OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves， so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves， as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects， plasma samples of intestinal wall metabolism， intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method； while comprehensive metabolic plasma samples， brain tissue samples， and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves， primarily consisting of flavonoids， organic acids， and others. A total of 16， 13， 11， and 5 prototype components were identified in intestinal wall metabolism， intestinal flora metabolism， hepatic metabolism， and comprehensive metabolic plasma samples， respectively. Additionally， 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin， trilobatin， phloretin-2- O -malonyl hexoside， and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves， such as phloridzin， trilobatin， phloretin， and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.

Psychological factors have become significant contributors to the onset and progression of insomnia. This article explored the treatment of insomnia from the perspective of “liver governs wei qi （defensive qi）”. The concept of “liver governs wei qi （defensive qi）” is summarized in three aspects， firstly， the liver assists the spleen and stomach in transformation and transportation， governing the generation of wei qi； secondly， the liver aids lung qi diffusion and dispersion， governing the distribution of wei qi； thirdly， the liver regulates circadian rhythms， governing the circulation of wei qi. It is proposed that the clinical treatment of insomnia should focus on the following methods： for regulating the liver to harmonize the five viscera， and facilitate the circulation of wei qi， medicinals entering the liver channel include Chaihu （Bupleuri radix）， Baishao （Paeoniae Radix Alba）， Zhizi （Gardeniae Fructus）， and Suanzaoren （Ziziphi Spinosae Semen） could be commonly used； for nourishing the liver， the treatment should align with the day-night rhythm， and herbs such as Baihe （Lilium）， Hehuan （Albizia julibrissin）， and Yejiaoteng （Polygoni multiflori caulis） are commonly used； for soothing the liver and address both mental and physical health to calm wei qi， treatment should advocate verbal counseling， psychological regulation， and health education. Ultimately， this treatment approach can free liver qi to flow， soothe qi movement， restore the motion of wei qi， regulate during day and night， balance yin and yang， and resolve insomnia effectively.

Triple-negative breast cancer(TNBC)is a highly aggressive and prognostically unfavorable subtype.Tertiary lymphoid structure(TLS)within the tumor microenvironment,comprising dendritic cells,B cells,T cells,and other immune cells,modulate the tumor immune response.The heterogeneity of TLS in TNBC,such as density,structural maturity,and molecular expression patterns,affects the tumor immune microenvironment and,consequently,treatment responses and clinical outcomes.Studies indicate a positive correlation between the density and maturity of TLS and the pathological complete response(pCR)of TNBC patients,with TLS enhancing the quantity of tumor-infiltrating immune cells and improving anti-tumor immune responses,thereby increasing sensitivity to chemotherapy and immunotherapy.Recent research has found that mature TLS are associated with effective immune responses,becoming significant predictors of treatment response.The combination of TLS with immune checkpoint inhibitors has shown promising prospects.Research demonstrates that promoting the formation or enhancing the functionality of TLS can improve anti-tumor immune effects and enhance treatment outcomes for TNBC patients.Targeting TLS may reduce immune evasion and increase the sensitivity to immunotherapy.However,clinical application of TLS still faces challenges,particularly the impact of their heterogeneity on treatment response.Current assessment methods for TLS are not standardized,lacking a uniform standard and diagnostic system,which limits their widespread application.Future research should focus on resolving these issues by developing standardized assessment tools and further exploring the role of TLS in immune escape and resistance mechanisms.This review aimed to summarize and analyze the existing research progress on TLS in TNBC,in order to provide new ideas for the development of personalized immunotherapy strategies.

