Climate change has evolved from an environmental issue into a global public health crisis, posing severe challenges to healthcare systems. Issues such as shifts in patient disease patterns, increased care demands for vulnerable populations, and insufficient resilience in nursing systems are becoming increasingly prominent. As the frontline of healthcare delivery, nursing practice directly confronts multiple health risks triggered by climate change. Under the Healthy China 2030 strategy, the role of nursing in addressing climate change cannot be overlooked. Therefore, this paper systematically reviewed the impacts of climate change on nursing practice and corresponding domestic and international strategies, and proposed recommendations for localized development pathways. First, strengthen climate health literacy in nursing education by integrating the climate change system into curricula and clinical practice. Second, promote nursing policy participation in global health governance to establish a climate-adaptive nursing policy system with Chinese characteristics. Finally, establish a multidisciplinary nursing research framework to foster integration among nursing science, climate science, public health, traditional Chinese medicine, and other relevant fields. This paper aims to provide theoretical foundations for constructing a climate-adaptive nursing system with Chinese characteristics, thereby advancing the coordinated development of Healthy China initiative and climate governance.

OBJECTIVE To prepare the β -cyclodextrin （ β -CD） inclusion complex with volatile oil from Qianghuo qushi qingwen granules， and to characterize and quantitatively analyze the inclusion complex. METHODS The comprehensive scores calculated by inclusion rate and inclusion compound yield were used as indicators for screening the inclusion method. The single-factor experiments and Box-Behnken response surface experiments were used to op timize the inclusion conditions， with the above comprehensive score as response value， and taking the ratio of β -CD to volatile oil， inclusion temperature and inclusion time as indexes. The volatile oil inclusion complex of Qianghuo qushi qingwen granules was prepared according to the determined optimal process， followed by validation. Ultraviolet （UV）-visible spectroscopy， thin-layer chromatography （TLC）， and microscopic imaging were also performed. Ultra-high performance liquid chromatography was used to determine the contents of perillaldehyde， pogostone and atractylodin. RESULTS The saturation aqueous solution method was adopted. The optimal inclusion process conditions were as follows： the ratio of β -CD to volatile oil was 7.5∶1， the inclusion temperature was 40 ℃， and the inclusion time was 2.2 h. In three verification experiments， the average inclusion rate was 72.32%， the average yield of inclusion compound was 74.45%， the average comprehensive score was 72.96 points， and the relative error with the predicted value （74.15 points） of the model was 1.61%. UV-visible spectroscopy， TLC and microscopic imaging showed that β -CD and volatile oil successfully formed a new inclusion complex. The average contents of perillaldehyde， pogostone and atractylodin were 4.498 2， 0.814 9， 0.905 7 mg/g， respectively， with RSDs of 0.31%， 0.56% and 0.63% （ n ＝3）. CONCLUSIONS A stable and feasible preparation process of the volatile oil inclusion complex of Qianghuo qushi qingwen granules is successfully established.

Objective To establish an "human serum - porcine aortic endothelial cells (PAEC) - human platelets" in vitro model and explore the mechanism of xenotransplantation-related coagulation dysfunction mediated by immune complexes - platelet FcγRⅡa (CD32a) receptor. Methods Healthy human serum was co-incubated with PAEC to prepare the supernatant containing immune complexes, which was then used to stimulate healthy human platelets, or directly treated with the serum of xenogeneic liver transplant recipients. Flow cytometry was used to detect platelet activation markers CD62P and surface IgG binding levels, and the platelet adhesion function was evaluated by platelet-PAEC adhesion experiments. CD32a blocking antibody IV.3 and SYK blocker SKYIN 4 were used to clarify the signaling pathways. Results The supernatant from the co-incubation of healthy human serum and PAEC could significantly induce platelet activation and endothelial adhesion. The use of the serum from xenogeneic liver transplant recipients could also significantly induce platelet activation. Antibody IV.3 and SYK blocker SKYIN 4 could significantly inhibit these effects. Conclusions In xenotransplantation, the immune complexes formed by human serum antibodies and porcine endothelial antigens may induce abnormal platelet activation through the platelet CD32a receptor, which is an important mechanism of non-complement-dependent post-transplant coagulation dysfunction, providing a new target for the intervention of coagulation complications in xenotransplantation.

