Objective To evaluate the rehabilitative effect of targeted sonic vibration load brushing method in stroke patients with oral phase swallowing disorders.Methods A total of 60 stroke patients with swallowing disor-ders,who hospitalized in the rehabilitation department of a Grade Ⅲ Class A hospital in Nanjing City from October 2023 to May 2024,were randomly assigned to an experimental group and a control group,with 30 patients in each group.Both groups received the conventional swallowing function training.The experimental group received targeted sonic vibration load brushing therapy,while the control group received routine oral care with manual toothbrushes.After 30 days of intervention,the swallowing function(Gugging Swallowing Screen,GUSS),modified Beck oral score,incidence of swallowing disorder-related complications,Swallowing Quality of Life(SWAL-QOL)scores,and oral care satisfaction were assessed in both groups.Results No sample detachment.After the intervention,the GUSS score for the experimental group was significantly higher than that of the control group,with a statistical difference(Z=-4.239,P＜0.001).Additionally,the modified Beck oral score and the overall complications rate related to swallowing disor-ders in the experimental group were significantly lower than those in the control group(both P＜0.05).Furthermore,the SWAL-QOL score and the oral care satisfaction score were both higher in the experimental group compared to those in the control group,with statistically significant differences(both P＜0.001).Conclusion Targeted sonic vibration load brushing method significantly improves swallowing function,enhances oral cleanliness,reduces the occurrence of swallowing disorder-related complications,and effectively improves patients' quality of life and nursing satisfaction.

Objective To investigate the relationship between the ratio of C-reactive protein(CRP)/preal-bumin(PAB)and severity of illness and onset in patients with primary knee osteoarthritis(KOA).Methods A total of 102 patients with primary KOA admitted to a hospital from October 2018 to October 2023 were selected as the study group,and 100 healthy people in a hospital during the same period were select-ed as the control group.According to the Kelgren-Lawrence(K-L)grading criteria,102 patients with primary KOA were divided into K-L grade Ⅰ group(n=21),K-L grade Ⅱ group(n=27),K-L grade Ⅲ group(n=34),and K-L grade Ⅳ group(n=20).The levels of CRP and PAB were measured by automatic biochemical analyzer,and the ratio of CRP/PAB was calculated.The predictive value of CRP,PAB and CRP/PAB ratio to the incidence of primary KOA was analyzed by receiver operating characteristic curve,and the influencing fac-tors of the incidence of primary KOA patients were analyzed by multivariate Logistic regression.Results There were significant differences in CRP,PAB and CRP/PAB ratio among primary KOA patients with different K-L grades(P＜0.05).The total score of Western Ontario and McMaster Universities Osteoar-thritis Index(WOMAC)for primary KOA patients from K-L group Ⅰ to K-L group Ⅳ were(40.91±5.18),(46.08±9.21),(51.24±7.46),(65.83±12.93)points,respectively.The difference was statistically signifi-cant(P＜0.05).In patients with primary KOA,CRP and CRP/PAB ratio were positively correlated with K-L grade and WOMAC total score,while PAB was negatively correlated with K-L grade and WOMAC total score(P＜0.05).CRP and CRP/PAB ratio in study group were higher than those in control group,and PAB level was lower than those in control group,the differences were statistically significant(P＜0.05).The area under the curve(AUC)and 95％CI of CRP and PAB levels were 0.781(0.736-0.831)and 0.853(0.781-0.876),respectively,and the AUC of CRP/PAB ratio was 0.937(0.892-0.987).Conclusion CRP and CRP/PAB ratio are highly expressed in patients with primary KOA,and PAB is low expressed in patients with pri-mary KOA,which is related to the severity of illness and onset in patients,and can be used as a potential marker to predict the severity of illness and onset in patients with primary KOA.

The biological nitrogen removal technology utilizing heterotrophic nitrification-aerobic denitrification (HN-AD) bacteria has shown effectiveness in wastewater treatment. However, the nitrogen removal efficiency of HN-AD bacteria significantly decreases as the salinity increases. To tackle the challenge of treating high-salt and high-nitrogen wastewater, we isolated a moderately halophilic HN-AD strain 5505 from a salt lake in Xinjiang. The strain was identified based on morphological, physiological, and biochemical characteristics and the 16S rRNA gene sequence. Single-factor experiments were carried out with NH₄⁺-N, NO₃^--N, and NO₂^--N as sole or mixed nitrogen sources to study the nitrifying effect, denitrifying effect, and nitrogen metabolism pathway of the strain. The strain was identified as Halomonas sp.. It can grow in the presence of 1%-25% (W/V) NaCl and exhibited efficient nitrogen removal ability in the presence of 3%-8% NaCl. At the optimal NaCl concentration (8%), the strain showed the NH₄⁺-N, NO₃^--N and NO₂^--N removal rates of 100.0%, 94.11% and 74.43%, respectively. Strain 5505 removed inorganic nitrogen mainly by assimilation, which accounted for over 62.68% of total nitrogen removal. In the presence of mixed nitrogen sources, strain 5505 showed a preference for utilizing ammonia, with a potential HN-AD pathway of NH₄⁺→NH₂OH→NO₂^-→NO₃^-→NO₂^-→NO/N₂O/N₂. The findings provide efficient salt-tolerant bacterial resources, enhance our understanding of biological nitrogen removal, and contribute to the nitrogen removal efficiency improvement in the treatment of high-salt and high-nitrogen wastewater.
Halomonas/classification* ; Nitrogen/isolation & purification* ; Denitrification ; Nitrification ; Wastewater/microbiology* ; Aerobiosis ; Biodegradation, Environmental ; Salinity

