Functional constipation （FC） is a common functional disorder of the intestines， mainly characterized by reduced bowel movement frequency， difficulty in defecation， a sensation of incomplete evacuation， and hard stools， which severely affect patients’ quality of life. Research indicates that the pathogenesis of FC is closely related to gut microbiota dysbiosis and abnormal bile acid secretion. Bile acids， as endogenous natural laxatives， promote bowel movements by enhancing colonic secretion and regulating intestinal motility； meanwhile， gut microbiota influence colonic transit function by regulating the enteric nervous system， immune system， and their metabolic products. Based on an overview of the relationship between gut microbiota and bile acid metabolism， this article systematically reviews the current research status on the mechanisms of traditional Chinese medicine （TCM） in treating FC by regulating the balance of the gut microbiota-bile acid axis. It is found that single Chinese medicinal herbs （such as Atractylodes macrocephala）， isolated compounds （such as Platycodon grandiflorum polysaccharides）， herbal formulas （such as Shanger huang pill）， acupuncture， and moxibustion can up-regulate the abundance of beneficial bacteria， reshape the microbial structure， correct bile acid metabolism， and activate the Takeda G-protein receptor 5/farnesoid X receptor pathway to treat FC.

Guided by the concept of quality by design(QbD), this study optimizes the calcination and quenching process of calcined Magnetitum and establishes the XRD characteristic spectra of calcined Magnetitum, providing a scientific basis for the formulation of quality standards. Based on the processing methods and quality requirements of Magnetitum in the Chinese Pharmacopoeia, the critical process parameters(CPPs) identified were calcination temperature, calcination time, particle size, laying thickness, and the number of vinegar quenching cycles. The critical quality attributes(CQAs) included Fe mass fraction, Fe~(2+) dissolution, and surface color. The weight coefficients were determined by combining Analytic Hierarchy Process(AHP) and the criteria importance though intercrieria correlation(CRITIC) method, and the calcination process was optimized using orthogonal experimentation. Surface color was selected as a CQA, and based on the principle of color value, the surface color of calcined Magnetitum was objectively quantified. The vinegar quenching process was then optimized to determine the best processing conditions. X-ray diffraction(XRD) was used to establish the characteristic spectra of calcined Magnetitum, and methods such as similarity evaluation, cluster analysis, and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to evaluate the quality of the spectra. The optimized calcined Magnetitum preparation process was found to be calcination at 750 ℃ for 1 h, with a laying thickness of 4 cm, a particle size of 0.4-0.8 cm, and one vinegar quenching cycle(Magnetitum-vinegar ratio 10∶3), which was stable and feasible. The XRD characteristic spectra analysis method, featuring 9 common peaks as fingerprint information, was established. The average correlation coefficient ranged from 0.839 5-0.988 1, and the average angle cosine ranged from 0.914 4 to 0.995 6, indicating good similarity. Cluster analysis results showed that Magnetitum and calcined Magnetitum could be grouped together, with similar compositions. OPLS-DA discriminant analysis identified three key characteristic peaks, with Fe_2O_3 being the distinguishing component between the two. The final optimized processing method is stable and feasible, and the XRD characteristic spectra of calcined Magnetitum was initially established, providing a reference for subsequent quality control and the formulation of quality standards for calcined Magnetitum.
X-Ray Diffraction/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Particle Size

Age-related macular degeneration (AMD) represents a predominant cause of blindness among older adults, with limited therapeutic options currently available. Oxidative stress, inflammation, and retinal pigment epithelium injury are recognized as key contributors to the pathogenesis of AMD. Regulated cell death plays a pivotal role in mediating cellular responses to stress, maintaining tissue homeostasis, and contributing to disease progression. Recent research has elucidated several regulated cell death pathways-such as apoptosis, ferroptosis, pyroptosis, necroptosis, and autophagy-that may contribute to the progression of AMD owing to cell death in the retinal pigment epithelium. These discoveries open new avenues for therapeutic interventions in patients with AMD. In this review, we provide a comprehensive summary and analysis of the latest advancements regarding the relationship between regulated cell death and AMD. Moreover, we examined the therapeutic potential of targeting regulated cell death pathways for the treatment and prevention of AMD, highlighting their roles as promising targets for future therapeutic strategies.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Guided by the pathogenesis of"structure-activity imbalance of lung collaterals",this paper proposes that structure-activity imbalance of lung collaterals is the initial factor of idiopathic pulmonary fibrosis(IPF)and elucidates the pathogenesis of abnormal changes in biomechanical properties of IPF.It is postulated that the changes of biomechanical properties of lung tissue are closely related to the injury of lung qi collaterals,the abnormal mechanical stress are closely related to the injury of lung blood collaterals,and the biomechanical response of intrapulmonary resident cells is closely related to the structure-activity imbalance of lung collaterals,which ultimately leading to abnormal increase in lung tissue stiffness and progressive scarring formation in lung tissue.Integrating traditional pathogenesis concepts with microscopic pathological changes,and the in-depth exploration of the correlation between the structure-activity imbalance of lung collaterals and the biomechanical properties of IPF can provide direction for exploring IPF medical-engineering cross research,which are of great significance for enriching the syndrome and treatment system of lung collateral diseases.

