Atopic dermatitis （AD） is an atopic disease with a complex etiology and pathogenesis resulting from the interaction of multiple factors. The NOD-like receptor pyrin domain-containing 3 （NLRP3） inflammasome is an important component of innate immunity and is involved in the onset and progression of AD， encompassing multiple processes such as inflammation， pyroptosis， and autophagy. Traditional Chinese medicine （TCM） has shown significant clinical efficacy in the treatment of AD and also offers advantages including flexible compatibility， multi-target effects， and low drug resistance. A large number of studies have shown that single Chinese medicinal components and compound prescriptions can treat atopic diseases by modulating the NLRP3 inflammasome. This article elaborates on the activation of the NLRP3 inflammasome and its influence on the pathogenesis and progression of AD， and summarizes recent studies on the mechanisms by which active constituents， extracts， and compound formulations of Chinese medicine treat AD through regulation of the NLRP3 inflammasome and related signaling pathways， with the aim of providing a reference for the clinical treatment of AD and the development of TCM.

Background The Qingcaosha Reservoir is facing issues of algal blooms and eutrophication, and the resulting increase in the level of chlorination disinfection by-products in the water has been a major concern. Objective To evaluate the impact of "Algae Monitoring and Control Program in Qingcaosha Reservoir" (hereinafter referred to as the program) on the control of trihalomethanes (THMs) in conventional finished water. Methods From 2011 to 2019, water samples were collected from the Lujiazui Water Plant once per season, one sample each time, and the concentrations of four THMs (trichloromethane, dichlorobromomethane, monochlorodibromomethane, and tribromomethane) were measured in the samples. Using 2014 when the program was implemented as a cut-off point, the entire study period was divided into two phases: pre-implementation (2011–2013) and post-implementation(2014–2019). Segmented linear regression with interrupted time series analysis was applied to assess the concentrations and trends of THMs in the finished water before and after the program launch. Results The concentration of total THMs in finished water increased by 1.561 µg·L⁻¹ (P=0.010) for each season of time extension before launching the program. The change in the concentration of total THMs in finished water was not statistically significant after the program launch, but the THMs concentration showed a decreasing trend as the slope was −0.626 (P=0.001). From 2017 until the end of 2019, the average concentration of THMs in finished water of Lujiazui Water Plant dropped to 10 μg·L⁻¹ or less. Conclusions The algae and eutrophication control measures in Qingcaosha Reservoir have achieved good results, controlling THMs in finished water at a low level, and the trend of THMs has changed from a yearly increase pattern before the program to a yearly decrease pattern after the program.

Objective To investigate the training needs and suggestions of advanced practice nurses in medical institutions in China,and to provide references for the formulation of training programs for advanced practice nurses.Methods By a convenient sampling method,from May to July in 2023,the heads of nursing nurses in medical institutions in 29 provinces,autonomous regions and municipalities directly under the Central Government were investigated,and the self-designed questionnaires were distributed in the form of electronic questionnaire.Results 1 287 medical institutions participated in the survey,with tertiary hospitals accounting for 65.50％.93.16％of medical institutions had the use needs of advanced practice nurses,and the top 3 professional fields hoping to prioritize in the APN training were in the order of critical illness,emergency treatment and intravenous treatment.Among the APN core competence,the most important one was direct clinical practice(92.77％),followed by professional development(89.43％)and scientific research and evidence-based practice(86.40％).71.72％of medical institutions suggested that the theoretical training time is 4 weeks,combining online and offline training(50.35％),and the clinical practice time should not be less than 12 weeks(97.66％).Theoretical learning course assignment(92.93％),case report(90.83％)and clinical practice reflection diary(88.19％)were the main process evaluation methods,while 1 case study with the completion of the report and defense(87.65％)and 1 evidence-based nursing practice research plan with the completion of a report and defense(77.93％)were the main final evaluation methods.Conclusion Advanced practice nurses are important roles in the process of nursing professional development,and medical institutions in our country have a high demand for the training of advanced practice nurses.It is imperative to carry out the training of advanced practice nurses.The suggestions of medical institutions on the training content and methods focus more on the training of core competence.On this basis,the admission conditions should be clarified,and the training program of advanced practice nurses for China's national conditions should be explored.

Spine is one of the most important skeletal structures in human body.It has the function of protecting the spinal cord,supporting body weight,slowing impact and allowing flexible movement of the trunk.The study of spinal biomechanics is very important for a comprehensive understanding of the structure and function of the spine and the pathogenesis of spinal diseases.In 2023,scholars at home and abroad have done a lot of researches on spine related biomechanics,including the cognition on basic biomechanics of the spine,the changes in mechanical properties of the spine under pathological conditions,and the design of various treatment methods of spinal diseases based on biomechanical researches.This review focuses on the research progress of spinal biomechanics in 2023,and several typical spinal diseases or pathological states are introduced in detail as examples.

