Mitochondrial quality control （MQC） homeostasis serves as a fundamental mechanism in maintaining the mitochondrial structure and function. Dysregulation of MQC contributes to the progression of acute ischemic stroke （AIS） through multiple pathways including disturbances in energy metabolism， increased oxidative stress， and imbalances in mitochondrial fusion and fission. Drawing upon the traditional Chinese medicine （TCM） theory of the kidney governing Yin and Yang， this study innovatively proposes an integrative model of "Yin-Yang dynamic balance-MQC homeostasis" to elucidate the underlying pathophysiological mechanisms. Specifically， kidney Yang deficiency and decline result in reduced driving force， thereby inhibiting mitochondrial fusion. This leads to decreased efficiency of oxidative phosphorylation and impaired adenosine triphosphate （ATP） production. Conversely， when kidney Yin is dysfunctional and excessive phlegm-blood stasis accumulates， mitochondrial fission becomes hyperactive， causing rapid accumulation of reactive oxygen species （ROS） and intensified oxidative stress. The interplay between these two pathological states culminates in the central TCM pathogenesis—Yin-Yang imbalance and disordered Qi and blood-of AIS. To address this pathogenesis， a therapeutic strategy is proposed： tonifying the kidney as the primary intervention to restore MQC homeostasis， supplemented by resolving phlegm and removing blood stasis to interrupt the deleterious cycle of cerebral vascular damage. This work integrates the holistic perspective of TCM with contemporary molecular insights， offering precise intervention targets along the "kidney-mitochondria axis" for the prevention and treatment of AIS， while establishing a novel integrative paradigm for stroke management that bridges traditional and modern medicine. Future research should focus on elucidating the molecular mechanisms through which TCM regulates MQC in AIS and integrating classical TCM theories with evidence-based medicine to facilitate the translation of theoretical insights into clinical applications.

OBJECTIVES: This study aimed to investigate the perception of dental outpatient care quality from multiple perspectives of administrators, physicians, nurses, and patients and propose nursing care quality evaluation indices that are consistent with the clinical reality to provide reference for the construction of a scientific, systematic, and comprehensive dental outpatient care quality evaluation system. METHODS: A total of 39 interviewees, including 7 administrators, 11 doctors, 11 nurses, and 10 patients, were selected for semi-structured in-depth interviews in five regionally representative tertiary-level A stomatological specialty hospitals nationwide during January-April 2024 by using a multistage sampling method. Colaizzi 7-step analysis was used to analyze and summarize the interview data. Themes were extracted on the basis of the Structure-Process-Outcome (SPO) three-dimensional quality assessment model. RESULTS: Five main themes and 15 secondary themes were extracted from three quality dimensions: structure, process, and result. The related topics of structural quality were as follows: disinfection and isolation norms, equipment and consumable management, nursing manpower ratio and nurse education structure, and emergency capability. The related topics of process quality were as follows: pre-diagnosis risk assessment, patient triage and guidance, communication and attitude, health education, humanistic care, continuous care, specialty operation, and four-hand operation. The related topics of result quality were as follows: satisfaction, adverse event management and analysis, effective complaints and disputes. CONCLUSIONS Structure quality is the foundation, process quality is the core, and result quality is the key in the evaluation of the quality of oral outpatient care. The standardization of disinfection and isolation, equipment and consumable management, allocation of reasonable nursing manpower and post capacity, implementation of high-quality nursing services, and improvement of the quality and satisfaction of medical cooperation are necessary guarantees to ensure the quality of oral outpatient care.
Humans ; Quality of Health Care ; Ambulatory Care/standards* ; Dental Care/standards* ; Outpatients

