Objective:To investigate the underlying mechanism behind the significant reduction in intracellular virus loads after respiratory syncytial virus (RSV) and influenza viruses infect respiratory epithelial cells overexpressing the chemokine (C-C motif) receptor 1 (CCR1).Methods:A549 cells were infected with respiratory syncytial virus (RSV), influenza A viruses (H1N1, H3N2), or influenza B virus (FluB), and the expression of chemokine (C-C motif) ligand 5 (CCL5) and CCR1 were detected by qRT-PCR, ELISA, and Western blot. After overexpressing or knocking down CCR1 in A549 cells, these cells were infected with RSV, H1N1, H3N2, or FluB, and the expression of CCR1, heat shock protein 90 (HSP90), cyclin-dependent kinase 1 (CDK1), and viral proteins were detected by qRT-PCR and Western blot. After stimulating CCR1-overexpressed A549 cells with CCL5, Western blot was used to detect the expression of HSP90 and CDK1, and co-immunoprecipitation was used to detect the interaction between HSP90 and CCR1. CCR1 -/- mice were infected with RSV, H1N1, or H3N2 to observe the changes in the expression of HSP90, CDK1, and viral proteins with Western blot, and the inflammation in lung tissues with HE staining. One-way analysis of variance and t test were used for statistical analysis. Results:RSV, H1N1, H3N2, and FluB infections induced high expression of CCL5 in A549 cells ( P<0.05), but the expression of CCR1 showed an overall downward trend. After activating its receptor CCR1, CCL5 inhibited the replication of RSV and influenza viruses by suppressing the activity of HSP90 ( P<0.05). The experiments conducted on CCR1 -/- mice confirmed that the enhanced activity of HSP90 facilitated the replication of RSV and influenza viruses. Conclusion:RSV and influenza viruses may reduce the binding of CCL5 to CCR1 by downregulating the expression of CCR1 in respiratory epithelial cells, thereby weakening the inhibitory effect of CCR1 on HSP90 activity, which enables them to evade host immune defense.

Objective:To explore the relationship between drug literacy and quality of life in patients with multiple chronic diseases.Methods:It was a cross-sectional study. Between March and October 2023, 260 patients with multiple chronic diseases from the General Medicine Department of Peking University Third Hospital were selected using a convenience sampling method. A medication literacy scale, a medication adherence scale, and a health survey scale (SF-36 scale) were used to conduct a questionnaire survey in the patients. The SF-36 scale reflected the quality of life of the patients (including physical health and mental health). A total of 260 questionnaires were distributed, 260 questionnaires were returned, and 240 were effective (92.3%). Single-factor analysis of medication literacy in those patients was conducted using F-test and t-test. The correlation between medication literacy and medication adherence, as well as between medication literacy and quality of life, was analyzed using Pearson′s test. The correlation between different factors and medication adherence, as well as quality of life, in those patients was analyzed using multiple linear regression. Results:Among the 240 patients with multiple chronic diseases, 134 were male and 106 were female, aged (65.84±11.56) years. The drug literacy scale score was (8.36±3.57) points, the SF-36 physical health score was (242.00±87.85) points, mental health score was (275.67±80.29) points, medication compliance scale score was (6.22±1.93) points. The drug literacy was positively correlated with medication compliance ( r=0.157) and mental health ( r=0.165) in patients with multiple chronic diseases (all P<0.05). The score of drug literacy ( SE=2.440), mental health score ( SE=2.523), perceptual impairment ( SE=2.046) and duration of disease ( SE=2.459) were positively correlated with the medication compliance of the patients, while the number of chronic diseases ( SE=-2.818) was negatively correlated with the medication compliance of the patients (all P<0.05). The score of drug literacy ( SE=0.121) and insensible perception disorder ( SE=0.399) were positively correlated with the quality of life of the patients, and the number of chronic diseases ( SE=-0.171) was negatively correlated with the quality of life of the patients (all P<0.05). Conclusion:The drug literacy of patients with multiple chronic diseases is at the medium level, and the drug literacy is positively correlated with medication compliance and quality of life.

