To investigate the changes in peripheral blood immune cells before and after the onset of septic shock in patients with malignant tumors, and to analyze the relationship between these immune cells and patient prognosis.

Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.

Objective To explore the feasibility of magnetic compression technique (MCR) in the treatment of severe single mid-ureteral stricture in a rabbit model. Methods After 10 female New Zealand rabbits were selected, the distal end of the right ureter was ligated with silk thread. Two weeks after the operation, when the right ureter was dilated, the mid-ureter was ligated again with silk thread to create a severe single mid-ureteral stricture animal model. Longitudinal incisions were made at the upper and lower ends of the ligation site, and cylindrical NdFeB magnets with central holes (sub-magnets and main magnets) were placed to anastomose and recanalize the mid-ureteral stricture. The magnets were adjusted to the appropriate position to automatically align and attract each other. The longitudinal incision sites of the ureter were sutured with 6-0 Prolene thread, and the abdominal cavity was closed layer by layer. The operation time was recorded. X-ray films were taken every two days to confirm the position of the magnets and record the time of magnet detachment. Three weeks after the operation, the anastomotic specimens were obtained, and the formation of the anastomosis was evaluated with gross observation and histological staining. Results Two weeks after ligation, all experimental rabbits showed obvious dilation of the right ureter. The mid-ureteral ligation and placement of the male and female magnets were successfully completed in all 10 experimental rabbits, with an operation time of (24.00±5.15)minutes. The male and female magnets attracted each other well. X-ray examination showed that the magnets detached and entered the distal ureter (14.0±1.9) days after magnetic compression. The recanalization of the severe single mid-ureteral stricture was successfully achieved. The gross specimens and histological examination of the anastomosis showed that the anastomosis remained patent and the mucosal healing was good. All experimental rabbits survived well after the operation without serious complications. Conclusion MCT provides a new idea and novel method for the treatment of mid-ureteral stricture. This study confirmed the feasibility of this technique in treating severe single mid-ureteral stricture in a rabbit model. The operation is relatively simple and has potential for clinical application.

Transfusion technicians constitute a core workforce in safeguarding blood safety, and the quality of their standardized training directly affects the operational efficiency of the blood services. At present, training programs for transfusion technicians across China have been developed in a diversified manner. Positive progress has been achieved in integrated theoretical and practical training, on-the-job faculty development, and regional collaborative training models. However, persistent challenges remain, including fragmented training providers, inconsistent training standards, limited coverage, and a disconnect between training and workforce utilization. Based on a review of current standardized training practice, this article systematically analyzes the structural challenges confronting current standardized training, and further proposes a framework for building a comprehensive training system, covering the definition and core components of standardized training, targeted improvement strategies and key assessment indicators. The study aims to facilitate the transformation of training for blood transfusion technicians in blood services from a project-based approach to an institutionalized model, and from fragmented implementation to a systematic framework.

Objective:To systematically analyze the current research landscape and development trends of 0.05% cyclosporine A (CsA) in the field of ocular surface diseases using bibliometric methods.Methods:Relevant literature on 0.05% CsA published between January 2000 and September 2024 was retrieved from the Web of Science Core Collection.A total of 244 articles that met the inclusion criteria were analyzed using the bibliometric visualization tool CiteSpace.The analysis included publication volume, core authors, research institutions and country distribution, keyword co-occurrence, burst detection, clustering, and co-citation patterns.Results:From January 2000 to September 2024, the overall number of publications showed a fluctuating upward trend, peaking in 2022.A total of 513 authors were identified, with Yoon Kyung Chul contributing the most publications.The research involved 331 institutions, with Chonnam National University and Harvard University showing outstanding performance.A total of 39 countries were involved, with the United States leading in publication volume (93 articles) and demonstrating high centrality and collaboration strength.China ranked fifth with 19 articles and has shown rapid growth in recent years.Keyword co-occurrence analysis revealed that the most central research themes were dry eye disease and 0.05% CsA.Other hotspots included allergic conjunctivitis, meibomian gland dysfunction, Sj?gren syndrome, and postoperative dry eye management.Clustering and timeline analyses indicated that research directions have expanded from basic therapy to novel formulations, combination treatments, and personalized approaches.Co-citation analysis showed that highly cited references had a significant influence om the field.Highly cited publications from the past three years reflected a sustained focus on novel formulations and long-term efficacy evaluation.Conclusions:0.05% CsA plays a crucial role in the treatment of various ocular surface diseases.Future research should focus on developing novel formulations, combination therapy strategies, and conducting large-scale, long-term clinical trials to optimize treatment outcomes and advance the field.

