Acute kidney injury (AKI) has high morbidity and mortality, but effective clinical drugs and management are lacking. Previous studies have suggested that macrophages play a crucial role in the inflammatory response to AKI and may serve as potential therapeutic targets. Emerging evidence has highlighted the importance of forkhead box protein O1 (FoxO1) in mediating macrophage activation and polarization in various diseases, but the specific mechanisms by which FoxO1 regulates macrophages during AKI remain unclear. The present study aimed to investigate the role of FoxO1 in macrophages in the pathogenesis of AKI. We observed a significant upregulation of FoxO1 in kidney macrophages following ischemia-reperfusion (I/R) injury. Additionally, our findings demonstrated that the administration of FoxO1 inhibitor AS1842856-encapsulated liposome (AS-Lipo), mainly acting on macrophages, effectively mitigated renal injury induced by I/R injury in mice. By generating myeloid-specific FoxO1-knockout mice, we further observed that the deficiency of FoxO1 in myeloid cells protected against I/R injury-induced AKI. Furthermore, our study provided evidence of FoxO1's pivotal role in macrophage chemotaxis, inflammation, and migration. Moreover, the impact of FoxO1 on the regulation of macrophage migration was mediated through RhoA guanine nucleotide exchange factor 1 (ARHGEF1), indicating that ARHGEF1 may serve as a potential intermediary between FoxO1 and the activity of the RhoA pathway. Consequently, our findings propose that FoxO1 plays a crucial role as a mediator and biomarker in the context of AKI. Targeting macrophage FoxO1 pharmacologically could potentially offer a promising therapeutic approach for AKI.

Objective:To summarize the best available evidence for donor and recipient site flap management in head and neck cancer patients undergoing free flap reconstruction.Method:Following the 6S evidence hierarchy model, a comprehensive search was conducted in databases and websites including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, National Comprehensive Cancer Network, Joanna Briggs Institute Evidence-Based Healthcare Database, Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period covered all publications up to May 1, 2024.Results:A total of 14 articles were included, comprising two clinical decisions, two guidelines, two systematic reviews, five expert consensuses, two randomized controlled trials, and one prospective cohort study.A total of 28 pieces of evidence were summarized from six aspects: establishing multidisciplinary collaboration, standardized assessment, prehabilitation training, donor site management strategies, recipient site management strategies, and risk identification and management.Conclusions:This study provides a comprehensive summary of evidence regarding donor and recipient site flap management in patients with head and neck cancer undergoing free flap reconstruction, offering an evidence-based foundation for guiding clinical nursing practice.

Objective:To develop a nomogram model for predicting the risk of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation (MV) and to validate the stability of the prediction performance of the model.Methods:The patients with MV admitted to the Department of Critical Care Medicine of General Hospital of Ningxia Medical University from January 2019 to December 2022 were retrospectively selected according to the order of admission. The patients with MV were divided into the non-VAP group and the VAP group according to whether VAP occurred. The clinical data of the two groups, including general information, disease, medication, condition, and operation-related indicators were collected as candidate predictors of the model for comparison. Multivariate logistic stepwise forward regression analysis was used to screen the predictors that finally entered the model, and a nomogram model was constructed. The model discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), the diagnostic test results of the model at the predicted threshold were calculated, the Hosmer-Lemeshow test was used to evaluate the model fit, and the Bootstrap resampling was used 1 000 times for internal validation, and model calibration and clinical applicability were evaluated by calibration curve and decision analysis curve, respectively.Results:A total of 1 250 patients with MV were included, including 1 102 patients in the non-VAP group and 148 patients in the VAP group, and the prevalence of VAP was 11.8%. The detection of multidrug-resistant organisms, chronic kidney disease, brain injury, oxygenation index, the place of tracheal intubation, reintubation, use of bronchoscopy, use of antibiotics, and MV duration were model predictors of VAP. The AUC of the nomogram model was 0.917 (95% CI: 0.895-0.939), the maximum Youden index of 0.697 corresponded to a prediction threshold of 0.096. The model accuracy, sensitivity and specificity were 0.836, 0.865, and 0.832, respectively. The positive predictive value and the negative predictive value were 0.409 and 0.979, respectively. The Hosmer- Lemeshow test indicated that the model fit well ( P=0.938). The results of the internal validation of the model showed that the predicted risk of the calibration curve was generally consistent with the actual risk, and the decision threshold probability of the decision analysis curve ranged from 2% to 90%. Conclusions:The nomogram model developed in this study is simple, convenient and has relatively stable prediction performance, which can be externally validated to evaluate the extrapolation of the model, and provide a basis for individualized clinical prediction of the risk of VAP in patients with MV.

