Objective To systematically evaluate the qualitative research on the experience and feeling of elderly patients with hip fracture during rehabilitation.Methods We searched databases including the PubMed,Embase,Web of Science,Cochrane Library,CNAIHL,CNKI,Wanfang,VIP,SinoMed.The literature of qualitative research on the exercise rehabilitation experience of stroke patients from the establishment of the database to August 17,2023 was retrieved.Results A total of 59 clear research topics were extracted,and 14 new categories were formed after induction and integration,which were finally merged into 5 integrated results.Integration results 1:Perceived benefits of exercise rehabilitation.Integration results 2:Multiple driving forces of exercise rehabilitation.Integration results 3:Gradual loss of patience in long-term rehabilitation.Integrated results 4:Generating new rehabilitation needs and actively coping with them.Integrated results 5:There are many difficulties in carrying out self-rehabilitation.Conclusion During the process of exercise rehabilitation for stroke patients,medical personnel should pay attention to the patients'actual feelings,inner needs,and the practical challenges they face in participating in exercise rehabilitation.Personalized exercise rehabilitation facilitation strategies should be developed for stroke patients,aiming for the scientific and precise advancement of exercise rehabilitation,and ultimately improving long-term rehabilitation outcomes for patients.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive bacteria from blood cultures in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Objective:To systematically integrate qualitative research on the real experience and management of cancer pain in adult cancer patients, so as to provide reference for improving the management of cancer pain in adult cancer patients and reducing their cancer pain.Methods:Qualitative research literature on the real experience and management of cancer pain in cancer patients was systematically searched in Cochrane Library, PubMed, Web of Science, CINAHL, Embase, ProQuest, Scopus, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data, and VIP. The search period was from database establishment to August 2023. The literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation Meta-synthesis method was used to integrate and summarize research results.Results:A total of 16 articles were included, and 78 results were extracted to form 11 categories, which were summarized into four integrated results of the cognitive status of adult cancer patients towards cancer pain, the impact of cancer pain on patients, self-management strategies for cancer pain, and medical experiences related to cancer pain.Conclusions:Adult cancer patients face obstacles in alleviating cancer pain, such as lack of awareness of cancer pain, negative impacts, inadequate self-management strategies, and poor medical experience. Patients need to improve their self-management strategies, and the country and medical institutions should provide comprehensive support to enable patients and clinical medical and nursing staff to manage cancer pain.

Objective:To establish a method for detecting the binding affinity of peptides to HLA-B*1301 by HLA molecular reconstitution after weak acid treatment,and its practicality was evaluated.Methods:C1R cells overexpressing HLA-B*1301 were treated with citrate buffer of different pH for different time.After neutralization of pH,cells were resuspended in culture medium con-taining β2m and brefeldin A.Cells were incubated at 37℃with peptide(peptide group)or without peptide(blank control),after addition of anti-HLA antibody,the cells were detected by flow cytometry.Ratio of fluorescence intensity between peptide group and blank control group was used as an index to measure the level of HLA molecular remodeling,and then represented the interactions between peptide and HLA-B*1301 molecule.Results:HLA-polypeptide complex was denatalized and dissociated after being treated with pH3.0 buffer for 1 min,and only HLA heavy chain molecules were retained on the cell surface.The addition of peptides with binding force could significantly improve the level of HLA molecular remodeling,and the binding force of peptides with HLA-B*1301 could be evaluated by this method.Conclusion:HLA molecular reconstitution assay is a simple and reliable method to detect the binding of peptides to HLA-B*1301,which can also provide reference for the study of other low frequency HLA molecular antigen pre-sentation patterns.

Objective:To evaluate and summarize the best evidence on fatigue management in children with tumors both domestically and internationally, providing reference for medical and nursing staff to improve fatigue symptoms in children.Methods:The evidence on fatigue management in children with tumors, including best practices, recommended practices, guidelines, systematic reviews, evidence summaries, and expert consensus, was systematically retrieved from clinical decision support systems, guideline websites, professional association websites, and databases both domestically and internationally. The search period was from database establishment to April 2023. Two researchers independently conducted literature quality evaluation and evidence extraction.Results:A total of 17 articles were included, including four guidelines and 13 systematic reviews. Thirty-two best pieces of evidence were extracted from six aspects of assessment and screening, identification of risk factors, health education, exercise intervention, medication intervention, and other interventions of fatigue in children with tumors.Conclusions:The best evidence for fatigue management in children with tumors is summarized, which can provide a basis for medical and nursing staff to improve their fatigue symptoms. It is recommended that medical and nursing staff combine clinical context, professional opinions, and patient wishes to screen the best evidence and develop personalized fatigue management programs.

