Objective:To develop a non-pharmacological nursing intervention program based on enhanced recovery after surgery (ERAS) and wrist-ankle acupuncture for postoperative nausea and vomiting (PONV) in gynecological laparoscopic surgery, and to evaluate its effectiveness.Methods:Through systematic literature retrieval, evidence screening, and expert consultation, a non-pharmacological intervention program for PONV based on ERAS and wrist-ankle acupuncture was established. Patients undergoing gynecological laparoscopic surgery in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to May 2025 were selected using convenience sampling. The observation group received the ERAS and wrist-ankle acupuncture-based intervention program, while the control group received sham acupuncture on the basis of routine nursing care. The Rhodes Index of Nausea, Vomiting, and Retching (R-INVR) , the Postoperative Patient Comfort Scale (PPCS) , adverse event incidence, and patient satisfaction were used to evaluate intervention effects.Results:A total of 96 patients completed the study, including 49 in the observation group and 47 in the control group. After the intervention, 13 patients in the observation group and 23 in the control group had R-INVR scores ≥4, with a statistically significant difference between groups ( P<0.05) . The PPCS score was (70.76±16.11) in the observation group and (61.09±12.24) in the control group, with a significant difference ( t=3.321, P<0.05) . Patient satisfaction was higher in the observation group than in the control group ( P<0.05) . During the treatment period, all patients had stable vital signs, and no serious adverse reactions or allergic responses to drugs or acupuncture were observed. Conclusions:The ERAS and wrist-ankle acupuncture-based non-pharmacological nursing intervention program is reasonable and effective. From the perspective of patient safety, it can reduce the severity of PONV in gynecological laparoscopic surgery and improve patient comfort and satisfaction.

Excessive fat accumulation,viral infections and sustained inflammatory responses caused by non-alcoholic and alcoholic factors can contribute to liver inflammation,fibrosis and carcinogenesis,promoting the development of chronic liver disease.Gaining an in-depth understanding of the etiologic factors and underlying mechanisms that lead to chronic liver disease can help identify potential therapeutic targets for targeted therapy.Lactate,as an important substance in hepatic metabolism,has been found to be involved in the process of chronic liver disease through various pathways,and this review will provide a useful reference for the prevention and treatment of chronic liver disease.

Objective:To investigate the factors influencing the delayed onset of intrapartum fever following epidural labor analgesia and their impact on maternal and neonatal outcomes.Methods:Select parturients who experienced intrapartum fever following labor analgesia(T≥38.0℃,age≥18 years,singleton pregnancy,ASA classification Ⅱ)between January 1,2021,and December 31,2023.Group them based on the median time of intra-partum fever onset after labor analgesia:those with onset times less than the median were classified as the ear-ly-onset fever group,and those with onset times greater than the median were classified as the late-onset fever group.Using univariate and multivariate Logistic regression analysis to explore factors influencing the delay in in-trapartum fever onset and the pregnancy outcomes of the mothers and newborns in both groups.Results:A total of 253 parturients were included,and the time range of onset of intrapartum fever following epidural labor analgesi-a was 1.83-28.42 hours,with a median fever onset time of 8.00 hours.There were 126 cases in the early-onset group and 127 in the late-onset group.Multivariate Logistic regression analysis indicated that primiparous women,artificial membrane rupture,and neonatal birth weight were independent risk factors for delayed fever onset(OR＞1,P＜0.05),whereas the administration of oxytocin prior to labor analgesia was found to be a protective factor(OR＜1,P＜0.05).The late-onset group exhibited higher levels of white blood cells(WBC),C-reactive pro-tein,longer hospital stays,higher hospitalization costs,greater diagnosis rates of chorioamnionitis,higher NICU ad-mission rates,as well as a higher incidence of neonatal pneumonia,for newborns compared to the early-onset group(P＜0.05).Conclusions:Primiparous women,artificial membrane rupture,and higher neonatal birth weight may be associated with delayed onset of intrapartum fever,while oxytocin administration prior to labor analgesia may offer some protective benefit.The later the onset of intrapartum fever,the worse the clinical outcomes for both mother and infants.

Objective To observe CT manifestations of Fitz-Hugh-Curtis syndrome(FHCS).Methods Data of 23 patients with FHCS were retrospectively analyzed,and non-enhanced and enhanced abdominal and pelvic CT manifestations were observed.Results All 23 cases were found with pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion.The main manifestations of pelvic inflammation included pelvic effusion(23/23,100％),inflammatory changes of uterus and accessories(17/23,73.91％),and the latter presented as tubal thickening(8/17,47.06％)or tubal cystic dilatation and effusion(9/17,52.94％),with ovarian enlargement(8/9,88.89％)or nodules on uterine surface(1/9,11.11％).The main CT manifestations of peritonitis were peritoneal thickening(23/23,100％)and peritoneal nodules(15/23,65.22％),of perihepatic inflammation were mainly liver capsule enhancement(23/23,100％),subcapsular transient perfusion abnormality(16/23,69.57％),perihepatic effusion(20/23,86.96％)and perihepatic"violin-string sign"(16/23,69.57％).No inflammation in the bare area of liver was noticed.Among 23 cases,3 cases(3/23,13.04％)complicated with mechanical ileus,19 cases(19/23,82.61％)were accompanied by mesenteric or retroperitoneal lymph nodes enlargement with uniform or circular enhancement.Conclusion The main CT manifestations of FHCS included pelvic inflammation,peritonitis,perihepatic inflammation,as well as abdominal and pelvic adhesion,having certain characteristics.

