ObjectiveTo investigate the effects of Astragali Radix polysaccharides （APS） on the polarization of BV2 microglial cells in an oxygen-glucose deprivation/reoxygenation （OGD/R） model through regulation of the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway. MethodsThe OGD/R injury model of BV2 microglia was established and divided into blank group， OGD/R group and APS group （0.4 g·L^-1 APS）. Neuroinflammatory injury was induced by lipopolysaccharide （LPS） and treated with APS. The cells were divided into blank group， LPS group （1 mg·L^-1 LPS） and APS group （0.4 g·L^-1 APS+1 mg·L^-1 LPS）. Cell viability was detected using the cell counting kit-8 （CCK-8） assay. Cell morphology was observed under an inverted microscope. Nitric oxide （NO） content in the cell supernatant was determined by the Griess assay. The secretion levels of tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， IL-10， and IL-4 were measured by enzyme-linked immunosorbent assay （ELISA）. Immunofluorescence （IF） was used to detect the double-positive rates of ionized calcium-binding adapter molecule-1/inducible nitric oxide synthase （Iba-1⁺/iNOS⁺） and ionized calcium-binding adapter molecule-1/arginase 1 （Iba-1⁺/Arg1⁺）， as well as the nuclear translocation rate of nuclear factor-κB p65 （NF-κB p65）. Protein expression levels of Iba-1， iNOS， Arg1， TLR4， and NF-κB p65 were detected by Western blot. ResultsIn the OGD/R injury model， compared with the blank control group， BV2 microglial cells in the OGD/R group were activated and exhibited amoeboid morphological changes. The secretion levels of NO， TNF-α， and IL-6 were significantly increased （P<0.01）. The double-positive expression rate of Iba-1⁺/iNOS⁺ and the protein expression of Iba-1 and iNOS were significantly increased （P<0.01）. The nuclear translocation rate of NF-κB p65 and the protein expression levels of TLR4 and NF-κB p65 were significantly increased （P<0.01）. The levels of IL-10 and IL-4 were significantly decreased （P<0.01）， and the double-positive expression rate of Iba-1⁺/Arg1⁺ and Arg1 protein expression were significantly decreased （P<0.01）. Compared with the OGD/R group， the APS group （0.4 g·L^-1） showed reduced cell activation， significantly decreased secretion levels of NO， TNF-α， and IL-6 （P<0.01）， significantly decreased double-positive expression rate of Iba-1⁺/iNOS⁺ and relative protein expression of Iba-1 and iNOS （P<0.01）， significantly decreased nuclear translocation rate of NF-κB p65 and protein expression levels of TLR4 and NF-κB p65 （P<0.01）， significantly increased levels of IL-10 and IL-4 （P<0.01）， and significantly increased double-positive expression rate of Iba-1⁺/Arg1⁺ and Arg1 protein expression （P<0.01）. In the LPS-induced neuroinflammation model， compared with the blank control group， the LPS group showed increased cell activation， significantly increased levels of NO， TNF-α， and IL-6， significantly increased Iba-1⁺/iNOS⁺ double-positive expression rate， NF-κB p65 nuclear translocation rate， and protein expression levels of Iba-1， iNOS， TLR4， and NF-κB p65 （P<0.01）， while IL-10 and IL-4 levels， Iba-1⁺/Arg1⁺ double-positive expression rate， and Arg1 protein expression were significantly decreased （P<0.01）. Compared with the LPS group， the APS group showed reduced cell activation， significantly decreased levels of NO， TNF-α， and IL-6， Iba-1⁺/iNOS⁺ double-positive expression rate， NF-κB p65 nuclear translocation rate， and protein expression levels of Iba-1， iNOS， TLR4， and NF-κB p65 （P<0.01）， while IL-10 and IL-4 levels， Iba-1⁺/Arg1⁺ double-positive expression rate， and Arg1 protein expression were significantly increased （P<0.01）. ConclusionAPS may reduce microglial activation and promote their polarization toward the M2 phenotype by inhibiting activation of the TLR4/NF-κB signaling pathway， thereby alleviating the neuroinflammatory response induced by OGD/R.

ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

Degenerative retinoschisis(RS)is a common peripheral retinal degeneration that typically remains asymptomatic and follows a benign clinical course. However, its morphological resemblance to rhegmatogenous retinal detachment(RRD)presents a diagnostic challenge, as the two conditions demand fundamentally different management and carry distinct prognoses. Precise differentiation is therefore clinically imperative. Recent advances in multimodal imaging have substantially refined the diagnostic accuracy and differential assessment of degenerative RS, establishing spectral-domain optical coherence tomography(SD-OCT)as the definitive reference standard. When the disease progresses to progressive symptomatic schisis-related retinal detachment(PSSRD), prompt surgical intervention, including scleral buckling, pars plana vitrectomy, or a combined approach, is mandated to preserve visual function. Clinical decision-making must be individualized, with the surgical strategy carefully tailored to the specific characteristics of eachcase. This review provides a systematic synthesis of current evidence on the natural history, imaging hallmarks, and surgical management of degenerative RS and its complications, aiming to inform and optimize clinical practice.

