Myelodysplastic syndrome (MDS), a myeloid tumor derived from the malignant clones of hematopoietic stem cells, has an annually increasing incidence. The contemporary research direction has shifted to analyzing the synergistic effect of immune surveillance collapse and abnormal bone marrow microenvironment in the pathological process of MDS. Against this backdrop, the immune checkpoint molecule TIM3 has emerged as a key target because of its persistently high expression on the surface of important immune cells such as T and NK cells. The abnormal activation of the TIM3 pathway is the mechanism by which solid tumors and hematological malignancies achieve immune escape and is a key hub in the formation of immune exhaustion phenotypes. This work integrates the original discoveries of our team with the latest international progress, systematically demonstrating the bidirectional regulatory network of TIM3 between the malignant clone proliferation of MDS and the immunosuppressive microenvironment. Integrating the evidence from emerging clinical trials allows us to consider the clinical significance of TIM3-targeted blocking for MDS, providing a transformative path to overcome the resistance of traditional treatments and marking a new chapter in the active immune reconstitution of MDS treatment.

Objective To analyze risk factors for poor postoperative wound healing in spinal tuberculo-sis patients and construct prediction models along with a risk scoring table using machine learning algorithms,providing references for early prevention and management.Methods Clinical data from 420 spinal tuberculo-sis patients treated at four tertiary hospitals in Guizhou Province between January 2017 and February 2024 were retrospectively analyzed.Risk factors were identified through univariate and multivariate analyses.Logis-tic regression,random forest,and support vector machine prediction models were constructed.Model perform-ance was evaluated using receiver operating characteristic(ROC)curves,precision,recall,accuracy,and F1-score.A risk prediction scoring table for poor postoperative wound healing was subsequently developed.Re-sults Among the 420 patients with spinal tuberculosis,132 experienced poor postoperative wound healing,with an incidence rate of 31.43%.Logistic regression analysis showed that BMI≤18.5 kg/m2,preoperative albumin≤30 g/L,combined surgical procedure,intraoperative blood loss>1 000 mL,direct bilirubin>8 μmol/L within 3 days after surgery,neutrophil count≤75×109/L within 3 days after surgery,and postopera-tive drainage volume>500 mL were risk factors for poor postoperative wound healing(P<0.05).In the comparison among the three risk prediction models constructed based on machine learning algorithms,the ran-dom forest model demonstrated the best predictive performance.A risk prediction scoring table was construc-ted based on the partial regression coefficients from the multivariate analysis,with a total score range from 0 to 11 points.A score>6 points indicated an increased risk of poor postoperative wound healing.The area un-der the ROC curve(AUC)for this risk prediction scoring table was 0.846(95%CI:0.769 to 0.923),indica-ting good predictive performance.Conclusion The random forest model based on machine learning algorithms and the risk prediction scoring table have certain predictive value for assessing the risk of poor postoperative wound healing in patients with spinal tuberculosis;they can assist healthcare professionals in early identifica-tion of high-risk patients.

Objective:To systematically analyze the prevalence and influencing factors of psychiatric comorbidities in refractory epilepsy (RE) .Methods:The literature on the prevalence and/or influencing factors of psychiatric comorbidities in adults with RE was electronically searched in China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Database, PubMed, Web of Science, Embase, CINAHL, OVID, UpToDate, and Cochrane Library. The search period was from the establishment of the database to July 31, 2024. Two researchers independently conducted literature screening, quality assessment and data extraction, and used RevMan 5.4 for Meta-analysis.Results:A total of 11 papers were included, with a total sample size of 1 953 cases, with a prevalence of 52.00% (cross sectional studies) and 53.00% (cohort studies) . Gender [ OR=4.76, 95% CI (3.69, 6.15) ] , epilepsy disease perception [ OR=1.10, 95% CI (1.01, 1.19) ] , seizure type [ OR=1.63, 95% CI (1.23, 2.15) ] , seizure frequency [ OR=1.54, 95% CI (1.04, 2.29) ] , epileptogenic foci location [ OR=2.72, 95% CI (1.69, 4.37) ] , disease duration [ OR=1.76, 95% CI (1.39, 2.24) ] , and medication [ OR=3.26, 95% CI (2.09, 5.08) ] were the influencing factors of psychiatric comorbidity in RE. Conclusions:The prevalence of psychiatric comorbidities in patients with RE is high, and studies of influencing factors lack specificity. Clinical monitoring of this population should be strengthened, and relevant influencing factors should be comprehensively analyzed to provide intervention targets for early preventive management and to safeguard the long-term management of patients with epilepsy.

