Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

Objective:To investigate the value of triglyceride glucose index(TyG)and monocyte to high-density lipoprotein choles-terol ratio(MHR)in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated by heart fail-ure(HF),as well as the correlation of TyG and MHR with cardiac function in AECOPD patients.Methods:A retrospective analysis was performed for the clinical data of 298 AECOPD patients who were admitted to The First Hospital of Lanzhou University from January 2020 to December 2021,and according to the clinical manifestation,B-type natriuretic peptide/N-terminal B-type natriuretic peptide precursor,and echocardiography,the 298 AECOPD patients were divided into HF group with 127 patients and non-HF group with 171 patients.Related clinical indicators were compared between the two groups,and a regression analysis was used to identify the pos-sible risk factors for HF in AECOPD patients.The receiver operat-ing characteristic(ROC)curve analysis was used to investigate the value of TyG and MHR alone or in combination in the diagnosis of AECOPD complicated by HF,and a correlation analysis was used to investigate the correlation of TyG and MHR with cardiac function parameters(ejection fraction,ventricular wall thickness,cardiac chamber size,and valve regurgitation velocity)and pulmonary artery pressure in AECOPD patients.Results:The binary logistic regres-sion analysis showed that fasting blood glucose,absolute monocyte count,high-density lipoprotein cholesterol(HDL-C),arrhythmia,TyG,and MHR were independent risk factors for HF in AECOPD patients,and the HF group had significantly higher levels of TyG and MHR than the non-HF group(P<0.001).TyG had an area under the ROC curve(AUC)of 0.805(95%CI=0.754-0.856,P<0.001)in the diagnosis of AECOPD complicated by HF,and MHR had an AUC of 0.762(95%CI=0.707-0.817,P<0.001),while TyG combined with MHR had an AUC of 0.870(95%CI=0.828-0.912,P<0.001).The correlation analysis showed that TyG was negatively correlated with left ventricular ejection fraction and left ventricular fractional shortening and was positively correlated with end-diastolic interven-tricular septal thickness,mitral regurgitation velocity,and left ventricular end-diastolic posterior wall thickness,while MHR was nega-tively correlated with left ventricular stroke volume and left ventricular fractional shortening and was positively correlated with end-diastolic interventricular septal thickness,right ventricular anteroposterior diameter,right ventricular superior-inferior diameter,right ventricular transverse diameter,tricuspid regurgitation velocity,left ventricular end-diastolic posterior wall thickness,and pulmonary artery pressure.Conclusion:Fasting blood glucose,absolute monocyte count,HDL-C,arrhythmia,TyG,and MHR are independent risk factors for AECOPD complicated by HF.Both TyG and MHR have a certain value in the diagnosis of HF,and the combination of TyG and MHR has a better efficacy than each indicator alone in the diagnosis of AECOPD complicated by HF.TyG is correlated with the cardiac function parameters such as left ventricular ejection fraction,ventricular wall thickness,and mitral regurgitation velocity in patients with AECOPD and may have a stronger correlation with the left ventricle;MHR is correlated with right ventricular chamber size,tricuspid regurgitation velocity,and pulmonary artery pressure and may have a stronger correlation with the right ventricle.

Objective To explore the different potential subtypes of psychosocial adaptation among young and middle-aged stroke patients,and analyze the relationship between different potential subtypes and quality of life,so as to provide references for the subsequent development of targeted interventions.Methods A total of 406 young and middle-aged stroke patients in 4 tertiary hospitals in Suzhou from June 2023 to June 2024 were recruited by convenience sampling.The General Information Questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale and the EuroQol five-dimensional questionnaire were conducted for investigation.Latent profile analysis was used to explore the potential subtypes of psychosocial adaptation among young and middle-aged stroke patients.Generalized linear regression analysis was conducted with quality of life as dependent variables.Results A total of 380 young and middle-aged stroke patients were included.The psychosocial adaptation of patients could be classified into 3 potential subtypes:high adaptation level type(23.90％),medium adaptation level with health concerns type(46.40％),and low adaptation level with psychological barriers type(29.70％).The results of generalized linear regression analysis showed that potential subtypes of psychosocial adaptation were the influencing factors for quality of life in young and middle-aged stroke patients(P＜0.05).Conclusion There was group heterogeneity in psychosocial adaptation among young and middle-aged stroke patients,and the potential subtype of psychosocial adaption was an important factor affecting the quality of life of patients.It is suggested that medical staff should focus on patients with low adaptation level with psychological barriers type,and take targeted interventions according to characteristics of different subtypes of patients,so as to improve their quality of life.

