ObjectiveTo understand the infection characteristics of multidrug-resistant organisms (MDROs) in hospitalized patients in a tertiary sentinel hospital in Shanghai, so as to provide an evidence for the development of targeted prevention and control measures. MethodsData of MDROs strains and corresponding medical records of some hospitalized patients in a hospital in Shanghai from 2021 to 2023 were collected, together with an analysis of the basic information, clinical treatment, underlying diseases and sources of sample collection. ResultsA total of 134 strains of MDROs isolated from hospitalized patients in this hospital were collected from 2021 to 2023 , including 63 strains of methicillin-resistant Staphylococcus aureus (MRSA), 57 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), and 14 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP). Of the 134 strains, 30 strains were found in 2021, 47 strains in 2022 and 57 strains in 2023. The male-to-female ratio of patients was 2.05∶1, with the highest percentage (70.90%) in the age group of 60‒<90 years. The primary diagnosis was mainly respiratory disease, with lung and respiratory tract as the cheif infection sites. There was no statistically significant difference in the distribution of strains between different genders and infection sites (P>0.05). However, the differences in the distribution of strains between different ages and primary diagnosis were statistically significant (P<0.05). Patients who were admitted to the intensive care unit (ICU), had urinary tract intubation, were not artery or vein intubated, were not on a ventilator, were not using immunosuppresants or hormones, and were not applying radiotherapy or chemotherapy were in the majority. There was no statistically significant difference in the distribution of strains for whether received radiotherapy or chemotherapy or not (P>0.05), while the differences in the distribution of strains with ICU admission history, urinary tract intubation, artery or vein intubation, ventilator use, and immunosuppresants or hormones use or not were statistically significant (all P<0.05). The type of specimen was mainly sputum, the hospitalized ward was mainly comprehensive ICU, the sampling time was mainly in the first quarter throughout the year, the number of underlying diseases was mainly between 1 to 2 kinds, the application of antibiotics ≥4 kinds, and those who didn’t receive any surgery recently accounted for the most. There were statistically significant differences in the distribution of strains between different specimen types, wards occupied and history of ICU stay (P<0.05), but no statistically significant difference in the distribution of strains between different sampling times, number of underlying diseases and types of antibiotics applied (P>0.05). ConclusionThe situation of prevention and control on MDROs in this hospital is still serious. Focus should be placed on high-risk factors’ and infection monitoring and preventive measures should be strengthened to reduce the incidence rate of MDROs infection.

Helicobacter pylori (Hp) is currently classified as a class I carcinogen that can cause gastric cancer, research in recent years on how Hp infection causes the occurrence and progression of gastric cancer has attracted much attention. As the primary virulence factor of Hp, cytotoxicity-associated gene A (CagA) has been extensively studied and reported to function as a key excreted toxin for Hp to induce gastric infection, colonization and promote inflammatory-carcinogenic transformation of host cells. Patients infected with CagA-positive strains have a higher risk of developing tumors compared to those infected with CagA-negative strains. Based on previous studies, this article further elaborates on the import process, biological activity, and related molecular mechanisms of virulence protein CagA in the occurrence and development of gastric cancer induced by Hp infection.

Objective:To investigate the efficacy, feasibility, and safety of task-oriented exercise training for hospitalized elderly diabetic patients.Methods:This study is a parallel randomized controlled trial with a positive control and a single-blinded assessor.From July 2020 to July 2021, we included 84 elderly patients with type 2 diabetes who were hospitalized in the Department of Endocrinology at Beijing Hospital.These patients were randomly divided into two groups: the task-oriented exercise training group(TOE group)and the regular exercise training group(regular group). The TOE group participants were trained using a task-oriented exercise program that was specifically developed by our research team.On the other hand, the regular group participants were trained using a classical program that comprised of all exercise modes.Each subject received individualized exercise training for 10 consecutive days while staying in the hospital.We evaluated the efficacy, feasibility, and safety of the training programs by measuring the physical fitness of the participants, assessing the feasibility of the program, and monitoring any exercise-related adverse events that occurred.Results:A total of 79 subjects completed the entire intervention and follow-up period, with 40 subjects in the TOE group and 39 subjects in the regular group.In terms of efficacy, both groups showed improvement in their physical fitness indexes after the intervention, with no significant differences in the degree of improvement between the two groups(all P>0.05). When considering feasibility, the TOE group had a higher proportion of prospective feasibility at 87.5%(35 out of 40)compared to the regular group at 71.8%(28 out of 39). Similarly, the TOE group had a higher proportion of practical feasibility at 75.0%(30 out of 40)compared to the regular group at 53.8%(21 out of 39). The TOE group showed a significant advantage in practical feasibility between the two groups( χ2=3.862, P=0.049). As for safety, there were no exercise-related adverse events during the intervention in either group. Conclusions:The efficacy and safety of the task-oriented exercise program for hospitalized elderly diabetic patients is comparable to that of the regular program.Additionally, the task-oriented program is more feasible than the regular program.

