BACKGROUND:Intestinal flora is a diverse and dynamic microbial community located in the human gastrointestinal tract,which plays a crucial role in maintaining human immunity and health.In recent years,the concept of"gut-lung axis"has been proposed,suggesting that intestinal flora is closely related to the lung,and exercise can regulate respiratory diseases by maintaining the balance of intestinal flora.OBJECTIVE:To review the relationship between intestinal flora and different respiratory diseases such as pneumonia,lung cancer,asthma and chronic pulmonary obstruction,and the influence of different exercise modes on intestinal flora and respiratory diseases,providing new ideas for an in-depth exploration of the mechanisms by which exercise regulates the role of intestinal flora in respiratory diseases.METHODS:CNKI and PubMed databases were searched for relevant literature published from 1944 to 2024,using the search terms of"intestinal flora,gut bacteria,respiratory illness,pneumonia,lung cancer,asthma,chronic obstructive pulmonary diseases,aerobic exercise,resistance training"in Chinese and English,respectively.Totally 101 documents were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Intestinal flora plays an important role in the regulation of respiratory diseases such as pneumonia,lung cancer,asthma and chronic pulmonary obstruction diseases.(2)Different exercise modes are closely related to intestinal flora.Aerobic exercise can play a beneficial role in the regulation of intestinal flora by improving insulin sensitivity,increasing microbial diversity and inhibiting systemic chronic inflammation.Resistance exercise can decrease the permeability of intestinal mucosa and promote the production of short-chain fatty acids.Aerobic exercise combined with resistance exercise can also increase the diversity of intestinal flora and affect the composition of intestinal flora.(3)Exercise can improve respiratory diseases by regulating inflammatory response and reducing oxidative stress damage as well as improving cardiopulmonary function and exercise performance.(4)Exercise plays a key role in the prevention and treatment of respiratory diseases by regulating intestinal flora,inhibiting inflammatory response,regulating oxidative stress,improving intestinal barrier permeability and maintaining intestinal flora homeostasis.

Objective To construct a nursing follow-up checklist for patients undergoing autologous hematopoietic stem cell transplantation,providing a basis for postoperative follow-up care.Methods Using evidence-based methods,the literature from major guide websites and databases using Chinese and English search terms was retrieved,and their quality was evaluated.The relevant items were extracted,and a first draft was formed.15 experts were selected in relevant fields from 14 tertiary hospitals in 13 provinces,cities,and autonomous regions across the country for Delphi inquiry.The nursing follow-up checklist was revised again based on expert opinions and clinical practice.The nursing follow-up checklist was initially applied and then revised again to form the final draft.Results 15 experts include 12 undergraduate and 3 master's degree holders.The positivity coefficients of the 2 rounds of inquiry were 100％;the authority coefficients of the experts were 0.815;the Kendall coefficients were 0.119 and 0.144,respectively;the differences were statistically significant(P＜0.001).The final nursing follow-up checklist was formed,which includes 6 primary indicators,including physiological status,psychological status,social and family support,living conditions,disease knowledge,and laboratory tests.19 patients(95％)found the follow-up content to be comprehensive.The follow-up nurses's satisfaction rate exceeded 85％.There were 27 secondary indicators and 61 tertiary indicators,with coefficients of variation of all indicators less than 0.25.Conclusion The nursing follow-up checklist is scientific,reliable,and practical,which can provide a basis for clinical nursing staff to follow up and comprehensively manage patients after autologous hematopoietic stem cell transplantation.

Objective To analyze the risk factors for upper arm ports(UAP)related infections and develop a nomogram for predicting the UAP related infections.Methods Patients(n=6 028)with UAP between 2014 and 2023 in Renji Hospital,Shanghai Jiao Tong University School of Medicine were included and assigned to a training set(n=4 219)or a validation set(n=1 809).Least Absolute Shrinkage and Selection Operator(LASSO)regression were built and non-zero factors were screened out.Multivariate logistic regression was performed for these non-zero factors to screen significant factors out for constructing a prediction model.The performance of the model was evaluated by the area under curve(AUC)of the receiver operating characteristic(ROC)curves,calibration curves,the decision curve analysis(DCA)curve,and clinical impact curves(CICs)in both training set and validation set.Results The model incorporated gender,venous access,venous status,catheter-related thrombosis(CRT),and diameter of catheter.The model performed well.The AUC of ROC was 0.801 in the training set and 0.746 in the validation set.The calibration curve was close to the ideal curve,indicating good discriminative ability of the model.The DCA curve suggested that the model could help make beneficial clinical decisions when the risk assessment value was 30％-41％.CICs proved that the model had good clinical value.Conclusions A model was successfully constructed to predict UAP-related infections.The brachial/basilic vein and 5F catheter was proposed as the first choice.Thicker catheter diameter,male,CRT,abnormal venous status,and axillary vein approach may increase the risk of UAP related infection.

