ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

BackgroundIndividuals with chronic multimorbidity exhibit a high prevalence of sleep disturbances， which impair their physical and psychological well-being and impede chronic disease management. Although sleep quality is closely influencing with psychological functioning， empirical evidence regarding the longitudinal trajectories of sleep quality and their influencing factors in this population remains insufficient. ObjectiveTo investigate the longitudinal trajectories of sleep quality and associated factors among patients with chronic multimorbidity from hospitalization through 6 months post-discharge， aiming to facilitate the early identification of high-risk individuals and the development of personalized sleep interventions. MethodsA total of 228 inpatients with chronic multimorbidity， primarily with cardiovascular and metabolic chronic conditions， were enrolled via random sampling at The Third People's Hospital of Fuyang from January 2023 to September 2024. Baseline assessments were conducted during hospitalization using the general socio-demographic questionnaire， the Sleep Dysfunction Rating Scale （SDRS）， the Ruminative Response Scale （RRS）， and the Hospital Anxiety and Depression Scale （HADS）. Sleep quality was further evaluated using the SDRS at 1-， 3-， and 6-month post-discharge. Latent class growth model was employed to delineate trajectories of sleep quality. Multivariate logistic regression analysis was subsequently performed to identify influencing factors of sleep quality. ResultsA total of 201 patients with chronic diseases were included.Based on four predefined assessment time points （baseline， 1 month， 3 months， 6 months post-discharge）， the latent class growth model identified three distinct trajectories of sleep quality： persistent high sleep disturbance （n=72， 35.82%）， moderate sleep disturbance-progression （n=73， 36.32%）， and low sleep disturbance （n=56， 27.86%）. Multivariate logistic regression analysis revealed that， compared with the low sleep disturbance group， multiple factors increased the odds of membership in the persistent high sleep disturbance group： per capita monthly household income of <3 000 yuan （β=13.131， P<0.01） or 3 000–5 000 yuan （β=5.913， P<0.05）， aged 45–65 years （β=9.536， P<0.05）， presence of 3 （β=7.792， P<0.05） or >3 comorbid chronic conditions （β=6.626， P<0.05）， as well as higher RRS （β=0.334， P<0.01） and HADS score （β=1.628， P<0.01）. Additionally， patients aged 45–65 years （β=2.777， P<0.05）， with 3 （β=3.802， P<0.01） or >3 comorbid chronic conditions （β=2.463， P<0.01）， and with higher RRS （β=0.111， P<0.01） and HDAS scores （β=0.350， P<0.05） also demonstrated significantly increased odds of belonging to the moderate sleep disturbance–progression group. ConclusionThere is significant population heterogeneity in sleep quality trajectories among patients with chronic multimorbidity， with age， per capita household monthly income， number of comorbidities， rumination， and anxiety/depression symptoms being identify as the primary influencing factors.

OBJECTIVE To investigate the clinical efficacy and safety of Zhengxintai granules as in the treatment of microvascular angina （MVA） following percutaneous coronary intervention （PCI） in patients with acute ST-segment elevation myocardial infarction （STEMI） and qi deficiency and blood stasis syndrome. METHODS Patients with STEMI and qi deficiency and blood stasis syndrome who underwent PCI and developed MVA and were admitted to the Jinan Fourth People’s Hospital （Jinan Cardiovascular Hospital） from March 2022 to March 2025 were selected， they were randomly divided into the control group and the observation group according to a random number table， with 76 cases in each group. Patients in the control group received conventional Western medicine treatment combined with a placebo， while patients in the observation group received Zhengxintai granules （5 mg per dose， three times daily， for 8 weeks） in addition to conventional Western medicine treatment. The clinical efficacy [including the total effective rate of traditional Chinese medicine （TCM） syndrome improvement and the total effective rates of Western clinical efficacy] was compared between the two groups. The following indicators were detected before and after treatment： TCM syndrome scores， angina pectoris episodes [daily attack frequency， duration per attack， Visual Analogue Scale （VAS） score]， cardiac function indicators [lactate dehydrogenase （LDH）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， left ventricular end-diastolic dimension （LVEDD）， left ventricular end-systolic dimension （LVESD）， left ventricular ejection fraction （LVEF）， cardiac output （CO）， fractional shortening （FS）]， coagulation function indicators [thrombin time （TT）， prothrombin time （PT）， fibrinogen （FIB）]， fibrinolytic marker （D-dimer）， vascular endothelial function indicators [vascular endothelial growth factor （VEGF）， nitric oxide （NO）， endothelin-1 （ET-1）] and myocardial microcirculation hemodynamic indicators [end-diastolic velocity （EDV）， peak systolic velocity （PSV）， resistance index （RI）， pulsatility index （PI）]. The quality of life [Seattle Angina Questionnaire （SAQ） score] and the incidence of adverse reactions were also compared between the two groups. RESULTS There was no patient dropout during the entire course of the study. The total effective rates of improvement in TCM syndromes and the total effective rates of Western clinical efficacy in the observation group were significantly higher than those in the control group （93.42% vs. 82.89%， 94.74% vs. 84.21%， P＜0.05）. Before the treatment， the comparison of each examination indicator between the two groups showed no statistically significant differences （P＞0.05）. Compared with before treatment， the TCM syndrome scores， the number of daily angina pectoris attacks and the duration of each attack， the VAS scores， LDH， NT-proBNP， FIB， D-dimer， ET-1 levels， LVEDD， LVESD， RI and PI after treatment in both groups were significantly reduced， shortened or decreased （P＜0.05）； VEGF and NO levels， LVEF， CO， FS， TT， PT， EDV， PSV， and the standard scores of five dimensions including angina pectoris stability， as well as the total scores of SAQ， all significantly increased or prolonged （P＜0.05）. Furthermore， the improvements in the aforementioned indicators （except for LVEF） in the observation group were significantly greater than those in the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS Zhengxintai granules， when used as an adjunct to conventional Western medicine， can significantly alleviate the related symptoms of MVA in STEMI patients with qi deficiency and blood stasis syndrome after PCI， repair damaged cardiac function， restore the balance of the coagulation-fibrinolysis system， improve vascular endothelial function and myocardial microcirculation perfusion， and significantly enhance the quality of life of patients

