Objective To investigate the therapeutic potential of human umbilical cord-derived mesenchymal stem cells(hUCMSCs)in modulating the cGAS-STING-NF-κB signaling pathway in chronic intermittent hypoxia(CIH)mice.Methods Twenty-four C57BL/6 mice were divided into the control group,the model group,the hUCMSCs group and the hUCMSCs+STING agonist(DMXAA)group,with 6 mice in each group.Except for the control group,the other groups were exposed to hypoxic conditions for 8 hours daily for a total of 8 weeks to establish the CIH mouse model.After 8 weeks,mice were anesthetized for cardiac blood collection followed by euthanasia and lung tissue collection.Serum levels of IL-6,TNF-α,IL-1β and IL-17A were measured by ELISA.Pulmonary inflammatory infiltration and collagen deposition were assessed by HE and Masson staining.E-Cadherin and α-SMA expression levels were evaluated by immunohistochemistry.Expression levels of cGAS,STING and NF-κB mRNA were detected by RT-qPCR,while protein expression levels of E-Cadherin,N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB were analyzed by Western blot assay.Results Compared with the control group,levels of IL-6,IL-1β,TNF-α and IL-17A increased in the model group,inflammation and fibrosis scores increased,mRNA expression levels of cGAS,STING and NF-κB increased,and protein expression levels of N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB increased.In contrast,E-Cadherin protein expression was significantly decreased(P＜0.05).Compared with the model group,IL-6,IL-1β,TNF-α and IL-17A decreased in the hUCMSCs group,mRNA expression levels of cGAS,STING and NF-κB were decreased,protein expression levels of N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB were also decreased.Meanwhile,E-Cadherin protein expression was significantly increased(P＜0.05).STING activator DMXAA reversed the protective effects of hUCMSCs in CIH mice(P＜0.05).Conclusion Intravenous administration of hUCMSCs alleviates pulmonary inflammatory infiltration and epithelial-mesenchymal transition in mouse model of intermittent hypoxia,which may be related to the down-regulation of the cGAS-STING-NF-κBsignaling pathway.

Sleep-related breathing disorders(SBDs)are a group of disorders characterized by abnormal breathing patterns during sleep,with obstructive sleep apnea(OSA)being the most common type.Pulmonary hypertension(PH)is characterized pathophysiologically by pulmonary vasoconstriction and vascular remodeling,with initial clinical diagnosis typically relying on echocardiography.SBDs and PH have a bidirectional relationship in many aspects,with shared pathophysiological mechanisms such as hypoxia,inflammation and oxidative stress being common.The percentage of sleep time with nocturnal oxygen saturation＜0.90(T90)can assess the risk of pulmonary hemodynamic and right ventricular function deterioration in OSA patients,but this indicator still has limitation in clinical application.Currently,there is limited domestic research on the bidirectional relationship between SBDs and PH in China.This article reviews the bidirectional relationship between SBDs and PH in terms of epidemiology,potential mechanisms,screening and treatment.It also analyzes the relevance of OSA and PH based on current domestic and international clinical studies,providing a theoretical basis for further exploration of these two diseases.

Sleep-related breathing disorders(SBDs)are a group of disorders characterized by abnormal breathing patterns during sleep,with obstructive sleep apnea(OSA)being the most common type.Pulmonary hypertension(PH)is characterized pathophysiologically by pulmonary vasoconstriction and vascular remodeling,with initial clinical diagnosis typically relying on echocardiography.SBDs and PH have a bidirectional relationship in many aspects,with shared pathophysiological mechanisms such as hypoxia,inflammation and oxidative stress being common.The percentage of sleep time with nocturnal oxygen saturation＜0.90(T90)can assess the risk of pulmonary hemodynamic and right ventricular function deterioration in OSA patients,but this indicator still has limitation in clinical application.Currently,there is limited domestic research on the bidirectional relationship between SBDs and PH in China.This article reviews the bidirectional relationship between SBDs and PH in terms of epidemiology,potential mechanisms,screening and treatment.It also analyzes the relevance of OSA and PH based on current domestic and international clinical studies,providing a theoretical basis for further exploration of these two diseases.

