Simmering method is one of the traditional processing methods of Chinese materia medica， which has been documented in the herbal literature and medical books of the past dynasties and has a great variety， but at present， there are not many specific varieties of Chinese materia medica involved， and there are few related researches. By reviewing the ancient and modern related information， the authors have organized and analyzed the historical evolution， processing purpose， modern representative Chinese materia medica（processing technology， quality evaluation， pharmacological research） of simmering method. After sorting out， it was found that the simmering method was widely used in ancient times， which was first seen in Huashi Zhongzangjing of the Eastern Han dynasty， and was enriched and developed through the Tang， Song， Jin， Yuan， Ming and Qing dynasties， and entered its heyday in Ming and Qing dynasties along with the economic prosperity and development of the Ming dynasty， involving as many as 159 varieties of Chinese materia medica， and gradually perfecting the processing theory of the simmering method. However， the number of varieties that still use the simmering method in modern times significantly decreased. The main purposes of using simmering method in modern Chinese materia medica are to reduce adverse reactions， moderate medicinal properties， enhance therapeutic effects， remove non-medicinal parts， and facilitate further processing， etc. This paper combed the key information of simmering methods for Chinese materia medica from ancient to modern times， which can provide a literature basis for the clinical application and modern research of simmered products of Chinese materia medica.

Denosumab, a human monoclonal antibody, is used for the prevention of malignant tumor-related bone events and the treatment of osteoporosis with high fracture risk. Since its approval in China in 2019, denosumab-related osteonecrosis of the jaw (DRONJ) has attracted increasing attention. DRONJ, similar to bisphosphonate-related osteonecrosis of the jaw, often occurs after tooth extraction and manifests as exposed bone necrosis, purulent discharge, facial swelling and pain, severely impacting patients′ quality of life. However, the perioperative management strategies for DRONJ differ from those for bisphosphonate-related osteonecrosis of the jaw. This article summarizes the perioperative management strategies for high-risk DRONJ patients from aspects such as oral hygiene care, antibiotic use, drug discontinuation during the perioperative period, and surgical strategy selection, aiming to provide guidance for oral surgeons in managing tooth extraction in denosumab-treated patients.

Objective:To analyze the research hotspots and trends of the consolidated framework for implementation research (CFIR) in nursing through bibliometrics, so as to provide reference for implementation research in nursing in China.Methods:The article on the application of CFIR in nursing was searched in the Web of Science core collection, with a search period from database establishment to August 8, 2023. CiteSpace 6.2.R4 software was used for analysis.Results:A total of 165 articles were included. The overall number of articles on the application of CFIR in nursing was on the rise. The top five countries with the highest number of publications were the United States, Canada, Australia, the United Kingdom, and the Netherlands. The top five institutions in terms of publication volume were the United States Department of Veterans Affairs, the Veterans Health Administration, the University of North Carolina, the University of Pennsylvania, and the Feinberg School of Medicine. Research hotspots included implementation science, implementation research, qualitative research, acceptability, barriers, systematic review, health disparities, symptom management, quality improvement, primary health care, and so on.Conclusions:The research on CFIR in the domestic nursing field is still in its early stages. We should draw on the experience of foreign study, verify the applicability of the Chinese version of CFIR and the connotation of its various elements, and promote the development of high-quality nursing implementation research.

The rational use of medical consumables in clinical practice is of great significance for improving medical quality and controlling medical costs. In June 2023, a tertiary hospital established a management organization system, formulated a list of key monitored medical consumables, built supporting information system and database, and established a warning mechanism, to explore the rationality evaluation path for clinical use of medical consumables through in-depth analysis of the entire hospital-department-disease-surgical procedure. This evaluation path achieved good results. Taking absorbable hemostatic gauze as an example, through implementing this evaluation path, problems with the clinical use of this consumable were promptly identified, and targeted improvements were made. After rectification, the number of absorbable hemostatic gauze used in the third quarter of 2023 (209.0 pieces) had decreased compared to the second quarter of the same year (254.0 pieces), and clinical use was more reasonable and standardized. This evaluation path achieved refined control over key monitored medical consumables, which could provide references for other hospitals to carry out the management of clinical rational use of medical consumables.

