Objective To investigate the current status and barriers to implementing non-accompanied care services in medical institutions in Zhejiang Province,and to provide a basis for the improvement of standardized management of such services.Methods A self-designed questionnaire was conducted from September to October 2024 among all secondary and tertiary medical institutions in Zhejiang Province to assess the implementation status and barriers to non-accompanied care services.Results A total of 397 questionnaires were distributed,with 389 valid responses,yielding a valid response rate of 97.98％.Non-accompanied care services were implemented in 118 institutions(30.33％).Among these,90 institutions(76.27％)had established management systems for non-accompanied wards;71 institutions(60.17％)had a medical nursing assistant-to-bed ratio lower than 1∶5;41 institu-tions(34.75％)provided tiered training for medical nursing assistants;93 institutions(78.81％)required patients to bear the full cost of the service.Compared with secondary medical institutions,tertiary medical institutions have more complete management system for non-accompanied care services.The main obstacles hindering the development of non-accompanied care services include an imperfect management system for non-accompanied wards,a shortage of medical nursing assistants,a lack of standardized training for such assistants,inconsistent charging standards,and low acceptance among patients and their families.Conclusion The promotion of non-accompanied care services in medical institutions in Zhejiang Province has achieved initial success.However,challenges persist,including incomplete management systems,uneven development across hospital tiers,and imperfect charging mechanisms.It is recommended that relevant authorities strengthen policy support,enhance standardized training for healthcare nursing assistants,refine cost-sharing mechanisms,and improve the quality and sustainability of non-accompanied care services through multi-party collaboration.

Pseudohypoaldosteronism type Ⅰ(PHA Ⅰ)is a rare inherited disease,mainly caused by the deficiency of the aldosterone receptor or by reduced or absent binding between aldosterone and its receptor.It typically manifests as neonatal hyponatremia,hyperkalaemia,metabolic acidosis,accompanied by dehydration,vomiting,weight loss,and even shock.PHA Ⅰ is classified into renal-type with mutations in the salt corticosteroid receptor and multi-organ with mutations in any of the three subunits of the epithelial sodium channel(α,β or γ).The renal-type,which is inherited in an autosomal dominant manner,is caused by mutations in the aldosterone receptor with an isolated nephrogenic salt-loss syndrome,and the clinical symptoms are milder compared with those of the multi-organ type,which may improve with age.However,severity varies among individuals depending on the degree of salt loss,and if not treated in time,it may lead to shock due to repeated dehydration or even cardiac arrest due to high potassium.Currently,domestic studies have found that the human salt corticosteroid receptor is encoded by the NR3C2 gene,which is located between the regions of 4q31.1 and 4q31.2.This case reports a child with nephrogenic PHA Ⅰ due to a new-onset variant of the NR3C2(4q31.22)gene,who had chromosomal anomalies in the fetus and demonstrated high blood pressure,high blood potassium and low sodium after birth.The diagnosis of renal neonatal PHA Ⅰ was confirmed by the presence of a microdeletion of NR3C2 gene(4q31.22 region)in the child,which was demonstrated by a genome-wide chromosomal assay and accompanied by a significant elevation of the plasma aldosterone level(>2 000 pg/mL),and by the presence of a microdeletion of NR3C2 gene(4q31.22 region)in the child.Electrolyte disorders were corrected after oral administration of concentrated sodium chloride,and the condition remained stable at the 1-month follow-up.

Objective:To analyze the research trends and hotspots of bupivacaine liposomes from 1994 to 2023 using bibliometrics.Methods:A comprehensive search was conducted for the literature related to bupivacaine liposomes in the Web of Science Core Collection from 1994 to 2023. The CiteSpace software was used to conduct an in-depth analysis of the included literature data, including publication year, country, institution, author, journal, cited references, keywords, etc.Results:A total of 875 papers related to bupivacaine liposomes were included. The research and development of bupivacaine liposomes were divided into 3 stages: slow development (1994-2011), a sharp rise (2011-2021), and stabilization (2021-2023). The United States was in a leading position in terms of the number of publications, centrality, and author cooperation, and Harvard University had the largest number of publications. de Paula E had the most publications, Bramlett K had the highest number of citations, and Boogaerts J had the highest centrality of publications. Journals such as Anesthesia and Analgesia made significant contributions to this field. The most cited references focused on the infiltration of wounds and the periprosthetic injection of bupivacaine liposomes. The keyword analysis showed that local anesthetics, postoperative pain, etc. were commonly used keywords, and enhanced recovery after surgery was an emerging hotspot. Conclusions:Bupivacaine liposomes show good application prospects in the field of peripheral nerve block due to their unique pharmacological properties and safety characteristics and are expected to prolong the duration of postoperative analgesia. However, there is a difference between the actual effect and the expectation, and more clinical trials are needed to evaluate the curative effect, providing a more solid and reliable theoretical basis and practical guidance for clinical practice.

