Traditional Chinese medicine (TCM) exerts integrative effects on complex diseases owing to the characteristics of multiple components with multiple targets. However, the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians, which has been a major challenge in the global acceptance and application of TCM. Therefore, a standardized TCM prescription system needs to be explored to promote its clinical application. In this study, we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation. We tested its efficacy against intracerebral hemorrhage (ICH). First, the top 100 ICH targets in the GeneCards database were screened according to their relevance scores. Then, SymMap and Traditional Chinese Medicine Systems Pharmacology (TCMSP) databases were applied to find out the target-related ingredients and ingredient-containing herbs, respectively. The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets. The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions. The absorbed components in the serum were detected. In a mouse model of ICH, the new prescription exerted multifaceted effects, including improved neurological function, as well as attenuated neuronal damage, cell apoptosis, vascular leakage, and neuroinflammation. These effects matched well with the core pathological changes in ICH. The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise, multipronged, unbiased, and standardized TCM prescriptions for complex diseases. This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.

Traditional Chinese medicine(TCM)exerts integrative effects on complex diseases owing to the char-acteristics of multiple components with multiple targets.However,the syndrome-based system of diagnosis and treatment in TCM can easily lead to bias because of varying medication preferences among physicians,which has been a major challenge in the global acceptance and application of TCM.Therefore,a standardized TCM prescription system needs to be explored to promote its clinical application.In this study,we first developed a gradient weighted disease-target-herbal ingredient-herb network to aid TCM formulation.We tested its efficacy against intracerebral hemorrhage(ICH).First,the top 100 ICH targets in the GeneCards database were screened according to their relevance scores.Then,SymMap and Traditional Chinese Medicine Systems Pharmacology(TCMSP)databases were applied to find out the target-related ingredients and ingredient-containing herbs,respectively.The relevance of the resulting ingredients and herbs to ICH was determined by adding the relevance scores of the corresponding targets.The top five ICH therapeutic herbs were combined to form a tailored TCM prescriptions.The absorbed components in the serum were detected.In a mouse model of ICH,the new prescription exerted multifaceted effects,including improved neurological function,as well as attenuated neuronal damage,cell apoptosis,vascular leakage,and neuroinflammation.These effects matched well with the core pathological changes in ICH.The multi-targets-directed gradient-weighting strategy presents a promising avenue for tailoring precise,multipronged,unbiased,and standardized TCM prescriptions for complex diseases.This study provides a paradigm for advanced achievements-driven modern innovation in TCM concepts.

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:To investigate the impact of hyperuricemia on the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective cohort study was conducted on data from 3 959 PCOS patients who received IVF-ET treatment at the Reproductive Centers of Henan Provincial People's Hospital and Jiangxi Provincial Maternal and Child Health Hospital between January 2016 and December 2021. The patients were divided into hyperuricemia group (>357 μmol/L, n=1 126) and normal uric acid group (≤357 μmol/L, n=2 833) based on their uric acid levels. Baseline data, clinical and laboratory indicators were compared between the two groups. Univariate and multivariate regression analyses were performed on factors influencing clinical outcomes. Multivariate logistic regression analysis was used to compare the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle between the two groups, clarifying the impact of hyperuricemia on clinical outcomes in PCOS patients. Results:There were no significant differences between the two groups in terms of age, duration of infertility, baseline testosterone level, type of infertility, and the rate of unusable embryos (all P>0.05). Body mass index [BMI, (25.15±3.75) kg/m 2], fasting blood glucose [(4.99±0.80) mmol/L] and fasting insulin levels [17.19 (11.78, 25.30) mU/L] in hyperuricemia group were higher than those in normal uric acid group [(23.60±3.64) kg/m 2, P<0.001; (4.88±0.81) mmol/L, P<0.001;12.40 (8.59, 17.86) mU/L, P<0.001], while their baseline luteinizing hormone [7.62 (4.68, 11.18) U/L] and anti-Müllerian hormone [7.62 (5.34, 10.73) μg/L] levels were lower than those in normal uric acid group [7.88 (4.98, 11.91) U/L, P=0.024; 7.95 (5.49, 11.73) μg/L, P<0.001], with statistically significant differences. Multivariate logistic regression analysis indicated that female BMI, endometrial thickness on human chorionic gonadotropin (hCG) injection day, and the number of transferable embryos were factors influencing the live birth rate per transfer cycle ( OR=1.02, 95% CI: 1.00-1.04, P=0.044; OR=0.95, 95% CI: 0.92-0.97, P<0.001; OR=0.97, 95% CI: 0.95-0.99, P=0.006). Fasting blood glucose, endometrial thickness on hCG injection day, and the number of transferable embryos were factors influencing the cumulative live birth rate per oocyte retrieval cycle ( OR=1.14, 95% CI: 1.01-1.29, P=0.036; OR=0.92, 95% CI: 0.87-0.97, P=0.002; OR=0.70, 95% CI: 0.66-0.75, P<0.001). Compared with the normal uric acid group, the hyperuricemia group in PCOS patients had not a statistically signifcant decrease in the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle ( OR=0.93, 95% CI: 0.72-1.19, P=0.548; OR=1.18, 95% CI: 0.87-1.60, P=0.300). Conclusion:Hyperuricemia does not affect the live birth rate per transfer cycle or the cumulative live birth rate per oocyte retrieval cycle in PCOS patients undergoing IVF-ET.

