Central venous lesion represents one of the common complications affecting vascular access in hemodialysis patients, potentially compromising hemodialysis efficacy. The management of symptomatic central venous lesion remains a critical challenge in clinical practice. Current primary treatment strategies include percutaneous transluminal angioplasty and percutaneous transluminal stenting. Advances in techniques such as sharp recanalization and the mother-child platform approach, along with the development of high-pressure balloons, paclitaxel- coated balloons, and covered stents, have significantly improved procedural success rates. However, unresolved issues persist, including standardized treatment protocols, technical considerations for lesion traversal, and optimal stent selection criteria. This article comprehensively reviews the treatment principles, lesion passage techniques, treatment techniques, and recent advancements of central venous lesion.

Central venous lesion represents one of the common complications affecting vascular access in hemodialysis patients, potentially compromising hemodialysis efficacy. The management of symptomatic central venous lesion remains a critical challenge in clinical practice. Current primary treatment strategies include percutaneous transluminal angioplasty and percutaneous transluminal stenting. Advances in techniques such as sharp recanalization and the mother-child platform approach, along with the development of high-pressure balloons, paclitaxel- coated balloons, and covered stents, have significantly improved procedural success rates. However, unresolved issues persist, including standardized treatment protocols, technical considerations for lesion traversal, and optimal stent selection criteria. This article comprehensively reviews the treatment principles, lesion passage techniques, treatment techniques, and recent advancements of central venous lesion.

OBJECTIVE To explore the correlation between changes in intestinal toxicity and changes in component composition of the Mongolian medicine Euphorbiae pekinensis Radix(EPR)before and after processing with milk.METHODS Mice were given 95%ethanol extract of raw EPR,milk-processed EPR and water-processed EPR by gavage.The purgative effect and intestinal inflam-matory toxicity changes of EPR before and after milk processing were investigated using the fecal water content and the levels of inflam-matory factors TNF-α and IL-1β in each intestinal segment of mice as indicators;LC-MS/MS was used to analyze the composition changes of the 95%alcohol extract of EPR before and after milk processing.RESULTS Compared with the blank group,the raw and water processed products of EPR could significantly increase the water content of mouse feces and the levels of TNF-α and IL-1β in each intestinal segment(P＜0.05);compared with the raw product group,all indicators in the milk processing group were significantly reduced(P＜0.05),while there was no significant difference in the water processing group,indicating that water processing cannot at-tenuate toxicity,and the auxiliary material milk is the key auxiliary material to reduce the toxicity of EPR.Mass spectrometry analysis results showed that a total of 50 components were identified in EPR,including 38 terpenoid components,6 phenolic acid components,and 6 other components.The content of each component decreased to varying degrees after milk processing.Principal component analy-sis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were performed on the mass spectrum data of raw ma-terials and products,and it was found that the components of raw materials and products can be obviously clustered into 2 categories.13 differential components of raw materials and products were screened through t test,and 11 of which were terpene compo-nents,indicating that the composition of terpene components changed significantly after milk processing.17 components derived from EPR were detected in the residual liquid of milk excipients after processing,of which 16 were terpenoids,indicating that the terpenoid components of EPR were transferred to the excipient milk during the soaking and processing processes.CONCLUSION The toxicity of EPR is reduced and the purgative effect is alleviated after milk processing.The attenuation mechanism may be that during the milk soaking and processing processes,terpenoid components are transferred to the milk,and the content of toxic components in the decoc-tion pieces is reduced,thereby reducing the toxicity.

Objective To explore the relationships between headache and pulmonary function,chronic lung disease(CLD)in middle-aged and elderly people in China.Methods This cross-sectional study collected data from participants aged 45 and above in the 2015 China Health and Retirement Longitudinal Study(CHARLS).Headache was diagnosed based on self-report,and CLD and asthma were defined by self-reported doctor diagnoses or a combination of health assessments and medication use.Peak expiratory flow(PEF)was used as an indicator of pulmonary function.Multivariable logistic regression model was used to analyze the correlations between PEF,asthma,CLD,and headache.Relationship between PEF and headache was analyzed by restricted cubic spline(RCS)analysis and subgroup analysis.Results Among 12 661 middle-aged and elderly participants,the prevalence of headache was 14.42%(1 826/12 661),with a prevalence of 9.07%(558/6 151)in males and 19.48%(1 268/6 510)in females.After full adjustment for covariates,each 1 L/s increase in PEF was associated with a 7%reduction in the risk of headache(odds ratio[OR]=0.93,95%confidence interval[CI]0.90-0.96,P＜0.001).Categorizing PEF into quartiles(Q1-Q4),as the increase of PEF,the risk of headache significantly decreased(ORs for Q2,Q3,and Q4 were 0.92,0.82,and 0.72,respectively,Ptrend＜0.001).Additionally,asthma(OR=1.78,95%CI 1.43-2.20,P＜0.001)and CLD(OR=2.21,95%CI 1.92-2.53,P＜0.001)were positively associated with the risk of headache.RCS analysis indicated a negative linear correlation between PEF and the risk of headache(Poverall＜0.001,Pnon-linear=0.57).Subgroup analysis revealed that a history of hypertension had a significant impact on the negative association between PEF and headache(Pinteraction＜0.001).Conclusion There is a significant negative correlation between PEF and headache among middle-aged and elderly people in China,while asthma and CLD are positively associated with headache.Improving lung function in middle-aged and elderly populations may be an effective strategy for preventing or alleviating headache.

