Objective This study systematically evaluated the clinical efficacy of Shangke Jiegu tablet in the treatment of fracture,and explored the mechanism of action of Shangke Jiegu tablet and the compatibility of each efficacy group from the"Disease-Symptom-Formula"perspective.Methods Clinical research literatures on the use of Shangke Jiegu tablet for fracture intervention were retrieved from Chinese databases(CNKI,Wanfang Database,VIP database)and English databases(PubMed,Cochrane Library,EMbase),covering the period from the inception of the databases to January 2024.Risk assessment tools were used to evaluate the literature's quality,and the data were extracted and analyzed using Stata 16.0 software.Gene sets associated with fracture symptoms were identified through the TCMIP platform(version 2.0).Differential gene expression related to fractures was obtained from the GEO database.Chemical composition and candidate target profiles of the 12 herbs in Shangke Jiegu tablets were collected from TCMIP v 2.0.An interaction network between fracture-related genes and drug candidate targets was established,and core network targets were screened based on topological features,with functional enrichment analysis performed.Results A total of 14 articles were incorporated into the Meta-analysis,encompassing a total sample size of 1 293 cases,indicating an overall response rate of Shangke Jiegu tablets in fracture therapy(RR=1.24,95%CI:1.18-1.31,P<0.001).The"Disease-Symptom-Formula"association network analysis indicated that the pathways related to the putative targets of Shangke Jiegu tablet were primarily involved in bone healing,nerve and blood system regulation,and immune-inflammation regulation.Different efficacy groups within the prescriptions showed varying emphases on these roles.Conclusions Shangke Jiegu tablet may facilitate fracture healing by regulating blood and nervous systems,correcting immune-inflammatory imbalances,and maintaining bone and energy metabolism.The comprehensive effects include the dissipation of blood stasis,the promotion of blood circulation,the alleviation of swelling and pain,the regeneration of muscles and bones,and the clearance of heat and detoxification.These findings support the clinical advantages and positioning of Shangke Jiegu tablet.

To summarize the nursing experience of a patient with severe pneumonia complicated with hypopituitarism.Key points of nursing:perform airway management and improve oxygenation index;implementing goal-oriented nutrition support programmes to improve nutritional status;continuously preventing and monitoring the occurrence of pituitary crisis;carrying out early lung rehabilitation training combining traditional Chinese medicine and Western medicine;delivering continuity of care to improve disease management capacity.After 24 days of careful treatment and nursing,the patient gets better and was discharged.

