Hyperuricemia （HUA） is a common metabolic disorder characterized by persistently elevated serum uric acid levels, leading to uric acid-related renal injury through complex mechanisms involving inflammation, oxidative stress, and fibrosis. Key traditional Chinese medicine （TCM） formulas （e.g., Simiao Powder, Tongfengning） and individual herbal compounds （alkaloids, flavonoids, polysaccharides） with urate-lowering and renal protective properties were systematically summarized, including their mechanisms of regulating uric acid transporters （organic anion transporter 3, urate anion transporter 1, glucose transporter type 9）, inhibiting inflammatory responses （via NF-κB signaling）, reducing oxidative stress （via mitochondrial pathways and antioxidant enzyme enhancement）, and attenuating renal fibrosis （via PI3K/AKT signaling）. The challenges of current studies mainly focus on unclear mechanisms of action and insufficient clinical research. Future research may further explore TCM resources, clarify dual-action mechanisms of urate reduction and renal protection, and identify new therapeutic strategies for hyperuricemia-related renal injury.

Background With the widespread application of ionizing radiation technology in non-medical fields, the number of non-medical radiation workers has steadily increased over the years. Individual dose monitoring serves as a crucial measure to safeguard the occupational health of non-medical radiation workers, as it can accurately identify occupational health risks and optimize radiation protection strategies. Objective To analyze the individual monitoring data of radiation workers from partial non-medical sectors in Shanghai from 2016 to 2023, to obtain the status of occupational radiation exposure and to provide a reference basis for non-medical radiation hygiene supervision and protection management. Methods The study subjects consisted of radiation workers from non-medical institutions in Shanghai who recieved individual dose monitoring at a Class-A radiation health technical service institution between 2016 and 2023. Under the Specifications for individual monitoring of occupational external exposure (GBZ 128-2019), thermoluminescence dosimetry was used for measuring personal dose equivalent, H_p(10), of various occupations encompassing industrial irradiation, industrial radiography, radioisotope production, accelerator operation, other industrial applications, education, and veterinary medicine. Kruskal-Wallis H test was used for comparison among multiple groups, Bonferroni method was adopted for pairwise comparison, and Mann-Kendall test was conducted for trend analysis to analyze the per-capita annual effective dose and its variation over time across different occupational categories of radiation workers. Results A total of 13728 person-times of non-medical radiation workers were monitored from 2016 to 2023, accumulating a collective effective dose of 3025.69 person-mSv. The per-capita annual effective dose M(P₂₅, P₇₅) was 0.14(0.08, 0.25) mSv. There were statistically significant differences in the per-capita annual effective dose of radiation workers in different years (H=874.826, P< 0.05). Similarly, significant variations were identified among various occupational categories (H=115.569, P< 0.05). Among them, the per-capita annual effective dose of radiological workers engaged in the production of radioactive isotopes was the highest, at 0.21(0.14, 0.32) mSv, followed by those in veterinary medicine, at 0.17 (0.11, 0.61) mSv; the difference between these two groups was not statistically significant (Z=1.231, P > 0.05), but both were significantly higher than those in other occupational categories (Z=3.913, 9.761, P<0.05). The veterinary medicine category had the highest proportion of monitored individuals with annual effective dose exceeding 1 mSv to the total number of monitored individuals(NR₁), reaching 17.12%, and the industrial radiography category showed the highest proportion of workers exposed to more than the annual investigation level 5 mSv to the total number of monitored individuals (NR₅), at 0.16%. Conclusion From 2016 to 2023, the overall individual doses of some non-medical radiation workers in Shanghai remain low, indicating well-controlled radiation levels in workplaces and low exposure risks. It is necessary to focus on radiation workers engaged in radioisotope production, veterinary medicine and industrial radiography.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To investigate the therapeutic effects and mechanisms of Jianyang Tablets(mainly with the functions of tonifying the kidneys,replenishing essence,invigorating yang,and alleviating erectile dysfunction)on erectile dysfunction(ED)in rats with liver depression and kidney deficiency syndrome.Methods The 60 male SD rats were randomly divided into a normal group,a model group,a Tadalafil group,and low-,medium-,and high-dose Jianyang Tablets groups.Except for the normal group,all other groups underwent a 14-day composite modeling protocol combining intramuscular hydrocortisone injections and limb immobilization to induce ED with liver depression and kidney deficiency syndrome.Treatments were administered for 28 consecutive days after successful modeling.The body mass differences were recorded and compared before and after the experiment.Behavioral assessments included open-field test and mounting test were conducted.Enzyme-linked immunosorbent assay(ELISA)was used to measure nitric oxide synthase(NOS),cyclic adenosine monophosphate(cAMP),and cyclic guanosine monophosphate(cGMP)levels in penile cavernous tissues.Nitric oxide(NO)level was quantified using the Griess reagent colorimetric method.Results Compared with the normal group,the model group exhibited reduced horizontal activity grid counts in the open-field test,prolonged mounting latency,decreased mounting frequency,decreased body mass,and reduced levels of NOS,NO,cGMP,and cAMP in penile cavernous tissues,with statistical significance(P＜0.05 or P＜0.01).Compared with the model group,the Tadalafil group and medium-and high-dose Jianyang Tablets groups showed increased horizontal activity grid counts and vertical activity counts in the open-field test,shortened mounting latency,elevated mounting frequency,increased body mass,and upregulated levels of NOS,NO,cGMP,and cAMP in penile cavernous tissues,with statistical significance(P＜0.05 or P＜0.01).No significant differences were observed among the intervention groups for the aforementioned indices(P＞0.05).Conclusion Jianyang Tablets effectively improves erectile function in rats with liver depression and kidney deficiency syndrome,potentially mediated by modulation of the NO-cGMP signaling pathway.

