Objective To investigate the effects of parecoxib sodium on pain and Toll-like receptor 4(TLR4)/p38 mitogen activated protein kinase(p38MAPK)pathway in rats with femoral fracture.Methods Sixty rats were randomly separated into sham operation group,model group,TLR4 inhibitor(TAK-242)group(3 mg/kg),parecoxib sodium group(10 mg/kg),and parecoxib sodium+TLR4 activator lipopolysaccharide group(10 mg/kg parecoxib sodium+15 mg/kg LPS),with 12 rats in each group.Except for the sham operation group,rats in all other groups were used to establish a femoral fracture model by transverse cutting of the mid femur.After 28 days of treatment in each group,X-rays were used to detect the degree of fracture healing in rats.The mechanical pain threshold(PWMT)and thermal pain threshold(PWTL)of rats were measured.ELISA was applied to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-10 in serum.Micro-CT method was applied to detect changes in femoral bone density(BMD),bone volume fraction(BV/TV),trabecular thickness(Tb.Th),and trabecular quantity(Tb.N)in rats.HE staining was applied to observe the pathological changes of bone tissue at the fracture site in rats.Western blot was applied to detect the expression of TLR4/p38MAPK pathway related proteins in bone tissue at the fracture site.Results Compared with the sham operation group,the fracture lines of rats in the model group were obvious,with a small amount of callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N decreased,while the levels of serum IL-6,TNF-α,and IL-10,and the levels of TLR4 and p-p38MAPK/p38MAPK proteins in the bone tissue at the fracture site increased(P＜0.05).Compared with the model group,the fracture lines in the TAK-242 group and the parecoxib sodium group were blurred,and there was an increase in callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N,the serum IL-10 level increased,while the serum IL-6,TNF-αlevels,the TLR4 and p-p38MAPK/p38MAPK protein levels in bone tissue at the fracture site decreased(P＜0.05).LPS could upregulate the phosphorylation levels of TLR4 and p38MAPK,and weaken the relieving effects on anti-inflammatory and pain of parecoxib sodium on fracture rats.Conclusion Paracoxib sodium may alleviate pain and accelerate fracture healing in rats with femoral fractures by inhibiting the TLR4/p38MAPK pathway and suppressing inflammatory responses.

This articles summarized the clinical experience of national TCM master Professor Yan Shiyun in using ointment prescriptions to treat chronic pharyngitis.Professor Yan Shiyun believes that the etiology and pathogenesis of chronic pharyngitis are based on inflammation of the deficiency fire,with phlegm heat accumulation as the symptoms.Dysfunction of organs such as the liver,gallbladder,spleen and stomach,lungs and kidneys,as well as retention of wind pathogens,are also important pathological mechanisms.Based on the differentiation of Tibetan symptoms,the clinical approach advocates for a comprehensive understanding of the patients'condition,focusing on the core pathogenesis.The main treatment methods include regulating yin and yang,clearing phlegm and heat,regulating spleen and stomach,dispelling wind and clearing throat,and comprehensively considering other syndromes.The use of compound prescriptions for comprehensive treatment has shown significant therapeutic effects.The commonly used medicinal combination is Physalis Calyx Seu Fructus,Chebulae Fructus Immaturus and Arctii Fructus.

Objective This study aims to develop an early in-hospital temperature management protocol for heat stroke patients and assess its effectiveness,providing guidance for rapid cooling and precise target temperature control.Methods The protocol was developed through a Delphi expert consultation combined with expert panel meetings.A multi-center,non-randomized,historical control study was conducted,utilizing convenience sampling to select heat stroke patients from the emergency departments of 7 tertiary hospitals in Zhejiang Province,China,between June and August 2024 as an experimental group.The protocol was implemented in this group,while the control group consisted of heat stroke patients treated between June and August 2022,prior to protocol implementation.Cooling rates,target temperature attainment rates,and clinical outcomes were compared between the 2 groups.Results The final protocol included 6 primary indicators,23 secondary indicators,and 56 tertiary indicators.After protocol implementation,the experimental group achieved a cooling rate of 0.08(0.05～0.09)℃/min within 0.5 hours,significantly higher than the control group,which had a rate of 0.04(0.02～0.06)℃/min(P＜0.001).The target temperature attainment rates at 0.5 hours and 2.0 hours were 55.93％and 98.31％,respectively,significantly higher than the rates of 15.87％and 61.11％in the control group(P＜0.001).The mechanical ventilation rate,hospitalization rate,ICU admission rate,and mortality rate in the experimental group were 25.42％,61.02％,44.07％,and 8.47％,respectively.Logistic regression analysis revealed that the early in-hospital temperature management protocol significantly reduced the risk of mechanical ventilation and hospitalization in heat stroke patients,with odds ratios(ORs)of 0.294 and 0.300,respectively(both P＜0.05).Conclusion The developed protocol for early in-hospital temperature management in heat stroke patients is scientific,systematic,and practical.It improves cooling rates and target temperature attainment,thereby enhancing the prognosis of heat stroke patients.

