Objective To explore the application value of stage rehabilitation intervention under the Health action process approach(HAPA)model(SRI-HAPAM)combined with tranexamic acid(TXA)in elderly patients with femoral neck fracture(FNF)undergoing total hip arthroplasty(THA).Methods Elderly FNF patients with unilateral THA in the First Affiliated Hospital of Wenzhou Medical University from December 2022 to June 2023 were enrolled.According to the random number table method,the patients were divided into routine nursing(RN)group and TXA+SRI-HAPAM group.The RN group received conventional treatment after surgery,and the TXA+SRI-HAPAM group received TXA combined with SRI-HAPAM after surgery.The bleeding indexes[hidden blood loss(HBL),explicit blood loss(EBL)and blood transfusion volume(BTV)],and the levels of hemoglobin(Hb),C-reactive protein(CRP)and D-dimer(DD)were compared between the two groups at 24 h after surgery.The hip function[joint deformity(JD),joint function(JF),joint pain(JP),joint motion(JM)and total hip function(THF)],anxiety and depression[self-rating anxiety scale and self-rating depression scale],satisfaction with care,and complications were compared between the two groups at 3 months after surgery.Results A total of 100 elderly patients with unilateral THA due to FNF were included in the study,including 54 in the TXA+SRI-HAPAM group and 46 in the RN group.Before operation,there was no significant difference in Hb,CRP,DD,JD,JF,JP,JM,THF and SAS between the two groups(P>0.05).At 24 hours after operation,Hb decreased in the two groups,while CRP and DD increased(P<0.05),and the decrease in Hb and the increase in CRP and DD,as well as HBL,EBL and BTV in the TXA+SRI-HAPAM group,were lower than those in the RN group(P<0.05).At 3 months after operation,JD,JF,JP,JM and THF in both groups increased compared with those before operation,while SAS and SDS decreased compared with those before operation(P<0.05),and the functional scores of JD,JF,JP,JM and THF in the TXA+SRI-HAPAM group were significantly higher than those in the RN group,and the scores of SAS and SDS were lower than those in the RN group(P<0.05).3 months after surgery,the nursing satisfaction of the TXA+SRI-HAPAM group was significantly higher than that of the RN group,and the total complication rate was lower than that of the RN group(P<0.05).Conclusion Compared the Routine nursing,TXA combined with SRI-HAPAM more effectively promotes postoperative recovery in patients with THA.

BACKGROUND:Gold nanoparticles are of great significance in the development of multifunctional transdermal drug delivery systems.Smaller gold nanoparticles can penetrate the dermis through the intercellular pathway,but are limited to their easy agglomeration and colloidal morphology,which makes it difficult to exert effects on low delivery efficiency. OBJECTIVE:To develop an ultrasound-optimized hydrogel delivery system by combining phase change nanodroplets with bio-adhesive hydrogel for percutaneous delivery of gold nanoparticles. METHODS:The ultrasound-responsive nanodroplets loaded with gold nanoparticles were prepared by the emulsion solvent evaporation method and loaded into the polydopamine-modified methylacryloyl gelatin hydrogel to prepare a composite hydrogel scaffold.The structure and chemical composition of the ultrasound-responsive nanogold carrier were characterized.The microstructure,porosity,permeability,rheology,in vitro hemostasis,and antibacterial properties of the composite hydrogel were characterized.The cell compatibility of the hydrogel scaffold was evaluated by live/dead staining,and the optimization effects of low-intensity pulsed ultrasound on the permeability,porosity,and mechanical properties of hydrogel were evaluated. RESULTS AND CONCLUSION:(1)Transmission electron microscopy and ultraviolet-visible spectroscopy proved the successful construction of nanogold carriers.The particle size and potential results demonstrated that the synthesized nanoscaled ultrasonic responsive carrier had good stability.(2)Live/dead cell staining proved that the prepared composite hydrogel scaffold had certain biocompatibility.(3)Scanning electron microscopy exhibited that the prepared composite hydrogel scaffold had a porous network structure,and numerous pores of about 2 μm appeared inside the macropores after the addition of nanodroplets and ultrasonic irradiation.The permeability experiment displayed that low-intensity pulsed ultrasound could optimize the porosity and permeability of hydrogel materials.The hemostatic performance of the composite hydrogel scaffold was better than that of the hemostatic sponge and polydopamine@methylacrylylated gelatin hydrogel scaffold.Under the irradiation of low-intensity pulsed ultrasound,the composite hydrogel scaffolds had good antioxidant effects and antibacterial properties.(4)Thermal imaging results manifested that gold nanoparticles were encapsulated in ultrasound-responsive nanobubbles,and more uniform dispersion could be obtained under ultrasonic excitation.(5)The results of the mechanical property test demonstrated that the storage modulus of the hydrogel increased before and after loading gold nanoparticles-nanodroplets,which showed stronger mechanical properties.The elongation at break was 122%,and the ductility was better than that without gold nanoparticles-nanodroplets(P<0.05).(6)These findings indicate that the composite hydrogel scaffold has good biocompatibility,antibacterial property,oxidation resistance,and hemostatic effect.

