ObjectiveTo explore the effect of elbow-wrist functional orthosis on plantar pressure distribution and balance function in stroke patients with hemiplegia. MethodsFrom June, 2024 to April, 2025, 60 patients with post-stroke hemiplegia were recruited from Huashan Hospital, Fudan University, and Shanghai Hebin Rehabilitation Hospital. They were randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine neurological rehabilitation, while the intervention group received additional training with an elbow-wrist functional orthosis on the affected side, for eight weeks. Before and after intervention, the Modified Ashworth Scale (MAS) of the elbow joint, plantar pressure symmetry index (SI), plantar contact area and mean plantar pressure were recorded, and balance and mobility were assessed using the Berg Balance Scale (BBS), Timed Up & Go Test (TUGT) and 10-Meter Walk Test (10MWT). ResultsTwo cases dropped out in the control group. After treatment, MAS grades of the elbow joint, forefoot SI, affected side plantar pressure area, BBS scores, TUGT and 10MWT of both groups improved (|Z| > 3.969, |t| > 3.528, P < 0.01), while the hindfoot SI and average pressure of the affected foot improved in the intervention group (∣t∣ > 4.264, P < 0.001). Except for TUGT and 10MWT, the intervention group was superior to the control group (∣Z∣ > 2.030, ∣t∣ > 2.096, P < 0.05). ConclusionThe elbow-wrist functional orthosis can enhance balance function in stroke patients with hemiplegia by reducing upper-limb spasticity, optimizing center-of-gravity distribution, and improving postural control.

Nervous system diseases， also known as neuropathies， encompass a wide range of conditions， primarily including Alzheimer's disease （AD）， Parkinson's disease （PD）， Huntington's disease， and other neurodegenerative disorders， as well as depression， subarachnoid hemorrhage， cerebral ischemia-reperfusion injury， vascular dementia， and other neurological diseases. These diseases pose serious threats to the health and lives of patients， bringing heavy burdens to society and families. The pathogenesis of nervous system diseases is highly complex， involving mechanisms such as neuroinflammation， oxidative stress， apoptosis， endoplasmic reticulum stress， mitochondrial dysfunction， brain-derived neurotrophic factor deficiency， reduced cholinergic activity， axonal injury， and demyelination. In recent years， the incidence and mortality of nervous system diseases have been rising annually. Currently， western medicine primarily focuses on symptomatic treatment， often accompanied by many adverse reactions， including lethargy， excessive sedation， dizziness， headaches， tachycardia， liver function damage， metabolic disorders， and incomplete recovery after surgery. As a traditional Chinese medicine， Salviae Miltiorrhizae Radix et Rhizoma has effects such as promoting blood circulation， removing blood stasis， cooling the blood， clearing the heart， nourishing the blood， and calming the nerves. It can play a role in the treatment and protection against nervous system diseases through multiple targets， pathways， and mechanisms. Studies have found that the water-soluble phenolic acids and fat-soluble diterpenoid quinones in Salviae Miltiorrhizae Radix et Rhizoma are the main active ingredients for the treatment of nervous system diseases. This paper summarized the effects of the active components and compounds of Salviae Miltiorrhizae Radix et Rhizoma on nervous system diseases over the past ten years， aiming to provide a theoretical basis and research ideas for the development and application of active components and compounds of Salviae Miltiorrhizae Radix et Rhizoma in nervous system diseases.

Objective To search,evaluate and summarise the best evidence on pre-rehabilitation before surgery for elderly patients with hip fracture so as to provide an evidence-based basis for further standardisation in clinical practice.Methods Based on the"6S Pyramid"evidence model,desktop searches were conducted across databases and websites including Medlive,BMJ Best Practice,UpToDate,the World Health Organization,the Guidelines International Network(GIN),British National Institute for Health and Care Excellence(NICE),American National Guideline Clearinghouse(NGC),Canadian Medical Association:Clinical Practice Guidelines Infobase(CMA),Scottish Intercollegiate Guidelines Network(SIGN),the Registered Nurses'Association of Ontario(RNAO),American College of Sports Medicine(ACSM),American Academy of Orthopaedic Surgeons(AAOS),European Society for Clinical Nutrition and Metabolism(ESPEN),American Society for Parenteral and Enteral Nutrition(ASPEN),the Enhanced Recovery After Surgery Society(ERASS),Cochrane Library,Joanna Briggs Institute,PubMed,CINAHL,Web of Science,Embase,Scopus,Science Direct,CNKI,Wanfang Data,Vip,and SinoMed.The research targeted evidence on pre-rehabilitation in elderly patients with hip-fracture before surgery,encompassing clinical decisions,guidelines,evidence summaries,best practices,expert consensus,systematic reviews and randomized controlled trials(RCTs).The search items spanned from the inception of database to 31st December,2023.Two researchers trained with evidence-based knowledge evaluated the quality of the included literature and extracted and summarised the evidence.Results A total of 14 documents were included,consisting of 2 clinical decisions,4 guidelines,1 best practice,4 expert consensus and 3 systematic reviews.Evidence was summarised into 7 domains from 25 pieces of evidence:multidisciplinary management,preoperative assessment,preoperative health education,multi-modal analgesia,nutritional management,exercise intervention and assessment and prevention of complication risks.Conclusion The best evidence summarised in this study provides a basis for pre-rehabilitation in elderly patients with hip fracture before surgery.Nurses should adapt the findings to specific contexts,standardise the preoperative rehabilitation procedures,and improve clinical outcomes for the patients.

