The c-Jun N-terminal kinase （JNK） signaling pathway， a key member of the mitogen-activated protein kinase （MAPK） family， plays a central role in the pathogenesis and progression of central nervous system （CNS） diseases by regulating core biological processes such as apoptosis， inflammatory responses， synaptic plasticity， and autophagy. This article sorts out and analyzes relevant literature published domestically and internationally in recent years， summarizing the mechanisms of action of the JNK signaling pathway in common CNS diseases and the research progress in traditional Chinese medicine （TCM） interventions in CNS diseases through the regulation of the JNK signaling pathway. Studies have shown that active components of TCM， such as berberine， paeoniflorin， and astragaloside Ⅳ， as well as compound formulations like Heixiaoyao san， Ditan tang， and Buyang huanwu tang， can exert neuroprotective effects in various CNS disorders， including Alzheimer’s disease， Parkinson’s disease， cerebral ischemia-reperfusion injury， and epilepsy， by inhibiting the aberrant activation of the JNK signaling pathway， thereby alleviating neuroinflammation， oxidative stress， and neuronal apoptosis， while improving synaptic function and cognitive behavioral deficits， regulating autophagy， and maintaining blood-brain barrier integrity.

Alzheimer’s disease （AD） is an age-related neurodegenerative disorder. Marrow-sea insufficiency serves as the fundamental basis for the onset of AD. Early syndrome differentiation-based intervention helps to delay disease progression， and improve patients’ cognitive function. Qifu yin is a representative specialized prescription for AD with marrow-sea insufficiency syndrome. Studies demonstrate that Qifu yin exerts neuroprotective effects through multiple pathways， including inhibiting the abnormal deposition of amyloid β -protein and hyperphosphorylation of tau protein， alleviating neuroinflammation， regulating oxidative stress and mitochondrial dysfunction， modulating the cholinergic system， and improving synaptic plasticity. Qifu yin combined with Western medicine such as donepezil， memantine， and butylphthalide， or combined with external therapies such as acupuncture， can effectively improve cognitive function and activities of daily living in AD patients with favorable safety. Future research should focus on the core pathogenesis and key targets of AD with marrow-sea insufficiency syndrome， provide in-depth elucidation of the scientific connotation of Qifu yin’s “tonifying the kidney to produce marrow”， and further conduct high-quality clinical studies to provide scientific evidence for the prevention and treatment of AD with marrow-sea insufficiency syndrome.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

Objective To systematically evaluate the assessment tools of adolescent chronic disease patients'transition readiness to adults at home and abroad,and to provide references for medical personnel to choose appropriate tools.Methods CNKI,Wan Fang Data,CBM,PubMed,Web of Science,Embase and Cochrane were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses to adulthood from inception to August,2024.Literature screening and data extraction of the tools were extracted independently by 2 researchers.At the same time,the criteria for the selection of health measurement tools based on consensus(COSMIN)systematic evaluation guidelines were used to evaluate the inclusion assessment tools,and recommendations were finally formed.Results A total of 29 articles were included,involving 9 universal and 5 specific assessment tools of adolescent chronic illnesses transition readiness.The Transition Readiness Assessment Questionnaire has satisfactory content validity and internal consistency,and it is recommended as Grade A.The Grade C included the Am I ON TRAC for adult care?Questionnaire and the State Assessment Questionnaire for Transition,Epilepsy-specific Transition Readiness Assessment Questionnaire and the Readiness for Adult Care in Rheumatology,while the others are recommended as Grade B.Conclusion There are a variety of tools to assess the transition readiness of adolescents with chronic diseases to adults,and there are few tools suitable for adolescents with chronic diseases in China,with few specific tools.After comprehensive consideration,the Transition Readiness Assessment Questionnaire can be recommended temporarily.

