ObjectiveTo construct and evaluate a mouse model that simulates the pathological progression of immune checkpoint inhibitor-associated pneumonitis (CIP), in order to address the critical issue of the lack of standardized animal models in this research field. MethodsThirty-five SPF-grade 6-week-old male C57BL/6J mice were randomly assigned to a control group (n=5), a bleomycin (BLM) group (n=15), and a BLM+programmed death-1 (PD-1) monoclonal antibody (BLM+PD-1) group (n=15). Corresponding drugs were administered via intraperitoneal injection for intervention. The general condition, body weight changes, survival rate, and pulmonary histopathological alterations were systematically monitored. ResultsCompared with the BLM group, the BLM+PD-1 group exhibited significantly more severe pulmonary fibrosis, characterized by progressive body weight loss and more severe deterioration of general conditions. Histopathological examination showed that pulmonary inflammation was alleviated 4 weeks post-modeling in the BLM group. In contrast, pulmonary lesions continued to worsen in the BLM+PD-1 group, with no evidence of resolution of inflammation 28 days post-modeling. Quantitative immunohistochemical analysis revealed that the positive expression rate of interleukin-17A (IL-17A) in lung tissues reached 34.28% in the BLM+PD-1 group 14 days post-modeling, which was markedly higher than that in the BLM group (24.02%, P < 0.000 1). The positive expression rate of α-smooth muscle actin (α-SMA) was 12.40% in the BLM+PD-1 group 14 days post-modeling, nearly twice the level in the BLM group (5.87%). 28 days post-modeling, the positive expression rate of α-SMA remained at 7.72% in the BLM+PD-1 group, while it declined to 3.38% in the BLM group. ConclusionThe addition of a PD-1 inhibitor to bleomycin treatment accelerates the progression of pulmonary interstitial fibrosis and effectively recapitulates the pathological process of lung injury and fibrosis driven by aberrant immune activation during clinical immunotherapy. Accordingly, this study successfully establishes a dynamic CIP animal model recapitulating the progression from early inflammatory response to pulmonary fibrosis. This model addresses the critical shortage of animal models for this condition and offers an experimental platform for further mechanistic studies and the development of therapeutic strategies.

Lumbar spinal stenosis (LSS) is a common disabling condition in the elderly, and its clinical assessment relies not only on imaging and neurofunctional indicators but also on traditional Chinese medicine (TCM) syndrome differentiation. To evaluate the concordance between existing LSS animal models and clinical characteristics of TCM and Western medicine, clarify their advantages and limitations, and explore their translational potential, Chinese and English databases, including CNKI, Wanfang Data, PubMed, and Web of Science, are searched using combinations of the terms "lumbar spinal stenosis," "model," "guideline," "consensus," and "norm" from inception to the end of June 2025. After screening, a total of 21 publications are included, of which 15 report animal experimental studies, and 6 are guidelines, consensus statements, or normative documents. Based on these, the existing modeling methods are summarized, diagnostic indicators are extracted from clinical guidelines and expert consensus, and clinical concordance is evaluated using an assessment system proposed in the relevant literature. The results show that the existing animal models are categorized into three concordance levels: high (laminectomy/spinous process removal with filling; laminectomy/spinous process + ligament/muscle removal with filling; autologous bone backfilling), moderate (nylon tape dural binding method, adjustable screws, fixation combined with removal of ligament/muscle), and low (balloon compression method, adjustable balloon compression method, bipedal standing, ligament/muscle resection, steel wire cerclage method). Overall, current animal models of LSS generally perform well in terms of structural construction but show clear limitations in replicating clinical diagnostic logic and TCM syndromes. Future research should enhance syndrome phenotype collection and enrich TCM-based evaluation systems based on existing models. Additionally, multifactorial integrated modeling strategies should be introduced to extend the depth of syndrome-level simulation. This study aims to analyze LSS animal models that can faithfully recapitulate disease pathogenesis, conform to clinical realities of both Western medicine and TCM clinical practice, and have broad application potential, so as to narrow the translational gap between experimental findings and clinical practice.

