Objective To investigate the intervention mechanism of Bushen Zhupai Decoction on polycystic ovary syndrome rats with insulin resistance based on IL-6/PI3K/AKT signaling pathway Methods A rat model of polycystic ovary syndrome with insulin resistance was established by feeding high-fat diet combined with oral administration of letrozole,and the blank group was fed with ordinary diet.The modeled rats were randomly divided into model group,metformin group and Bushen Zhupai Decoction low-,medium-and high-dosage groups.The corresponding intervention were given for 28 days.Fasting blood glucose(FBG)content was detected,and insulin resistance index(HOMA-IR)was calculated.ELISA was used to detect serum fasting insulin(FINS),testosterone(T),estradiol(E2),luteinizing hormone(LH)and follicle stimulating hormone(FSH)contents.HE staining was used to observe the morphology of ovarian tissue.Immunohistochemistry was used to detected the expressions of interleukin(IL)-6,p-PI3K,p-AKT and GLUT4 in ovarian tissue.Western blot was used to detect the protein expressions of IL-6,PI3K,p-PI3K,AKT,p-AKT and GLUT4 in ovarian tissue,while RT-PCR was used to detect the mRNA expressions of IL-6,PI3K,AKT and GLUT4.Results Compared with the blank group,the body mass,FBG,FINS and serum T and LH contents of the model group rats significantly increased(P<0.01),while the serum E2 and FSH contents significantly decreased(P<0.01);ovarian tissue showed polycystic changes,with reduced layers and loose arrangement of granulosa cells,the expression of IL-6 protein and mRNA in ovarian tissue significantly increased(P<0.01),the expressions of p-PI3K,p-AKT and GLUT4 proteins significantly decreased(P<0.01),and the expressions of PI3K,AKT and GLUT4 mRNA significantly decreased(P<0.01).Compared with the model group,the body mass of rats in each administration group decreased,and the contents of FBG,FINS and serum T and LH decreased(P<0.01,P<0.05),while the contents of E2 and FSH increased;polycystic changes in ovarian tissue were reduced,mature follicles increased,and granulosa cells were tightly arranged,the expression of IL-6 protein and mRNA in ovarian tissue decreased,the expressions of p-PI3K,p-AKT,GLUT4 protein and PI3K,AKT,GLUT4 mRNA increased.Bushen Zhupai Decoction high-dosage group showed statistical significance(P<0.01).Conclusion Bushen Zhupai Decoction can improve reproductive and metabolic disorders in polycystic ovary syndrome with insulin resistance rats,and its mechanism may be related to inhibiting IL-6 expression,activating the PI3K/AKT signaling pathway,and alleviating insulin resistance.

Objective: To explore the relative importance of different food attributes and levels in food decision making of school aged children, and to understand their meal preferences, so as to provide the evidence for formulating precise intervention strategies for dietary behaviours of school aged children. Methods: From May to June 2024, a total of 854 children aged 11 to 15 years old were selected from 2 middle schools (each school in urban and rural areas) in both Hubei Province and Anhui Province by stratified cluster random sampling method to conduct a D-optimal discrete choice experiment. The mixed Logit model was used to analyze children s preference for meal attributes and different levels, and to calculate the relative importance (RI) of attributes and willingness to pay (WTP) in meal choices. Results: The included five food attributes had statistical significance on meal choice of school aged children ( P <0.05). The relative importance of food attributes affecting the meal choices of school aged children in descending order were dining mode ( RI =31.26%), food varieties ( RI =30.56%), cooking method( RI =23.84%), taste( RI =8.06%) and price ( RI =6.27%). Among them, school aged children preferred home cooked meals ( β =0.74) (WTP=86.3 yuan),varied foods(grain/tubers+vegetables+fish, meat, eggs and beans) ( β =0.61) (WTP=71.9 yuan), fried/roasted cooking ( β =0.51) and spicy taste ( β =0.33).Price was negatively correlated with meal choices( β =-0.01) ( P <0.05). Based on residential area and body mass index (BMI), the stratified analysis showed that dining mode was highest in the relative importance for rural children with overweight and obese children ( RI =31.28%,34.17%), both of whom preferred home cooked meals ( β =0.76, 0.91), and meals containing fish, meat, eggs and beans with grain/tubers or grain/tubers and vegetables in terms of food choice (area: β =0.53, 0.53 ; BMI: β =0.55, 0.56) ( P <0.05). Conclusions School aged children have different preferences for different attributes of meals. The quality of school meals should be improved,the cost of buying healthy meals should be reduced,targeted family health education should be carried out,and healthy cooking methods should be advocated.

Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

Objective:To investigate the clinically curative effect of composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel in treating deep Ⅱ burn wound.Methods:A total of 108 patients with superficially deep Ⅱ burns,who admitted to Tangdu Hospital,Air Force Medical University within 48 hours during March 2022 and October 2024,were selected.Patients were randomly divided into conventional treatment group and the combined treatment group by using a random number table,with 54 patients in each group.All patients underwent enzymatic debridement(collagenase ointment)to conduct conventional treatment.The combined treatment group received treatment with composite dressings of adipose-derived mesenchymal stem cell exosomes(ADSCs-Exo)combined with chitosan hydrogel,while the conventional treatment group received treatment with silver sulfadiazine dressings(SSD)on the basis of conventional treatment.The healing rates of wound,Vancouver Scar Scale(VSS)scores,the levels of serum inflammatory factors included interleukin-6(IL-6),interleukin-1β(IL-1β),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α),as well as curative efficacy rates,and adverse reactions between two groups were compared at different time points after treatment.Results:There was not statistically significant difference in healing rates of wound between the two groups at the 7th day after treatment(P>0.05).At the 14th day and the 21th day after treatment,the average healing rates of wound in the combined treatment group were respectively(67.69±8.57)%and(89.46±7.54)%,which were higher than(59.50±4.93)%and(75.52±9.11)%in the conventional treatment group,and the differences were statistically significant(t=6.087,8.662,P<0.05).The average VSS score was(6.42±1.20)points in the combined treatment group after treatment,which was lower than that in the conventional treatment group(8.94±1.58),and the difference was statistically significant(t=9.33,P<0.05).Before treatment,there were not statistically significant difference in VAS scores and the levels of serum inflammatory factor between the two groups(P>0.05).At the 7th day,the 14th day and the 21th day after treatment,the VAS scores in the combined treatment group were significantly lower than those in the conventional treatment group(t=10.008,12.004,13.899,P<0.05),respectively.At the 21th day after treatment,the levels of IL-6,IL-1β,CRP,and TNF-α of the combined treatment group were significantly lower than those of the conventional treatment group(t=3.400,4.490,7.293,5.900,P<0.05).The efficacy rate of clinical treatment in the combined treatment group was 96.30%,which was higher than 83.33%of the conventional treatment group,with a statistical significance(x2=7.942,P<0.05).The incidence of adverse reaction in the combined treatment group was 14.81%,which was lower than 24.07%of the conventional treatment group,without statistical significance(P>0.05).Conclusion:Compared with conventional silver sulfadiazine dressing,the composite dressing of adipose mesenchymal stem cell exosomes and chitosan hydrogel can quickly promote the re-epithelialization process in treating patients with superficially deep Ⅱ burns at the middle to late stage,and improve the healing rate,and relieve the inflammatory reaction and pain perception of patients for wound,and enhance efficiency and safety.

