"Stagnation" is an important pathological state in the development and progression of malignant tumors. However， its intrinsic connection with different stages of tumor evolution has not been clearly elucidated in previous studies. Drawing on clinical practice， this paper proposes the theory of stagnant toxin， emphasizing stage-specific pathogenesis and differentiated treatment strategies for tumors based on the varying manifestations of stagnation at each phase. The theory interprets the pathogenesis of stagnant toxin across the stages of tumor development through the five elements "wood， fire， earth， metal， and water" corresponding respectively to wood stagnation in the precancerous stage， metal stagnation in the postoperative phase， fire stagnation during adjuvant therapy， earth stagnation in the progressive stage， and water stagnation in the advanced stage. Each type of stagnation reflects a distinct pathogenic mechanism， such as wood stagnation giving rise to disease， metal stagnation inducing residual symptoms， fire stagnation resulting in ulceration， earth stagnation spreading toxin transmission， and water stagnation leading to critical deterioration. Accordingly， the treatment principles include guiding wood stagnation with counterflow， dispersing metal stagnation to harmonize symptoms， venting fire stagnation to regress ulcers， depleting earth stagnation to block progression， and controlling water stagnation to preserve vitality. This theoretical framework offers a traditional Chinese medicine perspective for understanding and treating malignant tumors based on the concept of stagnant toxin.

Lung cancer （LC） is a significant global public health issue， with both its incidence and mortality rates ranking among the highest worldwide. The age-standardized incidence and mortality rates are increasing annually， posing a serious threat to the life and health of LC patients. Radical surgical resection is the primary treatment for malignant lung tumors. However， postoperative multidimensional functional impairments， including respiratory， mucosal， and psychological functions， are common. These impairments not only reduce patients' quality of life and affect their treatment tolerance and duration， but also negatively correlate with prognosis， facilitating disease recurrence and metastasis. At present， postoperative functional dysfunction after LC surgery remains a key clinical challenge that urgently needs to be addressed. There is a lack of standardized and regulated postoperative rehabilitation treatment management and traditional Chinese medicine （TCM） differentiation and treatment strategies for LC. Focusing on the core underlying pathogenesis of "Qi sinking" after LC surgery， and guided by the classical TCM theory of "lungs governing Qi"， this study， based on the core concept of the "five perspectives on treatment" theory， innovatively proposes the respiratory dysfunction as the core pathogenesis of "Qi sinking in the chest" during the rapid rehabilitation phase， mucosal dysfunction as the core pathogenesis of "Yin deficiency and Qi sinking" during the postoperative adjuvant treatment phase， and the psychological dysfunction as the core pathogenesis of "Qi sinking with emotional constraint" during the consolidation phase. Accordingly， stage-specific dynamic functional protection strategies are constructed. In the rapid rehabilitation phase， the strategy emphasizes tonifying Qi and uplifting sinking Qi， with differentiation and treatment based on the principle of ''descending before ascending''. In the adjuvant treatment phase， the approach focuses on nourishing Yin and uplifting Qi， with prescription combinations that integrate unblocking and tonification. In the consolidation phase， the strategy aims to resolve constraint and uplift Qi， with clinical treatment emphasizing a combination of dynamic and static methods. At each stage of functional rehabilitation， clinical differentiation and treatment should support healthy Qi and eliminate pathogenic factors simultaneously. This study is the first to propose the concept of postoperative functional protection in TCM， offering a new approach for TCM differentiation and treatment in the full-cycle， stage-based， and dynamic protection of postoperative function in LC patients. It is expected to contribute to the construction and development of an integrated TCM-Western medicine comprehensive program for cancer prevention and treatment in China.

Tumor treatment-related adverse reactions are a major focus of clinical concern， among which recurrent aphthous oral ulcers （RAU） associated with targeted therapy for lung cancer （LC） are among the most painful and distressing for patients. Currently， modern medical interventions show limited efficacy， and there is an urgent need for more effective treatment strategies. This study differentiates RAU associated with targeted therapy for LC from chemotherapy-related and ordinary oral ulcers， elucidates the pathophysiological basis of such ulcers， and traces the theoretical origin of "Yin deficiency and Qi collapse". Based on the new system of "five perspectives on diagnosis and treatment" for tumor prevention and treatment， with a focus on the core and symptom perspectives and rooted in the traditional concept of "lung dominating Qi"， we innovatively propose the concept of "medicine-induced ulcer" and are the first to introduce the theory of "Yin deficiency and Qi collapse" into the syndrome differentiation and treatment of RAU associated with targeted therapy for LC （i.e.， medicine-induced ulcer）. We propose that "Yin deficiency and Qi collapse" is the core pathogenesis of medicine-induced ulcers， in which the collapse of formless Qi is the key to their onset， while the deficiency and stasis of tangible Yin and blood constitute the root of recurrence. A hierarchical strategy for syndrome differentiation and treatment is established： first treating the collapse of formless Qi， then replenishing tangible deficiencies， and concurrently preventing recurrence. We emphasize that treatment should address both root and manifestation， with appropriate prioritization. In the acute phase， while relieving symptoms and promoting ulcer healing by nourishing Qi， uplifting collapse， and generating body fluids， attention should also be paid to nourishing spleen Yin， facilitating the circulation of nutritive Qi， and alleviating stasis to target the root pathogenesis and reduce recurrence. A verified case is presented to support this approach. This study enriches the theoretical framework and clinical methods of traditional Chinese medicine （TCM） in the treatment of RAU associated with targeted therapy for LC， promotes symptom management of treatment-related adverse reactions through integrated TCM and Western medicine， and provides theoretical support for the construction and development of a comprehensive differentiation and treatment system for lung cancer prevention， treatment， and rehabilitation.

