Objective To elucidate the molecular mechanisms underlying the effects of Kanggan Mixture(KGM)on key targets in rats with acute lung injury,network pharmacology and in vivo micro-CT experiments were employed.Methods Network pharmacology was utilized to forecast the target genes and principal pathways involved in the intervention of KGM in acute lung injury(ALI).Lipopolysaccharide(LPS)-induced ALI rat models were utilized,and micro-computed tomography(micro-CT)was employed to evaluate the extent of lung injury in vivo.Experiments were conducted to verify the intervention mechanism of KGM on ALI rats.Results The findings revealed that 190 chemical constituents were identified from KGM,and 579 potential targets and 204 pathways associated with KGM's impact on ALI were predicted.The principal components of KGM,such as quercetin,luteolin,kaempferol,betulin,and lupenone,exhibit anti-viral,anti-inflammatory,and immunomodulatory properties by targeting TP53,AKT1,SRC,EP300,and STAT3,and modulating the FoxO signaling pathway,TNF signaling pathway,PI3K-Akt signaling pathway,and MAPK signaling pathway,demonstrating an influence on acute lung injury.Micro-CT results suggest that KGM can improve lung texture enhancement and lung injury in ALI rats,with an increase in end-expiratory lung volume(inspiratory phase-expiratory phase).The HE and W/D ratio results indicate that KGM can improve lung tissue injury and reduce the lung tissue wet/dry weight ratio(P<0.01).Blood cell analysis results show that the anti-inflammatory agent can decrease the WBC(white blood cell count)and N%(neutrophil percentage)in ALI rats'blood(P<0.01),and increase lymphocytes(P<0.05).Real-time quantitative PCR,WES,and immunohistochemistry results suggest that KGM can decrease the mRNA expression,protein distribution,and protein expression levels of TP53,AKT1,SRC,EP300,and STAT3 in lung tissue of ALI rats(P<0.05).Conclusion KGM has a certain intervention effect on acute lung injury,mainly achieved through the core targets STAT3,EP300,SRC,AKT1,and TP53.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To explore the level of positive psychological capital and its trends in traumatic lower limb amputation patients during the 15 months after surgery, and to identify the time period when the patients' level of positive psychological capital is weak, so as to provide a basis for interventions.Methods:This study was a prospective longitudinal study. Convenience sampling was used to select 143 patients with traumatic lower limb amputation admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022 for the study. General information questionnaire, Positive Psychological-Capital Questionnaire (PPQ) were used on the third postoperative day (T1) , on the day of discharge (T2) , 1 month (T3) , 2 months (T4) , 3 months (T5) , 6 months (T6) , 9 months (T7) , 12 months (T8) , and 15 months (T9) after discharge for a total of nine time points to administer the questionnaire to the patients. One-way repeated-measures ANOVA and plotting of results were performed on the nine time-point data using Graph Pad prism 9.5 software and SPSS 21.0 software, and the data were compared two-by-two using the Bonferroni multiple comparison test.Results:There were 143, 139, 132, 129, 122, 120, 119, 118, and 116 patients who participated in the survey from T1 to T9 time points, with a loss to follow-up rate of 18.88% (27/143) . PPQ scores of 116 traumatic lower limb amputation patients at nine time points were (103.25±9.03) , (108.53±9.32) , (104.38±9.60) , (99.71±9.61) , (95.82±9.55) , (91.49±9.41) , (93.34±9.29) , (93.53±9.14) , (93.62±9.05) , and the mean PPQ scores were lower than the theoretical mean (104) at all time points except T2 and T3 time points. One-way repeated-measures ANOVA showed that the difference in the change in the level of positive psychological capital of patients after traumatic lower limb amputation from postoperative day 3 to 15 months after discharge was statistically significant ( F=990.144, P<0.01) . Bonferroni's multiple comparison test showed that there was no statistically significant difference in two-by-two comparisons between T7, T8, and T9 time points with each other ( P>0.05) , and the rest of the two-by-two comparisons were statistically significant ( P<0.05) . Changes in the total PPQ score and the curves of the self-efficacy dimension, resilience dimension, hope dimension, and optimism dimension scores all showed a trend of a brief increase, followed by a continuous decrease, and then a slow increase to a plateau. Conclusions:Traumatic lower limb amputation patients show a wide range of changes in positive psychological capital levels from postoperative day 3 to 15 months after discharge, with a trend of a brief increase at discharge, followed by a steady decline, and then a slow increase to a plateau. Healthcare professionals should pay dynamic attention to the psychological state and psychological strength of patients after traumatic lower limb amputation and provide targeted interventions at different stages after discharge.