Objective:To investigate the impact of the progesterone concentration on human chorionic gonadotropin (hCG) trigger day in fresh cycles versus thawed transfer cycles (the freeze-all strategy) with an antagonist protocol, and to compare the differences in clinical outcomes.Methods:This retrospective cohort study included a total of 2 165 cycles conducted at Henan Provincial People′s Hospital with cleavage-stage embryo (at least one top-quality) transfer between January 2017 and December 2023, with serum progesterone levels on hCG trigger day all≤6.34 nmol/L (i.e. 2 ng/ml). Multivariate logsitic regression analysis and curve fitting were performed based on different serum progesterone levels on hCG trigger day [≤3.17 nmol/L (i.e. 1 ng/ml) or 1-2 ng/ml].Results:Multivariate regression analysis, by using cycle type (either fresh or frozen-thawed cycle) as the exposure variable, showed that the clinical pregnancy rate (≤1 ng/ml: OR=0.93, 95% CI: 0.75-1.14; 1-2 ng/ml: OR=1.05, 95% CI: 0.58-1.87) and live birth rate (≤1 ng/ml: OR=0.90, 95% CI: 0.71-1.13; 1-2 ng/ml: OR=1.53, 95% CI: 0.79-3.00) had no statistically significant differences in group of progesterone concentration ≤1 ng/ml or in group of 1-2 ng/ml. Using serum progesterone levels on hCG trigger day as a continuous variable for curve fitting analysis, the clinical pregnancy rate in fresh or thawed cycles showed no significant changes with increasing progesterone levels. Conclusions:In the antagonist protocol with cleavage-stage embryo transfer (at least one top-quality), when the serum progesterone level on hCG day is ≤2 ng/ml, there are no significant differences in clinical outcomes between thawed cycles and fresh cycles, including clinical pregnancy rate and live birth rate. Transferred in fresh cycles or choosing the freeze-all strategy could be selected based on the actual situation of the patients.

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 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.

Objective:To investigate the impact of hyperuricemia on the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective cohort study was conducted on data from 3 959 PCOS patients who received IVF-ET treatment at the Reproductive Centers of Henan Provincial People's Hospital and Jiangxi Provincial Maternal and Child Health Hospital between January 2016 and December 2021. The patients were divided into hyperuricemia group (>357 μmol/L, n=1 126) and normal uric acid group (≤357 μmol/L, n=2 833) based on their uric acid levels. Baseline data, clinical and laboratory indicators were compared between the two groups. Univariate and multivariate regression analyses were performed on factors influencing clinical outcomes. Multivariate logistic regression analysis was used to compare the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle between the two groups, clarifying the impact of hyperuricemia on clinical outcomes in PCOS patients. Results:There were no significant differences between the two groups in terms of age, duration of infertility, baseline testosterone level, type of infertility, and the rate of unusable embryos (all P>0.05). Body mass index [BMI, (25.15±3.75) kg/m 2], fasting blood glucose [(4.99±0.80) mmol/L] and fasting insulin levels [17.19 (11.78, 25.30) mU/L] in hyperuricemia group were higher than those in normal uric acid group [(23.60±3.64) kg/m 2, P<0.001; (4.88±0.81) mmol/L, P<0.001;12.40 (8.59, 17.86) mU/L, P<0.001], while their baseline luteinizing hormone [7.62 (4.68, 11.18) U/L] and anti-Müllerian hormone [7.62 (5.34, 10.73) μg/L] levels were lower than those in normal uric acid group [7.88 (4.98, 11.91) U/L, P=0.024; 7.95 (5.49, 11.73) μg/L, P<0.001], with statistically significant differences. Multivariate logistic regression analysis indicated that female BMI, endometrial thickness on human chorionic gonadotropin (hCG) injection day, and the number of transferable embryos were factors influencing the live birth rate per transfer cycle ( OR=1.02, 95% CI: 1.00-1.04, P=0.044; OR=0.95, 95% CI: 0.92-0.97, P<0.001; OR=0.97, 95% CI: 0.95-0.99, P=0.006). Fasting blood glucose, endometrial thickness on hCG injection day, and the number of transferable embryos were factors influencing the cumulative live birth rate per oocyte retrieval cycle ( OR=1.14, 95% CI: 1.01-1.29, P=0.036; OR=0.92, 95% CI: 0.87-0.97, P=0.002; OR=0.70, 95% CI: 0.66-0.75, P<0.001). Compared with the normal uric acid group, the hyperuricemia group in PCOS patients had not a statistically signifcant decrease in the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle ( OR=0.93, 95% CI: 0.72-1.19, P=0.548; OR=1.18, 95% CI: 0.87-1.60, P=0.300). Conclusion:Hyperuricemia does not affect the live birth rate per transfer cycle or the cumulative live birth rate per oocyte retrieval cycle in PCOS patients undergoing IVF-ET.

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.