Pseudohypoaldosteronism type Ⅰ(PHA Ⅰ)is a rare inherited disease,mainly caused by the deficiency of the aldosterone receptor or by reduced or absent binding between aldosterone and its receptor.It typically manifests as neonatal hyponatremia,hyperkalaemia,metabolic acidosis,accompanied by dehydration,vomiting,weight loss,and even shock.PHA Ⅰ is classified into renal-type with mutations in the salt corticosteroid receptor and multi-organ with mutations in any of the three subunits of the epithelial sodium channel(α,β or γ).The renal-type,which is inherited in an autosomal dominant manner,is caused by mutations in the aldosterone receptor with an isolated nephrogenic salt-loss syndrome,and the clinical symptoms are milder compared with those of the multi-organ type,which may improve with age.However,severity varies among individuals depending on the degree of salt loss,and if not treated in time,it may lead to shock due to repeated dehydration or even cardiac arrest due to high potassium.Currently,domestic studies have found that the human salt corticosteroid receptor is encoded by the NR3C2 gene,which is located between the regions of 4q31.1 and 4q31.2.This case reports a child with nephrogenic PHA Ⅰ due to a new-onset variant of the NR3C2(4q31.22)gene,who had chromosomal anomalies in the fetus and demonstrated high blood pressure,high blood potassium and low sodium after birth.The diagnosis of renal neonatal PHA Ⅰ was confirmed by the presence of a microdeletion of NR3C2 gene(4q31.22 region)in the child,which was demonstrated by a genome-wide chromosomal assay and accompanied by a significant elevation of the plasma aldosterone level(>2 000 pg/mL),and by the presence of a microdeletion of NR3C2 gene(4q31.22 region)in the child.Electrolyte disorders were corrected after oral administration of concentrated sodium chloride,and the condition remained stable at the 1-month follow-up.

Brain organoid-on-chip platforms have emerged as groundbreaking tools in neural disease modeling and drug discovery, offering a unique and highly accurate simulation of human organ physiology and function compared with traditional cell culture systems. This technology is a harmonious fusion of organ-on-a-chip and organoid culture technologies, leveraging their strengths to provide the most realistic in vitro replication of the in vivo environment, both physically and biologically. As both technologies continue to advance rapidly, this platform is highly promising in vitro platform for disease modeling. In this review, we summarize the historical developments, recent advancements, limitations, and future prospects of brain organoid-on-chip technology, aiming to illuminate the transformative potential of this platform in advancing our understanding and treatment of neural diseases.

Objective To observe the protective effects of Yiqi Jiedu Decoction on ionizing radiation-induced small intestinal functional injury in mice,and explore whether it alleviates such injury by inhibiting small intestinal ferroptosis,thereby providing scientific support for the discovery and development of intestinal radiation protection drugs in aerospace medicine.Methods A total of 378 male Balb/c mice were randomly divided into 7 groups:blank control group,model group,positive drug group,high-dose Yiqi Jiedu Decoction group,low-dose Yiqi Jiedu Decoction group,Liproxstatin-1 pre-irradiation administration group,and Liproxstatin-1 post-irradiation administration group,with 54 mice in each group.Each group was further divided into 3 batches,with 18 mice per batch.Seven days after preventive administration,all groups except the blank control group were subjected to a single whole-body irradiation with 2.0 Gy 60Co γ-rays.The general condition and morphological structure of the small intestine were observed at 1,3,and 7 days post-irradiation.The small intestinal charcoal propulsion rate,serum D-xylose content,and lactic acid content were measured,along with the levels of Fe,LPO,MDA,GSH,and SOD activity in the small intestine.Results Yiqi Jiedu Decoction could mitigate the decrease in body weight of mice after 2.0 Gy 60Co γ-ray irradiation,improve the morphological structure of the small intestine,reduce the small intestine charcoal propulsion rate,increase serum D-xylose levels,and decrease total serum lactate levels.It also alleviated mitochondrial shrinkage in the small intestine and reduced the contents of Fe and MDA in small intestine tissues.Conclusion Yiqi Jiedu Decoction may alleviate ionizing radiation-induced small intestinal functional injury by inhibiting ferroptosis in the small intestine,providing a new strategy for intestinal radiation injury in deep space exploration missions such as manned spaceflight.

