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 compare the repair effects of resin super-porcelain inlays and cast porcelain onlays on posterior tooth defects after root canal treatment.Methods A total of 198 patients with posterior tooth defects(235 teeth)who were admitted to Zhenjiang Stomatological Hospital from February 2019 to March 2022 were selected and divided into study group(99 cases,116 teeth)and control group(99 cases,119 teeth)according to random number table method.After root canal therapy,the control group was repaired with resin super-porcelain inlays,and the study group was repaired with cast porcelain onlays.The repair result,periodontal index,complications and satisfaction were compared between the two groups.Results The success rate of repair in the study group was higher than that in the control group(93.10%vs.84.87%,P<0.05).The failure rate of repair in the study group was lower than that in the control group(5.17%vs.12.61%,P<0.05).There was no significant difference in the repair time or defect rate between the two groups(P>0.05).Twelve months after repair,sulcus bleeding index(SBI),gingival papilla index(PIS)and plaque index(PLI)were decreased in both groups(P<0.05),and these indexes in the study group were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The satisfaction rate of repair in the study group was higher than that in the control group(94.83%vs.81.51%,P<0.05).Conclusion Compared with the resin super-porcelain inlays after root canal treatment,the cast porcelain onlays has better repair effect.It can improve the satisfaction of patients and promote periodontal health with high safety and reliability.

Objective To construct and evaluate a mouse model of renal fibrosis(RF)combined with Qi deficiency and dampness stasis,and investigate the changes in protein and metabolic pathways using multiomics.Methods Twenty-four C57BL/6J mice were divided randomly into normal(N),model(M),and RF and syndrome combined groups(BZ)(n=8/group).The experiment lasted 6 weeks.A mouse model of RF with Qi deficiency and dampness stasis was established by "cyclosporine A+high-fat diet+swimming exhaustion+constant temperature and humidity".The model was evaluated by detecting general signs,renal function,tongue RGB(red,green,blue)values,hemorheology indexes,blood lipids,and inflammation and oxidation indexes,combined with hematoxylin and eosin,Masson,periodic acid-Schiff,and Oil red O staining,terminal deoxynucleotidyl transferase dUTP nick end labeling apoptosis,and transforming growth factor-β immunofluorescence analysis of renal tissue.Differential proteins and metabolites were screened by renal proteomics combined with serum metabolomics and subjected to pathway enrichment analysis.Results Body mass of mice in the BZ group began to decline at week 3(P＜0.05)and decreased significantly at week 4(P＜0.01),while food and water consumption decreased,the fur became messy and less glossy,mood and activity decreased,and stools became watery.Serum creatinine,blood urea nitrogen,urine albumin-creatinine ratio,and N-acetyl-beta-glucosaminidase(NAG)were significantly higher in the BZ group compared with those in the N group(P＜0.05,P＜0.01),and serum creatinine and NAG levels were significantly different compared with those in the M group.The R value of tongue images was significantly lower in the BZ group compared with that in the N group(P＜0.01),while the B value was significantly higher(P＜0.05).The viscosity of the whole blood multi-shear rate and the hematocrit were higher in the BZ group compared with those in the N and M groups,and the platelet volume was higher than in the N group(P＜0.05,P＜0.01).Total cholesterol,low-density lipoprotein cholesterol,C-reactive protein,interleukin-6,and malondialdehyde levels were significantly increased in the BZ group compared with those in the N and M groups(P＜0.01),and superoxide dismutase activity was significantly decreased compared with that in the N group(P＜0.05).Renal tubule vacuolation,inflammatory cell infiltration,glomerular basement membrane thickening,collagen fiber hyperplasia,and lipid accumulation were evident,and renal cell apoptosis and transforming growth factor-β deposition were increased in the BZ group.There were 299 differential proteins in the BZ and N groups,including 180 up-regulated and 119 down-regulated proteins,and 323 differential metabolites,including 205 up-regulated and 118 down-regulated.Primary bile acid biosynthesis,taurine and hypotaurine metabolism,and biosynthesis of unsaturated fatty acids were co-enriched in differential proteins and differential metabolites,involving three differential proteins and nine differential metabolites.Among these,docosapentaenoic acid(22n-3),eicosapentaenoic acid,taurine,3-sulfinoalanine,taurocholic acid,Acnat1,Acnat2,and Hsd17b12 showed high prediction accuracy.Conclusions We successfully constructed an RF animal model of Qi deficiency and dampness stasis using the "cyclosporine A+high-fat diet+exhaustion of swimming+constant temperature and humidity" method.Biosynthesis of unsaturated fatty acids and taurine and hypotaurine metabolism may play important roles in this RF mouse model of Qi deficiency and dampness stasis.

