with statistically significant differences(P＜0.05).The scores for exami-nation cooperation[(23.91±3.82)points],nursing cooperation[(24.19±4.03)points],standardized medication use[(24.26±3.94)points],and rational diet[(23.77±3.62)points]in the intervention group were higher than those in the control group[(20.16±3.53),(19.64±3.46),(23.05±3.68),and(18.85±3.41)points,respectively],with statistically significant differences(P＜0.05).The satisfaction rate of family members with nursing work in the intervention group was higher than that in the control group,with a statistically significant difference(98.92％versus 89.25％,P＜0.05).Conclusion The dual-track nursing intervention model has a signifi-cant application effect in children with lobar pneumonia.It can accelerate their recovery process,improve treatment compliance,promote pulmonary function improvement,and enhance family mem-bers' satisfaction.

Objective:To investigate the association between dietary diversity and the risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) .Methods:A total of 553 patients diagnosed with CHD and undergoing PCI in the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between May and November 2023 were enrolled using a convenience sampling method. A Semi-Quantitative Food Frequency Questionnaire was used to assess patients' dietary intake after PCI, and the Dietary Diversity Score (DDS) was calculated. Patients were followed up for one year to determine the incidence of MACE.Results:History of hypertension, history of hyperlipidemia, body mass index, use of antiplatelet agents, use of diuretics, triglycerides, smoking index and DDS were identified as factors influencing the occurrence of MACE after PCI ( P<0.05) . Among these, higher dietary diversity had a protective effect against MACE. Conclusions:After PCI, patients with lower DDS experienced MACE more frequently than those with higher scores. Increased dietary diversity can effectively help prevent MACE in patients after PCI.

Objective:To investigate the independent and interactive effects of sleep quality and sleep chronotype on the severity of coronary artery lesions in patients with coronary heart disease.Methods:From September 2023 to January 2024, 322 inpatients with coronary heart disease diagnosed by coronary angiography in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Harbin Medical University were selected for the study using the convenience sampling method. Pittsburgh Sleep Quality Index and the Chinese version of the Munich Chronotype Questionnaire were used to investigate the sleep quality and sleep chronotype, and the Gensini score was used to evaluate the severity of coronary artery lesions. Multiple ordered Logistic regression was used to explore the factors influencing the severity of coronary artery lesions in patients with coronary heart disease.Results:Multiple ordered Logistic regression analysis showed that total cholesterol, history of diabetes mellitus, sleep quality, and sleep chronotype were influencing factors in the severity of coronary artery lesions in patients with coronary heart disease ( P<0.05) . There were statistically significant main and interaction effects of sleep quality and sleep chronotype on the severity of coronary artery lesions ( P<0.05) . Conclusions:Sleep quality and sleep chronotype in patients with coronary heart disease have not only independent but also interactive effects on the severity of coronary artery lesions. Nursing staff can provide guidance and interventions for sleep quality and sleep chronotype that may help control the progression of coronary artery lesions in patients with coronary heart disease.

Objective To mine and analyze adverse drug reaction(ADR)signals of fluorouracil injections within real-world settings,and to offer a reference for the safe use of medications in clinical practice and for post-marketing safety assessments by pharmaceutical license holders.Methods The ADR reports for fluorouracil injections extracted from the database of the National Adverse Drug Reaction Monitoring System of Hubei province were collected from January 2004 to April 2024.The retrospective review was used to analyze the basic information,medication details and ADR manifestations of the patient.The ADR signals were mined and analyzed by using the reporting odds ratio(ROR)method,the Medicines and Healthcare Products Regulatory Agency(MHRA)method,and the Bayesian confidence propagation neural network(BCPNN)method.Results The study identified 1,292 ADR reports involving fluorouracil injections,encompassing 1,429 instances of the drug and 1,901 ADR manifestations across 18 system-organ classes.The demographic analysis revealed a male predominance and a peak proportion(61.07％)among patients aged 45 to 64 years.The majority of the underlying diseases were digestive system malignancies,accounting for 73.37％of the cases.ADRs were predominantly reported within the first 5 days post-administration(77.17％),with a favorable outcome in 85.84％of the patients.The ROR method identified 35 risk signals,including 15 novel signals,while the MHRA method identified 33 signals,with 14 being novel.The BCPNN method detected 19 signals,of which 6 were novel.Notably,elevated aspartate aminotransferase and alanine aminotransferase levels emerged as novel ADRs with significant signal strength across all three detection methods.Conclusion The common ADR signals of fluorouracil injections are consistent with instruction.However,it is essential to increase vigilance regarding ADRs such as liver and gallbladder system diseases,which are not recorded in the drug instruction,to bolster the safety profile of fluorouracil injections in clinical use.