OBJECTIVE To observe the impact of Bifidobacterium quadruple viable organisms combined with inter-ferons on serum amyloid A(SAA),transforming growth factor-β(TGF-β),25-hydroxyvitamin D3[25(OH)D3]and intestinal function of the children with rotavirus-induced viral diarrhea.METHODS A total of 88 children with rotavirus-induced viral diarrhea who were treated in Affiliated Hospital of Jiangnan University from Mar.2020 to Dec.2023 were recruited as the research subjects and were randomly divided into the conventional group with 44 cases(conventional symptomatic therapy plus interferons)and the combination group with 44 cases(the conven-tional symptomatic therapy plus Bifidobacterium quadruple viable organisms),and both groups were continuously treated for 5 days.The clinical curative effect and improvement of clinical symptoms were observed and compared between the two groups.The changes of peripheral blood immune function indexes,inflammatory factors,intesti-nal function indexes,SAA,TGF-β and 25(OH)D3 were analyzed.RESULTS There was no significant difference in the effective rate of treatment between the combination group and the conventional group after the treatment for 5 days(Z=1.375,P=0.169).The duration of stool property back to normal,fever abatement,number of defeca-tion times back to normal,cessation of diarrhea,virus turning to be negative and disappearance of abdominal pain was shorter in the combination group than in the conventional group(P＜0.05).The immune function,inflamma-tory factors and intestinal function indexes were improved more remarkably in the combination group than in the conventional group after the treatment for 5 days(P＜0.05).The levels of SAA,TGF-β and 25(OH)D3 of the combination group were respectively(3.84±0.35)pg/ml,(4.87±0.28)pg/ml and(50.63±7.14)pg/ml after the treatment for 5 days,higher than those of the conventional group.CONCLUSION Bifidobacterium quadruple viable organisms combined with interferons can effectively shorten the recovery time of clinical symptoms of the children with rotavirus-induced viral diarrhea,relieve the inflammatory reactions,improve the intestinal function and immune function,and stabilize the levels of serum SAA,TGF-β and 25(OH)D3.

Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.

Objective To explore the effect of the preservation of infrapatellar fat pad on pain,incision healing and function recovery in patients with knee osteoarthritis after joint replacement.Methods The clinical data of 127 patients with knee osteoarthritis who underwent joint replacement in the hospital from June 2019 to September 2022 were retrospectively collected.According to the preservation of infrapatellar fat pad,the subjects were divided into a control group(removing infrapatellar fat pad,67 cases)and an observation group(preserving infrapatellar fat pad,60 cases).The changes in length of patellar tendon,pain,knee function and range of motion were analyzed.The occurrence of adverse reactions was statistically analyzed.Results At 12 months after surgery,the length of patellar tendon was reduced.The length of patellar tendon in observation group[(38.8±6.24)mm]was longer than that in control group[(36.2±6.71)mm](P＜0.05).Observation group of patellar tendon length rate is lower than the control group[(4.1±1.18)％vs(10.7±3.01)％],there was statistical significance between the two groups(P＜0.05).Pain in both groups was alleviated at 1 month,3 months,6 months and 12 months after surgery.The changes in observation group were greater than those in control group(P＜0.05).During follow-up,the incidence of adverse reactions in observation group(6.67％)was lower than that in control group(14.93％)(P＞0.05).The range of motion and function of knee joint were improved at 12 months after surgery,and the improvement in observation group was greater than that in control group(P＜0.05).Conclusion Preserving infrapatellar fat pad is more beneficial to relieving postoperative pain and restoring knee function in patients with knee osteoarthritis after joint replacement.Therefore,the intact infrapatellar fat pad should be preserved as possible in clinical practice.

OBJECTIVE To observe the impact of Bifidobacterium quadruple viable organisms combined with inter-ferons on serum amyloid A(SAA),transforming growth factor-β(TGF-β),25-hydroxyvitamin D3[25(OH)D3]and intestinal function of the children with rotavirus-induced viral diarrhea.METHODS A total of 88 children with rotavirus-induced viral diarrhea who were treated in Affiliated Hospital of Jiangnan University from Mar.2020 to Dec.2023 were recruited as the research subjects and were randomly divided into the conventional group with 44 cases(conventional symptomatic therapy plus interferons)and the combination group with 44 cases(the conven-tional symptomatic therapy plus Bifidobacterium quadruple viable organisms),and both groups were continuously treated for 5 days.The clinical curative effect and improvement of clinical symptoms were observed and compared between the two groups.The changes of peripheral blood immune function indexes,inflammatory factors,intesti-nal function indexes,SAA,TGF-β and 25(OH)D3 were analyzed.RESULTS There was no significant difference in the effective rate of treatment between the combination group and the conventional group after the treatment for 5 days(Z=1.375,P=0.169).The duration of stool property back to normal,fever abatement,number of defeca-tion times back to normal,cessation of diarrhea,virus turning to be negative and disappearance of abdominal pain was shorter in the combination group than in the conventional group(P＜0.05).The immune function,inflamma-tory factors and intestinal function indexes were improved more remarkably in the combination group than in the conventional group after the treatment for 5 days(P＜0.05).The levels of SAA,TGF-β and 25(OH)D3 of the combination group were respectively(3.84±0.35)pg/ml,(4.87±0.28)pg/ml and(50.63±7.14)pg/ml after the treatment for 5 days,higher than those of the conventional group.CONCLUSION Bifidobacterium quadruple viable organisms combined with interferons can effectively shorten the recovery time of clinical symptoms of the children with rotavirus-induced viral diarrhea,relieve the inflammatory reactions,improve the intestinal function and immune function,and stabilize the levels of serum SAA,TGF-β and 25(OH)D3.

