BACKGROUND:It has been confirmed that ferroptosis is closely related to the mechanism of various nervous diseases.However,the pathological mechanisms of ferroptosis and peripheral nerve injury need to be further studied and clarified.OBJECTIVE:To review the role and mechanism of ferroptosis in the treatment of peripheral nerve injury.METHODS:The articles related to ferroptosis and nervous system injuries were searched in CNKI and PubMed databases from database inception to May 2024.The keywords were"ferroptosis,peripheral nerve injury,antioxidant defense system,Schwann cells,macrophage,neuroinflammation,neuropathic pain"in Chinese and English,respectively.Sixty eligible articles were finally included for review.RESULTS AND CONCLUSION:The occurrence of ferroptosis is closely related to abnormal intracellular iron metabolism,reactive oxygen species accumulation and lipid peroxidation.Ferroptosis occurs in both Schwann cells and macrophages after peripheral nerve injury,leading to changes in the microenvironment and further inducing diseases such as neuroinflammation and neuropathic pain.Increasing studies have shown that nerve injury is closely related to ferroptosis,and inhibition of ferroptosis can promote tissue repair and functional recovery after peripheral nerve injury.Therefore,it is of great significance to study the mechanism underlying the occurrence and regulation of ferroptosis after peripheral nerve injury.Current research on the role and regulation of ferroptosis after peripheral nerve injury is still in its infancy,and more in-depth studies are needed to provide more strategies to promote repair after peripheral nerve injury.

Objective:To explore the dilemmas in the discharge preparation process of postoperative breast cancer patients within the framework of Meleis' Transition Theory, and to provide evidence for the development of nursing interventions to improve discharge readiness.Methods:This was a qualitative study. Using purposive sampling, postoperative breast cancer patients hospitalized in the Department of Breast Surgery of Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University between September and October 2024 were selected for the study. Semi-structured, in-depth interviews were conducted. Data were analyzed and themes extracted using Colaizzi's seven-step analysis method.Results:A total of four themes were extracted: personal status-patients experienced complex emotions at discharge; disease knowledge preparation-patients had insufficient mastery of relevant knowledge after discharge; coping ability-patients lacked confidence in home self-care after returning home; social support-patients desired support from peers and medical staff.Conclusions:Postoperative breast cancer patients face multiple dilemmas during discharge preparation. Medical staff are advised to pay attention to the psychological status of discharged patients and develop individualized emotional coping strategies; provide professional information and meet patients' fertility and sexual health knowledge needs; optimize health education models to enhance patients' home coping ability; and strengthen the integration of mobile health with nursing practice to build a multidimensional support system.

Objective:To translate the European organization for research and treatment of cancer quality of life questionnaire-head and neck 43(EORTC QLQ-H&N43) and to conduct cultural debugging and reliability and validity testing for the Chinese version of the scale.Methods:The Chinese version of EORTC QLQ-H&N43 was formed through literal translation, integration, back translation, group discussion, cultural adjustment, and pre-investigation of the English version of the scale. From March 2023 to December 2023, convenience sampling was used to investigate 254 patients with head and neck tumors at the Cancer Hospital of the Chinese Academy of Medical Sciences, including 197 males and 57 females, aged (55.6±13.6) years. SPSS 25.0 statistical software was used to analyze the performance of the scale.Results:The Chinese version of EORTC QLQ-H&N43 retained all 43 items. After evaluation by 5 experts, the content validity index (I-CVI) at the item level of the scale ranged from 0.80 to 1.00, and the average content validity index (S-CVI/Ave) at the scale level was 0.991. Through exploratory factor analysis, a total of 9 common factors were extracted, with a cumulative variance contribution rate of 68.158%; Cronbach′s α coefficient of the total scale was 0.943, and the half reliability was 0.896.Conclusion:The Chinese version of EORTC QLQ-H&N43 has good reliability and validity, which can be used as an effective tool to evaluate the quality of life of head and neck cancer patients in China.

