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.

ObjectiveEndothelial cell dysfunction being the core link. This study explores the molecular mechanism of Danshen Tongluo formula in treating coronary artery disease-dominated panvascular disease with endothelial cell changes as the core through animal experiments and single-cell transcriptome sequencing. MethodsA rat model of coronary artery disease-dominated panvascular disease was established by ligating the left anterior coronary artery. Rats were randomized into a blank group， a model group， and a Danshen Tongluo formula （28 mg·kg^-1·d^-1） group. The efficacy was evaluated by examining the cardiac ultrasound， determination of the plasma level of N-terminal pro-brain natriuretic peptide， and pathological staining. After single-cell sequencing， SingleR package， public datasets， and related literature were used for annotation of the cells. Cell chat was used for intercellular communication and ligand-receptor analysis， and scmetabolism was used for metabolic analysis of endothelial cells. ResultsAnimal experiments showed that Danshen Tongluo formula reduced the N-terminal pro-brain natriuretic peptide （ NT-proBNP ） level （P<0.05）， ameliorated myocardial cell damage and fibrosis， and increase left ventricular ejection fractions （LVEF） in the rat model of heart failure after myocardial infarction（P<0.05）. Single-cell sequencing results showed that Danshen Tongluo formula increased the proportion of arterial endothelial cells， venous endothelial cells， and capillary-arterial endothelial cells， while reducing the proportion of capillary-venous endothelial cells. In addition， this formula increased the interaction intensity of endothelial cells with cardiomyocytes and M1 macrophages and reduced the interaction intensity of endothelial cells with fibroblasts and T cells. Danshen Tongluo formula upregulated CXCL12-CXCR4 signaling in endothelium-B cells and Ptprm-Ptprm signaling in endothelial endothelial cells， while downregulating Mif-（CD74⁺CXCR44） signaling in endothelium-M1 macrophages and Mif-（CD74⁺CD44） signaling in endothelium-M2 macrophages. It reduced the citric acid cycle， oxidative phosphorylation， and glycolysis and increased the glycolysis/oxidative phosphorylation ratio in endothelial cells. GO and KEGG enrichment analysis showed that arterial endothelial cells， venous endothelial cells， and venous capillary endothelial cells can all regulate oxidative phosphorylation， cell adhesion molecules， and tyrosine metabolism. Lymphatic endothelial cells regulate immunity and vascular constriction to participate in the metabolism of various amino acids and fatty acids. ConclusionDanshen Tongluo Formula can ameliorate coronary artery disease-dominated panvascular disease by changing the composition of endothelial cells and regulating the communication between myocardial endothelial cells and non-endothelial cells.

