Objective To retrieve,analyze and synthesize evidence on post-transplant diabetes mellitus(PTDM)in lung transplant patients,providing reference for clinical healthcare professionals in preventing and managing PTDM in lung transplant patients.Methods Based on the"6S"evidence model,systematic searches were conducted across guideline websites,professional associations,and Chinese/English databases regarding post-transplant diabetes mellitus(PTDM)in lung transplant patients.The search period spanned from data-base inception to January 2025.Two researchers independently completed literature screening,quality assess-ment,and evidence extraction.Results A total of 14 articles were included,comprising 1 clinical decision,2 guidelines,5 expert consensuses,2 specifications,1 evidence summary,and 3 systematic reviews.Twenty-four pieces of best evidence were synthesized from seven aspects:risk factors,diagnosis,screening,prevention,treatment,glycemic control targets,and health education.Conclusion The best evidence for preventing and managing post-transplant diabetes mellitus in lung transplant patients provides an evidence-based foundation for clinical practice among healthcare professionals.Evidence should be selected and applied according to spe-cific clinical situations and patient needs.

Objective:To provide evidence-based recommendations for the prevention and management of lower limb ischemia in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients during treatment according to search, evaluate, and summarize the best evidence on the prevention and management of lower limb ischemia in patients with VA-ECMO.Methods:Based on the PIPOST framework (population, intervention, professional, outcome, setting, and type of evidence), an evidence-based question was formulated. A systematic search was conducted according to the "6S" evidence pyramid model in both domestic and international databases, as well as professional association websites, for all evidence related to the prevention and management of lower limb ischemia in VA-ECMO patients (aged ≥18 years). The types of evidence included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and original studies. The search was conducted from the construction of the databases to February 2024. Two researchers independently conducted a literature quality evaluation, extracted and summarized evidence from the studies that met the quality criteria.Results:A total of 13 articles were included, consisting of 3 clinical decisions, 3 guidelines, 3 expert consensus, 3 systematic reviews, and 1 randomized controlled trial. A total of 18 pieces of evidence in 7 dimensions were summarized, including risk factors of VA-ECMO lower limb ischemia, evaluation before catheterization, evaluation and monitoring during treatment, prevention of lower limb ischemia, treatment of lower limb ischemia, management of distal perfusion catheter (DPC), and monitoring after VA-ECMO weaning.Conclusion:This evidence summary provides evidence-based recommendations for the prevention and management of lower limb ischemia in VA-ECMO patients, aiming to assist clinical healthcare professionals in developing tailored strategies for the prevention and management of lower limb ischemia based on during VA-ECMO support.

Objective:To investigate the infection and treatment of helicobacter pylori (HP) in flying personnel, as well as their cognition of HP.Methods:By using cluster sampling method, the flying personnel who recuperated at the Second Sanatorium of Air Force Healthcare Center for Special Services Hangzhou were selected for questionnaire survey. They were divided into positive group and negative group according to whether they were infected with HP. The cognition of HP (such as whether they had known HP, how to detect HP, and the symptoms, infection route, as well as the knowledge on treatment and prevention of HP) were compared between 2 groups. The differences on infection situation at different ages, personal lifestyle, diet and living environment were also compared. The treatment of flying personnel in positive group during their stay in the sanatorium was investigated and analyzed among different age groups.Results:A total of 347 flying personnel were included, with 161 in the positive group and 186 in the negative group. The HP infection rate in the rural population before joining the army was higher than that in the urban population, with a significant difference ( χ2=7.19, P=0.007). But there were no significant differences on whether they had long-term smoking history, preferred strong tea or coffee, spicy and fried food and whether their family members were infected ( χ2=0.05-5.92, all P>0.05). The questionnaire showed that the cognition of the negative group was significantly better than the positive group on whether they understood the infection route, symptoms and preventive measures of HP ( χ2=8.28, 12.00, 48.22, P=0.005, 0.001,<0.001), but there was no difference between 2 groups on whether they had known HP, detection methods and treatment after infection ( P>0.05). The treatment rate in positive group was only 29.19% (47/161), and there was no significant difference in the treatment rate among different age groups ( P>0.05). Conclusions:There is a high HP infection rate in flying personnel on base of the survey. The poor awareness of HP would affect the treatment rate and the basic cognition would be beneficial to active prevention. The survey also shows that the environment factors are seemed more sensitive to HP than dietary habit.

