The historical development of endogenous wind （内风） is traced with time as the thread， based on the progression of factors such as syndromes， causes of disease， and pathogenesis. It is believed that the concept of wind syndrome originated in The Inner Canon of Yellow Emperor （《黄帝内经》）， encompassing both exogenous wind （外风） and endogenous wind syndrome. Over time， exogenous wind syndrome gradually evolved into mild syndromes and severe syndromes， while endogenous wind syndrome emerged from severe syndromes of exogenous wind. Endogenous wind syndrome has both syndrome and pathogenic attributes， and its theoretical system has gradually become more refined. Based on the theories of ancient and modern medical practitioners， and combining the holistic perspectives with Xiang （象） thinking， it is proposed that endogenous wind has both physiological and pathological distinctions. The physiological endogenous wind refers to the liver's moderate dispersing and regulating function， which helps to distribute qi （气）， blood， and body fluids， while pathological endogenous wind arises from abnormal liver dispersal. Therefore， in clinical practice， different treatment methods， such as tonifying， unblocking， and warming， can be applied according to the differentiation of deficiency and excess in the pathogenesis.

Objective To evaluate the impact of overall burden of cerebral small vessel disease(CSVD)combined with intracranial large artery atherosclerosis(ICAS)on cognitive function in very old patients.Methods A total of 178 advanced elderly patients admitted to Department of General Medicine of Wuhan Central Hospital between January 2013 and December 2022 were re-cruited in this retrospective study.According to the results of Montreal Cognitive Assessment Scale,they were divided into dementia group(n=83)and non-dementia group(n=95).All pa-tients underwent brain MRI imaging,MRI susceptibility weighted imaging and cerebral angiogra-phy.Based on these imaging findings of MRI,the effect of total burden score of CSVD and athero-sclerosis on cognition were evaluated.The volumes of 14 different gyri in the left and right brain were measured in the patients with CSVD burden score ≤2 and those ≥3.Results There were significantly more patients with numbers of microbleeding foci＞10 and lacunar foci ≥5 in the dementia group than the non-dementia group(P＜0.01).But,no statistical difference was seen in intracranial and extracranial arterial stenosis between the two groups(P＞0.05).The volumes of left and right anterior cingulate gyrus,left and right paracingulate cortex,right hippocampus,left parahippocampal gyrus,right transverse temporal gyrus and left inferior temporal gyrus were no-tably smaller in the CSVD score ≥3 group than the CSVD ≤2 group(1723.444 vs 1867.167,1590.167 vs 1595.670,1481.466 vs 1509.540,1543.831 vs 1585.505,1038.345 vs 1305.831,1220.525 vs 1392.352,P＜0.05).Conclusion Cognitive function in the advanced elderly is mainly affected by the burden of CSVD,and atherosclerotic stenosis of large arteries is not the main fac-tor affecting cognitive function.The total burden of CSVD is correlated with atrophy of some gyri.

Objective:To investigate the effects of Bifidobacterium animalis subsp. lactis BB-12 on hippocampal neuroinflammation and cognitive function of mice after whole brain radiotherapy. Methods:A total of sixty male C57BL/6J mice aged 7-8 weeks were randomly divided into 5 groups with 12 mice in each group: control group (Con group), probiotic group (BB-12 group), irradiation group (IR group), irradiation and Memantine group (IR+ Memantine group), irradiation and probiotic group (IR+ BB-12 group). The model of radiation-induced brain injury of mice was established by 10 Gy whole brain radiotherapy with a medical linear accelerator. Y-maze test was used to evaluate the cognitive function. The activation of microglia and astrocytes was observed by immunofluorescence staining. The expressions of inflammatory cytokines interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) were detected by quantitative real-time reverse transcription polymerase chain reaction (QRT-PCR) and Western blot.Results:Y-maze test showed that, compared with Con group, the percentage of the times of reaching the novel arm in the total times of the three arms decreased significantly in the IR group ( t=5.04, P<0.05). BB-12 mitigated radiation-induced cognitive dysfunction ( t=4.72, P<0.05). Compared with Con group, the number ( t=3.05, 7.18, P<0.05) and circularity index ( t=6.23, 2.52, P<0.05) of Iba1 and GFAP positive cells were increased, the microglia and astrocytes were activated in the hippocampus of IR group, but these alterations were eliminated by BB-12. After whole brain IR, the mRNA and protein expression levels of inflammatory cytokines IL-1β, IL-6 and TNF-α in the hippocampus of mice were significantly increased compared with Con group ( tmRNA =4.10, 3.04, 4.18, P<0.05; tprotein=11.49, 7.04, 8.42, P<0.05), which were also significantly reduced by BB-12 compared with IR group ( tmRNA=4.20, 3.40, 2.84, P<0.05; tprotein=6.36, 4.03, 3.75, P<0.05). Conclusions:Bifidobacterium animalis BB-12 can suppress neuroinflammation mediated by microglia and astrocytes in the hippocampus of mice after radiotherapy and alleviates IR-induced cognitive dysfunction. Therefore, BB-12 has potential application in alleviating radiation induced brain injury.