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Objective:To investigate the mechanism of bladder cancer treatment by using Scutellaria barbata and Codonopsis pilosula drug pair through network pharmacology. Methods:The drug composition of the drug pair was screened using TCMSP, and their action targets were predicted using Swiss Target Prediction. GeneCards was used to obtain disease targets of bladder cancer, and venny 2.1 was used to obtain intersection targets. PPI analysis was performed using STRING, and a network diagram was constructed using Cytoscape. GO and KEGG analysis were conducted using Metascape. A drug-target-pathway network map was constructed using Cytoscape software. Nude mice were randomly divided into a model group and a treatment group to establish a bladder cancer mouse model. On the 8th day after model formation, the mice in the model group were administered intragastrically with a dose of 342.86 mg/kg, 0.2 ml, twice/day. On the 28th day after modeling, the tumor size of nude mice was measured. Prostaglandin G/H Synthetase 2 (PTGS2), PTGS1, Nuclear Receptor Coactivator 2 (NCOA2), Retinoic Acid X Receptor α (RXRA), Progesterone Receptor (PGR), Mitogen-Activated Protein Kinase 1 (MAPK1), Reticuloendothelial Proliferation virus oncogene homology A (RELA), and Akt1 levels were detected by enzyme-linked immunosorbent assay.Results:The results show that 45 active components of the drug pair directly acted on 187 disease targets through multiple pathways to treat bladder cancer, in which Quercetin, luteolin, wogonin, 7-Methoxy-2-methyl isoflavone, baicalein, beta-sitosterol, Stigmastero, and other core ingredients, as well as PTGS2, PTGS1, NCOA2, RXRA, PGR, MAPK1, RELA, and Akt1 are critical targets. The results of gene function annotation analysis show that the biological processes most likely related to crossover genes mainly involved responses to hormones, cell responses to lipids, responses to foreign stimuli, and responses to bacterial molecules. The cell components mainly involves transcription regulatory complexes, membrane rafts, membrane microregions, and RNA polymerase Ⅱ transcriptional regulatory complexes, etc. The molecular functions mainly involve transcription factor binding, DNA-binding transcription factor binding, RNA polymerase Ⅱ specific DNA-binding transcription factor binding, nuclear receptor activity, ligand-activated transcription factor activity, etc. The results of pathway enrichment analysis suggests that the main signaling pathways are AGE-RAGE, IL-17, PI3K-Akt, TNF, MAPK, HIF-1, apoptosis, p53, toll-like receptor, etc. Animal experiments show that the Scutellaria barbata and Codonopsis pilosula drug pair can significantly improve tumor size and also improve the expression levels of PTGS2, PTGS1, NCOA2, RXRA, PGR, MAPK1, RELA, and Akt1. Conclusions:The Scutellaria barbata and Codonopsis pilosula drug pair can regulate PTGS2, PTGS1, NCOA2, RXRA, PGR, MAPK1, RELA, and Akt1 and other diseases mainly through the regulation of AGE-RAGE, IL-17, PI3K-Akt, TNF, MAPK, HIF-1, apoptosis, p53, toll-like receptor, and other signaling pathways. Targeting enzyme activity and cell apoptosis can treat bladder cancer by regulating these biological processes.

OBJECTIVE: To compare 3 commonly used methods for drug delivery via the lumbar spinal subarachnoid space in rats. METHODS: We compared the effects of 3 methods for drug delivery via the lumbar spinal subarachnoid space in Sprague Dawley rats, namely acute needle puncture, chronic catheterization via laminectomy, and non-laminectomized catheterization. Body weight changes of the rats were measured, and their general and neurological conditions were assessed after the surgeries. The motor function of the rats was examined using rota rod test both before and after the surgeries. Nociceptive tests were performed to assess nociception of the rats. HE staining was used to examine local inflammation caused by the surgeries in the lumbar spinal cord tissue, and lidocaine paralysis detection and toluidine blue dye assay were used to confirm the precision of drug delivery using the 3 methods. RESULTS: Both needle puncture and catheterization via laminectomy resulted in a relatively low success rate of surgery and caused neurological abnormalities, severe motor dysfunction, hyperalgesia, allodynia and local inflammation. Catheterization without laminectomy had the highest success rate of surgery, and induced only mild agitation, slight cerebral spinal fluid leakage, mild sensory and motor abnormalities, and minimum pathology in the lumbar spinal cord. Catheterization without laminectomy produced less detectable effects on the behaviors in the rats and was well tolerated compared to the other two methods with also higher precision of drug delivery. CONCLUSIONS Catheterization without laminectomy is a safe, accurate and effective approach to lumbar drug delivery in rats.

