Objective:To conduct a scoping review of the role responsibilities and competencies of oncology nurse specialist in the management of cutaneous immune-related adverse events (cirAEs), with a view to providing scientific guidance and reference for nursing practice in the field of oncology immunotherapy.Methods:Using the scoping review methodology as the framework, the relevant literatures on oncology nurse specialist in the management of cirAEs in databases including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biology Medicine from their inception to September 20, 2024 were systematically searched. Two researchers independently screened the included literature, extracted information, and conducted a summary analysis.Results:A total of 24 articles were included. Based on the summary and categorization of the literature, six categories were identified, including dynamic monitoring and assessment, classification and intervention of cirAEs, precise symptom management, multidisciplinary management, continuity of care, and specialized training, along with 18 related responsibility items.Conclusions:Oncology nurse specialist plays a significant role in the management of cirAEs. In the future, it should draw on the training models and curricula of advanced practice oncology nurses from abroad to optimize oncology nurse specialist training and nursing practices, thereby enhancing the professionalism of nursing services and the quality of patient care.

Objective:To explore the role of LncRNA NKILA/NF-κB signal pathway in the injury of keratinocytes in oral lichen planus(OLP).Methods:Immortalized human epidermal cells(HaCaTs)were induced by bacterial lipopolysaccharide(LPS)to establish an in vitro cell model of OLP.HaCaTs stably overexpressing NKILA were constructed by lentivirus method.HaCaTs were divided into 4 groups:Control group,Control+LPS group,empty vector infected with lentivirus(NC)+LPS group,overexpressed NKILA(OE)+LPS group.Cell proliferation,apoptosis,total superoxide dismutase(SOD)activity,lipid malondialdehyde oxide(MDA),reactive oxygen species(ROS),expression of related inflammatory factors,p65(nuclear,mass)and NF-κB signaling pathway related protein expression and p65 expression and localization were respectively detected.Results:Compared with Control group,the expression of NKILA,cell proliferation activity and SOD enzyme activity in Control+LPS group were significantly de-creased,while the apoptosis rate,MDA,ROS,IL-6,IL-1β,TNF-α and p65(nuclear and plasma)expression levels were signifi-cantly up-regulated(P＜0.05).Compared with Control+LPS group,the cell proliferation activity and SOD activity were increased in OE+LPS group,and the expression levels of cell apoptosis,MDA,ROS,IL-6,IL-1β,TNF-α and p65(nuclear and plasma)were significantly decreased(P＜0.05),and the localization of p65 protein in the nucleus was significantly decreased in OE+LPS group.Conclusion:LncRNA NKILA may reduce the damage of keratinocytes in oral lichen planus by inhibiting NF-κB signal pathway.

