Objective To investigate the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in thymic T follicular helper cells (TFH) and its significance in patients with myasthenia gravis (MG). Methods Fifteen MG patients who underwent surgical treatment at the Myasthenia Gravis Comprehensive Diagnosis and Treatment Center of Henan Provincial People’s Hospital from June 2022 to June 2023 were selected as a MG group, including 7 males and 8 females, aged 12-30 years. Twelve patients who underwent partial thymectomy to optimize surgical field exposure during cardiac surgery at Fuwai Central China Cardiovascular Hospital from June 2022 to June 2023 were selected as a control group, including 5 males and 7 females aged 20-35 years. Thymus single cell suspension was obtained by grinding the thymus tissue, and flow cytometry was used to detect the expression of α7nAChR in TFH cells. The thymus cell suspension was purified using density gradient centrifugation, followed by immunomagnetic bead separation to obtain CD4+T cells. CXCR5 antibody and coupled magnetic beads were added to isolate TFH cells. Real-time fluorescent polymerase chain reaction and Western blotting were performed to further investigate the expression of α7nAChR in TFH cells. Results Compared with the control group, the proportion of thymic TFH cells in the MG group was significantly increased (P<0.05), along with significantly decreased mRNA and protein expression levels of α7nAChR within these cells (P<0.01). Conclusion The findings suggest that there is a reduced expression of α7nAChR within thymic TFH cells in MG patients, leading to weakened immunosuppressive function which may indirectly contribute to disease onset and progression.

Objective:To systematically evaluate the qualitative study on real experiences of HIV/AIDS adolescents transitioning to adult healthcare.Methods:The qualitative research on the real experiences of HIV/AIDS adolescents transitioning to adult healthcare was electronically searched in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from January 1, 2010, to November 5, 2024. The methodological quality of the included literature was evaluated according to the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were synthesized through the aggregate integration method.Results:A total of 11 articles were included, 52 outcomes were distilled, and similar outcomes were grouped into nine new categories, which were synthesized to form three integrative outcomes (attitudes toward transitioning to adult healthcare, multiple dilemmas faced in transitioning to adult healthcare, and need for comprehensive support during transition to adult healthcare) .Conclusions:HIV/AIDS adolescents have complex attitudes about transitioning to adult healthcare and face multifaceted challenges in the transition process. Healthcare professionals should pay attention to the real experiences of adolescents during the transition period and work with parents and peers to provide holistic support, and meet the diverse needs of adolescents.

Objective:To systematically evaluate the qualitative study on real experiences of HIV/AIDS adolescents transitioning to adult healthcare.Methods:The qualitative research on the real experiences of HIV/AIDS adolescents transitioning to adult healthcare was electronically searched in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from January 1, 2010, to November 5, 2024. The methodological quality of the included literature was evaluated according to the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were synthesized through the aggregate integration method.Results:A total of 11 articles were included, 52 outcomes were distilled, and similar outcomes were grouped into nine new categories, which were synthesized to form three integrative outcomes (attitudes toward transitioning to adult healthcare, multiple dilemmas faced in transitioning to adult healthcare, and need for comprehensive support during transition to adult healthcare) .Conclusions:HIV/AIDS adolescents have complex attitudes about transitioning to adult healthcare and face multifaceted challenges in the transition process. Healthcare professionals should pay attention to the real experiences of adolescents during the transition period and work with parents and peers to provide holistic support, and meet the diverse needs of adolescents.

Objective:To systematically integrate the real experience of professional caregivers in the medical transition of adolescents with chronic diseases.Methods:Computerized searches were conducted in databases including Cochrane Library, PubMed, Web of Science, CINAHL, Embase, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the real experience of professional caregivers involved in the medical transition of adolescents with chronic diseases. The search timeframe was from the inception of the database until September 11, 2024. The quality of the included studies was assessed using the criteria for evaluating the qualitative research quality of the Australia Joanna Briggs Institute Evidence-Based Health Care Centre. Meta-synthesis was employed to synthesize the results.Results:A total of ten studies were included, yielding 42 research results that were categorized into 11 themes. The final integrated findings were divided into three categories: professional caregivers' attitudes towards medical transition, barriers to medical transition for adolescents with chronic diseases, and factors facilitating medical transition for adolescents with chronic diseases.Conclusions:Professional caregivers' attitudes towards the medical transition of adolescents with chronic diseases are complex, with a perception of various barriers to the transition. It is essential for healthcare administrators to pay attention to these issues and implement targeted interventions. Furthermore, improving the transition service process will support adolescents in making a smooth and successful transition to the adult healthcare system.

