BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The st...This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly f...The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.展开更多
The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory ...The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.展开更多
The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia ...The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.展开更多
Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration...Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
With the increasing popularity of blockchain applications, the security of data sources on the blockchain is gradually receiving attention. Providing reliable data for the blockchain safely and efficiently has become ...With the increasing popularity of blockchain applications, the security of data sources on the blockchain is gradually receiving attention. Providing reliable data for the blockchain safely and efficiently has become a research hotspot, and the security of the oracle responsible for providing reliable data has attracted much attention. The most widely used centralized oracles in blockchain, such as Provable and Town Crier, all rely on a single oracle to obtain data, which suffers from a single point of failure and limits the large-scale development of blockchain. To this end, the distributed oracle scheme is put forward, but the existing distributed oracle schemes such as Chainlink and Augur generally have low execution efficiency and high communication overhead, which leads to their poor applicability. To solve the above problems, this paper proposes a trusted distributed oracle scheme based on a share recovery threshold signature. First, a data verification method of distributed oracles is designed based on threshold signature. By aggregating the signatures of oracles, data from different data sources can be mutually verified, leading to a more efficient data verification and aggregation process. Then, a credibility-based cluster head election algorithm is designed, which reduces the communication overhead by clarifying the function distribution and building a hierarchical structure. Considering the good performance of the BLS threshold signature in large-scale applications, this paper combines it with distributed oracle technology and proposes a BLS threshold signature algorithm that supports share recovery in distributed oracles. The share recovery mechanism enables the proposed scheme to solve the key loss issue, and the setting of the threshold value enables the proposed scheme to complete signature aggregation with only a threshold number of oracles, making the scheme more robust. Finally, experimental results indicate that, by using the threshold signature technology and the cluster head election algorithm, our scheme effectively improves the execution efficiency of oracles and solves the problem of a single point of failure, leading to higher scalability and robustness.展开更多
BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recover...BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.展开更多
A large amount of volatile organic compounds (VOCs) will be produced in the printing industry, which not only directly harms people's health, but also is one of the important reasons for inducing PM2.5 to cause ai...A large amount of volatile organic compounds (VOCs) will be produced in the printing industry, which not only directly harms people's health, but also is one of the important reasons for inducing PM2.5 to cause air pollution. How to effectively control and improve the emission of organic waste gas has become an important issue to be solved urgently. This paper introduces that the regenerative oxidation furnace (RTO) can realize the energy cascade utilization of high-temperature flue gas discharged by RTO by adding flue gas lithium bromide absorption refrigeration unit after the organic waste gas is incinerated and decomposed at high temperature. The energy-saving scheme has been successfully applied to practical engineering cases, and can directly use high-temperature flue gas to provide refrigeration demand for users, thus realizing efficient purification of organic waste gas, improving energy utilization rate and saving energy consumption. At the same time, aiming at the practical application of this project, the lithium bromide refrigerator and control system are specially designed, which has practical and effective popularization significance for the project transformation of other industries.展开更多
Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhance...Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhanced networkmanagement capabilities than those of traditional networks.However,because SDN is designed to ensure high-level service availability,it faces additional challenges.One of themost critical challenges is ensuring efficient detection and recovery from link failures in the data plane.Such failures can significantly impact network performance and lead to service outages,making resiliency a key concern for the effective adoption of SDN.Since the recovery process is intrinsically dependent on timely failure detection,this research surveys and analyzes the current literature on both failure detection and recovery approaches in SDN.The survey provides a critical comparison of existing failure detection techniques,highlighting their advantages and disadvantages.Additionally,it examines the current failure recovery methods,categorized as either restoration-based or protection-based,and offers a comprehensive comparison of their strengths and limitations.Lastly,future research challenges and directions are discussed to address the shortcomings of existing failure recovery methods.展开更多
Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive s...Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive schemes have longer recovery times while proactive schemes provide faster recovery but overwhelm the memory of switches by flow entries.As SDN adoption grows,ensuring efficient recovery from link failures in the data plane becomes crucial.In particular,data center networks(DCNs)demand rapid recovery times and efficient resource utilization to meet carrier-grade requirements.This paper proposes an efficient Decentralized Failure Recovery(DFR)model for SDNs,meeting recovery time requirements and optimizing switch memory resource consumption.The DFR model enables switches to autonomously reroute traffic upon link failures without involving the controller,achieving fast recovery times while minimizing memory usage.DFR employs the Fast Failover Group in the OpenFlow standard for local recovery without requiring controller communication and utilizes the k-shortest path algorithm to proactively install backup paths,allowing immediate local recovery without controller intervention and enhancing overall network stability and scalability.DFR employs flow entry aggregation techniques to reduce switch memory usage.Instead of matching flow entries to the destination host’s MAC address,DFR matches packets to the destination switch’s MAC address.This reduces the switches’Ternary Content-Addressable Memory(TCAM)consumption.Additionally,DFR modifies Address Resolution Protocol(ARP)replies to provide source hosts with the destination switch’s MAC address,facilitating flow entry aggregation without affecting normal network operations.The performance of DFR is evaluated through the network emulator Mininet 2.3.1 and Ryu 3.1 as SDN controller.For different number of active flows,number of hosts per edge switch,and different network sizes,the proposed model outperformed various failure recovery models:restoration-based,protection by flow entries,protection by group entries and protection by Vlan-tagging model in terms of recovery time,switch memory consumption and controller overhead which represented the number of flow entry updates to recover from the failure.Experimental results demonstrate that DFR achieves recovery times under 20 milliseconds,satisfying carrier-grade requirements for rapid failure recovery.Additionally,DFR reduces switch memory usage by up to 95%compared to traditional protection methods and minimizes controller load by eliminating the need for controller intervention during failure recovery.Theresults underscore the efficiency and scalability of the DFR model,making it a practical solution for enhancing network resilience in SDN environments.展开更多
The rapidly growing demand for lithium iron phosphate(LiFePO_(4))as the cathode material of lithium-ion batteries(LIBs)has aggravated the scarcity of phosphorus(P)reserves on Earth.This study introduces an environment...The rapidly growing demand for lithium iron phosphate(LiFePO_(4))as the cathode material of lithium-ion batteries(LIBs)has aggravated the scarcity of phosphorus(P)reserves on Earth.This study introduces an environmentally friendly and economical method of P recovery from municipal wastewater,providing the P source for LiFePO_(4) cathodes.The novel approach utilizes the sludge of Fe-coagulant-based chemical P removal(CPR)in wastewater treatment.After a sintering treatment with acid washing,the CPR sludge,enriched with P and Fe,transforms into purified P-Fe oxides(Fe2.1P1.0O5.6).These oxides can substitute up to 35%of the FePO_(4) reagent as precursor,producing a carbon-coated LiFePO_(4)(LiFePO_(4)/C)cathode with a specific discharge capacity of 114.9 mA·h·g^(-1)at current density of 17 mA·g^(-1)),and cycle stability of 99.2%after 100 cycles.The enhanced cycle performance of the as-prepared LiFePO_(4)/C cathode may be attributed to the incorporations of impurities(such as Ca^(2+)and Na^(+))from sludge,with improved stability of crystal structure.Unlike conventional P-fertilizers,this P recovery technology converts 100%of P in CPR sludge into the production of value-added LiFePO_(4)/C cathodes.The recovered P from municipal wastewater can meet up to 35%of the P demand in the Chinese LIBs industry,offering a cost-effective solution for addressing the pressing challenges of P scarcity.展开更多
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
文摘This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金supported by European Union Funding Programme,PNRR,No. 760058(to DMH)the UEFISCDI Project,No. PN-III-P4-IDPCE-2020-059(to APW)
文摘The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.
基金supported by the Deutsche Forschungsgemeinschaft(DFG),TRR274(Project ID 408885537,Sy Nergy,EXC 2145/ID 390857198,to FMB)。
文摘The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.
基金supported by the National Natural Science Foundation of China,Nos.82071387(to HT),81971172(to YW)the Natural Science Foundation of Zhejiang Province,China,No.LY22H090012(to HT)the Basic Research Project of Wenzhou City,China,No.Y20220923(to MZ)。
文摘The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.
基金supported in part by NIH R01 NS100531,R01 NS103481NIH R21NS130241(to LD)+3 种基金Merit Review Award I01 BX002356,I01 BX003705 from the U.S.Department of Veterans AffairsIndiana Spinal Cord and Brain Injury Research Foundation(No.19919)Mari Hulman George Endowment Funds(to XMX)Indiana Spinal Cord&Brain Injury Research Fund from ISDH(to NKL and LD)。
文摘Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
基金supported by the National Natural Science Foundation of China(Grant No.62102449)the Central Plains Talent Program under Grant No.224200510003.
