Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

This paper explores the application and advancements of cross-cultural nursing concepts in the management of ICU patients. It identifies the core elements of humanistic care from a cross-cultural perspective, introduces relevant international research findings, and provides an in-depth analysis of existing challenges within the domestic healthcare context. Constructive suggestions are proposed to enhance the quality of life of ICU patients.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

This paper explores the application and advancements of cross-cultural nursing concepts in the management of ICU patients. It identifies the core elements of humanistic care from a cross-cultural perspective, introduces relevant international research findings, and provides an in-depth analysis of existing challenges within the domestic healthcare context. Constructive suggestions are proposed to enhance the quality of life of ICU patients.

Objective:To construct a humanistic care nursing program for adult ICU patients, providing guidance for the clinical practice of humanistic care in ICUs.Methods:Based on a literature review and clinical practice experience, a preliminary humanistic care nursing program for adult ICU patients was drafted. From August to September 2024, the Delphi method was used to conduct two rounds of expert consultation with 16 experts to revise the content of each item and the overall program, resulting in the final version of the humanistic care nursing program for ICU adult patients. The experts' engagement was measured by the effective response rate of the questionnaires, their authority by the expert authority coefficient, and the coordination of expert opinions by the Kendall's coefficient of concordance.Results:The effective response rate for the Delphi expert consultation questionnaires was 100.00% (16/16) in both rounds. The expert authority coefficients were 0.872 and 0.875, respectively. After the second round of consultation, the Kendall's coefficients for the importance, applicability, and feasibility of each level of item ranged from 0.119 to 0.313 ( P<0.05). The final humanistic care nursing program for adult ICU patients included three first-level items, 12 second-level items, and 55 third-level items. Conclusions:The humanistic care nursing program for adult ICU patients constructed in this study is scientific, targeted, and feasible, providing guidance for the clinical practice of humanistic care in ICU settings.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective:To investigate the association between fasting blood glucose (FBG) variability and the risk of developing gestational diabetes mellitus.Methods:Ninety patients with gestational diabetes mellitus admitted to Jiaxing Maternity and Child Health Care Hospital between January 2022 and April 2023 were included in this study. Based on the blood glucose results obtained from the 75 g oral glucose tolerance test, these patients were divided into two groups: the normal blood glucose group (Group A, n = 56) and the elevated blood glucose group (Group B, n = 34). Multivariate logistic binary regression analysis was conducted to identify independent risk factors for gestational diabetes mellitus. Additionally, an analysis was conducted to investigate the association between long-term fasting blood glucose standard deviation (SD FBG), coefficient of variation (CV FBG), average successive variability of fasting blood glucose (ASV FBG), and the severity of gestational diabetes mellitus. Results:The FBG levels [(6.83 ± 1.03) mmol/L vs. (4.62 ± 0.58) mmol/L], 1-hour postprandial blood glucose [(13.03 ± 1.39) mmol/L vs. (11.42 ± 1.04) mmol/L], and 2-hour postprandial blood glucose [(10.23 ± 1.51) mmol/L vs. (9.42 ± 0.74) mmol/L] between the two groups ( F = 887.43, 144.76, 10.39, all P < 0.05). Furthermore, the glycated hemoglobin levels were significantly elevated in Group B [(7.19 ± 1.01) mmol/L] compared with Group A [(5.03 ± 0.42) mmol/L, t =14.15, P < 0.05). When compared with Group A, patients in Group B exhibited significantly higher values for ASV FBG [(0.58 ± 0.23) mmol/L vs. (0.36 ± 0.26) mmol/L], SD FBG [(0.55 ± 0.38) mmol/L vs. (0.41 ± 0.21) mmol/L], and CV FBG [(9.43 ± 2.45) mmol/L vs. (6.94 ± 1.31) mmol/L] ( t = 4.06, 2.25, 6.28, all P < 0.05). Additionally, the age and pre-pregnancy body mass index were significantly higher in Group B compared with Group A ( t = 3.82, 7.53, both P < 0.05). Age, pre-pregnancy body mass index, fasting blood glucose, 1-hour postprandial blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, ASV FBG, SD FBG, and CV FBG were identified as risk factors for severe gestational diabetes mellitus ( OR = 1.230, 1.887, 301.406, 3.957, 1.947, 41.861, 5.421, 2.057, all P < 0.05). Furthermore, SD FBG, ASV FBG, and CV FBG were positively correlated with the severity of gestational diabetes mellitus ( r = 0.234, 0.555, 0.408, all P < 0.05). Conclusion:Fasting blood glucose variability is positively correlated with the risk of developing gestational diabetes mellitus. Age, pre-pregnancy body mass index, fasting blood glucose, 1-hour postprandial blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, ASV FBG, SD FBG, and CV FBG are also risk factors affecting the severity of gestational diabetes mellitus.

