Objective To design and fabricate an integrated optoelectrical fiber to enable the simultaneous transmission of high-power laser and electrical current, thereby developing a novel tool for urological surgery.Methods A miniature metal sleeve was installed at the front end of a medical high-energy optical fiber, and corresponding conductive circuits were configured. The fiber was connected to a fiber thulium laser and a bipolar plasma generator simultaneously. Experiments of simulated vaporization were conducted on ex vivo porcine kidney tissues using thulium laser (50 W), plasma (100 W), and thulium laser + plasma (50 W+100 W), respectively. Tissue removal efficiency was calculated using the weighing method:tissue clearance rate (g/min)=[mass before vaporization (g) - mass after vaporization (g)]/vaporization time (min). Lateral tissue thermal damage was assessed with hematoxylin-eosin (HE) staining. One-way analysis of variance and least significant difference test were used for statistical analysis.Results The integrated optoelectrical fiber was successfully constructed, which could simultaneously and continuously transmit thulium laser and plasma electrocision current. The tissue clearance rate of the thulium laser+plasma group was significantly higher than that of the thulium laser group and plasma group [(0.49±0.13) g/min vs. (0.14±0.02) g/min vs. (0.11±0.04) g/min, P＜0.001]. The average lateral thermal damage depth of the thulium laser + plasma group showed no statistically significant difference compared to the thulium laser group [(985.5±178.5) μm vs.(957.5±197.4) μm, P＞0.05], but both were significantly higher than that of the simple plasma group [(499.6±78.0) μm] (P＜0.001). Conclusion The thulium laser + plasma energy transmitted simultaneously by the integrated optoelectrical fiber can vaporize kidney tissue more efficiently without additional thermal damage.

OBJECTIVE To investigate the requirements for infusion sets specified in the package inserts of monoclonal antibody drugs commonly used for intravenous infusion in China， and to provide a reference for the rational selection of infusion sets for this class of drugs in clinical practice. METHODS The “Drug Query” section of the official website of the National Medical Products Administration， including the “Domestically Manufactured Drugs” and “Overseas Manufactured Drugs” databases， as well as the DXY “Yongyao Zhushou” database， were searched to collect the package inserts of monoclonal antibody drugs available on the domestic market as of November 2025 that had requirements for intravenous infusion sets. Relevant requirements for infusion set materials， filter pore size， and filter materials were extracted， classified， and analyzed. RESULTS A total of 55 monoclonal antibody drugs for intravenous infusion were included， comprising 45 anticancer drugs （81.82%）， 5 immunomodulatory drugs （9.09%）， and 5 drugs for other diseases （9.09%）. The package inserts of 44 drugs （80.00%） had clear requirements for the filter pore size of infusion sets， of which 36 drugs （65.45%） required a pore size of 0.2 μm or 0.22 μm. The package inserts of 16 drugs （29.09%） specified the filter material， all of which recommended polyethersulfone. The package inserts of 25 drugs （45.45%） specified the infusion set material， primarily polyvinyl chloride， polyethylene， or polypropylene. CONCLUSIONS The requirements for infusion sets vary among different monoclonal antibody drugs， with differences mainly concentrated in two aspects： material compatibility and filter pore size. In clinical practice， the selection should be based on the drug package inserts， following the principles of “compatibility first， appropriate filtration， and system integration”， and standardized management should be achieved through the development of quick-reference manuals specifically addressing the requirements for infusion sets and the integration of relevant requirements into the prescription review and dispensing systems.

