Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

Objective:To investigate the expression and clinical significance of gamma-aminobutyric acid receptor-associated protein-like 1 (GABARAPL1) in patients with gouty arthritis (GA).Methods:Differentially expressed genes (DEGs) between GA patients and healthy controls were identified by the Gene Expression Omnibus (GEO) database, followed by the screening of autophagy-related DEGs (au-DEGs) associated with GA. Peripheral blood single nucleated cells (PBMCs) were collected from 80 male GA patients and 60 healthy controls treated at the Affiliated Taizhou People′s Hospital of Nanjing Medical University between March to December 2023. Real-time quantitative PCR (qRT-PCR) was employed to assess the expression of au-DEGs, bisulfite sequencing PCR (BSP) was used to determine the methylation status of the GABARAPL1 promoter, and chromatin immunoprecipitation combined with qPCR (ChIP-qPCR) was used to analyze the binding activity of histone H3 to the GABARAPL1 promoter. Spearman ′s Correlations between GABARAPL1 expression and clinical indicators such as serum uric acid (UA) were analyzed. The diagnostic efficacy of GABARAPL1 in PBMCs for GA was evaluated using receiver operating characteristic (ROC) curves. Results:The relative expression of GABARAPL1 in PBMCs was significantly higher in GA patients compared to healthy controls (1.91±0.72 vs. 0.84±0.39, t=11.27, P<0.001). Spearman correlation analysis revealed that GABARAPL1 expression was positively correlated with UA, white blood cell count, neutrophil count, monocyte count, globulin, urea, and creatinine ( r=0.61, 0.40, 0.46, 0.32, 0.28, 0.22, 0.34; P<0.05 for all), and negatively correlated with lymphocyte count, albumin, high-density lipoprotein cholesterol, apolipoprotein A1, and estimated glomerular filtration rate ( r=-0.18, -0.34, -0.33, -0.50, -0.22; P<0.05 for all). ROC curve analysis showed that GABARAPL1 in PBMCs had high diagnostic efficacy for GA, with an area under the curve of 0.936. No significant differences in the methylation levels of GABARAPL1 promoter regions MC1 and MC2 were observed between GA patients and healthy controls ( t=2.28、1.43, P<0.05 for all), whereas histone H3 acetylation levels were significantly elevated in GA patients ( t=11.19, P<0.001). Conclusion:The expression of GABARAPL1 in PBMCs is significantly upregulated in GA patients, which may be associated with increased histone H3 acetylation at its promoter. The high expression of GABARAPL1 may contribute to the pathogenesis of GA by regulating autophagy and holds promise as a diagnostic biomarker and potential therapeutic target for GA.

Objective To systematically evaluate qualitative studies on the experience of inhalation therapy for patients with chronic obstructive pulmonary disease(COPD),in order to provide a basis for healthcare professionals to optimize the care strategies.Methods A systematic search was conducted for qualitative studies on the experience of inhalation therapy for patients with COPD included in domestic and international databases,with a timeframe from the establishment of the database to September 2024.Literature quality was evaluated using the Australian JBI Centre for Evidence-Based Health Care Literature Quality Assessment Criteria for Qualitative Research,and the results were integrated by a pooled integration approach.Results A total of 12 articles were included,and 84 original findings were extracted and summarized into 10 new categories to form 4 integrated results,including low level of drug literacy,differences in perceived efficacy,multiple medication burdens,and multi-dimensional support for inhalation therapy.Conclusion COPD patients have multiple experiences during inhalation therapy.Medical staff should strengthen drug education,enhance patients'cognition and medication skills,foster a positive treatment attitude,and integrate multiple resources to improve patients'inhalation therapy experience.

OBJECTIVE To report a case of hepatitis B virus （HBV） reactivation induced by iparomlimab and tuvonralimab， summarize the clinical characteristics and potential mechanisms of such adverse reactions induced by immune-checkpoint inhibitors （ICIs）， and provide references for clinical application. METHODS From the perspective of a clinical pharmacist， a retrospective analysis was conducted on the treatment course of a patient with metastatic cervical cancer who experienced HBV reactivation after receiving iparomlimab and tuvonralimab. Additionally， an analysis of the correlation with adverse reactions was performed， and the clinical characteristics， risk factors， potential mechanisms， key points of treatment approaches and pharmaceutical care associated with HBV reactivation induced by ICIs were summarized. RESULTS & CONCLUSIONS The patient developed HBV reactivation and severe liver injury after using iparomlimab and tuvonralimab. The condition improved following drug discontinuation， and symptomatic treatment such as glucocorticoids. According to Naranjo’s Assessment Scale and China’s Measures for the Reporting and Monitoring of Adverse Drug Reactions， the association between iparomlimab and tuvonralimab and HBV reactivation was judged as “highly probable”， and it was identified as a new adverse reaction； the correlation between iparomlimab and tuvonralimab， paclitaxel and liver injury was “highly probable”. HBV reactivation in hepatitis B patients receiving standardized antiviral therapy is very rare after ICIs treatment； HBV reactivation is related to the overactivation of the immune system and disruption of immune balance induced by ICIs. For such patients， glucocorticoids should be administered for treatment， accompanied by pharmaceutical care， including pre- medication risk assessment and monitoring of relevant indicators during treatment.

