Osteoarthritis （OA） is characterized by articular cartilage degeneration， synovial hyperplasia， hyperosteogeny， and narrowing of joint space， which can be caused by trauma， inflammation， and other factors. With the increasing global population aging， the incidence of OA is rising year by year， making it a major public health problem that urgently needs to be addressed. Exploring effective treatment schemes is particularly important. The pathogenesis of OA is complex， including oxidative stress， autophagy， and apoptosis. Recent studies have found that ferroptosis， a new type of cell death， is also an important pathogenic factor in OA， characterized by a series of complex changes such as iron ion accumulation， glutathione （GSH） depletion， and mitochondrial dysfunction. Research shows that inhibiting ferroptosis in chondrocytes can promote chondrocyte proliferation， delay extracellular matrix （ECM） degradation， and reduce synovial hyperplasia and inflammation. Targeting ferroptosis is a new direction in the treatment of OA. OA treatment includes intra-articular injections of steroids or hyaluronic acid and artificial joint replacement， but there are limitations. Traditional Chinese medicine （TCM） has been widely used in the treatment of various diseases because of its low cost， low drug resistance， and few side effects. Cell and animal experiments have further confirmed that TCM can intervene in the treatment of OA with ferroptosis from multiple targets， multiple levels， and aspects， but the mechanism of its treatment of OA based on ferroptosis has not been clarified. This paper discussed iron metabolism， lipid peroxidation， cysteine/glutamate transporter system Xc^- （system Xc^-）/GSH/glutathione peroxidase 4 （GPX4） pathway， nicotinamide adenine dinucleotide phosphate（NADPH）/ferroptosis suppressor protein 1 （FSP1）/coenzyme Q₁₀ （CoQ₁₀） pathway， tumor protein p53 in OA， and related molecular targets of Chinese medicine monomers and compounds on ferroptosis inhibition. Their potential therapeutic mechanisms were further analyzed to provide theoretical guidance for the treatment of OA by TCM and useful reference for the research and development of related drugs.

Objective To investigate the clinical features of elderly patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)and the risk factors affecting the short-term prognosis of patients.Methods A retrospective analysis was performed for 417 patients with HBV-ACLF who were admitted to The General Hospital of Western Theater Command from January 2015 to January 2023,and related clinical data were collected,including general status,routine blood test results,biochemical parameters,and conditions of liver cirrhosis and decompensated events(ascites,hepatic encephalopathy,and their severities).The patients were followed up to observe 90-day survival.According to the age,the patients were divided into elderly group(with 106 patients aged≥60 years)and non-elderly group(with 311 patients aged＜60 years),and according to the 90-day survival,the elderly group were further divided into survival group with 41 patients and death/transplantation group with 65 patients.The independent-samples t test or the Mann-Whitney U test was used for comparison of quantitative data between two groups,and the chi-square test was used for comparison of qualitative data between two groups.The binary logistic regression analysis was used to determine the independent influencing factors for the risk of death within 90 days in elderly patients with HBV-ACLF,and a nomogram model was constructed for predicting the risk of death.The receiver operating characteristic(ROC)curve was used to investigate the value of the model in predicting the prognosis of HBV-ACLF patients in both the training set and the validation set.Calibration curve and decision curve were plotted for the models constructed in the training set and the validation set,and the model was assessed in terms of the degree of fitness and predicting benefits.Results The elderly patients had a significantly higher 90-day mortality rate than the non-elderly patients(P＜0.05),and compared with the non-elderly group,the elderly group had significantly higher incidence rate in female individuals,basic incidence rate of liver cirrhosis,incidence rate and grade of hepatic encephalopathy,incidence rate of ascites,and liver fibrosis markers(aspartate aminotransferase-to-platelet ratio index and fibrosis-4)(all P＜0.05),as well as significantly lower total cholesterol,high-density lipoprotein,albumin,alpha-fetoprotein,and lymphocytes(all P＜0.05).As for the elderly patients with HBV-ACLF,there were significant differences between the survival group and the death/transplantation group in total cholesterol,total bilirubin,international normalized ratio(INR),alpha-fetoprotein,platelet,creatinine,serum sodium,monocytes,and the incidence rate and grade of hepatic encephalopathy(all P＜0.05).In addition,the multivariate logistic regression analysis showed that INR(odds ratio[OR]=11.351,95%confidence interval[CI]:1.942-66.362,P＜0.05),monocyte count(OR=23.636,95%CI:1.388-402.529,P＜0.05),total bilirubin(OR=1.007,95%CI:1.001-1.013,P＜0.05),and platelet count(OR=0.968,95%CI:0.945-0.993,P＜0.05)were independent influencing factors for the 90-day prognosis of elderly patients with HBV-ACLF,and the nomogram model constructed based on these factors had a relatively high predictive value,with an area under the ROC curve of 0.915,a sensitivity of 88.0%,and a specificity of 86.7%.The nomogram model showed relatively high efficiency and degree of fitness in the verification set,and the decision curve suggested that the model had good benefits,with a higher prediction efficiency compared with the commonly used prediction models such as MELD score and COSSH-ACLF Ⅱ score.Conclusion Elderly HBV-ACLF patients may have a high short-term mortality rate due to the reductions in liver synthesis,reserve function,and regenerative ability and immune dysfunction.INR,monocyte count,total bilirubin,and platelet count have a relatively high value in predicting the risk of death in elderly HBV-ACLF patients,and the nomogram model constructed based on these factors has a relatively high prediction efficiency.

