Objective To determine the molecular mechanism of Yuchang granule (YCG) against ulcerative colitis （UC） by network pharmacology-based approach combined with molecular docking. Methods TCMSP and HIT database were utilized to search the active components and potential targets of YCG. The effective targets of UC were obtained by GeneCards, CTD, and DisGeNET databases. Venn Diagram was exploited to receive common targets of YCG and UC. Network maps of the TCM of YCG-active component-common targets were constructed by the Cytoscape software to gain key active components. Protein-protein interaction （PPI） of common targets was constructed by the STRING database obtaining core common targets. The mechanism and therapeutic effects of YCG on UC were explored via gene ontology （GO） and the biological pathway （KEGG） enrichment analyses. Molecular docking technology was carried out to verify the combination of core active components with key common targets. Results 98 active components and 237 potential targets were sieved from YCG, and 1061 effective targets were screened from UC. 94 common targets of YCG and UC were regarded as potential therapeutic targets. Bioinformatics analysis revealed that quercetin, luteolin, β-quebrachol, stigmasterol, and kaempferol may be the potential candidate agents. Tumor necrosis factor （TNF）, serine/threonine-protein kinase （AKT1）, tumor protein p53 （TP53）, interleukin-6 （IL-6） and IL-1β could become potential therapeutic targets. KEGG showed pathways in cancer, AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, and IL-17 signaling pathway might play an important role in YCG against UC. Molecular docking results showed that quercetin combined well with TNF, AKT1, and TP53. And stigmasterol did well with AKT1. Conclusion This study comprehensively illustrated the potential candidate agents, potential therapeutic targets, and pathways of YCG against UC. It also illustrated that YCG could act on multiple targets through multi-pathway treating UC.

Objective Patients with lung cancer often experience interrelated symptoms such as fatigue, pain, and sleep disturbances during chemotherapy, forming a core symptom cluster that significantly impacts daily functioning, treatment experience, and quality of life. Currently, evidence on non-pharmacological management of this core symptom cluster is scattered, and there is a lack of standardized, patient- and caregiver-friendly guidance tools that are easy to understand and implement. This patient guideline aims to provide decision support for self-management of the core symptom cluster in patients undergoing chemotherapy for lung cancer. Methods Guided by evidence-based methodology, qualitative interviews and on-site questionnaire surveys were conducted to identify the health-related needs of stakeholders. Domestic and international guideline websites, relevant professional association websites, and comprehensive databases were systematically searched according to the inclusion and exclusion criteria. The included literature was evaluated for quality, and recommendations were extracted, integrated, and graded to form a summary of the best evidence. Based on the identified health issues and evidence summary, preliminary recommendations for the patient guideline were developed. The recommendations were then revised through two rounds of Delphi expert consultation, and consensus was reached on the strength of recommendations, forming the final version of the patient guideline. Results The patient guideline covered four major sections: screening and assessment of core symptom clusters, daily management, intervention measures, and timing of referral. The core content included nine aspects: screening of core symptom clusters, assessment, lifestyle habits, dietary interventions, sleep environment, exercise interventions, psychological interventions, Traditional Chinese Medicine interventions, and referral indications. In total, the guidelines addressed 16 health issues and provided 25 recommendations. Conclusion The development process of this patient guideline is rigorous and fully considered the needs of patients. Expert review concludes that the recommendations are highly feasible and appropriate.

Depression is a common mental illness that has a negative impact on patient quality of life,as well as representing a serious economic burden to society.The strategy of interfering with depression based on signaling pathways has recently attracted widespread attention.The cAMP pathway is an important cellular signaling pathway that plays a key role in the pathogenesis of and interventions for depression.In this review,we addresses recent studies on cAMP pathway-based interventions in depression,to provide a theoretical basis for regulating the cAMP pathway and its cascade mechanism in depression.

Depression is a common mental illness that has a negative impact on patient quality of life,as well as representing a serious economic burden to society.The strategy of interfering with depression based on signaling pathways has recently attracted widespread attention.The cAMP pathway is an important cellular signaling pathway that plays a key role in the pathogenesis of and interventions for depression.In this review,we addresses recent studies on cAMP pathway-based interventions in depression,to provide a theoretical basis for regulating the cAMP pathway and its cascade mechanism in depression.

Objective:To explore effects of early endoscopic enteral nutrition support on immunoglobulin and T lymphocyte subsets in patients with severe intracerebral hemorrhage.Methods:A total of 120 patients with severe intracerebral hemorrhage admit-ted to The First People's Hospital of Chenzhou were enrolled between August 2019 and June 2022,who were divided into gastric tube group and intestinal tube group according to random number table method,with 60 cases in each group.Gastric tube group was given nasogastric tube 12～24 h after admission,while intestinal tube group was given gastroscope-assisted nasojejunal tube for early nutri-tion support.NIHSS and GCS scores,nutritional indexes[albumin(Alb),prealbumin(PAB),hemoglobin(Hb)],IgG,IgA,IgM and T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+)levels on the following day and 14 d after admission,and complications were compared between two groups.Results:At 14 d after admission,NIHSS score in intestinal tube group were significantly lower than gastric tube group,while GCS score,peripheral blood Alb,PAB,Hb,IgG,IgA,IgM,CD3+T,CD4+T and CD4+T/CD8+T levels were signifi-cantly higher than gastric tube group(P<0.05).After treatment,incidences of gastrointestinal bleeding,reflux esophagitis,gastric retention and vomiting in intestinal tube group were lower than gastric tube group(P<0.05).Conclusion:Early endoscopic enteral nutrition support can effectively improve nutritional status and enhance immune function in patients with severe intracerebral hemorrhage,which is beneficial to improve prognosis.

