Cardiovascular disease (CVD) has emerged as one of the leading global causes of mortality, with their pathological progression closely linked to immune-metabolic dysregulation. Advances in immunometabolomics have unveiled the central role of metabolic reprogramming in cardiovascular injury. The metabolic reprogramming in immune cells critically regulates inflammatory responses, oxidative stress, and vascular remodeling, profoundly contributing to the pathogenesis of atherosclerosis, myocardial ischemia-reperfusion injury, and heart failure. The rapid development of immunometabolomic technologies has brought high-resolution dynamic mapping of metabolic-immune network interactions, driving the precise identification of metabolic targets and metabolites. Consequently, immune-metabolism-targeted intervention strategies exhibit promising therapeutic potential, particularly in modulating inflammatory microenvironment and improving cardiac metabolic homeostasis. Future efforts should integrate clinical translational research to develop personalized metabolic immunotherapies, offering novel directions for CVD prevention and treatment. This review synthesizes recent progress in immunometabolism research related to CVD, highlights advancements in immunometabolomic technologies, and outlines future therapeutic prospects for immune-metabolic interventions in CVD management.

Objective:To investigate the effects of learning flow experience on system thinking in medical students under the mixed mode.Methods:Medical students who completed Medical Statistics of the 2022-2023 academic year were enrolled.Then learning attitudes,learning flow experience,and system thinking were investigated using SATS-36 Scale,Adolescent Learning Flow Experience Questionnaire,and Systems Thinking Scale.Linear correlation analysis explored relationships among these variables.Multiple linear regression and restricted cubic spline(RCS)model analyzed linear/non-linear relationships between learning flow experience and system thinking after adjusting for gender,major,and learning attitude.Results:Among the 349 medical students surveyed,the mean score for learning attitudes was(4.31±0.59)and for learning flow experience was(3.33±0.65),both indicating a moderate to high level.The mean score for systems thinking was(59.01±13.57),indicating a moderate level.Positive correlations were found among learning flow experience,learning attitudes,and system thinking.Significant gender and major differences were observed in learning flow experience.After controlling for gender,major,and learning attitudes,multiple linear regression analysis revealed a significant linear trend between learning flow experience and system thinking(P＜0.01).RCS model analysis indicated a significant J-shaped nonlinear relationship between learning folw experience and system thinking(P for non-linearity＜0.01).Using the median score of 3.16 as the inflection point,when the learning flow experience score was＜3.16,it had no significant effect on medical students'system thinking(P=0.51).When the score was≥3.16,system thinking increased significantly with increasing learning flow experience(Beta per SD=0.56,95%CI:0.44-0.68,P＜0.01).Conclusions:The learning flow experience of medical students under the mixed mode can promote their system thinking.When the flow experience score is≥3.16,higher levels of learning flow experience are associated with increased systems thinking.Different dimensions of learning flow experience exhibit varying strengths of correlation with systems thinking.

Objective:To explore the causes of lack of compliance with life care in hematopoietic stem cell transplantation recipients while living alone in the transplant warehouse, and to provide a basis for developing targeted promotion measures.Methods:Using purposive sampling method, from June to December 2023, on-site observations were conducted on the voluntary completion of life care by hematopoietic stem cell transplant patients (with a 30 day observation period) admitted to the Blood Transplantation Center of the First Affiliated Hospital of Wenzhou Medical University. The compliance was calculated after the observation period. Patients with a compliance of less than 80% were selected, and semi-structured interviews were conducted with 17 of them after informed consent. The Colaizzi 7-step analysis method was applied to organize and analyze the interview data.Results:Three core themes on lack of compliance were distilled, namely physical factors impeding compliance (somatic specific symptoms leading to distraction, somatic non-specific symptoms leading to activity intolerance), psychological factors impeding compliance (negative emotions, comfort zone dilemmas, regression phenomena, constraints of personality psychological traits), and cognitive factors impeding compliance (subjective cognitive unperceived benefit, poor modeling resulting in cognitive biases, limited perceived attention) .Conclusions:The behavioral causes of lack of compliance with life care of hematopoietic stem cell transplant patients while living alone in the transplant warehouse are due to multiple factors of the body and mind, among which psychologically mediated mechanisms are key to compliance. Healthcare professionals should pay attention to both the physiological and psychological needs of patients, actively alleviate physical symptoms, appropriately provide psychological care to remove psychological barriers, help them actively seek family and social support, and promote cognitive improvement, thereby improving compliance.

