Objective:To explore the latent categories and influencing factors of health activation among community-dwelling older adults with chronic diseases.Methods:Older patients with chronic diseases attending three community health centers in Hefei City from August to December 2023 were selected for the study using the convenience sampling method. The survey utilized the General Information Questionnaire, Consumer Health Activation Index, Chinese version of the Life-Space Assessment, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Mplus 8.3 software was applied for latent profile analysis to examine patients' health activation, and unordered multicategory Logistic regression was used to explore the factors influencing different categories of health activation.Results:A total of 382 questionnaires were distributed, and 368 valid questionnaires were recovered, with a valid recovery rate of 96.34%. Three latent categories of health activation existed in community-dwelling older adults with chronic diseases, which were named as low health activation-high efficiency-coping inability group (16.85%, 62/368) , medium health activation group (27.99%, 103/368) , and high activation perception-action group (55.16%, 203/368) . Multicategory logistic regression analysis indicated that place of residence, age, self-rated health status, life space, social support, and active coping strategies were significant factors influencing the health activation of different latent categories of community-dwelling older adults with chronic diseases (all P<0.05) . Conclusions:The health activation of community-dwelling older adults with chronic diseases can be classified into three latent categories. Primary healthcare providers should identify the characteristics of patients in different categories and implement targeted nursing interventions to enhance their health activation levels.

Objective To comparatively observe the value of different machine learning(ML)models for predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods Totally 207 patients with pathologically diagnosed PTC were enrolled and divided into metastasis group(n=103)and non-metastasis group(n=104)according to lymph nodes pathology findings after surgical resection,also divided into training set(n=144)and validation set(n=63)with a ratio of 7∶3.Random forest(RF),decision tree(DT),K-nearest neighbor(KNN),logistic regression(LR)and support vector machine(SVM)models were constructed through combining clinical information and ultrasonic manifestations of lymph nodes.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficacy of these ML models for predicting PTC CLNM.Results Patients'age,transverse diameter/longitudinal diameter ratio of lymph node≥0.5,lymph nodes with cystic change,microcalcification,disappearance of lymphatic gate,hypoechoic mass and unclear border were all impact factors of PTC CLNM,among which microcalcification had the highest contribution to the models.In training set,AUC of DT and RF models were both 0.987,with accuracy reached 93.06%.In validation set,AUC of DT and RF models was 0.817 and 0.895,respectively,all higher than those of other models.The accuracy,specificity and positive predictive value of RF model in validation set was 84.13%,93.10%and 92.86%,respectively,and RF model was the best one among all 5 ML models.Conclusion Among different ML models,RF model was the best one for predicting PTC CLNM.

Objective To comparatively observe the value of different machine learning(ML)models for predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods Totally 207 patients with pathologically diagnosed PTC were enrolled and divided into metastasis group(n=103)and non-metastasis group(n=104)according to lymph nodes pathology findings after surgical resection,also divided into training set(n=144)and validation set(n=63)with a ratio of 7∶3.Random forest(RF),decision tree(DT),K-nearest neighbor(KNN),logistic regression(LR)and support vector machine(SVM)models were constructed through combining clinical information and ultrasonic manifestations of lymph nodes.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficacy of these ML models for predicting PTC CLNM.Results Patients'age,transverse diameter/longitudinal diameter ratio of lymph node≥0.5,lymph nodes with cystic change,microcalcification,disappearance of lymphatic gate,hypoechoic mass and unclear border were all impact factors of PTC CLNM,among which microcalcification had the highest contribution to the models.In training set,AUC of DT and RF models were both 0.987,with accuracy reached 93.06%.In validation set,AUC of DT and RF models was 0.817 and 0.895,respectively,all higher than those of other models.The accuracy,specificity and positive predictive value of RF model in validation set was 84.13%,93.10%and 92.86%,respectively,and RF model was the best one among all 5 ML models.Conclusion Among different ML models,RF model was the best one for predicting PTC CLNM.

