Objective: To explore the interrelationships between mental vulnerability, cognitive emotion regulation strategies, and positive psychological capital in medical postgraduates, so as to provide precise intervention targets for mental health services in universities. Methods: From April to June 2025, a convenience sampling method was used to select 1 461 medical postgraduates from three colleges in Hubei Province. Participants were assessed using the Mental Vulnerability Questionnaire (MVQ), the Cognitive Emotion Regulation Questionnaire-Chinese Version (CERQ-C) and the Positive Psychological Capital Questionnaire (PPQ). The network analysis model was constructed using a Gaussian graphical model. Results: The network analysis revealed that the edge connection between somatic symptoms and mental symptoms was the strongest, followed by the connection between refocus on planning and positive reappraisal within cognitive emotion regulation, with edge weights of 0.69 and 0.59, respectively. Interpersonal problems within psychological vulnerability exhibited the highest expected influence( EI =1.27), serving as the core node of the network. Rumination within cognitive emotion regulation demonstrated the highest bridge expected influence( BEI =0.33), playing a critical connecting role among psychological vulnerability, cognitive emotion regulation, and positive psychological capital. Conclusion In the mental health network of medical postgraduates, mental vulnerability, cognitive emotion regulation, and positive psychological capital interact through their respective key dimensions, jointly affect overall mental health.

Xuefu zhuyu decoction is a classic formula for promoting blood circulation and resolving blood stasis， characterised by its remarkable ability to treat different diseases with the same approach. Qi stagnation and blood stasis， the primary syndrome for which this formula is indicated， has been found through modern medical research to be intrinsically linked to a wide range of pathophysiological processes， including microcirculatory disorders， abnormalities in hemorheology， inflammatory responses and endothelial dysfunction； which opens up vast scope for the innovative application of traditional formulas. In terms of pharmacological effect and mechanism， the formula exerts a synergistic regulatory effect across multiple key pathological pathways， including the regulation of coagulation function， the maintenance of vascular structure and function， anti-inflammatory and immunomodulatory actions， the mitigation of oxidative stress， and the modulation of programmed cell death （such as pyroptosis and ferroptosis）. This systematically demonstrates its scientific rationale， which is based on integrated regulation through multiple constituents， multiple targets and multiple pathways. In terms of clinical application， the formula has expanded from cardiovascular diseases to multiple disciplines， including gastroenterology， respiratory medicine， urology， neurology， endocrinology， gynaecology and andrology， with evidence-based medical evidence continuing to accumulate. Current research still faces bottlenecks such as a relatively low level of clinical evidence， insufficient systems biology analysis of the mechanisms underlying the compound’s formulation， and a weak correlation between quality control indicators and therapeutic efficacy. Future efforts should focus on conducting multicentre randomised controlled trials for conditions where the formula demonstrates particular efficacy， deepening research into the relationship between integrated pharmacology and spectrum-efficacy relationship， and promoting the precise application and formulation innovation of classical herbal formulas.

Xuefu zhuyu decoction is a classic formula for promoting blood circulation and resolving blood stasis， characterised by its remarkable ability to treat different diseases with the same approach. Qi stagnation and blood stasis， the primary syndrome for which this formula is indicated， has been found through modern medical research to be intrinsically linked to a wide range of pathophysiological processes， including microcirculatory disorders， abnormalities in hemorheology， inflammatory responses and endothelial dysfunction； which opens up vast scope for the innovative application of traditional formulas. In terms of pharmacological effect and mechanism， the formula exerts a synergistic regulatory effect across multiple key pathological pathways， including the regulation of coagulation function， the maintenance of vascular structure and function， anti-inflammatory and immunomodulatory actions， the mitigation of oxidative stress， and the modulation of programmed cell death （such as pyroptosis and ferroptosis）. This systematically demonstrates its scientific rationale， which is based on integrated regulation through multiple constituents， multiple targets and multiple pathways. In terms of clinical application， the formula has expanded from cardiovascular diseases to multiple disciplines， including gastroenterology， respiratory medicine， urology， neurology， endocrinology， gynaecology and andrology， with evidence-based medical evidence continuing to accumulate. Current research still faces bottlenecks such as a relatively low level of clinical evidence， insufficient systems biology analysis of the mechanisms underlying the compound’s formulation， and a weak correlation between quality control indicators and therapeutic efficacy. Future efforts should focus on conducting multicentre randomised controlled trials for conditions where the formula demonstrates particular efficacy， deepening research into the relationship between integrated pharmacology and spectrum-efficacy relationship， and promoting the precise application and formulation innovation of classical herbal formulas.

