Ulcerative colitis（UC） is a chronic non-specific inflammatory bowel disease characterized by inflammation and ulceration of the colonic mucosa and submucosa， and its complex pathogenesis involves immune abnormality， oxidative stress and other factors. The nuclear transcription factor E₂-related factor 2（Nrf2）， encoded by the Nfe212 gene， plays a central role in antioxidant responses. It not only activates various antioxidant response elements such as heme oxygenase-1（HO-1） and quinone oxidoreductase 1（NQO1）， but also enhances the activity of glutathione-S-transferase（GST） and superoxide dismutase 1（SOD1）， effectively eliminating reactive oxygen species（ROS） accumulated in the body， and mitigating oxidative stress-induced damage to intestinal mucosa. In addition， Nrf2 can reduce the release of inflammatory factors and infiltration of immune cells by regulating immune response， cell apoptosis and autophagy pathways， thereby alleviating intestinal inflammation and promoting the repair and regeneration of damaged mucosa. Based on this， this paper reviews the research progress of Chinese materia medica in the prevention and treatment of UC by modulating the Nrf2 signaling pathway. It deeply explores the physiological role of Nrf2， the molecular mechanism of activation， the protective effect in the pathological process of UC， and how active ingredients in Chinese materia medica regulate the Nrf2 signaling pathway through multiple pathways to exert their potential mechanisms. These studies have revealed in depth that Chinese materia medica can effectively combat oxidative stress by regulating the Nrf2 signaling pathway. It can also play a role in anti-inflammatory， promoting autophagy， inhibiting apoptosis， protecting the intestinal mucosal barrier， and promoting intestinal mucosal repair， providing new ideas and methods for the multi-faceted treatment of UC.

Objective To explore the relationship between education level and the risk of all-cause mortality in the middle-aged and elderly (≥45 years old) population in China. Methods Using data from five surveys from 2011-2020, years of education, age, gender, marital status, type of household, alcohol consumption status, smoking status, physical activity, limited ability to perform activities of daily living (ADLs), chronic disease status, and body mass index were collected. According to the survival status，the study participants were divided into a survival group (n=8625) and an all-cause mortality group (n=1735). Cox proportional risk regression model was used to analyze the relationship between years of education and the risk of all-cause mortality in middle-aged and elderly people with stratified analysis. Results The survey was conducted on 10360 research subjects, including 4 983 males and 5 377 females, with an age M(Q_R) of 59(8) years old. A total of 88 187 person years (average 8.512 person years) were followed up, and a total of 1735 deaths were reported over 9 years. The all-cause mortality rate was 19.674 ‰, with an education period M(Q_R) of 5(8) years and a survival time M(Q_R) of 9 (0) years. After adjusting for confounding factors, for every 1 year increase in education, the risk of all-cause mortality decreased by 2.60% [HR=0.974, 95% CI (0.960-0.988)]. The stratified analysis results showed that in the population aged 45-59, for every 1 year increase in education, the risk of all-cause mortality decreased by 1.00% [HR=0.990, 95% CI (0.959,1.021)]; In the population aged 60-74 and over 75, for every 1 year increase in education, the risk of all-cause mortality decreased by 2.70% [HR=0.973, 95% CI (0.948, 0.999)] and 3.50% [HR=0.965, 95% CI (0.929, 1.003)], respectively. Conclusion Improving the education level of middle-aged and elderly people (≥ 45 years old) in China can reduce the risk of all-cause mortality, and elderly education should be vigorously promoted.

