Bronchial asthma （asthma） is a heterogeneous disease characterized by airflow limitation， airway remodeling， and recurrent symptoms such as wheezing， shortness of breath， chest tightness， and cough. Its prevalence is gradually increasing， and a portion of patients are still poorly controlled， leading to a serious social and medical burden. Modern studies have proposed the concept of the "lung-gut axis"， which is based on the crosstalk between microorganisms and their metabolites in the lungs and large intestine， and have indicated that microbial dysbiosis in these organs may affect the onset and progression of asthma. Traditional Chinese medicine （TCM） has found the phenomenon of lung-intestinal comorbidity and put forward the importance of "lung-intestinal coordination therapy" in the treatment of lung-related diseases. It has been found that intestinal flora and their metabolites can modulate immune responses through the lung-gut axis， demonstrating great potential for predicting asthma susceptibility， anticipating phenotypes， assessing asthma severity， and guiding treatment. TCM comopunds that embody lung-intestinal coordination therapy， including herbal formulas， single herbs， acupuncture， moxibustion， acupoint application， and spinal pinching therapy， has been shown to regulate intestinal flora， improve metabolism， regulate immunity， alleviate lung inflammation， reduce mucus secretion， inhibit airway remodeling， effectively alleviate symptoms， and delay lung function decline. Based on "lung-intestinal coordination therapy"， this paper used intestinal flora as the entry point to summarize the underlying mechanisms of TCM in asthma treatment and highlighted the pivotal role of intestinal flora in asthma， providing a new idea for its clinical treatment through the intestinal flora .

This study was aimed at understanding the pollution distribution pattern of avian influenza virus in the environ-ment in poultry related places in Shandong Province,to provide a scientific basis for the prevention,control,prediction,and early warning regarding human infection with avian influenza.From 2020 to 2023,6 523 environmental samples were collected in 16 cities in Shandong Province from four types of poultry-related places.Fluorescence quantitative PCR was used for nucleic acid testing of influenza A virus.Positive samples were further identified for the H5,H7,and H9 subtypes of avian influenza virus.The epidemiological characteristics of avian influenza viruses in the poultry related environment of Shandong Province were described,and inter-rate comparisons were performed with the x2 test.During 2020-2023,6 523 environmental samples were collected,and 1 007 cases positive for avian influenza virus were detected,with a positivity rate of 15.44％.H5,H7,and H9 subtypesand mixed infections were detected.H9 was the main subtype(88.48％)in positive specimens.A significant difference in positivity rates was observed among regions(x2=431.956,P＜0.001),and the highest positivity rate was 28.93％.Significant differences in positivity rates were observed among monitoring sites(x2=304.604,P＜0.001),sample types(x2=109.678,P＜0.001),and quarters(x2=64.963,P＜0.001).The positive detection rate was highest at monitoring sites in urban and rural live poultry markets(20.12％),and the positive detection rate of samples collected by wiping meat cut-ting board surfaces was higher than that of other samples(22.56％).The peak positive detection rate occurred in spring(20.31％).Widespread contamination with avian influenza virus was observed in poultry environments in Shandong Prov-ince.The H9 subtype,the main pathogen,coexisted with H5 and H7 subtypes,thus posing a risk of human infection with avian influenza.Therefore,prevention and control of avian influenza must be strengthened in key seasons,areas,places,and links.

Acute ST-segment elevation myocardial infarction(STEMI)is one of the main causes of death and disa-bility in the East and the West.Though medical technology develops rapidly,its morbidity and mortality are still high.High mobility group box 1(HMGB1)is a kind of damage associated molecule patterns(DAMPs)that is re-leased from inflammatory cells and necrotic cells,causing inflammatory activation,releasing inflammatory factors,triggering the coagulation cascade,regulating cell migration,chemotaxis,apoptosis and autophagy.This review aims to describe the advances in the mechanism of HMGB1 involved in acute STEMI,and hope to provide new ideas for the prevention,treatment and prognosis improvement of STEMI.

