BACKGROUND: For lung transplant recipients (LTRs), rehabilitation management after lung transplantation is a crucial link affecting the recovery of pulmonary function. This study systematically summarizes and generalizes the relevant evidences on postoperative pulmonary function rehabilitation management in LTRs, thereby providing a basis for formulating clinical strategies for postoperative pulmonary function rehabilitation management in this patient population. METHODS: Based on the "6S" evidence model, a systematic search was conducted in domestic and international databases and websites, including UpToDate, BMJ Best Practice, Cochrane Library, Web of Science, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, Guidelines International Network (GIN), and China Yimai Tong Guidelines Network, from the establishment of each database to July 2025. Relevant evidences on postoperative pulmonary function rehabilitation management for LTRs were extracted, and two researchers independently conducted quality assessment, evidence extraction, and integration of the included literature. RESULTS: A total of 18 studies were included, consisting of 3 expert consensuses, 4 systematic reviews/evidence summaries, 4 randomized controlled trials (RCTs), 5 quasi-experimental studies, and 2 cohort studies. A total of 30 pieces of best evidence were summarized, covering 8 themes: rehabilitation assessment, early intervention, exercise training, nutritional management, medication management, respiratory function training, psychological support, and long-term follow-up. CONCLUSIONS Based on evidence-based principles, this study summarizes the best evidence for postoperative pulmonary function rehabilitation training in LTRs and proposes 30 clinically applicable recommendations, which provides a theoretical basis for the clinical implementation of pulmonary function rehabilitation management. Clinical medical and nursing staff should combine specific clinical scenarios and professional judgments to translate the evidence into practice, and provide scientific rehabilitation management and guidance for LTRs.
Humans ; Lung Transplantation/rehabilitation* ; Lung/surgery* ; Transplant Recipients

Objective To investigate the rehabilitation outcome in hemiplegic stroke patients with upper limb dysfunction treated with electromyographic(EMG)biofeedback therapy in combination with an intelligent Tongluo therapeutic apparatus.Methods A total of 132 stroke patients with hemiplegia were chosen and divided into observation group and control group according to the rehabilitation strategies,with 66 cases in each group.Control group was treated with EMG biofeedback therapy,while observation group was given the integrated therapy of EMG biofeedback therapy and intelligent Tongluo therapeutic apparatus.The two groups were compared for motor function of the hemiplegic upper limb(shoulder,hand and wrist muscle),integrated electromyography(iEMG)in the affected limb flexion and extension(biceps brachii and triceps brachii),range of motion of the shoulder joint(abduction,external rotation,internal rotation)and Barthel index of activities of daily living(ADL).Results The differences in the iEMG of biceps brachii and triceps brachii of the elbow joint,motor function of the hemiplegic upper limb,range of motion of the shoulder joint and ADL between two groups before treatment were trivial(P>0.05).The treatment in observation group increased the iEMG of biceps brachii and triceps brachii in elbow flexion(P<0.05),decreased the iEMG of biceps brachii in elbow extension but increased the iEMG of triceps brachii in elbow extension(P<0.05),and these improvements were more significant than those in control group(P<0.05).After treatment,the scores for shoulder function,hand function,and wrist muscle function in observation group increased from(12.23±2.76)to(26.77±4.28),(6.54±1.34)to(15.35±2.46),and(2.36±0.46)to(8.13±2.52),and the scores of the above indexes were higher than those in control group(P<0.05).The shoulder abduction,external rotation and internal rotation ranges of motion in observation group after treatment were greater than those before treatment[(90.77±8.35)° vs(61.23±6.35)°,(45.36±5.33)° vs(26.33±4.65)°,(52.55±5.86)° vs(32.44±3.87)°],and the observation group had greater shoulder ranges of motion than control group(P<0.05).The ADL score in observation group after treatment was higher than that before treatment[(62.45±5.25)vs(33.35±4.85),P<0.05],and it was also higher than that in control group(P<0.05).Conclusion EMG biofeedback therapy combined with intelligent Tongluo therapeutic apparatus can effectively improve the iEMG in the affected limb flexion and extension,enhance the ranges of motion of the shoulder joint,and ultimately improve the upper limb motor function and life quality of hemiplegic stroke patients.

