To systematically interpret the "Guideline on positioning and early mobilisation in the critically ill by an expert panel".

The development background,evidence quality,and key recommendations of the guideline were systematically reviewed.The focus was placed on interpreting the core recommendations regarding positioning and early mobilisation,and clinical practice considerations aligned with China's national context were proposed accordingly.

The guideline put forward 46 recommendations,encompassing 23 on positioning management,19 on early mobilisation,4 on assistive devices,and 2 on neuromuscular electrical stimulation.Key recommendations included:head-of-bed elevation≥40° for intubated patients;early initiation of prone positioning ventilation(for at least 12 hours) in ARDS patients with PaO₂/FiO₂<150 mmHg;and commencement of early mobilisation within 72 hours of ICU admission.

This guideline provides an evidence-based foundation for positioning management and early mobilisation in ICU patients.It is recommended to enhance healthcare staff training,establish multidisciplinary collaboration mechanisms,and improve assessment and monitoring systems to ensure standardized implementation.

To construct a physical activity program for young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery and to evaluate its application effects.

Literature related to physical activity during home-based rehabilitation after lung cancer surgery was extracted and analyzed. Focus group interviews were conducted to understand the physical activity intervention needs of young and middle-aged patients after early-stage lung cancer surgery.A preliminary version of the physical activity program was developed and reported using the TIDieR intervention template.The preliminary program was revised through two rounds of Delphi expert consultations.The final version of the physical activity program for young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery was formed.Totally 50 young and middle-aged patients with early-stage lung cancer who were hospitalized in the thoracic surgery department of a grade A tertiary hospital in Suzhou from September to October 2023 and scheduled for lung cancer resection were recruited and randomly divided into control group and intervention group.The control group received routine discharge guidance,while the intervention group additionally received the developed physical activity program.The physical activity levels and physical function of the two groups were compared before the intervention and after 8 weeks of intervention. Intervention compliance,incidence of adverse events,and patient acceptance of the intervention program were also collected.

The effective response rates for both rounds of the Delphi survey were 100%.The expert authority coefficient in the second round was 0.86,The Kendall's coefficient of concordance was 0.337(all P<0.001).The coefficient of variation ranged from 0.00 to 0.11.The final program included 12 modules and 25 items.A total of 50 middle-aged and young patients with early-stage lung cancer were recruited in this study. After excluding 12 cases,38 patients were finally included,with 19 cases in the control group and 19 cases in the intervention group respectively.Application results showed that after 8 weeks of intervention,the physical activity levels and physical function of the intervention group were higher than those of the control group(P<0.05).No adverse events occurred in either group during the intervention.The intervention group demonstrated good compliance and high acceptance of the program.

The constructed program is scientific and practical.It could help to improve the physical activity levels and physical function of young and middle-aged patients during home-based rehabilitation after early-stage lung cancer surgery.The program is well-accepted by patients.It has demonstrated good applicability.

To compare the long-term trends in colorectal cancer(CRC) mortality rates in China and the United States(U.S.) from 1992 to 2021 and to provide scientific evidence for CRC prevention and control in China.

Based on data from the GBD2021 database,CRC mortality burden data for China and the U.S.from 1992 to 2021 were extracted.The Age-Period-Cohort(APC) model was used to evaluate the independent effects of age,period,and cohort,while decomposition analysis quantified the contributions of aging,population growth,and epidemiological changes to CRC mortality.

From 1992 to 2021,colorectal cancer deaths increased in both China and the United States.However,the age-standardized mortality rate(ASMR) declined in both countries,with males consistently bearing a higher mortality burden than females.According to the age-period-cohort(APC) model,colorectal cancer mortality rose sharply with age in both countries,particularly among individuals aged 50 years and older.In China,the overall mortality rate increased from 0.53 per 100 000 to 236.50 per 100 000,while in the United States it rose from 0.11 per 100 000 to 171.02 per 100 000. The period effect demonstrated a downward trend in both countries,with the period rate ratio decreasing from 1.10 to 0.91 in China and from 1.07 to 0.85 in the United States.The cohort effect also showed a continuous decline,with China's cohort rate ratio decreasing from 1.34 to 0.46 and the U.S.declining from 2.54 to 0.74.Although the U.S.exhibited higher cohort risks,its reduction was more pronounced.Decomposition analysis further indicated that the rise in colorectal cancer deaths in China was primarily driven by population aging and population growth,whereas the mortality changes in the United States were predominantly attributable to improvements in epidemiological factors.