Objective To investigate the effects of Zhoufei Pingchuan Capsules on the balance of peripheral blood helper T lymphocyte 17 cell/regulatory T lymphocyte cell(Th17/Treg)and related inflammatory factors in peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD)with lung-kidney qi deficiency syndrome.Methods Totally 40 COPD patients were randomly divided into the study group and the control group,with 20 cases in each group.Another 20 cases were in the healthy group.The control group was given tiotropium bromide powder inhalation,18 μg/time,1 time/d,inhalation;on the basis of the control group,the study group was given Zhoufei Pingchuan Capsules,3 pills/time,3 times/d,orally.All patients were treated for 8 weeks.The healthy group was not given any intervention.Forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),maximum mid-expiratory flow(MMEF),carbon monoxide diffusing capacity/alveolar ventilation(DLCO/VA),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),COPD assessment test(CAT)score,Th17/Treg ratio,cytokines interleukin(IL)-17,IL-22,IL-10,and transforming growth factor-β1(TGF-β1)were compared before and after treatment.Results Compared with before treatment,the lung function indexes(FEV1,FEV1/FVC,MMEF,DLCO/VA),blood gas indexes(PaO2,PaCO2)and CAT score in the study group after treatment were significantly improved(P<0.05).After treatment,the mean values of MMEF,DLCO/VA,PaCO2 and CAT score in the study group were better than those in the control group(P<0.05).Compared with before treatment,the levels of Th17,IL-17 and IL-22 in the study group were significantly lower,and the levels of Treg,IL-10 and TGF-β1 were significantly higher(P<0.05).After treatment,there were significant differences in Th17,Treg,IL-17,IL-22,IL-10 and TGF-β1 among the three groups(P<0.01).Further pairwise comparison showed that Th17 ranked in the order of high and low was control group>study group>healthy group,Treg in the order of high and low was healthy group>study group>control group,the levels of IL-17 and IL-22 in the order of high and low were control group>study group>healthy group,and the levels of IL-10 and TGF-β1 in the order of high and low were healthy group>study group>control group,with statistical significance(P<0.05).Conclusion Zhoufei Pingchuan Capsules can improve the lung function,arterial blood gas and symptom score of patients with lung-kidney qi deficiency syndrome in stable stage of COPD.Its mechanism may be related to regulating the balance of Th17/Treg,down-regulating the levels of Th17,IL-17 and IL-22,and up-regulating the levels of Treg,IL-10 and TGF-β1,in order to reduce airway inflammation and regulate immune homeostasis.

AIM:To explore the influence factors of the treatment zone diameter(TZD)and its correlation with axial length growth(ALG)after Paragon CRT orthokeratology.METHODS: Retrospective clinical study. The data of 226 myopic patients(226 eyes)wearing Paragon CRT orthokeratology from April 2020 to September 2022 were collect. The correlated factors of TZD after wearing lens for 1mo, and the relationship between the overlapping treatment zone/ pupil area ratio and the ALG after wearing lens for 1a were analyzed.RESULTS: After wearing lens for 1mo, the TZD was negatively correlated with central corneal thickness(CCT)and positively correlated with the flat corneal eccentricity. After wearing lens for 1a, the ALG of the small TZD group(0.25±0.18mm)was significantly smaller than that of the large TZD group(0.34±0.24mm, P=0.002), and the ALG of the small area ratio group(0.24±0.19mm)was significantly smaller than that of the large area ratio group(0.35±0.23mm,P<0.001). Age and overlapping treatment zone area/pupil area ratio were significantly associated with the ALG in multivariate linear regression(all P<0.05).CONCLUSION: The wearers with thicker CCT and smaller flat corneal eccentricity usually had smaller TZD, and both the TZD and the overlapping treatment zone area/pupil area ratio were correlated with the ALG.

Metaverse technology, which fully combines virtual reality, augmented reality, digital twins, blockchain, Internet of Things and other technologies, enjoys promising prospects and advantages in medical care. This article reviews the types of Metaverse key technologies and their application status in medical care, proposes to develop "Metaverse + nursing" in the future, and looks forward to it, in order to promote the integration of Metaverse and nursing theory and practice and lay the foundation for subsequent research.

Objective:To explore the application effect of time-sensitive incentive nursing in patients with multiple myeloma (MM) .Methods:From January 2019 to May 2021, the convenient sampling method was used to select 86 MM patients admitted to Henan Provincial People's Hospital as the research objects. According to the time of admission, 43 patients admitted from January 2019 to January 2020 were divided into the control group and 43 patients admitted from February 2020 to May 2021 were divided into the study group. The control group was given routine nursing, while the study group was given time-sensitive incentive nursing based on the control group. The psychological resilience and quality of life of the two groups before and after intervention were compared, and the occurrence of adverse reactions between the two groups during intervention was statistically analyzed.Results:After the intervention, the dimension scores of psychological resilience scale and the dimension scores of quality of life scale in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The incidence of gastrointestinal reactions in the study group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Time-sensitive incentive nursing can improve the psychological resilience of MM patients, reduce the occurrence of gastrointestinal reactions caused by chemotherapy and improve the quality of life.

Objective:To establish an index system for frailty risk assessment of maintenance hemodialysis patients, and scientifically evaluate frailty risk status of maintenance hemodialysis patients.Methods:With the biopsychosocial medical model as the theoretical framework, semi-structured interview method and Delphi expert consultation method were used to establish and screen indicators and analytic hierarchy process was used to determine the weight of indicators, and an indicator system for frailty risk assessment of patients with maintenance hemodialysis was constructed.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were respectively 100.00% (22/22) and 95.45% (21/22), the expert authority coefficients were respectively 0.85 and 0.84, the Kendall's harmony coefficients of the importance of expert opinions were respectively 0.149 and 0.201, and the Kendall's harmony coefficients of the feasibility of expert opinions were respectively 0.134 and 0.175. Finally, the frailty risk evaluation system for maintenance hemodialysis patients was established, including 3 primary indexes, 8 secondary indexes and 36 tertiary indexes.Conclusions:The established frailty risk evaluation index system for patients with maintenance hemodialysis is scientific and practical and comprehensive in content, which can better reflect the specialty characteristics and provide a basis for frailty risk assessment for maintenance hemodialysis patients.

