Ferroptosis exhibits a clear “double-edged sword” effect in liver fibrosis， with its impact strictly dependent on the type of target cells. In hepatocytes， ferroptosis induced by specific signaling pathways （such as glutathione peroxidase 4 inhibition） is a key factor for driving hepatic injury and initiating fibrogenesis， and dying hepatocytes activate hepatic stellate cells by releasing damage-associated molecules； on the contrary， in activated hepatic stellate cells， ferroptosis becomes a therapeutic target for promoting liver fibrosis regression， and selective elimination can be achieved by disrupting their distinctive antioxidant defense mechanisms. Moreover， ferroptosis modulates the dynamic balance of the fibrotic liver microenvironment by regulating macrophage polarization and intercellular communication. Based on the above mechanisms， targeting ferroptosis has emerged as a promising strategy for precise treatment. This article summarizes related research advances and discusses the major challenges and future directions for clinical translation.

Objective To analyze personal external exposure dose monitoring results of pet hospital radiation workers in Beijing from 2022 to 2024, and to provide scientific evidence for developing effective monitoring protocols, standardizing radiological practices in pet hospitals, and protecting the health of both workers and the public. Methods Personal dose equivalents, H_p(10), were measured using GR-200A thermoluminescent dosimeters. Monitoring included radiation workers at 286 pet hospitals across all 16 districts of Beijing from 2022 to 2024. Each monitoring cycle lasted no more than 90 days. Annual effective doses were calculated by summing the results of four consecutive quarterly cycles. Data were processed and analyzed using Access and TLPS 6.41 software. All evaluations complied with national laws, regulations, and technical standards. Results A total of 1,579 person-time measurements were recorded. Only 51.87% of workers completed the full four-cycle annual monitoring schedule. Over the study period, the mean annual effective dose was 0.29 mSv, and the median dose was 0.14 mSv. The collective effective dose was 238.34 man-mSv. Notably, 94.26% of workers had annual effective doses below 1.0 mSv, and only 0.12% had doses at or above 5 mSv. Dose levels showed a statistically significant downward trend (P<0.05). Both independent and chain-branded clinics had a median annual effective dose of 0.14 mSv. In independent clinics, the proportion of workers with doses below 1.0 mSv increased from 80.77% in 2022 to 98.82% in 2024. In chain-branded clinics, this proportion rose from 96.88% to 98.11% over the same period. Conclusion Radiation exposure among pet hospital workers in Beijing remains at low levels, well below regulatory limits, and shows an overall declining trend. The disparity in personal doses between independent and chain-branded pet hospitals has diminished over time. Nevertheless, the industry still faces challenges such as high staff turnover and low monitoring completion rates. Expanding monitoring coverage and harmonizing protection standards would provide a scientific basis for precise, nationwide regulation.

Objective:To systematically evaluate the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on common metabolic diseases.Methods:Following the PICOS framework to construct the search formula, we systematically searched the Web of science, PubMed, Cochrane Library, CNKI, Wanfang, and VIP databases for randomized controlled trials (RCTs) investigating the effect of the DASH diet on multiple metabolic indices including body weight, body mass index (BMI), fasting blood glucose, triglycerides, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in patients with metabolic disorders (e.g., obesity, diabetes mellitus, and hypertension) published both in China and abroad from 1 January 2000 to 31 December 2023. The search terms were combinations of MeSH and free-text terms, and the raw data obtained from the search were screened according to the inclusion and exclusion criteria to determine the articles that were finally included in the analysis. The differences in these metabolic indices were compared between the intervention group group (using DASH diet) and the control group. The quality of the studies was assessed quantitatively using the modified Jadad scale and qualitatively using the Risk of Bias 2 (RoB 2) tool by two reviewers independently. Data analysis was conducted using Stata 18.0 software, with the I 2 test for heterogeneity evaluation and funnel plots for qualitative assessment of publication bias. Results:A total of 13 RCTs were included, involving 1 653 participants. Meta-analysis showed that the intervention group had more favorable effects on SBP ( SMD:-0.91, 95%CI: -1.55–-0.27; Z=-2.79, P<0.005) and DBP ( SMD: -0.98, 95%CI: -1.62–-0.33; Z=-2.96, P<0.05) than the control diet. Fasting blood glucose ( SMD: 0.21, 95% CI: 0.01–0.41; Z=2.06, P=0.04) was statistically significant. There were no significant differences in body weight, BMI, fasting blood glucose, and triglyceride outcomes betweeen these two groups. Conclusions:DASH diet is effective in controlling SBP and DBP in patients with metabolic disorders and may be useful in clinical adjunctive therapy. However, current evidence does not support an independent improvement in glycolipid metabolic markers.

