ObjectiveTo explore the effect of the medical-community linkage model on activities of daily living, psychological status and motor function of stroke patients in the community. MethodsA total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District, Beijing, from January, 2024 to August, 2025 were enrolled and randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine medicine, dietary care and rehabilitation management, while the intervention group underwent rehabilitation with the medical-community linkage model, for twelve weeks. They were assessed with modified Barthel Index (MBI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Fugl-Meyer Assessment (FMA) before and after intervention. ResultsAfter intervention, the MBI, HAMA, HAMD and FMA scores of patients improved in both groups (|t| > 5.599, P < 0.001), and improved more in the intervention group than in the control group (P < 0.05), except MBI. The HAMA and HAMD scores of family members decreased in both groups (|t| > 10.333, P < 0.001), and decreased more in the intervention group than in the control group (t > 5.681, P < 0.001). ConclusionThe medical-community linkage model can further improve the motor function of stroke patients in community, as well as the psychological status of both patients and their family members.

Objective To analyze the prevalence and risk factors of underscreening among cervical cancer screening participants in Wuxiang County,Shanxi Province in 2019,providing evidence-based support for optimizing mobilization strategies.Methods Data from cervical cancer screening programs conducted between 2019 and 2024 in Wuxiang County were retrospectively collected.The follow-up screening behaviors of women screened in 2019 were analyzed,and factors associated with underscreening were identified.Results A total of 3759 women underwent cervical cancer screening in 2019.Among them,492 women(13.09％)with abnormal primary screening results requiring follow-up in 12 months,yet only 43(8.74％)completed;2154 women(57.30％)with negative liquid-based cytology testing(LCT)results needed re-screening after 3 years,701(32.54％)completed;1113 women(29.61％)with negative HPV/combined results needed re-screening after 5 years,734(65.95％)completed.Overall,2299 women(60.69％)exhibited underscreening.Multivariate analysis showed that underscreening was more likely among community residents than rural residents(OR=2.309,P=0.018),older women(OR=1.065,P＜0.001),those in organized screening compared to opportunistic screening(OR=3.789,P＜0.001),those undergoing LCT(OR=4.607,P＜0.001)or combined screening instead of human papillomavirus testing(OR=3.624,P＜0.001),and those with abnormal screening results(OR=6.859,P＜0.001).Conclusion Substantial proportions of cervical cancer screening participants demonstrate poor adherence to guideline-recommended screening intervals,and particularly need to focus on older women and those with abnormal screening results.Implementation of electronic screening record systems and emphasizing knowledge of periodical screening in health education could enhance compliance with"70％screening coverage"target for cervical cancer prevention.

Objective:To investigate the clinical application effects of free transplantation of lobulated inguinal flaps.Methods:This study was a retrospective observational study. From July 2019 to April 2024, 34 patients with skin defect wounds whose wounds in one part met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 28 males and 6 females, aged 26 to 59 years. The wound area in the recipient area ranged from 3.0 cm×2.0 cm to 25.0 cm×20.0 cm. The lobulated inguinal flap pedicled with the branch of the superficial circumflex iliac artery were obtained in 19 patients, and the lobulated inguinal flap pedicled with the main artery of the superficial circumflex iliac artery and the superficial inferior epigastric artery were obtained in 15 patients. The total area of the flaps ranged from 6.0 cm×2.2 cm to 27.0 cm×23.0 cm. The flaps were divided into 2 to 4 lobes, and the area of each lobe ranged from 2.0 cm×1.0 cm to 17.0 cm×12.0 cm. Each lobe of the flaps was reassembled, spliced, or directly transplanted onto the wounds, and the donor wounds were sutured in layers. The survival of each lobe of the flaps and wound healing in the recipient and donor areas were observed, and the wound recovery in the recipient and donor areas were followed up. At the last follow-up, the patient's satisfaction with the efficacy was assessed by 5-grade Likert scale.Results:A small amount of necrosis appeared in the tip of one lobe of the flaps in 4 patients after surgery, which healed after trimming. The flaps of the remaining 30 patients survived. The wounds in the recipient areas healed smoothly. There was a small amount of necrosis at the suture edge of the donor areas in 3 patients, which healed after local trimming and dressing change. The donor wounds healed well in the remaining 31 patients. During the follow-up of 6 to 42 months, all the recipient wounds were well repaired, and the shape of the donor areas was good. At the last follow-up, 15 patients were very satisfied with the efficacy, 15 were relatively satisfied, and 4 were generally satisfied.Conclusions:Through preoperative ultrasonic examination and positioning, the inguinal flap is designed according to the course of blood vessels and lobulated with the branch of the superficial circumflex iliac artery or the main artery of the superficial circumflex iliac artery and the superficial inferior epigastric artery as the pedicles. The anatomical process is reliable and the blood flow of the flap after being lobulated is rich, which can meet the repair needs of various skin defect wounds. The repair effect is good, and the damage in the donor area is small, which is worthy of promotion.

