Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

A traditional Chinese medicine(TCM)monomer is a bioactive compound extracted from Chinese herbal medicines possessing determined biological activity and pharmacological effects,and has gained much attention for treating neuronal diseases.However,the application of TCM monomers is limited by their low solubility and poor ability to cross the blood-brain barrier(BBB).Exosomes are small extracellular vesicles(EVs)ranging in size from 30 to 150 nm in diameter and can be used as drug delivery carriers that directly target cells or tissues with unique advantages,including low toxicity,low immunogenicity,high stability in blood,and the ability to cross the BBB.This review discusses the biogenesis,components,stability,surface modification,isolation technology,advantages,and disadvantages of exosomes as drug carriers and compares exosomes and other similar drug delivery systems.Furthermore,exosome-encapsulated TCM monomers exert neuroprotective roles,such as anti-inflammation,anti-apoptosis,anti-mitophagy,and anti-oxidation,in various neuronal diseases,including Alzheimer's disease(AD),Parkinson's disease(PD),multiple sclerosis(MS),and cerebral ischemia and reperfusion(CI/R)injury,as well as anti-drug resistance,anti-tumorigenesis,anti-angiogenesis,and promotion of apoptosis in brain tumors,providing more inspiration to promote the development of an exosome-based delivery tool in targeted therapy for neuronal diseases.

Arachidonic acid can be transformed into a variety of metabolites that trigger an inflammatory response through cyclooxygenase, lipoxygenase, cytochrome P450 enzymes, and other metabolic pathways. Moreover, it plays a key role in the occurrence and development of inflammatory diseases. In recent years, multi-target drugs based on the arachidonic acid metabolic pathway have become an important direction of anti-inflammatory drug research. This article summarizes the opportunities and challenges of arachidonic acid metabolic pathways as well as their interference in the development of anti-inflammatory drugs, reviews the research progress of multi-target drug design, synthesis, and anti-inflammatory activity based on the arachidonic acid metabolic pathway, and discusses the difficulties and prospects of multi-target drugs based on metabolic pathways in anti-inflammatory drug development, aiming to provide some reference and inspiration for the study of multi-target anti-inflammatory drugs based on the arachidonic acid metabolic pathway.

A traditional Chinese medicine (TCM) monomer is a bioactive compound extracted from Chinese herbal medicines possessing determined biological activity and pharmacological effects, and has gained much attention for treating neuronal diseases. However, the application of TCM monomers is limited by their low solubility and poor ability to cross the blood-brain barrier (BBB). Exosomes are small extracellular vesicles (EVs) ranging in size from 30 to 150 nm in diameter and can be used as drug delivery carriers that directly target cells or tissues with unique advantages, including low toxicity, low immunogenicity, high stability in blood, and the ability to cross the BBB. This review discusses the biogenesis, components, stability, surface modification, isolation technology, advantages, and disadvantages of exosomes as drug carriers and compares exosomes and other similar drug delivery systems. Furthermore, exosome-encapsulated TCM monomers exert neuroprotective roles, such as anti-inflammation, anti-apoptosis, anti-mitophagy, and anti-oxidation, in various neuronal diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), and cerebral ischemia and reperfusion (CI/R) injury, as well as anti-drug resistance, anti-tumorigenesis, anti-angiogenesis, and promotion of apoptosis in brain tumors, providing more inspiration to promote the development of an exosome-based delivery tool in targeted therapy for neuronal diseases.

Against the backdrop of high-quality development in public hospitals,scientific post establishment and staffing are key to optimizing human resource allocation and enhancing operational efficiency.Taking Shenzhen Yantian District People's Hospital(Group)as an example,this paper addresses issues such as unclear job responsibilities and imbalanced personnel struc-ture by systematically implementing post establishment and staffing practices through third-party cooperation.Utilizing multiple methods including efficiency-based staffing,scheduling-based staffing,and ratio-based staffing,combined with workload meas-urement and a dynamic adjustment mechanism,precise allocation for clinical,medical technical,and administrative posts was a-chieved.Results showed a reduction of 46 redundant personnel hospital-wide,the proportion of administrative staff decreased to 15％,the doctor-to-nurse ratio met national standards,the overall bed-to-nurse ratio reached 1∶0.8,and labor costs were signif-icantly optimized.The study indicates that post establishment and staffing must be based on actual workload,dynamically adjus-ted in line with hospital strategy,and require hospital-wide collaborative promotion.This research provides a practical pathway worthy of reference for human resource management in public hospitals.

Objective:To summarize the best evidence for oral nutrition management of patients with inflammatory bowel disease (IBD) and to evaluate its effectiveness.Methods:From May 2023 to March 2024, IBD patients, the medical and nursing staff in the Department of Proctology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, were selected as study subjects using convenience sampling method. Evidence-based nursing was used to summarize the best evidence for oral nutrition management of IBD patients, formulate review indicators, develop best evidence-based practice programs for clinical application through status review and barrier factor analysis. Effectiveness was evaluated at the system level, medical and nursing staff level, and patient level.Results:After evidence-based practice, a multidisciplinary management team and management system for oral nutrition was established at the system level. At the medical and nursing staff level, the oral nutrition knowledge score increased from [50.00 (40.00, 60.00) ] to [100.00 (85.00, 100.00) ], with a statistically significant difference ( P<0.01), and the implementation rate of the three review indicators improved from 0 to 100.00%. At the patient level, oral nutrition knowledge and attitude scores improved from [10.00 (8.00, 12.00) ] and [35.00 (31.00, 40.00) ] to [16.00 (16.00, 16.00) ] and [48.00 (45.00, 48.00) ], respectively, with statistically significant differences ( P<0.01), and the implementation rate of each of the review indicators rose above 80.00% except for indicator 6. The patients' nutrition indicators, including body mass index, waist circumference, left upper arm midpoint circumference and left hand grip strength were improved, and the difference was statistically significant ( P<0.05) . Conclusions:The implementation of evidence-based practice programs can improve the standardization of clinical work of healthcare professionals, enhance patients' nutrition knowledge and attitude, and promote their rational dietary behaviors, thus improving their nutrition status and quality of life.

