Objective:To systematically review the current situation and risk factors of social isolation among elderly people in Chinese communities.Methods:The research on social isolation of elderly people in Chinese communities was electronically searched on China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc, PubMed, Embase, Web of Science, and Cochrane Library. The search period was from database establishment to August 1, 2023. Two researchers independently conducted literature screening, quality evaluation, and data extraction, and used Stata 17.0 software to conduct Meta-analysis on the incidence and risk factors of social isolation among elderly people in the community.Results:A total of 29 articles were included, with a total of 49 713 samples. Meta-analysis showed that the incidence of social isolation among elderly people in Chinese communities was 29.5%. Advanced age, education below college level, poor self-rated health, lack of exercise, coexistence of chronic diseases, impaired daily living activities, hearing loss, depression, lack of spouse, low family care, low social support, and low social participation were the main risk factors for social isolation among elderly people in the community ( OR ranging from 1.57 to 3.34, P<0.05) . Conclusions:The incidence of social isolation among elderly people in Chinese communities is high, and there are many risk factors. Medical and nursing staff should strengthen early screening for social isolation among the elderly and provide early intervention for the risk factors.

Objective To systematically evaluate the application effect of virtual reality exposure in children undergoing surgeiy,providing guidance for clinical practice.Methods A systematic search of PubMed,Web of Science,Cochrane Library,Embase,CNKI,VIP,WanFang Data and CBM was conducted for randomised controlled trials on the effects of virtual reality exposure in children undergoing surgeiy.The search time was limited to March 21,2024.There were 2 researchers who independently screened the literature,extracted data and evaluated quality.Meta-analysis was performed using RevMan 5.4 software.Results A total of 9 studies with 900 children were included.The results of Meta-analysis showed that the level of preoperative anxiety in the experimental group was lower than that in the control group,and the difference was statistically significant[SMD=-0.65,95％CI(-0.95,-0.35),P＜0.001].The caregiver satisfaction in the experimental group was higher than that in the control group,and the difference was statistically significant[SMD=0.40,95％CI(0.10,0.70),P=0.010].However,there was no statistically significant difference when comparing the level of postoperative pain between the 2 groups[SMD=-1.16,95％CI(-2.83,0.51),P=0.180].Subgroup analyses showed that the preoperative anxiety levels of the children were lower when the intervention was performed with gamified interactive virtual reality videos compared with ordinary virtual reality videos and ordinary interactive virtual reality videos[SMD=-0.96,95％CI(-1.36,-0.56),P＜0.001].Compared with ≤4 min,children had lower levels of preoperative anxiety when the length of the intervention was 5 mnin[SSMD=-0.96,95％CI(-1.36,-0.56),P＜0.001].Conclusion The implementation of virtual reality exposure was effective in relieving preoperative anxiety and improving caregiver satisfaction,but further research is needed to investigate the effect on the children's postoperative pain levels.

Objective To systematically evaluate the application effect of virtual reality exposure in children undergoing surgeiy,providing guidance for clinical practice.Methods A systematic search of PubMed,Web of Science,Cochrane Library,Embase,CNKI,VIP,WanFang Data and CBM was conducted for randomised controlled trials on the effects of virtual reality exposure in children undergoing surgeiy.The search time was limited to March 21,2024.There were 2 researchers who independently screened the literature,extracted data and evaluated quality.Meta-analysis was performed using RevMan 5.4 software.Results A total of 9 studies with 900 children were included.The results of Meta-analysis showed that the level of preoperative anxiety in the experimental group was lower than that in the control group,and the difference was statistically significant[SMD=-0.65,95％CI(-0.95,-0.35),P＜0.001].The caregiver satisfaction in the experimental group was higher than that in the control group,and the difference was statistically significant[SMD=0.40,95％CI(0.10,0.70),P=0.010].However,there was no statistically significant difference when comparing the level of postoperative pain between the 2 groups[SMD=-1.16,95％CI(-2.83,0.51),P=0.180].Subgroup analyses showed that the preoperative anxiety levels of the children were lower when the intervention was performed with gamified interactive virtual reality videos compared with ordinary virtual reality videos and ordinary interactive virtual reality videos[SMD=-0.96,95％CI(-1.36,-0.56),P＜0.001].Compared with ≤4 min,children had lower levels of preoperative anxiety when the length of the intervention was 5 mnin[SSMD=-0.96,95％CI(-1.36,-0.56),P＜0.001].Conclusion The implementation of virtual reality exposure was effective in relieving preoperative anxiety and improving caregiver satisfaction,but further research is needed to investigate the effect on the children's postoperative pain levels.

Objective:To summarize the clinical features of chronic non-bacterial osteomyelitis (CNO) in children.Methods:Clinical data of 8 CNO patients admitted to the Department of Rheumatology and Immunology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2020 were retrospectively analyzed.The clinical characteristics of 8 children with CNO were summarized and compared with those reported abroad.Results:A total of 8 CNO patients were recruited, involving 3 males and 5 females with the mean age of onset (7.2±3.2)years, and the average diagnosis time 25.9 months, respectively.The common clinical symptoms included bone pain (7 cases, 87.5%), arthritis (4 cases, 50.0%), and fever (3 cases, 37.5%). The main manifestations on X-ray and CT scans were bone destruction and progressive osteosclerosis.Magnetic resonance imaging (MRI) showed bone marrow edema, periostitis, soft tissue swelling, and enhancement.All of them had more than one site of bone involvement.Seven patients(87.5%) had bilateral bone involvement, with the most common site of tibia (22.0%), followed by femur (17.1%) and mandible (9.8%). Bone biopsy was performed in 8 patients, and 4 cases showed osteonecrosis, 4 cases showed bone fibrosis and 2 cases showed osteomyelitis.The etiological examination of the bone was negative.Eight children received non-steroid anti-inflammatory drugs alone or in combination with glucocorticoids, disease-modifying antirheumatic drugs (DMARDs), bisphosphonates or tumor necrosis factor-α(TNF-α) antagonists.After treatment, the patients were followed up for 3 months to 2 years.Eight children improved.Their inflammatory indexes were normal, and had no disability, teratology or multiple organ damage.Conclusions:Pediatric CNO is more common in children of school age, with a long course of disease.The main manifestations are multi-site bone pain and arthritis.Imaging studies indicate multiple bone involvement, which is more common at lower extremities.Non-steroids anti-inflammatory drugs, glucocorticoids, DMARDs, bisphosphonates and TNF-α antagonists are effective to CNO.