Objective To analyze drug resistance and clustering of environmental and clinical isolates of Acinetobacter baumannii (A. baumannii) in ICU of a medical institution in Shanghai. Methods The isolates of A. baumannii from ICU environments and clinic were used to analyze the contamination and distribution in 2021-2024. Antimicrobial susceptibility testing was carried out with microbroth dilution method. Whole genome sequencing was performed out of strains for MLST typing and SNP clustering. Results The detection rate of contamination in ICU environment was 7.67%, and the most serious contamination was found in pillows, bedding, hospital gowns and other items that patients directly contacted. Clinical isolates were predominantly from sputum specimens. The environmental and clinical isolates had a high level of resistance to third generation cephalosporins, third generation quinolones and carbapenems (more than 85%). Environmental isolates had a low level of resistance to polymyxin B, but none of the clinical isolates were resistant. MLST typing showed that ST2 was the dominant clone (66.67%), and SNP clustering found that isolates from different sources but with the same ST type were clustered together. Conclusion ST2 is the dominant clone of A. baumannii isolates in this medical institution, and there is cross-contamination between different samples. Monitoring of drug resistance and disinfection should be further strengthened to prevent the emergence and spread of pan-resistant or even fully resistant strains.

Objective To explore the risk factors of progression to dementia within 2 years in patients with recent subcortical small infarction (RSSI) complicated with cognitive dysfunction. Methods A total of 340 patients with RSSI complicated with cognitive dysfunction who were treated in the hospital and completed 2-year follow-up were selected from February 2021 to February 2025. According to whether the patients progressed to dementia, they were classified into dementia group (n=105) and non-dementia group (n=235). The clinical data were compared between both groups, and the independent risk factors were screened by Logistic regression analysis. Results Multivariate logistic regression analysis suggested that history of hypertension (OR=1.919), history of diabetes mellitus (OR=1.597), multiple infarctions (OR=1.455), severe white matter lesions (OR=1.595), no cognitive function training (OR=1.923), increased infarct size (OR=1.069), reduced MMSE score (OR=0.945) and increased levels of NfL (OR=1.049) and IL-6 (OR=1.038) were independent risk factors for the progression to dementia (all P<0.05). Conclusion The progression to dementia in patients with recent subcortical small infarction and cognitive dysfunction is affected by multiple factors. In clinical practice, the integration of vascular risk factors, imaging features, cognitive assessment and serum biomarkers (NfL, IL-6) helps to construct an early risk prediction model and implement targeted interventions for high-risk groups.

Urinary incontinence is the most common complication after radical prostatectomy.Traditional Chinese medicine treatments for this disease,such as acupuncture,are diverse and have definite therapeutic effects.The disease is located in the bladder,and its etiology and pathogenesis are mostly related to the dysfunction of the kidney,spleen,triple energizer and other viscera.In view of the insufficiency of kidney essence,decline of the gate of vitality fire(mingmen fire),Qi deficiency leading to impaired bladder containment,compounded by obstruction of meridians from pathogenic factors including blood stasis,damp-heat,and phlegm turbidity.The"Shuanggu Yitong"acupuncture achieves"Dual fortification"through tonifying the kidney and primordial qi consolidation,combined with spleen strengthening and qi supplementation.Additionally,"purging"targets the elimination of blood stasis,phlegm turbidity,damp-heat and other solid evils.This integrated approach combines acupuncture and moxibustion modalities with reinforcing-reducing needle manipulation techniques,simultaneously addressing both the symptoms and root causes of the problem.By coordinating pathogen elimination with constitutional regulation,this method demonstrates favorable therapeutic outcomes in clinical practice and is worthy of further clinical promotion.

To summarize the nursing experience of a patient with Danon disease after heart transplantation.Nursing key points:closely monitor heart function,prevent right heart failure;phased analgesic and sedative measures were implemented to reduce the occurrence of related complications.Skeletal muscle function was evaluated and rehabilitation training was strengthened to promote the prognosis of patients.The patient was transferred to the general ward 5 days after operation,and was discharged 22 days after operation.

Objective:Based on the process theory of stress effect, the mediating effect of health literacy and perceived social support between perceived control and fatigue symptom of asthmatic patients was analyzed, which provide the evidence for the formulation of intervention programs to relieve fatigue in patients.Methods:Adopting a cross-sectional survey design, from January 2019 to November 2023, asthmatic patients at The First Affiliated Hospital of Anhui Medical University (Feidong County People′s Hospital) were selected by convenience sampling method and investigated by the General Information Questionnaire, Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale. Pearson correlation analysis was used to investigate the correlation between fatigue symptom, perceived control, health literacy, and perceived social support in asthma patients. A structural equation model was constructed using AMOS24.0 software and conduct mediation analysis.Results:A total of 260 questionnaires were distributed, and 241 valid questionnaires were collected. There were 110 males and 131 females aged (55.48 ± 15.03) years old. The scores of Fatigue Severity Scale, Perceived Control of Asthma Questionnaire, Health Literacy Management Scale, and Perceived Social Support Scale were (4.27 ± 1.68), (31.72 ± 8.51), (85.71 ± 19.36), (46.97 ± 11.79) points, respectively. Pearson correlation analysis showed that fatigue symptom was negatively correlated with perceived control, health literacy, and perceived social support ( r=-0.719, -0.716, -0.767, all P<0.01). The mediating model showed that perceived control had a significant direct effect on fatigue symptom ( β=-0.204, 95% CI-0.252--0.169). Moreover, perceived control also indirectly affected fatigue symptom through the independent mediating effect of health literacy ( β=-0.378, 95% CI-0.405--0.202), the independent mediating effect of perceived social support ( β=-0.227, 95% CI-0.381--0.203), and the chain mediating effect of health literacy and perceived social support ( β=-0.089, 95% CI-0.142--0.025), which accounting for 77.3% of the total effect. Conclusions:Health literacy and perceived social support play a mediating role in the correlation between perceived control and fatigue symptom, which can promote health literacy and perceived social support and thus alleviate fatigue symptom in asthmatic patients.