Objective:To construct a risk prediction model of hyperuricemia (HUA) for community-dwelling residents.Methods:This cross-sectional study was conducted from March to November 2020. A total of 1 967 residents in the Nanzhai community of Taiyuan city were selected by stratified sampling method as study subjects, among whom 1 555 (80%) subjects served as the training set and the remaining 412 (20%) as the validation set. Blood uric acid was measured in all subjects and level>420 mmol/L was defined as HUA. The risk factors of HUA were determined with multivariate logistic regression analysis, and a risk prediction model was constructed. The Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic (ROC) curve were used to evaluate the predictive performance of the model.Results:Among the 1 555 residents in the training set, HUA was detected in 285 cases (18.3%). The detection rate in men was significantly higher than that in women [29.8% (220/739) vs. 8.0% (65/816), χ 2=123.17, P<0.05]. Compared to non-HUA group, the waist circumference and BMI, and the proportion of smoking, drinking, staying up late, and prevalence of hypertension and dyslipidemia were significant higher in HUA group. There was significant difference in the frequency of drinking tea, coffee, milk, and eating fruits, as well as the amount of beverages consumed between the two groups ( P<0.05). Multivariate logistic regression analysis showed that high BMI ( OR=1.132, 95 %CI:1.070-1.197, P<0.001), coffee consumption ( OR=1.337, 95 %CI:1.027-1.742, P=0.032), and dyslipidemia ( OR=1.479, 95 %CI:1.049-2.086, P=0.025) were risk factors of HUA, while female sex ( OR=0.213, 95 %CI:0.146-0.390, P<0.001) was protective factor of HUA. When all factors were included in the logistic regression model, gender, BMI, coffee consumption, beverage intake, sodium salt intake, sleep quality, and dyslipidemia ( OR=0.213, 1.113, 1.353, 0.788, 1.320, 0.788, 1.651) were important components of the HUA prediction model. By substituting the constant, these factors, and the regression coefficients into the logistic regression equation, the Logit(P) formula was obtained: Logit(P)=-1.530-1.547×gender+0.107×BMI+0.303×coffee consumption frequency-0.238×sodium salt intake+0.278×beverage intake-0.238×sleep quality+0.502×dyslipidemia. The ROC curve showed an area under the curve ( AUC) of 0.750. The Hosmer-Lemeshow goodness-of-fit test: P=0.632, indicating a satisfactory fit. When the formula was applied to the validation set for internal validation, the AUC was 0.745. Conclusion:The occurrence of HUA is influenced by multiple factors. The prediction model constructed in this study has good prediction performance,which may be used to predict the risk of HUA in primary care settings for community-dwelling residents.