A 3-month-old female infant was admitted for incessant crying for 3 days.Examination revealed a rapidly growing massive retroperitoneal mass that was difficult to resect.Needle biopsy confirmed infantile fibrosarcoma.Initial chemotherapy with the VAC regimen(vincristine,actinomycin D,and cyclophosphamide)was administered,but the response was poor.The common fusion in infantile fibrosarcoma is ETV6-NTRK3,and next-generation sequencing detected an RBPMS-NTRK3 gene fusion in this patient.To our knowledge,this is the first reported case of infantile fibrosarcoma with RBPMS-NTRK3 fusion in China.Treatment with larotrectinib resulted in marked tumor shrinkage.

Objective:To establish a stable rat model of sequelae of pelvic inflammatory disease(SPID)with clinical characteristics,and to provide a reliable experimental model for the study of the pharmcological effect and mechanism of SPID.Methods:Twenty-four 7-week-old SD rats were divided into sham operation group,model-A(108 cfu/mL mixed bacterial solution,0.2 mL),model-B(109 cfu/mL mixed bacterial solution 0.2 mL),and model-C(108 cfu/mL E.coli 0.2 mL).The weight of the rat's uterine was weighed and the uterine index was calculated.The automatic hematology analyzer was used to detect the blood routine;hematoxylin-eosin staining(HE)and masson staining were used to detect uterine pathlogical changes in rats.Enzyme-linked immunosorbent assay(ELISA)was used to detect interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in rat uterine tissue homogenates.Western blot was used to detect the expression of proteins related to NF-κB signaling pathway.Results:Compared with the sham operation group,the uterine index of model-A,model-B,and model-C were significantly increased(P＜0.05,P＜0.01).The levels of WBC and NE in the model-A increased significantly(P＜0.01).The level of LY in model-B decreased significantly(P＜0.01).The levels of IL-1β,TNF-α in model-A,model-B,and model-C were significantly increased(P＜0.01).The levels of IL-6 in model-A and model-B were significantly increased(P＜0.05,P＜0.01).The collagen volume fraction of model-A and model-B were significantly increased(P＜0.01).Mechanism study indicates that the expression levels of p-IKKβ/IKKβ,p-IκBα/IκBα and p-p65/p65 in model-A were significantly increased(P＜0.01),and the expression levels of IκBα/β-actin were significantly decreased(P＜0.01).The expression level of p-IKKβ/IKKβ in model-B was significantly increased(P＜0.01).Conclusions:A stable rat model of SPID that conforms to clinical characteristics can be successfully constructed by combining 0.2 mL of mixed bacterial solution with a concentration of 108 cfu/mL and mechanical injury.This modeling method intervened in the expression of the NF-κB inflammatory signaling pathway.

This study explored the effects and underlying mechanism of Raf kinase inhibitory protein(RKIP)on apoptosis in mast cells sensitized by Echinococcus granulosus cyst fluid.Bone marrow-derived mast cells(BMMCs)were isolated and cultured from RKIP knockout(KO)and wild-type(WT)C57BL/6 mice.Cells were divided into control and sensitized groups.The sensitized group was incubated for 24 h in RPMI1640 medium containing 10%serum from mice infected with E.granulosus,then activated for 3 h or 6 h with E.granulosus cyst fluid.The control group was incubated for 24 h in RPMI1640 medium,and then received an equal vol-ume of PBS.Cells and supernatants were collected for analysis.Flow cytometry was used to detect the expression of CD117 and FcεRⅠα on BMMCs.The levels of β-hexosaminidase,IL-4,and TNF-α in the supernatant were quantified with ELISA.Western blot analy-sis was used to assess expression changes in RKIP,apoptosis-related proteins,and pathway proteins in BMMC before and after sensi-tization.Flow cytometry analysis revealed that after 4 weeks of induction,the CD117 and FcεRⅠα double-positivity rates on both WT and KO BMMC exceeded 90%.ELISA indicated that the E.granulosus cyst fluid resulted in significantly greater β-hexosaminidase re-lease(F=16.88,P<0.05),and levels of IL-4(F=16.51,P<0.05)and TNF-α(F=9.78,P<0.05)in the KO sensitized group than the WT sensitized group.With respect to the WT control group,the WT sensitized group showed significantly down-regulated pro-tein expression levels of RKIP(F=8.20,P<0.05)and Bcl-2(F=101.40,P<0.01)after 3 h,but significantly up-regulated levels of p-PI3K(F=8.04,P<0.05),p-Akt(F=32.52,P<0.01),p-P65(F=13.29,P<0.05),and cleaved-caspase-3(F=46.34,P<0.01).With respect to the WT sensitized group,the KO sensitized group showed significantly up-regulated protein expression of p-PI3K(F=8.45,P<0.05),p-Akt(F=8.58,P<0.05),p-P65(F=11.02,P<0.05),and Bcl-2(F=84.50,P<0.001)after 3 h,but significantly down-regulated expression of cleaved-caspase-3(F=15.66,P<0.05).In conclusion,RKIP may inhibit the PI3K/Akt/NF-κB pathway,thereby inducing apoptosis in mast cells sensitized by E.granulosus cyst fluid.This process may help ease aller-gic reactions caused by mast cells in echinococcosis,thus offering a promising new approach for preventing and treating such reactions.

