Objective:To explore the high-risk factors for parenteral nutrition associated cholestasis（PNAC）in extremely/ultra-low birth weight infants，and establish a risk Alignment Diagram prediction model.Methods:We retrospectivly analyzed the clinical data of hospitalized extremely/ultra-low birth weight infants admitted to Neonatology Department at Quanzhou Children's Hospital from January 2019 to December 2020，using multivariate Logistic regression analysis to screen for independent risk factors for the occurrence of PNAC.An Alignment Diagram model prediction model for PNAC was constructed by using R software，and the performance of the model was evaluated through receiver operating characteristic curves.Results:A total of 203 extremely/ultra-low birth weight infants were included，with a median gestational age of 29.14（28.00，30.86）weeks and a median birth weight of 1　170（1　000,1　300）g.Among them，26（12.81%）cases developed PNAC.Multivariate Logistic regression analysis showed that the duration of parenteral nutrition（ OR=1.015 ，95% CI 1.003-1.034），the cumulative amount of glucose（ OR=1.014 ，95% CI 1.001-1.028），small for gestational age（ OR=3.455 ，95% CI 1.127-10.589），and neonatal sepsis（ OR=3.142 ，95% CI 1.039-9.503）were independent risk factors for PNAC（ P＜0.05）；The four independent risk factors mentioned above were introduced into R software to construct an Alignment Diagram model，the area under the receiver operating characteristic curve was 0.835（95% CI 0.842-0.731），and the results of the Hosmer Limeshow goodness of fit test show that：χ 2=5.34，degree of freedom=8， P=0.72.A calibration curve indicated good consistency between the predicted probability of the model and the actual occurrence rate，with good accuracy. Conclusion:The Alignment Diagram model constructed based on four independent risk factors of the duration of parenteral nutrition，glucose accumulation，small for gestational age infants，and neonatal sepsis exhibits high predictive ability，and is expected to provide an intuitive and convenient visualization tool for preventing or reducing the occurrence of PNAC in extremely/ultra-low birth weight infants

Primary central nervous system lymphoma (PCNSL) is a highly aggressive malignant lymphoma. As most chemotherapy drugs have difficulty in crossing the blood-brain barrier, PCNSL shows a difficulty in clinical treatment, a high recurrence rate and a poor prognosis. Early identification of relapsed patients and prompt initiation of salvage therapy play a critical role in the improvement of patients' prognosis. Brain biopsy is the gold standard to identify recurrence, while the risk of operation failure and complications is still high. Non-invasive imaging techniques are beneficial for early identification of recurrence in PCNSL and can provide an important basis for guiding relapsed patients to adjust treatment plans in time. However, there is no unified evaluation standard for imaging methods of monitoring the relapsed lesions of PCNSL. With the further research of the pathophysiological mechanism of PCNSL, biomarker detection has become a new method to identify recurrence and more clinical evidence is still needed in the future.

Objective:To develop a Core Competency Scale for Ophthalmic Specialist Nurses and test its reliability and validity.Methods:This study was a questionnaire development study. This study transformed the core competency evaluation indicators for ophthalmic specialist nurses constructed through literature review, semi-structured interviews, expert consultations, and other methods to form the initial draft of the Core Competency Scale for Ophthalmic Specialist Nurses. From October 2022 to March 2023, a survey was conducted on 364 ophthalmic specialist nurses in China using purposive and snowball sampling. Item analysis, exploratory factor analysis, and reliability testing were performed on the scale.Results:The final Core Competency Scale for Ophthalmic Specialist Nurses included six dimensions of ophthalmic specialized knowledge, ophthalmic specialized skills, essential nursing practice ability, communication and education ability, scientific research ability, and professional competence, totaling 30 items. Exploratory factor analysis extracted six common factors, with a cumulative variance contribution rate of 73.077%. The total Cronbach's α coefficient of the scale was 0.955, the half reliability coefficient was 0.796, and the retest reliability coefficient was 0.973.Conclusions:The Core Competency Scale for Ophthalmic Specialist Nurses has good reliability and validity, which can be used to evaluate the core competency of ophthalmic specialist nurses.

Objective:To investigate humoral and antigen-specific T cell immune responses induced by oral administration of WGP-OVA in C57BL/6 mice.Methods:C57BL/6 mice were orally administered with PBS,WGP and WGP-OVA for 17 days,respec-tively.The serum immunoglobulin levels including IgG1,IgG2a,IgG3 and IgM of mice were detected using LEGENDplexTM Multi-An-alyte Flow Assay Kit.HE staining was used to compare the size of lymphoid nodules in spleens.FACS was used to analyze the percent-age of F4/80+macrophages and F4/80+SIINFEKL+macrophages in inguinal lymph nodes(ILNs).In addition,the T cell-mediated im-munity stimulated by the WGP-OVA oral vaccine was analyzed by ILNs-infiltrating antigen-specific CD8+T cell using MHC Tetramer assay.Results:Oral administration of WGP-OVA significantly increased the contents of IgG1,IgG2a,IgG3 and IgM in the serum,and enlarged the lymphoid nodules in spleens,compared to those orally administered with PBS.Oral administration of WGP-OVA pro-moted the ILNs-infiltration of F4/80+macrophages,and enhanced the antigen-presentation of OVA in macrophages in ILNs.Moreover,the expansion of OVA specific CD8+CTLs in ILNs was also stimulated by WGP-OVA.Conclusion:WGP-OVA involved in both the humoral and antigen-specific T cell immune responses in C57BL/6 mice.

