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Utilization of the posterior iliac line for visualizing posterior column screws in obturator oblique view

by Hongtao Li, Li Xu, Longxin An, Xiaojing Li, Linjing Zhang, Jun Liu, Kaili Zhai, Xuecheng Sun, Naibo Feng

Purpose

To evaluate whether posterior column screws penetrate the posterior cortical surface of the acetabulum when assessed using obturator oblique radiographic imaging.

Methods

Computed tomography (CT) scans were performed on the right acetabulum of 50 healthy adults to measure the angle (α) between the posterior wall of the acetabulum and the sagittal plane at the level of the femoral head’s maximal diameter. In addition, five cadaveric pelvises were subjected to C-arm fluoroscopic imaging. A 6 cm long, 1.5 mm Kirschner wire was positioned along the posterior surface of the acetabular posterior column, aligned with the greater sciatic notch, and imaged in both the 45° and α-degree obturator oblique views. The radiographic line visualized from the Kirschner wire in the obturator oblique view was defined as the posterior iliac line, and its anatomical relationship with the posterior surface of the posterior column was analyzed. Subsequently, a 2.5 mm Kirschner wire was inserted into the posterior column at the standard entry point for screw placement using an electric drill, with the wire tip intentionally positioned between the posterior iliac line and the posterior rim in the 45° obturator oblique view. The trajectory of the wire was assessed under both 45° and α-degree obturator oblique views to determine its relation to the osseous corridor.

Results

The measured angle between the posterior surface of the acetabular posterior column and the sagittal plane was (60.2 ± 2.5)°. In the 45° obturator oblique view, the posterior iliac line corresponded with the outer edge of the iliac crest superiorly and the outer edge of the ischium inferiorly, while the posterior wall was projected posterior to the midpoint of the posterior iliac line. In the α° obturator oblique view, the posterior iliac line maintained this alignment but intersected centrally with the posterior acetabular wall. The 2.5 mm Kirschner wire remained within the osseous corridor under the 45° view but potentially extended beyond it under the α° view.

Conclusion

When the posterior column screw is visualized posterior to the posterior iliac line in the 45° obturator oblique view, further assessment using a α° view is necessary. If the screw appears anterior to the posterior iliac line in the α° view, it indicates that the posterior cortical surface has not been breached.

Risk factors for skin rash among patients with cancer receiving epidermal growth factor receptor inhibitors: a scoping review protocol

Por: Zhang · L. · Zhai · Y. · Wang · Y. · Wang · T. · Tan · J.-Y. · Sun · D. · Wang · Y. · Chen · Y. · Zheng · W. · Jiang · N. · Zhou · L.
Introduction

Skin rash is the most common adverse effect in patients with cancer receiving epidermal growth factor receptor inhibitors (EGFRIs), which can impair quality of life and lead to treatment discontinuation. Numerous primary studies have explored factors that may predict the development of skin rash. However, the wide range of variables and substantial heterogeneity among these studies limit the availability of high-quality, synthesised evidence. A comprehensive scoping review is therefore warranted to systematically map and synthesise the risk factors for EGFRI-induced skin rash in patients with cancer.

Methods and analysis

This scoping review will be conducted following the Joanna Briggs Institute methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. An initial search strategy was developed and piloted in PubMed. The comprehensive search will include PubMed, Embase, Web of Science Core Collection, CINAHL Ultimate, CENTRAL (Cochrane Central Register of Controlled Trials), SinoMed, CNKI (China National Knowledge Infrastructure) and Wanfang Database. Grey literature sources, including ProQuest Dissertations & Theses Global, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform, will also be searched. All searches were conducted from database inception to 30 January 2026, restricted to human studies published in English or Chinese. All original quantitative studies, including cohort, case–control and cross-sectional designs, will be eligible for inclusion. Two independent reviewers will screen studies for eligibility, extract relevant data and assess study quality. Any discrepancies will be resolved through discussion or consultation with a third reviewer. Results will be presented in tabular and/or graphical formats, accompanied by a descriptive summary of the risk factors for EGFRI-induced skin rash.