Objective To systematically evaluate the assessment tools of adolescent chronic disease patients'transition readiness to adults at home and abroad,and to provide references for medical personnel to choose appropriate tools.Methods CNKI,Wan Fang Data,CBM,PubMed,Web of Science,Embase and Cochrane were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses to adulthood from inception to August,2024.Literature screening and data extraction of the tools were extracted independently by 2 researchers.At the same time,the criteria for the selection of health measurement tools based on consensus(COSMIN)systematic evaluation guidelines were used to evaluate the inclusion assessment tools,and recommendations were finally formed.Results A total of 29 articles were included,involving 9 universal and 5 specific assessment tools of adolescent chronic illnesses transition readiness.The Transition Readiness Assessment Questionnaire has satisfactory content validity and internal consistency,and it is recommended as Grade A.The Grade C included the Am I ON TRAC for adult care?Questionnaire and the State Assessment Questionnaire for Transition,Epilepsy-specific Transition Readiness Assessment Questionnaire and the Readiness for Adult Care in Rheumatology,while the others are recommended as Grade B.Conclusion There are a variety of tools to assess the transition readiness of adolescents with chronic diseases to adults,and there are few tools suitable for adolescents with chronic diseases in China,with few specific tools.After comprehensive consideration,the Transition Readiness Assessment Questionnaire can be recommended temporarily.

Objective To investigate the expression of ferritinophagy-related gene ELAV-like RNA binding protein 1(ELAVL1)in multiple myeloma(MM)and elucidate its diagnostic and prognostic value for MM.Methods First,we analyzed ELAVL1 expression level in healthy controls and MM patients using data from the GEO and TCGA databases.Subsequently,bone marrow specimens were collected from 28 newly diagnosed MM patients and 20 healthy controls,and qRT-PCR was employed to validate ELAVL1 expression.The diagnostic and prognostic potential of ELAVL1 was assessed using ROC curve analysis and Kaplan-Meier survival curves.Additionally,univariate and multivariate COX regression analyses were performed to identify independent risk factors for MM prognosis.Finally,KEGG and GO enrichment analyses were performed using the DAVID online platform.Results The level of ELAVL1 expression was significantly higher in newly diagnosed MM patients and refractory/relapsed MM patients than in the healthy controls(P＜0.001).Moreover,ELAVL1 expression was positively correlated with the International Staging System(ISS)stage of MM(P＜0.01).Furthermore,qRT-PCR validation confirmed that ELAVL1 expression was elevated in the 28 newly diagnosed MM patients compared to the 20 healthy controls(P＜0.001).ROC curve analysis demonstrated that ELAVL1 could effectively differentiate between newly diagnosed MM patients,healthy controls,and MGUS patients(P＜0.001 and P=0.000 2,respectively).Survival analysis revealed that high ELAVL1 expression was associated with shorter progression-free survival(P=0.0141)and overall survival(P=0.008 0).Univariate and multivariate COX regression analyses identified high ELAVL1 expression as an independent risk factor for poor MM prognosis(P=0.005 0).KEGG analysis suggested that ELAVL1 might be involved in the Hippo and MAPK signaling pathways.Conclusion High ELAVL1 expression in MM may serve as a biomarker for diagnosis and poor prognosis.ELAVL1 may promote MM initiation and progression via the Hippo and MAPK signaling pathways.

BACKGROUND/OBJECTIVES: Chronic renal failure (CRF) is a complex pathological condition that lacks a cure. Certain Chinese medicines, such as melittin, a major component in bee venom, have shown efficacy in treating CRF patients. On the other hand, the mechanisms underlying the therapeutic effects of melittin are unclear.MATERIALS/METHODS: A 5/6 nephrectomy model (5/6 Nx) of renal failure was established on rats for in vivo assays, and mouse podocyte clone 5 (MPC5) mouse podocyte cells were treated with angiotensin II (AngII) to establish an in vitro podocyte damage model. The 24-h urine protein, serum creatinine, and blood urea nitrogen levels were evaluated after one, 2, and 4 weeks. Hematoxylin and eosin staining, Masson staining, and periodic acid-Schiff staining were used to examine the pathological changes in kidney tissues. A cell counting kit 8 assay was used to assess the cell viability. Reverse transcription polymerase chain reaction and Western blot were used to assess the mRNA and protein levels in the cells, respectively. RESULTS: In the rat 5/6 Nx, melittin reduced the 24-h urinary protein excretion and the serum creatinine and blood urea nitrogen levels. Furthermore, the renal pathology was improved in the melittin-treated 5/6 Nx rats. Melittin promoted podocin, nephrin, Beclin 1, and the LC3II/ LC3I ratio and inhibited phosphorylated mammalian target of rapamycin (mTOR)/mTOR in 5/6 Nx-induced rats and AngII-induced MPC5 mouse podocyte cells. Moreover, inhibiting autophagy with 3-MA weakened the effects of melittin on podocin, nephrin, and the LC3II/ LC3I ratio in podocytes. CONCLUSION Melittin may offer protection against kidney injury, probably by regulating podocyte autophagy. These results provide the theoretical basis for applying melittin in CRF therapy.

