Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease(COPD)patients,and to provide a basis for constructing a full cycle precision rehabilitation management system.Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1,2024,using convenience sampling.Their active exercise rehabilitation behaviour(number of exercise projects,duration)and related symptoms(dyspnea,fatigue,anxiety)were continuously monitored for a week by using baseline survey,daily active exercise rehabilitation behavior assessment questionnaire,daily symptom assessment questionnaire.A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms.Results 58 patients were included.During the 1-week ecological momentary assessment,the system triggered a total of 1,218 momentary assessments and obtained 1,120 valid responses(with the valid response rate of 91.95％),with patients completing an average of(2.76±0.39)assessments per day.Multilevel linear models showed that momentary dyspnoea,fatigue,anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour(P＜0.05).Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients.Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations,strengthen patient self-management efficiency through dynamic monitoring and hierarchical management,and achieve long-term optimization of lung rehabilitation effects.

Aim To perform high-throughput screen-ing of immunomodulatory traditional Chinese medicine(TCMs)based on an in vitro B cell differentiation-antibody secretion model,identifying active herbal candidates with immune-enhancing properties to pro-vide novel therapeutic options and theoretical support for influenza virus treatment in immunocompromised in-dividuals.Methods B cells were stimulated with dif-ferent concentrations of cytosine-phosphate-guanine oli-godeoxynucleotide 2006(CpG)and nterleukin-2(IL-2)to promote proliferation,differentiation,and anti-body secretion,and the effects of varying concentra-tions of the solvent DMSO were also evaluated.The op-timal conditions for the B cell differentiation-anti-body secretion model were determined based on the se-cretion levels of three antibody isotypes.The feasibility of the model was further validated using rapamycin,a known B cell function inhibitor.On this basis,a high-throughput screening platform for immunomodulatory a-gents was optimized and established.Subsequently,the immune-enhancing activity of 465 polarity extract from TCMs was evaluated.Results The optimal con-ditions for the model were determined as 2 mg·L-1 CpG,1.67 × 106 nkat·L-1 IL-2,and DMSO with a volume fraction of 0.1％.Rapamycin effectively inhib-ited B cell differentiation into plasmablast and signifi-cantly reduced antibody production,indicating the reli-ability of the model.Multiple rounds of screening re-vealed that the dichloromethane extract of licorice,the dichloromethane extract of Vinegar-processed Curcumae Rhizoma,the cyclohexane extract of Honey-prepared Radix Asteris,and the aqueous extract of Siphonostegia chinensis Benth were identified to significantly promote both B cell proliferation and differentiation and anti-body secretion at a concentration of 600 μg·L-1.Conclusion This study successfully optimizes an in vitro B cell differentiation-antibody secretion model and identifies several TCM extracts,including licorice,with potential immune-enhancing activity.

Objective To systematically evaluate malnutrition risk factors in diabetic foot patients through systematic review and inform evidence-based nutritional interventions.Methods A top-down search of the literature on risk factors for malnutrition in patients with diabetic foot was conducted according to the"6S"pyramid model,using a computerized decision-making system,clinical guideline websites,professional association websites and databases,with a timeframe of up to March 2025 for the search.Totally 2 researchers independently performed literature screening,quality assessment,and data extraction.Meta-analysis was conducted using Stata 18 software.Results Totally 23 studies with a total sample size of 5 068 cases were included.There were 10 influencing factors being extracted,including age(OR=2.709),BMI(MD=0.709),duration of diabetes mellitus(OR=2.589),glyco-sylated hemoglobin(OR=2.190),albumin(MD=0.578),hemoglobin(OR=2.948),infection(OR=1.816),C-reactive protein(OR=2.228),Wagner classification of diabetic foot(OR=4.620)and degree of self-care(OR=0.220).The incidence of malnutrition in DFU patients who were assessed by the MNA-SF tool,the MNA tool and GLIM tool were 52.2％,70.2％and 41.4％.Conclusion The incidence of malnutrition in DFU patients is relatively high.Healthcare providers should continuously monitor the nutritional status of diabetic foot patients and implement personalized intervention plans to prevent malnutrition.