Objective:To systematically integrate the real experience of professional caregivers in the medical transition of adolescents with chronic diseases.Methods:Computerized searches were conducted in databases including Cochrane Library, PubMed, Web of Science, CINAHL, Embase, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the real experience of professional caregivers involved in the medical transition of adolescents with chronic diseases. The search timeframe was from the inception of the database until September 11, 2024. The quality of the included studies was assessed using the criteria for evaluating the qualitative research quality of the Australia Joanna Briggs Institute Evidence-Based Health Care Centre. Meta-synthesis was employed to synthesize the results.Results:A total of ten studies were included, yielding 42 research results that were categorized into 11 themes. The final integrated findings were divided into three categories: professional caregivers' attitudes towards medical transition, barriers to medical transition for adolescents with chronic diseases, and factors facilitating medical transition for adolescents with chronic diseases.Conclusions:Professional caregivers' attitudes towards the medical transition of adolescents with chronic diseases are complex, with a perception of various barriers to the transition. It is essential for healthcare administrators to pay attention to these issues and implement targeted interventions. Furthermore, improving the transition service process will support adolescents in making a smooth and successful transition to the adult healthcare system.

Objective:To determine the efficacy and influencing factors of thymectomy for bulbar myasthenia gravis.Methods:The clinical data of 120 patients with bulbar myasthenia gravis admitted to the Myasthenia Gravis Comprehensive Diagnosis and Treatment Center of Henan Provincial People's Hospital from March 2018 to June 2023 were collected, with 61 males and 59 females. There were 66 patients with thymoma and 54 patients with non-thymoma. The duration of bulbar muscle involvement before operation ranged from 11 days to 108 months. Preoperative AChR-Ab was positive in 105 cases and negative in 15 cases. There were 28 cases with bulbar muscle involvement as the initial symptom and 92 cases as the non-initial symptom. There were 7 cases with crisis and 113 cases without crisis in the past. The postoperative efficacy was evaluated according to the Myasthenia Gravis post-treatment status evaluation program of the American Myasthenia Gravis Society. Univariate analysis and logistic regression analysis were used to analyze the factors that may affect the surgical efficacy. Results:All 120 patients successfully underwent extended thymectomy, there was no perioperative death. The follow-up time was 3-57 months, with a median of 24 months. Twenty-two patients (18.33%) achieved complete durable remission, 1 patient (0.83%) maintained remission, 65 patients (54.17%) had minimal symptoms, and 20 patients (16.70%) improved. No change in 8 cases (6.67%), no aggravation cases (0), deterioration in 2 cases (1.67%), and death in 2 cases (1.67%). 23 cases(19.17%) achieved clinical remission and 85 cases (70.83%) achieved partial remission. Univariate analysis showed that positive AChR-Ab before operation and duration of bulbar muscle involvement before operation were the influencing factors of surgical efficacy in patients with bulbar MG, and the difference was statistically significant ( P<0.05). Logistic regression analysis showed that positive AChR-Ab before operation and the duration of bulbar muscle involvement before operation were independent influencing factors of surgical efficacy. Conclusion:Thymectomy can effectively relieve the symptoms of bulbar myasthenia gravis. Patients with positive AChR-Ab before surgery and shorter duration of bulbar muscle involvement may benefit more from thymectomy.

Amplifying "eat me signal" during tumor immunogenic cell death (ICD) cascade is crucial for tumor immunotherapy. Inspired by the indispensable role of adenosine triphosphate (ATP, a necessary "eat me signal" for ICD), a versatile ICD amplifier was developed for chemotherapy-sensitized immunotherapy. Doxorubicin (DOX), ATP and ferrous ions (Fe²⁺) were co-assembled into nanosized amplifier (ADO-Fe) through π‒π stacking and coordination effect. Meanwhile, phenylboric acid-polyethylene glycol-phenylboric acid (PBA-PEG-PBA) was modified on the surface of ADO-Fe (denoted as PADO-Fe) by the virtue of d-ribose unit of ATP. PADO-Fe could display active targetability against tumor cells via sialic acid/PBA interaction. In acidic microenvironment, PBA-PEG-PBA would dissociate from amplifier. Moreover, high H₂O₂ concentration would induce hydroxyl radical (·OH) and oxygen (O₂) generation through Fenton reaction by Fe²⁺. DOX and ATP would be released from the amplifier, which could induce ICD effect and "ICD adjuvant" to amplify this process. Together with programmed death ligands 1 (PD-L1) checkpoint blockade immunotherapy, PADO-Fe could not only activate immune response against primary tumor, but also strong abscopal effect against distant tumor. Our simple and multifunctional ICD amplifier opens a new window for enhancing ICD effect and immune checkpoint blockade therapy.