Objective To explore the challenges faced by online appointment nurses during nasogastric intubation and to provide a reference for improvement of the quality and safety of the services provided by online appointment nursing.Methods A purposive sampling was employed to select 13 online appointment nurses from our hospital who had previously provided home nasogastric intubation services for patients.Semi-structured interviews were conducted with the online appointment nurses.The results acquired from the interviews were analysed using Colaizzi's method.Results Two themes were identified.Theme 1 covered the increased risks of nasogastric intubation due to the patients themselves and home environment,which included 4 sub-themes of difficulties in identification and response due to complex conditions of patient,high risk of a sudden asphyxia with poor resuscitation facility,psychological stress from unfamiliar home environment,and more challenges in risk identification due to limited conditions for performing home-based intubation procedures;Theme 2 covered the coping strategies of online-scheduled nurses,which included the improvement of knowledge and skills in emergency nursing to improve comfidence and judge ability of intubation,the strengthening of nurse-patient communication to build a trust and cooperation,the conduct of thorough assessment to ensure procedural safety,and the use of alternative tools and collaboration with family members.Conclusion Online appointment nurses face challenges and risks from both of the procedures and patients themselves during home based nasogastric intubation.Hospitals and relevant management should actively implement corresponding strategies,provide training and guidance for online appointment nurses,develop relevant regulations,and improve the management mechanisms of the internet platform to ensure the safety of home based nasogastric intubation for online appointment nurses and improve the quality of the"Internet Plus Nursing Services."

Sonodynamic therapy (SDT) can potentially induce immunogenic cell death in tumor cells, leading to the release of ATP, and facilitating the initiation of an immune response. Nevertheless, the enzymes CD39 and CD73 can swiftly convert ATP into immunosuppressive adenosine (ADO), resulting in an immunosuppressive tumor microenvironment (TME). This study introduced a nanomedicine (QD/POM1@NP@M) engineered to reprogram TME by modulating the CD39/CD73/ADO pathway. The nanomedicine encapsulated sonosensitizers silver sulfide quantum dots, and the CD39 inhibitor POM1, while also incorporating homologous tumor cell membranes to enhance targeting capabilities. This integrated approach, on the one hand, stimulates the release of ATP via SDT, thereby initiating the immune response. In addition, it reduced the accumulation of ADO by inhibiting CD39 activity, which ameliorated the immunosuppressive TME. Upon administration, the nanomedicine demonstrated substantial anti-tumor efficacy by facilitating the infiltration of anti-tumor immune cells, while reducing the immunosuppressive cells. This modulation effectively transformed the TME from an immunologically "cold" state to a "hot" state. Furthermore, combined with the checkpoint inhibitor α-PDL1, the nanomedicine augmented systemic anti-tumor immunity and promoted the establishment of long-term immune memory. This study provides an innovative strategy for combining non-invasive SDT and ATP-driven immunotherapy, offering new ideas for future cancer treatment.

Periodontal bone defects, primarily caused by periodontitis, are highly prevalent in clinical settings and manifest as bone fenestration, dehiscence, or attachment loss, presenting a significant challenge to oral health. In regenerative medicine, harnessing developmental principles for tissue repair offers promising therapeutic potential. Of particular interest is the condensation of progenitor cells, an essential event in organogenesis that has inspired clinically effective cell aggregation approaches in dental regeneration. However, the precise cellular coordination mechanisms during condensation and regeneration remain elusive. Here, taking the tooth as a model organ, we employed single-cell RNA sequencing to dissect the cellular composition and heterogeneity of human dental follicle and dental papilla, revealing a distinct Platelet-derived growth factor receptor alpha (PDGFRA) mesenchymal stem/stromal cell (MSC) population with remarkable odontogenic potential. Interestingly, a reciprocal paracrine interaction between PDGFRA⁺ dental follicle stem cells (DFSCs) and CD31⁺ Endomucin⁺ endothelial cells (ECs) was mediated by Vascular endothelial growth factor A (VEGFA) and Platelet-derived growth factor subunit BB (PDGFBB). This crosstalk not only maintains the functionality of PDGFRA⁺ DFSCs but also drives specialized angiogenesis. In vivo periodontal bone regeneration experiments further reveal that communication between PDGFRA⁺ DFSC aggregates and recipient ECs is essential for effective angiogenic-osteogenic coupling and rapid tissue repair. Collectively, our results unravel the importance of MSC-EC crosstalk mediated by the VEGFA and PDGFBB-PDGFRA reciprocal signaling in orchestrating angiogenesis and osteogenesis. These findings not only establish a framework for deciphering and promoting periodontal bone regeneration in potential clinical applications but also offer insights for future therapeutic strategies in dental or broader regenerative medicine.
Receptor, Platelet-Derived Growth Factor alpha/metabolism* ; Humans ; Neovascularization, Physiologic/physiology* ; Dental Sac/cytology* ; Single-Cell Analysis ; Transcriptome ; Mesenchymal Stem Cells/metabolism* ; Bone Regeneration ; Animals ; Dental Papilla/cytology* ; Periodontium/physiology* ; Stem Cells/metabolism* ; Regeneration ; Angiogenesis

