OBJECTIVE:Patients with osteoporotic vertebral compression fractures still have residual back pain after vertebral augmentation.The current research is characterized by limited sample size,complex confounding factors,and inconsistent research results.To gain a deeper understanding of this phenomenon,the aim of this study was to identify and evaluate the risk factors for residual back pain after surgery through a systematic review and meta-analysis.METHODS:A comprehensive search was conducted in CNKI,VIP,WanFang,CBMdisc,PubMed,The Cochrane Library,Embase,and Web of Science for case-control studies on residual back pain after vertebral body augmentation for osteoporotic vertebral compression fractures from database inception to July 2024.The search terms were a combination of subject terms and free terms.The basic information,patient characteristics,surgical-related indicators,and risk factors for surgical back pain of the included studies were extracted.After evaluating the bias risk of all included studies,a meta-analysis was conducted using Stata 14.0 software on the relevant indicators.RESULTS:(1)21 case-control studies with a total of 8 043 patients were included.Among them,965 patients developed back pain.The quality score of all 21 studies was ≥7.(2)The meta-analysis results showed that age(WMD=0.98,95％CI:0.40-1.56,P=0.010),bone mineral density(WMD=-0.28,95％CI:-0.34 to-0.21,P=0.000),the number of vertebral fractures(OR=3.50,95％CI:2.65-4.62,P=0.000),thoracolumbar fracture index(OR=3.65,95％CI:2.61-5.11,P=0.000),cement volume(OR=6.89,95％CI:2.62-18.17,P=0.000),and cement distribution(OR=2.38,95％CI:1.93-2.93,P=0.000)were risk factors for the development of back pain after vertebral body augmentation in patients with osteoporotic vertebral compression fractures.CONCLUSION:Current evidence indicates that age,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,bone cement injection volume,and the distribution of bone cement are risk factors for low back pain.Specifically,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,and non-uniform distribution of bone cement are identified as independent risk factors for low back pain.Patients exhibiting these high-risk factors require vigilant monitoring and prompt intervention to mitigate the occurrence of clinical low back pain,thereby enhancing patient outcomes and quality of life.

OBJECTIVE:Patients with osteoporotic vertebral compression fractures still have residual back pain after vertebral augmentation.The current research is characterized by limited sample size,complex confounding factors,and inconsistent research results.To gain a deeper understanding of this phenomenon,the aim of this study was to identify and evaluate the risk factors for residual back pain after surgery through a systematic review and meta-analysis.METHODS:A comprehensive search was conducted in CNKI,VIP,WanFang,CBMdisc,PubMed,The Cochrane Library,Embase,and Web of Science for case-control studies on residual back pain after vertebral body augmentation for osteoporotic vertebral compression fractures from database inception to July 2024.The search terms were a combination of subject terms and free terms.The basic information,patient characteristics,surgical-related indicators,and risk factors for surgical back pain of the included studies were extracted.After evaluating the bias risk of all included studies,a meta-analysis was conducted using Stata 14.0 software on the relevant indicators.RESULTS:(1)21 case-control studies with a total of 8 043 patients were included.Among them,965 patients developed back pain.The quality score of all 21 studies was ≥7.(2)The meta-analysis results showed that age(WMD=0.98,95％CI:0.40-1.56,P=0.010),bone mineral density(WMD=-0.28,95％CI:-0.34 to-0.21,P=0.000),the number of vertebral fractures(OR=3.50,95％CI:2.65-4.62,P=0.000),thoracolumbar fracture index(OR=3.65,95％CI:2.61-5.11,P=0.000),cement volume(OR=6.89,95％CI:2.62-18.17,P=0.000),and cement distribution(OR=2.38,95％CI:1.93-2.93,P=0.000)were risk factors for the development of back pain after vertebral body augmentation in patients with osteoporotic vertebral compression fractures.CONCLUSION:Current evidence indicates that age,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,bone cement injection volume,and the distribution of bone cement are risk factors for low back pain.Specifically,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,and non-uniform distribution of bone cement are identified as independent risk factors for low back pain.Patients exhibiting these high-risk factors require vigilant monitoring and prompt intervention to mitigate the occurrence of clinical low back pain,thereby enhancing patient outcomes and quality of life.

