ObjectiveTo investigate the mechanism of action of modified Shaofu Zhuyutang in antagonizing cellular pyroptosis and fibrosis in ectopic endometrial tissues of endometriosis through the Toll-like receptor 4/nuclear factor-κB/NOD-like receptor protein 3 （TRL4/NF-κB/NLPR3） signaling pathway. MethodsSeventy-two SPF-grade female SD rats were randomly divided into a sham-operated group （n = 12） and a modeling group （n = 60）. The rats in the sham-operated group underwent a caesarean section， while the rats in the modeling group were used to establish an endometriosis model through the auto-transplantation method. After successful modeling， the animals were randomly divided into the model group， progesterone group （0.25 mg·kg^-1）， and modified Shaofu Zhuyutang low-， medium-， and high-dose groups （7.5， 15， 30 g·kg^-1）， with 12 animals in each group. After 4 weeks of drug administration， voluntary activity and heat pain latency were observed. The rats were sacrificed for tissue collection， and Masson staining were used to observe histopathological changes in the endometrial tissues. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum levels of interleukin-18 （IL-18）， interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and transforming growth factor-β （TGF-β）. Immunohistochemistry （IHC） was used to detect the protein expression area of tumor necrosis factor-related factor 6 （TRAF6） and NLPR3 in the endometrial tissues. Immunofluorescence （IF） was used to detect the relative fluorescence intensity of Caspase-1 and gasdermin D （GSDMD） in the endometrial tissues. Western blot was employed to measure the relative expression of TRL4， myeloid differentiation factor 88 （MyD88）， TRAF6， NF-κB p65， phosphorylated NF-κB p65 （p-NF-κB p65）， and NLPR3 proteins in endometrial tissues. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRL4， MyD88， TRAF6， NF-κB， and NLPR3 in the endometrial tissues. ResultsCompared with the sham-operated group， rats in the model group showed reduced voluntary activity and shorter heat pain latency. Serum levels of IL-18， IL-1β， TNF-α， and TGF-β were elevated. The relative expression areas of TRAF6 and NLPR3 proteins were increased， and the relative fluorescence intensity of Caspase-1 and GSDMD was enhanced. The relative expression of TRL4， MyD88， TRAF6， NF-κB p65， p-NF-κB p65， and NLPR3 proteins， along with the expression of TRL4， MyD88， TRAF6， NF-κB， and NLPR3 mRNA， were significantly increased （P<0.01）. Compared with the model group， rats in the progesterone group and the modified Shaofu Zhuyutang medium- and high-dose groups exhibited improved voluntary activity， longer heat pain latency， the fibrosis of endometrial tissue is alleviated. Serum levels of IL-18， IL-1β， TNF-α， and TGF-β were decreased. The relative expression areas of TRAF6 and NLPR3 proteins decreased， and the relative fluorescence intensity of Caspase-1 and GSDMD weakened. The relative expression of TRL4， MyD88， TRAF6， p-NF-κB p65， NLPR3 proteins， and TRL4， MyD88， TRAF6， NF-κB， and NLPR3 mRNA expression were reduced （P<0.05， P<0.01）. ConclusionModified Shaofu Zhuyutang may play a therapeutic role in endometriosis by interfering with key proteins in the TRL4/NF-κB/NLPR3 signaling pathway， reducing NLRP3 inflammasome-induced cellular pyroptosis， antagonizing the fibrosis process in ectopic endometrial tissues， improving the inflammatory microenvironment in the pelvic cavity， and alleviating pain.

Objective The medication pattern of doctor Chen Jie in treating functional dyspepsia(FD)in children and the potential mechanism of action of core drug group were explored through data mining and network pharmacology methods.Methods The prescriptions for pediatric FD treated by doctor Chen Jie in the outpatient department of Second Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2024 were collected to establish a prescription database.Excel 2019 and SPSS software were applied to statistically analyze the nature,taste,meridian tropism and frequency of drugs included in the prescriptions,and association rule analysis and cluster analysis were conducted.The potential mechanism of action of the core drug group was explored by using the network pharmacology method.Results A total of 603 prescriptions were included,involving 160 kinds of drugs,with a cumulative frequency of medication reaching 5012 times.Among them,the medicinal nature and flavour were mainly warm and sweet,and channel tropism were mainly the spleen,stomach and lung meridians.The core drug group obtained through association rules and cluster analysis was"Fuchao Baizhu-Fuling-Chenpi".Network pharmacological analysis was conducted on the core drug group,and it was found that its main components included naringenin,atractylenolide Ⅰ,atractylone,and hederagenin,as well as core genes such as AKT1,TNF,IL-6,ESR1,and IL-1β.The main enrichment pathways were lipids and atherosclerosis,advanced glycation end product-advanced glycation end product receptor signaling pathway,cancer pathway,etc..Conclusion Doctor Chen Jie's medication for treating FD in children mainly focuses on invigorating spleen and replenishing qi,regulating qi-flowing for eliminating dampness.The core drug group,"Fuchao Baizhu-Fuling-Chenpi",exerts its effects through multiple components,multiple targets and multiple pathways.

Advance care planning helps older chronic disease patients and their families receive health care that meets their preferences. This article reviews the concept, assessment tools, influencing factors, and current status of interventions around advance care planning for older patients with chronic disease to inform medical and nursing staff.

Advance care planning helps older chronic disease patients and their families receive health care that meets their preferences. This article reviews the concept, assessment tools, influencing factors, and current status of interventions around advance care planning for older patients with chronic disease to inform medical and nursing staff.

