Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

Objective:To study the diagnostic value and correlation of contrast-enhanced ultrasound time-intensity curve in the main pathological features of cervical cancer.Methods:From August 2021 to August 2023, 100 patients with cervical cancer and 100 patients with benign cervical tumors examined in Dingzhou People’s Hospital were selected for study. Patients with benign cervical tumors were included in the control group, and patients with cervical cancer were included in the observation group.The two groups of patients were examined by PHILIPS EPIQ7 C color Doppler ultrasound diagnostic instrument and PHILIPS EPIQ5 color Doppler ultrasound diagnostic instrument to obtain the quantitative parameters of the time-intensity curve of the two groups. The bivariate Spearman correlation test was used to analyze the main pathological features of cervical cancer patients (lesion diameter, pathological type, vascular invasion, lymph node metastasis, differentiation degree, clinical stage) and the correlation between radiotherapy and chemotherapy and the acquisition of time-intensity curve. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of the time-intensity curve.Results:The time to peak (TTP) value of the cervical cancer group was lower than that of the control group, and the peak intensity (PI) and maximum peak intensity ratio (PI/PIc) values were higher than those of the control group, the differences were statistically significant ( P<0.05). Compared with patients with non-squamous cell carcinoma, vascular invasion < 1/2, no lymph node metastasis, moderate to high differentiation, stage I-II, and after radiotherapy and chemotherapy, patients with squamous cell carcinoma, vascular invasion ≥ 1/2, lymph node metastasis, low differentiation, stage III-IV, and before radiotherapy and chemotherapy had lower TTP values, higher PI and PI/PIc values, and the differences were statistically significant ( P<0.05). Pathological type, vascular invasion, lymph node metastasis, differentiation degree and clinical stage were negatively correlated with TTP, and positively correlated with PI and PI/PIc ( P<0.05) .Chemoradiotherapy was positively correlated with TTP, and negatively correlated with PI and PI/PIc ( P<0.05). The sensitivity and specificity of combined detection of time intensity curve were higher than those of TTP, PI, PI/Ic, area under curve (AUCTC) and mean transit time (MTT), and the differences were statistically significant ( P<0.05). The AUC values of combined detection of TTP, PI, PI/PIc and time intensity curve were all > 0.85, and the diagnostic value was high. Conclusions:The time-intensity curve of contrast-enhanced ultrasound is closely related to the main pathological features of cervical cancer, such as pathological type, lymph node metastasis and staging. According to the changes, the effect of radiotherapy and chemotherapy can be judged, which can provide a good reference for the diagnosis and treatment of cervical cancer.

Objective:To analyze the preventive effect of stratified combination nursing guided by Connelly pediatric thrombosis risk model on venous thromboembolism (VTE) in children with traumatic fractures, and provide a theoretical basis for reducing the risk of VTE occurrence.Methods:A randomized controlled trial was conducted, and 94 children with traumatic fractures admitted to Beijing Jishuitan Hospital, Capital Medical University from January to June 2023 were selected as research subjects by convenience sampling method. According to the time of admission, the 47 children admitted from January to March 2023 were included in the control group, and the 47 children admitted from April to June 2023 were included in the observation group. The control group was treated with routine nursing, and the observation group was treated with stratified combination nursing guided by Connelly pediatric thrombosis risk model. The deep vein thrombosis (DVT), VTE, hospitalization related indicators (time to first get out of bed, length of hospital stay and other complications) were compared between the two groups. The platelet count (PLT) and D-dimer levels were compared between the two groups after 1 week of intervention. The scores of the Newcastle Nursing Satisfaction Scale (NSNS) were compared between the family members of two groups sick children.Results:There were 29 males and 18 females in the control group, aged (9.09 ± 1.59) years, and 32 males and 15 females in the observation group, aged (9.34 ± 1.46) years. The total incidence of VTE in the observation group was 2.13% (1/47), which was lower than 12.77% (6/47) in the control group, and the difference was statistically significant ( χ2=3.86, P<0.05). After intervention, the levels of PLT and D-dimer in the control group and observation group were (173.26 ± 20.16)×10 9/L, (168.56 ± 19.66)×10 9/L, (0.40 ± 0.12) mg/L and (0.36 ± 0.10) mg/L, which were lower than (202.71 ± 24.51)×10 9/L, (203.15 ± 25.26) × 10 9/L, (1.19 ± 0.14) mg/L, (1.15 ± 0.11) mg/L before intervention, and the differences were statistically significant ( t values were 6.36 to 36.43, all P<0.05). The time to first get out of bed and the length of hospital stay were (2.21 ± 0.55) and (6.21 ± 1.54) in the control group, and (1.76 ± 0.45) and (5.13 ± 1.21) in the observation group, respectively, and the differences between the two groups were statistically significant ( t=4.34, 3.78, both P<0.05). The total incidence of other complications was 17.02% (8/47) in the control group and 4.26% (2/47) in the observation group, and the difference between the two groups was statistically significant ( χ2=4.03, P<0.05). The satisfaction of family members in the control group was 78.72% (37/47) and 93.62% (44/47) in the observation group, and the difference of sick children between the two groups was statistically significant ( χ2=4.37, P<0.05). Conclusions:Stratified combination nursing guided by Connelly's thrombosis risk model in children can improve the level of D-dimer and PLT, reduce the occurrence of VTE, and shorten the first time of children getting out of bed and staying in hospital, which is conducive to postoperative rehabilitation of children with traumatic fractures.

