Objective To explore the latent classes and influencing factors of blood glucose trajectories after transplantation in lung transplantation patients,and provide references for identifying high-risk population of post-transplant diabetes mellitus.Methods 122 lung transplantation patients who were hospitalized in a tertiary A general hospital in Hangzhou from January 2022 to March 2023 were selected conveniently as survey subjects.Socio-demographic and disease-related data were collected,and fasting plasma glucose at 1 week before surgery(T0),1 week after surgery(T1),1 month after surgery(T2),3 months after surgery(T3),6 months after surgery(T4),1 year after surgery(T5)were collected.Growth mixture model was used to identify categories of blood glucose trajectories after lung transplantation,and binary Logistic regression analysis was used to explore the influencing factors.Results A total of 109 lung transplantation patients were enrolled in the study,and 2 latent classes of blood glucose trajectories were identified:high risk(23.85％)and low risk(76.15％)of post-transplant diabetes mellitus.BMI,drinking history,afternoon blood glucose and tacrolimus trough concentration were the influencing factors of latent classes of blood glucose trajectories after lung transplantation(all P＜0.05).Conclusion There are 2 latent classes of blood glucose trajectories after lung transplantation,namely high risk and low risk of post-transplant diabetes mellitus.Medical staff should pay attention to diabetes screening and assessment of lung transplantation patients who are overweight or obese,have a drinking history before transplantation,have high afternoon blood glucose in early stage of transplantation and have high tacrolimus trough concentration in stable stage of transplantation,so as to formulate a comprehensive and individualized blood glucose management program.

Objective To explore the latent classes and influencing factors of blood glucose trajectories after transplantation in lung transplantation patients,and provide references for identifying high-risk population of post-transplant diabetes mellitus.Methods 122 lung transplantation patients who were hospitalized in a tertiary A general hospital in Hangzhou from January 2022 to March 2023 were selected conveniently as survey subjects.Socio-demographic and disease-related data were collected,and fasting plasma glucose at 1 week before surgery(T0),1 week after surgery(T1),1 month after surgery(T2),3 months after surgery(T3),6 months after surgery(T4),1 year after surgery(T5)were collected.Growth mixture model was used to identify categories of blood glucose trajectories after lung transplantation,and binary Logistic regression analysis was used to explore the influencing factors.Results A total of 109 lung transplantation patients were enrolled in the study,and 2 latent classes of blood glucose trajectories were identified:high risk(23.85％)and low risk(76.15％)of post-transplant diabetes mellitus.BMI,drinking history,afternoon blood glucose and tacrolimus trough concentration were the influencing factors of latent classes of blood glucose trajectories after lung transplantation(all P＜0.05).Conclusion There are 2 latent classes of blood glucose trajectories after lung transplantation,namely high risk and low risk of post-transplant diabetes mellitus.Medical staff should pay attention to diabetes screening and assessment of lung transplantation patients who are overweight or obese,have a drinking history before transplantation,have high afternoon blood glucose in early stage of transplantation and have high tacrolimus trough concentration in stable stage of transplantation,so as to formulate a comprehensive and individualized blood glucose management program.

This paper summarizes the nursing experience of a pregnant woman with congenital heart disease who developed pulmonary artery hypertension crisis after cesarean section.Nursing key points:monitoring and management of inhaled nitric oxide therapy to reduce pulmonary hypertension;providing sequential respiratory support care and dynamically adjusting oxygen therapy regimen;precise volume regulation and alertness to serious complications;optimizing puerperal supervision strategy to reduce the risk of infection;preventing and controlling stress bleeding and implementing a stepped dietary management strategy;implementing phased rehabilitation training to accelerate the recovery process;carrying out personalized psychological care and health education.With comprehensive nursing care,the patient recovered well and was discharged smoothly after an 18-day hospital stay.