Objective The medication pattern of doctor Chen Jie in treating functional dyspepsia(FD)in children and the potential mechanism of action of core drug group were explored through data mining and network pharmacology methods.Methods The prescriptions for pediatric FD treated by doctor Chen Jie in the outpatient department of Second Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2024 were collected to establish a prescription database.Excel 2019 and SPSS software were applied to statistically analyze the nature,taste,meridian tropism and frequency of drugs included in the prescriptions,and association rule analysis and cluster analysis were conducted.The potential mechanism of action of the core drug group was explored by using the network pharmacology method.Results A total of 603 prescriptions were included,involving 160 kinds of drugs,with a cumulative frequency of medication reaching 5012 times.Among them,the medicinal nature and flavour were mainly warm and sweet,and channel tropism were mainly the spleen,stomach and lung meridians.The core drug group obtained through association rules and cluster analysis was"Fuchao Baizhu-Fuling-Chenpi".Network pharmacological analysis was conducted on the core drug group,and it was found that its main components included naringenin,atractylenolide Ⅰ,atractylone,and hederagenin,as well as core genes such as AKT1,TNF,IL-6,ESR1,and IL-1β.The main enrichment pathways were lipids and atherosclerosis,advanced glycation end product-advanced glycation end product receptor signaling pathway,cancer pathway,etc..Conclusion Doctor Chen Jie's medication for treating FD in children mainly focuses on invigorating spleen and replenishing qi,regulating qi-flowing for eliminating dampness.The core drug group,"Fuchao Baizhu-Fuling-Chenpi",exerts its effects through multiple components,multiple targets and multiple pathways.

The operating room was the core department of a hospital,and its operational efficiency had a significant impact on the high-quality development of a hospital.An analysis has revealed that low efficiency and irrational allocation in the operating room were mainly due to the lack of operational regulations and norms,the unreasonable arrangement of surgical specialties,and the unbalanced allocation of supporting resources.To address these issues,the First Affiliated Hospital of Zhengzhou University has taken into account the overall allocation of resources for the central operating room and the central operating room,and formulated strategies to improve operational efficiency,including adjusting the operational mechanism,optimizing the structure of surgical specialties,and providing corresponding supporting resources.Based on the adjustment of surgical structure,the implementation effect of the program was measured and evaluated,which provided practical strategies for optimizing operating room efficiency in hospitals.

The increasing operating pressure of large public hospitals has forced hospitals to focus on opening up income sources and reducing expenditure.The purchase and maintenance of medical equipment is one of the important economic activities of hospi-tals.However,there are problems in large public hospitals,such as the argumentation for equipment acquisition ignoring evaluation of operational efficiency,the costing model that leads to a lack of willingness of departments to purchase equipment,and the lack of standard processes and systems for renting medical equipment among departments.Based on this,it explores the establishment of a medical equipment sharing operation mechanism in large public hospitals,promotes the improvement of the efficiency of medical equipment use in large public hospitals by establishing a medical equipment sharing center,standardizing the purchase of shared equipment,entering shared equipment information,setting up shared equipment leasing specifications,and clarifying the equipment return process and maintenance,so as to effectively control hospital operating costs,and help the high-quality development of public hospitals.

The operating room was the core department of a hospital,and its operational efficiency had a significant impact on the high-quality development of a hospital.An analysis has revealed that low efficiency and irrational allocation in the operating room were mainly due to the lack of operational regulations and norms,the unreasonable arrangement of surgical specialties,and the unbalanced allocation of supporting resources.To address these issues,the First Affiliated Hospital of Zhengzhou University has taken into account the overall allocation of resources for the central operating room and the central operating room,and formulated strategies to improve operational efficiency,including adjusting the operational mechanism,optimizing the structure of surgical specialties,and providing corresponding supporting resources.Based on the adjustment of surgical structure,the implementation effect of the program was measured and evaluated,which provided practical strategies for optimizing operating room efficiency in hospitals.

The increasing operating pressure of large public hospitals has forced hospitals to focus on opening up income sources and reducing expenditure.The purchase and maintenance of medical equipment is one of the important economic activities of hospi-tals.However,there are problems in large public hospitals,such as the argumentation for equipment acquisition ignoring evaluation of operational efficiency,the costing model that leads to a lack of willingness of departments to purchase equipment,and the lack of standard processes and systems for renting medical equipment among departments.Based on this,it explores the establishment of a medical equipment sharing operation mechanism in large public hospitals,promotes the improvement of the efficiency of medical equipment use in large public hospitals by establishing a medical equipment sharing center,standardizing the purchase of shared equipment,entering shared equipment information,setting up shared equipment leasing specifications,and clarifying the equipment return process and maintenance,so as to effectively control hospital operating costs,and help the high-quality development of public hospitals.

Objective:To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese.Methods:A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ 2 test was applied to compare the counting data between two or multiple groups. Results:A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95% CI 8.9-9.1), 10.5 (95% CI 10.4-10.6), and 11.4 (95% CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95% CI 4.6-4.8) years, between P2 and P5 was 4.5 (95% CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95% CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95% CI 9.5-10.6), 9.3 (95% CI 9.2-9.4), and 8.6 (95% CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95% CI 12.4-13.7), 11.6 (95% CI 11.4-11.7), and 11.1 (95% CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in normal group and thin group was 4.7 and 4.5 years, 4.6 and 4.7 years, respectively. Conclusions:The ages of sexual characteristics development and menarche tend in Tongzhou District of Beijing to be earlier than that being reported of Beijing's survey 20 years ago. Girls characterized as overweight and obese not only start puberty at an earlier age than girls of normal weight, but also have a shorter developmental process.