Objective:To explore the current research status, hotspots, and trends of self-advocacy among patients with chronic diseases, and to provide a reference for conducting research on self-advocacy in chronic diseases.Methods:A computer-based search was conducted in the China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, and the Web of Science Core Collection for literature related to self-advocacy among patients with chronic diseases, with the time frame from database inception to October 1, 2024. The CiteSpace 6.3.R1 software was used to perform visual analysis on publication volume, countries, institutions, authors, keywords, and citation status.Results:A total of 721 articles were included in the study. The country with the largest number of publications related to self-advocacy among patients with chronic diseases was the United States. Authors and journals were mainly from the fields of psychology and sociology. Research hotspots mainly included women, cancer, breast cancer, quality of life (health-related quality of life), cancer screening, and individual experiences. Future research trends are expected to focus on influencing factors and theoretical research, impacts on medical decision-making, psychological and social support, as well as the development of scales and assessment tools of self-advocacy.Conclusions:Research on self-advocacy in China started relatively late. It is suggested that in the future, domestic scholars conduct multi-center and large-sample studies on self-advocacy among populations in different regions and with various types of chronic diseases.

Objective To explore the relationship between blood glucose(BG)control levels and Clopidogrel resistance(CR)in patients with type 2 diabetes mellitus(T2DM)complicated with acute ischemic cerebrovascular disease(CIS).Methods A total of 92 patients with T2DM complicated with CIS admitted to our hospital from January 2020 to December 2022 were selected as the research subjects and were divided into the simple T2DM+CIS group(n=32)and the CR group(n=60)based on whether CR occurred after the use of Clopidogrel.Pearson correlation analysis was used to explore the correlation between BG control levels and platelet activation indicators.Logistic regression analysis was conducted to investigate the relationship between hemoglobin A1c(HbA1c)levels and the occurrence of CR.Restricted cubic spline analysis was performed to examine the dose-response relationship between HbA1c fluctuations and the occurrence of CR in patients with T2DM complicated with CIS.Results The CR group had higher values for age,smoking,hyperlipidemia,cerebrovascular disease,peripheral arteriosclerosis,platelet activity units,2-hour postprandial blood glucose(2 hPG),HbA1c,platelet aggregation rate(PagT),platelet count(PLT),platelet volume distribution width(PDW),and platelet hematocrit(PCT)compared to the T2DM+CIS group(P<0.05).The platelet inhibition rate,fasting insulin(FIns),and platelet aggregation rate(PadT)were lower in the CR group than in the T2DM+CIS group(P<0.05).Pearson correlation analysis showed that FIns was positively correlated with PadT(P<0.05),negatively correlated with PagT,PLT,PDW and PCT(P<0.05);2 hPG and HbA1c was negatively correlated with PadT(P<0.05),positively correlated with PagT,PLT,PDW and PCT(P<0.05).Logistic regression analysis revealed that after adjusting for confounding factors,in the total population and gender subgroups,compared with the Q1 group,the CR risk in the Q2 to Q4 groups gradually increased(Pfor trend<0.001).The restricted cubic spline plot showed that in the total population and among men and women,the association strength between HbA1c levels and the risk of CR was non-linear dose-response relationship(P=0.005,0.003,0.002).When HbA1c was higher than the cutoff value,the risk of CR increased as the HbA1c level increased.Conclusions The fluctuation of HbA1c is independently associated with the risk of CR.The poorer the BG control,the higher the risk of CR.