Objective:To analyze clinical characteristics of Mycoplasma pneumoniae-induced rash and mucositis in children. Methods:Clinical data were collected from children diagnosed with Mycoplasma pneumoniae -induced rash and mucositis in the Department of Dermatology, Capital Center for Children's Health, Captital Medical University from August 1, 2023, to December 1, 2023, and their clinical features were analyzed. Results:A total of 15 children with Mycoplasma pneumoniae-induced rash and mucositis were collected, including 8 males and 7 females, aged 4 to 12 years. They were clinically characterized by obvious mucositis, and skin lesions were relatively mild. Oral mucosal involvement was observed in 13 cases, including lip ulcers (12 cases), oral mucositis (7 cases), tongue ulcers (3 cases), and glossitis (1 case) ; ocular mucosal involvement was reported in 7 cases, including suppurative conjunctivitis (4 cases), and eyelid edema (3 cases) ; 3 children had vulvogenital mucosal involvement, including coronary sulcus ulcers (1 case), urethral meatus ulcers (1 case), labia minora ulcers (1 case), and perianal ulcers (1 case) ; 1 child had nasal mucosal ulcers. Skin lesions occurred on the upper limbs in 5 cases, on the lower limbs in 6 cases, on the face in 2 cases, on the vulva in 2 cases, as well as on the trunk in 1 case. The types of skin lesions included targetoid erythema in 11 cases, vesiculobullous lesions in 6 cases and atypical targetoid erythema in 2 cases. PCR for the detection of Mycoplasma pneumoniae in vesiculobullous fluids showed negative results in the 6 patients with vesiculobullous lesions. The patients received systemic and topical treatment with antibiotic agents and glucocorticoids, as well as supportive therapy. Main pulmonary symptoms as well as skin and mucosal lesions of the 15 children subsided within 3 weeks, and they all had a favorable prognosis, without obvious complications or sequelae. Conclusion:Mycoplasma pneumoniae-related skin and mucosal lesions predominantly present as mucositis, with mild or absent skin involvement. The disorder usually has a mild course, characterized by short disease duration and favorable prognosis.

Silver nanoparticles(AgNPs)are employed as disinfectants due to their extensive antimi-crobial properties,but their biosafety in the livestock industry has not been comprehensively as-sessed.In this study,16 Black-skin Red-crowned chickens aged 32 weeks were randomly divided in-to four groups and sprayed with AgNP solution at the concentration of 0,0.064,0.128 or 0.256 g/L,respectively,every 72 h in their coops for 30 d.The effects of AgNPs as the disinfectant on lung tissue in chicken were investigated through calculation of organ coefficients,observation of lung tissue sections,analysis of bronchoalveolar lavage fluid,measurement of inflammatory factors,de-tection of silver residue in lung tissue,and exploration of signaling pathways in pulmonary fibrosis.The results indicated that chickens in the 0.128 and 0.256 g/L AgNPs treatment groups showed the blurred pulmonary lobule boundaries,the destroyed alveolar structure,and the significant in-crease in pulmonary fibrosis.These pathological changes were accompanied by the decrease in lung organ coefficient,the reduced SP-C content,the increased total protein concentration in lavage flu-id,and the elevated LDH and silver content in lung tissue.The levels of IL-6 and TNF-α in the 0.128 and 0.256 g/L AgNPs treatment groups were significantly higher than the control group,which suggested that AgNPs exposure could induce the pulmonary inflammatory responses.High concentrations of AgNPs can trigger pulmonary tissue fibrosis,damaging the structure and func-tions of lungs.The relative mRNA expression levels of NF-κB in all AgNPs treatment groups,TGF-β in the 0.128 g/L AgNPs treatment group,and Smad3 in the 0.128 and 0.256 g/L AgNPs treatment groups were significantly higher than these in the control group,respectively.Spraying chickens with 0.128 or 0.256 g/L AgNPs for disinfection led to pulmonary deposition of AgNPs,causing direct structural and functional damages to the lungs.It could also induce the chronic pul-monary inflammation through the NF-κB pathway and promote the TGF-β/Smad3 pathway to in-crease collagen synthesis,leading to pulmonary fibrosis.Therefore,the application of high concen-trations of AgNPs in livestock farming requires careful consideration of their potential biological safety issues.