AIM To investigate the effects of Rutong Ruanjian Tablets on angiogenesis in cancer tissues of rats with preneoplastic breast cancer(PBC).METHODS 60 female SD rats were randomly divided into a blank group of 10 rats and a model group of 50 rats for the establishment of the PBC models of Liver-Qi Stagnation and Blood Stasis Pattern with 9 weeks of oral administration of 7,12-dimethylbenz[a]anthracene(DMBA)and cervical ligation.After successful modeling,the rats were randomly divided into the model group,the tamoxifen group(3.2 mg/kg),the Rutong Ruanjian Tablets group(128 mg/kg),the 3,5-difluorobenzoyl group(DAPT,5 mg/kg),and the Rutong Ruanjian Tablets(128 mg/kg via gavage)+DAPT(5 mg/kg intraperitoneal injection)group,for 1 month corresponding drug administration,with 10 rats in each group.Then the rats had their cancer progression and syndrome scores observed;their angiogenesis evaluated by assessment of microvascular density(MVD);their vascular endothelial growth factor(VEGF)expression assessed by immunohistochemistry;and their mRNA and protein expressions of proteins related to the DLL4/Notch1/Hes1 pathway measured using RT-qPCR,immunohistochemistry and Western blot.RESULTS During carcinogenesis of rats induced by DMBA,there was gradual disappearance of E-cadherin expression and consistency of HE staining result with the PBC progression confirming the success of the modeling.Compared with the blank group,the model group showed increased MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).Compared with the model group,the Rutong Ruanjian Tablets group exhibited reduced MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).The Rutong Ruanjian Tablets+DAPT group showed reduced mRNA expression of Notch1 and Hes1,and protein expressions of DLL4,Notch1 and Hes1 compared to the Rutong Ruanjian Tablets group(P＜0.05,P＜0.01).CONCLUSION Rutong Ruanjian Tablets can inhibit angiogenesis and attenuate cancer progression in PBC rats of Liver-Qi Stagnation and Blood Stasis Pattern,and the mechanism may lie in the downregulation of DLL4/Notch1/Hes1 signaling pathway related proteins.

Aim To perform high-throughput screen-ing of immunomodulatory traditional Chinese medicine(TCMs)based on an in vitro B cell differentiation-antibody secretion model,identifying active herbal candidates with immune-enhancing properties to pro-vide novel therapeutic options and theoretical support for influenza virus treatment in immunocompromised in-dividuals.Methods B cells were stimulated with dif-ferent concentrations of cytosine-phosphate-guanine oli-godeoxynucleotide 2006(CpG)and nterleukin-2(IL-2)to promote proliferation,differentiation,and anti-body secretion,and the effects of varying concentra-tions of the solvent DMSO were also evaluated.The op-timal conditions for the B cell differentiation-anti-body secretion model were determined based on the se-cretion levels of three antibody isotypes.The feasibility of the model was further validated using rapamycin,a known B cell function inhibitor.On this basis,a high-throughput screening platform for immunomodulatory a-gents was optimized and established.Subsequently,the immune-enhancing activity of 465 polarity extract from TCMs was evaluated.Results The optimal con-ditions for the model were determined as 2 mg·L-1 CpG,1.67 × 106 nkat·L-1 IL-2,and DMSO with a volume fraction of 0.1％.Rapamycin effectively inhib-ited B cell differentiation into plasmablast and signifi-cantly reduced antibody production,indicating the reli-ability of the model.Multiple rounds of screening re-vealed that the dichloromethane extract of licorice,the dichloromethane extract of Vinegar-processed Curcumae Rhizoma,the cyclohexane extract of Honey-prepared Radix Asteris,and the aqueous extract of Siphonostegia chinensis Benth were identified to significantly promote both B cell proliferation and differentiation and anti-body secretion at a concentration of 600 μg·L-1.Conclusion This study successfully optimizes an in vitro B cell differentiation-antibody secretion model and identifies several TCM extracts,including licorice,with potential immune-enhancing activity.

