ObjectiveTo observe the effect of rehabilitation robot training on abdominal muscles thickness and balance ability in children with hemiplegia. MethodsFrom October, 2024 to December, 2025, 58 children with hemiplegia were admitted to Beijing Bo'ai Hospital and randomly divided into control group (n = 29) and experimental group (n = 29). Both groups received conventional rehabilitation treatment, and the experimental group received rehabilitation robot training in addition, for four weeks. The thickness of bilateral external oblique, internal oblique and transversus abdominis, Berg Balance Scale (BBS) score, the time of Timed Up and Go Test (TUGT), the center of pressure (COP) ellipse area, and self-selected walking speed (SWS) and maximum walking speed (MWS) of 10-meter walk test were compared before and after training. ResultsThree cases dropped out in each group. After training, the thickness of the external oblique, internal oblique and transverse abdominis on the hemiplegic side increased significantly in the experimental group (|t| > 7.280, P < 0.001, Cohen's d = 1.43~2.01), and was better in the experimental group than in the control group (|t| > 2.895, P < 0.01, Cohen's d = 0.80~1.60); the BBS score increased in both groups (|t| > 6.667, P < 0.001, Cohen's d = 1.30~4.06), and was better in the experimental group than in the control group (t = -2.721, P < 0.01, Cohen's d = 0.75). The time of TUGT decreased in both groups (t > 5.790, P < 0.001, Cohen's d = 1.14~2.68), and was better in the experimental group than in the control group (t = 2.290, P < 0.05, Cohen's d = 0.63). The SWS and MWS increased in both groups (|Z| > 2.910, P < 0.01, r = 0.40~0.68), and were better in the experimental group than in the control group (|Z| > 2.912, P < 0.05, r = 0.40~0.45), and the differences remained significant after correction. ConclusionRehabilitation robot training can improve the thickness of external oblique, the internal oblique and transversus abdominis muscles on the hemiplegic side in children with hemiplegia, and improve their balance and walking functions.

Objective To explore the effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia.Methods From October,2023 to January,2025,a total of 52 children with hemiplegia admitted to Beijing Bo'ai Hospital were randomly divided into control group(n=26)and observation group(n=26).Both groups received conven-tional rehabilitation therapy,while the observation group additionally received Lokomat robotic-assisted gait training,for four weeks.Before and after intervention,the self-selected walking speed(SWS)and maximum walking speed(MWS)of 10-meter Walk Test,6-minute walking distance(6MWD),Physiological Cost Index(PCI),as well as gait line length asymmetry ratio,single support line asymmetry ratio,stance phase asymmetry ratio and step length ratio were compared.Results After intervention,SWS,MWS and 6MWD improved in both groups(|Z|>2.910,P<0.01),and were better in the the observation group than in the control group(|Z|>2.069,P<0.05);PCI significantly decreased in both groups(|Z|>4.458,P<0.001),and was lower in the observation group than in the control group(Z=-2.435,P<0.05);the gait line length asymmetry ratio,single support line asymmetry ratio and stance phase asymmetry ratio improved in both groups(Z=3.398,|t|>2.211,P<0.05),and were better in the observation group than in the control group(Z=2.802,|t|>2.107,P<0.05).Conclusion Lokomat robotic-assisted gait training can effectively improve walking speed and endurance in children with hemiplegia,reduce energy expenditure,enhance walking efficiency,and promote gait symmetry,thereby fa-cilitating symmetrical gait patterns.