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associat-ed infections for patients after renal transplantation,and to provide a reference for the rational selection of antibac-terial drugs for anti-infective treatment in such patients.METHODS Clinical data were collected from 89 hospital-ized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabili-tation and Recuperation Center(formerly known as 281 Hospital)from 2017 to 2021.The pathogenic bacteria de-tected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospi-tal-associated infection,including 74 gram-negative bacterial strains(83.15％)and 15 gram-positive bacterial strains(16.85％).The predominant pathogenic bacterial strains were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa.Respiratory tract infection was the most common.E.coli showed severe drug re-sistance,with high drug resistance rates to various antibacterial drugs(complete drug resistance to piperacillin and ampicillin).K.pneumoniae was generally drug resistant to ampicillin.Enterobacter cloacae showed high sensitivi-ty to carbapenems,amikacin and enzyme inhibitor combinations.P.aeruginosa had low drug resistance rates to imipenem and meropenem.Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin,erythromycin and gentamicin,and no drug-resistant strains to vancomycin and linezolid were found.CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal trans-planted patients with postoperative hospital-associated infections,with a high detection rate of E.coli and a severe drug resistance situation.Therefore,it is necessary to strengthen the monitoring of drug resistance in renal trans-plant recipients and make rational choices of antibacterial drugs.

Objective To conduct a scoping review of studies related to latent class trajectory analysis of glucose metabolism indicators in diabetes mellitus patients,so as to clarify the method of latent category trajectory analysis,evaluation indicators and the changing trajectories of different glucose metabolism indicators in diabetes mellitus patients,and to establish foundation for diabetes management and research.Methods Based on Arksey's framework for scoping study,a literature search was performed in CNKI,Wanfang,CBM,Web of Science,PubMed,Embase,Cochrane Library,CINAHL database inception to January 28,2024.Totally 2 researchers independently screened the literature and extracted data.Results A total of 22 pieces of the literature were included.Latent class growth model was the most commonly used model in latent class trajectory analysis,and 4 softwares are available for implementation.The current evaluation indicators for trajectory results are various,with the Bayesian information criterion and average posterior probability as the most frequently utilized.Hemoglobin is the most commonly used glucose metabolism indicators for trajectory analysis,and the number of identified trajectories ranged from 2 to 5.Most studies showed that diabetic patients exhibited a"low-stable"pattern in glucose metabolism indicators.Conclusion Latent class trajectory analysis represents a novel longitudinal data analysis approach that can identify potential subgroups of diabetic patients with similar development trajectory.The models and evaluation indicators employed are diverse,and the stability test of the models can be enhanced in the future.Through trajectory identification,it is recommended that clinical staff pay greater attention to the longitudinal trend of the glucose metabolism indicators and incorporate it into the long-term blood glucose management goal of diabetic patients.

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associat-ed infections for patients after renal transplantation,and to provide a reference for the rational selection of antibac-terial drugs for anti-infective treatment in such patients.METHODS Clinical data were collected from 89 hospital-ized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabili-tation and Recuperation Center(formerly known as 281 Hospital)from 2017 to 2021.The pathogenic bacteria de-tected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospi-tal-associated infection,including 74 gram-negative bacterial strains(83.15％)and 15 gram-positive bacterial strains(16.85％).The predominant pathogenic bacterial strains were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa.Respiratory tract infection was the most common.E.coli showed severe drug re-sistance,with high drug resistance rates to various antibacterial drugs(complete drug resistance to piperacillin and ampicillin).K.pneumoniae was generally drug resistant to ampicillin.Enterobacter cloacae showed high sensitivi-ty to carbapenems,amikacin and enzyme inhibitor combinations.P.aeruginosa had low drug resistance rates to imipenem and meropenem.Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin,erythromycin and gentamicin,and no drug-resistant strains to vancomycin and linezolid were found.CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal trans-planted patients with postoperative hospital-associated infections,with a high detection rate of E.coli and a severe drug resistance situation.Therefore,it is necessary to strengthen the monitoring of drug resistance in renal trans-plant recipients and make rational choices of antibacterial drugs.

