Objective:To explore the potential category characteristics of social participation in colorectal cancer patients with stoma and analyze the influencing factors of different potential categories, so as to provide references for formulating and implementing targeted nursing measures.Methods:By using the convenience sampling method, colorectal cancer patients with stoma who were hospitalized or had outpatient follow-up visits at Guilin Hospital of Integrated Traditional Chinese and Western Medicine and the Second Affiliated Hospital of Guilin Medical University from January to December 2024 were selected as the survey subjects. A cross-sectional survey was conducted using the general information questionnaire, the voluntary participation Questionnaire, the Existential Anxiety Scale, the Family Support Scale and the Social Support Rating Scale. Potential profile analysis was used to identify the categories of social participation characteristics of colorectal cancer stoma patients, and multivariate Logistic regression was used to analyze the related influencing factors.Results:A total of 240 valid questionnaires were finally retrieved. Among the 240 colorectal cancer patients with stoma, 126 were male and 114 were female, aged 34-75 (55.63 ± 6.52) years. The social participation score of colorectal cancer patients with stoma was (55.84 ± 8.62) points. The results of potential profile analysis showed that the social participation of colorectal cancer patients with stoma could be divided into three potential categories: low participation-inefficient social life type accounted for 38.3% (92/240), medium participation-efficient indoor participation type accounted for 36.3% (87/240), and high participation-efficient outdoor participation type accounted for 25.4% (61/240). The results of multivariate Logistic regression analysis showed that, taking the high participation-efficient outdoor participation type as the reference, age, educational level, presence absence of stoma-related complications, existence of meaningless anxiety, family support, and social support were the influencing factors of low participation-inefficient social life type and medium participation-efficient indoor participation type ( OR values ranged from 0.163 to 1.879, all P<0.05). Conclusions:There are obvious classification characteristics in the social participation of colorectal cancer patients with stoma. Nursing staff can formulate and implement targeted intervention strategies based on different classification characteristics. Starting from the existence of meaningless anxiety in patients, an effective family and social support system should be established to improve their social participation.

Objective:To understand the hindrance and promoting factors of colonoscopy compliance in high-risk adenoma patients 3 months after resection, and to provide reference for formulating targeted nursing intervention strategies.Methods:An interview outline was formulated based on the health action process approach theory. A descriptive qualitative research method was used to select 13 patients with high-risk adenoma after resection in Guilin Integrated Traditional Chinese and Western Medicine Hospital from April to May 2024 for semi-structured interviews according to the purposive sampling method. Content analysis was used to analyze the data and refine the themes.Results:Among the 13 patients, there were 8 males and 5 females, aged 42-70 years old.A total of 2 themes and 8 sub-themes were extracted, including hindering factors (fear of disease outcome, risk perception barriers, low self-efficacy and lack of behavior plan) and promoting factors (establishing correct health beliefs, perceiving the benefits of health behavior, enhancing personal efficacy and advocating health behavior plan).Conclusions:The compliance of colonoscopy in patients with high-risk adenoma after resection is affected by a series of obstacles and promoting factors. In the future, targeted intervention strategies can be formulated based on the health action process approach theory to improve their compliance with colonoscopy.