ObjectiveStarting from the etiology， pathogenesis， and treatment strategies of endometriosis and adenomyosis， to integrate and sort out the academic characteristics of contemporary renowned experts and schools in the field of traditional Chinese medicine gynecology. MethodsAccording to the systematic review of text and opinion （SrTO） process developed by the Joanna Briggs Institute （JBI） in Australia， this paper determined literature screening criteria by searching China National Knowledge Infrastructure （CNKI）， VIP， Wanfang， and China Biomedical Literature Database. Information was extracted after literature screening， and quality evaluation was conducted using the JBI Narrative， Text， and Opinion Systematic Review Strict Evaluation Checklist. The JBI Narrative， Opinion， Text Evaluation， and Review Tool Summary Table was used for information synthesis， and data analysis and display were conducted in the form of text and charts. ResultsThe 146 articles related to 39 renowned experts and 19 articles related to 10 schools of thought were included. Research has found that contemporary experts and schools in traditional Chinese medicine gynecology consider blood stasis as the core pathogenesis in understanding the etiology and pathogenesis of two diseases and related infertility. Their viewpoints varied from multiple aspects such as clinical symptom characteristics， meridian circulation location， pathological product evolution， disease duration， emotional psychology， lifestyle habits， preference for food and drink， innate endowment， and acquired injury. In terms of treatment， it was advocated to divide the stage， treat according to different types， adapt to the times， integrate nature and humans， and combine multiple methods to treat comprehensively when necessary. It was also recommended to skillfully use insects， make good use of classic formulas and small prescriptions， pay attention to protecting the spleen and stomach and regulating emotions， and make good use of self-formulated empirical formulas for internal or external use. Besides， individualized long-term management of patients was also advocated. ConclusionThis study applies the SrTO process to systematically summarize the academic ideas of contemporary renowned experts and schools in traditional Chinese medicine gynecology regarding the causes， mechanisms， diagnosis， and treatments of endometriosis， providing a scientific and standardized reference for future theoretical exploration.

Objective:To prepare domestic 64Cu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE), and to verify its distribution and preliminary diagnostic value in neuroendocrine tumors (NETs). Methods:DOTATATE was labeled with the domestic 64Cu to obtain 64Cu-DOTATATE. The lipophilicity, in vitro stability, and pharmacokinetics were studied. Biodistribution experiments and microPET imaging were performed on NCI-H727 (somatostatin receptor (SSTR)2 positive expression) tumor-bearing nude mice. The preliminary clinical applications were conducted on 10 NETs patients (5 males, 5 females; age (58.5±13.0) years) from Chinese PLA General Hospital between May 2023 and April 2024. Data were analyzed by using independent-sample t test. Results:64Cu-DOTATATE was successfully prepared with the radiochemical purity greater than 98%, log P of -2.609±0.051 and good stability. Pharmacokinetic experiments in BALB/c mice suggested rapid blood clearance of the drug (elimination half-time of 22.78min). Biodistribution results in tumor-bearing mice showed that 64Cu-DOTATATE was mainly metabolized through the liver and kidneys, with significant tumor uptake at 1h ((2.519±0.273) percentage activity of injection dose per gram of tissue (%ID/g)) and sustained high uptake at 24h ((4.331±0.549)%ID/g). MicroPET imaging of tumor-bearing mice showed a slight increase in uptake and good retention at 24h, with a significant statistical difference compared to the blocked group ((2.197±0.250) vs (0.985±0.064) % ID/g; t=6.40, P=0.008). The tumor/liver ratios were 0.075±0.007, 0.083±0.011, 0.118±0.005, 0.263±0.031 at 1, 2, 6 and 24h, respectively. Preliminary clinical application indicated that 64Cu-DOTATATE exhibited good targeting in patients, and the liver radioactivity distribution was moderate (SUV max=10.62±3.46), providing good image quality. Conclusion:Domestic 64Cu-DOTATATE PET/CT imaging is a promising imaging evaluation method in NETs with the value for further clinical research.

