OBJECTIVE To investigate the mechanism of pachymic acid on renal injury in pregnancy induced hypertension （PIH） rats by regulating the silent information regulator transcript 1/peroxisome proliferator-activated receptor γ coactivator-1α （Sirt1/PGC-1α） pathway. METHODS Pregnant SD rats were prepared by co-caging and PIH model was induced using N-nitro-L- arginine methyl ester （L-NAME） method. PIH rats were randomly divided into model group， L-pachymic acid （low-dose pachymic acid， 10 mg/kg） group， H-pachymic acid （high-dose pachymic acid， 20 mg/kg） group， and H-pachymic acid+EX527 （20 mg/kg pachymic acid+10 mg/kg EX527） group， with 6 rats in each group. Another 6 normal pregnant rats were selected as blank group. Each group was given relevant medicine or solvent intragastrically or intraperitoneally daily， once a day， for 28 consecutive days. After the last administration， 24 h urinary protein and tail artery systolic blood pressure （SBP） were measured in pregnant rats from each group， along with the levels of serum creatinine （Scr）， blood urea nitrogen （BUN），uric acid （UA）， and cystatin C （Cys-C）. The contents of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， and 8-hydroxy-2′-deoxyguanosine （8-OHdG） in renal tissue， as well as the mRNA and protein expression levels of Sirt1 and PGC-1α， were also determined. Meanwhile， renal histopathological changes in rats from each group were evaluated using hematoxylin-eosin （HE） staining and periodic acid-Schiff （PAS） staining. RESULTS Compared with model group， L-pachymic acid group and H-pachymic acid group exhibited significant decreases in 24 h urine protein quantification， tail artery SBP， Scr， BUN， UA， Cys-C levels， glomerulosclerosis index score of renal tissue， renal tubular injury score， the percentage of PAS positive area， MDA and 8-OHdG （P＜0.05）. Conversely， the contents of SOD and GSH-Px， along with the mRNA and protein expression levels of Sirt1 and PGC-1α， were significantly increased （P＜0.05）. Moreover， these improvements were more pronounced in H-pachymic acid group （P＜0.05）. Compared with H-pachymic acid group， the aforementioned indicators in pregnant rats from the H-pachymic acid+EX527 group showed significant reversal （P＜0.05）. CONCLUSIONS Pachymic acid significantly ameliorates renal injury induced by PIH in rats， potentially through activation of the Sirt1/PGC-1α pathway.

Objective: To explore the characteristics of the diversity and composition of oral microbial flora with age, and to provide a reference for understanding the succession of oral microecology at different ages. Methods: Oral rinse 16S rRNA (V4 region) sequencing data from 9 021 participants 14-69 years of age in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Alpha diversity (Observed OTUs, Faith’s PD, Shannon Index), beta diversity (Bray-Curtis and UniFrac), and genus-level composition were examined using weighted generalized linear models (GLMs), including quadratic terms for age and adjusting for key covariates (gender, race/ethnicity, BMI, smoking status, and periodontitis severity). Results: Alpha diversity demonstrated a clear inverted U-shaped trajectory across age, peaking at 25-30 years old and declining thereafter. This trend remained consistent across sex, race, smoking, and periodontal health strata. Beta diversity analyses revealed a modest but steady age-related shift in community structure. Genus-level analyses revealed that Rothia, Prevotella_6, and Lactobacillus increased steadily with age, while Haemophilus, Porphyromonas, and Corynebacterium declined significantly. Notably, potential periodontopathogens, such as Fusobacterium and Treponema_2, peaked in early adulthood before declining with age. Conclusion Age is an important driver of oral microbial succession, and the oral microbiome exhibits dynamic changes across different life stages. Future longitudinal and multi-omic studies are warranted to elucidate the mechanisms underlying these age-related trajectories.

