Objective:To conduct evidence synthesis on disease communication between parents and their minor children from the perspective of parents with cancer, so as to provide information for clinical healthcare providers to deliver improved health education to patients and their children.Methods:Computer retrieval was implemented in PubMed, CINAHL, Embase, Web of Science, PsycINFO, Cochrane Library, ProQuest, China National Knowledge Infrastructure, and Wanfang Data. The search period was from January 1, 2000 to March 6, 2025. The literature was assessed according to the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The JBI aggregative integration method was employed for the Meta-synthesis.Results:A total of nine articles were included. Thirty-two results were extracted, divided into ten categories, and integrated into five results, namely willingness to communicate illness, factors influencing communicating willingness, disease communication strategies, supporting children's coping, and perceptions of illness information.Conclusions:Disease communication between cancer parents and their minor children is influenced by multiple factors and exhibits complex diversity. Healthcare providers should fully understand and accurately recognize the distinct approaches of parents with cancer, offering guidance, advice, and encouragement whenever possible, and should dynamically provide timely medical support and assistance tailored to the evolving needs of patients throughout different stages of their disease treatment.

ObjectiveTo analyze the research hotspot and future trend of non-invasive brain stimulation (NIBS) in Alzheimer's disease. MethodsRelevant literature on application of NIBS in Alzheimer's disease from January, 2014 to October, 2024 was retrieved from the Web of Science Core Collection database. CiteSpace 6.4.R1 was used to perform a bibliometric analysis and to create knowledge maps, including annual publication volume, countries, institutions, authors, keywords and co-cited references. ResultsA total of 731 articles were included, showing an increasing trend in annual publication volume. The United States was the leading country in publication volume, Harvard University was the most productive institution, and Giacomo Koch was the most prolific author. Brain Stimulation was the most frequently cited journal. Highly focused keywords included cognitive impairment, memory, dementia, transcranial magnetic stimulation and transcranial direct current stimulation. Bursting keywords in the past two years included transcranial alternating current stimulation, functional magnetic resonance imaging, brain-derived neurotrophic factor and oxidative stress. ConclusionResearch interest in NIBS within the field of Alzheimer's disease has been steadily increasing. The research hotspots include the effect and mechanism of NIBS on cognitive function and the impact of stimulating different brain regions on cognitive outcome. Future research may focus on integrating NIBS with techniques such as functional magnetic resonance imaging to achieve individualized and precise stimulation.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Cholangiocarcinoma(CCA)is a highly aggressive and heterogeneous biliary malignancy characterized by challenges in early diagnosis,limit-ed efficacy of traditional chemotherapy,and poor prognosis.Due to its significant heterogeneity at the genomic,epigenetic,and molecular levels,mo-lecular testing and targeted therapy have become increasingly important in CCA management,form-ing an integral part of the era of precision oncolo-gy.The development of next-generation sequenc-ing(NGS)has advanced research into the molecu-lar subtypes and therapeutic targets of CCA,includ-ing FGFR2 fusions/rearrangements,IDH1 muta-tions,and BRAF mutations.Recently,two phase Ⅲ clinical trials,TOPAZ-1 and KEYNOTE-966,have es-tablished the pivotal role of immunotherapy com-bined with chemotherapy in advanced CCA.While precision diagnosis and treatment in CCA have shown promising progress,this field remains in its exploratory phase and faces numerous challenges.This review summarizes recent advancements in the diagnosis,molecular targeted therapy,immuno-therapy,resistance mechanisms,and the develop-ment of novel strategies for CCA.

Objective:To conduct evidence synthesis on disease communication between parents and their minor children from the perspective of parents with cancer, so as to provide information for clinical healthcare providers to deliver improved health education to patients and their children.Methods:Computer retrieval was implemented in PubMed, CINAHL, Embase, Web of Science, PsycINFO, Cochrane Library, ProQuest, China National Knowledge Infrastructure, and Wanfang Data. The search period was from January 1, 2000 to March 6, 2025. The literature was assessed according to the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The JBI aggregative integration method was employed for the Meta-synthesis.Results:A total of nine articles were included. Thirty-two results were extracted, divided into ten categories, and integrated into five results, namely willingness to communicate illness, factors influencing communicating willingness, disease communication strategies, supporting children's coping, and perceptions of illness information.Conclusions:Disease communication between cancer parents and their minor children is influenced by multiple factors and exhibits complex diversity. Healthcare providers should fully understand and accurately recognize the distinct approaches of parents with cancer, offering guidance, advice, and encouragement whenever possible, and should dynamically provide timely medical support and assistance tailored to the evolving needs of patients throughout different stages of their disease treatment.