Against the backdrop of high-quality development in public hospitals,scientific post establishment and staffing are key to optimizing human resource allocation and enhancing operational efficiency.Taking Shenzhen Yantian District People's Hospital(Group)as an example,this paper addresses issues such as unclear job responsibilities and imbalanced personnel struc-ture by systematically implementing post establishment and staffing practices through third-party cooperation.Utilizing multiple methods including efficiency-based staffing,scheduling-based staffing,and ratio-based staffing,combined with workload meas-urement and a dynamic adjustment mechanism,precise allocation for clinical,medical technical,and administrative posts was a-chieved.Results showed a reduction of 46 redundant personnel hospital-wide,the proportion of administrative staff decreased to 15％,the doctor-to-nurse ratio met national standards,the overall bed-to-nurse ratio reached 1∶0.8,and labor costs were signif-icantly optimized.The study indicates that post establishment and staffing must be based on actual workload,dynamically adjus-ted in line with hospital strategy,and require hospital-wide collaborative promotion.This research provides a practical pathway worthy of reference for human resource management in public hospitals.

Objective:To summarize the best evidence for oral nutrition management of patients with inflammatory bowel disease (IBD) and to evaluate its effectiveness.Methods:From May 2023 to March 2024, IBD patients, the medical and nursing staff in the Department of Proctology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, were selected as study subjects using convenience sampling method. Evidence-based nursing was used to summarize the best evidence for oral nutrition management of IBD patients, formulate review indicators, develop best evidence-based practice programs for clinical application through status review and barrier factor analysis. Effectiveness was evaluated at the system level, medical and nursing staff level, and patient level.Results:After evidence-based practice, a multidisciplinary management team and management system for oral nutrition was established at the system level. At the medical and nursing staff level, the oral nutrition knowledge score increased from [50.00 (40.00, 60.00) ] to [100.00 (85.00, 100.00) ], with a statistically significant difference ( P<0.01), and the implementation rate of the three review indicators improved from 0 to 100.00%. At the patient level, oral nutrition knowledge and attitude scores improved from [10.00 (8.00, 12.00) ] and [35.00 (31.00, 40.00) ] to [16.00 (16.00, 16.00) ] and [48.00 (45.00, 48.00) ], respectively, with statistically significant differences ( P<0.01), and the implementation rate of each of the review indicators rose above 80.00% except for indicator 6. The patients' nutrition indicators, including body mass index, waist circumference, left upper arm midpoint circumference and left hand grip strength were improved, and the difference was statistically significant ( P<0.05) . Conclusions:The implementation of evidence-based practice programs can improve the standardization of clinical work of healthcare professionals, enhance patients' nutrition knowledge and attitude, and promote their rational dietary behaviors, thus improving their nutrition status and quality of life.

Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.

Objective:To investigate the correlation between pulmonary ultrasound on pulmonary consolidation and T lymphocytes,cytokines in predicting the progression of neonatal pneumonia.Methods:A total of 80 pediatric patients with pulmonary consolidation,who admitted to neonatal ward of Beijing Chao-yang Hospital and were confirmed by the first ultrasound examination on lung from February 2021 to February 2023,were divided into study group,and 50 children,who underwent physical examination during the same period,were divided into control group.The cell subsets and cytokines between two groups were compared.The study group was further divided into mitigation group and progression group according to the disease conditions of pediatric patients of study group after they received 3 d treatment.Multifactor logistic regression was adopted to analyze the correlation among the T lymphocytes,cytokines and the progression of disease.Results:The CD3+,CD8+,CD4+/CD8+cell subsets of T lymphocytes and cytokines such as IL-17-A,TNF-α and ICAM-1 of study group were significantly higher than those of control group(t=16.483,4.933,4.113,22.933,22.433,19.525,P<0.05),respectively,and the CD4+level was significantly lower than that of control group(t=7.773,P<0.05).The CD3+cell subsets and cytokine levels such as IL-17A,TNF-α and ICAM-1 of progression group were significantly higher than those of mitigation group(t=6.815,4.631,4.307,P<0.05),however the CD4+level was significantly lower than that of mitigation group(t=3.044,P<0.05).The results of the multivariate Logistic regression analysis showed that the decrease of CD3+expression,the increase of IL-17A expression and the increase of the area of pulmonary consolidation were the risk factors of the progress of neonatal pneumonia(β=-0.176,0.777,0.931,P<0.05),respectively.The results of the Pearson-correlation analysis showed that CD3+was negative correlation with the progression of neonatal pneumonia(r=-0.295,P<0.001),however,the IL-17A and the area of pulmonary consolidation showed a positive correlation with the progression of neonatal pneumonia(r=0.677,0.517,P<0.001).Conclusion:The CD3+expression,IL-17A of peripheral blood and the area of pulmonary consolidation are significantly predictive factors of pneumonia progression,and are closely related to the progression of pneumonia.