Objective:To explore the potential category characteristics of social participation in colorectal cancer patients with stoma and analyze the influencing factors of different potential categories, so as to provide references for formulating and implementing targeted nursing measures.Methods:By using the convenience sampling method, colorectal cancer patients with stoma who were hospitalized or had outpatient follow-up visits at Guilin Hospital of Integrated Traditional Chinese and Western Medicine and the Second Affiliated Hospital of Guilin Medical University from January to December 2024 were selected as the survey subjects. A cross-sectional survey was conducted using the general information questionnaire, the voluntary participation Questionnaire, the Existential Anxiety Scale, the Family Support Scale and the Social Support Rating Scale. Potential profile analysis was used to identify the categories of social participation characteristics of colorectal cancer stoma patients, and multivariate Logistic regression was used to analyze the related influencing factors.Results:A total of 240 valid questionnaires were finally retrieved. Among the 240 colorectal cancer patients with stoma, 126 were male and 114 were female, aged 34-75 (55.63 ± 6.52) years. The social participation score of colorectal cancer patients with stoma was (55.84 ± 8.62) points. The results of potential profile analysis showed that the social participation of colorectal cancer patients with stoma could be divided into three potential categories: low participation-inefficient social life type accounted for 38.3% (92/240), medium participation-efficient indoor participation type accounted for 36.3% (87/240), and high participation-efficient outdoor participation type accounted for 25.4% (61/240). The results of multivariate Logistic regression analysis showed that, taking the high participation-efficient outdoor participation type as the reference, age, educational level, presence absence of stoma-related complications, existence of meaningless anxiety, family support, and social support were the influencing factors of low participation-inefficient social life type and medium participation-efficient indoor participation type ( OR values ranged from 0.163 to 1.879, all P<0.05). Conclusions:There are obvious classification characteristics in the social participation of colorectal cancer patients with stoma. Nursing staff can formulate and implement targeted intervention strategies based on different classification characteristics. Starting from the existence of meaningless anxiety in patients, an effective family and social support system should be established to improve their social participation.

Objective:To understand the hindrance and promoting factors of colonoscopy compliance in high-risk adenoma patients 3 months after resection, and to provide reference for formulating targeted nursing intervention strategies.Methods:An interview outline was formulated based on the health action process approach theory. A descriptive qualitative research method was used to select 13 patients with high-risk adenoma after resection in Guilin Integrated Traditional Chinese and Western Medicine Hospital from April to May 2024 for semi-structured interviews according to the purposive sampling method. Content analysis was used to analyze the data and refine the themes.Results:Among the 13 patients, there were 8 males and 5 females, aged 42-70 years old.A total of 2 themes and 8 sub-themes were extracted, including hindering factors (fear of disease outcome, risk perception barriers, low self-efficacy and lack of behavior plan) and promoting factors (establishing correct health beliefs, perceiving the benefits of health behavior, enhancing personal efficacy and advocating health behavior plan).Conclusions:The compliance of colonoscopy in patients with high-risk adenoma after resection is affected by a series of obstacles and promoting factors. In the future, targeted intervention strategies can be formulated based on the health action process approach theory to improve their compliance with colonoscopy.

Aim To investigate the levels of a disintegrin and metalloprotease 10(ADAM-10)and soluble uro-kinase plasminogen activator receptor(suPAR)in the serum of hypertension patients with atherosclerosis and their relation-ship with the severity of disease.Methods From February 2021 to February 2023,125 hypertension patients with atherosclerosis who visited our hospital were collected as the study group,and 76 healthy people were collected as control group.The patients in the study group were grouped into mild group(n=40),moderate group(n=42)and severe group(n=43)according to the degree of atherosclerosis,after 60 days of treatment,the patients were grouped into a good prog-nosis group(n=74)and a poor prognosis group(n=51)based on their prognosis.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum ADAM-10 and suPAR levels;Clinical data of patients with different prognosis were compared;Pearson method was applied to analyze the relationship between serum ADAM-10,suPAR levels and carotid in-tima-media thickness(IMT)in patients with hypertension and atherosclerosis;Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with hypertension and atherosclerosis;Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of ADAM-10 and suPAR alone and jointly for poor prognosis of hypertension with atherosclerosis.Results The levels of serum ADAM-10 and suPAR were significantly higher in the study group than those in control group(P＜0.05);The serum ADAM-10 and suPAR levels in moderate group and severe group were obviously higher than those in mild group(P＜0.05),while the serum ADAM-10 and suPAR levels were obviously higher in severe group than those in moderate group(P＜0.05);The serum ADAM-10 and suPAR levels,left and right IMT,systolic blood pressure,and diastolic blood pressure of patients with poor prognosis were signifi-cantly higher than those of patients with good prognosis(P＜0.05);Pearson correlation analysis showed that serum ADAM-10 and suPAR levels in patients with hypertension and atherosclerosis were positively correlated with systolic blood pres-sure,diastolic blood pressure and IMT(P＜0.001);Logistic regression analysis showed that the increased levels of systolic blood pressure,diastolic blood pressure,ADAM-10,suPAR and IMT were risk factors for poor prognosis of hypertension patients with atherosclerosis(P＜0.05);ROC curve analysis showed that the area under the curve(AUC)of serum AD-AM-10 and suPAR levels alone and jointly predicting poor prognosis of hypertension with atherosclerosis was 0.819,0.830 and 0.900,respectively,the combination of the two was superior to their individual predictions(Zcombination-AD AM-10=2.766,P=0.006;Zcombination-suPAR=2.602,P=0.009).Conclusion The levels of serum ADAM-10 and suPAR in patients with hypertension and atherosclerosis are significantly increased,and are positively correlated with the severity of atherosclero-sis.Both of them have a high predictive value for evaluating the prognosis of patients with hypertension and atherosclerosis.