Objective:To systematically compares the medial plantar venous flap (MPVF) and the lateral toe flap (LTF) reconstruction of digit-pulp defect, aiming to establish whether there exist significant differences between the 2 flaps in flap survival rate, two-point discrimination (TPD), score of Vancouver Scar Scale (VSS) and score of digit-pulp defect reconstruction evaluation.Methods:With a prospective cohort design, this study enrolled 36 patients who were admitted in Department of Hand Surgery, Longgang Eighth People's Hospital of Shenzhen for digit-pulp defects with bone or tendon exposure between January 2024 and September 2024. According to the random grouping method, participants were divided into 2 groups. The MPVF group comprised 18 patients (21 digits) of 13 males (15 digits) and 5 females (6 digits), aged 13-58 (mean 44±12) years. The MPVF group included 9 left and 12 right digits, with distribution as follows: 2 thumbs, 5 index fingers, 7 middle fingers, 5 ring fingers and 2 little fingers. The soft tissue defect area ranged from 2.0 cm × 1.0 cm to 9.2 cm × 3.3 cm (mean 6.69 cm 2± 6.69 cm 2). Flap dimensions ranged from 2.1 cm×1.1 cm to 9.5 cm×3.5 cm (mean 7.54 cm 2±7.22 cm 2). Donor sites were closed primarily or by full-thickness skin grafts harvested from the leg. The LTF group included 18 patients (21 digits) of 15 males (17 digits) and 3 females (4 digits), aged 22-62 (mean 41±12) years. The affected digits in LTF group comprised 12 left and 9 right digits, with a distribution of: 3 thumbs, 9 index fingers, 5 middle fingers, 2 ring fingers and 2 little fingers. The area of soft tissue defect ranges from 1.4 cm × 1.0 cm to 3.9 cm × 1.8 cm (mean 3.93 cm 2± 1.80 cm 2). Flap dimensions ranged from 1.5 cm×1.2 cm to 4.0 cm×1.9 cm (mean 4.52 cm 2±1.89 cm 2). Donor sites were closed primarily, or by full-thickness skin grafts harvested through extension of proximal wound extension or from calf for defect coverage. Patients were contacted for postoperative follow-up by telephone or WeChat to arrange a visit of outpatient clinic or a home visit by surgeon. Statistical analysis was conducted to compare the 2 groups regarding: gender, age and flap dimensions, flap survival rate at 2 weeks after surgery and TPD of flaps, VSS scores, and digit-pulp defect reconstruction evaluation scale scores at 4 months and 6 months postoperatively. P<0.05 indicates a statistically significant difference. Results:The comparative analysis revealed no statistically significant differences between 2 groups in baseline characteristics: gender distribution ( χ2=0.53, P=0.47), mean age ( t=0.75, P=0.46), flap dimensions ( t=1.86, P=0.08), confirming a demographic and surgical parameter equivalence in subsequent outcome comparisons ( P>0.05). All flaps survived at 2 weeks after surgery. All skin grafts at donor sites demonstrated complete viability with uneventful primary wound healing. At 4 months after surgey, the TPD in the MPVF group were 14.71 mm±1.90 mm and 7.81 mm±1.78 mm, respectively, compared to 14.48 mm±1.57 mm and 7.67 mm±1.39 mm in the LTF group at 6 months after surgery. The VSS scores were 1.67±1.11 and 1.29±0.72 for MPVF versus 1.86±1.15 and 1.38±0.81 for LTF at corresponding time points. The digit-pulp defects reconstruction evaluation scale scores showed 88.43±2.62 and 91.43±3.59 for MPVF versus 88.19±2.70 and 91.19±3.50 for LTF. Statistical analysis revealed no significant differences (all P>0.05) at 2 postoperative time points. Conclusion:The MPVF demonstrated non-inferior clinical efficacy to the LTF in reconstruction of digit-pulp defects, with comparable outcomes in flap survival rate at 2 weeks, and in TPD, VSS scores, digit-pulp defect reconstruction evaluation scale scores at 4 months and at 6 month after surgey.

Objective:To systematically synthesize the experiences and needs of thyroid cancer patients and their stakeholders in participating in treatment decision-making, so as to provide evidence-based theoretical support for the development of localized decision aids and the implementation of shared decision-making in China.Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Literature Database for qualitative studies on the experiences and needs of thyroid cancer patients and their stakeholders in treatment decision-making. The search covered the period from the establishment of the databases to May 20, 2025. The 2020 version of the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research was used to assess study quality. Aggregative synthesis was applied to integrate the findings.Results:A total of 19 studies were included, from which 94 individual findings were extracted. These findings were categorized into 15 new categories and further synthesized into four overarching themes: role dynamics in treatment decision-making; challenging trade-offs between risks and benefits of treatment choices; multifactorial influences on treatment decisions; and multidimensional support needs.Conclusions:Treatment decision-making among thyroid cancer patients involves complex role identification, conflicting emotional experiences, and risk-benefit deliberations influenced by multiple factors. It is essential to build a "clinician-family-society" decision-support ecosystem encompassing informational, psychological, and social support. Future efforts should focus on developing culturally appropriate decision aids that integrate emotional support and innovative technologies to promote shared decision-making, enhance decision quality, and improve patient satisfaction.

Objective:To summarize the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms.Methods:Following the scoping review framework of Arksey and O'Malley, literature on the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms was electronically retrieved from databases including the Cochrane Library, Embase, PubMed, Web of Science, CINAHL, IEEE Xplore, China Biology Medicine disc, Wanfang Data, and China National Knowledge Infrastructure. The search period was from database establishment to August 5, 2025.Results:A total of 21 articles were included. Types of head and neck neoplasms included oropharyngeal cancer, nasopharyngeal cancer, oral cancer, tongue cancer, laryngeal cancer, hypopharyngeal cancer, and others. The application forms of digital health technologies involved virtual reality technology, telemedicine systems, interactive mobile health APPs/digital health platforms, and wearable devices. Interactive mobile health apps/digital health platforms were currently the most widely adopted form, with some applications integrating wearable devices for physiological data monitoring. The main components of the intervention included guiding swallowing training methods, training monitoring/supervision and feedback, swallowing function screening/assessment, and health education.Conclusions:The application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms is still in its early stages, but its advantages in enhancing rehabilitation accessibility and promoting patient adherence have already begun to emerge. Nevertheless, it also faces challenges such as limited user-friendliness, insufficient personalized feedback, and a lack of humanistic care. It is necessary to further explore and develop personalized, precision-oriented intelligent swallowing rehabilitation systems tailored to the specific needs of swallowing rehabilitation for head and neck cancer patients. High-quality clinical studies should be conducted to validate long-term efficacy, thereby providing intelligent solutions for clinical nursing practices in swallowing rehabilitation for these patients.