Objective To explore the effect of Lokomat robotic-assisted gait training on lower limb motor function in children with hemiplegia.Methods From October,2023 to January,2025,a total of 52 children with hemiplegia admitted to Beijing Bo'ai Hospital were randomly divided into control group(n=26)and observation group(n=26).Both groups received conven-tional rehabilitation therapy,while the observation group additionally received Lokomat robotic-assisted gait training,for four weeks.Before and after intervention,the self-selected walking speed(SWS)and maximum walking speed(MWS)of 10-meter Walk Test,6-minute walking distance(6MWD),Physiological Cost Index(PCI),as well as gait line length asymmetry ratio,single support line asymmetry ratio,stance phase asymmetry ratio and step length ratio were compared.Results After intervention,SWS,MWS and 6MWD improved in both groups(|Z|>2.910,P<0.01),and were better in the the observation group than in the control group(|Z|>2.069,P<0.05);PCI significantly decreased in both groups(|Z|>4.458,P<0.001),and was lower in the observation group than in the control group(Z=-2.435,P<0.05);the gait line length asymmetry ratio,single support line asymmetry ratio and stance phase asymmetry ratio improved in both groups(Z=3.398,|t|>2.211,P<0.05),and were better in the observation group than in the control group(Z=2.802,|t|>2.107,P<0.05).Conclusion Lokomat robotic-assisted gait training can effectively improve walking speed and endurance in children with hemiplegia,reduce energy expenditure,enhance walking efficiency,and promote gait symmetry,thereby fa-cilitating symmetrical gait patterns.

ObjectiveTo investigate the contamination status, transmission risk and drug resistance of Klebsiella pneumoniae (KP) on the object surfaces in the surrounding environment of hospitalized patients infected with carbapenem-resistant Klebsiella pneumoniae (CRKP) , so as to provide a scientific guidance for the prevention and control of healthcare-associated infection. MethodsSamples from the surfaces of objects in the surrounding environment of CRKP infected patients living in the intensive care unit (ICU) and hand specimens from healthcare workers were collected for KP isolation and identification, as well as drug susceptible test in a medical institution located in Minhang District, Shanghai from 2021 to 2023. Additionally, both univariate and multivariate logistic regression analyses were used to identify the influencing factors associated with KP contamination in the hospital environment. ResultsA total of 546 surface samples were collected from the surrounding environment objects of 15 patients infected with CRKP, with a KP detection rate of 6.59% (36/546).The KP detection rate in the ICU of general ward (10.22%) was higher than that in the ICU of emergency department (2.94%) (χ²=12.142, P<0.001). Moreover, the KP detection rate on the surfaces of patient-contacted items (15.66%) was higher than that on shared-use items (6.25%), cleaning items (10.00%), and medical supplies (3.30%) (χ²=17.943, P<0.001). Besides, the detection rate of KP in items sent out of hospital for disinfection (15.38%) was higher than that in those self-disinfected (4.20%) (χ²=19.996, P<0.001).The highest detection rate of KP was observed in high-temperature washing (15.13%, 18/119) (χ²=21.219, P<0.001), while the lowest detection rate was observed in antibacterial hand sanitizer with trichlorohydroxydiphenyl ether sanitizing factor (0, 0/60) ( χ²=21.219, P<0.001).The detection rate of KP in samples taken more than 24 hours after the last disinfection (23.08%) was higher than that in those taken at 4 to24 hours (12.90%) and less than 4 hours (4.22%) (χ²=23.398,P<0.001).ICU of general ward (OR=4.045, 95%CI: 2.206‒7.416), patient-contacted items (OR=3.113, 95%CI: 1.191‒8.141), and self-disinfection ( OR=0.241, 95%CI:0.144‒0.402) were influencing factors for KP contamination in environmental surface. From 2021 to 2023, the drug resistance rates of hospital environmental KP isolates showed an upward trend (P<0.001) to antibiotics such as ceftazidime and gentamicin. Furthermore, high drug resistance rates of KP (>90%) were observed to ciprofloxacin, levofloxacin, cefotaxime, ceftriaxone, and cefepime. ConclusionCRKP can be transmitted outward through the surfaces of objects in the patients’ surroundings, and the drug resistance situation is severe. In clinical settings, it is necessary to implement isolation measures for CRKP infection patients, to increase the frequency of disinfection for objects in their surroundings, to strengthen hand hygiene practices, and to use antibiotics appropriately.