BACKGROUND:This review explores the current research status and frontier hot spots of functional magnetic resonance imaging(fMRI)in the field of traditional Chinese medicine(TCM)for the treatment of ischemic stroke,and attempts to grasp future research trends,with a view to providing a reference for subsequent research in this field. OBJECTIVE:To visualize and analyze the hotspots and frontiers in the TCM treatment of ischemic stroke based on fMRI using CiteSpace knowledge mapping combined with binary logistic regression equations,in order to grasp the future research trends and further explore the distribution of brain regions with abnormal neural activity related to the types of post-stroke dysfunction. METHODS:CNKI,WanFang,VIP,Chinese Biomedical Literature Database and Web of Science core set database were searched.CiteSpace was used to plot keyword co-occurrence,keyword clustering timeline,burst term detection,co-cited literature mapping to analyze hotpots and frontiers in this field.Binary logistic regression analysis fitted the distribution of brain regions with abnormal neural activity associated with different dysfunction after ischemic stroke. RESULTS AND CONCLUSION:A total of 354 articles were included for CiteSpace knowledge mapping analysis.The number of annual publications showed that the research popularity has been raised from 2000 to 2022 with a good development prospect,but the core strength is mainly concentrated in China.Keywords co-occurrence and clustering time line analysis showed that aphasia,hemiplegia and cognitive impairment are the hot poststroke dysfunction types.Electroacupuncture,acupuncture and head acupuncture are hotspot intervention measures.Functional connectivity is a hotspot analysis method,and resting fMRI is a hotspot scanning technology.The time span of each research hotspot is long,indicating that it has a certain research value and the relevant research is gradually deepening,promoting the research progress in this field.However,acupuncture is the main intervention measure,and there is a lack of research on traditional Chinese medicine,Chinese patent medicine,acupuncture and medicine combination and other TCM therapy.Burst term detection results showed that functional connectivity,graph theory,degree centrality,default mode network,randomized controlled trials have great influence and strong explosive power.They are the current and future frontier hot spots in this field,suggesting that future research should focus on the brain network information integration and strengthen the scientific and rigorous clinical trial design.The results of co-cited literature analysis showed that the epidemiological investigation of ischemic stroke,the safety and effectiveness of acupuncture in the treatment of stroke,the brain activation patterns under different tasks,and the neuropathological mechanism of brain network dysfunction after stroke are the theoretical basis of this field.Future research direction in this field is to explore TCM-targeted brain regions and neural networks to reveal the brain effect mechanism of TCM promoting neural remodeling after stroke.A total of 255 articles were included for binary Logistic regression analysis.The results showed that sensorimotor cortex and premotor area dysfunction are positively correlated with the incidence of motor dysfunction after stroke;hippocampus,cerebellum posterior lobe,precuneus,inferior temporal gyrus and anterior cingulate nerve dysfunction are positively correlated with the incidence of cognitive impairment after stroke;cuneus,angular gyrus and prefrontal lobe neural dysfunction were positively correlated with the incidence of affective disorder after stroke;anterior cingulate,cerebellum posterior lobe neural dysfunction are positively correlated with the incidence of swallowing disorder after stroke.The above brain regions are the core brain regions of the sensorimotor network,default mode network and reward loop,suggesting that functional abnormalities within or between brain networks related to dysfunction may be potential target areas for TCM intervention,but the specific changes in neural activity activation or inhibition still need to be refined.

Objective:To observe the effect of fractional flow reserve derived from computed tomography(FFRcT)measurement system based on iterative algorithm in diagnosing survival prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)after they underwent emergency percutaneous coronary intervention(PCI).Methods:A total of 98 patients with acute STEMI complicated with multi vessel disease(MVD)were prospectively selected from the Affiliated Hospital of Inner Mongolia Medical University during October 2022 and February 2024.All patients were divided into two groups according to random double-blind method:FFRCT guidance group(49cases)and coronary angiography(CAG)guidance group(49cases).The FFRCT guidance group used FFRCT as the diagnostic basis,which carried out complete revascularization strategy according to FFRCT examination results.CAG guidance group handled infarct-related vessels as the CAG guidance.The basic clinical data,operation details of PCI surgery/technical indicators and utilization indicators of related resource of the two groups were observed,and angina pectoris attack and major adverse cardiovascular events(MACE)and other prognosis indicators of related survival of the two groups were observed and followed up.The primarily observed endpoints were all-cause death,heart failure,stroke,MACE,and composite endpoint event of stroke and revascularization again within 24 months follow-up.Results:The proportion of undergoing PCI on non-infarct-related vessel was 55.10％(27/49)in FFRCT group.In the comparison of operation detail of surgery/technique indicator after PCI surgery between two groups,the operation time of FFRCT guidance group was(65±10)min,which was longer than that[(60±8)min]of CAG guidance group,and the total length of stent was(31±10)mm,which was shorter than that[(36±10)mm]of CAG guidance group.There were statistically significant differences in the above two indicators between the two groups(t=-4.062,-6.710,P＜0.05),respectively.There were no statistically significant differences in the amount of contrast agent,average diameter of stent and length of stay between the two groups(P＞0.05).Compared with the CAG group,the incidences of non-lethal myocardial infarction,primary endpoint events,recurrent angina pectoris,and revascularization of FFRCT group significantly reduced within 24 months follow-up,and the differences of them between two groups were statistically significant(x2=4.926,5.273,6.091,5.804,P＜0.05),respectively.Conclusion:Using FFRCT measurement system based on iterative algorithm in PCI process of emergency for patients with acute STEMI complicated with MVD to examine and guide revascularization is safe and effective,which is worthy of recognition.It has obvious advantages over CAG guidance in reducing the risk of cardiovascular and cerebrovascular events,and in improving prognosis after PCI.