Objective:To systematically synthesize the experiences and needs of thyroid cancer patients and their stakeholders in participating in treatment decision-making, so as to provide evidence-based theoretical support for the development of localized decision aids and the implementation of shared decision-making in China.Methods:A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, VIP, Wanfang Data, and China Biomedical Literature Database for qualitative studies on the experiences and needs of thyroid cancer patients and their stakeholders in treatment decision-making. The search covered the period from the establishment of the databases to May 20, 2025. The 2020 version of the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research was used to assess study quality. Aggregative synthesis was applied to integrate the findings.Results:A total of 19 studies were included, from which 94 individual findings were extracted. These findings were categorized into 15 new categories and further synthesized into four overarching themes: role dynamics in treatment decision-making; challenging trade-offs between risks and benefits of treatment choices; multifactorial influences on treatment decisions; and multidimensional support needs.Conclusions:Treatment decision-making among thyroid cancer patients involves complex role identification, conflicting emotional experiences, and risk-benefit deliberations influenced by multiple factors. It is essential to build a "clinician-family-society" decision-support ecosystem encompassing informational, psychological, and social support. Future efforts should focus on developing culturally appropriate decision aids that integrate emotional support and innovative technologies to promote shared decision-making, enhance decision quality, and improve patient satisfaction.

Objective:To summarize the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms.Methods:Following the scoping review framework of Arksey and O'Malley, literature on the application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms was electronically retrieved from databases including the Cochrane Library, Embase, PubMed, Web of Science, CINAHL, IEEE Xplore, China Biology Medicine disc, Wanfang Data, and China National Knowledge Infrastructure. The search period was from database establishment to August 5, 2025.Results:A total of 21 articles were included. Types of head and neck neoplasms included oropharyngeal cancer, nasopharyngeal cancer, oral cancer, tongue cancer, laryngeal cancer, hypopharyngeal cancer, and others. The application forms of digital health technologies involved virtual reality technology, telemedicine systems, interactive mobile health APPs/digital health platforms, and wearable devices. Interactive mobile health apps/digital health platforms were currently the most widely adopted form, with some applications integrating wearable devices for physiological data monitoring. The main components of the intervention included guiding swallowing training methods, training monitoring/supervision and feedback, swallowing function screening/assessment, and health education.Conclusions:The application of digital health technology in swallowing rehabilitation for patients with head and neck neoplasms is still in its early stages, but its advantages in enhancing rehabilitation accessibility and promoting patient adherence have already begun to emerge. Nevertheless, it also faces challenges such as limited user-friendliness, insufficient personalized feedback, and a lack of humanistic care. It is necessary to further explore and develop personalized, precision-oriented intelligent swallowing rehabilitation systems tailored to the specific needs of swallowing rehabilitation for head and neck cancer patients. High-quality clinical studies should be conducted to validate long-term efficacy, thereby providing intelligent solutions for clinical nursing practices in swallowing rehabilitation for these patients.

Objective To investigate the damage mechanism of extracellular vesicles(EVs)derived from ves-tibular schwannoma(VS)on HEI-OC1 cells and the protective effect of the ferroptosis inhibitor ferrostatin-1(Fer-1).Methods Tumor tissues and clinical data were collected from four patients with stage Ⅱ or Ⅲ VS,classified as grade D according to the AAO-HNS hearing classification.Primary VS cells were extracted,and their conditioned supernatant was collected.EVs were isolated using ultracentrifugation and identified.HEI-OC1 cells were cultured in vitro and divided into three groups:the control group(no treatment),the EVs group(treated with 3000 parti-cles/cell VS-EVs for 24 hours),and the EVs+Fer-1 group(pretreated with 20 μmol/L Fer-1 for 2 hours followed by co-culture with 3000 particles/cell VS-EVs for 24 hours).Cell viability was assessed using the CCK-8 assay,re-active oxygen species(ROS)levels were quantified using the DCFH-DA fluorescent probe,and lipid peroxidation was evaluated using the BODIPY 581/591 C11 probe.Results Compared with the control group,the EVs group showed significantly reduced cell viability(P＜0.001)and increased levels of ROS(P＜0.001)and lipid peroxides(P＜0.001).However,the EVs+Fer-1 group exhibited significantly restored cell viability(P＜0.001)and re-duced levels of ROS and lipid peroxidation(P＜0.001).Conclusion VS-derived EVs disrupts redox homeostasis,promotes intracellular accumulation of lipid peroxides and ROS,and induces ferroptosis in HEI-OC1 cells.Fer-1 significantly alleviates VS-EVs-induced ferroptosis,thereby protecting HEI-OC1 cells from damage.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.