Visfatin,also known as nicotinamide phosphoribosyl transferase(NAMPT)or pre-B-cell colony-enhancing factor,is a proinflam-matory adipokine.Its immunomodulatory effects are closely associated with its pro-inflammatory activity,influencing the secretion of vari-ous cytokines and the function of immune cells.Visfatin exerts pro-tumorigenic effects in most cancers.The tumor immune microenviron-ment(TIME)comprises immune cells within the tumor tissue and an array of secreted cytokines.Growing evidence suggests that visfatin plays a regulatory role in the TIME by promoting inflammatory responses and modulating the polarization of immune cells,their secretory functions,surface protein expression,and energy metabolism,thereby influencing cancer progression.These newly discovered mechanisms provide a critical foundation for the application of NAMPT inhibitors(NAMPTi)in cancer immunotherapy.This review summarizes recent ad-vances in understanding the role of visfatin in tumor immunology and explores the therapeutic potential of NAMPTi in oncology.

To summarize the nursing experience of a patient with Danon disease after heart transplantation.Nursing key points:closely monitor heart function,prevent right heart failure;phased analgesic and sedative measures were implemented to reduce the occurrence of related complications.Skeletal muscle function was evaluated and rehabilitation training was strengthened to promote the prognosis of patients.The patient was transferred to the general ward 5 days after operation,and was discharged 22 days after operation.

Visfatin,also known as nicotinamide phosphoribosyl transferase(NAMPT)or pre-B-cell colony-enhancing factor,is a proinflam-matory adipokine.Its immunomodulatory effects are closely associated with its pro-inflammatory activity,influencing the secretion of vari-ous cytokines and the function of immune cells.Visfatin exerts pro-tumorigenic effects in most cancers.The tumor immune microenviron-ment(TIME)comprises immune cells within the tumor tissue and an array of secreted cytokines.Growing evidence suggests that visfatin plays a regulatory role in the TIME by promoting inflammatory responses and modulating the polarization of immune cells,their secretory functions,surface protein expression,and energy metabolism,thereby influencing cancer progression.These newly discovered mechanisms provide a critical foundation for the application of NAMPT inhibitors(NAMPTi)in cancer immunotherapy.This review summarizes recent ad-vances in understanding the role of visfatin in tumor immunology and explores the therapeutic potential of NAMPTi in oncology.

Objective To explore the potential profile characteristics and influencing factors of social participation in young and middle-aged stroke patients based on the theoretical framework of international classification of functioning,disability and health,so as to provide a basis for formulating personalized intervention measures.Methods From May to October 2024,convenience sampling was used to select young and middle-aged stroke patients in the First Affiliated Hospital of Jinan University as research objects.The data were collected through the general information questionnaire,impact on participation and autonomy questionaire and stroke stigma scale.The potential profile analysis was used to classify the patients' social participation level,and the disordered multinomial Logistic regression was used to analyze its influencing factors.Results The social participation of young and middle-aged stroke patients could be divided into three types:independent social life type(47.87％),limited social interaction type(28.20％)and weakened family responsibility type(23.93％).Stigma,stroke type and personal history of stroke were the influencing factors of different types of social participation(P＜0.05).Conclusion There is heterogeneity in the level of social participation in young and middle-aged stroke patients.Medical staff should provide personalized rehabilitation guidance according to different potential categories to improve the level of social participation and quality of life of patients.

Objective To explore the internal correlation mechanism among symptoms and influencing factors in first-ever subacute stroke patients.Methods A cross-sectional survey method was employed to conveniently select stroke patients hospitalized in a tertiary hospital in Guangdong Province from October 2022 to June 2023.Data were collected using a general information questionnaire,Symptom Experience Scale for Stroke Survivors,Fear of Progression Questionnaire-Short Form,Acceptance of Illness Scale,Herth Hope Index,and the Memorial University of Newfoundland Scale of Happiness.Results A total of 316 stroke patients were included.The incidence of symptom burden ranged from 17.41％to 87.97％,with the core,bridge,and sentinel symptoms as decreased attention and restricted limb movements,restricted limb movements and decreased self-care ability,and limb weakness and delayed response,respectively.Age,stroke type,disease stage,self-care ability,fear of disease progression,hope level,and happiness level were predictive factors for symptom burden in patients.Mixed network analysis showed direct correlation between foot inversion and stroke type,fear of disease progression was directly associated with limb weakness and limb pain.Low mood was directly correlated with hope level and happiness level.Conclusion Symptoms in patients with first-episode subacute stroke are interrelated.Nurses should pay attention to the identification of core,bridge,and sentinel symptoms,understand the associations between symptoms and influencing factors,and provide comprehensive and personalized clinical symptom management strategies for patients.