Hyperuricemia （HUA） is a common metabolic disorder characterized by persistently elevated serum uric acid levels, leading to uric acid-related renal injury through complex mechanisms involving inflammation, oxidative stress, and fibrosis. Key traditional Chinese medicine （TCM） formulas （e.g., Simiao Powder, Tongfengning） and individual herbal compounds （alkaloids, flavonoids, polysaccharides） with urate-lowering and renal protective properties were systematically summarized, including their mechanisms of regulating uric acid transporters （organic anion transporter 3, urate anion transporter 1, glucose transporter type 9）, inhibiting inflammatory responses （via NF-κB signaling）, reducing oxidative stress （via mitochondrial pathways and antioxidant enzyme enhancement）, and attenuating renal fibrosis （via PI3K/AKT signaling）. The challenges of current studies mainly focus on unclear mechanisms of action and insufficient clinical research. Future research may further explore TCM resources, clarify dual-action mechanisms of urate reduction and renal protection, and identify new therapeutic strategies for hyperuricemia-related renal injury.

The promulgation of the Technical Specifications for Clinical Use of Blood (2025 Edition) signifies that China's clinical blood transfusion management has transitioned from mere technical operations to a new stage centered on patient blood management (PBM). Through an in-depth comparison of the new and old specifications, this paper analyzes the core transformations regarding conceptual reconstruction, legal alignment, technological upgrades, and closed-loop management. The new specifications establish PBM principles, reinforce legal safeguards for informed consent and emergency treatment, and construct a comprehensive, refined quality control system by specifying compatibility testing standards and introducing a post-transfusion evaluation system. Medical institutions should seize this opportunity to update management protocols and information systems, deepen multidisciplinary collaboration, and drive the profound transformation of clinical blood use from focusing solely on safety assurance to placing equal emphasis on science and value.

Objective:To investigate the current use of ulinastatin in the treatment of critically ill children by pediatricians in China.Methods:A anonymous questionnaire survey was conducted among 147 pediatric critical care physicians from 36 hospitals across 16 provinces,autonomous regions,and municipalities in China.The survey content consists of three parts: respondents' basic information, the application status of ulinastatin, and the clinical indicators referenced for evaluating the use of ulinastatin. Descriptive statistical analysis was performed on the collected data.Results:Among the 147 respondents,99.32%(146/147) were from tertiary hospitals；72.11%(106/147) worked in specialized ICUs,and 4.08%(6/147)in emergency medicine departments.A total of 68.03%(100/147) of the physicians reported using ulinastatin in clinical practice.The main diseases for which ulinastatin was used were pancreatitis(26.40%),sepsis and septic shock(23.76%),capillary leak syndrome(21.78%),acute respiratory distress syndrome(8.91%),and disseminated intravascular coagulation(6.27%).A total of 90.00% of physicians combined ulinastatin with other medications,including glucocorticoids(26.82%),albumin(23.51%),plasma(17.22%),and immunoglobulins(13.58%). Clinical indicators referenced during ulinastatin use included elevated interleukin(IL)-6(76.87%),tumor necrosis factor-α(44.22%),IL-8(31.97%),IL-1(19.73%),IL-18(10.20%),blood lactate(59.18%),decreased serum albumin levels(70.07%),increased pleural or peritoneal effusion(67.35%),skin and mucosal edema(65.31%),and elevated thrombomodulin among the four coagulation parameters(58.50%).Conclusion:Ulinastatin is mainly used for the treatment of critical illnesses such as pancreatitis and sepsis.Most physicians combine ulinastatin with other drugs,such as glucocorticoids and albumin.Clinical indicators commonly referenced when using ulinastatin include elevated IL-6,increased lactate,and increased pleural effusion,which suggest a high inflammatory state and endothelial damage.