The pathogenesis of central nervous system （CNS） diseases is complex， seriously affecting patients' physical and mental health and imposing a heavy economic burden on society. Western medicine shows limited efficacy in treating CNS diseases and is often associated with numerous adverse reactions and contraindications. Chinese medicine Lycii Fructus exhibits multiple pharmacological effects， including immune regulation， enhancement of hematopoietic function， liver protection， anti-tumor， hypoglycemic， antipyretic， anti-aging， and anti-radiation activities， and has gradually been applied in clinical treatment. In recent years， the active components of Lycii Fructus have attracted considerable attention for their potential therapeutic effects on CNS diseases. Studies indicate that these active components may exert neuroprotective effects through anti-inflammatory and antioxidant actions， inhibition of neuronal apoptosis， and repair of neuronal damage， involving multiple targets and pathways. This review summarizes the therapeutic effects of Lycii Fructus active components in CNS diseases over the past decade by searching PubMed， CNKI， Wanfang Data， and other electronic databases， aiming to provide new treatment strategies and insights for future research on Lycii Fructus in CNS disorders.

INTRODUCTION: Pregnancy-associated breast cancer (PABC) is described as breast cancer diagnosed within pregnancy or within 1 year postpartum. PABC is becoming more common due to delayed childbearing, with older maternal age increasing the likelihood of tumorigenesis coinciding with pregnancy. Our review aims to outline the important principles of managing PABC, and discusses future fertility implications, genetic testing and postnatal considera-tions that are not often considered in other existing reviews. METHOD: A literature search was conducted using PubMed, Cochrane and Google Scholar databases. RESULTS: A persistent breast mass in pregnant women should be evaluated with a breast ultrasound. Total mastectomy is the standard treatment in the first trimester. Chemotherapy is contraindicated in the first trimesters, but can be given in the second and third trimester, and stopped before 35 weeks. Radiotherapy should be delayed until delivery, and hormone receptor therapy is contraindicated in pregnancy. A multidisciplinary team involving an obstetrician, medical oncologist and other allied health professionals is crucial. Delivery should be planned as close to 37 weeks as possible, and at least 3 weeks after the last chemotherapy cycle. Vaginal delivery is preferred, and breastfeeding can resume 14 days after the last chemotherapy regime. CONCLUSION A breast mass in a pregnant woman should not be dismissed. PABC must be managed by multidisciplinary teams at tertiary medical centres with access to surgery and chemoradiation therapies. Management strategies must include safe manage-ment and delivery of the fetus, contraception and future fertility planning.
Humans ; Female ; Pregnancy ; Breast Neoplasms/diagnosis* ; Pregnancy Complications, Neoplastic/diagnosis* ; Mastectomy ; Delivery, Obstetric