Objective:To investigate the infection and treatment of helicobacter pylori (HP) in flying personnel, as well as their cognition of HP.Methods:By using cluster sampling method, the flying personnel who recuperated at the Second Sanatorium of Air Force Healthcare Center for Special Services Hangzhou were selected for questionnaire survey. They were divided into positive group and negative group according to whether they were infected with HP. The cognition of HP (such as whether they had known HP, how to detect HP, and the symptoms, infection route, as well as the knowledge on treatment and prevention of HP) were compared between 2 groups. The differences on infection situation at different ages, personal lifestyle, diet and living environment were also compared. The treatment of flying personnel in positive group during their stay in the sanatorium was investigated and analyzed among different age groups.Results:A total of 347 flying personnel were included, with 161 in the positive group and 186 in the negative group. The HP infection rate in the rural population before joining the army was higher than that in the urban population, with a significant difference ( χ2=7.19, P=0.007). But there were no significant differences on whether they had long-term smoking history, preferred strong tea or coffee, spicy and fried food and whether their family members were infected ( χ2=0.05-5.92, all P>0.05). The questionnaire showed that the cognition of the negative group was significantly better than the positive group on whether they understood the infection route, symptoms and preventive measures of HP ( χ2=8.28, 12.00, 48.22, P=0.005, 0.001,<0.001), but there was no difference between 2 groups on whether they had known HP, detection methods and treatment after infection ( P>0.05). The treatment rate in positive group was only 29.19% (47/161), and there was no significant difference in the treatment rate among different age groups ( P>0.05). Conclusions:There is a high HP infection rate in flying personnel on base of the survey. The poor awareness of HP would affect the treatment rate and the basic cognition would be beneficial to active prevention. The survey also shows that the environment factors are seemed more sensitive to HP than dietary habit.

Objective : To investigate the expression of N6-methyladenosine modification ( m6 A) and related en- zymes FTO，METTL3 and YTHDF2 in gastric epithelial cells infected with Helicobacter pylori (Hp) ，and to analyze its expression and clinical significance in gastric cancer by using online websites． Methods : Gastric epithelial cells GES-1 and AGS were infected with Hp GZ7 strain，and the multiplicity of infection was 30 ∶ 1．Total RNA and total protein were collected after infecting 24 h，and the m6 A modification level of total RNA was detected by RNA dot hybridization．The mRNA and protein expressions of FTO ，METTL3 and YTHDF2 were detected by q-PCR and Western blot．The expression difference of FTO，METTL3 and YTHDF2 in gastric cancer tissues and normal tissues and their expression in Stage classification were analyzed by GEPIA，and the relationship between the expression of FTO，METTL3 and YTHDF2 and prognosis was analyzed by Kaplan-Meier Plotter. Results : Compared with the un- infected group，the m6 A modification level of total RNA in both Hp-infected GES-1 and AGS cells significantly de- creased，the mRNA and protein expression levels of FTO increased，and the mRNA and protein levels of METTL3 and YTHDF2 decreased，with statistical significance (P＜0. 05) ．The expression level of FTO in gastric cancer tis- sues was higher than that in normal tissues，with statistical significance (P＜0. 05) ，YTHDF2 was higher than that in normal tissues，with no statistical significance，and the expression level of METTL3 was lower than that in nor- mal tissues，with no statistical significance．Patients with high expression of FTO and METTL3 had a lower survival rate，while patients with high expression of YTHDF2 had a higher survival rate．The expression of FTO was signifi- cantly correlated with Stage classification (P＜0. 05) ，while the expression of METTL3 and YTHDF2 was not sig- nificantly correlated with Stage classification． Conclusion Hp infection can change the level of m6 A and the ex- pression of related enzymes FTO，YTHDF2 and METTL3，suggesting that m6 A methylation may play a role in the occurrence and development of Hp-induced gastric cancer.