Purpose To investigate the expression of chromogranin A(CgA)in gastroenteropancreatic neuroendo-crine neoplasms(GEP-NENs)and its relationship with clinicopathological features.Methods The clinicopathological data of GEP-NENs diagnosed in the Department of Pathology,Beijing Chao-yang Hospital,Capital Medical University from May 2011 to December 2024 were retrospectively analyzed.Immunohistochemical staining was applied to evaluate the expression of CgA,and the patients were divided into CgA(+)group and CgA(-)group.Differences in clinico-pathological features between the 2 groups were compared.Results The age of 229 patients ranged from 21 to 89 years,with an average age of 54.4 years.The most common primary site was the rectum(56.8％,130/229),fol-lowed by the stomach(16.6％,38/229),pancreas(14.4％,33/229),small intestine(6.1％,14/229),and colon(6.1％,14/229).There were 206 cases of single lesion and 23 cases of multiple lesions(number of tumors ≥2).There were 153 cases of G1(66.8％),29 cases of G2(12.7％),7 cases of G3(3.1％),and 40 cases of neuroendocrine carcinoma(NEC,17.5％).The positive rates of CgA in G1,G2,G3,and NEC groups were 37.2％,75.8％,71.4％,and 65.0％,respectively,with statistically significant differences(P＜0.001).The positive rates of CgA in T1,T2,T3,and T4 were 37.2％,83.3％,75.9％,and 57.7％,respectively,with statistically significant differences(P＜0.001).There were significant differences in age,vascular invasion,lymph node metasta-sis,and number of tumors between CgA(+)group and CgA(-)group(P＜0.001),but there was no significant difference in sex,tumor location,Syn,and CD56 expression between the two groups(P=0.595,P=0.098,P=0.173,P=0.557).Conclusion Immunohistochemical antibody CgA is a useful marker for GEP-NENs.CgA positiv-ity may be a poor prognostic factor for GEP-NENs patients.

This article summarizes the experience of providing remote nursing care for a pediatric patient with severe burns using augmented reality(AR)technology.Key nursing points include:to establish a remote management team to enhance multidisciplinary collaboration;to conduct remote nursing ward rounds to provide real-time guidance for clinical nursing practice;to remotely guide PICC(Peripherally Inserted Central Catheter)insertions and conduct precise fluid management;to remotely assess ward environments and provide guidance on disinfection and isolation measures;to alleviate pediatric pain through comprehensive management measures.After meticulous care and treatment,the patient's condition stabilized after 23 days,and the patient was transferred to a specialized hospital for continued treatment requiring skin grafting.

Objective:To investigate the imaging characteristics of clear cell acanthoma (CCA) by dermoscopy and reflectance confocal microscopy (RCM) .Methods:A retrospective analysis was conducted on 12 patients diagnosed with CCA through histopathological examination at the Department of Dermatology, Wuhan No.1 Hospital, from 2020 to 2024. Dermoscopic and RCM features of these cases were summarized.Results:Among the 12 CCA patients, 3 were males and 9 were females, and they were aged 50.08 ± 10.43 years. Clinically, CCA lesions were typically presented as red or brown papules or nodules with well-defined borders, ranging in diameter from 3 mm to 2 cm. Histopathological examination showed that the tumor manifested as psoriasiform or papillary hyperplasia with a thickened spinous layer and a distinct boundary surrounded by the normal skin; proliferating cells were larger with lightly stained cytoplasm; neutrophil infiltration was observed in the epidermis, and vascular dilation was observed in the dermal papillae and superficial dermis; periodic acid-Schiff staining revealed abundant glycogen in the cells. In 10 patients examined by dermoscopy, dotted, globular, or glomerular vessels were arranged in a beaded pattern in all the 10 patients, and collar-like scales were seen at the edges of the lesions in 6 patients. In 6 patients examined by RCM, RCM images all revealed epidermal hyperplasia, thickened spinous layers, large keratinocytes with enlarged nuclei and abundant cytoplasm that blended in with the intercellular demarcations, disordered honeycomb structure of the epidermis, and dilation and up-thrust of blood vessels in the dermal papillae and superficial dermis; segmented cell infiltration was observed in the epidermis of 4 patients. As measured, the longest diameters of cells in the upper part of the CCA spinous layer ranged from 30.25 μm to 35.13 μm; the longest diameters of spinous layer cells at the CCA follicles (19.39 ± 2.93 μm) were significantly lower than those of the surrounding spinous layer cells (30.95 ± 5.66 μm, t = 5.73, P < 0.001) . Conclusions:CCA presents a distinctive vascular pattern on dermoscopy, and the majority of histological features can be visualized by RCM. Dermoscopy and RCM can be relatively reliable auxiliary diagnostic methods for CCA.