From 1992 to 2021,the ASMR for CRC declined in both China and the U.S.;however,CRC mortality changes in China were primarily driven by aging and population growth,highlighting the need for enhanced screening and intervention for older males.Epidemiological improvements had more pronounced effect in the U.S.,emphasizing the need for China to strengthen CRC prevention and screening efforts for the aging population and further to improve the impact of epidemiological changes.

To develop a course outline for "Clinical integrated diagnosis and treatment for advanced practice nurses",aiming to bridge the training of master of nursing specialist(MNS) postgraduates with the cultivation of advanced practice nurses in China.

The "Clinical integrated diagnosis and treatment for advanced practice nurses" course outline was established through literature review,semi-structured interviews, and a modified Delphi method.

Twenty-six experts were selected for two rounds of correspondence.The positive response rates for the two rounds were 92.86% and 100.00%,respectively.The authority coefficients of the experts were 0.896 and 0.915,and Kendall's harmony coefficients were 0.147 and 0.358(both P<0.001).The finalized course outline included four dimensions:course objectives,course content,course arrangement,and teaching and assessment methods.

The constructed course outline for "Clinical integrated diagnosis and treatment for advanced practice nurses" demonstrates scientific validity and feasibility.And it could provide a new reference and reform strategies for training advanced,practice nurses in China.

To investigate the causal relationship between 11 trace elements(calcium,iron,zinc,selenium,magnesium,copper,vitamin A,vitamin C,vitamin D,vitamin E,carotene),22 common dietary factors(alcohol consumption,beef,bread,cereal,cheese,coffee,cooked vegetable,dried fruit,fresh fruit,lamb,non-oily fish,oily fish,pork,poultry,processed meat,raw vegetable,salt added to food,tea,hot drinks,carbonated beverage,garlic intake,Chinese chive) and hyperemesis gravidarum using Mendelian randomization.

All data were summarized by using Genome-Wide Association Studies(GWAS),with single nucleotide polymorphisms(SNPs) as instrumental variables.Analyses were performed using inverse variance weighting,weighted mode,MR Egger,and weighted median.Cochrane's Q test was used to identify heterogeneity of results.MR Egger intercept test and "leave-one-out" test were applied to evaluate the robustness of the associations between the 11 trace elements,22 dietary factors and hyperemesis gravidarum.

The results showed that vitamin D supplementation could reduce the risk of hyperemesis gravidarum[OR=0.48,95%CI(0.30,0.75)].No significant effects of the other 10 trace elements or 22 dietary factors on the risk of hyperemesis gravidarum were observed(P>0.05).There was no horizontal pleiotropy or heterogeneity(P>0.05),indicating the robustness of the results.

Vitamin D could reduce the risk of hyperemesis gravidarum.No effects of the other 10 trace elements or 22 dietary factors on increasing or decreasing the risk of hyperemesis gravidarum were found temporarily.

To explore the group characteristics of medical staff with occupational exposure in different positions of public hospitals and compare their differences.

A retrospective analysis was conducted on the occupational exposure data reported by 637 medical staff from 4 public hospitals in 2 districts(Jiangsu province and Xinjiang Production and Construction Corps) from January 1,2018,to December 31,2022.A portrait study was carried out from the dimensions of sociodemographic characteristics and occupational exposure characteristics.Co-occurrence analysis and Apriori algorithm were used to explore the strong correlation characteristics and map the portraits.

The annual number of reported occupational exposure cases among medical staff was 139.0(109.0,140.0).Co-occurrence analysis showed that there were 5-7 high-intensity co-occurrence factors for doctors,nurses,standardized training interns,and logistics staff.For doctors,the co-occurrence intensity between "exposure during operation" and "standardized disposal" was the highest;for the other groups,the co-occurrence intensity between "sharp instrument injury" and "hand as the exposure site" was the highest.Association rule analysis yielded a total of 75 rules(confidence=0.70-1.00,lift=1.529-14.108),among which there were 2,42,27,and 4 rules strongly correlated with doctors,nurses,standardized training interns,and logistics staff,respectively.Portrait characteristics showed that the common characteristics of medical staff in all positions were sharp instrument injury,hand as the exposure site,and standardized disposal;the heterogeneous characteristics were reflected in age,gender,exposure location,exposure timing,and exposure source.