Under stress,the cold-inducible RNA-binding protein(CIRP)is translocated from the nucleus to the cytoplasm and subsequently released outside the cell.Extracellular CIRP(eCIRP),acting as a damage-associated mo-lecular pattern,amplifies inflammation through various mechanisms and leads to an uncontrolled inflammatory response,thereby contributing to the occurrence and progression of sepsis and other critical pathological processes.Certain CIRP-tar-geting drugs have demonstrated promising anti-sepsis effects through the reduction of CIRP expression,the decrease of eCIRP release,the neutralization of eCIRP,or the intervention in receptor binding.This review examines the release mechanism of CIRP and the role of eCIRP in the development of sepsis,with the aim of providing new insights for the pre-vention and treatment of sepsis by targeting eCIRP.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To study the relationship between the mandibular bone arch and the dental arch in patients with skeletal Class Ⅱ malocclusion and compare it with the Class Imalocclusion by establishing a 3D digital model.Methods A total of 25 cases with skeletal Class Ⅱ malocclusion and 25 cases with skeletal Class Ⅰ normal occlusion were selected.The mandibular model was scanned and a three-dimensional digital model was set up.After the determination of the WALA ridge and the FA point,the reference plane and coordinate system was established.Four degree polynomial curve fitting was performed with WALA ridge and FA point coordinates to re-present the corresponding basal and dental arch curves.The width difference between the basal arch curve and the dental arch curve was measured and calculated at 3 mm,10 mm,and 18 mm away from the horizontal axis of the coordinate.The differences of basal bone and dental arch width between skeletal Class Ⅱ and skeletal Class Ⅰ malocclusion was compared.Results The width differences be-tween the arch and the dental arch in the anterior,middle and posterior mandibular segments of skeletal Class Ⅱ patients were-1.58 mm,1.80 mm and 3.80 mm,respectively.The width differences between the arch and the dental arch in the anterior,middle and pos-terior mandibular segments of skeletal Class Ⅰ patients were 2.08 mm,2.92 mm and 4.24 mm,respectively.There was a significant difference between skeletal Class Ⅱ and skeletal Class Ⅰ in the anterior and middle segments(P＜0.05),but no significant difference in the posterior segment(P＞0.05).Conclusion In skeletal Class Ⅰ patients,the width of the basal bone is larger than that of the dental arch,and the dental arch was located medial to the basal bone.In skeletal Class Ⅱ patients,the width of the anterior arch is larger than the width of the basal bone,that is,the dental arch is located outside the basal bone.The width difference of the basal arch in skeletal Class Ⅱ is smaller than that in skeletal Class Ⅰ.

Objective To study the relationship between the mandibular bone arch and the dental arch in patients with skeletal Class Ⅱ malocclusion and compare it with the Class Imalocclusion by establishing a 3D digital model.Methods A total of 25 cases with skeletal Class Ⅱ malocclusion and 25 cases with skeletal Class Ⅰ normal occlusion were selected.The mandibular model was scanned and a three-dimensional digital model was set up.After the determination of the WALA ridge and the FA point,the reference plane and coordinate system was established.Four degree polynomial curve fitting was performed with WALA ridge and FA point coordinates to re-present the corresponding basal and dental arch curves.The width difference between the basal arch curve and the dental arch curve was measured and calculated at 3 mm,10 mm,and 18 mm away from the horizontal axis of the coordinate.The differences of basal bone and dental arch width between skeletal Class Ⅱ and skeletal Class Ⅰ malocclusion was compared.Results The width differences be-tween the arch and the dental arch in the anterior,middle and posterior mandibular segments of skeletal Class Ⅱ patients were-1.58 mm,1.80 mm and 3.80 mm,respectively.The width differences between the arch and the dental arch in the anterior,middle and pos-terior mandibular segments of skeletal Class Ⅰ patients were 2.08 mm,2.92 mm and 4.24 mm,respectively.There was a significant difference between skeletal Class Ⅱ and skeletal Class Ⅰ in the anterior and middle segments(P＜0.05),but no significant difference in the posterior segment(P＞0.05).Conclusion In skeletal Class Ⅰ patients,the width of the basal bone is larger than that of the dental arch,and the dental arch was located medial to the basal bone.In skeletal Class Ⅱ patients,the width of the anterior arch is larger than the width of the basal bone,that is,the dental arch is located outside the basal bone.The width difference of the basal arch in skeletal Class Ⅱ is smaller than that in skeletal Class Ⅰ.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Under stress,the cold-inducible RNA-binding protein(CIRP)is translocated from the nucleus to the cytoplasm and subsequently released outside the cell.Extracellular CIRP(eCIRP),acting as a damage-associated mo-lecular pattern,amplifies inflammation through various mechanisms and leads to an uncontrolled inflammatory response,thereby contributing to the occurrence and progression of sepsis and other critical pathological processes.Certain CIRP-tar-geting drugs have demonstrated promising anti-sepsis effects through the reduction of CIRP expression,the decrease of eCIRP release,the neutralization of eCIRP,or the intervention in receptor binding.This review examines the release mechanism of CIRP and the role of eCIRP in the development of sepsis,with the aim of providing new insights for the pre-vention and treatment of sepsis by targeting eCIRP.

