This article systematically reviews the current research status as well as diagnosis and treatment strategies of traditional Chinese medicine （TCM） for gastroesophageal reflux disease （GERD）. Studies demonstrate that TCM， based on the "disease-syndrome combination" approach， exhibits multi-target advantages in alleviating symptoms of various GERD subtypes， promoting mucosal repair， regulating emotions， and facilitating the reduction of western medication. To address clinical challenges such as symptom overlap and limited therapeutic efficacy， strategies have been proposed including "treating different diseases with the same method" and integrated regulation based on viscera correlation. Future efforts should focus on elucidating the mechanisms of compound prescriptions， promoting TCM drug development under the "three-combination" evaluation framework that integrates TCM theory， human experience and clinical trial evidence， and optimizing integrated traditional and western medicine models to enhance GERD management.

Objective To investigate the epidemiological characteristics of malaria and provide a basis for developing improved prevention and control measures. Methods Data were obtained from the Chinese Disease Prevention and Control Information System. Malaria surveillance data for Nanning City from January 1,2023, to December 31,2024, were exported from the Infectious Disease Reporting Information Management Subsystem. The characteristics of the two groups of malaria cases were compared. Results A total of 103 imported malaria cases were reported in Nanning City in 2024, representing a 38.32% decrease compared with the same period of the previous year. No statistically significant difference were observed between cases reported in 2023 and 2024 in terms of average age, gender ratio, proportion of parasite species, and monthly reporting distribution;however, statistically significant differences were found in the proportion of reporting areas and current residence areas(χ2= 13.572 and 10.355, respectively; P = 0.001 and 0.035, respectively). The proportion of cases reported in Shanglin County and the proportion of cases residing in Shanglin County were both lower than those during the same period of the previous year. Conclusions The high aggregation of imported malaria cases in Nanning City has decreased. Medical institutions in areas other than Shanglin County should strengthen their vigilance against malaria.

Background/Aims: Non-pharmacological treatments are crucial for managing irritable bowel syndrome (IBS), yet patient engagement remains a challenge. Understanding patients' knowledge, attitudes, and practices regarding these treatments is essential for improving care. Methods: A cross-sectional study was conducted across 5 hospitals, from October 2023 to February 2024. A self-designed knowledge, attitudes, and practices questionnaire along with the IBS quality of life and IBS severity scoring system was administered, and 496 valid responses were analyzed. Statistical analyses included correlation tests, multivariate linear regression, and mediation effect analysis. Results: The median scores for knowledge, attitude, and practice were 28, 25.5, and 21, respectively. Significant positive correlations were found between knowledge-attitude (r = 0.195), knowledge-practice (r = 0.364), and attitude-practice (r = 0.151). The multivariate linear regression analysis further indicated that knowledge (β = 0.399, P < 0.001) and attitude (β = 0.219, P = 0.022) positively correlated with the practical performance. SEM revealed that knowledge had a significant direct effect on both attitude (β = 0.186, P = 0.013) and practice (β = 0.356, P = 0.006). However, the direct effect of attitude on practice was not significant, and attitude did not mediate the relationship between knowledge and practice. Conclusions IBS patients exhibit a significant gap between their positive attitudes and their actual practices concerning non-pharmacological treatments. Knowledge is a direct driver of practice, but positive attitudes alone are insufficient to translate into behavior. Healthcare providers must move beyond simply fostering positive attitudes and focus on targeted educational interventions that provide actionable knowledge and skills to improve patient outcomes.

The global incidence rate of cancer is increasing yearly,and chemotherapy-induced gastrointestinal mucosal injury has become a crucial factor affecting patients'therapeutic prognosis;however,there is currently a lack of effective therapeutic drugs to address this issue.There is thus an urgent need to establish more ideal animal models of chemotherapy-induced gastrointestinal mucosal injury,to support the exploration of its pathogenesis and the development of therapeutic drugs.This review considered relevant literature published during the period from 2019 to 2024,to provide a comprehensive summary and analysis from several perspectives,including the selection of experimental animals,chemotherapeutic drugs and modeling method,evaluation indicators,and practical applications.Furthermore,we highlight several existing issues with current models,including the lack of standardized modeling method,insufficient research on models with a tumor background,and inadequate exploration of novel cell death mechanisms.This collation of the literature also revealed the gradual emergence of traditional Chinese medicine as a research hotspot,with potential for the treatment of gastrointestinal mucosal injury.Further studies of effective medicines are warranted to identify interventional strategies for chemotherapy-induced gastrointestinal mucosal injury.

