As the place for gas exchange, the lungs are metabolically active, and their energy consumption are essential for regulating common cell functions and maintaining the unique function of lung tissues to synthesize pulmonary surfactants. The metabolic pathways of pulmonary cells mainly include glycolysis, pentose phosphate pathway, and tricarboxylic acid cycle. Recent studies have found that changes in pulmonary cells metabolism are closely related to a variety of lung diseases. Herein, we review the main pathways of pulmonary cells metabolism and the relationship between changes in cell metabolism and the four lung diseases of chronic obstructive pulmonary disease (COPD), asthma, idiopathic pulmonary fibrosis (IPF), and pulmonary hypertension (PH), to find new ways to treat lung diseases.

Objective:To investigate the therapeutic effect of nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on systemic lupus erythematosus (SLE) patients and its immune function.Methods:Sixty-two patients with systemic lupus erythematosus admitted to Third People′s Hospital of Hangzhou from March 2017 to March 2019 were randomly divided into observation group (31 cases) and control group (31 cases) by random number table. The patients in the control group were treated with prednisone and methotrexate, while the patients in the observation group were treated with nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on the basis of the control group. Both groups were treated for 3 months. The therapeutic effects of the two groups were compared, and the changes of complement C3 and C4, immune function before and after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group [96.77%(30/31) vs.74.19%(23/31)], and there was significant difference ( χ2=6.369, P<0.05). The levels of complement C3 and C4 in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of complement C3 and C4 in two groups were significantly increased ( P<0.05), and the levels of complement C3 and C4 in observation group were significantly higher than those in control group [(1.08 ± 0.15) g/L vs. (0.81 ± 0.13) g/L, (0.24 ± 0.05)g/L vs. (0.18 ± 0.03) g/L], and there were significant differences ( t=7.574, 5.729, P<0.05). The levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups were significantly increased ( P<0.05), and the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in observation group were significantly higher than those in control group [(65.72 ± 5.62)% vs. (58.93 ± 4.25)%, (41.03 ± 1.75)% vs.(38.21 ± 1.43)%, 1.65 ± 0.09 vs.1.41 ± 0.12], and there were significant differences ( t=5.365, 6.948, 8.908, P<0.05). The levels of IgA, IgG and IgM in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of IgA, IgG in two groups were increased, the level of IgM in two groups was decreased, and there were significant differences ( P<0.05). The levels of IgA, IgG in observation group were significantly higher than those in control group [(1.85 ± 0.38) g/L vs. (2.54 ± 0.42) g/L, (12.19 ± 1.63) g/L vs. (14.53 ± 1.37) g/L], and there were significant differences ( t=6.783, 6.119, P<0.05). Conclusions:Nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate in treating SLE is effective, which can effectively improve the levels of complement C3 and C4 and immune function.

Objective:To understand the status quo and influencing factors of evidence-based nursing competencies among oncology nurses and provide a reference for enhancing this competency among oncology nurses.Methods:From September 2022 to January 2023, totally 300 practicing nurses from Zhejiang Cancer Hospital were selected by convenience sampling and surveyed with the Chinese version of the Evidence-Based Practice Belief-Knowledge-Practice Scale. Univariate analysis and multiple linear regression were employed to analyze factors affecting the evidence-based nursing competencies of these nurses.Results:The evidence-based nursing competency scores of the 300 oncology nurses were (44.50±10.78) . Among the three dimensions, the belief dimension had the highest average item score, while the practice dimension had the lowest. Multiple linear regression analysis revealed that gender, age, evidence-based training, participation in evidence-based projects, reading professional literature, publication of papers within the last five years and medical statistical level were influencing factors of their evidence-based nursing competencies (all P<0.05) . Conclusions:The evidence-based nursing competencies of oncology nurses are at a relatively low level. Nursing managers and educators should focus on female nurses, older nurses, intensify evidence-based nursing training efforts, and thus enhance the evidence-based nursing competencies and overall research quality of the nursing team.

Clopidogrel is one of the anti-platelet drugs, which is widely used in the world.It plays an important role in the treatment of patients with acute coronary syndrome and those undergoing percutaneous coronary intervention.Clopidogrel is effective in inhibiting the activity of platelets, decreasing the incidence of thrombosis in the stent, and then reducing the risk of adverse cardiovascular events in affected individuals. However, some patients still have coronary thrombosis after taking clopidogrel.This phenomenon is known as clopidogrel resistance or clopidogrel non-response or low response. Identification of clopidogrel resistance is of great significance in preventing the occurrence of adverse cardiovascular events.This paper provides guidance for the clinical treatment of clopidogrel resistance by discussing the definition, mechanisms and laboratory evaluation of clopidogrel resistance.

