ObjectiveTo systematically evaluate the application of narrative education in undergraduate nursing teaching， to understand the current application status of narrative education， and to provide a theoretical basis for the subsequent establishment of a sound narrative education system. MethodsA systematic search was conducted for studies published in Chinese and English databases on applying narrative education to undergraduate nursing teaching， with the search period ranging from database inception to February 23， 2025. Literature was screened， and relevant information was extracted. A rigorous quality evaluation was conducted on the included studies， and a descriptive analysis was performed on their content. ResultsA total of 20 papers were included， involving 3，180 research subjects， all of whom were undergraduate nursing students. The results of descriptive analysis showed that the teaching model of narrative education primarily encompassed reading narrative works， watching films and videos， performing narrative scenarios， and writing reflective journals. The course setting and content covered pre-teaching preparation and in-teaching implementation. The evaluation of teaching effectiveness included the evaluation of teachers’ teaching methods （student evaluation/self-evaluation） and the evaluation of students’ learning effectiveness （course grade evaluation/humanistic care scale/empathy scale assessment， and others）. ConclusionNarrative education combines abstract concepts with concrete clinical situations， which not only enriches students’ learning experiences but also enhances their humanistic literacy. Meanwhile， it provides teachers with opportunities to develop their narrative teaching skills， which requires them to possess profound professional knowledge and employ narrative techniques to guide students in reflection and critical thinking， thereby improving teaching quality and learning outcomes. Future efforts should consistently deepen the connotation research of narrative education and build a systematic nursing education system.

Objective To investigate the performance of serum epithelial fatty acid-binding protein (E-FABP) and epithelial neutrophil-activating peptide-78 (ENA-78) levels combined with computed tomography angiography (CTA) in assessing the severity of coronary atherosclerotic (CA) stenosis in patients with coronary heart disease (CHD). Methods A total of 160 CHD patients admitted to our hospital between October 2021 and October 2023 were enrolled. Based on coronary angiography results, patients were divided into a mild stenosis group (65 cases) and a moderate-to-severe stenosis group (95 cases). All patients underwent CTA. Serum levels of E-FABP and ENA-78 were measured using ELISA. Receiver operating characteristic curves were plotted to determine the diagnostic cutoff value of CTA combined with serum E-FABP and ENA-78 for assessing CA stenosis severity. A fourfold table was used to evaluate the diagnostic performance of CTA combined with serum E-FABP and ENA-78. Results CTA identified 64 patients with stenosis <50% and 96 patients with stenosis ≥50%. The agreement rates between CTA and coronary angiography were 87.69% in the mild group and 92.63% in the moderate-to-severe group. Serum levels of E-FABP and ENA-78 were significantly higher in the moderate-to-severe group than in the mild group (P<0.05). According to receiver operating characteristic analysis, the areas under the curve for E-FABP, ENA-78, and CTA in diagnosing CA stenosis severity were 0.828, 0.855, and 0.901, respectively. The areas under the curve for their combined use was 0.986. The diagnostic accuracies of CTA, E-FABP, and ENA-78 were 90.63%, 83.75%, and 83.23%, respectively, while the combined approach achieved a diagnostic accuracy of 93.13%. Conclusion Serum levels of E-FABP and ENA-78 are significantly elevated in CHD patients with moderate-to-severe CA stenosis. The combination of CTA with E-FABP and ENA-78 can improve the accuracy of assessing the severity of CA stenosis.

This paper summarizes Professor HAN Mingxiang's clinical experience in treating chronic obstructive pulmonary disease （COPD）. He believes that the key pathomechanism of COPD in the acute exacerbation stage is the invasion of external pathogens triggering latent illness， while lung qi deficiency is the primary mechanism in the stable stage. The core pathological factors throughout disease progression are deficiency， phlegm， and blood stasis. Treatment emphasizes a staged and syndrome-based approach. During the acute exacerbation stage， for wind-cold invading the lung syndrome， the self-formulated Sanzi Wenfei Decoction （三子温肺汤） is used to relieve the exterior， dispel cold， warm the lung， and resolve phlegm. For phlegm-dampness obstructing the lung syndrome， Huatan Jiangqi Fomulation （化痰降气方） is prescribed to warm the lung， transform phlegm， descend qi， and calm wheezing. For phlegm-heat obstructing the lung syndrome， Qingfei Huatan Fomulation （清肺化痰方） is applied to clear heat， resolve phlegm， moisten the lung， and stop coughing. For phlegm and blood stasis interlocking syndrome， Qibai Pingfei Fomulation （芪白平肺方） is used to tonify qi， resolve phlegm， and activate blood circulation to remove stasis. During the stable stage， for lung qi deficiency syndrome， Shenqi Wenfei Decoction （参芪温肺汤） is employed to warm the lung， tonify qi， resolve phlegm， and eliminate turbidity. For lung-spleen qi deficiency syndrome， Shenqi Buzhong Decoction （参芪补中汤） is utilized to strengthen the spleen， tonify qi， and reinforce metal （lung） from earth （spleen）. For lung-kidney deficiency syndrome， Shenqi Tiaoshen Fomulation （参芪调肾方） is prescribed to tonify the lung， warm yang， and regulate kidney function to calm wheezing. These strategies provide insights into the traditional Chinese medicine treatment of COPD.