Objective:To compare the the cultivation effects of human embryos in dry and humid incubators.Methods:A total of 479 infertile patients who underwent in vitro fertilization (IVF) treatment at Reproductive Center of Guiyang Maternal and Child Health Care Hospital from October 2020 to April 2022. The study was divided into two stages. The first stage of the study was a self-comparative research with 95 cases from the same period and source. The embryos were divided into dry and humid incubator groups to compare the embryo development indicators. In the second stage of the study, the patients were divided into six groups, including 10 μL humid incubator group ( n=64), 20 μL humid incubator group ( n=64), 30 μL humid incubator group ( n=64), 10 μL dry incubator group ( n=64), 20 μL dry incubator group ( n=64), and 30 μL dry incubator group ( n=64). The general clinical data, embryo development indicators, pregnancy outcomes, and the osmotic pressure and pH values of each group at 24 h, 48 h and 72 h were detected and compared. Results:After cultivation of the same patient's embryos in dry and humid incubator, the total blastocyst formation rate [62.3% (162/260)] and high-quality blastocyst rate [24.6% (64/260)] in dry incubator were lower than those in the humid incubator [71.6% (252/352), P=0.015; 32.1% (113/352), P=0.043]. Compared with the other microdroplet groups, the osmotic pressure of cleavage culture medium in 10 μL group of dry incubator at 48 h and 72 h and blastocyst culture medium were significantly increased, the differences among the groups were significant (cleavage culture medium, all P<0.001; blastocyst culture medium, P=0.006, P=0.008). There was no significant difference in pH value among different microdroplet volume groups at the same period (all P>0.05). There were no significant differences in general data among the different microdroplet groups (all P>0.05). Compared with the other microdroplet groups, 10 μL dry incubator group exhibited significantly lower transferable embryo rate (all P<0.001). When compared with 20 μL and 30 μL groups in both dry and humid incubators, 10 μL dry incubator group showed a lower day 5 blastocyst formation rate, lower total blastocyst formation rate, and lower high-quality blastocyst formation rate, the differences among the groups were significant (all P<0.05). There were no significant differences in the number of transferred embryos, the ratio of cleavage-stage embryos and the ratio of high-quality embryos among different groups (all P>0.05). Compared with the other microdroplet groups, the clinical pregnancy rate, the embryo implantation rate, the live birth rate of fresh transplanted embryos and the cumulative pregnancy rate in 10 μL group in the dry incubator decreased, and the miscarriage rate increased, but all were not significant (all P>0.05). Conclusion:Compared with humid incubators, there are no significant differences in embryo development and pregnancy outcomes for droplet volumes of 20 μL or above in dry incubators. However, the 10 μL microdroplet culture in the dry incubator is not conducive to embryonic development, which may be related to the increased osmotic pressure of the microdroplet.

Objective:To investigate the effect of risk forewarning hierarchical management on mental state,major adverse cardiovascular events(MACE)and quality of life in patients with acute coronary syndrome after percutane-ous coronary intervention(PCI).Methods:This randomized controlled study enrolled 152 patients with acute coro-nary syndrome who underwent PCI in the First Hospital of Qinhuangdao between July 2021 and June 2023.Patients were randomly divided into control group(n=76,conventional intervention program)and intervention group(n=76,additional risk forewarning hierarchical management).After 3-month intervention,mental state[Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)scores],health literacy[perceived knowledge scale for coronary heart diseases(PKS-CHD)score],quality of life[Seattle angina questionnaire(SAQ)score]and in-cidence of MACE were compared between the two groups.Results:Compared to those in the control group,patients in the intervention group had significantly higher total score of PKS-CHD[(35.08±3.59)points vs.(30.53±3.85)points],SAQ dimensional scores of physical limitation[(15.24±1.73)points vs.(13.26±1.45)points],an-ginal stability[(16.84±1.39)points vs.(15.18±1.48)points],disease perception[(17.00±1.46)points vs.(14.34±1.93)points],anginal frequency[(18.55±1.18)points vs.(16.11±1.39)points]and treatment satis-faction[(17.12±1.45)points vs.(14.04±1.93)points](P＜0.001 all),and significantly lower HAMA score[(11.89±1.64)points vs.(13.55±1.56)points],HAMD score[(12.61±1.76)points vs.(16.42±1.92)points]and the incidence of MACE(8.00％vs.28.38％)(P＜0.001 all).Conclusion:Risk forewarning hierarchical man-agement may effectively relieve patients'negative emotions,improve their health literacy and quality of life,and significantly reduce the risk of MACE in patients with acute coronary syndrome after PCI.