POEMS syndrome is a rare condition associated with plasma cell disorders， and it often involves multiple systems and has diverse clinical manifestations. This article reports two cases of POEMS syndrome with hepatosplenomegaly as the initial manifestation. During the course of the disease， the patients presented with lower limb weakness， hepatosplenomegaly， lymph node enlargement， ascites， hypothyroidism， positive M protein， and skin hyperpigmentation， and ¹⁸F-FDG PET-CT imaging revealed bone lesions mainly characterized by osteolytic changes and plasma cell tumors. There was an increase in the serum level of vascular endothelial growth factor. The patients were finally diagnosed with POEMS syndrome， and the symptoms were relieved after immunomodulatory treatment.

Objective:To explore the current state of thriving at work among orthopedic nurses and analyze its influencing factors, so as to provide a basis for nursing administrators to promote the development of orthopedic nurses.Methods:Convenience sampling was used to select 469 orthopedic nurses from the Honghui Hospital, Xi'an Jiaotong University from January to February 2025 as research subjects. The General Information Questionnaire, Thriving at Work Scale (TWS), Leisure Crafting Scale (LCS), and General Self-Efficacy Scale (GSES) were used to investigate general information, thriving at work, leisure crafting, and self-efficacy. Pearson correlation analysis was employed to investigate the correlation between orthopedic nurses' thriving at work, leisure crafting, and general efficacy. Multiple linear regression was used to analyze the factors influencing the thriving at work of orthopedic nurses.Results:A total of 469 questionnaires were distributed, with 442 valid responses collected, with a valid response rate of 94.24%. The TWS score of orthopedic nurses was (35.70±5.20). Pearson correlation analysis revealed that scores on TWS were positively correlated with scores on both LCS and GSES ( r=0.593, 0.569; P<0.01). Multiple linear regression analysis revealed that being an only child, liking nursing work, interest in the nursing profession, leisure crafting, and general self-efficacy were factors influencing the thriving at work of orthopedic nurses ( P<0.05) . Conclusions:The thriving at work of orthopedic nurses is at a moderate level. Orthopedic nurses who are only children, the better the leisure crafting and general self-efficacy of orthopedic nurses have the higher their thriving at work. Orthopedic nursing managers should provide a supportive environment to enhance orthopedic nurses' intrinsic motivation, thereby promoting their thriving at work.

Objective:To explore the pain sensations and experiences of patients with post-stroke hemiplegic shoulder pain, and to provide reference for the formulation of intervention plans.Methods:Objective sampling method was used to conduct semi-structured interviews on 15 patients with post-stroke hemiplegic shoulder pain in the department of neurology and rehabilitation department of Wuhan No.1 Hospital from January to March 2024. The interview outline was established based on the information-knowledge-attitude-practice (IKAP) theory, and the data were analyzed, summarized and extracted by Colaizzi 7-step analysis method.Results:According to the four core components of the IKAP theory, ten themes were extracted. The information and knowledge included the neglect of the importance of early management for hemiplegic shoulder pain, the lack of understanding of the relevant knowledge about hemiplegic shoulder pain, and the use of restricted or incorrect attribution methods in relation to hemiplegic shoulder pain. The attitude included a perception of pain as uncontrollable, the suppression of pain expression, the concern regarding the persistent presence of pain, and the experience of negative emotions. The practice included the adverse effects stemming from hemiplegic shoulder pain, the strategies employed to cope with hemiplegic shoulder pain, and the expectation of multifaceted social support.Conclusions:Patients with post-stroke hemiplegic shoulder pain bear many burdens and have needs in terms of pain experiences. Healthcare professionals need to strengthen pain health education and guidance, help patients develop correct pain cognition and beliefs, refine the pain management system, assist patients in establishing a diverse social support system, enhance their pain coping abilities, and comprehensively promote the rehabilitation of the disease.