Objective:To explore effects of early endoscopic enteral nutrition support on immunoglobulin and T lymphocyte subsets in patients with severe intracerebral hemorrhage.Methods:A total of 120 patients with severe intracerebral hemorrhage admit-ted to The First People's Hospital of Chenzhou were enrolled between August 2019 and June 2022,who were divided into gastric tube group and intestinal tube group according to random number table method,with 60 cases in each group.Gastric tube group was given nasogastric tube 12～24 h after admission,while intestinal tube group was given gastroscope-assisted nasojejunal tube for early nutri-tion support.NIHSS and GCS scores,nutritional indexes[albumin(Alb),prealbumin(PAB),hemoglobin(Hb)],IgG,IgA,IgM and T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+)levels on the following day and 14 d after admission,and complications were compared between two groups.Results:At 14 d after admission,NIHSS score in intestinal tube group were significantly lower than gastric tube group,while GCS score,peripheral blood Alb,PAB,Hb,IgG,IgA,IgM,CD3+T,CD4+T and CD4+T/CD8+T levels were signifi-cantly higher than gastric tube group(P<0.05).After treatment,incidences of gastrointestinal bleeding,reflux esophagitis,gastric retention and vomiting in intestinal tube group were lower than gastric tube group(P<0.05).Conclusion:Early endoscopic enteral nutrition support can effectively improve nutritional status and enhance immune function in patients with severe intracerebral hemorrhage,which is beneficial to improve prognosis.

Objective The study aimed to elucidate the evolution of the syndromes in Traditional Chinese Medicine(TCM)and TCM syndrome elements in different chronic stages of psoriasis vulgaris.Methods A database was constructed using electronic medical records collected from July 2019 to March 2024 from 1,049 patients with psoriasis vulgaris.The study used Sankey diagrams and network association graphs to analyze the evolution of TCM syndromes and their elements in patients at the different stages:initial diagnosis,progressive stage(Week 2-3),progressive stage(Week 4-5),skin lesion improvement stage(Week 6-7),and remission stage.The syndrome elements network was constructed using community detection algorithms,and the association rules between local skin lesion syndrome differentiation and overall syndrome differentiation were displayed using heatmaps.Results(ⅰ)Initial diagnosis.In the syndrome differentiation of local skin lesions,blood heat syndrome was the most common(79.79％);among the disease location of TCM syndrome elements(called"disease location"),liver was the most prevalent(35.62％);and among the pathological factors of TCM syndrome elements(called"pathological factors"),fire(heat)was the most common(75.48％).(ⅱ)Active stage(Week 2-3).In the syndrome differentiation of local skin lesions,blood heat syndrome remained the most prevalent(73.13％);among the disease location,liver was still the most prevalent(31.71％);and among the pathological factors,fire(heat)continued to be the most common(82.11％),while dampness(22.26％)and qi stagnation(8.39％)began to increase.(ⅲ)Active stage(Week 4-5).The syndrome differentiation of local skin lesions was dominated by blood heat syndrome(45.91％)and blood dryness syndrome(37.19％);among disease location,the interior was the most prevalent(15.25％);and among the pathological factors,fire(heat)remained the most common(50.66％),with an increase in yin deficiency(34.26％).(ⅳ)Skin lesion improvement stage(Week 6-7).In the syndrome differentiation of local skin lesions,both blood dryness syndrome(49.44％)and blood stasis syndrome(33.33％)increased;among the disease location,meridians increased most significantly and became the most prevalent(13.44％);and among the pathological factors,blood stasis increased most significantly and became the most prevalent(28.20％).(ⅴ)Remission stage.In the syndrome differentiation of local skin lesions,blood stasis syndrome became the primary(55.69％),while the percentage of blood dryness syndrome decreased(21.16％);meridians(25.71％)and blood stasis(62.34％)remained the most predominant syndrome elements related to disease location or pathological factors.Conclusion The overall pattern of TCM syndromes in psoriasis vulgaris evolved from excess to deficiency.From the initial diagnosis to the active phase(Week 2-3),heat syndrome dominated;during the active phase(Week 4-5),heat syndrome coexisted with damp syndrome or yin deficiency syndrome;changes in the syndrome element network were the most significant during the lesion improvement phase,with blood stasis gradually increasing and peaking during the remission phase.Blood stasis,dampness,and qi stagnation were pervasive throughout psoriasis vulgaris;qi stagnation and blood stasis may be the main elements causing further deterioration and prolonged course of the disease during the active phase in patients.

