Objective To identify key genes and potential therapeutic drugs associated with Alzheimer's disease(AD)based on microglial senescence using bioinformatics analysis,providing new targets and insights for AD diagnosis and treatment.Methods Gene expression datasets related to microglial senescence and AD,specifically GSE62420 and GSE74615,were downloaded from the Gene Expression Omnibus(GEO)database.Differential Expressed Genes(DEGs)were identified using R software.Functional enrichment analysis,including gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis,was performed using the DAVID online tool.The STRING database was used to construct the protein-protein interaction(PPI)network,and the CytoHubba plugin in Cytoscape software was applied to identify hub genes.The differential expression of hub genes was validated using the GSE129296 and GSE208386 datasets.Potential therapeutic drugs targeting these genes were predicted using the DSigDB database.Results A total of 35 DEGs,including 34 upregulated and 1 downregulated gene,were identified from the intersection of the GSE74615 and GSE62420 datasets.GO and KEGG enrichment analyses indicated that these DEGs were significantly involved in gene expression regulation,protein binding,metal ion binding,and the hypoxia-inducible factor 1(HIF-1)signaling pathway.PPI network analysis and CytoHubba screening identified ten hub genes:HIF1A,secreted phosphoprotein 1(SPP1),integrin alpha X(ITGAX),triggering receptor expressed on myeloid cells(TREM2),glycoprotein non-metastatic melanoma protein B(GPNMB),anexelekto receptor tyrosine kinase(AXL),Cystatin F(CST7),interleukin-12B(IL12B)、lipoprteinlipase(LPL)and fatty acid-binding protein 5(FABP5).Validation using the GSE129296 dataset showed that HIF1A,SPP1,ITGAX,TREM2,GPNMB,AXL,CST7 and FABP5 were significantly upregulated in microglia of AD mice,and the differences were statistically significant(t=8.411～29.49,all P<0.05).Further validation using the GSE208386 dataset indicated that LPL,SPP1,AXL and CST7 were significantly upregulated during microglial senescence,and the differences were statistically significant(t=4.755～5.964,all P<0.05).Based on these validation results,SPP1,AXL and CST7 were identified as key genes in AD.Drug prediction analysis using DSigDB revealed that potential therapeutic compounds targeting these genes exhibit anti-aging,anti-tumor,anti-inflammatory and DNA damage repair effects.Conclusion The key genes SPP1,AXL and CST7,identified based on microglial senescence,may serve as potential biomarkers for AD.Furthermore,multiple potential therapeutic drugs were predicted,offering new targets and strategies for AD diagnosis and treatment.

Objective To construct an animal model of post-stroke depression(PSD)based on the theory of"depression,stasis,phlegm",with the aim of developing and validating an objective assessment system.Methods Rats were divided randomly into five groups:control,depression,stroke,PSD,and Baishile decoction groups.A PSD syndrome-based animal model was established in rats using a combination of middle cerebral artery occlusion(MCAO)and chronic unpredictable mild stress(CUMS)."Depression,stasis,phlegm"were then evaluated in the model rats using the Morris water maze,open field,forced swimming,and sucrose preference tests,and by detection of neurotransmitter levels,brain tissue pathology,tongue and forepaw color RGB values,and blood rheology.Results PSD rats exhibited significantly shorter target quadrant dwelling times,platform crossings,and climbing and rearing frequencies,a significantly lower sucrose preference,and a significantly higher immobility time in the forced swim test compared with control rats.Hematoxylin and eosin and Nissl staining revealed brain tissue damage in PSD rats.Serum and cerebrospinal fluid levels of 5-hydroxytryptamine(5-HT)were significantly decreased,glutamate levels were significantly increased,and tongue and forepaw RGB values were all decreased.Blood rheology showed a hypercoagulable state and blood lipid metabolism-related indicators were significantly abnormal.Rats in the Baishile decoction group showed significant improvements compared with the PSD group,including increased target quadrant dwelling times,number of platform crossings,and climbing and rearing frequencies,increased sucrose preference,decreased immobility time in the forced swim test,improved brain tissue pathology,increased serum and cerebrospinal fluid levels of 5-HT,decreased glutamate levels,increased tongue and claw RGB values,and varying degrees of improvement in blood rheology and blood lipid metabolism-related indicators.Conclusions The combination of MCAO and CUMS successfully established a syndrome-based animal model of PSD exhibiting the characteristics of"depression,stasis,phlegm",with corresponding objective assessment criteria.