Objective To investigate the effects of DNA Cross-Link Repair 1A(DCLRE1A)on mitochondrial func-tion in lens epithelial cells(LECs).Methods Thirty eyes from 30 patients with age-related cataracts(ARC)were select-ed and divided into three groups:cortical type(ARCC group),nuclear type(ARNC group),and posterior subcapsular type(ARPC group),with 10 cases in each group.Additionally,10 eyes from 10 age-matched patients diagnosed with epiretinal membrane and having clear lenses were selected as the control group.Western blot was used to detect the ex-pression levels of DCLRE1A protein in the anterior capsule tissues of patients in each group and in the lens epithelial cell line(SRA01/04)treated with hydrogen peroxide(H2O2)in vitro and overexpressed DCLRE1A model(OE-DCLRE1A group).The effects of overexpressed DCLRE1A on the expression levels of mitochondrial transcription factor(TFAM)and peroxisome proliferator-activated receptor-γ coactivator-1α(PGC1α)proteins were also detected.Normal cultured SRA01/04 cells were randomly divided into Control group(untreated),H2 O2 group,H2 O2+HA group(transfected with control plasmid HA),and H2O2+OE-DCLRE1A group(transfected with DCLRE1A plasmid).RT-PCR was used to measure mtD-NA expression in each group cells.Changes in mitochondrial membrane potential(MMP)and mitochondrial reactive oxy-gen species(ROS)in each group were detected by immunofluorescence staining.Results Western blot analysis showed that compared with the control group cells,the relative expression levels of DCLRE1A protein in the anterior capsule tis-sues of patients in the ARCC,ARNC,and ARPC groups were all decreased,with statistically significant differences(all P＜0.001).In the in vitro H2O2-induced oxidative damage model,compared with the Control group,the relative expression level of DCLRE1A protein in the H2O2 group was significantly decreased(P＜0.001).The overexpression efficiency results of DCLRE1A showed that,compared with the Control group,the relative expression level of DCLRE1A protein in the OE-DCLRE1A group cells was significantly increased,with statistical significance(P＜0.001).RT-PCR results showed that compared with the H2O2+HA group,the expression level of mtDNA in the H2O2+OE-DCLRE1A group was significantly in-creased(P＜0.001).Western blot analysis showed that compared with the H2O2+HA group,the relative expression levels of TFAM and PGC1α proteins in the H2O2+OE-DCLRE1A group were significantly increased(P＜0.001).Immunofluores-cence staining results showed that compared with the H2O2+HA group,the MMP level in the H2O2+OE-DCLRE1A group was significantly restored,and the accumulation of mitochondrial ROS was reduced(P＜0.001).Conclusion Under H2O2-induced oxidative stress conditions,DCLRE1A promotes the repair of damaged mtDNA in LECs by regulating mito-chondrial biogenesis,thereby reducing LEC apoptosis and participating in the occurrence and development of ARC.

