This article summarized the clinical experience of professor XU Jingfan，a traditional Chinese medicine （TCM） master， in treating spleen and stomach diseases with aromatic herb Shichangpu （Rhizoma Acori Tatarinowii）， based on the theory of 'aromatics acting on the spleen'. Shichangpu is commonly combined with Peilan （Herba Eupatorii） to aromatically awaken the spleen， and self-made Xingpi Kaiwei Formula （醒脾开胃方） can be used for postprandial distress syndrome of the spleen-stomach disharmony type. It is paired with Diyu （Radix Sanguisorbae） to resolve turbidity and promote wound healing， with a self-made Changyu Decoction （菖榆煎） for retention enema in chronic colitis and inflammatory bowel disease. When paired with Yujin （Radix Curcumae）， it can be used to promote qi and resolve constraint， and can be combined with modified Sini Powder （四逆散） for epigastric pain of liver-stomach disharmony type. Paired with Fangfeng （Radix Saposhnikoviae） to dispel wind and resolve dampness， and together with Tongxie Important Formula （痛泻要方）， it is used to treat diarrhea-predominant irritable bowel syndrome of liver constraint and spleen deficiency type. It is paired with Yizhiren （Fructus Alpiniae Oxyphyllae） for its warming and astringing properties， and together with modified Linggui Zhugan Decoction （苓桂术甘汤） for phlegm-rheum due to spleen-stomach yang deficiency type. Clinically， great importance is also attached to tongue inspection related to Shichangpu， closely focusing on the pathogenesis of internal accumulation of damp turbidity in the middle jiao （焦）. Moreover， when treating spleen and stomach diseases， the dosage should be light and flexible.

Objective:To evaluate the progress and trends in perioperative management of postoperative delirium(POD)in the elderly over the past decade,providing insights for future research in China.Methods:Literature related to perioperative management of POD in elderly patients was retrieved from the Web of Science database published from Jan 1,2014,to Dec 31,2023.Articles and reviews were selected,and CiteSpace 6.3.1 software was used for duplicate removal and comprehensive analysis.Results:A total of 655 relevant publications were included,showing an overall increasing trend in annual output.China contributed 147 publications(22.44%,147/655),while the United States produced 134 publications(20.46%,134/655).Research hotspots focused on"hip fracture","neurocognitive disorders","Alzheimer's disease",and"oxidative stress".Conclusions:Research on the prevention and treatment of POD in elderly patients is growing globally.Although China has produced a substantial number of publications,its academic influence remains relatively limited.While clinical studies have elucidated strategies for POD prevention and treatment,further research is needed to validate intervention efficacy and explore underlying mechanisms.

Objective:To develop a 5-year mortality risk prediction model for patients with small cell neuroendocrine carcinoma of the cervix(SCNEC).Methods:Based on the Surveillance,Epidemiology,and End Results(SEER)database and R software version 4.3.3,variables were screened via Lasso regression,followed by multivariable logistic regression and stepwise regression to develop a 5-year mortality risk prediction model for SCNEC patients.The Akaike Information Criterion(AIC),C-index,receiver operating characteristic(ROC)curve,Hosmer-Lemeshow test,and calibration curve were employed to evaluate the model.Results:Age,M stage,surgical status,and lymph node metastasis were ultimately selected as variables to construct the 5-year mortality risk prediction model for SCNEC patients.The model demonstrated superior predictive performance compared to FIGO staging(P＜0.01).The Hosmer-Lemeshow test yielded a P-value＞0.05.The C-index values for the training and validation sets were 0.808 and 0.755,respectively,with the areas under the ROC curves of 0.826 and 0.744.The calibration curves of the model fluctuated near the diagonal line,indicating good agreement between predicted and observed outcomes.The decision curve analysis demonstrated significant clinical net benefit.Results showed that higher mortality risk was associated with advanced age,M1 status,lymph node metastasis,and lack of surgical opportunity.Conclusions:The model exhibits good discriminatory power and accuracy,providing significant benefits to patients.Enhanced management should be implemented for patients with advanced age,distant metastasis,lymph node metastasis,or ineligibility for surgery.Lymph node metastasis is an independent risk factor for 5-year mortality in patients with SCNEC.

Objective:To develop and evaluate the reliability and validity of a questionnaire for assessing long-term care needs among community-dwelling older adults.Methods:Guided by the International Classification of Functioning, Disability and Health (ICF), an initial item pool for the questionnaire was constructed based on literature review, descriptive qualitative research, and expert consultations. The draft questionnaire was formulated by transforming the established indicator system for long-term care needs into survey items. Using stratified sampling, a total of 622 older adults from community settings in Changsha were surveyed between June and August 2021. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing were conducted.Results:The final questionnaire consists of three subscales (mental function, physical function, and activity and participation), comprising a total of 47 items. The item-level content validity index ( I- CVI) ranged from 0.830 to 1.000, and the scale-level content validity index ( S- CVI) was 0.915. EFA results showed that the extracted factors aligned well with the predefined dimensions after adjustment, with factor loadings exceeding 0.600 and cumulative variance contributions exceeding 70.000% for all subscales. CFA results indicated good model fit across all subscales and the overall questionnaire, confirming stable structural validity. The Cronbach's α coefficients ranged from 0.877 to 0.970, and test-retest reliability coefficients ranged from 0.901 to 0.957. Conclusions:The long-term care needs assessment questionnaire for community-dwelling older adults demonstrates strong reliability and validity, and can serve as a reliable tool for evaluating long-term care needs in this population.

