Recent data suggest that vascular endothelial growth factor receptor inhibitor (VEGFRi) can enhance the anti-tumor activity of the anti-programmed cell death-1 (anti-PD-1) antibody in colorectal cancer (CRC) with microsatellite stability (MSS). However, the comparison between this combination and standard third-line VEGFRi treatment is not performed, and reliable biomarkers are still lacking. We retrospectively enrolled MSS CRC patients receiving anti-PD-1 antibody plus VEGFRi (combination group, n=54) or VEGFRi alone (VEGFRi group, n=32), and their efficacy and safety were evaluated. We additionally examined the immune characteristics of the MSS CRC tumor microenvironment (TME) through single-cell and spatial transcriptomic data, and an MSS CRC immune cell-related signature (MCICRS) that can be used to predict the clinical outcomes of MSS CRC patients receiving immunotherapy was developed and validated in our in-house cohort. Compared with VEGFRi alone, the combination of anti-PD-1 antibody and VEGFRi exhibited a prolonged survival benefit (median progression-free survival: 4.4 vs. 2.0 months, P=0.0024; median overall survival: 10.2 vs. 5.2 months, P=0.0038) and a similar adverse event incidence. Through single-cell and spatial transcriptomic analysis, we determined ten MSS CRC-enriched immune cell types and their spatial distribution, including naive CD4⁺ T, regulatory CD4⁺ T, CD4⁺ Th17, exhausted CD8⁺ T, cytotoxic CD8⁺ T, proliferated CD8⁺ T, natural killer (NK) cells, plasma, and classical and intermediate monocytes. Based on a systemic meta-analysis and ten machine learning algorithms, we obtained MCICRS, an independent risk factor for the prognosis of MSS CRC patients. Further analyses demonstrated that the low-MCICRS group presented a higher immune cell infiltration and immune-related pathway activation, and hence a significant relation with the superior efficacy of pan-cancer immunotherapy. More importantly, the predictive value of MCICRS in MSS CRC patients receiving immunotherapy was also validated with an in-house cohort. Anti-PD-1 antibody combined with VEGFRi presented an improved clinical benefit in MSS CRC with manageable toxicity. MCICRS could serve as a robust and promising tool to predict clinical outcomes for individual MSS CRC patients receiving immunotherapy.
Humans ; Colorectal Neoplasms/drug therapy* ; Male ; Female ; Immunotherapy ; Middle Aged ; Aged ; Tumor Microenvironment/immunology* ; Retrospective Studies ; Microsatellite Instability ; Transcriptome ; Single-Cell Analysis ; Programmed Cell Death 1 Receptor/immunology* ; Gene Expression Profiling ; Immune Checkpoint Inhibitors/therapeutic use* ; Adult ; Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors*

Objective To develop a symptoms assessment scale for lung transplant recipients in early postoperative period,and assess its reliability and validity so as to provide clinical staff with a tool to evaluate the symptoms in the patients in the early period after lung transplantation.Methods With a symptom experience model,a preliminary item pool was established through literature reviews,semi-structured interviews and expert panel meetings between December 2021 and January 2022.Based on the preliminary item pool,an initial scale was proposed after two rounds of expert consultation between February and March 2022.The initial scale was finalised after all items had revised for language expression based on the results of cognitive interviews conducted in March 2022.Subsequently,the final version of the scale was applied in the survey of 116 recipients of lung transplant in the early postoperative stage at Wuxi People's Hospital between April 2022 and February 2023.The reliability and validity of scale were then further tested.Results A total of 112 patients responded to the questionnaire survey.The developed scale comprised 5 dimensions:psychology-related symptoms,respiratory related symptoms,digestive related symptoms,circulatory related symptoms and other symptoms,with 18 symptom items in total.Content validity indexes of the Item-level content validity index(I-CVI))were 0.833 to 1.000 and the Scale-level content validity index(S-CVI)was at 0.954.Exploratory factor analysis revealed five common factors with a cumulative variance contribution rate of 82.366%.All the factors exhibited positive correlations with the scale,with the correlation coefficient at 0.760 to 0.837(P<0.01).The scale demonstrated a Cronbach α coefficient of 0.943,and the Cronbach α coefficients of the five common factors ranged from 0.869 to 0.941.Additionally,the scale exhibited a split-half reliability of 0.840,and the split-half reliability of the five common factors ranged from 0.830 to 0.937.Conclusions The symptoms assessment scale for lung transplant recipients in early postoperative period developed in this study exhibits good reliability and validity.It is feasible for evaluation of early symptoms in lung transplant recipients.