Objective:To investigate the underlying mechanism behind the significant reduction in intracellular virus loads after respiratory syncytial virus (RSV) and influenza viruses infect respiratory epithelial cells overexpressing the chemokine (C-C motif) receptor 1 (CCR1).Methods:A549 cells were infected with respiratory syncytial virus (RSV), influenza A viruses (H1N1, H3N2), or influenza B virus (FluB), and the expression of chemokine (C-C motif) ligand 5 (CCL5) and CCR1 were detected by qRT-PCR, ELISA, and Western blot. After overexpressing or knocking down CCR1 in A549 cells, these cells were infected with RSV, H1N1, H3N2, or FluB, and the expression of CCR1, heat shock protein 90 (HSP90), cyclin-dependent kinase 1 (CDK1), and viral proteins were detected by qRT-PCR and Western blot. After stimulating CCR1-overexpressed A549 cells with CCL5, Western blot was used to detect the expression of HSP90 and CDK1, and co-immunoprecipitation was used to detect the interaction between HSP90 and CCR1. CCR1 -/- mice were infected with RSV, H1N1, or H3N2 to observe the changes in the expression of HSP90, CDK1, and viral proteins with Western blot, and the inflammation in lung tissues with HE staining. One-way analysis of variance and t test were used for statistical analysis. Results:RSV, H1N1, H3N2, and FluB infections induced high expression of CCL5 in A549 cells ( P<0.05), but the expression of CCR1 showed an overall downward trend. After activating its receptor CCR1, CCL5 inhibited the replication of RSV and influenza viruses by suppressing the activity of HSP90 ( P<0.05). The experiments conducted on CCR1 -/- mice confirmed that the enhanced activity of HSP90 facilitated the replication of RSV and influenza viruses. Conclusion:RSV and influenza viruses may reduce the binding of CCL5 to CCR1 by downregulating the expression of CCR1 in respiratory epithelial cells, thereby weakening the inhibitory effect of CCR1 on HSP90 activity, which enables them to evade host immune defense.

Objective:To explore the relationship between drug literacy and quality of life in patients with multiple chronic diseases.Methods:It was a cross-sectional study. Between March and October 2023, 260 patients with multiple chronic diseases from the General Medicine Department of Peking University Third Hospital were selected using a convenience sampling method. A medication literacy scale, a medication adherence scale, and a health survey scale (SF-36 scale) were used to conduct a questionnaire survey in the patients. The SF-36 scale reflected the quality of life of the patients (including physical health and mental health). A total of 260 questionnaires were distributed, 260 questionnaires were returned, and 240 were effective (92.3%). Single-factor analysis of medication literacy in those patients was conducted using F-test and t-test. The correlation between medication literacy and medication adherence, as well as between medication literacy and quality of life, was analyzed using Pearson′s test. The correlation between different factors and medication adherence, as well as quality of life, in those patients was analyzed using multiple linear regression. Results:Among the 240 patients with multiple chronic diseases, 134 were male and 106 were female, aged (65.84±11.56) years. The drug literacy scale score was (8.36±3.57) points, the SF-36 physical health score was (242.00±87.85) points, mental health score was (275.67±80.29) points, medication compliance scale score was (6.22±1.93) points. The drug literacy was positively correlated with medication compliance ( r=0.157) and mental health ( r=0.165) in patients with multiple chronic diseases (all P<0.05). The score of drug literacy ( SE=2.440), mental health score ( SE=2.523), perceptual impairment ( SE=2.046) and duration of disease ( SE=2.459) were positively correlated with the medication compliance of the patients, while the number of chronic diseases ( SE=-2.818) was negatively correlated with the medication compliance of the patients (all P<0.05). The score of drug literacy ( SE=0.121) and insensible perception disorder ( SE=0.399) were positively correlated with the quality of life of the patients, and the number of chronic diseases ( SE=-0.171) was negatively correlated with the quality of life of the patients (all P<0.05). Conclusion:The drug literacy of patients with multiple chronic diseases is at the medium level, and the drug literacy is positively correlated with medication compliance and quality of life.