Objective:To investigate the predictive value of changes in body mass index (BMI) and blood glucose indicators in early pregnancy for gestational diabetes mellitus (GDM).Methods:A total of 126 pregnant women with GDM who were admitted to the Department of Obstetrics at Jiaxing Maternity and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed and included in the GDM group. Additionally, 140 healthy pregnant women were included in the non-GDM group. Changes in BMI and levels of blood glucose indicators [fasting blood glucose (FBG), 1-hour postprandial blood glucose, 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin during early pregnancy were compared between the two groups. Influential factors for GDM were analyzed using a multivariate logistic regression model. The predictive value of changes in BMI and blood glucose indicators during early pregnancy for GDM was assessed using receiver operating characteristic curves.Results:The BMI at 10 [(24.60 ± 0.82) kg/m2] and 14 weeks of pregnancy [(23.50 ± 0.85) kg/m2] in the GDM group was significantly higher compared with the non-GDM group (both P < 0.05). The levels of FBG [(5.98 ± 0.36) mmol/L], 1-hour postprandial blood glucose [(10.95 ± 0.83) mmol/L], and 2hPG [(8.60 ± 0.82) mmol/L] in the GDM group were also significantly higher than those in the non-GDM group ( t = 12.25, 23.90, 5.98, all P < 0.001). The levels of total cholesterol [(6.35 ± 1.10) mmol/L] and triglycerides [(3.23 ± 0.60) mmol/L] in the GDM group were significantly higher compared with the non-GDM group ( t = 6.45, 7.45, both P < 0.001). The number of cesarean sections ( n = 69 cases) and the incidence of adverse delivery outcomes [26.98% (34/126)] in the GDM group were significantly higher than those in the non-GDM group ( χ2 = 16.72, 12.71, both P < 0.001). Multivariate logistic regression analysis indicated that BMI at 10 weeks of pregnancy, BMI at 14 weeks of pregnancy, FBG, and 2hPG were independent risk factors for GDM ( OR = 1.292, 6.514, 2.601, 1.784, all P < 0.05). According to Receiver Operating Characteristic curve analysis, the area under the curve (AUC) (95% CI) for BMI at 10 and 14 weeks of pregnancy were 0.717 (0.630-0.795) and 0.719 (0.631-0.796), respectively. The AUC (95% CI) for FBG and 2hPG levels were 0.731 (0.635-0.813) and 0.802 (0.712-0.873), respectively. The AUC (95% CI) for the combined evaluation of these indicators was 0.911 (0.839-0.958), indicating that the combined evaluation had a higher predictive value for GDM than the use of a single indicator ( P < 0.05). Conclusions:The changes in BMI and blood glucose indicators during early pregnancy are closely related to the occurrence of GDM. The combination of these measurements has a high predictive value for GDM and is of significant importance for its prevention.

This paper explores the application and advancements of cross-cultural nursing concepts in the management of ICU patients. It identifies the core elements of humanistic care from a cross-cultural perspective, introduces relevant international research findings, and provides an in-depth analysis of existing challenges within the domestic healthcare context. Constructive suggestions are proposed to enhance the quality of life of ICU patients.

Objective:To extract, evaluate, and summarize evidence related to family participation in delirium management of ICU patients and provid a reference for clinical practice.Methods:A systematic search was conducted in databases such as UpToDate, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Medlive, Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Biology Medicine disc. The search covered clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials related to family participation in ICU delirium management, with a timeframe up to March 20, 2024. Two researchers independently screened literature, assessed quality, extracted evidence, and graded it.Results:A total of 28 articles were included, comprising seven evidence summaries, five guidelines, three expert consensuses, six systematic reviews, and seven randomized controlled trials. The findings were synthesized into five themes: visitation, assessment, non-pharmacological management, psychological and physical care, and health education, with a total of 26 best evidence points.Conclusions:The best evidence summarized in this study provides an evidence-based foundation for ICU healthcare providers to guide and encourage family participation in delirium management, which aida in the prevention of delirium in ICU patients.

