Objective:To establish a set of dynamic definition methods and key operational techniques for community pediatric services contents within the framework of an integrated children health services model.Methods:This was a cross-sectional study. From December 2023 to June 2024, a study was conducted at the Shanghai Gumei Community Health Service Center. The study was divided into three phases: identifying the health needs of community children (Phase A), developing the service content and methods for community children (Phase B), and establishing a community children service network (Phase C). A variety of methods, including questionnaires and focus group interviews, were comprehensively employed in each phase to develop the ABC demand network and its construction approach for community children, and to establish a networked service system.Results:A total of 512 questionnaires were distributed in Phase A, of which 499 were returned for an effective recovery rate of 97.5%. Of the parents, 488 (97.8%, 488/499) would actively seek information related to children′s health. Of those parents, 90.6% (452/499), 80.8% (403/499), and 71.9% (359/499) expressed concern about their children′s growth and development, mental health and social adaptation, and the prevention and treatment of common, frequently occurring diseases, respectively. The research clarified the health needs of children in the community and the health issues of children in different age groups. This included the mental health and social adaptation of community children, as well as common and frequently occurring diseases. The study also revealed a lack of mental health and social adaptation's services for children in the community. After sorting the community′s services into categories such as children′s growth and development detection, diagnosis and treatment of common diseases, and planned immunizations, and establishing corresponding service methods, it was found that Gumei community Health Service Center had strong diagnostic service capabilities for children aged 0-3 and 4-6, but need improved for children aged 7-12 and 13-15. At the same time, a service network consisting of five major categories, represented by medical alliances, has been established to address unmet needs in diagnosis and rehabilitation care for mental health and social adaptation, as well as major diseases.Conclusions:The study has developed an ABC demand network and its construction method for community children. It provides new ideas for defining the content of community pediatric services and establishing supporting methods, and it offers a practical basis for the constructing a community pediatric service system.

The risk prediction approach integrating disease and syndrome aligns more precisely with the clinical diagnosis and treatment needs of osteoporosis.Prior research has established a consensus on the model development methodology encompassing"Target outcome selection→ Key information collection→ Data mining and modeling →Model performance evaluation".Building on this foundation,a cohort of osteoporosis patients and syndrome cases with stable follow-up is established.Utilizing artificial intelligence algorithms,critical information in traditional Chinese medicine(TCM)symptoms and syndromes is objectively characterized and quantified alongside imaging data.Employing multi-omics sequencing technology,we seek to identify highly specific microscopic molecular information,analyze potential correlations among various dimensions of information,and develop a multidimensional risk prediction model for osteoporosis with distinctive TCM attributes.This model aims to identify biomarkers with both"disease"and"syndrome"characteristics,thereby advancing the precision diagnosis and treatment system for osteoporosis.

Objective:To establish a set of dynamic definition methods and key operational techniques for community pediatric services contents within the framework of an integrated children health services model.Methods:This was a cross-sectional study. From December 2023 to June 2024, a study was conducted at the Shanghai Gumei Community Health Service Center. The study was divided into three phases: identifying the health needs of community children (Phase A), developing the service content and methods for community children (Phase B), and establishing a community children service network (Phase C). A variety of methods, including questionnaires and focus group interviews, were comprehensively employed in each phase to develop the ABC demand network and its construction approach for community children, and to establish a networked service system.Results:A total of 512 questionnaires were distributed in Phase A, of which 499 were returned for an effective recovery rate of 97.5%. Of the parents, 488 (97.8%, 488/499) would actively seek information related to children′s health. Of those parents, 90.6% (452/499), 80.8% (403/499), and 71.9% (359/499) expressed concern about their children′s growth and development, mental health and social adaptation, and the prevention and treatment of common, frequently occurring diseases, respectively. The research clarified the health needs of children in the community and the health issues of children in different age groups. This included the mental health and social adaptation of community children, as well as common and frequently occurring diseases. The study also revealed a lack of mental health and social adaptation's services for children in the community. After sorting the community′s services into categories such as children′s growth and development detection, diagnosis and treatment of common diseases, and planned immunizations, and establishing corresponding service methods, it was found that Gumei community Health Service Center had strong diagnostic service capabilities for children aged 0-3 and 4-6, but need improved for children aged 7-12 and 13-15. At the same time, a service network consisting of five major categories, represented by medical alliances, has been established to address unmet needs in diagnosis and rehabilitation care for mental health and social adaptation, as well as major diseases.Conclusions:The study has developed an ABC demand network and its construction method for community children. It provides new ideas for defining the content of community pediatric services and establishing supporting methods, and it offers a practical basis for the constructing a community pediatric service system.

