Objective:To compare the efficacy and safety of Rotarex mechanical thrombectomy (Rotarex) combined with drug-coated balloon (DCB) versus percutaneous transluminal angioplasty (PTA) combined with DCB in the treatment of femoropopliteal artery in-stent restenosis (ISR).Methods:A multicenter, prospective, randomized controlled trial was conducted. 46 patients with femoropopliteal artery ISR admitted to five hospitals (Beijing Friendship Hospital, Capital Medical University; Beijing Chaoyang Hospital, Capital Medical University; Beijing Jishuitan Hospital, Capital Medical University; Xuanwu Hospital, Capital Medical University; Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University) from July 2020 to June 2024 were enrolled. Patients were randomly divided into the Rotarex+ DCB group ( n=24) and the PTA+ DCB group ( n=22) using a random number table. The clinical data of the two groups were collected, including clinical characteristics, Fontaine classification, stent placement location, stent duration, and lesion length. The primary endpoint was the target blood vessel patency rate at 6 and 12 months postoperatively; the secondary endpoints included improvement in clinical symptoms (Fontaine classification), rate of reintervention, and safety indicators. Measurement data were expressed as mean±standard deviation ( ± s), and the t-test was used for comparison between groups; count data were expressed as the number of cases and percentages, and intergroup comparisons were performed using the Chi-test or Fisher exact probability method. Results:At 12 months postoperatively, the target blood vessel patency rate in the Rotarex+ DCB group was significantly higher than that in the PTA+ DCB group (81.8% vs 45.5%, P=0.012), and the proportion of patients in Fontaine classification stage I was also higher (86.4% vs 45.5%, P=0.004). The results at the 6-month follow-up were consistent (target blood vessel patency rate: 87.0% vs 59.1%, P=0.035). In terms of safety, no severe complications such as arterial rupture, amputation, or procedure-related death occurred during the perioperative period in either group. During the postoperative follow-up, no amputation or procedure-related deaths occurred in either group. Conclusion:For the treatment of femoropopliteal artery ISR, Rotarex mechanical thrombectomy combined with DCB is significantly superior to PTA+ DCB in terms of 12-month target blood vessel patency rate and improvement of clinical symptoms, with comparable safety.

Objective This study aims to investigate the current status and determinants of compassion fatigue symptoms among orthopedic nurses,and to analyze the interrelationships among these determinants to provide references for targeted intervention development.Methods From May to June 2024,a convenience sampling method was employed to recruit orthopedic nurses from 20 tertiary hospitals across 14 provinces and cities in China.The survey instruments encompassed the general demographic information sheet,the Compassion Fatigue Scale,the Social Support Rating Scale,the Nurses' Psychological Capital Questionnaire,and the Professional Identity Questionnaire.The data were analyzed using univariate analysis,Spearman correlation analysis,and multiple linear regression analysis.A structured equation model was also developed.Results Totally 1 397 valid questionnaires were collected,and the effective response rate was 96.94％(1 397/1 441).The average score of compassion fatigue symptoms was 47.41±12.16.The multiple linear regression analysis indicated that professional identity,social support,psychological capital,length of service,and frequency of night shifts per week were independent determinants of compassion fatigue symptoms(P＜0.05).The path analysis demonstrated a good fit with the specified indicators.Psychological capital exhibited a direct mediating effect on compassion fatigue symptoms(β=-0.15,P＜0.05).Furthermore,professional identity(β=1.46,P＜0.001;β=-0.38,P＜0.001)and social support(β=0.14,P＜0.001;β=-0.99,P＜0.001)served as mediators in the relationship between psychological capital and compassion fatigue symptoms.Conclusion The compassion fatigue symptoms among orthopedic nurses are relatively severe.It is imperative for nursing managers to address associated factors of compassion fatigue symptoms among orthopedic nurses and implement effective preventive strategies to mitigate its level.

Objective This study aims to investigate the current status and determinants of compassion fatigue symptoms among orthopedic nurses,and to analyze the interrelationships among these determinants to provide references for targeted intervention development.Methods From May to June 2024,a convenience sampling method was employed to recruit orthopedic nurses from 20 tertiary hospitals across 14 provinces and cities in China.The survey instruments encompassed the general demographic information sheet,the Compassion Fatigue Scale,the Social Support Rating Scale,the Nurses' Psychological Capital Questionnaire,and the Professional Identity Questionnaire.The data were analyzed using univariate analysis,Spearman correlation analysis,and multiple linear regression analysis.A structured equation model was also developed.Results Totally 1 397 valid questionnaires were collected,and the effective response rate was 96.94％(1 397/1 441).The average score of compassion fatigue symptoms was 47.41±12.16.The multiple linear regression analysis indicated that professional identity,social support,psychological capital,length of service,and frequency of night shifts per week were independent determinants of compassion fatigue symptoms(P＜0.05).The path analysis demonstrated a good fit with the specified indicators.Psychological capital exhibited a direct mediating effect on compassion fatigue symptoms(β=-0.15,P＜0.05).Furthermore,professional identity(β=1.46,P＜0.001;β=-0.38,P＜0.001)and social support(β=0.14,P＜0.001;β=-0.99,P＜0.001)served as mediators in the relationship between psychological capital and compassion fatigue symptoms.Conclusion The compassion fatigue symptoms among orthopedic nurses are relatively severe.It is imperative for nursing managers to address associated factors of compassion fatigue symptoms among orthopedic nurses and implement effective preventive strategies to mitigate its level.

