Objective To explore the latent classes and influencing factors of blood glucose trajectories after transplantation in lung transplantation patients,and provide references for identifying high-risk population of post-transplant diabetes mellitus.Methods 122 lung transplantation patients who were hospitalized in a tertiary A general hospital in Hangzhou from January 2022 to March 2023 were selected conveniently as survey subjects.Socio-demographic and disease-related data were collected,and fasting plasma glucose at 1 week before surgery(T0),1 week after surgery(T1),1 month after surgery(T2),3 months after surgery(T3),6 months after surgery(T4),1 year after surgery(T5)were collected.Growth mixture model was used to identify categories of blood glucose trajectories after lung transplantation,and binary Logistic regression analysis was used to explore the influencing factors.Results A total of 109 lung transplantation patients were enrolled in the study,and 2 latent classes of blood glucose trajectories were identified:high risk(23.85％)and low risk(76.15％)of post-transplant diabetes mellitus.BMI,drinking history,afternoon blood glucose and tacrolimus trough concentration were the influencing factors of latent classes of blood glucose trajectories after lung transplantation(all P＜0.05).Conclusion There are 2 latent classes of blood glucose trajectories after lung transplantation,namely high risk and low risk of post-transplant diabetes mellitus.Medical staff should pay attention to diabetes screening and assessment of lung transplantation patients who are overweight or obese,have a drinking history before transplantation,have high afternoon blood glucose in early stage of transplantation and have high tacrolimus trough concentration in stable stage of transplantation,so as to formulate a comprehensive and individualized blood glucose management program.

Objective To explore the latent classes and influencing factors of blood glucose trajectories after transplantation in lung transplantation patients,and provide references for identifying high-risk population of post-transplant diabetes mellitus.Methods 122 lung transplantation patients who were hospitalized in a tertiary A general hospital in Hangzhou from January 2022 to March 2023 were selected conveniently as survey subjects.Socio-demographic and disease-related data were collected,and fasting plasma glucose at 1 week before surgery(T0),1 week after surgery(T1),1 month after surgery(T2),3 months after surgery(T3),6 months after surgery(T4),1 year after surgery(T5)were collected.Growth mixture model was used to identify categories of blood glucose trajectories after lung transplantation,and binary Logistic regression analysis was used to explore the influencing factors.Results A total of 109 lung transplantation patients were enrolled in the study,and 2 latent classes of blood glucose trajectories were identified:high risk(23.85％)and low risk(76.15％)of post-transplant diabetes mellitus.BMI,drinking history,afternoon blood glucose and tacrolimus trough concentration were the influencing factors of latent classes of blood glucose trajectories after lung transplantation(all P＜0.05).Conclusion There are 2 latent classes of blood glucose trajectories after lung transplantation,namely high risk and low risk of post-transplant diabetes mellitus.Medical staff should pay attention to diabetes screening and assessment of lung transplantation patients who are overweight or obese,have a drinking history before transplantation,have high afternoon blood glucose in early stage of transplantation and have high tacrolimus trough concentration in stable stage of transplantation,so as to formulate a comprehensive and individualized blood glucose management program.

This paper summarizes the nursing experience of a pregnant woman with congenital heart disease who developed pulmonary artery hypertension crisis after cesarean section.Nursing key points:monitoring and management of inhaled nitric oxide therapy to reduce pulmonary hypertension;providing sequential respiratory support care and dynamically adjusting oxygen therapy regimen;precise volume regulation and alertness to serious complications;optimizing puerperal supervision strategy to reduce the risk of infection;preventing and controlling stress bleeding and implementing a stepped dietary management strategy;implementing phased rehabilitation training to accelerate the recovery process;carrying out personalized psychological care and health education.With comprehensive nursing care,the patient recovered well and was discharged smoothly after an 18-day hospital stay.