Based on the different medical systems and textual contexts within Inner Canon of Yellow Emperor （《黄帝内经》）， this paper argues that "opening， closing， and pivot" in the three yin and three yang theory encompasses both spatial and temporal dimensions. From the spatial perspective， the concepts of opening， closing and pivot are used to describe the dynamic movement of qi within the meridian system. In The Spiritual Pivot·Root and Knot （《灵枢·根结》）， the theory primarily explains the superficial-deep and exterior-interior hierarchy of the meridians， emphasizing the movement of channel qi and the transmission of disease. By contrast， Basic Questions·Treatise on the Separation and Union of Yin and Yang （《素问·阴阳离合论篇》） primarily explains the relationships of separation and union between yin and yang among different regions and orientations on the same body-surface level. From the temporal perspective， the theory also explains the waxing and waning of yin and yang according to seasonal changes throughout the year， and has been applied to clinical practice within the theory of the five circuits and six qi. Therefore， opening， closing， and pivot in the three yin and three yang theory encompasses multiple connotations， including meridian structure， spatial distribution， seasonal qi transformation， and the annual circulation of climatic qi. Clarifying these different levels and their respective scopes of application is essential for accurately understanding the rich connotations of the opening， closing and pivot theory.

ObjectiveTo explore the therapeutic effect and mechanism of Huangqi Xiayuxue decoction against hepatocellular carcinoma based on network pharmacology， animal experiments， and cell experiments. MethodsThe active ingredients and corresponding targets of Huangqi Xiayuxue decoction were screened via databases including the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）. Hepatocellular carcinoma-related targets were retrieved from the GeneCards database. The common targets shared by Huangqi Xiayuxue decoction and hepatocellular carcinoma were subjected to Gene Ontology （GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analyses. Huangqi Xiayuxue decoction-containing plasma was prepared. The cell counting kit-8 （CCK-8） assay was adopted to observe the effects of different volume fractions （5%， 10%， 15%， and 20%） of Huangqi Xiayuxue decoction-containing plasma on the proliferation of HepG2， MHCC-97H， Hepa1-6， and Huh-7 cells， and the concentration for subsequent experiments was determined. Flow cytometry was adopted to detect the effects of Huangqi Xiayuxue decoction-containing plasma （5%， 10%， 15%， and 20%） on the apoptosis of MHCC-97H cells. A mouse model of subcutaneous xenograft hepatocellular carcinoma was established. The model mice were assigned into low-， medium-， and high-dose （4.63， 9.25， 18.5 g·kg^-1） Huangqi Xiayuxue decoction and sorafenib （20 mg·kg^-1） groups. Body mass and tumor volume of mice were dynamically monitored during the intervention period. After 3 weeks of intervention， hematoxylin-eosin （HE） staining was performed to observe tumor morphology. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL） assay was employed to detect cell apoptosis. Immunohistochemistry （IHC） was adopted to examine the expression of cysteinyl aspartate-specific proteinase-3 （Caspase-3）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in the tumor tissue. Real-time PCR and Western blot were employed to verify the changes in apoptosis-related factors and the phosphatidylinositol 3-kinase/protein kinase B/forkhead box O1 （PI3K/Akt/FoxO1） signaling pathway. ResultsA total of 220 common targets shared by Huangqi Xiayuxue decoction and hepatocellular carcinoma were screened out by network pharmacology， among which tumor protein p53 （TP53）， Akt1， and signal transducer and activator of transcription 3 （STAT3） were the core targets. Pathway enrichment analysis indicated that the common targets were involved in cell apoptosis and proliferation， as well as the PI3K/Akt and FoxO signaling pathways. Cell experiments showed that compared with the blank plasma group， all volume fractions of Huangqi Xiayuxue decoction-containing plasma inhibited the proliferation of HepG2， MHCC-97H， Hepa1-6， and Huh-7 cells （P<0.01）. The proportion of early apoptotic cells in MHCC-97H cells was increased after treatment with different volume fractions of Huangqi Xiayuxue decoction-containing plasma （P<0.01）. Animal experiments revealed that Huangqi Xiayuxue decoction inhibited the growth of tumor volume， promoted tumor cell apoptosis in the high-dose group， up-regulated the protein and mRNA levels of Bax and Caspase-3， down-regulated the protein and mRNA levels of Bcl-2， and reduced the phosphorylation level of the PI3K/Akt/FoxO1 signaling pathway （P<0.05， P<0.01）. ConclusionHuangqi Xiayuxue decoction exerts anti-hepatocellular carcinoma effects by inhibiting the activation of the PI3K/Akt/FoxO1 signaling pathway and promoting hepatocellular carcinoma cell apoptosis.