To summarize the nursing experience of a patient with rhabdomyolysis complicated with acute kidney injury receiving continuous renal replacement therapy combined with hemoperfusion.Nursing points:to establish a multidisciplinary care team before treatment in order to provide whole-process management;to develop personalized nutrition management to improve nutrition status;to closely monitor the circulation of blood volume,to be alert to the occurrence of extracorporeal circulation clotting and bleeding events;to conduct strict capacity management to correct electrolyte and acid-base balance disorders;to monitor the condition of deep vein thrombosis of lower extremity and prevent pulmonary embolism;to beware of first-use syndrome to implement response measures rapidly;to carry out limb function exercise to prevent muscle atrophy.After careful treatment and care,the patient was successfully discharged from the hospital after 12 d.The patient was followed up in the outpatient clinic for 3 months.Outpatient follow-up lasted for 3 months,and all indicators were in the normal range,and the patient recovered well.

Objective:To investigate the proliferation kinetics of T cells in patients with B-cell hematologic malignancies who received CAR19 T cell therapy.Methods:Observational study. Flow cytometry was used to monitor the levels of CAR19+and CAR19-T cell expansion and the dynamic changes of T lymphocyte subsets before and after CAR19 T cell therapy. The 52 patients with B-cell hematologic malignancies (including 12 B-ALL and 40 NHL) who received CAR19 T cell therapy in the First Affiliated Hospital of Soochow University from November 2021 to December 2023 were recruited in this study. Patients were divided into complete response group and incomplete response group according to the efficacy evaluation criteria in the treatment guidelines for B-cell hematologic malignancies. T test or non-parametric rank sum test were used to compare the differences of CAR19+and CAR19-T cell subsets between the two groups.Results:At the peak of CAR19+T cell expansion, there was no statistic difference of CAR19+T cell subsets between the complete response group and the incomplete response group. After 6 months, the percentage of CD4+T cells (CD3+CD4+CD8-) in CAR19-T cells in patients was lower than the pre-treatment level(48.0+27.2,63.1+19.7,<0.01), and the percentages of CD197+CD45RA+and CD197-CD45RA-subsets recovered to the pre-treatment level, while the percentage of CD197-CD45RA+subset(4.2+3.0,21.1+15.6,<0.01) was lower than the pre-treatment level. The percentage of CD8+T cells (CD3+CD4-CD8+) returned to pre-treatment level after 6 months, CD197-CD45RA-subset in CD8+T cells returned to pre-treatment level, while CD197+CD45RA+subset(16.6+8.7,35.1+30.1,<0.01),CD197+CD45RA-subset(18.7+9.1,25.8+19.1,<0.01) were still lower than pre-treatment level.Conclusion:After CAR19 T cell treatment, there was no significant differences in the proportions of CAR19+T cell subsets in patients with different therapeutic effects. After treatment, the proportion of CAR19-CD3+CD4-CD8+cells recovered earlier than CD3+CD4+CD8-cells, and the dynamic changes of each subgroup were different. This therapeutic regimen has a great impact on the subpopulation of CAR19-T cells in vivo, and the reconstruction of such T cells takes a long time.