ObjectiveTo determine the optimal combination of the effective monomer components "quercetin-kaempferol-abietic acid-boswellic acid" in Fujin Shengjisan for promoting diabetic ulcer （DU） wound healing through uniform design， thereby achieving the modern application of the ancient formula. MethodsFollowing the principle of "uniform design-pharmacodynamic experiment-mathematical modeling and model verification"， the U₁₄（14⁵） uniform design table was adopted.The four monomer components of Chinese medicine were considered as the independent variables， and the proliferation rate of human umbilical vein endothelial cells （HUVECs） induced by glucose was used as the pharmacodynamic indicator. A mathematical model was constructed using DPS software to correlate the effective monomer components with the pharmacodynamic indicator. The results of uniform design were verified through CCK-8 assay， cell scratch healing， tube formation， Western blot， and Real-time PCR. ResultsAmong the 14 compatibility groups， compared with the high-glucose model group， compound compatibility group 6 showed the strongest proliferation effect and statistical significance （P<0.05）. Four quadratic polynomial regression equations （Y₁-Y₄） were obtained through DPS modeling. Considering the model's fit， stability， and practical application， equations Y₁-Y₃ were selected for the follow-up verification. To ensure experiment reproducibility， group 6 was used for validation. Group 6 and equations Y₁-Y₃ were renamed as compound prescription ① to compound prescription④， respectively， to represent the modern application of the ancient FJSJ Powder through compatibility of monomer components. Verification experiments showed that in the CCK-8， scratch healing， and tube formation assays， the cell viability， wound healing rate， and tube formation number of HUVECs stimulated with 50 mmol·L^-1 glucose were significantly reduced compared with the blank group. Moreover， the expression levels of angiogenesis-related cytokines， vascular endothelial growth factor （VEGF） and fibroblast growth factor 2 （FGF2）， and CD31 secretion were significantly down-regulated. However， after intervention with compound prescriptions ① to ④， compound prescriptions ① and ③ significantly improved the biological functions of HUVECs induced by 50 mmol·L^-1 glucose. Further analysis of the regression coefficients of compound prescriptions ① and ③， and the relative dose ratios of each monomer component， indicated that abietic acid， quercetin， and boswellic acid promoted angiogenesis of HUVECs in the high glucose environment， with a major effect （positive partial correlation coefficients， all > 0.9）. Abietic acid and boswellic acid， as well as kaempferol and boswellic acid， promoted angiogenesis in HUVECs through interaction （positive partial correlation coefficients）. ConclusionCompound prescriptions ① and ③ are the optimal combinations. They can reverse the inhibitory effects of high glucose， stimulate the proliferation， migration， and tube formation abilities of HUVECs in a high glucose environment， and promote the expression of vascular endothelial growth factorA（VEGFA）， FGF2， and CD31， thereby promoting angiogenesis and facilitating DU wound healing. This finding not only confirms the good reproducibility and feasibility of compound prescriptions ① and ③ but also provides new insights and methods for the rational construction of mathematical models to further study the compatibility theory of Chinese medicine.

