MicroRNA(miRNA)serves as a novel regulatory factor in viral and bacterial co-infections,exhibiting dual regulatory roles during pathogen infections.On the one hand,it exerts protective effects by modulating viral replication cycles and host anti-infection immune responses.On the other hand,it can be exploited by pathogens to promote infection progression,including influencing viral replication,antiviral immune responses,and regulating bacterial adhesion and proliferation.Mixed viral and bacterial infections lead to high mortality rates.By binding to specific target gene mRNA,miRNA degrades or inhibits its translation,thereby regulating target gene expres-sion,which may ultimately serve as potential diagnostic and therapeutic targets.This paper reviews recent ad-vances in research on the role of miRNA in viral and bacterial infections,particularly its mechanisms in co-infec-tions,aiming to provide theoretical reference for further research on the infection mechanisms.

Objective:To evaluate the relationship between the neutrophil-to-lymphocyte ratio (NLR) during the perioperative period and early postoperative recurrence in patients with advanced gastric cancer.Methods:In this prospective study, 188 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-75 yr, with a body mass index of 20-30 kg/m 2, with radiological staging of T 2-4N xM 0, underwent elective gastric cancer radical surgery under general anesthesia at the Fourth Hospital of Hebei Medical University from January 2018 to April 2022, were selected. The NLR was measured at 1 day before operation and postoperative days 1, 3 and 5. The difference between postoperative and preoperative NLR (ΔNLR) was calculated. Based on the presence or absence of tumor recurrence and/or metastasis within 2 yr after surgery, the patients were divided into recurrence group and non-recurrence group. The Cox proportional hazards regression model was employed to evaluate the early postoperative recurrence and perioperative NLR in patients with advanced gastric cancer. Results:A total of 171 patients ultimately completed the follow-up. There were 77 cases in recurrence group and 94 in non-recurrence group. Compared to non-recurrence group, NLR and ΔNLR were significantly increased on the 5th day after operation in recurrence group ( P<0.05). The elevated NLR and ΔNLR at postoperative day 5 were independent risk factors for recurrence within 2 yr in patients with advanced gastric cancer ( HR=1.026, P<0.05). Conclusions:NLR may not be associated with the risk of early postoperative recurrence in the patients with advanced gastric cancer, and further evaluation with large-scale studies is needed.

Objective:To investigate the effect of the transfer of blastocysts that have not re-expanded after 2-4 h of thawing on pregnancy and neonatal outcomes.Methods:A retrospective cohort study was performed to analyze the clinical data from 2 428 vitrified frozen-thawed single blastocyst transfer cycles at the Reproductive Medicine Center of the 901st Hospital of the Joint Logistics Support Force of PLA between January 2015 and March 2024. Based on the re-expansion status of the blastocoel cavity after thawing, the cycles were divided into group A (110 non-re-expanded) and group B (2 318 re-expanded). After propensity score matching, there were 109 cycles in each group. Pregnancy and neonatal outcomes between the two groups were compared.Results:Before propensity score matching, there were statistical differences in percentage of good-quality blastocyst transfer, percentage of degree 4 blastocyst, percentage of endometriosis and others in reasons for infertility between the two groups (all P<0.05). After propensity score matching, there were no statistical differences in baseline characteristics between the two groups (all P>0.05). The clinical pregnancy rate [27.52% (30/109)], the ongoing pregnancy rate [21.10% (23/109)] and the live birth rate [19.27% (21/109)] in group A were all significantly lower than those in group B [61.47% (67/109), 51.38% (56/109), 47.70% (52/109), all P<0.001]. Neonatal outcomes showed no statistically significant differences between the two groups in terms of birth weight, neonatal length, malformation rate, monozygotic twin rate and male neonatal rate (all P>0.05). Conclusion:Transfer of non-re-expanded blastocysts after thawing may reduce clinical pregnancy rate but does not negatively affect neonatal outcomes.

Objective:To investigate the effect of the transfer of blastocysts that have not re-expanded after 2-4 h of thawing on pregnancy and neonatal outcomes.Methods:A retrospective cohort study was performed to analyze the clinical data from 2 428 vitrified frozen-thawed single blastocyst transfer cycles at the Reproductive Medicine Center of the 901st Hospital of the Joint Logistics Support Force of PLA between January 2015 and March 2024. Based on the re-expansion status of the blastocoel cavity after thawing, the cycles were divided into group A (110 non-re-expanded) and group B (2 318 re-expanded). After propensity score matching, there were 109 cycles in each group. Pregnancy and neonatal outcomes between the two groups were compared.Results:Before propensity score matching, there were statistical differences in percentage of good-quality blastocyst transfer, percentage of degree 4 blastocyst, percentage of endometriosis and others in reasons for infertility between the two groups (all P<0.05). After propensity score matching, there were no statistical differences in baseline characteristics between the two groups (all P>0.05). The clinical pregnancy rate [27.52% (30/109)], the ongoing pregnancy rate [21.10% (23/109)] and the live birth rate [19.27% (21/109)] in group A were all significantly lower than those in group B [61.47% (67/109), 51.38% (56/109), 47.70% (52/109), all P<0.001]. Neonatal outcomes showed no statistically significant differences between the two groups in terms of birth weight, neonatal length, malformation rate, monozygotic twin rate and male neonatal rate (all P>0.05). Conclusion:Transfer of non-re-expanded blastocysts after thawing may reduce clinical pregnancy rate but does not negatively affect neonatal outcomes.