Ulcerative colitis （UC） is a chronic， non-specific inflammatory bowel disease. The pathogenesis of this disease is complex and is attributed to multiple factors. Intestinal mucosal barrier damage is the basic pathological change of UC， and intestinal flora disorder is one of the important characteristics of UC. Intestinal flora plays a key role in the pathological process of UC by regulating intestinal mucosal immunity and inflammatory response to repair the damaged intestinal mucosal barrier. At present， western medicine has the advantages of rapid action onset and significant short-term efficacy， but the curative effect of long-term use is not good， accompanied by many adverse reactions， causing great physical and mental pain to patients. Therefore， it is urgent to explore new treatment methods with definite long-term efficacy and mild adverse reactions. A large number of studies have shown that Chinese medicine can regulate intestinal flora through multiple targets in an all-around way， restore the homeostasis of the flora， and repair the damaged intestinal mucosal barrier， thereby inhibiting the progression of UC. Numerous studies have shown that the active components， monomers， and compounds of Chinese medicine can effectively antagonize UC by regulating the intestinal flora to improve the intestinal mucosal immunity， reduce the inflammatory response of the intestinal mucosa， and restore the normal physiological function of the intestinal mucosal barrier， providing a new strategy for UC prevention and treatment. Although there are some studies of the regulation of intestinal flora by Chinese medicine to prevent and treat UC， those studies have the shortcomings of systematic and comprehensive inadequacy. Therefore， based on the research status of UC， intestinal flora， and Chinese medicine treatment， this study reviewed the relationship between intestinal flora and UC and clarified the key role of intestinal flora in the occurrence and development of UC. At the same time， this paper comprehensively summarized the Chinese medicine that targeted the regulation of intestinal flora for the treatment of UC in the past five years to provide new strategies and ideas for UC treatment.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease with complex etiology. The pathogenesis of this disease， due to a combination of factors， is complex and has not yet been elucidated. Among them， intestinal mucosal barrier damage is the basic pathological change of UC. As a non-destructive response of cells， autophagy regulates intestinal mucosal immunity， inflammation， oxidative stress， and bacterial homeostasis through degradation and reabsorption to actively repair damaged intestinal mucosal barrier， exerting a key role in the occurrence and development of UC. The disease is mainly treated clinically with aminosalicylic acid preparations， glucocorticoids， and immunosuppressants. Western medicine treatment of the disease has a fast onset of effect， and the short-term efficacy is definite， but the long-term application is easy to be accompanied by more adverse reactions. Moreover， some drugs are expensive， bringing great physical and mental pain and economic burden to patients. Therefore， it is urgent to explore new therapies with stable efficacy and mild adverse effects. In recent years， a large number of studies have shown that Chinese medicine can regulate autophagy of the intestinal mucosa with multiple targets and effects and repair the intestinal mucosal barrier function， thereby inhibiting the development of UC. Many experiments have shown that the active ingredient or monomers and compound formulas of Chinese medicine can improve the immunity of the intestinal mucosa， inflammation， oxidative stress， and flora by regulating the level of autophagy to maintain the normal function of the intestinal mucosal barrier to effectively intervene in UC， providing a new measure for the prevention and treatment of UC. However， there is a lack of systematic review of Chinese medicine in regulating the level of autophagy in the intestinal mucosa for the prevention and treatment of UC. Therefore， based on the current research on UC， autophagy process， and Chinese medicine treatment， this article reviewed the relationship of autophagy and its key target proteins with UC to clarify the key role of autophagy in UC production and systematically summarized Chinese medicines targeting the regulation of autophagy to treat UC in recent years to provide new ideas for the treatment and drug development of UC.

