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.

low transit constipation （STC） is a common functional intestinal disorder caused by impaired colonic transit function， characterized by reduced bowel movement frequency， hard stools， and difficulty in defecation. The mitogen-activated protein kinase （MAPK） signaling pathway， which mainly includes extracellular signal-regulated kinase （ERK）， c-Jun N-terminal kinase （JNK）， and p38 subtypes， plays a critical regulatory role in the occurrence and development of STC. This paper systematically reviews the multiple pathogenic mechanisms of the MAPK signaling pathway in STC and the research progress of traditional Chinese medicine （TCM） intervention.At the mechanistic level， the MAPK signaling pathway promotes the progression of STC through the following links：（1） Activation of p38 upregulates the expression of aquaporin 3 （AQP3）/AQP4 in the colon， leading to excessive reabsorption of water in the intestinal lumen； （2） It forms a positive feedback loop with nuclear factor-κB （NF-κB） to maintain low-grade intestinal inflammation， releases inflammatory factors such as tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β）， and inhibits smooth muscle contraction； （3） Overactivation of p38 downregulates the expression of occludin and mucin 2 while upregulates the expression of claudin-2， thereby disrupting the mucosal barrier； （4） The JNK/p38 signaling pathway activates the caspase cascade to induce apoptosis of intestinal epithelial cells， neurons， and interstitial cells of Cajal； （5） Abnormal ERK signaling and excessive activation of p38/JNK inhibit intestinal smooth muscle contraction and reduce 5-hydroxytryptamine secretion， ultimately resulting in impaired colonic transit function.At the intervention level， TCM compound formulas and single herbs have been proven to improve STC by regulating the MAPK signaling pathway. Their effects are syndrome type-dependent：yin-nourishing formulas （Zengye Chengqi Tang， Tongbian Tang） mainly regulate the ERK/AQP axis； yang-warming formulas （Jichuan Jian） target both ERK/JNK and anti-apoptosis； heat-clearing formulas （Sanren Tang） focus on p38/NF-κB anti-inflammation. A single drug can simultaneously cover multiple aspects including water metabolism， inflammation， barrier function， apoptosis， and intestinal motility.Current relevant studies still have limitations such as mechanisms mostly remaining at the correlational level and a lack of disease-syndrome integrated research models. Future studies should combine specific inhibitors or gene knockout to identify core targets， establish disease-syndrome integrated STC models， and use network pharmacology and molecular docking techniques to deeply analyze the fine mechanism of “component-target-phenotype”， so as to provide high-quality evidence for the precise regulation of the MAPK signaling pathway by TCM in the intervention of STC.

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 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.

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.

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.

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

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.

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.