Objective:To explore the impact of unpleasant symptoms and their antecedents on the functional performance of patients with chronic obstructive pulmonary disease (COPD) .Methods:From January 2020 to June 2023, convenience sampling was used to select COPD patients admitted to the Respiratory and Intensive Care Unit of Xinxiang Central Hospital as research subjects. The subjects were surveyed using the General Information Questionnaire, Functional Performance Inventory-Short Form (FPI-SF), Memory Symptom Assessment Scale (MSAS), Mishel Uncertainty in Illness Scale (MUIS), Social Support Rating Scale (SSRS), and the General Self-Efficacy Scale (GSES). Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading was used to evaluate subjects' lung function. Pearson correlation was used to explore the correlation between the scores FPI-SF, MSAS, MUIS, SSRS, GSES, and GOLD grading. Structural equation modeling was implemented to explore the impact of unpleasant symptoms and their antecedents on the functional performance of COPD patients.Results:A total of 279 questionnaires were distributed and 276 valid questionnaires were collected, with a valid response rate of 98.92%. Among 276 COPD patients, the scores of FPI-SF, MSAS, MUIS, SSRS, and GSES were (2.08±0.24), (2.08±0.28), (95.41±12.83), (43.94±5.94), and (23.78±4.88), respectively. Functional performance was negatively correlated with unpleasant symptoms, disease uncertainty, and GOLD grading ( r=-0.478, -0.353, -0.574; P<0.05) and positively correlated with social support and self-efficacy ( r=0.451, 0.364; P<0.05). Structural equation modeling showed that GOLD grading, disease uncertainty, and social support indirectly affected functional performance through unpleasant symptoms, while GOLD grading and social support directly affected functional performance, and self-efficacy played a partial mediating role between unpleasant symptoms and functional performance; the above differences were statistically significant ( P<0.05) . Conclusions:The functional performance of COPD patients is poor. Medical and nursing staff can develop comprehensive intervention measures, including physiology, psychology, social environment, and self-efficacy, to improve patients' functional performance.

Objective To verify the application effect of the muscle strength training based on Fogg behavior model for elderly frail patients,and provide references and bases for subsequent related research.Methods This paper constructed a muscle strength training program for elderly frail patients based on the Fogg behavior model.The exercise intervention process includes the stages of cultivating exercise awareness,scientific fitness guidance,and developing exercise habits.66 elderly frail people aged 60 and above who were hospitalized in 4 geriatric wards of a tertiary A hospital in Beijing from January to March 2022 were recruited,and they were randomly divided into a control group and an intervention group.The intervention group implemented a muscle strength training based on the Fogg behavior model,while the control group was given routine exercise guidance and education for 6 months.The muscle strength,cardiopulmonary function,and glucose and lipid metabolism of the 2 groups were compared at the end of 3 and 6 months of intervention.Results A total of 65 patients with 33 in the control group and 32 in the intervention group completed the study.The muscle strength of the intervention group showed better changes over time at 6 months compared to the control group(P<0.05).In terms of cardiopulmonary function,the intervention group had better lung capacity than the control group at 3 and 6 months,with statistically significant differences(t=2.166,P=0.034;t=3.385,P=0.001).There was no statistically significant difference in heart rates and left ventricular ejection fraction between the groups(P>0.05).In terms of glucose and lipid metabolism,only high-density lipoprotein in the intervention group was found to be superior to it in the control group at 3 and 6 months,with statistically significant differences(t=2.970,P=0.004;t=4.111,P<0.001).There was no statistically significant difference between blood glucose,low-density lipoprotein,total cholesterol,and triglycerides groups(P>0.05).Conclusion The muscle strength training based on the Fogg behavior model can effectively improve the muscle strength and lung function of frail elderly patients,and can also improve blood lipid metabolism to a certain extent,while there is no obvious effect on heart function and blood glucose control.