Objective To evaluate the comprehensive value of methicillin-resistant Staphylococcus aureus(MRSA)treatment drugs in artificial joint infections from multiple perspectives and to solve the problem of MRSA infections in artificial joints.Methods Through literature research,relevant literature was retrieved and clinical studies meeting the requirements were selected and summarized.The Analytic Hierarchy Process(AHP)was applied to collect comprehensive clinical evaluation evidence and to conduct evaluations across different dimensions according to evaluation guidelines;the Delphi method combined with AHP was used for expert anonymous questionnaire evaluation,and the data was compared and analyzed.Results A clini-cal comprehensive evaluation index model for the treatment of artificial joint infections was successfully established,and the yaahp analysis software was used to score the comprehensive clinical evaluation evidence in various directions.Treatment drugs,vancomy-cin,daptomycin,and linezolid,at various levels were calculated through the software,and it was concluded that linezolid has the highest clinical comprehensive evaluation score.Conclusion Among the treatment drugs for MRSA infections in artificial joints,linezolid has a higher clinical comprehensive value and can provide a reference for the clinical treatment of MRSA infec-tions in artificial joints.

Objective To analyze the influencing factors of malaria infection of labor service exported to overseas in Langfang City, in order to establish a visualization tool to assist clinicians in predicting the risk of malaria. Methods A total of 4 774 expatriate employees of the Nibei Pipeline Project of the Pipeline Bureau from October 2021 to August 2023 were taken as the subjects, and the gender, age, overseas residence area and Knowledge of malaria controlscores of the study subjects were investigated by questionnaire survey, and the possible risk factors of malaria were screened by logistic regression model. At the same time, the nomogram prediction model was established, and the subjects were divided into the training group and the validation group at a ratio of 2:1, and the area under the curve (ROC) and the decision curve were plotted to evaluate the prediction ability and practicability of the prediction model in this study. Results Among the 4 774 study subjects, 96 cases of malaria occurred, and the detection rate was 2.01%. Junior school （OR=1.723，95% CI:1.361-2.173）， and residence in rural areas（OR=2.091，95%CI:1.760 -3.100）were risk factors (OR>1), while protective measures（OR=0.826，95% CI : 0.781 - 0.901） and high malaria education scores （OR=0.872，95% CI : 0.621 - 0.899）were protective factors.The nomogram prediction model results showed that the area under the curve of the nomogram prediction model in the training group was 0.94 (95% CI : 0.85 - 1.00), while the validation group was 0.93 (95% CI : 0.80 - 1.00). The results of the decision curve showed that when the threshold probability of the population was 0-0.9, the nomogram model was used to predict the risk of malaria occurrence with the highest net income. Conclusion The nomogram prediction model (including gender, education, region, protection and malaria education score) established and validated in this study is of great value for clinicians to screen high-risk patients with malaria.