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.

Objective:To construct and verify a prediction and evaluation model based on dual-energy computed tomography(CT)radiomics for lymph node metastasis in gastric cancer,so as to provide more accurate and reliable method before lymph node in gastric cancer occurs metastasis.Methods:A total of eighty patients with gastric cancer admitted to Handan Central Hospital from January 2021 to December 2024 were retrospectively selected,and they were divided into a modeling group(48 cases)and a verification group(32 cases)using a random number table method according to a ratio of 3 to 2.The influencing factors were analyzed,and predictive model was constructed and verified by using univariate and binary logistics regression.The patients'general information,tumor size,differentiation degree,lesion location,and carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199)and carcinoembryonic antigen(CEA)were compared between two groups.Results:There were not significant differences in age,gender,body mass index(BMI),tumor size,degree of differentiation,lesion location in the modeling group(P>0.05).In the modeling group,the immunity concentration(IC)was(20.66±2.85)μg/mL,and normal immunity concentration(nIC)was(0.45±0.06)μg/mL,and the slope was(3.52±0.30).The three indicators were respectively(21.09±3.25)μg/mL,(0.47±0.05)μg/mL,(3.49±0.42)in verification group.There were significant differences in the three indicators among two groups(t=3.277,5.287,2.918,P<0.05).There were not significant differences in the tumor-related detection indicators between two groups(P>0.05).The results of binary logistics regression analysis showed that IC,nIC,and slope were influential factors in lymph node metastasis of gastric cancer(OR=2.564,1.647,1.786,P<0.05).The constructed prediction model by using Python Scikit-learn showed favorable appearance in the calibration curve with a slope closed to 1,which indicated a high degree of consistency between predicted risks and actual risks.Receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)of the modeling group was 0.896(95%CI:0.8154～0.9167),and the sensitivity and specificity were respectively 84.60%and 80.69%.The above three indicators were respectively 0.853(95%CI:0.7982～0.8671),86.66%and 80.00%in the verification group.Conclusion:A prediction and evaluation model for lymph node metastasis of gastric cancer based on dual-energy CT radiomics is successfully constructed,and its predictive efficiency and clinical application value are verified.

Objective To evaluate the effectiveness of WeChat group integrating with BOPPPS instructional model in the standardized training of nurses in an orthopedics department.Methods A total of 56 nurses in orthopedical standardized training from a hospital were selected and divided into a control group(28 nurses from September 2022 to August 2023)and an interven-tion group(28 nurses trained via WeChat groups and the BOPPPS model from September 2023 to August 2024).The two groups were compared in terms of their final assessment scores,critical thinking,and self-directed learning capabilities.Results After training,the intervention group had significantly higher scores in the final assessment,all items of the California Critical Thinking Disposition Inventory,and all dimensions of the Learning Ability Assessment Scale compared to the control group(all P＜0.05).Conclusion WeChat groups combined with the BOPPPS teaching mode effectively improves the self-directed learning ability,critical thinking skills,and assessment results of orthopedic nurses.