Objective To construct and evaluate a mouse model of renal fibrosis(RF)combined with Qi deficiency and dampness stasis,and investigate the changes in protein and metabolic pathways using multiomics.Methods Twenty-four C57BL/6J mice were divided randomly into normal(N),model(M),and RF and syndrome combined groups(BZ)(n=8/group).The experiment lasted 6 weeks.A mouse model of RF with Qi deficiency and dampness stasis was established by "cyclosporine A+high-fat diet+swimming exhaustion+constant temperature and humidity".The model was evaluated by detecting general signs,renal function,tongue RGB(red,green,blue)values,hemorheology indexes,blood lipids,and inflammation and oxidation indexes,combined with hematoxylin and eosin,Masson,periodic acid-Schiff,and Oil red O staining,terminal deoxynucleotidyl transferase dUTP nick end labeling apoptosis,and transforming growth factor-β immunofluorescence analysis of renal tissue.Differential proteins and metabolites were screened by renal proteomics combined with serum metabolomics and subjected to pathway enrichment analysis.Results Body mass of mice in the BZ group began to decline at week 3(P＜0.05)and decreased significantly at week 4(P＜0.01),while food and water consumption decreased,the fur became messy and less glossy,mood and activity decreased,and stools became watery.Serum creatinine,blood urea nitrogen,urine albumin-creatinine ratio,and N-acetyl-beta-glucosaminidase(NAG)were significantly higher in the BZ group compared with those in the N group(P＜0.05,P＜0.01),and serum creatinine and NAG levels were significantly different compared with those in the M group.The R value of tongue images was significantly lower in the BZ group compared with that in the N group(P＜0.01),while the B value was significantly higher(P＜0.05).The viscosity of the whole blood multi-shear rate and the hematocrit were higher in the BZ group compared with those in the N and M groups,and the platelet volume was higher than in the N group(P＜0.05,P＜0.01).Total cholesterol,low-density lipoprotein cholesterol,C-reactive protein,interleukin-6,and malondialdehyde levels were significantly increased in the BZ group compared with those in the N and M groups(P＜0.01),and superoxide dismutase activity was significantly decreased compared with that in the N group(P＜0.05).Renal tubule vacuolation,inflammatory cell infiltration,glomerular basement membrane thickening,collagen fiber hyperplasia,and lipid accumulation were evident,and renal cell apoptosis and transforming growth factor-β deposition were increased in the BZ group.There were 299 differential proteins in the BZ and N groups,including 180 up-regulated and 119 down-regulated proteins,and 323 differential metabolites,including 205 up-regulated and 118 down-regulated.Primary bile acid biosynthesis,taurine and hypotaurine metabolism,and biosynthesis of unsaturated fatty acids were co-enriched in differential proteins and differential metabolites,involving three differential proteins and nine differential metabolites.Among these,docosapentaenoic acid(22n-3),eicosapentaenoic acid,taurine,3-sulfinoalanine,taurocholic acid,Acnat1,Acnat2,and Hsd17b12 showed high prediction accuracy.Conclusions We successfully constructed an RF animal model of Qi deficiency and dampness stasis using the "cyclosporine A+high-fat diet+exhaustion of swimming+constant temperature and humidity" method.Biosynthesis of unsaturated fatty acids and taurine and hypotaurine metabolism may play important roles in this RF mouse model of Qi deficiency and dampness stasis.

Objective: This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade. Methods: A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy. Results: From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations. Conclusion Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.

Renal fibrosis， the final pathological outcome of end-stage chronic kidney diseases， is associated with inflammation， oxidative stress， epithelial-mesenchymal transdifferentiation （EMT）， and extracellular matrix deposition. It belongs to the categories of edema， ischuria， anuria and vomiting， and consumptive disease in traditional Chinese medicine （TCM）， with the key pathogenesis of Qi deficiency and blood stasis and the primary treatment principle of replenishing Qi and activating blood. Astragali Radix-Salviae Miltiorrhizae Radix et Rhizoma mainly contains astragalosides， polysaccharides， calycosin， salvianolic acid， and tanshinone， with the effect of tonifying Qi and activating blood. Studies have shown that this herb pair and its active components can delay the progress of renal fibrosis by regulating multiple signaling pathways. With consideration to the pathogenesis of Qi deficiency and blood stasis， this article reviews the research progress in the mitigation of renal fibrosis by Astragali Radix-Salviae Miltiorrhizae Radix et Rhizoma from the aspects of protecting glomerular filtration barrier， inhibiting EMT and mesangial cell proliferation， improving renal hemodynamics， and protecting renal function. Furthermore， the mechanisms were summarized. Specifically， Astragali Radix-Salviae Miltiorrhizae Radix et Rhizoma and its effective components can improve mitochondrial function and fatty acid metabolism， alleviate endoplasmic reticulum stress and autophagy disorders， and inhibit immune inflammation and oxidative stress by regulating nuclear factor E₂-related factor 2 （Nrf2）/PTEN-induced kinase 1 （Pink1）， Nrf2/antioxidant response element （ARE）， tumor necrosis factor-α （TNF-α）/nuclear transcription factor-κB （NF-κB）， miR-21/Smad7/transforming growth factor beta （TGF-β）， Wnt/β-catenin， long non-coding RNA-taurine up-regulated gene 1 （lncRNA-TUG1）/tumor necrosis factor receptor-associated factor 5 （TRAF5）， Ras-related C3 botulinum toxin substrate 1 （Rac1）/cell division cycle protein 42 （CDC42）， Ras homolog （Rho）/Rho-associated coiled-coil containing protein kinase （ROCK）， phosphatidylinositol-3-kinase （PI3K）/protein kinase B （Akt）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， peroxisome proliferator-activated receptor α （PPARα）/peroxisome proliferator-activated receptor γ coactivator l alpha （PGC-1α）， and p38 mitogen-activated protein kinase （p38 MAPK）. This review aims to provide references for the relevant research， give play to the role of Astragali Radix-Salviae Miltiorrhizae Radix et Rhizoma， and provide guidance for the clinical treatment of renal fibrosis.