Objective To construct the etoposide (VP-16)combined with cisplatin (DDP) chemotherapy scheme (EP chemotherapy scheme)resistant small cell lung cancer (SCLC)cell line H446/EP and to identify the drug resistance characteristics and explore the mechanism.Methods NCI-H446 cells were treated with increasing concentrations of VP-16 and DDP to construct an H446/EP cell line.H446/EP and NCI-H446 cells were used as the research objects.The cell viability was detected by MTT assay,and the resistance index (RI)of H446/EP cells was calculated.Cell cloning assay and Incucyte cell proliferation (label-free)assay were used to detect cell proliferation ability.Transcriptome sequencing was performed to analyze the enrichment of differentially expressed genes (DEGs)in the 2 cell lines.Western blotting was applied to detect the protein expression levels of drug resistance,DNA damage repair (DDR),and autophagy markers.Results MTT assay showed that the resistance index (RI)of H446/EP cells to VP-16,DDP,and DOX were 6.14,3.43,and 1.96,respectively.The results of cell cloning assay and Incucyte cell proliferation assay indicated that the proliferation ability was significantly higher in the H446/EP cells than the NCI-H446 cells (P<0.01).Transcriptome sequencing and pathway enrichment analysis displayed that the DEGs between H446/EP and NCI-H446 cells were enriched in tumor chemoresistance,DDR,and autophagy pathways.Western blot results showed the expression levels of MRP1,BCRP,RAD51,γ-H2AX,and LC3-Ⅱ/LC3-Ⅰ were significantly increased,and that of p62 was obviously decreased in the H446/EP cells when compared with the NCI-H446 cells (P<0.05).Conclusion An EP chemotherapy-resistant H446/EP cell line is successfully constructed.Stronger proliferation ability,increased expression of efflux transporters,and enhanced DDR and autophagy may be the mechanisms of the resistance of SCLC to EP chemotherapy scheme.

Premature ovarian insufficiency (POI) is characterized by the decline or loss of ovarian function before the age of 40 years and account for one major cause of female infertility. Its pathogenesis is complex. Recently, the research on microbiota and reproductive endocrine diseases has become a hot spot. This article reviews the involvement of microbiota in the occurrence and development of POI through immune response, inflammatory factors and metabolic function. At the same time, taking probiotics and fecal microbiota transplantation can correct the dysbiosis of flora, so as to improve the symptoms associated with POI. In the future, it is expected to provide new strategies for the diagnosis and treatment of POI through further research on the relationship between microbiota and POI.

Premature ovarian insufficiency (POI) is characterized by the decline or loss of ovarian function before the age of 40 years and account for one major cause of female infertility. Its pathogenesis is complex. Recently, the research on microbiota and reproductive endocrine diseases has become a hot spot. This article reviews the involvement of microbiota in the occurrence and development of POI through immune response, inflammatory factors and metabolic function. At the same time, taking probiotics and fecal microbiota transplantation can correct the dysbiosis of flora, so as to improve the symptoms associated with POI. In the future, it is expected to provide new strategies for the diagnosis and treatment of POI through further research on the relationship between microbiota and POI.