Objective To systematically retrieve,evaluate and summarise the best available evidence on prevention and management of diagnostic blood loss in critically ill adult patients and to provide guidance for standardising diagnostic blood sampling in clinical practice.Methods A structured evidence question was created using the PIPOST framework(Population,Intervention,Professional,Outcome,Setting and Type of evidence).Guided by the"5S"levels-of-evidence pyramid,a top-down systematic search was conducted on databases of BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)EBP Database,GIN,SIGN,RNAO,NICE,Medlive Guideline,WHO,National Blood Authority(Australia),National Health Commission of China,Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,Wanfang Data,CNKI,VIP,and SinoMed.Searched literature included clinical decision aids,guidelines,evidence summaries,systematic reviews Meta analysis,RCTs,quasi-experimental,cross-sectional,cohort studies and expert consensus/opinions.Search period covered between 1st January 2015 and 10th February 2025.Quality appraisal,evidence extraction,synthesis and grading were performed according to JBI and GRADE approaches.Results Nineteen articles were retrieved including five guidelines,five systematic reviews,one RCT,two quasi-experimental studies,two cross-sectional studies,one professional standard and three expert consensuses.A total of 26 recommendations were extracted and they were organised into five domains:education and training,blood-sampling assessment,frequency of sampling,strategies to minimise blood volume drawn,and quality control.Conclusion This evidence summary provides the best current guidance for preventing and managing iatrogenic blood loss caused by diagnostic testing in critically ill adults,providing evidence-based basis for standardizing blood tests by medical staff.

Objective To explore the efficacy of a compound nutrition preparation on wound healing after acute trauma and investigate the underlying mechanism primarily.Methods After skin wound model was successfully constructed on totally 60 male SD rats surgically,they were randomly divided into control group(CON group),whey protein group(WP group)and low-and high-dose nutritional formula groups(LDF and HDF groups),with 15 animals in per group.From the next day after surgery,the rats in each group were given corresponding nutritional interventions for 2 weeks.During the intervention,the wound conditions were observed and recorded,and the wound area was measured.The samples were collected on the 3rd,7th and 14th days after surgery,respectively.Serum albumin(ALB),prealbumin(PA),total protein(TP),inflammatory factors(TNF-α,IL-1β,IL-6 and IL-10),immunoglobulins(IgA,IgG and IgM)and hydroxyproline(Hyp)were detected by the corresponding reagent kits.The histopathologic changes of wound were observed with HE staining.Masson staining was used to observe the collagen fiber deposition in wound tissue.The angiogenesis of wound tissue was evaluated by immunohistochemical staining.Results Compared with the CON group,the wound healing speed,collagen synthesis and angiogenesis speed were significantly accelerated in the WP group,LDF group and HDF group(P＜0.05),and the effects were the most obvious in the HDF group.On the 3rd day after surgery,in the WP,LDF and HDF groups,the serum ALB,PA and TP levels were significantly increased(P＜0.05),serum TNF-α and IL-1β levels were obviously decreased(P＜0.05),and serum IL-10 level was notably increased(except WP group)when compared with the CON group.The serum IgG and IgM levels were significantly increased in the LDF group and HDF group(P＜0.05)and significant increment of IgA was only observed in the HDF group(P＜0.05).On the 7th day after modeling,the levels of ALB,PA and TP were significantly increased(P＜0.05),the levels of TNF-α,IL-1β and IL-6 were obviously decreased(P＜0.05),and the levels of IL-10 were remarkably increased(P＜0.05)in the HDF group than the CON group;The LDF group and HDF group had significantly elevated serum IgG and IgM levels(P＜0.05),but only the former group had statistically increased serum IgA level(P＜0.05).On the 14th day after modeling,the HDF group had significantly increased levels of ALB and TP(P＜0.05),decreased levels of IL-1β(P＜0.05),and raised levels of IgG and IgM when compared with the CON group(P＜0.05).Conclusion Our compound nutrition preparation promotes wound healing in rat model of acute trauma,which might be related to its improving the nutritional status,promoting collagen synthesis,and thus alleviating inflammatory response and enhancing immune function.

OBJECTIVE To observe the epidemiological characteristics,virulence and drug resistance genes in Kleb-siella oxytoca complex(KOX)strains isolated from the children in Suzhou so as to provide theoretical bases for clinical prevention and control.METHODS The clinical distribution and drug resistance of 101 strains of KOX that were isolated from Children's Hospital of Soochow University from Jan.2021 to Mar.2024 were retrospectively analyzed.Fifty strains were randomly selected to detect the expressions of 18 types of virulence genes and 12 types of drug resistance genes.RESULTS Of the 97 strains of KOX isolated from hospitalized children,32.67％from i-solated from sputum,27.72％from stools and 24.74％from urine;45.54％were isolated from hematology de-partment,18.81％from neonatology department and 10.89％from ICU.The strains expressed a variety of viru-lence genes,among which the ironophore-related genes entB(82.00％),irp-1(64.00％),irp-2(64.00％),ybtS(64.00％)and fyuA(64.00％)were dominant.Carbapenem-sensitive KOX(CS-KOX)strains were susceptible to most of the antibiotics,while the drug resistance rates of the CR-KOX strains to most of the antibiotics were relatively high.The detection rates of extended-spectrum β-lactamase gene CTX(56.52％)and carbapenemase gene NDM(78.26％)were relatively high among the CR-KOX strains;38.89％(7/18)of the strains expressed NDM gene and meanwhile expressed other carbapenemase genes.CONCLUSIONS The KOX strains isolated from the hospitalized children in Suzhou carry a variety of virulence and drug resistance genes,and there is risk of trans-mission of CR-KOX in the hospital.Therefore,it is necessary to attach great importance to the surveillance of drug-resistant strains for the long-term hospitalized children and raise the awareness of infection control so as to prevent the transmission of such bacteria.