Background and Aims:Body mass index(BMI),an important indicator of nutrition and health,is closely associated with postoperative complications.This study was performed to investigate the relationship between preoperative BMI and severe complications in patients undergoing liver resection for hepatolithiasis,aiming to provide preoperative guidance for clinicians,reduce the risk of postoperative complications,and ensure surgical safety and efficacy.Methods:The clinical data of 484 patients with hepatolithiasis who underwent liver resection between May 2006 and December 2022 at the First Affiliated Hospital of Army Medical University and Beijing Tsinghua Changgung Hospital were retrospectively collected.Patients were classified into low BMI group(≤18.4 kg/m2),normal BMI group(18.5-24.9 kg/m2),and high BMI group(≥25.0 kg/m2)based on preoperative BMI.Baseline characteristics,overall complications,severe complications,and other postoperative outcomes were compared between the normal BMI group and the low group as well as the high BMI group.Risk factors for severe complications after liver resection were analyzed.Results:Among the 484 patients,79(16.3％)were in the low BMI group,328(67.8％)in the normal BMI group,and 77(15.9％)in the high BMI group.The high BMI group had significantly higher ASA score,preoperative albumin level,and proportion of hypertension compared to the normal BMI group(all P＜0.05).Baseline characteristics in the low BMI group showed no significant differences compared to the normal BMI group(all P＞0.05).The incidence rates of overall complications were not significantly among the three groups(P＞0.05).However,the high BMI group had significantly higher incidence rates of severe complications(Clavien-Dindo grade Ⅲ-Ⅳ),postoperative infections,liver failure,and bile leakage compared to the normal BMI group;the low BMI group had significantly higher rates of perioperative blood transfusion,postoperative infections,liver failure,and reoperation compared to the normal BMI group(all P＜0.05).Univariate and multivariate Logistic regression analyses identified high BMI and preoperative total bilirubin ≥54 pmol/L as independent risk factors for severe complications after liver resection in patients with hepatolithiasis(both P＜0.05).Conclusion:Preoperative BMI is closely associated with the occurrence of complications after liver resection in patients with hepatolithiasis,with high BMI being an independent risk factor for severe complications.To mitigate the risk of severe complications,clinical practice should prioritize monitoring and management of individuals with high BMI and other risk factors

In recent years,there has been a gradual increase in the number of common diseases among children in China,especially younger children.Children are a unique population with distinct differences from adults,such as indications,dosage,accessories,and other characteristics,when it comes to using medication.Long-acting injections,in comparison to regular injections used for long-term treatment in children,can reduce sudden drug side effects and significantly decrease injection frequency.This greatly improves compliance among child patients and enhances clinical outcomes.Long-acting injections offer significant advantages for managing diseases in children.This paper reviews the progress made in basic research on long-acting injectable formulations for children based on interactions between drugs and materials.Additionally,potential future development directions are discussed to guide further advancements in long-acting injections specifically designed for children's needs.

Background and Aims:Body mass index(BMI),an important indicator of nutrition and health,is closely associated with postoperative complications.This study was performed to investigate the relationship between preoperative BMI and severe complications in patients undergoing liver resection for hepatolithiasis,aiming to provide preoperative guidance for clinicians,reduce the risk of postoperative complications,and ensure surgical safety and efficacy.Methods:The clinical data of 484 patients with hepatolithiasis who underwent liver resection between May 2006 and December 2022 at the First Affiliated Hospital of Army Medical University and Beijing Tsinghua Changgung Hospital were retrospectively collected.Patients were classified into low BMI group(≤18.4 kg/m2),normal BMI group(18.5-24.9 kg/m2),and high BMI group(≥25.0 kg/m2)based on preoperative BMI.Baseline characteristics,overall complications,severe complications,and other postoperative outcomes were compared between the normal BMI group and the low group as well as the high BMI group.Risk factors for severe complications after liver resection were analyzed.Results:Among the 484 patients,79(16.3％)were in the low BMI group,328(67.8％)in the normal BMI group,and 77(15.9％)in the high BMI group.The high BMI group had significantly higher ASA score,preoperative albumin level,and proportion of hypertension compared to the normal BMI group(all P＜0.05).Baseline characteristics in the low BMI group showed no significant differences compared to the normal BMI group(all P＞0.05).The incidence rates of overall complications were not significantly among the three groups(P＞0.05).However,the high BMI group had significantly higher incidence rates of severe complications(Clavien-Dindo grade Ⅲ-Ⅳ),postoperative infections,liver failure,and bile leakage compared to the normal BMI group;the low BMI group had significantly higher rates of perioperative blood transfusion,postoperative infections,liver failure,and reoperation compared to the normal BMI group(all P＜0.05).Univariate and multivariate Logistic regression analyses identified high BMI and preoperative total bilirubin ≥54 pmol/L as independent risk factors for severe complications after liver resection in patients with hepatolithiasis(both P＜0.05).Conclusion:Preoperative BMI is closely associated with the occurrence of complications after liver resection in patients with hepatolithiasis,with high BMI being an independent risk factor for severe complications.To mitigate the risk of severe complications,clinical practice should prioritize monitoring and management of individuals with high BMI and other risk factors

