When inflammation is continuously activated or dysregulated， it can induce chronic tissue injury and organ dysfunction， and participate in the occurrence and development of various inflammatory diseases such as atherosclerosis and inflammatory bowel disease. Owing to high targeting， long-acting efficacy and programmability， nucleic acid drugs provide a new direction for the treatment of inflammatory diseases. This article reviews the classification， mechanism of action and application progress of nucleic acid drugs in inflammatory diseases. It is found that small interfering RNA （siRNA） can specifically cut target mRNA through RNA interference to achieve inhibiting the expression of the target protein； antisense oligonucleotide （ASO） can inhibit target protein expression by inducing microRNA （miRNA） degradation or regulating splicing processes； miRNA can achieve network intervention by regulating multiple inflammatory target genes. At present， important breakthroughs have been made in the field of inflammatory diseases with siRNA drugs including Lumasiran， Nedosiran （for primary hyperoxaluria 1） and Inclisiran （for atherosclerosis）， ASO drugs including Donidalorsen （for hereditary angioedema）， Volanesorsen and Olezarsen （for familial chylomicronemia syndrome） and Lademirsen （for Alport syndrome）， as well as miRNA drugs including Obefazimod （for inflammatory bowel disease） and Remlarsen （for pathological fibrosis）. These drugs are expected to become a new generation of anti-inflammatory therapeutic strategies and bring more precise and efficient treatment options for patients with chronic inflammation and fibrotic diseases.

Objective:To conduct a comprehensive global review of research on toxic leadership behavior among nursing managers and to analyze the current research status.Methods:Literature related to toxic leadership behavior among nursing managers was retrieved from PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Science and Technology Journal Database, and China Biomedical Literature Database. The search period extended from the inception of each database to February 15, 2025. The included literature was then organized, analyzed, and summarized.Results:A total of 28 studies were included. There were 23 studies reported the occurrence of toxic leadership behavior among nursing managers, the incidence of toxic leadership behavior was almost at a moderately low level. There were 8 studies reported the influencing factors of toxic leadership behavior, its influencing factors encompassed three primary aspects: the organizational level, the personal characteristics of nursing managers, and characteristics of the nursing staff group. Assessment tools of toxic leadership behavior included the Toxic Leadership Behaviors of Nurse Managers, the Abuse Management Questionnaire, etc. The adverse consequences included increased nurse turnover intention, decreased nursing quality, and reduced organizational trust, etc. Interventions were planned and implemented from three perspectives: the hospital managers, nursing managers, and the nurses.Conclusions:The factors influencing toxic leadership behavior among nursing managers and its adverse consequences require further exploration. Therefore, more intervention studies are warranted to provide new insights and methods for preventing and reducing toxic leadership behavior.

To investigate the pathogenic mechanisms of a patient with type 1 diabetes mellitus (T1DM) complicated with fibrocalculous pancreatic diabetes at Tianjin Medical University General Hospital Airport Site in June 2024, clinical and genetic characteristic analyses were performed. Potential pathogenic genes were screened by whole-exome sequencing (WES), and Sanger sequencing validated the identified genetic variants within the family. The proband exhibited elevated blood glucose levels and positivity for tyrosine phosphatase antibodies, suggesting a diagnosis of T1DM. Multiple calcifications in the pancreas were observed in the proband. Genetic testing revealed that the proband carried two variants in the serine peptidase inhibitor Kazal type 1 (SPINK1) gene, namely, c.194+2T>C and c.-215G>A. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the c.194+2T>C mutation is preliminarily classified as pathogenic, while the c.-215G>A variant is classified as a variant of uncertain significance (VUS). Bioinformatics analysis indicated that the c.194+2T>C variant in the SPINK1 gene results in a truncated protein, affecting the three-dimensional structure and activity of the protein. This mutation is in complete linkage disequilibrium with the c.-215G>A variant, which may have a protective function and influence the clinical phenotype. Given that the patient also has T1DM and FCPD, there should be increased awareness of the co-occurrence of both types of diabetes to prevent misdiagnosis and underdiagnosis.