Objective To explore the repair effect and mechanism of human amniotic mesenchymal stem cells(hAMSCs)on endometrial injury.Methods hAMSCs were isolated using a two-enzyme digestion and then cultured.The third-passage(P3)cells were harvested to detect the surface markers by flow cytometry and to identify their trilineage differentiation potentials.Eighteen nulliparous female SD rats(8～9 weeks old,weighing 250～280 g)were randomly divided into 3 groups(n=6):normal control group,model group,and hAMSCs group.A rat model of intrauterine adhesions(IUA)was established in SD rats by using curettage combined with lipopolysaccharide(LPS)infection.In 2 weeks after modeling,the hAMSCs group received a bilateral uterine horn transplantation of 0.2 mL hAMSCs(1.0×10? cells/mL),while the model group received a same volume of PBS into both uterine horns.All rats were sacrificed in 2 weeks after transplantation.HE and Masson staining was used to observe endometrial thickness and gland number as well as endometrial fibrosis area.RT-qPCR and Western blotting were performed to detect the mRNA and protein levels of TGF-β1,Smad3,Smad7,epithelial-mesenchymal transition(EMT)markers(E-cadherin,Vimentin),fibrosis factor α-SMA,and endometrial estrogen receptor(ER)and progesterone receptor(PR)in endometrial tissues.Results The obtained cells were identified as hAMSCs due to the characteristics of surface markers and differentiation potentials.Compared with the normal control group,the model group showed decreased endometrial thickness,reduced gland number,increased fibrosis area,and enhanced mRNA and protein levels of fibrosis-related factors TGF-β1,Smad3,Vimentin,and α-SMA(P<0.01),while down-regulation of fibrosis-inhibiting molecule Smad7,the EMT marker E-cadherin,and endometrial receptors ER and PR at both mRNA and protein levels(P<0.01).hAMSCs transplantation increased endometrial thickness and gland number,decreased fibrosis area,and down-regulated mRNA expression of the aforementioned fibrosis-related factors(P<0.01),and up-regulated the mRNA expression levels of Smad7,E-cadherin,ER,and PR(P<0.01).The hAMSCs group also exhibited obviously down-regulated protein levels of TGF-β1,Smad3,and α-SMA(P<0.05),while enhanced protein levels of Smad7 and PR(P<0.05).Conclusion Intrauterine transplantation of hAMSCs can promote the repair of endometrial injury,and inhibits endometrial EMT and fibrosis through the TGF-β1/Smad7 signaling pathway.

Objective:To explore the expression of YARS1, the subform of protein-based tRNA synthase ( YARS1), and its prognostic effect on the analysis of gene set enrichment in hepatocellular carcinoma Methods:The expressional condition of the YARS1 gene in tumor tissue samples (374 cases) and adjacent tissue samples (50 cases) of hepatocellular carcinoma patients was compared and recorded by mining the Cancer Genome Atlas database. Hepatocellular carcinoma patients were divided into high expression and low expression groups according to this data. Logistic regression was used to analyze the relationship between YARS1 and the clinical pathological characteristics of hepatocellular carcinoma patients. The effect of YARS1 expression on the prognosis of hepatocellular carcinoma patients was analyzed by the Kaplan-Meier method and log-rank test. The prognostic value of the YARS1 gene for hepatocellular carcinoma was analyzed by univariate and multivariate Cox regression. Gene set enrichment analysis was used to evaluate the gene pathways related to YARS1 in the occurrence and development of hepatocellular carcinoma. Results:The expression of the YARS1 gene was higher in hepatocellular carcinoma tissue than in normal tissue ( P<0.001). The expression level of YARS1 was correlated with the grade of patients ( P<0.05), but not with age, gender, TNM stage, and others ( P>0.05). The results of Kaplan-Meier method and log-rank test showed that the survival rate was lower in patients with high YARS1 gene expression than that of patients with low YARS1 gene expression ( P<0.001). The results of multivariate Cox regression analysis showed that YARS1 was used as an independent prognostic factor for hepatocellular carcinoma [hazard ratio=1.10, 95% confidence interval (1.050-1.156), P<0.001]. The results of gene set enrichment analysis showed that YARS1 was involved in pyrimidine metabolism, purine metabolism, aminoacyl tRNA biosynthesis, fatty acid metabolism, ppar signal transduction pathway, oocyte meiosis, amino acid and nucleotide sugar metabolism, RNA degradation, complement pathway, valine and isoleucine degradation, spliceosome, and other pathways. Conclusion:The high expression of YARS1 is associated with the progression and prognosis of hepatocellular carcinoma. Therefore, this gene is expected to become a novel biomarker and a sort of target for biological therapy in hepatocellular carcinoma.