Objective To understand the current status of research on lung cancer immunotherapy to provide a reference for further investigation and future topic selection in this field. Methods CiteSpace visualization analysis software was used to analyze 400 Chinese studies in CNKI and 5 001 English studies in the Web of Science database from 2005 to 2021, with "lung cancer" and "immunotherapy" as keywords. Keyword co-occurrence analysis was performed on 17 English studies of "Lung Cancer" "Immunotherapy" and "Single cell sequencing" in the Web of Science database. Results "Non-small cell lung cancer" "immunosuppressants" "PD-L1" "dendritic cells" and "cytokine-induced killer cells" are current research hotspots in lung cancer immunotherapy. Monoclonal antibody drugs including nivolumab, pembrolizumab, atezolizumab, and durvalumab are hotspot drugs. Immunotherapy combined with chemotherapy as well as PD-L1 expression have become the focus of continuous research. The majority of studies on lung cancer immunotherapy are conducted in the United States, followed by China. Conclusion Lung cancer immunotherapy has gradually become a research hot spot in China. In the future, in-depth research is needed to provide cutting-edge directions for lung cancer immunotherapy.

Objective:To investigate the effect of tripartite motif-containing 23 (Trim23) on the differentiation and maturation of dendritic cells and the possible mechanism.Methods:Mouse bone marrow-derived dendritic cells (BMDCs) were prepared from bone marrow cells of C57BL/6 mice with the presence of Flt3L. Real-time quantitative PCR and Western blot were used to detect the expression of Trim23 in BMDCs after LPS stimulation. An overexpression vector for full-length Trim23 (Trim23 OE) was constructed and transfected into BMDCs, and the pcDNA3.1 empty vector was used as control. Flow cytometry was used to detect the expression of CD80, CD86, CD40 and MHCⅡ on the surface of vector-transfected BMDCs after LPS stimulation and ELISA was used to detect the secretion of IL-12p40, TNF-α, IL-6 and IL-10 by these cells. CD8 + and CD4 + T cells were isolated from spleen and lymph nodes of OT-Ⅰ and OT-Ⅱ mice by magnetic beads and co-cultured with LPS-treated BMDCs in the presence of ovalbumin (OVA). Flow cytometry was used to detect the proliferation and differentiation of CD8 + and CD4 + T cells. Western blot was performed to analyze the phosphorylation of p38, ERK1/2 and AKT in BMDCs. Two overexpression vectors for Trim23 mutants lacking RING or ARF domain (Trim23 ΔRING and Trim23 ΔARF) were constructed and transfected into BMDCs. Then flow cytometry and ELISA were used to detect the expression of surface molecules and cytokines. Results:The expression of Trim23 in BMDCs was significantly down-regulated after LPS stimulation. The expression of MHCⅡ, CD86 and CD80 and the secretion of TNF-α and IL-6 decreased significantly in BMDCs overexpressing Trim23. Furthermore, overexpression of Trim23 inhibited the ability of BMDCs to induce the proliferation and differentiation of CD4 + T cells and the proliferation of CD8 + T cells. Western blot showed that the phosphorylation of p38 and ERK1/2 decreased significantly in Trim23-overexpressing BMDCs. Compared with wildtype Trim23, overexpression of Trim23 ΔRING had no significant influence on the expression of surface molecules (MHCⅡ and CD86) and the secretion of cytokines (TNF-α and IL-6) in BMDCs stimulated by LPS. Conclusions:Trim23 overexpression inhibited the maturation and immune activation of BMDCs via MAPK signal pathway and its RING domain. This study provided reference for targeting Trim23 to improve the immune response of dendritic cell-based tumor vaccines.

