Objective To investigate the current symptom status of maintenance hemodialysis(MHD)patients,analyze the influencing factors from the perspective of multidimensional symptom burden,extract symptom groups,and construct a symptom network.Methods A total of 490 patients who received MHD at the blood purification center of a tertiary hospital in Shanghai from March to April 2025 were selected using a convenience sampling method.30 symptoms of MHD patients were investigated using a modified dialysis symptom index table.SPSS and R software were utilized to analyze the influencing factors,extract symptom groups,and construct a multidimensional symptom network.Results A total of 488 valid questionnaires were collected,with a valid questionnaire recovery rate of 99.59％.The median number of symptoms experienced by patients was 6(interquartile range:4,8),with the top 5 symptoms being dry skin(69.88％),fatigue or tiredness(56.97％),itching(56.97％),worry(50.20％),and dry mouth(46.31％).Multidimensional analysis indicated that age,duration of dialysis,education level,and complications were influencing factors of symptom burden scores across different dimensions.6 stable symptom groups were extracted,namely skin discomfort,fatigue and pain,gastrointestinal tract,sleep disorders,water-electrolyte imbalance,and uremia.The results of the symptom network analysis revealed that difficulty of falling asleep had the highest intensity centrality(rs=2.18,2.25,2.12).Conclusion The symptom association is relatively stable,and difficulty of falling asleep is the core symptom.This finding can assist clinical medical staff in achieving efficiency and precision in symptom group management.

OBJECTIVE To investigate the improvement effect and mechanism of desloratadine citrate disodium in mice with hypersensitivity pneumonitis(HP).METHODS Sixty mice were randomly divided into blank control group(normal saline),model group(normal saline),prednisone group(positive control,20 mg/kg)and desloratadine citrate disodium low-,medium-and high-dose groups(0.5,1,2 mg/kg),with 10 mice in each group.Except for the blank control group,mice in other groups were intraperitoneally injected with ovalbumin(OVA)and exposed to OVA inhalation to establish the HP model.On day 22 post-modeling,mice in each group were administered the corresponding drugs or normal saline,once a day,for 11 consecutive days.After the last administration,lung function and airway hyperreactivity were assessed.The levels of interleukin-1β(IL-1β),IL-4 and IL-6 in serum as well as the levels of IL-8,IL-13 and IL-17A in bronchoalveolar lavage fluid were determined.Pathological changes in lung tissue of mice were evaluated using Masson staining.Furthermore,the expressions of fibrosis-related proteins,including transforming growth factor β1(TGF-β1),type Ⅲ collagen(Col-Ⅲ)and fibronectin(FN)were determined in lung tissues.RESULTS Compared with the blank control group,the model group showed significant deterioration in lung function(P＜0.01),while airway resistance and serum levels of IL-1β,IL-4,IL-6 and the levels of IL-8,IL-13 and IL-17A in the bronchoalveolar lavage fluid were increased significantly(P＜0.01).The lung tissues exhibited alveolar collapse,atrophy,and structural disarray,along with the formation of extensive deposits of blue collagen fibers,the percentage of positive staining increased significantly(P＜0.01).Additionally,the expression levels of TGF-β1,Col-Ⅲ,and FN proteins in the lung tissues were also increased significantly(P＜0.01).After intervention with desloratadine citrate disodium,the pathological changes in the lung tissues of mice in each dosage group of desloratadine citrate disodium showed varying degrees of improvement,and most of the aforementioned indicator levels were significantly reversed(P＜0.05 or P＜0.01).CONCLUSIONS Desloratadine citrate disodium can improve the lung function and airway hyperreactivity of HP mice,inhibit the release of inflammatory factors in serum and bronchoalveolar lavage fluid,and reduce the deposition of collagen fibers.Its mechanism of action may be related to anti-inflammatory,immunomodulatory,and antifibrotic effects.