Objective:To analyze the morphologic changes and the extent of severity in end-stage heart disease; and to explore the correlation with their clinical features.Methods:Twelve cases of recipients who underwent pediatric cardiac allograft transplantation were collected from May 2022 to November 2023 at the Seventh Medical Center of People′s Liberation Army of China General Hospital. Gross pathologic examinations were performed and morphological changes were observed under a light microscope after HE, Masson′s trichrome, and reticulin staining. Semi-quantitative analysis of morphologic changes was performed. One case received DMD genetic testing, one received mtDNA variation testing for mitochondriopathy, and 1 received metagenomics next-generation sequencing. Clinical data and related literature were reviewed for comprehensive analysis.Results:There were 12 recipient hearts including 11 dilated cardiomyopathy (DCM) and 1 fulminant myocarditis (FM). The median age of DCM was 12 years (range, 3 to 15 years). DCM showed cardiomyocyte hypertrophy, cardiomyocyte disarray, nuclear morphological changes, interstitial fibrosis and fatty infiltration. One DCM was confirmed as Becker muscular dystrophy by DMD genetic testing. No pathogenic mutations were found in 1 patient that received mtDNA variation testing. H. influenzae was detected in the case of FM. FM showed diffuse and full-thickness inflammatory cell infiltration by large numbers of lymphocytes and plasma cells, scattered eosinophils, and few neutrophils.Conclusions:Cardiac transplantation is an excellent treatment for end-stage heart disease. The morphological features of DCM include cardiomyocyte hypertrophy, nuclear morphological changes, interstitial fibrosis and fatty infiltration. The severity of the lesion is influenced by multiple factors. FM predominantly presents diffuse infiltration of lymphocytes and plasma cells.

Objective:To analyze the morphologic changes and the extent of severity in end-stage heart disease; and to explore the correlation with their clinical features.Methods:Twelve cases of recipients who underwent pediatric cardiac allograft transplantation were collected from May 2022 to November 2023 at the Seventh Medical Center of People′s Liberation Army of China General Hospital. Gross pathologic examinations were performed and morphological changes were observed under a light microscope after HE, Masson′s trichrome, and reticulin staining. Semi-quantitative analysis of morphologic changes was performed. One case received DMD genetic testing, one received mtDNA variation testing for mitochondriopathy, and 1 received metagenomics next-generation sequencing. Clinical data and related literature were reviewed for comprehensive analysis.Results:There were 12 recipient hearts including 11 dilated cardiomyopathy (DCM) and 1 fulminant myocarditis (FM). The median age of DCM was 12 years (range, 3 to 15 years). DCM showed cardiomyocyte hypertrophy, cardiomyocyte disarray, nuclear morphological changes, interstitial fibrosis and fatty infiltration. One DCM was confirmed as Becker muscular dystrophy by DMD genetic testing. No pathogenic mutations were found in 1 patient that received mtDNA variation testing. H. influenzae was detected in the case of FM. FM showed diffuse and full-thickness inflammatory cell infiltration by large numbers of lymphocytes and plasma cells, scattered eosinophils, and few neutrophils.Conclusions:Cardiac transplantation is an excellent treatment for end-stage heart disease. The morphological features of DCM include cardiomyocyte hypertrophy, nuclear morphological changes, interstitial fibrosis and fatty infiltration. The severity of the lesion is influenced by multiple factors. FM predominantly presents diffuse infiltration of lymphocytes and plasma cells.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Background::Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.Methods::A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.Results::Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs. 39.8% [92/231] vs. 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685–11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068–2.343), traditional systemic (adjusted OR = 1.887, 95% CI= 1.263–2.818), and nonsystemic treatment (adjusted OR= 1.602, 95% CI= 1.117–2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680–1.274, compared to no treatment), according to multivariable logistic regression analysis. Conclusions::A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.

Objective:To explore the talent cultivation model of nursing professional group under the 1+X certificate system, to build a talent cultivation system for nursing professional groups with "three progressions, four integrations, and five cocultivation"Methods:From 1 July 2021 to 31 December 2023, built a professional group course system of "mutual sharing of foundations, mutual generation of majors, mutual selection of positions, and progressive improvement of abilities". Aligned course content with X certificate content. Deepen the reform of the three education systems, create a "dual teacher" teaching team that combines full-time and part-time work, and build teaching resources that connect the cloud and the ground. The application effect of this model was evaluated in 2021 nursing majors in Cangzhou Medical College by cluster sampling.Results:There were 748 students majoring in nursing in class of 2021, 150 boys aged 19-22(20.00 ± 1.23), 598 girls, aged 19-21(19.00 ± 2.57). There were 118 students majoring in midwifery in class of 2021, all of them were girls, aged 18-20(18.00 ± 2.11). There were 128 students majoring in rehabilitation therapy technology in class of 2021, 66 boys aged 19-21(19.00 ± 2.11), 62 girls aged 19-21(19.00 ± 2.54). Nursing professional group completed the "Basic Nursing Technology Training Guidance", "Elderly Care" and other 5 self-compiled textbooks, 730 students had participated in the X certificate assessment, 729 students e passed the assessment, the passing rate was 99.9%.Conclusions:The talent cultivation model of "three progressions, four integrations, and five co cultivation" in the nursing professional group can cultivate students′ professional abilities, and cultivate a composite technical and skilled talent with multiple abilities and interconnections in one job.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.