Objective: To investigate the association between habitual reading/writing postures and the co-occurrence of common health conditions (overweight/obesity, visual impairment, hypertension, and scoliosis) and comorbidities among children and adolescents, in order to provide data support for the joint prevention of common diseases and comorbidities among children and adolescents. Methods: From September 2021 to June 2022, a multi-stage cluster random sampling method was used to select a total of 4 577 children and adolescents from 16 primary and secondary schools in Ningxia: Jinfeng District of Yinchuan City, Shapotou District of Zhongwei City, Yanchi County of Wuzhong City, and Pingluo County of Shizuishan City. A weighted complex sampling design was used to investigate the association of habitual reading and writing postures with common comorbidities in children and adolescents. Results: The prevalence rates of common diseases among children and adolescents in Ningxia were as follows: overweight/obesity was 22.87%, visual impairment was 62.52%, scoliosis was 2.30%, and hypertension was 1.30%. The prevalence of multimorbidity (co-occurrence of ≥2 conditions) among Ningxia children and adolescents was 15.95%. Multivariate unconditional Logistic regression analysis showed that frequent/always collapsing waist and sitting forward with head lowered increased the risk of common comorbidities in children and adolescents ( OR =1.90, P <0.05). Compared with the corresponding reference group, male children and adolescents aged 9 to 12 years and boys had relatively lower risks of overweight/obesity ( OR =0.71, 0.70); the risk of poor vision among children and adolescents aged 9 to 12 years, male, and urban was relatively low ( OR =0.59, 0.60, 0.73)( P < 0.05 ). Children and adolescents who often/always sat leaning to the left or right were at higher risk of poor vision ( OR =1.78); urban children and adolescents had a higher risk of developing scoliosis ( OR =3.71); children and adolescents aged 9 to 12 had a relatively low risk of developing hypertension ( OR =0.09), and children and adolescents who often/always bent their backs and sat forward on their knees had a higher risk of hypertension ( OR =5.03)( P <0.05). Conclusions Ningxia has a high incidence of common diseases and multiple diseases among children and adolescents, frequent or always collapsing waist and sitting forward with head lowered is associated with common comorbidities in children and adolescents in Ningxia. Proper postural measures for reading and writing should be carried out as soon as possible to encourage children and adolescents to develop good reading and writing habits for effectively preventing and controlling the occurrence of common diseases.

Objective: To evaluate the efficacy and safety of the single-use hemoperfusion device (UA230) in treating refractory gout (RG) via plasma perfusion. Methods: Thirty-four RG patients aged 18-65 years were recruited and randomly divided into a control group (febuxostat therapy, n=17) and an experimental group (plasma perfusion combined with febuxostat therapy, n=17). Differences in serum uric acid (SUA) levels and urate-lowering rates between the two groups were analyzed using t-tests. Between-group differences in incidence of adverse reactions were analyzed using chi-square tests. Results: At 7 and 14 days post-treatment, SUA levels in the experimental group were significantly lower than those in the control group, with a higher urate-lowering rate (all P<0.05). However, no statistically significant differences in SUA levels or urate-lowering rate were observed at 28 days post-treatment (all P>0.05). The incidence of adverse reactions showed no significant difference between the two groups (χ =0.15, P>0.05). Conclusion: The single-use hemoperfusion device (UA230), combined with plasma perfusion technology, is a safe and effective treatment for RG. It may serve as a novel therapeutic approach for RG patients in clinical practice.