This study investigated the role of the nuclear factor of activated T cells c3 (NFATc3) in vascular smooth muscle cells (VSMCs) during aortic aneurysm and dissection (AAD) progression and the underlying molecular mechanisms. Cytoplasmic and nuclear NFATc3 levels were elevated in human and mouse AAD. VSMC-NFATc3 deletion reduced thoracic AAD (TAAD) and abdominal aortic aneurysm (AAA) progression in mice, contrary to VSMC-NFATc3 overexpression. VSMC-NFATc3 deletion reduced extracellular matrix (ECM) degradation and maintained the VSMC contractile phenotype. Nuclear NFATc3 targeted and transcriptionally upregulated matrix metalloproteinase 9 (MMP9) and MMP2, promoting ECM degradation and AAD development. NFATc3 promoted VSMC phenotypic switching by binding to eukaryotic elongation factor 2 (eEF2) and inhibiting its phosphorylation in the VSMC cytoplasm. Restoring eEF2 reversed the beneficial effects in VSMC-specific NFATc3-knockout mice. Cabamiquine-targets eEF2 and inhibits protein synthesis-inhibited AAD development and progression in VSMC-NFATc3-overexpressing mice. VSMC-NFATc3 promoted VSMC switch and ECM degradation while exacerbating AAD development, making it a novel potential therapeutic target for preventing and treating AAD.

Increasing evidence has revealed an unexpected localization of mature microRNA(miRNA)in the nucleus,exerting additional and broader functions.These findings differ from the traditional view that miRNAs in the cyto-plasm inhibit gene expression through their canonical regulation via post-transcriptional mechanisms.Metabolic diseases involve multiple organs throughout the body and rely highly on miRNA regulation.Notably,recent studies have demon-strated the newly discovered nuclear function of miRNA in regulating metabolic dysfunction-associated pathological pro-cesses.In this review,according to the classification of metabolic diseases,we summarize the current knowledge on nuclear miRNA non-canonical regulation including their working modes and potential targets,such as directly binding on gene pro-moters,noncoding RNA,or proteins,etc.,to suggest a viable strategy for the treatment of metabolic diseases.

Increasing evidence has revealed an unexpected localization of mature microRNA(miRNA)in the nucleus,exerting additional and broader functions.These findings differ from the traditional view that miRNAs in the cyto-plasm inhibit gene expression through their canonical regulation via post-transcriptional mechanisms.Metabolic diseases involve multiple organs throughout the body and rely highly on miRNA regulation.Notably,recent studies have demon-strated the newly discovered nuclear function of miRNA in regulating metabolic dysfunction-associated pathological pro-cesses.In this review,according to the classification of metabolic diseases,we summarize the current knowledge on nuclear miRNA non-canonical regulation including their working modes and potential targets,such as directly binding on gene pro-moters,noncoding RNA,or proteins,etc.,to suggest a viable strategy for the treatment of metabolic diseases.

Objective To study microbial characteristics of pulmonary in children with community-acquired pneumonia(CAP)of different severity,in order to provide a basis for accurate diagnosis and antibiotic treatment of pneumonia children,and provide new strategies and perspectives for the diagnosis and treatment of pulmonary microbiota in pneumonia children.Methods Bronchoalveolar lavage fluid(BALF)from 64 children with CAP of different severity hospitalized in Department of Pediatrics,Jingmen People's Hospital were collected from January to December 2023,the children were divided into severe pneumonia group(n=34)and common pneumonia group(n=30).Microbiome information of the lungs of children with CAP of different severity were obtained through metagenomic sequencing of BALF,microbial structure diversity analysis,species classification analysis,and differential analysis on the microbial bioinformatics data of two groups of samples obtained were performed.Results Alpha diversity analysis showed that there were statistically significant differences(P<0.05)in the Chao1 index,ACE index,Shannon index,and Simpson index between two groups.The principal coordinate analysis(PCoA)of Beta diversity showed a statistically significant difference in the composition of microbial communities between two groups(F=4.221,P=0.005).Through species classification analysis,it was found that at the genus level,mycoplasma was the main genus in the BALF samples of severe pneumonia group,followed by Streptococcus and Haemophilus,Streptococcus was the main genus in the BALF samples of common pneumonia group,followed by Mycoplasma and Haemophilus.Children of two groups showed statistically significant differences in microbial abundance among the top 20 species at the genus level(P<0.05),including Mycoplasma,Streptococcus,Rhodococcus,Neisseria,Prevotella,Corynebacterium,and Pseudomonas.Species diversity analysis showed that at the genus level,there were 47 species with differences(P<0.05).Conclusion There are differences in the abundance,diversity,structure,and composition of pulmonary microbiota in children with CAP of different severity.The dominant microbiota varies among children with CAP of different severity.This study enriches the pulmonary microbiome data of children with CAP.