Objective To explore the effects of Humulus lupulus L. extract (HLE) and xanthohumol (XN) on preventing glucocorticoid-induced osteoporosis (GIOP). Methods The GIOP model was established by intraperitoneal injection of dexamethasone (DEX). Bone microstructure, bone mineral density and serum biochemical indexes were evaluated by Micro-CT and ELISA kits. The levels of cells proliferation and ALP activity, and the expression of bone formation related proteins were assayed with primary osteoblasts injured by DEX. Results HLE and XN significantly alleviated the bone microstructure damage, enhanced the bone mineral density, and improved the trabecular parameters in GIOP mice. In vitro experiments showed that HLE and XN can prevent bone loss not only by improving cell proliferation and ALP activity, but also through increasing the expression of bone γ-glutamic acid-containing proteins (BGP), bone morphogenetic protein 2 (BMP-2) and runt-related transcription factor 2 (Runx-2). Conclusion This study confirmed that HLE and XN had anti-GIOP effects for the first time. It provides a new resource for the development of anti-osteoporosis medications.

Objective:To investigate the iodine content distribution of drinking water in Jiangsu Province.Methods:In 2017, the iodine content in drinking water of residents in townships (streets, hereinafter referred to as townships) of Jiangsu Province was investigated. Administrative villages (neighborhood committees, hereinafter referred to as administrative villages) of Jiangsu Province were selected as units for the investigation of townships with the median water iodine greater than 10 μg/L. Delimitation criteria: the median iodine content of water < 40 μg/L was iodine deficiency area, 40-100 μg/L was suitable iodine area, and > 100 μg/L was high iodine area.Results:A total of 1 285 townships were surveyed in 101 counties (cities, districts) in 13 cities, and the median water iodine in townships was 7.28 μg/L. Among them, there were 875 townships with median water iodine < 10 μg/L, accounting for 68.09%; 315 townships 10-< 40 μg/L, accounting for 24.51%; 56 townships 40-100 μg/L, accounting for 4.36%; 39 townships > 100 μg/L, accounting for 3.04%. The water iodine survey at the administrative village level was conducted in 5 864 administrative villages in 410 townships in 6 cities. Among them, 769 administrative villages with median water iodine < 10 μg/L, accounting for 13.11%; 3 558 administrative villages 10 - < 40 μg/L, accounting for 60.68%; 613 administrative villages 40 - 100 μg/L, accounting for 10.45%; and 924 administrative villages > 100 μg/L, accounting for 15.76%.Conclusion:According to the water iodine, there are iodine deficiency, suitable iodine and high iodine areas in Jiangsu Province, mainly in iodine deficiency areas.

Objective:To explore design of an intelligent teaching platform based on the training path of medical education and its application in clinical nursing teaching and management.Methods:Starting from three stages of medical education in colleges and universities, post-graduation education, continuing education and teacher development and training, combining the whole process of nursing teaching, relying on the nursing management information platform, the intelligent nursing teaching platform was designed and developed by using the front and rear separation design framework and the whole station HTTPS encrypted connection. The platform included teaching plans, teaching training, exam management, teaching feedback, teaching resources and system management modules. Among them, the teaching training module was divided into six sub-modules, such as college education, post-graduation education, continuing education, teacher development, advanced training and base training. The intelligent teaching platform was applied to clinical nursing teaching and management.Results:The use of the platform improved the quality of nursing teaching, provided independent learning environment for nurses and helped the hospital save time and labor costs.Conclusions:The application of intelligent nursing teaching platform effectively saves nursing labor cost and teaching management cost and promotes the development of nursing teaching training assessment and management towards the direction of informatization, which is a training management platform worthy of wide application by nursing teaching managers.