Objective To investigate the effects of five-element music on depressive behaviors and intestinal flora in offspring of fear-stress rats during pregnancy.Methods Thirty-six 0.5-day pregnant Wistar rats were divided randomly into a control group,fear-stress group,and five-element music group,and the subsequent litters continued the maternal grouping.Pregnant rats in the fear-stress and five-element music groups were modeled on days 1～19 of gestation using the bystander electric method,while the five-element music group was also exposed to Feather Tune five-element music intervention.The fear behavior and serum glucocorticoid(GC)levels in pregnant rats were assessed on day 20 of pregnancy by open field test and enzyme-linked immunosorbent assay,respectively,to evaluate the effectiveness of the model.Depression in 3-week-old offspring was evaluated by open field,tail suspension,and sucrose preference tests.Norepinephrine(NE),dopamine(DA),and 5-hydroxytryptamine(5-HT)levels in the hippocampus of the offspring were measured by high-performance liquid chromatography.Changes in the intestinal flora of the offspring were analyzed by 16S rRNA sequencing.Expression levels of the proximal colonic proteins claudin1,occludin,and ZO1 in the offspring were measured by Western blot assay.Results Pregnant rats in the fear-stress group stayed longer in the area around the open field(P＜0.05),had fewer entries into the central area(P＜0.001),and had higher serum GC levels compared with those in the blank group(P＜0.001).In contrast,five-element music exposure reversed these behavioral changes(P＜0.05)and serum GC levels(P＜0.001)in the fear-stress group.Offspring in the fear-stress group exhibited decreased open-field crossing frequency(P＜0.01),reduced sucrose preference index,and longer immobility time in the tail suspension test(P＜0.05),compared with those in the blank group,together with significantly decreased NE,DA,and 5-HT levels in the hippocampus(P＜0.05).Rats in the fear-stress group showed decreased diversity of the intestinal flora(P＜0.01)and significant alterations in flora structure,including higher abundance of Proteobacteria,Enterobacteriaceae,Enterococcus,and Escherichia(P＜0.05),and lower abundance of Spirochaetes,Spirochaetaceae,Lachnospiraceae,Ruminococcaceae,Treponema,Prevotella,Coprococcus,Allobaculum,Ruminococcus,and Dorea(P＜0.05).The proximal colonic proteins Claudin1,Occludin,and ZO1 were significantly downregulated(P＜0.05).The open-field crossing frequency,sucrose preference index,and duration of tail suspension immobilization were improved in the five-element music group compared with those in the fear-stress group(P＜0.05),while DA and 5-HT levels were significantly restored in the hippocampus(P＜0.05),species diversity of the intestinal flora increased(P＜0.01)and changes in the abundance of the flora were reversed,and the proximal colonic proteins Occludin and ZO1 expression were significantly upregulated(P＜0.05).Conclusions Five-element music intervention during pregnancy can ameliorate fear-stress-induced depression behaviors and intestinal flora disorders in the offspring.

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

AIM:To investigate the regulatory mechanism of silent information regulator 6(Sirt6)on nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathway and ferroptosis in skeletal muscle aging in-duced by D-galactose(D-Gal)in mice.METHODS:A D-Gal-induced mouse aging model was established and randomly divided into control and D-Gal groups.In vitro,D-Gal-treated C2C12 mouse myoblasts were treated with ferroptosis ago-nist erastin(Era)and inhibitor ferrostatin-1(Fer-1),Sirt6 agonist MDL-800 and inhibitor OSS-128167,and Nrf2 siRNA.Mouse body weight and forelimb relative grip strength were monitored.RT-qPCR and Western blot were used to measure the expression of Sirt6,Nrf2,HO-1,P53,P21,P16,muscle ring finger protein 1,muscle atrophy F-box,solute carrier family 7 member 11,and glutathione peroxidase 4 in gastrocnemius muscle and myoblasts.Hematoxylin-eosin staining was performed to examine muscle fiber diameter.Levels of reactive oxygen species(ROS),mitochondrial ROS,mitochon-drial membrane potential,senescence-associated β-galactosidase activity,glutathione,lipid peroxidation,and Fe2? con-centration were measured in myoblasts and myotubes.Immunofluorescence staining was used to detect myosin heavy chain(MyHC)expression in myotubes.RESULTS:Mice in the D-Gal group exhibited significant reductions in body weight and forelimb grip strength(P<0.01),upregulation of aging and muscle atrophy markers,and decreased mRNA and pro-tein levels of ferroptosis markers and Sirt6(P<0.01).Additionally,gastrocnemius muscle fiber diameter significantly de-creased(P<0.01).In D-Gal-treated myoblasts and myotubes,aging and muscle atrophy markers were elevated(P<0.01),MyHC expression was reduced,and protein levels of ferroptosis-related markers,Sirt6,Nrf2,and HO-1 were de-creased(P<0.05 or P<0.01).Fer-1 pre-treatment alleviated these changes(P<0.05 or P<0.01).MDL-800 significantly improved D-Gal-induced aging and muscle atrophy in myoblasts and myotubes,while increasing the expression of ferropto-sis-related proteins(P<0.05 or P<0.01).However,the addition of Erastin abolished the beneficial effects of MDL-800(P<0.05 or P<0.01).Following Nrf2 siRNA transfection,the ability of MDL-800 to improve ferroptosis and the quality of myotube formation was significantly diminished(P<0.05 or P<0.01).CONCLUSION:Sirt6 inhibits ferroptosis in myo-blasts through the Nrf2/HO-1 signaling pathway,thereby alleviating age-related changes in myoblasts and the decline in myotube formation quality,which is beneficial for improving skeletal muscle aging.