After entering the body from the drug delivery site, antitumor nanomedicines need to cross a series of physiopathological barriers to reach the target site of action to effectively exert antitumor therapeutic effects. The ligand modification strategy is a classic method to enhance the efficiency of nanomedicine delivery in vivo, but the contradiction between the single ligand modification strategy, which is characterized by unity and stage, and the in vivo delivery process, which is characterized by versatility and whole-process characteristics, determines that nanomedicines modified by a single ligand alone cannot satisfy the target efficacy requirements. Therefore, the use of multiligand combinatorial modification strategies by virtue of nanomedicine surface area advantages is key to advancing the next generation of smart nanomedicines. In this paper, on the basis of summarizing and classifying the commonly used functional ligands for in vivo delivery, the advantages and research progress of multiligand combination modification of antitumor nanomedicines are discussed with special focus, and the multiligand combination modification is classified as synergistic and complementary according to the combination of the ligands, which is of great significance to ensure that antitumor nanomedicines can overcome the multiple physiopathological barriers to achieve precise delivery.

Objective The leptin receptor,encoded by the LEPR gene,is involved in tumorigenesis.A potential functional variant of LEPR,rs1137101(Gln223Arg),has been extensively investigated for its contribution to the risk of digestive system(DS)cancers,but results remain conflicting rather than conclusive.Here,we performed a case-control study and subsequent meta-analysis to examine the association between rs1137101 and DS cancer risk. Methods A total of 1,727 patients with cancer(gastric/liver/colorectal:460/480/787)and 800 healthy controls were recruited.Genotyping of rs1137101 was conducted using a polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)assay and confirmed using Sanger sequencing.Twenty-four eligible studies were included in the meta-analysis. Results After Bonferroni correction,the case-control study revealed that rs1137101 was significantly associated with the risk of liver cancer in the Hubei Chinese population.The meta-analysis suggested that rs1137101 is significantly associated with the risk of overall DS,gastric,and liver cancer in the Chinese population. Conclusion The LEPR rs1137101 variant may be a genetic biomarker for susceptibility to DS cancers(especially liver and gastric cancer)in the Chinese population.

Objective To construct an intervention programme for breastfeeding among mothers of infants with congenital heart disease and to verify its effect.Methods Taking the capability-opportunity-motivation-behaviour model as the theoretical basis,the first draft of the intervention programme was formed through literature search and semi-structured interviews,and 8 experts in the relevant fields were selected to conduct expert validation and determine the content of the program.By the consecutive sampling method,infants and their mothers who attended the cardiothoracic disease clinic of a tertiary-level children's specialist hospital in Shanghai from 4 May to 24 June 2023,with a day-old age of≤14 d and a confirmed diagnosis of CHD,were selected as the study subjects.They were divided into an experimental group and a control group,with 16 cases in each group,by the method of randomized grouping by district.The experimental group received breastfeeding intervention for mothers of infants with CHD on the basis of routine care;the control group received routine care and basic disease education and breastfeeding counselling.At 1 and 3 months of the infants with CHD,the 2 groups were compared in terms of exclusive breastfeeding rate,daily human milk as a percentage of total feeds,weight for age Z-score and height for age Z-score.Results A total of 1 round of expert validation was conducted,with a valid questionnaire recovery rate of 100％and an expert authority coefficient of 0.94.The breastfeeding intervention programme for mothers of infants with CHD is a comprehensive approach that encompasses 3 key dimensions,including capability,opportunity,and motivation.The programme is designed to enhance mothers'ability to recognize feeding signals,master breastfeeding techniques,and maintain successful breastfeeding practices.It also addresses common breastfeeding challenges and provides effective solutions.Additionally,it includes strategies for breastmilk management and fosters family support for breastfeeding.The programme offers medical information support on breastfeeding and aims to elevate mothers'understanding of its benefits.It involves systematic monitoring and recording of breastfeeding volumes,as well as thorough assessments and guidance on infant growth and development,including but not limited to the 10 specific entries related to the infant's progress.The results of the generalized estimating equations and repeated measures analysis of variance revealed statistically significant between-group differences(P＜0.05)in the rates of exclusive breastfeeding,the proportion of daily human milk as a percentage of total feeds,and the weight-for-age(WAZ)and height-for-age(HAZ)z-scores of infants across the 2 groups at various time points.The results of simple effect analysis showed that the differences in exclusive breastfeeding rate,the proportion of daily human milk as a percentage of total feeds,WAZ and HAZ between the 2 groups before intervention were not statistically significant(P＞0.05).At the age of 3 months of the infants after the intervention,the rate of exclusive breastfeeding in the experimental group was higher than that in the control group,and the difference was statistically significant(P=0.003).The proportion of daily human milk as a percentage of total feeds for infants in the intervention group at 1 and 3 months of age was higher than that in the control group,with a statistically significant difference(P＜0.05).At 3 months of age,WAZ of the experimental group was higher than that of the control group,and the difference was statistically significant(P=0.037);HAZ of the experimental group was higher than that of the control group at 1 and 3 months of age after intervention,and the difference was statistically significant(P＜0.05).Conclusion The breastfeeding intervention programme for mothers of infants with CHD,constructed on the basis of the COM-B model in this study,was comprehensive,feasible and acceptable.Implementation of the programme has potential positive effects on increasing exclusive breastfeeding rates and the daily human milk as a percentage of total feeds,and may also have a positive impact on WAZ and HAZ of infants.