Cholangiocarcinoma(CCA)is a highly aggressive and heterogeneous biliary malignancy characterized by challenges in early diagnosis,limit-ed efficacy of traditional chemotherapy,and poor prognosis.Due to its significant heterogeneity at the genomic,epigenetic,and molecular levels,mo-lecular testing and targeted therapy have become increasingly important in CCA management,form-ing an integral part of the era of precision oncolo-gy.The development of next-generation sequenc-ing(NGS)has advanced research into the molecu-lar subtypes and therapeutic targets of CCA,includ-ing FGFR2 fusions/rearrangements,IDH1 muta-tions,and BRAF mutations.Recently,two phase Ⅲ clinical trials,TOPAZ-1 and KEYNOTE-966,have es-tablished the pivotal role of immunotherapy com-bined with chemotherapy in advanced CCA.While precision diagnosis and treatment in CCA have shown promising progress,this field remains in its exploratory phase and faces numerous challenges.This review summarizes recent advancements in the diagnosis,molecular targeted therapy,immuno-therapy,resistance mechanisms,and the develop-ment of novel strategies for CCA.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Objective:To analyze the effect of analysis plan, do, check, and action (PDCA) cycle in improving the completion rate of sepsis bundle treatment in sepsis patients and the knowledge-attitude-practice of sepsis bundle treatment in medical staff.Methods:Using the historical control method, sepsis patients admitted to the Emergency Trauma Intensive Care Unit of Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected as the research objects by convenience sampling. The 35 patients admitted from January to December 2021 will be included in the control group; from June 2022 to June 2023, 28 patients were admitted to the observation group. The control group received routine nursing care, while the observation group received intervention based on the PDCA cycle. The completion rate of sepsis bundle treatment before and after PDCA cycle implementation was compared. The 27 nurses and 5 doctors working in trauma care unit were investigated by using a self-designed questionnaire on their knowledge and practice level of sepsis bundle treatment. The completion rate of sepsis bundle treatment before and after the implementation of PDCA cycle was compared.Results:The control group included 19 males and 16 females, aged (61.77 ± 8.64) years. The observation group included 13 males and 15 females, aged (60.61 ± 10.20) years. After the implementation of PDCA cycle, the completion rate of 3h bundle treatment for sepsis in the observation group was 89.29% (25/28), which was higher than 31.42% (10/35) in the control group, with a statistically significant difference ( χ2=23.22, P<0.05). The completion rate of sepsis bundle treatment within 6 hours in the observation group was 11/11, which was higher than 5/9 in the control group, with a statistically significant difference ( χ2=6.11, P<0.05). Moreover, after the implementation of PDCA cycle, the total score and sub-scale scores of the knowledge-attitude-practice among medical staffs increased from 86.60 ± 10.33, 21.00 ± 4.74, 18.00 ± 1.58, and 47.60 ± 4.10 to 100.00 ± 5.20, 27.60 ± 2.51, 19.60 ± 0.55, and 52.80 ± 2.28 respectively, with statistically significant differences ( t values were -5.10 - -3.14, all P<0.05). Conclusions:PDCA cycle can improve the completion rate of sepsis bundle treatment and improve the level of knowledge, attitude and practice of medical staff.

ObjectiveTo investigate the prevalence and influencing factors of overweight， obesity and central obesity among elderly residents in Xuhui District， and to analyze the epidemiological status of central obesity in elderly people with different body mass indexes. MethodsThe third round of health status and health service utilization monitoring data in Xuhui District was used. The information collected from questionnaire survey and physical examination were analyzed. SPSS 20.0 software was used for χ² test， trend χ² test and multinominal logistic regression analysis. Results5 096 survey subjects were included. The prevalence of overweight， general obesity， and central obesity in the residents aged 60 and above in Xuhui District were 34.3%， 6.5%， and 29.2%， respectively. There was gender difference in the rates of overweight， obesity， and central obesity among the residents. The overweight and central obesity rates in males were higher than those in females， while the obesity rate was lower than that in females （P<0.05）. Multinominal logistic regression analysis showed that in comparison with the normal weight non-central obesity group drinking only at party （OR=1.729， 95%CI： 1.184‒2.525）， and hypertension （OR=1.637， 95%CI： 1.305‒2.053）， were highly associated with normal weight with central obesity. Aged 60‒ years （OR=1.589， 95%CI： 1.190‒2.120）， aged 70‒ years （OR=1.763， 95%CI： 1.327‒2.342）， male （OR=1.379， 95%CI： 1.134‒1.676）， hypertension （OR=2.231， 95%CI： 1.878‒2.649）， former smokers （OR=1.437， 95%CI： 1.027‒2.011）， drinking at party only （OR=1.491， 95%CI： 1.107‒2.006）， and drinking ≥3 times per week （OR=1.611， 95%CI： 1.116‒2.325）， were highly associated with overweight combined with central obesity. Aged 60‒ years （OR=3.817， 95%CI： 2.251‒6.474）， aged 70‒ years （OR=3.084， 95%CI： 1.838‒5.175）， hypertension （OR=3.683， 95%CI： 2.753‒4.929）， diabetes （OR=2.085， 95%CI： 1.511‒2.878）， former smokers （OR=1.835， 95%CI： 1.043‒3.226）， were highly associated with compound obesity. Central obesity was found in the elderly residents with different BMI categories， and the rate of central obesity increased with the increase of BMI grade. ConclusionThe prevalence of overweight， obesity and central obesity among the elderly aged 60 years and above in Xuhui District is not optimistic. Attention should be paid to the elderly under 80 years old who are with hypertension and/or diabetes， alcohol consumption， low educational level and not doing physical exercise. Especially for the central obesity population with normal BMI， measures should be taken to prevent and intervene the occurrence of obesity and related diseases.

A teaching clinic is an outpatient clinic specialized for teaching, where trainees are responsible for medical activities such as medical history taking, physical examination, and diagnosis and treatment, under the assistance and guidance of teachers. Only a few hospitals in China have built up teaching clinics for standardized training of pediatric residents. This paper summarizes the experience in the operation management of the standardized residency training teaching clinic in Children's Hospital, Zhejiang University School of Medicine. The teaching clinic takes teaching as its core task, adheres to humanistic care, and follows the principle of hierarchical progression. Its operation involves organizational approval, preliminary arrangements, outpatient appointments, the implementation of teaching activities, and other processes, which are carried out under organizational management and quality management. We have explored a preliminary strategy for evaluating the teaching effects of teaching clinics, and proposed some suggestions for the future development of pediatric residency training teaching clinics such as increasing objective evaluation methods and increasing pediatric subspecialty teaching clinics.