Objective:To investigate the imaging characteristics of clear cell acanthoma (CCA) by dermoscopy and reflectance confocal microscopy (RCM) .Methods:A retrospective analysis was conducted on 12 patients diagnosed with CCA through histopathological examination at the Department of Dermatology, Wuhan No.1 Hospital, from 2020 to 2024. Dermoscopic and RCM features of these cases were summarized.Results:Among the 12 CCA patients, 3 were males and 9 were females, and they were aged 50.08 ± 10.43 years. Clinically, CCA lesions were typically presented as red or brown papules or nodules with well-defined borders, ranging in diameter from 3 mm to 2 cm. Histopathological examination showed that the tumor manifested as psoriasiform or papillary hyperplasia with a thickened spinous layer and a distinct boundary surrounded by the normal skin; proliferating cells were larger with lightly stained cytoplasm; neutrophil infiltration was observed in the epidermis, and vascular dilation was observed in the dermal papillae and superficial dermis; periodic acid-Schiff staining revealed abundant glycogen in the cells. In 10 patients examined by dermoscopy, dotted, globular, or glomerular vessels were arranged in a beaded pattern in all the 10 patients, and collar-like scales were seen at the edges of the lesions in 6 patients. In 6 patients examined by RCM, RCM images all revealed epidermal hyperplasia, thickened spinous layers, large keratinocytes with enlarged nuclei and abundant cytoplasm that blended in with the intercellular demarcations, disordered honeycomb structure of the epidermis, and dilation and up-thrust of blood vessels in the dermal papillae and superficial dermis; segmented cell infiltration was observed in the epidermis of 4 patients. As measured, the longest diameters of cells in the upper part of the CCA spinous layer ranged from 30.25 μm to 35.13 μm; the longest diameters of spinous layer cells at the CCA follicles (19.39 ± 2.93 μm) were significantly lower than those of the surrounding spinous layer cells (30.95 ± 5.66 μm, t = 5.73, P < 0.001) . Conclusions:CCA presents a distinctive vascular pattern on dermoscopy, and the majority of histological features can be visualized by RCM. Dermoscopy and RCM can be relatively reliable auxiliary diagnostic methods for CCA.

Purpose To investigate the expression of chromogranin A(CgA)in gastroenteropancreatic neuroendo-crine neoplasms(GEP-NENs)and its relationship with clinicopathological features.Methods The clinicopathological data of GEP-NENs diagnosed in the Department of Pathology,Beijing Chao-yang Hospital,Capital Medical University from May 2011 to December 2024 were retrospectively analyzed.Immunohistochemical staining was applied to evaluate the expression of CgA,and the patients were divided into CgA(+)group and CgA(-)group.Differences in clinico-pathological features between the 2 groups were compared.Results The age of 229 patients ranged from 21 to 89 years,with an average age of 54.4 years.The most common primary site was the rectum(56.8％,130/229),fol-lowed by the stomach(16.6％,38/229),pancreas(14.4％,33/229),small intestine(6.1％,14/229),and colon(6.1％,14/229).There were 206 cases of single lesion and 23 cases of multiple lesions(number of tumors ≥2).There were 153 cases of G1(66.8％),29 cases of G2(12.7％),7 cases of G3(3.1％),and 40 cases of neuroendocrine carcinoma(NEC,17.5％).The positive rates of CgA in G1,G2,G3,and NEC groups were 37.2％,75.8％,71.4％,and 65.0％,respectively,with statistically significant differences(P＜0.001).The positive rates of CgA in T1,T2,T3,and T4 were 37.2％,83.3％,75.9％,and 57.7％,respectively,with statistically significant differences(P＜0.001).There were significant differences in age,vascular invasion,lymph node metasta-sis,and number of tumors between CgA(+)group and CgA(-)group(P＜0.001),but there was no significant difference in sex,tumor location,Syn,and CD56 expression between the two groups(P=0.595,P=0.098,P=0.173,P=0.557).Conclusion Immunohistochemical antibody CgA is a useful marker for GEP-NENs.CgA positiv-ity may be a poor prognostic factor for GEP-NENs patients.