Objective Exploring the effect of Bian-stone-based herbal heat therapy on herbal heat ironing in gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients.Methods Convenience sampling method was used to select 68 cases of hematopoietic stem cell transplantation patients who attended the hematology department of a tertiary-level Chinese medicine hospital in Hangzhou from October 2023 to April 2024 as the study subjects,and the SPSS 26.0 statistical software was used to generate a random number for grouping into an experimental and a control group,with 34 cases in each group.On the basis of intravenous antiemetic medication and routine,the experimental group implemented the Bian-stone-based herbal heat therapy on the basis of intravenous antiemetic medication and conventional nursing care.In the control group,intravenous antiemetic drugs and routine care were used,and the intervention duration of both groups was 14 d,of which 7 d was a course of treatment,with a total of 2 courses of treatment.The incidence of gastroin-testinal reactions,Gastrointestinal Symptom Rating Scale(GSRS)score,Pepsin Ⅰ(PG Ⅰ),Pepsin Ⅱ(PG Ⅱ),and the ratio of PG Ⅰ to PG Ⅱ(PGR)before and after the intervention were compared between the 2 groups.Results The final sample of 66 cases was collected in this study,and 1 patient was dislodged from each of the control group and the experimental group.The comparison of the incidence of gastrointestinal reactions between the 2 groups within 14 days showed that the incidences of nausea,vomiting,abdominal distension,and diarrhea were lower in the experimental group than those in the control group(P＜0.05).GSRS scores on days 1,8,and 14 of intervention were compared,and there were effects between groups in both groups(F=5.338,P=0.017).The levels of PG Ⅰ,PG Ⅱ in the experimental group on day 8 of the intervention were lower than those in the control group.The levels of PGR was higher than that in the control group(all P＜0.05).The safety of the 2 groups after treatment was evaluated,and the results showed that no serious adverse events occurred in the 2 groups.Conclusion Bian-stone-based herbal heat therapy can improve gastrointestinal reactions and reduce the incidence of gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients,which provides clinical guidance for the application of Bian-stone-based herbal heat therapy by nursing staff in the future.

To analyze the current state and issues of ideological education for graduate students of general practice, from April 10 to Dec 19, 2024, a literature review was conducted on publications from Jan 1, 2001, to Dec 19, 2024, in the CNKI, Wanfang, and VIP databases to identify research entry points. Purposive sampling was used to select postgraduate students majoring in general practice at Guangzhou Medical University and their corresponding faculty as the study participants. A semi-structured in-depth interview method was employed to investigate the current state of ideological and political education. Faculty evaluations of students and their recommendations for ideological and political education were also considered. Thematic framework analysis was applied to the interview data for categorization, integration, and theme extraction. The literature review revealed that enhancing professional identity can strengthen career commitment, leading to the design of an ideological and political education interview outline focused on professional belief and professional identity. The study included 13 general practice postgraduates (mean age: 24.5±1.4 years), of whom 8 were directional students and 5 were non-directional students. Additionally, 7 general practice faculty members were included (mean age: 41.3±5.4 years), with an average of 16.3±5.6 years of experience in general practice education. Five themes were extracted from the interviews: the necessity of ideological and political education, the relationship between professional belief and its educational effects, the intrinsic motivation of ideological beliefs, the influence of external factors on beliefs, and effective approaches to ideological and political education. The study also identified current issues in ideological and political education for general practice postgraduates, including inadequate career planning guidance, reluctance to work in underdeveloped areas, over-reliance on the role modeling of faculty mentors, lack of systematic courses and frameworks for ideological and political education, and limited opportunities for team projects and communication platforms. The current state of ideological and political education for general practice postgraduates reveals deficiencies in career planning support, systematic course construction, practical opportunities, and communication platforms. Education methods remain overly simplistic and are significantly influenced by external factors, underscoring the need for optimization and enhancement.