Purpose The current study aims to elucidate the interrelationships among IREB2,FBXL5,iron ho-meostasis,and the therapeutic efficacy of neoadjuvant chemotherapy.Methods A total of 97 samples,classified into colorectal cancer neoadjuvant chemotherapy-resistant and-sensitive groups,along with their corresponding paracancer-ous normal mucosa were collected.The expression levels of FBXL5,IREB2,TFRC and FTH1 were detected by immu-nohistochemistry,Werstern blot and RT-qPCR.The contents of ferroptosis-related markers Fe2+,MDA,ROS and GSH were detected by applying the kit,and the levels of these markers were analyzed.The relationship between each factor in different colorectal cancer tissues and tumor regression rate and prognosis of neoadjuvant chemotherapy were ana-lyzed.Results(1)The expression of IREB2,FBXL5,TFRC and FTH1 in colorectal cancer was higher than that in normal intestinal mucosa(P＜0.05),and the expression of FBXL5 and FTH1 in colorectal cancer drug-resistant group was lower than that in the sensitive group,whereas the expression of IREB2 and TFRC was higher than that in the sen-sitive group(P＜0.05);(2)The correlation analysis showed a positive correlation between the expression of IREB2 and TFRC in the drug-resistant group,and a negative correlation with the expression of FBXL5 and FTH1 in the drug-resistant group.TFRC expression in the colorectal cancer resistance group were positively correlated(P＜0.05)and negatively correlated with the expression of FBXL5 and FTH1(P＜0.05);(3)the content of Fe2+and GSH was high-er than that of the sensitivity group in the colorectal cancer resistance group,and the level of ROS was lower than that of the sensitivity group(P＜0.05);(4)Fe2+was positively correlated with the expression of IREB2,TFRC,and neg-atively correlated with the expression of FBXL5 and FTH1,and was negatively correlated with the expression of FBXL5 and FTH1.FTH1 expression were both negatively correlated(P＜0.05);(5)tumor regression rate was positively cor-related with the expression of FBXL5 and FTH1,and negatively correlated with the expression of IREB2 and TFRC,as well as positively correlated with the level of ROS,and negatively correlated with Fe2+and GSH(P＜0.05);(6)The expression of IREB2 and TFRC was positively correlated with tumor diameter and lymph node metastasis,and the ex-pression of FBXL5 and FTH1 was negatively correlated with tumor diameter and lymph node metastasis,and the expres-sion of FBXL5 was also negatively correlated with the depth of tumor infiltration(P＜0.05);(7)Kaplan-Meier analy-sis showed that lymph node metastasis,FBXL5,IREB2,TFRC,FTH1,and TRG grading were closely related to the prognosis of colorectal cancer patients(P＜0.05).Cox multivariate regression analysis indicated that lymph node me-tastasis,high expression of IREB2 and TFRC,low expression of FBXL5 and FTH1,and low tumor regression grade(TRG)were risk factors for the ineffectiveness of neoadjuvant chemotherapy in colorectal cancer patients.Conclusion FBXL5 and IREB2 are not only associated with high iron homeostasis,but also closely related to the efficacy and prognosis of neoadjuvant chemotherapy for colorectal cancer.In the future,they may become new targets for the treat-ment of colorectal cancer and improve the prognosis of patients.

Objective To simulate modern social stress using a pre-pregnancy chronic mild stress(CMS)model and to explore the mechanisms of emotional,behavioral,and neurodevelopmental changes in male offspring of pre-pregnancy liver qi stagnation female mice through corticosterone(CORT)-brain-derived neurotrophic factor(BDNF)extracellular signal-regulated kinase(ERK)1/2 signaling cascade-mediated hippocampal injury.This study aimed to elucidate the impact of negative life events on offspring and the interventional mechanism of Shuyu Capsules.Methods CMS stress was used to induce pre-pregnancy depression in female rats(liver qi stagnation state),followed by intervention with Shuyu and fluoxetine capsules.After screening,male rats were mated and 12 male offspring from each group were selected for behavioral testing and detection of serum CORT levels by enzyme-linked immunosorbent assay.BDNF,ERK1/2,phospho(p)-ERK1/2,cAMP-response element binding protein(CREB),and p-CREB protein levels in the hippocampus were detected by Western Blot,and BDNF,ERK1,ERK2,and CREB mRNA levels in the hippocampus were detected by reverse transcription-polymerase chain reaction(RT-PCR),to verify the effects of pre-pregnancy CMS on the BDNF-ERK1/2-CREB signaling pathway and to investigate the key micro-mechanisms of Shuyu Capsules on emotional and learning memory-related behaviors of male offspring of females with pre-pregnancy liver qi stagnation syndrome.Results The distance,number of entries,and duration of stay in the central area in open-field experiments were significantly reduced in offspring in the model group(all P＜0.05).The escape latency during the exploration period of the water-maze experiment was significantly prolonged(P＜0.05)and the swimming distance,duration of the target quadrant,and number of platform crossings were significantly reduced(P＜0.05,P＜0.05,P＜0.01),the suspension time and frequency in the forced-swimming experiment were increased(P＜0.05,P＜0.01),and the incubation period was shortened(P＜0.05)in offspring in the model group.Prophylactic treatment with Shuyu Capsules and fluoxetine improved the depression-like behavior and cognitive impairment in the offspring in the model group.Biochemical tests showed that CORT levels were increased in the CMS model group(P＜0.05),BDNF,p-ERK1/2,and p-CREB protein levels in the hippocampus were decreased(all P＜0.05),and BDNF,ERK1,ERK2,and CREB mRNA levels were significantly reduced(P＜0.01,P＜0.05,P＜0.01,P＜0.05).Treatment with Shuyu Capsules and fluoxetine increased the CORT content and BDNF,ERK1/2,and CREB protein and mRNA levels in male offspring to varying degrees.Conclusions High levels of CORT in offspring act selectively on the hippocampus,exerting adverse effects on the emotional and learning memory functions of rats by downregulating the BDNF-ERK1/2 signaling cascade.The Chinese medicine Shuyu Capsules can reduce the impact of an adverse intrauterine environment on offspring development by correcting abnormal levels and pathways of glucocorticoids.