Objective Using different concentrations of Coxsackievirus B3(CVB3)to infect young SD rats.To investigate the distribution of coxsackievirus B3(CVB3)in rat tissues and the immune response and inflammatory factors,to clarify the immunopathological mechanism of viral infection and provide an experimental basis for drug screening and efficacy evaluation.Methods Young SD rats(7 days old)were injected intraperitoneally with different doses of CVB3(TCID50=10-3.34/100 μL)and the proportions of lymphocyte subsets(CD4+,CD8+)in whole blood at days 4 and 8 were detected by flow cytometry.The CVB3 loads in the heart,liver,spleen,brain,kidney,and gastrointestinal tissues were detected by real-time fluorescence quantitative polymerase chain reaction,TNF-α and IFN-γ levels were detected by enzyme-linked immunosorbent assay,and histomorphologic changes were observed by hematoxylin and eosin staining.Results Different doses of CVB3 caused different degrees of diarrhea and decreased body mass in young rats.CVB3 was mainly distributed in the stomach,small intestine,large intestine,and stools,with the highest load in the large intestine and stools.The stock solution group(TCID50=10-3.34/100 μL)increased the proportion of CD8+T cells in the whole blood in young rats and decreased the CD4+/CD8+ratio(P＜0.05,P＜0.01).Compared with the nomal group high TNF-α and low IFN-γ expression were observed in the large intestine of young rats in the concentrate group(P＜0.05,P＜0.01),and submucosal edema and inflammatory cell infiltration were observed in the large intestine(cecum and rectum).There were no significant differences in the proportion of lymphocyte subsets,TNF-α and IFN-γ levels,and morphological changes in whole blood of young rats in the group 10-1,10-2,and 10-3(P＞0.05).Conclusions Different doses of CVB3 can induce infections in young SD rats.CVB3(TCID50=10-3.34/100 μL)causes pathological changes in the large intestine(cecum and rectum)in young rats,and high virus replication can increase levels of inflammatory factors and cause an imbalance of immune cells.CVB3 may have a unique pathogenic mechanism in young rats,providing a theoretical basis for developing evaluation strategies for drugs against CVB3 virus infections.

Objective Using different concentrations of Coxsackievirus B3(CVB3)to infect young SD rats.To investigate the distribution of coxsackievirus B3(CVB3)in rat tissues and the immune response and inflammatory factors,to clarify the immunopathological mechanism of viral infection and provide an experimental basis for drug screening and efficacy evaluation.Methods Young SD rats(7 days old)were injected intraperitoneally with different doses of CVB3(TCID50=10-3.34/100 μL)and the proportions of lymphocyte subsets(CD4+,CD8+)in whole blood at days 4 and 8 were detected by flow cytometry.The CVB3 loads in the heart,liver,spleen,brain,kidney,and gastrointestinal tissues were detected by real-time fluorescence quantitative polymerase chain reaction,TNF-α and IFN-γ levels were detected by enzyme-linked immunosorbent assay,and histomorphologic changes were observed by hematoxylin and eosin staining.Results Different doses of CVB3 caused different degrees of diarrhea and decreased body mass in young rats.CVB3 was mainly distributed in the stomach,small intestine,large intestine,and stools,with the highest load in the large intestine and stools.The stock solution group(TCID50=10-3.34/100 μL)increased the proportion of CD8+T cells in the whole blood in young rats and decreased the CD4+/CD8+ratio(P＜0.05,P＜0.01).Compared with the nomal group high TNF-α and low IFN-γ expression were observed in the large intestine of young rats in the concentrate group(P＜0.05,P＜0.01),and submucosal edema and inflammatory cell infiltration were observed in the large intestine(cecum and rectum).There were no significant differences in the proportion of lymphocyte subsets,TNF-α and IFN-γ levels,and morphological changes in whole blood of young rats in the group 10-1,10-2,and 10-3(P＞0.05).Conclusions Different doses of CVB3 can induce infections in young SD rats.CVB3(TCID50=10-3.34/100 μL)causes pathological changes in the large intestine(cecum and rectum)in young rats,and high virus replication can increase levels of inflammatory factors and cause an imbalance of immune cells.CVB3 may have a unique pathogenic mechanism in young rats,providing a theoretical basis for developing evaluation strategies for drugs against CVB3 virus infections.