Objective To investigate the mechanism by which fatty acid-binding protein 4(Fabp4)regulates neuroinflamma-tion after traumatic brain injury(TBI).Methods Adult wild-type C57 male mice were randomly divided into sham group and TBI group,with 6 mice in each group.Fabp4 knockout(Fabp4-/-)male mice were randomly divided into sham group and TBI group,with 6 mice in each group.Western blot was used to detect the expression levels of Fabp4,IL-1β,TNF-α,NLRP3,Caspase-1,and ASC proteins in brain tissue from each group.Brain water content was assessed using the wet-to-dry weight method,and neuronal damage was evaluated by Nissl staining.Immunofluorescence double staining was performed to detect the expression of microglial M1 polarization markers(CD86 and iNOS),M2 polarization marker(CD206),and astrocytic polarization marker(C3).Enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of pro-inflammatory factors IL-1βand TNF-α in the culture supernatant of BV2 cells.MitoSOX red fluorescence staining was used to assess mitochondrial ROS levels in BV2 cells,and ELISA was employed to determine the levels of malondialdehyde(MDA)and 8-hydroxy-2'-deox-yguanosine(8-OHdG)in brain tissue after TBI.Immunofluorescence was performed to detect NLRP3 protein expression in BV2 cells.Results In wild-type mice,the expression of Fabp4 protein in the injured brain region was significantly increased at 12 hours post-TBI compared to the sham group(P＜0.01)and peaked at 3 days post-injury(P＜0.01).Compared to the wild-type TBI group,protein expression levels of IL-1β and TNF-α were reduced(P＜0.01),and brain water content was decreased(P＜0.05)in Fabp4-/-mice from TBI group.Nissl staining revealed that the volume of brain damage following TBI was reduced af-ter Fabp4 deletion(P＜0.05).Immunofluorescence experiments showed that M1 polarization of microglia was inhibited after Fabp4 deletion(P＜0.01),and M2 polarization was promoted(P＜0.01).Fabp4 deletion had no significant effect on astrocytic polarization.BV2 cell experiments demonstrated that the levels of IL-1β and TNF-α in the culture supernatant were increased(P＜0.01)after Fabp4 overexpression,and mitochondrial ROS production was elevated(P＜0.01).After LPS stimulation,Fabp4 protein expression in BV2 cells was increased(P＜0.01),the levels of IL-1β and TNF-α(P＜0.05)as well as mitochondrial ROS(P＜0.01)were reduced after BMS309403 intervention.In the mouse model,the levels of MDA and 8-OHdG in the brain tissue of Fabp4-/-TBI mice were significantly lower than those of wild-type TBI mice(P＜0.01).The levels of NLRP3,ASC,and Caspase-1 proteins in BV2 cells were increased after Fabp4 overexpression(P＜0.01),while ROS scavenger treatment reversed this effect(P＜0.01,P＜0.05,P＜0.01).In the mouse model,the levels of NLRP3,ASC,and Caspase-1 proteins in Fabp4-/-TBI mice were significantly lower than those in wild-type TBI mice(P＜0.01,P＜0.05,P＜0.01).Conclusion Fabp4 pro-motes microglia-induced neuroinflammation after TBI by regulating mitochondrial ROS production and NLRP3 inflammasome formation.These findings suggest that Fabp4 may serve as a potential therapeutic target for TBI.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.

Home rehabilitation is the main rehabilitation model for elderly patients with hip fractures in China, and the application of digital health technology shows great potential in improving the quality of home rehabilitation for this population. This paper describes the concept of digital health technology, the current application status of different types of digital health technology in home rehabilitation for elderly patients with hip fractures, and discusses existing issues and future prospects, aiming to provide a reference for digital home rehabilitation nursing for elderly hip fracture patients.

Nanomaterials have been used in a variety of industries recently,involving foods,chemi-cals and biomedicine.There are multiple routes through which humans are exposed to nanomaterials,and their toxic effects deserve more attention.In vivo studies have confirmed that nanomaterials expo-sure can lead to toxicity in such target organs as the heart,liver,kidney,skin and nerve.The toxicity mechanism is related to changes in organelles such as the endoplasmic reticulum,lysosomes and mito-chondria.Increasing studies suggest that mitochondria are critical targets for the toxicity of nanomaterials.Mitochondrial biogenesis serves as an important mechanism for maintaining mitochondrial homeostasis,which plays a vital role in the process of nanomaterials-induced cellular toxicity.This article summarizes the current research on the effects of nanomaterials on mitochondrial biogenesis,and elaborates the mechanism through which nanomaterials disrupt mitochondrial biogenesis by triggering oxidative stress,upsetting the homeostasis of calcium ion and disturbing toxicity pathways.This article is expected to provide a reference for toxicity testing and risk assessment of nanomaterials.