[Objective]To analyze the digital research literature in the field of traditional Chinese medicine culture,to understand the hot topics and lineage of research on digitization of traditional Chinese medicine culture and analyze the future development trend.[Methods]China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases were searched to collect relevant journal literature in the field of digitization of traditional Chinese medicine culture from January 2006 to February 2024.CiteSpace 6.1.R6 software was used to analyze the evidence visualization of the included literature,including the trend of publication,the cooperation of authors and institutions,journal distributions,keyword co-occurrence,clustering and burst word analysis,and the visualization map was drawn.[Results]A total of 523 documents were included in the analysis.The number of studies on digitization of traditional Chinese medicine culture was generally on the rise;there were 82 core authors,with a total of 184 articles(35.18%),and the core group of authors had not yet been formed.Research institutions were mainly located in Beijing and Shanghai,and there was less exchange and cooperation among different institutions and scholars.High-frequency keywords in the field of digitization of traditional Chinese medicine culture included Chinese medicine,communication,new media and international communication,etc.,of which cultural self-confidence,integrated media and popularization of science were hot and cutting-edge topics in recent years.[Conclusion]In the past years,the digital research on Chinese medicine culture had shown more obvious features of digital integration,more focused direction of digital empowerment,and a focus on digital inheritance and dissemination direction research.In the future,researchers should further improve the construction of the research system,promote the cooperation of scholars in different fields,adopt interdisciplinary research methods and promote the diversification of research contexts.

Objective To explore the principles and methods for extracting terminology related to the pathogenesis of cough disease,as well as the standardization issues in constructing the category structure of"pathogenesis-syndrome";To provide references for standardized research on the pathogenesis of cough disease.Methods The principle of defining the pathogenesis of cough disease was based on the physiological dysfunction and pathological characteristics of lung manifestation.Using ontology technology,literature induction,comparative analysis and other methods,with the help of terminology concepts,Clinical Diagnosis and Treatment Terminology in Traditional Chinese Medicine Part 1:Diseases and important ancient books of TCM throughout history related to the pathogenesis of cough disease were sorted,summarized,and extracted.The relationship between the"pathogenesis-syndrome"category of cough disease was analyzed and the structure was constructed.Results Preliminary principles and methods for standardizing the extraction of pathogenesis terminology of cough disease were formulated,including screening scope,inclusion and exclusion criteria,etc.The content of cough disease entries in Clinical Diagnosis and Treatment Terminology in Traditional Chinese Medicine Part 1:Diseases was defined for pathogenesis terminology,and the hierarchical structure of terminology was established to clarify the connotation and extension of terminology,thereby determining the category relationship of terminology and forming a category structure of"pathogenesis-syndrome"mapping relationship.On this basis,by extracting pathogenesis terms of cough disease from important ancient books of TCM throughout history,a category structure table of"pathogenesis-syndrome"for cough disease in TCM was formed.Conclusion On the basis of formulating standardized extraction principles and methods of pathogenesis terminology for TCM cough disease,a research model for the"pathogenesis-syndrome"category structure of TCM cough disease is constructed.This model has the characteristics of systematicity,clear hierarchical relationships,rich connotation of terminology,and extensibility,providing a new research paradigm for pathogenesis research.

