Acute liver injury (ALI) serves as a critical precursor and major etiological factor in the progression and ultimate manifestation of various hepatic disorders. The prevention and treatment of ALI is still a serious global challenge. Given the limited therapeutic options for ALI, exploring novel targeted therapeutic agents becomes imperative. The potential therapeutic efficacy of inhibiting RIPK2 is highlighted, as it may provide significant benefits by attenuating the MAPK pathway and NF-κB signaling. Herein, we propose a CMD-OPT model, a two-stage molecular optimization tool for the rapid discovery of RIPK2 inhibitors with optimal properties. Compound RP20, which targets the ATP binding site, demonstrated excellent kinase specificity, ideal oral pharmacokinetics, and superior therapeutic effects in a model of APAP-induced ALI, positioning RP20 as a promising preclinical candidate. This marks the first application of RIPK2 inhibitors in ALI treatment, opening a novel therapeutic pathway for clinical applications. These results highlight the efficacy of the CMD-OPT model in producing lead compounds from known active molecules, showcasing its significant potential in drug discovery.

Nine novel compounds, comprising seven tetrahydroanthraquinones (auxarthrolones A-G, 1-7), a γ-butenolide glycoside (malfilamentoside E, 26), and a γ-butenolide (auxarthrolide A, 27), together with eighteen known compounds (8-25) were isolated from rice-based solid culture of Auxarthron umbrinum (A. umbrinum) DSM3193 using the one strain many compounds (OSMAC) approach. The structural elucidation of these compounds was accomplished through nuclear magnetic resonance (NMR), mass spectrometry (MS), and NMR calculation combined with DP4+ analysis or MAEΔΔδ parameter, while the absolute configurations of new compounds were established through single-crystal X-ray diffraction, electronic circular dichroism (ECD) spectroscopic data analysis and/or chemical derivatization. Austrocortilutein (10) and auxarthrol H (14) demonstrated moderate cytotoxicity against U87 and U251 [half maximal inhibitory concentration (IC₅₀) 3.5-12.1 μmol·L^-1]. Additionally, auxarthrolone A (1), auxarthrol H (14), eupolyphagin B (15), and 7-hydroxy-2-(2-hydroxypropyl)-5-methylchromone (17) exhibited torsional effects on fibroblast proliferation challenges induced by oleic acid, thus demonstrating fibroblast proliferation-promoting activity.
4-Butyrolactone/pharmacology* ; Molecular Structure ; Anthraquinones/pharmacology* ; Humans ; Animals ; Mice ; Cell Line, Tumor ; Magnetic Resonance Spectroscopy

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Nursing is closely related to life cycle health of human beings. With the changing needs of health care and the dynamic development of nursing discipline, the problems to be solved in nursing are becoming more and more complex. However, the knowledge, methods and tools of nursing are not enough to solve these problems. Therefore, promoting the development of nursing discipline by multi-disciplinary integration has become an inevitable trend. This article reviews the "history, present" and future of "nursing+" multi-disciplinary intersection and integration development, especially in the past decade, and discusses the function and significance of nursing interdisciplinary discipline, so as to provide new ideas for the development of "nursing+" multi-disciplinary intersection and integration.

This paper introduced the concept of caloric restriction and its main intervention types, and reviewed the application progress of caloric restriction in elderly obese people from the aspects of physical measurement parameters, cardiovascular and metabolic indicators, cognitive function and mental health, in order to provide reference for the construction of health management strategies for elderly obese people.

Objective:To understand the current situation of the construction of provincial level and above gerontological nurse specialists (GNSs) training bases in China, including the establishment of bases, training program settings, admission criteria for GNSs, and requirements for training teachers, so as to provide reference for optimizing the training of GNSs.Methods:This study is a cross-sectional survey. From August to October 2021, a self-designed questionnaire was used to investigate the geriatric nursing committees of nursing associations at provincial level and above. A total of 32 electronic questionnaires were distributed to nursing associations in 31 provinces/autonomous regions/municipalities directly under the Central Government and the Geriatric Nursing Committee of the Chinese Nursing Association, and 32 valid questionnaires were recovered, with an effective recovery rate of 100.0% (32/32) .Results:In China, 25 nursing associations at or above the provincial level set up training bases for GNSs, and about 3 400 GNSs were trained. 80.0% (20/25) of training bases required a minimum education level of tertiary education and a minimum professional title of junior nurse for GNS trainees. 64.0% (16/25) of training bases required a minimum of 5 working years for GNS trainees. More than half of the training bases required training teachers with a bachelor's degree or above, and a professional title of supervisor nurse or above.Conclusions:The training base for GNSs in China is in a stage of exploration and rapid development. The training system, student admission criteria, and teacher requirements for GNSs among various training bases have not yet formed a unified standard, and further standardization are needed.

