ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

ObjectiveTo explore the academic characteristics of contemporary renowned Chinese medicine masters in treating diabetic kidney disease （DKD） from the perspectives of principles， methods， formulas， and medications. MethodsIn strict accordance with the Systematic Review of Text and Opinion （SrTO） process developed by the Joanna Briggs Institute （JBI）， an Australian evidence-based healthcare center， the databases including China National Knowledge Infrastructure （CNKI）， VIP Database， Wanfang Data， and China Biomedical Literature Service System （SinoMed） were searched. Based on predefined inclusion and exclusion criteria， text information extraction， quality evaluation， and text information synthesis were conducted sequentially. The data were analyzed and presented in the form of text and figures. ResultsA total of 215 articles related to 43 contemporary renowned experts in the fields of Chinese medicine nephrology and endocrinology were included. The study found that the academic thoughts of these masters in the treatment of DKD are extensive， involving multiple levels such as disease understanding， therapeutic strategies， formula application， and medication use. In terms of disease understanding， the primary pathogenesis is characterized by deficiency in the root and excess in the manifestation. It is emphasized that internal factors， such as congenital endowment deficiency， interact with external factors such as improper diet， emotional disturbances， invasion of exogenous pathogens， and delayed or inappropriate treatment， to jointly induce the disease. This further gives rise to various pathogenetic theories， including obstruction of renal collaterals by blood stasis， toxin-induced damage to renal collaterals， latent wind disturbing the kidney， and internal heat leading to mass formation. In terms of therapeutic strategies and medication use， the principal treatment method is to replenish Qi and nourish Yin. Stage-based and syndrome-differentiated treatments are advocated. Flexible use of insect-derived drugs and wind-dispelling drugs is emphasized， along with proficiency in applying classical formulas and drug pairs. Integrated internal and external treatments， as well as the combined application of multiple therapeutic approaches， are commonly employed for comprehensive management. Meanwhile， the concept of "preventive treatment of disease" is upheld， and individualized long-term management of patients is advocated. ConclusionThrough the SrTO process， the academic thoughts of contemporary renowned Chinese medicine masters in the treatment of DKD have been systematically and standardly synthesized， providing a scientific and standardized basis for future theoretical exploration.

ObjectiveTo investigate the effects of Astragali Radix polysaccharides （APS） on the polarization of BV2 microglial cells in an oxygen-glucose deprivation/reoxygenation （OGD/R） model through regulation of the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway. MethodsThe OGD/R injury model of BV2 microglia was established and divided into blank group， OGD/R group and APS group （0.4 g·L^-1 APS）. Neuroinflammatory injury was induced by lipopolysaccharide （LPS） and treated with APS. The cells were divided into blank group， LPS group （1 mg·L^-1 LPS） and APS group （0.4 g·L^-1 APS+1 mg·L^-1 LPS）. Cell viability was detected using the cell counting kit-8 （CCK-8） assay. Cell morphology was observed under an inverted microscope. Nitric oxide （NO） content in the cell supernatant was determined by the Griess assay. The secretion levels of tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， IL-10， and IL-4 were measured by enzyme-linked immunosorbent assay （ELISA）. Immunofluorescence （IF） was used to detect the double-positive rates of ionized calcium-binding adapter molecule-1/inducible nitric oxide synthase （Iba-1⁺/iNOS⁺） and ionized calcium-binding adapter molecule-1/arginase 1 （Iba-1⁺/Arg1⁺）， as well as the nuclear translocation rate of nuclear factor-κB p65 （NF-κB p65）. Protein expression levels of Iba-1， iNOS， Arg1， TLR4， and NF-κB p65 were detected by Western blot. ResultsIn the OGD/R injury model， compared with the blank control group， BV2 microglial cells in the OGD/R group were activated and exhibited amoeboid morphological changes. The secretion levels of NO， TNF-α， and IL-6 were significantly increased （P<0.01）. The double-positive expression rate of Iba-1⁺/iNOS⁺ and the protein expression of Iba-1 and iNOS were significantly increased （P<0.01）. The nuclear translocation rate of NF-κB p65 and the protein expression levels of TLR4 and NF-κB p65 were significantly increased （P<0.01）. The levels of IL-10 and IL-4 were significantly decreased （P<0.01）， and the double-positive expression rate of Iba-1⁺/Arg1⁺ and Arg1 protein expression were significantly decreased （P<0.01）. Compared with the OGD/R group， the APS group （0.4 g·L^-1） showed reduced cell activation， significantly decreased secretion levels of NO， TNF-α， and IL-6 （P<0.01）， significantly decreased double-positive expression rate of Iba-1⁺/iNOS⁺ and relative protein expression of Iba-1 and iNOS （P<0.01）， significantly decreased nuclear translocation rate of NF-κB p65 and protein expression levels of TLR4 and NF-κB p65 （P<0.01）， significantly increased levels of IL-10 and IL-4 （P<0.01）， and significantly increased double-positive expression rate of Iba-1⁺/Arg1⁺ and Arg1 protein expression （P<0.01）. In the LPS-induced neuroinflammation model， compared with the blank control group， the LPS group showed increased cell activation， significantly increased levels of NO， TNF-α， and IL-6， significantly increased Iba-1⁺/iNOS⁺ double-positive expression rate， NF-κB p65 nuclear translocation rate， and protein expression levels of Iba-1， iNOS， TLR4， and NF-κB p65 （P<0.01）， while IL-10 and IL-4 levels， Iba-1⁺/Arg1⁺ double-positive expression rate， and Arg1 protein expression were significantly decreased （P<0.01）. Compared with the LPS group， the APS group showed reduced cell activation， significantly decreased levels of NO， TNF-α， and IL-6， Iba-1⁺/iNOS⁺ double-positive expression rate， NF-κB p65 nuclear translocation rate， and protein expression levels of Iba-1， iNOS， TLR4， and NF-κB p65 （P<0.01）， while IL-10 and IL-4 levels， Iba-1⁺/Arg1⁺ double-positive expression rate， and Arg1 protein expression were significantly increased （P<0.01）. ConclusionAPS may reduce microglial activation and promote their polarization toward the M2 phenotype by inhibiting activation of the TLR4/NF-κB signaling pathway， thereby alleviating the neuroinflammatory response induced by OGD/R.

