Gliomas, especially high-grade gliomas such as glioblastoma multiforme (GBM), are primary malignant tumors of the central nervous system, characterized by high proliferative capacity, invasiveness, and therapeutic resistance. The development of GBM relies heavily on continuous metabolic reprogramming to adapt to the unique intracranial microenvironment, with nicotinamide adenine dinucleotide (NAD⁺) metabolic remodeling playing a pivotal role. Dysregulation of NAD⁺ and its associated metabolic pathways sustains increased intracellular NAD⁺ levels, which drive the malignant proliferation and invasive potential of GBM, correlating with worsened patient prognosis. This review systematically summarizes the current research landscape of NAD⁺ metabolic remodeling in GBM, elucidates the mechanisms by which NAD⁺ contributes to GBM pathogenesis and progression, and explores the clinical potential of NAD⁺-targeted diagnostic and therapeutic strategies to provide novel insights and directions for the clinical management of GBM.

Objective:To explore the correlation between weekend moderate-to-vigorous physical activity(MVPA), weekday sedentary behavior(SB)and the risk of frailty in the elderly population monitored by wearable devices, and to provide a scientific basis for lifestyle interventions for frailty in the elderly.Methods:This study was based on the data of the UK Biobank from 2013 to 2015.A cross-sectional study design was adopted, and 33, 212 elderly people aged 60 and above with complete physical activity monitoring data were selected.The Frailty Index(FI)constructed by the deficit accumulation method was used to assess the frailty status.The correlation between the combined effect of weekday SB and weekend MVPA and the frailty status was analyzed, and the differences between genders were explored.Results:There were significant differences in physical activity indicators among the elderly with different frailty statuses.As the degree of frailty increased, the MVPA-related indicators showed a downward trend, while the weekday SB time gradually increased.There were sex differences in physical activity patterns and frailties.Compared with women, men had longer SB time on weekdays, lower metabolic equivalent of weekly MVPA consumption, and higher MVPA time on weekends, but the frailties index of women was slightly higher than that of men.After adjusting for confounding factors, the frailty risks for men and women in the subgroup with the lowest weekday SB and the highest weekend MVPA duration decreased by 46.9% and 59.8%, respectively( P<0.001)when compared to the highest-risk group. Conclusions:Based on the monitoring data from wearable devices, elderly individuals who reduced their SB time during weekdays and increased their MVPA time on weekends were associated with a lower risk of frailty, especially among women; which providing a new perspective for lifestyle-based intervention strategies for frailty among the elderly.

To summarize the nursing experience of walking rehabilitation training assisted by extracorporeal membrane oxygenation in 2 cases of heart or lung transplant patients before surgery.The main points of nursing care:to set up a multidisciplinary team to formulate a rehabilitation exercise program;phased rehabilitation exercise to improve the preparation of body functions before walking training;multi-dimensional safety management to prevent and deal with walking training-related complications;to strengthen the assessment and monitoring,and implement personalized nutritional programs;to carry out positive psychological interventions to alleviate the anxiety.After undergoing active treatment and care,and after 3 d and 6 d of walking exercise assisted by extracorporeal membrane oxygenation,respectively,both of them finally underwent organ transplantation successfully,recovered well after the operation,and were transferred to the general ward to continue treatment.