BACKGROUND: The optimal antidepressant dosages remain controversial. This study aimed to analyze the efficacy of antidepressants and characterize their dose-response relationships in the treatments of major depressive disorders (MDD). METHODS: We searched multiple databases, including the Embase, Cochrane Central Register of Controlled Trials, PubMed, and Web of Science, for the studies that were conducted between January 8, 2016, and April 30, 2023. The studies are double-blinded, randomized controlled trials (RCTs) involving the adults (≥18 years) with MDD. The primary outcomes were efficacy of antidepressant and the dose-response relationships. A frequentist network meta-analysis was conducted, treating participants with various dosages of the same antidepressant as a single therapy. We also implemented the model-based meta-analysis (MBMA) using a Bayesian method to explore the dose-response relationships. RESULTS: The network meta-analysis comprised 135,180 participants from 602 studies. All the antidepressants were more effective than the placebo; toludesvenlafaxine had the highest odds ratio (OR) of 4.52 (95% confidence interval [CI]: 2.65-7.72), and reboxetine had the lowest OR of 1.34 (95%CI: 1.14-1.57). Moreover, amitriptyline, clomipramine, and reboxetine showed a linear increase in effect size from low to high doses. The effect size of toludesvenlafaxine increased significantly up to 80 mg/day and subsequently maintained the maximal dose up to 160 mg/day while the predictive curves of nefazodone were fairly flat in different dosages. CONCLUSIONS: Although most antidepressants were more efficacious than placebo in treating MDD, no consistent dose-response relationship between any antidepressants was observed. For most antidepressants, the maximum efficacy was achieved at lower or middle prescribed doses, rather than at the upper limit. REGISTRATION No. CRD42023427480; https://www.crd.york.ac.uk/prospero/display_record.php?
Humans ; Antidepressive Agents/therapeutic use* ; Depressive Disorder, Major/drug therapy* ; Dose-Response Relationship, Drug ; Randomized Controlled Trials as Topic

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Clinical data of two patients with X-linked adrenoleukodystrophy (X-ALD) initially presenting as Addison′s disease were collected from the Department of Endocrinology, First Medical Center of Chinese PLA General Hospital. Relevant medical history, clinical features, laboratory tests, and genetic results were analyzed. The two male patients, aged 7 years (case 1) and 15 years (case 2), initially presented with generalized skin hyperpigmentation, without any family history of similar disorders. Both had normal growth and development, and adrenal CT and brain MRI revealed no significant abnormalities. Elevated very long-chain fatty acid (VLCFA) levels were detected. Genetic analyses identified a maternally inherited missense mutation (c.830G>A, p.Gly277Glu) in the ATP-binding cassette subfamily D member 1 (ABCD1) gene in case 1, and a missense mutation (c.1499G>T, p.Gly500Val) in case 2. Protein structural predictions indicated both mutations as potentially damaging or damaging, and both were classified as likely pathogenic according to American College of Medical Genetics and Genomics (ACMG) criteria (PM1/PM2/PP3_Moderate and PM2/PP3_Moderate/PM6, respectively), supporting their correlation with the clinical phenotype. Clinicians should maintain vigilance for X-ALD in male patients presenting with Addison′s disease, and combined VLCFA and genetic testing can effectively prevent misdiagnosis or delayed diagnosis.

AIM:To display the distribution of evi-dence in the field of Yiqifumai injection treatment for heart failure.METHODS:To retrieve relevant da-tabases such as CBM,CNKI,Wanfang,VIP,Co-chrane Library,PubMed,Embase,and Web of Sci-ence,and search for the China Clinical Trial Regis-try,ClinicalTrials.gov and collect clinical studies,sys-tematic evaluations,and guideline studies on the treatment of heart failure with Yiqifumai injection.The evidence map research method use a table to display the proportion of literature,sample size,co-morbidities,and quality evaluations of systematic evaluations.Use a pie chart to display the propor-tion distribution of research types,a line chart to describe publication trends,and a bubble chart to display the distribution of evidence.RESULTS:The overall number of articles on the treatment of heart failure with Yiqifumai injection is in a steady development stage.Clinical studies are mainly small sample,single center,short-term randomized controlled trials,with a sample size of 60-100 cases and an intervention duration of mostly 14 days.The underlying disease is mainly coronary heart dis-ease.Clinical research evidence tends to support the therapeutic effect of Yiqifumai injection com-bined with conventional Western medicine in im-proving heart failure patients'heart function and quality of life.However,there are also issues such as low overall quality of research,unreasonable clinical trial design,small sample size,incomplete selection of outcome indicators,low international recognition of certain outcome indicators,and lack of reporting on long-term outcomes The overall quality of randomized controlled trials andsystem-atic evaluation methodology is low.CONCLUSION:In the future,more large sample,multicenter clini-cal randomized controlled trials should be conduct-ed to obtain higher-level evidence-based medicine evidence to fully demonstrate the advantages of traditional Chinese medicine treatment,and pro-mote the common development of traditional Chi-nese medicine cardiology and evidence-based med-icine.