Ethics and dissemination

This scoping review will rely exclusively on the collection and analysis of published and/or publicly available sources; therefore, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals, presentation at scientific conferences and via digital science communication platforms.

Experience of patients with total knee arthroplasty for knee osteoarthritis in China: a patient journey map based on qualitative research

Por: Zhan · Y.-f. · Yang · L. · Zhang · S.-z. · Wu · B.-y. · Li · H.-w. · Zhai · Z.-j. · Bian · W.-w. · Liu · Y.
Objectives

This study aimed to address the lack of a holistic understanding of the total knee arthroplasty (TKA) journey in China by systematically mapping patient experiences to identify interconnected needs, emotional transitions and critical pain points across the entire care continuum.

Design

A longitudinal descriptive qualitative study using patient journey mapping methodology. Data from three sequential one-on-one semistructured interviews (preoperative, in-hospital postoperative and home rehabilitation phases) were chronologically coded into journey stages.

Setting

A tertiary hospital in Shanghai, China.

Participants

Twelve patients scheduled for elective TKA, aged 61–80 years (mean 70.25±5.86).

Results

Five categories with 17 subcategories were identified: (1) declining quality of life drives the need for change, (2) trust compensates for information gaps in decision-making, (3) hospital adaptation challenges heighten anxiety, (4) strong support needs emerge post-surgery and (5) navigating complex home recovery needs with insecurity. The patient journey was mapped across four stages: intention to change, consultation and decision-making, hospitalisation and surgery and rehabilitation and recovery. Analysis revealed several cross-stage issues: (1) the influence of disease status and treatment decision quality on postoperative outcomes, (2) inadequate preadmission preparation hindering hospital adaptation and comorbidity management and (3) insufficient predischarge planning leading to negative post-hospital rehabilitation experiences.

Conclusions

Quality deficits in early-stage interactions can trigger a cascading effect on subsequent patient experience and clinical outcomes. During the two critical phases of selecting a healthcare provider and deciding on surgery, patients undergo a transition from ‘insufficient information support’ to ‘reliance on trust’. However, irrational decision-making and unrealistic expectations collectively form a potential risk for postoperative decisional regret and dissatisfaction. Underused preoperative preparation leads to difficulties during hospitalisation, while inadequate discharge support hinders home recovery. Identifying these cross-stage pain points highlights timely intervention opportunities. Future improvements can be achieved through process redesign and technology integration, such as intelligent decision aids and remote rehabilitation systems, to enhance overall patient experience and outcomes.

Enhancing the Resilience of Bereaved Parents: Practical Experiences and Needs Perceived by Healthcare Professionals

ABSTRACT

Aims

To explore the practical experiences and perceived needs of healthcare professionals in fostering resilience among bereaved parents.

Design

A qualitative descriptive study was conducted.

Methods

Twenty-seven healthcare professionals were recruited from the Paediatric Palliative Care Special Group of the Paediatrics Society of the Chinese Medical Association. The participants included 9 physicians, 7 nurses and 11 social workers from 22 hospitals and 5 community-based services. In-depth interviews were conducted between July and December 2022. Data were analysed using content analysis.

Results

Guided by the Society-to-Cells Resilience Theory, this study identified 10 categories of practical experiences and seven of perceived needs, encompassing multiple levels: society (integrating multidisciplinary resource; preserving relevant cultural tradition; advocating for system enhancements; raising public awareness), community (establishing an accessible support network; fostering an inclusive community; offering proactive community support), family (providing anticipatory guidance; enhancing family cohesion; navigating bereavement resources; providing ongoing follow-up and support), individual (evaluating grief-related experiences; offering tailored personal support; sustaining connections; addressing spiritual needs) and physiological (managing body reactions; maintaining physical well-being).

Conclusion

This study provides insights from healthcare professionals, highlighting practices and identifying significant gaps in current approaches to building resilience in bereaved parents. The findings suggest that resilience is a socially constructed, multidimensional process that can be nurtured through a holistic approach to better support this vulnerable group.

Impact

The study's findings lay the foundation for developing targeted interventions to foster resilience among bereaved parents. A holistic, empowering approach is essential to strengthen their coping mechanisms and facilitate healing at multiple levels, ultimately contributing to the creation of a robust, effective support system for this resilient yet vulnerable population.