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

AIM:To investigate the regulatory mechanism of silent information regulator 6(Sirt6)on nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathway and ferroptosis in skeletal muscle aging in-duced by D-galactose(D-Gal)in mice.METHODS:A D-Gal-induced mouse aging model was established and randomly divided into control and D-Gal groups.In vitro,D-Gal-treated C2C12 mouse myoblasts were treated with ferroptosis ago-nist erastin(Era)and inhibitor ferrostatin-1(Fer-1),Sirt6 agonist MDL-800 and inhibitor OSS-128167,and Nrf2 siRNA.Mouse body weight and forelimb relative grip strength were monitored.RT-qPCR and Western blot were used to measure the expression of Sirt6,Nrf2,HO-1,P53,P21,P16,muscle ring finger protein 1,muscle atrophy F-box,solute carrier family 7 member 11,and glutathione peroxidase 4 in gastrocnemius muscle and myoblasts.Hematoxylin-eosin staining was performed to examine muscle fiber diameter.Levels of reactive oxygen species(ROS),mitochondrial ROS,mitochon-drial membrane potential,senescence-associated β-galactosidase activity,glutathione,lipid peroxidation,and Fe2? con-centration were measured in myoblasts and myotubes.Immunofluorescence staining was used to detect myosin heavy chain(MyHC)expression in myotubes.RESULTS:Mice in the D-Gal group exhibited significant reductions in body weight and forelimb grip strength(P<0.01),upregulation of aging and muscle atrophy markers,and decreased mRNA and pro-tein levels of ferroptosis markers and Sirt6(P<0.01).Additionally,gastrocnemius muscle fiber diameter significantly de-creased(P<0.01).In D-Gal-treated myoblasts and myotubes,aging and muscle atrophy markers were elevated(P<0.01),MyHC expression was reduced,and protein levels of ferroptosis-related markers,Sirt6,Nrf2,and HO-1 were de-creased(P<0.05 or P<0.01).Fer-1 pre-treatment alleviated these changes(P<0.05 or P<0.01).MDL-800 significantly improved D-Gal-induced aging and muscle atrophy in myoblasts and myotubes,while increasing the expression of ferropto-sis-related proteins(P<0.05 or P<0.01).However,the addition of Erastin abolished the beneficial effects of MDL-800(P<0.05 or P<0.01).Following Nrf2 siRNA transfection,the ability of MDL-800 to improve ferroptosis and the quality of myotube formation was significantly diminished(P<0.05 or P<0.01).CONCLUSION:Sirt6 inhibits ferroptosis in myo-blasts through the Nrf2/HO-1 signaling pathway,thereby alleviating age-related changes in myoblasts and the decline in myotube formation quality,which is beneficial for improving skeletal muscle aging.