Objective:To investigate factors associated with the concentration of hydroxychloroquine (HCQ) and its metabolites in peripheral blood of patients with systemic lupus erythematosus (SLE) who were receiving long-term oral HCQ treatment.Methods:SLE patients who had been taking HCQ for more than 3 months were recruited. Clinical characteristics, laboratory test results and SLE disease activity index (SLEDAI) scores were examined. The concentrations of HCQ and its metabolites from peripheral blood were measured by high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). Student's-test and Nonpara-metric tests were used to compare quantitative data, Chi-square and Fisher's exact tests were used to analyze qualitative data. Correlation between the test results was assessed by correlation coefficient. Variables with P values less than 0.05 in univariate analysis were entered into a logistic regression model. Results:In total, 191 SLE patients on long-term HCQ treatment were included in the analysis. Medians of HCQ blood concentrations ([HCQ]), desethylhydroxychloroquine (DHCQ) blood concentrations ([DHCQ]), desethylchloroquine (DCQ) blood concentrations ([DCQ]) and bisdesethylchloroquine (BDCQ) blood concentrations ([BDCQ]) were 523.19 (402.63, 677.88) ng/ml, 291.79 (212.30, 432.51) ng/ml, 49.37 (35.00, 73.05) ng/ml, 21.78(14.37, 52.46) ng/ml respectively. On multivariate analysis, weight-adjusted oral HCQ dose [ OR(95% CI)=1.366 (1.053, 1.772) , P=0.019], the course of hydroxychloroquine [ OR (95% CI) =0.991 (0.984, 0.999), P=0.026], estimated glomerular filtration rate [ OR(95% CI)=0.984 (0.971, 0.997), P=0.014] and platelet count [ OR (95% CI)=1.010 (1.005, 1.015), P<0.001] were associated with [HCQ]. [HCQ], [DCQ], [BDCQ], [BDCQ]/[HCQ] were negatively correlated with estimated glomerular filtration rate (eGFR) ( r=-0.20, P=0.006; r=-0.19, P=0.010; r=-0.26, P<0.001; r=-0.15, P=0.044, respectively) after adjusted for age, course of disease, duration of HCQ treatment and weight adjusted HCQ dosage, [DHCQ]/[HCQ] was negatively correlated with the SLEDAI score ( r=-0.16, P=0.027) when the effects of glucocorticoid was controlled, [BDCQ]/[HCQ] among different renal function levels was statistically significant ( H=12.46, P=0.014). Conclusion:The factors associated with HCQ blood concentrations in SLE patients on long-term oral HCQ treatment are weight-adjusted HCQ dosage, duration of hydroxychloroquine intake and renal function. In addition, [BDCQ] is closely correlated with renal function, [DHCQ] is correlated with SLE disease activity.

To analyze the positivity rate and titer of antinuclear antibody (ANA), as well as nuclear pattern and target antigen of ANA in healthy pregnant women during early pregnancy in Qingdao area. A prospective cohort study design was used to include a total of 9 528 healthy pregnant women registered at the Women and Children′s Hospital Affiliated to Qingdao University from March 2023 to June 2024.Indirect immunofluorescence assay (IIF) was used to detect ANA, its titer and cell staining pattern. Fifteen specific antibodies were tested using the magnetic bar code immunofluorescent luminescence method. Logistic regression model was used to analyze the risk factors of pregnancy with autoimmune disease(AID). The results showed that among 9 528 pregnant women in early pregnancy, 1 346 cases (14.1%) were positive of ANA, including 1 011 cases with a titer of 1∶100 (10.6%), 236 cases (2.5%) with a titer of 1∶320, and 99 cases (1.0%) were detected at a titer >1∶320. Among the 1 346 ANA-positive pregnant women, nuclear granular type accounted for the highest proportion (483 cases, 35.9%), followed by speckled type (347 cases, 25.8%) and cytoplasmic type (176 cases, 13.1%).Then, pregnant women with ANA titers ≥1∶100 were detected 15 specific antibodies.Anti-SSA was tested in 121 cases accounted for the majority, followed by 110 cases with anti-Ro-52, 56 cases with anti-SSB, 51 cases with anti-mitochondrial M2 subtype antibodies and 37 cases with anti-centromere B. In conclusion,in healthy pregnant women in Qingdao area, ANA positivity rate was 14.1%, and the titer of ANA was mainly at 1∶100.The predominant nuclear patterns were nuclear granular and speckled types.The specific autoantibodies were mainly anti-SSA antibodies and anti-Ro-52 antibodies.The detection of ANA and specific autoantibodies is of great significance for early prediction, diagnosis, and intervention of autoimmune diseases during pregnancy.