Objective:To analyze the epidemiological characteristics and injury patterns of eye trauma in children and adolescents in China.Methods:A multicenter cross-sectional, retrospective, observational study. Based on the Chinese Eye Trauma Registry database, 189 patients (189 eyes) aged 0-18 years (13.4%, 189/1 412) of 1 412 patients (1 435 eyes) with eye trauma who were hospitalized from January to December 2023 were included in the study. Patients were recruited from 23 tertiary general hospitals or ophthalmology specialty hospitals located in 17 provincial-level administrative regions across six major geographical areas in China (North China, East China, South China, Central China, Northwest China, and Southwest China). The analysis focused on population characteristics, epidemiological features, injury patterns, and visual outcomes of children from different geographical regions and age groups. Among the 189 eyes, 95 eyes underwent secondary surgery. A total of 23 eyes were excluded due to non-cooperation during examination, no light perception, or only light perception. Ultimately, 72 eyes were included in the statistical analysis. Of these, 36 eyes had follow-up data and were used to observe postoperative visual outcomes.Results:Among 189 patients, 143 were males (75.7%, 143/189) and 46 were females (24.3%, 46/189). Age 8.73 (1-18) years old. The gender composition of all age groups was mainly male. The geographical distribution showed that East China had the largest number of cases, 55 (29.1%, 55/189). There were 70 cases (37.0%, 70/189) in 7-10 years old. The type analysis of eye trauma showed that in 189 eyes, mechanical ocular trauma accounted for 130 eyes, of which 105 (80.8%, 105/130) eyes had open globe injuries and 25 (19.2%, 25/130) eyes had closed globe injuries. 122 eyes received emergency surgery within 24 h after injury (accounts for 83.6% of emergency surgical cases, 122/146). In 36 eyes with complete follow-up data, the initial visual acuity distribution was: blind 23 eyes (63.9%), low visual acuity 6 eyes (16.7%), visual acuity ≥0.3 in 7 eyes (19.4%). At the last follow-up, visual acuity improved in 12 eyes (33.3%) with blindness, 8 eyes (22.2%) with low visual acuity, and 16 eyes (44.4%) with visual acuity ≥ 0.3. The final visual outcome showed that the disability rate was 22.2% (8/36) and the blindness rate was 33.3% (12/36).Conclusions:Children and adolescents account for 13.4% of the hospitalized patients with eye trauma in the same period, and there is a significant gender difference (male accounted for 75.7%). There are obvious age-specific distribution rules in the causes, locations and clinical features of eye trauma in children and adolescents of different ages.

Objective:To summarize the best available evidence for donor and recipient site flap management in head and neck cancer patients undergoing free flap reconstruction.Method:Following the 6S evidence hierarchy model, a comprehensive search was conducted in databases and websites including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, National Comprehensive Cancer Network, Joanna Briggs Institute Evidence-Based Healthcare Database, Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period covered all publications up to May 1, 2024.Results:A total of 14 articles were included, comprising two clinical decisions, two guidelines, two systematic reviews, five expert consensuses, two randomized controlled trials, and one prospective cohort study.A total of 28 pieces of evidence were summarized from six aspects: establishing multidisciplinary collaboration, standardized assessment, prehabilitation training, donor site management strategies, recipient site management strategies, and risk identification and management.Conclusions:This study provides a comprehensive summary of evidence regarding donor and recipient site flap management in patients with head and neck cancer undergoing free flap reconstruction, offering an evidence-based foundation for guiding clinical nursing practice.