This paper reviewed the overview, assessment tools, influencing factors and intervention measures of guilt of family caregivers of dementia patients, aiming to provide reference for formulating targeted intervention measures to reduce guilt of family caregivers of dementia patients.

The Satir model, grounded in humanism and oriented towards growth, is a psychological therapy model aimed at enhancing self-esteem, improving communication, and facilitating personal integration of mind and body, achieving internal and external harmony. In recent years, the Satir model has garnered increasing attention from nursing educators and scholars. This study provides a comprehensive review of the theoretical foundations, therapeutic techniques, and applications of the Satir model in the field of nursing in China. The aim is to offer new perspectives and theoretical references for the nursing practice of the Satir model and to enrich psychological nursing methods.

AIM: To investigate the injury of emodin (EMO) in reduce of glomerular mesangial cells (MCs) in lupus nephritis by targeting forkhead protein K2 (FOXK2) through miR-96-5p. METHODS: The contents of 24 h urine protein, serum urea nitrogen (BUN) and serum creatinine (Scr) in MRL / faslpr mice (lupus nephritis group) and MRL / MPJ mice (control group) were detected. MCs were separated, purified and divided into: MCs group (MCs without any treatment), L-EMO group (MCs treated with 10 μmol/L Emodin), M-EMO group (MCs treated with 25 μmol / L Emodin), H-EMO group (MCs treated with 50 μmol / L Emodin), H-EMO + miR-96-5p-NC group (MCs treated with 50 μmol / L Emodin and transfected with miR-96-5p-NC), and H-EMO + miR-96-5p-minic group (MCs treated with 50 μmol/ L Emodin and transfected with miR-96-5p-minic). Double luciferase report experiment was used to verify the targeting relationship between miR-96-5p and FOXK2. The real-time quantitative fluorescent polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-96-5p. Western blot was used to detect the expression of FOXK2 and apoptosis related proteins. The enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of inflammatory factors in MCs. cell count kit 8 (CCK-8) was used to determine the activity of MCs. Annexin-V FITC/PI double staining was used to detect apoptosis of MCs. RESULTS: Compared with the control group, 24 h urinary protein content, serum BUN and Scr levels in the lupus nephritis group were significantly increased (P< 0.05). Compared with the MCs group, the miR-96-5p expression, interleukin1β (IL-1β), interleukin6 (IL-6), tumor necrosis factor-α (TNF-α), A450 value and B-lymphoblastoma-2 (Bcl-2) protein in the L-EMO group, M-EMO group and H-EMO group were significantly decreased (P<0.05), the FOXK2 level, cell apoptosis rate, Bcl-2 related X gene (Bax), aspartate specific cysteine proteinase-3 (cleaved Caspase-3) protein levels were significantly increased, respectively (P<0.05), the effect of Emodin was dose-dependent. Compared with the H-EMO group and H-EMO+miR-96-5p-NC group, H-EMO+miR-96-5p-minic group obviously increased the miR-96-5p expression, inflammatory factor levels, A450 value and Bcl-2 protein level (P<0.05), and obviously decreased FOXK2 level and cell apoptosis rate (P< 0.05). CONCLUSION: EMO can reduce the injury of lupus nephritis MCs by down-regulating miR-96-5p and then up-regulating FOXK2.

Objective:To investigate the diagnostic value of endoscopic ultrasonography (EUS) in pancreatic duct stones.Methods:The clinicopathologic data of 204 patients undergoing EUS for symptoms such as abdominal pain, abdominal distension and jaundice suspected of pancreatic duct stones, who were admitted to the General Hospital of Western Theater Command from January 2019 to April 2023 were retrospectively analyzed. Of 159 patients were finally enrolled, including 47 females and 112 males, aged (51.8±13.9) years. Surgery or endoscopic retrograde cholangiopancreatography (ERCP) is considered the " gold standard" for the diagnosis of pancreatic duct stones. Of 38 patients (23.9%) had abdominal ultrasound, 143 (89.9%) had CT scan and 93 (58.5%) had magnetic resonance cholangiopancreatography (MRCP) at the same time. The diagnostic accuracy of imaging examinations in pancreatic duct stones was compared.Results:In 159 patients, 61 (38.4%) were diagnosed of pancreatic duct stones. In the 159 patients, 61 (38.4%) were diagnosed of pancreatic duct stones by EUS. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, Youden index and accuracy of EUS for pancreatic duct stones were 98.4%, 99.0%, 98.4%, 99.0%, 97.3% and 98.7%, respectively. The accuracy of EUS in diagnosing pancreatic duct stones was higher than that of percutaneous ultrasound, CT and MRCP (χ 2=7.71, 13.76, and 5.70, P=0.012, <0.001, 0.033). The diagnostic accuracy of EUS is comparable with operation and ERCP (Kappa=0.854, P<0.001). Conclusion:EUS could be a superior imaging approach to diagnose the pancreatic duct stone.