Objective:To investigate the effect of lumbar sympathetic ganglion block (LSGB) on postoperative ileus (POI) in patients undergoing colonic surgery.Methods:Ninety patients scheduled for elective laparoscopic colonic surgery in the same treatment group at the Nanjing First Hospital from March 2022 to August 2023 were selected and randomly divided into a control group and an observation group using a random number table, with 45 patients in each group. The observation group received ultrasound-guided LSGB before anesthesia, while the control group received no intervention. Both groups received standardized anesthesia protocols and management after entering the operating room. The time to gastrointestinal motility recovery (first defecation time), first flatus time, first feeding time, number of cases requiring gastric tube decompression, postoperative hospital stay, number of cases with nausea and vomiting, intraoperative additional and titrated sufentanil dosage, remifentanil dosage, first patient-controlled intravenous analgesia (PCIA) press time, sufentanil dosage at 4, 8, 12, 16, and 24 hours postoperatively, and the number of analgesic pump presses were recorded.Results:Compared with the control group, the observation group had shorter first defecation and flatus times, earlier first feeding time, shorter postoperative hospital stay, and fewer cases of nausea (all P<0.05). The observation group also had less intraoperative sufentanil supplementation and titration, later first PCIA press time (all P<0.05), and significantly fewer sufentanil dosages and analgesic pump presses at 4, 8, 12, 16, and 24 hours postoperatively compared with the control group (all P<0.05). Conclusions:LSGB reduces the incidence of POI in colonic surgery patients, decreases opioid use, and shortens hospital stay.

To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.

Objective:To separate and purify the polysaccharides from Polygonatum filipes,characterize their primary structure and investigate the immunomodulatory effects on RAW264.7 macrophages.Methods:Crude polysaccharides from Polygonatum filipes were extracted by ultrasound assisted method,then Polygonatum filipes polysaccharides(CSPFPs)were obtained after elimination of the proteins with combined papain-Sevag method.The total sugar content was determined by phenol-sulfuric acid method.Structures of CSPFPs were analyzed by fourier transform infrared spectroscopy(FT-IR),high performance gel permeation chromatography(HPGPC)and high performance liquid chromatography(HPLC).Effects of CSPFPs on cell viability,pinocytic activity,TNF-α secretion,MAPK and NF-κB signaling pathways of RAW264.7 cells were explored by MTT,Neutral red,ELISA and Western blot,respectively.Results:Extraction rate of CSPFPs by ultrasound-assisted method was 41.61%,which contained total sugar content of 94.00%.CSPFPs with Mw of 3 125 Da was composed of arabinose(1.85%),galactose(6.14%),glucose(56.41%)and mannose(35.60%).The in vitro experiments showed that CSPFPs were non-cytotoxic and enhanced the pinocytic activity,TNF-α secretion and phosphorylation levels of p38,ERK,JNK,p65,IκB and IKK,indicating the activation of MAPK and NF-κB signaling pathways under the concentra-tion of 2.5～200 μg/ml.Conclusion:The ultrasound-assisted method can efficiently isolate CSPFPs with immunomodulatory activity,which provides basic data for the development and application of CSPFPs as an immunostimulant.

Cardiac arrest leads to abrupt cessation of cardiac ejection and effective systemic circulation,placing patients in a life-threatening state.Despite advancements in cardiopulmonary resuscitation(CPR)techniques significantly improving the rate of return of spontaneous circulation,overall hospital discharge rates remain low,primarily due to severe hypoxic-ischemic encephalopathy following CPR,which is the leading cause of mortality or prolonged coma.Accurately predicting neurological prognosis post-CPR is critical for optimizing therapeutic strategies and improving long-term outcomes.This review systematically explores diverse methods for predicting neurological prognosis after CPR,encompassing traditional neurological examinations,cerebral performance category scales,hemodynamic monitoring,and advanced approaches such as neuroimaging,serum biomarkers,neuroelectrophysiological assessments,inflammatory indicators,brain-computer interface technology,and multimodal detection.These methods collectively reflect the severity of brain injury and potential for functional recovery.Neurological examinations and cerebral performance category scales provide rapid initial assessments of functional status;neuroimaging visually delineates the extent of structural brain damage;serum biomarkers and inflammatory indicators evaluate metabolic and immune responses to injury;neuroelectrophysiological monitoring captures real-time neuronal activity.Furthermore,emerging brain computer interface technology and multimodal approaches integrate multiple modalities,offering novel possibilities for precise assessment and dynamic monitoring.By synthesizing reliable prognostic tools,this review facilitates early and accurate evaluation of brain injury severity and recovery potential,guiding timely clinical interventions and providing evidence-based references for post-CPR.

