ObjectiveTo explore the effect of the medical-community linkage model on activities of daily living, psychological status and motor function of stroke patients in the community. MethodsA total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District, Beijing, from January, 2024 to August, 2025 were enrolled and randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine medicine, dietary care and rehabilitation management, while the intervention group underwent rehabilitation with the medical-community linkage model, for twelve weeks. They were assessed with modified Barthel Index (MBI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Fugl-Meyer Assessment (FMA) before and after intervention. ResultsAfter intervention, the MBI, HAMA, HAMD and FMA scores of patients improved in both groups (|t| > 5.599, P < 0.001), and improved more in the intervention group than in the control group (P < 0.05), except MBI. The HAMA and HAMD scores of family members decreased in both groups (|t| > 10.333, P < 0.001), and decreased more in the intervention group than in the control group (t > 5.681, P < 0.001). ConclusionThe medical-community linkage model can further improve the motor function of stroke patients in community, as well as the psychological status of both patients and their family members.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

ObjectiveTo investigate the prevalence of gynecological and breast diseases among retired or economically disadvantaged women in part of Pudong New Area of Shanghai under the policy support of screening gynecological diseases and breast diseases for retired and women with economic difficulties in life in Shanghai, to analyze the characteristics of these diseases, so as to provide a scientific basis for the improvement of relevant prevention and treatment strategies. MethodsBased on the gynecological census data of 13 031 cases in five towns, including Xinchang Town, Xuanqiao Town, Laogang Town, Wanxiang Town and Shuyuan Town, conducted by Shanghai Pudong Hospital in 2023, descriptive analysis methods were used to explore the prevalence and age characteristics of common gynecological and breast diseases. ResultsThe total detection rate of gynecological and breast diseases among women in the screening area in this study was 68.29%, with uterine fibroid (22.35%), sarcoidosis of the breast (17.06%), cervicitis (15.37%), vaginitis (8.39%) and ovarian cyst (2.61%) ranking the top 5 in the detection rate among the screening population. The differences of the detection rates in the four major diseases [uterine fibroid (χ²=233.217, P<0.001), breast nodules(χ²=169.896, P<0.001), cervicitis (χ²=388.683, P<0.001), and ovarian cysts (χ²=72.298, P<0.001)] by different age groups were statistically significant (P<0.05) . Moreover, the results of pairwise comparison of different age groups showed that the detection rates in the age group under 45 years old and 45‒55 years old were higher than that in the age group of 55‒65 years old and over 65 years old. ConclusionThe detection rate of gynecological and breast diseases in the younger age group was higher, indicating a certain trend of younger onset of diseases. Uterine fibroid, sarcoidosis of the breast , and reproductive tract diseases such as cervicitis, vaginitis, and ovarian cyst are the main diseases affecting the research subjects. Therefore, medical institutions can combine routine work in screening diseases and carry out corresponding health education and health promotion activities for these key diseases to improve women’s health.

Central nervous system（CNS） disorders are characterized by complex pathological mechanisms and the presence of the blood-brain barrier（BBB）， which significantly limits the effectiveness of drug therapy. Traditional drug delivery modes include oral administration， intravenous injection and transdermal delivery， which have certain advantages， but it is difficult for the drugs to effectively cross the BBB. Therefore， it is crucial to find drug delivery modes that can efficiently traverse the BBB. Nasal drug delivery， as a non-invasive method， can realize the targeted delivery of drugs to the CNS via three pathways， including olfactory neurons， trigeminal neurons and blood circulation， and shows a broad application prospect in the treatment of CNS diseases. Numerous studies have further confirmed that nasal drug delivery combined with novel drug delivery systems such as lipid nanocarriers， nanoparticles， nanoemulsions and composite in situ gels can effectively load the active components of traditional Chinese medicine（TCM）， and significantly increase drug concentration in the brain， which provides new strategies for the treatment of CNS diseases. In this paper， the current status of drug delivery for CNS diseases was systematically sorted out， the characteristics of nasal drug delivery were discussed in depth， and the research progress of passive targeting， active targeting， and "guiding the meridian" drug delivery strategies for the nasal-to-brain transport of TCM active components was summarized and analyzed， which was aimed to provide references and insights for the development of drugs for CNS diseases and the application of TCM in nasal-to-brain delivery.

Central nervous system（CNS） disorders are characterized by complex pathological mechanisms and the presence of the blood-brain barrier（BBB）， which significantly limits the effectiveness of drug therapy. Traditional drug delivery modes include oral administration， intravenous injection and transdermal delivery， which have certain advantages， but it is difficult for the drugs to effectively cross the BBB. Therefore， it is crucial to find drug delivery modes that can efficiently traverse the BBB. Nasal drug delivery， as a non-invasive method， can realize the targeted delivery of drugs to the CNS via three pathways， including olfactory neurons， trigeminal neurons and blood circulation， and shows a broad application prospect in the treatment of CNS diseases. Numerous studies have further confirmed that nasal drug delivery combined with novel drug delivery systems such as lipid nanocarriers， nanoparticles， nanoemulsions and composite in situ gels can effectively load the active components of traditional Chinese medicine（TCM）， and significantly increase drug concentration in the brain， which provides new strategies for the treatment of CNS diseases. In this paper， the current status of drug delivery for CNS diseases was systematically sorted out， the characteristics of nasal drug delivery were discussed in depth， and the research progress of passive targeting， active targeting， and "guiding the meridian" drug delivery strategies for the nasal-to-brain transport of TCM active components was summarized and analyzed， which was aimed to provide references and insights for the development of drugs for CNS diseases and the application of TCM in nasal-to-brain delivery.