Objective:To explore the latent categories and influencing factors of health activation among community-dwelling older adults with chronic diseases.Methods:Older patients with chronic diseases attending three community health centers in Hefei City from August to December 2023 were selected for the study using the convenience sampling method. The survey utilized the General Information Questionnaire, Consumer Health Activation Index, Chinese version of the Life-Space Assessment, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Mplus 8.3 software was applied for latent profile analysis to examine patients' health activation, and unordered multicategory Logistic regression was used to explore the factors influencing different categories of health activation.Results:A total of 382 questionnaires were distributed, and 368 valid questionnaires were recovered, with a valid recovery rate of 96.34%. Three latent categories of health activation existed in community-dwelling older adults with chronic diseases, which were named as low health activation-high efficiency-coping inability group (16.85%, 62/368) , medium health activation group (27.99%, 103/368) , and high activation perception-action group (55.16%, 203/368) . Multicategory logistic regression analysis indicated that place of residence, age, self-rated health status, life space, social support, and active coping strategies were significant factors influencing the health activation of different latent categories of community-dwelling older adults with chronic diseases (all P<0.05) . Conclusions:The health activation of community-dwelling older adults with chronic diseases can be classified into three latent categories. Primary healthcare providers should identify the characteristics of patients in different categories and implement targeted nursing interventions to enhance their health activation levels.

Objective To determine the improved effect of methylene blue(MB)on cognitive func-tion in brain-inflammatory-aging rats and investigate the underlying mechanism.Methods A total of 38 healthy 12-month-old SD rats were randomly divided into healthy control group,lipopo-lysaccharide(LPS)group,MB vehicle group and MB group,with 8 rats in the control and 10 rats in the other three groups.LPS was injected into the fourth ventricle with aid of a subcutaneous sustained release pump to establish a rat model of brain chronic inflammatory aging.MB of 0.5 mg/(kg·d)was added into the pump in the rats from the MB group.T-maze test and new object recognition test were employed to evaluate the learning and memory abilities of the rats.The acti-vation of microglia and astrocytes in the hippocampal CA1 region of the rats was detected by im-munofluorescence assay.The release of inflammatory factors IL-1β and IL-6 was measured by ELISA,and neuronal death in the CA1 region was assessed by neuronal nuclei(NeuN)fluores-cence staining.Results There was no significant difference in the exploration time for new and old objects between the LPS group and the MB solvent group(P＞0.05).The MB group spent significantly longer time in exploring the new objects than the old object(22.50±4.32 s vs 11.60± 3.01 s,P=0.000).The alternating selection rate of new arm and expression level of NeuN antigen were significantly decreased,and the expression levels of ionized calcium binding adaptor mole-cule-1(Iba-1)and glial fibrillary acidic protein(GFAP)and the contents of IL-1β and IL-6 were obviously increased(P＜0.05)in the LPS group and the MB vehicle group than the healthy con-trol group.Compared with the MB vehicle group,the MB group had notably increased alternating selection rate of new arms and higher NeuN expression level,and decreased Iba-1 and GFAP ex-pression and IL-1β and IL-6 contents(P＜0.05).Conclusion Subcutaneous administration of MB could significantly inhibit the damages of spatial learning and memory abilities in the LPS-induced brain chronic inflammatory aging rats.The mechanism may be closely associated with MB inhibi-ting inflammatory glial cells and protecting hippocampal pyramidal neurons.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the efficacy of electromagnetic guidance and bedside ultrasound in the placement of nasointestinal feeding tubes in neurocritical care patients,providing a reference for nurses to accurately and efficiently place tubes at the bedside. Methods A tatal of 85 patients were selected as the study subjects,who required nasoenteric tube placement and treated in the department of neurocritical care unit of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2023. Patients were randomly divided into an experimental group (43 cases) and a control group (42 cases) using a random number table. The experimental group used electromagnetic guidance-assisted nasointestinal tube placement,while the control group utilized bedside ultrasound technology. The differences in the success rate of one-time tube placement,placement time,and complications between the two groups were compared. Results The success rate of one-time tube placement in the experimental group was higher than that in the control group[97.67％ (42/43) vs. 95.24％ (40/42)],but the difference was not statistically significant (P>0.05). The placement time in the experimental group was significantly reduced compared to the control group (minutes:16.23±3.06 vs. 25.07±3.26,P<0.05),and the number of positioning attempts was significantly fewer[attempts:1 (1,3) vs. 3 (3,4),P<0.05]. Scores for theoretical knowledge,operational practice,placement preparation,catheter position visualization,and catheter position interpretation in the experimental group were significantly lower than those in the control group[theoretical knowledge score:2.67±0.52 vs. 4.67±0.52,operational practice score:2.50±0.55 vs. 5.00±0.00,placement preparation score:2.33 (2.00,3.00) vs. 3.00 (2.00,4.00),catheter position visualization score:1.83±0.41 vs. 4.83±0.41,catheter position interpretation score:1.83±0.41 vs. 3.83±0.41,all P<0.05]. The technical difficulty score was significantly lower in the experimental group than in the control group (11.17±0.75 vs. 21.33±0.82,P<0.05). The incidence of nasal bleeding complications in the experimental group was significantly lower than that in the control group[6.98％ (3/43) vs. 23.81％ (10/42),P<0.05]. No other placement complications occurred in either group. Conclusions The success rates of one-time tube placement using electromagnetic navigation and bedside ultrasound for bedside placement of nasointestinal feeding tubes were comparable,but electromagnetic guidance offered higher efficiency and safety. It is suggested that bedside ultrasound be used for gastrointestinal evaluation before electromagnetic guidance-assisted tube placement to assist nurses in implementing personalized pre-placement preparations,thereby further increasing the success rate of tube placement.