Objective To investigate the therapeutic potential of human umbilical cord-derived mesenchymal stem cells(hUCMSCs)in modulating the cGAS-STING-NF-κB signaling pathway in chronic intermittent hypoxia(CIH)mice.Methods Twenty-four C57BL/6 mice were divided into the control group,the model group,the hUCMSCs group and the hUCMSCs+STING agonist(DMXAA)group,with 6 mice in each group.Except for the control group,the other groups were exposed to hypoxic conditions for 8 hours daily for a total of 8 weeks to establish the CIH mouse model.After 8 weeks,mice were anesthetized for cardiac blood collection followed by euthanasia and lung tissue collection.Serum levels of IL-6,TNF-α,IL-1β and IL-17A were measured by ELISA.Pulmonary inflammatory infiltration and collagen deposition were assessed by HE and Masson staining.E-Cadherin and α-SMA expression levels were evaluated by immunohistochemistry.Expression levels of cGAS,STING and NF-κB mRNA were detected by RT-qPCR,while protein expression levels of E-Cadherin,N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB were analyzed by Western blot assay.Results Compared with the control group,levels of IL-6,IL-1β,TNF-α and IL-17A increased in the model group,inflammation and fibrosis scores increased,mRNA expression levels of cGAS,STING and NF-κB increased,and protein expression levels of N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB increased.In contrast,E-Cadherin protein expression was significantly decreased(P＜0.05).Compared with the model group,IL-6,IL-1β,TNF-α and IL-17A decreased in the hUCMSCs group,mRNA expression levels of cGAS,STING and NF-κB were decreased,protein expression levels of N-Cadherin,α-SMA,Vimentin,cGAS,STING and NF-κB were also decreased.Meanwhile,E-Cadherin protein expression was significantly increased(P＜0.05).STING activator DMXAA reversed the protective effects of hUCMSCs in CIH mice(P＜0.05).Conclusion Intravenous administration of hUCMSCs alleviates pulmonary inflammatory infiltration and epithelial-mesenchymal transition in mouse model of intermittent hypoxia,which may be related to the down-regulation of the cGAS-STING-NF-κBsignaling pathway.

Objective:To explore the clinical efficacy and safety of moderate-dose glucocorticoid treatment in patients with advanced thymoma.Methods:A retrospective analysis was conducted on clinical data of 56 patients with thymoma who received glucocorticoid treatment at Beijing Tongren Hospital, Capital Medical University, from January 2018 to March 2023. Among them, there were 33 males and 23 females; aged from 28 to 72 years old, with a median age of(43.8±11.2)years old. There were 16 cases of type B1 thymoma, 23 cases of type B2, and 17 cases of type B3. There were 17 cases with myasthenia gravis and 1 case with pure red blood cell aplasia. All patients had received radiotherapy or chemotherapy. Patients received moderate-dose glucocorticoid treatment(50 mg/day), and tumor response was evaluated by CT scan after 2 weeks of treatment. The tumor treatment effect and adverse reactions were recorded.Results:Among the patients, 22 cases achieved partial remission, and 3 cases achieved complete remission, resulting in an overall objective response rate (ORR) of 44.6%. Among them, 23 patients had type B2 thymoma, with 17 achieving partial remission and 3 achieving complete remission, resulting in an ORR of 87.0%. Among the 16 patients with type B1 thymoma, 5 achieved partial remission. No efficacy was observed in 17 patients with type B3 thymoma. The follow-up period ranged from 2 to 26 months, and 2 patients experienced thymoma recurrence.Conclusion:Moderate-dose glucocorticoid treatment demonstrates effective and safe outcomes in advanced or invasive thymoma, particularly for the treatment of type B2 thymoma.

Objective:Analyzed the clinicopathological features of thymoma with alopecia areata, and discussed the pathogenesis and treatment methods.Methods:The clinicopathologic data of patients with thymoma who underwent surgery from August 1, 2015 to July 31, 2020 in Beijing Tongren Hospital, Capital Medical University were reviewed. Transversally analyzed the patients of thymoma with alopecia areata and longitudinally compared with the patients of thymoma without alopecia areata after 1﹕10 matched by propensity score matching.Results:A total of 252 patients of thymoma were enrolled, including 6 patients with alopecia areata, accounting for 2.38%. The anti-AchR antibody, CD4 + /CD8 + T inversion in serum and myasthenia gravis were present in the all 6 thymoma patients with alopecia areata, which were significantly higher than those in the group of thymoma without alopecia areata. Besides myasthenia gravis, the proportion of complicated with other autoimmune diseases in thymoma patients with alopecia areata was significantly higher than that of thymoma patients without alopecia areata[83.33%(5/6) vs. 20.00%(12/60), P=0.003]. After operation, 5 patients’ alopecia areata were improved in 6 thymoma patients with alopecia areata(83.33%, 5/6). Conclusion:The thymoma patients with alopecia areata always complicated with myasthenia gravis and other autoimmune diseases. The pathogenesis may be associated with autoimmune CD8 + T lymphocytes produced by thymoma. At present, surgery is still the most effective way to improve thymoma-associated alopecia areata.