ObjectiveTo investigate the current status of latent tuberculosis infection (LTBI) among the elderly population in rural areas of Changxing County, Zhejiang Province, and to provide an evidence for the development of LTBI prevention and control measures. MethodsBetween January and May 2024, elderly individuals participating in urban and rural residents’ health checkups were screened for Mycobacterium tuberculosis infection using a domestically produced interferon-γ release assay (IGRA) kit. Individuals tested positive by IGRA but without active tuberculosis were classified as LTBI cases. The prevalence of LTBI among the participants was subsequently analyzed. ResultsAmong the 6 765 subjects, 637 tested positive by IGRA, including one identified active tuberculosis patient, resulting in a LTBI prevalence rate of 9.40%. There was a statistically significant difference in positivity rates across different IGRA methodologies (χ²=35.530, P<0.001). Higher LTBI rate was observed in males, individuals with a history of diabetes mellitus, and those with a history of pulmonary tuberculosis, exhibiting statistically significant differences (χ²=32.401, P<0.001; χ²=5.789, P=0.020; χ²=39.248, P<0.001, respectively.) No statistically significant difference in LTBI rate was found across different age groups (χ²=0.238, P=0.971). ConclusionThe prevalence of LTBI among the elderly rural residents in Changxing County is relatively low. Male, individuals with a history of diabetes mellitus, and those with a history of pulmonary tuberculosis have an increased risk of LTBI, warranting targeted risk monitoring and timely interventions.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

OBJECTIVE To investigate the current status of water management for terminal rinsing of digestive en-doscope in medical institutions in Fujian Province,and to provide reference for improving regional quality control standards.METHODS An electronic questionnaire survey was conducted from Jul.2024 to Aug.2024 through convenient sampling in secondary and above hospitals of 9 prefecture-level cities in Fujian Province.The survey covered topics such as water treatment system configuration,maintenance and water quality monitoring.RESULTS A total of 108 questionnaires were distributed and 104 valid questionnaires were collected,with an effec-tive response rate of 96.30％.The survey revealed that 78.85％(82/104)of the hospitals adopted separate water supply for each department,and 82.69％used purified water for terminal rinsing.Only 19.23％installed the final filter membrane at the water outlet.In addition,66.35％of the hospitals did not specify the service life of the wa-ter supply pipeline,and the pipeline disinfection implementation rate was 60.58％,but 31.75％of them had ir-regular disinfection frequencies,with chlorine-based disinfectants(50.79％)and peracetic acid(34.92％)being the main disinfectants.The regular conductivity monitoring rate was 47.12％,and the microbial monitoring cov-erage rate reached 90.38％,with the monitoring frequency mainly being once every quarter(60.64％),but only 20.21％used R2A medium,and 12.77％adopted the membrane filtration method for inoculation.Tertiary hospi-tals were superior to secondary hospitals in terms of film membrane pore size pass rate(87.50％vs.56.86％),pipeline disinfection implementation rate(71.43％vs.50.91％)and advanced detection method application(P＜0.05).CONCLUSIONS There are issues in the management of water used for terminal rinsing of digestive endo-scopes in Fujian Province,including non-standard equipment maintenance,inconsistent monitoring methods and insufficient awareness among management personnel.It is recommended to enhance management quality by optimizing the water treatment system setup,establishing standardized monitoring procedures and strengthening professional training for personnel.

AIM:To construct a network calcula-tor based on machine learning(ML)models to pre-dict the risk of delayed awakening from anaesthesia in breast cancer(BC)patients.METHODS:A total of 435 BC patients surgically treated at our hospital from January 2023 to June 2024 were selected.The Boruta algorithm was used to screen for important characteristic variables for the risk of delayed awak-ening from anaesthesia.All patients were randomly assigned to a training set(n=261)and a test set(n=174)based on a 3:2 ratio and nine ML models were constructed and trained.Nine ML models were evaluated on the basis of receiver operating charac-teristic(ROC)curves for a random sample of 10 sub-jects and the clinical utility of the models was as-sessed using decision curve analysis.Combined with SHapley Additive exPlanations(SHAP)bar graphs,summary graphs and force diagrams additional in-terpretation and visualization of the ML model.Con-struction of a network calculator for predicting the risk of delayed awakening from anesthesia in BC pa-tients using the R package.RESULTS:Of the 435 BC patients,25.1%experienced delayed awakening from anesthesia.Boruta algorithm screened seven feature variables.The ROC curve shows that the XG-Boost model has the highest area under the curve(AUC)for 10 random samples among the 9 ML mod-els,and the decision curve shows that the XGBoost model has a significant clinical net benefit.The SHAP bar graph shows the importance of ASA classi-fication,surgery time,anesthesia time,intraopera-tive blood loss,propofol,preoperative anemia,and intraoperative hypothermia,and the SHAP summa-ry graph reflects the distribution of the ranges of in-fluence of the seven important characteristic vari-ables,which are"separated at the ends."The SHAP force diagram visualization XGBoost model predict-ed the risk of delayed awakening from anesthesia for individual patients with a predictive value of 0.998 for patients with delayed awakening from an-esthesia and 0.008 91 for patients without delayed awakening from anesthesia.A web-based calculator(https://xz-nomogram.shinyapps.io/DE_web/)based on an interpretable XGBoost model effective-ly predicts the risk of delayed awakening from anes-thesia in BC patients.CONCLUSION:ASA classifica-tion,surgery time,propofol,intraoperative blood loss,anaesthesia time,preoperative anaemia and intraoperative hypothermia are important charac-teristic variables for the risk of delayed awakening from anaesthesia in BC patients.The network calcu-lator based on the interpretable XGBoost model can accurately and quickly quantify the risk of de-layed awakening from anaesthesia,which can help clinicians to effectively adjust the treatment strate-gy and better improve the prognosis of patients.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.