Objective : To explore the effects and mechanisms of Kobophenol A ( KPA) on lipopolysaccharide ( LPS) -induced M1 macrophage polarization，and to provide a theoretical basis for the treatment of inflammatory immune diseases and the development of new drugs． Methods: The M1 macrophage polarization model of RAW264. 7 was established by LPS induction，and the peroxiredoxin 6 ( Prdx6) knockdown model was constructed using the Prdx6 inhibitor MJ33 and Prdx6-siRNA．RAW264. 7 cells，a mouse macrophage cell line，were treated with various concentrations of KPA． Cell viability was assessed using the CCK-8 assay．The expression levels of Prdx6 and M1 macrophage polarization-related proteins，including inducible nitric oxide synthase ( iNOS) and cyclooxygenase-2 ( COX-2) ，were detected by Western blot and immunofluorescence staining．The expression levels of Prdx6 and M1 macrophage polarization-related genes iNOS，interleukin-6 ( IL-6) ，and tumor necrosis factor α ( TNF-α) ，were measured by RT-qPCR. Flow cytometry was employed to detect the expression of cluster of differentiation 86 ( CD86) ，a marker of M1 macrophages． Results: Compared with the LPS-induced M1 macrophage polarization model ， KPA significantly reversed the morphological changes of M1 macrophage polarization in RAW264. 7 macrophages and decreased the expression of M1 macrophage polarization-related proteins iNOS，COX- 2，CD86 and related genes iNOS，IL-6，TNF-α ( all P＜0. 05) ．In addition，LPS significantly downregulated the expression of Prdx6 in RAW264. 7 macrophages，while KPA upregulated the expression of Prdx6．Moreover，treatment with the Prdx6 inhibitor MJ33 significantly upregulated the expression of iNOS，a marker of M1 macrophage polarization，in RAW264. 7 macrophages，whereas treatment with KPA significantly downregulated the expression of iNOS ( all P＜0. 05) ． Conclusion KPA inhibits LPS-induced M1 polarization of RAW264. 7 macrophages by upregulating the expression of Prdx6．

Objective To investigate the relationship between serum cyclophilin A(CypA),ischemia modi-fied albumin(IMA),galectin-3(Gal-3)levels and oxidative stress and cognitive impairment(CI)in patients with acute cerebral infarction(ACI)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 168 patients with ACI complicated with OSAHS who were admitted to the hospital from December 2020 to October 2023 were selected,and the levels of serum CypA,IMA,Gal-3 and oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]in patients with different severity(mild group,moderate group,severe group)were compared.The correlation between serum CypA,IMA,Gal-3 lev-els and oxidative stress indexes were analyzed by Pearson method.The incidence of CI in patients with ACI complicated with OSAHS were statistically analyzed,the levels of serum CypA,IMA and Gal-3 were com-pared between normal cognitive group and CI group,and the risk factors of CI in patients with ACI complicat-ed with OSAHS were analyzed by multivariate Logistic regression model.Results The levels of serum CypA,IMA,Gal-3 and MDA in mild group,moderate group and severe group increased in turn(P<0.05),and ser-um SOD level decreased in turn(P<0.05).Serum CypA,IMA and Gal-3 in ACI patients complicated with OSAHS were negatively correlated with SOD(P<0.05),and positively correlated with MDA(P<0.05).Of 168 ACI patients complicated with OSAHS,79 cases(47.02%)had CI and were included in the CI group.Compared with normal cognitive group,the serum levels of CypA,IMA and Gal-3 in CI group were signifi-cantly increased(P<0.05).Multivariate Logistic regression model analysis showed that apnea hypopnea in-dex(AHI)≥20 times/h,frontal and temporal lobe infarction,elevated CypA level,elevated IMA level,and el-evated Gal-3 level were risk factors for CI in ACI patients complicated with OSAHS(P<0.05).Conclusion The high expression of serum CypA,IMA and Gal-3 in patients with ACI complicated with OS-AHS is significantly correlated with oxidative stress and CI.The increase of serum CypA,IMA and Gal-3 lev-els indicates an increased risk of CI in patients with ACI complicated with OSAHS,and early detection of the three has good clinical value in evaluating the condition of patients with ACI complicated with OSAHS.