No Patient or Public Contribution

This study was about the experiences and perceptions of healthcare providers. It was designed and conducted by researchers who were both researchers and healthcare providers.

Embedding a Palliative Care Nurse Consultant Within a General Medicine Ward: A Prospective Exploratory Study

ABSTRACT

Aim

To describe patient outcomes for patients at high risk of mortality (with a prognosis of three months or less to live) where a Palliative Care Nurse Consultant (PCNC) was embedded in a General Medicine team. To explore patients and/or their carers feedback and allied health, nursing professionals' perspectives on integrating a palliative care approach in the General Medicine ward.

Design

Prospective exploratory study.

Methods

SQUIRE reporting guidelines was adopted for the study reporting. This study was conducted over six weeks in a general medicine ward at Monash Medical Centre in Melbourne, Australia. Participants were 20 patients aged > 65 years with non-malignant, chronic conditions at high risk of mortality within three months and had 18 nursing and allied health professionals involved in their care. Quantitative data were analysed descriptively and qualitative survey data were analysed thematically.

Results

Twenty patients participated, with an average age of 87 years. 55% spoke a language other than English. PCNC interventions, focused on care coordination and family liaison, were found to facilitate timely referrals to other support services, improve communication and better address end-of-life care needs. Healthcare professionals recognised the benefits of PCNC involvement; however, a key qualitative theme was staff reluctance to raise palliative care needs due to perceived role boundaries and limited confidence. While PCNC presence improved communication and advocacy, barriers included time constraints and patient/family resistance.

Conclusion

Embedding a PCNC in a general medicine team appears to enhance care coordination and support timely palliative care integration. Addressing barriers and optimising workflow can improve patient, carer and clinician experience as well as improve resource utilisation.

Implications for the Profession and/or Patient Care

The model has the potential to enhance patient-centred care and clinician support in acute general medicine settings.

Impact

The research will have an impact on acute care settings, particularly general medicine units, by informing models of integrated palliative care for patients with complex needs and enhancing staff capability and confidence in providing timely, person-centred care.

Patient or Public Contribution

Patients or members of the public were not involved in the design, conduct, analysis or manuscript preparation of this study. The project was a prospective observational study with limited scope and resources, which did not include a formal patient or public involvement component.

Exploring the Humanistic Care Competencies of Nurses in Infectious Disease Hospitals in China: A Modified Delphi Study

ABSTRACT

Aim

This study aims to develop an indicator system for assessing the humanistic care competencies of nurses in infectious disease hospitals and provide a scientific measurement tool to understand the current humanistic care competencies level of infectious disease nurses.

Design

A mixed-methods design integrating qualitative interviews and a modified Delphi study.

Methods

Initially, we derived a list of potential indicators of humanistic care for nurses in infectious disease hospitals from literature reviews and interviews with a nominal group technique (n=41). Following this, 26 experts from across China participated in two Delphi rounds from May to July 2023. Then the indicators were screened, revised and supplemented using the boundary value method and expert opinions. Next, the hierarchical analysis method was utilised to determine the weights of the indicators.

Results

The average effective response rate across the two Delphi rounds was 94%. The authority coefficients for the first and second rounds were 0.85 and 0.90, respectively, suggesting the experts were highly authoritative. There was a consistent rating among experts with a coordination coefficient for each indicator (p < 0.001). Ultimately, this study identified 4 primary indicators, 8 secondary indicators, and 35 tertiary indicators. The four primary indicators and their weights are basic care competency (0.158), therapeutic care competency (0.544), spiritual care competency (0.158) and safety care competency (0.140).

Conclusion

This research provides a scientifically rigorous and comprehensive framework to evaluate the humanistic care competencies of nurses in infectious disease hospitals in China. This system will serve as an effective tool for evaluating the humanistic care competencies of nurses in specialized infectious disease hospitals in China and other overseas regions.