Objective To investigate the correlation between the expression of lectin galactoside binding soluble-3 binding protein(LGALS3BP),GTP enzyme activating protein SH3 functional region binding protein 1(G3BP1)and Wnt/β-catenin pathway genes in endometrial cancer(EC)tissues and its clinical prognostic significance.Methods 138 patients with EC treated in Cangzhou Central Hospital from February 2016 to February 2019 were selected.qRT-PCR was used to detect the expression of LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes Wnt5a mRNA,β-catenin mRNA and matrix metalloproteinase-9(MMP-9)mRNA in cancer and adjacent tissues.The expression of LGALS3BP protein and G3BP1 protein in cancer and adjacent tissues was detected by immunohistochemistry.Pearson correlation analysis was used to analyze the correlation between LGALS3BP mRNA,G3BP1 mRNA and Wnt/β-catenin pathway genes.Kaplan-Meier curve was used to analyze the effect of LGALS3BP mRNA and G3BP1 mRNA on the survival and prognosis of EC patients.COX regression model was used to analyze the factors affecting the prognosis of EC patients.Results The expression of LGALS3BP mRNA(3.01±0.34),G3BP1 mRNA(2.87±0.33),Wnt5a mRNA(2.29±0.26),β-catenin mRNA(3.25±0.41)and MMP-9 mRNA(2.68±0.36)in EC cancer tissues were higher than those in adjacent tissues(1.10±0.23,1.06±0.24,0.84±0.17,0.88±0.26,0.69±0.17),and the differences were statistically significant(t=52.109～58.719,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in EC was positively correlated with the expression of Wnt5a mRNA,β-catenin mRNA and MMP-9 mRNA(r=0.675～0.781,all P<0.001).The expression of LGALS3BP protein(3.54±0.47 vs 0.51±0.16)and G3BP1 protein(2.84±0.44 vs 0.42±0.13)in EC cancer tissues were higher than that in adjacent tissues,and the differences were statistically significant(t=71.692,61.962,all P<0.001).The expression of LGALS3BP mRNA and G3BP1 mRNA in cancer tissues of EC patients with FIGO stage Ⅲ and lymph node metastasis were higher than that of FIGO stage Ⅰ～Ⅱ and no lymph node metastasis,and the differences were statistically significant(t=40.279～557.671,all P<0.001).The 5-year survival rate of LGALS3BP mRNA high expression group was 58.82%(40/68),which was lower than that of low expression group 94.29%(66/70),and the difference was statistically significant(Log-rank χ2=24.970,P<0.001).The 5-year survival rate of G3BP1 mRNA high expression group was 62.12%(41/66),which was lower than that of low expression group 90.28%(65/72),and the difference was statistically significant(Log-rank χ2=15.960,P<0.001).FIGO stage Ⅲ,lymph node metastasis,high expression of LGALS3BP mRNA and high expression of G3BP1 mRNA were risk factors for poor prognosis of EC patients(Wald χ2=7.847～12.054,all P<0.001).Conclusion The expression of LGALS3BP and G3BP1 mRNA is elevated in EC,both of which are associated with Wnt/β-catenin pathway genes,promoting the malignant progression of EC tumors,and are new tumor markers for evaluating the prognosis of EC patients.

Objective:To explore the effects of multi-dimensional nursing based on empowerment theory in patients undergoing thoracoscopic and laparoscopic esophagectomy.Methods:A convenience sampling method was used to select 110 esophageal cancer patients who were admitted to Henan Provincial People's Hospital from August 2022 to April 2024. Patients were randomly divided into two groups using a random number table: the control group and the observation group, with 55 patients in each group. The control group received routine care, while the observation group received multi-dimensional nursing based on empowerment theory in addition to routine care. The two groups were compared in terms of stress responses (heart rate, systolic blood pressure, diastolic blood pressure) , self-care ability, nutritional status (hemoglobin, albumin) , and nursing satisfaction.Results:After the intervention, the observation group had lower heart rate, systolic blood pressure, and diastolic blood pressure compared to the control group, with statistically significant differences ( P<0.01) . The self-care ability score in the control group was lower than that in the observation group, with a statistically significant difference ( P<0.01) . The observation group also had higher hemoglobin and albumin levels compared to the control group, with statistically significant differences ( P<0.01) . The nursing satisfaction rate in the observation group was higher than that in the control group, with a statistically significant difference ( P<0.05) . Conclusions:Multi-dimensional nursing based on empowerment theory can effectively reduce stress responses, improve self-care ability, enhance nutritional status, and increase nursing satisfaction in esophageal cancer patients.