Objective:To investigate the expressions of C-X3-C motif chemokine ligand 1(CX3CL1)and C-X-C motif chemokine ligand 12(CXCL12)in the peripheral blood of elderly patients with severe pneumonia(SP)complicated with respiratory failure(RF)and its clinical significance.Methods:This study was a single-center prospective study,235 elderly patients with SP complicated with RF who were admitted to our hospital from May 2021 to May 2024(SP complicated with RF group),120 elderly patients with simple SP during the same period(simple SP group)and 120 elderly healthy individuals undergoing physical examination during the same period(healthy control group)were selected.SP complicated with RF group was divided into survival group(164 cases)and death group(71 cases)according to the 28 d prognosis after admission.The influencing factors of prognosis were analyzed by using the multivariate unconditional logistic regression model,and the receiver operating characteristic(ROC)curve was drawn to predict the value of poor prognosis.Results:The levels of CX3CL1 and CXCL12 in the peripheral blood in SP complicated with RF group were higher than those in simple SP group and which were higher than those in healthy control group(P＜0.05).The 28 d death rate after admission of 235 elderly patients with SP complicated with RF was 30.21％(71/235).Compared with survival group,the levels of CX3CL1 and CXCL12 in the peripheral blood in the death group increased(P＜0.05).The independent risk factors for death in elderly patients with SP complicated with RF were elevated procalcitonin(PCT),lactic acid,CX3CL1 and CXCL12(P＜0.05).The area under the curve(AUC)of ROC in peripheral blood CX3CL1 combined with CXCL12 in predicting death in elderly patients with SP complicated with RF was 0.886,which was better than 0.782 and 0.793 predicted by CX3CL1 and CXCL12 in the peripheral blood alone(P＜0.05).Conclusion:The levels of CX3CL1 and CXCL12 in the peripheral blood of elderly patients with SP complicated with RF increase,which is closely related to poor prognosis,peripheral blood CX3CL1 combined with CXCL12 in predicting the risk of death has a good efficacy in elderly patients with SP complicated with RF.

Aim To study the therapeutic effect of al-licin on senna-induced diarrhea in mice and to explore the underlying mechanism.Methods Forty-eight C57BL/6J mice were randomly divided into six groups:control,model,loperamide positive control group(2 mg·kg-1),allicin low-dose group(6 mg·kg-1),allicin medium-dose group(12 mg·kg-1)and allicin high-dose group(18 mg·kg-1).Except for the con-trol group,the diarrhea model was induced in the other groups by intragastric administration of senna leaf ex-tract.After drug administration,several diarrhea indi-ces were measured:the rate of loose stools,diarrhea index,accumulated frequency of loose stools at differ-ent time points within 5 hours,and small intestine pro-pelling rate.Serum levels of TNF-α and IL-6 were de-tected by ELISA.Serum NO content was determined u-sing the Griess method.The activities of SOD and CAT,as well as MDA content in the ileum and colon,were measured.The pathological changes and the ex-pression of mRNA related to intestinal barrier proteins in the ileum and colon were evaluated using HE stai-ning and RT-qPCR.Results Allicin improved diar-rhea symptoms in mice induced by senna leaf.It re-duced the rate of loose stools,diarrhea index,cumula-tive number of loose stools in five hours,and the intes-tinal propulsion rate.Allicin also protected the intesti-nal mucosa,decreased serum TNF-α and IL-6 levels,and lowered MDA content in the intestines.It in-creased serum NO levels and enhanced SOD and CAT activities in the intestines.Additionally,allicin upreg-ulated the mRNA expression of AQP1,AQP4,and ZO-1 in intestinal tissues.Conclusions Allicin has a significant therapeutic effect on senna-induced diarrhea in mice.The underlying molecular mechanisms may involve anti-inflammatory and antioxidant effects,in-creased NO content,and upregulation of mRNA ex-pression of aquaporins and tight-junction proteins.

