The Warburg effect, originally discovered by Otto Warburg, refers to the metabolic reprogramming of tumor cells from aerobic oxidation to glycolysis, enabling rapid energy production to support their growth and metastasis. This process is accompanied by the massive production and accumulation of lactate both intracellularly and extracellularly. The resulting acidic microenvironment impairs the normal physiological functions of immune cells and promotes tumor progression. An increasing number of studies indicate that lactate, a key metabolite in the tumor microenvironment (TME), acts as a pivotal immunosuppressive signaling molecule that modulates immune cell function. This review aims to comprehensively examine lactate's role as an immunosuppressive molecule in TME. It focuses on mechanisms such as membrane receptor binding, functional reshaping of immune cells via lactate shuttle transport, epigenetic regulation of gene expression through histone lactylation, and modulation of protein structure and function through nonhistone lactylation, emphasizing lactate's importance in immune regulation within the TME. Ultimately, this review offers novel insights into immunosuppressive therapies aimed at targeting lactate function.
Humans ; Neoplasms/metabolism* ; Tumor Microenvironment/immunology* ; Lactic Acid/immunology* ; Warburg Effect, Oncologic ; Animals ; Glycolysis ; Epigenesis, Genetic

Objective:Elderly patients with sarcopenia and cognitive impairment are prone to experiencing more severe adverse events.This study aimed to analyze body composition and gait characteristics in this population, as well as to identify sensitive gait indicators of sarcopenia in individuals with cognitive impairment.Methods:A total of 200 elderly individuals from 3 different nursing homes in Suzhou were recruited for this study.The participants' overall cognitive function was assessed using the Beijing version of the Montreal Cognitive Assessment(MoCA-BJ), body composition was evaluated through bioelectrical impedance analysis, and gait was assessed using a wearable gait analysis system.Gait predictors of sarcopenia with cognitive impairment were then identified and used to construct predictive models.Results:The study encompassed 83 participants, divided into three groups: 35 in the control group(cognitively normal, without sarcopenia), 24 in the sarcopenia with mild cognitive impairment(MCI)group, and 24 in the sarcopenia with dementia group.When compared to the control group, individuals in the sarcopenia with MCI group exhibited lower Skeletal Muscle Mass Index[(5.6±0.8)kg/m 2vs.(7.4±0.8)kg/m 2], Total Protein[(6.7±1.1)kg vs.(8.9±1.5)kg], and Arm Muscle Circumference[(21.4±1.7)cm vs.(24.1±2.3)cm](all P<0.05).Similarly, in comparison to the control group, those in the sarcopenia with dementia group displayed a shorter stride length[(0.45±0.17)m vs.(0.65±0.22)m], slower gait speed[(0.38±0.13)m/s vs.(0.55±0.18)m/s], smaller turn velocity[(89.8±23.4)degrees/s vs.(116.8±26.3)degrees/s], and longer turn duration[(3.2±0.5)s vs.(2.8±0.3)s](all P<0.05).Notably, turn duration was identified as having predictive value for sarcopenia with MCI[Area under the curve(AUC)=0.673, sensitivity 70.8%, specificity 68.6%], while a model incorporating age and turn velocity demonstrated strong predictive power for sarcopenia with dementia(AUC=0.87, sensitivity 83.3%, specificity 85.7%). Conclusions:Compared to the control group, the group with both sarcopenia and cognitive impairment exhibited lower levels of muscle strength, nutritional status, and gait performance.This study also introduced the concept that gait indicators associated with turns could be a significant predictor of sarcopenia in individuals with cognitive impairment.Furthermore, the use of wearable devices for gait assessment may offer a novel approach to identifying these at-risk individuals.

A total of 225 patients with colorectal cancer (CRC) admitted to the General Hospital of Shaoxing Second Hospital Medical community from May 5, 2020 to May 28, 2022 were enrolled (CRC group), and 101 healthy subjects underwent colorectal examination were selected as the control group. The tissue biopsy samples of all subjects were obtained by colonoscopy, and subjected to Sanger sequencing to determine the polymorphism sites of the syndecan-2 (SDC2) gene. The association between SDC single nucleotide polymorphism (SNP) and colorectal cancer in CRC patients was analyzed with logistic regression. The logistic regression analysis showed that the gene polymorphism of SDC2 rs2515127 was associated with colorectal cancer ( OR=1.643, 95% CI: 1.025-2.337, P=0.012). The frequency of GG, AG and AA the in genotypes of SDC2 rs2515127 was 60.7% (102/168), 30.4% (51/168) and 8.9% (15/168), respectively. The results showed that the gene polymorphism of SDC2 rs2515127 was associated with colorectal cancer, and the frequencies of GG and AG genotypes were higher in the genotypes of SDC2 rs2515127.