Objective:To understand the barriers to active aging among elderly people in western China and provide reference for formulating targeted interventions.Methods:This study was a qualitative study. From September to December 2022, purposive sampling was used to select 15 elderly people from Chengdu as the research subject for semi-structured interviews. Data analysis was conducted using the Colizzi 7-step analysis method.Results:The barriers to the active aging of elderly people in western China included three themes and six sub-themes, namely low levels of health self-management (low level of health awareness, lack of healthy lifestyle), hindered social participation (low personal willingness to participate in society, weak social participation support system), and weak social security system (heavy burden of medical care, poor accessibility of multi-channel elderly care services) .Conclusions:There are many barriers in the active aging process of elderly people in the western region of China. While improving the elderly care system and expanding service supply, society should fully consider the needs of the elderly, exert their subjective initiative, create an active aging atmosphere, and promote the smooth realization of active aging for the elderly in western China.

Objective:To translate the English version of the Medical Office Survey on Patient Safety Culture (MOSPSC) into Chinese, and conduct cross-cultural adjustment and reliability and validity tests.Methods:After obtaining the authorization and consent of the original questionnaire agency in May 2018, forward translation, synthesis, back translation and expert consultation of the English version of MOSPSC were carried out to form the Chinese version of MOSPSC. From December 2018 to January 2019, convenience sampling was used to select the outpatient staff working in five ClassⅢ general hospitals in Chengdu as the research object to evaluate the reliability and validity of the questionnaire.Results:A total of 420 questionnaires were distributed, 396 valid questionnaires were recovered. The Chinese version of MOSPSC included 10 dimensions, 38 items, and another 3 items to investigate and evaluate the status quo of outpatient quality and safety issues. The Cronbach's alpha coefficient of the questionnaire was 0.901 for the employee level and 0.978 for the management level. The split-half reliability of the questionnaire was 0.907 for the employee level, 0.971 for the management level, and 0.408 to 0.975 for each dimension. The test-retest reliability of the employee level of the questionnaire was 0.960, and the test-retest reliability of each dimension was from 0.438 to 0.943. The item-level content validity index of the questionnaire was from 0.66 to 1.00, and the average scale-level content validity index of the questionnaire was 0.91.Conclusions:The Chinese version of MOSPSC maintains good equivalence with the source questionnaire after strict cross-cultural adjustment, and has good content validity, internal consistency reliability and test-retest reliability, which is suitable for the investigation of patient safety culture in the outpatient setting of China.

Peripherally inserted central catheter-related venous thrombosis (PICC-RVT) is one of the most serious complications in catheterized patients. The high incidence of PICC-RVT in cancer patients is the leading cause of unplanned extubation, which not only increases hospital costs, but also prolongs hospital stay. PICC-RVT is preventable but difficult to treat. Changing the previous clinical thinking of "heavy treatment and light prevention", and developing a PICC-RVT risk prediction model for cancer patients can assess the risk of thrombosis in patients in advance, and is helpful for the stratified prevention and treatment of PICC-RVT, and can reduce the incidence of PICC-RVT and improve its adverse outcomes. This article reviews the published PICC-RVT risk prediction models at home and abroad, so as to provide a reference for clinical medical and nursing staff to select appropriate thrombosis risk prediction tools based on the characteristics of various specialty disease.

Objective:To analyze the effect of role standardized progressive nursing model on delivery fear and delivery outcome of primiparas.Methods:Using the convenient sampling method, a total of 200 primiparas who were admitted to Ruian Maternal and Child Health Hospital of Zhejiang Province from January to December 2020 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 100 cases in each group. Patients in the control group were given routine nursing intervention, while patients in the observation group were given role standardization progressive nursing mode on the basis of the control group. Childbirth Attitude Questionnaire (CAQ) and Childbirth Self-Efficacy Inventory-32 (CBSEI-32) were used to investigate, and the outcomes of delivery in the two groups were counted.Results:Before intervention, there was no statistically significant difference in CAQ and CBSEI-32 scores between two groups ( P>0.05) . After intervention, the scores and total scores of all dimensions of CAQ in the observation group were lower than those in the control group, and the outcome expectation, delivery self-efficacy expectation score in CBSEI-32 were higher than those in the control group, and the differences were all statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of postpartum hemorrhage, lateral perineal resection and premature rupture of membranes in the observation group ( P>0.05) . The cesarean section rate in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The role standardized progressive nursing model can alleviate the fear of delivery, improve the sense of self-efficacy during delivery and improve the outcome of delivery, which is worthy of clinical application.