Objective:To establish contact dermatitis pruritus model and detect itch,anxiety and depression-like behaviors.To observe the activation of the medial prefrontal cortex(mPFC)neurons and provide morphological evi-dence for its involvement in the regulation of itch perception information.Methods:A model of contact dermatitis pruri-tus was constructed with diphenylcyclopyrenone(DCP)applied on the neck and back of the mouse,and the itch per-ception video tracking system was used to detect the scratching behavior.Open field and suspended tail behavioral ex-periments were conducted to explore the anxiety and depression-like behaviors of mice under contact dermatitis.The dis-tribution of c-Fos and p-ERK1/2 positive cells in the mPFC of contact dermatitis model mice was investigated by immu-nofluorescence staining.Results:The contact dermatitis pruritus model was successfully established,and the bouts of scratching in the contact dermatitis model group was significantly higher than that in the control group(P＜0.05).The results of open field test showed that the time and distances were significantly reduced in the central area of the contact dermatitis model group.The results of the tail suspension experiment suggested that the time of immobility increased sig-nificantly in the contact dermatitis model group(P＜0.05).There were more c-Fos positive and p-ERK1/2 positive cells in the mPFC compared with the control group(P＜0.05).Conclusion:Bouts of scratching were increased in the contact dermatitis group and the mice had anxiety and depression-like behaviors.In the contact dermatitis state,mPFC neurons were activated,providing morphological evidence for the involvement of mPFC neurons in contact dermatitis pruritus and accompanying affective disorders such as anxiety and depression.

In recent years, as researchers delve deeply into the cell death mechanisms, ferroptosis, as a new iron-dependent cell death mode, has gradually become a research hotspot.It is mainly triggered by iron overload and lipid peroxidation in organisms.Sepsis-induced liver injury is an important pathophysiological process in the systemic inflammatory response caused by infection, which is closely related to various cell death modes.This review aims to explore the research progress on ferroptosis in sepsis-induced liver injury, including the mechanism of ferroptosis occurrence in sepsis-induced liver injury, its relationship with sepsis-induced liver injury, and possible therapeutic strategies for ferroptosis.

Familial acute necrotizing encephalopathy，also known as acute necrotizing encephalopathy type 1（ANE1），is a rapidly progressing rare encephalopathy with high morbidity and mortality rates.Although the etiology and pathogenesis remain unclear，mutations in genes such as RANBP2 and CPTⅡ are known to be related to its occurrence and development.Additionally，pathogen infections and cytokine storms are also considered potential influencing factors.Compared to isolated acute necrotizing encephalopathy，the clinical manifestations of ANE1 are more diverse，making diagnosis and treatment more complex.Currently，there are no specific therapeutic strategies for ANE1，and the effectiveness of immunomodulatory therapy remains controversial.Mitochondrial cocktail therapy and interleukin inhibitors have shown some therapeutic potential.The prognosis for ANE1 is generally poor，with survivors likely to experience severe neurological deficits and have a risk of recurrence.Early diagnosis and treatment are crucial for improving prognosis.

BackgroundThe occurrence rate of dangerous behaviors in patients with severe mental disorders is higher than that of the general population. In China， there is limited research on the prediction of dangerous behaviors in community-dwelling patients with severe mental disorders， particularly in terms of predicting models using data mining techniques other than traditional methods. ObjectiveTo explore the influencing factors of dangerous behaviors in community-dwelling patients with severe mental disorders and testing whether the classification decision tree model is superior to the Logistic regression model. MethodsA total of 11 484 community-dwelling patients with severe mental disorders who had complete follow-up records from 2013 to 2022 were selected on December 2023. The data were divided into a training set （n=9 186） and a testing set （n=2 298） in an 8∶2 ratio. Logistic regression and classification decision trees were separately used to establish predictive models in the training set. Model discrimination and calibration were evaluated in the testing set. ResultsDuring the follow-up period， 1 115 cases （9.71%） exhibited dangerous behaviors. Logistic regression results showed that urban residence， poverty， guardianship， intellectual disability， history of dangerous behaviors， impaired insight and positive symptoms were risk factors for dangerous behaviors （OR=1.778， 1.459， 2.719， 1.483， 3.890， 1.423， 2.528， 2.124， P<0.01）. Being aged ≥60 years， educated， not requiring prescribed medication and having normal social functioning were protective factors for dangerous behaviors （OR=0.594， 0.824， 0.422， 0.719， P<0.05 or 0.01）. The predictive effect in the testing set showed an area under curve （AUC） of 0.729 （95% CI： 0.692~0.766）， accuracy of 70.97%， sensitivity of 59.71%， and specificity of 72.05%. The classification decision tree results showed that past dangerous situations， positive symptoms， overall social functioning score， economic status， insight， household registration， disability status and age were the influencing factors for dangerous behaviors. The predictive effect in the testing set showed an AUC of 0.721 （95% CI： 0.705~0.737）， accuracy of 68.28%， sensitivity of 64.46%， and specificity of 68.60%. ConclusionThe classification decision tree does not have a greater advantage over the logistic regression model in predicting the risk of dangerous behaviors in patients with severe mental disorders in the community. ［Funded by Chengdu Medical Research Project （number， 2020052）］

In order to promote the innovative application of Sanjiao theory and Yingwei theory， this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases， integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body， and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi， and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion， which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis， which contributes to T cell exhaustion and is correlated with nutrient deprivation， lipid accumulation， and high lactate levels in the immunosuppressed tumor microenvironment， as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction， Shengming decoction， and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation， and hypoxia inducible factor-1α （HIF-1α） may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.