Objective This study aimed to develop and empirically evaluate a sarcopenia management program for lung transplant candidates based on the Transtheoretical Model(TTM).The objective was to improve preopera-tive muscle condition and enhance patients' tolerance to lung transplantation.Methods Using the TTM as the the-oretical framework,the sarcopenia management program was developed through a literature review and 2 rounds of expert consultations.A convenience sampling method was employed to recruit inpatients from the lung transplant department of a tertiary hospital in Zhejiang Province between January 2022 and January 2024.Patients admitted between February 2023 and January 2024 were assigned to an intervention group,while those admitted between January 2022 and January 2023 were allocated to a control group.The intervention group received an 8-week sar-copenia management program based on the TTM in addition to standard prehabilitation care,whereas the control group received only standard prehabilitation care.Outcome measurements included pre-and post-intervention com-parisons of the modified Strength,Assistance with Walking,Rise from a Chair,Climb Stairs,Falls,and Calf Circum-ference(SARC-CalF)score,handgrip strength,6-minute walking distance(6MWD),and upper arm circumference,as well as their respective changes before and after the intervention.Additionally,stage-based behavioral change as-sessment and adverse event incidence were compared between the 2 groups.Results A total of 8 patients from the intervention group and 9 from the control group dropped out,resulting in a final sample of 32 patients in the intervention group and 31 in the control group.Compared to the control group,the intervention group demonstrated significantly greater improvements in SARC-CalF scores,handgrip strength,6MWD,and upper arm circumference(P＜0.05).After the intervention,the intervention group had a statistically significant difference in behavioral stage tran-sition compared to the control group(P＜0.05).During the intervention process,neither group experienced any ad-verse events.Conclusion The sarcopenia management program based on the TTM effectively improved patient ad-herence,enhanced preoperative muscle condition,and demonstrated potential benefits in improving physical function and nutritional status.

Objective:To investigate the clinicopathological features, immunophenotypes, and molecular characteristics of PRRX1-rearranged fibroblastic tumor and to discuss their differential diagnoses.Methods:Four cases of PRRX1-rearranged fibroblastic tumor retrieved from Anning First People′s Hospital and Fudan University Shanghai Cancer Center and their clinicopathological features, immunophenotypes and molecular profiles were analyzed. The literature was reviewed.Results:All 4 cases occurred in adult women with an age of 34(27,41) years. Three tumors occurred in the low extremities and 1 in the trunk. The patients presented with a slowly growing mass or swelling, accompanied by pain in 1 patient. Three tumors were located in the subcutis, and 1 tumor in the intermuscular space. The duration lasted for 6 months to 1 year. Tumor ranged in size from 4.0 to 15.8 cm (mean 7.3 cm). At lower power, the tumors were well circumscribed, showing a multinodular architecture. They were composed of bland ovoid to short spindled cells arranged irregularly with interstitial ropey collagen fibers, and set in a fibrous to fibromyxoid matrix with a close resemblance to low-grade fibromyxoid sarcoma. However, all 4 tumors showed negative staining for MUC4. Two tumors were focally positive for S-100 and SOX10. Apart from vimentin, they were all negative for other immunohistochemical stains including SMA, desmin, CD34, STAT6 and β-catenin. The expression of H3K27Me3 was retained. The proliferative index measured by Ki-67 was less than 5%. RNA-sequencing analysis identified PRRX1::NCOA1 fusions in 3 cases, and PRRX1::KMT2D fusion in 1 case. Subsequent FISH study confirmed NCOA1 rearrangement in 3 cases harboring NCOA1 rearrangement. On follow-up (1-14 months), no patient developed either local recurrence or distant metastasis.Conclusions:PRRX1-rearranged fibroblastic tumor is a novel entity of soft tissue tumor that has a predilection for the trunk and extremities, characterized by PRRX1 gene rearrangement and benign clinical course. Familiarity with its clinicopathological features is helpful in the distinction from low-grade fibromyxoid sarcoma and other spindle cell tumors with overlapping features.