Laboratory animals are essential in scientific research and experimental teaching in colleges and universities. Disciplines such as life sciences, medicine, pharmacy, chemistry, and biomedical engineering heavily rely on animal experiments. The standardized barrier environmental facility for laboratory animals provides a fundamental platform for stable, scientific, and reliable animal experiment results. Rigorous access management for such facilities is a vital safeguard for maintaining standardized operations of facilities, controlling the quality and stability of laboratory animals, mitigating pathogen contamination risks among animals and laboratory staff, and preventing biosecurity incidents such as zoonotic disease outbreaks. Taking the small-scale barrier facilities for laboratory rats and mice at Nanjing University's Xianlin Campus, operational since 2019, as an example, this study focuses on the safety access management system of these facilities. Based on five years of operational data and accumulated experience in studying and optimizing the access management system, this study, from the perspectives of management system development and the formulation and implementation of standard operating procedures, reviews five aspects of access management: personnel access, animals access, material access, equipment access, and air circulation control. Furthermore, these aspects are systematically analyzed and summarized to serve as a reference for the construction and management of the laboratory animal facilities in universities, while also contributing to scientific research, public health security, and the well-being of experimental personnel.

Immunosuppressants(including cyclosporine,tacrolimus,mycophenolate esters,glucocorticoids,etc.)are the first choice of drugs to prevent organ rejection after liver transplantation,which can effectively reduce the host immune response to the graft,improve the success rate of transplantation,and prolong the survival of patients.Liver transplantation is associated with intestinal flora,while immunosuppressive agents interact with intestinal flora.Immunosuppressive agents change the abundance,composition and metabolites of intestinal flora,while a series of enzymes and metabolites produced by intestinal flora may chemically alter the absorption and metabolism of immunosuppressants.In addition,the incidence of postoperative infection in liver transplantion patients is relatively high,while gut flora affects inflammatory factors,and immunosuppressants interact with inflammatory factors.To some extent,immunosuppressants can be thought of as acting through intestinal flora in patients after liver transplantation.

Objective:To observe any effect of combining visual deprivation training (VDT) with repeated low-frequency transcranial magnetic stimulation (rTMS) in the treatment of lower limb motor dysfunction among stroke survivors.Methods:Fifty stroke survivors were randomly assigned to either a control group or an experimental group ( n=25 each). In addition to routine rehabilitation treatment, the control group received rTMS targeting the primary motor cortex (M1, lower limb representation area) of the unaffected hemisphere, while the experimental group also received VDT. Before and after 4 weeks of the treatments, everyone′s lower limb motor function, balance, gait and ability in the activities of daily living were evaluated using the Fugl-Meyer lower extremity assessment (FMA-LE), the root mean square (RMS) values generated through surface electromyography of the affected tibialis anterior muscle, the Berg Balance Scale (BBS), the Timed Up and Go Test (TUGT), the Tinetti Gait Assessment (TGA), and the modified Barthel Index (MBI). Results:After the treatment, both groups showed significant improvements in their average FMA-LE, BBS, TUGT, TGA and MBI results, as well as in the RMS values of the affected tibialis anterior muscle. The experimental group showed significantly greater improvement compared to the control group.Conclusions:The combination of VDT and low-frequency rTMS can effectively improve the lower limb motor function, balance and gait of stroke survivors. It is more effective than rTMS alone. The combined therapy is worthy of clinical application and promotion.

Objective:To observe any effect of combining visual deprivation training (VDT) with repeated low-frequency transcranial magnetic stimulation (rTMS) in the treatment of lower limb motor dysfunction among stroke survivors.Methods:Fifty stroke survivors were randomly assigned to either a control group or an experimental group ( n=25 each). In addition to routine rehabilitation treatment, the control group received rTMS targeting the primary motor cortex (M1, lower limb representation area) of the unaffected hemisphere, while the experimental group also received VDT. Before and after 4 weeks of the treatments, everyone′s lower limb motor function, balance, gait and ability in the activities of daily living were evaluated using the Fugl-Meyer lower extremity assessment (FMA-LE), the root mean square (RMS) values generated through surface electromyography of the affected tibialis anterior muscle, the Berg Balance Scale (BBS), the Timed Up and Go Test (TUGT), the Tinetti Gait Assessment (TGA), and the modified Barthel Index (MBI). Results:After the treatment, both groups showed significant improvements in their average FMA-LE, BBS, TUGT, TGA and MBI results, as well as in the RMS values of the affected tibialis anterior muscle. The experimental group showed significantly greater improvement compared to the control group.Conclusions:The combination of VDT and low-frequency rTMS can effectively improve the lower limb motor function, balance and gait of stroke survivors. It is more effective than rTMS alone. The combined therapy is worthy of clinical application and promotion.