Objective Exploring the effect of Bian-stone-based herbal heat therapy on herbal heat ironing in gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients.Methods Convenience sampling method was used to select 68 cases of hematopoietic stem cell transplantation patients who attended the hematology department of a tertiary-level Chinese medicine hospital in Hangzhou from October 2023 to April 2024 as the study subjects,and the SPSS 26.0 statistical software was used to generate a random number for grouping into an experimental and a control group,with 34 cases in each group.On the basis of intravenous antiemetic medication and routine,the experimental group implemented the Bian-stone-based herbal heat therapy on the basis of intravenous antiemetic medication and conventional nursing care.In the control group,intravenous antiemetic drugs and routine care were used,and the intervention duration of both groups was 14 d,of which 7 d was a course of treatment,with a total of 2 courses of treatment.The incidence of gastroin-testinal reactions,Gastrointestinal Symptom Rating Scale(GSRS)score,Pepsin Ⅰ(PG Ⅰ),Pepsin Ⅱ(PG Ⅱ),and the ratio of PG Ⅰ to PG Ⅱ(PGR)before and after the intervention were compared between the 2 groups.Results The final sample of 66 cases was collected in this study,and 1 patient was dislodged from each of the control group and the experimental group.The comparison of the incidence of gastrointestinal reactions between the 2 groups within 14 days showed that the incidences of nausea,vomiting,abdominal distension,and diarrhea were lower in the experimental group than those in the control group(P＜0.05).GSRS scores on days 1,8,and 14 of intervention were compared,and there were effects between groups in both groups(F=5.338,P=0.017).The levels of PG Ⅰ,PG Ⅱ in the experimental group on day 8 of the intervention were lower than those in the control group.The levels of PGR was higher than that in the control group(all P＜0.05).The safety of the 2 groups after treatment was evaluated,and the results showed that no serious adverse events occurred in the 2 groups.Conclusion Bian-stone-based herbal heat therapy can improve gastrointestinal reactions and reduce the incidence of gastrointestinal reactions during the preconditioning period of hematopoietic stem cell transplantation patients,which provides clinical guidance for the application of Bian-stone-based herbal heat therapy by nursing staff in the future.

To analyze the current state and issues of ideological education for graduate students of general practice, from April 10 to Dec 19, 2024, a literature review was conducted on publications from Jan 1, 2001, to Dec 19, 2024, in the CNKI, Wanfang, and VIP databases to identify research entry points. Purposive sampling was used to select postgraduate students majoring in general practice at Guangzhou Medical University and their corresponding faculty as the study participants. A semi-structured in-depth interview method was employed to investigate the current state of ideological and political education. Faculty evaluations of students and their recommendations for ideological and political education were also considered. Thematic framework analysis was applied to the interview data for categorization, integration, and theme extraction. The literature review revealed that enhancing professional identity can strengthen career commitment, leading to the design of an ideological and political education interview outline focused on professional belief and professional identity. The study included 13 general practice postgraduates (mean age: 24.5±1.4 years), of whom 8 were directional students and 5 were non-directional students. Additionally, 7 general practice faculty members were included (mean age: 41.3±5.4 years), with an average of 16.3±5.6 years of experience in general practice education. Five themes were extracted from the interviews: the necessity of ideological and political education, the relationship between professional belief and its educational effects, the intrinsic motivation of ideological beliefs, the influence of external factors on beliefs, and effective approaches to ideological and political education. The study also identified current issues in ideological and political education for general practice postgraduates, including inadequate career planning guidance, reluctance to work in underdeveloped areas, over-reliance on the role modeling of faculty mentors, lack of systematic courses and frameworks for ideological and political education, and limited opportunities for team projects and communication platforms. The current state of ideological and political education for general practice postgraduates reveals deficiencies in career planning support, systematic course construction, practical opportunities, and communication platforms. Education methods remain overly simplistic and are significantly influenced by external factors, underscoring the need for optimization and enhancement.

Objective To analyze the postoperative effect of probiotics combined with Peitu Shengjin moxibustion and cupping on adenomatous colorectal polyps (ACP).Methods Patients with ACP diagnosed and treated in Zhejiang Provincial Hospital of Traditional Chinese Medicine from August 2021 to May 2022 were recruited as study subjects,and were divided into control group(probiotics) and test group (probiotics combined with Peitu Shengjin moxibustion and cupping).The main outcome measure of this study was the 1-year recurrence rate of ACP.The secondary outcome measures were the treatment efficiency and the traditional Chinese medicine (TCM) syndrome scores at 4 weeks and 1 year after ACP surgery.Results The study finally included 199 patients,with 100 in the control group and 99 in the test group.The 1-year postoperative treatment efficiency of the test group was higher than that of the control group (P=0.012);the recurrence rate was lower than that of the control group (P<0.05).There was no statistically significant difference in the comparison of polyp size and number between the two groups of patients with recurrence (P>0.05).Before treatment,there was no statistically significant difference between the two groups in the comparison of stool habit score,stool nature score,blood in stool score,stool frequency score,abdominal pain score and total score (P>0.05).The stool habit score,stool nature score,stool blood score,stool frequency score,abdominal pain score and total score of the patients in both groups were significantly lower than those of the preoperative period at 4 weeks and 1 year after the operation (P<0.05).Stool habit score,stool nature score,stool blood score,stool frequency score,abdominal pain score and total score were lower in the test group than in the control group at 4 weeks and 1 year postoperatively (P<0.05).Conclusion Probiotics combined with Peitu Shengjin moxibustion and cupping can effectively improve the TCM syndrome scores after ACP surgery and reduce the recurrence rate of ACP.

