ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

Objective To observe the effect of mild moxibustion at"Qihai","Guanyuan"and"Zhongji"on GnRH and its receptor in rats with gynecological cold coagulation and blood stasis syndrome(CCBS);To explore the mechanism of moxibustion on reproductive function of gynecological CCBS.Methods Totally 48 female SD rats were randomly divided into blank group,model group,moxibustion group,inhibitor group,inhibitor+moxibustion group and angonist group,with 8 rats in each group.The gynecological CCBS model was prepared by ice bath and adrenalin injection.GnRHant or GnRHa injection and mild moxibustion intervention were given to each treatment group.The score of CCBS symptoms and the amount of microcirculation blood perfusion in uterus were detected,the morphology of ovarian tissue and uterine tissue were observed by HE staining,serum reproductive hormones(GnRH,FSH,LH)and neurotransmitters(DA,GABA)contents were detected by ELISA,the expressions of GnRHR,FSHR and LHR mRNA and protein in ovarian and uterine tissue were detected by immunohistochemistry,RT-qPCR and Western blot.Results Compared with the blank group,the symptom score of CCBS in model group was significantly increased,the amount of microcirculation blood perfusion in uterus was decreased,the ovarian follicles were decreased,and the endometrial epithelium was thinner and the structure was chaotic,the contents of serum GnRH,FSH,LH,GABA decreased,DA content increased;the mRNA and protein expressions of GnRHR,FSHR and LHR in ovarian tissue decreased(P<0.01).Compared with the model group,the symptom score of CCBS in each intervention group were significantly decreased,the amount of microcirculation blood perfusion in uterus increased,ovarian follicles increased,endometrium thickened and glands increased,the contents of serum GnRH,FSH,LH,GABA increased,DA content decreased;the mRNA and protein expressions of GnRHR,FSHR and LHR were increased(P<0.05,P<0.01).Conclusion Moxibustion can regulate GnRH and its receptor and improve HPO axis function by regulating neurotransmitters,so as to improve the general state and reproductive function of gynecological CCBS model rats.

ObjectiveTo investigate the effect of Naoqingtong decoction （NQT） on the kidney damage and the inflammatory factors NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain （ASC）， cysteinyl aspartate-specific proteinase-1 （Caspase-1）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in spontaneously hypertensive rats （SHRs）. MethodsTwenty-four SHRs were randomized into a model group， a low-dose （12.9 g·kg^-1·d^-1） NQT （NQT-L） group， a high-dose （25.8 g·kg^-1·d^-1） NQT group （NQT-H）， and a captopril （CTP， 20 mg·kg^-1·d^-1） group， with 6 rats in each group. In addition， 6 homozygous male Wistar-Kyoto rats were used as the control group. The control and model groups were administrated with the same amount of normal saline by gavage for 8 weeks. General behaviors of rats were observed during the intervention period， and the blood pressure was measured periodically. At the end of intervention， the body mass was weighed， and both kidneys were collected and weighed for the calculation of the renal index. Hematoxylin-eosin staining was performed to observe the pathological changes in the kidney tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue. ResultsDuring the experiment period， the control group had normal mental status， food intake， and activity， while the model group showed thinning of hair， loss of luster， reduced activity， loss of appetite， fecal adhesion， and irritability， and some of the skin had scratches or blood scabs. The above symptoms were alleviated to different degrees after 8 weeks of NQT administration. An intelligent non-invasive sphygmomanometer was used to measure the tail artery pressure of rats， which showed that the systolic and diastolic blood pressure of rats in the model group was higher than that in the control group （P<0.01）. Compared with the model group， drug interventions lowered the systolic and diastolic blood pressure （P<0.05， P<0.01）. Compared with the control group， the model group showed severe pathological damage in the kidney tissue， which was alleviated in each drug intervention group. Compared with the control group， the model group showed up-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. Compared with the model group， the drug intervention groups showed down-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. ConclusionNQT can lower the blood pressure in SHRs by inhibiting the activation of NLRP3 inflammasomes， suppressing renal inflammation， and ameliorating hypertensive kidney damage.