OBJECTIVES: This study aimed to construct an evaluation index system for nursing quality management in outpatient dental clinics based on the structure-process-outcome model and provide an objective standard for the evaluation of nursing quality in outpatient dental clinics. METHODS: Through literature review, multi-subject interviews, and expert meetings, the first draft of the evaluation index for nursing quality management in outpatient dental clinics was formulated. The Delphi method was adopted to select and invite 15 experts in the fields of hospital infection management, nursing management, and specialized oral care from across the country to modify the first draft. RESULTS: The positive coefficients of the experts in the two rounds of consultation were 86.7% and 92.3%, respectively. The total authority coefficients of the experts were 0.791 and 0.717, respectively. The mean scores of the importance and feasibility of the third-level indices in the two rounds of consultation were all ≥4.333; the coefficients of variation were all ≤0.150; and the Kendall's coordination coefficients were 0.308 and 0.184 respectively, with P<0.05 for all. These results indicated that the experts were motivated to participate in this study. They recognized the importance and feasibility of the overall items in this index system, and their opinions were relatively consistent. Finally, an evaluation index system, which included 3 first-level indices, 7 second-level indices, 22 third-level indices, and 69 index connotations, for nursing quality management in outpatient dental clinics was determined. The weights of the three first-level indicators were all 0.333. Patient satisfaction (0.076, outcome dimension), hand hygiene (0.061, outcome dimension), chair care ratio (0.057, structural dimension), and turnover rate (0.057, structural dimension) were the top tertiary indicators in terms of portfolio weight. CONCLUSIONS The construction method of the evaluation index system for nursing quality management in outpatient dental clinics is scientific and reliable. It can provide a reference for the evaluation of the management level of nursing quality in outpatient dental clinics and promote the continuous improvement of nursing quality in outpatient dental clinics.
Humans ; Dental Clinics ; Delphi Technique

Flavonoid 3-O-glucosyltransferase (3GT) is a key enzyme in the glucosidation of anthocyanins. To investigate the 3GT gene in rhododendron, we cloned an open reading frame (ORF) of 3GT gene (named Rh3GT) from Rhododendron hybridum Hort (Red cultivar) and then characterized this gene and the deduced protein in terms of the biochemical characteristics, expression level, and enzymatic function. The results showed that Rh3GT had a full length of 993 bp and encoded 330 amino acid residues. The deduced protein was hydrophilic, stable, weak acid, belonging to the glycosyltransferase family (GT-B type), with glutamine (Q) at position 44 in the PSPG box. The phylogenetic analysis showed that Rh3GT was most closely related to Vc3GT from Vaccinium corymbosum and Vm3GT from Vaccinium myrtillus. Rh3GT was expressed in the stems, leaves, and flowers and almost not expressed in the roots, with the highest expression level in petals during full blooming stage. Introduction of pCAMBIAL1302-Rh3GT into petals significantly up-regulated the expression level of Rh3GT and increased the total anthocyanin accumulation. Rh3GT was successfully expressed in Escherichia coli BL21 in the form of inclusion bodies with a size of about 36 kDa. The results of HPLC showed that the recombinant Rh3GT after denaturation, purification, and dilution could catalyze the synthesis of cyanidin and UDP-glucose to synthesize cyanidin 3-O-glucoside, indicating that the expressed protein had 3GT activity. This study provides basic data for further studying the molecular regulation mechanism of anthocyanin biosynthesis and theoretical support for molecular breeding of rhododendron.
Rhododendron/classification* ; Glucosyltransferases/metabolism* ; Cloning, Molecular ; Escherichia coli/metabolism* ; Recombinant Proteins/biosynthesis* ; Anthocyanins/biosynthesis* ; Phylogeny ; Plant Proteins/metabolism* ; Amino Acid Sequence

As a common malignant tumor of the digestive tract, esophageal cancer exhibits a high incidence rate globally. Due to its high mortality rate in advanced stages, early prevention of esophageal cancer is particularly important and urgent. Currently, the treatment for early esophageal cancer primarily involves surgical intervention, with Endoscopic mucosal Dissection (ESD) gaining attention for its minimally invasive nature and favorable prognostic outcomes. However, post-ESD esophageal stricture, as a common complication, severely impacts the quality of life of patients after surgery. The current methods for preventing and treating post-ESD stricture are diverse, including but not limited to pharmacological treatments and Endoscopic Balloon Dilation (EBD). Although these methods alleviate symptoms to some extent, they have not achieved ideal efficacy, and thus, there are no unified or clear standards for the prevention of post-ESD esophageal stricture. This review provides a brief overview of the mechanisms of occurrence, risk factors, and prevention and treatment research related to post-ESD esophageal stricture, with the aim of offering guidance and reference for clinical treatment.