Objective To elucidate the molecular mechanisms underlying the effects of Kanggan Mixture(KGM)on key targets in rats with acute lung injury,network pharmacology and in vivo micro-CT experiments were employed.Methods Network pharmacology was utilized to forecast the target genes and principal pathways involved in the intervention of KGM in acute lung injury(ALI).Lipopolysaccharide(LPS)-induced ALI rat models were utilized,and micro-computed tomography(micro-CT)was employed to evaluate the extent of lung injury in vivo.Experiments were conducted to verify the intervention mechanism of KGM on ALI rats.Results The findings revealed that 190 chemical constituents were identified from KGM,and 579 potential targets and 204 pathways associated with KGM's impact on ALI were predicted.The principal components of KGM,such as quercetin,luteolin,kaempferol,betulin,and lupenone,exhibit anti-viral,anti-inflammatory,and immunomodulatory properties by targeting TP53,AKT1,SRC,EP300,and STAT3,and modulating the FoxO signaling pathway,TNF signaling pathway,PI3K-Akt signaling pathway,and MAPK signaling pathway,demonstrating an influence on acute lung injury.Micro-CT results suggest that KGM can improve lung texture enhancement and lung injury in ALI rats,with an increase in end-expiratory lung volume(inspiratory phase-expiratory phase).The HE and W/D ratio results indicate that KGM can improve lung tissue injury and reduce the lung tissue wet/dry weight ratio(P<0.01).Blood cell analysis results show that the anti-inflammatory agent can decrease the WBC(white blood cell count)and N%(neutrophil percentage)in ALI rats'blood(P<0.01),and increase lymphocytes(P<0.05).Real-time quantitative PCR,WES,and immunohistochemistry results suggest that KGM can decrease the mRNA expression,protein distribution,and protein expression levels of TP53,AKT1,SRC,EP300,and STAT3 in lung tissue of ALI rats(P<0.05).Conclusion KGM has a certain intervention effect on acute lung injury,mainly achieved through the core targets STAT3,EP300,SRC,AKT1,and TP53.

Objective:To explore the level of positive psychological capital and its trends in traumatic lower limb amputation patients during the 15 months after surgery, and to identify the time period when the patients' level of positive psychological capital is weak, so as to provide a basis for interventions.Methods:This study was a prospective longitudinal study. Convenience sampling was used to select 143 patients with traumatic lower limb amputation admitted to the Department of Emergency Medicine of the First Affiliated Hospital of Zhengzhou University from January 2021 to November 2022 for the study. General information questionnaire, Positive Psychological-Capital Questionnaire (PPQ) were used on the third postoperative day (T1) , on the day of discharge (T2) , 1 month (T3) , 2 months (T4) , 3 months (T5) , 6 months (T6) , 9 months (T7) , 12 months (T8) , and 15 months (T9) after discharge for a total of nine time points to administer the questionnaire to the patients. One-way repeated-measures ANOVA and plotting of results were performed on the nine time-point data using Graph Pad prism 9.5 software and SPSS 21.0 software, and the data were compared two-by-two using the Bonferroni multiple comparison test.Results:There were 143, 139, 132, 129, 122, 120, 119, 118, and 116 patients who participated in the survey from T1 to T9 time points, with a loss to follow-up rate of 18.88% (27/143) . PPQ scores of 116 traumatic lower limb amputation patients at nine time points were (103.25±9.03) , (108.53±9.32) , (104.38±9.60) , (99.71±9.61) , (95.82±9.55) , (91.49±9.41) , (93.34±9.29) , (93.53±9.14) , (93.62±9.05) , and the mean PPQ scores were lower than the theoretical mean (104) at all time points except T2 and T3 time points. One-way repeated-measures ANOVA showed that the difference in the change in the level of positive psychological capital of patients after traumatic lower limb amputation from postoperative day 3 to 15 months after discharge was statistically significant ( F=990.144, P<0.01) . Bonferroni's multiple comparison test showed that there was no statistically significant difference in two-by-two comparisons between T7, T8, and T9 time points with each other ( P>0.05) , and the rest of the two-by-two comparisons were statistically significant ( P<0.05) . Changes in the total PPQ score and the curves of the self-efficacy dimension, resilience dimension, hope dimension, and optimism dimension scores all showed a trend of a brief increase, followed by a continuous decrease, and then a slow increase to a plateau. Conclusions:Traumatic lower limb amputation patients show a wide range of changes in positive psychological capital levels from postoperative day 3 to 15 months after discharge, with a trend of a brief increase at discharge, followed by a steady decline, and then a slow increase to a plateau. Healthcare professionals should pay dynamic attention to the psychological state and psychological strength of patients after traumatic lower limb amputation and provide targeted interventions at different stages after discharge.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