Acute Gelsemium poisoning is a systemic disease primarily affecting the central nervous system and respiratory symptoms caused by the ingestion of a substantial amount of Gelsemium within a short period. It manifests as sudden onset and rapid progression, primarily caused by accidental ingestion due to misidentification, and posing significant health risks. The compilation of the Technical Plan for Emergency Health Response to Acute Gelsemium Poisoning describes in detail the specialized practice and technical requirements in the process of handling acute Gelsemium poisoning, including accident investigation and management, laboratory testing and identification, in-hospital treatment, and health monitoring. The guidelines clarify key procedures and requirements such as personal protection, investigation elements, etiology determination, medical rescue, and health education. The key to acute Gelsemium poisoning investigation lies in promptly identifying the toxin through exposure history, clinical manifestations, and sample testing. Because there is no specific antidote for Gelsemium poisoning, immediate removal from exposure, rapid elimination of the toxin, and respiratory monitoring are critical on-site rescue measures. Visual identification of food or herbal materials, followed by laboratory testing to determine Gelsemium alkaloids in samples is a rapid effective screening method. These guidelines offer a scientific, objective, and practical framework to support effective emergency responses to acute Gelsemium poisoning incidences.

Objective To analyze the value of 18F-fluorodeoxyglucose(18F-FDG)PET/CT in differentiating benign and malignant lymphadenopathy in children,adolescents,and young adults.Methods The clinical and 18F-FDG PET/CT data of 40 children,adolescent and young adult patients with lymphadenopathy as the initial diagnosis who underwent 18F-FDG PET/CT were retrospectively collected.The imaging features and parameters of 18F-FDG PET/CT were analyzed,and receiver operating characteristic(ROC)curves were plotted to evaluate its diagnostic value.Results Of the 40 patients,21 had malignant lymphadenopathy and 19 had benign lymphadenopathy.18F-FDG PET/CT showed that the distribution of lymph nodes in the body was mainly divided into the following two categories:widespread/scattered distribution or localized distribution.However,mediastinal lymph nodes in the benign patients were usually not or less involved.In addition,the maximum diameter and maximum short diameter of malignant lymph nodes were significantly higher than those of benign(Z=-4.189,-4.190,all P＜0.001),while there was no statistically significant difference in the maximum standardized uptake value(SUVmax)(Z=-1.882,P＞0.05).ROC curve analysis showed that the best cutoff values of the maximum diameter and maximum short diameter of lymph nodes for differentiating benign and malignant lymphadenopathy were 24.5 mm and 16.5 mm,with the area under the curve(AUC)of both 0.887,sensitivities of 95.2％and 90.5％,and specificities of 78.9％and 73.7％,respectively.Conclusion The distribution characteristics of lymph nodes on 18F-FDG PET/CT,as well as the maximum diameter and maximum short diameter of lymph nodes in imaging parameters,are helpful in distinguishing benign and malignant lymphadenopathy in children,adolescents,and young adults.

Objective:To analyze the efficacy and safety of 3D-printing-assisted anterolateral thigh perforator flap surgery for the treatment of complex soft tissue defects around the ankle joint.Methods:A total of 160 patients with skin and soft tissue defects around the ankle joint at the First People′s Hospital of Xiaoshan District, Hangzhou, from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a control group and an observation group according to the surgical approach, with 80 patients in each group. The control group underwent traditional anterolateral thigh perforator flap surgery, which included 43 males and 37 females, with an age of 21-62 (34.7±5.6) years. The observation group underwent 3D-printing-assisted anterolateral thigh perforator flap surgery, which included 45 males and 35 females, with an age of 20-66 (34.8±5.6) years. The operative time, flap healing time, and hospital stay duration were compared between the two groups. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF-α) were compared between the two groups before surgery and 3 days postoperatively. The ankle joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, the range of motion (ROM) was assessed using the ROM score, and the flap sensation was evaluated using the modified Highet grading system before surgery, 6 months postoperatively, and at the last follow-up. The incidence of adverse reactions such as arterial crisis, venous crisis, infection, and necrosis during the perioperative period was observed. Patient satisfaction was assessed 6 months after treatment.Results:All patients in both groups successfully completed the surgery, with no cases excluded. The operative time, flap healing time, and hospital stay duration were significantly shorter in the observation group than those in the control group (all P<0.001). Compared with preoperative levels, the levels of IL-6, IL-8, CRP, and TNF-α were significantly reduced in both groups 3 days postoperatively (all P<0.001), and these levels were significantly lower in the observation group than those in the control group at 3 days postoperatively (all P<0.001). Six months postoperatively and at the last follow-up, the AOFAS and ROM scores were significantly higher in the observation group than those in the control group (all P<0.05), and the flap sensation grading was significantly better in the observation group than that in the control group (all P<0.05). The incidence of adverse reactions was 7.5% (6/80) in the observation group, which was significantly lower than 18.8% (15/80) in the control group ( P=0.024). The patient satisfaction rate was 95.0% (76/80) in the observation group, which was significantly higher than 72.5% (58/80) in the control group ( P<0.001). Conclusion:3D-printing-assisted anterolateral thigh perforator flap repair for skin and soft tissue defects around the ankle joint can improve perioperative indicators, reduce the incidence of postoperative adverse reactions, promote the recovery of flap sensation and ankle function, attenuate the inflammatory response of the body, and enhance patient satisfaction.