Objective:To study the curative effect of rehmannia glutinosa leaves total glycoside capsules and the role of mitochondrial autophagy on nucleos(t)ide drug-induced renal injury.Methods:Adefovir dipivoxil (ADV) was used to construct a hepatitis B virus (HBV) transgenic mouse model for renal injury. Renal function was measured in each group at one and two weeks of modeling. Mitochondrial autophagy indicators were measured at two weeks of modeling in renal tissue. Transmission electron microscopy was used to detect mitochondrial autophagy phenomena in renal tissue. The model was established for two weeks. Mouse with renal injury were treated with rehmannia glutinosa leaves total glycoside capsules or isotonic saline for eight weeks by intragastric administration. Renal function was measured. Renal tissue morphology was observed. Mitochondrial autophagy indicators were detected in renal tissue. The protective effect of different concentrations of verbascoside (the main active ingredient of rehmannia glutinosa capsule) was observed on HK-2 cell damage induced by ADV. HK-2 cells were divided into control, ADV, and ADV plus verbascoside groups. The effects of verbascoside at different times and concentrations were observed on the HK-2 mitochondrial autophagy indicators. Fifty patients with chronic hepatitis B were collected who presented with renal injury after treatment with nucleos(t)ide analogs. The random number method was used to divide 29 cases into a control group that received conventional treatment. The treatment group of 21 cases was treated with rehmannia glutinosa leaves total glycoside capsules on the basis of the control group. Serum creatinine (Scr) and urinary protein were detected at eight weeks.The χ2 test or t-test was used for statistical analysis. Results:Compared with the control group, two weeks of modeling in the ADV group induced renal function injury in HBV mice. The expression of autophagy indicators was higher in the renal tissue of the ADV group than that of the control group. Transmission electron microscopy had revealed mitochondrial autophagy in the renal tissue of the ADV group. Compared with the control group, the renal function of HBV mice treated with rehmannia glutinosa leaves total glycoside capsules improved for two months, and the expressions of autophagy indicators were down-regulated.Verbascoside promoted proliferation in ADV-damaged HK-2 cells, and the expression of autophagy indicators was down-regulated compared with the ADV alone group. In 50 patients with renal function injury, the urinary protein improvement was significantly superior in the treatment group than that in the control group, with eighteen and three cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with a statistically significant difference ( χ2 ?=?9.975 0, P ?=?0.001 6). Serum creatinine was decreased in the treatment group compared with the control group, with 11 and 10 cases being effective and ineffective in the treatment group and 12 and 17 cases being effective and ineffective in the control group, with no statistically significant difference ( χ2 ?= 0.593 5, P ?=?0.441 1). Conclusion:Rehmannia glutinosa leaves total glycoside capsule can improve the nucleos(t)ide drug-induced renal function injury in chronic hepatitis B, possibly playing a role via inhibiting PINK1/Parkin-mediated mitochondrial autophagy.

Long non-coding RNAs (lncRNAs) are aberrantly expressed in keloids, and some lncRNAs can interact with miRNAs and act as competitive endogenous RNAs (ceRNAs) to regulate downstream mRNA expression. These RNA molecules are interconnected to form a complex ceRNA regulatory network, playing an important role in the occurrence and development of keloids. This review summarizes the relationship of lncRNAs and their mediated ceRNA regulatory networks with keloids, in order to further explore the pathogenesis of keloids.