Objective To explore the mechanism of Bushen Zhupai Decoction in treating ovarian fibrosis in polycystic ovary syndrome(PCOS)model rats based on IL-17/TRAF6/NF-κB signaling pathway.Methods Totally 60 SPF grade female SD rats were randomly divided into blank group,model group,Yousiyue group and TCM low-,medium-and high-dosage groups,with 10 rats in each group.The PCOS model was replicated by gavage of 1 mg/kg letrozole for 21 days.The Yousiyue group was given a 10 mg/kg solution of drospirenone ethinylestradiol tablets by gavage,TCM low-,medium-and high-dosage groups were given 8.82,17.64 and 35.28 g/kg of Bushen Zhupai Decoction by gavage,once a day for 28 consecutive days.HE and Masson staining were used to observe the morphology of ovarian tissue and ovarian fibrosis,the contents of serum IL-17,IL-18 and IL-1β were detected by ELISA,the mRNA expression of IL-17,TRAF6,NF-κB p65 and TGF-β1 in ovarian tissue were determined by RT-qPCR,the protein expression of TRAF6,NF-κB p65,TGF-β1,α-SMA,E-cadherin and the positive expression of IL-17RA,TRAF6,NF-κB p65,TGF-β1 and α-SMA in ovarian tissue were detected by Western blot and immunohistochemical staining respectively.Results Compared with the blank group,the body mass,ovarian mass and ovarian index significantly increased of rats in model group,with follicular cystic dilation,thinning of granulosa cell layer,and significant increase in fibrosis positive range(P<0.01),the serum contents of IL-17,IL-18 and IL-1β significantly increased(P<0.01),the expressions of IL-17,TRAF6,NF-κB p65,TGF-β1 mRNA and IL-17RA,TRAF6,NF-κB p65,TGF-β1 and α-SMA proteins significantly increased(P<0.01,P<0.05),the expression of E-cadherin protein significantly decreased(P<0.01).Compared with the model group,the ovarian index of rats in Yousiyue group and TCM medium-and high-dosage groups significantly decreased(P<0.01,P<0.05),the rats in TCM high-dosage group showed dominant follicles,increased thickness of granulosa cell layer,and significantly reduced fibrosis positive range(P<0.01),the serum contents of IL-17,IL-18 and IL-1β significantly decreased in Yousiyue group and TCM low-,medium-and high-dosage groups(P<0.01),the mRNA expressions of IL-17,TRAF6,NF-κB p65,TGF-β1,and the protein expressions of IL-17RA,TRAF6,NF-κB p65,TGF-β1 and α-SMA in ovarian tissue significantly decreaed in TCM high-dosage group(P<0.01,P<0.05),the expression of E-cadherin protein significantly increased(P<0.01).Conclusion Bushen Zhupai Decoction can decrease the body mass,improve the ovarian index,decrease the expressions of inflammatory factors and improve the status of ovarian fibrosis in PCOS rats.The mechanism may be related to the regulation of IL-17/TRAF6/NF-κB signaling pathway.

This article summarizes the experience of providing remote nursing care for a pediatric patient with severe burns using augmented reality(AR)technology.Key nursing points include:to establish a remote management team to enhance multidisciplinary collaboration;to conduct remote nursing ward rounds to provide real-time guidance for clinical nursing practice;to remotely guide PICC(Peripherally Inserted Central Catheter)insertions and conduct precise fluid management;to remotely assess ward environments and provide guidance on disinfection and isolation measures;to alleviate pediatric pain through comprehensive management measures.After meticulous care and treatment,the patient's condition stabilized after 23 days,and the patient was transferred to a specialized hospital for continued treatment requiring skin grafting.

Purpose To explore the clinicopathological features of EBV-positive nodal T-and NK-cell lymphoma.Methods Clinical and pathological data of 5 cases were collected.The expression of CD3,CD56,TIA-1,Granzyme B and other markers were detected by immunohistochemistry.The expression of EBER was detected by in situ hybrid-ization.The gene rearrangement and clonality were analyzed by PCR and polyacrylamide gel electrophoresis.The litera-tures were reviewed.Results The primary lesions of the 5 patients were all located in lymph nodes.All patients pres-ented with multiple lymphadenopathy,B symptoms,elevated lactate dehydrogenase(LDH)and C-reactive protein(CRP),and were in stage Ⅲ/Ⅳ.Histopathologically,the lesions show a diffuse infiltration of large to medium monot-onous tumor lymphocytes.Cell apoptosis,necrosis,and vascular invasion were not significant.Tumor cells of all cases were positive for CD3 but negative for CD56.All cases were positive for the cytotoxic markers.In situ hybridization de-tection showed that the majority of tumor cells were diffusely positive for EBER.Nevertheless,only 4 cases were posi-tive for TCR gene clonal rearrangement.Three patients received chemotherapy,2 patient declined the treatments.The median overall survival was only 3 months.Conclusions EBV-positive nodal T-and NK-cell lymphoma is an EBV-positive lymphoma of cytotoxic T-or NK-cell lineage presenting primarily with nodal disease,which is more common in elderly males.The patient has obvious symptoms and signs,rapid disease progression,and poor prognosis.Under-standing the clinicopathological features of EBV-positive nodal T-and NK-cell lymphoma can help differentiate it from other EBV-positive T-and NK-cell lymphoid proliferations and lymphomas.