Objective Based on a complete Freund's adjuvant(CFA)-induced chronic inflammatory pain model,we compared and analyzed the differences in anti-inflammatory and analgesic effects of moxibustion intervention initiated at different timepoints,aiming to identify the optimal timing for moxibustion intervention.The goal is to establish standardized intervention protocols for basic research on the anti-inflammatory and analgesic effects of moxibustion.Methods Male C57BL/6 mice were randomly divided into 3 groups based on the moxibustion initiation timepoints of 4,7,and 10 d after modeling.Then,the mice in each group were randomly assigned to 3 subgroups,including a control group,a model group,and a moxibustion group,with 8 mice in each subgroup.Chronic inflammatory pain was induced by injecting 20 μL of CFA into the sole of the right hind paw.Moxibustion applied at the"Zusanli"acupoint for 30 minutes started on the 4th,7th,and 10th days after modeling,and the intervention continued for 7 days.The latency of paw withdrawal to thermal radiation was measured to evaluate the pain threshold before modeling,after modeling,and on the 1st,4th,and 7th days of treatment.Foot volume was measured to assess toe swelling before modeling,after modeling,and on the 1st and 7th days of treatment.Results Compared with the control group,the model group exhibited a reduced pain threshold(P＜0.0001)and increased paw volume(P＜0.0001).Compared with the model group,the subgroups receiving moxibustion intervention initiated on the 4th,7th,and 10th days post-modeling exhibited an increased pain threshold(P＜0.05,P＜0.0001).However,the paw volume of the subgroups receiving moxibustion intervention initiated on the 4th day post-modeling increased(P＜0.0001),while those of the subgroups receiving moxibustion intervention initiated on the 7th and 10th days post-modeling decreased(P＜0.0001).Among the intervention subgroups receiving moxibustion initiated on days 4,7,and 10,the day 7 intervention-initiating subgroup showed significant increase in pain threshold(P＜0.05,P＜0.0001),and the day 7 and day 10 intervention-initiating subgroups showed significantly reduced paw volume(P＜0.0001).Conclusion Considering both the analgesic and anti-inflammatory effects of moxibustion,day 7 post-modeling may be the optimal time for moxibustion to achieve effective anti-inflammatory and analgesic outcomes.

Gestational diabetes mellitus(GDM)is closely associated with short-term and long-term adverse outcomes for both mothers and fetuses.In recent years,with the global prevalence of obesity and type 2 diabetes mellitus(T2DM)constantly rising,there is a significant increase in GDM incidence,with notable regional variations.Current challenges in GDM management include insufficient early screening or diagnosis,limited personalized intervention strategies,and poor adherence to long-term follow-up.Key research priorities for the future include optimizing screening methods for high-risk populations,enhancing targeted lifestyle interventions,and establishing effective follow-up and long-term health management systems.In December 2024,the American Diabetes Association(ADA)released the Standards of Care in Diabetes—2025(hereafter referred to as ADA[2025]),providing updated perspectives on the diagnosis and treatment of diabetes mellitus,as well as an overview of the definition,screening and diagnostic criteria,and management strategies for GDM.Based on ADA(2025)and the circumstances of clinical practice in China,we summarized the latest advancements in GDM research,aiming to improve comprehensive management strategies to prevent,delay,and improve adverse outcomes associated with GDM.