Objective:To evaluate the effect of different doses of compound sodium chloride injection combined with norepinephrine on prevention of hypotension after lumbar anesthesia in the patients undergoing caesarean section.Methods:A total of 150 patients with a singleton fetus, aged 18-45 yr, at ≥37 weeks of gestation, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, with height ≥150 cm, weighing ≤100 kg, with body mass index < 40 kg/m 2, scheduled for elective caesarean section under lumbar anesthesia, were divided into 3 groups ( n=50 each) by the random number table method: compound sodium chloride injection 4, 8 and 12 ml·kg -1·h -1 groups (group A, group B, group C). Compound sodium chloride injection 4 ml/kg was intravenously injected for liquid preload before lumbar anesthesia, and 0.5% hyperbaric bupivacaine 12.5 mg was injected to the subarachnoid space for lumbar anesthesia. Norepinephrine was intravenously injected at a dose of 6 μg immediately after intrathecal injection, followed by an infusion of 0.05 μg·kg -1·min -1, and infusion was stopped at 5 min after delivery. Compound sodium chloride injection was intravenously infused simultaneously at a rate of 4, 8 and 12 ml·kg -1·h -1 in A, B and C groups, respectively. The maximum diameter of inferior vena cava (IVCmax) and the minimum diameter of inferior vena cava (IVCmin) were measured by ultrasound, and inferior vena cava collapse index (IVC-CI) was calculated at 1 min before fluid preload (T 1), immediately after fluid preload (T 2), at 5 min after anesthesia (T 3), at 5 min after fetal delivery (T 4) and immediately before leaving the operating room (T 5). The incidence of intraoperative adverse events (hypotension, severe hypotension, bradycardia, hypertension, nausea, and vomiting) and neonatal outcomes (umbilical artery blood gas index and Apgar score at 1 and 5 min after birth) were recorded. Results:Compared with group A, IVCmin was significantly increased and IVC-CI was decreased at T 5 in group B, and IVCmin and IVCmax were significantly increased and IVC-CI was decreased at T 5 in group C ( P<0.05). There was no significant difference in IVCmax, IVCmin and IVC-CI at each time point between group B and group C ( P>0.05). There was no significant difference in the incidence of hypotension, severe hypotension, bradycardia, hypertension, nausea and vomiting among the three groups ( P>0.05). There was no significant difference in the results of blood gas analysis of the umbilical artery and Apgar score at each time point after birth among the three groups ( P>0.05). Conclusions:Compound sodium chloride injection 4, 8 and 12 ml·kg -1·h -1 combined with norepinephrine can effectively prevent the occurrence of hypotension after lumbar anesthesia in the patients undergoing caesarean section without increasing maternal and infant adverse events, and the effect of 8 and 12 ml·kg -1·h -1 for volume supplementation is better than that of 4 ml·kg -1·h -1.

Objective:To investigate the arterial blood pressure levels of fighter pilots and to analyze the risk factors associated with blood pressure in fighter pilots.Methods:A retrospective analysis was conducted on the physical examination data and questionnaire data of the fighter pilots who underwent aeromedical assessment at Air Force Healthcare Center for Special Services Hangzhou. They were divided into hypertension group [SBP≥140 mmHg (1 mmHg=0.133 kPa) and (or) DBP≥90 mmHg], normal high blood pressure group [120 mmHg≤SBP<140 mmHg and (or) 80 mmHg≤DBP<90 mmHg] and normal blood pressure group (SBP<120 mmHg and DBP<80 mmHg) according to the blood pressure level. The differences of physiological and biochemical indicators among the pilots of 3 groups were compared, and the risk factors affecting blood pressure were analyzed by multiple Logistic regression.Results:A total of 414 fighter pilots were included, with 9 (2.17%) in the hypertension group, 274 (66.18%) in the normal high blood pressure group, and 131 (31.64%) in the normal blood pressure group. There were significant differences in age, flying hours, body mass index, waist circumference, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, and blood uric acid among the pilots of different blood pressure groups ( F=2.97-11.08, all P<0.05), but no significant difference in HDL-C ( P>0.05). The risk factors for increased the blood pressure of fighter pilots included alcohol consumption ( OR=9.865, P=0.021), salt consumption ( OR=8.971, P=0.033), blood uric acid ( OR=1.013, P=0.046), BMI ( OR=1.431, P=0.001) and waist circumference ( OR=1.340, P=0.039). The protective factor was the consumption of vegetables and fruits ( OR=0.623, P=0.033). Conclusions:High sodium diet, overweight or obesity, excessive alcohol consumption, increased blood uric acid and low consumption of vegetables and fruits may be the risk factors result in high blood pressure of fighter pilots.

Objective:To investigate the arterial blood pressure levels of fighter pilots and to analyze the risk factors associated with blood pressure in fighter pilots.Methods:A retrospective analysis was conducted on the physical examination data and questionnaire data of the fighter pilots who underwent aeromedical assessment at Air Force Healthcare Center for Special Services Hangzhou. They were divided into hypertension group [SBP≥140 mmHg (1 mmHg=0.133 kPa) and (or) DBP≥90 mmHg], normal high blood pressure group [120 mmHg≤SBP<140 mmHg and (or) 80 mmHg≤DBP<90 mmHg] and normal blood pressure group (SBP<120 mmHg and DBP<80 mmHg) according to the blood pressure level. The differences of physiological and biochemical indicators among the pilots of 3 groups were compared, and the risk factors affecting blood pressure were analyzed by multiple Logistic regression.Results:A total of 414 fighter pilots were included, with 9 (2.17%) in the hypertension group, 274 (66.18%) in the normal high blood pressure group, and 131 (31.64%) in the normal blood pressure group. There were significant differences in age, flying hours, body mass index, waist circumference, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, and blood uric acid among the pilots of different blood pressure groups ( F=2.97-11.08, all P<0.05), but no significant difference in HDL-C ( P>0.05). The risk factors for increased the blood pressure of fighter pilots included alcohol consumption ( OR=9.865, P=0.021), salt consumption ( OR=8.971, P=0.033), blood uric acid ( OR=1.013, P=0.046), BMI ( OR=1.431, P=0.001) and waist circumference ( OR=1.340, P=0.039). The protective factor was the consumption of vegetables and fruits ( OR=0.623, P=0.033). Conclusions:High sodium diet, overweight or obesity, excessive alcohol consumption, increased blood uric acid and low consumption of vegetables and fruits may be the risk factors result in high blood pressure of fighter pilots.