Objective To explore the effect of visual deprivation training combined with proprioceptive training on balance function of hemiplegic patients after stroke.Methods A total of 80 stroke patients with hemiplegia in Jiangsu Shengze Hospital were selected from May,2022 to March,2024,and randomly divided into control group(n=20),proprioceptive training group(n=20),visual de-privation group(n=20)and combined group(n=20).All the groups received routine rehabilitation training,while the proprioceptive training group added proprioceptive training,the visual deprivation group added balance training under visual deprivation,and the combined group added visual deprivation training and proprioceptive training,for four weeks.They were assessed with ProKin Balance Test and Training System,Berg Balance Scale(BBS),10-metre walking test(10MWT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE)and Functional Gait Assessment(FGA)before and after treatment.Results The intra-group effect(F>96.618,P<0.001)and interaction effect(F>5.444,P<0.01)were significant in mean longitudinal velocity and mean horizontal velocity.The intra-group effect(F>177.671,P<0.001),inter-group effect(F>3.761,P<0.05)and interaction effect(F>7.555,P<0.001)were significant in movement el-lipse area and movement length both with eyes open and closed.The intra-group effect(F>221.902,P<0.001)and interaction effect(F>7.586,P<0.001)were significant in the time of 10MWT,and the scores of BBS,FMA-LE and FGA;and the inter-group effect were significant in FGA score(F=5.258,P<0.01).Post Hoc test showed that all the indicators were better in the combined group and the visual deprivation group than in the con-trol group(P<0.05);as well as in the proprioceptive training group than in the control group(P<0.05)except mean longitudinal velocity with eyes open,mean horizontal velocity with eyes closed,and movement length with eyes open;while all the indicators were better in the combined group than both in the visual deprivation group and the proprioceptive training group(P<0.05);there was no significant difference between the visual depriva-tion group and the proprioceptive training group for all the indicators(P>0.05).Conclusion Both visual deprivation training and proprioceptive training can improve balance,lower limb motor function and walking of hemiplegic stroke patients,and the combination is more effective.

Objective:To evaluate the efficacy and safety of Luofuoshan-Baicao oil (LBO) and wind medicated oil for the treatment of Aedes albopictus bites. Methods:A paired self-controlled study was conducted. Thirty-six healthy volunteers were recruited from Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2023 to March 2023. Each participant's forearms were subjected to Aedes albopictus bites, with 3 bites on each arm. For the first 18 participants, LBO was applied to the left arm, and wind medicated oil to the right arm; for the latter 18 participants, wind medicated oil was applied to the left arm, and LBO to the right arm. The observation period was 24 hours. Within the first 3 hours after the mosquito bites, the topical agents were applied once every other hour for a total of 3 sessions, with an applicator centered on the bite site at a dose of approximately 50 μl, covering a skin area of about 2 cm in diameter; after 3 hours, participants applied the topical agents themselves until symptoms subsided or the 24-hour observation period ended. All subjects were followed up at the occurrence of skin lesions after mosquito bites, 0 to 3 hours after the first treatment, as well as 24 hours after the first treatment. During the follow-up, the effects of both topical agents on pruritus, erythema, papules, or wheals were evaluated, differences in treatment frequency were analyzed, and treatment-related adverse events were recorded. The time to disappearance of pruritus after treatment was statistically analyzed using Kaplan-Meier survival analysis, and intergroup differences were analyzed using the log-rank (Mantel-Cox) test. Two independent samples t-test was used for comparisons of other measurement data, and Pearson's chi-square test or Fisher's exact test was used for comparisons of count data between groups. Results:Within 3 hours after the first treatment, the time to initial disappearance of pruritus was significantly shorter in the LBO group (20.71 ± 1.92 min) than in the wind medicated oil group (28.30 ± 2.20 min, P < 0.05). The cumulative pruritus rate (the proportion of participants with pruritus among all participants) over time showed an overall stable fluctuation, and the cumulative pruritus rates at all observation points were significantly lower in the LBO group than in the wind medicated oil group ( P<0.05). After 3 hours of treatment, the mean values of changes in erythema diameters were 25.83 mm in the LBO group and 26.24 mm in the wind medicated oil group, while the mean values of changes in papule or wheal diameters were 8.25 mm in the LBO group and 9.18 mm in the wind medicated oil group; within 24 hours after the first treatment, the average time to disappearance of papules or wheals was 71.85 minutes in the LBO group and 73.01 minutes in the wind medicated oil group, while the average time to disappearance of erythema was 82.27 minutes in the LBO group and 84.86 minutes in the wind medicated oil group; there were no significant differences in the above observational indices between the two groups (all P > 0.05). The number of pruritus episodes within 24 hours of treatment was 56 in both the LBO group and wind medicated oil group, and the treatment frequency was 107 in both two groups; there were also no significant differences in the frequencies of pruritus episodes or treatment (both P > 0.05). No adverse events or reactions occurred during the trial. Conclusion:LBO was more effective than wind medicated oil in reducing the time to disappearance of pruritus after Aedes albopictus bites, with a high safety profile.