Docynia delavayi (Franch.) Schneid. is an economic fruit plant with high medicinal and edible values. The TCP gene family plays a vital role in plant growth and development. To explore the function of the TCP gene family in the growth and development of D. delavayi. In this study, the TCP gene family (DdeTCP) members were identified from the D. delavayi genome and their expression levels at different stages of seed germination and fruit development were analyzed. The results showed that a total of 18 DdeTCP genes were identified from the D. delavayi genome, with uneven location on 11 chromosomes. The phylogenetic tree showed that the 18 DdeTCPs could be classified into class Ⅱ (3) and class Ⅱ (15), suggesting that functional differentiation occurred among the DdeTCP family members. DdeTCP11 highly homologous to AtTCP14 was highly expressed in the early stage of seed germination, which suggested that this gene played a key role in seed germination. In addition, DdeTCP16 in class Ⅱ had a high expression level during the fruit ripening stage, which indicated that it might be related to fruit ripening. The findings lay a foundation for probing into the roles of the DdeTCP gene family in the growth and development of D. delavayi.
Phylogeny ; Gene Expression Regulation, Plant ; Multigene Family ; Genome, Plant/genetics* ; Plant Proteins/genetics* ; Transcription Factors/genetics* ; Germination/genetics* ; Fruit/growth & development* ; Genes, Plant

Objective To investigate the predictive value of neuregulin 4(Nrg4)combined withγ-aminobutyric acid(GABA)in cognitive dysfunction among patients with severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 169 patients with severe OSAHS were se-lected as study subjects and divided into normal cognitive function group(n=89)and cognitive dys-function group(n=80)based on cognitive function assessment results.General information of the pa-tients was collected,and the levels of Nrg4 and GABA were detected by enzyme-linked immunosor-bent assay(ELISA).Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of Nrg4 and GABA for cognitive dysfunction in OSAHS patients.Results The proportions of patients with a history of hypertension and diabetes,as well as the levels of diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were significantly higher in the cognitive dysfunction group than those in the normal cognitive function group(P＜0.05).The levels of Nrg4 and GABA were significantly lower in the cognitive dysfunction group than in the normal cognitive function group(P＜0.05).The Montreal Cognitive Assessment(MoCA)score in the cognitive dys-function group was significantly lower than that in the normal cognitive function group[(12.36±2.35)versus(28.25±1.02),P＜0.05].Multivariate Logistic regression analysis revealed that a history of hypertension and diabetes,diastolic blood pressure,TC,TG,HDL-C,and LDL-C were risk factors for cognitive dysfunction in patients with severe OSAHS(P＜0.05),while Nrg4,GABA,and MoCA scores were protective factors(P＜0.05).ROC curve analysis showed that combined de-tection of Nrg4 and GABA had a higher predictive value for cognitive dysfunction in patients with se-vere OSAHS compared with either marker alone(P＜0.05).Conclusion A history of hyperten-sion and diabetes,diastolic blood pressure,TC,TG,HDL-C,LDL-C,Nrg4,GABA,and MoCA scores are all factors influencing cognitive dysfunction in patients with severe OSAHS.Combined de-tection of Nrg4 and GABA can effectively predict cognitive dysfunction in these patients.