Objective:To explore the clinical efficacy of different modes of continuous negative pressure wound therapy (NPWT) on venous ulcer wounds of lower limbs, and to analyze the influencing factors.Methods:From January 2018 to December 2019, 53 patients with venous ulcer of lower limbs who met the inclusion criteria and hospitalized in the Affiliated Hospital of Jiangnan University were recruited in this prospective randomized controlled study. According to the random number table, the patients were divided into single negative pressure therapy (SNPT) group (19 patients, 11 males and 8 females), cyclic alternating negative pressure therapy (CANPT) group (17 patients, 12 males and 5 females), and routine dressing change (RDC) group (17 patients, 10 males and 7 females), aged (47±11), (49±10), and (47±10) years respectively. After admission, patients in SNPT group were given continuous NPWT with the single negative pressure setting at -13.3 kPa, patients in CANPT group were also given continuous NPWT but with the cyclic alternating negative pressure setting from -16.0 to -10.7 kPa, while patients in RDC group were given dressing change with vaseline gauze soaked with iodophor. The wound healing rate was calculated on treatment day 7 and 14. Transcutaneous oxygen pressure (TcPO 2) around the wound was detected by TcPO 2 meter before treatment and on treatment day 7 and 14. The wound exudate/drainage fluid was collected on treatment day 1, 4, 7, 10, and 14, with the pH value measured using a pH meter, and the volume of exudate/drainage fluid recorded. Before treatment and on treatment day 7 and 14, venous blood was collected to detect the serum levels of interleukin 1β (IL-1β), IL-6, tumor necrosis factor α(TNF-α), transforming growth factor-β 1 (TGF-β 1), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Before treatment and on treatment day 7 and 14, wound exudates were collected for bacterial culture, and Visual Analogue Scale and Hamilton Anxiety Scale were used to evaluate the degree of wound pain and anxiety of patients respectively. The length of hospital stay and the total treatment cost were counted. Analysis of variance for repeated measurement, one-way analysis of variance, least significant difference test, Kruskal Wallis H test, Mann Whitney U test, chi-square test, Fisher′s exact probability method test, and Bonferroni correction were used to analyze the data. According to the wound healing rate on treatment day 14, the efficiency of patients were divided into two grades of significant healing with wound healing rate≥70% and non significant healing with wound healing rate<70%. According to the two categories of wound healing rate as dependent variables, the levels of TcPO 2, IL-1β, IL-6, TNF-α, TGF-β 1, VEGF, bFGF levels and bacterial detection, wound pain and anxiety before treatment, wound exudate/drainage fluid volume and pH value on treatment day 1 were taken as covariates, and binary classification multifactor logistic regression analysis was used to analyze the risk factors of significant wound healing. Results:(1) On treatment day 7, the wound healing rate of patients in SNPT group was (33±10) %, which was significantly higher than (24±9) % of RDC group ( P<0.05). On treatment day 14, the wound healing rates of patients in SNPT group and CANPT group were (71±15)% and (66±18)%, respectively, which were significantly higher than (45±19)% of RDC group ( P<0.01). (2) Compared with those of RDC group, the TcPO 2 value around the wound of patients was significantly increased in SNPT group on treatment day 14 and in CANPT group on treatment day 7 and 14 ( P<0.05 or P<0.01), the pH value of wound drainage fluid of patients was significantly decreased in SNPT group on treatment day 10 and 14 and in CANPT group on treatment day 7 and 14 ( P<0.05), the volume of wound drainage fluid of patients was significantly reduced in SNPT group on treatment day 10 and 14 and in CANPT group on treatment day 7, 10, and 14 ( Z=-4.060, -4.954, -2.413, -4.085, -4.756, P<0.05 or P<0.01), the serum levels of IL-1β, IL-6, and TNF-α of patients were significantly decreased in SNPT group and CANPT group on treatment day 7 and 14 ( P<0.01), the serum level of TGF-β 1 of patients was significantly increased in CANPT group on treatment day 14 ( P<0.05), the serum levels of VEGF and bFGF were significantly increased in SNPT group and CANPT group on treatment day 14 ( P<0.01), the bacteria detection proportion of wound exudate, wound pain, and anxiety scores of patients were significantly decreased in SNPT group and CANPT group on treatment day 7 and 14 ( P<0.01). Compared between the negative pressure therapy two groups, except the wound pain score of patients in CANPT group was significantly lower than that in SNPT group ( P<0.01) on treatment day 7, the other indicators mentioned above were similar. (3) The length of hospital stay of patients in SNPT group was similar to that in CANPT group ( P>0.05), which were significantly shorter than the time in RDC group ( P<0.01). The total treatment cost of patients among the three groups was similar ( F=1.766, P>0.05). (4) Before treatment, the serum levels of TNF-α and bFGF, TcPO 2 around the wound, and the degree of wound pain were risk factors for significant wound healing (odds ratio=1.109, 0.950, 1.140, 2.169, 95% confidence interval=1.012-1.217, 0.912-0.988, 1.008-1.290, 1.288-3.651, P<0.05 or P<0.01). Conclusions:Clinical application of continuous NPWT under single negative pressure mode and cyclic alternating negative pressure mode has a positive effect on improving the wound base and healing rate of venous ulcer of lower limbs. But cyclic alternating negative pressure mode is significantly more effective than single negative pressure mode in improving TcPO 2 around the wound, reducing wound pH value, reducing exudate volume and relieving pain. The serum levels of TNF-α and bFGF, TcPO 2 around the wound and the degree of wound pain were the risk factors that affect the wound healing significantly.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.

Chronic wounds have complex causes, are difficult to treat, and negatively affect patients＇quality of life. Assessment is the first step in wound management and has important guiding significance for subsequent treatment and health education. By summarizing the methods of chronic wound evaluation, this paper provides the guidance for clinical personnel to choose appropriate methods.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.