Diabetic nephropathy （DKD）， as a common microvascular complication of diabetes mellitus （DM）， is a major cause of end-stage renal disease （ESRD）. Its clinical manifestations include increased urinary protein excretion， thickening of the glomerular basement membrane， and renal tubulointerstitial fibrosis. The pathogenesis of DKD is complex and involves multiple factors， including disordered glucose metabolism， hemodynamic alterations， and oxidative stress. Although modern medical approaches can alleviate certain symptoms， they still have limitations such as insufficient therapeutic targeting and prominent adverse effects. The transforming growth factor-β/Smad （TGF-β/Smad） signaling pathway is not only a tissue fibrosis pathway that has attracted considerable attention in recent years， but also regulates multiple protein molecules， including the glomerular podocyte slit diaphragm protein Podocin， interleukin-1β （IL-1β）， and superoxide dismutase （SOD）， thereby participating in various pathological processes and ultimately mediating renal injury. Flavonoid compounds， owing to their sustained pharmacological effects， broad spectrum of action， and high safety profile， have become ideal candidates for targeted therapy research in DKD. Existing studies have shown that these compounds can exert inhibitory effects on renal fibrosis， alleviate inflammatory responses， protect podocytes， and reduce oxidative stress by regulating the interactions between the TGF-β/Smad signaling pathway and the aforementioned protein molecules， thereby maintaining renal structure and function， reducing proteinuria， and significantly improving DKD lesions. This review briefly outlines the composition and functions of the TGF-β/Smad signaling pathway， elucidates the mechanisms by which this pathway regulates DKD， and focuses on summarizing major studies from the past decade on flavonoid-based interventions in DKD through targeted inhibition of the TGF-β/Smad signaling pathway. Furthermore， it discusses the considerable therapeutic potential of flavonoids in the treatment of this disease， aiming to provide a scientific basis for future clinical prevention and treatment of DKD and to promote the development of targeted drugs.

Objective To observe the clinical efficacy of Dulongneedling in the treatment of vertigo in cervical spondylosis of vertebral artery(CSA).Methods A total of 46 cases of patients with definitive diagnosis of vertigo in CSA admitted to the outpatient clinic of the Acupuncture,Muxibustion and Rehabilitation Department of Guangdong Second Traditional Chinese Medicine Hospital from June to October 2024 were selected for the study.The patients were randomly divided into observation group and control group according to the random number table method,with 23 cases in each group.The observation group was treated with Dulongten-needling in shoulder and neck,and the control group was given conventional acupuncture treatment,the course of treatment for the two groups covered two weeks.After two weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the scores of Evaluation Scale For Cervical Vertigo(ESCV)before and after treatment were observed in the patients of the two groups.Three dimensional pseudo-continuous arterial spin labeling(3D-pCASL)technique was applied to determin the changes in cerebral blood flow(CBF)values in the region of region of interest(ROI),and the changes in CBF values in the patients of the two groups were compared.Results(1)The total effective rate of the observation group was 91.30%(21/23),and that of the control group was 78.26%(18/23),and the efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the ESCV scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(3)After treatment,the CBF change values of each ROI in the two groups showed elevated(positive),and the CBF change values of the right middle cerebral artery(R-MCA)in the control group showed decreased(negative).After treatment,the CBF change values of the observation group in the blood supply areas of the right posterior inferior cerebellar artery(R-PICA),right anterior inferior cerebellar artery(R-AICA),right anterior cerebral artery(R-ACA),branches from vertebral arteries(VA)and basilar arteries(BA),bilateral superior cerebellar arteries(SCA),and bilateral posterior cerebral arteries(PCA)were significantly elevated,and the observation group was significantly superior in improving the above ROIs in the CBF change value to that of the control group,the difference being statistically significant(P<0.05).Conclusion Dulongneedling in the treatment of vertigo in CSA can significantly improve the CBF of patients,reduce the clinical symptoms such as vertigo,neck and shoulder pain,headache.