Objective To study microbial characteristics of pulmonary in children with community-acquired pneumonia(CAP)of different severity,in order to provide a basis for accurate diagnosis and antibiotic treatment of pneumonia children,and provide new strategies and perspectives for the diagnosis and treatment of pulmonary microbiota in pneumonia children.Methods Bronchoalveolar lavage fluid(BALF)from 64 children with CAP of different severity hospitalized in Department of Pediatrics,Jingmen People's Hospital were collected from January to December 2023,the children were divided into severe pneumonia group(n=34)and common pneumonia group(n=30).Microbiome information of the lungs of children with CAP of different severity were obtained through metagenomic sequencing of BALF,microbial structure diversity analysis,species classification analysis,and differential analysis on the microbial bioinformatics data of two groups of samples obtained were performed.Results Alpha diversity analysis showed that there were statistically significant differences(P<0.05)in the Chao1 index,ACE index,Shannon index,and Simpson index between two groups.The principal coordinate analysis(PCoA)of Beta diversity showed a statistically significant difference in the composition of microbial communities between two groups(F=4.221,P=0.005).Through species classification analysis,it was found that at the genus level,mycoplasma was the main genus in the BALF samples of severe pneumonia group,followed by Streptococcus and Haemophilus,Streptococcus was the main genus in the BALF samples of common pneumonia group,followed by Mycoplasma and Haemophilus.Children of two groups showed statistically significant differences in microbial abundance among the top 20 species at the genus level(P<0.05),including Mycoplasma,Streptococcus,Rhodococcus,Neisseria,Prevotella,Corynebacterium,and Pseudomonas.Species diversity analysis showed that at the genus level,there were 47 species with differences(P<0.05).Conclusion There are differences in the abundance,diversity,structure,and composition of pulmonary microbiota in children with CAP of different severity.The dominant microbiota varies among children with CAP of different severity.This study enriches the pulmonary microbiome data of children with CAP.

Acute pancreatitis （AP） is a common clinical acute abdominal disease， which is characterized by acute onset， rapid development， severe disease， many complications， and high mortality rate. It can progress to severe AP （SAP） if not treated promptly in the early stage. The pathogenesis of AP is complex and involves multiple cellular and molecular levels. It is now clear that oxidative stress and reactive oxygen species （ROS） production are involved in the physiopathological process of AP， which is associated with a low quantity and activity of antioxidant enzymes in pancreatic cells. Nuclear factor E₂-related factor 2 （Nrf2） serves as the ''golden key'' to maintain redox homeostasis in tissue cells and constitutes an important signaling pathway for antioxidant response and inflammation in vivo by collaborating with downstream antioxidant enzymes such as heme oxygenase-1 （HO-1）. Traditional Chinese medicine has unique efficacy in treating diseases due to its multi-component， multi-target， multi-drug delivery， and multi-formulation characteristics. Based on the concept of synergy between traditional Chinese and Western medicine， traditional Chinese medicine is becoming a new craze in the treatment of AP. The level of oxidative stress and Nrf2/HO-1 signaling pathway in AP pancreatic tissue are in a dynamic change process， and the intervention of traditional Chinese medicine can clean ROS production， affect the inflammatory pathway， and reduce oxidative stress damage， so as to protect against pancreatic injury. This suggests that this pathway plays an important role in AP. This article reviews the recent literature on the regulation of the Nrf2/HO-1 signaling pathway by traditional Chinese medicine for AP and summarizes that the monomers of traditional Chinese medicine targeting this pathway are mainly heat-clearing and detoxifying， blood-activating and blood-stasis-removing， and Qi benefiting and middle warming， and the compounds of traditional Chinese medicine include Yinchenhao Decoction and QingYi Ⅱ， so as to provide a new direction for the prevention and treatment of AP and further drug development.