Objective: To summarize the best evidence for the management of patients with gastrointestinal graft-versushost disease after hematopoietic stem cell transplantation, and provide evidence-based references for clinical nursing work. Methods: A systematic search was conducted for relevant evidence on the management of patients with gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation from domestic and foreign databases, as well as websites of blood and bone marrow transplantation related societies. The search period was from the establishment of the database until February 2026. Results: After screening, a total of 19 articles were included, encompassing 3 clinical decisions, 1 recommended practice, 4 guidelines, 7 expert consensuses, and 4 evidence summaries. Twenty-five pieces of best evidence were summarized across 8 aspects: multidisciplinary collaboration, influencing factors, assessment and monitoring, diagnostic differentiation, symptom management, dietary nutrition, medication guidance, and health education. Conclusion: Summarizing the relevant evidence on the management of patients with gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation can provide evidence-based support for clinical medical staff, and it is recommended to apply it in combination with clinical practice and patient wishes.

To investigate the association between the systemic inflammatory response index (SIRI) and lung cancer prevalence based on the National Health and Nutrition Examination Survey (NHANES) database.

Objective:This study aims to evaluate the subcortical structural alteration patterns associated with five distinct neuropsychiatric symptoms (NPS) associated with Parkinson′s disease and provide macroscopic brain structural evidence to further explore their underlying pathophysiological mechanism.Methods:Clinical data and 3D-T 1 weighted images from 505 patients with Parkinson′s disease and 167 age-and sex-matched healthy controls were obtained from the Parkinson′s Progression Markers Initiative database (July 2010-August 2022). The subcortical nucleus volumes of the overall NPS patient group, as well as subgroups of patients with specific NPS subtypes (depression, anxiety, apathy, impulsive-compulsive behaviors (ICBs), and hallucinations), were measured and compared to those of healthy controls through mixed-effects models. Spatial similarity analysis and hierarchical clustering analysis of subcortical volume alteration patterns were employed to investigate the commonalities and specificities of subcortical damage in NPS. Results:NPS patients exhibited widespread subcortical atrophy, primarily concentrated in the bilateral putamen, bilateral hippocampus, and left amygdala (Cohen′s d=-0.38--0.12, FDR P<0.05). Subgroup analysis revealed that anxiety and depression were associated with gray matter atrophy in the bilateral putamen and amygdala (Cohen′s d=-0.73--0.32, FDR P<0.05), while apathy, hallucinations, and ICBs were linked to atrophy in the bilateral putamen, bilateral amygdala, and bilateral hippocampus (Cohen′s d=-0.61--0.11, FDR P<0.05,Cohen′s d=-0.43--0.36, P<0.05). Similarity and clustering analyses demonstrated high spatial correlation between anxiety and depression ( r=0.83, P<0.01), forming one cluster, whereas apathy, hallucinations, and ICBs formed another distinct cluster. Conclusion:NPS in Parkinson′s disease exhibit both commonalities and specificities. Apathy, hallucinations, and ICBs are associated with more severe subcortical damage patterns. These findings may provide new insights into the pathophysiology and progression of Parkinson′s disease.

Epidermal growth factor receptor inhibitor (EGFRI) -related paronychia is a condition clearly related to EGFRI therapy, characterized by periungual erythema, edema, purulent exudates, periungual or subungual granulomatous lesions, and sometimes accompanied by thinning, fragility or even splitting and seperation of nail plates. Inhibition of epidermal function, inflammation and secondary infections, as well as angiogenesis are the core processes in the occurrence and development of EGFRI-related paronychia. This review summarizes epidemiology, pathogenesis, clinical manifestations, prevention and treatment of EGFRI-related paronychia.

This article reported the diagnosis and management of a case of a child with Kabuki syndrome. Kabuki syndrome is characterized by distinct facial features, skeletal anomalies, abnormal skin texture, and intellectual disabilities, and is primarily caused by heterozygous mutations in the lysine methyltransferase 2D(KMT2D) gene. The onset in this patient was insidious, presenting with short stature and intellectual impairment. Genetic testing identified a pathogenic heterozygous variant in the KMT2D gene. This article focuses on analyzing the necessity and appropriateness of growth hormone therapy in children with Kabuki syndrome, and includes a review of relevant literature to improve clinicians′ understanding of this rare condition.