Ulcerative colitis (UC) is a chronic inflammatory disorder with a complex etiology, characterized by intestinal inflammation and barrier dysfunction. Platycodon grandiflorus polysaccharides (PGP), the primary component of Platycodon grandiflorus, and hesperidin (Hesp), a prominent active component in Citrus aurantium L. (CAL), have both demonstrated anti-inflammatory properties. This study aims to elucidate the underlying mechanism of the synergistic effect of PGP combined with Hesp on UC, focusing on the coordinated interaction between the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) and Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathways. A mouse model of UC induced by dextran sulfate sodium (DSS) and a cell model using lipopolysaccharide (LPS)-induced RAW264.7/IEC6 cells were employed to investigate the in vitro and in vivo anti-inflammatory effects of PGP combined with Hesp on UC and its potential mechanism of action. The results indicated that compared to the effects of either drug alone, the combination of PGP and Hesp significantly modulated inflammatory factor levels, inhibited oxidative stress, regulated colonic mucosal immunity, suppressed apoptosis, and restored intestinal barrier function in vitro and in vivo. Further in vitro studies revealed that PGP significantly inhibited the PI3K/AKT signaling pathway, while Hesp significantly inhibited the JAK2/STAT3 signaling pathway. The use of inhibitors and activators targeting both pathways validated the synergistic effects of PGP combined with Hesp on the PI3K/AKT and JAK2/STAT3 signaling pathways. These findings suggest that PGP combined with Hesp exhibits a synergistic effect on DSS-induced colitis, potentially mediated through the phosphatase and tensin homolog (PTEN)/PI3K/AKT and interleukin-6 (IL-6)/JAK2/STAT3 signaling pathways.
Animals ; STAT3 Transcription Factor/genetics* ; Janus Kinase 2/genetics* ; Polysaccharides/administration & dosage* ; Colitis, Ulcerative/chemically induced* ; Mice ; Signal Transduction/drug effects* ; Proto-Oncogene Proteins c-akt/genetics* ; Drug Synergism ; Male ; Hesperidin/administration & dosage* ; Platycodon/chemistry* ; Phosphatidylinositol 3-Kinases/genetics* ; Disease Models, Animal ; RAW 264.7 Cells ; Mice, Inbred C57BL

Objective To investigate the value of stress hyperglycemia ratio(SHR)in predicting symptomatic intracranial hemorrhage(sICH)after successful recanalization of endovascular ther-apy(EVT)in patients with non-diabetic acute large vascular occlusive(LVO)stroke.Methods A total of 150 non-diabetic patients with acute stroke due to LVO admitted in our hospital from June 2022 to June 2024 were recruited,and all of them underwent EVT and obtained successful recanalization.According to whether sICH occurred 24 h after surgery,they were divided into a sICH group(15 cases)and a non-sICH group(135 cases).They were also assigned into a poor prognosis group(55 cases)and a good prognosis group(95 cases)according to the prognosis in 3 months after surgery.The general clinical data were compared between groups,and multivariate logistic regression analysis was used to identify the influencing factors for sICH and prognosis after successful EVT recanalization in the non-diabetic acute stroke patients.ROC curves were plotted to analyze the predictive value of SHR in sICH and prognosis after successful EVT reca-nalization in the patients.Results Significantly larger proportion of embolic occlusion,higher NIHSS score at admission and SHR were observed in the sICH group than the non-SICH group(66.67％vs 37.04％,P＜0.05;20.15±3.68 vs 15.62±3.10,P＜0.01;1.25±0.25 vs 1.01±0.28,P＜0.01).The poor prognosis group had obviously larger female ratio,advanced age,higher NIHSS score at admission,larger proportion of previous stroke history and higher SHR than the good prognosis group(49.09％vs 29.47％,P＜0.05;75.41±5.38 years old vs 72.56±5.63 years old,P＜0.01;18.65±3.71 vs 16.27±3.21,P＜0.01;32.73％vs 14.74％,P＜0.05;1.16±0.23 vs 1.02±0.25,P＜0.01).Multivariate logistic regression analysis showed that embolic occlusion,NIHSS score at admission and SHR were risk factors for sICH after successful EVT recanaliza-tion in non-diabetic acute stroke due to LVO(OR=2.038,95％CI:1.138-4.234,P=0.000;OR=2.026,95％CI:1.173-4.317,P=0.000;OR=1.996,95％CI:1.101-4.027,P=0.000),while gender,age,NIHSS score at admission,previous stroke history,and SHR were risk factors for poor prognosis in the patients(OR=2.004,95％CI:1.085-3.407,P=0.000;OR=2.075,95％CI:1.138-4.067,P=0.000;OR=2.010,95％CI:1.208-4.106,P=0.000;OR=2.034,95％CI:1.137-4.821,P=0.000;OR=2.038,95％CI:1.138-4.234,P=0.000).ROC curve analysis showed that the AUC value of SHR in predicting sICH and prognosis of the non-diabetic patients with acute stroke due to LVO after successful EVT recanalization was 0.797 and 0.823,with a sensitivity of 80.00％and 81.82％,and a specificity of 82.22％and 80.00％,respectively.Conclusion SHR can affect sICH and prognosis after successful EVT recanalization in non-diabetic acute LVO stroke patients,and it has a certain predictive value for sICH and poor prog-nosis of the patients.