Objective:To conduct a scoping review of the characteristics, functions, risk of bias and applications of home-based self-management behavior assessment tools for lung transplant patients, so as to provide references for clinical medical staff to conduct further related research.Methods:The relevant literatures were systematically searched in China National Knowledge Infrastructure, Wanfang Database, VIP, China Biology Medicine disc, PubMed, Web of Science Core Collection, Embase, Cochrane Library and CINAHL databases. The search period was from the establishment of the databases to June 30, 2023. The scoping review method framework was used to screen the literature, extract information and standardize the report.Results:A total of 10 167 Chinese and English literatures were searched, and after deduplication and screening, 23 articles that met the criteria were finally included, involving 13 home-based self-management behavior assessment tools for lung transplant patients, including nine specific tools and four universal tools. There were eight kinds of lung transplantation patients whose reliability and validity were not verified. Of the 13 tools, those with single-dimensional assessments and single measures predominate. The level of home self-management behavior of lung transplant patients was reflected mainly through compliance, and medication management was the most frequently assessed content.Conclusions:At present, the measurement of home-based self-management behavior of lung transplant patients is mainly based on questionnaire surveys, and the evaluation tools are mostly single dimensional. The reliability and validity of most evaluation tools in the population of lung transplant patients are not yet clear, and there is a certain risk of bias. It is recommended that researchers pay attention to the reliability and validity verification report of the evaluation tool in the target population when selecting it, and integrate multiple measurement methods to reduce measurement errors.

Gonorrhea, caused by Neisseria gonorrhoeae, is one of the most frequently reported infectious diseases. With the increasing antibiotic resistance in Neisseria gonorrhoeae, gonorrhea has become a major public health problem worldwide, making it imperative to develop a safe and effective vaccine. Lipooligosaccharides (LOS), which exist on the outer surface of gram-negative bacteria, contain many important antigenic determinants. In recent years, a large number of studies have shown that LOS may become the most potential target of Neisseria gonorrhoeae vaccine and immunotherapy. This article reviewed the structure of LOS, its role in Neisseria gonorrhoeae infection, research progress in LOS vaccine and the challenges faced in vaccine development, aiming to provide reference for further study.

Objective: To analyze the research status,research hotspots and its changing trends of diabetes management in China. Methods: We searched the databases of CNKI,Wanfang and VIP to collect literature about diabetes management until December 7th of 2019;counted the number of published articles and journals;plotted the co-occurrence maps of authors and institutions,and time zone map of keywords by CiteSpace software,so as to analyze the research status,research hotspots and its changing trends of diabetes management. Results : A total of 8 435 articles were included,and the number of the articles was increasing year by year. The largest number,8 141 (96.51%) of published articles lay in the period from 2009 to 2019. The articles published in 826 journals,13 of which were in the core area. Diabetes New World published the largest number,419 (4.97%) of articles. Lou Qingqing was the author with the most articles published (26,accounting for 0.31%). Shanghai Jiao Tong University,West China Hospital of Sichuan University and the First Affiliated Hospital of Jinan University ranked the top three in articles published,with 70 articles accounting for 0.83%. The keywords that appeared more frequently were self-management,health education,blood glucose management,gestational diabetes,health management,community management and nursing management. The more centralized keywords were self-management,health education,gestational diabetes and community management. Self-management and health education had always been research hotspots. Family doctors and mobile health were new directions in recent years. Conclusions The volume of domestic articles on diabetes management has been increasing. Self-management and health education has always been hotspots,meanwhile,family doctor and mobile health have become new hotspots of diabetes management research.