Objective To observe the levels of serum NOD-like receptor thermal protein domain associated protein 3(NLRP3),cysteine protease 1(Caspase-1),and interleukin 1β(IL-1β)in patients with systemic lupus erythematosus(SLE)and to explore their correlation with traditional Chinese medicine(TCM)syndrome types,thus to assess the significance of NLRP3,Caspase-1 and IL-1β in TCM syndrome differentiation.Methods A total of 110 cases of SLE patients who met the inclusion criteria and 30 cases of healthy physical examinee from Linhai Hospital of Traditional Chinese Medicine during October 2020 to March 2024 were enrolled into the study.The serum NLRP3,Caspase-1,IL-1β levels of the two groups were compared,and the correlation between serum NLRP3,Caspase-1,IL-1β levels and the Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)scores was analyzed.Moreover,the distribution of the TCM syndrome types in 110 cases of SLE patients was investigated and then the correlation between TCM syndrome types and serum NLRP3,Caspase-1,and IL-1β levels in SLE patients was explored.Results(1)The serum NLRP3 and Caspase-1 levels of patients in SLE group were lower than those of healthy control group,and the serum IL-1β level was higher than that of healthy control group,and the differences were statistically significant(P<0.05).Spearman's correlation analysis showed that the SLEDAI score was negatively correlated with both of NLRP3 and Caspase-1(r=-0.854,-0.599,P<0.01),and SLEDAI score was positively correlated with IL-1β(r=0.584,P<0.01).(2)The TCM syndrome types in 110 cases of SLE patients ranking in descending order were as follows:excessive heat toxin syndrome(33.64%)>yang deficiency of spleen and kidney syndrome(25.45%)>internal heat due to yin deficiency syndrome(24.55%)>yin deficiency of liver and kidney syndrome(16.36%).(3)The serum NLRP3 and Caspase-1 levels were in ascending order while the serum IL-1β level was in descending order in SLE patients with the TCM syndrome types of excessive heat toxin syndrome,internal heat due to yin deficiency syndrome,yang deficiency of spleen and kidney syndrome,yin deficiency of liver and kidney syndrome,respectively.And the differences were all statistically significant(P<0.05).(4)The results of multivariate logistic regression analysis showed that serum NLRP3 and caspase-1 levels were negatively correlated with syndromes of yin deficiency of liver and kidney,yang deficiency of spleen and kidney,internal heat due to yin deficiency,and excessive heat toxin(P<0.05 or P<0.01),while serum IL-1β level was positively correlated with the above syndromes(P<0.05).Conclusion Serum NLRP3 and Caspase-1 levels in SLE patients are negatively correlated with the disease activity,and serum IL-1β level is positively correlated with the disease activity.There is a certain correlation between TCM syndrome types and NLRP3,Caspase-1 and IL-1β levels in SLE patients,indicating that NLRP3,Caspase-1 and IL-1β may be the potential biological indicators for TCM syndrome differentiation of SLE.

ObjectiveTo analyze the epidemiological and clinical characteristics of pertussis in Baoshan District, Shanghai from 2017 to 2024, so as to provide an evidence-based reference for optimizing prevention and control strategies. MethodsData on pertussis cases were collected from the China Disease Prevention and Control Information System, Shanghai Integrated Management and Immunization Service Information System, and follow-up epidemiological investigations. Descriptive epidemiological analyses were performed to analyze the epidemiological characteristics, clinical manifestations, and vaccine effectiveness. Joinpoint regression analyses were used to examine the temporal trends in incidence rates, and a Poisson model was constructed for spatiotemporal scan analyses. ResultsA total of 1 634 pertussis cases were reported in Baoshan District from 2017 to 2024, with a male-to-female ratio of 1.08∶1. More cases were observed in males than in females, with the age ranged from 20 days to 81 years. Among them, 59.92% were in the 6‒<11 years age group, and 63.34% were students. Low-level sporadic incidence persisted during 2017‒2023, followed by a sharp increase in 2024 (71.37/100 000). Starting in January 2024, the incidence rate showed an upward trend, peaking in May before declining. The majority of cases occurred between April and June. The trend in reported pertussis incidence rates in Baoshan District from 2017 to 2023 showed no statistically significant change (APC=10.039%, t=2.586, P=0.150). Incidence rate rose from January 2024, peaked in May (APC=133.641%, t=3.841, P=0.006), then declined significantly (APC=-47.816%, t=2.586, P<0.001). The 12 subdistricts of Baoshan District were divided into low, medium, and high population density areas, with an average annual reported incidence rate of 6.09/100 000, 8.19/100 000 and 11.96/100 000, respectively. The reported incidence rate increased with an increase in population density. Spatiotemporal scan analyses showed that cases clustered in the southwest and northeast of Baoshan District. Epidemiological follow-up investigations of 1 520 cases revealed that the main clinical symptoms were cough (97.63%) and sputum production (41.58%), and 98.13% of the cases were confirmed by positive nucleic-acid test results. Among the 1 475 cases with immunization records, 83.53% had completed the four-dose pertussis vaccine before onset. The complication incidence rates, from high to low, were in the 0-dose vaccination group, 1‒3-dose vaccination group and 4-dose vaccination group. The duration of cough, from long to short, was observed in the the 0-dose vaccination group, 1‒3-dose vaccination group and 4-dose vaccination group, correspondingly. ConclusionIt is recommended to improve the pertussis surveillance system in medical institutions and establish an active monitoring network, prioritizing deployment in school settings and areas with high population density. Enhancing diphtheria-tetanus-pertussis (DTP) vaccination coverage among 6-year-old children and further optimizing the pertussis immunization strategies are essential to prevent and reduce the risk of pertussis among school-aged children.