Objective To observe the potential mechanism of electroacupuncture regulating the erythropoietin-producing hepatocellular receptor B2/erythropoietin-producing hepatocellular receptor-interacting B2/big mitogen-activated protein kinase 1(EphB2/EphrinB2/BMK1) signaling pathway to improve neural damage in vascular dementia rats. Methods Eighty SD male adult rats were randomly divided into a sham surgery group, a model group, a non acupoint electroacupuncture group, a nimodipine group, and an electroacupuncture three needle group. The vascular dementia rat model was made by the modified Pulsinelli four vessel occlusion method. After grouping, the rats in each group were subjected to water maze test, HE staining, Nissl staining, and transmission electron microscopy(TEM) to observe the pathological changes in the hippocampal CA1 area, and the expression of EphB2 and BMK1 in the hippocampal CA1 area was detected by immunohistochemistry; Detection of EphB2 and BMK1 protein expression in rat hippocampal CA1 region was detected by Western blotting. Results Compared with the model group, the escape latency of vascular dementia rats treated with electroacupuncture and nimodipine decreased (P<0.05), while the number of crossing platforms significantly increased (P<0.05); The result of HE staining, Nissl staining and TEM showed that compared with the model group, the neurons in hippocampal CA1 area of rats in the EA Zhisanzhen group and nimodipine group were arranged orderly, and the morphology and structure of cells and organelle were complete; Immunohistochemical method and Western blotting showed that the expression of EphB2 and BMK1 in the CA1 region of hippocampus in the model group was significantly lower than that in the sham surgery group (P<0.05); Compared with the model group, the expression of EphB2 and BMK1 in the hippocampal CA1 region of rats in the electroacupuncture Zhisanzhen group significantly increased (P<0.05), while the expression of EphB2 and BMK1 in the hippocampal CA1 region of rats in the non acupoint electroacupuncture group was not statistically significant (P>0.05). Compared with the nimodipine group, the expression of EphB2 and BMK1 in the hippocampal CA1 region of rats in the electroacupuncture Zhisanzhen group significantly increased (P<0.05). Conclusion Electroacupuncture may improve the damage of hippocampal neurons in vascular dementia rats by increasing the expression of EphB2 and BMK1 in the CA1 region of the hippocampus, thereby improving the learning and memory of vascular dementia rats.

Objective:To investigate the clinical significance of vertebral body partition in the unipedicular percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.Methods:From July 2019 to October 2021, 89 patients with osteoporotic vertebral fracture were treated by unipedicular PVP at Department of Spinal Surgery, Zhengzhou Orthopaedic Hospital. They were 37 males and 52 females, with a mean age of (70.5±4.8) years (from 60 to 80 years). According to the vertebral body partition, the patients were divided into group a (32 cases), group b (20 cases), group c (21 cases), group d (11 cases), group e (0 case) and group f (5 cases). The therapeutic effects were evaluated by comparing the improvement rates of visual analogue scale (VAS) and Oswestry disability index (ODI) between preoperation and postoperative 1-day among all partition groups. The imaging efficacy was evaluated by comparing the proportions of bone cement diffusion area in the posteroanterior and lateral DR films and the leakage of bone cement among all partition groups.Results:The improvement rates of VAS score between preoperation and postoperation: group a [77.8 (75.0, 82.5) %] > group b [71.4 (71.4, 71.4) %] > group c [66.7 (66.7, 66.7) %] > group d [60.0 (60.0, 62.5) %] > group f [57.1 (50.0, 57.1)%], showing a statistically significant difference between any 2 groups ( P<0.001). The improvement rates of ODI score: group a (58.0%±4.2%) > group b (47.5%±2.5%) > group c (42.9%±2.9%) > group d (39.6%±3.2%) > group f (34.2%±8.4%), showing a statistically significant difference between any 2 groups ( P<0.001). The proportions of bone cement diffusion area: group a (76.9%±3.5%) > group b (71.3%±3.1%) > group c (66.1%±3.6%) > group d (60.2%±2.6%) > group f (54.0%±4.2%), showing a statistically significant difference between any 2 groups ( P<0.001). Bone cement leakage occurred in 7 cases, including 3 ones of anterior vertebral leakage (1 case in group a and 2 cases in group b), and 4 ones of leakage into the paravertebral venous plexus (2 cases in group c and 2 cases in group d). There was no intraspinal leakage, or symptoms of nerve compression or lesion. Conclusion:In the unipedicular PVP for osteoporotic vertebral fractures, our vertebral body partition can guide puncturing for bone cement injection because it indicates the optimal and the risky partitions.