Objective:To investigate the preventive and therapeutic effects and mechanisms of Dachaihu decoction(DCD)on dextran sodium sulfate(DSS)-induced ulcerative colitis(UC)and liver injury in mice,as well as the association between DCD benefits and gut microbiota modulation.Methods:Mice were treated with DCD(20.10 and 10.05 g/kg)for 2 weeks,with free access to drinking water containing 3%DSS in the second week to induce UC.Histopathological examination,RT-qPCR and 16S rRNA sequencing were used to investigate the effect of DCD on UC mice.Results:DCD pretreatment significantly alleviated weight loss,bloody diarrhea with mucus,histopathological abnormalities of the colon,and colon shortening in mice with DSS-induced UC.In addition,DCD pretreat-ment significantly upregulated the levels of Occludin,ZO-1,and MUC-2 in the colon and protected the intestinal barrier of mice.DCD pretreatment also alleviated inflammatory cell infiltration in the colon and the liver and significantly reduced the expression levels of the proinflammatory factors such as IL-1β,IL-6,TNF-α,iNOS,COX-2,and NLRP3,thereby exerting a protective effect against UC and liver injury.It should be noted that DCD corrected gut micro-biota imbalance in UC mice by enriching probiotic bacteria such as Lactobacillus and Bifidobacterium and reducing harmful bacteria such as Norank_f_Desulfovibrionaceae and Escherichia-Shigella.Conclusion:DCD can alleviate DSS-induced UC and exert a liver-protecting effect by protecting intestinal barrier,inhibiting inflam-mation,and regulating gut microbiota.

FLASH radiotherapy is moving from animal experiments to clinical trials. However, the research on radiation shielding of FLASH radiotherapy rooms has been still in the initial stage. This paper analyses the structural characteristics of the beam pulse of FLASH radiotherapy devices of different technical routes, and discusses the radiation shielding challenges facing the radiotherapy room from FLASH radiotherapy technology based on the current protection standards for the radiotherapy room at home and abroad. The purpose is to provide input to the research on radiation protection of FLASH radiotherapy and to promote the clinical development of FLASH radiotherapy.

FLASH radiotherapy is moving from animal experiments to clinical trials. However, the research on radiation shielding of FLASH radiotherapy rooms has been still in the initial stage. This paper analyses the structural characteristics of the beam pulse of FLASH radiotherapy devices of different technical routes, and discusses the radiation shielding challenges facing the radiotherapy room from FLASH radiotherapy technology based on the current protection standards for the radiotherapy room at home and abroad. The purpose is to provide input to the research on radiation protection of FLASH radiotherapy and to promote the clinical development of FLASH radiotherapy.

A 9-year-old male child presented with red plaques on the left upper limb for more than 5 years without obvious subjective symptoms. Topical glucocorticoids and calcineurin inhibitors did not markedly improve his condition. Skin examination showed dark red map-like plaques with clear borders on the extensor side of the left upper limb, with a few white scales attached to the surface and satellite lesions at the edge. There were no obvious abnormalities in routine blood and urine tests or immunological examinations. Histopathological examination revealed dense infiltration of abundant lymphocytes and plasma cells in the upper and middle dermis, with some inflammatory cells infiltrating the fat septa and focal formation of lymphoid follicles; immunohistochemical study showed positive staining for CD3 in interfollicular regions, CD20 in the follicular center, and CD38 in plasma cells, as well as for IgG Kappa chain and IgG Lambda chain; periodic acid-Schiff staining and acid-fast staining both showed negative results. A diagnosis of childhood benign lymphoplasmacytic plaque was made. The patient was treated with topical halometasone cream once a day in the morning, topical tacrolimus ointment once a night, and oral traditional Chinese medicine for promoting blood circulation and removing blood stasis. After 6 months of follow-up, the skin lesions became slightly flat, slightly lighter in color, and no new lesions occurred. Treatment and follow-up were ongoing.

Talents are the main force for the development of traditional Chinese medicine（TCM）， and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present， we are still exploring and developing in the fields of the formulation， implementation and evaluation indicators of TCM talent evaluation system. However， there are shortcomings and difficulties. For instance， insufficient stratification in the evaluation， excessive emphasis on the quantity of achievements， neglecting the quality of the achievements and the actual contribution， imperfect assessment indicators， and the weak characteristics of TCM. Therefore， national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard， in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value， ability and contribution. For the evaluation of TCM clinical talents， China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM（CCCL-TCM）， which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry， and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.

The ultra-high dose rate (UHDR) radiation has less side effect while keep comparable tumor control effect with conventional dose rate (CONV) radiation, which was named Flash effect. Recently, the Flash effect has been reported in many animal experiments with various types of radiations, animal species and body parts. However, the underlying mechanism of Flash has still been unraveled, making difficulties for the clinical application. This review pointed out the differences between the Flash effect and the UHDR effect in vitro and proposed three key scientific questions of Flash effect based on three well-known hypotheses, i. e., oxygen depletion, peroxyl radical recombination and immune cell protection. Finally, the research progresses and challenges of Flash mechanism study are concluded in order to give a clue for further deep investigation.

The axon initial segment (AIS) is a highly specialized axonal compartment where the action potential is initiated. The heterogeneity of AISs has been suggested to occur between interneurons and pyramidal neurons (PyNs), which likely contributes to their unique spiking properties. However, whether the various characteristics of AISs can be linked to specific PyN subtypes remains unknown. Here, we report that in the prelimbic cortex (PL) of the mouse, two types of PyNs with axon projections either to the contralateral PL or to the ipsilateral basal lateral amygdala, possess distinct AIS properties reflected by morphology, ion channel expression, action potential initiation, and axo-axonic synaptic inputs from chandelier cells. Furthermore, projection-specific AIS diversity is more prominent in the superficial layer than in the deep layer. Thus, our study reveals the cortical layer- and axon projection-specific heterogeneity of PyN AISs, which may endow the spiking of various PyN types with exquisite modulation.
Mice ; Animals ; Axon Initial Segment ; Synapses/physiology* ; Pyramidal Cells/physiology* ; Cerebral Cortex ; Axons/physiology*