ObjectiveTo investigate the mechanism by which Xiebai San regulates respiratory tract and intestinal mucosal immunity in rats with allergic asthma. MethodsForty male SD rats were randomly divided into four groups based on body weight: control group, model group, positive control group, and Xiebai San group. The model group, positive control group, and Xiebai San group were sensitized with ovalbumin to establish a rat model of allergic asthma. From day 21 (the aerosol challenge phase), each group received daily gavage interventions simultaneously: the positive control group was administered dexamethasone (0.068 mg/kg), the Xiebai San group received Xiebai San solution (2 g/mL, 11.3 mL/kg), while the control and model groups were given an equal volume of normal saline, once daily for 14 consecutive days. After euthanasia, lung and intestinal tissues were collected. Hematoxylin and eosin staining was used to observe histopathological changes. Transmission electron microscopy was employed to examine tissue ultrastructure. Immunohistochemistry was applied to detect the positive reaction areas of phosphatidyl-inositol 3-kinase (PI3K) and protein kinase B (Akt) proteins. Total protein and total RNA were extracted from lung and intestinal tissues, then the protein and mRNA expression levels of PI3K and Akt genes were detected by Western blotting and real-time quantitative PCR, respectively. ResultsHistopathological results showed alveolar emphysema accompanied by inflammatory cell infiltration, and intestinal mucosal injury with inflammatory cell infiltration in the model group as compared with the control group; the cellular structure of lung tissues was disrupted in the model group, with reduced organelles, while the ultrastructural lesions in the intestine were relatively mild. Compared with the model group, Xiebai San group exhibited milder pathological changes in lung tissues, with occasional alveolar wall damage and a small amount of inflammatory cell infiltration; the intestinal mucosal structure was improved, glands were arranged regularly, and pathological changes such as tissue loosening and inflammatory infiltration were alleviated; the cellular structure of lung tissues was relatively intact with reduced severity of lesions, and no ultrastructural pathological changes were observed in intestinal tissues. Immunohistochemistry and Western blotting results showed that compared with the control group, the specific positive reaction areas of PI3K and Akt in lung and intestinal tissues were significantly increased in the model group (all P<0.001); meanwhile, the protein expression levels of PI3K and Akt were significantly upregulated (all P<0.05). Compared with the model group, the positive area of Akt protein in lung tissue was significantly reduced in the Xiebai San group (P<0.001), and the positive area of PI3K in intestinal tissue was also significantly decreased (P<0.000 1). Additionally, the protein expression levels of PI3K and Akt in lung and intestinal tissues were significantly downregulated (all P<0.01). Real-time quantitative PCR results showed that compared with the control group, the mRNA expression levels of PI3K and Akt genes in lung and intestinal tissues were significantly elevated in the model group (all P<0.05). Compared with the model group, the mRNA expression levels of PI3K and Akt genes in lung and intestinal tissues were significantly reduced in the Xiebai San group (all P<0.05). ConclusionXiebai San exerts protective effects on rats with allergic asthma by inhibiting the expression of key nucleic acids and proteins in the PI3K-Akt signaling pathway in lung and intestinal tissues, improving the morphological structure of lung tissue, and maintaining intestinal mucosal integrity, and regulating intestinal mucosal immune function.