As an inevitable trend of social development, aging has generated a wide and far-reaching impact on every aspect of society, especially posing severe challenges for the heath system of all countries and regions around the world. Facing the objective reality of humans co-existing with diseases in a long term and people’s ever-growing demand for healthcare, the successful development of vaccine products can provide people with effective preventive measures to combat infectious diseases. This article summarizes the development and use of 4 vaccines that are suitable for the elder population, i.e., influenza vaccine, pneumococcal vaccine, varicella-zoster virus vaccine and respiratory syncytial virus vaccine, aiming to provide some reference for the development and popularization of these vaccines and to improve the well-being of the senior citizens.

Objective:To investigate the diagnostic potential of serum Dickkopf-related protein 3(Dkk3)as a novel biomarker for sarcopenia in an elderly Chinese population by examining its correlation with muscle mass, muscle strength, and physical function.Methods:The study included elderly individuals aged ≥60 years from the Health Examination Center of Jiangsu Provincial Hospital between 2021 and 2022, who had independent mobility and were free from acute diseases.Fat and muscle mass were measured using Dual-energy X-ray Absorptiometry(DXA). Grip strength and chair stand test times were employed to assess upper and lower limb muscle strength, respectively.Physical function was evaluated using the Short Physical Performance Battery(SPPB). Serum Dkk3 concentration was measured using a human Dkk3 enzyme-linked immunosorbent assay(ELISA)kit.Results:A total of 108 elderly participants(83 males)were included in the study, with an age range of 60 to 97 years(mean age: 70.6±10.8). Serum Dkk3 concentration was found to be negatively correlated with the skeletal muscle mass index(SMI)( R=-0.292, P=0.002), lower limb muscle mass( R=-0.320, P<0.001), upper limb muscle mass( R=-0.222, P=0.020), and hip muscle mass( R=-0.261, P=0.006). Functional assessments revealed negative correlations with grip strength( R=-0.204, P=0.035), 4-meter walking speed( R=-0.195, P=0.043), the three-position balance test( R=-0.245, P=0.011), and the SPPB score( R=-0.196, P=0.043). Regression analysis indicated that, after adjusting for age, sex, body mass index(BMI), and comorbidities, Dkk3 remained negatively associated with lower limb muscle mass( β=-0.197, P=0.012), hip muscle mass( β=-0.156, P=0.029), and the SPPB score( β=-0.001, P=0.013). The sarcopenia group exhibited a 55.6% higher serum Dkk3 level compared to the control group(76.68±37.62 ng/ml vs.49.27±25.88 ng/ml, P<0.001). Receiver Operating Characteristic(ROC)curve analysis determined the optimal diagnostic threshold to be 80.08 ng/ml, with an area under the curve of 0.726, a sensitivity of 41.98%, and a specificity of 96.30% for detecting sarcopenia. Conclusions:Serum Dkk3 is closely associated with reduced muscle mass in the lower limbs and hips, as well as a decline in physical function, in elderly individuals with sarcopenia.Given its cost-effectiveness and clinical utility, serum Dkk3 shows potential as a meaningful biomarker for diagnosing sarcopenia in the elderly.

Liver cancer stands as one of the most lethal malignant tumors globally,and liver transplantation presents a potent and effective therapeutic approach for affected individuals.However,the post-transplantation immune regulation is critical for the survival of the graft and the long-term prognosis of the patient.Energy metabolism plays a pivotal role in both the tumor microenvironment and immunomodulation following liver transplantation.This review explores the metabolic mechanisms within the tumor microenvironment,energy metabolism characteristics in liver transplantation,and the impact of post-transplantation energy metabolism on reducing liver cancer recurrence and mitigating transplant rejection.By gaining an in-depth comprehension of the intricate interplay between metabolic pathways and immune regulation,it is envisioned that innovative therapeutic strategies can be formulated.These strategies aim to enhance the outcomes for liver transplant recipients and offer more efficacious treatment options for those afflicted with liver cancer.