Implications for the Profession and/or Patient Care

This study provides a new tool to assess the humanistic care competencies of nurses in infectious disease hospitals. Form an effective humanistic care competencies index system that can be used to build and develop the need for nurses to possess different aspects of humanistic care competencies tailored to infectious disease patients in hospitals.

Patient or Public Contribution

No patients or public contribution.

Workflow Interruptions, Perceived Workload and Missed Nursing: Their Impact on Nurses' Health Status—A Structural Equation Model

ABSTRACT

Background

Nurses' health status significantly impacts their well-being and patient safety. Workflow interruptions, perceived workload, and missed nursing may potentially affect their physical and mental health. However, there is currently a lack of systematic studies on the relationships between these factors.

Objective

This study aims to explore how workflow interruptions influence nurses' health status through perceived workload and missed nursing, and provide strategies to promote nurses' health.

Methods

In October 2024, an online survey was conducted among 646 clinical nurses from three healthcare facilities in Henan Province. The survey covered nurses' demographic information, workflow interruptions, health status, perceived workload and missed nursing. Statistical analysis and model construction and validation were performed using SPSS 25.0 and AMOS 26.0 software.

Results

Workflow interruptions were significantly negatively correlated with both physical component summary and mental component summary. Perceived workload and missed nursing served as mediators between workflow interruptions and physical and mental component summaries.

Conclusion

Workflow interruptions directly affect nurses' health status and indirectly influence it through perceived workload and missed nursing. Therefore, strategies should be implemented to optimise workflows, reduce workflow interruptions, lower perceived workload and take measures to minimise missed nursing. Future research could explore how to implement workflow optimization to improve nurses' health status effectively.

Implications for the Profession and Patient Care

This study provides important guidance for improving nurses' health. The results reveal that optimising workflow and reducing work interruptions can effectively reduce nurses' perceived workload, thereby decreasing the occurrence of nursing omissions, and ultimately contributing to the overall improvement of nurses' health.

Reporting Method

This study adhered to the cross-sectional Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Patient or Public Contribution

No patient or public contribution.

Effects and safety of dapagliflozin in paediatric hereditary kidney disease: protocol for a multicentric, prospective, open and randomised crossover study (DAPA-PedHKD)

Por: Zhang · W. · Dou · Y. · Liu · J. · Liu · T. · Yan · W. · Shen · Q. · Xu · H. · Zhai · Y.
Introduction

Sodium-glucose cotransporter-2 inhibitors have demonstrated cardiorenal protective effects in adults with chronic kidney disease (CKD), but their efficacy and safety in paediatric CKD remain uncertain. Treatment for hereditary kidney disease in children is limited. This DAPA-PedHKD study aims to evaluate the effectiveness and safety of combining renin-angiotensin-aldosterone system inhibitors (RAASi) with dapagliflozin compare to RAASi alone in children with hereditary kidney disease accompanied by proteinuria.

Methods and analysis

DAPA-PedHKD is a multicentre, randomised, crossover, open-label clinical trial. Patients aged 6–18 years with hereditary kidney disease will be eligible. All patients must have received stable RAASi therapy for at least 4 weeks, with a baseline estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m2, and either a 24-hour urinary protein level of >0.2 g or a urinary protein-to-creatinine ratio (UPCR) of >0.2 mg/mg. Participants will be randomised in a 1:1 ratio to receive either dapagliflozin in addition to standard RAASi therapy or RAASi therapy alone for 12 weeks. After a 4-week washout period with continued RAASi therapy, participants will crossover to the other treatment for another 12 weeks. Outcome assessments will be conducted at baseline and at weeks 2, 6, 12, 16, 18, 22 and 28. The primary outcome is the change in 24-hour urinary protein excretion from baseline to week 12. Secondary outcomes include changes in the UPCR, urinary albumin-to-creatinine ratio, serum albumin, eGFR, blood pressure and body weight from baseline to week 12. Neither participants nor investigators are blinded to treatment allocation, and placebo control is not used.

Ethics and dissemination

This study has been approved by the Ethics Committee of the Children’s Hospital of Fudan University and 11 local ethics committees. We will publish results in peer-reviewed journals and present at international conferences.

Trial registration number

NCT06890143.