Objective:To systematically analyze the prevalence and influencing factors of psychiatric comorbidities in refractory epilepsy (RE) .Methods:The literature on the prevalence and/or influencing factors of psychiatric comorbidities in adults with RE was electronically searched in China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Database, PubMed, Web of Science, Embase, CINAHL, OVID, UpToDate, and Cochrane Library. The search period was from the establishment of the database to July 31, 2024. Two researchers independently conducted literature screening, quality assessment and data extraction, and used RevMan 5.4 for Meta-analysis.Results:A total of 11 papers were included, with a total sample size of 1 953 cases, with a prevalence of 52.00% (cross sectional studies) and 53.00% (cohort studies) . Gender [ OR=4.76, 95% CI (3.69, 6.15) ] , epilepsy disease perception [ OR=1.10, 95% CI (1.01, 1.19) ] , seizure type [ OR=1.63, 95% CI (1.23, 2.15) ] , seizure frequency [ OR=1.54, 95% CI (1.04, 2.29) ] , epileptogenic foci location [ OR=2.72, 95% CI (1.69, 4.37) ] , disease duration [ OR=1.76, 95% CI (1.39, 2.24) ] , and medication [ OR=3.26, 95% CI (2.09, 5.08) ] were the influencing factors of psychiatric comorbidity in RE. Conclusions:The prevalence of psychiatric comorbidities in patients with RE is high, and studies of influencing factors lack specificity. Clinical monitoring of this population should be strengthened, and relevant influencing factors should be comprehensively analyzed to provide intervention targets for early preventive management and to safeguard the long-term management of patients with epilepsy.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To systematically review and integrate the real feelings and needs of caregivers of children with liver transplantation.Methods:The computer search was conducted on China National Knowledge Infrastructure, China Biology Medicine disc, VIP, Wanfang Data, PubMed, Scopus, Web of Science, SDS, PsycINFO, CINAHL and Embase to collect qualitative studies on the real experiences of caregivers of children with liver transplantation. The search period was from establishment of the databases to July 31, 2023. The quality of the included literature was evaluated using the qualitative research appraisal tool of Australia Joanna Briggs Institute Evidence-based Health Care Center, and the results were analyzed using the Meta-integration method.Results:A total of eight articles were included, and 35 research results were extracted, which were summarized into 10 new categories and integrated into four results, namely, the dilemma of multiple challenges, complex emotional experience, multi-dimensional care needs and positive coping strategies.Conclusions:The caregivers of children with liver transplantation are faced with great pressure and difficulties in the process of care, and they are eager for multifaceted support. Medical staff should pay attention to the inner experience and needs of caregivers and construct supportive intervention programs to reduce their physical and mental burden and improve the quality of care for children with liver transplantation.

Objective:To investigate the current situation of supportive care needs for patients with glioma after surgery and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 168 postoperative patients with glioblastoma admitted to Beijing Tiantan Hospital Affiliated with Capital Medical University from January to May 2022 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey-34-item Short Form (SCNS-SF34), M.D.Anderson Symptom Inventory Brain Tumor Module (MDASI-BT) and Cancer Fatigue Scale (CFS) were used to investigate them. The multiple linear regression analysis was used to explore the influencing factors of supportive care needs in patients with glioma after surgery.Results:The score for supportive care needs in 168 postoperative patients with glioblastoma was (71.68±25.28). The results of multiple linear regression analysis showed that place of residence, occupational status, degree of symptom distress and fatigue degree were the influencing factors for supportive care needs of glioma patients after surgery ( P<0.05) . Conclusions:Patients with glioma after surgery have unmet supportive care needs, which are influenced by their place of residence, work status, disease symptoms and fatigue levels. Medical staff provide personalized guidance to postoperative patients to help them cope with postoperative symptoms, reduce fatigue levels and meet their supportive care needs.