Objective To explore the work experience of nurses in magnetic hospital under nursing management model. Methods A total of 15 clinical nurses were interviewed by the method of semi-structured interview, and data were analyzed using Colaizzi′s phenomenological analysis method. Results The work experiences of nurses in magnetic hospital under nursing management model were reduced to clinical work and management system. The experiences on clinical work were classified into 4 themes, including improving professional connotation, team climate, work standards and reducing gap between efforts and rewards. The experiences on management system were classified into 2 themes, including revolution and innovation, collaboration and support. Conclusions Through understanding the work experience of nurses in magnetic hospital under nursing management model, nurse managers can take targeted management measures to attract high-quality nursing professionals, reduce the nurse turnover rate and improve the quality of nursing.

OBJECTIVETo analyze the current research status of rehabilitation nursing for adult burn patients in China, and to disuss the related strategies.

METHODSChinese scientific articles on adult burn patients' rehabilitation nursing published from January 2003 to December 2013 were retrieved from 3 databases namely China Biology Medicine disc, Chinese Journals Full-text Database , and Chinese Science and Technology Journals Database . From the results retrieved, data with regard to publication year, journal distribution, research type, region of affiliation of the first author, and the main research content were collected. Data were processed with Microsoft Excel software.

RESULTSA total of 417 articles conforming with the criteria were retrieved. During the 11 years, the number of the relevant articles per year was on the rise, and the increasing rates in 2005, 2008, 2009, and 2013 were all above 30% . Regarding the distribution among journals, these 417 articles were published in 151 journals, with 188 articles in Source Journal for Chinese Scientific and Technical Papers , accounting for 45.08%. Regarding the research type, 173 out of the 417 articles were dealing with clinical experiences, accounting for 41.49% ; 172 out of the 417 articles were dealing with experimental studies, accounting for 41.25% . The regions of affiliation of the first author were mainly situated in Guangdong province, Shandong province, Hunan province, and Jiangsu province, with Guangdong province contributing 58 articles, accounting for 13.91%. The research content of these articles was mainly focused on psychological nursing, nursing model, and health education, respectively 188,101, and 85 articles, accounting for 45.08%, 24.22%, and 20.38%.

CONCLUSIONSThe research on rehabilitation nursing for adult burn patients in China has been carried out nationwide. Although the number of relevant papers is on the rise, the quality of these papers needs to be further improved. There is an urgent need for the guideline on rehabilitation nursing for adult burn patients in China so as to standardize the content and procedure of rehabilitation nursing.

Objective To find biological markers to predict the mathematical cognitive ability in order to set patients free from the pain and time-consuming behavioral tests. Methods 86 patients with stroke or brain traumatic injuries were recruited and acquired T1 and rest-ing-state functional MRI imaging data. And a mathematical task (7 calculation items, 2 counting items) and a word-reading task (140 items) was also finished. The partial correlative analysis was made between the score of mathematical task and the amplitude of low frequency fluc-tuation of each voxel of the whole brain with the word-reading performance as controlling task, and AlphaSim correction method was used with corrected P<0.05 (single voxel level:P<0.05;cluster size:>110 voxels). Results There were 5 cerebral regions whose amplitude of low frequency fluctuation significantly correlated with mathematical performance:left inferior parietal lobule (161 voxels, rpeak=0.34), left precu-neus/superior parietal lobule (141 voxels, rpeak=0.31), left middle temporal gyrus (359 voxels, rpeak=0.34), left middle frontal gyrus (491 vox-els, rpeak=0.36), and right middle frontal gyrus (156 voxels, rpeak=0.32). Conclusion The amplitude of low frequency fluctuation of left inferior parietal lobule, precuneus/superior parietal lobule, middle temporal gyrus, middle frontal gyrus, and right middle frontal gyrus could be used as predictors of mathematical cognitive ability for brain-damaged patients.