Objective:To adapt the Mindful Breastfeeding Scale (MINDF-BFS) into Chinese and assess its reliability and validity among breastfeeding mothers in China.Methods:Following the Beaton cross-cultural adaptation guideline, the original scale was translated, back-translated, discussed by experts, pre-tested, culturally adapted, and revised to develop the Chinese version of the MINDF-BFS. A convenience sampling method was used to select 305 postpartum women from Guangzhou Women and Children's Medical Center, Guangzhou Medical University, who visited between March and June 2024, as the study participants. The reliability and validity of the Chinese version of MINDF-BFS were evaluated.Results:The Chinese version of MINDF-BFS consisted of nine items, with the item-level content validity index ranged from 0.900 to 1.000, and the average scale-level content validity index was 0.990. Exploratory factor analysis extracted one common factor, with a variance contribution of 73.290%. Confirmatory factor analysis showed a good model fit. The Cronbach's α coefficient for the scale was 0.923, the split-half reliability coefficient was 0.915, and the test-retest reliability coefficient was 0.926.Conclusions:The Chinese version of MINDF-BFS has good psychometric properties and is suitable for assessing the mindful breastfeeding levels of Chinese postpartum women.

Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

Objective:To study the diagnostic value and correlation of contrast-enhanced ultrasound time-intensity curve in the main pathological features of cervical cancer.Methods:From August 2021 to August 2023, 100 patients with cervical cancer and 100 patients with benign cervical tumors examined in Dingzhou People’s Hospital were selected for study. Patients with benign cervical tumors were included in the control group, and patients with cervical cancer were included in the observation group.The two groups of patients were examined by PHILIPS EPIQ7 C color Doppler ultrasound diagnostic instrument and PHILIPS EPIQ5 color Doppler ultrasound diagnostic instrument to obtain the quantitative parameters of the time-intensity curve of the two groups. The bivariate Spearman correlation test was used to analyze the main pathological features of cervical cancer patients (lesion diameter, pathological type, vascular invasion, lymph node metastasis, differentiation degree, clinical stage) and the correlation between radiotherapy and chemotherapy and the acquisition of time-intensity curve. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of the time-intensity curve.Results:The time to peak (TTP) value of the cervical cancer group was lower than that of the control group, and the peak intensity (PI) and maximum peak intensity ratio (PI/PIc) values were higher than those of the control group, the differences were statistically significant ( P<0.05). Compared with patients with non-squamous cell carcinoma, vascular invasion < 1/2, no lymph node metastasis, moderate to high differentiation, stage I-II, and after radiotherapy and chemotherapy, patients with squamous cell carcinoma, vascular invasion ≥ 1/2, lymph node metastasis, low differentiation, stage III-IV, and before radiotherapy and chemotherapy had lower TTP values, higher PI and PI/PIc values, and the differences were statistically significant ( P<0.05). Pathological type, vascular invasion, lymph node metastasis, differentiation degree and clinical stage were negatively correlated with TTP, and positively correlated with PI and PI/PIc ( P<0.05) .Chemoradiotherapy was positively correlated with TTP, and negatively correlated with PI and PI/PIc ( P<0.05). The sensitivity and specificity of combined detection of time intensity curve were higher than those of TTP, PI, PI/Ic, area under curve (AUCTC) and mean transit time (MTT), and the differences were statistically significant ( P<0.05). The AUC values of combined detection of TTP, PI, PI/PIc and time intensity curve were all > 0.85, and the diagnostic value was high. Conclusions:The time-intensity curve of contrast-enhanced ultrasound is closely related to the main pathological features of cervical cancer, such as pathological type, lymph node metastasis and staging. According to the changes, the effect of radiotherapy and chemotherapy can be judged, which can provide a good reference for the diagnosis and treatment of cervical cancer.