Objective:To investigate the mechanism of tumor necrosis factor alpha-induced protein 3 ( Tnfaip3) gene affecting the intestinal inflammation in mice with dextran sulfate sodium (DSS) -induced colitis by regulating mitochondria. Methods:Female Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) mice ( n = 14) and wild-type (WT) mice ( n = 14) were collected and divided into 4 groups including wild type (WT) group, colitis model (WT-DSS) group, Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) group, Tnfaip3 heterozygous deficiency colitis model ( Tnfaip3 +/--DSS) group, with 7 mice in each group. Mice colitis in WT-DSS and Tnfaip3 +/--DSS groups were induced by drinking 3% DSS water for 7 days, while mice in WT and Tnfaip3 +/- groups were treated with tap water. Body weight and disease activity index (DAI) were evaluated daily. The mice were sacrificed after 7 days of modeling, the colon length was measured, the colon tissue damage was observed under the microscope, and the colon histopathological score was evaluated. The mRNA expressions of inflammatory factors as tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and nuclear factor κB (NF-κB) in colon tissue were detected by quantitative real-time PCR. Oxidative stress indicators such as malonic dialdehyde (MDA), total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) in colon tissue were detected. Transmission electron microscopy was used to observe the structures of mitochondria, lysosomes, and autophagic mitochondria, and calculate the numbers. Mitochondrial membrane potential JC-1 and adenosine-triphosphate (ATP) levels were detected, and Western blot was used to detect the expressions of mitophagy-related proteins PINK1, P62, and LC3B Ⅱ/LC3B Ⅰ in mitochondria and cytoplasm. Results:The survival rate of mice in all groups was 100%. Compared with WT group, the mice in Tnfaip3 +/- group had lower body weight, shorter colon and higher histopathological scores (all P < 0.05). Compared with WT-DSS group, the mice in Tnfaip3 +/--DSS group had lower body weight, higher DAI score, shorter colon, higher histopathological score, and higher mRNA expressions of inflammatory factors TNF-α, IL-1β and NF-κB in colon tissues (all P < 0.05). MDA level in colon tissues of Tnfaip3 +/- mice was higher than that of WT mice ( P < 0.05). Compared with WT-DSS group, the MDA level in Tnfaip3 +/--DSS group was higher, the levels of T-AOC, GSH-PX and SOD were lower (all P < 0.05). Compared with WT-DSS group, Tnfaip3 +/--DSS mice had more severe intestinal disordered mitochondrial structure, less mitochondrial number, higher mitochondrial membrane potential JC-1 level and lower mitochondrial ATP content, more number of lysosomes and autophagic mitochondria and higher expressions of proteins such as PINK1, P62 and ratio of LC3BⅡ/LC3BⅠ in mitochondria and cytoplasm (all P < 0.05) . Conclusion:Tnfaip3 gene may play a protective role in intestinal inflammation of colitis mice by regulating oxidative stress, mitochondria damage and mitophagy.

The nursing care of a case of Sheehan syndrome with infection and combined with diabetic ketoacidosis was summarized.To improve prognosis of the disease and guarantee patient's safety,key points of nursing care are as following:sufficient early liquid resuscitation and target-oriented management of blood glucose to correct internal environment disorder;dynamic monitoring of condition,implementing hormone replacement therapy by stages to prevent pituitary crises;to measure the mental state and implement cluster intervention measures to prevent infection worsening;regular follow-up and disease education to improve patients'disease self-management ability.After positive treatment and careful nursing care,no serious complications occurred,blood glucose was controlled well,and the case was in stable conditions and was discharged.

Objective:To investigate the mechanism of tumor necrosis factor alpha-induced protein 3 ( Tnfaip3) gene affecting the intestinal inflammation in mice with dextran sulfate sodium (DSS) -induced colitis by regulating mitochondria. Methods:Female Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) mice ( n = 14) and wild-type (WT) mice ( n = 14) were collected and divided into 4 groups including wild type (WT) group, colitis model (WT-DSS) group, Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) group, Tnfaip3 heterozygous deficiency colitis model ( Tnfaip3 +/--DSS) group, with 7 mice in each group. Mice colitis in WT-DSS and Tnfaip3 +/--DSS groups were induced by drinking 3% DSS water for 7 days, while mice in WT and Tnfaip3 +/- groups were treated with tap water. Body weight and disease activity index (DAI) were evaluated daily. The mice were sacrificed after 7 days of modeling, the colon length was measured, the colon tissue damage was observed under the microscope, and the colon histopathological score was evaluated. The mRNA expressions of inflammatory factors as tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and nuclear factor κB (NF-κB) in colon tissue were detected by quantitative real-time PCR. Oxidative stress indicators such as malonic dialdehyde (MDA), total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) in colon tissue were detected. Transmission electron microscopy was used to observe the structures of mitochondria, lysosomes, and autophagic mitochondria, and calculate the numbers. Mitochondrial membrane potential JC-1 and adenosine-triphosphate (ATP) levels were detected, and Western blot was used to detect the expressions of mitophagy-related proteins PINK1, P62, and LC3B Ⅱ/LC3B Ⅰ in mitochondria and cytoplasm. Results:The survival rate of mice in all groups was 100%. Compared with WT group, the mice in Tnfaip3 +/- group had lower body weight, shorter colon and higher histopathological scores (all P < 0.05). Compared with WT-DSS group, the mice in Tnfaip3 +/--DSS group had lower body weight, higher DAI score, shorter colon, higher histopathological score, and higher mRNA expressions of inflammatory factors TNF-α, IL-1β and NF-κB in colon tissues (all P < 0.05). MDA level in colon tissues of Tnfaip3 +/- mice was higher than that of WT mice ( P < 0.05). Compared with WT-DSS group, the MDA level in Tnfaip3 +/--DSS group was higher, the levels of T-AOC, GSH-PX and SOD were lower (all P < 0.05). Compared with WT-DSS group, Tnfaip3 +/--DSS mice had more severe intestinal disordered mitochondrial structure, less mitochondrial number, higher mitochondrial membrane potential JC-1 level and lower mitochondrial ATP content, more number of lysosomes and autophagic mitochondria and higher expressions of proteins such as PINK1, P62 and ratio of LC3BⅡ/LC3BⅠ in mitochondria and cytoplasm (all P < 0.05) . Conclusion:Tnfaip3 gene may play a protective role in intestinal inflammation of colitis mice by regulating oxidative stress, mitochondria damage and mitophagy.