ObjectiveTo explore the syndromes and mechanisms of depression induced by maternal separation （MS） combined with chronic restraint stress （RS） in mice. MethodOn postnatal day 0 （PD0）， the offspring mice were randomized into a blank group （NC） and a modeling group. The mouse model of depression was established by MS+RS for 21 days. After removal of female mice on PD21， the modeled mice were randomized into model， Wenyang， Jieyu， Wenyang Jieyu， and fluoxetine groups， with 15 mice in each group. The sucrose preference， tail suspension， and open field tests were carried out to evaluate the anxiety and depression-like behavior in mice. Enzyme-linked immunosorbent assay was used to measure the adrenocorticotrophic hormone （ACTH） and corticosterone （CORT） levels in mouse plasma. High performance liquid chromatography-electrochemical detector was used to determine the content of monoamine neurotransmitters in the hippocampus. Real-time fluorescence quantitative polymerase chain reaction was employed to determine the mRNA levels of genes in the 5-hydroxytryptamine （5-HT） system， hypothalamic-pituitary-adrenal （HPA） axis， and brain-derived neurotrophic factor （BDNF） signaling pathway in the hippocampus. Immunohistochemistry was employed to determine the expression levels of proteins in the 5-HT system and HPA axis in the hippocampus. The Simple Western system was used to determine the protein levels of BDNF and tyrosine kinase receptor B （TrkB） in the hippocampus. ResultCompared with the NC group， the model group exhibited depression-like behavior， which was significantly relieved by Wenyang Jieyu prescription and fluoxetine. Compared with the NC group， the model group showed elevated levels of CORT and ACTH in the plasma （P<0.01）， which， however， were lowered by Wenyang Jieyu prescription and fluoxetine （P<0.05， P<0.01）. Compared with the NC group， the model group showed inhibited expression of neurotransmitters in the hippocampus （P<0.05， P<0.01）， while Wenyang Jieyu prescription and fluoxetine restored the expression of neurotransmitters （P<0.05， P<0.01）. Compared with NC group， the model group showed inhibition of the 5-HTergic nerve and abnormal activation of the HPA axis， and Wenyang Jieyu prescription and fluoxetine regulated the abnormal state of the 5-HTergic nerve and HPA axis. Compared with NC group， the modeling down-regulated the mRNA and protein levels of BDNF and TrkB in the hippocampus （P<0.05， P<0.01）， which， however， were recovered in Wenyang， Jieyu， Wenyang Jieyu， and fluoxetine groups （P<0.05， P<0.01）. ConclusionThe mouse model of depression induced by MS+RS may present the syndrome of Yang deficiency and liver depression. Wenyang Jieyu prescription may increase the content of hippocampal neurotransmitters by regulating the 5-HT system and the BDNF signaling pathway mediated by the HPA axis， thereby alleviating depression-like behavior in mice.

