ObjectiveTo investigate the potential mechanism of Danggui Buxuetang （DBT） in the treatment of vascular dementia （VAD）. MethodsSixty male SD rats were randomly assigned to the sham-operated group， model group， DBT low-， medium-， and high-dose groups， and the donepezil group. Except for the sham-operated group， rats in all other groups underwent bilateral common carotid artery ligation. After successful modeling， DBT was administered at doses of 9.2， 18.4， 36.8 g·kg^-1 for the low-， medium-， and high-dose groups， respectively， while the donepezil group received 3 mg·kg^-1 donepezil solution by gavage once daily. After 4 consecutive weeks of drug treatment， rats underwent the Morris water maze test， novel object recognition test， Nissl staining to observe hippocampal neurons， and immunofluorescence staining to detect the expression of neuronal nuclear protein （NeuN） in the hippocampus. Western blot was used to assess the expression of PTEN-induced kinase 1 （PINK1）， Parkin， microtubule-associated protein 1 light chain 3Ⅱ （LC3Ⅱ）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax）. Transmission electron microscopy was used to observe hippocampal neuronal ultrastructure. Real-time PCR was used to detect the expression of NADPH oxidase subunits p22^phox and p47^phox in hippocampal tissues. The levels of malondialdehyde （MDA）， glutathione （GSH）， superoxide dismutase （SOD）， and total antioxidant capacity were measured to evaluate oxidative stress levels. ResultsIn the Morris water maze test， escape latency changed significantly over time in all groups except the model group. Compared with the sham-operated group， the model group showed significantly prolonged escape latency （P<0.01）. Compared with the model group， rats in the DBT groups and the donepezil group exhibited significantly shorter escape latency （P<0.05， P<0.01）. The number of crossings over the original platform was significantly reduced in the model group compared with the sham-operated group （P<0.01）， whereas rats in the DBT and donepezil groups showed significantly increased platform crossings compared with the model group （P<0.05， P<0.01）. Compared with the sham-operated group， exploration time of new objects was significantly reduced in the model group （P<0.01）. Compared with the model group， exploration time of new objects increased significantly in the medium- and high-dose DBT groups and the donepezil group （P<0.05， P<0.01）， while no significant change was observed in the low-dose DBT group. Compared with the high-dose DBT group， rats in the donepezil group had significantly prolonged escape latency and reduced platform crossings and new-object exploration time （P<0.05）. Nissl staining showed decreased density of healthy neurons in the CA1 and CA3 regions of the hippocampus in the model group， with loss of Nissl bodies and nuclear atrophy or disappearance. In the high-dose DBT group， neuronal density in CA1 and CA3 increased， with neurons arranged closely and displaying normal morphology. Immunofluorescence showed that compared with the sham-operated group， the hippocampal NeuN⁺ cell count in the VAD model group was significantly decreased（P<0.01）， compared with the VAD model group， the hippocampal NeuN⁺ cell count in the high-dose DBT group was significantly increased（P<0.01）. Compared with the sham-operated group， the expression of PINK1， Parkin， LC3Ⅱ， and Bax proteins was significantly increased（P<0.01）， while the expression of Bcl-2 was significantly decreased in the VAD model group（P<0.01）. Compared with the VAD model group， the high-dose DBT group showed significantly decreased expression of PINK1， Parkin， LC3Ⅱ， and Bax proteins（P<0.01）and significantly upregulated Bcl-2 expression（P<0.01）. The medium-dose DBT group exhibited significantly reduced expression of Parkin， LC3Ⅱ， and Bax proteins（P<0.05，P<0.01） and significantly increased Bcl-2 expression（P<0.01）， while no statistically significant differences were observed in the low-dose DBT group. Transmission electron microscopy showed mitochondrial pyknosis， thickened cristae， increased electron density， and the presence of mitochondrial autophagy in the model group. In contrast， hippocampal neurons in the high-dose DBT group contained abundant mitochondria with intact morphology， clear cristae， and uniform matrix. Compared with the sham-operated group， total antioxidant capacity， SOD activity， and GSH levels were significantly decreased， while MDA levels were significantly increased in the model group （P<0.01）. Compared with the model group， total antioxidant capacity and antioxidant levels （SOD， GSH） increased significantly， and MDA decreased significantly in the medium- and high-dose DBT groups （P<0.01）， while no significant changes were observed in the low-dose DBT group. Compared with the sham-operated group， mRNA expression of p22^phox and p47^phox was significantly increased in the model group （P<0.01）. Compared with the model group， expression of p22^phox and p47^phox was significantly decreased in the DBT groups （P<0.05， P<0.01）. ConclusionDBT may exert neuroprotective effects by regulating PINK1/Parkin-mediated mitochondrial autophagy， thereby improving learning and memory abilities and treating VAD.