Fistula-in-ano is a common anorectal disease that significantly affects patients' physical health due to pain and itching, and may lead to psychological disorders such as anxiety and depression. Complex fistula-in-ano, a more severe and challenging type of this disease, has attracted widespread attention in the medical field. Transanal opening of intersphincteric space(TROPIS), as an innovative surgical treatment, involves the excision of the fistula tract through the intersphincteric approach and the repair of the internal anal sphincter defect, showing a high success rate. Moreover, TROPIS has demonstrated good curative effects and a low incidence of postoperative complications in both short-term and long-term outcomes. Despite this, TROPIS has certain limitations and controversies, including the uncertain wound healing time after surgery. This article reviews the development, technical points, indications, contraindications, and efficacy and safety of TROPIS for the treatment of fistula-in-ano, and compares it with other surgical techniques, hoping to provide a reference for clinical physicians in the treatment of complex fistula-in-ano.

Objective To investigate the effects of Liuwei Dihuang Wan(LWDHW)combined with prednisone on immunoglobulin levels,coagulation function,and renal function in children with nephrotic syndrome(NS).Methods A total of 86 children diagnosed with NS and liver-kidney yin deficiency syndrome at the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2019 to January 2024 were randomly divided into a control group and an observation group,with 43 cases in each group.Both groups of children received conventional symptomatic treatment,including a low-salt diet,diuresis,anticoagulation,and lipid-lowering therapy.In addition,the control group received standard treatment with prednisone,while the observation group received the same treatment as the control group plus LWDHW in decoction for 3 months.Traditional Chinese medicine(TCM)syndrome scores,immunoglobulins(IgA,IgG,IgM),coagulation parameters[fibrinogen(FBG),activated partial thromboplastin time(APTT),prothrombin time(PT)],and renal function markers[serum creatinine(Scr),blood urea nitrogen(BUN)]were observed before and after treatment.Clinical efficacy and adverse events were compared.Results(1)After 3 months of treatment,the overall response rate in the observation group was 95.35％(41/43),while that in the control group was 79.07％(34/43).The intergroup comparison(by chi-square test)revealed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores for soreness/weakness of waist/knees,dizziness/tinnitus,feverish sensation in the chest,palms and soles,and afternoon tidal fever in both groups of children were significantly lower than thsoe before treatment(P＜0.05).Additionally,the reduction in scores for all TCM syndromes in the observation group was significantly greater than that in the control group(P＜0.05 or P＜0.01).(3)After treatment,the IgA and IgG levels in both groups of children increased compared to before treatment(P＜0.05).There was a trend of increased IgM levels in both groups after treatment,but the differences were not statistically significant(P＞0.05);the post-treatment intergroup comparison showed that the increase in IgA and IgG levels in the observation group was significantly greater than that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the PT levels of both groups of children were prolonged compared to before treatment(P＜0.05),the FBG levels were reduced compared to before treatment(P＜0.05),and the APTT levels showed no significant changes compared to before treatment(P＞0.05).After treatment,the improvement in PT and FBG levels in the observation group was significantly better than that in the control group(P＜0.01).(5)After treatment,the Scr and BUN levels in both groups decreased compared to before treatment(P＜0.05),and the reduction in Scr and BUN levels in the observation group was significantly greater than that in the control group(P＜0.01).(6)In terms of adverse reactions,the incidence rates in the observation group and control group were 6.97％(3/43)and 2.32％(1/43),respectively.There was no statistically significant difference between the two groups(x2=1.049,P＞0.05).Conclusion LWDHW combined with prednisone effectively improves clinical efficacy,alleviates TCM syndromes,modulates immune function,reduces hypercoagulability,and enhances renal function in children with NS and liver-kidney yin deficiency,with good safety.