Objective:To investigate the effects of learning flow experience on system thinking in medical students under the mixed mode.Methods:Medical students who completed Medical Statistics of the 2022-2023 academic year were enrolled.Then learning attitudes,learning flow experience,and system thinking were investigated using SATS-36 Scale,Adolescent Learning Flow Experience Questionnaire,and Systems Thinking Scale.Linear correlation analysis explored relationships among these variables.Multiple linear regression and restricted cubic spline(RCS)model analyzed linear/non-linear relationships between learning flow experience and system thinking after adjusting for gender,major,and learning attitude.Results:Among the 349 medical students surveyed,the mean score for learning attitudes was(4.31±0.59)and for learning flow experience was(3.33±0.65),both indicating a moderate to high level.The mean score for systems thinking was(59.01±13.57),indicating a moderate level.Positive correlations were found among learning flow experience,learning attitudes,and system thinking.Significant gender and major differences were observed in learning flow experience.After controlling for gender,major,and learning attitudes,multiple linear regression analysis revealed a significant linear trend between learning flow experience and system thinking(P＜0.01).RCS model analysis indicated a significant J-shaped nonlinear relationship between learning folw experience and system thinking(P for non-linearity＜0.01).Using the median score of 3.16 as the inflection point,when the learning flow experience score was＜3.16,it had no significant effect on medical students'system thinking(P=0.51).When the score was≥3.16,system thinking increased significantly with increasing learning flow experience(Beta per SD=0.56,95%CI:0.44-0.68,P＜0.01).Conclusions:The learning flow experience of medical students under the mixed mode can promote their system thinking.When the flow experience score is≥3.16,higher levels of learning flow experience are associated with increased systems thinking.Different dimensions of learning flow experience exhibit varying strengths of correlation with systems thinking.

Objective:To explore the causes of lack of compliance with life care in hematopoietic stem cell transplantation recipients while living alone in the transplant warehouse, and to provide a basis for developing targeted promotion measures.Methods:Using purposive sampling method, from June to December 2023, on-site observations were conducted on the voluntary completion of life care by hematopoietic stem cell transplant patients (with a 30 day observation period) admitted to the Blood Transplantation Center of the First Affiliated Hospital of Wenzhou Medical University. The compliance was calculated after the observation period. Patients with a compliance of less than 80% were selected, and semi-structured interviews were conducted with 17 of them after informed consent. The Colaizzi 7-step analysis method was applied to organize and analyze the interview data.Results:Three core themes on lack of compliance were distilled, namely physical factors impeding compliance (somatic specific symptoms leading to distraction, somatic non-specific symptoms leading to activity intolerance), psychological factors impeding compliance (negative emotions, comfort zone dilemmas, regression phenomena, constraints of personality psychological traits), and cognitive factors impeding compliance (subjective cognitive unperceived benefit, poor modeling resulting in cognitive biases, limited perceived attention) .Conclusions:The behavioral causes of lack of compliance with life care of hematopoietic stem cell transplant patients while living alone in the transplant warehouse are due to multiple factors of the body and mind, among which psychologically mediated mechanisms are key to compliance. Healthcare professionals should pay attention to both the physiological and psychological needs of patients, actively alleviate physical symptoms, appropriately provide psychological care to remove psychological barriers, help them actively seek family and social support, and promote cognitive improvement, thereby improving compliance.

ObjectiveTo reveal the correlation of Rehmannia glutinosa-soil feedback process with the formation of its continuous cropping obstacles through the identification of the root exudates of R. glutinosa and analysis of the specific rhizomicrobes recruited by the root exudate. MethodThe root exudates of R. glutinosa seedlings germinated under sterilized condition and those enriched in the rhizosphere of R. glutinosa cultivated in the field were collected and analyzed using the ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry（UPLC-Q-TOF-MS）. The highly abundant compounds identified in the root exudates were added into blank soil， and the soil microbial community was profiled using Illumina Miseq sequencing. The bacterial and fungal functions were predicted by PICRUSt and FUNGuild， respectively. ResultThe identification results showed that seven phenylethanoid glycosides were found in R. glutinosa root exudates， and acteoside possessed the highest abundance. In the soil enriched with acteoside， the bacterial genera such as Agromyces， Pseudomonas， Lysobacter， Sphingobium， Pseudoxanthomonas and Sphingomonas were enriched. For the fungi， the genera Neocosmospora， Plectosphaerella and Dactylonectria， and the species such as Neocosmospora rubicola， Plectosphaerella cucumerina， Dactylonectria alcacerensis and Fusarium solani showed higher abundance. The functional analysis indicated the above-mentioned bacterial genera may realize rapid proliferation by utilizing， biodegrading and transforming phenylethanoid glycosides， and some potential fungal pathogens were colonized. ConclusionThe R. glutinsoa-soil feedbacks were likely generated by the phenylethanoid glycosides in the root exudates together with the specific rhizomicrobes. The investigations of R. glutinsoa-soil feedbacks under continuous cropping system are critical to the further understanding of the underlying mechanisms related to its continuous cropping obstacles.