A 42-year-old male with chest tightness and dyspnea was admitted to the hospital. Chest CT indicated diffuse interstitial lung infiltration. Despite receiving anti-infective therapy, glucocorticoid therapy, and immunosuppressive agents, the patient developed refractory hypoxaemia. Endotracheal intubation and invasive mechanical ventilation failed to improve oxygenation. Therefore the patient was diagnosed with rapidly progressive interstitial lung disease (RP-ILD) accompanied by type Ⅰ respiratory failure. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was initiated, and oxygenation improved in this patient. The patient subsequently underwent bilateral lung transplantation with veno-arterio-venous (VAV) ECMO support. ECMO machine was withdrawn on day 1, and extubation was achieved on day 9 after surgery. Histopathology revealed fibrotic nonspecific interstitial pneumonia (NSIP) with hyaline membrane formation. The patient developed ICU-acquired myasthenia and received early rehabilitation, with gradual recovery of muscle strength. During follow-up, graft lung function remained stable. This case demonstrates that ECMO can serve as a bridge to lung transplantation in RP-ILD patients.

Objective:To investigate the relationships among coping styles,negative life events,meaning in life,and psychological resilience in adolescents.Methods:A total of 1 434 adolescents aged 13 to 17 years comple-ted online questionnaire survey.The Simplified Coping Style Questionnaire(SCSQ),Adolescent Self-Rating Life E-vents Checklist(ASLEC),Chinese Meaning in Life Questionnaire(C-MLQ),and Connor-Davidson resilience scale(CD-RISC)were used to assess coping styles,perceived impact of negative life events,experience and pursuit of meaning in life,and ability to cope with and adapt to adversity,respectively.Logistic regression was used to explore the associations among these variables.Results:A total of 723 students(50.4％)tended to adopt negative coping styles when facing adverse events.Positive coping styles were negatively associated with being in senior high school(OR=0.62,P＜0.05)and impact of life events(OR=0.97,P＜0.001),while positively associated with sense of meaning in life(OR=1.04,P＜0.001)and psychological resilience(OR=1.04,P＜0.001).Conclusion:Among adolescents,positive coping styles are inversely associated with impact of negative life events,and positively associ-ated with both the sense of life meaning and psychological resilience.

Objective:To investigate the effect of goal setting theory-guided health management on disease cognition, compliance with antiviral therapy and self-efficacy of patients with chronic hepatitis B (CHB) so as to provide a theoretical basis for developing clinical nursing plans for patients with CHB.Methods:A quasi-experiment study was conducted, and 60 patients with CHB who were admitted to Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine (the Third Affiliated Hospital of Anhui University of Chinese Medicine) from November 2022 to June 2023 were selected as the study subjects by convenience sampling method. They were randomly divided into the observation group and the control group by the envelope method, with 30 cases in each group. The control group received routine health management, and the observation group received goal setting theory-guided health management. Effects on disease cognition, compliance with antiviral therapy and self-efficacy of the two groups were analyzed.Results:There were 30 patients in each group completed the research. In the control group, there were 15 males, 15 females, aged (56.28 ± 5.97) years. In the observation group, there were 16 males, 14 females, aged (55.36 ± 6.21) years. After intervention, the scores for perceived benefit and acceptance [(20.36 ± 2.47) and (23.54 ± 2.67)] were higher than those of the control group [(16.33 ± 2.48) and (17.45 ± 2.68)], helplessness score of the observation group was (5.33 ± 0.67), lower than (10.21 ± 2.58) of the control group with significant differences ( t=6.31, 8.82, 10.03, all P<0.05). After intervention, compliance rate in the observation group [93.33% (28/30)] was higher than that in the control group [70.00% (21/30)], with significant difference ( χ2=5.46, P<0.05). After intervention, the General Self-Efficacy Scale score of the observation group was (31.25 ± 3.24), higher than (25.33 ± 2.67) of the control group, with significant difference ( t=7.72, P<0.05). Conclusions:Goal setting theory-guided health management can effectively improve compliance with antiviral therapy among patients with CHB, which may be related to the improvement of disease cognition and self-efficacy, and is worthy of clinical promotion.