BACKGROUND:At present,there is a main kind of operation,which is represented by the proximal femoral nail antirotation,to treat femoral intertrochanteric fractures,but some sequelae still occur such as internal fixation loosening,failure,and nail withdrawal.We designed a new femoral neck spiral blade system to solve this problem,so we analyze the mechanical structure by the finite element method that can be regard as the theoretical basis for the system.OBJECTIVE:To compare the mechanical properties of the new femoral neck spiral blade system and the proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture by the finite element method.METHODS:Based on the finite element model of the femur,the A1.2 and A2.2 femoral intertrochanteric fracture models were established according to the AO fracture classification principle of 2018 edition.The models were fixed with the proximal femoral nail antirotation and the new internal fixation system,applying an axial load of 700,1 400,and 2 100 N above the femoral head.The mechanical characteristics of the two internal fixation methods were respectively compared and analyzed by observing the maximum equivalent stress and the maximum deformation of each group.RESULTS AND CONCLUSION:(1)The maximum equivalent stress of the new internal fixation group under different compressive loads was smaller than that of the proximal femoral nail antirotation group.(2)In the A1.2 fracture model,under different compression loads,the deformation of the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.113 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 2.017 mm between the two.(3)In the A1.2 fracture model,under different compressive loads,the maximum deformation of the spiral blade fixed by the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.062 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 1.891 mm between the two.(4)The results indicate that the new femoral neck spiral blade system has a lower internal fixation stress value compared to the proximal femoral nail antirotation,and a smaller displacement value of the femur after fixation and internal fixation.It can more effectively fix fractures and prevent the spiral blade from retracting or cutting out in the femoral neck.

Objectives:To evaluate the biomechanical effects of transforaminal endoscopic lumbar discectomy(TELD)combined with a spinal dynamic stabilization system(SDSS)on the surgical segment using three-dimen-sional finite element(FE)analysis.Methods:The CT scan data from the lumbar spine of a healthy volunteer was selected.FE methods were employed to construct normal L3-S1 model(FE),as well as L3-S1 TELD and TELD+SDSS surgical models,with the surgical segment simulated at L4/5.After validating the models' effec tiveness through computational accuracy(ACC),a hybrid loading method was applied.An axial load of 150N was applied to the top of the L1 vertebral body,along with gradually increasing constraint torque.Range of motion(ROM)values were extracted to ensure the three models achieved the following ROM:flexion(15°),ex-tension(10°),lateral bending(5°),and rotation(3°).The ROM,peak stress at the intervertebral disc and pos-terior annulus fibrosus,and shear stress in the annulus fibrosus at the L4/5 segment under these six direc-tional conditions were compared across the three models.Results:The ROM values of L3-S1 segments under different loading conditions in flexion,extension,and rotation were compared with previous in vitro tests,with ACC exceeding 90％,validating the model's effectiveness.For L4/5 ROM:in TELD model,it was 4.47°(flex-ion),3.3°(extension),1.72°(left bending),1.73°(right bending),0.94°(left rotation),and 0.92°(right rotation);In TELD+SDSS model,it was 2.15°,1.21°,1.38°,1.43°,0.67°,0.67° respectively.The ROM in TELD model increased by 5％in flexion and 7％in extension,which in TELD+SDSS model reduced by 19-61％in all di-rections.For L4/5 disc stress:in TELD model,the peak stress was 14.58MPa,15.08MPa,7.92MPa,5.32MPa,0.9MPa,and 0.65MPa respectively under flexion,extension,left bending,right bending,left rotation,right ro-tation conditions;In TELD+SDSS model,it was 5.35MPa,1.77MPa,3.45MPa,3.42MPa,0.55MPa,and 0.48MPa.The peak stress of L4/5 disc in TELD model increased by 36％and 45％in extension and bend-ing,which in TELD+SDSS model reduced by 27-84％in all directions.For posterior annulus stress:the peak stress in TELD model was 2.04MPa,2.08MPa,1.44MPa,0.99MPa,0.41 MPa,and 0.29MPa respectively under flexion,extension,left bending,right bending,left rotation,right rotation conditions;In TELD+SDSS model,it was 0.54MPa,0.23MPa,0.72MPa,0.7MPa,0.21 MPa,and 0.18MPa.The peak stress at posterior annulus in TELD increased by 10-99％in flexion,extension,and lateral bending,while in TELD+SDSS model it reduced by 20-63％in all directions.For annulus shear stress:in TELD model,it was 0.4MPa,0.32MPa,and 0.2MPa in extension and left and right bending,which increased by 17％,76％,and 85％,while in TELD+SDSS mod-el,it reduced by 12-98％in all directions.Conclusions:TELD+SDSS retains certain lumbar motion,affecting lumbar stability less compared to TELD,and provides a low-pressure stress environment.

