The occurrence of diabetes mellitus （DM） is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver，fat，skeletal muscle，islets， and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response，improving insulin resistance，and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing，heat-clearing， and detoxicating medicinal，which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore，by summarizing the mechanisms between macrophage activation，polarization， and insulin resistance in various tissues，this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio，providing references for the future treatment of DM and its related complications with traditional Chinese medicine.

Research shows that epileptic seizures are essentially due to abnormal functions of neural circuits. Optogenetics regulates neural circuits by specifically expressing light-sensitive proteins in target neurons, which has now become an important tool in the research of temporal lobe epilepsy. Studies have shown that optogenetics focuses on brain regions such as the hippocampus, medial septal nucleus, cerebellum, and basal ganglia in studying temporal lobe epilepsy. This article reviews the research progress of optogenetics in exploring the pathogenesis and therapeutic targets of temporal lobe epilepsy, aiming to provide new ideas for temporal lobe epilepsy treatment.

Epilepsy is a chronic brain disorder characterized by abnormal synchronous neuronal discharges in the brain, often accompanied by various complications. The pathogenesis of epilepsy has not yet been fully elucidated. Optogenetics, a cutting-edge technique that integrates optics and genetics, enables precise modulation of specific neurons by regulating light-sensitive proteins. Utilizing optogenetic technology has facilitated the dissection of neural circuits involved in epileptic seizures within brain regions such as the hippocampus, thalamus, hypothalamus. It has also helped identify potential therapeutic targets for epilepsy-related complications, including cognitive impairment, sudden unexpected death in epilepsy and mood disorders.However, in the process of advancing from basic research to clinical treatment, its translational path is profoundly influenced by factors such as stimulation modes (the choice between open-loop and closed-loop systems), key parameters (light frequency), and intervention strategies (unilateral or bilateral target selection). The individualized customization of these factors represents the future direction for overcoming current translational bottlenecks and achieving precise treatment.

Objective:To explore the effectiveness of the I-PASS ABCDE structured handoff model in patients with respiratory failure in the intensive care unit (ICU) .Methods:A total of 35 nurses working in the ICU of the Affiliated Hospital of Jining Medical University were selected by convenience sampling from January 2020 to September 2021. From January to October 2020, the traditional handoff model was used (control group), while from November 2020 to September 2021, the I-PASS ABCDE structured handoff model was implemented (intervention group). The defect rate of clinical handoff, nurses' understanding of patients' conditions, handoff effectiveness, time spent on handoff, and nurse satisfaction with the handoff model were compared between the two groups.Results:The defect rate of clinical handoff in the intervention group was significantly lower than that in the control group. Scores for nurses' understanding of patients' conditions and handoff effectiveness were significantly higher in the intervention group than in the control group ( P<0.05), indicating statistical significance. Although handoff duration was longer in the intervention group than in the control group, the difference was not statistically significant ( P>0.05). Nurse satisfaction with the handoff model was significantly higher in the intervention group than in the control group ( P<0.05) . Conclusions:The application of the I-PASS ABCDE structured handoff model in ICU patients with respiratory failure can reduce handoff defects, improve handoff quality, and enhance nurses' satisfaction.

Research shows that epileptic seizures are essentially due to abnormal functions of neural circuits. Optogenetics regulates neural circuits by specifically expressing light-sensitive proteins in target neurons, which has now become an important tool in the research of temporal lobe epilepsy. Studies have shown that optogenetics focuses on brain regions such as the hippocampus, medial septal nucleus, cerebellum, and basal ganglia in studying temporal lobe epilepsy. This article reviews the research progress of optogenetics in exploring the pathogenesis and therapeutic targets of temporal lobe epilepsy, aiming to provide new ideas for temporal lobe epilepsy treatment.

Epilepsy is a chronic brain disorder characterized by abnormal synchronous neuronal discharges in the brain, often accompanied by various complications. The pathogenesis of epilepsy has not yet been fully elucidated. Optogenetics, a cutting-edge technique that integrates optics and genetics, enables precise modulation of specific neurons by regulating light-sensitive proteins. Utilizing optogenetic technology has facilitated the dissection of neural circuits involved in epileptic seizures within brain regions such as the hippocampus, thalamus, hypothalamus. It has also helped identify potential therapeutic targets for epilepsy-related complications, including cognitive impairment, sudden unexpected death in epilepsy and mood disorders.However, in the process of advancing from basic research to clinical treatment, its translational path is profoundly influenced by factors such as stimulation modes (the choice between open-loop and closed-loop systems), key parameters (light frequency), and intervention strategies (unilateral or bilateral target selection). The individualized customization of these factors represents the future direction for overcoming current translational bottlenecks and achieving precise treatment.