Objective To understand the epidemiological characteristics of road traffic accident injuries in Beijing can provide a theoretical basis for improving the pre-hospital emergency service capabilities and levels,and increasing patient survival rates while reducing disability,mortality rates.Methods A retrospective analysis was conducted on the medical records of 9207 patients who made pre-hospital emergency calls due to road traffic accident injuries at the Beijing Emergency Medical Center in 2023 to understand the patients' age,gender,injury time,injury location,injury degree and other characteristics.Results Traumatic diseases ranked first in the classification of emergency medical conditions in Beijing.Among them,road traffic accidents account for 37％.The ratio of male to female patients was 1.32∶1.The largest number of patients were aged 31-40,accounting for nearly 25％.The proportion of underage patients and those aged 71 and above was 12.16％.The differences in gender and age distribution were statistically significant,while the differences in gender distribution among different age groups were not statistically significant.Road traffic accident injuries occured most frequently in September and least in January.There were more cases in summer and autumn,and fewer in winter and spring.The most common injury sites in road traffic accidents were limbs/skin and head and neck,accounting for 81.06％.The patients with moderate severity of injuries were the most numerous,accounting for 85.29％.Conclusion To avoid road traffic accidents,prevention should be the priority.It is necessary to strengthen the joint governance of multiple departments and minimize the occurrence of road traffic accident from the source.Pre-hospital emergency care must focus on key populations and key seasons,strengthen professional skills training and resource allocation,ensure efficient and smooth connection between pre-hospital and in-hospital care.Popularize and publicize the importance of self-rescue and mutual rescue,promote first aid knowledge and skills training for the public,and create a social atmosphere where"rescue is right beside us".

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

Objective To investigate the dynamic characteristics of intestinal pathological development at different time points in a mouse model of colitis-associated colon cancer.Methods A colitis-cancer model was established in C57BL/6 mice using azoxymethane(AOM)combined with dextran sulfate sodium(DSS).Samples were collected at 7,10,and 14 weeks post-modeling and the spleen index,colon length,mass,and colon mass per unit length were measured.Histopathological changes in the colon were observed by hematoxylin and eosin and Masson staining.Expression levels of the cancer stem cell marker CD44 and Wnt signaling pathway genes Wnt2b,Lrp5,Axin2,and Znrf3 at different pathological stages were detected by reverse transcription quantitative real time PCR.Cancer-associated fibroblasts(FAP),CD44,the proliferation marker Ki67,and goblet cell MUC2 protein were detected by multiple immunofluorescence histochemistry(mIHC)and immunofluorescence.In addition,colon organoids were isolated from model mice at ten and fourteen weeks and cultured in vitro to observe changes in organoid morphology and marker expression.Results AOM/DSS-induced mice showed reduced,distorted,and branched colon crypt structures with a few collagen fibers at 7 weeks,and varying degrees of colon intraepithelial neoplasia,with an increased proportion of high-grade intraepithelial neoplasia over time and increased collagen fiber staining at ten and fourteen weeks.mRNA levels of CD44 and Wnt2b in the colon were significantly increased(P＜0.05)and Axin2 was decreased(P＜0.01)in model mice compared with control mice at fourteen week,and levels of Wnt2b,Lrp5,and Znrf3 were increased compared with seven-week mice(P＜0.01,P＜0.05,P＜0.01),and Axin2 was decreased(P＜0.01).mIHC staining showed increased expression of FAP and CD44 in the colon in model mice at ten and fourteen weeks,with decreased MUC2 expression.Colon organoids showed cystic dilation,especially at fourteen weeks,with more prominent expression of Ki67 and CD44.Conclusions The AOM/DSS-induced mouse model exhibited chronic colonic inflammation,low-grade intraepithelial neoplasia,and high-grade intraepithelial neoplasia at seven,ten,and fourteen weeks,respectively.The pathological microenvironment was characterized by fibroblast activation and abnormal proliferation of epithelial cells.