Objective: To explore the humanistic caring ability, and to analyze the relationship between the positive psychological qualities, emotional intelligence and humanistic caring ability among the nursing interns, and provide theoretical basis to improve nursing students’ humanistic caring ability. Methods: A total of 132 nursing interns from a three Level of first-class hospital in Liaoning province, were investigated by using the general questionnaire, caring ability inventory, emotional intelligence scale and Positive Mental Characters Scale for China normal university. Results: The score of humanistic caring ability was (180.74±18.75). Among them, the average score of cognitive was the highest (73.71±10.93) and the average score of courage was the lowest (48.43±11.91). Emotional intelligence and positive psychological qualities were positively correlated with the humanistic caring ability, and positive psychological qualities was a intermediate variable between emotional intelligence and humanistic caring ability, and the mediating effect size is 18.71%. Conclusion The level of humanistic caring ability in nursing interns is lower, which needs to be further improved. The emotional intelligence and positive psychological qualities have a significant positive effect on the humanistic caring ability. Schools and internship hospitals can improve their sense of humanistic caring ability by developing the emotional intelligence and positive psychological qualities to stabilize the development of nursing career.

Objective To observe the therapeutic effect of central venous catheter drainage and intrapleural injection of urokinase on tuberculous pleurisy patients.Methods 60 hospitalized patients with tuberculous pleurisy were selected,and they were divided into two groupsby simple random grouping method.Both two groups received 3HRZE/6HR anti-tuberculosis treatment.30 patients in the observation group were treated with central venous catheter drainage and intrapleural injection of urokinase.30 patients in the control group were treated with conventional pleurocentesis.The duration of pleural effussion drainage,incidence of pleural thickening,hospitalization time and expense,and the adverse reaction rate were observed during treatment.Results In the observation group,the curative effect at 1 week was 46.7％,the duration of pleural effussion drainage was (20.5 ± 6.7)days,the incidence rate of pleural thickening was 26.7％,the hospitalization time was (9.4 ± 2.7) days,the hospitalization expense was (6 675.4 ± 1 818.4) RMB,the incidence rate of adverse reaction was 3.3％.In the control group,the curative effect at 1 week was 20.0％,the duration of pleural effussion drainage was (25.1 ± 7.7) days,the incidence rate of pleural thickening was 46.7％,the hospitalization time was (10.3 ± 2.8)days,the hospitalization expense was (7 508.9 ± 1 692.1) RMB,the incidence rate of adverse reaction was 20..0％.There were statistically significant differences between the two groups in the curative effect at 1 week (x2 =4.800,P =0.028),duration of pleural effussion drainage (t =2.484,P =0.016),incidence of pleural thickening (t =4.444,P =0.035) and incidence rate of adverse reaction (x2 =4.043,P =0.044).No statistically significant differences were observed between the two groups in hospitalization time(t =1.270,P =0.209) and expense (t =1.838,P =0.071).Conclusion In comparison to conventional pleurocentesis,the treatment of central venous catheter drainage and intrapleural injection of urokinase for tuberculous pleurisy is markedly efective,it is safe and Worthy of popularizing in clinical application.

OBJECTIVE: To study the effect of curcumin on the oxidative stress induced by nano-silicon dioxide( SiO_2) in A549 cells and to explore its potential mechanism. METHODS: A549 cells were randomly divided into 6 groups. Nano-SiO_2 group cells were stimulated with nano-SiO_2 solution with a final concentration of 20 mg/L; curcumin low-,medium-,and high-dose group cells were treated with curcumin at final concentrations of 5,10,and 20 μmol/L respectively and 20 mg/L nano-SiO_2 solution; the solvent control group was treated with dimethyl sulfoxide with a volume fraction of 0. 10%. The cells in the blank control group were not given any treatment. The cells in these 6 groups were incubated for 12 hours,and the level of malondialdehyde( MDA) and the activity of total superoxide dismutase( T-SOD) in the cells were measured by spectrophotometer. The relative expression of mRNA and protein of nuclear factor E2-associated factor 2( NRF2),thioredoxin-1( TRX1),and thioredoxin interaction protein( TXNIP) were analyzed by real-time fluorescent quantitative polymerase chain reaction and Western blot respectively. RESULTS: The MDA level in A549 cells of nano-SiO_2 group increased( P < 0. 05),the T-SOD activity decreased( P < 0. 05),and the mRNA and protein relative expression of NRF2 and TRX1 were up-regulated( P < 0. 05),TXNIP relative expression of mRNA and protein were down-regulated( P <0. 05),when compared with the blank control group and the solvent control group. After intervention with curcumin,with the increased of curcumin concentration,the MDA level in A549 cells decreased,the T-SOD activity increased,the relative expression of NRF2 mRNA and TRX1 mRNA and protein was up-regulated,the mRNA and protein relative expression of TXNIP was down-regulated,and showed a dose-dependent manner( P < 0. 01). CONCLUSION: Curcumin can protect nano-SiO_2-induced oxidative stress in A549 cells. It may activate TRX system by regulating NRF2/antioxidant response elements pathway,exerting an anti-oxidation effect and protecting cells from excessive oxidative damage.