Objective To explore the clinical characteristics and influencing factors for prognosis of patients with bloodstream infection(BSI)caused by Stenotrophomonas maltophilia(S.maltophilia).Methods Clinical data of patients with S.maltophilia BSI in Liuzhou People's Hospital from January 2019 to December 2023 were retro-spectively analyzed.Patients were divided into good prognosis group and poor prognosis group according to their prognosis.Risk factors for poor prognosis were analyzed by univariate analysis and binary logistic regression analy-sis.Results From 2019 to 2023,a total of 36 patients were diagnosed with S.maltophilia BSI,with an average age of(51.8±22.6)years.The most common clinical symptom was fever(91.7％),followed by respiratory symp-toms(25.0％).33 patients(91.7％)had underlying diseases,31 patients(86.1％)had healthcare-associated in-fection,and 23 patients(63.9％)underwent invasive procedures before onset.Among the 36 patients with S.mal-tophilia BSI,12(33.3％)had a poor prognosis.Univariate analysis showed that underlying blood diseases,length of hospital stay ≥30 days,agranulocytosis,and elevation of C-reactive protein(CRP)were related to poor progno-sis of patients with S.maltophilia BSI(all P＜0.05).Binary logistic regression analysis results showed that underlying blood diseases,length of hospital stay ≥30 days,and agranulocytosis were independent risk factors for poor prognosis in patients(all P＜0.05).Conclusion Patients with S.maltophilia BSI are critically ill with high mortality.Underlying blood diseases,length of hospital stay ≥30 days,and agranulocytosis are independent risk factors for poor prognosis in patients.

Objective To investigate residents'willingness to use"internet+nursing services"of a community in Xiamen City and provide reference for the code of practice to promote the service.Methods A total of 350 community residents in Xiamen City were investigated by convenience sampling from January to December 2023.The questionnaire was self-designed with regard to their willingness to use"internet+nursing services".Results 336 questionnaires were effectively collected.The total score of willingness to use"internet+nursing services"of community residents in Xiamen City was(68.80±8.73)points,but only 19.6％of residents knew about"internet+nursing services".There were statistically significant differences in willingness to use among community residents with different ages,medical payment type,whether they knew"internet+nursing services"or not,and the number of service items needed(P＜0.05).Among them,age,whether they knew"internet+nursing services"or not and the number of service items needed were the main influencing factors of willingness to use(P＜0.05).Conclusion Community residents in Xiamen City show above the middle level of willingness to use"internet+nursing services".However,the popularity of"internet+nursing services"has a large room for improvement.The publicity to the residents should be strengthened,and the care needs of residents with different demographic characteristics should be considered.The supporting application functions of such platforms should be designed to meet the health needs of community residents,especially elderly patients with great demand for services.

The application of sensors to the monitoring of spinal morphology and motion was reviewed in terms of the research object and monitoring index.The present situation of the application of sensors was introduced,such as inertial sensor,stretchable strain sensor and electromagnetic sensor.The deficiencies of sensors applied to the monitoring of spinal morphology and motion were analyzed,and the future directions of the application were pointed out.[Chinese Medical Equipment Journal,2025,46(6):105-110]

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

Objective Exploring the application value of the teaching model combining Learning in Context(LIC)and Multidisciplinary Team(MDT)in clinical internships of thoracic surgery.Methods Eighty-eight undergraduate clinical medical students who underwent clinical internship in the Department of Thoracic Surgery at our hospital from September 2022 to June 2023 were selected as study subjects.They were randomly divided into observation group(n=45)and control group(n=43)u-sing random number table method.The control group received traditional clinical teaching,while the observation group received LIC combined with MDT teaching model.Theoretical knowledge mastery,clinical operational skills,and clinical thinking abilities were compared between the two groups,with 6-month long-term learning effectiveness follow-up evaluation.Time series analysis and radar chart analysis were employed to assess dynamic changes in teaching effectiveness and core competency development.Results The observation group showed significantly higher scores than the control group in theoretical knowledge,clinical opera-tional skills,clinical thinking abilities,teamwork and communication competencies,teaching method satisfaction,and autono-mous learning.Six-month follow-up evaluation revealed that the observation group's comprehensive development level was signifi-cantly higher than the control group.Time series analysis demonstrated that the observation group exhibited a steeper learning curve with greater improvement amplitude compared to the control group.Radar chart analysis showed more balanced development across eight core competency dimensions in the observation group.Conclusion The LIC combined with MDT teaching model can significantly improve thoracic surgery clinical internship students'theoretical knowledge mastery,operational skills,and clinical thinking abilities.