Objective:To investigate the application value of abdominal reticular rotation positioning card for subcutaneous injection of fondaparinux sodium in abdominal surgery.Methods:The retrospective cohort study was conducted. The clinical data of 140 patients who underwent subcutaneous injection of fondaparinux sodium in the Second Affiliated Hospital of Nanchang University from April to October 2019 were collected. There were 74 males and 66 females, aged (58±9)years. Of the 140 patients, 70 cases undergoing routine subcutaneous injection were allocated into control group, and 70 cases undergoing subcutaneous injection with abdominal reticular rotation positioning card were allocated into experimental group. Observation indicators: (1) subcutaneous injection; (2) conditions after subcutaneous injection. Measurement data with normal distribution were expre-ssed as Mean± SD, and comparison between groups was conducted by the t test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test. Results:(1) Subcutaneous injection. There were significant differences in the subcutaneous bleeding and subcutaneous induration between the two groups ( P<0.05). (2) Conditions after subcutaneous injection. There were significant differences in pain degree and nursing satisfaction between the two groups ( P<0.05). Conclusion:Compared with the conventional subcutaneous injection, the abdominal reticular rotation positioning card for subcutaneous injection of fondaparinux sodium in abdominal surgery can reduce the rate of subcutaneous bleeding and induration of the patients, relieve the pain of the patients, and improve the satisfaction.

Ulcerative colitis （UC） mainly occurs in the colon and rectum， with complex pathological mechanism. The occurrence of ulcerative colitis is associated with the uncontrollable inflammatory response of the intestine. The Western medicine therapy of UC mainly uses glucocorticoids and immunosuppressants to reduce intestinal inflammation. While blocking the progress of UC to a certain extent， it causes severe adverse reactions. More and more studies have confirmed that traditional Chinese medicine （TCM） has obvious advantages in the prevention and treatment of UC and can significantly reduce the recurrence of the disease. Pyroptosis， a novel form of cell death， can destroy cell structure， release intracellular pro-inflammatory substances， and mediate intestinal immune response in UC. TCM can promote pyroptosis （removing excess） or inhibit pyroptosis （replenishing deficiency）， which is consistent with the regulation of Yin and Yang. TCM plays a role in the treatment of UC mainly by inhibiting pyroptosis （replenishing deficiency） and reducing intestinal immune response. In recent years， a large number of studies have been carried out to decipher the mechanism of TCM in the treatment of UC via NOD-like receptor protein domain 3 （NLRP3）-mediated pyroptosis pathway. The results have demonstrated that NLRP3 pathway is the key target of TCM in the treatment of UC. However， a comprehensive summary remains to be carried out on the inhibition of NLRP3-mediated pyroptosis pathway by TCM in the treatment of UC. Therefore， we retrieved the articles in this field in recent years with the keywords "pyroptosis"， "NLRP3"， "ulcerative colitis"， and "Chinese medicine". The Chinese medicines regulating NLRP3 pathway mainly have the functions of clearing heat and drying dampness， harmonizing Qi and blood， moving Qi and dredging fu-organs， and invigorating spleen and removing dampness. The findings can help researchers to fully understand the mechanism of TCM in the treatment of UC via the NLRP3 pathway and provide a theoretical basis for the treatment of UC and further drug development.

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic intestinal disease characterized by abdominal pain and increased water content in stool. The pathological mechanism of this disease is complex and attributed to many factors， where the impairment of intestinal mucosal barrier is pivotal in the pathogenesis of IBS-D. The intercellular tight junction （TJ）in intestinal mucosa is mainly composed of Occludin，Claudins， and zonula occludens （ZOs），which is an important component of mechanical barrier and can significantly affect mucosal function. Since modern medicine holds that the pathogenesis of this disease is not fully revealed，symptomatic treatment is the first choice in clinical practice even though the outcomes are not satisfactory. According to traditional Chinese medicine （TCM），the epithelial barrier function in intestinal mucosa corresponds to the TCM theory of "the spleen acts as the guard". Many studies have reported that the active components of Chinese medicine and compound prescriptions can restore the intestinal epithelial barrier function of IBS-D rats by regulating TJ protein，reduce its permeability， and inhibit intestinal water and electrolyte exudation，thereby improving symptoms. This study reviewed the relationship of IBS-D with TJ and its key target proteins to clarify the key role of TJ in the pathophysiology of IBS-D and summarized the TCM treatment of IBS-D through the target regulation of TJ， with the purpose to provide a theoretical basis for the treatment of IBS-D and further drug development.