There are differences in key populations and typical characteristics of medical staff with occupational exposure in different positions.Analyzing and comparing their group characteristics could provide references for occupational safety and protection work.

To analyze the attribute characteristics of Traditional Chinese Medicine(TCM) health management needs among people with high-normal blood pressure based on the Kano model,providing a reference for improving TCM health services.

A total of 345 individuals with high-normal blood pressure registered at a grade A tertiary hospital and its community health center in Guangxi were selected as the study subjects.The Kano model was applied to identify the attributes of their TCM health management needs into must-be quality(M),one-dimensional quality(O),attractive quality(A),indifferent quality(I),and reverse quality(R).

Among the 36 demand items,12 were classified as must-be attributes,while 8 each were identified as one-dimensional,attractive,and indifferent attributes.Furthermore,26 indicators were screened for improvement.Prominent areas for enhancement included explanations of TCM concepts and knowledge related to high-normal blood pressure,the establishment of a TCM health information official network platform for high-normal blood pressure,and preventive monitoring of risk indicators.Within the same attribute category,the strongest improvement demands were for:convenient access to TCM diagnosis and treatment services with must-be attributes;explanations of TCM concepts and knowledge related to high-normal blood pressure with one-dimensional attributes; and collaboratively developing TCM health management plans with attractive attributes.

People with high-normal blood pressure have relatively high and multi-faceted demands for TCM health management,yet overall services remain insufficient.Future efforts should strengthen the convenience of TCM services to benefit communities and families,while addressing regional and demographic disparities.Furthermore,targeted measures should address deficiencies in areas such as TCM health education and shared decision-making.This includes gradually adjusting relevant talent training models,focusing on individual preferences,enhancing the promotion and application of TCM information platforms,and ultimately promoting the transformation of health awareness and behaviors in this population to effectively delay or curb disease progression.

To analyze the influencing factors of preoperative frailty in breast cancer patients and to develop a risk prediction model.

A total of 583 inpatients scheduled for surgical treatment in the breast surgery departments of two Grade A tertiary hospitals in Binzhou city,Shandong province,were selected between August 2024 and January 2025.They were randomly divided into a training set(408 cases) and a validation set(175 cases) in a 7∶3 ratio.Variables were screened using both Lasso regression and the Boruta algorithm.Four machine learning algorithms-support vector machine,decision tree,light gradient boosting machine,and extreme gradient boosting-were employed to develop prediction models.Model performance was compared based on accuracy,precision,sensitivity,specificity,F1-score,and the area under the receiver operating characteristic(ROC) curve(AUC).And the optimal model was interpreted using the SHAP method.

The incidence of preoperative frailty in breast cancer patients was 26.93%.Compared to the support vector machine,decision tree,and light gradient boosting machine models,the extreme gradient boosting model demonstrated the best performance,with an AUC of 0.909,accuracy of 0.829,precision of 0.646,sensitivity of 0.857,specificity of 0.818, and an F1-score of 0.737.The SHAP bar plot identified the top five influencing factors as age,hemoglobin,albumin,neutrophil percentage,and comorbidities.

The extreme gradient boosting model exhibits the best predictive performance and can serve as a reliable tool for healthcare providers to effectively assess and scientifically manage preoperative frailty in breast cancer patients.

To analyze the latent profiles of dementia fear among rural older adults and its influencing factors,aiming to provide a basis for developing targeted intervention strategies to promote healthy aging.

Using convenience sampling, 349 older adults from three rural areas in Hunan Province were selected from July to August 2023.A general information questionnaire, the Fear of Dementia Scale,and the Self-Perception of Aging Scale were used for investigation.Latent profile analysis was conducted to identify subgroups of dementia fear.Logistic regression analysis was applied to explore influencing factors.

Dementia fear among rural older adults could be divided into two latent profiles:no dementia fear group(32.67%) and moderate dementia fear group(67.33%). Logistic regression analysis showed that self-perception of aging(OR=1.113),age(OR=2.395,3.295),and exercise habits per week(OR=4.413) were influencing factors of latent profiles of dementia fear(P<0.05).

Dementia fear among rural older adults is at a moderate to low level with significant group heterogeneity.Individualized interventions should be implemented based on the characteristics of different subtypes to improve dementia fear of older adults.