Objective:To evaluate the clinical value of high-risk human papillomavirus (HPV) viral load for the cervical cancer screening and triage of high-risk HPV positive populations without additional tests.Methods:(1) This study conducted a retrospective analysis of 29 720 women aged 35-64 years who received cervical cancer screening in Quanzhou, China, in 2021. Fourteen high-risk HPV types (including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) were detected for cervical cancer primary screening using hybrid capture-chemiluminescence method. High-risk HPV positive samples were further subjected to HPV 16/18 genotyping using hybrid capture-chemiluminescence method. Among them, HPV 16/18 positive women were directly referred to colposcopy, while the other 12 high-risk HPV positive samples were further subjected to liquid based cytology test. Those with abnormal or suspicious cytology were referred to colposcopy. Biopsies were taken for histopathological examination of suspicious or abnormal individuals under colposcopy. (2) Ten cases of colposcopy loss or refusal to undergo examination were excluded, and the data from the 29 710 cases were analyzed. The HPV viral loads of the other 12 high-risk HPV positive populations were focused and evaluated their HPV viral loads for further cervical intraepithelial neoplasia (CIN) Ⅱ and above lesions (CINⅡ +) triage in cervical cancer screening. Results:(1) Among 29 720 women, 2 487 women (8.37%, 2 487/29 720) were positive for high-risk HPV, including 807 women (2.72%, 807/29 720) were positive for HPV 16/18 and 1 680 patients (5.65%, 1 680/29 720) were positive for the other 12 high-risk HPV types. Among 1 680 women who tested positive for the other 12 high-risk HPV types, 573 patients were atypical squamous cell carcinoma of unclear significance or above, 346 patients were CIN Ⅰ, 122 patients were CIN Ⅱ-Ⅲ, 9 patients were squamous cell carcinoma patients, and 4 patients were adenocarcinoma in situ. The immediate risk of CIN Ⅱ + in HPV 16/18 positive women (11.13%) was approximately four times higher than that of other 12 high-risk HPV positive women (2.74%). (2) Through the viral load analysis of the other 12 high-risk HPV types, we found that the viral load of the other 12 high-risk HPV provide a good value for the pathological results, with a clinical cutoff (CO) value of 11.21 relative light unit/CO (RLU/CO) for the CINⅡ + detection. Except for HPV 16/18 positive patients, when the viral load values of the other 12 high-risk HPV types were greater than 10 RLU/CO, these patients had a higher risk of CINⅡ +, with a positive predictive value of 31.29%. CINⅡ + was not found in any of the other 12 high-risk HPV positive with viral load values less than or equal to 10 RLU/CO. Conclusions:Using hybrid capture-chemiluminescence HPV tests for HPV 16/18 genotyping, combined with the viral loads (>10 RLU/CO) of the other 12 high-risk HPV analysis, one could triage HPV positive population without additional tests. Such triage strategy could promote the coverage of cervical cancer screening, particularly where cytology pathologists or economic resources are limited.

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

This review summarizes the health information needs of patients with brain tumors, covering aspects such as an overview, assessment tools, influencing factors, and intervention support, aiming to provide a reference for developing intervention programs to meet the health information needs of patients with brain tumors.

To provide scientific guidance and standardization for perioperative clinical nursing practice in patients undergoing percutaneous renal biopsy, relevant evidence on percutaneous renal biopsy nursing care was systematically retrieved and synthesized through an evidence-based approach. After two rounds of Delphi expert consultation and expert panel discussions, expert consensus on perioperative clinical nursing standards for patients undergoing percutaneous renal biopsy (hereinafter referred to as the "Consensus") was developed. The Consensus includes three primary themes: preoperative care, intraoperative care, and postoperative care, encompassing 21 secondary themes. It is characterized by scientific rigor, practical applicability, and comprehensiveness, and serves as a valuable reference and guide for clinical nursing professionals across medical institutions.

Objective To investigate the effects of parecoxib sodium on pain and Toll-like receptor 4(TLR4)/p38 mitogen activated protein kinase(p38MAPK)pathway in rats with femoral fracture.Methods Sixty rats were randomly separated into sham operation group,model group,TLR4 inhibitor(TAK-242)group(3 mg/kg),parecoxib sodium group(10 mg/kg),and parecoxib sodium+TLR4 activator lipopolysaccharide group(10 mg/kg parecoxib sodium+15 mg/kg LPS),with 12 rats in each group.Except for the sham operation group,rats in all other groups were used to establish a femoral fracture model by transverse cutting of the mid femur.After 28 days of treatment in each group,X-rays were used to detect the degree of fracture healing in rats.The mechanical pain threshold(PWMT)and thermal pain threshold(PWTL)of rats were measured.ELISA was applied to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-10 in serum.Micro-CT method was applied to detect changes in femoral bone density(BMD),bone volume fraction(BV/TV),trabecular thickness(Tb.Th),and trabecular quantity(Tb.N)in rats.HE staining was applied to observe the pathological changes of bone tissue at the fracture site in rats.Western blot was applied to detect the expression of TLR4/p38MAPK pathway related proteins in bone tissue at the fracture site.Results Compared with the sham operation group,the fracture lines of rats in the model group were obvious,with a small amount of callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N decreased,while the levels of serum IL-6,TNF-α,and IL-10,and the levels of TLR4 and p-p38MAPK/p38MAPK proteins in the bone tissue at the fracture site increased(P＜0.05).Compared with the model group,the fracture lines in the TAK-242 group and the parecoxib sodium group were blurred,and there was an increase in callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N,the serum IL-10 level increased,while the serum IL-6,TNF-αlevels,the TLR4 and p-p38MAPK/p38MAPK protein levels in bone tissue at the fracture site decreased(P＜0.05).LPS could upregulate the phosphorylation levels of TLR4 and p38MAPK,and weaken the relieving effects on anti-inflammatory and pain of parecoxib sodium on fracture rats.Conclusion Paracoxib sodium may alleviate pain and accelerate fracture healing in rats with femoral fractures by inhibiting the TLR4/p38MAPK pathway and suppressing inflammatory responses.