Objective:To explore the effect of group education intervention strategy based on harmonious nursing theory on understanding and application of pelvic floor knowledge and exercise skills in first gestation women, so as to promote the early recovery of pelvic floor function in postpartum women.Methods:This study was a quasi-experimental study. A total of 80 first gestation women in the pregnant women′s school of the First Hospital of Shanxi Medical University were selected as the research objects, 40 women from April to May 2023 were involved in the control group and 40 women from June to July 2023 were involved in the intervention group. The control group was given routine health education, while the intervention group was given group educational nursing intervention based on harmonious nursing theory. The Primary Prevention of Female Pelvic Floor Dysfunction-self-care Ability Scale was used to evaluate and compare the primary prevention self-care ability of pelvic floor dysfunction among pregnancy 1-4 weeks between the two groups before and after pregnancy intervention. Pelvic floor muscle strength was measured and pelvic floor function exercise compliance was evaluated during outpatient follow-up at 42-49 days postpartum (hereinafter referred to as postpartum 42 days) to evaluate and compare the rehabilitation effect of pelvic floor skills exercise between the two groups at 42 days postpartum.Results:Finally, the control group was (29.97 ± 3.68) years old involved 38 cases, and the intervention group was (29.79 ± 3.66) years old involved 38 cases. There was no significant difference in self-care ability score of primary prevention of pelvic floor dysfunction between the two groups before intervention ( P>0.05). After pregnancy intervention, the scores of self-care knowledge, self-care responsibility, self-care skills, self-regulation and total score of the intervention group were (58.13 ± 6.46), (11.73 ± 1.18), (10.16 ± 0.86), (29.21 ± 2.74) and (109.21 ± 8.92) points, respectively, which were higher than the control group (47.76 ± 4.25), (11.05 ± 1.09), (8.82 ± 1.78), (27.34 ± 2.18), (94.97 ± 6.46) points, and the differences between the two groups were statistically significant ( t values were - 8.26 - - 2.63, all P<0.05). In the intervention group, the maximum value of the fast muscle stage and the mean value of the slow muscle stage of the comparison of pelvic floor muscle strength between the two groups 42 days after delivery were 48.25(44.75, 53.45)μV and 31.00 (27.33, 34.23) μV, respectively, which were higher than the control group 36.80 (32.25, 44.28) μV and 22.40 (19.28, 25.88) μV, the differences between the two groups were statistically significant ( Z = - 4.98, - 5.37, both P<0.01). There was no significant difference in the average value of the pre-resting stage and the average value of the post-resting stage between the two groups ( P>0.05). Comparison of pelvic floor functional exercise compliance between the two groups showed that in the intervention group, the proportion of good compliance was 73.7% (28/38), and the proportion of general compliance was 26.3% (10/38), while in the control group, the proportion of general compliance was 86.8% (33/38) and the proportion of good compliance was 7.9% (3/38). The difference between the two groups was statistically significant ( χ2 = 34.46, P<0.01). Conclusions:Application of the theory of harmonious nursing group educational nursing intervention was carried out on the first gestation women, can effectively improve the first gestation women during pregnancy pelvic floor functional exercise primary prevention self-care ability level, strengthen puerperal women pelvic floor muscle, improve the puerperal pelvic floor functional exercise adherence, coordination and optimization of the first gestation women early for pelvic floor functional rehabilitation nursing process.