This study aims to investigate the mechanisms underlying the effects of the combined ac-tion of high-fat diet-induced obesity and the aflatoxin B1(AFB1)on hepatic oxidative stress and inflammatory responses.Thirty-six rats of similar weight and 4 weeks old were randomly divided into 4 groups,with 9 rats in each group:the blank control group(basal diet),the AFB1 group(0.4 mg/kg AFB1+basal diet),the HFD group(high-fat diet),and the HFD+AFB1 group(high-fat diet+0.4 mg/kg AFB1).Histological changes and lipid deposition were observed via hematox-ylin-eosin(HE)staining and Oil Red O staining.Levels of oxidative stress and inflammation-relat-ed factors were measured using commercial assay kits.The relative protein expression levels of factors involved in the Nrf2-Keap1 signaling pathway were assessed by Western blot analysis.The HE staining results showed that in the AFB1 group,the liver cells exhibited widespread watery de-generation,with shrunk and ruptured nuclei,inflammatory cells infiltration,and increased fibrosis.In the HFD group,liver cell fatty degeneration was observed,with cytoplasmic lipid droplet infil-tration.In the portal area,liver fibrosis was seen,with liver cell necrosis and inflammatory cell in-filtration in the fibrotic area,accompanied by lipofuscous granules.When HFD was applied to the AFB1 group,the abnormal state of liver interstitial and interstitial spaces was further aggravated,and a large number of lipid droplets appeared.The Oil Red O staining results showed that there were large numbers of dark red lipid droplets in the liver tissue of the HFD group,which were fused in strands.In the AFB1 group,lipid droplets could also be observed in the liver tissue of rats,but the number and degree were significantly less than those in the HFD group.The number and degree of red lipid droplets in the liver tissue of rats in the HFD+AFB1 group were higher than those in the AFB1 group and the HFD group.HFD exacerbated AFB1-induced oxidative stress by elevating ROS,MDA levels,and decreasing the expression of antioxidant stress factors such as CAT,SOD,Nrf2,HO-1,NQO1,and GCLC.Furthermore,the combined effect of HFD and AFB1 further significantly increased the levels of pro-inflammatory cytokines IL-2,IL-6,TNF-α,and IL-1β in the body.In summary,HFD treatment significantly exacerbated liver oxidative stress and in-flammatory responses in rats exposed to AFB1 through the Nrf2-keap1 signaling pathway.

Thyroid nodules are a common endocrine disorder with complex pathogenesis that remains incompletely understood. In recent years, studies have revealed that the gut microbiota may play a critical role in the occurrence and progression of thyroid nodules. This review systematically summarizes the current research progress on the association between gut microbiota and thyroid nodules, with a particular focus on potential mechanisms through which gut dysbiosis influences nodule formation via immune regulation, metabolic pathways, and gut barrier function. Evidence suggests that reduced gut microbial diversity, decreased abundance of specific beneficial bacteria, and an increased proportion of pro-inflammatory bacteria may contribute to a pro-inflammatory environment and metabolic disturbances associated with thyroid nodules. Furthermore, this review explores the potential of interventions such as probiotics, prebiotics, dietary modifications, and fecal microbiota transplantation in modulating gut microbiota and improving thyroid nodule outcomes. Although direct clinical evidence is currently lacking, the regulation of gut microbiota has emerged as a promising direction for the diagnosis and treatment of thyroid nodules, demonstrating significant clinical potential. Future efforts should focus on advancing basic and clinical research strategies to facilitate the translational application of findings in this field.