Objective:To systematically synthesize qualitative studies on healthcare professionals' experiences and needs regarding telemedicine services for diabetic foot ulcers (DFU), and to provide scientific evidence for further improvement of DFU telemedicine service systems.Methods:PubMed, Web of Science, Cochrane Library, CINAHL, Scopus, Embase, ProQuest, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc were searched for qualitative studies on healthcare professionals' experiences and needs in the process of constructing and using DFU telemedicine service platforms. The time limit was from the inception of the databases to December 2024. The included literature was appraised according to the 2016 Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research, and the results were integrated and summarized using meta-aggregation.Results:A total of 10 studies were included, from which 30 findings were extracted, forming 11 categories, and were synthesized into four integrated findings: healthcare professionals held divergent attitudes toward DFU telemedicine services, perceived multiple benefits, faced many challenges, and had multidimensional needs.Conclusions:Telemedicine services have provided healthcare professionals with great convenience in managing DFU patients, but challenges still exist. In the future, relevant platforms and systems should be continuously improved by integrating the needs of healthcare professionals and patients, while service processes and management mechanisms should be enhanced to improve the quality of telemedicine services.

OBJECTIVE: To assess the independent and combined effects of air pollutants, meteorological factors, and greenspace exposure on new tuberculosis (TB) cases. METHODS: TB case data from Shanghai (2013-2018) were obtained from the Shanghai Center for Disease Control and Prevention. Environmental data on air pollutants, meteorological variables, and greenspace exposure were obtained from the National Tibetan Plateau Data Center. We employed a distributed-lag nonlinear model to assess the effects of these environmental factors on TB cases. RESULTS: Increased TB risk was linked to PM _2.5, PM ₁₀, and rainfall, whereas NO ₂, SO ₂, and air pressure were associated with a reduced risk. Specifically, the strongest cumulative effects occurred at various lags: PM _2.5 ( RR = 1.166, 95% CI: 1.026-1.325) at 0-19 weeks; PM ₁₀ ( RR = 1.167, 95% CI: 1.028-1.324) at 0-18 weeks; NO ₂ ( RR = 0.968, 95% CI: 0.938-0.999) at 0-1 weeks; SO ₂ ( RR = 0.945, 95% CI: 0.894-0.999) at 0-2 weeks; air pressure ( RR = 0.604, 95% CI: 0.447-0.816) at 0-8 weeks; and rainfall ( RR = 1.404, 95% CI: 1.076-1.833) at 0-22 weeks. Green space exposure did not significantly impact TB cases. Additionally, low temperatures amplified the effect of PM _2.5 on TB. CONCLUSION Exposure to PM _2.5, PM ₁₀, and rainfall increased the risk of TB, highlighting the need to address air pollutants for the prevention of TB in Shanghai.
China/epidemiology* ; Humans ; Air Pollutants/analysis* ; Tuberculosis/epidemiology* ; Incidence ; Meteorological Concepts ; Particulate Matter/adverse effects* ; Environmental Exposure ; Male ; Female ; Adult ; Air Pollution ; Middle Aged

OBJECTIVE: To investigate hypertension (HTN) trends, key risk factors, and gender disparities in rural China, and to propose targeted strategies for improving HTN control in resource-limited settings. METHODS: This longitudinal study used data from the Henan Rural Cohort Study, including baseline (2015-2017; n = 39,224) and follow-up (2018-2022; n = 28,621) participants. HTN was defined as systolic/diastolic blood pressure ≥ 140/90 mmHg, self-reported diagnosis, or use of antihypertensive medication. Severity was classified using a 7-tier blood pressure (BP) staging system (optimal, normal, high normal, and HTN stages 1-4). A generalized linear mixed-effects model (GLMM) identified associated risk factors. RESULTS: HTN prevalence increased modestly from 32.7% (95% CI: 32.2-33.2) to 33.9% (95% CI: 33.3%-34.4%). Awareness and treatment improved from 20.1% to 25.3%, and from 18.8% to 24.4%, respectively, but control rates remained low (6.2% to 12.3%). After adjustment, women had a 1.53-fold higher HTN risk than men ( OR = 1.53, 95% CI: 1.43-1.63), revealing gender-specific trends. Key risk factors included alcohol use ( OR = 1.37, 95% CI: 1.27-1.47) and overweight status ( OR = 1.76, 95% CI: 1.66-1.86). BP staging showed an increase in optimal BP (42.3% to 45.8%), but stagnant management of advanced HTN stages. CONCLUSION Hypertension in rural China is shaped by behavioral risk factors and healthcare access gaps. Gender-sensitive, community-based interventions, including task-shifting models, are necessary to mitigate the growing burden of hypertension.
Humans ; Hypertension/etiology* ; China/epidemiology* ; Female ; Male ; Rural Population/statistics & numerical data* ; Prevalence ; Risk Factors ; Middle Aged ; Adult ; Aged ; Longitudinal Studies ; Sex Factors ; Cohort Studies ; East Asian People

