Objective To investigate the effects of extracellular vesicles(EVs)derived from synovial fluid of rheumatoid arthritis(RA)patients on angiogenesis of human umbilical vein endothelial cells,and to preliminarily explore the underlying mechanisms.Methods Synovial fluid samples of knee joint were collected from 20 patients with RA and 20 patients with osteoarthritis(OA)in this study.EVs were purified using ultracentrifugation.The morphology and size of EVs were observed by transmission electron microscopy and nanoparticle tracking analysis.CD9,CD63,cytochrome c(Cyt-c),vascular endothelial growth factor(VEGF),lysyl oxidase(LOX),matrix metalloproteinase 2(MMP2),tumour necrosis factor alpha(TNF-α),transforming growth factor beta1(TGF-β1)in EVs were detected using Western blot.Human umbilical vein endothelial cells(HUVEC)were treated with the EVs.The growth,migration and angiogenesis of HUVEC were observed by CCK8 assay,TranswellTM chamber assay,scratch test and matrigel angiogenesis assay,respectively.The effect of EVs on the PI3K/AKT pathway in HUVEC was assessed using Western blot.Results Both EVs from RA synovial fluid(RA-EVs)and OA synovial fluid(OA-EVs)were cup-shaped,mainly between 30-400 nm in diameter,expressing CD63 and CD9,but not Cyt-c.RA-EVs carried more VEGF,LOX,MMP2,TNF-α and TGF-β1 than OA-EVs.Compared with the OA-EVs intervention,RA-EVs significantly promoted the proliferation,migration,and angiogenesis of HUVECs,as well as upregulated PI3K/AKT phosphorylation.The inhibitor of PI3K suppressed angiogenesis induced by EVs.Conclusion EVs in synovial fluid of RA carried more cytokines and enzymes that related angiogenesis and inflammation.These EVs exert their pro-angiogenic effects by activating the PI3K/AKT pathway,then contributing to the pathological progression of RA.

Objective To understand the current status of fear of missing out(FoMO)social interaction in adole-scent patients with severe accidental trauma,and to explore its potential categorical characteristics,and analyze the influencing factors of different categories.Methods A convenience sampling method was employed to select 301 adolescent patients with severe accidental trauma admitted to the surgical and trauma ICU of a tertiary hospital in Chengdu City from January to December 2024.Data were collected using a general information survey,the Fear of Missing Out Scale,the Adolescent Learning Stress Scale,and the Self-Perceived Burden Scale.Latent profile analysis and multiple logistic regression analysis were used to determine different profiles and their influencing factors.Results A total of 245 adolescent patients with severe accidental trauma were ultimately included,with a Fear of Missing Out Scale score of(21.55±8.17),being categorized into 4 potential profiles of"independent type"(28.16％),"normal type"(19.59％),"social dependence type"(22.04％),and"information deficiency type"(30.20％).The results of multiple logistic regression analysis showed that literacy,per capita monthly family income,level of academic stress,level of self-awareness of medical staff care,being an only child,level of self-perceived burden,and length of hospitalization were the factors influencing the potential profiles of FoMO social interaction in adolescent patients with unintentional trauma(all P＜0.05).Conclusion There is group heterogeneity in FoMO social interaction among adolescent patients with severe accidental trauma.Medical staff should develop targeted intervention measures based on the classification characteristics of different profiles of missing anxiety in adolescent accidental trauma patients to alleviate their levels of FoMO social interaction.

Objective To investigate the effects of synovial fluid from patients with rheumatoid arthritis(RA)on the polarization of normal neutrophils and the MEK/ERK signaling pathway,thereby providing experimental evidence to elucidate the pathological mechanisms of RA and offering novel insights into its treatment.Methods Synovial fluid samples were collected from 20 RA patients and 20 osteoarthritis(OA)patients.ELISA was used to measure the levels of interferon-gamma(IFN-γ),tumor necrosis factor-alpha(TNF-α),transforming growth factor-beta(TGF-β)and interleukin-8(IL-8)in the synovial fluid.Neutrophils were isolated from the peripheral blood of healthy donors,and their purity was confirmed by flow cytometry.Neutrophils were then treated with synovial fluid and divided into four groups:Control(untreated),RA(treated with 10％RA synovial fluid),OA(treated with 10％OA synovial fluid),and anti-IFN-β(treated with 20 μg anti-IFN-β antibody as an N2-type control).Western blot was used to assess the changes in the expression of IFN-γ,TNF-α,TGF-β,MEK,p-MEK,ERK and p-ERK.Additionally,the MEK inhibitor PD0325901 was used to block the MEK/ERK pathway,and subsequent changes in IFN-γ and TGF-β expression in neutrophils were evaluated.Results The levels of IFN-γ,TNF-α,TGF-β and IL-8 in the synovial fluid of RA patients were significantly higher than those in OA patients.After intervention with RA synovial fluid,the relative expression of IFN-γ and TNF-α in neutrophils were significantly increased compared to those in the untreated control group and the OA group.While,TGF-β expression in the RA group was lower than that in both the control and anti-IFN-β groups.The relative expression of p-MEK and p-ERK in the RA group were significantly higher than those in the control,OA and Anti-IFN-β groups.Upon addition of the MEK inhibitor,the relative expression of p-MEK and p-ERK were reduced.Furthermore,in both the RA and OA groups,the relative expression levels of IFN-γ decreased,while the expression of TGF-β increased.Conclusion Synovial fluid from RA patients contains higher of IFN-γ,TNF-αand TGF-β,which activate neutrophils through phosphorylation of the MEK/ERK signaling pathway,promoting their polarization toward the pro-inflammatory N1 phenotype.