Lung transplantation is an important means to treat end-stage lung disease and improve the survival rate and quality of life of patients. However, many postoperative complications seriously affect the prognosis of recipients. Accurate identification of key prognostic factors and construction of individualized and accurate prediction models are of great significance for postoperative prognosis evaluation, treatment strategy formulation and clinical decision-making. In recent years, the clinical prediction model of lung transplantation has gradually changed from traditional statistical methods to machine learning-driven. Compared with traditional models such as Cox regression and Logistic regression, machine learning models such as random forest, support vector machine and artificial neural network have certain advantages in postoperative survival rate prediction, early warning of complications and pulmonary function evaluation. However, their application is also affected by insufficient sample size and poor interpretability of models. Under the condition of small samples, the traditional model still has important value in prediction accuracy. The appropriate prediction model should be selected according to the clinical status of lung transplantation in China, considering the factors such as sample size, variable complexity and model interpretability. In the future, a multi-center, large-sample lung transplantation database should be constructed to further optimize and tap the potential of machine learning algorithms to improve the robustness and clinical applicability of the model.

Objective To explore the mechanism of GS-9620 in improving imiquimod(IMQ)-induced psoriasis-like inflammation by regulating the Th1/Th17-related immune response,and to investigate its regulatory effect on the gut microbiota in mice.Methods An IMQ-induced psoriasis-like inflammation model was established in BALB/c mice.The severity of the skin lesions was evaluated by psoriasis area and severity index(PASI)score.The proportions of CD4+interleukin(IL)-17+and CD4+interferon(IFN)-γ+cells in spleen tissue were detected by flow cytometry.Levels of the inflammatory factors tumor necrosis factor(TNF)-α,IL-1β,and IL-6 in skin tissues were determined by enzyme-linked immunosorbent assay,and pathological analysis was performed by hematoxylin/eosin staining.The effects of GS-9620 on the structure of the gut microbiota in control,IMQ model,and GS-9620-treated mice were detected by 16S rRNA sequencing.Results GS-9620 significantly reduced the PASI score in IMQ-induced mice and effectively reduced the proportions of CD4+IL-17+and CD4+IFN-γ+cells in the spleen.GS-9620 also significantly down-regulated the expression levels of TNF-α,IL-1β,and IL-6 in skin tissues.16S rRNA sequencing showed that GS-9620 significantly regulated the abundance of gut microbiota related to inflammation,including the relative abundances of bacteria such as Lachnospiraceae_NK4A136_group,Lachnospiraceae_UCG-008,Alloprevotella,Desulfovibrio,Prevotellaceae_UCG-001,and Alistipes.Conclusions GS-9620 effectively alleviates IMQ-induced psoriasis-like skin inflammation in mice by regulating the expression of Th1/Th17-related inflammatory factors.It may also improve IMQ-induced clinical symptoms by regulating the structure of the gut microbiota,thus providing a new theoretical basis for the treatment of psoriasis.The result of this study provide important experimental evidence to support further investigations into the application of GS-9620 for the treatment of psoriasis.

Objective To systematically evaluate qualitative studies on the experience of inhalation therapy for patients with chronic obstructive pulmonary disease(COPD),in order to provide a basis for healthcare professionals to optimize the care strategies.Methods A systematic search was conducted for qualitative studies on the experience of inhalation therapy for patients with COPD included in domestic and international databases,with a timeframe from the establishment of the database to September 2024.Literature quality was evaluated using the Australian JBI Centre for Evidence-Based Health Care Literature Quality Assessment Criteria for Qualitative Research,and the results were integrated by a pooled integration approach.Results A total of 12 articles were included,and 84 original findings were extracted and summarized into 10 new categories to form 4 integrated results,including low level of drug literacy,differences in perceived efficacy,multiple medication burdens,and multi-dimensional support for inhalation therapy.Conclusion COPD patients have multiple experiences during inhalation therapy.Medical staff should strengthen drug education,enhance patients'cognition and medication skills,foster a positive treatment attitude,and integrate multiple resources to improve patients'inhalation therapy experience.