Objective:To explore the relationship between the dark triad, fear of missing out and smartphone addiction, as well as the mediating role of fear of missing out between the dark triad and smartphone addiction.Methods:A total of 408 college students were assessed using dirty dozen, fear of missing out scale, and mobile phone addiction index. SPSS 24.0 software was used for common method bias tests, descriptive statistical analysis, and correlation analysis. Mplus 8.3 software was employed to construct a structural equation model, and the Bootstrap method was used for mediation effect analysis.Results:The dark triad (36.14±9.06) was positively correlated with fear of missing out (22.55±6.60) and smartphone addiction (46.77±13.62) ( r=0.48, 0.45, both P<0.01). Fear of missing out was also positively correlated with smartphone addiction ( r=0.54, P<0.01). Fear of missing out played a partial mediating role in the relationship between the dark triad and smartphone addiction, with a total effect value of 0.495 and a mediating effect value of 0.217. Conclusion:Fear of missing out partially mediates the relationship between the dark triad and smartphone addiction. The dark triad not only directly predicts smartphone addiction but also indirectly influences smartphone addiction through fear of missing out.

Objective:To construct a management model for equipment in operating room on the basis of multi-criteria decision analysis(MCDA)method,and optimize management strategies and implement dynamic management.Methods:The dynamic monitoring and management for the operation and management of equipment in operating room was realized through combined the process of multi-criteria decision-making and the data platform of equipment in operating room,and construct the MCDA's framework for equipment in operating room.A total of 40 used equipment from operating room at Beijing Friendship Hospital Affiliated to Capital Medical University during January and December 2023 were selected as the research objects.The conventional management method was applied in 20 equipment during January and June 2023,and the management model(MCDA management method)of equipment in operating room was applied in 20 equipment during June to December 2023.The operational qualities of equipment,failure rates and qualification rates of sampling,and the scores of management effectiveness between two kinds management methods were compared.A self-designed survey questionnaire for satisfaction was adopted to investigate the satisfactions of managers,who used equipment in operating room,for the equipment that received clinical managements of two kinds of management methods.Results:The average rate of opening equipment,the increased extent of average cost-benefit and the increased extent of average social benefit of these equipment in operating room were respectively(91.58±3.36)%,(7.02±1.69)%and(7.25±1.36)%in using MCDA management method,all of which were higher than those in using conventional management method.However,the average transferring rate of MCDA management method was(7.69±1.54)%,which was lower than that of conventional management method,and the differences of them were all statistically significant(t=19.466,9.732,14.558,20.969,P<0.05).The failure rate of the equipment in operating room,which were managed by the MCDA method,was lower than that of these equipment were managed by the conventional method,while the pass rate of random inspection of equipment were managed by the MCDA methods was higher than those were managed by the conventional method,and the differences were statistically significant(x2=10.157,7.619,P<0.05).The scores of safety performance,speed of maintenance,cleaning quality and the speed of replacing equipment of adopting MCDA management method were all higher than those of adopting conventional management method,and the differences were statistically significant(t=17.952,15.149,13.527,10.474,P<0.05).The satisfaction rates of the managers of using equipment for adopting MCDA management method in the rationality of the process of medical equipment,the feasibility of the system,and the effectiveness of quality were all higher than those for adopting conventional management method,and the differences were significant(x2=5.454,6.667,5.963,P<0.05).Conclusion:The management of management model based on MCDA method for equipment in operating room can enhance the operational quality and management level for equipment,and reduce the operating risk and the incidence of adverse events in equipment,and improve the satisfactions of managers in using equipment.