Objective:To explore the value of fetal heart quantification technology in assessing the morphology and function of the fetal heart during normal pregnancy.Methods:This prospective cohort study selected normal fetuses from healthy pregnant women who underwent prenatal ultrasound examinations at Hunan Provincial People's Hospital from January 2023 to October 2024. Using the GE Voluson E10 color Doppler diasonography, routine obstetric ultrasound and fetal echocardiography were performed to assess fetal growth and development and to exclude intracardiac and extracardiac malformations. Clear four-chamber view (4CV) dynamic images of the heart showing the endocardium (duration ≥3 s) were collected. Speckle-tracking analysis was performed using fetal heart quantification software. The measured indicators included the global spherical index (GSI), end-diastolic length of the heart (L-ED), end-diastolic width of the heart (W-ED), and the global longitudinal strain (GLS), fractional area change (FAC), and 24-segment spherical index (SI) of the left ventricle (LV) and right ventricle (RV). The cases were divided into five groups based on gestational age at the time of prenatal ultrasound: 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks. One-way analysis of variance, two independent samples t-test, univariate linear regression analysis, and Pearson correlation analysis were used to explore the differences in the above indicators among different gestational age groups and their correlation with gestational age. Results:A total of 200 pregnant women were included in the cohort, four cases were excluded due to poor image quality that prevented accurate tracking and measurement of relevant indicators. Ultimately, 196 cases (20 +0 to 23 +6 weeks 40 cases, 24 +0 to 27 +6 weeks 34 cases, 28 +0 to 31 +6 weeks 41 cases, 32 +0 to 35 +6 weeks 48 cases, and 36 +0 to 40 +6 weeks 33 cases) were included in the study, with a successful image analysis rate of 98.0%. (1) There were statistically significant differences in 4CV L-ED, 4CV W-ED, LV-FAC, and RV-FAC among the groups at 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks [4CV L-ED: 28.0±3.0, 32.6±4.3, 40.9±4.3, 46.7±4.8, 53.1±5.8, F=3.72; 4CV W-ED: 21.9±1.8, 25.1±4.2, 31.7±3.0, 37.4±4.0, 42.0±4.9, F=2.61; LV-FAC: (51.4±8.0)%, (49.0±10.4)%, (47.3±7.3)%, (43.1±7.5)%, (40.7±8.2)%, F=2.94; RV-FAC: (49.9±10.8)%, (46.2±12.0)%, (46.3±8.3)%, (43.2±8.0)%, (41.9±5.6)%, F=3.09; all P<0.05].(2) The size of the normal fetal heart gradually increased with gestational age, while the heart morphology remained relatively stable (4CV L-ED and 4CV W-ED were positively correlated with gestational age, with regression coefficients of 1.313 and 1.325, respectively, both P<0.001;LV-FAC and RV-FAC were negatively correlated with gestational age with regression coefficients of -0.783 and -0.552, respectively, both P<0.001; GSI, LV-GLS and RV-GLS had no correlations with gestational age, all P>0.05). (3) The SI of LV segments 1 to 17 were higher than the SI of the corresponding RV segments, and the SI of RV segments 20-24 were higher than that of the corresponding LV segments (all P<0.001). Conclusion:Fetal heart quantification technology has a certain value in the assessment of fetal cardiac morphology and function.

Objective:To explore the relationship between blood urea nitrogen (BUN) levels and the risk of all-in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pneumonia.Methods:This study was a secondary analysis of a multicenter, retrospective cohort study, with data sourced from the DATADRYAD database of five hospitals in Japan (Kameda Hospital, Hyogo Hospital, Awa Hospital, Saiseikai Hospital, and Ichinomiyanishi Hospital). The database included 1 237 cases of AECOPD with pneumonia hospitalized from April 2008 to August 2019, aged≥40 years. After excluding 11 cases with missing BUN level data at admission, a total of 1 226 patients were included in this secondary analysis. BUN level at admission was used as the target independent variable, and all-cause in-hospital mortality during hospitalization was the dependent variable. Risk ratio regression analysis was used to assess the independent correlation between BUN level and the risk of in-hospital mortality due to AECOPD complicated with pneumonia; generalized additive models and smoothing curve fitting methods were applied to explore nonlinear relationships, followed by subgroup analyses to evaluate the consistency of the association across different subgroups and further validate the reliability of the findings.Results:After adjusting for potential confounding factors such as gender and age, BUN levels were positively correlated with the risk of all-cause in-hospital mortality [ OR=1.09(95% CI: 1.01-1.17), P=0.032]. There was a relationship between BUN levels and the risk of all-cause in-hospital mortality, with a turning point at 43.3 mg/dl. The sizes and 95% CI on either side of the turning point were 1.04(0.93-1.16) and 1.08(1.05-1.12), respectively. When BUN>43.3 mg/dl, BUN was correlated with the risk of all-cause in-hospital mortality, with an 8.0% increase in the risk of death for every 1.0 mg/dl increase in BUN ( P<0.05); when BUN<43.3 mg/dl, there was no significant relationship between BUN and the risk of all-cause in-hospital mortality ( P=0.534). Subgroup analysis indicated that in each subgroup of gender, age, source hospital, fever, respiratory, heart rate, crackles in the lungs, change in mental status, corticosteroid therapy, intubation, complete assistance with activities of daily living, medical insurance, and length of hospital stay, the OR value of BUN level had good stability (all OR>1.00) with the risk of all-cause mortality in AECOPD patients with pneumonia. Conclusions:BUN levels are associated with the risk of all-cause in-hospital mortality in patients with AECOPD complicated with pneumonia. When BUN>43.3 mg/dl, BUN levels are positively correlated with the risk of all-cause in-hospital mortality in these patients.