Objective: To evaluate the effects of problem-oriented respiratory rehabilitation nursing on lung function, activity ability, length of hospital stay, and retention time of closed chest drainage tube in patients undergoing thoracoscopic radical resection for lung cancer, so as to provide a basis for improving the prognosis of patients with lung cancer surgery. Methods: A total of 119 patients with lung cancer who underwent thoracoscopic radical resection for lung cancer in the First Affiliated Hospital of Anhui Medical University from October 2023 to June 2024 were selected and randomly divided into the intervention group (n=59) and the control group (n=60). The control group received routine respiratory rehabilitation nursing of thoracic surgery. On the basis of the treatment and guidance received by the control group, the intervention group implemented problem-oriented respiratory rehabilitation nursing. First second expiratory volume (FEV1) and forced vital capacity (FVC) were used to evaluate pulmonary function at 1 day before surgery and 3 days after surgery, and the 6-minute walk distance (6MWD) was used to evaluate physical activity. The incidence of pulmonary complications, length of hospital stay and retention time of closed chest drainage tube were collected through the hospital's electronic medical records system. The intervention effects between the two groups were compared using variance analysis of repeated-measures analysis of variance and log-rank test. Results: The mean age of the control group was (60.77±9.31) years, with 28 males and 32 females. There were 4 cases of squamous cell carcinoma, 55 cases of adenocarcinoma, and 1 case of small cell carcinoma. The tumors were located in the right lobe in 41 cases. The mean age of the intervention group was (58.71±10.01) years, with 23 males and 36 females. There were 2 cases of squamous cell carcinoma, 56 cases of adenocarcinoma, and 1 case of small cell carcinoma. The tumors were located in the right lobe in 37 cases. There were no statistically significant differences in age, gender, education level, pathological type, and tumor location between the two groups (all P>0.05). Three days after surgery, there was an interaction effect between the group and the time in FEV1, FVC, and 6MWD between the two groups. The FEV1 and 6MWD in the intervention group were higher than those in the control group (both P<0.05). There was no statistically significant difference in FVC between the groups (P>0.05). There were 3 cases of postoperative complications in the control group, and no cases in the intervention group. Log-rank test showed that the length of hospital stay and retention time of closed chest drainage tube after surgery in the intervention group were shorter than those in the control group (both P<0.05). Conclusion The problem-oriented respiratory rehabilitation nursing can improve the lung function and activity ability of patients with lung cancer after surgery, shorten the length of hospital stay and retention time of closed chest drainage tube, and improve the quality of life.

Objective:To investigate the effects of Xingnao Yisui Decoction on the behaviour of vascular dementia (VaD) rats and the apoptosis of neurons in the CA1 region of the hippocampus; To explore its mechanism of action.Methods:Totally 60 adult SD rats with similar levels of cognitive function were selected and divided into Xingnao Yisui Decoction high-, medium- and low-dosage groups, donepezil group, model group and sham-operation group according to the random number table method, with 10 rats in each group. Except for the sham-operation group, the VaD model was prepared using a modified bilateral common carotid artery ligation method in all the groups. Xingnao Yisui Decoction high-, medium- and low-dosage groups were gavaged with 19.62, 9.81, 4.91 g/(kg·d) of Xingnao Yisui Decoction respectively, the donepezil group was gavaged with 0.5 mg/(kg·d) of donepezil solution, and the sham-operation group and the model group were given equal amount of saline gavage, 1 time/d for 4 weeks. Morris water maze experiment was used to observe the behavioral changes in each group, TUNEL staining was used to observe the apoptosis of neurons in CA1 area of hippocampus. Realtime PCR was used to detect the mRNA expression of NF-κB and MMP-9. ELISA was used to detect the changes of serum NF-κB, MMP-9, p53, Bcl-2 and Bax protein levels.Results:Compared with the model group, the escape latency of rats in the donepezil group and Xingnao Yisui Decoction high-, medium- and low-dosage groups was shortened ( P<0.05); the times of crossing the platform and the stay time in the target quadrant increased ( P<0.05); the number of apoptotic cells in hippocampal CA1 region decreased ( P<0.01); the number of apoptotic cells in hippocampal CA1 region decreased ( P<0.01); the mRNA expression of NF- κB and MMP-9 in hippocampal mRNA level decreased ( P<0.01); the content of NF-κB, MMP-9, p53 and Bax decreased ( P<0.01), while the content of Bcl-2 increased ( P<0.01). Conclusion:Xingnao Yisui Decoction can effectively mediate the NF-κB-MMP-9 pathway to improve the permeability of the blood-brain barrier and regulate p53-Bcl-2-Bax to reduce apoptosis of neurons in CA1 area of hippocampus, thus significantly improve the learning and memory ability of VaD rats.