Effect of electroacupuncture on postoperative gastrointestinal dysfunction in patients with perioperative oesophageal cancer: study protocol for a randomised controlled trial

Por: Pan · B. · Xu · J. · Liu · H. · Jiang · H. · Jiang · G. · Zhai · X. · Hong · J.
Introduction

Postoperative gastrointestinal dysfunction (PGD) is a common complication in patients with oesophageal cancer (OC). This complication is also a crucial factor affecting the prognosis of patients and increasing their medical burden. Gastrointestinal decompression and gastrointestinal motility-promoting oral drugs can partially relieve the symptoms, but some limitations of these treatment methods remain. Alternative therapies offer a new option for postoperative patients. This experiment will evaluate the safety and efficacy of electroacupuncture for PGD in patients with OC.

Methods and analysis

From January 2024 to December 2025, 156 patients with perioperative EC will be recruited from three Grade-A tertiary hospitals in China. The participants will be randomly assigned to one of the three groups: electroacupuncture plus standard treatment group, sham electroacupuncture plus standard treatment group and standard treatment group at a 1:1:1 ratio (with the treatment conducted four sessions). The follow-up period is 30 days. The primary outcome indicator is the time of first defecation. The secondary outcome indicators are the time of first exhaust, quality of life after surgery, length of hospital stay after surgery, tolerance time for semiliquid and solid foods, time of first ambulation, I-FEED scores, demand for postoperative analgesics and defecation drugs, European Quality of Life-5 Dimensions-5 Levels scores, Hospital Anxiety and Depression Scale scores and changes in laboratory examination indicators. All adverse reactions will be recorded.

Ethics and dissemination

This study has been approved by the ethics committee of the First Affiliated Hospital of Naval Medical University (No CHEC-2024–209). Written informed consent was obtained from all participants before the formal start of the clinical trial. The results of the clinical trial will be disseminated in peer-reviewed publications.

Trial registration number

ITMCTR2024000118.

Patients sense of gain experience and its influencing factors: a cross-sectional study in Foshan, China

Por: Xia · P. · Liang · B. · Zeng · Q. · Wang · L. · Zhai · L. · Li · M. · Chen · L. · Yang · H. · He · H. · Xu · X. · Gong · W.
Objectives

Patients’ sense of gain experience (PSGE) is the comprehensive feeling throughout the treatment process, which is a critical benchmark for evaluating comprehensive medical and health system reform in China. This study aims to assess the current status of PSGE in public hospitals and identify important associated factors, providing evidence-based recommendations for improving healthcare services.

Design

This was a cross-sectional study conducted from October to November 2023.

Setting

A total of 14 public hospitals in Foshan, Guangdong Province, China.

Participants

There were 3223 responses, including 1592 from outpatients and 1631 from inpatients.

Primary outcome measure

PSGE was assessed across five domains: time accessibility, service accessibility, cost affordability, patient participation and efficacy predictability. Participants were also asked to provide an overall rating of the PSGE.

Results

The overall score for PSGE was 4.47±0.53 (mean±SD), with service accessibility receiving the highest score (4.68±0.50) and affordability the lowest (4.17±0.86). Secondary hospitals scored an overall PSGE of 4.55±0.50, while tertiary hospitals scored 4.42±0.54. Key factors associated with PSGE were overall satisfaction (β=0.164, p

Conclusions

This study found that patients reported a positive PSGE with service accessibility but reported a less positive PSGE with cost affordability. A tier-based disparity was evident, with secondary hospitals outperforming tertiary hospitals in overall PSGE outcome. Stronger PSGE was positively associated with higher scores in overall satisfaction, treatment satisfaction, satisfaction with medical reforms, patient loyalty and hospital reputation. Demographic and institutional factors, such as hospital level, patient type and household registration, were associated with the PSGE. Efforts can be focused on enhancing clinicians’ willingness and competence in discussing treatment costs during clinical encounters. It is essential for policymakers to address disparities in healthcare experiences among patient groups across hospital tiers to advance equitable, patient-centred systems.