The risk prediction approach integrating disease and syndrome aligns more precisely with the clinical diagnosis and treatment needs of osteoporosis.Prior research has established a consensus on the model development methodology encompassing"Target outcome selection→ Key information collection→ Data mining and modeling →Model performance evaluation".Building on this foundation,a cohort of osteoporosis patients and syndrome cases with stable follow-up is established.Utilizing artificial intelligence algorithms,critical information in traditional Chinese medicine(TCM)symptoms and syndromes is objectively characterized and quantified alongside imaging data.Employing multi-omics sequencing technology,we seek to identify highly specific microscopic molecular information,analyze potential correlations among various dimensions of information,and develop a multidimensional risk prediction model for osteoporosis with distinctive TCM attributes.This model aims to identify biomarkers with both"disease"and"syndrome"characteristics,thereby advancing the precision diagnosis and treatment system for osteoporosis.

OBJECTIVE To investigate the effect of Guanxinning tablets(GXN) on early heart failure model rats, and to explore the protective mechanism of GXN on heart failure rats from the perspective of intestinal flora. METHODS Six rats who underwent sham operation were set as sham operation group. Took 80 SD rats to undergo aortic arch stenosis and established a heart failure rat model. The surviving rats were divided into 4 groups, namely the model control group, the positive control group(captopril tablets 12.5 mg·kg–1), high-dose and low-dose of GXN group(600, 1 200 mg·kg–1). The 4 groups were administered continuously for 8 weeks. Cardiac ultrasonography was performed every 4 week. Serum NT-proBNP, hs-CRP, IL-6, TNF-α, SOD and MDA levels were measured. The effects of GXN on the structure and function of intestinal flora were observed based on the high-throughput sequencing technology and bioinformatics analysis of 16S gut microbiome. RESULTS Compared to the model control group, after giving different doses of GXN, the survival rate of rats increased, and the thickness of the ventricular wall decreased to varying degrees. The weight of the heart and coefficient of the heart were all reduced. GXN could also reduce the level of inflammatory factors, inhibit the level increase of NT-proBNP in rats, and increase the activity of serum SOD. In addition, GXN intervention could significantly improve the intestinal flora diversity of rats with heart failure, the possible target genera of GXN were Akkermansia genera, Phascolarctobacterium genera and Oxalobacter genera. The effect of GXN on intestinal function in rats with heart failure might be concentrated in non-homologous end-joining, influenza A, carotenoid synthesis, indole alkaloids biosynthesis, betalain biosynthesis, renin-angiotensin system and other biological pathways. CONCLUSION The protective effect of GXN on early heart failure rats may be related to the regulation of intestinal flora pathway.

Objective:To explore the quality improvement in the organization structure and management model of the integrated community child health services.Methods:This was a qualitative study, including two parts: cause analysis and service improvement suggestions. In the analysis part the data mining was conducted to identify valuable patterns and relationships in the comprehensive child health services. Semi-structured interviews were conducted with 12 relevant department heads and health workers of the comprehensive child health service team at Gumei Community Health Service Center in December 2023, and the causes of the key problems were explored. In the service improvement part, focus group discussions were held to propose suggestions, then improvement measures were formulated to address the identified problems.Results:Through data mining and semi-structured interviews, the key problems were identified: information isolation among multiple departments and lack of coordination mechanism in the comprehensive child health service team. A team organizational structure based on the "three definite" principle was established. The organizational structure should include the pediatric family doctor team, general practitioner management team and departments of pediatrics, maternal and child health care, immunization and child rehabilitation; the management model should include a cross-department resource and information sharing mechanism, the pediatric family doctor model, optimization and integration of physical space, and enhancement of publicity activities for the comprehensive child health services.Conclusion:Based on the analysis in Gumei health service center, this study identified key problems in community integrated child health services, and proposes the quality improvement measure in the organizational structure and management model of the service team.

Nonalcoholic fatty liver disease (NAFLD) is a clinical syndrome characterized by hepatic steatosis and fat deposition in hepatocytes in the absence of significant alcohol use. A growing number of studies have shown significant dysregulation of intestinal microbiota in patients with chronic liver disease and cirrhosis. Small intestinal bacterial overgrowth (SIBO) is a clinical syndrome induced by excessive bacteria in small intestine. This article reviewed the correlation between SIBO and NAFLD, as well as the effect of probiotics on treatment of NAFLD.