Objective: To analyze the temporal changes in lipid levels in patients following acute pancreatitis(AP) and explore the factors associated with post-AP serum triglyceride( TG) level changes. Methods: Patients diag- nosed with AP were included in this study. Clinical data were collected retrospectively , and lipid profile data from follow-up visits after discharge were tracked. Kaplan-Meier(K-M) curves were used to stratify follow-up duration ,iodine content detection. Thyroid volume was measured using a fully digital ultrasound imaging system , and goiter prevalence was calculated. Results: A total of 141 patients with 306 follow⁃up visits were included. Spearman correlation analysis showed a mild increase in lipid levels over time post⁃discharge : TG( r = 0. 159 , P = 0. 005) , total cholesterol(TC)( r = 0. 231 , P < 0. 000 1) , high⁃density lipoprotein cholesterol( HDL⁃C) ( r = 0. 181 , P = 0. 002) , and apolipoproteinA1 ( ApoA1) ( r = 0. 371 , P <0. 000 1) . In the univariate linear mixed model , male gender(β = 0. 160 ,P = 0. 007) , body mass index(BMI) (β= 0. 017 , P = 0. 007) , diabetes history(β = 0. 138 , P = 0. 030) , smoking history(β = 0. 166 ,P = 0. 004) , and recurrent AP(β = 0. 119 , P = 0. 029) were significantly associated with Lg(TG) levels (P < 0. 05) . In the multivariate model , BMI( β = 0. 019 , P = 0. 042) , smoking history ( β = 0. 155 , P = 0. 049 ) , and recurrent AP( β =0. 148 , P = 0. 032) remained significantly positively correlated with changes in Lg(TG) levels after AP , albeit with a low correlation strength (r < 0. 200) . Conclusion Lipid levels , including TG , TC , HDL⁃C and ApoA1 , tend to increase over time in AP patients after discharge , with this trend being more pronounced in those with hypertriglyceridemic acute pancreatitis. Post⁃AP TG levels are significantly influenced by BMI at the time of onset , smoking history and recurrent AP.

Objective:To investigate expression levels of various myeloid suppressor cells(MDSCs)in bone marrow of patients with chronic myeloid leukemia(CML),and the difference and correlation of expression levels of BCR-ABL fusion gene and WT1 in CML patients at different stages,and explore its clinical significance.To analyze and compare the distribution differences of various MDSCs in CML with different remission depths after treatment.Methods:Proportions of various MDSCs in 58 CML patients were de-tected by flow cytometry.Relative expressions of WT1 and BCR-ABL were detected by RQ-PCR.Iron deficiency anemia patients were served as control group,differences of the distribution of MDSCs in CML patients with different BCR-ABL expression,different WT1 expression,different CD34+cell numbers and different disease course,and expressions of various types of MDSC at 3,6,12 and 24 months after treatment in patients with chronic phase of CML were analyzed.At the same time,changes of cellular immune status in CML patients at different stages were detected,and correlations between the changes of lymphocyte subsets and MDSCs were compared.Results:Proportions of G-MDSC and e-MDSC in chronic phase of CML were significantly higher than that in normal control group(P<0.05).Proportions of G-MDSC and e-MDSC in CML patients in accelerated phase and blast crisis phase were significantly higher than that in CML patients in chronic phase(P<0.05).However,the difference in proportion of M-MDSC between accelerated phase of CML and chronic phase of CML had no statistical significance.Proportion of G-MDSC in CML patients was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.558 7,0.530 7,0.598 1),proportion of M-MDSC was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.132 1,0.144 6,0.157 8).Proportion of e-MDSC was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.604 3,0.620 7,0.625 9).G-MDSC was significantly lower in the best response group than that in warning/failure group at all stages of treatment.e-MDSC was differential in the best response and warning/failure groups at only 3 months of treatment.M-MDSC was not statistically significant in the best response and warning/failure groups at all stages of treatment.And only G-MDSC cell ratio was positively correlated with its BCR-ABL ratio(r=0.798 1).Per-centage of T lymphocyte in CML blast crisis phase was significantly lower than that in accelerated and chronic phases,while percentage of NK cells was higher.Only the proportion of G-MDSC was negatively correlated with the proportion of T lymphocyte(r=-0.815 2).Conclusion:Various MDSCs are positively correlated with BCR-ABL,WT1 gene and CD34+cells,and positively correlated with the tumor burden of CML patients,while the correlation of M-MDSC is weaker than that of G-MDSC and e-MDSC.With the remission of CML,G-MDSC decreases,while M-MDSC does not change.e-MDSC only shows differences in the early 3-month of treatment.Change of G-MDSC ratio may predict the effect of CML treatment.MDSCs can inhibit the proliferation of T lymphocyte,and inhibitory effect of G-MDSC is stronger than that of M-MDSC and e-MDSC.