To summarize the nursing experience of a patient with severe pneumonia complicated with hypopituitarism.Key points of nursing:perform airway management and improve oxygenation index;implementing goal-oriented nutrition support programmes to improve nutritional status;continuously preventing and monitoring the occurrence of pituitary crisis;carrying out early lung rehabilitation training combining traditional Chinese medicine and Western medicine;delivering continuity of care to improve disease management capacity.After 24 days of careful treatment and nursing,the patient gets better and was discharged.

The observation and nursing care of a case of fulminant type 1 diabetes mellitus related to immune checkpoint inhibitor were summarized.To improve prognosis of the disease and guarantee patients'safety,key points of nursing are as following:sufficient early liquid resuscitation to improve renal perfusion;dynamic monitoring and summary of blood glucose changes,implementing a target-oriented blood glucose management program;providing nutritional support;regularly follow-up and health education.After positive rescue and careful nursing,no serious complications occurred;blood glucose was controlled well;nutritional status was improved;the patient was in stable conditions and was discharged.Telephone follow-up of the patient for 3 months showed stable blood glucose and good condition.

Urinary tract infection (UTI) is one of the most common infectious diseases. It has the characteristics of high recurrence rate and prolonged course. At present, the problem of antibiotic resistance is becoming more and more serious, the incidence of adverse reactions is high, and the disadvantages of long-term administration appear, which brings severe challenges to the treatment of recurrent urinary tract infection. The prevention and treatment of UTI recurrence has become the focus of research. Recurrent urinary tract infection is related to the immune regulation mechanism of the body. Administration of immune regulation can provide new ideas for prevention and treatment. The vaccine based on immune regulation to prevent rUTI has made some progress. It can not only reduce the frequency of recurrences, but also decrease related symptoms. At the same time, the vaccine has good tolerance, high safety and good application prospect. This paper aims to summarize the progress of immune regulation and immune vaccines in vivo and clinical research.