Objective To investigate the prevalence and related factors of sarcopenia among non–bedridden older adults in the community of Baoshan District using the China mini sarcopenia risk assessment 7 (C-MSRA-7) combined with Ishii scoring system. Methods The older individuals consulting at 20 community health stations in Baoshan District between April 2025 and June 2025 were enrolled. Data were collected using a general information questionnaire, a dietary and lifestyle habits survey, the C-MSRA-7, and the mini nutritional assessment-short form (MNA-SF). Handgrip strength and anthropometric measurements were also obtained. Individuals with both Ishii score and C-MSRA-7 results positive were classified into the sarcopenia risk group, while the remaining participants were assigned to the non–sarcopenia risk group. Differences in lifestyle habits, dietary patterns, and nutritional status between the two groups were compared. Results A total of 2 611 valid questionnaires were retrieved. Univariate analysis showed statistically significant differences in alcohol consumption, physical activity frequency, body mass index (BMI), nutritional status, activities of daily living, and regularity of three meals in sarcopenia risk group (n＝486) and non–sarcopenia risk group (n＝2 125, P<0.05). Logistic regression analysis showed that advanced age (75–84 years: OR＝2.55, 95%CI 2.03–3.21; ≥85 years: OR＝3.98, 95%CI 2.24–7.07), underweight status (OR＝2.19, 95%CI 1.50–3.19), weight loss＞2 kg (OR＝4.52, 95%CI 2.68–7.64) past 3 months, lack of regular physical activity (OR＝1.77, 95%CI 1.24–2.52) , and alcohol consumption (OR＝1.48, 95%CI 1.07–2.05) were independent risk factors for sarcopenia (P<0.05). Behaviors related to healthy diet, including daily milk consumption (OR＝0.40, 95%CI 0.30–0.52), regular three meals (OR＝0.56, 95%CI 0.41–0.78), and high-quality protein intake (OR＝0.70, 95%CI 0.52–0.94), were protective factors (P<0.05). Conclusions Sarcopenia among community–dwelling, non–bedridden older adults is closely associated with physical activity levels, dietary habits, and nutritional status. Early identification of individuals at risk, enhanced nutritional education, and timely implementation of nutritional interventions and exercise programs are recommended for this population.

Objective Focusing on gynecological surgery,we constructed a prediction model for surgical duration by extracting features from unstructured surgical planning texts and integrating multimodal data via artificial intelligence technology.Methods The clinical data of 34 614 patients who underwent gynecologic surgeries at West China Second University Hospital,Sichuan University between January 2022 and October 2024 were collected.An embedding-transformer model was constructed to convert surgical planning texts into a one-dimensional numerical feature,referred to as the step feature.The predictive value of the step feature was assessed by comparing the performance improvements of linear regression,random forest,eXtreme Gradient Boosting(XGBoost),support vector regression,K-nearest neighbor regression,and artificial neural network algorithms in two scenarios—with and without the step feature as an input.The out-of-sample prediction accuracy of the models was assessed using mean absolute error(MAE),root mean squared error(RMSE),and R-squared(R2).Furthermore,the model interpretability was examined using SHapley Additive exPlanations(SHAP)values.Results SHAP results showed that the step feature had the highest predictive contribution.Temporal factors in surgical scheduling also influenced gynecological surgery duration.The XGBoost model demonstrated optimal performance on the test set,significantly improving prediction accuracy with a 40.43%increase in R2,while reducing MAE and RMSE by 21.27%and 20.13%,respectively,compared to the baseline model without the step feature.Conclusion The embedding-transformer model developed in this study effectively extracts features from surgical planning texts and enhances the predictive performance of machine learning models.The XGBoost prediction model can assist hospital administrators in implementing more refined management of gynecological surgeries and improving the utilization efficiency of surgical resources.

Objective Based on the background of disease diagnosis related groups(DRGs)in public hospitals to construct the nursing quality evaluation index system for percutaneous radiofrequency ablation(PRFA)of liver cancer so as to improve the nursing quality for PRFA of liver cancer.Methods Using three-dimensional quality model and through interview,literature analysis,two rounds of Delphi expert letter inquiry and analytic hierarchy process,the evaluation standard of PRFA nursing quality of liver cancer was established,and its effect was validated in clinical practice.Results The evaluation index system of PRFA nursing quality for liver cancer was constructed,which included 3 first-level indexes,9 second-level indexes and 22 third-level indexes.After clinical application,the incidence of intraoperative and postoperative moderate-severe pain,the incidence of high fever,and the 24-hour number of times required care in the intervention group were lower than those in the control group(P＜0.05),the incidence of postoperative Ⅲ degree vomiting in the intervention group was remarkably lower than that in the control group(P＜0.01),and the average hospitalization days in the intervention group were less than those in the control group(P＜0.05),and the average hospitalization expense in the intervention group was lower than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion The PRFA nursing quality evaluation index system for liver cancer is scientific and practical,which is helpful for improving the outcome of patients and promoting the quality of nursing.