Objective To investigate the effects of DNA Cross-Link Repair 1A(DCLRE1A)on mitochondrial func-tion in lens epithelial cells(LECs).Methods Thirty eyes from 30 patients with age-related cataracts(ARC)were select-ed and divided into three groups:cortical type(ARCC group),nuclear type(ARNC group),and posterior subcapsular type(ARPC group),with 10 cases in each group.Additionally,10 eyes from 10 age-matched patients diagnosed with epiretinal membrane and having clear lenses were selected as the control group.Western blot was used to detect the ex-pression levels of DCLRE1A protein in the anterior capsule tissues of patients in each group and in the lens epithelial cell line(SRA01/04)treated with hydrogen peroxide(H2O2)in vitro and overexpressed DCLRE1A model(OE-DCLRE1A group).The effects of overexpressed DCLRE1A on the expression levels of mitochondrial transcription factor(TFAM)and peroxisome proliferator-activated receptor-γ coactivator-1α(PGC1α)proteins were also detected.Normal cultured SRA01/04 cells were randomly divided into Control group(untreated),H2 O2 group,H2 O2+HA group(transfected with control plasmid HA),and H2O2+OE-DCLRE1A group(transfected with DCLRE1A plasmid).RT-PCR was used to measure mtD-NA expression in each group cells.Changes in mitochondrial membrane potential(MMP)and mitochondrial reactive oxy-gen species(ROS)in each group were detected by immunofluorescence staining.Results Western blot analysis showed that compared with the control group cells,the relative expression levels of DCLRE1A protein in the anterior capsule tis-sues of patients in the ARCC,ARNC,and ARPC groups were all decreased,with statistically significant differences(all P＜0.001).In the in vitro H2O2-induced oxidative damage model,compared with the Control group,the relative expression level of DCLRE1A protein in the H2O2 group was significantly decreased(P＜0.001).The overexpression efficiency results of DCLRE1A showed that,compared with the Control group,the relative expression level of DCLRE1A protein in the OE-DCLRE1A group cells was significantly increased,with statistical significance(P＜0.001).RT-PCR results showed that compared with the H2O2+HA group,the expression level of mtDNA in the H2O2+OE-DCLRE1A group was significantly in-creased(P＜0.001).Western blot analysis showed that compared with the H2O2+HA group,the relative expression levels of TFAM and PGC1α proteins in the H2O2+OE-DCLRE1A group were significantly increased(P＜0.001).Immunofluores-cence staining results showed that compared with the H2O2+HA group,the MMP level in the H2O2+OE-DCLRE1A group was significantly restored,and the accumulation of mitochondrial ROS was reduced(P＜0.001).Conclusion Under H2O2-induced oxidative stress conditions,DCLRE1A promotes the repair of damaged mtDNA in LECs by regulating mito-chondrial biogenesis,thereby reducing LEC apoptosis and participating in the occurrence and development of ARC.