International Journal of General Practice Nursing

Network Pharmacology and Molecular Dynamics Simulation Study on the Mechanism of Wuda Jiangjun Ointment in Treating Chronic Lumbar Muscle Strain

Yuming Zhang — 2026-04-03

Objective: To investigate the mechanism of Wuda Jiangjun Ointment in treating chronic lumbar muscle strain based on network pharmacology and molecular dynamics simulation. Methods: Active components of Wuda Jiangjun Ointment were identified using the TCMSP database, HERB database, and a review of relevant literature. SwissTarget Prediction, GeneCards, and OMIM databases were employed to predict targets related to chronic lumbar muscle strain. The intersection of drug and disease targets was obtained using the bioinformatics platform and imported into the STRING database to construct a protein-protein interaction (PPI) network. Cytoscape 3.10.2 software was used to visualize the PPI network and perform topological analysis to screen core targets. Functional enrichment analysis of GO and KEGG pathways for the intersecting targets was conducted using the DAVID database. A "drug-active component-disease-target" network diagram was constructed using Cytoscape 3.10.2. Molecular docking was performed using AutoDock software to simulate the binding of active components to target proteins. Furthermore, the Amber 24 software package was utilized to evaluate the binding stability between target proteins and active components. Results: A total of 75 active components and 350 corresponding potential targets of Wuda Jiangjun Ointment were screened, along with 2,159 disease targets for chronic lumbar muscle strain. There were 192 intersecting targets between the active components and the disease. Topological analysis of the PPI network identified TP53, AKT1, STAT3, etc., as core targets. Topological analysis of the "drug-active component-disease-target" network identified quercetin, dehydropipernonaline, tomentosin A, etc., as key components. GO and KEGG enrichment analyses indicated that the key pathways were primarily involved in the IL-17 signaling pathway, the AGE-RAGE signaling pathway in diabetic complications, and cellular senescence. Thus, the therapeutic mechanism was predicted to be related to inflammatory responses, among others. Molecular docking and molecular dynamics simulations verified that the core target proteins and active components exhibited good binding affinity. Conclusion: Wuda Jiangjun Ointment exerts anti-inflammatory effects and treats chronic lumbar muscle strain by participating in biological processes such as inflammatory responses through multiple components, targets, and pathways. This study provides a basis for further research into the molecular mechanisms.

Application of Airway Clearance Combined with Postural Care in Patients with Severe Traumatic Brain Injury

Qiang Wang — 2026-05-31

Objective: To explore the systemic changes in respiratory function, the progression of pulmonary complications, and the potential for neurological recovery in patients with severe traumatic brain injury (sTBI) when applying an integrated approach that combines systematic airway clearance techniques with posture adjustment guided by cranial-cerebral physiological data. Methods: A total of 104 eligible sTBI patients were randomly assigned to a study group receiving integrated intervention (54 cases) and a control group receiving standard care (50 cases). Standard care followed general guidelines for neurocritical care, while the integrated intervention group underwent an additional comprehensive procedure: twice-daily airway clearance including positioning percussion, high-frequency vibration drainage, and image-guided pulmonary drainage, along with individualized progressive posture adjustments (such as phased elevation of the head of the bed and selective lateral positioning under image guidance) based on continuous monitoring of intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Oxygenation index (PaO₂/FiO₂), respiratory mechanics parameters (plateau pressure, lung compliance), incidence of clinical pulmonary infection (CPIS criteria), duration of antimicrobial agent use, length of stay in the intensive care unit (ICU), and Glasgow Outcome Scale (GOS) at day 28 were evaluated and compared between the two groups before intervention, and on days 3 and 7. Results: By day 7 of intervention, the oxygenation index and lung compliance measurements in the study group were significantly higher than those in the control group (P<0.01). The proportion of patients with clinical pneumonia and the constituent ratio of severe pneumonia (CPIS≥8) in the study group were significantly reduced (P<0.05). The median duration of mechanical ventilation and the median length of ICU stay in the study group were shorter than those in the control group (P<0.01). The 28-day outcome assessment showed that the proportion of patients with favorable recovery outcomes (GOS 4–5) in the study group was higher than that in the control group (P<0.05). Conclusion: Implementing an integrated approach that combines structured airway maintenance with intracranial pressure-based posture control can effectively promote the recovery of pulmonary gas exchange efficiency in sTBI patients and reduce mechanical ventilation-related stress injury to lung tissue.