Objective:To investigate the feasibility and clinical effects of ultra early enteral nutrition (≤24 h) in critically ill children supported by extracorporeal membrane oxygenation (ECMO).Methods:A retrospective cohort study was conducted. Clinical data of 43 critically ill children who received ECMO support in the pediatric intensive care unit (PICU) of Shanghai Children′s Hospital from January 2016 to December 2023 were collected, including general information, nutritional support modalities, and enteral nutrition tolerance. Based on the timing of enteral nutrition initiation, patients were divided into the within 24 h enteral nutrition group and the after 24 h enteral nutrition group. Nutritive indicators, nutritional intake, duration of ECMO support, duration of mechanical ventilation duration, and mortality rates were compared between the 2 groups using the two independent sample t test, Mann-Whitney U test, χ2 test and Fisher′s exact test. Results:Among the 43 children, 25 were male and 18 were female, with an age of 47 (18, 97) months. There were no statistically significant differences between the within 24 h enteral nutrition group (21 cases) and the after 24 h enteral nutrition group (22 cases) in terms of age, body mass index Z score, total protein, albumin, hemoglobin levels before ECMO support, duration of ECMO support, duration of mechanical ventilation, length of PICU stay, number of enteral nutrition intolerance events, number of enteral nutrition interruption, or mortality rate (all P>0.05). The protein intake adequacy rate during ECMO support was higher in the within 24 h enteral nutrition group than in the after 24 h enteral nutrition group (0 (0, 21%) vs. 0 (0, 0), U=175.00, P<0.05). Conclusions:Ultra early enteral nutrition is safe for children supported by ECMO. Initiating enteral nutrition within 24 h can increase the proportion of days with adequate protein intake in ECMO children without increasing the occurance of enteral nutrition intolerance or interruptions.

Objective:To observe the application of biofeedback instrument in patients with Alzheimer's disease(AD)and the effect of that on cognitive conversion of them.Methods:A total of 150 AD patients who admitted to Shanghai Mental Health Center from February 2022 to February 2024 were selected.The patients were divided into the observation group(75 cases)and the control group(75 cases)according to randomized numerical table.The control group received medicine treatment combined with conventional training,while the observation group received the treatment with biofeedback instrument on the basis of control group.The application effect and cognitive conversion of two groups were compared.Results:After treatment,the compliance rate and satisfaction rate of family's members for treatment results in observation group were higher than those in control group,and the differences of them between two groups were significant(x2=15.213,6.313,8.451,P＜0.05).Compared with the various indicators of two groups before the biofeedback instrument was applied,they were improved after it was applied.The β-wave and sensorimotor rhythm(SMR)-wave of electroencephalogram,Mini-Mental State Examination(MMSE)scores,Montreal Cognitive Assessment(MoCA)scores of observation group were higher than those of control group,and the θ-wave and the scores of Activity of Daily Living Scale(ADL)were lower than those of control group,and the differences of them between two groups were significant(t=6.094,5.315,3.973,4.447,6.362,6.869,P＜0.05),respectively.There was no significant difference in the rate of adverse reactions between the two groups(P＞0.05).Conclusion:The application of biofeedback instrument in AD patients can promote cognitive conversion and improve self-care ability,which has higher safety.

Home rehabilitation is the main rehabilitation model for elderly patients with hip fractures in China, and the application of digital health technology shows great potential in improving the quality of home rehabilitation for this population. This paper describes the concept of digital health technology, the current application status of different types of digital health technology in home rehabilitation for elderly patients with hip fractures, and discusses existing issues and future prospects, aiming to provide a reference for digital home rehabilitation nursing for elderly hip fracture patients.

Kirsten rat sarcoma viral oncogene homolog(KRAS)protein inhibitors are a promising class of thera-peutics,but research on molecules that effectively penetrate the blood-brain barrier(BBB)remains limited,which is crucial for treating central nervous system(CNS)malignancies.Although molecular generation models have recently advanced drug discovery,they often overlook the complexity of bio-logical and chemical factors,leaving room for improvement.In this study,we present a structure-constrained molecular generation workflow designed to optimize lead compounds for both drug effi-cacy and drug absorption properties.Our approach utilizes a variational autoencoder(VAE)generative model integrated with reinforcement learning for multi-objective optimization.This method specifically aims to enhance BBB permeability(BBBp)while maintaining high-affinity substructures of KRAS in-hibitors.To support this,we incorporate a specialized KRAS BBB predictor based on active learning and an affinity predictor employing comparative learning models.Additionally,we introduce two novel metrics,the knowledge-integrated reproduction score(KIRS)and the composite diversity score(CDS),to assess structural performance and biological relevance.Retrospective validation with KRAS inhibitors,AMG510 and MRTX849,demonstrates the framework's effectiveness in optimizing BBBp and highlights its potential for real-world drug development applications.This study provides a robust framework for accelerating the structural enhancement of lead compounds,advancing the drug development process across diverse targets.