As a novel and promising antitumor target, AXL plays an important role in tumor growth, metastasis, immunosuppression and drug resistance of various malignancies, which has attracted extensive research interest in recent years. In this study, by employing the structure-based drug design and bioisosterism strategies, we designed and synthesized in total 54 novel AXL inhibitors featuring a fused-pyrazolone carboxamide scaffold, of which up to 20 compounds exhibited excellent AXL kinase and BaF3/TEL-AXL cell viability inhibitions. Notably, compound 59 showed a desirable AXL kinase inhibitory activity (IC₅₀: 3.5 nmol/L) as well as good kinase selectivity, and it effectively blocked the cellular AXL signaling. In turn, compound 59 could potently inhibit BaF3/TEL-AXL cell viability (IC₅₀: 1.5 nmol/L) and significantly suppress GAS6/AXL-mediated cancer cell invasion, migration and wound healing at the nanomolar level. More importantly, compound 59 oral administration showed good pharmacokinetic profile and in vivo antitumor efficiency, in which we observed significant AXL phosphorylation suppression, and its antitumor efficacy at 20 mg/kg (qd) was comparable to that of BGB324 at 50 mg/kg (bid), the most advanced AXL inhibitor. Taken together, this work provided a valuable lead compound as a potential AXL inhibitor for the further antitumor drug development.

ObjectiveTo study the differences in volatile oil content of bran-processed Atractylodes lancea and its standard decoction concentrate and freeze-dried powder， as well as the differences in the types and contents of chemical components in volatile oil， and to clarify the quality value transmitting. MethodTen batches of A. lancea rhizoma were collected and prepared into raw products and bran-processed products of A. lancea， standard decoction concentrate and freeze-dried powder of bran-processed A. lancea in order to extract the volatile oil， and the transfer rate of volatile oil in each sample was calculated. Quantitative analysis of the main chemical components（β-eudesmol， atractylon， atractylodin） in each volatile oil was performed by gas chromatography（GC） on the HP-5 quartz capillary column（0.32 mm×30 m， 0.25 μm） with a flame ionization detector（FID）， a split ratio of 10∶1 and a temperature program（initial temperature at 80 ℃， hold for 1 min， rise to 150 ℃ at 10 ℃·min^-1， hold for 10 min， rise to 155 ℃ at 0.5 ℃·min^-1， hold for 5 min， rise to 240 ℃ at 8.5 ℃·min^-1， hold for 8 min）. Cluster analysis and principal component analysis（PCA） were used to explore the overall differences in types and contents of chemical components between the standard decoction concentrate and freeze-dried powder. ResultThe transfer rates of volatile oil in the bran-processed products， standard decoction concentrate and freeze-dried powder were 70.51%， 1.57% and 40.90%， respectively. The average transfer rates of β-eudesmol， atractylon and atractylodin in the volatile oil of bran-processed A. lancea were 58.45%， 48.49% and 55.64%， respectively. In the standard decoction concentrate， only β-eudesmol and atractylodin were detected， and their average transfer rates were 0.22% and 0.10%， respectively. And only β-eudesmol was detected in the freeze-dried powder with the average transfer rate of 8.37%. The results of cluster analysis and PCA showed that there are obvious differences in the types and contents of chemical components between the standard decoction concentrate and freeze-dried powder. ConclusionThe quality value transmitting between bran-processed A. lancea and its standard decoction concentrate and freeze-dried powder is stable， and if the freeze-dried powder is selected as the reference material of dispensing granules， appropriate amount of volatile oil should be added back to make it consistent with the quality of the standard decoction concentrate.

