ObjectiveTo compare the contents and relative molecular weight distributions of proteins and polypeptides in Naoxuekang dropping pills， Huoxue Tongmai capsules and Maixuekang capsules of Hirudo single medicinal preparations， to evaluate the in vitro anticoagulant， antiplatelet and fibrinolytic activities of the three preparations， and to investigate the effects of temperature， pH and digestive enzymes on the anticoagulant activities of the three preparations. MethodsThe contents of soluble proteins and polypeptides in the three preparations were determined by bicinchoninic acid assay（BCA） and Bradford method， and the relative molecular weight distributions of the three preparations were determined by electrophoresis combined with gel chromatography. The antithrombin activity of the three preparations was evaluated by fibrinogen-thrombin time（Fibg-TT） method， and their anticoagulant activities were further assessed by the elongations of activated partial thromboplastin time（APTT）， prothrombin time（PT） and thrombin time（TT）. The antiplatelet aggregation activities of the three preparations were measured by turbidimetry and the fibrinolytic activities were measured by fibrin plate method. Relative TT was used as index to investigate the effects of temperature， pH and digestive enzyme buffer on anticoagulant activities of the three preparations. ResultsAt the lowest single dosage， the contents of proteins and polypeptides were in the order of Maixuekang capsules>Huoxue Tongmai capsules>Naoxuekang dropping pills. Both Huoxue Tongmai capsules and Maixuekang capsules had 11 electrophoretic bands between 4.0 kDa and 90 kDa， the bands of Maixuekang capsules were more clear in the range of >25 kDa， and there was 1 obvious band at 14 kDa for the two capsules. Huoxue Tongmai capsules had one specific band at 9.0 kDa and Maixuekang capsules had one specific band at 48.0 kDa. Naoxuekang dropping pills only had 2 electrophoretic bands at 6.5 kDa and 8.5 kDa， primarily containing peptides below 2 kDa， most of which were oligopeptides. The anticoagulant activity concentrations of the three preparations exhibited a certain dose-dependent effect. At the lowest single dosage， The anticoagulant activity concentrations were ranked as Naoxuekang dropping pills>Huoxue Tongmai capsules>Maixuekang capsules. The prolongation effect of the three preparations on coagulation time was dose-dependent. At the same concentration， the prolongation effect of Naoxuekang dropping pills and Huoxue Tongmai capsules was APTT prolongation rate>TT prolongation rate>PT prolongation rate， whereas for Maixuekang capsules， the sequence was TT prolongation rate>APTT prolongation rate>PT lengthening rate. At the single minimum dosage， the order of APTT prolongation rate was Maixuekang capsules>Huoxue Tongmai capsules≈Naoxuekang dropping pills， the order of PT prolongation rate was Naoxuekang dropping pills≈Maixuekang capsules>Huoxue Tongmai capsules， and the order of TT prolongation rate was Maixuekang capsules>Huoxue Tongmai capsules>Naoxuekang dropping pills. The three preparations showed dose-dependent effects on platelet aggregation induced by adenosine diphosphate（ADP） and arachidonic acid（AA）， and the effect induced by ADP was stronger than that induced by AA. The anti-platelet aggregation effect of Naoxuekang dropping pills was significantly stronger than that of Maixuekang capsules（P<0.01）， whereas Huoxue Tongmai capsules had the effect of promoting platelet aggregation. None of the three preparations had the ability to dissolve fibrin. The anticoagulant activity of Naoxuekang dropping pills was least affected by heating， while the activities of the two capsules decreased significantly within 5 min above 80 ℃， and continued to decrease within 2 h. Compared with pure water， the anticoagulant activities of the three preparations could be increased by 1-3 times under strong acidity（pH 1-3）. In the pepsin buffer， the anticoagulant activity of Naoxuekang dropping pills could be increased by 1-3 times， while the anticoagulant activities of Huoxue Tongmai capsules and Maxuekang capsules were significantly decreased， the lowest levels were about 60% and 20%， respectively. In trypsin buffer， the anticoagulant activities of Naoxuekang dropping pills， Huoxue Tongmai capsules and Maixuekang capsules decreased significantly， and the lowest levels decreased to about 41%， 41% and 35%， respectively. ConclusionThe contents of proteins and polypeptides and relative molecular weights of the preparations derived from lyophilized fresh Hirudo powder， dried Hirudo powder and reflux extract of Hirudo decrease sequentially， and the anticoagulant activity decrease gradually， but the anticoagulant pathway is different. And the anti-platelet aggregation activity of the reflux extract is significantly enhanced. The heat resistance and gastrointestinal stability of the three preparations increase successively， and the first two are suitable for enteric-soluble preparations， while the latter is suitable for routine oral administration. The above results can provide data reference for the rationality of different preparation methods， active substances， pharmacodynamics and mechanism of Hirudo preparations.

