ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective:To analyze the key β-amyloid protein (Aβ) deposition in brain regions affecting the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD).Methods:Based on the positron emission tomography data of Aβ in the Alzheimer's disease neuroimaging initiative database, the penalized generalized estimating equation (PGEE) and the mixed effects regression forest algorithm (MERF) were used to conduct dimensionality reduction analysis on 164 brain regions with Aβ deposition. Additionally, a multivariate longitudinal data joint model was used to screen the key Aβ deposition brain regions that influence the progression from MCI to AD.Results:Five key brain regions were commonly screened out by the PGEE and MERF models, they were the right prefrontal orbital cortex, the left superior temporal sulcus shore cortex, the right medial orbitofrontal cortex, the left putamen, and the right transverse temporal cortex, respectively. The results of the multivariate longitudinal data joint model based on these 5 Aβ deposition brain regions showed that, except the left superior temporal sulcus shore cortex, the longitudinal change trajectories of the other 4 Aβ deposition brain regions all affected the progression from MCI to AD ( P<0.05). Conclusion:The Aβ deposition in the right prefrontal orbital cortex, right medial orbitofrontal cortex, left putamen and right transverse temporal cortex affect the progression from MCI to AD.

Objective To systematically evaluate qualitative studies on the experience of inhalation therapy for patients with chronic obstructive pulmonary disease(COPD),in order to provide a basis for healthcare professionals to optimize the care strategies.Methods A systematic search was conducted for qualitative studies on the experience of inhalation therapy for patients with COPD included in domestic and international databases,with a timeframe from the establishment of the database to September 2024.Literature quality was evaluated using the Australian JBI Centre for Evidence-Based Health Care Literature Quality Assessment Criteria for Qualitative Research,and the results were integrated by a pooled integration approach.Results A total of 12 articles were included,and 84 original findings were extracted and summarized into 10 new categories to form 4 integrated results,including low level of drug literacy,differences in perceived efficacy,multiple medication burdens,and multi-dimensional support for inhalation therapy.Conclusion COPD patients have multiple experiences during inhalation therapy.Medical staff should strengthen drug education,enhance patients'cognition and medication skills,foster a positive treatment attitude,and integrate multiple resources to improve patients'inhalation therapy experience.

Objective To investigate the risk of chronic obstructive pulmonary disease(COPD)after asthma and explore factors influen-cing the onset and progression of asthma in patients with COPD.Methods A follow-up cohort was established based on the United Kingdom Biobank(UKB)database.The risk of asthma and COPD was predicted,and the influencing factors were analyzed using a mul-tistate model(MSM).Results Without considering the influence of covariates,the cumulative risk from COPD to mortality was the highest,followed by asthma to COPD,and asthma to mortality.Advanced age,male,diabetes mellitus(DM),high waist-to-hip ratio,hyper-tension,increased Townsend deprivation index,increased frequency of smoking,and family history were risk factors for developing COPD in the asthmatic population.Advanced age,male,DM,high waist-to-hip ratio,hypertension,increased Townsend deprivation index,and in creased frequency of smoking were risk factors for mortality in the asthmatic population.Advanced age,male,and DM and increased Townsend deprivation index were risk factors for mortality in the COPD population.Conclusion Advanced age,male,DM,high waist-to-hip ratio,hypertension,increased Townsend deprivation index,increased smoking frequency,and family history increased the risk of COPD in the asthmatic population.This MSM can be used to predict the influencing factors and degree of COPD after asthma,and reveal the change law of disease progression.

Objective To clarify the concept of caregiver fatigue in an aging society and to provide references in the elderly people nursing.Methods Literature on caregiver fatigue was systematically retrieved from databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Biomedical Literature Database,PubMed,EMbase,Scopus,and Web of Science from the inception to June 15th 2024.Walker and Avant's framework for concept analysis was performed to analyse the retrieved literature.Results Forty-one papers were included in the study.Caregiver fatigue was identified to comprise of five defining attributes:simultaneous physical and psychological burden,subjective perception,changing over time,negative impact arising from caregiving,and negative impact on both caregivers and care recipients.Antecedents included three perspectives:caregiver-related,care-recipient-related and environmental,The consequences included an impact on both the caregiver and the person being cared for.Empirical assessment indicators of fatigue include the checklist individual strength(CIS)and the fatigue assessment instrument(FAI)and fatigue scale-14(FS-14,FS-14).Conclusion Walker and Avant's conceptual analysis identifies five attributes of caregiver fatigue.Nurses should pay attention to and evaluate the degree of caregiver fatigue from multiple perspectives,thereby effectively identifying and intervening in the fatigue as early as possible.