Objective To systematically evaluate the efficacy and safety of the ceftazidime-avibactam(CAZ-AVI)regimen versus other regimens for treatment of carbapenem-resistant Enterobacteriaceae(CRE)bloodstream infections,and to provide an evidence-based foundation for drug selection in clinical CRE bloodstream infections.Methods A computerized search was conducted in Pubmed,Embase,Cochrane Library,Web of Science,Wanfang Medical Network,CNKI and China Science and Technology Journal Database for literature on CAZ-AVI for CRE bloodstream infections from the inception of each database up to November 2023.The literature quality evaluation and data extraction were independently performed by two researchers.A meta-analysis was performed using Review Manager 5.3 software.Results A total of 15 English articles and 1 580 patients were included.The results showed that the clinical cure rate[OR=3.32,95% CI=(2.25,4.90),P<0.000 01]and microbial clearance rate[OR=3.00,95% CI=(1.15,7.81),P=0.02]were significantly higher in the CAZ-AVI group than in the control group,and the 28 d/30 d all-cause mortality rate of patients in the CAZ-AVI group was lower than that of the control group[OR=0.38,95% CI=(0.29,0.51),P<0.000 01].The recurrence rates of infection in the two groups were equivalent and statistically non-significant[OR=0.75,95% CI=(0.39,1.42),P=0.37].Subgroup analysis indicated that the CAZ-AVI group had a lower all-cause mortality rate than the tigecycline group[OR=0.20,95% CI=(0.11,0.39),P<0.000 01].In terms of safety,the incidence of adverse events between the two groups was comparable and statistically non-significant[RR=0.47,95% CI=(0.20,1.07),P=0.07].However,the nephrotoxicity was significantly lower in the CAZ-AVI group than in the control group[OR=0.36,95% CI=(0.21,0.64),P=0.000 5].Conclusion Based on the findings of the current study,CAZ-AVI offers potential clinical advantages in the treatment of CRE bloodstream infections by improving clinical cure rates and reducing mortality rates.

Objective:To compare the effects of staged percutaneous coronary intervention(PCI)after emergency PCI and emergency culprit-only PCI on clinical outcomes of elderly patients with ST-segment elevation myocardial infarction(STEMI)and multivessel disease.Methods:A retrospective analysis was performed on 389 elderly patients with STEMI and multivessel lesions, aged ≥70 years and within 12 h of onset, admitted to the Clinical College of Thoracic Medicine, Tianjin Medical University, between January 2014 and September 2019.According to different revascularization strategies, enrolled patients were divided into the culprit-only PCI group(79.18%, 308)and the staged PCI group(20.82%, 81). Kaplan-Meier analysis and the Cox proportional hazards regression model were used to compare the incidences of major adverse cardiac and cerebrovascular events(MACCE), all-cause death, cardiac death, recurrent myocardial infarction, stroke and ischemia-driven revascularization between the two groups and to evaluate the effects of different revascularization strategies on MACCE and all-cause death.Then subgroup analysis was performed.Results:During a 56-month follow-up, 131 patients developed MACCE and 96 patients died.Compared with the culprit-only PCI group, the staged PCI group had a lower risk of MACCE( HR: 0.404, 95% CI: 0.227-0.716, P=0.002), all-cause death( HR: 0.354, 95% CI: 0.171-0.730, P=0.005), cardiac death( HR: 0.363, 95% CI: 0.157-0.838, P=0.018), and recurrent myocardial infarction( HR: 0.229, 95% CI: 0.055-0.953, P=0.043). There was no significant difference in the incidence of stroke or ischemia-driven revascularization between the two groups( P>0.05). The reduced risk with staged PCI for MACCE and for all-cause mortality persisted in all subgroups.Multivariate Cox proportional hazards regression revealed that, after adjusting for confounding factors, staged PCI was an independent protective factor for MACCE( HR: 0.44, 95% CI: 0.239-0.815, P=0.009)and for all-cause death( HR: 0.390, 95% CI: 0.90, P=0.020). Conclusion:Compared with culprit-only PCI, staged PCI can significantly improve the long-term prognosis of elderly patients ≥70 years with STEMI and multivessel disease within 12 h of onset.

With widespread popularization, the radiological diagnosis and treatment technology has played an increasingly important role in clinical practice. The tertiary general hospital is generally featured as multiple types of radioisotope and radiation equipment, wide involvement of departments and persons, and many ways of use and potential harms of the radiological diagnosis and treatment technology. Radiation protection has become a content that cannot be ignored in hospital management. This article analyzes the radiation protection management structure of the tertiary general hospital - Guangdong Provincial People’s Hospital. The hospital radiation protection management is gradually improved by clarifying the main leading department, refining duties and responsibilities, strengthening multi-departmental communication and cooperation, and sorting out key connection links. A closed loop of refined management is formed through digging and correcting problems and continuously improving the management level and work efficiency. Valid qualifications are ensured to be obtained in time by radiation workers, radioactive drugs, equipment, and the venues to guarantee the radiation safety of radiation workers and patients and to further promote the construction of the Safe Hospital.