OBJECTIVES: To explore the efficacy of low-intensity pulsed ultrasound (LIPUS) combined with nystatin for treatment of vaginal Candida albicans biofilm infection. METHODS: In vitro cultured Candida albicans biofilm were treated with LIPUS, nystatin, or both, and the minimum inhibitory concentration (MIC) of nystatin was determined. Crystal violet staining, confocal laser microscopy (CLSM) and scanning electron microscopy were used to quantify the biofilm and observe the activity and morphological changes of the biofilms; DCFH-DA was used to detect the changes in reactive oxygen species (ROS). Twenty female New Zealand White rabbits with vaginal inoculation of Candida albicans biofilm were randomized into 4 groups for treatment with normal saline, LIPUS, nystatin, or both LIPUS and nystatin. The changes in vulvar symptoms of the rabbits were observed, and the histopathological and ultrastructural changes of the vagina before and after treatment were observed using HE staining and transmission electron microscopy. RESULTS: In the combined treatment group, the MIC₅₀ and MIC₈₀ of nystatin in Candida albicans biofilms were both reduced by 50% compared with those in nystatin group, and the biofilm clearance rate increased by 26% and 68% compared with nystatin and LIPUS groups, respectively. Compared with nystatin and LIPUS treatment alone, the combined treatment produced stronger effects for inhibiting biofilm activity, causing structural disruption and promoting ROS production. In the rabbit models, the combined treatment more effectively improved vulvar symptoms and inflammatory infiltration, reduced residual vaginal hyphae/strains, and improved ultrastructure of the vaginal epithelium than LIPUS and nystatin treatment alone. CONCLUSIONS LIPUS combined with nystatin produces a significant synergistic antifungal effect against Candida albicans biofilm both in vitro and in vivo.
Animals ; Rabbits ; Female ; Biofilms/drug effects* ; Candida albicans/physiology* ; Nystatin/therapeutic use* ; Candidiasis, Vulvovaginal/microbiology* ; Ultrasonic Waves ; Antifungal Agents/therapeutic use* ; Vagina/microbiology* ; Ultrasonic Therapy ; Microbial Sensitivity Tests ; Combined Modality Therapy

Since the global outbreak in 2022, the mpox epidemic has evolved from an African endemic to a public health emergency of international concern. The 2024 mpox outbreak in the Democratic Republic of the Congo caused by the Clade Ⅰb lineage is yet another wake-up call, with markedly higher prevalence and fatality rates observed among children under 15 years of age, thereby presenting new challenges for the children. Therefore, it is necessary to strengthen prevention and control, block mother-to-child transmission routes, and establish innovative models with active community participation to reduce the risk of mpox transmission. In the future, it is urgent to analyze molecular mechanisms underlying the mother-to-child transmission of the virus, develop targeted antiviral drugs, establish a pediatric critical disease scoring system, and incorporate mpox vaccines into the World Health Organization′s expanded programme on immunization.

Objective:To explore the experience of clinical nurses in implementing nutritional management for patients with cirrhosis based on the nutrition care process and model, so as to provide references for nutritional management of patients with cirrhosis.Methods:From March to May 2024, 14 nurses from the Taihe County People's Hospital were selected for face-to-face semi-structured interviews using purposive sampling method. The Colaizzi's 7-step analysis was used to analyze the interview data.Results:A total of four themes were ultimately summarized, namely, multidimensional factors affecting patients' acceptance of nutritional management, nurses' professional competence affecting the implementation of nutritional management, deficiencies in practice affecting the implementation of nutritional management, and collaborative relationships between nurses and patients affecting the successful implementation of nutritional management.Conclusions:From the nurses' perspective, this study identifies strengths and weaknesses in the management and implementation of nutrition for patients with cirrhosis, which can provide a basis for further improvement and development of targeted nutritional management programs for patients with cirrhosis.