Objective To investigate the effects of five-element music on depressive behaviors and intestinal flora in offspring of fear-stress rats during pregnancy.Methods Thirty-six 0.5-day pregnant Wistar rats were divided randomly into a control group,fear-stress group,and five-element music group,and the subsequent litters continued the maternal grouping.Pregnant rats in the fear-stress and five-element music groups were modeled on days 1～19 of gestation using the bystander electric method,while the five-element music group was also exposed to Feather Tune five-element music intervention.The fear behavior and serum glucocorticoid(GC)levels in pregnant rats were assessed on day 20 of pregnancy by open field test and enzyme-linked immunosorbent assay,respectively,to evaluate the effectiveness of the model.Depression in 3-week-old offspring was evaluated by open field,tail suspension,and sucrose preference tests.Norepinephrine(NE),dopamine(DA),and 5-hydroxytryptamine(5-HT)levels in the hippocampus of the offspring were measured by high-performance liquid chromatography.Changes in the intestinal flora of the offspring were analyzed by 16S rRNA sequencing.Expression levels of the proximal colonic proteins claudin1,occludin,and ZO1 in the offspring were measured by Western blot assay.Results Pregnant rats in the fear-stress group stayed longer in the area around the open field(P＜0.05),had fewer entries into the central area(P＜0.001),and had higher serum GC levels compared with those in the blank group(P＜0.001).In contrast,five-element music exposure reversed these behavioral changes(P＜0.05)and serum GC levels(P＜0.001)in the fear-stress group.Offspring in the fear-stress group exhibited decreased open-field crossing frequency(P＜0.01),reduced sucrose preference index,and longer immobility time in the tail suspension test(P＜0.05),compared with those in the blank group,together with significantly decreased NE,DA,and 5-HT levels in the hippocampus(P＜0.05).Rats in the fear-stress group showed decreased diversity of the intestinal flora(P＜0.01)and significant alterations in flora structure,including higher abundance of Proteobacteria,Enterobacteriaceae,Enterococcus,and Escherichia(P＜0.05),and lower abundance of Spirochaetes,Spirochaetaceae,Lachnospiraceae,Ruminococcaceae,Treponema,Prevotella,Coprococcus,Allobaculum,Ruminococcus,and Dorea(P＜0.05).The proximal colonic proteins Claudin1,Occludin,and ZO1 were significantly downregulated(P＜0.05).The open-field crossing frequency,sucrose preference index,and duration of tail suspension immobilization were improved in the five-element music group compared with those in the fear-stress group(P＜0.05),while DA and 5-HT levels were significantly restored in the hippocampus(P＜0.05),species diversity of the intestinal flora increased(P＜0.01)and changes in the abundance of the flora were reversed,and the proximal colonic proteins Occludin and ZO1 expression were significantly upregulated(P＜0.05).Conclusions Five-element music intervention during pregnancy can ameliorate fear-stress-induced depression behaviors and intestinal flora disorders in the offspring.

Objective:To explore the learning experience of medical students in digital storytelling teaching,providing a theoretical basis for the practice and research of digital storytelling teaching.Methods:Qualitative research and mixed-method research containing qualitative studies on medical students'experiences in digital storytelling teaching were retrieved from domestic and foreign databases,with a retrieval time limit from database establishment to January 2024.The quality evaluation criteria for qualitative research from JBI Evidence-Based Healthcare Center were used to evaluate the quality of the included literature,and the meta-integration method was used to systematically integrate and analyze the results.Results:A total of 12 articles were included,44 research results were extracted,and 11 new categories were summarized and integrated into 3 integration results,including medical students benefit greatly from digital storytelling teaching;the unique advantages of digital storytelling as an emerging teaching tool;and the obstacles of digital storytelling in education.Conclusion:Medical students hold a positive attitude towards the teaching mode of digital storytelling and have gained a good learning experience from it.However,there are shortcomings such as the uneven quality of digital storytelling resources,and some medical students'unsuitability for the learning mode of digital storytelling.Further research is needed on ethical issues arising from the teaching mode of digital storytelling.

Objective To conduct a systematic review of relevant literature to understand the current status and influencing factors of telehealth readiness of clinical medical staff.Methods The Chinese and English databases of CNKI,Wanfang database,VIP,SinoMed,Pubmed,Embase,Cochrane Library,CINAHL,Web of Science were searched by computer.The Chinese and English literatures on the current status and influencing factors of remote health care readiness among medical staff personnel were collected.The search time was from the establishment of the database to July 12th,2023,and the literature was screened and evaluated.After data extraction and integration of the literature,descriptive analysis is conducted.Results 18 articles were ultimately included,involving 12 298 medical staff members.Research shows that the readiness of clinical medical staff for telehealth is currently at a moderate level and not optimistic.The relevant influencing factors are:medical staff factors,including general demography factors,willingness of medical care services,innovative self-efficacy,understanding and participation of telehealth care mode,and electronic information ability;organizational factors:including telemedicare policies,telemedicare training,sufficient human resource working environment and atmosphere,hospital level and type.Conclusions The readiness of clinical medical staff for remote health care is at a moderate level,but their willingness to participate in remote health care is high.It is recommended to construct a scientific and feasible remote health care training program for medical staff in the future to improve the quality of hospital services.