Objective:To explore the involvement of serum exosomal miR-17-5p in the pathogenesis of regulatory T (Treg) cells deficiency in premature ovarian insufficiency (POI) patients.Methods:In a case-control study, 32 Chinese Han women with POI and 32 Chinese Han women with regular menstrual cycles (healthy control, HC) attending the Department of Gynecological Endocrinology, the First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were recruited. The relative expressional level of serum exosomal miR-17-5p was confirmed by reverse transcription quantitative polymerase chain reaction (RT-qPCR). To understand how POI-exosome affects Treg cells, peripheral blood mononuclear cells (PBMC) of healthy volunteer were transfected with miR-17-5p, and cultured with PBS as the control or with exosomes derived from POI women or HC for 72 h. Subsequently, to evaluate the functionality of the miR-17-5p upregulated in POI-exosome, native CD4 + T cells from healthy donors were sorted by magnetic beads and induced into induced Treg (iTreg) cells in vitro, and the induction efficiency, the proliferation and apoptosis rates of iTreg cells were detected after transfection with miR-17-5p mimic/inhibitor. TargetScan, miRDB, miRTarBase and miRWalk were used to predict targets gene of miR-17-5p. Results:The expression level of serum exosomal miR-17-5p was markedly up-regulated in POI compared with HC ( P<0.001). Furthermore, after culture with POI-exosome [(0.93±0.40)%], the frequency of Treg cells was significantly reduced as compared with that culture with PBS [(3.77±0.89)%, P=0.005]. Subsequently, the frequency of Treg cells in miR-17-5p mimic group [(4.30±1.91)%] was significantly lower than that in negative control group [(11.97±1.82)%, P=0.007]. In contrast, both Th1 and Th17 did not be affected (both P>0.05). The induction efficiency of iTreg cells did not be influenced by transfection with miR-17-5p (both P>0.05), however, the iTreg cells apoptosis rate in miR-17-5p mimic group [(16.31±1.27)%] was significantly higher than that in negative control group [(13.01±1.80)%, P=0.035], while apoptosis rate was significantly lower [(7.97±0.71)%] and proliferation rate was higher [(88.83±0.25)%] in miR-17-5p inhibitor group than those in negative control group [(11.42±0.23)%, P=0.001; (87.60±0.70)%, P=0.045]. Transforming growth factor beta receptor 2 was most likely targets gene of miR-17-5p. Conclusion:The exosomal miRNA profile of patients with POI differed from that of HC, and miR-17-5p, which is markedly increased in POI patients, decreased the frequency of Treg cells by inhibiting iTreg cell proliferation and promoting iTreg cells apoptosis. Thus, our study suggested that exosomal miR-17-5p promoted iTreg cells apoptosis and resulted in Treg cells deficiency in POI pathogenesis.

Objective:To explore the involvement of serum exosomal miR-17-5p in the pathogenesis of regulatory T (Treg) cells deficiency in premature ovarian insufficiency (POI) patients.Methods:In a case-control study, 32 Chinese Han women with POI and 32 Chinese Han women with regular menstrual cycles (healthy control, HC) attending the Department of Gynecological Endocrinology, the First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2020 were recruited. The relative expressional level of serum exosomal miR-17-5p was confirmed by reverse transcription quantitative polymerase chain reaction (RT-qPCR). To understand how POI-exosome affects Treg cells, peripheral blood mononuclear cells (PBMC) of healthy volunteer were transfected with miR-17-5p, and cultured with PBS as the control or with exosomes derived from POI women or HC for 72 h. Subsequently, to evaluate the functionality of the miR-17-5p upregulated in POI-exosome, native CD4 + T cells from healthy donors were sorted by magnetic beads and induced into induced Treg (iTreg) cells in vitro, and the induction efficiency, the proliferation and apoptosis rates of iTreg cells were detected after transfection with miR-17-5p mimic/inhibitor. TargetScan, miRDB, miRTarBase and miRWalk were used to predict targets gene of miR-17-5p. Results:The expression level of serum exosomal miR-17-5p was markedly up-regulated in POI compared with HC ( P<0.001). Furthermore, after culture with POI-exosome [(0.93±0.40)%], the frequency of Treg cells was significantly reduced as compared with that culture with PBS [(3.77±0.89)%, P=0.005]. Subsequently, the frequency of Treg cells in miR-17-5p mimic group [(4.30±1.91)%] was significantly lower than that in negative control group [(11.97±1.82)%, P=0.007]. In contrast, both Th1 and Th17 did not be affected (both P>0.05). The induction efficiency of iTreg cells did not be influenced by transfection with miR-17-5p (both P>0.05), however, the iTreg cells apoptosis rate in miR-17-5p mimic group [(16.31±1.27)%] was significantly higher than that in negative control group [(13.01±1.80)%, P=0.035], while apoptosis rate was significantly lower [(7.97±0.71)%] and proliferation rate was higher [(88.83±0.25)%] in miR-17-5p inhibitor group than those in negative control group [(11.42±0.23)%, P=0.001; (87.60±0.70)%, P=0.045]. Transforming growth factor beta receptor 2 was most likely targets gene of miR-17-5p. Conclusion:The exosomal miRNA profile of patients with POI differed from that of HC, and miR-17-5p, which is markedly increased in POI patients, decreased the frequency of Treg cells by inhibiting iTreg cell proliferation and promoting iTreg cells apoptosis. Thus, our study suggested that exosomal miR-17-5p promoted iTreg cells apoptosis and resulted in Treg cells deficiency in POI pathogenesis.