Objective To explore the relationship between blood glucose(BG)control levels and Clopidogrel resistance(CR)in patients with type 2 diabetes mellitus(T2DM)complicated with acute ischemic cerebrovascular disease(CIS).Methods A total of 92 patients with T2DM complicated with CIS admitted to our hospital from January 2020 to December 2022 were selected as the research subjects and were divided into the simple T2DM+CIS group(n=32)and the CR group(n=60)based on whether CR occurred after the use of Clopidogrel.Pearson correlation analysis was used to explore the correlation between BG control levels and platelet activation indicators.Logistic regression analysis was conducted to investigate the relationship between hemoglobin A1c(HbA1c)levels and the occurrence of CR.Restricted cubic spline analysis was performed to examine the dose-response relationship between HbA1c fluctuations and the occurrence of CR in patients with T2DM complicated with CIS.Results The CR group had higher values for age,smoking,hyperlipidemia,cerebrovascular disease,peripheral arteriosclerosis,platelet activity units,2-hour postprandial blood glucose(2 hPG),HbA1c,platelet aggregation rate(PagT),platelet count(PLT),platelet volume distribution width(PDW),and platelet hematocrit(PCT)compared to the T2DM+CIS group(P<0.05).The platelet inhibition rate,fasting insulin(FIns),and platelet aggregation rate(PadT)were lower in the CR group than in the T2DM+CIS group(P<0.05).Pearson correlation analysis showed that FIns was positively correlated with PadT(P<0.05),negatively correlated with PagT,PLT,PDW and PCT(P<0.05);2 hPG and HbA1c was negatively correlated with PadT(P<0.05),positively correlated with PagT,PLT,PDW and PCT(P<0.05).Logistic regression analysis revealed that after adjusting for confounding factors,in the total population and gender subgroups,compared with the Q1 group,the CR risk in the Q2 to Q4 groups gradually increased(Pfor trend<0.001).The restricted cubic spline plot showed that in the total population and among men and women,the association strength between HbA1c levels and the risk of CR was non-linear dose-response relationship(P=0.005,0.003,0.002).When HbA1c was higher than the cutoff value,the risk of CR increased as the HbA1c level increased.Conclusions The fluctuation of HbA1c is independently associated with the risk of CR.The poorer the BG control,the higher the risk of CR.

Objective:To explore the current research status, hotspots, and trends of self-advocacy among patients with chronic diseases, and to provide a reference for conducting research on self-advocacy in chronic diseases.Methods:A computer-based search was conducted in the China National Knowledge Infrastructure, Wanfang Data, VIP, China Biology Medicine disc, and the Web of Science Core Collection for literature related to self-advocacy among patients with chronic diseases, with the time frame from database inception to October 1, 2024. The CiteSpace 6.3.R1 software was used to perform visual analysis on publication volume, countries, institutions, authors, keywords, and citation status.Results:A total of 721 articles were included in the study. The country with the largest number of publications related to self-advocacy among patients with chronic diseases was the United States. Authors and journals were mainly from the fields of psychology and sociology. Research hotspots mainly included women, cancer, breast cancer, quality of life (health-related quality of life), cancer screening, and individual experiences. Future research trends are expected to focus on influencing factors and theoretical research, impacts on medical decision-making, psychological and social support, as well as the development of scales and assessment tools of self-advocacy.Conclusions:Research on self-advocacy in China started relatively late. It is suggested that in the future, domestic scholars conduct multi-center and large-sample studies on self-advocacy among populations in different regions and with various types of chronic diseases.