Objective:To analyze the risk factors of falls among community-dwelling elderly people and provide references for the formulation of targeted fall prevention measures.Methods:This study was a cross-sectional survey. The multi-stage stratified random sampling method was used to conduct a questionnaire survey on the health and care needs of 5 997 community-dwelling elderly people in Beijing from February to August 2017. Logistic regression and association rules were used to analyze the risk factors of elderly people falling easily in community.Results:A total of 1 935 elderly people (32.27%, 1 935/5 997) experienced falls within 3 years. Logistic regression analysis showed that female, age ≥75 years, poor marital status (unmarried/widowed/divorced) , overweight or obesity, living in a bungalow, conscious general or unhealthy health, chronic diseases (diabetes/coronary heart disease/stroke/osteoarthropathy/Parkinson's disease, etc.) , medication taken ≥5 types, poor eyesight, poor hearing were risk factors for falls in the community-dwelling elderly people ( P<0.05) . The correlation between risk factors was explored by association rules, and it was found that the elderly with low socioeconomic level and decreased perceived health level, obesity accompanied by sensory disorders and multiple drug use, cardiovascular and cerebrovascular diseases and movement disorders had an increased risk of falling. Conclusions:Community nursing staffs should focus on screening the fall risk of elderly people in communities with low socioeconomic status, perceived poor health, obesity, sensory and perceptual disorders, co-existing diseases and multi-drug use, and reduce the fall risk of elderly people in communities through targeted measures such as modifying the living environment suitable for aging, wearing visual and hearing correction equipment, controlling of obesity, chronic disease management and simplification of drug prescriptions.

To cope with the increasing burden of disability care brought about by global aging, various countries have established long-term care insurance systems based on their national conditions. Germany and Japan have successively established a socialized long-term care insurance system and continuously improved the system through a series of reforms, providing a blueprint for long-term care insurance reform in other countries. This article reviews the reforms in Germany and Japan in updating evaluation tools, improving grading standards and service content, and enhancing institutional fairness, so as to provide reference for perfecting China's long-term care insurance system.

Artificial intelligence has shown broad application prospects in the field of nursing management, and is expected to become an important breakthrough point in improving the efficiency and level of nursing management. This study reviewed the current research status of artificial intelligence in the field of nursing management, summarized the progress of artificial intelligence in nursing personnel scheduling, disease risk management and optimizing nursing management processes, analyzed the opportunities and challenges of artificial intelligence application in nursing management, and provides reference for the development and application of artificial intelligence in nursing management in the future.

【Objective】 To establish a digital model of lumbar 4 and lumbar 5 vertebral bodies through three-dimensional imaging technology so as to explore the precise placement of pedicle screws during the lumbar posterior internal fixation operation. 【Methods】 CT scan image data set of lumbar spine included six specimens. Then lumbar modeling was produced using Mimics software， implanting pedicle screws was simulated with the computer to determine the reliability of pedicle screw for herringbone crest method， Weinstein method， and Magerl method. 【Results】 This study included six specimens （4 males and 2 females）， with an average age of 42.83 years. The distance from the right Magerl entry point to the actual entry point of the lumbar 4 vertebrae was significantly greater than that of the left side. The distance from the left herringbone crest entry point of lumbar 4 vertebrae to the actual entry point was significantly greater than Weinstein method and Magerl method （P<0.001 and P<0.001）， and the distance from the right herringbone crest entry point of lumbar 4 vertebrae to the actual entry point was significantly greater than Weinstein method （P=0.003）. Both left and right abduction angles of lumbar 4 vertebrae were true abduction angle >Magerl abduction angle > Weinstein abduction angle > herringbone abduction angle. The distances of true-Weinstein and true-herringbone ridges on the left side of lumbar 5 vertebrae were significantly greater than those on the right side （P=0.002 and P=0.004）， and the Weinstein abduction angle on the right side of lumbar 5 vertebrae was greater than that on the left side （P=0.003）. For the left and right sides of lumbar 5 vertebrae， the distance from herringbone crest entry point to the actual entry point was significantly greater than that of Weinstein method and Magerl method （P<0.001 and P<0.001）， and the distance from the Magerl entry point to the real entry point was significantly greater than that of the Weinstein method. The abduction angle of left and right sides of lumbar 5 vertebrae was as follows： true abduction angle > Magerl abduction angle > Weinstein abduction angle > herringbone abduction angle. 【Conclusion】 Both Weinstein entry point and Magerl entry point for lumbar 4 and lumbar 5 vertebra are close to the real entry point. The Weinstein abduction angle and Magerl abduction angle of lumbar 4 and lumbar 5 vertebrae have minor differences compared with real abduction angle. Therefore， it is recommended that Weinstein method is the preferred choice for lumbar 4 pedicle screw placement， while Weinstein method or Magerl method is the preferred choice for lumbar 5 pedicle screw placement.