Aim To explore the mechanism of action of Guizhi Jia Gegen decoction(GGD)in treating pneu-monia-enteritis induced by H1N1 influenza virus infec-tion in a mouse model,using network pharmacology and molecular docking techniques,followed by in vivo verification.Methods A pneumonia-enteritis mouse model was established,and the intervention effects of GGD on the model mice were evaluated using indica-tors such as body weight,rectal temperature,lung in-dex,colon length,H1N1 M gene expression,relative mRNA expression levels of inflammatory cytokines,and pathological sections of the lung and intestine.The targets of the blood-absorbed components of GGD were identified using the Swiss Target Prediction platform,and the disease targets were retrieved from the Gene-Cards platform.The intersecting targets were analyzed through PPI network analysis using the STRING data-base to identify core targets.GO analysis and KEGG pathway enrichment analysis were performed using the Metascape database.RT-qPCR was employed to vali-date the core targets and pathways.Molecular docking was conducted using AutoDock Tools software to verify the interactions between blood-absorbed components and key targets.Results GGD demonstrated signifi-cant therapeutic effects on the pneumonia-enteritis mouse model.The results of network pharmacology in-dicated that the therapeutic effects of GGD were strong-ly associated with targets such as TNF,ALB,PTGS2,MMP9,EGFR,ESR1,SRC,HSP90AA1,PPARG and MMP2.RT-qPCR results indicated that GGD could intervene in pneumonia-enteritis by regulating the targets TNF,ALB,EGFR and the related targets of the NF-κB pathway.Molecular docking results re-vealed that blood-absorbed components such as puerar-in and liquiritin could stably bind to TNF,ALB and EGFR.Conclusion Components such as puerarin and liquiritin in GGD may exert therapeutic effects on pneumonia-enteritis induced by H1N1 influenza virus infection by acting on targets such as TNF,ALB and EGFR.

BACKGROUND:Percutaneous retrograde screws and minimally invasive percutaneous plates are extensively used in the treatment of unilateral pubic ramus fractures.However,the above internal fixations have the disadvantages of mistakenly penetrating the hip joint and damaging the medial pelvic trophoblastic artery.A new type of retrograde superior pubic ramus intramedullary nail offers advantages,such as fewer radiographic exposures and shorter surgery times,but the validation of the biomechanical properties of the three endoprostheses is lacking.OBJECTIVE:To compare the biomechanical differences post-treatment of upper and lower pubic ramus fractures using percutaneous retrograde screws,minimally invasive percutaneous plates,and retrograde superior pubic ramus intramedullary nail under various conditions through finite element analysis.METHODS:Pelvic CT data were collected from one volunteer and imported into Mimics 20,Geomagic Wrap 2021,and SolidWorks 2019 to create geometric models of three types of internal fixation for treating unilateral pubic ramus fractures:hollow screw group,plate group,and intramedullary nail group.Each model was imported into Ansys 2022 software,where it was set up in vertical,book-opening,and shear conditions for preprocessing and calculation to compare and analyze the mechanical stability of the implants.RESULTS AND CONCLUSION:(1)In vertical conditions,the biomechanical stability of the hollow screw treatment for unilateral pubic fractures was superior to that of the steel plate and intramedullary nail,with the smallest peak stress in the implant,which was four times lower compared to the other two groups.(2)In book-opening conditions,the steel plate treatment for unilateral pubic fractures showed better biomechanical stability,particularly in reducing stress at the fracture ends of the upper pubic branch,with stress values five times higher in the other two groups.(3)In shear conditions,the intramedullary nail treatment for unilateral pubic fractures exhibited good biomechanical stability,maintaining the best pelvic displacement,with a 25％greater displacement observed in the other two groups.(4)These findings reveal the biomechanical differences of different implants:the peak stress of implants is the smallest under vertical working conditions with percutaneous retrograde screws.Minimally invasive percutaneous plates reduce the stress at the broken end of superior pubic branch under open-book working condition.Retrograde superior pubic ramus intramedullary nail of superior pubic branch maintains pelvic displacement under shear working condition.The surgeon can combine the biomechanical differences of the implants with the actual situation of pubic injury in clinical practice to make the best implant treatment.

Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease(COPD)patients,and to provide a basis for constructing a full cycle precision rehabilitation management system.Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1,2024,using convenience sampling.Their active exercise rehabilitation behaviour(number of exercise projects,duration)and related symptoms(dyspnea,fatigue,anxiety)were continuously monitored for a week by using baseline survey,daily active exercise rehabilitation behavior assessment questionnaire,daily symptom assessment questionnaire.A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms.Results 58 patients were included.During the 1-week ecological momentary assessment,the system triggered a total of 1,218 momentary assessments and obtained 1,120 valid responses(with the valid response rate of 91.95％),with patients completing an average of(2.76±0.39)assessments per day.Multilevel linear models showed that momentary dyspnoea,fatigue,anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour(P＜0.05).Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients.Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations,strengthen patient self-management efficiency through dynamic monitoring and hierarchical management,and achieve long-term optimization of lung rehabilitation effects.