Objective To explore the correlation between preoperative airway preparation and postoperative day 1 drainage volume in patients undergoing radical esophagectomy and the occurrence of postoperative pulmonary complications.Methods Analyzing the clinical data of esophageal cancer 147 patients who underwent thoracoscopic and laparoscopic radical surgery from January 2022 to June 2024,they were divided into PPCs group and non-PPCs group based on whether PPCs occurred postoperatively.Clinical data of the two groups were compared.Multivariate logistic regression analysis was applied to analyze the influencing factors for the occurrence of PPCs after radical resection of esophageal cancer,and a decision tree prediction model for postoperative PPCs was constructed.Receiver operating characteristic(ROC)curve was used to analyze the value of related factors in predicting the occurrence of PPCs after radical resection of esophageal cancer.Results Univariate analysis showed that age,albumin/fibrinogen ratio,neutrophil/lymphocyte ratio,preoperative respiratory preparation,and drainage volume on the first day after surgery were associated with the occurrence of PPCs after radical resection of esophageal cancer(P＜0.05).Multivariate logistic regression analysis indicated that age,albumin/fibrinogen ratio and drainage volume on the first day after surgery were independent influencing factors for the occurrence of PPCs after radical resection of esophageal cancer(P＜0.05).The decision tree model identified drainage volume on the first day after surgery,albumin/fibrinogen ratio,age and neutrophil/lymphocyte ratio as predictive factors.The incidence rate of PPCs in the group without preoperative respiratory preparation was significantly higher than that in the group with preoperative respiratory preparation(62.5％vs.37.5％,P＜0.05).A drainage volume of 246.59 ml on the first day after surgery was the optimal cutoff value for predicting the occurrence of PPCs after radical resection of esophageal cancer,and specificity was 93.04％,sensitivity was 87.5％,area under ROC curve(AUC)was 0.958,95％CI was 0.911-0.984.Moreover,the incidence rate of PPCs in patients with a drainage volume≤246.59 ml on the first day after surgery was significantly higher than that in patients with a drainage volume＞246.59 ml(77.78％vs.3.60％,P＜0.01).Conclusion Preoperative airway preparation and postoperative drainage volume are closely related to the occurrence of postoperative pulmonary complications(PPCs)after thoracoscopic radical surgery for esophageal cancer.Therefore,targeted measures should be taken for airway preparation before surgery,and changes in the patient's condition should be closely monitored after surgery to accurately determine the timing of drainage tube removal,which plays an important role in effectively preventing and treating PPCs.

Objective:To discuss the pay equity of operating room nurses in public hospitals and provide reference for promoting the salary performance reform of operating rooms.Methods:Using purposive sampling method, 22 cases of operating room nurses from 8 public hospitals in Sichuan Province were selected for semi-structured in-depth interviews from December 2023 to May 2024, and the themes were summarized and distilled by Colaizzi phenomenological data analysis.Results:Twenty-two operationg room nurses were interviewed, 6 males and 16 females with 25-55 years old. The sense of pay equity of operating room nurses was refined into 3 themes and 8 subthemes: ① sense of distributional equity: different representative groups have different views on the basic salary of the position, demand attention to the difference between different subspecialty surgeries, explicit the value embodiment of professional ability, and support for learning and growth; ②sense of procedural equity: the pay policy reflects the interests of the majority of the nurses, and the right to have a say in and ask questions about the pay policy; ③sense of interactive equity: explain the rationale for the pay policy information, focusing on nurses′feelings and perceptions.Conclusions:The sense of fairness of nurses in the operating rooms of public hospitals is expressed in the results of the distribution of subspecialty surgical work, the process of salary decision-making, and the sense of fairness in the interaction between supervisors and subordinates. Nursing managers should pay attention to the reasonable distribution of the pay-earnings ratio of the salaries of nurses in the operating rooms, safeguard the rights of nurses in the process of salary distribution, and pay attention to the sense of the operating room nurses in the implementation of the process or in deciding the results in order to enhance their fairness psychology.

Guided by the pathogenesis of"structure-activity imbalance of lung collaterals",this paper proposes that structure-activity imbalance of lung collaterals is the initial factor of idiopathic pulmonary fibrosis(IPF)and elucidates the pathogenesis of abnormal changes in biomechanical properties of IPF.It is postulated that the changes of biomechanical properties of lung tissue are closely related to the injury of lung qi collaterals,the abnormal mechanical stress are closely related to the injury of lung blood collaterals,and the biomechanical response of intrapulmonary resident cells is closely related to the structure-activity imbalance of lung collaterals,which ultimately leading to abnormal increase in lung tissue stiffness and progressive scarring formation in lung tissue.Integrating traditional pathogenesis concepts with microscopic pathological changes,and the in-depth exploration of the correlation between the structure-activity imbalance of lung collaterals and the biomechanical properties of IPF can provide direction for exploring IPF medical-engineering cross research,which are of great significance for enriching the syndrome and treatment system of lung collateral diseases.