Objective:To compare the performance differences of domestic and imported CD3/CD28 activation beads for manufacturing CAR-T cells,providing a backup or alternative for domestic CAR-T cell research and manufacture.Methods:A mature protocol using imported CD3/CD28 activation beads with a 1∶1 ratio for CD3+T cells was implemented as research control.Domestic beads were used with gradient ratios of 1∶2,1∶1,and 2∶1 to activate T cells.72 h after T cell activation,CAR-T cells were manufactured by CAR lentiviral infection and cell proliferation was monitored at 2-,4-,and 7-days post-infection.Flow Cytometry was used to detect CAR-T cell positivity 5 days after infection and to detectCD4/CD8 phenotype of CAR-T cells and PD1+TIM3+cell exhaustion ratio 8 days after infection.Results:CAR-T cells manufactured by domestic CD3/CD28 activation beads exhibited similar phenotype compared with those manufactured by imported CD4/CD8 beads.The positive rate of CAR-T cells prepared with domestic beads was slightly lower than that of imported beads(53.7%vs 57.9%).However,the proliferation of CAR-T cells manufactured by domestic beads was about twice that of cells manufactured by imported beads,and the exhaustion level was only half that of imported beads(4.21%vs 7.91%).Moreover,the use of domestic magnetic beads was lower than that of imported magnetic beads,which was advantageous for cutting the costs of CAR-T cells research and manufacture.Conclusion:Domestic CD3/CD28 activation beads used for CAR-T cells manufacturing demonstrate comparable overall performance to their imported counterparts,showing potential as a backup or alternative for imported beads.

BACKGROUND:Intestinal flora is a diverse and dynamic microbial community located in the human gastrointestinal tract,which plays a crucial role in maintaining human immunity and health.In recent years,the concept of"gut-lung axis"has been proposed,suggesting that intestinal flora is closely related to the lung,and exercise can regulate respiratory diseases by maintaining the balance of intestinal flora.OBJECTIVE:To review the relationship between intestinal flora and different respiratory diseases such as pneumonia,lung cancer,asthma and chronic pulmonary obstruction,and the influence of different exercise modes on intestinal flora and respiratory diseases,providing new ideas for an in-depth exploration of the mechanisms by which exercise regulates the role of intestinal flora in respiratory diseases.METHODS:CNKI and PubMed databases were searched for relevant literature published from 1944 to 2024,using the search terms of"intestinal flora,gut bacteria,respiratory illness,pneumonia,lung cancer,asthma,chronic obstructive pulmonary diseases,aerobic exercise,resistance training"in Chinese and English,respectively.Totally 101 documents were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Intestinal flora plays an important role in the regulation of respiratory diseases such as pneumonia,lung cancer,asthma and chronic pulmonary obstruction diseases.(2)Different exercise modes are closely related to intestinal flora.Aerobic exercise can play a beneficial role in the regulation of intestinal flora by improving insulin sensitivity,increasing microbial diversity and inhibiting systemic chronic inflammation.Resistance exercise can decrease the permeability of intestinal mucosa and promote the production of short-chain fatty acids.Aerobic exercise combined with resistance exercise can also increase the diversity of intestinal flora and affect the composition of intestinal flora.(3)Exercise can improve respiratory diseases by regulating inflammatory response and reducing oxidative stress damage as well as improving cardiopulmonary function and exercise performance.(4)Exercise plays a key role in the prevention and treatment of respiratory diseases by regulating intestinal flora,inhibiting inflammatory response,regulating oxidative stress,improving intestinal barrier permeability and maintaining intestinal flora homeostasis.

Objective:To summarize the best available evidence for donor and recipient site flap management in head and neck cancer patients undergoing free flap reconstruction.Method:Following the 6S evidence hierarchy model, a comprehensive search was conducted in databases and websites including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, National Comprehensive Cancer Network, Joanna Briggs Institute Evidence-Based Healthcare Database, Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period covered all publications up to May 1, 2024.Results:A total of 14 articles were included, comprising two clinical decisions, two guidelines, two systematic reviews, five expert consensuses, two randomized controlled trials, and one prospective cohort study.A total of 28 pieces of evidence were summarized from six aspects: establishing multidisciplinary collaboration, standardized assessment, prehabilitation training, donor site management strategies, recipient site management strategies, and risk identification and management.Conclusions:This study provides a comprehensive summary of evidence regarding donor and recipient site flap management in patients with head and neck cancer undergoing free flap reconstruction, offering an evidence-based foundation for guiding clinical nursing practice.