ObjectiveTo explore the therapeutic effect and mechanism of Huangqi Xiayuxue decoction against hepatocellular carcinoma based on network pharmacology， animal experiments， and cell experiments. MethodsThe active ingredients and corresponding targets of Huangqi Xiayuxue decoction were screened via databases including the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）. Hepatocellular carcinoma-related targets were retrieved from the GeneCards database. The common targets shared by Huangqi Xiayuxue decoction and hepatocellular carcinoma were subjected to Gene Ontology （GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analyses. Huangqi Xiayuxue decoction-containing plasma was prepared. The cell counting kit-8 （CCK-8） assay was adopted to observe the effects of different volume fractions （5%， 10%， 15%， and 20%） of Huangqi Xiayuxue decoction-containing plasma on the proliferation of HepG2， MHCC-97H， Hepa1-6， and Huh-7 cells， and the concentration for subsequent experiments was determined. Flow cytometry was adopted to detect the effects of Huangqi Xiayuxue decoction-containing plasma （5%， 10%， 15%， and 20%） on the apoptosis of MHCC-97H cells. A mouse model of subcutaneous xenograft hepatocellular carcinoma was established. The model mice were assigned into low-， medium-， and high-dose （4.63， 9.25， 18.5 g·kg^-1） Huangqi Xiayuxue decoction and sorafenib （20 mg·kg^-1） groups. Body mass and tumor volume of mice were dynamically monitored during the intervention period. After 3 weeks of intervention， hematoxylin-eosin （HE） staining was performed to observe tumor morphology. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL） assay was employed to detect cell apoptosis. Immunohistochemistry （IHC） was adopted to examine the expression of cysteinyl aspartate-specific proteinase-3 （Caspase-3）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in the tumor tissue. Real-time PCR and Western blot were employed to verify the changes in apoptosis-related factors and the phosphatidylinositol 3-kinase/protein kinase B/forkhead box O1 （PI3K/Akt/FoxO1） signaling pathway. ResultsA total of 220 common targets shared by Huangqi Xiayuxue decoction and hepatocellular carcinoma were screened out by network pharmacology， among which tumor protein p53 （TP53）， Akt1， and signal transducer and activator of transcription 3 （STAT3） were the core targets. Pathway enrichment analysis indicated that the common targets were involved in cell apoptosis and proliferation， as well as the PI3K/Akt and FoxO signaling pathways. Cell experiments showed that compared with the blank plasma group， all volume fractions of Huangqi Xiayuxue decoction-containing plasma inhibited the proliferation of HepG2， MHCC-97H， Hepa1-6， and Huh-7 cells （P<0.01）. The proportion of early apoptotic cells in MHCC-97H cells was increased after treatment with different volume fractions of Huangqi Xiayuxue decoction-containing plasma （P<0.01）. Animal experiments revealed that Huangqi Xiayuxue decoction inhibited the growth of tumor volume， promoted tumor cell apoptosis in the high-dose group， up-regulated the protein and mRNA levels of Bax and Caspase-3， down-regulated the protein and mRNA levels of Bcl-2， and reduced the phosphorylation level of the PI3K/Akt/FoxO1 signaling pathway （P<0.05， P<0.01）. ConclusionHuangqi Xiayuxue decoction exerts anti-hepatocellular carcinoma effects by inhibiting the activation of the PI3K/Akt/FoxO1 signaling pathway and promoting hepatocellular carcinoma cell apoptosis.