Objective To investigate the prevalence of metabolic syndrome(MS)and its influencing factors among adult residents in Zhifu district of Yantai city,and to provide data support and scientific basis for relevant departments to formulate policies and measures.Methods A total of 2412 residents in Zhifu district were selected by multi-stage stratified sampling method,and their basic information,personal health status,height,weight,blood pressure,fasting blood glucose,blood lipids and other indicators were collected by questionnaire survey,physical measurement and laboratory examination.The screening of MS was based on the diagnostic criteria of MS recommended by Chinese Diabetes Society(CDS).Results Among the adult residents in Zhifu district,the number of MS patients was 522,with a crude prevalence rate of 21.6%.The prevalence of MS in men was 26.9%higher than that in women(16.9%)(χ2=35.939,P<0.001).With the increase of age,the prevalence rate of MS showed an overall upward trend(linear trend test χ2=150.557,P<0.001).With the increase of education level,the prevalence rate of MS showed an overall downward trend(linear trend test χ2=81.670,P<0.001).The results of multivariate logistic regression analysis further showed that male and age increase were high risk factors for MS;higher education level,unmarried,engaged in static occupation,and increased activity were protective factors for MS.Conclusion The prevalence rate of MS in adult residents in Zhifu district of Yantai is basically equal to the national average level,suggesting that the government and health service institutions at all levels should take health exercise,smoking cessation and alcohol restriction as the entry point for health education and early diagnosis and treatment;meanwhile,targeted interventions should be carried out according to different characteristics of the population.

Objective To provide a scientific basis for cancer prevention and control in Zhifu district and Yantai city by comprehensively describing and analyzing the epidemiological characteristics and disease burden of malignant tumors in Zhifu district,and reduce the disease burden.Methods The data of cancer incidence and mortality collected by the Center for Disease Control and Prevention in Zhifu district from 2010 to 2020 were used to evaluate the incidence and mortality of cancer.The excel template and DismodII software released by WHO were used to calculate the disease burden indexes such as disability-adjusted life year(DALY),years of life lost(YLL),and DALY rate,and the Joinpoint regression model was used to analyze the trend of disease burden,and annual percent change and average annual percent change were calculated.Results The total DALY of malignant tumors in Zhifu district from 2010 to 2020 was 166192.75 person-years,with a DALY rate of 199.02‰.The disease burden of malignant tumors mainly came from YLL,accounting for 74.70%of DALY.Conclusion Zhifu malignant tumor disease burden is on the rise,the relevant departments still need to improve the registration of malignant tumors,improve the knowledge of the population through the way of public welfare propaganda,increase the screening of common malignant tumors,promote the progress of early diagnosis and treatment of cancer,reduce the disease burden brought by early death.To improve the tertiary prevention of malignant tumors.

Objective To explore the mediating effect of adversity quotient(AQ)in the relationship between organizational support and professional identity among nurses undergoing standard nursing training and to provide theoretical guidance for enhancing professional identity.Methods A total of 1,031 nurses receiving standardized training from 12 tertiary general hospitals in Jiangsu Province,were recruited using a convenience sampling.Data were collected using the self-rating scale for nurses'adversity,nurses'organizational support perception scale,and nurse professional identity assessment scale.Pearson correlation analysis was performed to examine associations among organizational support,AQ,and professional identity.Structural equation modeling(SEM)was used to test the mediating role of AQ.Results A total of 930 nurses undergoing standardized training completed the survey.The total scores for AQ,organizational support,and professional identity were 132.44±29.78,45.51±9.60,and 100.88±19.52,respectively.Organizational support was positively correlated with professional identity(r=0.753,P<0.01),but negatively with AQ(r=-0.720,P<0.01).AQ was also negatively associated with professional identity(r=-0.772,P<0.01).SEM analysis revealed that AQ partially mediated the relationship between organizational support and professional identity,accounting for 49.20%of the total effect(effect size=0.392).Conclusion Nurses undergoing standardized nursing training exhibit moderate professional identity.AQ serves as a key mediator between organizational support and professional identity.It indicates that improving organizational support and adversity quotient can strengthen their professional identity.

Objective To investigate the needs of the main caregivers of patients with spinal cord injury following neurogenic bowel dysfunction to participate in the whole process of intestinal management.Methods Nine main caregivers of patients with spinal cord injury in Jiangsu Province Hospital from January to Decem-ber,2024 were selected with objective sampling method.They were investigated face-to-face semi-structured in-depth interviews,and the data were analyzed,summarized and extracted by Colaizzi 7-step analysis method.Results Three themes and eight sub-themes were extracted:the needs of professional knowledge and skills standards in intestinal management(lack of intestinal training knowledge,lack of ability to acquire knowledge and different standards of medical institutions);the needs of physical ability and decision making ability participating in intesti-nal training(lack of participation,single decision-making behavior,excessive dependence on medical personnel);the desire for therapeutic benefits and the needs for building psychological confidence(concerns about the pa-tient's prognosis,overdependence on medication).Conclusion Clinical medical staff should pay attention to the actual needs and difficulties faced by the main caregivers of patients with neurogenic bowel dysfunction to participate in the entire intestinal management,and construct targeted training programs,strengthen the skills and knowledge training,to enhance their autonomy and responsi-bility,to achieve the rehabilitation goal better.