Objective:To compare the assisted-reproduction outcomes of two long-acting gonadotropin-releasing hormone agonists (GnRH-a) in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) during the long-term early follicular phase. Methods:A retrospective cohort study was conducted in the Reproductive Center of the Second Affiliated Hospital of Wenzhou Medical University from March 1, 2019 to July 31, 2019. A total of 802 patients were divided into leuprorelin acetate group (group A) and triptorelin group (group B) according to the difference of long-acting GnRH-a in the long-term early follicular phase, and the clinical and laboratory outcomes between the two groups were compared.Results:There were no significant differences in age, infertility duration, body mass index (BMI), basic hormone levels, infertility type, sex hormone level on the day of initiation of injection of gonadotropin (Gn), total duration and dosage of Gn used, duration of down-regulation, estradiol level and endometrial thickness on hCG injection day, the number of embryos transferred, clinical outcomes, total treatment cost, and owing to the uneven inner membrane, elevated progesterone, embryo quality problems, individual factors resulting in cancelling the transplant, between the two groups ( P>0.05). However, antral follicle count (AFC) (19.59±7.93), the number of retrieved oocytes (15.39±7.59), fertilized oocytes (11.20±6.53), cleaved oocytes (10.85±6.42), good-quality embryos on Day 3 (3.01±2.66), and blastocysts (5.27±4.02) in group B was larger than that in group A (17.68±7.23, 13.70±6.94, 9.50±5.43, 9.26±5.34, 2.57±2.33, 4.49±3.40) ( P=0.001, P=0.002, P<0.001, P=0.001, P=0.017, P=0.007). The levels of luteinizing hormone (LH) [(0.78±0.64) IU/L] and progesterone [(0.72±0.39) μg/L] on hCG injection day in group A were higher than those in group B [(0.55±0.30) IU/L, (0.64±0.36) μg/L] ( P<0.001, P=0.005). The rate of preventing the occurrence of ovarian hyperstimulation syndrome (OHSS) in group A [28.52% (75/263)] was higher than that in group B [14.95% (16/107), P=0.006]. Conclusion:Two long-acting GnRH-a drugs can achieve satisfactory down-regulation effect, laboratory and clinical outcomes in the long-term early follicular phase. Compared with the triptorelin, leuprolide acetate is relatively mild to pituitary inhibition, with an increasing trend of the clinical pregnancy rate.

Objective:To compare the assisted-reproduction outcomes of two long-acting gonadotropin-releasing hormone agonists (GnRH-a) in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) during the long-term early follicular phase. Methods:A retrospective cohort study was conducted in the Reproductive Center of the Second Affiliated Hospital of Wenzhou Medical University from March 1, 2019 to July 31, 2019. A total of 802 patients were divided into leuprorelin acetate group (group A) and triptorelin group (group B) according to the difference of long-acting GnRH-a in the long-term early follicular phase, and the clinical and laboratory outcomes between the two groups were compared.Results:There were no significant differences in age, infertility duration, body mass index (BMI), basic hormone levels, infertility type, sex hormone level on the day of initiation of injection of gonadotropin (Gn), total duration and dosage of Gn used, duration of down-regulation, estradiol level and endometrial thickness on hCG injection day, the number of embryos transferred, clinical outcomes, total treatment cost, and owing to the uneven inner membrane, elevated progesterone, embryo quality problems, individual factors resulting in cancelling the transplant, between the two groups ( P>0.05). However, antral follicle count (AFC) (19.59±7.93), the number of retrieved oocytes (15.39±7.59), fertilized oocytes (11.20±6.53), cleaved oocytes (10.85±6.42), good-quality embryos on Day 3 (3.01±2.66), and blastocysts (5.27±4.02) in group B was larger than that in group A (17.68±7.23, 13.70±6.94, 9.50±5.43, 9.26±5.34, 2.57±2.33, 4.49±3.40) ( P=0.001, P=0.002, P<0.001, P=0.001, P=0.017, P=0.007). The levels of luteinizing hormone (LH) [(0.78±0.64) IU/L] and progesterone [(0.72±0.39) μg/L] on hCG injection day in group A were higher than those in group B [(0.55±0.30) IU/L, (0.64±0.36) μg/L] ( P<0.001, P=0.005). The rate of preventing the occurrence of ovarian hyperstimulation syndrome (OHSS) in group A [28.52% (75/263)] was higher than that in group B [14.95% (16/107), P=0.006]. Conclusion:Two long-acting GnRH-a drugs can achieve satisfactory down-regulation effect, laboratory and clinical outcomes in the long-term early follicular phase. Compared with the triptorelin, leuprolide acetate is relatively mild to pituitary inhibition, with an increasing trend of the clinical pregnancy rate.