Objective To investigate the value of stress hyperglycemia ratio(SHR)in predicting symptomatic intracranial hemorrhage(sICH)after successful recanalization of endovascular ther-apy(EVT)in patients with non-diabetic acute large vascular occlusive(LVO)stroke.Methods A total of 150 non-diabetic patients with acute stroke due to LVO admitted in our hospital from June 2022 to June 2024 were recruited,and all of them underwent EVT and obtained successful recanalization.According to whether sICH occurred 24 h after surgery,they were divided into a sICH group(15 cases)and a non-sICH group(135 cases).They were also assigned into a poor prognosis group(55 cases)and a good prognosis group(95 cases)according to the prognosis in 3 months after surgery.The general clinical data were compared between groups,and multivariate logistic regression analysis was used to identify the influencing factors for sICH and prognosis after successful EVT recanalization in the non-diabetic acute stroke patients.ROC curves were plotted to analyze the predictive value of SHR in sICH and prognosis after successful EVT reca-nalization in the patients.Results Significantly larger proportion of embolic occlusion,higher NIHSS score at admission and SHR were observed in the sICH group than the non-SICH group(66.67％vs 37.04％,P＜0.05;20.15±3.68 vs 15.62±3.10,P＜0.01;1.25±0.25 vs 1.01±0.28,P＜0.01).The poor prognosis group had obviously larger female ratio,advanced age,higher NIHSS score at admission,larger proportion of previous stroke history and higher SHR than the good prognosis group(49.09％vs 29.47％,P＜0.05;75.41±5.38 years old vs 72.56±5.63 years old,P＜0.01;18.65±3.71 vs 16.27±3.21,P＜0.01;32.73％vs 14.74％,P＜0.05;1.16±0.23 vs 1.02±0.25,P＜0.01).Multivariate logistic regression analysis showed that embolic occlusion,NIHSS score at admission and SHR were risk factors for sICH after successful EVT recanaliza-tion in non-diabetic acute stroke due to LVO(OR=2.038,95％CI:1.138-4.234,P=0.000;OR=2.026,95％CI:1.173-4.317,P=0.000;OR=1.996,95％CI:1.101-4.027,P=0.000),while gender,age,NIHSS score at admission,previous stroke history,and SHR were risk factors for poor prognosis in the patients(OR=2.004,95％CI:1.085-3.407,P=0.000;OR=2.075,95％CI:1.138-4.067,P=0.000;OR=2.010,95％CI:1.208-4.106,P=0.000;OR=2.034,95％CI:1.137-4.821,P=0.000;OR=2.038,95％CI:1.138-4.234,P=0.000).ROC curve analysis showed that the AUC value of SHR in predicting sICH and prognosis of the non-diabetic patients with acute stroke due to LVO after successful EVT recanalization was 0.797 and 0.823,with a sensitivity of 80.00％and 81.82％,and a specificity of 82.22％and 80.00％,respectively.Conclusion SHR can affect sICH and prognosis after successful EVT recanalization in non-diabetic acute LVO stroke patients,and it has a certain predictive value for sICH and poor prog-nosis of the patients.

Objective:To explore the relationship between the dark triad, fear of missing out and smartphone addiction, as well as the mediating role of fear of missing out between the dark triad and smartphone addiction.Methods:A total of 408 college students were assessed using dirty dozen, fear of missing out scale, and mobile phone addiction index. SPSS 24.0 software was used for common method bias tests, descriptive statistical analysis, and correlation analysis. Mplus 8.3 software was employed to construct a structural equation model, and the Bootstrap method was used for mediation effect analysis.Results:The dark triad (36.14±9.06) was positively correlated with fear of missing out (22.55±6.60) and smartphone addiction (46.77±13.62) ( r=0.48, 0.45, both P<0.01). Fear of missing out was also positively correlated with smartphone addiction ( r=0.54, P<0.01). Fear of missing out played a partial mediating role in the relationship between the dark triad and smartphone addiction, with a total effect value of 0.495 and a mediating effect value of 0.217. Conclusion:Fear of missing out partially mediates the relationship between the dark triad and smartphone addiction. The dark triad not only directly predicts smartphone addiction but also indirectly influences smartphone addiction through fear of missing out.