Objectives:To evaluate the biomechanical effects of transforaminal endoscopic lumbar discectomy(TELD)combined with a spinal dynamic stabilization system(SDSS)on the surgical segment using three-dimen-sional finite element(FE)analysis.Methods:The CT scan data from the lumbar spine of a healthy volunteer was selected.FE methods were employed to construct normal L3-S1 model(FE),as well as L3-S1 TELD and TELD+SDSS surgical models,with the surgical segment simulated at L4/5.After validating the models' effec tiveness through computational accuracy(ACC),a hybrid loading method was applied.An axial load of 150N was applied to the top of the L1 vertebral body,along with gradually increasing constraint torque.Range of motion(ROM)values were extracted to ensure the three models achieved the following ROM:flexion(15°),ex-tension(10°),lateral bending(5°),and rotation(3°).The ROM,peak stress at the intervertebral disc and pos-terior annulus fibrosus,and shear stress in the annulus fibrosus at the L4/5 segment under these six direc-tional conditions were compared across the three models.Results:The ROM values of L3-S1 segments under different loading conditions in flexion,extension,and rotation were compared with previous in vitro tests,with ACC exceeding 90％,validating the model's effectiveness.For L4/5 ROM:in TELD model,it was 4.47°(flex-ion),3.3°(extension),1.72°(left bending),1.73°(right bending),0.94°(left rotation),and 0.92°(right rotation);In TELD+SDSS model,it was 2.15°,1.21°,1.38°,1.43°,0.67°,0.67° respectively.The ROM in TELD model increased by 5％in flexion and 7％in extension,which in TELD+SDSS model reduced by 19-61％in all di-rections.For L4/5 disc stress:in TELD model,the peak stress was 14.58MPa,15.08MPa,7.92MPa,5.32MPa,0.9MPa,and 0.65MPa respectively under flexion,extension,left bending,right bending,left rotation,right ro-tation conditions;In TELD+SDSS model,it was 5.35MPa,1.77MPa,3.45MPa,3.42MPa,0.55MPa,and 0.48MPa.The peak stress of L4/5 disc in TELD model increased by 36％and 45％in extension and bend-ing,which in TELD+SDSS model reduced by 27-84％in all directions.For posterior annulus stress:the peak stress in TELD model was 2.04MPa,2.08MPa,1.44MPa,0.99MPa,0.41 MPa,and 0.29MPa respectively under flexion,extension,left bending,right bending,left rotation,right rotation conditions;In TELD+SDSS model,it was 0.54MPa,0.23MPa,0.72MPa,0.7MPa,0.21 MPa,and 0.18MPa.The peak stress at posterior annulus in TELD increased by 10-99％in flexion,extension,and lateral bending,while in TELD+SDSS model it reduced by 20-63％in all directions.For annulus shear stress:in TELD model,it was 0.4MPa,0.32MPa,and 0.2MPa in extension and left and right bending,which increased by 17％,76％,and 85％,while in TELD+SDSS mod-el,it reduced by 12-98％in all directions.Conclusions:TELD+SDSS retains certain lumbar motion,affecting lumbar stability less compared to TELD,and provides a low-pressure stress environment.