Objective To compare clinical efficacy of different regimens in treatment of pruritus in maintenance hemodialysis(MHD)patients.Methods A total of 50 patients with MHD admitted to the Sixth People's Hospital of Jiujiang City from August 1,2022 to April 30,2024 as subjects and were divided into two groups according to random number table method.Control group(n=25)was treated with sodium thiosulfate.On this basis,gabapentin combination therapy was added in observation group(n=25).Effects of two groups were compared after 8 weeks of treatment.Results Total clinical effective rate of observation group was significantly higher than that of control group(P＜0.05).After 8 weeks of treatment,scores and total scores of all dimensions of quality of life in two groups were higher than before treatment,and observation group was higher than control group(P＜0.05).Conclusion Sodium thiosulfate combined with gabapentin in treatment of MHD patients with pruritus can not only relieve pruritus symptoms,improve sleep quality,but also have good safety.

Objective To investigate the effect of protocatechuic acid(PCA)on Toll-like receptor 4(TLR4)/nu-clear factor-kappa B(NF-κB)signal pathway in rats with ulcerative colitis(UC).Methods After modeling,rats were divided into control group,model group(5%trinitrobenzene sulfonic acid(TNBS)induction),low(L-PCA),middle(M-PCA),high(H-PCA)dose protocatechuic acid group(rats were given with PCA at doses of 20,40 and 80 mg/kg respectively),and intervention model group(LPS,rats were given with PCA at doses of 80 mg/kg and 0.8 mg/kg LPS solution intraperitoneally),and 12 rats in each group were given the drug continu-ously for 14 days.After treatment,rats were evaluated by disease activity index(DAI),and the morphology and apoptosis of colon were observed by hematoxylin eosin(HE)staining and TUNEL staining.The protein levels of Occludin,Zona occludens 1(ZO-1),claudin-1,Tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-10,TLR4 and p-p65/p65 in colon were detected by Western blotting.The expression of TLR4 protein in colon was de-tected by immunohistochemical staining.Results Compared with control group,the colon of model group rat showed obvious injury,DAI score and positive rate of TUNEL were increased(P＜0.05),the relative protein ex-pression of TNF-α,IL-1β,TLR4 and p-p65 were increased(P＜0.05),the relative protein expression of Occlu-din,ZO-1,claudin-1 and IL-10 were decreased(P＜0.05).Compared with model group,colonic injury was allevi-ated in L-PCA,M-PCA and H-PCA groups,DAI score and positive rate of TUNEL were decreased(P＜0.05),the relative protein expression of TNF-α,IL-1β,TLR4 and p-p65 were decreased(P＜0.05),the relative protein expression of Occludin,ZO-1,claudin-1 and IL-10 were increased(P＜0.05).Compared with H-PCA group,co-lon injury was aggravated in LPS group,DAI score and positive rate of TUNEL were increased(P＜0.05),the rel-ative protein expression of TNF-α,IL-1β,TLR4 and p-p65 was increased(P＜0.05),the relative protein expres-sion of Occludin,ZO-1,claudin-1 and IL-10 was decreased(P＜0.05).Conclusions Protocatechuic acid can al-leviate TNBS-induced colon injury in UC rats,improve intestinal barrier function,and inhibit colon inflammatory response,the mechanism of which is related to the activation of TLR4/NF-κB signaling pathway.

Acute pancreatitis(AP)is an autopeptic disease,which can be accompanied by systemic inflammation and multiple organ failure.Mesenchymal stem cells(MSCs)have been used in the treatment of AP and have shown good application potential.MSCs can act through multiple mechanisms to reduce pancreatic inflammation and enhance tissue repair.These mechanisms include homing to injury sites,anti-inflammatory and immunomodulatory effects,oxidative stress reduction,inhibition of apoptosis and suppression of autophagy.Additionally,MSCs can mitigate multi-organ damage associated with AP,impacting lungs,intestines,heart and other organs.Research on the application of MSCs in treating AP is predominantly at the preclinical animal study stage,with limited clinical investigations reported.This article reviews the mechanisms and research progress of MSCs in the treatment of AP,aiming to provide references for basic research and clinical applications.