To analyze the positivity rate and titer of antinuclear antibody (ANA), as well as nuclear pattern and target antigen of ANA in healthy pregnant women during early pregnancy in Qingdao area. A prospective cohort study design was used to include a total of 9 528 healthy pregnant women registered at the Women and Children′s Hospital Affiliated to Qingdao University from March 2023 to June 2024.Indirect immunofluorescence assay (IIF) was used to detect ANA, its titer and cell staining pattern. Fifteen specific antibodies were tested using the magnetic bar code immunofluorescent luminescence method. Logistic regression model was used to analyze the risk factors of pregnancy with autoimmune disease(AID). The results showed that among 9 528 pregnant women in early pregnancy, 1 346 cases (14.1%) were positive of ANA, including 1 011 cases with a titer of 1∶100 (10.6%), 236 cases (2.5%) with a titer of 1∶320, and 99 cases (1.0%) were detected at a titer >1∶320. Among the 1 346 ANA-positive pregnant women, nuclear granular type accounted for the highest proportion (483 cases, 35.9%), followed by speckled type (347 cases, 25.8%) and cytoplasmic type (176 cases, 13.1%).Then, pregnant women with ANA titers ≥1∶100 were detected 15 specific antibodies.Anti-SSA was tested in 121 cases accounted for the majority, followed by 110 cases with anti-Ro-52, 56 cases with anti-SSB, 51 cases with anti-mitochondrial M2 subtype antibodies and 37 cases with anti-centromere B. In conclusion,in healthy pregnant women in Qingdao area, ANA positivity rate was 14.1%, and the titer of ANA was mainly at 1∶100.The predominant nuclear patterns were nuclear granular and speckled types.The specific autoantibodies were mainly anti-SSA antibodies and anti-Ro-52 antibodies.The detection of ANA and specific autoantibodies is of great significance for early prediction, diagnosis, and intervention of autoimmune diseases during pregnancy.

Objective to explore the use of performance management as a lever in public hospitals to achieve quality improvement,efficiency enhancement,and high-quality development under the dual influences of na-tional civil service examination and Diagnosis-Related Groups(DRGs)payment policy reform.Methods A questionnaire survey was conducted to summarize the current situation and problems of performance assessment in public hospitals in China.Based on the identified problems,an upgraded performance management system was proposed,and key indicators were selected through a case study in a specific hospital.Results An empirical study in a specific hospital demonstrated the positive effects of the upgraded performance management system on hospital management improvement.Conclusion Public hospitals should establish a long-term mechanism for performance management,focusing on organizational positioning,indicator design,management levers,and talent development,to continuously support high-quality development.

The human brain undergoes rapid development during childhood, with significant improvement in a wide spectrum of cognitive and affective functions. Mapping domain- and age-specific brain activity patterns has important implications for characterizing the development of children’s cognitive and affective functions. The current mainstay of brain templates is primarily derived from structural magnetic resonance imaging (MRI), and thus is not ideal for mapping children’s cognitive and affective brain development. By integrating task-dependent functional MRI data from a large sample of 250 children (aged 7 to 12) across multiple domains and the latest easy-to-use and transparent preprocessing workflow, we here created a set of age-specific brain functional activity maps across four domains: attention, executive function, emotion, and risky decision-making. Moreover, we developed a toolbox named Developmental Brain Functional Activity maps across multiple domains that enables researchers to visualize and download domain- and age-specific brain activity maps for various needs. This toolbox and maps have been released on the Neuroimaging Informatics Tools and Resources Clearinghouse website (http://www.nitrc.org/projects/dbfa). Our study provides domain- and age-specific brain activity maps for future developmental neuroimaging studies in both healthy and clinical populations.

Drug-associated reward memories are conducive to intense craving and often trigger relapse. Simvastatin has been shown to regulate lipids that are involved in memory formation but its influence on other cognitive processes is elusive. Here, we used a mass spectrometry-based lipidomic method to evaluate the impact of simvastatin on the mouse brain in a cocaine-induced reinstatement paradigm. We found that simvastatin blocked the reinstatement of cocaine-induced conditioned place preference (CPP) without affecting CPP acquisition. Specifically, only simvastatin administered during extinction prevented cocaine-primed reinstatement. Global lipidome analysis showed that the nucleus accumbens was the region with the greatest degree of change caused by simvastatin. The metabolism of fatty-acids, phospholipids, and triacylglycerol was profoundly affected. Simvastatin reversed most of the effects on phospholipids induced by cocaine. The correlation matrix showed that cocaine and simvastatin significantly reshaped the lipid metabolic pathways in specific brain regions. Furthermore, simvastatin almost reversed all changes in the fatty acyl profile and unsaturation caused by cocaine. In summary, pre-extinction treatment with simvastatin facilitates cocaine extinction and prevents cocaine relapse with brain lipidome remodeling.