Objective:To understand healthcare professionals' perceptions and experiences of early rehabilitation exercise for extracorporeal membrane oxygenation (ECMO) patients, explore existing problems in the implementation of early rehabilitation exercise, and provide reference for constructing safe and effective early rehabilitation exercise programs for ECMO patients.Methods:This study was a qualitative study. Using purposeful sampling method, 13 ICU healthcare professionals (including doctors, rehabilitation therapists, and nurses) from three Class Ⅲ Grade A hospitals in Zhejiang Province that have implemented early rehabilitation exercise for ECMO patients were selected for semi-structured interviews from March to May 2024, and the interview data were collated and analyzed using the Colaizzi 7-step analysis method.Results:The perceptions and experiential perspectives of healthcare professionals on early rehabilitation exercise for ECMO patients can be summarized into three themes and 10 subthemes. The three themes were: healthcare professionals affirm the role of early rehabilitation exercise; lack of unified operational guidelines for early rehabilitation exercise; and patients and their families show high enthusiasm for participating in early rehabilitation exercise.Conclusions:Hospitals should regularly conduct related training on early rehabilitation exercise to enhance the practical skills of healthcare professionals. At the same time, healthcare professionals should focus on utilizing the positive role of patients and their families in the process of early rehabilitation exercise to improve the quality of ECMO patient rehabilitation care.

To summarize the nursing experience of walking rehabilitation training assisted by extracorporeal membrane oxygenation in 2 cases of heart or lung transplant patients before surgery.The main points of nursing care:to set up a multidisciplinary team to formulate a rehabilitation exercise program;phased rehabilitation exercise to improve the preparation of body functions before walking training;multi-dimensional safety management to prevent and deal with walking training-related complications;to strengthen the assessment and monitoring,and implement personalized nutritional programs;to carry out positive psychological interventions to alleviate the anxiety.After undergoing active treatment and care,and after 3 d and 6 d of walking exercise assisted by extracorporeal membrane oxygenation,respectively,both of them finally underwent organ transplantation successfully,recovered well after the operation,and were transferred to the general ward to continue treatment.

Objective:To understand healthcare professionals' perceptions and experiences of early rehabilitation exercise for extracorporeal membrane oxygenation (ECMO) patients, explore existing problems in the implementation of early rehabilitation exercise, and provide reference for constructing safe and effective early rehabilitation exercise programs for ECMO patients.Methods:This study was a qualitative study. Using purposeful sampling method, 13 ICU healthcare professionals (including doctors, rehabilitation therapists, and nurses) from three Class Ⅲ Grade A hospitals in Zhejiang Province that have implemented early rehabilitation exercise for ECMO patients were selected for semi-structured interviews from March to May 2024, and the interview data were collated and analyzed using the Colaizzi 7-step analysis method.Results:The perceptions and experiential perspectives of healthcare professionals on early rehabilitation exercise for ECMO patients can be summarized into three themes and 10 subthemes. The three themes were: healthcare professionals affirm the role of early rehabilitation exercise; lack of unified operational guidelines for early rehabilitation exercise; and patients and their families show high enthusiasm for participating in early rehabilitation exercise.Conclusions:Hospitals should regularly conduct related training on early rehabilitation exercise to enhance the practical skills of healthcare professionals. At the same time, healthcare professionals should focus on utilizing the positive role of patients and their families in the process of early rehabilitation exercise to improve the quality of ECMO patient rehabilitation care.