Objective To explore the effect of compound centella asiatica on diabetic kidney disease(DKD)by regulating intestinal microflora metabolism.Methods Sixty DKD patients who visited Hangzhou Ninth People's Hospital from January to December 2022 were randomly divided into experimental group and control group,with 30 patients in each group.Patients in control group received basic treatment guided by lifestyle and diet,while patients in experimental group received treatment with compound centella asiatica on the basis of control group.Both groups of patients were followed up for 6 months to measure gut microbiota metabolite levels,urinary protein,and other indicators.Results After treatment,the levels of short-chain fatty acid(SCFA)in experimental group increased,while the levels of trimethylamine oxide(TMAO),indophenol sulfate(IS),microalbuminuria/creatinine(ACR),and 24-hour urinary protein quantification(24hPro)decreased;24hPro and ACR of experimental group patients were lower than those of control group.ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA(P＜0.05).Conclusion ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA;Compound centella asiatica can increase the levels of SCFA in DKD patients,reduce the levels of TMAO,IS,and ACR,indicating that compound centella asiatica can regulate the metabolic levels of gut microbiota in DKD patients and reduce proteinuria.

Objective To explore the effect of bone grafting combined with locking plate fixation on the postoperative rehabilitation of patients with comminuted proximal humerus fractures.Methods A total of 84 patients with comminuted proximal humerus fractures who underwent surgery at Armed Forces Jiangxi General Hospital from January 2022 to July 2024 were enrolled.Using a randomized digital table method,the patients were divided into conventional group(n=42)and combined group(n=42).The combined group received bone grafting combined with locking plate fixation,while conventional group underwent single locked plate internal fixation.Perioperative indicators,shoulder joint function,range of motion,quality of life,and complications were compared between two groups.Results Compared with conventional group,intraoperative blood loss,surgical duration were longer while fracture healing time and hospitalization period were shorter in combined group,as well as postoperative drainage volume was lower(P＜0.05).Shoulder joint function of combined group was better than that of conventional group(P＜0.05).At 3 months after surgery,the short form health survey(SF-36)scores of patients in both groups were higher than those before surgery,and the SF-36 score of combined group was higher than that of conventional group(P＜0.05).The total incidence of complications in combined group was lower than that in conventional group,and the difference was statistically significant(P＜0.05).Conclusion Bone grafting combined with locking plate fixation for comminuted proximal humerus fractures is more safe,can shorten hospitalization time and fracture healing time,promote shoulder joint function improvement,improve patients' shoulder joint activity and quality of life.

Objective:To analyze the relationship between clinical symptoms，BIG score，laboratory examination and the prognosis of children with moderate to severe traumatic brain injury (TBI)，to determine the indicators associated with poor prognosis，in order to make early judgment for the prognosis of children with moderate to severe TBI.Methods:A total of 78 children with moderate to severe TBI were enrolled in the PICU of Jiangxi Provincial Children's Hospital from January 2022 to January 2023. Clinical data，laboratory tests，BIG scores and Glasgow prognostic score were collected upon admission. The patients were followed up for 6 months and divided into poor prognosis group（Glasgow prognostic score1-3）and good prognosis group（Glasgow prognostic score4-5）based on the Glasgow prognostic score. The indicators related to poor prognosis were selected，and the efficacy of the indicators to predict the prognosis was analyzed and compared.Results:There were statistical differences among BIG score，hemoglobin，lactic acid，glucose，respiratory failure，and hypotension shock（ P<0.05）. The BIG score was an independent risk factor for a poor prognosis. The BIG score had the highest AUC value（0.820）among the four indices. The combined indices（BIG score，hemoglobin，lactic acid，glucose）had the highest AUC value（0.851）and had better performance for predicting the prognosis of moderate to severe TBI in children than any of the four indexs alone. Conclusion:The BIG score can be an independent predictor of early outcome in children with moderate to severe TBI. The combination of BIG score，hemoglobin，lactic acid，and glucose has better performance for predicting the prognosis of moderate to severe TBI in children than any of the four indices alone.