Ulcerative colitis （UC） is a clinical chronic intestinal disease， and the damage of the intestinal epithelial mucus barrier is an important pathological mechanism of UC. Mucin 2 （MUC2） is a major component of the intestinal mucus barrier， and goblet cells are the “main force” of MUC2 secretion， maintaining and renewing the intestinal mucus layer to ensure its integrity. Therefore， repairing the intestinal mucus barrier by promoting the synthesis of MUC2 by goblet cells is an important strategy for the treatment of UC. Traditional Chinese medicine scholars believe that there is an inherent layer of “lipid membrane” or “fat paste” in the intestine， and pathological factors such as moisture and heat lead to the thinning of this structure， which is the fundamental pathogenesis of “diarrhea” and “intestinal dysentery”. It coincides with the damage of intestinal mucus barrier leading to UC in modern medicine. Based on this， this paper summarized the mechanism of Chinese herbal compounds or Chinese herbal active components in regulating intestinal mucus barrier to interfere with UC. It was found that Chinese herbal compounds such as Huanglian jiedu decoction， Shaoyao decoction and Compound Kusen decoction， as well as Chinese herbal active ingredients such as volatile oil of Atractylodes lancea， paeoniflorin and papaya triterpenes could promote the synthesis and secretion function of goblet cells， and achieve the purpose of “thickening intestine”， thus relieving UC symptoms.

Gastric cancer （GC） is a digestive tract tumor that occurs in the epithelial tissues of the gastric mucosa， seriously affecting the life and health of patients， and its mortality rate ranks the third among malignancies. Although medical technology has made great progress in recent years， the progression of GC still cannot be effectively controlled by surgery， chemotherapy， and targeted therapy. The pathogenesis of GC is extremely complex and is closely related to the tumor microenvironment， chronic inflammation， and immune escape， among which the reduction of tumor cell apoptosis is one of the important mechanisms for the occurrence and development of GC. Apoptosis refers to the process of spontaneous termination of cell life caused by genes under specific physiological or pathological conditions， which is of great significance for maintaining the stability of the internal environment. Researchers have found that in the GC state， mitochondrial endogenous apoptosis， endoplasmic reticulum stress， external death receptors， and other apoptosis pathways are regulated by multiple signaling pathways and genes， which together lead to the decline of GC cell apoptosis rate and thus promote the progression of GC. Chinese medicine is advantageous and characterized by multiple components， multiple targets， synergistic effect， and few adverse reactions. A large number of studies have shown that polysaccharide components， as effective components of Chinese medicine， have biological activities such as cancer inhibition， blood sugar control， anti-inflammation， antioxidant damage， and anti-virus， and can effectively inhibit the deterioration of GC by inducing cell apoptosis， gradually becoming a hot spot in GC drug research and development. However， systematic reviews on the apoptosis of GC induced by Chinese medicine polysaccharides are rarely reported. Therefore， this paper analyzed and summarized the studies of Chinese medicine polysaccharides in promoting apoptosis and interfering with GC， in order to provide a theoretical basis for the basic research， new drug development， and clinical application of Chinese medicine polysaccharides in the intervention of GC.

Ulcerative colitis （UC）， a disease that affects the colon or rectum， is characterized by long-term recurrent inflammation and eventually leads to ulcers in the inner wall of the intestine. The disease has a high incidence and is difficult to be cured， which causes severe physical and mental discomfort and economic burden to the patients. Therefore， it is urgent to develop new therapies with high cure rate and low side effect. The pathological mechanism of UC is complex and involves multiple factors. The intestinal mucosal barrier damage is the main pathological basis of UC， which is a hot topic and a new research direction. Intestinal tight junction （TJ）， as the structural basis of the intestinal mucosal mechanical barrier， can actively regulate mucosal function and play a key role in the pathogenesis of UC. Traditional Chinese medicine （TCM） can regulate TJ protein via multiple pathways and multiple targets， repair the intestinal mucosal barrier， and thus block the progression of UC. Studies have demonstrated that Chinese herbal medicines and their components， Chinese medicine compound prescriptions， and Chinese medicine preparations can treat UC by regulating TJ protein to maintain the function and reduce the permeability of intestinal epithelium， providing a new therapeutic strategy for UC. Although TCM has unique advantages that western medicine cannot replace by mediating TJ protein expression in UC， a comprehensive review of this field remains to be carried out. Focusing on the status of UC and TCM syndrome differentiation and treatment， we retrieved relevant articles with ''ulcerative colitis''， ''tight junction''， and ''Chinese medicine'' as the keywords， and summarized the relationship of TJ and its key target proteins with UC to clarify the critical role of TJ in UC pathophysiology. Furthermore， we summarized the Chinese medicines regulating TJ in the treatment of UC in recent years， aiming to provide a theoretical basis for the development of drugs for this disease.