Objective:To understand the functional requirements and suggestions of relevant stakeholders on the Internet platform for remote rehabilitation management of patients after arthroscopy, so as to provide a reference basis for building a home rehabilitation management scheme and developing a remote Internet platform.Methods:Based on the technology acceptance model, a descriptive qualitative study was conducted using purposive sampling and maximum difference method to select 11 arthroscopic postoperative patients, 4 patient caregivers, and 7 clinical professionals from the Sports Medicine Department of Wuxi Ninth People′s Hospital (Orthopaedic Hospital) from October to December 2022. A total of 22 stakeholders were interviewed in a semi-structured manner, and the Colaizzi was used to analyze the interview data.Results:Among 22 interviewers, 12 males, 10 females, aged 25-65 years. A total of four topics were summarized: the willingness to use the Internet platform for remote rehabilitation management, the demand for the content provided by the Internet platform for remote rehabilitation management, the demand for the module functions of the Internet platform for remote rehabilitation management, and the demand for the operability of the Internet platform for remote rehabilitation management.Conclusions:The general attitude of the stakeholder groups towards the use of the Internet platform for remote rehabilitation management of patients after arthroscopy is positive. It is hoped that the platform will have diversified functions and good usability, improve the compliance and enthusiasm of patients in home rehabilitation exercise, and thus promote the recovery of limb function.

Diaphragmatic dysfunction often occurs in ICU patients with prolonged mechanical ventilation, which seriously affects patients′prognosis. This article reviewed the progress of rehabilitation treatment of diaphragmatic dysfunction in ICU patients with mechanical ventilation, focused on the concept and assessment of diaphragm rehabilitation, the current status, evaluation indexes, emphasized the importance of nurses, analyzed the dilemmas and countermeasures in the application, which aimed to provide a reference for the promotion of diaphragm rehabilitation in clinical practice.

Objective To observe the clinical efficacy of Shujin Tougu Wash Recipe in the treatment of knee osteoarthritis and to analyze the changes in patients'serum metabolites before and after treatment.Methods A total of 30 patients with knee osteoarthritis were randomly divided into the observation group and the control group.Patients in the control group were treated with Glucosamine Hydrochloride Tablets.Patients in the observation group were treated with Shujin Tougu Wash Recipe.Two groups were treated for 3 weeks.The clinical efficacy was evaluated by observing the changes in the Visual Analogue Scale(VAS),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),and knee joint activity before and after treatment.Serum was collected from five patients from the observation group before and after treatment,and the changes in serum metabolites were detected by UPLC-MS untargeted metabolomics technology.Metabolic pathways were analyzed through the KEGG database.Results Compared with before treatment,the VAS and WOMAC scores of patients were reduced after treatment(P＜0.05),and the activity of the knee joint was increased(P＜0.05).Tthe Observation Group is better than the control group.There were 15 differential metabolites before and after treatment,among which the content of valproic acid,N-methylundecanamide,arachidonamide,spironolactone,propylene glycol,lysophosphatidylcholine,dehydroisoproporphyrinogen,and marcoticin increased after treatment,while the content of arginine,glycine,aspartic acid,pipecolate,fexofenadine,perindopril,alfuzosin,2-aminohexanoic acid,and all-trans-heptaprenyl diphosphate decreased.The metabolic pathways involved were mainly choline metabolism,retrograde endocannabinoid signaling pathway,linoleic acid metabolism,glycerophospholipid metabolism,α-linolenic acid metabolism,and arachidonic acid metabolism.Conclusion The treatment of knee osteoarthritis patients with Shujin Tougu Wash Recipe can significantly improve the clinical symptoms of patients,improve the quality of life of patients,and can regulate the levels of arginine,valproic acid,and lysophosphatidylcholine metabolites in patients'serum,affecting multiple metabolic pathways,and improving the inflammatory level of patients through correcting d lipid metabolism,and playing an analgesic effect.