In order to cultivate high-level medical talents, introducing information technology into medical teaching, the teaching faculty of the "Medical Functional Experiment" course constructed and explored an online-offline hybrid experimental problem-based learning (PBL) model guided by hypoxia pathophysiology problems. We explore the teaching method, implementation process, assessment, and effect evaluation of the experimental PBL model from the aspects of teaching objects, online teaching platform setting, and offline application, and also discuss its academic innovation points and application value. We hope to provide ideas for integrating the PBL concept into experimental teaching and help cultivate excellent innovative medical talents.

Indwelling urinary catheterization is one of the most widely used invasive procedures in clinical practice, playing a critical role in disease diagnosis, treatment, and monitoring. In 2024, the European Association of Urology Nurses (EAUN) released the Best Practice Guidelines for Indwelling Urinary Catheterization in Adults-Transurethral and Suprapubic Catheterization (hereinafter referred to as the Guideline), aiming to provide evidence-based clinical guidance and health education information for healthcare professionals. This article interprets the section on "Nursing Principles" within the Guideline, which spans the entire process of catheter management. Key aspects covered include pre-insertion preparation, catheter insertion procedure, catheter maintenance and securement, observation of urine color, prevention of constipation, and catheter removal. The aim is to help urology nurses and related healthcare personnel gain an in-depth understanding of the recommendations in the Guideline, promote its standardized application in clinical practice, improve the quality of indwelling catheter care, and ensure patient safety.

Purpose To explore the clinicopathological features of EBV-positive nodal T-and NK-cell lymphoma.Methods Clinical and pathological data of 5 cases were collected.The expression of CD3,CD56,TIA-1,Granzyme B and other markers were detected by immunohistochemistry.The expression of EBER was detected by in situ hybrid-ization.The gene rearrangement and clonality were analyzed by PCR and polyacrylamide gel electrophoresis.The litera-tures were reviewed.Results The primary lesions of the 5 patients were all located in lymph nodes.All patients pres-ented with multiple lymphadenopathy,B symptoms,elevated lactate dehydrogenase(LDH)and C-reactive protein(CRP),and were in stage Ⅲ/Ⅳ.Histopathologically,the lesions show a diffuse infiltration of large to medium monot-onous tumor lymphocytes.Cell apoptosis,necrosis,and vascular invasion were not significant.Tumor cells of all cases were positive for CD3 but negative for CD56.All cases were positive for the cytotoxic markers.In situ hybridization de-tection showed that the majority of tumor cells were diffusely positive for EBER.Nevertheless,only 4 cases were posi-tive for TCR gene clonal rearrangement.Three patients received chemotherapy,2 patient declined the treatments.The median overall survival was only 3 months.Conclusions EBV-positive nodal T-and NK-cell lymphoma is an EBV-positive lymphoma of cytotoxic T-or NK-cell lineage presenting primarily with nodal disease,which is more common in elderly males.The patient has obvious symptoms and signs,rapid disease progression,and poor prognosis.Under-standing the clinicopathological features of EBV-positive nodal T-and NK-cell lymphoma can help differentiate it from other EBV-positive T-and NK-cell lymphoid proliferations and lymphomas.