To understand the epidemiological characteristics and antimicrobial resistance of Esche-richia coli in free-range Tibetan pig populations,fecal samples from these pigs were collected be-tween 2021 and 2023 for pathogen isolation and identification.The isolated strains underwent anal-ysis of pathogenicity categories,phylogenetic grouping,and antimicrobial susceptibility profiles,a-long with resistance gene detection and mouse pathogenicity testing.The results showed that 123 strains of E.coli were isolated from 132 fecal samples.Enteropathogenicity tests revealed that 42.28％were EAEC(52/123),7.32％were EPEC(9/123),and 3.25％were STEC/EHEC(4/123).Phylogenetic analysis indicated that 78.86％(97/123)belonged to group A,while 11.38％(14/123)belonged to group B1.Antimicrobial susceptibility tests for 22 drugs showed the highest resistance rate to amoxicillin at 98.37％(121/123),followed by sulfamethoxazole at 73.98％(91/123).Resistance rates for ampicillin,tetracycline,erythromycin,and trimethoprim ranged from 48.78％to 51.22％.Furthermore,78.86％(97/123)of the isolates were resistant to three or more antibiotics.The detection of 52 drug-resistance genes in 10 categories showed that 15 drug-resist-ance genes were detected,and the detection rate was 28.85％(15/52).Among individual resistance genes,tetA had the highest detection rate at 63.41％(78/123),followed by tetB and qnrS with de-tection rates of 48.78％(60/123)and 38.21％(47/123),respectively.This study demonstrates that EAEC is the predominant strain of E.coli in free-range Tibetan pigs,with groups A and B1 being the major phylogenetic groups.The isolates exhibited a high degree of multidrug-resistant pheno-types,and the detection rates of resistance genes were also high.E.coli carrying virulence genes cause different degrees of pathological changes in the mouse ileum.The research results have sig-nificant public health implications and provide theoretical basis for the prevention,treatment,and clinical medication of E.coli disease in Tibetan pigs.

Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

To understand the epidemiological characteristics and antimicrobial resistance of Esche-richia coli in free-range Tibetan pig populations,fecal samples from these pigs were collected be-tween 2021 and 2023 for pathogen isolation and identification.The isolated strains underwent anal-ysis of pathogenicity categories,phylogenetic grouping,and antimicrobial susceptibility profiles,a-long with resistance gene detection and mouse pathogenicity testing.The results showed that 123 strains of E.coli were isolated from 132 fecal samples.Enteropathogenicity tests revealed that 42.28％were EAEC(52/123),7.32％were EPEC(9/123),and 3.25％were STEC/EHEC(4/123).Phylogenetic analysis indicated that 78.86％(97/123)belonged to group A,while 11.38％(14/123)belonged to group B1.Antimicrobial susceptibility tests for 22 drugs showed the highest resistance rate to amoxicillin at 98.37％(121/123),followed by sulfamethoxazole at 73.98％(91/123).Resistance rates for ampicillin,tetracycline,erythromycin,and trimethoprim ranged from 48.78％to 51.22％.Furthermore,78.86％(97/123)of the isolates were resistant to three or more antibiotics.The detection of 52 drug-resistance genes in 10 categories showed that 15 drug-resist-ance genes were detected,and the detection rate was 28.85％(15/52).Among individual resistance genes,tetA had the highest detection rate at 63.41％(78/123),followed by tetB and qnrS with de-tection rates of 48.78％(60/123)and 38.21％(47/123),respectively.This study demonstrates that EAEC is the predominant strain of E.coli in free-range Tibetan pigs,with groups A and B1 being the major phylogenetic groups.The isolates exhibited a high degree of multidrug-resistant pheno-types,and the detection rates of resistance genes were also high.E.coli carrying virulence genes cause different degrees of pathological changes in the mouse ileum.The research results have sig-nificant public health implications and provide theoretical basis for the prevention,treatment,and clinical medication of E.coli disease in Tibetan pigs.