BACKGROUND:At present,the clinical application of gastrointestinal stents is relatively common.Conventional self-expanding metal and plastic stents have the problems of easy displacement,difficulty to remove,and postoperative restenosis.With the advantages of biodegradability and low postoperative restenosis rate,biodegradable drug-eluting stents have become the hot spot in the research of gastrointestinal stents.OBJECTIVE:To summarize the research progress of biodegradable drug-eluting gastrointestinal stents and to provide a forecast of biodegradable drug-eluting gastrointestinal stents.METHODS:Relevant articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases from January 1994 to March 2024.The Chinese and English search terms were"biodegradable,drug-eluting stent,esophageal stent,biliary stent,pancreatic duct stent,intestinal stent,gastrointestinal stent."Finally,64 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)Biodegradable drug-eluting gastrointestinal stent is a medical device that uses biodegradable material as the main body of the stent,carries and locally elutes drugs for different therapeutic purposes,and plays the dual roles of physical support and drug therapy.By adjusting the properties of stent materials,improving manufacturing processes and auxiliary means,the degradation rate of stents can be accelerated or slowed down to meet clinical needs.Drug elution technology uses drug coatings,nanoparticles,and polymer drug-loaded films,as drug-loading platforms to accurately release drugs,increase local drug concentrations in lesions,and reduce drug loss and systemic absorption of toxic drugs.(2)The main structure of biodegradable drug-eluting gastrointestinal stent is one or more functional drugs combined with biodegradable polymers,metals or nanofiber materials.The available functional drugs are divided into anti-inflammatory and antiproliferative,antitumor,lithotripsy,and enzyme inhibitors.(3)Maintaining the stability of the mechanical properties of gastrointestinal stent and precise controlled drug release are the problems that need to be solved at this stage of biodegradable drug-eluting gastrointestinal stent.The development of new biodegradable materials and the continuous innovation of drug-carrying and drug-releasing methods,manufacturing processes and auxiliary means are the future research directions.

Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.

Acute pancreatitis(AP)is an autopeptic disease,which can be accompanied by systemic inflammation and multiple organ failure.Mesenchymal stem cells(MSCs)have been used in the treatment of AP and have shown good application potential.MSCs can act through multiple mechanisms to reduce pancreatic inflammation and enhance tissue repair.These mechanisms include homing to injury sites,anti-inflammatory and immunomodulatory effects,oxidative stress reduction,inhibition of apoptosis and suppression of autophagy.Additionally,MSCs can mitigate multi-organ damage associated with AP,impacting lungs,intestines,heart and other organs.Research on the application of MSCs in treating AP is predominantly at the preclinical animal study stage,with limited clinical investigations reported.This article reviews the mechanisms and research progress of MSCs in the treatment of AP,aiming to provide references for basic research and clinical applications.

Objective To compare clinical efficacy of different regimens in treatment of pruritus in maintenance hemodialysis(MHD)patients.Methods A total of 50 patients with MHD admitted to the Sixth People's Hospital of Jiujiang City from August 1,2022 to April 30,2024 as subjects and were divided into two groups according to random number table method.Control group(n=25)was treated with sodium thiosulfate.On this basis,gabapentin combination therapy was added in observation group(n=25).Effects of two groups were compared after 8 weeks of treatment.Results Total clinical effective rate of observation group was significantly higher than that of control group(P＜0.05).After 8 weeks of treatment,scores and total scores of all dimensions of quality of life in two groups were higher than before treatment,and observation group was higher than control group(P＜0.05).Conclusion Sodium thiosulfate combined with gabapentin in treatment of MHD patients with pruritus can not only relieve pruritus symptoms,improve sleep quality,but also have good safety.

BACKGROUND:At present,the clinical application of gastrointestinal stents is relatively common.Conventional self-expanding metal and plastic stents have the problems of easy displacement,difficulty to remove,and postoperative restenosis.With the advantages of biodegradability and low postoperative restenosis rate,biodegradable drug-eluting stents have become the hot spot in the research of gastrointestinal stents.OBJECTIVE:To summarize the research progress of biodegradable drug-eluting gastrointestinal stents and to provide a forecast of biodegradable drug-eluting gastrointestinal stents.METHODS:Relevant articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases from January 1994 to March 2024.The Chinese and English search terms were"biodegradable,drug-eluting stent,esophageal stent,biliary stent,pancreatic duct stent,intestinal stent,gastrointestinal stent."Finally,64 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)Biodegradable drug-eluting gastrointestinal stent is a medical device that uses biodegradable material as the main body of the stent,carries and locally elutes drugs for different therapeutic purposes,and plays the dual roles of physical support and drug therapy.By adjusting the properties of stent materials,improving manufacturing processes and auxiliary means,the degradation rate of stents can be accelerated or slowed down to meet clinical needs.Drug elution technology uses drug coatings,nanoparticles,and polymer drug-loaded films,as drug-loading platforms to accurately release drugs,increase local drug concentrations in lesions,and reduce drug loss and systemic absorption of toxic drugs.(2)The main structure of biodegradable drug-eluting gastrointestinal stent is one or more functional drugs combined with biodegradable polymers,metals or nanofiber materials.The available functional drugs are divided into anti-inflammatory and antiproliferative,antitumor,lithotripsy,and enzyme inhibitors.(3)Maintaining the stability of the mechanical properties of gastrointestinal stent and precise controlled drug release are the problems that need to be solved at this stage of biodegradable drug-eluting gastrointestinal stent.The development of new biodegradable materials and the continuous innovation of drug-carrying and drug-releasing methods,manufacturing processes and auxiliary means are the future research directions.

Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.