Objective To explore the efficiency of operating room(OR)and its influencing factors from a phenomeno-logical perspective,proposing corresponding improvement strategies.Methods A phenomenological method was adopted,invol-ving in-depth interviews with 13 surgical team members from a tertiary Traditional Chinese Medicine(TCM)orthopedic hospital in Henan Province,to collect and analyze their multifaceted understanding of OR efficiency.Results The study demonstrated eight interpretative ways of efficiency among team members.The overall framework was largely organization-oriented,with addi-tional human-centered considerations regarding the factors influencing efficiency.Conclusion A unified understanding is crucial for improving both efficiency and quality.This study suggests strategies to optimize OR processes through lean management and human-centered team development to enhance operating room efficiency.Additionally,it highlights the need for future research to incorporate more patient views.

Objective To propose a brain electrical phase prediction method based on long short-term memory network(LSTM)to improve the accuracy and robustness of phase synchronization prediction in transcranial magnetic stimulation(TMS).Methods First,an LSTM consisting of an input layer,an LSTM layer,an ReLU activation layer,a fully connected layer and a regression layer was constructed to capture the EEG signal features through the synergistic action of input gates,forgetting gates and output gates.Second,eye-open resting-state EEG data from 30 healthy subjects were trained using the LSTM to obtain a predictive model for EEG signal and EEG phase prediction.Finally,the LSTM method and the traditional autoregressive(AR)method were compared in terms of the phase prediction errors at the overall and individual levels and the prediction performance for peaks and troughs.A regression model was used to explore the relationships between instantaneous EEG amplitude,signal-to-noise ratio and phase prediction error with the LSTM method.Results The LSTM method achieved a total phase prediction error of 0.04°±5.69°,which was lower than that of the traditional AR method(-3.36°±51.13°).For each subject,the LSTM method demonstrated superior phase prediction accuracy compared to the traditional AR method(P＜0.001).The accuracy for predicting peaks(troughs)by the LSTM method(about 89％)was higher than that by the traditional AR method(about 10％).Unlike the traditional AR method,the LSTM method didnot result in linear relationships between instantaneous EEG amplitude,signal-to-noise ratio and phase prediction error,with Pvalues being 0.58 and 0.18,respectively.Conclusion The LSTM-based brain electrical phase prediction method shows high accuracy and robustness when used for EEG phase-synchronized TMS.[Chinese Medical Equipment Journal,2025,46(3):1-8]

This paper uses literature and network data to systematically sort out the theoretical and practical foundations of global public health cooperation,combines expert interviews to conduct empirical analyses,and further explores China's strategies for participating in global public health cooperation through quantitative statistics and text mining of interview data,and proposes a plan for China's participation in global public health cooperation under the current international situation.Under the countercurrents to globalization,China should take its own public health capacity building as the foundation,put global security and health equity at the core,with a philosophy of open cooperation and sustainable development,actively promote bilateral and multilateral cooperation,focus on cultivating global health talents,and enhance the effectiveness of disease prevention and control by making use of existing platforms,international mechanisms and digital health technologies,so as to help build a Global Community of Health for All.