Objective:To explore the effect of health management based on constitution identification in perimenopausal women.Methods:From November 2020 to April 2021, 244 perimenopausal women from Doumen Street, Yuecheng District, Shaoxing were selected as the research subject by convenience sampling method, and divided into the control group (121 cases) and the observation group (123 cases) according to their respective communities. The control group adopted routine health management, while the observation group implemented health management based on constitution identification on the basis of routine health management. Three months after intervention, the perimenopausal symptom scores between the two groups were compared. One year after intervention, the number of individuals with biased constitution and quality of life scores between the two groups were compared.Results:Three months after intervention, the scores of hot flashes, sweating, insomnia, dizziness, fatigue, muscle and joint pain, headache, palpitations, and total score of perimenopausal symptom of the observation group were lower than those of the control group, with statistically significant differences ( P<0.05). Three months after intervention, there were no significant differences in scores of paraesthesia, mood swings, depressive suspicion, skin ant sensation, sexual difficulties, urinary tract infection between the observation group and the control group ( P>0.05). One year after intervention, the number of individuals with biased constitution of the observation group was less than that of the control group, and the difference was statistically significant ( P<0.05). One year after intervention, the scores of physical health, mental health, social relationship, and total score of quality of life of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). One year after intervention, there was no statistically significant difference in the score of the surrounding environment between the observation group and the control group ( P>0.05) . Conclusions:Health management based on constitution identification can improve the perimenopausal symptoms of perimenopausal women, gradually change their biased constitution towards a calm constitution, and improve their quality of life.

ObjectiveTo predict the potential molecular mechanism of Erxian decoction in the treatment of anxiety disorder based on network pharmacology， and to verify the efficacy and mechanism using the animal model of maternal separation combined with restraint stress. MethodActive components and related targets of Erxian decoction were obtained by traditional Chinese medicine system pharmacology database and analysis platform （TCMSP） and SwissTargetPrediction. The targets related to anxiety disorder were screened out through GeneCards， therapeutic target database （TTD）， online mendelian inheritance in man database （OMIM）， and DrugBank， and the drug-disease intersection targets were obtained by taking intersections with the drug targets. The protein-protein interaction （PPI） network was constructed by the STRING database， and the core targets were screened out based on topological parameter analysis. Gene Ontology （GO） enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were carried out for the intersection targets through the Metascape platform. Maternal separation combined with restraint stress was used to induce the mouse model of anxiety disorder. From the end of lactation on the 21st postnatal day （PD21） to the completion of restraint stress on the 97^th postnatal day （PD97）， the mice were fed with Erxian decoction mixed with diet. The anxiety state of mice was evaluated by open field test and elevated O-maze test. The content of plasma corticosterone （CORT） in mice was detected by enzyme-linked immunosorbent assay （ELISA）. The expression levels of protein kinase B （Akt1）， mammalian target of rapamycin （mTOR）， brain-derived neurotrophic factor （BDNF）， postsynaptic density-95 （PSD95）， and synaptophysin in the hippocampus of mice were detected by Western blot and real-time quantitative polymerase chain reaction （Real-time PCR）. ResultNinty-seven active components and 227 action targets of Erxian decoction were obtained. There were 3 863 targets related to anxiety disorder， with 161 drug-disease intersection targets. Among these intersection targets， core targets such as Akt1， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor （TNF）， and mTOR were presumedly closely related to anxiety disorder. The results of KEGG pathway analysis showed that Erxian decoction mainly treated anxiety disorder through phosphatidylinositol 3-kinase （PI3K）/Akt， mitogen-activated protein kinase （MAPK）， and neuroactive ligand-receptor interaction signaling pathways. The results of animal experiments showed that compared with the model group， the Erxian decoction group significantly increased the time of mice spent in the central zone and central crossing times and time spent in the opened arm and opened arm crossing times， with significantly increased expression levels of p-Akt1， p-mTOR， BDNF， PSD95， and synaptophysin （Syp）. ConclusionErxian decoction has the multi-target and multi-pathway characteristics in the treatment of anxiety disorder， and its mechanism may be related to the improvement of synaptic plasticity and neuroinflammation by affecting Akt1， IL-1β， IL-6， TNF， mTOR， and other core targets and modulating PI3K/Akt， MAPK， as well as neuroactive ligand-receptor interaction signal pathways.