Objective:To summarize the best evidence of thirst management in peripheral surgical patients in China, and to provide theoretical basis for clinical thirst management.Methods:According to the PIPOST model, research questions were raised. According to the "6S" model, literature published by various guide websites, evidence-based databases, original research databases and professional association websites at home and abroad from database establishment to January 30, 2022 were systematically retrieved. Two researchers independently evaluated the quality of the literature and extracted and integrated the evidence of the literature that met the quality standards. The research team graded the evidence and determined the recommendation level.Results:A total of 15 literatures were selected, including 2 systematic reviews, 3 clinical decisions and 10 randomized controlled trials (RCTS) . A total of 23 evidences were sorted out, including 8 aspects such as drug factors affecting thirst, thirst assessment tools, preoperative thirst intervention strategy, postoperative safe drinking water assessment, postoperative thirst intervention strategy, nursing observation, health education and precautions.Conclusions:In the absence of uniform standards for perioperative thirst management, the evidence summarized in this study can provide evidence-based evidence for clinical nursing work.

Objective:To investigate the changes in total radioactivity in patient body with differentiated thyroid carcinoma (DTC) after 131I treatment and the factors influencing its metabolism. Methods:The clinical data from 218 patients after DTC treatment in the Department of Nuclear Medicine, the Second Affiliated Hospital of Air Force Medical University from September 2021 to April 2022 were retrospectively analyzed. Based on administrated 131I dose, 171 patients were divided into low-dose group (≤ 3.7 GBq) and 47 into high-dose group (>3.7 GBq) . A whole body dynamic radiation monitoring system was used to measure the in vivo residual activity of 131I 24, 48 and 72 h after 131I administration and to explore their influencing factors. Results:24, 48 and 72 h after adimination of 131I, the residual activity of 131I in the low-dose group patients was significantly lower than in the high-dose group patients ( t= -7.46, -3.31, -2.01, P<0.05) . The discharge compliance rate at 24 and 48 h in the low-dose group was significantly higher than that in the high-dose group (21.0% vs. 4.3%, 98.2% vs. 89.4%, χ2 = 7.23, 5.91, P<0.05) , and all patients could meet the discharge criteria at 72 h. Univariate analysis showed that the residual 131I activity at 24 and 48 h was dependent on age, body mass index (BMI) , basal metabolism rate (BMR) and thyroid stimulating hormone (TSH) . As have been shown by multiple linear regression analysis, in the low-dose group, the older age, the higher BMR and the higher TSH level at 24 h tended to the higher 131I residual activity in the body. At 48 h, the higher BMI and the higher TSH level lead to the higher 131I residual activity in patient body. Meanwhile, in the high-dose group, the higher age and BMR at 24 h, tended to the higher in vivo131I residual activity. The influencing factors were analyzed in terms that 131I residual activity reaching 400 MBq in patient body at 24 and 36 h. The result showed that at 24 h the lower TSH level leaded to the lower 131I residual activity in patient body. At 36 h, the younger age, the lower TSH level, and the smaller 131I treatment dose tended to the lower in vivo131I residual activity. Conclusions:Age, BMI, BMR and TSH levels are the influencing factors for the change in total activity in patient body after 131I treatment of DTC. Radiation dose assessment based on the above indicators can provide a reference for adjusting the length of hospitalization time.

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

Objective To observe the clinical effect of information support on anxiety and depression of premature infants with maternal separation.Methods A total of 180 cases with premature delivery were selected as research objects,and were randomly divided into observation group (n =90) and control group (n =90).The control group was treated with nursing intervention,while the observation group was given information support.The anxiety score,depression score,milk secretion and milk return rate of postpartum women at different stages of postpartum were compared.Results After 20 d,the SAS and SDS scores of the two groups after nursing were significantly improved compared with postpartum 2 d (P ＜ 0.05).After 20 d,the SAS score and SDS score of the observation group were significantly lower than that of the control group (P ＜ 0.05).On postpartum 1,3,5d,maternal milk secretion was significantly higher than the day of surgery (P ＜ 0.05),and maternal milk secretion in the above period in the observation group was higher than the control group (P ＜0.05).Delectation rate in the observation group was 5.56％,and 35.56％ in the control group,there was statistically significant difference (P ＜ 0.05).Conclusion The information support can significantly improve the status of maternal anxiety and depression,improve the amount of milk,reduce delectation rate,so it is conducive to improving the overall quality of care.