Objective:To explore the training experiences of palliative care nurses participating in a prognosis disclosure workshop based on Kolb's experiential learning model, and to provide references for future educational programs in palliative care nursing.Methods:Using purposive sampling, 11 nurses were recruited who had participated in the "Palliative Care Competency Training Program for Nurses" in Shanghai between March and May 2025 and selected the Third Affiliated Hospital of Naval Medical University as their clinical training site. Semi-structured interviews were conducted, and data were analyzed using Colaizzi's seven-step method.Results:A total of three major themes emerged: a sense of benefit from enhanced competencies; complex emotional experiences; recommendations for course optimisation.Conclusions:Workshops based on Kolb's experiential learning model offer positive value in palliative care education. They effectively improve core competencies such as communication and empathy. However, the emotional experiences of nurses must also be considered, and multifaceted optimizations to the training design are recommended to further enhance training outcomes.

Objective:To explore the training experiences of palliative care nurses participating in a prognosis disclosure workshop based on Kolb's experiential learning model, and to provide references for future educational programs in palliative care nursing.Methods:Using purposive sampling, 11 nurses were recruited who had participated in the "Palliative Care Competency Training Program for Nurses" in Shanghai between March and May 2025 and selected the Third Affiliated Hospital of Naval Medical University as their clinical training site. Semi-structured interviews were conducted, and data were analyzed using Colaizzi's seven-step method.Results:A total of three major themes emerged: a sense of benefit from enhanced competencies; complex emotional experiences; recommendations for course optimisation.Conclusions:Workshops based on Kolb's experiential learning model offer positive value in palliative care education. They effectively improve core competencies such as communication and empathy. However, the emotional experiences of nurses must also be considered, and multifaceted optimizations to the training design are recommended to further enhance training outcomes.

Objective:To systematically evaluate and synthesize qualitative research on the care experiences and coping strategies of family caregivers in home-based hospice care, so as to provide a reference for developing systematic support strategies for these caregivers.Methods:Qualitative studies on the care experience and coping strategies of family caregivers in home-based hospice care were electronically and systematically retrieved from PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, SinoMed, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to March 2025. The literature quality was assessed using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were analyzed and synthesized through the aggregative integration method. The quality rating of the integrated findings was conducted using the Confidence in the Qualitative Evidence developed by the Joanna Briggs Institute Center for Evidence-Based Health Care.Results:A total of 17 studies were included. Ninety research findings were extracted and categorized into 14 categories, ultimately synthesizing into four integrated findings, including the multifaceted impacts of home-based hospice care on family caregivers' physical and mental well-being and daily lives, the diverse coping strategies sought by family caregivers in home-based hospice care, the varying attitudes toward death among family caregivers, and the external difficulties and challenges faced by family caregivers. The integrated evidence rating indicated that three integrated evidence bodies were of moderate quality, while one evidence body was of low quality.Conclusions:Healthcare providers should recognize the multifaceted impact of home-based hospice care on family caregivers, identify caregiving challenges, and provide personalized support to enhance both the caregivers' quality of life and the patient's quality of dying.

Objective:To systematically evaluate and integrate the exercise experience of overweight or obese pregnant women during pregnancy, in order to provide basis for the formulation of standardized exercise programs for this population.Methods:We searched databases including PubMed, Cochrane Library, Web of Science, CINAHL, Embase, Ovid, PsycINFO, Chinese Biomedical Literature Database, VIP, Wanfang and China National Knowledge Infrastructure, from their inception to August 16, 2023, to collect qualitative studies on the exercise experience of overweight or obese pregnant women during pregnancy. The quality of included studies was evaluated according to Joanna Briggs Institute Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods.Results:A total of 11 studies were included. Sixty-one complete findings were grouped according to similarities to form 9 new categories. These categories resulted in 3 synthesized findings. Pregnant women with overweight or obesity were affected by promoting and hindering factors; careful balance of exercise risk and benefit for overweight or obese pregnant women during pregnancy; expectations and needs of overweight or obese pregnant women for exercise during pregnancy.Conclusions:Overweight or obese pregnant women highly rated the benefits and importance of exercise, but their participation and adherence to exercise is challenging. Medical staff should pay attention to the exercise experience of overweight or obese pregnant women during pregnancy, understand the driving factors and obstacles of exercise for overweight or obese pregnant women, in order to provide standardized and personalized exercise guidance programs for overweight or obese pregnant women.