Objective:To explore the effect of discharge preparation service based on timing theory on the care readiness and benefit finding of caregivers for elderly dementia patients.Methods:From January 2021 to December 2022, 100 caregivers of elderly dementia patients from the Neurology Department and Rehabilitation Department of Jingjiang People's Hospital were selected as the subject by convenient sampling. Caregivers were divided into a control group and a study group based on their enrollment time, with 50 cases in each group. The control group received routine nursing, while the study group was treated with discharge preparation services based on timing theory. The effect was evaluated using the Caregiver Preparedness Scale (CPS) and Caregiver Benefit Finding Questionnaire.Results:After intervention, the CPS score of the study group was (22.80±2.83), which was higher than the control group's (17.92±2.60), and the difference was statistically significant ( P<0.05). After three months of discharge, the score of the Caregiver Benefit Finding Questionnaire in the study group was (117.50±6.25), which was higher than the control group's (109.98±9.89), and the difference was also statistically significant ( P<0.05) . Conclusions:The discharge preparation service based on timing it right can improve the care readiness and benefit finding of caregivers for elderly dementia patients.

Objective To screen the biological markers in the assisted detection of childhood Kawasaki disease(KD).Methods A total of 208 children inpatients initially diagnosed as KD in this hospital from Janu-ary 2022 to December 2023 were selected as the KD group,and 208 healthy children undergoing physical ex-amination in this hospital were selected as the control group.Serum C reactive protein(CRP),white blood cells(WBC),platelets(PLT),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),antistreptolysin O(ASO),interleukin-6(IL-6),immunoglobulin IgG,IgA,IgM,IgE,complement C3,C4 and serum ferritin(Fer)in the two groups were detected,and the receiver operating characteristic(ROC)curve was used to e-valuate the value of the various biological indexes for diagnosing KD.Results The levels of CRP,WBC,PLT,ESR,IgM,complement C4,Fer,PCT and IL-6 in the KD group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The ROC curve showed that the areas under the curves(AUC)of CRP,WBC,ESR,PCT and IL-6 all were＞0.9,in which,AUC of CRP was 1.000,when 2.25 ng/L was the cut-off value,the sensitivity and specificity were 100.0％.AUC of IL-6 was 0.998,when 6.595 mg/L was the cut-off value,the sensitivity was 97.1％and the specificity was 99.0％.AUC of ESR was 0.987,when 18.50 mm/h was the cut-off value,the sensitivity was 96.0％and the specificity was 99.0％.Conclusion CRP,IL-6 and ESR have the higher diagnostic value for KD.

Intervertebral disc degeneration is widely recognized as one of the main causes of lower back pain.Intervertebral disc cells are the primary cellular components of the discs,responsible for synthesizing and secreting collagen and proteoglycans to maintain the structural and functional stability of the discs.Additionally,intervertebral disc cells are involved in maintaining the nutritional and metabolic balance,as well as exerting antioxidant and anti-inflammatory effects within the intervertebral discs.Consequently,intervertebral disc cells play a crucial role in the process of disc degeneration.When these cells are exposed to oxidative stress,mitochondria can be damaged,which may disrupt normal cellular function and accelerate degenerative changes.Mitochondria serve as the powerhouse of cells,being the primary energy-producing organelles that control a number of vital processes,such as cell death.On the other hand,mitochondrial dysfunction may be associated with various degenerative pathophysiological conditions.Moreover,mitochondria are the key site for oxidation-reduction reactions.Excessive oxidative stress and reactive oxygen species can negatively impact on mitochondrial function,potentially leading to mitochondrial damage and impaired functionality.These factors,in turn,triggers inflammatory responses,mitochondrial DNA damage,and cell apoptosis,playing a significant role in the pathological processes of intervertebral disc cell degeneration.This review is focused on exploring the impact of oxidative stress and reactive oxygen species on mitochondria and the crucial roles played by oxidative stress and reactive oxygen species in the pathological processes of intervertebral disc cells.In addition,we discussed current cutting-edge treatments and introduced the use of mitochondrial antioxidants and protectants as a potential method to slow down oxidative stress in the treatment of disc degeneration.