Objective:To evaluate the effects of comprehensive intervention on bowel function, anxiety, and quality of life in hospitalized elderly patients, and to assess its safety.Methods:Sixty-four elderly inpatients with mixed-type constipation were recruited between October 2020 and January 2021 and randomly assigned to the treatment group and the control group ( n=32 in each group). The control group received oral mosapride(5 mg each time, 3 times a day) plus one aloe capsule(once a day), whereas the treatment group was provided with a comprehensive intervention including dietary and defecation-behavior guidance, abdominal massage, and psychological support, and additionally took lorazepam(0.5 mg each time, once a day) on top of the control regimen for a 4-week treatment course. Bowel efficacy was recorded at baseline, 2 weeks and 4 weeks after intervention. Anxiety was assessed with the Hamilton anxiety scale (HAMA), and quality of life with the short-form 36 health survey (SF-36). Complications and adverse events were also monitored.SPSS 22.0 software was used for data analysis, and χ2 test or repeated measures ANOVA was used for comparison between the two groups. Results:After 2 and 4 weeks, the overall response rates in the treatment group were 84.37%(27/32) and 93.75%(30/32), respectively, and significantly higher than those in the control group (59.37%(19/32) and 62.50%(20/32); χ2=4.947, 9.143, both P<0.05). HAMA scores decreased from 20.50±2.11 to 14.75± 1.48 in the treatment group and from 20.13±1.60 to 17.75±1.98 in the control group ( Finteraction=18.36, P<0.001). SF-36 total scores improved from 75.82±5.11 to 89.35±5.21 in the treatment group and from 74.90±5.26 to 83.03±5.42 in the control group ( Finteraction=12.74, P<0.001). At both 2 and 4 weeks, the treatment group had lower HAMA scores and higher SF-36 scores than the control group (all P<0.05). The incidence of complications in the treatment group was lower than that in in the control group (6.25%(2/32) vs 37.50%(12/32), χ2=9.143, P<0.05). No serious adverse events occurred in either group. Conclusion:Comprehensive intervention significantly improves functional constipation in elderly inpatients, alleviates anxiety, enhances quality of life, and is well tolerated.

Objective To investigate the effects of synovial fluid from patients with rheumatoid arthritis(RA)on the polarization of normal neutrophils and the MEK/ERK signaling pathway,thereby providing experimental evidence to elucidate the pathological mechanisms of RA and offering novel insights into its treatment.Methods Synovial fluid samples were collected from 20 RA patients and 20 osteoarthritis(OA)patients.ELISA was used to measure the levels of interferon-gamma(IFN-γ),tumor necrosis factor-alpha(TNF-α),transforming growth factor-beta(TGF-β)and interleukin-8(IL-8)in the synovial fluid.Neutrophils were isolated from the peripheral blood of healthy donors,and their purity was confirmed by flow cytometry.Neutrophils were then treated with synovial fluid and divided into four groups:Control(untreated),RA(treated with 10％RA synovial fluid),OA(treated with 10％OA synovial fluid),and anti-IFN-β(treated with 20 μg anti-IFN-β antibody as an N2-type control).Western blot was used to assess the changes in the expression of IFN-γ,TNF-α,TGF-β,MEK,p-MEK,ERK and p-ERK.Additionally,the MEK inhibitor PD0325901 was used to block the MEK/ERK pathway,and subsequent changes in IFN-γ and TGF-β expression in neutrophils were evaluated.Results The levels of IFN-γ,TNF-α,TGF-β and IL-8 in the synovial fluid of RA patients were significantly higher than those in OA patients.After intervention with RA synovial fluid,the relative expression of IFN-γ and TNF-α in neutrophils were significantly increased compared to those in the untreated control group and the OA group.While,TGF-β expression in the RA group was lower than that in both the control and anti-IFN-β groups.The relative expression of p-MEK and p-ERK in the RA group were significantly higher than those in the control,OA and Anti-IFN-β groups.Upon addition of the MEK inhibitor,the relative expression of p-MEK and p-ERK were reduced.Furthermore,in both the RA and OA groups,the relative expression levels of IFN-γ decreased,while the expression of TGF-β increased.Conclusion Synovial fluid from RA patients contains higher of IFN-γ,TNF-αand TGF-β,which activate neutrophils through phosphorylation of the MEK/ERK signaling pathway,promoting their polarization toward the pro-inflammatory N1 phenotype.