To improve the effectiveness of bedside localization of nasointestinal tube(NIT)and facilitate the placement of nasointestinal tube into jejunum,we established a procedure and composed a teaching verse for bedside placement of nasointestinal tube based on relevant classical literature and our own practices.Verse content:enteral nutrition means a successful strategy to improve the outcome in critically ill patient management,never hesitate to place nasointestinal tubes when necessary.There are several methods to deal with it,but popularizing it remains a long way off.Half-sitting and swallowing into the esophagus,freely withdrawing signifies the stomach cavity.Passing through the pylorus using light tension on the tube in the right lateral decubitus position.Arriving at the jejunum with low resistance in the left lateral decubitus position.What are the signs of intragastric coiling?Tube return out of nose is the initial observation,Failure of air insufflation indicates tube coiling.Dyeing location surpasses imaging.Vacuum test is the most sensitive,Sequential change from acid to base is specific.Methylene blue test is dramatical for localization.Combining three methods is enough to navigate.Abdominal plain film is the goldan standard and can still be used in ultrasonic era.3-D image establishes overall view.CT reveals the tube route exactly.The teaching verse has become a powerful tool for clinical teaching of manual nasointestinal tube placement in a concise and easy-to-remember form.

Objective To summarise a clinical experience of nursing care for 3 children who were treated with ECMO for sepsis and complicated with fulminant myocarditis.Methods Clinical data in nursing cares for 3 children treated with ECMO for sepsis and complicated with fulminant myocarditis were collected and analysed,with the spotted difficulties in nursing care and proposed coping strategies.Results The 3 children survived and were transferred out of the(pediatric intensive care unit,PICU)with stable vital signs and haemodynamics after emergency treatment with ECMO and continuous renal replacement therapy(CRRT).Conclusion Children with sepsis leading to myocardial depression and subsequent heart failure require close observation of the changes and consequently specialised cares after having initiated an ECMO in emergency treatment.This includes ensuring proper fixation of the cannulas,managing anticoagulation,monitoring the speed,flow rate and pressure of ECMO,management of body temperature,skin care,sedation and pain,as well as prevention of complications.These nursing care measures would improve the survival rate after the treatment of ECMO.

Objective:To construct a fall risk prediction model for patients with hematologic malignancies and to provide a reference for the risk assessment and accurate management of falls.Methods:The prospective study design was adopted to facilitate the selection of 510 patients with hematologic malignant in Qilu Hospital of Shandong University for investigation, and relevant data such as patient demographic characteristics, disease treatment and drugs were collected. The LASSO-Logistic regression was used to screen the risk factors of falls in patients with hematologic malignancies, to construct a nomogram risk prediction model. The receiver operating characteristic curve (ROC) and calibration curve were used to evaluate the predictive performance of the model. Bootstrap resampling were used to validate internal validation of the model.Results:Among 510 patients with hematological malignancies, there were 273 males and 237 females, aged 53.0 (41.0, 63.0) years old. A total of 6 risk factors were included in the fall risk prediction model for patients with hematological malignancies, which were disease type ( OR = 0.185, 95% CI 0.061 - 0.562), body temperature ≥38 ℃ ( OR = 2.239, 95% CI 1.128 - 4.445), pain ( OR = 15.581, 95% CI 6.592 - 36.829), anemia ( OR = 4.097, 95% CI 1.536 - 10.927), days of bone marrow suppression ( OR = 3.341, 95% CI 1.619 - 6.893), and assessment of daily self-care ability ( OR = 3.160, 95% CI 1.051 - 9.506)(all P<0.05). The ROC curve of the fall risk prediction model was 0.884 (95% CI 0.841-0.927). The optimal threshold, sensitivity, and specificity of the risk prediction model were 0.248, 87.4% and 75.6%. The internal validation C statistic was 0.873. The Calibration curve was almost coincides with the ideal curve, and the model Brier score was 0.080. Conclusions:The constructed fall risk prediction model has good predictive performance, which can efficiently and objectively quantify the risk of falls, and provide a reference for the early assessment and effective prevention of falls in patients with hematological malignancies.

