Objective To analyze the potential biological relationship between Alzheimer disease(AD)and chronic periodontitis(CP)by bioinformatics.Methods We analyzed two datasets of AD and CP from the Gene Expression Omnibus database,and differentially expressed genes(DEGs)were identified from these datasets.Weighted gene co-expression network analysis(WGCNA)was used to identify the most relevant modules.Functional enrichment analysis of shared genes was performed,and a protein-protein interaction(PPI)network was constructed.MCODE was used to identify key modules,and machine learning was used to discover key genes.In addition,Gene Set Enrichment Analysis(GSEA)and CIBERSORT were used to investigate KLRB1-related molecular pathways and immune cell distribu-tion.Results The study identified 18 genes common to both AD and CP.MCODE analysis revealed five pivotal genes,machine learning identified 13 genes for AD,eight for CP,and KLRB1 was determined as a common gene for AD and CP.GSEA demonstrated the intricate involvement of these genes in disease-related pathways.Immunocellular analysis underscored a significant association between KLRB1 and γδT cells.Conclusion This research highlighted KLRB1 as a key gene for AD and CP,providing new insights into their molecular linkages.

Objective To develop a graded early mobility implementation pathway for critically ill adult patients in tertiary hospitals in Beijing and to preliminarily validate its feasibility and effectiveness.Methods Based on the"goal-directed"early mobility concept,a graded early mobility implementation pathway for critically ill patients was developed through evidence synthesis and the Delphi method,consisting of 3 components:patient inclusion,mobility implementation,and mobility evaluation.Using convenience sampling,patients meeting inclusion criteria in the general ICU of a tertiary hospital in Beijing from October 2024 to January 2025 were selected as participants.Among them,25 patients admitted from December 2024 to January 2025 were assigned to an experimental group and received early mobility interventions following the developed pathway.25 patients admitted from October to November 2024 served as a control group and received routine ICU mobility care.Outcomes including diaphragm excursion,muscle strength,ICU length of stay,and adverse events were compared between the 2 groups.Results The graded early mobility pathway achieved an implementation rate of 70.05％in the experimental group,significantly higher than it in the control group(P＜0.001),without increasing adverse events.Post-intervention diaphragm excursion in the experimental group was significantly greater than that in the control group(P=0.018).Conclusion The developed graded early mobility implementation pathway for ICU patients demonstrates scientific rigor and clinical practicality.It provides a reference for the widespread and effective implementation of early mobility in ICUs,standardizing its clinical application.

Objective:To explore the latent categories of hospice care attitudes among nurses in a geriatric hospital and to analyze the characteristic differences among these categories.Methods:A total of 434 in-service nurses from Beijing Geriatric Hospital were selected by convenience sampling from April to May 2024. Data were collected using the general information questionnaire, the Chinese version of the Frommelt Attitude Toward Care of the Dying Scale Form B, the Self-Efficacy in Coping with Death Scale, and the General Well Being Schedule. Latent profile analysis was used to identify potential categories of hospice care attitudes, and Logistic regression analysis was conducted to examine influencing factors.Results:A total of 434 questionnaires were distributed, and 431 valid responses were received, with a valid response rate of 99.31% (431/434). The hospice care attitudes of the 431 nurses were categorized into two latent profiles: "negative attitude-low communication willingness type" (55.45%, 239/431) and "positive attitude-high caring type" (44.55%, 192/431). Logistic regression analysis showed that participating in palliative care continuing education within the past year, having discussed death with patients, perceiving difficulties in caring for dying patients, self-efficacy in coping with death, and subjective well-being were statistically significant influencing factors of the latent categories of hospice care attitudes ( P<0.05) . Conclusions:Hospice care attitudes among nurses in geriatric hospitals can be classified into two latent categories: "negative attitude-low communication willingness type" and "positive attitude-high caring type". These are influenced by many factors. Nursing administrators should develop targeted interventions to support nurses in coping with stressors effectively and improving the quality of life of terminally ill patients.