As people's living standards improve， the development trend of diabetes has gradually become severe. Diabetes is a chronic inflammatory disease associated with abnormal expression of nuclear factor-kappa B （NF-κB） in patients. NF-κB exists in various tissue cells and participates in the regulation of a variety of genes related to immune function and inflammation. Varieties of factors can activate NF-κB when the body is stimulated by external factors， so as to produce inflammation and other reactions. Previous studies on NF-κB mainly focus on cancer， and the pathological mechanism of the treatment of diabetes by related signaling pathways and the progress of traditional Chinese medicine （TCM） treatment have not been systematically elaborated on. By referring to the relevant literature in China and abroad， it was found that NF-κB is not isolated in the development and progression of diabetes but is associated with signal molecules related to inflammation， oxidative stress， and energy metabolism， and it is involved in mediating inflammation， pancreatic β cell apoptosis， insulin signal transduction， and other physiological functions. Therefore， blocking the transmission of NF-κB signaling pathway is beneficial to the treatment of diabetes. At present， Western medicine for the treatment of diabetes mainly includes oral hypoglycemic drugs and insulin injections， but the adverse reactions are obvious. TCM has been characterized by multi-target， extensive action， and excellent curative effects in the treatment of diabetes. TCM and its compounds with functions of tonifying Qi and promoting blood circulation， regulating qi and eliminating phlegm， clearing heat and detoxifying， and nourishing Yin and moistening dryness can effectively intervene in the abnormal expression of NF-κB signaling pathway in vivo through anti-inflammatory effects. In this paper， the association between NF-κB signaling pathway and diabetes was summarized， and the modern research progress of TCM intervention of NF-κB signaling pathway in the treatment of diabetes in the past five years was reviewed， so as to lay a laboratory foundation for the study of a new pathological mechanism of diabetes based on NF-κB signaling pathway and provide new targets and research direction for the prevention and treatment of diabetes and development of related TCM.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

Mulberry (Morus alba L.) leaf is a well-established traditional Chinese botanical and culinary resource. It has found widespread application in the management of diabetes. The bioactive constituents of mulberry leaf, specifically mulberry leaf flavonoids (MLFs), exhibit pronounced potential in the amelioration of type 2 diabetes (T2D). This potential is attributed to their ability to safeguard pancreatic β cells, enhance insulin resistance, and inhibit α-glucosidase activity. Our antecedent research findings underscore the substantial therapeutic efficacy of MLFs in treating T2D. However, the precise mechanistic underpinnings of MLF's anti-T2D effects remain the subject of inquiry. Activation of brown/beige adipocytes is a novel and promising strategy for T2D treatment. In the present study, our primary objective was to elucidate the impact of MLFs on adipose tissue browning in db/db mice and 3T3-L1 cells and elucidate its underlying mechanism. The results manifested that MLFs reduced body weight and food intake, alleviated hepatic steatosis, improved insulin sensitivity, and increased lipolysis and thermogenesis in db/db mice. Moreover, MLFs activated brown adipose tissue (BAT) and induced the browning of inguinal white adipose tissue (IWAT) and 3T3-L1 adipocytes by increasing the expressions of brown adipocyte marker genes and proteins such as uncoupling protein 1 (UCP1) and beige adipocyte marker genes such as transmembrane protein 26 (Tmem26), thereby promoting mitochondrial biogenesis. Mechanistically, MLFs facilitated the activation of BAT and the induction of WAT browning to ameliorate T2D primarily through the activation of AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1)/peroxisome proliferator-activated receptor-gamma coactivator 1α (PGC-1α) signaling pathway. These findings highlight the unique capacity of MLF to counteract T2D by enhancing BAT activation and inducing browning of IWAT, thereby ameliorating glucose and lipid metabolism disorders. As such, MLFs emerge as a prospective and innovative browning agent for the treatment of T2D.
Mice ; Animals ; Adipose Tissue, Brown ; Sirtuin 1/pharmacology* ; Diabetes Mellitus, Type 2/metabolism* ; AMP-Activated Protein Kinases/metabolism* ; Morus/metabolism* ; Flavonoids/metabolism* ; Prospective Studies ; Signal Transduction ; Adipose Tissue, White ; Plant Leaves ; Uncoupling Protein 1/metabolism* ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolism*

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.