ObjectiveTo evaluate the clinical efficacy and safety of Notoginseng Radix et Rhizoma powder in treating dyslipidemia by regulating the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway. MethodSixty patients with dyslipidemia （syndrome of combined phlegm and stasis） treated in the Third Affiliated Hospital of Henan University of Chinese Medicine from May 2021 to June 2022 were selected in this study and randomized into two groups according to the randomized， double-blind control principle. The control group was treated with Xuezhikang capsules + Notoginseng Radix et Rhizoma powder placebo and the observation group with Notoginseng Radix et Rhizoma powder + Xuezhikang capsules placebo for 6 weeks. The clinical efficacy， traditional Chinese Medicine （TCM） syndrome scores， and liver and kidney function indicators were evaluated at weeks 0， 3， and 6. Enzyme-linked immunosorbent assay （ELISA） was employed to determine the expression of vascular endothelial growth factor （VEGF）， kinase insert domain receptor （KDR）， epidermal growth factor （EGF）， and epidermal growth factor receptor （EGFR） in the peripheral serum. Quantitative Real-time PCR was employed to measure the mRNA levels of KDR， EGFR， PI3K， and Akt in the mononuclear cells of the peripheral blood. ResultThe observation group （83.33%） showed the total effective rate comparable to that of the control group （89.66%） and no adverse reactions. Compared with before treatment， the patients in the observation group showed decreased TCM syndrome score and serum levels total cholesterol （TC）， triglyceride （TG）， and low-density lipoprotein cholesterol （LDL-C） and after being treated for 3 and 6 weeks （P<0.05）， the level of high-density lipoprotein cholesterol （HDL-C） showed an upward trend, but the difference was not statistically significant. After treatment， the two groups showed no significant differences. Compared with that before treatment, the mRNA expression of PI3K, Akt and EGFR in peripheral blood mononuclear cell and the expression of EGF, VEGF and KDR in serum of the observation group showed a downward trend with time, in which the mRNA expression of PI3K, Akt, VEGF and KDR decreased more significantly (P<0.05)，The expression levels of KDR mRNA and serum EGFR show a trend of first increasing and then decreasing.Compared with the control group after treatment, there was no statistically significant difference in mRNA expression of PI3K, Akt, EGFR, and KDR, as well as serum levels of EGF, EGFR, VEGF, and KDR between the two groups of patients at the same time point. ConclusionNotoginseng Radix et Rhizoma powder is safe and effective in correcting dyslipidemia. It may inhibit the PI3K/Akt signaling pathway by down-regulating the expression of VEGF/KDR to lower the blood lipid level.

According to understanding of the pathogenesis of acne, scholars have established animal models of acne inflammation, animal models of grafting human skin acne, and natural acne animal models. The acne inflammation model is mainly induced by bacterial infection, chemical drug application, and foreign matter injection. Natural acne animal models include animals that some are sensitivity to hormones and some have clinical symptoms of acne. It is necessary to select appropriate model animals and replicate model methods for the development of acne intervention products with different degrees and mechanisms. At present, there are only human evaluation standards of acne health functions in China, but no animal evaluation standards, which has affected the in-depth study of the pathogenesis of acne as well as the research and development progress of acne products. This article summarizes the conditions for the occurrence of acne, the characteristics of human skin, the bidirectional effect of Cutibacterium acnes on human skin, acne animal models, and commonly used observation and evaluation indicators, providing the reference for studying the pathogenesis of acne, promoting acne treatment and health care, and developing treatment products.

Objective:To explore the pathway of psychological capital and burnout on turnover intention of nurses in hematopoietic stem cell transplantation ward.Methods:The cross-sectional research design involved 180 registered nurses in hematopoietic stem cell transplantation wards from 16 tertiary grade A general hospitals with hematopoietic stem cell transplantation qualifications in Shandong province in October 2020. SPSS 22.0 was used to analyze the data, and Bootstrap method was used to test the mediating effect of psychological capital between burnout and turnover intention.Results:The average scores of psychological capital, burnout and turnover intention of nurses in hematopoietic stem cell transplantation ward were (4.70 ± 0.73), (2.44 ± 0.88) and (2.32 ± 0.68), respectively. There were significant differences in turnover intention among nurses in hematopoietic stem cell transplantation ward at different ages, transplant nursing age, marital status and night shift ( F=3.04, 3.34, t=2.43, -3.12, P<0.05); psychological capital was negatively correlated with burnout and turnover intention ( r=-0.698, -0.450, P<0.01), while burnout was positively correlated with turnover intention ( r=0.512, P<0.01) ; optimism in psychological capital partially mediated the relationship between burnout and turnover intention, and the mediating effect accounted for 52.7% of the total effect. Conclusions:The turnover intention of nurses in hematopoietic stem cell transplantation ward was at a high level, and psychological capital had a certain impact on turnover intention. Administrators should formulate targeted strategies to improve psychological capital, reduce the burnout and turnover intention of nurses in hematopoietic stem cell transplantation ward, in order to form a stable and high-quality team of nursing personnel for hematopoietic stem cell transplantation, and promote the development of transplantation nursing specialty in China.