As a key treatment method for end-stage liver diseases, long-term efficacy of liver transplantation is limited by rejection and serious complications such as liver and kidney toxicity, infection risks and tumor recurrence caused by immunosuppressive drugs. In recent years, nanotechnology, with its targeted delivery capabilities and spatio-temporal controlled release characteristics, has demonstrated great potential in precisely regulating immune responses. This article systematically reviews the multi-level application strategies and mechanisms of nanomedicine in the immunoreprogramming of liver transplantation, covering innate immunoreprogramming (phenotypic transformation of Kupffer cells or macrophages, inhibition of inflammasomes and mitochondrial repair), adaptive immune remodeling (targeted regulation of dendritic cells, gene silencing vectors and reprogramming of T cell functions), and elaborates on the strategies for coordinated regulation of the microenvironment. The article also focuses on the targeted application of liver sinusoidal endothelial cells. In response to clinical translation bottlenecks, innovative solutions such as the design of degradable polymer carriers, the construction of intelligent response systems and the optimization of large-scale production pathways are proposed, providing theoretical support and practical directions for achieving the paradigm shift from "global immunosuppression" to "precise immune tolerance".

Objective To explore the relationship between the aerocyst continual inflation and clocked deflation and ventilator-associated pneumonia. Methods 60 ICU hospitalized adult patients treated with tracheotomy or trachea canalization for above 24 hours were randomly divided into the tzadi-tional group and the experimental group with 30 patients in each group. After trachea canalization success-fully according to the nursing standard, the experimental group was treated with aerocyst continual inflation, the traditional group gased the ventilator and recorded the time, deflating the gas every 4 hours and inflating again after 5 minutes. The inflation time, nurse management and MOV(minimal occlusive volume)of the two groups were the same. The chest X-rays examination and deep sputum bacilli culture were implemented 12 hours after admission, before pulling out the ventilator and transferring out of ICU to evaluate the inci-dence of ventilator-associated pneumonia according to the infection diagnosis standard. Results The rate of ventilator-associated pneumonia in the experimental group was obviously lower than that of the tradition-al group. Conclusions The rate of ventilator-associated pneumonia reduces obviously in the ICU trachea canalization patients with aerocyst continual inflation.