Aim To examine the pathogenesis of disul-fide death gene in vascular dementia(VD)by bioin-formatics analysis of disulfide death differentially ex-pressed genes(DEGs)combined with experimental verification.Methods The death DEGs of disulfide were screened and their correlation was analyzed.The VD patients data in the data set were analyzed by clus-tering and typing and gene set variation.The clustering risk of DEGs was tested with a nomogram model,and the optimal learning model was predicted.After the es-tablishment of VD rat model,water maze test,HE stai-ning and RT-qPCR detection were performed to verify the results of health information.Results Four DEGs including SLC7A11 were obtained,which had antago-nistic or synergistic interaction with each other.The genetic data could be divided into two subtypes with significant differences.After typing,VD disulfide DEGs were mainly concentrated in GnRH signaling pathways.The accuracy of the nomogram prediction model was high.Generalized linear was the best ma-chine learning model.Compared with the sham opera-tion group,the escape latency of rats in the model group was prolonged,the number of crossing platforms decreased,the relative mRNA expression levels of Slc3a2 and Slc7a11 decreased,and LRPPRC in-creased.Conclusions SLC7A11 and other disulfide death DEGs and its related GnRH signaling pathway may be an important part of the pathogenesis of VD di-sulfide death.SLC3A2,LRPPRC and SLC7A11 can be used as characteristic genes in the regulation of VD by disulfide death,which may affect VD progression through the regulation of disulfide death.