Objectives:To evaluate the effectiveness of functionalized decellularized extracellular matrix(F-dECM)prepared from porcine auricular cartilage or porcine rib cartilage in repairing xenogeneic articular osteochondral defects.Methods:The por-cine auricular cartilage and rib cartilage were crushed and decellularized.Heparin modification and multi-factor loading were a-chieved through amide bond reaction.The physical characteristics of the particles were characterized by SEM observation and mer-cury intrusion.The chemical characteristics of the particles were characterized by tissue section staining and kit detection.The rabbit knee joint full-thickness defect models were established and implanted by different particles respectively.After 6 weeks and 12 weeks of operation,the samples were taken for gross observation,CT scanning and tissue sectioning to comprehensively evaluate the repair effect.Results:After heparin modification,the glycosaminoglycan lost during the decellularization process was replen-ished.Both heparinized auricular cartilage and costal cartilage presented a highly developed porous structure.Among them,the porosity and pore diameter of costal cartilage were both lower than those of auricular cartilage(P＜0.05).During the observation periods of 6 weeks and 12 weeks,the porcine costal cartilage F-dECM implantation group was superior to other experimental groups in knee joint repair effects(P＜0.05).Conclusion:Costal-derived F-dECM is a joint osteochondral defect repair material with application potential.

Objectives:To evaluate the effectiveness of functionalized decellularized extracellular matrix(F-dECM)prepared from porcine auricular cartilage or porcine rib cartilage in repairing xenogeneic articular osteochondral defects.Methods:The por-cine auricular cartilage and rib cartilage were crushed and decellularized.Heparin modification and multi-factor loading were a-chieved through amide bond reaction.The physical characteristics of the particles were characterized by SEM observation and mer-cury intrusion.The chemical characteristics of the particles were characterized by tissue section staining and kit detection.The rabbit knee joint full-thickness defect models were established and implanted by different particles respectively.After 6 weeks and 12 weeks of operation,the samples were taken for gross observation,CT scanning and tissue sectioning to comprehensively evaluate the repair effect.Results:After heparin modification,the glycosaminoglycan lost during the decellularization process was replen-ished.Both heparinized auricular cartilage and costal cartilage presented a highly developed porous structure.Among them,the porosity and pore diameter of costal cartilage were both lower than those of auricular cartilage(P＜0.05).During the observation periods of 6 weeks and 12 weeks,the porcine costal cartilage F-dECM implantation group was superior to other experimental groups in knee joint repair effects(P＜0.05).Conclusion:Costal-derived F-dECM is a joint osteochondral defect repair material with application potential.

Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index(H-CXI)and all-cause mortality in a population with abnormal liver function.Methods The study was based on the America National Health and Nutrition Examination Survey(NHANES)data from 2011～2014,which included 2 752 cases of people with abnormal liver function and followed up until December 31,2019,using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality,and restricted cubic spline analysis to explore the nonlinear relationship.Results There were 244 all-cause deaths during a mean follow-up time of 82.70±3.86 months.H-CXI was ana-lyzed as a categorical variable(quartiles),and Cox regression analyses showed that in model 2,the risk of all-cause mortality was reduced in groups Q2,Q3 and Q4 compared with group Q1(HR=0.41,95%CI:0.21～0.82,P=0.012 1;HR=0.34,95%CI:0.16～0.69,P=0.003 1;HR=0.24,95%CI:0.09～0.67,P=0.006 3).Subgroup analyses revealed an interaction between stroke and all-cause mortality,and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality.Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function,and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

Objective To investigate the current status of acceptance of disability(AOD)among young and middle-aged spinal cord injury patients and analyze the factors influencing it,in order to provide a basis for nursing managers to develop targeted interventions.Methods From February to July 2024,a convenience sample of 330 young and middle-aged spinal cord injury patients who were hospitalized in 3 tertiary-level hospitals in Henan Province was selected.The survey was conducted using a general information questionnaire,the Brief Adaptation to Disability Scale-Revised,Perceived Social Support Scale,Connor-Davidson Resilience Scale-10 item,Brief Illness Perception Questionnaire,Medical Coping Modes Questionnaire.Results A total of 322 patients were included in the final analysis,yielding a valid response rate of 97.58％.The AOD score for young and middle-aged spinal cord injury patients was(25.99±6.68).Multiple linear regression analysis revealed that gender,education level,type of paralysis,injury duration,pain intensity,social support,psychological resilience,disease perception,and coping styles(confrontation and submission)were influencing factors of AOD(P＜0.05).Conclusion AOD among young and middle-aged spinal cord injury patients is at a moderate level.Healthcare professionals should pay particular attention to male patients,those with low literacy,quadriplegia,shorter injury durations,high pain intensity,low social support,weak psychological resilience,strong disease perception,and yielding coping styles.Timely interventions are recommended to enhance AOD,strengthen rehabilitation outcomes,and improve prognosis.

