ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.

ObjectiveTo investigate the effects of Simiaowan on intestinal barrier function and adenosine triphosphate （ATP） binding cassette transporter G2 （ABCG2） expression in hyperuricemic （HUA） rats， and elucidate its therapeutic mechanisms. MethodsForty male Sprague Dawley （SD） rats were randomized into a normal group， a model group， low-dose （282.6 mg·kg^-1） and high-dose （565.2 mg·kg^-1） Simiaowan groups， and a Benzbromarone （4.7 mg·kg^-1） group. The HUA model was established via intraperitoneal injection of potassium oxonate （ip） combined with oral gavage of hypoxanthine （ig） for 14 days. Following modeling， treatments were administered for 14 days. Samples were collected and weighed 4 h after final dosing. Blood uric acid and hepatic function were analyzed. Histopathological changes were evaluated by hematoxylin-eosin （HE） staining， and Chiu's scoring was conducted. Enzyme-linked immunosorbent assay （ELISA） quantified tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， lipopolysaccharide （LPS）， diamine oxidase （DAO）， and D-lactic acid （D-LA） levels. Real-time polymerase chain reaction （Real-time PCR）， Western blot， and immunohistochemistry assessed the expression of Claudin-1， Occludin， occludens-1 （ZO-1）， and ABCG2 mRNAs and proteins. 16S rDNA amplicon sequencing characterized ileal microbiota. ResultsCompared with the normal group， the model group exhibited epithelial shedding in the ileal villus， structural disruption， infiltration of extensive inflammatory cells， and significantly elevated Chiu's scores （P<0.01）. The DAO， TNF-α， IL-6， IL-1β， LPS， and D-LA levels in the ileum were markedly increased （P<0.01）， while mRNA and protein expressions of Claudin 1， Occludin， ZO-1， and ABCG2， as well as positive staining area and proportion， were significantly reduced （P<0.01）. Compared with the model group， the Simiaowan groups at all doses showed improved epithelial damage in the ileal villus， significantly lowered Chiu's scores （P<0.01）， significantly reduced DAO， TNF-α， IL-6， IL-1β， LPS， and D-LA levels in the ileum （P<0.01）， and upregulated mRNA and protein expressions of Claudin 1， Occludin， ZO-1， and ABCG2， as well as positive staining area and proportion （P<0.01）. The 16S rDNA results showed that in the model group， the α-diversity index of the ileal microbiota was increased， and species diversity and richness were enhanced， with microbiota dysfunction observed. The community structure of the gut microbiota was significantly different from that of the normal microbiota. The abundance of probiotics was decreased， and the abundance of pathogenic bacteria was increased， with butyrate-producing bacteria showing a low abundance. In contrast， Simiaowan at all doses reduced species diversity and richness， regulated microbiota dysfunction， and promoted the shift of the structure of the gut microbiota community towards a normal one. This increased the abundance of beneficial bacteria， decreased the abundance of harmful bacteria， and restored the abundance of butyrate-producing bacteria. ConclusionSimiaowan enhances ileal uric acid excretion and further alleviates HUA by modulating the gut microbiota composition to improve the intestinal barrier and upregulate the expression of the urate transporter ABCG2 in HUA rats.

Bedridden patients with cardiopulmonary diseases,elderly long-term bedridden patients,and certain postoperative patients require elevation of their lower limbs to a position above the heart.Traditionally,this is achieved by placing items such as clothing,blankets,or soft objects like leg pads under the lower limb as cushions.However,this method can lead to uneven force distribution on the patient's legs,potentially causing vascular compression and discomfort.To address these issues,the medical staff of department of brain surgery of the Second People's Hospital of Tongxiang City had developed a multi-functional foot pad device incorporating height adjustment,pressure dispersion,and heating functions,based on biomechanical principles.This device has been granted a National Utility Model Patent of China(patent number:ZL 2021 2 3217248.8).The device consists of a cushion plate,a backing plate,a raised block,a rotating shaft,a fixed shaft,a support frame,a chute,a footrest,a gaiter strap,a connecting belt,an extension plate,a drive motor,and a power cord.It allows for angular adjustments ranging from 15°-45° through the use of a rotating backing plate and a chute-supported frame.The arc-shaped footrest,designed ergonomically,and an intelligent temperature control system enable precise adaptation to individual anatomical characteristics.The usage procedure involves placing the adjustable foot pad on a flat bed,positioning the patient's leg in the footrest,securing it with the gaiter strap,adjusting it to a comfortable height,activating the intelligent temperature control system for heating,and promoting limb blood circulation.This device offers an innovative solution for preventing lower extremity deep vein thrombosis(LE-DVT)by employing a multi-dimensional intervention strategy that combines mechanical prevention with physical therapy effects.The adjustable heating foot pad is easy to operate,provides comfort and convenience,and reduces complications such as LE-DVT formation,thereby alleviating the economic burden on patients,enhancing quality of life,and increasing patient and family satisfaction.It is highly suitable for clinical application.