Objective:To explore the effectiveness of the I-PASS ABCDE structured handoff model in patients with respiratory failure in the intensive care unit (ICU) .Methods:A total of 35 nurses working in the ICU of the Affiliated Hospital of Jining Medical University were selected by convenience sampling from January 2020 to September 2021. From January to October 2020, the traditional handoff model was used (control group), while from November 2020 to September 2021, the I-PASS ABCDE structured handoff model was implemented (intervention group). The defect rate of clinical handoff, nurses' understanding of patients' conditions, handoff effectiveness, time spent on handoff, and nurse satisfaction with the handoff model were compared between the two groups.Results:The defect rate of clinical handoff in the intervention group was significantly lower than that in the control group. Scores for nurses' understanding of patients' conditions and handoff effectiveness were significantly higher in the intervention group than in the control group ( P<0.05), indicating statistical significance. Although handoff duration was longer in the intervention group than in the control group, the difference was not statistically significant ( P>0.05). Nurse satisfaction with the handoff model was significantly higher in the intervention group than in the control group ( P<0.05) . Conclusions:The application of the I-PASS ABCDE structured handoff model in ICU patients with respiratory failure can reduce handoff defects, improve handoff quality, and enhance nurses' satisfaction.

BACKGROUND/OBJECTIVES: Activating brown adipose tissue (BAT) and browning of white adipose tissue (WAT) can protect against obesity and obesity-related metabolic conditions.Cryptotanshinone (CT) regulates lipid metabolism and significantly ameliorates insulin resistance. Adenosine-5'-monophosphate (AMP)-activated protein kinase (AMPK), a receptor for cellular energy metabolism, is believed to regulate brown fat activity in humans.MATERIALS/METHODS: The in vivo study included high-fat-fed obese mice administered orally 200/400 mg/kg/d CT. They were evaluated through weight measurement, the intraperitoneal glucose tolerance test (IPGTT), intraperitoneal insulin tolerance test (IPITT), cold stimulation test, serum lipid (total cholesterol, triglycerides, and low-density lipoprotein) measurement, hematoxylin and eosin staining, and immunohistochemistry.Furthermore, the in vitro study investigated primary adipose mesenchymal stem cells (MSCs) with incubation of CT and AMPK agonists (acadesine)/inhibitor (Compound C).Cells were evaluated using Oil Red O staining, Alizarin red staining, flow cytometry, and immunofluorescence staining to identify and observe the osteogenic versus adipogenic differentiation. Quantitative real-time polymerase chain reaction and the Western blot were used to observe related gene expression. RESULTS: In the diet-induced obesity mouse model mice CT suppressed body weight, food intake, glucose levels in the IPGTT and IPTT, serum lipids, the volume of adipose tissue, and increased thermogenesis, uncoupling protein 1, and the AMPK pathway expression. In the in vitro study, CT prevented the formation of lipid droplets from MSCs while activating brown genes and the AMPK pathway. AMPK activator enhanced CT’s effects, while the AMPK inhibitor reversed the effects of CT. CONCLUSION CT promotes adipose tissue browning to increase body thermogenesis and reduce obesity by activating the AMPK pathway. This study provides an experimental foundation for the use of CT in obesity treatment.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Klebsiella pneumoniae(K.pneumoniae)is an important pathogen that can cause severe hospital-and community-acquired infections.To systematically investigate its methylation features,we determined the whole-genome sequences of 14 K.pneumoniae strains covering varying serotypes,multilocus sequence types,clonal groups,viscosity/virulence,and drug resistance.Their methy-lomes were further characterized using Pacific Biosciences single-molecule real-time and bisulfite technologies.We identified 15 methylation motifs[13 N6-methyladenine(6mA)and two 5-methylcytosine(5mC)motifs],among which eight were novel.Their corresponding DNA methyl-transferases were also validated.Additionally,we analyzed the genomic distribution of GATC and CCWGG methylation motifs shared by all strains,and identified differential distribution pat-terns of some hemi-/un-methylated GATC motifs,which tend to be located within intergenic regions(IGRs).Specifically,we characterized the in vivo methylation kinetics at single-base resolu-tion on a genome-wide scale by simulating the dynamic processes of replication-mediated passive demethylation and MTase-catalyzed re-methylation.The slow methylation of the GATC motifs in the replication origin(oriC)regions and IGRs implicates the epigenetic regulation of replication initiation and transcription.Our findings illustrate the first comprehensive dynamic methylome map of K.pneumoniae at single-base resolution,and provide a useful reference to better understand epigenetic regulation in this and other bacterial species.