Objective:To compare the resting energy expenditure(REE)characteristics among young men with different body mass indexes(BMI).Methods:Thirty young men[average age was(26.93± 4.16)years]were enrolled in this study.They underwent resting metabolism tests in the Department of Sports Medicine of Peking University Third Hospital from December 2017 to June 2021.The resting meta-bolic rate(RMR)was measured by indirect calorimetry,the body composition was measured by bioresis-tance antibody component analyzer.The REE characteristics were analyzed,and 11 predictive equations were used to estimate RMR and compared with the measured value.The differences were analyzed by paired t-test and intra-class correlation coefficient(ICC).Results:The RMR of the overall 30 young men was(1 960.17±463.11)kcal/d(1 kcal=4.186 8 kJ).Including(1 744.33±249.62)kcal/d in those with normal BMI,which was significantly lower than that in those who were overweight or obese[(2 104.06±520.32)kcal/d,P＜0.01],but the weight-corrected RMR in those with normal BMI was significantly higher than that in those who were overweight or obese[(24.02±2.61)kcal/(kg·d)vs.(19.98±4.38)kcal/(kg·d),P＜0.01].The RMR was significantly and positively correlated with body weight,adiposity,lean body mass,body surface area,and extracellular fluid in the subjects with diffe-rent BMI(all P＜0.05).The predicted values of the 11 prediction equations were not in good agreement with the measured values(all ICC＜0.75),with relatively high agreement between the pre-dicted and measured values of the World Health Organization(WHO)equation in overweight obese young men(ICC=0.547,P＜0.01).Conclusion:There were significant differences in RMR among young men with different BMI,and the RMR after weight correction should be considered for those who were overweight or obese.The consistency between the predicted values of different prediction equations and the actual measured values of RMR was relatively poor,and it is recommended to accurately measure RMR by indirect calorimetry.For overweight or obese young men,the WHO prediction equation can be considered to calculate RMR,but it is necessary to establish an RMR prediction equation applicable to different BMI populations.

Objective To understand the proficiency level and sources of Traditional Chinese Medicine(TCM)health education among hemodialysis patients,in order to provide the basis for promoting the application of TCM nursing in hemodialysis patients.Methods Utilizing a convenience sampling approach,we conducted a survey from April to May 2023 involving hemodialysis patients from 7 tertiary TCM hospitals across Beijing,Hebei Province,Sichuan Province,and other regions.Custom-made questionnaires were utilized,gathering general information,respons-es conceming the level of mastery on TCM health education,and their primary sources of such knowledge.Results A total of 413 questionnaires were disseminated,and 392 proved valid,yielding a valid response rate of 94.92％.The score of patient's knowledge on TCM health education averaged(8.25±3.73),and an average score rate of 48.53％was obtained.In the patients undergoing hemodialysis,a relatively larger number of people possess knowl-edge of TCM health knowledge about relieving symptoms(50.8％～55.9％)and traditional Chinese daily life routines(56.4％～90.1％).However,fewer people are aware of how to use the five-tone therapy method for emotional inter-vention(40.8％)and principle of taking restorative Traditional Chinese Medicine(24.5％～36.7％),the dietary prin-ciples of"nurturing yang in spring and summer,and nurturing yin in autumn and winter"(14.3％),and theories of TCM kidney functions(9.9％).Approximately 23.0％of the patients sourced their TCM health education knowledge from new media platforms.Compared with new media method alone,patients who utilized only traditional education-al platforms(P=0.020),and those who combined both new media and traditional methods(P=0.018)demonstrated higher proficiency in TCM health education.Conclusion Hemodialysis caregivers are urged to develop a TCM health education framework that emphasizes emotional well-being and traditional wellness concepts,thereby fostering patient-centric TCM health ideologies.Hemodialysis education personnel are encouraged to leverage new media whilst ensuring education quality and effective outcomes.