To summarize the nursing experience of a patient with rhabdomyolysis complicated with acute kidney injury receiving continuous renal replacement therapy combined with hemoperfusion.Nursing points:to establish a multidisciplinary care team before treatment in order to provide whole-process management;to develop personalized nutrition management to improve nutrition status;to closely monitor the circulation of blood volume,to be alert to the occurrence of extracorporeal circulation clotting and bleeding events;to conduct strict capacity management to correct electrolyte and acid-base balance disorders;to monitor the condition of deep vein thrombosis of lower extremity and prevent pulmonary embolism;to beware of first-use syndrome to implement response measures rapidly;to carry out limb function exercise to prevent muscle atrophy.After careful treatment and care,the patient was successfully discharged from the hospital after 12 d.The patient was followed up in the outpatient clinic for 3 months.Outpatient follow-up lasted for 3 months,and all indicators were in the normal range,and the patient recovered well.

Objective:To investigate the proliferation kinetics of T cells in patients with B-cell hematologic malignancies who received CAR19 T cell therapy.Methods:Observational study. Flow cytometry was used to monitor the levels of CAR19+and CAR19-T cell expansion and the dynamic changes of T lymphocyte subsets before and after CAR19 T cell therapy. The 52 patients with B-cell hematologic malignancies (including 12 B-ALL and 40 NHL) who received CAR19 T cell therapy in the First Affiliated Hospital of Soochow University from November 2021 to December 2023 were recruited in this study. Patients were divided into complete response group and incomplete response group according to the efficacy evaluation criteria in the treatment guidelines for B-cell hematologic malignancies. T test or non-parametric rank sum test were used to compare the differences of CAR19+and CAR19-T cell subsets between the two groups.Results:At the peak of CAR19+T cell expansion, there was no statistic difference of CAR19+T cell subsets between the complete response group and the incomplete response group. After 6 months, the percentage of CD4+T cells (CD3+CD4+CD8-) in CAR19-T cells in patients was lower than the pre-treatment level(48.0+27.2,63.1+19.7,<0.01), and the percentages of CD197+CD45RA+and CD197-CD45RA-subsets recovered to the pre-treatment level, while the percentage of CD197-CD45RA+subset(4.2+3.0,21.1+15.6,<0.01) was lower than the pre-treatment level. The percentage of CD8+T cells (CD3+CD4-CD8+) returned to pre-treatment level after 6 months, CD197-CD45RA-subset in CD8+T cells returned to pre-treatment level, while CD197+CD45RA+subset(16.6+8.7,35.1+30.1,<0.01),CD197+CD45RA-subset(18.7+9.1,25.8+19.1,<0.01) were still lower than pre-treatment level.Conclusion:After CAR19 T cell treatment, there was no significant differences in the proportions of CAR19+T cell subsets in patients with different therapeutic effects. After treatment, the proportion of CAR19-CD3+CD4-CD8+cells recovered earlier than CD3+CD4+CD8-cells, and the dynamic changes of each subgroup were different. This therapeutic regimen has a great impact on the subpopulation of CAR19-T cells in vivo, and the reconstruction of such T cells takes a long time.

【Objective:】 To analyze and explore the key points of the ethical review of real-world research in pediatric population, and to provide reference for ethical review of real-world research in pediatric population. 【Methods:】 According to the characteristics of real-world research and pediatric clinical trials, the review points of real-world research in pediatric population were analyzed and discussed in comparison with the principles and focus of ethical review in general clinical research. 【Results:】 The ethics committee should pay particular attention to the review of informed consent, privacy protection, risk benefit assessment, cost and compensation, and should also take into account the research design, data governance, research conflicts of interest, research registration and publication, etc., and conduct scientific and reasonable ethical review of real-world research in pediatric population. 【Conclusion:】 Clinical trials in pediatric population should have stricter and scientific ethical review, which can not only protect the interests of vulnerable groups of minors, but also standardize real-world research in pediatric population and promote the healthy development of pediatric clinical research, so as to better protect children and promote their health.