Objective To identify the potential immune biomarkers of critical limb ischemia(CLI)in patients with diabetes.Methods From January 2018 to December 2023,102 patients who were definitely diagnosed as CLI and diabetes foot ulcers(DFU)requiring percutaneous transluminal angioplasty and foot surgery were enrolled.Serum levels of 18 cellular immune and inflammatory factors including soluble CD40 ligand(sCD40L),IFN-α,IFN-γ,IL-2,IL-4,IL-6,IL-8,IL-10,IL-13,IL-18,et cetera,were measured in these patients.Results The levels of circulating serum sICAM-1 and endothelin-1 showed a negative correlation with the recovery of DFU.Moreover,PAI-1 and endothelin-1 were related to the demand for neovascular reconstruction.The circulating serum levels of thrombomodulin and sCD40L were associated with new and recurrent lesions.Conclusion The level of circulating biomarkers related to the immunity of vascular endothelial cell can be used to predict the risk of new or recurrent CLI in patients with diabetes.

Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

Objective To identify the potential immune biomarkers of critical limb ischemia(CLI)in patients with diabetes.Methods From January 2018 to December 2023,102 patients who were definitely diagnosed as CLI and diabetes foot ulcers(DFU)requiring percutaneous transluminal angioplasty and foot surgery were enrolled.Serum levels of 18 cellular immune and inflammatory factors including soluble CD40 ligand(sCD40L),IFN-α,IFN-γ,IL-2,IL-4,IL-6,IL-8,IL-10,IL-13,IL-18,et cetera,were measured in these patients.Results The levels of circulating serum sICAM-1 and endothelin-1 showed a negative correlation with the recovery of DFU.Moreover,PAI-1 and endothelin-1 were related to the demand for neovascular reconstruction.The circulating serum levels of thrombomodulin and sCD40L were associated with new and recurrent lesions.Conclusion The level of circulating biomarkers related to the immunity of vascular endothelial cell can be used to predict the risk of new or recurrent CLI in patients with diabetes.

Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.

Objective:To establish a nurse-led admission standard system for fracture liaison service coordinators based on the Delphi method.Methods:From January to June 2023, using the onion model as the theoretical framework, a preliminary evaluation system for the admission criteria of fracture liaison service liaison coordinator led by nurses was formulated through literature search and expert group discussions. Using purposive sampling method, a total of 18 experts were selected for 2 rounds of questionnaire inquiry to evaluate the importance of the indicator system.Results:The response rates of the two rounds of inquiry questionnaires were both 100.00% (18/18), with the expert authority coefficients of 0.859 and 0.873. The Kendall harmony coefficients of various levels and overall indicators were 0.257 to 0.367 (all P<0.01). The final version of the fracture liaison service coordinator admission standard system included four primary indicators, 23 secondary indicators and 59 tertiary indicators. Conclusions:The experts' opinions on the admission criteria system for fracture liaison service coordinators constructed based on the onion model as the theoretical framework in this study are concentrated, which has high scientificity and reliability, and can provide scientific basis for the selection of fracture liaison service coordinators in China.

Objective:To explore the direct impact of self-efficacy on the sense of personal mastery and the indirect impact mediated by uncertainty in illness in aged patients with chronic heart failure (CHF), and provide a theoretical basis for developing interventions to improve the sense of personal mastery in this patient population.Methods:Totally 240 aged CHF patients hospitalized in the Department of Geriatrics at the China-Japan Union Hospital of Jilin University from January to November 2023 were selected by convenience sampling. They were surveyed using the Personal Mastery Scale (PMS), the Mishel Uncertainty in Illness Scale (MUIS), and the General Self-Efficacy Scale (GSES). The Bootstrap method was employed to test the mediating effect of uncertainty in illness between self-efficacy and the sense of personal mastery.Results:A total of 240 questionnaires were distributed, with 221 valid responses collected, yielding a response rate of 92.08%. The total score for the PMS was (21.49±5.92), the total score for the MUIS was (75.00±20.94), and the total score for the GSES was (21.15±6.10). Mediating effect analysis showed that the total effect of self-efficacy on the sense of personal mastery was 0.557 (95% CI: 0.438-0.659; P=0.001) ; the direct effect was 0.311 (95% CI: 0.157-0.455; P=0.001) ; and the indirect effect through uncertainty in illness was 0.246 (95% CI: 0.169-0.344; P<0.001). Uncertainty in illness partially mediated the relationship between self-efficacy and the sense of personal mastery, accounting for 44.17% of the total effect. Conclusions:The sense of personal mastery in aged CHF patients is relatively low. Clinical healthcare providers should implement interventions to enhance patients' self-efficacy and reduce uncertainty in illness, thereby improving their sense of personal mastery.