Objective:To investigate the prognosis of postoperative adjuvant therapy for hepatocellular carcinoma after conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 103 patients with initially unresectable hepatocellular carcinoma (HCC) who were admitted to 11 medical centers in China, including Mengchao Hepatobiliary Hospital of Fujian Medical University et al, from November 2019 to May 2023 were collected. There were 83 males and 20 females, aged (54±12)years. All 103 patients underwent conversion therapy of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) successfully followed by sequential hepatectomy, of which 72 patients undergoing postoperative adjuvant therapy were divided into the adjuvant therapy group, and 31 patients undergoing postoperative follow-up monitoring were divided into the follow-up monitoring group. Observation indicators: (1) follow-up and postoperative condi-tions; (2) analysis of factors influencing recurrence-free survival time of patients; (3) stratified ana-lysis. Comparison of count data between group was conducted using the chi-square test or Fisher exact probability. The R software was used to draw survival curves, and the Log-rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the Cox proportional hazard model. Results:(1) Follow-up and postoperative conditions. All 103 patients were followed up for 21.0(range, 1.9?47.2)months, with the median recurrence-free survival time of 28.7 months and the 1-, 2-, 3-year recurrence-free survival rates of 68.6%, 55.6%, 41.2%. The median overall survival time of 103 patients was unreached, and the 1-, 2-, 3-year overall survival rates were 90.9%, 82.1%, 69.6%, respectively. The median recurrence-free survival time was 33.1 months in patients of the adjuvant therapy group, with the 1-, 2-year recurrence-free survival rates as 77.2%, 61.5%. The median recurrence-free survival time was 11.1 months in patients of the follow-up monitoring group, with the 1-, 2-year recurrence-free survival rates as 46.6%, 40.8%. There was a significant difference in recurrence-free survival between the two groups of patients ( χ2=5.492, P<0.05). (2) Analysis of factors influencing recurrence-free survival time of patients. Results of multivariate analy-sis showed that pathologic complete response and postoperative adjuvant therapy were independent factors influencing recurrence-free survival time of HCC patients undergoing conversion therapy of combined targeted therapy and immunotherapy followed by sequential hepatectomy ( hazard ratio=0.297, 0.492, 95% confidence interval as 0.137?0.647, 0.268?0.903, P<0.05). (3) Stratified analysis. Of the 71 patients with non-pathologic complete response, the median recurrence-free survival time of 48 patients in the adjuvant therapy group was 24.0 months, with the 1-, 2-year recurrence-free survival rates as 67.4%, 48.8%. The median recurrence-free survival time of 23 patients with non-pathological complete response in the follow-up monitoring group was 7.4 months, with the 1-, 2-year recurrence-free survival rates as 35.0%, 26.3%. There was a significant difference in recurrence-free survival between the 48 patients with non-pathologic complete response in the adjuvant therapy group and the 23 patients with non-pathologic complete response in the follow-up monitoring group ( χ2=5.241, P<0.05). Conclusion:For HCC patients with conversion therapy of TKIs and ICIs followed by sequential hepatectomy, postoperative adjuvant therapy, compared to postoperative follow-up monitoring, can prolong the recurrence-free survival time of patients, of whom cases with non-pathologic complete response can benefit from adjuvant therapy.

Objective:To explore the potential profile characteristics of family health in patients with chronic diseases, analyze the influencing factors of different family health categories, and further investigate the relationship between family health categories and the quality of life in patients with chronic diseases, providing a scientific basis for targeted intervention strategies.Methods:This study was a cross-sectional survey. The data for the study were obtained from the Chinese Residents' Psychology and Behavior Survey Research Database. A multistage sampling method was employed to select 1 808 patients with chronic diseases as survey respondents from July to September 2021. Data were collected using the General Information Questionnaire, the Family Health Scale, and the European 5-Dimensional 5-Level Health Scale(EQ-5D-5L). Potential profiles of family health in patients with chronic diseases were identified using latent profile analysis. Univariate analysis and multiple Logistic regression were used to examine influencing factors, and generalized linear regression was performed to analyze the impact of different family health categories on quality of life.Results:A total of 1 808 chronic disease patients were enrolled, comprising 986 males and 822 females, with a age of (55.23 ± 7.02) years. The scores of family health, EQ-5D-5L, EuroQol Visual Analogue Scale were 38(34, 43), 0.94(0.84, 1.00), and 78(63, 87) points. The family health of patients with chronic diseases were categorized into three potential profiles: the low family health group (418 cases accounting for 23.1%), the medium family health group (747 cases accounting for 41.3%), and the high family health group (643 cases accounting for 35.6%). Multivariate Logistic regression analysis showed that family type, marital status, nature of household, education level, number of siblings and type of health insurance were significant factors influencing family health categories ( OR values were 0.464-2.503, all P<0.05). The family health was an important factor influencing quality of life ( χ2 values were 4.05-100.68, all P<0.05). Conclusions:There is significant heterogeneity in the family health of patients with chronic diseases, which can be divided into three distinct categories. Patients with higher family health levels have better quality of life. Medical professionals should develop precise intervention programs tailored to the characteristics of each category to improve family health levels and enhance the quality of life of patients with chronic diseases.