Cardiac arrest leads to abrupt cessation of cardiac ejection and effective systemic circulation,placing patients in a life-threatening state.Despite advancements in cardiopulmonary resuscitation(CPR)techniques significantly improving the rate of return of spontaneous circulation,overall hospital discharge rates remain low,primarily due to severe hypoxic-ischemic encephalopathy following CPR,which is the leading cause of mortality or prolonged coma.Accurately predicting neurological prognosis post-CPR is critical for optimizing therapeutic strategies and improving long-term outcomes.This review systematically explores diverse methods for predicting neurological prognosis after CPR,encompassing traditional neurological examinations,cerebral performance category scales,hemodynamic monitoring,and advanced approaches such as neuroimaging,serum biomarkers,neuroelectrophysiological assessments,inflammatory indicators,brain-computer interface technology,and multimodal detection.These methods collectively reflect the severity of brain injury and potential for functional recovery.Neurological examinations and cerebral performance category scales provide rapid initial assessments of functional status;neuroimaging visually delineates the extent of structural brain damage;serum biomarkers and inflammatory indicators evaluate metabolic and immune responses to injury;neuroelectrophysiological monitoring captures real-time neuronal activity.Furthermore,emerging brain computer interface technology and multimodal approaches integrate multiple modalities,offering novel possibilities for precise assessment and dynamic monitoring.By synthesizing reliable prognostic tools,this review facilitates early and accurate evaluation of brain injury severity and recovery potential,guiding timely clinical interventions and providing evidence-based references for post-CPR.

Objective·To investigate the therapeutic effect of combined vitamin D and docosahexaenoic acid(DHA)supplementation on preschool children with attention deficit hyperactivity disorder(ADHD).Methods·From April 2021 to May 2021,a total of 1 412 children aged 4 to 6 years from eight kindergartens in Pudong New Area of Shanghai,including Tangqiao Street,Chuansha Town,and Heqing Town,were randomly selected by stratified cluster random sampling method.Attention and hyperactivity symptom assessment was performed using the Conner's Scale,Diagnosis and Statistical Manual of Mental Disorders(fifth edition,DSM-Ⅴ),and Swanson,Nolan,and Pelham(version Ⅳ,SNAP-Ⅳ)Scale,and other neurodevelopmental disorders were excluded using the Wechsler Intelligence Scale.A total of 82 preschool children with ADHD were enrolled,and after fully informing them of the intervention measures,they were divided into an intervention group(n=64)and a control group(n=18)based on their parents' choice.The control group received routine health education.In addition to routine health education,the intervention group received daily supplementation of Vitamin D(800 IU)and DHA(400 mg).Venous blood samples were collected from both groups at baseline,3 months,and 12 months for the measurement of serum 25 hydroxy vitamin D[25(OH)D]and DHA levels.ADHD symptoms were evaluated using Conner's Scale,SNAP-Ⅳ Scale,and DSM-Ⅴ.Results·After 3 and 12 months of intervention in the intervention group,serum 25(OH)D levels and DHA levels were significantly higher(P<0.05),the ADHD symptom scores,including impulsivity-hyperactivity and hyperactivity index scores in Conner's Scale,the attention and hyperactivity/impulsivity scores in SNAP-Ⅳ Scale,and the attention and hyperactivity/impulsivity scores in DSM-Ⅴ,were significantly reduced compared with the scores before the intervention(P<0.05).There was no significant difference in serum 25(OH)D and DHA levels,or ADHD symptom scores,at the 3-and 12-month follow-ups compared to baseline.After 3 months of nutritional intervention in the intervention group,the hyperactivity/impulsivity scores in SNAP-Ⅳ Scale and DSM-Ⅴ were significantly improved compared to the control group(P<0.05).After 12 months of intervention,conduct problems,impulsive-hyperactivity and hyperactivity index scores in Conner's Scale,and hyperactivity/impulsivity scores in SNAP-Ⅳ Scale and DSM-Ⅴ showed significant improvement compared to the control group(P<0.05).Conclusion·Combined supplementation with vitamin D and DHA significantly improves serum 25(OH)D and DHA levels and alleviates ADHD symptoms in preschool children.

Objective:To investigate the effect of lumbar sympathetic ganglion block (LSGB) on postoperative ileus (POI) in patients undergoing colonic surgery.Methods:Ninety patients scheduled for elective laparoscopic colonic surgery in the same treatment group at the Nanjing First Hospital from March 2022 to August 2023 were selected and randomly divided into a control group and an observation group using a random number table, with 45 patients in each group. The observation group received ultrasound-guided LSGB before anesthesia, while the control group received no intervention. Both groups received standardized anesthesia protocols and management after entering the operating room. The time to gastrointestinal motility recovery (first defecation time), first flatus time, first feeding time, number of cases requiring gastric tube decompression, postoperative hospital stay, number of cases with nausea and vomiting, intraoperative additional and titrated sufentanil dosage, remifentanil dosage, first patient-controlled intravenous analgesia (PCIA) press time, sufentanil dosage at 4, 8, 12, 16, and 24 hours postoperatively, and the number of analgesic pump presses were recorded.Results:Compared with the control group, the observation group had shorter first defecation and flatus times, earlier first feeding time, shorter postoperative hospital stay, and fewer cases of nausea (all P<0.05). The observation group also had less intraoperative sufentanil supplementation and titration, later first PCIA press time (all P<0.05), and significantly fewer sufentanil dosages and analgesic pump presses at 4, 8, 12, 16, and 24 hours postoperatively compared with the control group (all P<0.05). Conclusions:LSGB reduces the incidence of POI in colonic surgery patients, decreases opioid use, and shortens hospital stay.

To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.