Objective To retrieve,assess and summarize the best evidence on breast milk expression of premature infants' mothers in maternal separation so as to provide high-quality evidence for medical staff to carry out breast feeding guide. Methods Guidelines,systematic reviews,recommended practices and evidence summaries were retrieved in the UpToDate,WHO,Academy of Breastfeeding Medicine(ABM), Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario(RNAO), National Guideline Clearinghouse(NGC),PubMed,Embase,Chinese Biological Medicine,Chinese National Knowledge Infrastructure,WanFang data,VIP and the evidence-based nursing database of Fudan University from January 2008 to December 2018. Results A total of 7 literatures were included,two guidelines,one clinical decision,two systematic reviews and two evidence summaries. A total of 19 evidences were gathered in 7 aspects,such as training for medical staff,parents' education,selection of breast pump,preparation before expression,operational skills of breast expression,measures for increasing lactation and expression effects monitor. Conclusions Clinical medical staff should lay down the individualized nursing measures for maternal women to ensure breast milk collected as soon as possible,gain enough breast milk and fill the bill of growth and development of premature infants.

Objective To investigate the expression levels of IFN-γ, IL-4, IL-6 in the plasma of HBV chronic patients.To acknowledge the correlation between the immune function of T-cell with chronic hepatitis B virus.Methods The expression levels of IFN-γ, IL-4, IL-6 in the plasma were determined by ELISA in 42 cases of chronic hepatitis B (CHB group), 30 cases of cirrhosis (LC group), 30 cases of primary liver cancer (HCC group) and 30 cases of health control (NC group).Combine with the load of HBV DNA, HBeAg and ALT, the expression levels of IFN-γ, IL-4, IL-6 were re-analysed.Results The expression levels of IFN-γ, IL-4 and IL-6 in the researched groups were statistically significantly different.The expression levels of IFN-γ, IL-4, IL-6 in CHB, LC and HCC groups were higher than NC group with significance.The expression level of IL-4 in the CHB group was higher than LC and HCC groups with significance.The expression level of IL-6 in the HCC group was higher than CHB and LC groups with significance.Compared with the control group, the ratio of IFN-γ/IL-4 in CHB, LC and HCC groups were decreased with significance.There was significantly positive correlation between the expression level of IL-4 with the load of HBV DNA (r=0.757, P＜0.001).The expression level of IFN-γhad negative correlation between the load of HBV DNA (r=-0.786, P＜0.001) with the level of ALT (r=-0.713, P＜0.001) with significance.There was no significant correlation between HBeAg with the cytokines in the serum of patients with chronic HBV.Conclusion The results showed the immune function of T-cell play important role in chronic HBV patients.That would provide a good basis on CHB treatment.The expression levels of IL-6 were higher in HCC group with significance, which provided the direction for the deep study of liver cancer.

Objective To study the effects of rituximab combined with CHOP chemotherapy on serum Thymidine kinase 1 (TK-1) and vascular endothelial growth factor (VEGF) in patients with non-Hodgkin lymphoma,and to provide guidance for clinical research.Methods A total of 24 patients with non-Hodgkin's lymphoma treated in our hospital from January 2013 to March 2016 were randomly divided into the control group and the observation group,and each with 12 cases.All patients were examined before and after treatment,the control group was only treated with CHOP chemotherapy,and the observation group was treated with rituximab combined with CHOP chemotherapy.The patients were followed up within 1-2 years after treatment.The therapeutic effects of all patients were observed,the TK-1 and VEGF levels were measured and the incidence rate of adverse reactions was recorded.Results The efficiency rates of patients in the observation group and the control group were 66.67％ and 50.00％,respectively after treatment,and the observation group was significantly better than the control group,the difference was statistically significant (P＜0.05);the TK-1 and VEGF levels of the two groups were significantly decreased after treatment (P＜0.05),there was a statistically significant difference.But the two indexes of observation group was significantly lower than the control group,the difference was significant (P＜0.05);the control group showed 1 case of liver dysfunc tion after treatment,4 cases of gastrointestinal dysfunction,1 case of decreased white blood cells,while the observation group were 1,3 and 1 case,respectively.There were no significant differences between two groups (P＞0.05).Conclusion With the treatment of rituximab combined with CHOP chemotherapy,serum TK-1 and VEGF levels of patients with non-Hodgkin lymphoma decreased significantly,the poor prognosis has been significantly improved,and this treatment is worth popularizing in clinical application.