Objective:To explore the effect of Swanson theory combined with hand touch on the existential distress of patients with advanced lung cancer, in order to provide reference for clinical humanistic care.Methods:A non synchronous controlled study was conducted using convenience sampling to select advanced lung cancer patients admitted to the Oncology Department of the First People's Hospital of Yongkang City, Zhejiang Province from October 2023 to March 2024 as the control group, and advanced lung cancer patients admitted from April to October 2024 as the experimental group. The control group received routine care, while the experimental group received Swanson theory combined with hand touch intervention on the basis of routine care. The Existential Distress Scale (EDS) and Functional Assessment of Cancer Therapy- General (FACT-G) scores of the two groups were compared before and 2 weeks after intervention.Results:During the study period, there were 3 dropouts in the experimental group and 2 dropouts in the control group. Finally, 37 cases were included in the experimental group, including 16 males and 21 females, with an age of (62.35 ± 12.13) years. There were 38 cases in the control group, including 25 males and 13 females, with an age of (65.68 ± 13.46) years. After 2 weeks of intervention, the EDS score of the experimental group patients was (6.65 ± 2.89) points, while that of the control group was (8.16 ± 2.27) points. The difference between the two groups was statistically significant ( t = 2.52, P<0.05). After intervention, the social/family status dimension, emotional status dimension, and total score of FACT-G in the experimental group were (15.35 ± 4.18), (19.27 ± 3.54), and (57.46 ± 14.69) points, respectively, which were better than the control group's (13.08 ± 3.77), (16.53 ± 3.88), and (50.58 ± 11.86) points. The difference between the two groups was statistically significant ( t = - 2.47, - 3.20, - 2.24, all P<0.05). Conclusions:The combination of Swanson theory and hand touch can effectively reduce the existential distress of patients with advanced lung cancer, improve their quality of life, and embody the concept of nursing humanistic care into simple and safe intervention measures, providing reference for clinical humanistic care.

Objective:To evaluate the relationship between the neutrophil-to-lymphocyte ratio (NLR) during the perioperative period and early postoperative recurrence in patients with advanced gastric cancer.Methods:In this prospective study, 188 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-75 yr, with a body mass index of 20-30 kg/m 2, with radiological staging of T 2-4N xM 0, underwent elective gastric cancer radical surgery under general anesthesia at the Fourth Hospital of Hebei Medical University from January 2018 to April 2022, were selected. The NLR was measured at 1 day before operation and postoperative days 1, 3 and 5. The difference between postoperative and preoperative NLR (ΔNLR) was calculated. Based on the presence or absence of tumor recurrence and/or metastasis within 2 yr after surgery, the patients were divided into recurrence group and non-recurrence group. The Cox proportional hazards regression model was employed to evaluate the early postoperative recurrence and perioperative NLR in patients with advanced gastric cancer. Results:A total of 171 patients ultimately completed the follow-up. There were 77 cases in recurrence group and 94 in non-recurrence group. Compared to non-recurrence group, NLR and ΔNLR were significantly increased on the 5th day after operation in recurrence group ( P<0.05). The elevated NLR and ΔNLR at postoperative day 5 were independent risk factors for recurrence within 2 yr in patients with advanced gastric cancer ( HR=1.026, P<0.05). Conclusions:NLR may not be associated with the risk of early postoperative recurrence in the patients with advanced gastric cancer, and further evaluation with large-scale studies is needed.

MicroRNA(miRNA)serves as a novel regulatory factor in viral and bacterial co-infections,exhibiting dual regulatory roles during pathogen infections.On the one hand,it exerts protective effects by modulating viral replication cycles and host anti-infection immune responses.On the other hand,it can be exploited by pathogens to promote infection progression,including influencing viral replication,antiviral immune responses,and regulating bacterial adhesion and proliferation.Mixed viral and bacterial infections lead to high mortality rates.By binding to specific target gene mRNA,miRNA degrades or inhibits its translation,thereby regulating target gene expres-sion,which may ultimately serve as potential diagnostic and therapeutic targets.This paper reviews recent ad-vances in research on the role of miRNA in viral and bacterial infections,particularly its mechanisms in co-infec-tions,aiming to provide theoretical reference for further research on the infection mechanisms.