Objective To investigate the efficacy of electromagnetic guidance and bedside ultrasound in the placement of nasointestinal feeding tubes in neurocritical care patients,providing a reference for nurses to accurately and efficiently place tubes at the bedside. Methods A tatal of 85 patients were selected as the study subjects,who required nasoenteric tube placement and treated in the department of neurocritical care unit of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2023. Patients were randomly divided into an experimental group (43 cases) and a control group (42 cases) using a random number table. The experimental group used electromagnetic guidance-assisted nasointestinal tube placement,while the control group utilized bedside ultrasound technology. The differences in the success rate of one-time tube placement,placement time,and complications between the two groups were compared. Results The success rate of one-time tube placement in the experimental group was higher than that in the control group[97.67％ (42/43) vs. 95.24％ (40/42)],but the difference was not statistically significant (P>0.05). The placement time in the experimental group was significantly reduced compared to the control group (minutes:16.23±3.06 vs. 25.07±3.26,P<0.05),and the number of positioning attempts was significantly fewer[attempts:1 (1,3) vs. 3 (3,4),P<0.05]. Scores for theoretical knowledge,operational practice,placement preparation,catheter position visualization,and catheter position interpretation in the experimental group were significantly lower than those in the control group[theoretical knowledge score:2.67±0.52 vs. 4.67±0.52,operational practice score:2.50±0.55 vs. 5.00±0.00,placement preparation score:2.33 (2.00,3.00) vs. 3.00 (2.00,4.00),catheter position visualization score:1.83±0.41 vs. 4.83±0.41,catheter position interpretation score:1.83±0.41 vs. 3.83±0.41,all P<0.05]. The technical difficulty score was significantly lower in the experimental group than in the control group (11.17±0.75 vs. 21.33±0.82,P<0.05). The incidence of nasal bleeding complications in the experimental group was significantly lower than that in the control group[6.98％ (3/43) vs. 23.81％ (10/42),P<0.05]. No other placement complications occurred in either group. Conclusions The success rates of one-time tube placement using electromagnetic navigation and bedside ultrasound for bedside placement of nasointestinal feeding tubes were comparable,but electromagnetic guidance offered higher efficiency and safety. It is suggested that bedside ultrasound be used for gastrointestinal evaluation before electromagnetic guidance-assisted tube placement to assist nurses in implementing personalized pre-placement preparations,thereby further increasing the success rate of tube placement.

Objective To analyze the important abnormal results of physical examination of the staff in our hospital in recent 2 years,and to provide evidence for the health management of the staff in our hospital.Methods The physical examina-tion data of hospital staff in recent 2 years were retrospectively analyzed,and the important abnormal results were statistically ana-lyzed.Results A total of 3 584 employees participated in physical examination,including753 males and 2831 females.There were 92 cases with significant abnormal results,and the total detection rate was 2.57%.The detection rate of significant abnor-mal results was slightly lower in males(17cases,2.26%)than in females(75cases,2.65%),and the age of females[(48.89±19.53)years]was lower than that of males[(55.68±17.43)years].The age group with the most significant detec-tion rate of important abnormal results was 50-59 years old(3.07%),and the diseases detected by important abnormal results were as follows:There were 26 thyroid tumors,19 lung tumors,13 breast tumors,12 space occupying cases(3 liver,4 kidney,2 adrenal glands,1 adnexa,1 pancreas,1 mediastinum),9 vascular lesions,6 abnormal tumor markers,5 cervical lesions,1 tuberculosis,and 1 subdural hematoma.Among them,thyroid tumors,breast tumors,lung tumors and cervical lesions were the main cases in women,and vascular diseases,lung tumors,space-occupying lesions(liver and kidney)and thyroid tumors were the main cases in men.Conclusion Physical examination is of great significance in detecting important abnormal diseases.We should attach great importance to physical examination,detect serious diseases as early as possible,and strengthen health man-agement accordingly.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*