Objective To compare the clinical and functional differences between transoral and submandibular approach in mandibu-lar segmental resection and reconstruction with free fibula flaps(FFFs).Methods Patients who underwent mandibular segmental re-section and FFFs reconstruction in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanjing Medical University from January 2015 to March 2023 were retrospectively analyzed.All cases were divided into transoral approach and submandibular approach groups.Clinical characteristics of the patients were recorded including age,gender,follow-up time,pathologi-cal diagnosis,body mass index(BMI),American Society of Anesthesiologists(ASA)classification,James Brown classification of mandibular defect and number of fibular segments.The perioperative indexes,such as average operation time,average bleeding vol-ume,average blood transfusion volume,average drainage volume,average hospitalization time and postoperative complications such as malocclusion,fistula,infection,flap failure,and restriction of mouth opening were compared between the two groups.The University of Washington Quality of Life Questionnaire was used to investigate the appearance,function of swallow and speech more than 6-month postoperatively.Results The average intraoperative bleeding and postoperative drainage were significantly lower in the transoral ap-proach group than in the submandibular approach group(P=0.013 9,P=0.001 9).The appearance score was significantly higher in the transoral approach group than in the submandibular approach group(83.52±12.37)vs.(67.19±13.64)(P＜0.000 1).The differ-ences between the two groups in other variables were not statistically significant.Conclusion Cases of transoral approach had signifi-cantly better aesthetic outcomes compared with those of submandibular approach.

Objective To develop a postoperative precision nursing program for children with obstructive sleep apnea-hypopnea syndrome(OSAHS),so as to provide references for the improvement of nursing quality for children with OSAHS.Methods Literature in precision nursing for children with OSAHS was systematically reviewed and summarised based on precision nursing theory and a postoperative precision nursing program was drafted.Using the Delphi's Method,two rounds of expert consultation were conducted and the postoperative precision nursing program for children with OSAHS was revised and finalised.Results The response rates of the two rounds of expert consultation were 100.00%with the expert authority coefficient of 0.875.The Kendall coefficient of concordance(W)of levels 1,2 and 3 indices in the second round of expert consultation were 0.289,0.203,0.187,respectively(all P<0.01).The importance score of each inclicator ranged from 4.50～4.94.The coefficient of variations for the three-level indices ranged from 0.05 to 0.21.The finalised program composed 8 level-1 indices(postoperative position assessment,intervention,prevention and care of bleeding,maintaining postoperative airway patency,postoperative nausea and vomiting care,postoperative pain assessment and care,dietary care,complication prevention and care,discharge guidance),16 level-2 indices,and 22 level-3 indices.Conclusion The postoperative precision nursing program for the children with OSAHS is scientific,innovative and applicable.It provides clinical references for nursing of the children with OSAHS.

Objective:To gain an in-depth understanding of the barriers to active management in elderly patients with chronic heart failure (CHF) and to provide evidence for targeted interventions.Methods:A descriptive qualitative research method was adopted. Using purposive sampling, a total of 14 elderly CHF patients admitted to the Department of Cardiovascular Medicine, the First Affiliated Hospital of Bengbu Medical College, from January to February 2025 were selected as study participants. Based on the Theoretical Domains Framework (TDF), a semi-structured in-depth interview guide was developed. NVivo 12.0 software was used to organize and code the data, and directed content analysis was applied.Results:Eight TDF-related domains of barriers were identified and summarized into four themes: misconceptions of disease and information processing barriers (knowledge; memory, attention, and decision processes) ; dependence on family members and limited accessibility of medical resources (social influence; environmental context and resources) ; negative goal motivation and low management confidence (goals; beliefs about consequences and capabilities) ; and emotional management obstacles and fatigue from self-regulation (emotion) .Conclusions:On the basis of meeting elderly CHF patients' knowledge needs, healthcare professionals should expand their access to information, improve social support systems, stimulate intrinsic motivation and self-efficacy, and alleviate negative emotions and fatigue related to self-regulation, thereby enhancing the positivity of self-health management and achieving sustainability in health management.

Objective The aim of this study was to explore the predictive value of the systemic inflammatory immune nutri-tion score(SIINS)for the prognosis of immunotherapy for advanced gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 202 patients with advanced gastric cancer who received treatment with programmed death-1(PD-1)inhibitors at the Harbin Medical University Cancer Hospital from October 2018 to July 2022.The LASSO regression analysis was used to screen prognostic indicators,construct SIINS indicator,determine the optimal cutoff value for predicting prognosis using subject operating characteristic curves,and divide patients into the high SIINS and low SIINS groups.Independent prognostic factors for overall survival(OS)were determined using univariate and multivariate Cox regression analyses.Results Four indicators,including lymphocyte count,lactate dehydrogenase,and neutrophil lymphocytes,were selected to construct the SIINS index.The prognosis of patients in the high SIINS group was significantly lower than that in the low SIINS group(P<0.05).The results of the multifactorial Cox regression a-nalysis showed that the Eastern Cooperative Oncology Group(ECOG)score,Geriatric Nutritional Risk Index(GNRI),SIINS,treatment regimen,and number of treatment lines(P<0.05)could serve as the independent predictive prognosis of immunotherapy for advanced gastric cancer.Conclusion SIINS can predict the prognosis of patients with advanced gastric cancer treated with PD-1 inhibitors.