文摘With the increasing popularity of blockchain applications, the security of data sources on the blockchain is gradually receiving attention. Providing reliable data for the blockchain safely and efficiently has become a research hotspot, and the security of the oracle responsible for providing reliable data has attracted much attention. The most widely used centralized oracles in blockchain, such as Provable and Town Crier, all rely on a single oracle to obtain data, which suffers from a single point of failure and limits the large-scale development of blockchain. To this end, the distributed oracle scheme is put forward, but the existing distributed oracle schemes such as Chainlink and Augur generally have low execution efficiency and high communication overhead, which leads to their poor applicability. To solve the above problems, this paper proposes a trusted distributed oracle scheme based on a share recovery threshold signature. First, a data verification method of distributed oracles is designed based on threshold signature. By aggregating the signatures of oracles, data from different data sources can be mutually verified, leading to a more efficient data verification and aggregation process. Then, a credibility-based cluster head election algorithm is designed, which reduces the communication overhead by clarifying the function distribution and building a hierarchical structure. Considering the good performance of the BLS threshold signature in large-scale applications, this paper combines it with distributed oracle technology and proposes a BLS threshold signature algorithm that supports share recovery in distributed oracles. The share recovery mechanism enables the proposed scheme to solve the key loss issue, and the setting of the threshold value enables the proposed scheme to complete signature aggregation with only a threshold number of oracles, making the scheme more robust. Finally, experimental results indicate that, by using the threshold signature technology and the cluster head election algorithm, our scheme effectively improves the execution efficiency of oracles and solves the problem of a single point of failure, leading to higher scalability and robustness.
文摘BACKGROUND Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis,a common acute abdominal condition.Despite surgical advances,postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life.Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.AIM To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.METHODS This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital.Patients were randomly divided into two groups:Routine treatment group(n=60)and laser acupuncture intervention group(n=60).There were no significant statistical differences in baseline characteristics(age,gender,body mass index,appendicitis severity)between the two groups.The routine treatment group received standard postoperative care,while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care.Key observation indicators included time to first exhaust,time to first bowel movement,time to gastrointestinal function recovery,and postoperative complication rates.RESULTS Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group.Specifically,time to first exhaust was significantly shortened(intervention group:12.5±2.3 hours vs control group:18.7±3.1 hours,P<0.05),time to first bowel movement was earlier(intervention group:36.4±4.6 hours vs control group:48.2±5.7 hours,P<0.05),postoperative complication rate was significantly reduced(intervention group:8.3%vs control group:20.0%,P<0.05),postoperative pain score was significantly lower(intervention group:3.2±1.1 vs control group:4.7±1.5,P<0.05),and intestinal motility recovery was faster and more effective.CONCLUSION Laser acupuncture,as an auxiliary treatment method,can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy,reduce complications,and improve postoperative comfort.This technique has advantages such as minimal invasiveness,rapid recovery,and few side effects,making it worthy of further clinical promotion and application.
文摘A large amount of volatile organic compounds (VOCs) will be produced in the printing industry, which not only directly harms people's health, but also is one of the important reasons for inducing PM2.5 to cause air pollution. How to effectively control and improve the emission of organic waste gas has become an important issue to be solved urgently. This paper introduces that the regenerative oxidation furnace (RTO) can realize the energy cascade utilization of high-temperature flue gas discharged by RTO by adding flue gas lithium bromide absorption refrigeration unit after the organic waste gas is incinerated and decomposed at high temperature. The energy-saving scheme has been successfully applied to practical engineering cases, and can directly use high-temperature flue gas to provide refrigeration demand for users, thus realizing efficient purification of organic waste gas, improving energy utilization rate and saving energy consumption. At the same time, aiming at the practical application of this project, the lithium bromide refrigerator and control system are specially designed, which has practical and effective popularization significance for the project transformation of other industries.
文摘Software-defined networking(SDN)is an innovative paradigm that separates the control and data planes,introducing centralized network control.SDN is increasingly being adopted by Carrier Grade networks,offering enhanced networkmanagement capabilities than those of traditional networks.However,because SDN is designed to ensure high-level service availability,it faces additional challenges.One of themost critical challenges is ensuring efficient detection and recovery from link failures in the data plane.Such failures can significantly impact network performance and lead to service outages,making resiliency a key concern for the effective adoption of SDN.Since the recovery process is intrinsically dependent on timely failure detection,this research surveys and analyzes the current literature on both failure detection and recovery approaches in SDN.The survey provides a critical comparison of existing failure detection techniques,highlighting their advantages and disadvantages.Additionally,it examines the current failure recovery methods,categorized as either restoration-based or protection-based,and offers a comprehensive comparison of their strengths and limitations.Lastly,future research challenges and directions are discussed to address the shortcomings of existing failure recovery methods.