The incidence,disability and mortality of nervous system diseases have risen sharply worldwide.At present,the pathogenesis and mechanism of nervous system diseases have not been clarified.Tongqiao Huoxue Decoction in Yi Lin Gai Cuo has the effects of promoting blood circulation and removing blood stasis,dredging orifices and activating collaterals.This article reviewed the clinical trials and basic research of Tongluo Huoxue Decoction and its modified prescriptions in the treatment of neurological diseases in recent years.It showed that this prescription is often used in the treatment of blood stasis syndrome at the brain orifices,which has a significant effect on improving brain function and treating a variety of intractable diseases related to brain nerves;its pharmacological mechanisms involve regulating neurotransmitters,restoring nerve function,inhibiting oxidative stress along with inflammatory responses,optimizing hemodynamics and blood rheology retarding vascular remodeling,and promoting angiogenesis.

The incidence,disability and mortality of nervous system diseases have risen sharply worldwide.At present,the pathogenesis and mechanism of nervous system diseases have not been clarified.Tongqiao Huoxue Decoction in Yi Lin Gai Cuo has the effects of promoting blood circulation and removing blood stasis,dredging orifices and activating collaterals.This article reviewed the clinical trials and basic research of Tongluo Huoxue Decoction and its modified prescriptions in the treatment of neurological diseases in recent years.It showed that this prescription is often used in the treatment of blood stasis syndrome at the brain orifices,which has a significant effect on improving brain function and treating a variety of intractable diseases related to brain nerves;its pharmacological mechanisms involve regulating neurotransmitters,restoring nerve function,inhibiting oxidative stress along with inflammatory responses,optimizing hemodynamics and blood rheology retarding vascular remodeling,and promoting angiogenesis.

Objective:To conduct a comprehensive global review of research on toxic leadership behavior among nursing managers and to analyze the current research status.Methods:Literature related to toxic leadership behavior among nursing managers was retrieved from PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Science and Technology Journal Database, and China Biomedical Literature Database. The search period extended from the inception of each database to February 15, 2025. The included literature was then organized, analyzed, and summarized.Results:A total of 28 studies were included. There were 23 studies reported the occurrence of toxic leadership behavior among nursing managers, the incidence of toxic leadership behavior was almost at a moderately low level. There were 8 studies reported the influencing factors of toxic leadership behavior, its influencing factors encompassed three primary aspects: the organizational level, the personal characteristics of nursing managers, and characteristics of the nursing staff group. Assessment tools of toxic leadership behavior included the Toxic Leadership Behaviors of Nurse Managers, the Abuse Management Questionnaire, etc. The adverse consequences included increased nurse turnover intention, decreased nursing quality, and reduced organizational trust, etc. Interventions were planned and implemented from three perspectives: the hospital managers, nursing managers, and the nurses.Conclusions:The factors influencing toxic leadership behavior among nursing managers and its adverse consequences require further exploration. Therefore, more intervention studies are warranted to provide new insights and methods for preventing and reducing toxic leadership behavior.

To investigate the pathogenic mechanisms of a patient with type 1 diabetes mellitus (T1DM) complicated with fibrocalculous pancreatic diabetes at Tianjin Medical University General Hospital Airport Site in June 2024, clinical and genetic characteristic analyses were performed. Potential pathogenic genes were screened by whole-exome sequencing (WES), and Sanger sequencing validated the identified genetic variants within the family. The proband exhibited elevated blood glucose levels and positivity for tyrosine phosphatase antibodies, suggesting a diagnosis of T1DM. Multiple calcifications in the pancreas were observed in the proband. Genetic testing revealed that the proband carried two variants in the serine peptidase inhibitor Kazal type 1 (SPINK1) gene, namely, c.194+2T>C and c.-215G>A. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the c.194+2T>C mutation is preliminarily classified as pathogenic, while the c.-215G>A variant is classified as a variant of uncertain significance (VUS). Bioinformatics analysis indicated that the c.194+2T>C variant in the SPINK1 gene results in a truncated protein, affecting the three-dimensional structure and activity of the protein. This mutation is in complete linkage disequilibrium with the c.-215G>A variant, which may have a protective function and influence the clinical phenotype. Given that the patient also has T1DM and FCPD, there should be increased awareness of the co-occurrence of both types of diabetes to prevent misdiagnosis and underdiagnosis.