Objective:To analyze the characteristics of anonymous online dating and related factors of not being tested for HIV among men who have sex with men and to provide the basis for developing targeted HIV prevention strategies and intervention measures.Methods:Using a cross-sectional study design, respondents were recruited with the assistance of MSM social organizations from April to July 2023 in eight cities in Shandong Province. Snowball sampling, activity venues, and networks were employed, targeting a sample size of 400 people per city. A face-to-face questionnaire survey collected data on sociodemographic characteristics, drug use, sexual intercourse, and online informed dating. Blood samples were also collected for HIV and syphilis antibody testing.Results:In the past six months, 2 787 MSM sought homosexual partners through the Internet, and 78.26% (2 181/2 787) chose to make anonymous online dating. Before having homosexual sex with online sexual partners, 10.41% (290/2 787) of them did not ask each other about HIV infection status and 33.37% (930/2 787) of them not being tested for HIV. There were statistically significant differences in the distribution of age, marital status, household registration, education level, sexual orientation, ways to find male sexual partners, not asking online sexual partners about their HIV status before sexual intercourse, no mutual HIV testing with online sexual partners before sexual intercourse, and syphilis antibody between anonymous and non-anonymous online dating persons (all P<0.05). The results of multivariate logistic regression analysis showed that <25 years old (a OR=1.43, 95% CI: 1.15-1.77) and ≥35 years old age group (a OR=1.61, 95% CI: 1.29-2.01), people with no AIDS knowledge (a OR=2.37, 95% CI: 1.25-4.49), drug users (a OR=1.38, 95% CI: 1.17-1.63), online dating anonymous (a OR=2.19, 95% CI: 1.76-2.73), HIV antibody positive (a OR=3.61, 95% CI: 2.22-5.88) and no intervention services in the last 1 year (a OR=1.58, 95% CI: 1.05-2.38) were the related factors of MSM not being tested for HIV before having sexual intercourse through online dating. Conclusions:The phenomenon of anonymous online dating was common among MSM in Shandong Province, and the proportion of MSM not being tested for HIV before having sexual intercourse through anonymous online dating was relatively high. It is necessary to strengthen health publicity and promote informed dating in MSM.

Objective To explore the interaction between vitamin D(VD)and hemoglobin A1c(HbA1c)and its relationship with type 2 diabetes mellitus(T2DM)combined with osteoporosis(OP).Methods A total of 228 T2DM patients admitted to our hospital from February 2020 to April 2023 were selected and divided into OP group(n=65),osteopenia group(n=89)and T2DM group(n=74)according to the standard deviation of bone mineral density(BMD)decline.Logistic regression was used to analyze the relationship of 25-hydroxyvitamin D[25(OH)D]and HbA1c with OP.Restricted cubic spline model was used to analyze the dose-response relationship of 25(OH)D and HbA1c with OP in different genders.Results DM duration,fasting plasma glucose(FPG),C-telopeptide of type Ⅰ collagen,fasting insulin(FIns)and 2 hIns in the T2DM,osteopenia and OP groups were increased(P<0.05),while osteocalcin,25(OH)D,lumbar L1～L4,BMD of femoral neck and its proximal end,and total hip were decreased(P<0.05).The age and HbA1c in OP group were higher than those in T2DM and osteopenia groups(P<0.05),and the proportion of taking calcium preparations was lower than that in T2DM group(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,serum 25(OH)D(OR 0.145,95%CI 0.036～0.204)and HbA1c(OR 1.108,95%CI 1.013～1.140)were influencing factors of OP in T2DM patients.There was no nonlinear dose-response relationship between 25(OH)D,HbA1c and OP both in male and female T2DM patients.There were multiplication and additive interactions between serum 25(OH)D and HbA1c(P<0.05).Conclusions There is a multiplicative and additive interaction between serum 25(OH)D and HbA1c,both of which are risk factors for concurrent OP in T2DM patients.

Objective:To evaluate the diagnostic performance of fecal calprotectin (FC) in predicting endoscopic activity of ulcerative colitis (UC), and to compare it with high-sensitivity C reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) .Methods:A cross-sectional stydy was conducted. UC patients diagnosed at Peking Union Medical College Hospital between May 2023 and July 2025 were retrospective enrolled. Patients were divided into the endoscopically active group and endoscopic remission group according to endoscopic activity. FC levels were measured using latex-enhanced turbidimetric immunoassay (LETIA). Receiver operating characteristic (ROC) curves and logistic regression models were used to assess diagnostic efficacy. Subgroup analyses were conducted according to disease extent.Results:A total of 166 UC patients were enrolled, including 92 males and 74 females with the age of 40.00 (32.00, 52.00) years old and disease course 5.00 (2.00, 10.75) years. Forty-six patients were assigned to the active group, while the remaining 120 were assigned to the remission group. FC levels were significantly higher in the active group than in the remission group (620.72 μg/g vs. 29.00 μg/g, P < 0.001), with an AUC of 0.894 at a cutoff value of 122.54 μg/g. hsCRP and ESR had lower AUC (0.712 and 0.736, respectively). The combination of FC, hsCRP, and ESR slightly improved specificity (AUC 0.898). FC was strongly correlated with the endoscopic activity ( r =0.669, P < 0.001) but not with disease extent. Conclusions:FC measured by latex-enhanced turbidimetric immunoassay had comparable diagnostic accuracy to ELISA-based methods commonly used abroad, and provided a reference cutoff value of 122.54 μg/g. FC outperforms hsCRP and ESR in assessing intestinal inflammation in UC and it is less affected by disease extent, making it a reliable non-invasive biomarker for UC monitoring.