Objective Through the analysis of the clinical characteristics of post-interventional complications of ventilator-associ-ated pneumonia(VAP)in patients with hypertension and acute large vessel occlusive cerebral infarction(AIS-LVO),we aim to develop and validate a risk prediction model.Methods We conducted a retrospective analysis of clinical data from 107 patients hospitalized for hypertension with AIS-LVO at Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine between July 2020 and Au-gust 2023.Patients were categorized into two groups based on their hospitalization:the VAP group,consisting of 64 patients who devel-oped VAP,and the non-VAP group,comprising 43 patients who did not experience VAP.Least absolute shrinkage and selection opera-tor regression(LASSO)analysis was employed to identify potential predictors.Subsequently,a nomogram model was constructed using multifactorial Logistic regression analysis.The model's discriminative ability,calibration,and clinical utility were assessed using the area(AUC)under the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Results In 107 patients with hypertension and AIS-LVO who underwent interventional surgery,the incidence of VAP was 59.8％.The results revealed statistically significant differences between the two groups in terms of age,presence of atrial fibrillation,admission national institutes of health stroke scale(NIHSS)score,admission glasgow coma scale(GCS)score,impaired consciousness,swallowing dysfunction,opera-tive time,postoperative 24-hour systemic inflammatory response index(SIRI),duration of mechanical ventilation,length of ICU stay,and the presence of an indwelling gastrostomy tube(P＜0.05).Additionally,the incidence of poor functional outcomes was 57.8％in the VAP group compared to 14.0％in the non-VAP group,indicating a worse prognosis for patients in the VAP group.The variables i-dentified through LASSO regression screening were included in a multifactorial Logistic regression analysis.This analysis revealed that the SIRI and the duration of mechanical ventilation were independent risk factors for the development of VAP following intervention in patients with hypertension and AIS-LVO(P＜0.05).Conversely,the admission GCS score was identified as a protective factor(P＜0.05).These three indicators were utilized to construct a prognostic nomogram model.The model's internal validity was assessed using the Boot-strap method with 1000 resamples,and the calibration curves were found to be in close agreement with the ideal fitted line,exhibiting a mean absolute error of 0.029,indicating good curve accuracy.The Logistic regression model's goodness of fit was evaluated using the Hos-mer and Lemeshow test,which yielded a x2 value of 5.38 and a P-value of 0.716,suggesting a good fit.The AUC of the model was 0.812(95％confidence interval 0.730-0.894),and the DCA indicated that the model has favorable clinical applicability.Conclusion A prediction model based on admission GCS score,postoperative 24-hour SIRI,and duration of mechanical ventilation demonstrates a robust predictive value for the incidence of VAP following intervention in patients with hypertension and acute ischemic stroke with AIS-LVO.

Objective To examine the expression and validate the localization of the neurotrophin neuritin(NRN1)in human tissues using bioinformatics and experimental methods.Methods The tissue-specific expression of NRN1 was analyzed using the Human Pro-tein Atlas(HPA)database.NRN1 mRNA and protein expression were experimentally validated using real-time quantitative PCR and immunohistochemistry,respectively.A pEGFP-C1-NRN1 green fluorescent protein fusion vector was transfected into 293 cells,and NRN1 localization was assessed using immunofluorescence.Endogenous NRN1 localization was also examined in hippocampal HT22 cells.Results According to the HPA database,NRN1 expression was enriched in the cerebral cortex,parathyroid gland,adipose tissue,and placenta.Experimental validation confirmed NRN 1 expression in all the aforementioned tissues,with highest levels observed in the brain and spleen.Immunofluorescence analysis revealed that NRN 1 was predominantly localized to the membrane in HT22 cells and to the cyto-plasm in 293 cells.Conclusion NRN 1 is expressed in various human tissues,with notably high expression in the brain.It is primarily localized to the cell membrane and cytoplasm.

Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

Objective Through the analysis of the clinical characteristics of post-interventional complications of ventilator-associ-ated pneumonia(VAP)in patients with hypertension and acute large vessel occlusive cerebral infarction(AIS-LVO),we aim to develop and validate a risk prediction model.Methods We conducted a retrospective analysis of clinical data from 107 patients hospitalized for hypertension with AIS-LVO at Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine between July 2020 and Au-gust 2023.Patients were categorized into two groups based on their hospitalization:the VAP group,consisting of 64 patients who devel-oped VAP,and the non-VAP group,comprising 43 patients who did not experience VAP.Least absolute shrinkage and selection opera-tor regression(LASSO)analysis was employed to identify potential predictors.Subsequently,a nomogram model was constructed using multifactorial Logistic regression analysis.The model's discriminative ability,calibration,and clinical utility were assessed using the area(AUC)under the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Results In 107 patients with hypertension and AIS-LVO who underwent interventional surgery,the incidence of VAP was 59.8％.The results revealed statistically significant differences between the two groups in terms of age,presence of atrial fibrillation,admission national institutes of health stroke scale(NIHSS)score,admission glasgow coma scale(GCS)score,impaired consciousness,swallowing dysfunction,opera-tive time,postoperative 24-hour systemic inflammatory response index(SIRI),duration of mechanical ventilation,length of ICU stay,and the presence of an indwelling gastrostomy tube(P＜0.05).Additionally,the incidence of poor functional outcomes was 57.8％in the VAP group compared to 14.0％in the non-VAP group,indicating a worse prognosis for patients in the VAP group.The variables i-dentified through LASSO regression screening were included in a multifactorial Logistic regression analysis.This analysis revealed that the SIRI and the duration of mechanical ventilation were independent risk factors for the development of VAP following intervention in patients with hypertension and AIS-LVO(P＜0.05).Conversely,the admission GCS score was identified as a protective factor(P＜0.05).These three indicators were utilized to construct a prognostic nomogram model.The model's internal validity was assessed using the Boot-strap method with 1000 resamples,and the calibration curves were found to be in close agreement with the ideal fitted line,exhibiting a mean absolute error of 0.029,indicating good curve accuracy.The Logistic regression model's goodness of fit was evaluated using the Hos-mer and Lemeshow test,which yielded a x2 value of 5.38 and a P-value of 0.716,suggesting a good fit.The AUC of the model was 0.812(95％confidence interval 0.730-0.894),and the DCA indicated that the model has favorable clinical applicability.Conclusion A prediction model based on admission GCS score,postoperative 24-hour SIRI,and duration of mechanical ventilation demonstrates a robust predictive value for the incidence of VAP following intervention in patients with hypertension and acute ischemic stroke with AIS-LVO.

Objective The measurement characteristics of body image specificity evaluation tools for burn patients were systematically evaluated,aims to provide reference for selecting appropriate assessment tools.Methods CNKI,Wanfang data knowledge service platform,VIP database,China Biomedical Literature Service system,PubMed,Embase,Web of Science,PsycINFO and CINAHL were searched by computer to collect and evaluate the measurement characteristics of burn patients'body image specificity evaluation tools from the establishment of the database to April 15,2024.There were 2 researchers who independently reviewed the collected literature,looked for the full text and extracted information.At the same time,the methodological quality and measurement performance of such assessment tools were systematically evaluated under the guidance of consensus-based standards for the selection of health measurement instrument(COSMIN)guidelines.Finally,the quality and strength were rated to form a recommendation.Results A total of 6 studies were included,including 3 evaluation tools for body image specificity of burn patients,namely the Body Image Quality of Life Inventory into Brazilian Portuguese(BIQLI-BP),Satisfaction with Appearance Scale(SWAP),and the Derriford Appearance Scale 59(DAS59).In the development of PROMs,the overall quality of BIQLI-BP,SWAP and DAS59 is"doubtful".In terms of content validity,the methodological quality of BIQLI-BP,SWAP and DAS59 was evaluated as"doubtful".In terms of construct validity,the methodological quality of SWAP and DAS59 was evaluated as"good"and"very good"respectively,while the methodological quality of BIQLI-BP was"inadequate".In terms of internal consistency,the methodological quality of BIQLI-BP,SWAP and DAS59 was"very good".In terms of stability,the BIQLI-BP and DAS59 were"unreported",and the methodological quality evaluation of the SWAP was"doubtful".In terms of criterion validity,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"inadequate".In terms of measurement errors,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"doubtful".In the aspect of hypothesis test,except that the DAS59 scale is"unreported",the methodological quality of BIQLI-BP scale is"very good"and the evaluation of SWAP scale is"doubtful".Conclusion Among the existing body image specificity evaluation tools for burn patients,the SWAP has good measurement performance and it can be recommended for the time being.The number of specific evaluation tools for body image of burn patients in China is relatively insufficient,and more localization studies should be carried out in the future.