Objective:To investigate expression levels of various myeloid suppressor cells(MDSCs)in bone marrow of patients with chronic myeloid leukemia(CML),and the difference and correlation of expression levels of BCR-ABL fusion gene and WT1 in CML patients at different stages,and explore its clinical significance.To analyze and compare the distribution differences of various MDSCs in CML with different remission depths after treatment.Methods:Proportions of various MDSCs in 58 CML patients were de-tected by flow cytometry.Relative expressions of WT1 and BCR-ABL were detected by RQ-PCR.Iron deficiency anemia patients were served as control group,differences of the distribution of MDSCs in CML patients with different BCR-ABL expression,different WT1 expression,different CD34+cell numbers and different disease course,and expressions of various types of MDSC at 3,6,12 and 24 months after treatment in patients with chronic phase of CML were analyzed.At the same time,changes of cellular immune status in CML patients at different stages were detected,and correlations between the changes of lymphocyte subsets and MDSCs were compared.Results:Proportions of G-MDSC and e-MDSC in chronic phase of CML were significantly higher than that in normal control group(P<0.05).Proportions of G-MDSC and e-MDSC in CML patients in accelerated phase and blast crisis phase were significantly higher than that in CML patients in chronic phase(P<0.05).However,the difference in proportion of M-MDSC between accelerated phase of CML and chronic phase of CML had no statistical significance.Proportion of G-MDSC in CML patients was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.558 7,0.530 7,0.598 1),proportion of M-MDSC was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.132 1,0.144 6,0.157 8).Proportion of e-MDSC was positively correlated with values of BCR-ABL,WT1 genes and proportion of CD34+cells(r=0.604 3,0.620 7,0.625 9).G-MDSC was significantly lower in the best response group than that in warning/failure group at all stages of treatment.e-MDSC was differential in the best response and warning/failure groups at only 3 months of treatment.M-MDSC was not statistically significant in the best response and warning/failure groups at all stages of treatment.And only G-MDSC cell ratio was positively correlated with its BCR-ABL ratio(r=0.798 1).Per-centage of T lymphocyte in CML blast crisis phase was significantly lower than that in accelerated and chronic phases,while percentage of NK cells was higher.Only the proportion of G-MDSC was negatively correlated with the proportion of T lymphocyte(r=-0.815 2).Conclusion:Various MDSCs are positively correlated with BCR-ABL,WT1 gene and CD34+cells,and positively correlated with the tumor burden of CML patients,while the correlation of M-MDSC is weaker than that of G-MDSC and e-MDSC.With the remission of CML,G-MDSC decreases,while M-MDSC does not change.e-MDSC only shows differences in the early 3-month of treatment.Change of G-MDSC ratio may predict the effect of CML treatment.MDSCs can inhibit the proliferation of T lymphocyte,and inhibitory effect of G-MDSC is stronger than that of M-MDSC and e-MDSC.

Objective:To explore the correlation between weekend moderate-to-vigorous physical activity(MVPA), weekday sedentary behavior(SB)and the risk of frailty in the elderly population monitored by wearable devices, and to provide a scientific basis for lifestyle interventions for frailty in the elderly.Methods:This study was based on the data of the UK Biobank from 2013 to 2015.A cross-sectional study design was adopted, and 33, 212 elderly people aged 60 and above with complete physical activity monitoring data were selected.The Frailty Index(FI)constructed by the deficit accumulation method was used to assess the frailty status.The correlation between the combined effect of weekday SB and weekend MVPA and the frailty status was analyzed, and the differences between genders were explored.Results:There were significant differences in physical activity indicators among the elderly with different frailty statuses.As the degree of frailty increased, the MVPA-related indicators showed a downward trend, while the weekday SB time gradually increased.There were sex differences in physical activity patterns and frailties.Compared with women, men had longer SB time on weekdays, lower metabolic equivalent of weekly MVPA consumption, and higher MVPA time on weekends, but the frailties index of women was slightly higher than that of men.After adjusting for confounding factors, the frailty risks for men and women in the subgroup with the lowest weekday SB and the highest weekend MVPA duration decreased by 46.9% and 59.8%, respectively( P<0.001)when compared to the highest-risk group. Conclusions:Based on the monitoring data from wearable devices, elderly individuals who reduced their SB time during weekdays and increased their MVPA time on weekends were associated with a lower risk of frailty, especially among women; which providing a new perspective for lifestyle-based intervention strategies for frailty among the elderly.