Background and Aims:Obesity is often accompanied by symptoms of disordered eating.Although bariatric metabolic surgery can alleviate these symptoms,there are significant individual differences in postoperative outcomes,and effective predictive indicators are lacking.Liver and kidney function,along with lipid profiles,are closely related to metabolic status and may serve as useful markers for preoperative risk stratification and prognosis prediction.This study was conducted to explore the relationship between preoperative metabolic indicators and symptoms of disordered eating,thereby identifying postoperative recovery patterns among obese patients to support individualized management strategies.Methods:A total of 41 obese patients who underwent sleeve gastrectomy at Shanghai Sixth People's Hospital between September 2020 and June 2023 were enrolled,along with 36 healthy volunteers recruited during the same period.Participants completed the Eating Disorder Inventory-2(EDI-2)questionnaire,and serum samples were collected to assess liver function,kidney function,and lipid levels prior to surgery.The Mantel test was used to analyze correlations between metabolic indicators and EDI-2 scores.Latent profile analysis(LPA)was conducted using the indicators significantly correlated with EDI-2 scores to identify subgroups within the obese cohort.Linear mixed models were then applied to examine the trajectories of postoperative symptom changes across subgroups.Results:Levels of cystatin C,cholinesterase,gamma-glutamyl transferase,triglycerides,and apolipoprotein E were significantly higher in the obese group compared to the healthy group(all P＜0.05),and EDI-2 total score was also significantly elevated(P＜0.05);the prealbumin level in the healthy group was significantly higher than that in the obese group(P＜0.05).These six indicators were positively correlated with EDI-2 score(all r＞0.20,P＜0.05).Based on these markers,the LPA classified the obese group into two subgroups,with subgroup 2 exhibiting higher levels of most metabolic indicators than subgroup 1.During the 18-month postoperative follow-up,both subgroups showed reductions in EDI-2 score,but symptom improvement in subgroup 2 occurred later(month 6)compared to subgroup 1(month 4).Conclusion:Preoperative levels of cholinesterase,gamma-glutamyl transferase,prealbumin,triglycerides,and apolipoprotein E may serve as predictive indicators for improvement in disordered eating symptoms.Recovery patterns after bariatric surgery vary among obese patients with different metabolic profiles,highlighting the need for tailored intervention strategies.

Background and Aims:Obesity is often accompanied by symptoms of disordered eating.Although bariatric metabolic surgery can alleviate these symptoms,there are significant individual differences in postoperative outcomes,and effective predictive indicators are lacking.Liver and kidney function,along with lipid profiles,are closely related to metabolic status and may serve as useful markers for preoperative risk stratification and prognosis prediction.This study was conducted to explore the relationship between preoperative metabolic indicators and symptoms of disordered eating,thereby identifying postoperative recovery patterns among obese patients to support individualized management strategies.Methods:A total of 41 obese patients who underwent sleeve gastrectomy at Shanghai Sixth People's Hospital between September 2020 and June 2023 were enrolled,along with 36 healthy volunteers recruited during the same period.Participants completed the Eating Disorder Inventory-2(EDI-2)questionnaire,and serum samples were collected to assess liver function,kidney function,and lipid levels prior to surgery.The Mantel test was used to analyze correlations between metabolic indicators and EDI-2 scores.Latent profile analysis(LPA)was conducted using the indicators significantly correlated with EDI-2 scores to identify subgroups within the obese cohort.Linear mixed models were then applied to examine the trajectories of postoperative symptom changes across subgroups.Results:Levels of cystatin C,cholinesterase,gamma-glutamyl transferase,triglycerides,and apolipoprotein E were significantly higher in the obese group compared to the healthy group(all P＜0.05),and EDI-2 total score was also significantly elevated(P＜0.05);the prealbumin level in the healthy group was significantly higher than that in the obese group(P＜0.05).These six indicators were positively correlated with EDI-2 score(all r＞0.20,P＜0.05).Based on these markers,the LPA classified the obese group into two subgroups,with subgroup 2 exhibiting higher levels of most metabolic indicators than subgroup 1.During the 18-month postoperative follow-up,both subgroups showed reductions in EDI-2 score,but symptom improvement in subgroup 2 occurred later(month 6)compared to subgroup 1(month 4).Conclusion:Preoperative levels of cholinesterase,gamma-glutamyl transferase,prealbumin,triglycerides,and apolipoprotein E may serve as predictive indicators for improvement in disordered eating symptoms.Recovery patterns after bariatric surgery vary among obese patients with different metabolic profiles,highlighting the need for tailored intervention strategies.