Mitigating Nurse Turnover in Urban China: Income Inequality and Nurse–Patient Relationships as Moderators of Occupational Stress

ABSTRACT

Aim

This study examined the moderating effects of income inequality and nurse–patient relationships on the association between occupational stress and nurse turnover intentions in large urban hospitals in China, providing evidence for developing targeted retention strategies.

Design

A cross-sectional study.

Methods

Data from 13,298 nurses in 46 hospitals in Xi'an, China (October–December 2023) were analysed using hierarchical regression to assess associations between occupational stress, organisational and professional turnover intentions and the moderating roles of the expected income achievement rate (calculated as [actual/expected income] × 100%) and nurse–patient relationship quality.

Results

Eighty-three percent of nurses reported moderate-to-severe occupational stress. Compared to nurses experiencing mild stress, those with moderate/severe stress demonstrated significantly higher organisational and professional turnover intentions. After adjusting for covariates, significant interaction effects were observed. Higher expected income achievement rate showed a modest but significant moderating effect, associated with reduced turnover intentions. While the nurse–patient relationship also moderated this relationship, its protective effect was attenuated under conditions of severe stress. Despite small effect sizes, the consistent patterns and theoretical coherence of these interactions warrant further investigation.

Conclusion

Occupational stress significantly predicts nurse turnover intentions in urban Chinese hospitals, with income inequality and nurse–patient relationship quality serving as modifiable moderating factors. Interventions should integrate equitable compensation, nurse–patient relationship enhancement programmes and stress management initiatives.

Impact

This study demonstrates that equitable income consistently buffers the effects of occupational stress on nurse turnover, while nurse–patient relationships show stress-level-dependent moderation. By implementing region-specific compensation benchmarks and structured communication training, healthcare policymakers can effectively address economic security and relational care quality in workforce stabilisation.

Reporting Method

The study has been reported following the STROBE guidelines.

Patient or Public Contribution

No patient or public contribution.

Evaluating the effects of liraglutide, empagliflozin and linagliptin on mild cognitive impairment remission in patients with type 2 diabetes (LIGHT-MCI): study protocol for a multicentre, randomised controlled trial with an extension phase

Por: Yu · C. · Yang · H. · Zhang · B. · Chen · S. · Yang · S. · Li · F. · Zhu · W. · Zhai · B. · Wu · T. · Zhao · S. · Zhang · W. · Tong · X. · Duan · Y. · Zhang · L. · Chao · Y. · Wu · J. · Zhu · X. · Wang · K. · Ye · X. · Zhang · X. · Xu · X. · Cheng · H. · Liu · J. · Zhang · J. · Wang · Y. · Zhang · Z. · Ya
Introduction

Diabetes is a significant modifiable risk factor for cognitive dysfunction. There are currently no effective treatments that delay or reverse the progression of cognitive dysfunction. Accumulating evidence demonstrates that specific antidiabetes medications hold promise in improving cognitive function. However, the comparative effects of various antidiabetic drug classes on cognitive protection remain to be fully elucidated. This study aims to investigate and compare the cognitive benefits of liraglutide, empagliflozin and linagliptin on achieving mild cognitive impairment (MCI) remission in individuals with type 2 diabetes (T2D).

Methods and analysis

The LIGHT-MCI trial is an investigator-initiated, multicentre, open-label, parallel-group, randomised, superiority trial involving T2D patients with MCI, consisting of a 48-week core study followed by an extension phase through to 76 weeks. A total of 396 participants will be randomly allocated 1:1:1 to receive liraglutide, empagliflozin or linagliptin treatment. The primary outcome measure is the efficacy difference of liraglutide, empagliflozin and linagliptin in achieving MCI remission in individuals with T2D. The key secondary outcome measures include changes in scores of general cognition and various cognitive subdomains (including processing speed, executive function, immediate memory, visuospatial construction ability, language, attention and delayed memory), basic and instrumental daily living ability, MRI-derived normalised measures of total brain volume, cerebral microstructures, cortical and nuclear volume, white matter hyperintensity, volume, white matter microstructural integrity, odour-induced brain activation and resting-state functional connectivity, olfactory function and metabolic parameters.