Objective To examine the expression and validate the localization of the neurotrophin neuritin(NRN1)in human tissues using bioinformatics and experimental methods.Methods The tissue-specific expression of NRN1 was analyzed using the Human Pro-tein Atlas(HPA)database.NRN1 mRNA and protein expression were experimentally validated using real-time quantitative PCR and immunohistochemistry,respectively.A pEGFP-C1-NRN1 green fluorescent protein fusion vector was transfected into 293 cells,and NRN1 localization was assessed using immunofluorescence.Endogenous NRN1 localization was also examined in hippocampal HT22 cells.Results According to the HPA database,NRN1 expression was enriched in the cerebral cortex,parathyroid gland,adipose tissue,and placenta.Experimental validation confirmed NRN 1 expression in all the aforementioned tissues,with highest levels observed in the brain and spleen.Immunofluorescence analysis revealed that NRN 1 was predominantly localized to the membrane in HT22 cells and to the cyto-plasm in 293 cells.Conclusion NRN 1 is expressed in various human tissues,with notably high expression in the brain.It is primarily localized to the cell membrane and cytoplasm.

Objective The measurement characteristics of body image specificity evaluation tools for burn patients were systematically evaluated,aims to provide reference for selecting appropriate assessment tools.Methods CNKI,Wanfang data knowledge service platform,VIP database,China Biomedical Literature Service system,PubMed,Embase,Web of Science,PsycINFO and CINAHL were searched by computer to collect and evaluate the measurement characteristics of burn patients'body image specificity evaluation tools from the establishment of the database to April 15,2024.There were 2 researchers who independently reviewed the collected literature,looked for the full text and extracted information.At the same time,the methodological quality and measurement performance of such assessment tools were systematically evaluated under the guidance of consensus-based standards for the selection of health measurement instrument(COSMIN)guidelines.Finally,the quality and strength were rated to form a recommendation.Results A total of 6 studies were included,including 3 evaluation tools for body image specificity of burn patients,namely the Body Image Quality of Life Inventory into Brazilian Portuguese(BIQLI-BP),Satisfaction with Appearance Scale(SWAP),and the Derriford Appearance Scale 59(DAS59).In the development of PROMs,the overall quality of BIQLI-BP,SWAP and DAS59 is"doubtful".In terms of content validity,the methodological quality of BIQLI-BP,SWAP and DAS59 was evaluated as"doubtful".In terms of construct validity,the methodological quality of SWAP and DAS59 was evaluated as"good"and"very good"respectively,while the methodological quality of BIQLI-BP was"inadequate".In terms of internal consistency,the methodological quality of BIQLI-BP,SWAP and DAS59 was"very good".In terms of stability,the BIQLI-BP and DAS59 were"unreported",and the methodological quality evaluation of the SWAP was"doubtful".In terms of criterion validity,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"inadequate".In terms of measurement errors,the BIQLI-BP and DAS59 scales were"unreported",and the methodological quality evaluation of the SWAP scale was"doubtful".In the aspect of hypothesis test,except that the DAS59 scale is"unreported",the methodological quality of BIQLI-BP scale is"very good"and the evaluation of SWAP scale is"doubtful".Conclusion Among the existing body image specificity evaluation tools for burn patients,the SWAP has good measurement performance and it can be recommended for the time being.The number of specific evaluation tools for body image of burn patients in China is relatively insufficient,and more localization studies should be carried out in the future.

Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

Objective:To assess the methodological and measurement quality of comprehensive assessment tools for evaluating senile dementia, in order to provide evidence-based guidance for clinical selection of the best assessment tool.Methods:Manually searched CNKI, Wanfang Database, VIP Database, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, CINAHL, ProQuest, Ovid and Scopus databases to collect and evaluate comprehensive assessment tool measurements forsenile dementia. For research on academic attributes, the search time limit was from the establishment of the database to January 4th, 2024. Two researchers independently screened the literature and extracted information, used the COSMIN guidelines to evaluate the included assessment tools, and formed final recommendations.Results:A total of 14 articles were included, including 9 comprehensive assessment tools for the elderly with dementia. Among them, the Care Needs Assessment Scale for Alzheimer′s Disease Patients had moderate and above evidence proving that its content validity and internal consistency were "sufficient", so it was a category A strong recommendation. The remaining 8 evaluation tools were all category B recommendations.Conclusions:Among the existing comprehensive assessment tools for the elderly with dementia, the Care Needs Assessment Scale for Alzheimer′s Disease Patients has good reliability and validity. This scale has 4 dimensions and 16 items. However, there are uncertainties and unmentioned measurement properties of the scale in terms of cross-cultural validity/measurement equivalence, stability, measurement error, hypothesis testing, calibration validity, and responsiveness. More evidence is needed in the future to further comprehensively validate and improve it, providing a basis for selecting a more effective, comprehensive and high-quality comprehensive assessment tool for the elderly with dementia.

Objective:To analyze the influences of leukocytes on improving blood glucose control in patients with type 2 diabetes mellitus (T2DM) and periodontitis after periodontal mechanical therapy.Methods:Thirty-five patients visiting Peking University Third Hospital from March 2011 to August 2012, as well as thirty-four patients visiting Peking University School and Hospital of Stomatology from March 2011 to August 2012 and December 2016 to December 2018 were selected in this research. These subjects were non-smokers, and with moderate to severe chronic periodontitis and T2DM. The full set of periodontal examinations including probing depth (PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were conducted. Besides, counts of white blood cells (WBC), parameters of glucose and lipids metabolites such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA 1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) in serum were examined before treatment. Then, oral hygiene instruction, scaling and root planing (SRP) were carried out. Three months after SRP, the baseline examinations were repeated in all patients. According to the baseline leukocyte counts, the patients were divided into subgroups: low WBC group (WBC<6.19×10 9/L) and high WBC group (WBC≥6.19×10 9/L). Paired t-test for comparison of changes after treatment, analysis of co-variance for comparing the intervention effects between subgroups, and multifactor Logistic regression analysis were performed. Results:Three months after SRP, all periodontal indexes were significantly improved in both groups. Leukocyte counts decreased significantly in high WBC group (6.89±1.53 vs. 7.64±1.51, P=0.008). In high WBC group, HbA 1c (7.18±1.09 vs. 7.67±1.35, P=0.001) and LDL (2.67±0.85 vs. 3.28±0.76, P=0.042) decreased significantly, while there were no such differences in low WBC group. Influence of leukocyte level on HbA 1c ( OR=0.12, P=0.038) and LDL ( OR=0.15, P=0.001) improvement was statistically significant. Hierarchical analysis showed such improvement notably perform in female [HbA 1c ( OR=0.30, P=0.021), LDL ( OR=0.34, P=0.001)] and severe periodontitis group [HbA 1c ( OR=0.15, P=0.025), LDL ( OR=0.24, P=0.017)]. Through interaction test, female and leukocyte counts at baseline had relative excess risk affecting the effect of periodontal intervention on HbA 1c ( P=0.036) and LDL ( P=0.005). Conclusions:SRP could significantly improve the blood glucose and lipid control in patients who had T2DM and chronic periodontitis with relative higher leukocytes level. Female patients with severe periodontitis showed more obviously effects.