Objective:To investigate the current status of nursing service quality from patients' perspectives and analyze its influencing factors.Methods:A convenience sampling method was used to select 615 adult inpatients who met the inclusion and exclusion criteria from two tertiary general hospitals and one secondary general hospital between April and June 2024. Patients from 22 clinical departments, including internal medicine, surgery, gynecology, otorhinolaryngology, traditional Chinese medicine, and rehabilitation, were surveyed using a demographic questionnaire and the nursing service quality evaluation scale from patients' perspective.Results:The overall nursing service quality score from patients' perspective was (106.18±12.80) points, with a standardized score of (84.94±10.24) points. Among the four modules, the highest to lowest scores were: emotional and psychological support, professional and technical competence, information and communication, and comfort and convenience, with standardized scores of (87.53±10.83), (87.23±9.87), (84.97±11.83), and (80.74±12.57), respectively. The top three ranked dimensions were respect, professionalism, and safety, while the lowest three were guidance, comfort, and convenience. Multiple linear regression analysis showed that daytime nurse-to-patient ratio, night-shift nurse-to-patient ratio, patients' education level, and patient age were significant influencing factors of nursing service quality from patients' perspectives ( P<0.05) . Conclusions:Nursing service quality from patients' perspectives was at a good level. Department-level factors influencing nursing service quality were primarily nurse-to-patient ratios, while patient-level factors included age and education level.

Objective To analyze the prevalence and risk factors of underscreening among cervical cancer screening participants in Wuxiang County,Shanxi Province in 2019,providing evidence-based support for optimizing mobilization strategies.Methods Data from cervical cancer screening programs conducted between 2019 and 2024 in Wuxiang County were retrospectively collected.The follow-up screening behaviors of women screened in 2019 were analyzed,and factors associated with underscreening were identified.Results A total of 3759 women underwent cervical cancer screening in 2019.Among them,492 women(13.09％)with abnormal primary screening results requiring follow-up in 12 months,yet only 43(8.74％)completed;2154 women(57.30％)with negative liquid-based cytology testing(LCT)results needed re-screening after 3 years,701(32.54％)completed;1113 women(29.61％)with negative HPV/combined results needed re-screening after 5 years,734(65.95％)completed.Overall,2299 women(60.69％)exhibited underscreening.Multivariate analysis showed that underscreening was more likely among community residents than rural residents(OR=2.309,P=0.018),older women(OR=1.065,P＜0.001),those in organized screening compared to opportunistic screening(OR=3.789,P＜0.001),those undergoing LCT(OR=4.607,P＜0.001)or combined screening instead of human papillomavirus testing(OR=3.624,P＜0.001),and those with abnormal screening results(OR=6.859,P＜0.001).Conclusion Substantial proportions of cervical cancer screening participants demonstrate poor adherence to guideline-recommended screening intervals,and particularly need to focus on older women and those with abnormal screening results.Implementation of electronic screening record systems and emphasizing knowledge of periodical screening in health education could enhance compliance with"70％screening coverage"target for cervical cancer prevention.