Objective:To explore the prognostic risk factors of thymoma patients after resection, and establish a novel nomogram to predict progression free survival(PFS) of patients with thymoma.Methods:A retrospectively analysis was performed on clinicopathological datas of 267 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital from January 2010 to December 2019. The univariate and multivariate Cox risk ratio models were used to analyze the related factors that might affect PFS, and the prediction nomogram of PFS after thymoma resection was established using the screened independent risk factors. Then the predictive ability of the model was evaluated. Results:The univariate analysis showed that age, type of surgery, completeness of resection, WHO histologic classification, TNM stage and postoperative adjuvant therapy were significantly correlated with PFS after thymoma resection( P<0.05). The multivariate analysis showed that only age and TNM stage were independent prognostic factors affecting PFS after thymoma resection( P<0.05). The concordance index( C- index) of the prediction model for the prognosis of thymoma patients established by this method was 0.866(95% CI: 0.809-0.923), which had remarkable predictive efficiency. Conclusion:The nomogram model is constructed and verified based on age and TNM stage, excluding the interference of other clinicopathological factors on prognosis assessment, and which is convenient for clinicians to quickly and individually evaluate the prognosis of patients after thymoma resection.

Objective:To seek the effect of group education under the BOPPPS model(bridge-in, objective, pre-assessment, participatory learning, post-assessment, summary) on the breastfeeding competency of first gestation women, to improve the breastfeeding competency of first gestation women and promote the realization of postpartum breastfeeding.Methods:Eighty-one first gestation women were chosen from the gestation class of the First Affiliated Hospital of Shanxi Medical University, the quasi-experimental research method was adopted, 40 women from January to February 2022 were involved in the control group and 41 women from May to June 2022 were involved in the intervention group. The control group was assigned common education, while the intervention group was assigned group education based on BOPPPS model. Breastfeeding Competency Scale (BCS) and breastfeeding family support questionnaire were used to compare breastfeeding competency and family support level of the two groups before and after intervention, and the skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days after delivery were compared between the two groups.Results:Before intervention, there was no significant difference in breastfeeding competency and family support level between the two groups (all P>0.05). After 4 weeks of intervention, the scores of breastfeeding competency and family support were (147.59 ± 13.50), (3.16 ± 0.18) points in the intervention group, more than those in the control group (125.48 ± 16.87), (2.87 ± 0.22) points, the differences were statistically significant between the two groups ( t=-6.52, -6.30, both P<0.05). The skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days postpartum were 75.6%(31/41), 53.7%(22/41) in the intervention group, more than those in the control group 52.5%(21/40), 30.0%(12/40), the differences were statistically significant between the two groups ( χ 2=4.71, 4.65, both P<0.05). Conclusions:Group education based on BOPPPS model can improve the level of breastfeeding competency and family support of gestation women. It increases the skin contact rate, and plays a good role in promoting the increase of pure breastfeeding rate.

Objective:To explore the prognosis and clinical risk factor of thymoma patients after resection.Methods:A retrospectively analysis of 154 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital (Myasthenia Gravis & Thymoma Diagnosis and Treatment Center, Capital Medical University) from January 2005 to December 2015, and then the progress-free survival was calculated by Kaplan- Meier method, the differences between curves were analyzed by log- rank test. There were 74 males and 80 females; the median age was 52(22-77)years. 121 cases(78.6%)complicated with myashenia gravis. Thymoma cases were classfied into 5 cases A, 35 cases AB, 27 cases B1, 56 cases B2 and 31 cases B3 respectively. There were 80, 16, 45 and 13 patients with Masaoka-Koga type Ⅰ-Ⅳ, respectively. 122 cases were treated by thoracoscopic assisted operation, 32 cases were treated by median sternum. The risk factors about group of gender, age, thymoma-associated MG (Myasthenia Gravis), completeness of resection, histologic type and Masaoka-Koga stage were calculated by Cox regression analysis. Results:The overall 1-, 5- 10-year progress-free survival rate of 154 cases were 98.7%, 88.3%, and 78.7%, respectively. The adverse prognostic factors for progress-free survival were age, completeness of resection, WHO histologic classification and Masaoka-Koga stage at univariate analysis. The age, WHO histologic classification and Masaoka-Koga stage were the independent risk factors at multivariate analysis.Conclusion:For thymoma, we suggest early discovery and early treatment. For the thymoma patients who are available for surgical treatment, all the tumor, thymus and surrounding adipose tissue should be resected. For the thymoma patients whose tumors cannot excise completely, adjuvant radiotherapy can reduce the risk for tumor recurrence after resection. For patients with thymoma after surgery, MG treatment is particularly critical for prognosis.