OBJECTIVE To investigate the ameliorative effects of Coptidis Rhizoma-Ophiopogonis Radix herb pair （HLMD） in rats with type 2 diabetes mellitus （T2DM） and its potential mechanisms.METHODS Male Wistar rats were randomly divided into a control group （6 rats） and a model induction group （30 rats）. The T2DM rat model was established by feeding a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. The successfully modeled rats were subsequently divided into the model group， the metformin group （200 mg/kg）， and the low-， medium-， and high-dose HLMD groups （100， 200 and 400 mg/kg， respectively）， with six rats in each group. Rats in each group were administered the corresponding drug solution or normal saline by oral gavage once daily for six consecutive weeks. Body weight， fasting blood glucose （FBG）， the area under the curve （AUC） of the oral glucose tolerance test， serum lipid profiles [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C）]， and inflammatory cytokine [interleukin-6 （IL-6）， IL-1β， tumor necrosis factor-α （TNF-α）， and IL-10] levels were measured. Histopathological changes in liver and pancreatic tissues， as well as hepatic lipid accumulation， were evaluated. Changes in gut microbiota composition were analyzed in the control， model， and high-dose HLMD groups. Network pharmacology and molecular docking analyses were performed to identify potential therapeutic targets of HLMD against T2DM， followed by experimental validation.RESULTS Compared with the model group， the body weight generally recovered in rats in all HLMD dose groups， while FBG levels consistently decreased. Histopathological abnormalities， including disrupted pancreatic islet architecture， disorganized hepatocyte arrangement， hepatic cord necrosis， and lipid accumulation， were alleviated to varying degrees. AUC （except for the low-dose group）， levels of TC， TG， LDL-C， IL-6（except for the low-dose group）， IL-1β and TNF-α， Simpson and Shannon indices， as well as the relative abundances of Firmicutes， Proteobacteria， and Clostridium were significantly reduced； meanwhile， the levels of HDL-C（except for the low-dose group） and IL-10 （except for the low-dose group）， as well as the relative abundances of Bacteroidota and Ligilactobacillus were significantly increased （ P ＜0.05）. Network pharmacology and molecular docking analyses suggested that the active constituents of HLMD， including quercetin， adenosine， oleanolic acid， stigmasterol， and ophiopogonin D′， may exert antidiabetic effects by targeting key proteins such as protein kinase B1（Akt1）， TNF， IL-6， P53 and IL-1β. Experimental validation further demonstrated that HLMD significantly downregulated the protein expressions of P53 （except for the low-dose group）， IL-6 （except for the low-dose group）， IL-1β and TNF-α in the liver tissues of T2DM rats （ P ＜0.05）.CONCLUSIONS HLMD alleviates glucose and lipid metabolism disorders， attenuates inflammatory responses， and ameliorates hepatic and pancreatic tissue damage in T2DM rats. These beneficial effects may be associated with the modulation of gut microbiota composition and the downregulation of inflammation-related targets， including P53， IL-6， IL-1β and TNF-α.

BACKGROUND: Narrative care is emerging as a new discipline to achieve high-quality nursing. It can be seen in clinical studies on improving the management of schizophrenia, depression and chronic diseases, but its application in surgical patients with lung cancer is rarely reported. The aim of this study was to study the effect on improving symptom cluster management and post-traumatic growth of surgical patients through narrative care model, and to explore its clinical advantages in promoting physical and mental rehabilitation of lung cancer patients. METHODS: A total of 82 patients with lung cancer who underwent surgical treatment in the First Affiliated Hospital of Zhejiang University from July 2024 to October 2024 were selected as the study objects by convenience sampling, and randomly divided into the control group and observation group according to random number method, with 41 cases in each group. The control group received routine nursing; On this basis, the observation group was integrated into three consecutive narrative nursing sessions on the day of admission, 3 days after surgery and 1 week after surgery. After collecting the general data of the patients before intervention, the Generalized Anxiety Scale, the Pittsburgh Sleep Quality Index, the Chinese Version of the Lung Cancer Patients Quality of Life Assessment Scale and the Chinese Version of the Post-traumatic Growth Assessment Scale were used. After each narrative intervention, the two groups of patients were assessed again, and the scores of the two groups were compared at the three stages. RESULTS: The scores of anxiety, sleep, quality of life and post-traumatic growth level of the patients on