Objective : To construct folate modified D ⁃α ⁃tocopheryl polyethylene glycol 1000 succinate ( TPGS) oparticles on the cytotoxicity and spliced X ⁃box binding protein 1 ( XBP1s) of mouse leukemia cells of monocyte macrophage (RAW264. 7) . Methods : Mixed FA⁃TPGS and rhodamine B (RhB) labeled XBP1 siRNA solution in a proportion of 5 ∶ 1 and obtained the nano⁃complex coated with XBP1 siRNA(FT@ XBP1) . FT@ XBP1 nanocarriers were characterized by transmission electron microscope , dynamic light scattering , ultraviolet visible spectrum analysis and/or fluorescence analysis. And the release of siRNA from FA⁃TPGS nano⁃carriers was calculated simultaneously. The cell cytotoxicity of FT@ XBP1 nanomaterials were detected by scanning electron microscopy (SEM) , CCK⁃8 and flow cytometry. And the inhibited effect of XBP1 s of RAW264. 7 cells was checked by Western blot. Results FA modified TPGS could effectively bind XBP1 siRNA. And the average particle size of FT@ XBP1 nanocarriers were(200 ± 20) nm. The relative release assays showed that acidic environments (pH 5. 0) was beneficial for siRNA to release from FT@ XBP1 . Both CCK⁃8 and apoptosis assay showed that the effects of FT@ XBP1 on the proliferation and apoptosis of RAW264. 7 cells were relatively small , and FT@ XBP1 could significantly inhibit the expression of XBP1 s protein in RAW264. 7(P < 0. 001) . Conclusion TPGS nanoparticles modified with folic acid can effectively encapsulate XBP1 siRNA and inhibit XBP1 s expression of RAW264. 7 cells with good cellular compatibility.

Objective : To construct folate modified D ⁃α ⁃tocopheryl polyethylene glycol 1000 succinate ( TPGS) nanomaterials (FA⁃TPGS) , which can stably load and effectively release siRNA , and to observe the effects of nanoparticles on the cytotoxicity and spliced X ⁃box binding protein 1 ( XBP1s) of mouse leukemia cells of monocyte macrophage (RAW264. 7) . Methods : Mixed FA⁃TPGS and rhodamine B (RhB) labeled XBP1 siRNA solution in a proportion of 5 ∶ 1 and obtained the nano⁃complex coated with XBP1 siRNA(FT@ XBP1) . FT@ XBP1 nanocarriers were characterized by transmission electron microscope , dynamic light scattering , ultraviolet visible spectrum analysis and/or fluorescence analysis. And the release of siRNA from FA⁃TPGS nano⁃carriers was calculated simultaneously. The cell cytotoxicity of FT@ XBP1 nanomaterials were detected by scanning electron microscopy (SEM) , CCK⁃8 and flow cytometry. And the inhibited effect of XBP1 s of RAW264. 7 cells was checked by Western blot. Results : FA modified TPGS could effectively bind XBP1 siRNA. And the average particle size of FT@ XBP1 nanocarriers were(200 ± 20) nm. The relative release assays showed that acidic environments (pH 5. 0) was beneficial for siRNA to release from FT@ XBP1 . Both CCK⁃8 and apoptosis assay showed that the effects of FT@ XBP1 on the proliferation and apoptosis of RAW264. 7 cells were relatively small , and FT@ XBP1 could significantly inhibit the expression of XBP1 s protein in RAW264. 7(P < 0. 001) . Conclusion TPGS nanoparticles modified with folic acid can effectively encapsulate XBP1 siRNA and inhibit XBP1 s expression of RAW264. 7 cells with good cellular compatibility.

Objective:To construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.
Biomarkers, Tumor/genetics* ; Head and Neck Neoplasms/genetics* ; Humans ; Kaplan-Meier Estimate ; RNA ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate

Objective:To understand the current situation and demand of intracavity electrocardiographic positioning technique training for PICC specialist nurses in Shandong Province, and provide a reference for further improving and improving the training of PICC specialist nurses.Methods:From July 7-23, 2019, a total of 903 PICC specialist nurses in Shandong Province were selected by the convenience sampling method. The nurses were investigated by the self-made general information questionnaire of PICC specialist nurses in Shandong Province and the training demand questionnaire of intracavity electrocardiographic positioning technique.Results:40.75% (368/903) PICC specialist nurses had participated in intracavity electrocardiographic positioning technique training; 84.27% (761/903) PICC specialist nurses thought it necessary to conduct intracavity electrocardiographic positioning technique training. PICC specialist nurses had various training on intracavity electrocardiographic positioning technique, the average content requirements were all above 4.67 points. The highest score of theoretical training content was the judgment of the relationship between catheter tip position and electrocardiogram P wave (4.80 ± 0.47), and the highest score of operation training content was the intracavitary electrocardiography guided PICC catheterization (4.74 ± 0.55). 94.24%(851/903) PICC specialist nurses hoped to achieve the goal of improving clinical nursing practice ability through intracavity electrocardiographic positioning technique training. Intravenous therapy specialist academic conference was the main hoped training form(76.85%, 694/903). Multiple regression analysis showed that the number of years of catheterization, job position and understanding of the technology were the influencing factors of PICC specialist nurses′ training needs for intracavity electrocardiographic positioning technique ( t = -3.73,3.12, -3.63, all P<0.05). Conclusions:The training rate of intracavity electrocardiographic positioning technique was low, but PICC specialist nurses had higher training requirements for intracavity electrocardiographic positioning technique. Managers should pay attention to the training of intracavity electrocardiographic positioning technique, and develop targeted training programs to further improve the clinical practice capabilities of the PICC specialist nursing team.