Objective To investigate the relationship between serum levels of micro RNA(miR)-497-5p,fibroblast growth factor-2(FGF2)and brain-derived neurotrophic factor(BDNF),with cognitive dysfunction in Parkinson's disease(PD)patients.Methods From April 2022 to April 2024,86 PD patients(study group)treated in Wuhan Xinzhou District People's Hospital and 60 healthy individuals(control group)who underwent physical examination in Wuhan Xinzhou District People's Hospital were selected.Serum miR-497-5p levels were determined by real-time quantitative polymerase chain reaction(RT-qPCR),and serum FGF2 and BDNF levels were measured by enzyme linked immunosorbent assay(ELISA).Spearman was applied to analyze the correlation between serum miR-497-5p,FGF2,BDNF levels and montreal cognitive assessment(MoCA score).Logistic analysis was applied to analyze the factors influencing cognitive dysfunction in PD patients.Receiver operating characteristic(ROC)was applied to analyze the diagnostic value of serum miR-497-5p,FGF2 and BDNF for cognitive dysfunction in PD patients.Results The serum miR-497-5p(2.73±0.67)expression level in the study group was obviously increased than that in the control group(1.04±0.34),while the expression levels of FGF2(1.94±0.45ng/ml)and BDNF(8.31±2.44ng/ml)were obviously reduced than those in the control group(2.71±0.69ng/ml,12.81±3.07ng/ml),with significate differences(t=17.977,8.161,9.850,all P<0.05).Serum miR-497-5p was negatively correlated with MoCA score(r=-0.331,P<0.05),while FGF2 and BDNF levels were positively correlated with MoCA score(r=0.404,0.361,all P<0.05).Cognitive dysfunction group had significantly higher disease duration,FGF2,BDNF levels,and MoCA scores than the cognitively normal group.The course of disease and miR-497-5p levels in the cognitive dysfunction group were obviously higher than that in the normal cognitive function group,FGF2,BDNF levels,and MoCA scores in the cognitive dysfunction group were obviously lower than that in the normal cognitive function group(t=2.350～11.792,all P<0.05).The course of disease and serum miR-497-5p were risk factors for cognitive dysfunction in PD patients(Wald χ2=4.712,5.704,all P<0.05),while MoCA score,serum FGF2,and BDNF were protective factors for cognitive dysfunction in PD patients(Wald χ2=4.499,5.556,5.217,all P<0.05).The AUC and sensitivity of the combination of serum miR-497-5p,FGF2,and BDNF in PD patients with cognitive impairment were higher than those of individual diagnosis.The diagnostic effect of the combination of miR-497-5p,FGF2,and BDNF in PD patients with cognitive dysfunction was better than that of individual diagnosis,and the differences were statistically significant(Z=2.279,2.236,2.123,all P<0.05).Conclusion Elevated serum miR-497-5p level and decreased FGF2 and BDNF levels can increase the risk of cognitive dysfunction in PD patients,and the combination of the three has good diagnostic value for cognitive dysfunction in PD patients.

Objective To investigate the relationship between serum levels of micro RNA(miR)-497-5p,fibroblast growth factor-2(FGF2)and brain-derived neurotrophic factor(BDNF),with cognitive dysfunction in Parkinson's disease(PD)patients.Methods From April 2022 to April 2024,86 PD patients(study group)treated in Wuhan Xinzhou District People's Hospital and 60 healthy individuals(control group)who underwent physical examination in Wuhan Xinzhou District People's Hospital were selected.Serum miR-497-5p levels were determined by real-time quantitative polymerase chain reaction(RT-qPCR),and serum FGF2 and BDNF levels were measured by enzyme linked immunosorbent assay(ELISA).Spearman was applied to analyze the correlation between serum miR-497-5p,FGF2,BDNF levels and montreal cognitive assessment(MoCA score).Logistic analysis was applied to analyze the factors influencing cognitive dysfunction in PD patients.Receiver operating characteristic(ROC)was applied to analyze the diagnostic value of serum miR-497-5p,FGF2 and BDNF for cognitive dysfunction in PD patients.Results The serum miR-497-5p(2.73±0.67)expression level in the study group was obviously increased than that in the control group(1.04±0.34),while the expression levels of FGF2(1.94±0.45ng/ml)and BDNF(8.31±2.44ng/ml)were obviously reduced than those in the control group(2.71±0.69ng/ml,12.81±3.07ng/ml),with significate differences(t=17.977,8.161,9.850,all P<0.05).Serum miR-497-5p was negatively correlated with MoCA score(r=-0.331,P<0.05),while FGF2 and BDNF levels were positively correlated with MoCA score(r=0.404,0.361,all P<0.05).Cognitive dysfunction group had significantly higher disease duration,FGF2,BDNF levels,and MoCA scores than the cognitively normal group.The course of disease and miR-497-5p levels in the cognitive dysfunction group were obviously higher than that in the normal cognitive function group,FGF2,BDNF levels,and MoCA scores in the cognitive dysfunction group were obviously lower than that in the normal cognitive function group(t=2.350～11.792,all P<0.05).The course of disease and serum miR-497-5p were risk factors for cognitive dysfunction in PD patients(Wald χ2=4.712,5.704,all P<0.05),while MoCA score,serum FGF2,and BDNF were protective factors for cognitive dysfunction in PD patients(Wald χ2=4.499,5.556,5.217,all P<0.05).The AUC and sensitivity of the combination of serum miR-497-5p,FGF2,and BDNF in PD patients with cognitive impairment were higher than those of individual diagnosis.The diagnostic effect of the combination of miR-497-5p,FGF2,and BDNF in PD patients with cognitive dysfunction was better than that of individual diagnosis,and the differences were statistically significant(Z=2.279,2.236,2.123,all P<0.05).Conclusion Elevated serum miR-497-5p level and decreased FGF2 and BDNF levels can increase the risk of cognitive dysfunction in PD patients,and the combination of the three has good diagnostic value for cognitive dysfunction in PD patients.