Objective To construct and preliminary verify a postoperative pulmonary rehabilitation nursing programme for children with double lung transplantation,aiming to promote early recovery and provide references for clinical nursing practice.Methods A convenience sampling approach was employed to select 25 cases pediatric patients who underwent bilateral lung transplantation at a tertiary teaching hospital in Hangzhou between January 2020 and September 2024,and they were divided into an experimental group and a control group according to the time of admission to the hospital.The experimental group received the newly developed post-transplant rehabilitation nursing program,which encompassed fluid management,mechanical ventilation,sequential oxygen therapy,pulmonary function training,exercise management,and process facilitation.In contrast,the control group received the standard post-lung transplantation rehabilitation protocol.Key outcomes,including mechanical ventilation duration,ICU stay,total hospitalization time,activity level,pulmonary function,incidence of adverse events and rehabilitation adherence,were compared between the 2 groups.Results Finally,24 cases completed the study,including 11 cases in the experimental group and 13 cases in the control group.After the intervention,the experimental group exhibited significantly shorter mechanical ventilation time compared to it in the control group(P=0.009).Additionally,at discharge,the intervention group demonstrated higher activity levels and better rehabilitation compliance(P＜0.05).Conclusion The pulmonary rehabilitation nursing program for children with double lung transplantation is scientifically sound,safe,and feasible.The implementation of this program is beneficial for the early discontinuation of mechanical ventilation,improving postoperative mobility,and enhancing compliance with pulmonary rehabilitation.

To summarize the nursing experience of 14 children after double lung transplantation for secondary bronchiolitis obliterans after hematopoietic stem cell transplantation(HSCT).Nursing points:to improve preoperative evaluation,actively improve the body status;to conduct the whole-process ECMO management to achieve early safe evacuation;to carry out the task feedback breathing training game to promote lung function;to implement the interest-oriented game exercise to promote muscle strength;to conduct the symptom-matched nutritional support,coping with gastrointestinal graft-host disease;to improve discharge preparation and empower primary caregivers.After careful nursing care,all of the 14 children were discharged smoothly.The follow-up result showed that the children had normal lung function and activities of daily living.

Objective To explore the current status of bone metabolism abnormalities after lung transplantation and its influencing factors,and provide scientific references for the formulation of nursing intervention measures.Methods A retrospective analysis of the clinical data of 125 patients undergoing lung transplantation at a lung transplant center from June 2021 to August 2023 was conducted.The paired sample t-test was used to compare the trends in bone mineral density(BMD)before and after transplantation.Postoperative BMD was compared to domestic age-matched norms using the single sample t-test.Univariate analysis and unordered multinomial logistic regression were employed to identify factors associated with bone metabolism abnormalities post-transplantation.Results The incidence of bone metabolism abnormalities after lung transplantation was 62.4％,with osteopenia and osteoporosis rates at 36.8％and 25.6％,respectively.The BMD of the femoral neck and left hip joint generally showed a declining trend post-transplantation(P＜0.001).Additionally,both male and female patients had lower BMD than the age-matched national norms(P＜0.001).Logistic regression analysis indicated that pre-transplant Activities of Daily Living(ADL)score was a significant factor for post-transplant osteopenia(OR 0.957,95％CI 0.928～0.987).Female gender,pre-transplant low body weight,obesity,reduced forced expiratory volume in one second/forced vital capacity percentage(FEV1/FVC),and ADL score were significant factors for post-transplant osteoporosis,with OR values of 7.181,7.521,15.465,0.960,0.964;95％CI were 1.287～40.061,2.039～27.738,1.158～206.586,0.937～0.983,0.930～0.999,respectively.Conclusion Bone metabolism abnormalities are common in patients post-lung transplantation.Healthcare providers should pay particular attention to female patients,those with low pre-transplant body weight,obesity,reduced FEV1/FVC,and lower ADL scores.Timely,individualized,and multidisciplinary interventions are crucial to slowing postoperative bone loss,reducing the incidence of bone metabolism abnormalities,and improving the health-related quality of life for these patients.

To summarize the nursing experience of 14 children after double lung transplantation for secondary bronchiolitis obliterans after hematopoietic stem cell transplantation(HSCT).Nursing points:to improve preoperative evaluation,actively improve the body status;to conduct the whole-process ECMO management to achieve early safe evacuation;to carry out the task feedback breathing training game to promote lung function;to implement the interest-oriented game exercise to promote muscle strength;to conduct the symptom-matched nutritional support,coping with gastrointestinal graft-host disease;to improve discharge preparation and empower primary caregivers.After careful nursing care,all of the 14 children were discharged smoothly.The follow-up result showed that the children had normal lung function and activities of daily living.