Hepatic encephalopathy is a serious complication of liver cirrhosis and can cause neuropsychiatric symptoms such as cognitive impairment and motor impairment. More than 30% of patients with liver cirrhosis may develop hepatic encephalopathy， posing a huge economic burden to the health of patients and bringing many challenges to clinical diagnosis and treatment. Therefore， early identification， diagnosis， and treatment are the key to improving patient prognosis. Based on the clinical experience of our center， this article elaborates on hepatic encephalopathy from the aspects of pathogenesis， time dimension， minimal hepatic encephalopathy， and non-organic brain lesions， in order to provide new ideas or strategies for the diagnosis and treatment of hepatic encephalopathy in liver cirrhosis.

【Objective】 To evaluate the safety and efficacy of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture. 【Methods】 The clinical data of patients who underwent endoscopic Allium ureteral stent implantation for ureteral stricture in our hospital during Aug.2020 and Dec.2022 were retrospectively analyzed, and the surgical conditions and adverse events were recorded. The data of serum creatinine, blood urea nitrogen, glomerular filtration rate (GFR) and renal pelvis width under ultrasound were compared before surgery and 1, 3, 6 and 12 months after surgery. 【Results】 A total of 52 patients with ureteral stricture of 1.1 (0.7, 2.0)cm were included. All operations were successful. The operation time was 82.5 (70, 114)min, intraoperative blood loss 20 (10, 20)mL, and postoperative hospitalization stay 1 (1, 2) day. During the follow-up of (13.2±7.8) months, 14 patients had stent displacement, 5 had stone obstruction of stent tubes, 7 had occasional hematuria after movement, 9 had intermittent lumbar and abdominal pain, and 1 had recurrent urinary tract infection. The serum creatinine, blood urea nitrogen and renal pelvis width of 1 month, 3, 6 and 12 months after surgery were significantly decreased, while GFR was significantly increased. 【Conclusion】 Long-term indwelling of Allium ureteral stent is effective in the treatment of ureteral stricture, but the high incidence of stent displacement should arouse attention.

ObjectiveTo observe the effect of Jiaji electroacupuncture combined with neurodynamic mobilization on nerve conduction velocity and the expression of Netrin-1, Slit2 and Rho GTPases after sciatic nerve injury in rabbits. MethodsA total of 216 New Zealand rabbits were randomly divided into nomal control group (NC), vector virus group (VV), Jiaji electroacupuncture combined with neurodynamic mobilization group (EN), Netrin-1 group (N1), Slit2 group (S2) and N1+S2 group. Each group was divided into three subgroups according to the postoperative treatment time points (one, two and four weeks), with twelve rabbits in each subgroup. The rabbit model of Sunderland Ⅲ degree injury of the left sciatic nerve was established by clamping method. There was no intervention in NC, and virus was injected during the preparation of the model. Jiaji electroacupuncture and neurodynamic mobilization were administrated three days after operation in EN group. Nerve conduction velocity of sciatic nerve was measured with electromyography. The sciatic nerve and L_4-6 spinal cords were obtained, the expression of Netrin-1 and Slit2 mRNA were detected real-time quantitative polymerase chain reaction and immunofluorescence double staining, and the expression of Rac1, Cdc42 and RhoA protein were observed via Western blotting. ResultsOne, two and four weeks after modeling, the nerve conduction velocity was more in EN group and N1+S2 group than in N1 group and S2 group (P < 0.05); the Netrin-1 and Slit2 mRNA expression were higher in the EN group and N1+S2 group than in the VV group and NC group (P < 0.05); the protein expression of Rac1 and Cdc42 were higher, and the protein expression of RhoA was lower in EN group and N1+S2 group than in N1 group, S2 group and VV group (P < 0.05). ConclusionJiaji electroacupuncture combined with nerve mobilization may promote the axonal regeneration by regulating the expression of Netrin-1 and Slit2, adjusting the imbalance of Rho GTPases enzyme system, and then promoting cytoskeleton reorganization and peripheral nerve regeneration after injury.