Impact of Standardized Anticoagulation Management Optimization on the Operational Quality and Clinical Outcomes of Continuous Renal Replacement Therapy

Hongfei Deng — 2026-05-31

Objective: To evaluate the impact of optimizing a standardized anticoagulation management protocol on the operational quality of continuous renal replacement therapy (CRRT) and related clinical outcomes. Methods: This was a single-center retrospective quality improvement study. Adult patients who underwent CRRT for ≥24 hours in the Intensive Care Unit of Linfen People’s Hospital between 2023 and 2025 were included. According to the implementation stages of the optimized anticoagulation management protocol, patients were divided into three annual groups. The distribution of anticoagulation strategies, filter lifespan per session, incidence of unplanned circuit interruption, bleeding complications, and ICU length of stay were compared among the three groups. Results: A total of 289 patients were included. With the implementation of the standardized anticoagulation management protocol, the proportion of regional citrate anticoagulation increased from 45.5% in 2023 to 83.5% in 2025. Filter lifespan was significantly prolonged (45.3 ± 12.1 h vs 72.4 ± 11.6 h, P < 0.001), while the incidence of unplanned circuit interruption and bleeding complications decreased over time (both P < 0.05). ICU length of stay also showed a downward trend (P = 0.009). Conclusion: The establishment and implementation of a CRRT-centered standardized anticoagulation management protocol were associated with prolonged filter lifespan, reduced complication rates, and improved operational quality of CRRT. This management approach may enhance the safety of blood purification therapy in critically ill patients in the ICU.

Application of Quality Control Circle Activities in Improving the Standardization Rate of Robot-Assisted Pancreaticoduodenectomy Cooperation Among Rotating Nurses in the Operating Room

Yanshan Zhang — 2026-05-31

This study aimed to explore the effect of Quality Control Circle (QCC) activities on improving the standardization rate of robot-assisted pancreaticoduodenectomy cooperation among rotating nurses in the operating room. A total of 26 surgeries were divided into the control group (13 cases, routine mode) and the observation group (13 cases, QCC mode) based on time. With the PDCA cycle, targeted quality improvement was conducted. Results showed that the cooperation standardization rate in the observation group increased from 77.88% to 97.76%, preoperative instrument preparation time shortened from (15.3±2.1) min to (8.5±1.2) min, and error incidence dropped from 15.38% to 1.54% (P<0.05). Medical-nursing satisfaction also improved significantly. QCC can effectively standardize cooperation, optimize surgery flow, and enhance satisfaction, providing a feasible scheme for nursing quality control in complex robotic surgeries.

Tracing the Trajectory: The Evolutionary Application and Optimisation of Blended Learning Models in Psychiatric Nursing

Qingjie Ma — 2026-05-31

Objective: To review the current application status of online-offline blended teaching in psychiatric nursing courses, clarify the theoretical foundations, practical key points, and existing challenges of this teaching model, and provide references for the reform of psychiatric nursing course teaching. Methods: Systematically summarize relevant research on the blended teaching model in psychiatric nursing, focusing on core content such as model development, practical implementation, teaching effectiveness, and challenges encountered. Analyze experiences and problems in course design, implementation pathways, and the transformation of teacher and student roles both domestically and internationally. Results: Blended teaching can effectively enhance the theoretical knowledge level, clinical skill operation ability, and humanistic care literacy of psychiatric nursing students. However, in practical application, it faces challenges such as difficulties in integrating course content, imperfect technical support systems, and insufficient teacher training. Conclusion: Blended teaching is an innovative teaching model suitable for the characteristics of psychiatric nursing courses. It is necessary to address existing challenges specifically to promote the continuous optimization and widespread adoption of this model in the field of psychiatric nursing education.