Objective:To investigate the effect of goal setting theory-guided health management on disease cognition, compliance with antiviral therapy and self-efficacy of patients with chronic hepatitis B (CHB) so as to provide a theoretical basis for developing clinical nursing plans for patients with CHB.Methods:A quasi-experiment study was conducted, and 60 patients with CHB who were admitted to Anhui Provincial Hospital of Integrated Traditional Chinese and Western Medicine (the Third Affiliated Hospital of Anhui University of Chinese Medicine) from November 2022 to June 2023 were selected as the study subjects by convenience sampling method. They were randomly divided into the observation group and the control group by the envelope method, with 30 cases in each group. The control group received routine health management, and the observation group received goal setting theory-guided health management. Effects on disease cognition, compliance with antiviral therapy and self-efficacy of the two groups were analyzed.Results:There were 30 patients in each group completed the research. In the control group, there were 15 males, 15 females, aged (56.28 ± 5.97) years. In the observation group, there were 16 males, 14 females, aged (55.36 ± 6.21) years. After intervention, the scores for perceived benefit and acceptance [(20.36 ± 2.47) and (23.54 ± 2.67)] were higher than those of the control group [(16.33 ± 2.48) and (17.45 ± 2.68)], helplessness score of the observation group was (5.33 ± 0.67), lower than (10.21 ± 2.58) of the control group with significant differences ( t=6.31, 8.82, 10.03, all P<0.05). After intervention, compliance rate in the observation group [93.33% (28/30)] was higher than that in the control group [70.00% (21/30)], with significant difference ( χ2=5.46, P<0.05). After intervention, the General Self-Efficacy Scale score of the observation group was (31.25 ± 3.24), higher than (25.33 ± 2.67) of the control group, with significant difference ( t=7.72, P<0.05). Conclusions:Goal setting theory-guided health management can effectively improve compliance with antiviral therapy among patients with CHB, which may be related to the improvement of disease cognition and self-efficacy, and is worthy of clinical promotion.

Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis(ALNM)of stage cT1N0 breast invasive ductal carcinoma(IDC).Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected,including 23 cases with and 54 cases without ALNM.Univariate and multivariate binary logistic regression analysis were used to analyze clinical data,laboratory indicators and ultrasonic manifestations,then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model,ultrasound model and combined model,respectively,and nomogram of the combined model was drawn.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of each model.The consistency of results of combined model and actual results was analyzed using calibration curve.Decision curve analysis(DCA)was used to explore the clinical value of each model.Results Serum carbohydrate antigen 153(CA153)(OR=1.132),platelet-to-lymphocyte ratio(PLR)(OR=1.020)and echo attenuation behind the lesion on ultrasound(OR=8.789)were all independent predictors of ALNM in stage cT1N0 breast IDC(all P＜0.05),and the area under the curve(AUC)of laboratory indexes model,ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757,0.616 and 0.836,respectively.The consistency of the predicted results of combined model and actual results was good.When the threshold was higher than 0.15,the net benefit of combined model was higher than that of the other 2 models.Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC.

Objective To investigate the dynamic characteristics of intestinal pathological development at different time points in a mouse model of colitis-associated colon cancer.Methods A colitis-cancer model was established in C57BL/6 mice using azoxymethane(AOM)combined with dextran sulfate sodium(DSS).Samples were collected at 7,10,and 14 weeks post-modeling and the spleen index,colon length,mass,and colon mass per unit length were measured.Histopathological changes in the colon were observed by hematoxylin and eosin and Masson staining.Expression levels of the cancer stem cell marker CD44 and Wnt signaling pathway genes Wnt2b,Lrp5,Axin2,and Znrf3 at different pathological stages were detected by reverse transcription quantitative real time PCR.Cancer-associated fibroblasts(FAP),CD44,the proliferation marker Ki67,and goblet cell MUC2 protein were detected by multiple immunofluorescence histochemistry(mIHC)and immunofluorescence.In addition,colon organoids were isolated from model mice at ten and fourteen weeks and cultured in vitro to observe changes in organoid morphology and marker expression.Results AOM/DSS-induced mice showed reduced,distorted,and branched colon crypt structures with a few collagen fibers at 7 weeks,and varying degrees of colon intraepithelial neoplasia,with an increased proportion of high-grade intraepithelial neoplasia over time and increased collagen fiber staining at ten and fourteen weeks.mRNA levels of CD44 and Wnt2b in the colon were significantly increased(P＜0.05)and Axin2 was decreased(P＜0.01)in model mice compared with control mice at fourteen week,and levels of Wnt2b,Lrp5,and Znrf3 were increased compared with seven-week mice(P＜0.01,P＜0.05,P＜0.01),and Axin2 was decreased(P＜0.01).mIHC staining showed increased expression of FAP and CD44 in the colon in model mice at ten and fourteen weeks,with decreased MUC2 expression.Colon organoids showed cystic dilation,especially at fourteen weeks,with more prominent expression of Ki67 and CD44.Conclusions The AOM/DSS-induced mouse model exhibited chronic colonic inflammation,low-grade intraepithelial neoplasia,and high-grade intraepithelial neoplasia at seven,ten,and fourteen weeks,respectively.The pathological microenvironment was characterized by fibroblast activation and abnormal proliferation of epithelial cells.