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

OBJECTIVE: To investigate the effectiveness of joystick technique assisted closed reduction and cannulated screw fixation in the treatment of femoral neck fracture. METHODS: Seventy-four patients with fresh femoral neck fractures who met the selection criteria between April 2017 and December 2018 were selected and divided into observation group (36 cases with closed reduction assisted by joystick technique) and control group (38 cases with closed manual reduction). There was no significant difference in gender, age, fracture side, cause of injury, Garden classification, Pauwels classification, time from injury to operation, and complications (except for hypertension) between the two groups ( P>0.05). The operation time, intraoperative infusion volume, complications, and femoral neck shortening were recorded and compared between the two groups. Garden reduction index was used to evaluate the effect of fracture reduction, and score of fracture reduction (SFR) was designed and was used to evaluate the subtle reduction effect of joystick technique. RESULTS: The operation was successfully completed in both groups. There was no significant difference in operation time and intraoperative infusion volume between the two groups ( P>0.05). All patients were followed up 17-38 months, with an average of 27.7 months. Two patients in the observation group received joint replacement due to failure of internal fixation during the follow-up, and the other patients had fracture healing. Within 1 week after operation, the Garden reduxtion index of the observation group was better than the control group; the SFR score of the observation group was also higher than that of the control group; the proportion of femoral neck shortening within 1 week after operation and at 1 year after operation in the observation group were lower than those in the control group. The differences of the above indexes between the two groups were significant ( P<0.05). CONCLUSION The joystick technique can improve the effectiveness of closed reduction of femoral neck fractures and reduce the incidence of femoral neck shortening. The designed SFR score can directly and objectively evaluate the reduction effect of femoral neck fracture.
Humans ; Treatment Outcome ; Bone Screws ; Femoral Neck Fractures/surgery* ; Plastic Surgery Procedures ; Fracture Fixation, Internal/methods* ; Retrospective Studies

Objective:To introduce a novel technique note about anterior decompression through transoral axis slide and rotation osteotomy (ASRO) and identify its imaging parameters related to osteotomy, and to explore its clinical application value.Methods:CT data of cervical spine of 90 subjects were collected, including 54 males and 36 females. The age ranged from 26 to 72 years, with an average age of 48.7 years. The Mimics software was used to reconstruct the atlantoaxial three-dimensional model. We plan to perform osteotomy on both sides of the axis of the vertebral body in the anteroposterior direction and the ASRO related anatomical parameters were measured, including the minimum osteotomy angle, the maximum osteotomy angle, the minimum and maximumdistance between the osteotomy trajectory and the inner side of the articular surface, the length of the upper articular surface of the axis side mass, the depth of osteotomy at the highest point and lowest point of the axial osteotomy surface and the minimum osteotomy depth. A 56-year-old female patient was admitted to the hospital due to atlantoaxial dislocation with failure of occipital-cervical fusion, difficulty walking, weakness and hypoaesthesia in four limbs. Imaging revealed that narrow space between the transversal walking wire and upper-posterior of the odontoid process, compressing the spinal cord from the front and the back respectively. The ASRO technique was performed on the patient under neuro-electrophysiological monitoring, and the osteotomy angle, osteotomy depth, narrowest width of the upper cervical spinal canal, the medullary, spinal cord angle were measured and Japanese Orthopaedic Association Scores (JOA) cervical myelopathy evaluation were performed after the operation to evaluate the surgical treatment effect.Results:The minimum osteotomy angle and the maximum osteotomy angle was 14.7°± 4.36° and 33.0°± 8.67°. The minimum and maximumdistance between the osteotomy trajectory and the inner side of the articular surface, and the length of the upper articular surface of the axis side mass was 6.0±1.80 mm, 12.2±3.17 mm, and 17.2±1.90 mm, the ratio of the former two to the latter was 34%±8.7% and 70%± 15.0%. The depth of osteotomy at the upper edge, lower edge and narrowest place of the axial osteotomy surface were 6.0±1.80 mm, 12.2±3.17 mm and 17.2±1.90 mm. The postoperative imaging of the patient showed that the osteotomy angle was 17.1° on left side and 16.5° on right side, and the depth of osteotomy at the upper edge, lower edge and narrowest place of the axial osteotomy surface were 17.1 mm, 13.2 mm, and 9.1 mm on left side, and 17.4 mm, 11.8 mm, 8.46 mm on right side. All measured values met the ranges which were shown in the imaging anatomical study. The narrowest width of the upper cervical spinal canal increased from 6.58 mm to 15.28 mm, the medullary spinal cord angle increased from 131.7° to 153.8°postoperatively, and the cervical spine JOA score recovered from 6 points to 14 points, suggesting that the postoperative spinal canal space is obvious increased, the compression on the front of the spinal cord was significantly reduced. The patient's symptoms improved significantly.Conclusion:ASRO technique is a good choice for salvage of failed posterior occipitocervical fusion and some irreducible atlantoaxial dislocation because of the anterior bony fusion. It could direct decompress the spinal cord anteriorly, avoid the odontoid resection, which is a safe and feasible new technique.