Objective To analyze and clarify the concept of family communication collective efficacy in hospitalized patients.Methods A systematic search was conducted in databases including China National Knowledge Infrastructure(CNKI),VIP Database,WanFang Database,PubMed Database and Web of Science(WOS)for studies related to family communication efficacy.The search timeframe spanned from the inception of each database to December 2024.Rodgers'evolutionary concept analysis method was applied to analyze the retrieved literature.Results A total of 40 articles were included.The analysis shows that the evolution process of the concept of family collective communication efficacy in hospitalized patients was introduced,encompassing the evolution of the family communication concept and the intersection and integration of family systems theory and collective efficacy theory.Family communication collective efficacy in hospitalized patients was characterized by four attributes:shared beliefs,emotional support,role allocation and coordination,and an integrated communication system.Its antecedents included factors such as sources of efficacy information,family member characteristics,and family team characteristics.The consequences were observed at three levels:individual,family,and healthcare system,including manifesting as bidirectional influences on individual health outcomes,family functioning,and healthcare quality improvement.Conclusions The core attributes of family communication collective efficacy in hospitalized patients were clarified through concept analysis.In the future,localized assessment tools should be developed based on these attributes to facilitate the implementation and evaluation of interventions aimed at enhancing family communication collective efficacy.

Objective To analyze the influence of Dapagliflozin on ventricular remodeling,soluble suppression of tumorigenicity-2(sST2)and brain natriuretic peptide(BNP)in patients with elderly ST-segment elevation myocardial infarction(STEMI)complicated with type 2 diabetes mellitus(T2DM)after percutaneous coronary intervention(PCI).Methods From April 2021 to March 2023,118 elderly patients with STEMI complicated with T2DM treated by PCI were selected from People's Hospital of Hengshui.They were divided into conventional hypoglycemic therapy control(Con,n=59)group and conventional hypoglycemic therapy combined with Dapagliflozin(Dap,n=59)group according to the treatment strategy.All the participants were treated for 24 weeks.The general data,biochemical indexes,BNP,N-terminal pro-B-type natriuretic peptide(NT-proBNP),soluble growth stimulating expression factor 2(sST2)and lipoprotein-associated phospholipase A2(LP-PLA2),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and left ventricular mass index(LVMI)were compared between the two groups.Results After 24 weeks of treatment,the BNP,NT-proBNP,fasting plasma glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),LVEDD,LVESD,LVMI,serum sST2 and LP-PLA2 were lower in Dap group than in Con group(P<0.05),while the LVEF was higher in Dap group than in Con group(P<0.05).The total incidence rate of major adverse cardiovascular events was significantly lower in Dap group than in Con group(P<0.05).The incidence rates of adverse drug reactions were 6.78%and 5.08%in the two groups respectively(P>0.05).Conclusions Dapagliflozin can improve the cardiac function and glucose metabolism status in elderly patients with STEMI and T2DM after PCI,and alleviate the ventricular remodeling,with good safety.

Objective The aim of this study was to explore the predictive value of the systemic inflammatory immune nutri-tion score(SIINS)for the prognosis of immunotherapy for advanced gastric cancer.Methods A retrospective analysis was conducted on the clinical data of 202 patients with advanced gastric cancer who received treatment with programmed death-1(PD-1)inhibitors at the Harbin Medical University Cancer Hospital from October 2018 to July 2022.The LASSO regression analysis was used to screen prognostic indicators,construct SIINS indicator,determine the optimal cutoff value for predicting prognosis using subject operating characteristic curves,and divide patients into the high SIINS and low SIINS groups.Independent prognostic factors for overall survival(OS)were determined using univariate and multivariate Cox regression analyses.Results Four indicators,including lymphocyte count,lactate dehydrogenase,and neutrophil lymphocytes,were selected to construct the SIINS index.The prognosis of patients in the high SIINS group was significantly lower than that in the low SIINS group(P<0.05).The results of the multifactorial Cox regression a-nalysis showed that the Eastern Cooperative Oncology Group(ECOG)score,Geriatric Nutritional Risk Index(GNRI),SIINS,treatment regimen,and number of treatment lines(P<0.05)could serve as the independent predictive prognosis of immunotherapy for advanced gastric cancer.Conclusion SIINS can predict the prognosis of patients with advanced gastric cancer treated with PD-1 inhibitors.

Objective To evaluate the effectiveness of the PDCA cycle in critical value management.Methods PDCA cycle method was applied to manage critical values in an occupational disease hospital.Critical value data from October 2021 to March 2022 were analyzed to identify root causes,followed by corrective measures development and implementation.Post-inter-vention data,from July 2022 to November 2022,were compared with the pre-management data to evaluate the implementation effect of the PDCA cycle on critical value management.Results The application of the PDCA cycle led to a statistically signifi-cant increase in the execution compliance rate for emergency value execution in medical and technical departments increased to 100.00％,and in the clinical departments to 96.77％(P＜0.05).Conclusion PDCA cycle can improve the qualified rate of the implementation of critical value system,ensure patients safety,significantly reduce medical risks,and advance the level of standardization and precision in critical value management within our hospital.