Objective To search,evaluate and summarise the best evidence on pre-rehabilitation before surgery for elderly patients with hip fracture so as to provide an evidence-based basis for further standardisation in clinical practice.Methods Based on the"6S Pyramid"evidence model,desktop searches were conducted across databases and websites including Medlive,BMJ Best Practice,UpToDate,the World Health Organization,the Guidelines International Network(GIN),British National Institute for Health and Care Excellence(NICE),American National Guideline Clearinghouse(NGC),Canadian Medical Association:Clinical Practice Guidelines Infobase(CMA),Scottish Intercollegiate Guidelines Network(SIGN),the Registered Nurses'Association of Ontario(RNAO),American College of Sports Medicine(ACSM),American Academy of Orthopaedic Surgeons(AAOS),European Society for Clinical Nutrition and Metabolism(ESPEN),American Society for Parenteral and Enteral Nutrition(ASPEN),the Enhanced Recovery After Surgery Society(ERASS),Cochrane Library,Joanna Briggs Institute,PubMed,CINAHL,Web of Science,Embase,Scopus,Science Direct,CNKI,Wanfang Data,Vip,and SinoMed.The research targeted evidence on pre-rehabilitation in elderly patients with hip-fracture before surgery,encompassing clinical decisions,guidelines,evidence summaries,best practices,expert consensus,systematic reviews and randomized controlled trials(RCTs).The search items spanned from the inception of database to 31st December,2023.Two researchers trained with evidence-based knowledge evaluated the quality of the included literature and extracted and summarised the evidence.Results A total of 14 documents were included,consisting of 2 clinical decisions,4 guidelines,1 best practice,4 expert consensus and 3 systematic reviews.Evidence was summarised into 7 domains from 25 pieces of evidence:multidisciplinary management,preoperative assessment,preoperative health education,multi-modal analgesia,nutritional management,exercise intervention and assessment and prevention of complication risks.Conclusion The best evidence summarised in this study provides a basis for pre-rehabilitation in elderly patients with hip fracture before surgery.Nurses should adapt the findings to specific contexts,standardise the preoperative rehabilitation procedures,and improve clinical outcomes for the patients.

Purpose/Significance The relative positions of causality words are utilized to assist deep learning models to improve cau-sality prediction and mine medical text gain information.Method/Process The relative position information of causality words in medical texts is represented as a relational feature layer embedded in a pre-trained language model,and the baseline model is integrated for enti-ty recognition and relationship extraction.Result/Conclusion The F1 value of the model embedded in the relational feature layer is im-proved by 2.92 percentage points and 6.41 percentage points compared with the baseline models BERT-BiLSTM-CRF and CasRel,re-spectively,with better causal prediction capacity.

Neurodegenerative diseases are a group of diseases caused by degeneration and dysfunction of the cells and tissues of the central nervous system， mainly including Alzheimer's disease （AD）， Parkinson's disease （PD）， and epilepsy. A common clinical manifestation of these diseases is cognitive decline. Neurodegenerative diseases are more common in the elderly. As population aging is aggravating， neurodegenerative diseases have aroused increasing concern since they seriously affect human health and quality of life. The pathogenesis of neurodegenerative diseases is complex， mainly related to mitochondrial dysfunction， apoptosis， neurotoxin， neurotransmitter abnormalities， oxidative stress， and inflammation. Although western drugs on the market can attenuate the symptoms of neurodegenerative diseases， they may induce severe adverse reactions and are thus not conducive to long-term use by the patients. The Chinese herbal medicine Angelicae Sinensis Radix was first recorded in the Shennong's Classic of Materia Medica （Shen Nong Ben Cao Jing）. It has the functions of activating blood， tonifying blood， modulating the immune system， regulating menstruation， and relieving pain. This paper summarizes the research progress in the effects of Angelicae Sinensis Radix and the prescriptions containing this medicine on neurodegenerative diseases in recent 10 years， aiming to provide a reference for the future application and research of Angelicae Sinensis Radix in the treatment of neurodegenerative diseases.