Objective To explore the mechanism of GS-9620 in improving imiquimod(IMQ)-induced psoriasis-like inflammation by regulating the Th1/Th17-related immune response,and to investigate its regulatory effect on the gut microbiota in mice.Methods An IMQ-induced psoriasis-like inflammation model was established in BALB/c mice.The severity of the skin lesions was evaluated by psoriasis area and severity index(PASI)score.The proportions of CD4+interleukin(IL)-17+and CD4+interferon(IFN)-γ+cells in spleen tissue were detected by flow cytometry.Levels of the inflammatory factors tumor necrosis factor(TNF)-α,IL-1β,and IL-6 in skin tissues were determined by enzyme-linked immunosorbent assay,and pathological analysis was performed by hematoxylin/eosin staining.The effects of GS-9620 on the structure of the gut microbiota in control,IMQ model,and GS-9620-treated mice were detected by 16S rRNA sequencing.Results GS-9620 significantly reduced the PASI score in IMQ-induced mice and effectively reduced the proportions of CD4+IL-17+and CD4+IFN-γ+cells in the spleen.GS-9620 also significantly down-regulated the expression levels of TNF-α,IL-1β,and IL-6 in skin tissues.16S rRNA sequencing showed that GS-9620 significantly regulated the abundance of gut microbiota related to inflammation,including the relative abundances of bacteria such as Lachnospiraceae_NK4A136_group,Lachnospiraceae_UCG-008,Alloprevotella,Desulfovibrio,Prevotellaceae_UCG-001,and Alistipes.Conclusions GS-9620 effectively alleviates IMQ-induced psoriasis-like skin inflammation in mice by regulating the expression of Th1/Th17-related inflammatory factors.It may also improve IMQ-induced clinical symptoms by regulating the structure of the gut microbiota,thus providing a new theoretical basis for the treatment of psoriasis.The result of this study provide important experimental evidence to support further investigations into the application of GS-9620 for the treatment of psoriasis.

Objective:To investigate the expression and clinical significance of gamma-aminobutyric acid receptor-associated protein-like 1 (GABARAPL1) in patients with gouty arthritis (GA).Methods:Differentially expressed genes (DEGs) between GA patients and healthy controls were identified by the Gene Expression Omnibus (GEO) database, followed by the screening of autophagy-related DEGs (au-DEGs) associated with GA. Peripheral blood single nucleated cells (PBMCs) were collected from 80 male GA patients and 60 healthy controls treated at the Affiliated Taizhou People′s Hospital of Nanjing Medical University between March to December 2023. Real-time quantitative PCR (qRT-PCR) was employed to assess the expression of au-DEGs, bisulfite sequencing PCR (BSP) was used to determine the methylation status of the GABARAPL1 promoter, and chromatin immunoprecipitation combined with qPCR (ChIP-qPCR) was used to analyze the binding activity of histone H3 to the GABARAPL1 promoter. Spearman ′s Correlations between GABARAPL1 expression and clinical indicators such as serum uric acid (UA) were analyzed. The diagnostic efficacy of GABARAPL1 in PBMCs for GA was evaluated using receiver operating characteristic (ROC) curves. Results:The relative expression of GABARAPL1 in PBMCs was significantly higher in GA patients compared to healthy controls (1.91±0.72 vs. 0.84±0.39, t=11.27, P<0.001). Spearman correlation analysis revealed that GABARAPL1 expression was positively correlated with UA, white blood cell count, neutrophil count, monocyte count, globulin, urea, and creatinine ( r=0.61, 0.40, 0.46, 0.32, 0.28, 0.22, 0.34; P<0.05 for all), and negatively correlated with lymphocyte count, albumin, high-density lipoprotein cholesterol, apolipoprotein A1, and estimated glomerular filtration rate ( r=-0.18, -0.34, -0.33, -0.50, -0.22; P<0.05 for all). ROC curve analysis showed that GABARAPL1 in PBMCs had high diagnostic efficacy for GA, with an area under the curve of 0.936. No significant differences in the methylation levels of GABARAPL1 promoter regions MC1 and MC2 were observed between GA patients and healthy controls ( t=2.28、1.43, P<0.05 for all), whereas histone H3 acetylation levels were significantly elevated in GA patients ( t=11.19, P<0.001). Conclusion:The expression of GABARAPL1 in PBMCs is significantly upregulated in GA patients, which may be associated with increased histone H3 acetylation at its promoter. The high expression of GABARAPL1 may contribute to the pathogenesis of GA by regulating autophagy and holds promise as a diagnostic biomarker and potential therapeutic target for GA.

Lung transplantation is an important means to treat end-stage lung disease and improve the survival rate and quality of life of patients. However, many postoperative complications seriously affect the prognosis of recipients. Accurate identification of key prognostic factors and construction of individualized and accurate prediction models are of great significance for postoperative prognosis evaluation, treatment strategy formulation and clinical decision-making. In recent years, the clinical prediction model of lung transplantation has gradually changed from traditional statistical methods to machine learning-driven. Compared with traditional models such as Cox regression and Logistic regression, machine learning models such as random forest, support vector machine and artificial neural network have certain advantages in postoperative survival rate prediction, early warning of complications and pulmonary function evaluation. However, their application is also affected by insufficient sample size and poor interpretability of models. Under the condition of small samples, the traditional model still has important value in prediction accuracy. The appropriate prediction model should be selected according to the clinical status of lung transplantation in China, considering the factors such as sample size, variable complexity and model interpretability. In the future, a multi-center, large-sample lung transplantation database should be constructed to further optimize and tap the potential of machine learning algorithms to improve the robustness and clinical applicability of the model.