Objective:To evaluate the effects of laser moxibustion(LM)on tumor-related immunity in tumor-bearing mice.Methods:Thirty male C57BL/6 mice were randomized into a control group,a model group,and an LM group,with 10 mice in each group.Mice in the control group did not receive any intervention,and mice in the model group and LM group were injected into the right armpit with 1×107 cells/mL Lewis lung carcinoma cells to induce tumor models.From the first day after the injection,the LM group mice were irradiated with LM at Guanyuan(CV4)and bilateral Zusanli(ST36),5 min each point for a total of 15 min,once daily for 15 consecutive days.From the day of visible tumor formation(i.e.,day 8),mice in the model and LM groups were measured every other day with a vernier caliper to calculate the tumor volume.On day 16 after injection,the serum,lung,spleen,and tumors of the mice were harvested.Hematoxylin-eosin staining was used to observe tumor pulmonary metastasis.Changes in the serum levels of programmed death 1(PD-1)and programmed death-ligand 1(PD-L1)were analyzed by enzyme-linked immunosorbent assay;the abundance of PD-1 and PD-L1 proteins in tumors was determined by Western blotting;and the proportions of lymphocyte subsets and myeloid-derived suppressor cells(MDSCs)in tumors and spleen were determined by flow cytometry.Results:Compared to the model group,the tumor volume of mice in the LM group decreased significantly on days 8 and 10(P<0.05);the lung tissues of the LM group showed no apparent tumor atypia;the proportion of monocytic MDSCs(M-MDSCs)in the tumors of LM group mice decreased(P<0.05);the PD-1 and PD-L1 levels in the serum of mice in the LM group declined with statistically significant variation in the reduction of PD-L1(P<0.01);PD-1 and PD-L1 protein expression in the tumor tissues of mice in the LM group reduced significantly(P<0.01).Conclusion:LM intervention can reduce the expression of PD-1 and PD-L1 in the serum of tumor-bearing mice,decrease the expression of PD-1 and PD-L1 proteins and the proportion of M-MDSCs in tumor tissues.These effects may be one of the mechanisms by which LM slows the early-stage growth of Lewis lung carcinoma tumor in mice.

BACKGROUND:Successful uterine spiral artery remodeling is necessary for normal pregnancy,in which vascular smooth muscle cells are important cells.Interferon-γ is associated with the loss of vascular smooth muscle cells during early pregnancy.However,the specific mechanism is not fully understood. OBJECTIVE:To investigate the effects of interferon-γ on migration and apoptosis of vascular smooth muscle cells through NLRP3/caspase-1/GSDMD pyroptosis pathway. METHODS:Human vascular smooth muscle cells were divided into control group and interferon-γ group.The control group was cultured normally,and the interferon-γ group was treated with 10 ng/mL interferon-γ for 24 hours.The migration ability of vascular smooth muscle cells was detected by Transwell assay.The apoptosis of vascular smooth muscle cells was detected by TUNEL assay and flow cytometry.The mRNA expression levels of NLRP3 and caspase-1 were detected by qPCR.Western blot assay was utilized to detect NLRP3,caspase-1,and cleaved N-terminal GSDMD protein expression levels. RESULTS AND CONCLUSION:Compared with the control group,the migration ability and apoptosis rate of vascular smooth muscle cells in interferon-γ group were significantly increased(P<0.05).Compared with the control group,the mRNA expression levels of NLRP3 and caspase-1 in vascular smooth muscle cells of interferon-γ group were significantly increased(P<0.05).Compared with control group,the expression levels of NLRP3,caspase-1,and cleaved N-terminal GSDMD protein in vascular smooth muscle cells in the interferon-γ group were significantly increased(P<0.05).The results suggest that interferon-γ may regulate the migration and apoptosis of vascular smooth muscle cells through NLRP3/caspase-1/GSDMD pyroptosis pathway.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.