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.

Objective: To explore the longitudinal correlation between smartphone multitasking and depressive symptoms, so as to provide an evidence based basis for promoting the mental health of college students. Methods: A total of 967 college students were recruited from one university in Taiyuan, Chongqing, and Shenzhen cities, China, by using multi stage randomized cluster sampling from October to December 2021 at baseline, and a follow up survey was conducted in May 2022. Smartphone multitasking behaviors were assessed by means of the Assessment of Smartphone Multitasking for Adolescents (ASMA), and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) among college students. Chi square tests were performed to compare the differences in depressive symptoms between different groups of demographic characteristics, and binary Logistic regression models were employed to analyze the associations between smartphone multitasking and depressive symptoms among college students. Results: The rates of depressive symptoms among college students at baseline and follow up were 35.2% and 42.3%, respectively. Compared to the low level smartphone multitasking index group at baseline, the moderate and high level groups were more likely to experience depressive symptoms at baseline (moderate level group: OR=1.74, 95%CI =1.22-2.50, high level group: OR=2.77, 95%CI =1.94-3.95) and followup (moderate level group: OR=1.41, 95%CI =1.01-1.95, high level group: OR=1.64, 95%CI =1.17-2.29) ( P <0.05). In addition, compared to the persistently low smartphone multitasking index, increased risk of depressive symptoms was associated with maintaining a moderate to high ( OR=2.94, 95%CI =1.83-4.71), and a higher ( OR=2.07, 95%CI =1.31-3.27) or lower smartphone multitasking index ( OR=2.02, 95%CI =1.27-3.19) ( P <0.05). Moreover, higher smartphone multitasking index scores were positively associated with the risk of new-onset depressive symptoms at follow up ( OR=1.87, 95%CI=1.07-3.27, P <0.05). Conclusions Smartphone multitasking behaviors are find to be associated with an increased risk of depressive symptoms in college students. There is a need to reduce smartphone multitasking in order to decrease depressive symptoms and promote students mental health.

Objective To analyze the effects of arthroscopic meniscus treatment on knee osteoarthritis on the effective rate,VAS score,HSS score and TNF-α level.Methods We selected 86 patients with knee osteoarthritis caused by meniscus injury who were treated in our hospital from June 2019 to May 2020 as the research subjects.The treatment method was selected according to the patient's wishes,with 43 patients who chose conventional conservative treatment included in the control group and 43 patients who chose arthroscopic meniscus therapy included in the study group.The treatment effectiveness,visual ana-logue scale(VAS)score,HSS knee joint score and tumor necrosis factor-α(TNF-α)index levels were compared between the two groups of patients.Results The effective rate of treatment in the study group was significantly higher than that in the control group(P＜0.05);there was no significant difference between the study group and the control group in the VAS score,HSS score,and TNF-α level before treatment(P＞0.05).After treatment,the VAS score,HSS score and TNF-α level of the group were improved.The VAS score and TNF-α level of the study group after treatment were lower than those of the control group(P＜0.05),and the HSS score was higher than the control group.Group(P＜0.05).Conclusion The arthroscopic meniscus treatment for patients with knee osteoarthritis has a significant effect,which can effectively reduce the pain and inflammation of the patients and improve the function of the knee joint.

Through the SWOT analysis of the operating room of a public hospital,it finds out the blocking points and pain points in the operating room during the operation process.Combined with PDCA circular management,it breaks the difficulties in the operating room process,and truly penetrates the concept and essence of"improving quality and efficiency"into the daily operation and management of the operating room,further implements refined management,and promotes the high-quality and sustainable development of the hospital.

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.