Objective:To investigate the clinicopathological features, immunophenotypes, and molecular characteristics of PRRX1-rearranged fibroblastic tumor and to discuss their differential diagnoses.Methods:Four cases of PRRX1-rearranged fibroblastic tumor retrieved from Anning First People′s Hospital and Fudan University Shanghai Cancer Center and their clinicopathological features, immunophenotypes and molecular profiles were analyzed. The literature was reviewed.Results:All 4 cases occurred in adult women with an age of 34(27,41) years. Three tumors occurred in the low extremities and 1 in the trunk. The patients presented with a slowly growing mass or swelling, accompanied by pain in 1 patient. Three tumors were located in the subcutis, and 1 tumor in the intermuscular space. The duration lasted for 6 months to 1 year. Tumor ranged in size from 4.0 to 15.8 cm (mean 7.3 cm). At lower power, the tumors were well circumscribed, showing a multinodular architecture. They were composed of bland ovoid to short spindled cells arranged irregularly with interstitial ropey collagen fibers, and set in a fibrous to fibromyxoid matrix with a close resemblance to low-grade fibromyxoid sarcoma. However, all 4 tumors showed negative staining for MUC4. Two tumors were focally positive for S-100 and SOX10. Apart from vimentin, they were all negative for other immunohistochemical stains including SMA, desmin, CD34, STAT6 and β-catenin. The expression of H3K27Me3 was retained. The proliferative index measured by Ki-67 was less than 5%. RNA-sequencing analysis identified PRRX1::NCOA1 fusions in 3 cases, and PRRX1::KMT2D fusion in 1 case. Subsequent FISH study confirmed NCOA1 rearrangement in 3 cases harboring NCOA1 rearrangement. On follow-up (1-14 months), no patient developed either local recurrence or distant metastasis.Conclusions:PRRX1-rearranged fibroblastic tumor is a novel entity of soft tissue tumor that has a predilection for the trunk and extremities, characterized by PRRX1 gene rearrangement and benign clinical course. Familiarity with its clinicopathological features is helpful in the distinction from low-grade fibromyxoid sarcoma and other spindle cell tumors with overlapping features.

Nocturnal enuresis (NE) is a common pediatric disease with unclear pathogenesis.The prevailing hypothesis is that NE is caused by a discrepancy between nocturnal urine output and bladder capacity and sleep-wake disturbances.Monosymptomatic nocturnal enuresis (MNE) with nocturnal polyuria is a common subtype of NE, which can be effectively treated by Desmopressin.However, it is possible that some children may demonstrate an inability to respond favorably to this form of therapy and become resistant to it, which significantly impacts their physical and mental health and overall quality of life.In this article, recent advances in the pathogenesis and treatment of Desmopressin-resistant MNE with nocturnal polyuria in children were reviewed to provide a reference for its treatment.

Objective: To assess the awareness and associated factors of wild mushroom poisoning among students in Guizhou Province, so as to provide a scientific foundation for wild mushroom poisoning prevention and control among students. Methods: By a multi stage stratified cluster random sampling method, 1 162 students from Guizhou Province were selected in May 2024. The questionnaire survey was administered to evaluate knowledge regarding wild mushroom poisoning. Data were analyzed employing the χ 2 test and Logistic regression model. Results: Among the nine questions assessing awareness of wild mushroom poisoning, only three had the awareness rate exceeding 70%. Binary Logistic regression analysis revealed that students who "actively learn about the prevention of wild mushroom poisoning" ( OR=0.48, 95%CI =0.26-0.92) and "spread knowledge about wild mushroom poisoning to others" ( OR=0.47, 95%CI =0.33-0.69) scored higher on the wild mushroom poisoning knowledge questions ( P <0.05). Conversely, students with a habit of consuming wild mushrooms ( OR=1.52, 95%CI =1.15-2.02) scored lower ( P < 0.05 ). 42.3% of the students suggested that scientific dissemination and publicity about wild mushrooms should be intensified. Conclusions The awareness rate of wild mushroom poisoning knowledge among students in Guizhou Province requires further attention. Comprehensive knowledge should be disseminated systematically through various channels to further improve students awareness of the prevention and control of wild mushroom poisoning.