Ethics and dissemination

The LIGHT-MCI trial has received approval from the Ethics Committees of the Drum Tower Hospital Affiliated to Nanjing University Medical School (2022-092-02) and other participating centres in accordance with the principles of the Declaration of Helsinki and the International Conference on Harmonisation for Good Clinical Practice (ICH GCP E6). Informed consent is required for participation. Findings from this trial are disseminated through peer-reviewed publications, conference presentations, newsletters and social media.

Trial registration number

NCT05313529.

Kun-Qi birth cohort (KQBC) study for the incidence, aetiology and risk factors of chronic kidney disease in Chinese children: a cohort profile

Por: Shen · Y. · Liu · T. · Liu · J. · Han · X. · Wu · J. · Xie · L. · Chen · X. · Xu · B. · Sun · Y. · Xu · S. · Zhang · Q. · Xie · N. · Zhang · L. · Ji · J. · Mo · W. · Liu · Y. · Shi · X. · Shen · J. · Qiu · W. · Huang · J. · Shen · Q. · Zhai · Y. · Xu · H. · On behalf of the KQBC group · Xu · Zhai · She
Purpose

The Kun–Qi birth cohort (KQBC) was established to investigate the incidence, aetiology and risk factors of chronic kidney disease (CKD) in early childhood (0–6 years). Additionally, the study analysed developmental phenotypic trajectories and their associated paediatric diseases.

Participants

Infants registered or residing in Kunshan and Qidong, Jiangsu Province, who participated in the Chinese Child Healthcare Programme (0–6 years) were enrolled. The baseline population was stratified into enhanced and basic cohorts. General characteristics, periconceptional and perinatal information and health check-up data were collected from each participant. Dual screening (urinary ultrasound and urine dipstick tests) was conducted during scheduled check-ups. Structured CKD questionnaires were administered, and biosamples (urine and dried blood spots) were obtained for the long-term storage and analysis using standard procedures. Based on the proposed referral procedure, participants with abnormal results were referred for further diagnosis and evaluation.

Findings to date

The KQBC enrolled 10 127 infants (5392 boys and 4735 girls) with a mean age of 2.11±1.68 months. Urinary system ultrasound and urine dipstick screening showed positivity rates of 8.9% (900/10 083) and 6.5% (532/8233), respectively. Baseline ultrasound screening facilitated timely surgical intervention in six children. Among the 7965 respondents, only 13% demonstrated awareness of paediatric CKD. Additionally, 7273 dried blood spots and 7990 urine specimens were collected and stored. A paediatric CKD screening platform was developed.

Future plans

According to our plan, the KQBC will be followed up for 3–6 years to investigate the incidence, aetiology and risk factors of early onset CKD. In-depth developmental phenotypes, such as urinary multiomics and ultrasound imaging, should be studied for longitudinal paediatric kidney health. We aim to develop multimodal risk prediction models by integrating genomics and artificial intelligence algorithms. The KQBC also enables prospective cohort studies addressing extensive research questions.

Trial registration number

NCT06018831.

Efficacy and safety of acupuncture for IgA vasculitis abdominal pain: protocol for a systematic review and meta-analysis

Por: Zhao · P. · Ren · X. · Zhai · W.-S.
Introduction

Abdominal pain is one of the most common symptoms in patients with IgA vasculitis (IgAV), adversely affecting both physical and mental health. Clinical studies have demonstrated that acupuncture can quickly alleviate pain and reduce the duration of abdominal pain episodes. Given its growing acceptance in clinical practice, acupuncture is increasingly being adopted for managing IgAV-related abdominal pain. The objective of this systematic review is to evaluate and synthesise evidence regarding the efficacy and safety of acupuncture for IgAV abdominal pain.