Objective To explore the correlation between cardiac remodeling and the occurrence of contrast-associated acute kidney injury(CA-AKI)assessed by echocardiography.Methods A retrospective analysis was conducted on the clinical data of 100 patients with coronary artery disease(CAD)who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from March 2021 to March 2024.The patients were divided into CA-AKI group and non-CA-AKI group according to whether CA-AKI occurred.Baseline data and echocardiographic parameters,inclu-ding left ventricular end-diastolic internal diameter index(LVIDDI),left ventricular end-systolic in-ternal diameter index(LVIDSI),and left ventricular mass index(LVMI),were collected and com-pared between the two groups.Logistic regression analysis was used to screen for independent influen-cing factors of CA-AKI occurrence.Results The level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the CA-AKI group was higher than that in the non-CA-AKI group,and the difference was statistically significant(P＜0.001).Compared with the non-CA-AKI group,the CA-AKI group had higher levels of C-reactive protein and glycosylated hemoglobin(HbA1c),as well as a higher proportion of patients with diabetes and anemia,and the differences were statistically significant(P＜0.05).Echocardiographic data showed that LVMI,LVIDDI,and LVIDSI in the CA-AKI group were all higher than those in the non-CA-AKI group,and the differences were statistically sig-nificant(t=2.057,3.429,2.975;P＜0.05).The left ventricular ejection fraction(LVEF)level in the CA-AKI group was lower than that in the non-CA-AKI group,and the difference was statisti-cally significant(t=3.005,P=0.003).Univariate Logistic regression analysis showed that diabe-tes,anemia,inflammation,NT-proBNP,HbA1c,LVMI,LVIDDI,LVIDSI,LVEF,ventricular hy-pertrophy,and ventricular dilation were significantly associated with the occurrence of CA-AKI(P＜0.05).Multivariate Logistic regression analysis results showed that LVMI(OR=3.81;95％CI,1.04 to 8.50;P=0.045),LVIDDI(OR=4.21;95％CI,2.02 to 6.08;P＜0.001),LVIDSI(OR=1.61;95％CI,1.27 to 2.03;P=0.024),ventricular hypertrophy(OR=3.42;95％CI,1.83 to 4.44;P=0.001),and ventricular dilation(OR=2.93;95％CI,1.43 to 3.74;P=0.033)were independent influencing factors for the occurrence of CA-AKI.Conclusion Cardiac remodeling is significantly correlated with the risk of CA-AKI in CAD patients.Clinicians should take protective measures timely for patients with abnormal cardiac structure to prevent the occurrence of CA-AKI.

Objective To explore the factors affecting the success rate of operation in patients with end-stage renal disease by analyzing and comparing the differences of patients'basic conditions and clinical laboratory data.Methods A total of 107 patients who underwent forearm autogenous arteriovenous fistula surgery in Nujiang Lisu Autonomous Prefecture People's Hospital from January 2021 to August 2024 were selected and divided into AVF failure group and AVF success group according to whether internal fistula occluded during the operation or within 1 week after the operation.The basic data and clinical laboratory data of enrolled patients were collected.Correlation statistical methods were used to compare whether there were differences between the two indexes.Results Univariate analysis showed that there were statistically significant differences between the two groups in smoking history,diabetes history,nephritic syndrome history,gender,preoperative blood pressure,hemoglobin,low density lipoprotein and total cholesterol(P<0.05).However,There was no significant difference between the two in history,age,white blood cell count,neutrophil count,lymphocyte count,monocyte count,platelet,creatinine,urea nitrogen,triglyceride,blood calcium,blood phosphorus,calcium-phosphorus product,fibrinogen,D-dimer and albumin(P>0.05).Binary Logistic regression analysis showed that gender,diabetes history,nephritic syndrome history,preoperative blood pressure,hemoglobin and low-density lipoprotein were independent risk factors for AVF initiation failure(P<0.05).Conclusion Female patients,history of diabetes mellitus,history of nephrotic syndrome,low hemoglobin,elevated low-density lipoprotein,and poor blood pressure control are independent factors affecting the failure of AVF initiation.

Objective To observe the mechanism of action of electroacupuncture at Neiguan(PC6)points for alleviating lipopolysaccharide(LPS)-induced myocadial dysfunction in sepsis model mice.Methods Forty-eight male C57BL/6 mice were randomly divided into four groups,namely normal control group,saline+electroacupuncture group,sepsis model group,and sepsis+electroacupuncture group.The rats in the sepsis model group and sepsis+electroacupuncture group were given intraperitoneal injection of LPS(5 mg/kg)to induce the sepsis model.The mice were treated with electroacupuncture immediately after injection.At hour 6 after the LPS intervention,the left ventricular short-axis end-systolic diameter(LVIDs)and fractional shortening(FS)of the left ventricular were monitored by color doppler echocardiography.The levels of inflammatory factors such as tumor necrosis factor alpha(TNF-α)and interleukin 6(IL-6)in serum were detected by enzyme-linked immunosorbent assay(ELISA),and the protein expression levels of Rho-kinase(ROCK)1 and ROCK2,and phosphorylation levels of myosin phosphatase substrate 1(MYPT1)and myosin light chain 2(MLC2)in cardiac tissues were detected by Western Blot.Results Compared with the normal control group,the LVIDs in mice in the sepsis model group was increased(P<0.05),FS was decreased(P<0.05),the levels of TNF-α and IL-6 in serum were all elevated(P<0.001),and the level of phosphorylation of MYPT1,a substrate of ROCK,in cardiac tissues was significantly elevated(P<0.05);compared with the sepsis model group,the LVIDs in the sepsis+electroacupuncture group was decreased(P<0.05),FS was increased(P<0.05),the levels of TNF-α and IL-6 in serum were decreased(P<0.05 or P<0.01),and the phosphorylation level of MYPT1 was significantly reduced(P<0.05),and the protein expression levels of ROCK1 and ROCK2 as well as the phosphorylation level of MLC2 had no significant differences(P>0.05).Conclusion Electroacupuncture at Neiguan points may reduce systemic and local inflammatory reaction levels in mice with sepsis model to improve cardiac function through inhibiting the activation of Rho/ROCK signaling pathway in cardiac tissues,thus producing myocardial protection efficacy.