Objective To study the effect of the transbrachial artery approach on the success rate of puncture,revascularization time,and postprocedural complications in patients with acute ST-segment elevation myocardial infarction(STEMI)treated by percutaneous coronary intervention(PCI).Methods The clinical data of 324 patients with STEMI who underwent PCI between September 2020 and May 2024 at our hospital were retrospectively analyzed.According to the different approaches,the patients were divided into a brachial artery group(127 cases)and a radial artery group(197 cases).Their procedural parameters(X-ray exposure time,contrast agent dosage,puncture time,puncture success rate,and revascularization time)and hospital length-of-stay,cardiac function indicators,including left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),left ventricular end-systolic volume index(LVESVI),and left ventricular end-diastolic volume index(LVEDVI),before surgery and 3 months after PCI,and the incidence of complications were compared between the two groups of patients.Furthermore,a difference-in-differences method was adopted for the logistic model to evaluate the effects of different approaches.Results There were no statistical differences in the general data between the brachial artery group and the radial artery group.Compared with those of the radial artery group,the revascularization time and length-of-stay of the brachial artery group were shortened,and the success rate of puncture was increased(P<0.05).There were no significant differences in X-ray exposure time or contrast agent dosage between the two groups.The changes in LVEF,LVFS,LVESVI,and LVEDVI from baseline to 3 months post-PCI were(10.97±7.15)%,(3.29±5.90)%,(22.11±9.30)mL/m2,and(18.13±6.68)mL/m2,respectively,in the brachial artery group,while those in the radial artery group were(10.61±7.13)%,(4.38±6.04)%,(23.13±9.60)mL/m2,and(19.34±7.27)mL/m2,respectively,without statistical differences.Difference-in-differences analysis revealed that there were no statistical differences in the effects of different approaches on LVEF,LVFS,LVESVI,and LVEDVI between the brachial artery group and the radial artery group.During follow-up,no complications,such as coronary perforation,coronary dissection,or stent thrombosis,were observed in either group,and there were no statistical differences in the complication incidence between the two groups.Conclusion The transbrachial artery approach can shorten the revascularization time and length-of-stay of patients with STEMI treated by PCI.It has a high success rate of puncture and can promote the recovery of postoperative cardiac function without increasing postoperative complications.

Objective To systematically analyze the domestic and foreign literature related to interventional nursing care for patients with coronary heart disease in the past 10 years and to make a further understanding of the research status,hot spots and trends in this field so as to provide useful reference for the in-depth research in this field.Methods A computerized retrieval of academic papers concerning the interventional nursing care for patients with coronary heart disease from the databases of CNKI,Wanfang,VIP-CMJD,PubMed and Web of Science was conducted.The retrieval time period was from 1 January,2014 to February 27,2024.NoteExpress and CiteSpace software were used to make visualization analysis for the literature meeting the inclusion and exclusion criteria.Results A total of 4 098 Chinese articles and 381 English articles were enrolled in the analysis.Between 2014 and 2021,the number of domestic and foreign documents was on the rise.The number of foreign publications continued to increase in 2022,thereafter,the number of publications was declined in 2023.The authors with the most published academic papers were WANG Jing(15 articles)and Ayman Elbadawi(7 articles).The research keywords involved a wide range,and the research focus was on the characteristics and perioperative care of coronary heart disease,including quality of life,evidence-based nursing care,complications,myocardial infarction,outcome,mortality,etc.The obvious trend of research was to emphasize the psychological nursing,continuation nursing and rehabilitation nursing for patients with coronary heart disease receiving interventional treatment.Conclusion Although the number of research publications concerning the interventional nursing care for patients with coronary heart disease in the past decade is very large,the authors and institutions lack effective communication and collaboration.In order to improve the overall health,self-care ability and quality of life of patients,the future studies should further strengthen the quality of research,focus on key population,and innovate nursing pattern.

Objective To make an investigation on the current situation of the general surgical nurse's knowledge-attitude-practice for mechanical prevention of venous thromboembolism(VTE),and to analyze its influencing factors,so as to provide scientific basis for improving the mechanical prevention care work of VTE.Methods Using convenience sampling method,from April 2023 to May 2023 a total of 508 general surgery nurses from 28 provinces,municipalities and autonomous regions were selected as the study subjects.A VTE mechanical prevention knowledge-attitude-practice questionnaire designed based on expert consensus was used to conduct the questionnaire survey.Linear regression analysis was used to determine the related factors affecting the knowledge-attitude-practice level of mechanical prevention care work of VTE in general surgery nurses.Results Multiple linear regression analysis showed that the sub-specialty of vascular surgery(P＜0.001)and the frequency of VTE mechanical prevention theory training in hospital(P=0.023)were the factors influencing VTE mechanical prevention knowledge dimension score of general surgery nurses;the sub-specialty of vascular surgery(P=0.033)was the factor influencing attitude dimension score;the sub-specialty of vascular surgery(P＜0.001)and the frequency of VTE mechanical prevention theory training in hospital(P=0.043)were the factors influencing practice dimension score.Conclusion General surgery nurses have a high level of attitude and practice in mechanical prevention of VTE for hospitalized patients,but their knowledge reserve is relatively insufficient.Therefore,the study of VTE-related knowledge and vascular surgery specialty should be strengthened,meanwhile,the frequency of VTE mechanical prevention training at the hospital and department level should be increased.