Objective:To investigate the impact of elevated glucose-induced RNA oxidation on pancreatic β-cell function, activity, and underlying molecular mechanisms.Methods:Rat pancreatic islet β-cell tumour INS-1 cells were cultured in vitro and subjected to nucleic acid oxidation assessment using isotope dilution ultra-high performance liquid tandem mass spectrometry(ID LC MS/MS)following high glucose exposure.In vitro simulation of increased RNA oxidation in INS-1 cells was achieved using 8-oxoguanosine-5'-triphosphate(8-oxoGTP).Cell proliferation was evaluated through CCK-8 assay, apoptosis was measured via flow cytometry, and gene expression of insulin(INS), pancreatic-duodenal homologous cassette 1(PDX1), cysteine-aspartate proteinase 3(Casp3), and cysteine aspartate protease 6(Casp6)was analyzed at the mRNA level.Additionally, whole transcriptome sequencing was performed to elucidate the molecular mechanisms underlying the impact of RNA oxidation on INS-1 cells.Results:Elevated glucose levels induced an increase in RNA oxidation within INS-1 cells.This heightened RNA oxidation led to the inhibition of INS-1 cell proliferation, a reduction in mRNA levels of INS and PDX1 genes, and the promotion of apoptosis-related casp3 and casp6 gene mRNA synthesis.Transcriptome sequencing analysis unveiled that the elevated RNA oxidation caused differential expression of mRNA, lncRNA, miRNA, and circRNA in INS-1 cells.This included a significant down-regulation of transcription factors such as Mafa, Pdx1, Pax6, and Mnx1, alongside an up-regulation of various miRNAs like rno-miR-124-3p, rno-miR-133a-3p, rno-miR-3120, rno-miR-212-3p, and rno-miR-7a-2-3p.These molecular changes contributed to the altered expression of associated lncRNAs, ultimately hindering insulin synthesis and secretion, as well as β-cell proliferation.Conclusions:Increased RNA oxidation down-regulates the levels of key β-cell transcription factor mRNAs, contributes to the differential expression of related non-coding RNAs(ncRNAs), particularly lncRNAs, impacts β-cell insulin synthesis and secretion, hinders cell proliferation, and serves as a significant factor in β-cell dysfunction and decreased activity in type 2 diabetes mellitus(T2DM).

With the deepening of the concept of enhanced recovery after surgery(ERAS),clinical techniques and applications aimed at reducing perioperative stress,reducing postoperative complications,and promoting early postoperative recovery have gradually attracted attention.Transcutaneous electrical acu-point stimulation(TEAS),as a new type of combination of transcutaneous electrical nerve stimulation and acupuncture acupoint technology,has significant effects in reducing body stress,improving the quality of postoperative recovery,and reducing postoperative complications.The purpose of this article is to review the research progress of TEAS in early postoperative recovery at home and abroad in recent years,so as to pro-vide a reference for optimizing perioperative anesthesia management.

Objective:To investigate the current situation and influencing factors of clinical nurses'clinical decision-making ability,and provide a reference and evidence for improving and enhancing the correct clinical decision-making ability of clinical nurses.Methods:A total of 300 clinical nurses in Shaanxi Province were selected as the research subjects by using the convenience sampling method.The General Information Questionnaire,Clinical Decision-Making Scale,and Comprehensive Decision-Making Style Scale were used to conduct the investigation and study.The influencing factors of clinical nurses'clinical decision-making ability were analyzed by using single-factor analysis and multivariate linear regression.Results:The total score of clinical nurses'clinical decision-making ability was(163.85±13.78)points,reaching the high-level standard of clinical decision-making ability(146.68-200.00)points.The results of Spearman rank correlation analysis showed that there was a significant positive correlation between the total score and the score of each dimension of clinical decision-making ability and the score of rational decision-making style(P<0.05).The score of the dimension of searching for information or new information was only negatively correlated with the score of intuitive-impulsive decision-making style(P<0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,clarifying goals and values,the total score of clinical decision-making ability,and the dimensions of finding alternative solutions(P<0.05).The results of multiple linear regression showed that rational decision-making style can positively affect clinical nurses'clinical decision-making ability,while avoidance decision-making style can negatively affect it.Conclusion:The clinical nurses'clinical decision-making ability has been maintained at a relatively constant high level,and it is greatly influenced by rational and avoidant decision-making styles.Medical managers need to organize targeted training activities and other measures to promote the construction of clinical nurses'rational decision-making style and minimize the influence of avoidant decision-making style,thus improving the clinical nurses'clinical decision-making ability.