Objectives:To evaluate the clinical values of cervical vertebral bone quality(CVBQ)score and cervical endplate bone quality(CEBQ)score in predicting the settlement of Zero Profile(Zero-P)cage after an-terior cervical discectomy and fusion(ACDF).Methods:A retrospective analysis was performed on 72 patients who underwent ACDF with Zero-P cage in the Second Affiliated Hospital of Soochow University.General pa-tient information(including sex,age,comorbidity),laboratory parameters(such as blood calcium and blood glu-cose),surgical details(surgical level and cage type),and imaging data(preoperative cervical MRI and anteropos-terior and lateral X-rays within one week and after more than three months)were collected.On the lateral X-rays taken within one week and＞3 months postoperatively,the heights of the upper and lower margins of vertebrae were measured,and the difference between was defined as the cage subsidence distance.Patients with a subsidence distance ≥ 2mm were assigned to the subsidence group,and those with＜2mm subsidence distance were divided to the non-subsidence group.On preoperative cervical sagittal T1-weighted MRI,plac-ing regions of interest(ROIs)in the medullary region of adjacent vertebral bodies,the subchondral bone region of the endplates,and the cerebrospinal fluid(CSF)in the cerebellomedullary cistern.CVBQ and CEBQ values were the ratios of the average signal intensity of the medullary region of the surgical adjacent vertebral bodies(for CVBQ)and the subchondral bone region of the endplates(for CEBQ)to the signal intensity of the cere-brospinal fluid in the cerebellomedullary cistern.A stratified analysis by gender was conducted to further clarify whether the predictive value of bone quality scores for subsidence is influenced by gender factors.The Pearson correlation coefficient was used to assess the relationship of CVBQ and CEBQ with cage subsidence distance.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic efficacy of CVBQ and CEBQ for cage subsidence.Univariate logistic regression analysis was performed to screen for po-tential risk factors,after that age and diabetes,which showed statistical significance,along with CVBQ and CEBQ,were incorporated into the multivariate analysis to assess their independent effects.Results:Cage sub-sidence occurred in 14 patients(subsidence rate:19.4％).Compared with the non-subsidence group,the subsi-dence group of patients was older(male:61.4±16.5 years vs 51.1±10.8 years,P=0.049;female:62.6±13.1 years vs 51.2±7.8 years,P=0.005)and had a higher proportion of patients with diabetes(male:42.9％vs 3.4％,P=0.018;female:42.9％vs 6.9％,P=0.040).Both CVBQ and CEBQ were significantly higher in the subsidence group(CVBQ-male:2.75±0.73 vs 2.02±0.53,P=0.004;female:2.84±0.69 vs 2.00±0.40,P=0.005;CEBQ-male:2.82±0.688 vs 2.05±0.56,P=0.004;female:2.94±0.68 vs 2.05±0.42,P=0.002).Pearson correlation analysis re-vealed a moderate positive correlation between both CVBQ(r=0.58,P＜0.001)and CEBQ(r=0.59,P＜0.001)with subsidence distance.ROC curve analysis indicated that both CVBQ(AUC=0.83)and CEBQ(AUC=0.85)had good predictive values for subsidence,with CEBQ showing slightly better predictive performance.Univariate logistic regression analysis identified age,diabetes,CEBQ,and CVBQ as risk factors for subsidence(P＜0.05).Multivariate analysis showed that after adjusting for age and diabetes,both CEBQ(OR=11.466,P=0.004)and CVBQ(OR=8.804,P=0.005)remained independent risk factors for subsidence,while age and diabetes lost in-dependent significance.The strength of association with subsidence was greater in CEBQ than in CVBQ.Conclusions:Patients with higher CVBQ and CEBQ scores are more likely to experience fusion cage subsi-dence,and both CEBQ and CVBQ can be used to predict cage subsidence in patients after single-level ACDF,CEBQ has better predictive ability than CVBQ.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Objectives:To evaluate the clinical values of cervical vertebral bone quality(CVBQ)score and cervical endplate bone quality(CEBQ)score in predicting the settlement of Zero Profile(Zero-P)cage after an-terior cervical discectomy and fusion(ACDF).Methods:A retrospective analysis was performed on 72 patients who underwent ACDF with Zero-P cage in the Second Affiliated Hospital of Soochow University.General pa-tient information(including sex,age,comorbidity),laboratory parameters(such as blood calcium and blood glu-cose),surgical details(surgical level and cage type),and imaging data(preoperative cervical MRI and anteropos-terior and lateral X-rays within one week and after more than three months)were collected.On the lateral X-rays taken within one week and＞3 months postoperatively,the heights of the upper and lower margins of vertebrae were measured,and the difference between was defined as the cage subsidence distance.Patients with a subsidence distance ≥ 2mm were assigned to the subsidence group,and those with＜2mm subsidence distance were divided to the non-subsidence group.On preoperative cervical sagittal T1-weighted MRI,plac-ing regions of interest(ROIs)in the medullary region of adjacent vertebral bodies,the subchondral bone region of the endplates,and the cerebrospinal fluid(CSF)in the cerebellomedullary cistern.CVBQ and CEBQ values were the ratios of the average signal intensity of the medullary region of the surgical adjacent vertebral bodies(for CVBQ)and the subchondral bone region of the endplates(for CEBQ)to the signal intensity of the cere-brospinal fluid in the cerebellomedullary cistern.A stratified analysis by gender was conducted to further clarify whether the predictive value of bone quality scores for subsidence is influenced by gender factors.The Pearson correlation coefficient was used to assess the relationship of CVBQ and CEBQ with cage subsidence distance.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic efficacy of CVBQ and CEBQ for cage subsidence.Univariate logistic regression analysis was performed to screen for po-tential risk factors,after that age and diabetes,which showed statistical significance,along with CVBQ and CEBQ,were incorporated into the multivariate analysis to assess their independent effects.Results:Cage sub-sidence occurred in 14 patients(subsidence rate:19.4％).Compared with the non-subsidence group,the subsi-dence group of patients was older(male:61.4±16.5 years vs 51.1±10.8 years,P=0.049;female:62.6±13.1 years vs 51.2±7.8 years,P=0.005)and had a higher proportion of patients with diabetes(male:42.9％vs 3.4％,P=0.018;female:42.9％vs 6.9％,P=0.040).Both CVBQ and CEBQ were significantly higher in the subsidence group(CVBQ-male:2.75±0.73 vs 2.02±0.53,P=0.004;female:2.84±0.69 vs 2.00±0.40,P=0.005;CEBQ-male:2.82±0.688 vs 2.05±0.56,P=0.004;female:2.94±0.68 vs 2.05±0.42,P=0.002).Pearson correlation analysis re-vealed a moderate positive correlation between both CVBQ(r=0.58,P＜0.001)and CEBQ(r=0.59,P＜0.001)with subsidence distance.ROC curve analysis indicated that both CVBQ(AUC=0.83)and CEBQ(AUC=0.85)had good predictive values for subsidence,with CEBQ showing slightly better predictive performance.Univariate logistic regression analysis identified age,diabetes,CEBQ,and CVBQ as risk factors for subsidence(P＜0.05).Multivariate analysis showed that after adjusting for age and diabetes,both CEBQ(OR=11.466,P=0.004)and CVBQ(OR=8.804,P=0.005)remained independent risk factors for subsidence,while age and diabetes lost in-dependent significance.The strength of association with subsidence was greater in CEBQ than in CVBQ.Conclusions:Patients with higher CVBQ and CEBQ scores are more likely to experience fusion cage subsi-dence,and both CEBQ and CVBQ can be used to predict cage subsidence in patients after single-level ACDF,CEBQ has better predictive ability than CVBQ.