Methods and analysis

Eight databases will be systematically searched from their inception to 1 June 2025: China National Knowledge Infrastructure, Chinese Biomedical Literature Database (China Biology Medicine), VIP Database, Wanfang Database, PubMed, Embase, Cochrane Library and Web of Science. Only randomised controlled trials investigating acupuncture for IgAV abdominal pain, published in Chinese or English, will be included. Two independent researchers will perform study selection, data extraction and risk-of-bias assessment. The primary outcomes include symptom and sign scores and time to abdominal pain resolution. Secondary outcomes comprise recurrence rate, incidence of adverse events and urinalysis results. Risk of bias will be evaluated using the Cochrane Risk of Bias Tool (V.2.0). Meta-analyses will be conducted using Review Manager software (V.5.3). For continuous data, we will calculate standardised mean differences with 95% CIs. For dichotomous outcomes, relative risks and 95% CIs will be calculated. Subgroup analyses will be performed where feasible. The overall evidence quality will be graded using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Ethics and dissemination

Ethical approval is not required for this study as it does not involve the collection of primary patient data. The results of this meta-analysis will be disseminated through peer-reviewed publications.

PROSPERO registration number

CRD42023483770

Cognitive behavioural therapy and related interventions for sleep disorders in children and adults with autism spectrum disorder: protocol for a systematic review and meta-analysis

Por: Zhai · Q. · Wu · Y. · Wu · Y. · Ji · Y. · Li · Y. · Xu · R. · Zhong · Y. · Xiao · B. · Zhou · L.
Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by deficits in social communication and repetitive behaviours, often accompanied by sleep disturbances. These sleep problems, including prolonged sleep latency and fragmented sleep, affect more than half of autistic individuals, exacerbating functional impairments and diminishing quality of life. Cognitive behavioural therapy (CBT) has shown promise in addressing sleep disturbances in ASD, with preliminary studies indicating improvements in sleep quality. However, no systematic review has comprehensively summarised the effects of CBT on sleep in autistic individuals.

Methods and analysis

This systematic review and meta-analysis will synthesise evidence on the efficacy of CBT for improving sleep quality in individuals with ASD. We will search multiple databases (eg, PubMed, Web of Science) for studies published until May 2025. Inclusion criteria encompass randomised controlled trials, single-arm studies and observational studies involving children and adults with ASD and moderate sleep problems. Interventions targeting sleep quality using CBT techniques will be considered. Data extraction will focus on study details, participant information, intervention specifics and sleep outcome measures (eg, total sleep time, sleep onset latency, etc). Risk of bias will be assessed using tools such as Cochrane Risk of Bias Tool V.2, Risk Of Bias In Non-randomised Studies—of Interventions and Review Manager 5.3. A meta-analysis will be conducted using Stata 18, with heterogeneity evaluated using the I² statistic and Cochran’s Q test.

Ethics and dissemination

Given that the dataset for this investigation is derived from publicly accessible databases, there is no direct interaction with patients; thus, ethical approval is not required.

PROSPERO registration number

CRD42025643701.

Telitacicept for systemic lupus erythematosus: protocol of a systematic review and meta-analysis

Por: Ren · X. · Zhao · P. · Zhang · J. · Yu · X. · Zhai · W.
Introduction

Systemic lupus erythematosus (SLE) is a chronic and complex multisystem autoimmune disease with high mortality. Telitacicept is a new strategy for the treatment of SLE, inhibiting the maturity, proliferation and differentiation of B cells, and thus, reduces disease activity. However, the effectiveness and safety of telitacicept in patients with SLE are not yet established.

Methods and analysis

Five English databases (Pubmed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature) and four Chinese databases (China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database and Sinomed) will be searched from database inception to 1 June 2025. Two investigators will independently conduct study selection, data extraction and quality assessment. Outcomes include disease activity, incidence of flares, organ damage, several immune-related laboratory parameters and adverse events. Risk ratio with 95% CI and mean difference or standardised mean difference will be used as measures of effect sizes, in order to pool the data using either a random-effect model or fixed-effect model according to the heterogeneity of studies. Subgroup analysis and sensitivity analysis will be performed to explore the source of heterogeneity and evaluate the robustness of the results. We will use the Risk of Bias 2 tool and Risk of Bias In Non-Randomized Studies of Interventions tools to assess the quality of the included studies, and use the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system to assess the certainty of evidence.

Ethics and dissemination

No ethical approval is required since this review is based on previously published studies. The findings of this study will be presented at international conferences or published in a peer-reviewed journal.

PROSPERO registration number

CRD42024558180.

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