Objective:To explore the effects of fast-track surgery (FTS) combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality in patients during anesthesia of craniocerebral surgery.Methods:According to block randomization method, 120 patients with craniocerebral trauma meeting inclusion criteria in the hospital were divided into three groups between January 2018 and December 2020, 40 in each group. The control group was given routine awakening intervention, intervention 1 group was given routine awakening intervention and acupuncture at Neiguan acupoint, and intervention 2 group was given FTS and treatment of intervention 1 group. At 10 min after entering the room, immediately after tracheal intubation and immediately after extubation, level of serum cortisol (COR) was detected by electrochemical luminescence apparatus. The level of serum dopamine was detected by ELISA. The blood pressure and heart rates were recorded. The recovery quality during anesthesia was compared, including recovery time, recovery time of spontaneous breathing, extubation time and recovery time of orientation. The cognitive function of patients was evaluated by Neurobehavioral Cognitive Status Examination (NSCE). The incidence of intestinal paralysis, nausea and vomiting, and hospitalization time were observed and recorded during treatment.Results:Immediately after tracheal intubation and extubation, systolic blood pressure in intervention 2 group, intervention 1 group and control group were significantly decreased ( F=12.03, 13.96), levels of serum COR ( F=91.40, 53.76), and dopamine ( F=29.72, 69.39) were significantly decreased ( P<0.01). The recovery time of orientation during anesthesia [(39.09±3.12)min vs. (41.57±3.54)min, (43.84±3.28)min, F=34.65] in intervention 2 group was significantly shorter than that of the intervention 1 group and control group ( P<0.01), and hospitalization time [(9.36±1.78)d vs. (10.92±1.81)d, (12.10±1.95)d, F=1.44] was significantly shorter than that of the intervention 1 group and control group ( P<0.05). Conclusion:The FTS combined with acupuncture at Neiguan acupoint can reduce stress level during anesthesia, improve recovery quality and relieve postoperative cognitive dysfunction in patients undergoing craniocerebral surgery.

Objective:To investigate the effect of ketamine on dryness maintenance of breast cancer (BC) cells by regulating LncRNA PVT1/MYC axis.Methods:BC cell line MCF-7 was treated with different concentration of ketamine (0, 5, 10 or 20 g/ml) or treated with 20g/ml ketamine for different periods (0, 24, 48 or 72h) . Furthermore, the expression of METTL3, PVT1 and MYC in MCF-7 cells was interfered and MCF-7 cells were divided into different groups.Western blot was used to detect the expression levels of stem cell characteristic related molecules (OCT4 and SOX2) . The expression level of PVT1/MYC in each group was detected by qRT-PCR. MeRIP analysis was used to detect THE m6A methylation level of PVT1.Results:Ketamine treatment significantly reduced the number of BC globules and inhibited the protein expression of OCT4 and SOX2 in a dose-and time-dependent manner (all P<0.05) . Ketamine regulated m6A level of METTL3-mediated PVT1. Compared with ketamine+pcDNA3.1 group (207±11) , the number of globules formed in ketamine+PVT1 group (311±15) was significantly increased ( t=12.06, P<0.001) , and the protein expression levels of OCT4 and SOX2 were increased ( t=9.68, P<0.001; t=11.50, P<0.001) . MYC was a downstream regulatory gene of PVT1. Compared with ketamine+PVT1+ Si-NC group, ketamine+PVT1+si-MYC group significantly reduced the number of spheroid formation ( t=0.54, P=0.005) and the expression levels of OCT4 and SOX2 proteins ( t=5.98, P=0.004) ( t=7.33, P=0.002) . Conclusion:Ketamine mediates the expression of PVT1 and its downstream gene MYC by inhibiting THE m6A level of PVT1, thus inhibiting the stem cell-like characteristics of BC cells.