Objective:To evaluate the effects of comprehensive intervention on bowel function, anxiety, and quality of life in hospitalized elderly patients, and to assess its safety.Methods:Sixty-four elderly inpatients with mixed-type constipation were recruited between October 2020 and January 2021 and randomly assigned to the treatment group and the control group ( n=32 in each group). The control group received oral mosapride(5 mg each time, 3 times a day) plus one aloe capsule(once a day), whereas the treatment group was provided with a comprehensive intervention including dietary and defecation-behavior guidance, abdominal massage, and psychological support, and additionally took lorazepam(0.5 mg each time, once a day) on top of the control regimen for a 4-week treatment course. Bowel efficacy was recorded at baseline, 2 weeks and 4 weeks after intervention. Anxiety was assessed with the Hamilton anxiety scale (HAMA), and quality of life with the short-form 36 health survey (SF-36). Complications and adverse events were also monitored.SPSS 22.0 software was used for data analysis, and χ2 test or repeated measures ANOVA was used for comparison between the two groups. Results:After 2 and 4 weeks, the overall response rates in the treatment group were 84.37%(27/32) and 93.75%(30/32), respectively, and significantly higher than those in the control group (59.37%(19/32) and 62.50%(20/32); χ2=4.947, 9.143, both P<0.05). HAMA scores decreased from 20.50±2.11 to 14.75± 1.48 in the treatment group and from 20.13±1.60 to 17.75±1.98 in the control group ( Finteraction=18.36, P<0.001). SF-36 total scores improved from 75.82±5.11 to 89.35±5.21 in the treatment group and from 74.90±5.26 to 83.03±5.42 in the control group ( Finteraction=12.74, P<0.001). At both 2 and 4 weeks, the treatment group had lower HAMA scores and higher SF-36 scores than the control group (all P<0.05). The incidence of complications in the treatment group was lower than that in in the control group (6.25%(2/32) vs 37.50%(12/32), χ2=9.143, P<0.05). No serious adverse events occurred in either group. Conclusion:Comprehensive intervention significantly improves functional constipation in elderly inpatients, alleviates anxiety, enhances quality of life, and is well tolerated.

Objective:To explore the interactive transfer effects between ICU transferred patients' and their primary caregivers' transfer readiness and relocation stress using the Actor-Partner Interdependence Model (APIM) .Methods:A convenience sampling method was used to select 304 pairs of ICU patients and their primary caregivers, who were transferred from the ICU between January and July 2024 at West China Hospital of Sichuan University. A general information questionnaire, ICU patients Transfer Readiness Scale, Relocation Stress Syndrome Scale-Short Form, Caregiver Preparedness Scale, and Family Relocate Stress Syndrome Scale were used to collect data. The APIM was applied to analyze the relationship between ICU patients' and caregivers' transfer readiness and relocation stress.Results:The transfer readiness scores of 304 pairs of ICU patients and their primary caregivers were (65.22±10.04) and (14.57±4.84) , respectively, and the relocation stress scores were (25.06±5.34) and (50.35±7.38) , respectively. APIM analysis showed that the transfer readiness of ICU patients negatively predicted their own relocation stress ( P<0.05) , and the transfer readiness of primary caregivers negatively predicted their own relocation stress ( P<0.05) . The ICU patients' transfer readiness negatively predicted the primary caregivers' relocation stress ( P<0.05) , while the transfer readiness of primary caregivers did not significantly predict the ICU patients' relocation stress ( P>0.05) . Conclusions:ICU patients' relocation stress is influenced by their own transfer readiness, while primary caregivers' relocation stress is jointly influenced by both their own and the patients' transfer readiness. This suggests that healthcare providers should pay attention to the transmission of relocation stress between ICU patients and their families and actively explore family-based intervention strategies.