Objective:To evaluate the item properties and applicability of the eHealth Literacy Scale in Web 3.0 context (eHLS-Web 3.0) among diabetic patients by applying classical test theory (CTT) and item response theory (IRT) to provide a new effective tool for assessing the level of eHealth literacy among diabetic patients.Methods:A cross-sectional study design was adopted and 230 diabetic patients from the inpatient endocrinology department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University were selected by convenience sampling from November 2022 to May 2023 and were surveyed by using the self-general information questionnaire and eHLS-Web 3.0. The correlation coefficient method, Cronbach α coefficient, Guttman split-half reliability coefficient, and structural validity in CCT were used, and discriminant validity, convergent validity, and Samejima Graded Response model in IRT were used to evaluate the scale items. Results:The CTT results showed that Cronbach α coefficient for the eHLS-Web 3.0 was 0.973, the Guttman split-half reliability coefficient was 0.894, and the correlation coefficient between the items and the total score of the scale ranged from 0.708 to 0.845 (all P<0.01). Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 76.75%, and the confirmatory factor analysis model had a good fit. The reliability of each dimension combination was >0.60, and the average variance extracted was >0.50. The square root of the average variance extracted from each dimension (0.817, 0.875, 0.845) was greater than the correlation coefficient between this dimension and other dimensions (0.742, 0.763, 0.715). The IRT results showed that the discrimination parameter of all the items ranged from 2.174 to 4.054, the difficulty coefficients increased with the increase of the level (- 2.471 - 2.187), and the average information content of all the items ranged from 1.217 to 2.609. Conclusions:The eHLS-Web 3.0 has good characteristics among diabetic patients as tested by CTT and IRT, and can be used as an effective tool to assess the eHealth literacy level of diabetic patients in China.

This paper summarized the game mechanism, application status and application effect of serious games in self-management education for children and adolescents with type 1 diabetes mellitus (T1DM), and put forward the existing shortcomings and suggestions, which can provide references for Chinese medical personnel to carry out health education and develop relevant serious games in the future.

Aim To establish a gait analysis system based on DeepLabCut(DLC)algorithm for evaluating motor function in aged mice.Methods Based on DLC algorithm in deep learning technology,treadmill device and fully closed design were used in the system,including software and hardware.This system was applied to evaluate gait characteristics of mice due to aging un-der different movement modes.Correlation analysis was used to explore the effects of body weight and body length on gait indica-tors.Results This system realized the synchronous analysis of three-dimensional gait(lateral and ventral plane)of mice at specific gait speed,and automatically quantified 47 gait indica-tors.Using this system,it was found that during walking(15 cm·s-1),the standard deviation of body turning angle decreased,forelimb sway duration,standard deviation of knee angle,mean outward angles of left and right hind paw increased in 8 and 15 month-old mice,compared with 2-month-old mice.However,15-month-old mice showed decreased walking frequency,and in-creased stride width,total duration of double support,and knee extension and contraction distance.In addition,at trot(20 cm·s-1),15-month-old mice were unable to walk steadily,and 8-month-old mice had increased total duration of double support and mean outward angles of left hind paw,compared with 2-month-old mice.Correlation analysis revealed that indicators like walking frequency,stride width,forelimb sway duration,total duration of double support,standard deviation of knee an-gle,knee extension and contraction distance,were not affected by changes in body weight and body length.Conclusions The gait analysis system based on DLC algorithm can achieve a more sensitive,accurate and comprehensive evaluation of the gait of aged mice,distinguishing the gait characteristics of aged mice to maintain gait stability,and selecting behavioral indicators that better reflect the gait changes of aged mice.It provides a meth-odological basis for more effective assessment of efficacy and side effects of drugs for anti-aging and anti-decline of motor coordina-tion in the future.

Cervical cancer is one of the most common malignant tumors of the female reproductive system.Magnetic resonance imaging(MRI)has the characteristics of high soft tissue resolution,non-invasive and great repeatability.It has developed rapidly in recent years,and has been gradually applied to the diagnosis,staging,treatment and prognosis of early cervical cancer.It is an indispensable imageological examination method in the diagnosis and treatment of early cervical cancer.This article reviews the application of conventional MRI and functional MRI in early cervical cancer,in order to provide reference for the clinical diagnosis and treatment of early cervical cancer.