Humanistic care is the essence of nursing. The implementation of humanistic care in ICU nursing can alleviate patients' negative psychological experiences, enhance treatment adherence, and improve patient outcomes. This article provides a comprehensive review of the concept of humanistic care, evaluation tools for ICU nursing humanistic care, multi-level current situation, and influencing factors. The aim is to offer insights for developing a multi-dimensional humanistic care framework for ICU patients, nurses, and healthcare institutions, based on the "humanistic care transmission chain".

Objective:To perform a Meta-synthesis of qualitative studies on the positive psychological experiences of cardiac surgery patients post-operation, and to analyze and evaluate these experiences.Methods:A systematic search was conducted in PubMed, Web of Science, CINAHL, Embase, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, with the search period from the establishment of the database to March 10, 2024. The quality of the included literature was assessed using the Australia Joanna Briggs Institute for Evidence-Based Healthcare Centre Database Quality Assessment Criteria for Qualitative Research (2016). Results were integrated using the Meta synthesis method.Results:A total of 13 studies were included, of which one study was rated as Grade A and 12 as Grade B. 46 research outcomes were identified, which were summarized into 10 new categories and integrated into three main results: awakening of self-awareness, changes in health behaviors, and perceived social support.Conclusions:Cardiac surgery patients post-operation exhibit positive psychology. Medical staff should be able to identify and understand the supporting factors for these psychological states, correctly guide and maintain the positive psychological state of patients, and help facilitate active recovery.

Objective:To summary the best evidence of integrated traditional Chinese and Western medicine exercise rehabilitation for phase I cardiac rehabilitation after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and to provide an evidence-based basis for clinical practice.Methods:The literature on integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI was systematically searched in UpToDate, National Guideline Clearinghouse, Guidelines International Network, Scottish Intercollegiate Guidelines Network, Canadian Medical Association Clinical Practice Guideline, Chinese Medical Association, China National Knowledge Infrastructure, Medlive, VIP, China Biology Medicine disc, Wanfang Data, Scops, Cochrane Library, PubMed, and Web of Science, etc. The search period was from database establishment to May 20, 2024. Literature quality assessment and data extraction were performed independently by two researchers.Results:A total of 19 papers were included, including four guidelines, eight expert consensus, six systematic reviews, and one randomized controlled trial. Thirty-two pieces of best evidence were summarized from eight areas containing pre-rehabilitation assessment, timing of exercise, type of exercise, exercise program, exercise monitoring, frequency of exercise, criteria for termination of exercise, and health education and follow-up.Conclusions:The summary of the best evidence of integrated Chinese and Western medicine exercise rehabilitation among AMI patients in phase I after PCI provides an evidence-based basis for standardizing the process and practice standards of exercise rehabilitation among AMI patients in phase I after PCI.

Objective:To explore the current status, research hotspots, and development trends of shared decision-making in the field of cardiovascular disease nursing, and to provide a reference for future research.Methods:Relevant literature on shared decision-making in cardiovascular disease nursing published up to October 31, 2024, was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure. CiteSpace 6.4.R1 software was used for visualized analysis.Results:A total of 2 748 publications were identified, including 2 446 in English and 302 in Chinese. The overall number of publications has shown an increasing trend. Research hotspots include quality of life, palliative care, machine learning, and artificial intelligence. The emerging trend involves integrating evidence-based approaches with artificial intelligence technologies to build scientific evidence frameworks that support patients in making optimal decisions.Conclusions:Research on shared decision-making in cardiovascular disease nursing has been increasing year by year but remains largely concentrated in developed countries. Future studies should draw on international research frontiers while considering China's national and cultural contexts, enhance academic exchange and collaboration, and explore effective strategies to promote shared decision-making between Medical staff and patients.