Objective:To explore the value of fetal heart quantification technology in assessing the morphology and function of the fetal heart during normal pregnancy.Methods:This prospective cohort study selected normal fetuses from healthy pregnant women who underwent prenatal ultrasound examinations at Hunan Provincial People's Hospital from January 2023 to October 2024. Using the GE Voluson E10 color Doppler diasonography, routine obstetric ultrasound and fetal echocardiography were performed to assess fetal growth and development and to exclude intracardiac and extracardiac malformations. Clear four-chamber view (4CV) dynamic images of the heart showing the endocardium (duration ≥3 s) were collected. Speckle-tracking analysis was performed using fetal heart quantification software. The measured indicators included the global spherical index (GSI), end-diastolic length of the heart (L-ED), end-diastolic width of the heart (W-ED), and the global longitudinal strain (GLS), fractional area change (FAC), and 24-segment spherical index (SI) of the left ventricle (LV) and right ventricle (RV). The cases were divided into five groups based on gestational age at the time of prenatal ultrasound: 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks. One-way analysis of variance, two independent samples t-test, univariate linear regression analysis, and Pearson correlation analysis were used to explore the differences in the above indicators among different gestational age groups and their correlation with gestational age. Results:A total of 200 pregnant women were included in the cohort, four cases were excluded due to poor image quality that prevented accurate tracking and measurement of relevant indicators. Ultimately, 196 cases (20 +0 to 23 +6 weeks 40 cases, 24 +0 to 27 +6 weeks 34 cases, 28 +0 to 31 +6 weeks 41 cases, 32 +0 to 35 +6 weeks 48 cases, and 36 +0 to 40 +6 weeks 33 cases) were included in the study, with a successful image analysis rate of 98.0%. (1) There were statistically significant differences in 4CV L-ED, 4CV W-ED, LV-FAC, and RV-FAC among the groups at 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks [4CV L-ED: 28.0±3.0, 32.6±4.3, 40.9±4.3, 46.7±4.8, 53.1±5.8, F=3.72; 4CV W-ED: 21.9±1.8, 25.1±4.2, 31.7±3.0, 37.4±4.0, 42.0±4.9, F=2.61; LV-FAC: (51.4±8.0)%, (49.0±10.4)%, (47.3±7.3)%, (43.1±7.5)%, (40.7±8.2)%, F=2.94; RV-FAC: (49.9±10.8)%, (46.2±12.0)%, (46.3±8.3)%, (43.2±8.0)%, (41.9±5.6)%, F=3.09; all P<0.05].(2) The size of the normal fetal heart gradually increased with gestational age, while the heart morphology remained relatively stable (4CV L-ED and 4CV W-ED were positively correlated with gestational age, with regression coefficients of 1.313 and 1.325, respectively, both P<0.001;LV-FAC and RV-FAC were negatively correlated with gestational age with regression coefficients of -0.783 and -0.552, respectively, both P<0.001; GSI, LV-GLS and RV-GLS had no correlations with gestational age, all P>0.05). (3) The SI of LV segments 1 to 17 were higher than the SI of the corresponding RV segments, and the SI of RV segments 20-24 were higher than that of the corresponding LV segments (all P<0.001). Conclusion:Fetal heart quantification technology has a certain value in the assessment of fetal cardiac morphology and function.

This paper summarizes the current situation of the cultivation of specialized Traditional Chinese Medicine (TCM) geriatric nursing talents under the background of the integration of medical care and elderly care, including the cultivation status, necessity, feasibility, and existing problems. Based on this, reflections and prospects are put forward, aiming to further promote the cultivation of specialized TCM nursing talents, facilitate the in-depth integration of TCM nursing and geriatric nursing, and drive the high-quality development of nursing.

Objective:To construct an exercise management program for inpatients with postmenopausal osteoporosis (PMOP) based on the health action process approach (HAPA) .Methods:Using HAPA as a theoretical basis, the literature on exercise management in PMOP inpatients was systematically searched and relevant evidence was extracted. On this basis, the first draft of an exercise management program for PMOP inpatients was constructed by combining the results of semi-structured interviews with 16 PMOP inpatients. The first draft of the exercise management program for PMOP inpatients was revised after two rounds of Delphi expert consultation.Results:A total of 15 experts were invited for two rounds of expert consultation. In the two rounds of consultation, the effective recovery rate of the questionnaire was 100.0% (15/15), the expert authority coefficient was 0.880, and Kendall's harmony coefficient was 0.156 and 0.208, respectively ( P<0.01). The final exercise management program for PMOP inpatients consisted of three first-level items, nine second-level items, and 48 third-level items. Conclusions:The exercise management program for PMOP inpatients is scientific and comprehensive, which can provide a reference for nursing staff.