Objective:To investigate the neuroprotective effect of vanillin on experimental autoimmune encephalomyelitis(EAE)rats by regulating C-X-C motif chemokine ligand 12(CXCL12)/chemokine(C-X-C motif)receptor(CXCR4)signaling path-way.Methods:A total of 50 rats were injected with 400 μl guinea pig spinal cord and water in oil mixture of complete Freund's adju-vant to establish EAE rat model,and were divided into model group,low-dose vanillin group(50 mg/kg),medium-dose vanillin group(100 mg/kg),high-dose vanillin group(200 mg/kg)and positive drug group(5 mg/kg prednisone acetate),another 10 rats were only injected with the mixture of the same amount of normal saline and complete Freud adjuvant as control group,since the first day of mod-eling,all rats were given corresponding drugs by gavage for 16 consecutive days,and after modeling,rats in each group were scored for neurological function every day;HE and LFB staining were used to observe the pathology and demyelination of spinal cord in rats;levels of serum TNF-α,IL-1β and IL-6 were detected by ELISA;immunohistochemistry was used to detect expressions of CD68 and Iba-1 in spinal cord of rats;Western blot was used to detect expressions of CXCL12 and CXCR4 proteins in spinal cord of rats.Results:Compared with control group,rats in model group showed obvious infiltration of inflammatory cells,a large number of inflammatory cells gathered around the small blood vessels,and the structure of myelin sheath in spinal cord of rats was abnormal,accompanied by a large number of myelin sheath loss,the neurological function score,inflammatory infiltration score and demyelination score of spinal cord,serum TNF-α,IL-1β and IL-6 levels,spinal cord CD68 and Iba-1 proteins,CXCL12 and CXCR4 proteins expressions in-creased obviously(P<0.05);compared with model group,inflammatory cell infiltration and myelin sheath loss of rats in low,medium and high doses groups and positive drug group were obviously alleviated,neurological function score,inflammatory infiltration score and demyelination score of spinal cord,serum TNF-α,IL-1β and IL-6 levels,and expressions of CD68 and Iba-1 proteins in spinal cord decreased obviously(P<0.05),while expressions of CXCL12 and CXCR4 proteins in spinal cord further increased(P<0.05).Conclusion:Vanillin inhibits inflammatory response and alleviates nerve injury in EAE rats,and its mechanism may be related to acti-vation of CXCL12/CXCR4 signaling pathway.

Objective:To systematically evaluate the factors influencing the physical activity levels of patients with chronic obstructive pulmonary disease (COPD) .Methods:Computer retrieval of literature related to the influencing factors of physical activity in patients with COPD in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP Database, and China Biology Medicine disc, and the search period was from the establishment of the databases to March 2024. Two researchers independently screened the literature and conducted quality assessment according to inclusion and exclusion criteria. Meta-analysis was conducted using RevMan 5.4 software.Results:A total of 14 studies were included. The results of the Meta-analysis showed that gender [ OR=1.54, 95% CI (1.21, 1.96) ], degree of dyspnea [ OR=1.74, 95% CI (1.37, 2.21) ], fatigue [ OR=2.06, 95% CI (1.48, 2.87) ], and depression [ OR=1.63, 95% CI (1.30, 2.04) ] were influencing factors of physical activity levels in COPD patients ( P<0.05) . Conclusions:The physical activity levels of COPD patients are influenced by gender, degree of dyspnea, fatigue, and depression. Healthcare providers should develop personalized intervention goals and plans to improve patients' participation in and adherence to physical activity.

Objective:To explore the latent classes of intrinsic capacity and their influencing factors among hospitalized older adults, providing a basis for developing targeted intervention strategies.Methods:A convenience sampling method was used to recruit 371 hospitalized older adults from Beijing Hospital between April 2022 and July 2023. The integrated care for older people comprehensive assessment tool was used to assess the intrinsic capacity of hospitalizd older adults, along with grip strength tests. Latent class analysis (LCA) was employed to classify the intrinsic capacity of hospitalizd older adults, and multinomial Logistic regression analysis was conducted to explore the influencing factors of different latent classes.Results:Among the 371 older adults, 78.98% (293/371) exhibited declines in various dimensions of intrinsic capacity, with impairment detection rates of 36.39% (135/371) in cognition, 34.23% (127/371) in mobility, 21.02% (78/371) in vitality, 33.69% (125/371) in psychological well-being, and 47.98% (178/371) in sensory function. The LCA results identified three latent classes of intrinsic capacity: high mobility-moderate sensory group (39.08%, 145/371) , low cognition-high mobility group (26.68%, 99/371) , and low mobility group (34.23%, 127/371) . Multinomial Logistic regression analysis revealed that age, gender, monthly family income, polypharmacy, and grip strength were influencing factors of the latent classes of intrinsic capacity ( P<0.05) . Conclusions:The intrinsic capacity of hospitalized older adults is heterogeneous. It is essential to promptly identify the characteristics of intrinsic capacity in different groups, with particular attention to older adults in the low cognition-high mobility group and low mobility group, and implement targeted interventions to prevent and improve adverse outcomes.