文摘Link failure is a critical issue in large networks and must be effectively addressed.In software-defined networks(SDN),link failure recovery schemes can be categorized into proactive and reactive approaches.Reactive schemes have longer recovery times while proactive schemes provide faster recovery but overwhelm the memory of switches by flow entries.As SDN adoption grows,ensuring efficient recovery from link failures in the data plane becomes crucial.In particular,data center networks(DCNs)demand rapid recovery times and efficient resource utilization to meet carrier-grade requirements.This paper proposes an efficient Decentralized Failure Recovery(DFR)model for SDNs,meeting recovery time requirements and optimizing switch memory resource consumption.The DFR model enables switches to autonomously reroute traffic upon link failures without involving the controller,achieving fast recovery times while minimizing memory usage.DFR employs the Fast Failover Group in the OpenFlow standard for local recovery without requiring controller communication and utilizes the k-shortest path algorithm to proactively install backup paths,allowing immediate local recovery without controller intervention and enhancing overall network stability and scalability.DFR employs flow entry aggregation techniques to reduce switch memory usage.Instead of matching flow entries to the destination host’s MAC address,DFR matches packets to the destination switch’s MAC address.This reduces the switches’Ternary Content-Addressable Memory(TCAM)consumption.Additionally,DFR modifies Address Resolution Protocol(ARP)replies to provide source hosts with the destination switch’s MAC address,facilitating flow entry aggregation without affecting normal network operations.The performance of DFR is evaluated through the network emulator Mininet 2.3.1 and Ryu 3.1 as SDN controller.For different number of active flows,number of hosts per edge switch,and different network sizes,the proposed model outperformed various failure recovery models:restoration-based,protection by flow entries,protection by group entries and protection by Vlan-tagging model in terms of recovery time,switch memory consumption and controller overhead which represented the number of flow entry updates to recover from the failure.Experimental results demonstrate that DFR achieves recovery times under 20 milliseconds,satisfying carrier-grade requirements for rapid failure recovery.Additionally,DFR reduces switch memory usage by up to 95%compared to traditional protection methods and minimizes controller load by eliminating the need for controller intervention during failure recovery.Theresults underscore the efficiency and scalability of the DFR model,making it a practical solution for enhancing network resilience in SDN environments.
基金supported by the National Natural Science Foundation of China(52100093,52270128,and 52261135627)the Guangdong Basic and Applied Basic Research Foundation(2023A1515011734 and 2021B1515120068)+2 种基金the Municipal Science and Technology Innovation Council of the Shen-zhen Government(KCXFZ20211020163556020 and SGDX20230116092359002)the Research Grants Council(17210219)the Innovation and Technology Fund(ITS/242/20FP)of the Hong Kong SAR Government。
文摘The rapidly growing demand for lithium iron phosphate(LiFePO_(4))as the cathode material of lithium-ion batteries(LIBs)has aggravated the scarcity of phosphorus(P)reserves on Earth.This study introduces an environmentally friendly and economical method of P recovery from municipal wastewater,providing the P source for LiFePO_(4) cathodes.The novel approach utilizes the sludge of Fe-coagulant-based chemical P removal(CPR)in wastewater treatment.After a sintering treatment with acid washing,the CPR sludge,enriched with P and Fe,transforms into purified P-Fe oxides(Fe2.1P1.0O5.6).These oxides can substitute up to 35%of the FePO_(4) reagent as precursor,producing a carbon-coated LiFePO_(4)(LiFePO_(4)/C)cathode with a specific discharge capacity of 114.9 mA·h·g^(-1)at current density of 17 mA·g^(-1)),and cycle stability of 99.2%after 100 cycles.The enhanced cycle performance of the as-prepared LiFePO_(4)/C cathode may be attributed to the incorporations of impurities(such as Ca^(2+)and Na^(+))from sludge,with improved stability of crystal structure.Unlike conventional P-fertilizers,this P recovery technology converts 100%of P in CPR sludge into the production of value-added LiFePO_(4)/C cathodes.The recovered P from municipal wastewater can meet up to 35%of the P demand in the Chinese LIBs industry,offering a cost-effective solution for addressing the pressing challenges of P scarcity.