Objective:To explore the expression of YARS1, the subform of protein-based tRNA synthase ( YARS1), and its prognostic effect on the analysis of gene set enrichment in hepatocellular carcinoma Methods:The expressional condition of the YARS1 gene in tumor tissue samples (374 cases) and adjacent tissue samples (50 cases) of hepatocellular carcinoma patients was compared and recorded by mining the Cancer Genome Atlas database. Hepatocellular carcinoma patients were divided into high expression and low expression groups according to this data. Logistic regression was used to analyze the relationship between YARS1 and the clinical pathological characteristics of hepatocellular carcinoma patients. The effect of YARS1 expression on the prognosis of hepatocellular carcinoma patients was analyzed by the Kaplan-Meier method and log-rank test. The prognostic value of the YARS1 gene for hepatocellular carcinoma was analyzed by univariate and multivariate Cox regression. Gene set enrichment analysis was used to evaluate the gene pathways related to YARS1 in the occurrence and development of hepatocellular carcinoma. Results:The expression of the YARS1 gene was higher in hepatocellular carcinoma tissue than in normal tissue ( P<0.001). The expression level of YARS1 was correlated with the grade of patients ( P<0.05), but not with age, gender, TNM stage, and others ( P>0.05). The results of Kaplan-Meier method and log-rank test showed that the survival rate was lower in patients with high YARS1 gene expression than that of patients with low YARS1 gene expression ( P<0.001). The results of multivariate Cox regression analysis showed that YARS1 was used as an independent prognostic factor for hepatocellular carcinoma [hazard ratio=1.10, 95% confidence interval (1.050-1.156), P<0.001]. The results of gene set enrichment analysis showed that YARS1 was involved in pyrimidine metabolism, purine metabolism, aminoacyl tRNA biosynthesis, fatty acid metabolism, ppar signal transduction pathway, oocyte meiosis, amino acid and nucleotide sugar metabolism, RNA degradation, complement pathway, valine and isoleucine degradation, spliceosome, and other pathways. Conclusion:The high expression of YARS1 is associated with the progression and prognosis of hepatocellular carcinoma. Therefore, this gene is expected to become a novel biomarker and a sort of target for biological therapy in hepatocellular carcinoma.

Objective:To analyze the epidemiological characteristics and injury patterns of eye trauma in children and adolescents in China.Methods:A multicenter cross-sectional, retrospective, observational study. Based on the Chinese Eye Trauma Registry database, 189 patients (189 eyes) aged 0-18 years (13.4%, 189/1 412) of 1 412 patients (1 435 eyes) with eye trauma who were hospitalized from January to December 2023 were included in the study. Patients were recruited from 23 tertiary general hospitals or ophthalmology specialty hospitals located in 17 provincial-level administrative regions across six major geographical areas in China (North China, East China, South China, Central China, Northwest China, and Southwest China). The analysis focused on population characteristics, epidemiological features, injury patterns, and visual outcomes of children from different geographical regions and age groups. Among the 189 eyes, 95 eyes underwent secondary surgery. A total of 23 eyes were excluded due to non-cooperation during examination, no light perception, or only light perception. Ultimately, 72 eyes were included in the statistical analysis. Of these, 36 eyes had follow-up data and were used to observe postoperative visual outcomes.Results:Among 189 patients, 143 were males (75.7%, 143/189) and 46 were females (24.3%, 46/189). Age 8.73 (1-18) years old. The gender composition of all age groups was mainly male. The geographical distribution showed that East China had the largest number of cases, 55 (29.1%, 55/189). There were 70 cases (37.0%, 70/189) in 7-10 years old. The type analysis of eye trauma showed that in 189 eyes, mechanical ocular trauma accounted for 130 eyes, of which 105 (80.8%, 105/130) eyes had open globe injuries and 25 (19.2%, 25/130) eyes had closed globe injuries. 122 eyes received emergency surgery within 24 h after injury (accounts for 83.6% of emergency surgical cases, 122/146). In 36 eyes with complete follow-up data, the initial visual acuity distribution was: blind 23 eyes (63.9%), low visual acuity 6 eyes (16.7%), visual acuity ≥0.3 in 7 eyes (19.4%). At the last follow-up, visual acuity improved in 12 eyes (33.3%) with blindness, 8 eyes (22.2%) with low visual acuity, and 16 eyes (44.4%) with visual acuity ≥ 0.3. The final visual outcome showed that the disability rate was 22.2% (8/36) and the blindness rate was 33.3% (12/36).Conclusions:Children and adolescents account for 13.4% of the hospitalized patients with eye trauma in the same period, and there is a significant gender difference (male accounted for 75.7%). There are obvious age-specific distribution rules in the causes, locations and clinical features of eye trauma in children and adolescents of different ages.

Post-extubation dysphagia is a common problem in tracheal intubation patients. Timely identification of post-extubation dysphagia is helpful for clinical medical staff to adjust nursing strategies and improve patients' prognosis. This paper reviews the screening and evaluation tools of post-extubation dysphagia in tracheal intubation patients, so as to provide a reference for medical staff to identify post-extubation dysphagia patients in early stage.