Objective To observe the effect of preoperative exercise on consciousness,lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October,2024 to March,2025 were randomly divided into control group(n=27)and prerehabilitation group(n=27).The control group received routine preoperative treatment and nursing,while the prerehabilitation group additionally received exercise for two weeks.They were assessed with Coma Recovery Scale-Revised(CRS-R),and observed diaphragm mobility with sonography,before and three days after operation;and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.Results CRS-R scores improved in both groups after operation(|t|>5.451,P<0.001),and it was greater in the prehabilitation group than in the control group(t=2.812,P<0.01).CRS-R subscale scores improved in auditory and motor functions in the control group(|Z|>2.000,P<0.05),and they were improved in auditory,visual,motor,verbal and arousal functions in the prehabilitation group(|Z|>2.282,P<0.01).CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group(|Z|>2.320,P<0.05).Diaphragmatic mobility improved in the prehabilitation group(t=-7.782,P<0.001),and it was better than in the control group(t=2.044,P<0.05).The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group(|t|>3.654,P<0.01).Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation,especially the level of motor and arousal,as well as the lung function,and accelerate the recovery process.

Objective To observe the effect of preoperative exercise on consciousness,lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October,2024 to March,2025 were randomly divided into control group(n=27)and prerehabilitation group(n=27).The control group received routine preoperative treatment and nursing,while the prerehabilitation group additionally received exercise for two weeks.They were assessed with Coma Recovery Scale-Revised(CRS-R),and observed diaphragm mobility with sonography,before and three days after operation;and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.Results CRS-R scores improved in both groups after operation(|t|>5.451,P<0.001),and it was greater in the prehabilitation group than in the control group(t=2.812,P<0.01).CRS-R subscale scores improved in auditory and motor functions in the control group(|Z|>2.000,P<0.05),and they were improved in auditory,visual,motor,verbal and arousal functions in the prehabilitation group(|Z|>2.282,P<0.01).CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group(|Z|>2.320,P<0.05).Diaphragmatic mobility improved in the prehabilitation group(t=-7.782,P<0.001),and it was better than in the control group(t=2.044,P<0.05).The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group(|t|>3.654,P<0.01).Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation,especially the level of motor and arousal,as well as the lung function,and accelerate the recovery process.

Objective To assess the efficacy of tandem mass spectrometry-specific indicators in diagnosing β-ketothiolase deficiency(BKD)and to elucidate the associated gene variations contributing to the corresponding pathogenic phenotype,thereby facilitating rapid and accurate diagnosis of BKD.Methods Data from tandem mass spectrometry(MS/MS)screening of dried blood spots collected from 16,071 children between January 2018 and December 2021,along with results from gas chromatography-mass spectrometry(GC-MS)analysis and high-throughput sequencing of positive cases,were analyzed retrospectively.The study aimed to evaluate the contribution of specific MS/MS indicators in the clinical diagnosis of BKD and to trace the genetic etiology of this disease.Results Among the 16 071 subjects screened by MS/MS,37 cases(2.30‰)exhibited elevated C5OH levels,41 cases(2.55‰)showed increased C5∶1 levels,and 2 cases were diagnosed with BKD based on GC-MS analysis.When diagnosing BKD using C5OH as a single indicator,the false positive rate was 0.22%,which is lower than that of C5∶1(0.24%).The positive predictive value for C5OH was 5.40%,higher than that of C5∶1(4.88%).Among the 16 071 pediatric patients,only 2 cases were diagnosed with BKD due to elevated C5OH combined with increased C5∶1 levels,resulting in a positive predictive value of 100%.Whole exome sequencing of these two BKD patients revealed that both carried acetyl-CoA acetyltransferase 1(ACAT1)gene double allele missense heterozygous mutations.The four previously unreported mutation sites were c.949G>C(p.Asp317His),c.1063G>A(p.Ala355Thr),c.146G>A(p.Arg49Lys),and c.700G>A(p.Glu234Lys).These findings provide novel insights into the genetic basis of BKD.Conclusions The MS/MS screening indicator C5OH demonstrates superior diagnostic efficacy compared to C5∶1 in diagnosing BKD,as evidenced by lower false positive rates and higher positive predictive values.When diagnosing BKD,the use of combined indicators significantly enhances the accuracy of biochemical diagnosis compared to single indicators.Exome sequencing revealed that all BKD patients carried previously unreported mutations in the ACAT1.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Strengthening ideological and political work is crucial for promoting the high-quality development of public hospitals.From the perspective of the 5W theory of communication,this paper deconstructs and analyzes the five key elements within the ideological and political work of public hospitals:the communicator,the message,the channel,the audience,and the effect.It identifies existing challenges,including the multiple roles of communicators,a disconnect between message content and context,the overwhelming volume of information through numerous channels,the heightened subjective consciousness of the audi-ence,and a lack of feedback mechanisms for assessing effectiveness.The causes of these challenges are analyzed.Corresponding strategies are proposed,such as introducing multi-agent collaboration,strengthening the integration of Party building with profes-sional services,consolidating platform development,enhancing emotional communication,and establishing feedback agendas.These measures aim to improve the effectiveness and pertinence of ideological and political education in public hospitals,thereby advancing their high-quality development.