Objective:To investigate the self-perceived cognitive decline status in the community population,and to explore the association between different dietary habits and self-perceived cognitive decline.Methods:A cross-sectional study was carried out in 11 879 community residents in the three regions of Weifang,Jining,and Zoucheng in Shandong Province.The Ascertain Dementia-8 and dietary habits information questionnaire were used to assess self-perceived cognitive decline and dietary habits,and their association were analyzed using single factor and multivariate logistic regression.Results:The detection rate of self-perceived cognitive decline was 21.4％.Lo-gistic regression showed that smoking in the past was positively associated with self-perceived cognitive decline(OR=1.40,95％CI:1.14-1.73).However,intake of fruits(often,OR=0.70,95％CI:0.52-0.94;everyday,OR=0.60,95％CI:0.44-0.81),nuts(daily,OR=0.62,95％CI:0.44-0.88),mushrooms(often,OR=0.74,95％CI:0.57-0.92)and high tryptophan foods(sometimes,OR=0.79,95％CI:0.68-0.91;everyday,OR=0.54,95％CI:0.34-0.87)were negatively associated with self-perceived cognitive decline.Conclusion:Smoking history might be a risk factor for self-perceived cognitive decline,and high frequency intake of fruits,nuts,mush-rooms,and high tryptophan foods might protective factors for it.

Objective:To systematically synthesize qualitative studies on healthcare professionals' experiences and needs regarding telemedicine services for diabetic foot ulcers (DFU), and to provide scientific evidence for further improvement of DFU telemedicine service systems.Methods:PubMed, Web of Science, Cochrane Library, CINAHL, Scopus, Embase, ProQuest, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc were searched for qualitative studies on healthcare professionals' experiences and needs in the process of constructing and using DFU telemedicine service platforms. The time limit was from the inception of the databases to December 2024. The included literature was appraised according to the 2016 Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research, and the results were integrated and summarized using meta-aggregation.Results:A total of 10 studies were included, from which 30 findings were extracted, forming 11 categories, and were synthesized into four integrated findings: healthcare professionals held divergent attitudes toward DFU telemedicine services, perceived multiple benefits, faced many challenges, and had multidimensional needs.Conclusions:Telemedicine services have provided healthcare professionals with great convenience in managing DFU patients, but challenges still exist. In the future, relevant platforms and systems should be continuously improved by integrating the needs of healthcare professionals and patients, while service processes and management mechanisms should be enhanced to improve the quality of telemedicine services.

Objective:To investigate the self-perceived cognitive decline status in the community population,and to explore the association between different dietary habits and self-perceived cognitive decline.Methods:A cross-sectional study was carried out in 11 879 community residents in the three regions of Weifang,Jining,and Zoucheng in Shandong Province.The Ascertain Dementia-8 and dietary habits information questionnaire were used to assess self-perceived cognitive decline and dietary habits,and their association were analyzed using single factor and multivariate logistic regression.Results:The detection rate of self-perceived cognitive decline was 21.4％.Lo-gistic regression showed that smoking in the past was positively associated with self-perceived cognitive decline(OR=1.40,95％CI:1.14-1.73).However,intake of fruits(often,OR=0.70,95％CI:0.52-0.94;everyday,OR=0.60,95％CI:0.44-0.81),nuts(daily,OR=0.62,95％CI:0.44-0.88),mushrooms(often,OR=0.74,95％CI:0.57-0.92)and high tryptophan foods(sometimes,OR=0.79,95％CI:0.68-0.91;everyday,OR=0.54,95％CI:0.34-0.87)were negatively associated with self-perceived cognitive decline.Conclusion:Smoking history might be a risk factor for self-perceived cognitive decline,and high frequency intake of fruits,nuts,mush-rooms,and high tryptophan foods might protective factors for it.