Application Research of Virtual Cases Based on Generative AI (such as Large Language Models) in Clinical Reasoning Teaching for General Practitioner Training Programs

Wei Zhao — 2026-05-31

This article elucidates that generative AI virtual cases offer advantages such as abundant resources, strong interactivity, and timely feedback. By implementing application approaches—including establishing virtual case repositories, conducting scenario simulations, developing evaluation systems, and training instructors—it can effectively enhance the clinical reasoning abilities of general practice residency trainees, thereby providing a novel model and methodology for general practice education.

Analysis of Existing Problems and Improvement Countermeasures in Practical Teaching of Higher Vocational Nursing

Qing Gao — 2026-05-31

Practical teaching of high vocational nursing programs is essential for the cultivation of high-tech talents. Teaching and practicing are separated from clinical practice, which is currently a problem of insufficient training grounds, a lack of practical teaching skills by staff who teach the courses, and this severely restricts the output of talent with competence. The principal difficulties that cause such matters have a curriculum which is outdated compared with the work needed, as well as an unsatisfactory collaboration between schools and hospitals, which results in too simple ways of evaluating students’ skills. This paper puts forward some ideas about making improvements to jobs based on abilities, integrating theories and actions, and developing skills bit by bit. Modular course content restructuring is required, double-certification faculty teams need to be built, and advanced simulation training sites must be set up. To improve on all those by enhancing the operations of the school-hospital collaborations, putting in place multiple different types of evaluations, setting aside resources for investments, which will be constantly monitored. Countermeasures are proposed to systematically increase the level of practical teaching, so as to improve students’ clinical adaptability and career growth possibilities.

Development of a Risk Warning Factor Assessment Scale for Malnutrition in Stroke Recovery Patients

Zhenzhen Rao — 2026-05-31

Objective: To develop a risk warning factor assessment scale for malnutrition in patients during the recovery phase of stroke, providing a basis for evaluating malnutrition risk in this population. Methods: Literature review and group discussions were initially used to screen potential risk factors for malnutrition in stroke recovery patients. The modified Delphi method was then employed to finalize the risk factor assessment scale. From 1st April 2022 to 1st June 2022, two rounds of expert consultations were conducted via WeChat, face-to-face interviews, and email. Data from the experts’ ratings and modification suggestions for each item were recorded using Excel 2013, and statistical analysis was performed using SPSS 26.0 to determine the final risk warning factor assessment scale. Results: Two rounds of expert consultations were completed, with response rates (active coefficients) of 96% and 100%, respectively. The judgment basis (Ca) for the two rounds was 0.926 and 0.933, familiarity (Cs) scores were 0.800 and 0.808, and authority coefficients (Cr) were 0.863 and 0.871. The Kendall’s W values for importance in the two rounds were 0.192 and 0.154 (both P < 0.001), while the Kendall’s W values for correlation were 0.071 and 0.061 (both P < 0.05), indicating consistency in the experts’ evaluations of the indicators. The item-level content validity index (I-CVI) ranged from 0.875 to 1.000, and the scale-level content validity index (S-CVI) was 0.977, demonstrating good content validity of the assessment scale. The final risk factor assessment scale consisted of 38 items across three dimensions. Conclusion: The developed malnutrition risk assessment scale for stroke recovery patients exhibits good scientific rigor and practicality, providing a reference for identifying malnutrition risks in this population.

Research on the Current Situation and Improvement Methods of First-Aid Skill Practical Teaching for Higher Vocational Nursing

Haitong Xu — 2026-05-31

First aid skills are a major part of the professional competence of high vocational nursing talent. The quality of practical teaching directly relates to how many people who will be working with sick people can fix someone else’s problems and save them. Now, with higher vocational nursing first aid practice teaching still has some shortcomings with what is covered in the courses, who is doing the teaching, and having all the necessary tools and resources available for students, as well as an evaluation of students’ and teachers’ performance, that kind of thing would be holding back raising these students’ working abilities. Based on a thorough investigation into current teaching, the study identifies problem situations and reasons within, offering tangible solutions concerning curriculum organization changes and innovative teaching techniques, along with improved standards for evaluations. And support mechanisms, like institutional guarantee, medical education cooperation, resource investment, and so on, are also discussed to offer more ideas about changing first aider practical training for university nursing.