Objective:To investigate the current status of knowledge, attitude, and practice (KAP) of intensive care unit (ICU) medical staff for post-intensive care syndrome (PICS) and explore its influencing factors.Methods:The cross-sectional investigation study with stratified sampling was conducted. From June to September 2024, ICU medical staff from general hospitals in 5 regions (Chongqing, Beijing, Shaanxi, Jiangsu, and Gansu) were selected as the research subjects. The KAP of PICS questionnaire was distributed in the form of an electronic questionnaire. Observation indicators: (1) results of the questionnaire survey; (2) general information of ICU medical staff; (3) KAP scores of PICS and the correlation among various dimensions; (4) analysis of influencing factors for KAP of PICS. Comparison of measurement data with normal distribution between groups was conducted using the independent samples t test. One-way analysis of variance (ANOVA) was applied for com-parison among multiple groups, and post-hoc LSD test was used for pairwise comparison. Comparison of count data between groups was conducted using the chi-square test. Pearson correlation analysis was adopted for correlation analysis. Multiple linear regression analysis was used for univariate and multivariate analyses. Results:(1) Results of questionnaire survey. A total of 410 questionnaires were distributed and retrieved, among which 408 were valid, with an effective rate of 99.512%(408/410). (2) General information of ICU medical staff. Among the 408 ICU medical staff, there were 79 males and 329 females. Eight cases were under 25 years old, 248 cases were 25-35 years old, 132 cases were 36-40 years old, and 20 cases were over 40 years old. In terms of professional title, there were 10 junior nurses, 130 junior nurse practitioners, 228 intermediate nurse practitioners, and 40 senior nurse practitioners. About the educational background, 34 cases had a junior college degree, 347 cases had a bachelor's degree, and 27 cases had a master's degree or above. Regarding the hospital level, 25 nurses worked in secondary hospitals and 383 cases in tertiary hospitals. In terms of ICU type, 181 cases were from specialized ICU and 227 cases from general ICU. About working experience in ICU, 41 nurses had less than 5 years, 207 cases had 5-10 years, and 160 cases had more than 10 years. (3) KAP scores of PICS and the correlation among various dimensions. The total KAP score of PICS among the 408 ICU medical staff was 88.7±14.2, with 40.2±9.2 for the knowledge dimension, 22.0±5.6 for the attitude dimension, and 26.5±6.3 for the practice dimension. Pearson correlation analysis showed that the knowledge dimension of PICS among ICU medical staff was significantly positively correlated with both the attitude dimension and the practice dimension ( r=0.15, 0.69, P<0.05); the attitude dimension was positively correlated with the practice dimension ( r=0.23, P<0.05).(4) Analysis of influencing factors for KAP of PICS. Results of multivariate analysis showed that age (25-35 years old, 36-40 years old, over 40 years old), educational background and hospital level were independent influencing factors for the KAP of PICS among ICU medical staff ( t=2.23, 1.97, 2.84, 0.15, 2.04, P<0.05). Conclusions:The KAP of PICS among ICU medical staff is relatively good, while their practical ability still needs to be improved. Age, educational background, and hospital level are independent influencing factors for the KAP of PICS among ICU medical staff.

OBJECTIVES: Psoriasis is associated with lipid metabolism disorders, but the underlying mechanisms remain unclear. This study aims to investigate the role of trimethylamine N-oxide (TMAO) in lipid metabolism dysregulation in psoriasis. METHODS: An imiquimod (IMQ)-induced psoriasis-like mouse model was used to assess lipid metabolism parameters, TMAO levels, and liver flavin monooxygenase 3 (FMO3) mRNA expression. Blood samples from healthy individuals and psoriatic patients were collected to measure serum TMAO levels and lipid profiles. To clarify the role of TMAO in the lipid metabolism disorder of mice with psoriasis model, exogenous TMAO, choline, or 3,3-dimethyl-1-butanol (DMB) were administered via intraperitoneal injections or diet in IMQ-treated mice. Liver tissues from the mouse models were subjected to RNA sequencing to identify TMAO-regulated signaling pathways. RESULTS: IMQ-induced psoriatic mice exhibited abnormal glucose, insulin, and lipid levels. IMQ treatment also downregulated the hepatic mRNA expression of glucose transporter 2 (Glut2) and silence information regulator 1 (Sirt1), while upregulating glucose transporter 4 (Glut4) and peroxisome proliferator-activated receptor gamma (PPARγ). Elevated serum TMAO levels were observed in both psoriatic patients and IMQ-treated mice. Additionally, liver FMO3 mRNA expression was increased in the psoriatic mouse model. In patients, TMAO levels positively correlated with Psoriasis Area and Severity Index (PASI) scores, serum triglyceride (TG), and total cholesterol (TC) levels. The intraperitoneal injection of TMAO exacerbated lipid dysregulation in IMQ-treated mice. A choline-rich diet further aggravated lipid abnormalities and liver injury in psoriatic mice, whereas DMB treatment alleviated these effects. RNA-Seq analysis demonstrated that TMAO upregulated hepatic microRNA-122 (miR-122), which may suppress the expression of gremlin 2 (GREM2), thus contributing to lipid metabolism disorder. CONCLUSIONS TMAO may promote lipid metabolism dysregulation in psoriasis by modulating the hepatic miR-122/GREM2 pathway.
Animals ; Methylamines/blood* ; Mice ; Psoriasis/chemically induced* ; Lipid Metabolism/drug effects* ; Humans ; Male ; Liver/metabolism* ; Female ; Oxygenases/genetics* ; Disease Models, Animal ; Lipid Metabolism Disorders/etiology* ; Adult ; Mice, Inbred C57BL