Objective:To clarify the effect and related factors of antiviral therapy on the change of esophageal varices in patients with hepatitis B virus-related cirrhosis.Methods:Fifty-two cases with hepatitis B virus-related cirrhosis who underwent endoscopy before and after antiviral therapy were selected from prospective cohorts. Patients were divided into three groups: no, mild, and moderate-severe based on the degree of esophageal varices. The changes in the severity of esophageal varices in each group were compared after antiviral therapy. Clinical characteristics (platelet, liver and kidney function, liver stiffness, and virological response) of patients with different regressions were analyzed. Measurement data were analyzed by independent sample t-test, one-way ANOVA, Mann-Whitney U test and Kruskal-Wallis H test, and Chi-Square test was used for count data.Results:All patients received entecavir-based antiviral therapy. The median treatment time was 3.1 (2.5-4.4) years. The proportion of patients without esophageal varices increased from 30.8% to 51.9%, the proportion of mild esophageal varices decreased from 40.4% to 30.8%, and the proportion of patients with moderate-to-severe esophageal varices decreased from 28.8% to 17.3% ( χ2=14.067, P=0.001). A total of 40.4% of patients had esophageal varices regression, and 13.5% had esophageal varices progression. The progression rate was significantly higher in patients with moderate-severe esophageal varices than patients with mild and no esophageal varices ( χ2=28.126, P<0.001), and 60.0% of patients with moderate-severe esophageal varices still remained in moderate-severe state after antiviral treatment. Baseline platelet count and 5-year mean change rates were significantly lower in patients with progressive moderate-to-severe esophageal varices than in those without progression (+3.3% vs. +34.1%, Z=7.00, P=0.027). Conclusion:After effective antiviral treatment, 40.4% of patients with hepatitis B virus-related cirrhosis combined with esophageal varices has obtained esophageal varices regression, but those with moderate to severe esophageal varices still have a considerable risk of progression while receiving mono antiviral treatment only. Thrombocytopenia and without significant improving are the clinical signs of progression risk after receiving antiviral treatment.

Objective:To explore the therapeutic effect of drug ion implantation on viral or bacterial keratitis.Methods:A total of 200 patients with viral keratitis and another 200 patients with bacterial keratitis who were admitted to our hospital for ophthalmic treatment from April 2018 to April 2019 were selected as research subjects, through double-blind, prospective, randomized controlled method patients were divided into two groups, namely the control group given routine treatment, and drug treatment group cases were treated on the basis of the routine treatment with drug iontophoresis technology. The effective rate, visual acuity, length of stay, complication rate, half-year recurrence rate and nursing satisfaction were observed.Results:The treatment effective rate of the experimental group was 100%, the effective rate of vision treatment was 100%, and the nursing satisfaction rate was 93%, which was significantly higher than that of the control group, ( χ2=4.082, P=0.043; χ2=4.082, P=0.043; χ2=59.282, P<0.001). The duration of hospitalization of the patients in the experimental group (8.93±1.69)d, the cost of hospitalization (5627.12±482.34) yuan, the recurrence rate of half a year was 2%, and the incidence of complications was 4%, which was significantly lower than that of the control group ( t=6.522, P=0.000; t=10.985, P<0.001; χ2=5.674, P=0.017; χ2=10.010, P=0.002). Conclusions:Drug ion implantation technology wasbetter than conventional drug treatment in the treatment of viral and bacterial keratitis, and the treatment operation is more convenient, did not produce adverse reactions, is worth promoting in ophthalmic treatment as an optional treatment method .

?? [Abstract]? Objective? To explore the effects of perioperative humanistic care on medium and advanced gynecologic malignant tumor patients. Methods? From January 2015 to December 2016, we selected 102 medium and advanced gynecologic malignant tumor patients at Beijing Obstetrics and Gynecology Hospital of Capital Medical University. Humanistic care was carried out during the perioperative period. We observed postoperative recovery, psychological state and the incidence of complications among patients. Results? Patients were all with successful operations, stable psychological state and no complications, and they discharged from hospitals steadily. Conclusions? Perioperative humanistic care has important clinical significance in improving psychological state among medium and advanced gynecologic malignant tumor patients and promoting patients' recovery.

Objective To explore the effectiveness of the individualized surgical fixation for the treatment of mandibular fractures in children.Methods The individualized mandibular fixation methods were used to treat mandibular fractures in 85 children in Department of Plastic and Reconstructive Surgery in Xijing Hospital from April 2010 to July 2015.Depending on the fracture types and 3D pre simulation with stress and tension band fixation,six methods of treatment were used,including titanium plate,titanium plate-dental arch bars,biodegradable plate-dentalarch bars,biodegradable plate-occlusal splint,occlusal splint,and anchorage devices.Postoperative occlusal relationship,mouth opening and masticatory function were evaluated.Results Fixation of titanium plate was used in 10 cases,titanium plate-dental arch bars in 25 cases,biodegradable plate-dentalarch bars in 20 cases,biodegradable plate-occlusal splint 15 cases,individualized occlusal splint in 3 cases and anchorage devices in 12 cases.The treatment outcomes were good in the combined methods of open reduction with personalized fixation for children with mandibular fractures,and the reduction was satisfactory.Occlusal relationship had a good recovery after operation.Eating and functional training started earlier in these pediatric patients after operation.Conclusions For pediatric mandibular fractures,open reduction and fixation with appropriate methods can lead to favorable anatomic morphology and occlusion relationship.The application of 3D imaging technology in analyzing the fracture and showing tooth germ in the jaw helps the improvement of surgical efficiency and avoidance of unwanted tooth germ injuries.Personalized dental arch bar and splint provide good strength for external fixation or assist fixation on strain band.