Objective:To explore the nutritional knowledge, attitude and practice (KAP) in patients during the waiting period for lung transplantation, analyze its influencing factors, and provide a reference for individualized nutritional intervention during the perioperative period of lung transplantation.Methods:Totally 240 patients during the waiting period for lung transplantation after lung transplantation evaluation in The Respiratory Center, Wuxi People's Hospital between January and December 2018 were selected using convenient sampling, and investigated with the self-made nutritional KAP questionnaire for patients during the waiting period for lung transplantation. And the influencing factors to their nutritional KAP were analyzed.Results:The nutritional knowledge of patients during the waiting period for lung transplantation was average, with a score of (18.71±4.53) ; the nutritional attitude was good, with a score of (38.00±6.49) ; the nutritional practice was average, with a score of (36.75±4.89) . Multiple linear regression analysis showed that the influencing factors of nutritional knowledge were economic status and whether it was complication with neurological diseases ( P<0.05) ; the influencing factors of nutritional attitude were occupation and serum protein ( P<0.05) ; the influencing factors of nutritional practice were age, educational level and whether it was complicated with urinary system disease ( P<0.05) . Conclusions:The nutritional KAP of patients during the waiting period for lung transplantation is affected by age, economic status, comorbidity, occupation and educational level and serum protein. In the perioperative nutritional management of lung transplantation patients, we should fully consider various factors, provide targeted and precision nutritional interventions, improve the nutritional practice and status of patients by improving their nutritional knowledge and attitude.

Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.

Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.

Objective To investigate the criteria of hemodynamic parameters for diagnosis of intracranial segment vertebral artery stenosis with transcranial color-coded sonography (TCCS ). Methods A total of 622 outpatients or inpatients with suspected posterior circulation ischemia were enrolled retrospectively,from which 216 patients were selected with TCCS,color Doppler flow imaging (CDFI)screen,and digital subtraction angiography (DSA)examination,including 33 patients (15. 3%) had normal intracranial vertebral arteries,the stenosis rates<50% were 45 cases (20. 8%),50%-69%were 44 cases (20. 4%),and 70%-99% were 94 cases (43. 5%). The mean velocity (MV)of intracranial segment,the ratios SPRP (PSV1/PSV2 ),SPRE (EDV1/EDV2 )of the systolic and end diastolic flow velocity between the intracranial segment and the intervertebral space segment were calculated respectively by detecting the intracranial segment of vertebral artery,the intervertebral space segment peak systolic velocity (PSV1 ,PSV2 )and end diastolic velocity (EDV2 ,EDV1 ). The DSA findings were used as the criteria,the area under the receiver operating characteristic (ROC ) curve was calculated and the optimal cut-off points were obtained. Results The optimal cut-off points of TCCS diagnosis of intracranial vertebral artery stenosis were as follows:the parameter standards of stenosis rate <50% were 110 cm/s≤PSV1≤145 cm/s and 65 cm/s≤MV≤85 cm/s,the parameter standards of stenosis rate 50%-69%were 145 cm/s≤PSV1≤190 cm/s and 85 cm/s≤MV≤115 cm/s,and the parameter standards of stenosis rate 70%-99% were PSV1≥190 cm/s and MV≥115 cm/s. Conclusion TCCS may effectively evaluate the hemodynamic changes of intracranial vertebral artery stenosis and provide reference for the ultrasound evaluation criteria of intracranial vertebral artery stenosis.

Objective To observe the clinical efficacy of acupuncture plus moxibustion in the treatment of benign prostatic hyperplasia.Method Sixty cases of benign prostatic hyperplasia were randomly divided into two groups, 30 cases in the treatment group, 30 cases in the control group. The treatment group was intervened by Acupuncture and moxibustion, while the control group was by orally takingJingzhu Qianlie Longbitong capsules. The International Prostate Symptom Score (IPSS), Quality of Life score (QOL), maximal urinary flow rate (Qmax), residual urine volume (RUV) were compared before and after 3 courses of treatment. Result The total effective rate was 93.3% in the treatment group, versus 66.7% in the control group, and the difference was statistically significant (P<0.05); the IPSS score, QOL score, Qmax, and RUV were significantly changed in both groups after intervention (P<0.05).Conclusion The treatment group and the control group both show improvements in IPSS, QOL score and Qmax and reduction of RUV, which proves that acupuncture plus moxibustion can produce a content efficacy in treating benign prostatic hyperplasia.