This paper summarizes the current situation of the cultivation of specialized Traditional Chinese Medicine (TCM) geriatric nursing talents under the background of the integration of medical care and elderly care, including the cultivation status, necessity, feasibility, and existing problems. Based on this, reflections and prospects are put forward, aiming to further promote the cultivation of specialized TCM nursing talents, facilitate the in-depth integration of TCM nursing and geriatric nursing, and drive the high-quality development of nursing.

Objective:To construct an exercise management program for inpatients with postmenopausal osteoporosis (PMOP) based on the health action process approach (HAPA) .Methods:Using HAPA as a theoretical basis, the literature on exercise management in PMOP inpatients was systematically searched and relevant evidence was extracted. On this basis, the first draft of an exercise management program for PMOP inpatients was constructed by combining the results of semi-structured interviews with 16 PMOP inpatients. The first draft of the exercise management program for PMOP inpatients was revised after two rounds of Delphi expert consultation.Results:A total of 15 experts were invited for two rounds of expert consultation. In the two rounds of consultation, the effective recovery rate of the questionnaire was 100.0% (15/15), the expert authority coefficient was 0.880, and Kendall's harmony coefficient was 0.156 and 0.208, respectively ( P<0.01). The final exercise management program for PMOP inpatients consisted of three first-level items, nine second-level items, and 48 third-level items. Conclusions:The exercise management program for PMOP inpatients is scientific and comprehensive, which can provide a reference for nursing staff.

Objective:To explore the relationship between blood urea nitrogen (BUN) levels and the risk of all-in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with pneumonia.Methods:This study was a secondary analysis of a multicenter, retrospective cohort study, with data sourced from the DATADRYAD database of five hospitals in Japan (Kameda Hospital, Hyogo Hospital, Awa Hospital, Saiseikai Hospital, and Ichinomiyanishi Hospital). The database included 1 237 cases of AECOPD with pneumonia hospitalized from April 2008 to August 2019, aged≥40 years. After excluding 11 cases with missing BUN level data at admission, a total of 1 226 patients were included in this secondary analysis. BUN level at admission was used as the target independent variable, and all-cause in-hospital mortality during hospitalization was the dependent variable. Risk ratio regression analysis was used to assess the independent correlation between BUN level and the risk of in-hospital mortality due to AECOPD complicated with pneumonia; generalized additive models and smoothing curve fitting methods were applied to explore nonlinear relationships, followed by subgroup analyses to evaluate the consistency of the association across different subgroups and further validate the reliability of the findings.Results:After adjusting for potential confounding factors such as gender and age, BUN levels were positively correlated with the risk of all-cause in-hospital mortality [ OR=1.09(95% CI: 1.01-1.17), P=0.032]. There was a relationship between BUN levels and the risk of all-cause in-hospital mortality, with a turning point at 43.3 mg/dl. The sizes and 95% CI on either side of the turning point were 1.04(0.93-1.16) and 1.08(1.05-1.12), respectively. When BUN>43.3 mg/dl, BUN was correlated with the risk of all-cause in-hospital mortality, with an 8.0% increase in the risk of death for every 1.0 mg/dl increase in BUN ( P<0.05); when BUN<43.3 mg/dl, there was no significant relationship between BUN and the risk of all-cause in-hospital mortality ( P=0.534). Subgroup analysis indicated that in each subgroup of gender, age, source hospital, fever, respiratory, heart rate, crackles in the lungs, change in mental status, corticosteroid therapy, intubation, complete assistance with activities of daily living, medical insurance, and length of hospital stay, the OR value of BUN level had good stability (all OR>1.00) with the risk of all-cause mortality in AECOPD patients with pneumonia. Conclusions:BUN levels are associated with the risk of all-cause in-hospital mortality in patients with AECOPD complicated with pneumonia. When BUN>43.3 mg/dl, BUN levels are positively correlated with the risk of all-cause in-hospital mortality in these patients.