[摘 要] 目的：探讨在靶向HER2的CAR的CD3ζ链胞内区引入YRHQ基序对CAR-T细胞的特异性杀伤活性及免疫记忆形成的影响。方法：通过DNA合成获得包含靶向HER2的编码抗原受体H28ζ或H28ζ(YRHQ)的DNA片段，通过慢病毒载体将不同CAR的DNA片段分别转导健康人外周血T细胞，制备靶向HER2的H28ζ-CAR-T及H28ζ(YRHQ)-CAR-T细胞。扩增过程中对不同CAR-T细胞进行计数，FCM检测CAR的表达率。将CAR-T细胞分别与HER2阳性的SKOV3、MDA-MB-453或HER2阴性的MCF-7细胞共培养，LDH释放法检测其杀伤活性，ELISA法检测IL-2、IFN-γ和颗粒酶B的水平，WB法检测STAT3磷酸化水平及免疫检查点分子TIM-3和PD-1的表达，通过FCM检测CCR7、CD45RO的表达，分析CAR-T细胞的表型。结果：H28ζ-CAR-T和H28ζ(YRHQ)-CAR-T细胞扩增能力较好，体外培养7 d时扩增4~5倍。H28ζ-CAR和H28ζ(YRHQ)-CAR表达率分别为（33.3±2.85）%和（28.30±3.2）%。H28ξ(YRHQ)-CAR-T细胞的杀伤活性较H28ζ-CAR-T细胞更高（P<0.05）。经HER2抗原刺激后，与T细胞或H28z-CAR-T细胞比较，H28ξ(YRHQ)-CAR-T细胞的STAT3磷酸化水平较H28ξ-CAR-T细胞明显升高（P<0.01）；而两者间PD-1和TIM-3的表达无明显差异。未经抗原刺激的CAR-T细胞CCR7和CD45RO表达与正常T细胞比较差异无统计学意义（均P>0.05），与SKOV3细胞共培养后，与T细胞或H28z-CAR-T细胞比较，H28ξ(YRHQ)-CAR-T细胞中TEM细胞比例明显增加、TCM细胞比例明显减少（均P<0.05）。结论：在CD3胞内区引入YRHQ基序可在一定程度上提高CAR-T细胞的杀伤潜力。

Objective: To assess the effects of acute exposure to electronic cigarette ( e-cigarette ) on leukocyte and total protein levels in bronchoalveolar lavage fluid ( BALF ) and pulmonary surfactant protein expression in a mouse model, so as to provide insights into the elucidation of the mechanism underlying the damages to the respiratory system caused by e-cigarette. Methods: Twenty-one C57BL/6N female mice were randomly divided into the blank control group, the solvent control group and the nicotine group. Mice in the solvent control group and the nicotine group were exposed to the solvent aerosol or e-cigarette aerosol containing 25 mg/mL nicotine for 3 hours daily, while mice in the blank control group were bred in clean air. Following 3-day exposure, mouse BALF and lung specimens were collected. The cell morphology was observed using microscopy following Wright-Giemsa staining and the leukocyte count was estimated in BALF, while the total protein expression was quantified using bicinchoninic acid ( BCA ) assay. In addition, the mRNA expression of pulmonary surfactant protein genes was detected in mouse lung specimens using quantitative real-time PCR ( qPCR ) assay. Results: All mice in three groups grew well without obvious abnormality or death seen. Wright-Giemsa staining showed a higher number of mononuclear macrophages in mouse BALF in the nicotine group than in the blank control group and the solvent control group. The leukocyte counts were ( 2.00±0.77 )×107, ( 1.79±0.99 )×107 and ( 4.00±1.35 )×107 cells/L ( F=9.199, P=0.002 ), and the total protein levels were ( 0.16±0.03 ), ( 0.12±0.02 ) and ( 0.16±0.04 ) mg/mL in mouse BALF in the blank control group, solvent control group and nicotine group ( F=3.610, P=0.048 ), and the relative mRNA expression of pulmonary surfactant protein B (SP-B) and SP-D was 1.00±0.14, 0.82±0.12 and 0.74±0.07 ( F=5.491, P=0.028 ), and 1.00±0.06, 0.90±0.02 and 0.71±0.15 in mouse lung specimens, respectively ( F=10.460, P=0.005 ). The leukocyte count was significantly higher in the nicotine group than in the blank control group and solvent control group (P=0.007, 0.003), and the total protein content was higher in the nicotine group than in the solvent control group ( P=0.060 ), while the relative SP-B mRNA expression was lower in the nicotine group than in the blank control group ( P=0.025 ), and the relative SP-D mRNA expression was lower in the nicotine group than in the blank control group and solvent control group ( P=0.004, 0.041 ). Conclusion Acute exposure to e-cigarette results in elevated intrapulmonary inflammatory responses, pulmonary capillary barrier impairment and reduced pulmonary surfactant protein expression.