Objective To analyze the potential biological relationship between Alzheimer disease(AD)and chronic periodontitis(CP)by bioinformatics.Methods We analyzed two datasets of AD and CP from the Gene Expression Omnibus database,and differentially expressed genes(DEGs)were identified from these datasets.Weighted gene co-expression network analysis(WGCNA)was used to identify the most relevant modules.Functional enrichment analysis of shared genes was performed,and a protein-protein interaction(PPI)network was constructed.MCODE was used to identify key modules,and machine learning was used to discover key genes.In addition,Gene Set Enrichment Analysis(GSEA)and CIBERSORT were used to investigate KLRB1-related molecular pathways and immune cell distribu-tion.Results The study identified 18 genes common to both AD and CP.MCODE analysis revealed five pivotal genes,machine learning identified 13 genes for AD,eight for CP,and KLRB1 was determined as a common gene for AD and CP.GSEA demonstrated the intricate involvement of these genes in disease-related pathways.Immunocellular analysis underscored a significant association between KLRB1 and γδT cells.Conclusion This research highlighted KLRB1 as a key gene for AD and CP,providing new insights into their molecular linkages.

Objective To develop a graded early mobility implementation pathway for critically ill adult patients in tertiary hospitals in Beijing and to preliminarily validate its feasibility and effectiveness.Methods Based on the"goal-directed"early mobility concept,a graded early mobility implementation pathway for critically ill patients was developed through evidence synthesis and the Delphi method,consisting of 3 components:patient inclusion,mobility implementation,and mobility evaluation.Using convenience sampling,patients meeting inclusion criteria in the general ICU of a tertiary hospital in Beijing from October 2024 to January 2025 were selected as participants.Among them,25 patients admitted from December 2024 to January 2025 were assigned to an experimental group and received early mobility interventions following the developed pathway.25 patients admitted from October to November 2024 served as a control group and received routine ICU mobility care.Outcomes including diaphragm excursion,muscle strength,ICU length of stay,and adverse events were compared between the 2 groups.Results The graded early mobility pathway achieved an implementation rate of 70.05％in the experimental group,significantly higher than it in the control group(P＜0.001),without increasing adverse events.Post-intervention diaphragm excursion in the experimental group was significantly greater than that in the control group(P=0.018).Conclusion The developed graded early mobility implementation pathway for ICU patients demonstrates scientific rigor and clinical practicality.It provides a reference for the widespread and effective implementation of early mobility in ICUs,standardizing its clinical application.

Objective:To explore the latent categories of hospice care attitudes among nurses in a geriatric hospital and to analyze the characteristic differences among these categories.Methods:A total of 434 in-service nurses from Beijing Geriatric Hospital were selected by convenience sampling from April to May 2024. Data were collected using the general information questionnaire, the Chinese version of the Frommelt Attitude Toward Care of the Dying Scale Form B, the Self-Efficacy in Coping with Death Scale, and the General Well Being Schedule. Latent profile analysis was used to identify potential categories of hospice care attitudes, and Logistic regression analysis was conducted to examine influencing factors.Results:A total of 434 questionnaires were distributed, and 431 valid responses were received, with a valid response rate of 99.31% (431/434). The hospice care attitudes of the 431 nurses were categorized into two latent profiles: "negative attitude-low communication willingness type" (55.45%, 239/431) and "positive attitude-high caring type" (44.55%, 192/431). Logistic regression analysis showed that participating in palliative care continuing education within the past year, having discussed death with patients, perceiving difficulties in caring for dying patients, self-efficacy in coping with death, and subjective well-being were statistically significant influencing factors of the latent categories of hospice care attitudes ( P<0.05) . Conclusions:Hospice care attitudes among nurses in geriatric hospitals can be classified into two latent categories: "negative attitude-low communication willingness type" and "positive attitude-high caring type". These are influenced by many factors. Nursing administrators should develop targeted interventions to support nurses in coping with stressors effectively and improving the quality of life of terminally ill patients.