"Fostering virtue through education"is the fundamental task of higher medical education.Specialized curriculum is the basic carrier of ideological and political education construction.Microbiology and Immunology is a basic course of medicine,which is closely related to people's health,clinical diagnosis and treatment.Based on the professional knowledge system of the curriculum,teaching team carried out the exploration of ideological and political education in both theoretical and experimental teaching.In order to train socialist medical qualified personnel with both virtue and ability,we integrated ideological and political education into all aspects of teaching and the whole process,such as teachers'teaching ability,curriculum teaching objectives,teaching content,teaching methods,etc.

Objective:To understand the current status of existential distress in patients with advanced lung cancer and analyze its influencing factors, so as to provide a reference for developing targeted intervention programs.Methods:A total of 320 patients with advanced lung cancer were selected using convenience sampling from two Class Ⅲ Grade A hospitals in Weifang between February 2022 and August 2023. The data were collected using a General Information Questionnaire, the Chinese Version of the Existential Distress Scale (EDS), the Social Support Revalued Scale (SSRS), the Chinese Version of the Strategies Used by People to Promote Health (SUPPH), and Patient Health Questionnaire-9 (PHQ-9). Spearman correlation analysis was conducted to analyze the relationships between EDS, SSRS, SUPPH, and PHQ-9 scores, and multiple linear regression analysis was used to identify the influencing factors of existential distress in patients with advanced lung cancer. A total of 320 questionnaires were distributed, with 318 valid responses, yielding a valid response rate of 99.38% (318/320) .Results:The total EDS score for the 318 patients was 3.00 (2.00, 4.00). EDS scores were positively correlated with PHQ-9 scores and negatively correlated with SSRS and SUPPH scores ( P<0.01). Multiple linear regression analysis showed that marital status, social support, self-management efficacy, and depression were influencing factors of existential distress in patients with advanced lung cancer ( P<0.05) . Conclusions:Patients with advanced lung cancer experience mild existential distress. Medical staff should assess existential distress levels, paying close attention to patients who are divorced or widowed, have low levels of social support and self-management efficacy, or are experiencing depression. Early interventions should be developed to alleviate negative emotions and help patients rebuild their sense of meaning, thereby improving psychological well-being and reducing survival distress.

Graphene family nanomaterials(GFNs)are highly popular in the field of bone tissue engineering because of their excellent mechanical properties,biocompatibility,and ability to promote the osteogenic differentiation of stem cells.GFNs play a multifaceted role in promoting the bone regeneration microenvironment.First,GFNs activate the ad-hesion kinase/extracellularly regulated protein kinase(FAK/ERK)signaling pathway through their own micromorphology and promote the expression of osteogenesis-related genes.Second,GFNs adapt to the mechanical strength of bone tis-sue,which helps to maintain osseointegration;by adjusting the stiffness of the extracellular matrix,they transmit the me-chanical signals of the matrix to the intracellular space with the help of focal adhesions(FAs),thus creating a favorable physiochemical microenvironment.Moreover,they regulate the immune microenvironment at the site of bone defects,thus directing the polarization of macrophages to the M2 type and influencing the secretion of relevant cytokines.GFNs also act as slow-release carriers of bioactive molecules with both angiogenic and antibacterial abilities,thus accelerating the repair process of bone defects.Multiple types of GFNs regulate the bone regeneration microenvironment,including scaffold materials,hydrogels,biofilms,and implantable coatings.Although GFNs have attracted much attention in the field of bone tissue engineering,their application in bone tissue regeneration is still in the basic experimental stage.To promote the clinical application of GFNs,there is a need to provide more sufficient evidence of their biocompatibility,elucidate the mechanism by which they induce the osteogenic differentiation of stem cells,and develop more effective form of applications.

Objective:To explore the feasibility and safety of remote programming technology based on 5G cloud technology support platform in postoperative follow-up of cardiovascular implantable electronic devices(CIED).Methods:This study was a multicenter cross-sectional study. CIED patients from 12 hospitals lacking full-time follow-up specialists in Sichuan Province were enrolled from June 2021 to October 2021. All patients′ devices received remote inspecting and programming by the follow-up specialist of the remote follow-up center of the Third People′s Hospital of Chengdu through 5G cloud technology support platform. The baseline data, device alarm events, device reprogramming events, adverse reactions and satisfaction questionnaire survey results were collected.Results:A total of 195 CIED implantation patients were included, with an age of (72.5±11.3) years, including 103 males (52.6%). All patients completed remote inspecting and programming successfully, with a duration of (5.8±4.0) min. Ninety-one patients′ CIED were reprogrammed, with a total of 104 parameter adjustments. No abnormal communication or adverse events occurred. The satisfaction questionnaire showed that 97.9%(191/195) of the patients trusted or relatively trusted remote follow-up and 86.7%(169/195) of the patients were willing to choose remote follow-up mode for device management.Conclusion:The remote programming based on 5G cloud technology support platform may be feasible and safe for postoperative follow-up of CIED patients.