Objective To investigate the effects of extracellular vesicles(EVs)derived from synovial fluid of rheumatoid arthritis(RA)patients on angiogenesis of human umbilical vein endothelial cells,and to preliminarily explore the underlying mechanisms.Methods Synovial fluid samples of knee joint were collected from 20 patients with RA and 20 patients with osteoarthritis(OA)in this study.EVs were purified using ultracentrifugation.The morphology and size of EVs were observed by transmission electron microscopy and nanoparticle tracking analysis.CD9,CD63,cytochrome c(Cyt-c),vascular endothelial growth factor(VEGF),lysyl oxidase(LOX),matrix metalloproteinase 2(MMP2),tumour necrosis factor alpha(TNF-α),transforming growth factor beta1(TGF-β1)in EVs were detected using Western blot.Human umbilical vein endothelial cells(HUVEC)were treated with the EVs.The growth,migration and angiogenesis of HUVEC were observed by CCK8 assay,TranswellTM chamber assay,scratch test and matrigel angiogenesis assay,respectively.The effect of EVs on the PI3K/AKT pathway in HUVEC was assessed using Western blot.Results Both EVs from RA synovial fluid(RA-EVs)and OA synovial fluid(OA-EVs)were cup-shaped,mainly between 30-400 nm in diameter,expressing CD63 and CD9,but not Cyt-c.RA-EVs carried more VEGF,LOX,MMP2,TNF-α and TGF-β1 than OA-EVs.Compared with the OA-EVs intervention,RA-EVs significantly promoted the proliferation,migration,and angiogenesis of HUVECs,as well as upregulated PI3K/AKT phosphorylation.The inhibitor of PI3K suppressed angiogenesis induced by EVs.Conclusion EVs in synovial fluid of RA carried more cytokines and enzymes that related angiogenesis and inflammation.These EVs exert their pro-angiogenic effects by activating the PI3K/AKT pathway,then contributing to the pathological progression of RA.

Objective:To explore the interactive transfer effects between ICU transferred patients' and their primary caregivers' transfer readiness and relocation stress using the Actor-Partner Interdependence Model (APIM) .Methods:A convenience sampling method was used to select 304 pairs of ICU patients and their primary caregivers, who were transferred from the ICU between January and July 2024 at West China Hospital of Sichuan University. A general information questionnaire, ICU patients Transfer Readiness Scale, Relocation Stress Syndrome Scale-Short Form, Caregiver Preparedness Scale, and Family Relocate Stress Syndrome Scale were used to collect data. The APIM was applied to analyze the relationship between ICU patients' and caregivers' transfer readiness and relocation stress.Results:The transfer readiness scores of 304 pairs of ICU patients and their primary caregivers were (65.22±10.04) and (14.57±4.84) , respectively, and the relocation stress scores were (25.06±5.34) and (50.35±7.38) , respectively. APIM analysis showed that the transfer readiness of ICU patients negatively predicted their own relocation stress ( P<0.05) , and the transfer readiness of primary caregivers negatively predicted their own relocation stress ( P<0.05) . The ICU patients' transfer readiness negatively predicted the primary caregivers' relocation stress ( P<0.05) , while the transfer readiness of primary caregivers did not significantly predict the ICU patients' relocation stress ( P>0.05) . Conclusions:ICU patients' relocation stress is influenced by their own transfer readiness, while primary caregivers' relocation stress is jointly influenced by both their own and the patients' transfer readiness. This suggests that healthcare providers should pay attention to the transmission of relocation stress between ICU patients and their families and actively explore family-based intervention strategies.

Objective To understand the current status of fear of missing out(FoMO)social interaction in adole-scent patients with severe accidental trauma,and to explore its potential categorical characteristics,and analyze the influencing factors of different categories.Methods A convenience sampling method was employed to select 301 adolescent patients with severe accidental trauma admitted to the surgical and trauma ICU of a tertiary hospital in Chengdu City from January to December 2024.Data were collected using a general information survey,the Fear of Missing Out Scale,the Adolescent Learning Stress Scale,and the Self-Perceived Burden Scale.Latent profile analysis and multiple logistic regression analysis were used to determine different profiles and their influencing factors.Results A total of 245 adolescent patients with severe accidental trauma were ultimately included,with a Fear of Missing Out Scale score of(21.55±8.17),being categorized into 4 potential profiles of"independent type"(28.16％),"normal type"(19.59％),"social dependence type"(22.04％),and"information deficiency type"(30.20％).The results of multiple logistic regression analysis showed that literacy,per capita monthly family income,level of academic stress,level of self-awareness of medical staff care,being an only child,level of self-perceived burden,and length of hospitalization were the factors influencing the potential profiles of FoMO social interaction in adolescent patients with unintentional trauma(all P＜0.05).Conclusion There is group heterogeneity in FoMO social interaction among adolescent patients with severe accidental trauma.Medical staff should develop targeted intervention measures based on the classification characteristics of different profiles of missing anxiety in adolescent accidental trauma patients to alleviate their levels of FoMO social interaction.