Objective:To conduct simulated graduation skill assessment and annual skill assessment by self-designed objective structured clinical examination (OSCE) for standardized training of radiation oncology residents.Methods:The structured examination, standardized questions and standardized tasks of each disease were designed by teaching team of radiation oncology in the University of Hong Kong-Shenzhen Hospital. The implementation effect of the annual assessment and simulated completion assessment of standardized training for residents in radiation oncology from Class 2019 to 2021 was prospectively observed. The difference between scores by two independent examiners was analyzed by the paired t-test. The overall feedback of residents and examiners for the implementation were collected after the completion of OSCE. Results:A total of 18 residents participated in 67 sessions of 3-station skill assessments of different diseases, including 2 make-up tests. There was no difference in the score pairing and grade pairing tests between two examiners at 3 stations ( t=0.85, -0.68, -1.16; P=0.401, 0.499, 0.255). A total of 91.3% of the residents reported that the assessment well reflected their actual clinical competency. Conclusions:The current program of OSCE assessment for radiation oncology meets objectification, standardization and high efficiency, and achieves the goal of making trainers familiar with the graduation skill assessment and assessing comprehensive clinical competence. It is a reproducible and flexible structured assessment model.

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

Objective:The causes of infertility are complex and diverse, and congenital adrenal hyperplasia (CAH) is often overlooked in screening for infertility. In this study, CAH was diagnosed in women with high androgenemia who were infertile during childbearing age, and the diagnosis and treatment of CAH in pregnant women was investigated.Methods:This study included 20 women with high androgenemia and infertility in the childbearing age who were referred to the Endocrinology Department after visiting the Reproductive Medicine Center of the First Affiliated Hospital of Nanjing Medical University from December 2016 to April 2019. All patients were tested for blood hormone levels, glucose, and lipid metabolism, underwent ACTH stimulation test, uterus and bilateral ovarian B-ultrasound, adrenal computed cosmography (CT), etc. Full-length sequencing of the CYP21A2 gene was performed as necessary.Results:Among the 20 women with hyperandrogenism who were infertile, there were 7 cases of CAH (35.0%), including 6 cases of 21-hydroxylase deficiency (21-OHD) confirmed by gene sequencing; 10 cases of polycystic ovary syndrome (PCOS); 3 cases of idiopathic hyperandrogenemia (IHA). Sex hormone results showed that testosterone in CAH group was significantly higher than that in PCOS group and IHA group [(4.4±2.0 vs 2.9±0.4, 2.8±0.8) nmol/L, P<0.05]; ACTH stimulation test showed that the 17-hydroxyprogesterone (17-OHP) in CAH group was significantly higher than that in PCOS group [(101.0±100.8 vs 1.4±0.8) ng/ml, P<0.05]. There was no significant difference between CAH group and IHA group [(101.0±100.8 vs 3.0±1.8)ng/ml, P>0.05]. However, the 17-OHP (60 min) in CAH group was significantly higher than that in PCOS group and IHA group [(200.1±80.8 vs 3.1±1.2, 3.4±0.2) ng/ml, P<0.05]. Glucocorticoid therapy was given to patients with CAH, and 4 patients had successful pregnancy. No clinical symptoms of CAH and external genital malformations were found in the offspring of patients who had been delivered. Conclusions:The ACTH stimulation test is of great significance in the differential diagnosis of CAH, especially 21-OHD. Genetic testing helps to identify the type of mutation in CAH patients. On the one hand, glucocorticoid therapy may improve the pregnancy rate of CAH patients, on the other hand, it can help to reduce the status of maternal high androgen and avoid masculine manifestation of female offspring.

Family physicians contracted service is an important choice to deepen the reform of China′s healthcare reform and achieve the strategic goal of " health for all" . In order to effectively promote the contracted service, the central government has successively issued a number of policy documents, which are echoed by the localities in their proactive explorations, achieving remarkable results. But there are also multiple roadblocks hindering the contracted service to progress. This article referred to the three-circle theory and studied policy implementation from the three dimensions of policy value, policy resources, and policy impetus. A thorough analysis of the problems in the implementation process revealed such main problems as insufficient family physicians, inadequacy of supporting policies and low level of policy acceptance among the young healthy age groups. The follow-up work will promote the long-term implementation of the family physicians contracted service policy by enriching the family physicians team, enriching supporting policies, and focusing on promotions to key age groups.