Objective:To explore the relationship between blood test indicators and their changes and impaired fasting blood glucose, and to conduct risk prediction research.Methods:This study selected people who underwent a physical examination at a health management center in Jinan from 2018 to 2019, with an interval of 6 months or more between the two physical examinations, and had no history of diabetes and normal fasting blood sugar during the first year of the physical examination. We took the fasting blood glucose level in the second year as the dependent variable, and took the general examination and blood test indicators in the first year as well as the changes of these indicators as independent variables to construct the model. First, the random forest model was used to screen the independent variables, and then the logistic regression model is fitted to calculate the effect values of the independent variables.Results:A total of 4 416 subjects were enrolled in this study. After a 1-year follow-up, 3.45% (133/3 851) subjects developed prediabetic blood glucose, and 0.42% (16/3 851) developed diabetic blood glucose. The sensitivity of the model using blood test indicators to predict the risk of impaired fasting blood glucose after 1 year was 67.1%, and the specificity was 100.0%. The risk of impaired fasting blood glucose after 1 year was high in the population with older age ( OR value was 1.024, 95% CI 1.014-1.035), higher systolic blood pressure ( OR value was 1.018, 95% CI 1.011-1.025), higher body mass index ( OR value was 1.079, 95% CI 1.036-1.125), higher uric acid ( OR value was 1.003, 95% CI 1.002-1.005), higher glutamyl transpeptidase ( OR value was 1.006, 95% CI 1.003-1.010), lower creatinine ( OR value was 0.971, 95% CI 0.957-0.985), lower AST/ALT ( OR value was 0.614, 95% CI 0.411-0.917)) and lower estimated glomerular filtration rate ( OR value was 0.972, 95% CI 0.958-0.988). The sensitivity of the model using the changes of blood test indicators to predict the risk of impaired fasting blood glucose after 1 year was 65.2%, and the specificity was 99.7%. The risk of impaired fasting blood glucose is high in the population with increased triglycerides ( OR value was 1.152, 95% CI 1.057-1.257), increased alkaline phosphatase ( OR value was 1.021, 95% CI 1.012-1.030), increased albumin ( OR value was 1.087, 95% CI 1.029-1.148), increased aspartate aminotransferase ( OR value was 1.006, 95% CI 1.003-1.009), increased weight ( OR value was 1.049, 95% CI 1.019-1.081) within 1 year. Conclusions:The possibility of impaired fasting blood glucose after 1 year is high in the population with older age, higher systolic blood pressure, higher body mass index, higher uric acid, higher glutamyl transpeptidase, lower creatinine, lower AST/ALT and lower estimated glomerular filtration rate. The possibility of impaired fasting blood glucose is high in the population with increased triglycerides, increased alkaline phosphatase, increased albumin, increased aspartate aminotransferase and increased weight with in 1 year. When the above situation occurs in the physical examination, the blood glucose should be monitored and timely intervention should be taken to prevent the development of diabetes.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.