Objective:To investigate the current status of nursing service quality from patients' perspectives and analyze its influencing factors.Methods:A convenience sampling method was used to select 615 adult inpatients who met the inclusion and exclusion criteria from two tertiary general hospitals and one secondary general hospital between April and June 2024. Patients from 22 clinical departments, including internal medicine, surgery, gynecology, otorhinolaryngology, traditional Chinese medicine, and rehabilitation, were surveyed using a demographic questionnaire and the nursing service quality evaluation scale from patients' perspective.Results:The overall nursing service quality score from patients' perspective was (106.18±12.80) points, with a standardized score of (84.94±10.24) points. Among the four modules, the highest to lowest scores were: emotional and psychological support, professional and technical competence, information and communication, and comfort and convenience, with standardized scores of (87.53±10.83), (87.23±9.87), (84.97±11.83), and (80.74±12.57), respectively. The top three ranked dimensions were respect, professionalism, and safety, while the lowest three were guidance, comfort, and convenience. Multiple linear regression analysis showed that daytime nurse-to-patient ratio, night-shift nurse-to-patient ratio, patients' education level, and patient age were significant influencing factors of nursing service quality from patients' perspectives ( P<0.05) . Conclusions:Nursing service quality from patients' perspectives was at a good level. Department-level factors influencing nursing service quality were primarily nurse-to-patient ratios, while patient-level factors included age and education level.

Objective:To construct a risk prediction model of hyperuricemia (HUA) for community-dwelling residents.Methods:This cross-sectional study was conducted from March to November 2020. A total of 1 967 residents in the Nanzhai community of Taiyuan city were selected by stratified sampling method as study subjects, among whom 1 555 (80%) subjects served as the training set and the remaining 412 (20%) as the validation set. Blood uric acid was measured in all subjects and level>420 mmol/L was defined as HUA. The risk factors of HUA were determined with multivariate logistic regression analysis, and a risk prediction model was constructed. The Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic (ROC) curve were used to evaluate the predictive performance of the model.Results:Among the 1 555 residents in the training set, HUA was detected in 285 cases (18.3%). The detection rate in men was significantly higher than that in women [29.8% (220/739) vs. 8.0% (65/816), χ 2=123.17, P<0.05]. Compared to non-HUA group, the waist circumference and BMI, and the proportion of smoking, drinking, staying up late, and prevalence of hypertension and dyslipidemia were significant higher in HUA group. There was significant difference in the frequency of drinking tea, coffee, milk, and eating fruits, as well as the amount of beverages consumed between the two groups ( P<0.05). Multivariate logistic regression analysis showed that high BMI ( OR=1.132, 95 %CI:1.070-1.197, P<0.001), coffee consumption ( OR=1.337, 95 %CI:1.027-1.742, P=0.032), and dyslipidemia ( OR=1.479, 95 %CI:1.049-2.086, P=0.025) were risk factors of HUA, while female sex ( OR=0.213, 95 %CI:0.146-0.390, P<0.001) was protective factor of HUA. When all factors were included in the logistic regression model, gender, BMI, coffee consumption, beverage intake, sodium salt intake, sleep quality, and dyslipidemia ( OR=0.213, 1.113, 1.353, 0.788, 1.320, 0.788, 1.651) were important components of the HUA prediction model. By substituting the constant, these factors, and the regression coefficients into the logistic regression equation, the Logit(P) formula was obtained: Logit(P)=-1.530-1.547×gender+0.107×BMI+0.303×coffee consumption frequency-0.238×sodium salt intake+0.278×beverage intake-0.238×sleep quality+0.502×dyslipidemia. The ROC curve showed an area under the curve ( AUC) of 0.750. The Hosmer-Lemeshow goodness-of-fit test: P=0.632, indicating a satisfactory fit. When the formula was applied to the validation set for internal validation, the AUC was 0.745. Conclusion:The occurrence of HUA is influenced by multiple factors. The prediction model constructed in this study has good prediction performance,which may be used to predict the risk of HUA in primary care settings for community-dwelling residents.