Objective:To construct a management model for equipment in operating room on the basis of multi-criteria decision analysis(MCDA)method,and optimize management strategies and implement dynamic management.Methods:The dynamic monitoring and management for the operation and management of equipment in operating room was realized through combined the process of multi-criteria decision-making and the data platform of equipment in operating room,and construct the MCDA's framework for equipment in operating room.A total of 40 used equipment from operating room at Beijing Friendship Hospital Affiliated to Capital Medical University during January and December 2023 were selected as the research objects.The conventional management method was applied in 20 equipment during January and June 2023,and the management model(MCDA management method)of equipment in operating room was applied in 20 equipment during June to December 2023.The operational qualities of equipment,failure rates and qualification rates of sampling,and the scores of management effectiveness between two kinds management methods were compared.A self-designed survey questionnaire for satisfaction was adopted to investigate the satisfactions of managers,who used equipment in operating room,for the equipment that received clinical managements of two kinds of management methods.Results:The average rate of opening equipment,the increased extent of average cost-benefit and the increased extent of average social benefit of these equipment in operating room were respectively(91.58±3.36)%,(7.02±1.69)%and(7.25±1.36)%in using MCDA management method,all of which were higher than those in using conventional management method.However,the average transferring rate of MCDA management method was(7.69±1.54)%,which was lower than that of conventional management method,and the differences of them were all statistically significant(t=19.466,9.732,14.558,20.969,P<0.05).The failure rate of the equipment in operating room,which were managed by the MCDA method,was lower than that of these equipment were managed by the conventional method,while the pass rate of random inspection of equipment were managed by the MCDA methods was higher than those were managed by the conventional method,and the differences were statistically significant(x2=10.157,7.619,P<0.05).The scores of safety performance,speed of maintenance,cleaning quality and the speed of replacing equipment of adopting MCDA management method were all higher than those of adopting conventional management method,and the differences were statistically significant(t=17.952,15.149,13.527,10.474,P<0.05).The satisfaction rates of the managers of using equipment for adopting MCDA management method in the rationality of the process of medical equipment,the feasibility of the system,and the effectiveness of quality were all higher than those for adopting conventional management method,and the differences were significant(x2=5.454,6.667,5.963,P<0.05).Conclusion:The management of management model based on MCDA method for equipment in operating room can enhance the operational quality and management level for equipment,and reduce the operating risk and the incidence of adverse events in equipment,and improve the satisfactions of managers in using equipment.

Objective:To analyze the correlation between the skin temperature changes in the radiation area and the occurrence of radiodermatitis during postoperative radiotherapy for female breast cancer and to explore the application value of skin temperature monitoring in the early warning of radiodermatitis risks.Methods:A total of 103 patients who received three-dimensional conformal radiotherapy after radical mastectomy in the Fourth Hospital of Hebei Medical University were continuously enrolled from May to November, 2022 in this study. Their skin temperature in the radiation area and radiodermatitis were recorded weekly. The relationships between relative skin temperature differences and different grades of radiodermatitis were determined. The optimal cut-off values for grade ≥ radiodermatitis were calculated, and the predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Furthermore, the radiodermatitis risks under different skin temperatures were compared using binary logistic regression.Results:There was a positive correlation between the skin temperature in the radiation field and the grade of radiodermatitis. The optimal cut-off values for the average relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), the maximum relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), and the relative skin temperature difference of the supraclavicular block (under 30 Gy/15 fractions) were 0.45℃, 0.55℃, 0.15℃, respectively. The patients were divided into low- and high-risk groups based on the optimal cut-off values (0.45℃, 0.55℃, and 0.15℃). Binary logistic regression result showed that the risks of grade ≥ 2 radiodermatitis in the high-risk group were 5.71, 4.29, and 5.15 times those in the low-risk group, respectively ( OR = 5.71, 95% CI 1.81-17.99, P = 0.003; OR = 4.29, 95% CI 1.65-11.12, P = 0.003; OR = 5.15, 95% CI 2.16-12.31, P < 0.001). Conclusions:Skin temperature monitoring using medical infrared thermometers can be used to effectively predict the occurrence of grade ≥ 2 radiodermatitis. The skin temperature changes in the radiotherapy area should be closely observed. The risk of grade ≥ 2 radiodermatitis will increase when the mean and maximum relative temperature differences of the chest wall increase by 0.45℃ and 0.55℃, respectively under 40 Gy/20 fractions of radiotherapy or when the relative temperature differences of the supraclavicular block increases by 0.15℃ under 30 Gy/15 fractions of radiotherapy.