Objective:To investigate the effect of lumbar sympathetic ganglion block (LSGB) on postoperative ileus (POI) in patients undergoing colonic surgery.Methods:Ninety patients scheduled for elective laparoscopic colonic surgery in the same treatment group at the Nanjing First Hospital from March 2022 to August 2023 were selected and randomly divided into a control group and an observation group using a random number table, with 45 patients in each group. The observation group received ultrasound-guided LSGB before anesthesia, while the control group received no intervention. Both groups received standardized anesthesia protocols and management after entering the operating room. The time to gastrointestinal motility recovery (first defecation time), first flatus time, first feeding time, number of cases requiring gastric tube decompression, postoperative hospital stay, number of cases with nausea and vomiting, intraoperative additional and titrated sufentanil dosage, remifentanil dosage, first patient-controlled intravenous analgesia (PCIA) press time, sufentanil dosage at 4, 8, 12, 16, and 24 hours postoperatively, and the number of analgesic pump presses were recorded.Results:Compared with the control group, the observation group had shorter first defecation and flatus times, earlier first feeding time, shorter postoperative hospital stay, and fewer cases of nausea (all P<0.05). The observation group also had less intraoperative sufentanil supplementation and titration, later first PCIA press time (all P<0.05), and significantly fewer sufentanil dosages and analgesic pump presses at 4, 8, 12, 16, and 24 hours postoperatively compared with the control group (all P<0.05). Conclusions:LSGB reduces the incidence of POI in colonic surgery patients, decreases opioid use, and shortens hospital stay.

Objective:To explore the latent profile characteristics of fatigue in patients with non-small cell lung cancer (NSCLC) complicated by radiation-induced pulmonary fibrosis (RIPF), and to provide evidence for developing precision nursing strategies.Methods:A convenience sample of 120 patients with RIPF and NSCLC who received treatment at the First Affiliated Hospital of Zhengzhou University between January 2022 and December 2023 was recruited. Baseline demographic and clinical data and the Multidimensional Fatigue Inventory (MFI) were collected. Latent profile analysis (LPA) was performed to classify fatigue levels, and multinomial logistic regression was used to identify influencing factors. A total of 120 questionnaires were distributed, and 116 valid responses were obtained, with a valid response rate of 96.67% (116/120) .Results:LPA identified three latent classes of fatigue among the 116 patients: the physiological-cognitive compound fatigue group ( n=52), the emotional-sleep disturbance group ( n=38), and the mildly adaptive group ( n=26). Multinomial logistic regression revealed that age, Eastern Cooperative Oncology Group performance status (ECOG-PS), Karnofsky Performance Status (KPS), sleep quality, and anxiety were significant factors associated with the physiological-cognitive compound fatigue group ( P<0.05). Sleep quality, anxiety, depression, pain, and KPS were significant factors associated with the emotional-sleep disturbance group ( P<0.05) . Conclusions:Patients with RIPF and NSCLC can be classified into three subtypes of fatigue. Differentiated nursing strategies should be developed accordingly to achieve precise and individualized interventions.

Objective:To investigate the current status of fertility concerns among early-stage endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) patients with fertility preservation, and analyze its influencing factors.Methods:Convenience sampling was used to select early-stage EC and AEH patients with fertility preservation at Peking University People's Hospital from January to December 2021 as study subjects. The study subjects were surveyed using the General Information Questionnaire, Chinese version of the Reproductive Concerns after Cancer Scale (RCAC), and Social Support Rating Scale (SSRS). Pearson correlation was employed to examine the relationship between fertility concerns and social support in early-stage EC and AEH patients with fertility preservation. Single-factor analysis and multiple linear regression analysis were used to examine the factors influencing fertility concerns in early-stage EC and AEH patients with fertility preservation.Results:A total of 170 questionnaires were distributed, and 167 valid questionnaires were collected, with a valid response rate of 98.24% (167/170). The RCAC and SSRS scores of 167 early-stage EC and AEH patients with fertility preservation were (56.58±10.58) and (34.22±8.21), respectively. Educational level, disease type and staging, marital status, and social support were statistically significant factors influencing fertility concerns among early-stage EC and AEH patients undergoing fertility preservation ( P<0.05), explaining 32.80% of the total variance. Conclusions:Early-stage EC and AEH patients with fertility preservation exhibit high levels of fertility concerns. Clinical practice should develop individualized psychological intervention programs for patients with high education level, unmarried status, high pathological grading, and lack of social support to improve their physical and mental health.