Objective To investigate that ox-LDL inhibits endothelial differentiation of bone marrow mesenchymal stem cells (MSCs) in rats and its underlying mechanism .Methods Cultured MSCs were divided into four groups:blank groups , ox-LDL groups ( 5 μg/mL ox-LDL ) , ox-LDL +NAC groups ( 5 μg/mL ox-LDL and pre-treated NAC), and negative LDL groups (5 μg/mL nLDL).Cell morphology, endothelial marker and differentiation effi-ciency as well as signal of oxidative and pathway protein were detected after induction by Western blot , real-time PCR.Results MSCs can differentiate into endothelial cells with the expression of endothelial marker vWF , Flk-1 and CD31 at the mRNA and protein level , vascular morphology , ox-LDL obvious inhibited endothelial differentia-tion of MSCs ( P<0.05 ) , but NAC can reverse the inhibition , the amount of ROS in ox-LDL groups was higher than that in ox-LDL+NAC groups ( P <0.05 ) , The expression of phosphorylated Akt decreased distinctly after treatment with ox-LDL( P<0.05 ) , NAC can stimulated its expression close to normal .Conclusions ox-LDL can inhibit endothelial differentiation of MSCs via ROS , NAC in this procese shows inhibition to effect of ox-LDL and Akt signaling also played a critical role .

Nuclear factor erythroid-2 related factor 2 ( Nrf2 ) is an important nuclear transcription factor which protects cells a-gainst oxidative stress injury. Upon exposure to reactive oxygen species ( ROS) or electrophilic stress, Nrf2 can translocate into the nucleus, and then bind to the antioxidant response element ( ARE) , regulating the expression of several antioxidant enzymes and phase Ⅱ detoxifying enzymes which aimed at the detoxifica-tion and elimination of harmful exogenous chemicals, resulting in the facilitation of hepatoprotection. Oxidative stress is the com-mon pathogenesis of many liver diseases, while the Nrf2-ARE signaling pathway is extremely important in the prevention and progression of many liver diseases. Nrf2 has more recently been implicated as a new therapeutic target in treating liver diseases. Here, we focus on the most common liver diseases and the devel-opment of these conditions where activation of Nrf2 may alleviate disease progression, so as to provide reference for related re-search in the future.

Objective To improve training effects and enhance nurses′capabilities of treating batches of patients with inhalation injury by analyzing nurses′core competencies .Methods We carried out core competency training forforty two nurses who participate Shanghai ‘11? 15 ’ big fire rescue in 2010 for one week . We assessed the professional knowledge and skills of forty two nurses before and after training , and inquired their own core competencies before and after training and their satisfaction with the training by using self -rating scale surveys and satisfaction questionnaires .After that, we analyzed, organized and summarized the acquired data.Results There were nineteen patients with inhalation injury in which 27.28% of them acquired medium and 85.71% of them obtained serious pneumonia , and all patients discharged with cured .After the training, forty two nurses′theory scores increased from (67.60 ±9.23) to (82.31 ±4.98) points, and their skill scores increased from (63.93 ±6.68) to (77.60 ±3.72) points with statistical differences (t=-9.09, -11.59,respectively;P<0.05).The theory knowledge and operation skill of nurse from different departments improved after training (P<0.05).All participants satisfied instructor of training, the course design and all course and 97 .62% pleased theory course setting .Conclusions Nurses′core competences training supported by treating batches of patients with inhalation injury will help to improve the ability of nurses to tackle with sudden public health incidents .

Objective To detect the effect of ox‐LDL on self‐renewal and Oct‐4 express of MSCs in vitro .Methods MSCs cul‐tured in vitro were divided into 4 groups :blank control(no reagents in culture system ) ,ox‐LDL (1 ,5 ,10 ,20 μg/mL ox‐LDL were added into culture system) ,ox‐LDL+NAC(corresponding ox‐LDL were added into culture system after NAC treatment ) ,negative control(corresponding nLDL were added into culture system ) .Growth curve were drawn at different time ,Oct‐4 ,a stem cell special marker ,were detected by real‐time PCR ,the production of ROS (reactive oxygen species ,ROS) in culture system were measured with electron paramagnetic resonance spectroscopy .Results proliferation of MSCs was inhibited by ox‐LDL ,when concentration of ox‐LDL was more than 5μg/mL ;apoptosis of MSCs appeared as well as attenuated expression of Bcl‐2 ,ox‐LDL generated a signifi‐cant amount of ROS in the culture system ,which was completely prevented by NAC .Conclusion The proliferation and Oct‐4 ex‐pression of MSCs were inhibited by ox‐LDL ,which may be related to increase of ROS in culture system .