Objective:To investigate the effect of circular RNA bromodomain PHD finger transcription factor (circBPTF) targeting microRNA (miR)-224-3p on the damage of human retinal vascular endothelial cells (HRECs) induced by high glucose.Methods:HRECs were divided into control group and high glucose group, which were cultured with medium containing 5.5 mmol/L glucose and 30 mmol/L glucose for 48 hours, respectively.HRECs were transfected with siRNA negative control (si-NC), siRNA of circBPTF (si-circBPTF), miRNA mimic control (miR-NC), and miR-224-3p by Lipofectamine 2000, followed by cultured in 30 mmol/L glucose medium for 48 hours and were recorded as si-NC group, si-circBPTF group, miR-NC group and miR-224-3p group, respectively.HRECs were transfected with si-circBPTF and anti-miR-NC or si-circBPTF and anti-miR-224-3p by double transfection method, and then treated with 30 mmol/L glucose medium for 48 hours and were recorded as anti-miR-NC group and anti-miR-224-3p group, respectively.The expression of circBPTF and miR-224-3p was detected by real-time fluorescence quantitative PCR.Cell apoptosis was detected by flow cytometry.Reactive oxygen species (ROS) level was determined by 2′, 7′-dichlorodihydrofluorescein diacetate probe.Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were detected by colorimetric method.Expression of cleaved-caspase-3/caspase-3 and cleaved-caspase-9/caspase-9 proteins was detected by Western blot.The interaction between circBPTF and miR-224-3p was identified by the dual luciferase reporter method.Results:Compared with the control group, the apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, ROS level, MDA content, and circBPTF relative expression were significantly increased and SOD activity and miR-224-3p expression were decreased in the high glucose group (all P<0.05).Compared with the si-NC group, circBPTF relative expression, ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression, and cell apoptosis rate were significantly reduced and SOD activity was significantly increased in the si-circBPTF group (all P<0.05).Compared with the miR-NC group, miR-224-3p relative expression and SOD activity were significantly enhanced and ROS level, MDA content, cleaved-caspase-3/caspase-3 protein expression, cleaved-caspase-9/caspase-9 protein expression and cell apoptosis rate were significantly reduced in the miR-224-3p group (all P<0.05).The relative luciferase activity of HRECs after co-transfection of wild type circBPTF and miR-224-3p mimic was 0.43±0.04, which was significantly decreased compared with 0.99±0.06 after co-transfection of wild type circBPTF and miR-NC ( t=23.297, P<0.05).Compared with anti-miR-NC group, the relative expression of miR-224-3p and SOD activity were significantly decreased and ROS level, MDA content, cell apoptosis rate, cleaved-caspase-3/caspase-3 protein expression, and cleaved-caspase-9/caspase-9 protein expression were significantly increased in the anti-miR-224-3p group (all P<0.05). Conclusions:Interfering with circBPTF can inhibit high glucose induced HRECs apoptosis and oxidative stress damage by targeting miR-224-3p.

Objective To develop a combined model integrating radiomics and 3D deep learning features for improving the predictive efficacy of overall survival in non-small cell lung cancer(NSCLC)patients undergoing radiotherapy,thereby providing a foundation for optimizing individualized radiotherapy strategies.Methods A retrospective analysis was conducted on 522 NSCLC patients from 3 centers.Radiomics features were extracted from the tumor region of interest on radiotherapy planning CT scans,and a 3D-SE-ResNet was constructed to extract deep learning features.Following feature extraction,features were selected via univariate Cox analysis and Lasso-Cox regression,and a combined model was established by fusing the two feature types through principal component analysis.The discriminative ability of the model was evaluated using the concordance index(C-index)and the area under the receiver operating characteristic curve(AUC),while the risk stratification efficacy was verified by Kaplan-Meier survival analysis.Results The predictive performance of deep learning features was significantly superior to that of radiomics features(C-index:0.73 vs 0.65).The combined model achieved the highest predictive performance in the training set,internal test set,and external test set(C-index:0.74,0.69,0.72 respectively),with higher AUC values for predicting 1-year,2-year,and 3-year OS than either single model.Kaplan-Meier analysis showed significant differences in survival between the high-and low-risk groups(Log-rank test,P<0.001),and calibration curves indicated good consistency between predicted and actual survival outcomes.Conclusion The combined model integrating radiomics and 3D deep learning features can accurately predict survival outcomes in NSCLC patients undergoing radiotherapy.The multi-center validation results support its potential application in prognosis stratification for individualized radiotherapy.