Objective To explore the challenges faced by online appointment nurses during nasogastric intubation and to provide a reference for improvement of the quality and safety of the services provided by online appointment nursing.Methods A purposive sampling was employed to select 13 online appointment nurses from our hospital who had previously provided home nasogastric intubation services for patients.Semi-structured interviews were conducted with the online appointment nurses.The results acquired from the interviews were analysed using Colaizzi's method.Results Two themes were identified.Theme 1 covered the increased risks of nasogastric intubation due to the patients themselves and home environment,which included 4 sub-themes of difficulties in identification and response due to complex conditions of patient,high risk of a sudden asphyxia with poor resuscitation facility,psychological stress from unfamiliar home environment,and more challenges in risk identification due to limited conditions for performing home-based intubation procedures;Theme 2 covered the coping strategies of online-scheduled nurses,which included the improvement of knowledge and skills in emergency nursing to improve comfidence and judge ability of intubation,the strengthening of nurse-patient communication to build a trust and cooperation,the conduct of thorough assessment to ensure procedural safety,and the use of alternative tools and collaboration with family members.Conclusion Online appointment nurses face challenges and risks from both of the procedures and patients themselves during home based nasogastric intubation.Hospitals and relevant management should actively implement corresponding strategies,provide training and guidance for online appointment nurses,develop relevant regulations,and improve the management mechanisms of the internet platform to ensure the safety of home based nasogastric intubation for online appointment nurses and improve the quality of the"Internet Plus Nursing Services."

In recent years,there has been a gradual increase in the number of common diseases among children in China,especially younger children.Children are a unique population with distinct differences from adults,such as indications,dosage,accessories,and other characteristics,when it comes to using medication.Long-acting injections,in comparison to regular injections used for long-term treatment in children,can reduce sudden drug side effects and significantly decrease injection frequency.This greatly improves compliance among child patients and enhances clinical outcomes.Long-acting injections offer significant advantages for managing diseases in children.This paper reviews the progress made in basic research on long-acting injectable formulations for children based on interactions between drugs and materials.Additionally,potential future development directions are discussed to guide further advancements in long-acting injections specifically designed for children's needs.

Epilepsy is a chronic brain disease characterized by seizures， and is one of the most common nervous system diseases in clinic practice with the recurrent， transient， and refractory characteristics. Clinically， western medicine therapy is mainly adopted in the treatment of epilepsy， but it is not conducive to long-term use for patients on account of severe side effects， which can result in abnormalities in the digestive system， central nervous system， hematopoietic system， urinary system， and liver function to varying degrees. Syndrome differentiation is usually used for the treatment of epilepsy by traditional Chinese medicine （TCM）， which can avoid the side effects of western medicine treatment on the basis of improving patients' syndromes. The literature on TCM in the treatment of epilepsy in China and abroad indicates that the syndrome differentiation in TCM is often based on phlegm， blood stasis， wind， and deficiency， and the treatment methods include acupuncture， acupoint catgut embedding， moxibustion， Chinese medicine monomer， drug pair， and compound decoction. The various treatments of TCM play an important role in the comprehensive treatment of epilepsy through multiple channels and links， such as reducing the degree and number of seizures. This paper comprehensively summarized the clinical experience of TCM in the treatment of epilepsy， systematically expounded various treatment methods and ideas of TCM in the treatment of epilepsy， and deeply discussed the mechanism of TCM in the treatment of epilepsy， aiming to provide a theoretical basis for the clinical formulation of a reasonable individualized treatment plan for epilepsy and diversified ideas for the more effective treatment of epilepsy by TCM.