Objective: To investigate the effect of early multi-dimensional cardiac rehabilitation (CR) nursing mode on patients after percutaneous coronary intervention (PCI). Methods: From August 2017 to July 2018, 100 patients with coronary heart disease (CHD) underwent PCI in the Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University were selected as subjects. According to the random number table, the patients were divided into control group and observation group, 50 in each group. The control group received routine CR nursing intervention, and the observation group was given early multi-dimensional CR nursing mode for intervention. All patients were followed up for 6 months. The incidence of major cardiovascular adverse events (MACE) was observed 1 month and 6 months of follow-up. Patients with somatization were evaluated on the 2nd day after PCI and in the first month of follow-up using the Somatic Self-rating Scale (SSS). In the first month and the 6th month of follow-up, patient compliance was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: During the study period, 3 patients were detached from each group, and there were 47 patients in both groups who completed the study. The incidence of MACE in the control group in 1 month and 6 months was 8.51% (4/47) and 4.26% (2/47), respectively. The incidence of MACE in the observation group was 10.64% (5/47) and 4.26%, (2/47) respectively. There was no significant difference in the incidence of MACE between the two groups (χ² value was 0.123, 0.000, P>0.05). In the first month of follow-up, the SSS scores of the control group (34.32±6.59) and the observation group (31.04±7.04) were lower than those of the second day after surgery (37.21±6.19, 37.43±7.29), and the difference was statistically significant (t value was 4.633, 2.660, P<0.05). The SSS scores of the observation group were lower than those of the control group, and the difference was statistically significant (t value was 2.330, P<0.05). In the first month of follow-up, there was no significant difference in MMAS-8 score between the two groups (P>0.05). In the 6th month of follow-up, the MMAS-8 score (5.72±0.62) in the control group was lower than the first month of follow-up (6.93±0.54), and the difference was statistically significant (t value was 10.028, P<0.05). The MMAS-8 score of the control group was lower than that of the observation group (6.89±0.58), and the difference was statistically significant (t value was 9.490, P<0.05). There was no significant difference in MMAS-8 score between the observation group in the first month of follow-up and the sixth month of follow-up (P>0.05). Conclusion Early multi-dimensional CR nursing mode has a limited effect on improving the incidence of MACE in patients after PCI, but it can effectively reduce the somatization symptoms of patients and maintain good medication compliance.

Objective:To provide Parkinson's patients with health education consultation and personalized rehabilitation programs through the construction and standardized management of Parkinson's care and nursing studio, and to improve the quality of continuous rehabilitation of Parkinson's patients after discharge.Methods:Using the convenient sampling method, 168 patients who attended the Parkinson Care and Nursing Studio in Beijing Tiantan Hospital from April 2018 to June 2019 were selected as the subjects. Parkinson's care and nursing studio was set reasonably, a standardized management system was established, the service objects in the process of diagnosis and treatment were clarified, and the work content of the nursing studio was determined. The Parkinson's care and nursing studio team was led by the head nurse of the Department of Dyskinesia. Multidisciplinary collaboration was adopted, and there were 12 members in this team. An electronic file of the visited patient was established, and the patient's physical function and structure, the individual ability to complete tasks or actions, and the ability to participate in family and society were fully evaluated. Based on this, an objective and individualized rehabilitation training program was developed. Analyze studio workload and patients' satisfacation rate, comepare patient's medication compliance before and after intervention.Results:Since the opening of the Parkinson's Care Studio in April 2018, 12 members have been sent out in rotation, and a total of 168 patients have been treated. Parkinson's nursing care studio has a high evaluation and the very satisfied rate was 95.6%. After the intervention, the patient's medication compliance increased, and the difference was statistically significant before and after the intervention ( P<0.05) . Conclusions:The construction and standardized management of Parkinson's care and nursing studio will help improve the disease management and medication compliance of patients with Parkinson's disease, and it will be beneficial to the improvement of nurses' own value.

Objective? To explore the status quo of subsyndromal delirium (SSD) in surgical intensive care unit (ICU) patients and to analyze its influencing factors. Methods? Totally 135 surgical ICU patients admitted in a Class Ⅲ Grade A hospital in Beijing from June 2016 to February 2017 were selected. Confusion Assessment Model for Intensive Care Unit (CAM-ICU) was used to evaluate the morbidity of SSD on a daily basis. The patients' general information, vision and hearing conditions, Mini-Mental State Examination (MMSE) scores, Acute Physiology and Chronic Health Evaluation Scoring System (APACHEⅡ) scores, mechanical ventilation, constraints, oxygenation index and laboratory measurements such as blood albumin, hemoglobin, Na+, Cl-, K+, Ca2+ and other data were collected until they were transferred from ICU. Univariate analysis was used to analyze potential risk factors, and unconditioned Logistic regression analysis was used to analyze the independent risk factors of SSD in surgical ICU patients. Results? The morbidity rate of SSD was 34.1% (46/135), and the morbidity rate of delirium was 28.9% (39/135). According to univariate analysis, there was statistically significant difference in age, educational background, marital status, operation or not, APACHEⅡscores, MMSE scores, use of constraints, use of mechanical ventilation, and incidence of hypoproteinemia or hyponatremia between patients with SSD and without SSD (P＜0.05). Logistic regression analysis revealed that MMSE, hypoproteinemia and constraints were independent prognostic factors affecting the incidence of SSD in surgical ICU patients (OR=0.848, 3.325, 3.393; P＜ 0.05). Conclusions? The incidence rate of SSD in surgical ICU patients is high. Patients with lower MMSE scores, hypoproteinemia and use of constraints are more susceptible to SSD.