Objective:To systematically evaluate the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on common metabolic diseases.Methods:Following the PICOS framework to construct the search formula, we systematically searched the Web of science, PubMed, Cochrane Library, CNKI, Wanfang, and VIP databases for randomized controlled trials (RCTs) investigating the effect of the DASH diet on multiple metabolic indices including body weight, body mass index (BMI), fasting blood glucose, triglycerides, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in patients with metabolic disorders (e.g., obesity, diabetes mellitus, and hypertension) published both in China and abroad from 1 January 2000 to 31 December 2023. The search terms were combinations of MeSH and free-text terms, and the raw data obtained from the search were screened according to the inclusion and exclusion criteria to determine the articles that were finally included in the analysis. The differences in these metabolic indices were compared between the intervention group group (using DASH diet) and the control group. The quality of the studies was assessed quantitatively using the modified Jadad scale and qualitatively using the Risk of Bias 2 (RoB 2) tool by two reviewers independently. Data analysis was conducted using Stata 18.0 software, with the I 2 test for heterogeneity evaluation and funnel plots for qualitative assessment of publication bias. Results:A total of 13 RCTs were included, involving 1 653 participants. Meta-analysis showed that the intervention group had more favorable effects on SBP ( SMD:-0.91, 95%CI: -1.55–-0.27; Z=-2.79, P<0.005) and DBP ( SMD: -0.98, 95%CI: -1.62–-0.33; Z=-2.96, P<0.05) than the control diet. Fasting blood glucose ( SMD: 0.21, 95% CI: 0.01–0.41; Z=2.06, P=0.04) was statistically significant. There were no significant differences in body weight, BMI, fasting blood glucose, and triglyceride outcomes betweeen these two groups. Conclusions:DASH diet is effective in controlling SBP and DBP in patients with metabolic disorders and may be useful in clinical adjunctive therapy. However, current evidence does not support an independent improvement in glycolipid metabolic markers.

Objective To investigate the causal relationship between gut microbiota and obstruc-tive sleep apnea syndrome(OSA)using a two-sample bidirectional Mendelian randomization(MR)approach.Methods Eligible single nucleotide polymorphisms(SNPs)were selected from genome-wide association study(GWAS)databases as instrumental variables.A bidirectional MR analysis was conducted to evaluate the causal effects between gut microbiota and OSA.Various statistical methods,including the inverse variance weighted(IVW)method,MR-Egger regression,the weighted model method,and the weighted median method,were employed for association assessment.The MR pleiot-ropy residual sum and outlier(MR-PRESSO)test,along with Cochran's Q test and the leave-one-out cross-validation method,were used to assess heterogeneity and pleiotropy.Results According to the IVW method analysis,an increased abundance of the genus Faecalibacterium(sp002397985)(OR=0.847,95％CI,0.719 to 0.997,P=0.046)was associated with a reduced risk of OSA.Conversely,increased abundances of the genera Bacteroides(OR=1.075,95％CI,1.016 to 1.138,P=0.012),Haemophilus(sp001679485)(OR=1.106,95％CI,1.016 to 1.203,P=0.021),Streptococcus(OR=1.168,95％CI,1.036 to 1.316,P=0.011),and Blautia(sp002159835)(OR=1.169,95％CI,1.035 to 1.319,P=0.012)were associated with an elevated risk of OSA.The reverse MR analysis revealed no significant association between the risk of OSA and the abundance of gut microbiota.The results of Cochran's Q test,MR-Egger test,and MR-PRESSO test indicated no het-erogeneity or horizontal pleiotropy(P＞0.05).Conclusion Causal relationships exist between the five genera(Faecalibacterium,Bacteroides,Haemophilus,Streptococcus,and Blautia)and the risk of OSA.

Military training represents one of the most essential activities for troops during peacetime,of which the prevention and treatment of training-induced injuries are a very important part.Recent findings of research suggest that cold atmospheric plasma(CAP)exhibits a distinctive and multifaceted superiority in terms of broad-spectrum sterilization,rapid blood coagulation and healing promotion for wounds.Consequently,CAP has good prospects of applications in diverse fields such as clinical medicine,emergency rescue and military medicine.Based on a review of the research progress in plasma medicine,the applicability of CAP in the prevention and treatment of military training injuries was discussed in this paper by focusing on the urgent issues related to military training injury,including the typical application scenarios and methods for CAP,the safety and effectiveness of plasma trauma prevention and treatment,and the key issues facing the prevention and treatment of military training injuries.