Objective:To explore the dilemmas in the discharge preparation process of postoperative breast cancer patients within the framework of Meleis' Transition Theory, and to provide evidence for the development of nursing interventions to improve discharge readiness.Methods:This was a qualitative study. Using purposive sampling, postoperative breast cancer patients hospitalized in the Department of Breast Surgery of Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University between September and October 2024 were selected for the study. Semi-structured, in-depth interviews were conducted. Data were analyzed and themes extracted using Colaizzi's seven-step analysis method.Results:A total of four themes were extracted: personal status-patients experienced complex emotions at discharge; disease knowledge preparation-patients had insufficient mastery of relevant knowledge after discharge; coping ability-patients lacked confidence in home self-care after returning home; social support-patients desired support from peers and medical staff.Conclusions:Postoperative breast cancer patients face multiple dilemmas during discharge preparation. Medical staff are advised to pay attention to the psychological status of discharged patients and develop individualized emotional coping strategies; provide professional information and meet patients' fertility and sexual health knowledge needs; optimize health education models to enhance patients' home coping ability; and strengthen the integration of mobile health with nursing practice to build a multidimensional support system.

AIM:To display the distribution of evi-dence in the field of Yiqifumai injection treatment for heart failure.METHODS:To retrieve relevant da-tabases such as CBM,CNKI,Wanfang,VIP,Co-chrane Library,PubMed,Embase,and Web of Sci-ence,and search for the China Clinical Trial Regis-try,ClinicalTrials.gov and collect clinical studies,sys-tematic evaluations,and guideline studies on the treatment of heart failure with Yiqifumai injection.The evidence map research method use a table to display the proportion of literature,sample size,co-morbidities,and quality evaluations of systematic evaluations.Use a pie chart to display the propor-tion distribution of research types,a line chart to describe publication trends,and a bubble chart to display the distribution of evidence.RESULTS:The overall number of articles on the treatment of heart failure with Yiqifumai injection is in a steady development stage.Clinical studies are mainly small sample,single center,short-term randomized controlled trials,with a sample size of 60-100 cases and an intervention duration of mostly 14 days.The underlying disease is mainly coronary heart dis-ease.Clinical research evidence tends to support the therapeutic effect of Yiqifumai injection com-bined with conventional Western medicine in im-proving heart failure patients'heart function and quality of life.However,there are also issues such as low overall quality of research,unreasonable clinical trial design,small sample size,incomplete selection of outcome indicators,low international recognition of certain outcome indicators,and lack of reporting on long-term outcomes The overall quality of randomized controlled trials andsystem-atic evaluation methodology is low.CONCLUSION:In the future,more large sample,multicenter clini-cal randomized controlled trials should be conduct-ed to obtain higher-level evidence-based medicine evidence to fully demonstrate the advantages of traditional Chinese medicine treatment,and pro-mote the common development of traditional Chi-nese medicine cardiology and evidence-based med-icine.

Objective:To explore the reliability and validity of the Chinese version of Hammersmith Neonatal Neurological Examination (C-HNNE).Methods:A prospective cohort study.One hundred and fourteen neonates born in Longgang District Maternity & Child Healthcare Hospital of Shenzhen City between October 2022 and August 2023, who were hospitalized in the Neonatology or Obstetrics Department after birth and met the inclusion criteria, were enrolled as study subjects.They were divided into an early preterm group(34 cases), a mid-late preterm group(50 cases), and a full-term group(30 cases) based on gestational age.The first C-HNNE assessment was completed within 24 hours after birth, and 20 cases from each group were selected for inter-rater reliability assessment; 48 hours after the first C-HNNE assessment, 20 cases from each group were selected to undergo the C-HNNE assessment again for test-retest reliability assessment.At corrected 4 months of age, short-term neurodevelopmental outcomes were determined by pediatric rehabilitation physicians using clinical examination combined with general movements (GMs) assessment.Inter-rater reliability and test-retest reliability were assessed by calculating intra-class correlation coefficient (ICC). The optimal cutoff scores of the C-HNNE for each group were determined by plotting receiver operating characteristic(ROC) curves.Predictive validity was determined by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results:The highest sensitivity for predicting neonatal corrected neuromotor developmental outcome at 4 months of age was achieved when the optimal C-HNNE scores were taken as 22.25, 25.25, and 29.25 in the early preterm, mid-late preterm, and term groups, respectively.The ICCs for the inter-rater reliability of the total C-HNNE score and subscale scores in all 3 groups were above 0.7, indicating good reliability.The ICCs for test-retest reliability of some individual items were<0.6, indicating moderate reliability.In terms of validity, the correlation coefficients between the total C-HNNE scores and the GMs scores of the three groups were 0.550, 0.483, 0.473 (all P<0.01), and the sensitivity of the C-HNNE for predicting neurodevelopmental developmental outcomes in neonates corrected to 4 months of age was 82.9%, specificity was 70.4%, PPV was 58.0%, and NPV was 89.3%. Conclusions:C-HNNE demonstrates good reliability and validity and can be used as a routine bedside examination program for early neonatal life.