Exercise Intervention for Depression from the Perspective of Gut Microbiota Dysbiosis: A Review

Xiaotong Liu — 2026-05-31

Depression is a mental disorder with a complex pathogenesis. In recent years, the “gut-brain axis” theory has revealed the key role of gut microbiota dysbiosis in its development. Studies have shown that exercise can effectively improve gut microbiota dysbiosis and alleviate depressive symptoms. From the perspective of gut microbiota dysbiosis, this paper systematically explores the potential mechanisms of exercise in preventing and treating depression. The paper reviews how exercise intervenes in neurotransmitter pathways and HPA axis function through multiple dimensions, such as regulating microbial structure, inhibiting the proliferation of pro-inflammatory bacteria, and promoting the synthesis of short-chain fatty acids. Combined with the traditional Chinese medicine (TCM) theory of “Yu syndrome”, the article proposes an integrated prevention and treatment approach of “exercise—gut microbiota—brain function.” Finally, it looks forward to future research directions.

Current Status and Influencing Factors of Cardiovascular and Metabolic Comorbidities in Ischemic Stroke Patients

Hui Yang — 2026-05-31

This study aims to explore the epidemiological characteristics, influencing factors, and specific impacts on clinical prognosis of cardiometabolic multimorbidity (CMC) in patients with ischemic stroke. By analyzing the clinical data of 864 hospitalized patients with ischemic stroke, the study found that CMC is highly prevalent in this population, with an overall prevalence of 68.29%, among which hypertension, dyslipidemia, and diabetes mellitus are the most common types of comorbidities. Multivariable Logistic regression analysis revealed that advanced age, smoking, high salt intake, and lower socioeconomic status are key risk factors for the occurrence of CMC. Regarding the impact on prognosis, this study confirmed that the CMC status significantly increases the risk of the first stroke occurrence, which grows exponentially with the number of metabolic abnormalities. Follow-up data showed that the one-year recurrence rate in the CMC group (15.68%) was significantly higher than that in the non-CMC group (9.24%). Furthermore, patients with CMC exhibited more severe neurological deficits during the acute phase and slower recovery of long-term activities of daily living. Based on these findings, the study proposes the construction of a full-chain management system ranging from primary prevention to intensive secondary prevention, emphasizing the central role of the Multidisciplinary Team (MDT) model in improving the prognosis of patients with complex multimorbidity. This study provides important evidence-based medical grounds for optimizing clinical management pathways and public health prevention strategies for stroke patients in China.

Construction and Application of a “Five- Proactive” Predictive Nursing Management System in A Tertiary Hospital: A Practice Innovation for High-Quality Development

Na Wang — 2026-05-31

Background: Under the National Health Commission’s Further Improvement of Nursing Service Action Plan (2023–2025) and the context of high-quality development in public hospitals, traditional reactive nursing models have shown limitations in patient safety and quality outcomes. Objective: To develop and implement a predictive nursing management system integrating “Prediction–Early Warning–Prevention–Emergency Response” and a supporting “Five-Prevention System” (risk prediction, safety early warning, proactive prevention, emergency preparedness, and practical simulation). Methods: Taihe Hospital, a large tertiary hospital in Shiyan, China, systematically introduced a predictive nursing model starting in 2024. Interventions included tiered training (14 themes, 648 sessions, 19,622 nurse attendances), information technology upgrades (I-EWS, tri‑color risk warning system), risk stratification (unit/nurse manager/nurse levels), performance incentives, and regular emergency drills. Outcome indicators included adverse event reporting, complication rates, length of stay, and patient/nurse satisfaction. Results: After implementation, the proportion of reported grade‑IV adverse events significantly increased (indicating earlier detection of potential risks). Elective surgery complication rates, unplanned readmission rates, and average length of stay all decreased. Nurse professional value and patient satisfaction improved markedly. Several serious adverse events (e.g., postoperative neck hematoma leading to airway compression) were prevented through early warning and intervention. Conclusions: The predictive nursing “Five‑Prevention System” is feasible and effective in shifting nursing practice from reactive to proactive, improving patient safety and nurse empowerment. The model provides a replicable pathway for nursing management transformation in large public hospitals.