Objective:To explore the effect of Swanson theory combined with hand touch on the existential distress of patients with advanced lung cancer, in order to provide reference for clinical humanistic care.Methods:A non synchronous controlled study was conducted using convenience sampling to select advanced lung cancer patients admitted to the Oncology Department of the First People's Hospital of Yongkang City, Zhejiang Province from October 2023 to March 2024 as the control group, and advanced lung cancer patients admitted from April to October 2024 as the experimental group. The control group received routine care, while the experimental group received Swanson theory combined with hand touch intervention on the basis of routine care. The Existential Distress Scale (EDS) and Functional Assessment of Cancer Therapy- General (FACT-G) scores of the two groups were compared before and 2 weeks after intervention.Results:During the study period, there were 3 dropouts in the experimental group and 2 dropouts in the control group. Finally, 37 cases were included in the experimental group, including 16 males and 21 females, with an age of (62.35 ± 12.13) years. There were 38 cases in the control group, including 25 males and 13 females, with an age of (65.68 ± 13.46) years. After 2 weeks of intervention, the EDS score of the experimental group patients was (6.65 ± 2.89) points, while that of the control group was (8.16 ± 2.27) points. The difference between the two groups was statistically significant ( t = 2.52, P<0.05). After intervention, the social/family status dimension, emotional status dimension, and total score of FACT-G in the experimental group were (15.35 ± 4.18), (19.27 ± 3.54), and (57.46 ± 14.69) points, respectively, which were better than the control group's (13.08 ± 3.77), (16.53 ± 3.88), and (50.58 ± 11.86) points. The difference between the two groups was statistically significant ( t = - 2.47, - 3.20, - 2.24, all P<0.05). Conclusions:The combination of Swanson theory and hand touch can effectively reduce the existential distress of patients with advanced lung cancer, improve their quality of life, and embody the concept of nursing humanistic care into simple and safe intervention measures, providing reference for clinical humanistic care.

Postoperative pulmonary complications are common in thoracic surgery, which are the main influencing factors of poor prognosis, prolonged hospital stay, increased medical burden and increased postoperative mortality. Therefore, effective early diagnosis, early diagnosis and timely treatment of postoperative pulmonary complications after thoracic surgery is of great significance to improve the prognosis of patients. This article will review the definition, mechanism, risk factors and preventive measures of pulmonary complications after thoracic surgery.

Objective To investigate the factors influencing gastrointestinal bleeding associated with esophagogastric fundal varices bleeding(EGVB)in patients with liver cirrhosis 5 years after endoscopic treatment.Methods A retrospective enrollment was conducted on 181 patients with liver cirrhosis who underwent endoscopic treatment with EGVB at the First Affiliated Hospital of University of Science and Technology of China from February 2017 to May 2019,followed up for a minimum duration of 5 years.The demographic characteristics including gender,age,etiology of liver cirrhosis(viral,alcoholic,autoimmune,others),presence of ascites,hepatic encepha-lopathy severity(none,stage 1～2,stage 3),portal vein thrombosis status,occurrence of liver cancer or portal hypertensive gastric disease along with other complications were recorded.Additionally,peripheral blood indexes[aspartate aminotransferase(AST),alanine aminotransferase(ALT),white blood cell count(WBC),total biliru-bin(TBIL),albumin(ALB),platelet count(PLT)],prothrombin time parameters[prothrombin time(PT)and prothrombin time international normalized ratio(PTINR)],portal vein diameter and splenic vein diameter measure-ments as well as Child grade assessment were collected alongside sequential treatment details and rebleeding time.According to the occurrence of rebleeding within 5 years after endoscopic treatment,the 181 cases were divided into two groups:the non-rebleeding group(n=124)and the rebleeding group(n=57).Univariate and multivariate analyses were conducted to identify risk factors associated with rebleeding within 5 years after endoscopic treatment.Additionally,Kaplan-Meier analysis was performed to assess the cumulative bleeding rate at 1,3,and 5 years.Results The results of both univariate analysis and binary logistic regression analysis revealed that elevated TBIL levels and increased portal vein diameter were significant risk factors for rebleeding within 5 years following endo-scopic treatment in patients with EGVB(P<0.05).The Kaplan-Meier curve demonstrated that out of the 181 patients,there were 41 cases of cumulative bleeding within 1 year,54 cases within 3 years,and 57 cases within 5 years,resulting in cumulative bleeding rates of 22.65%,29.83%,and 31.49%respectively.Conclusions The long-term rebleeding rate remains elevated following endoscopic treatment of EGVB in cirrhotic patients,with TBIL levels and portal vein diameter identified as independent risk factors for long-term rebleeding after endoscopic treatment of EGVB in liver cirrhosis.Therefore,patients with higher TBIL levels and/or cirrhosis should be given priority for endoscopic treatment of EGVB.