Objective Bibliometric analysis software VOSviewer and CiteSpace were applied to analyze literatures related to acupuncture for myocardial Ischemia/Reperfusion(I/R)injury published in Chinese and English,to explore the status quo,dynamic trend and hot spots in the field,in order to provide reference for future research.Methods Based on the literature on acupuncture and moxibustion for myocardial I/R injury published in CNKI and Web of Science Core Collection database,VOSviewer and CiteSpace software were used to analyze literature publication trends,authors,institutions,countries,journals,keywords and citations,and draw graphs and tables to show the development status of the field and analyze the future development direction.Results Both Chinese and English literatures on the treatment of myocardial I/R injury by acupuncture and moxibustion show an increasing trend,which is one of the academic hotspots with great potential at present.In terms of Chinese literature,Yan Jie is the scholar who has published the most papers,and Hunan University of Traditional Chinese Medicine is the representative of the high production institution.The journal of Acupuncture Research has published the most papers.In terms of English literature,lu sheng-feng is the representative scholar with a high number of publications,Nanjing University of Chinese Medicine is the institution with the largest number of publications,and Evidence-Based Complementary and Alternative Medicine is the journal with the largest number of publications.The authors in the field have weak interinstitutional cooperation and exchange,and their research is mainly from China,with little international collaboration and exchange.At present,acupuncture treatment of myocardial I/R injury covers three aspects:specific acupoints,molecular biological mechanisms and clinical studies,which mainly focus on seven hot spots.Conclusion The bibliometric visual analysis visually demonstrated the current status,hot spots and frontier trends of acupuncture in the treatment of myocardial I/R injury.In the future,it is necessary to strengthen international collaboration,promote exchanges and cooperation between scholars and institutions,and promote the publication of multi-center,large-sample and high-level clinical randomized controlled studies;At the same time,the effect mechanism was further discussed from the perspectives of new molecular biological mechanisms,new intervention measures and point selection,and clinical translational research was carried out.

A 3-month-old female infant was admitted for incessant crying for 3 days.Examination revealed a rapidly growing massive retroperitoneal mass that was difficult to resect.Needle biopsy confirmed infantile fibrosarcoma.Initial chemotherapy with the VAC regimen(vincristine,actinomycin D,and cyclophosphamide)was administered,but the response was poor.The common fusion in infantile fibrosarcoma is ETV6-NTRK3,and next-generation sequencing detected an RBPMS-NTRK3 gene fusion in this patient.To our knowledge,this is the first reported case of infantile fibrosarcoma with RBPMS-NTRK3 fusion in China.Treatment with larotrectinib resulted in marked tumor shrinkage.

Objective:To develop a non-pharmacological nursing intervention program based on enhanced recovery after surgery (ERAS) and wrist-ankle acupuncture for postoperative nausea and vomiting (PONV) in gynecological laparoscopic surgery, and to evaluate its effectiveness.Methods:Through systematic literature retrieval, evidence screening, and expert consultation, a non-pharmacological intervention program for PONV based on ERAS and wrist-ankle acupuncture was established. Patients undergoing gynecological laparoscopic surgery in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to May 2025 were selected using convenience sampling. The observation group received the ERAS and wrist-ankle acupuncture-based intervention program, while the control group received sham acupuncture on the basis of routine nursing care. The Rhodes Index of Nausea, Vomiting, and Retching (R-INVR) , the Postoperative Patient Comfort Scale (PPCS) , adverse event incidence, and patient satisfaction were used to evaluate intervention effects.Results:A total of 96 patients completed the study, including 49 in the observation group and 47 in the control group. After the intervention, 13 patients in the observation group and 23 in the control group had R-INVR scores ≥4, with a statistically significant difference between groups ( P<0.05) . The PPCS score was (70.76±16.11) in the observation group and (61.09±12.24) in the control group, with a significant difference ( t=3.321, P<0.05) . Patient satisfaction was higher in the observation group than in the control group ( P<0.05) . During the treatment period, all patients had stable vital signs, and no serious adverse reactions or allergic responses to drugs or acupuncture were observed. Conclusions:The ERAS and wrist-ankle acupuncture-based non-pharmacological nursing intervention program is reasonable and effective. From the perspective of patient safety, it can reduce the severity of PONV in gynecological laparoscopic surgery and improve patient comfort and satisfaction.