Objective:To summarize the clinical and genetic characteristics of early-onset spinocerebellar ataxia type 5 (SCA5) caused by SPTBN2 gene mutation. Methods:The clinical and genetic data of a child with early-onset SCA5 diagnosed in the Department of Children′s Rehabilitation, Women and Children′s Hospital Affiliated to Qingdao University in February 2022 were retrospectively analyzed. The literatures related to early-onset SCA5 in major databases at home and abroad were retrieved and summarized.Results:The patient, a 4 years and 1 month old girl, was admitted to hospital because of "unable to stand independently at 2 years and 3 months", primarily presented with developmental delay, ataxia, hypotonia, and tendon hyperreflexia during infancy. Progressive cerebellar atrophy was observed on brain magnetic resonance imaging. A de novo heterozygous mutation of the SPTBN2 c.793G>C(p.Asp265His) was identified in the patient. Following hospitalization, the child received comprehensive rehabilitation therapy encompassing physical, occupational, language, educational interventions as well as bicycle ergometer training and transcranial magnetic stimulation. The patient was followed-up for more than 1 year to 4 years and 1 month old, whose motor function, cognitive abilities, and language skills were improved to some extent. A total of 13 English articles and 1 Chinese article were retrieved from the databases. A total of 20 early-onset SCA5 patients have been reported, with onset ages all within 12 months. Infants exhibited decreased muscle tone and delayed motor milestones, with the main clinical manifestations of ataxia, generalized developmental delay, and cerebellar atrophy. The previously reported cases involved 11 mutation sites in the SPTBN2 gene, and the main types of mutations were de novo missense mutations. The mutation site in this case has not been reported in the previous literature. Conclusions:Early-onset SCA5 is a rare autosomal dominant disorder caused by heterozygous mutations in the SPTBN2 gene. The main clinical manifestations include ataxia from infancy, developmental retardation and cerebellar atrophy. Early rehabilitation intervention can improve the degree of the dysfunction.

Objective:To assess the clinical value of nomogram based on high resolution magnetic resonance vessel wall imaging (HR-VWI) features in differentiating moyamoya disease (MMD) from atherosclerotic moyamoya syndrome (A-MMS).Methods:Eighty-four patients with digital subtraction angiography (DSA)-confirmed MMD and 73 patients with DSA-confirmed A-MMS were enrolled from Department of Medical Imaging, Affiliated Hospital of Jining Medical University from June 2020 to November 2023. All patients underwent HR-VWI. A retrospective analysis was performed on their imaging data. Univariate analysis was used to compare the differences in imaging characteristics between the two groups. Multivariate Logistic regression analysis was used to screen independent influencing factors for differentiating MMD from A-MMS and a nomogram was constructed accordingly. Receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the validity and calibration of the nomogram.Results:Univariate analysis showed that age, pattern of vessel wall thickening, maximum vessel wall thickness, enhancement degree of vessel wall, vessel external diameter, ipsilateral anterior cerebral artery involvement and dot sign were statistically different between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=6.990, 95% CI: 2.340-20.360, P<0.001), pattern of vessel wall thickening ( OR=0.066, 95% CI: 0.014-0.307, P<0.001), vessel external diameter ( OR=5.224, 95% CI: 1.672-16.324, P=0.005), ipsilateral anterior cerebral artery involvement ( OR=0.160, 95% CI: 0.038-0.679, P=0.013) and dot sign ( OR=0.081, 95% CI: 0.018-0.364, P=0.001) were independent influencing factors for differentiating MMD from A-MMS. ROC curve showed that area under the curve (AUC) of this nomogram was 0.884 (95% CI: 0.821-0.947, P<0.001), and the calibration curve showed a good fit between the predicted probability and actual probability. Conclusion:Nomogram based on HR-VWI features can effectively differentiate MMD from A-MMS.