the 3 days and 1 week postoperatively were better in the observation group than in the control group, and the differences were all statistically significant (P<0.05). In addition, the results within the groups showed that the anxiety scores of the observation group and the control group gradually decreased in the preoperative period, 3 days and 1 week postoperatively; the post-traumatic growth scores gradually increased in the preoperative period, 3 days and 1 week postoperatively; however, due to the stress of the surgery and postoperative discomfort, the sleep scores of the patients of the two groups on 3 days postoperatively were higher than those in the preoperative period and 1 week postoperatively, and the sleep scores of the patients of 1 week postoperatively were significantly lower than those in the preoperative period; and the quality of life of the patients on the 3 days postoperatively scores were lower than preoperative period and 1 week postoperatively, and the quality of survival scores in 1 week postoperatively were higher than the preoperative period, and the differences were statistically significant (P<0.05). CONCLUSIONS The application of narrative nursing to lung cancer surgery patients is conducive to alleviating perioperative symptom clusters, helping patients achieve post-traumatic growth, and enhancing their psychosocial adaptability and quality of survival.
Humans ; Lung Neoplasms/psychology* ; Male ; Female ; Middle Aged ; Quality of Life ; Aged ; Adult ; Posttraumatic Growth, Psychological

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective:To analyze the mediating effect of post-traumatic growth between medical coping styles and compliance with rehabilitation exercise in young and middle-aged stroke patients.Methods:By convenience sampling, 217 stroke patients admitted to the Department of Neurology, Xinxiang Central Hospital from March 2023 to February 2024 were selected as the research objects. The investigation was carried out using a basic information questionnaire, Medical Coping Style Questionnaire (SCSQ), Post-Traumatic Growth Inventory (PTGI), and Exercise Compliance Questionnaire. Pearson correlation analysis was used to analyze the relationships among post-traumatic growth, medical coping styles, and compliance with rehabilitation exercise. The structural equation model was established using AMOS 21.0 software and the mediating effect was verified.Results:A total of 217 questionnaires were distributed, and 209 valid questionnaires were collected, with the valid questionnaire recovery rate being 96.31%. The PTGI score of the 209 patients was (45.62±10.52) ; the positive coping score in SCSQ was (14.05±3.46), and the negative coping score was (15.23±3.67) ; the compliance score with rehabilitation exercise was (31.62±4.38). Post-traumatic growth was positively correlated with the total and dimensional scores of positive coping and rehabilitation exercise compliance ( P<0.05), and negatively correlated with negative coping ( P<0.05) ; positive coping was positively correlated with the total scores and scores of each dimension of compliance with rehabilitation exercise ( P<0.05). Post-traumatic growth played a partial mediating role between medical coping styles and compliance with rehabilitation exercise, and the mediating effect accounted for 25.00% (0.037/0.148) of the total effect. Conclusions:In the early stage of the stable period, young and middle-aged stroke patients show obvious negative coping, have insufficient post-traumatic growth levels, and have good compliance with rehabilitation exercise, with room for improvement. Post-traumatic growth plays a partial mediating role between medical coping styles and compliance with rehabilitation exercise in young and middle-aged stroke patients.

Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation mo-dalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.Methods From May,2023 to October,2024,62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group(n=31)and experimental group(n=31).Both groups received conventional rehabilitation,and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side,while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition,for four weeks.They were as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale(MAS),Semmes Weinstein Monofilament Test(SWMT)and modified Barthel index(MBI)before and after treatment.Results One case dropped out in control group and one in the experimental group.After treatment,the scores of FMA-UE,MAS,SWMT and MBI increased in both groups(|t|>5.464,P<0.001),expect the score of SWMT in the control group(P>0.05),and all scores were better in the experimental group than in the control group(|t|>2.195,P<0.05).Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure func-tion of stroke patients,and improve their activity of daily living.