Objective To explore the current status of bone metabolism abnormalities after lung transplantation and its influencing factors,and provide scientific references for the formulation of nursing intervention measures.Methods A retrospective analysis of the clinical data of 125 patients undergoing lung transplantation at a lung transplant center from June 2021 to August 2023 was conducted.The paired sample t-test was used to compare the trends in bone mineral density(BMD)before and after transplantation.Postoperative BMD was compared to domestic age-matched norms using the single sample t-test.Univariate analysis and unordered multinomial logistic regression were employed to identify factors associated with bone metabolism abnormalities post-transplantation.Results The incidence of bone metabolism abnormalities after lung transplantation was 62.4％,with osteopenia and osteoporosis rates at 36.8％and 25.6％,respectively.The BMD of the femoral neck and left hip joint generally showed a declining trend post-transplantation(P＜0.001).Additionally,both male and female patients had lower BMD than the age-matched national norms(P＜0.001).Logistic regression analysis indicated that pre-transplant Activities of Daily Living(ADL)score was a significant factor for post-transplant osteopenia(OR 0.957,95％CI 0.928～0.987).Female gender,pre-transplant low body weight,obesity,reduced forced expiratory volume in one second/forced vital capacity percentage(FEV1/FVC),and ADL score were significant factors for post-transplant osteoporosis,with OR values of 7.181,7.521,15.465,0.960,0.964;95％CI were 1.287～40.061,2.039～27.738,1.158～206.586,0.937～0.983,0.930～0.999,respectively.Conclusion Bone metabolism abnormalities are common in patients post-lung transplantation.Healthcare providers should pay particular attention to female patients,those with low pre-transplant body weight,obesity,reduced FEV1/FVC,and lower ADL scores.Timely,individualized,and multidisciplinary interventions are crucial to slowing postoperative bone loss,reducing the incidence of bone metabolism abnormalities,and improving the health-related quality of life for these patients.

Objective To observe the value of T2 mapping for quantitatively evaluating the changes of junctional zone and outer myometrium caused by endometrial fibrosis.Methods A total of 73 infertility patients with endometrial fibrosis confirmed by hysteroscopy(disease group)and 33 healthy women of childbearing age(control group)were prospectively enrolled,and MR examinations were performed at the late proliferative phase of endometrium.The thickness and T2 value of junctional zone,T2 value of outer myometrium on anterior,posterior and fundus wall of midsagittal corpus uteri were measured,and the mean value of the above measurements on the three walls were calculated.Receiver operating characteristic curves were constructed,the areas under the curves(AUC)were calculated to explore the efficacy of those with significant difference among the mean thickness and the mean T2 value of junctional zone,the mean T2 value of outer myometrium and their combination for evaluating endometrial fibrosis.Results The thickness and T2 value of anterior wall,posterior wall,fundus wall and the mean junctional zone in disease group were all significantly higher than those in control group(all P＜0.001).No significant difference of T2 value of anterior wall,posterior wall,fundus wall nor the mean outer myometrium was found between groups(all P＞0.05).The mean thickness and the mean T2 value of junctional zone and their combination could be used to effectively evaluate endometrial fibrosis,with AUC of 0.839,0.822 and 0.922,respectively,and their combination had the best performance(both P＜0.01).Conclusion T2 mapping could be used to quantitatively evaluate the injury of junctional zone caused by endometrial fibrosis.

This paper summarizes the nursing experience of a pregnant woman with congenital heart disease who developed pulmonary artery hypertension crisis after cesarean section.Nursing key points:monitoring and management of inhaled nitric oxide therapy to reduce pulmonary hypertension;providing sequential respiratory support care and dynamically adjusting oxygen therapy regimen;precise volume regulation and alertness to serious complications;optimizing puerperal supervision strategy to reduce the risk of infection;preventing and controlling stress bleeding and implementing a stepped dietary management strategy;implementing phased rehabilitation training to accelerate the recovery process;carrying out personalized psychological care and health education.With comprehensive nursing care,the patient recovered well and was discharged smoothly after an 18-day hospital stay.