Objective:To investigate the effect of donor blood lipid levels and the degree of fat deposition on the pancreatic surface on the outcome of islet isolation.Method:A retrospective analysis was conducted on 171 cases of islet isolation data from organ donors between May 2015 and December 2024. According to the percentage of fat deposition area on the surface of the pancreatic capsule after trimming, the samples were divided into three groups: mild surface fat group (<30%, 60 cases) , moderate surface fat group (30%–70%, 55 cases) , and severe surface fat group (>70%, 56 cases). The modified Ricordi method was used to digest pancreatic tissue, and islets were purified by continuous density gradient centrifugation. The digestion efficiency, digestion time, islet yield (islet equivalent/quantity) , purity, score, and size were analyzed and compared among groups. One-way ANOVA was used for inter-group comparisons, and Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between blood lipid levels and islet isolation parameters.Result:The severe surface fat group had significantly higher pre-purification and post-purification islet equivalents, islet number, amount of digested pancreatic tissue, donor triglyceride levels, and low density lipoprotein (LDL) levels than the other groups (all P<0. 05) . Correlation analysis showed that LDL level was positively correlated with pre-purification islet equivalents (62 cases, r=0. 298, P=0. 019) and islet number (58 cases, r=0. 285, P=0. 030) . Donor high density lipoprotein (HDL) level was negatively correlated with post-purification islet equivalents (54 cases, r= – 0. 282, P=0. 039) ; donor triglyceride level was positively correlated with the amount of digested tissue (56 cases, r=0. 268, P=0. 046) and negatively correlated with purity (51 cases, r= - 0. 297, P=0. 035) ; donor very low density lipoprotein (VLDL) level was positively correlated with the amount of digested tissue (67 cases, r=0. 337, P=0. 005) and negatively correlated with purity (61 cases, r=- 0. 348 , P=0. 006) ; donor total cholesterol level was negatively correlated with pancreatic digestion efficiency (34 cases, r= - 0. 370, P=0. 032) , and the above differences were all statistically significant. Conclusion:Pancreata with heavier surface fat deposition can yield a higher number of islets. Meanwhile, donor blood lipid levels are correlated with islet isolation outcomes and can serve as important indicators for donor pancreas selection.

Objective:To explore the facilitators and barriers of home-based pulmonary rehabilitation in patients with pulmonary hypertension, in order to provide a basis for medical staff to formulate precise pulmonary rehabilitation interventions.Methods:The maximum variation purposive sampling method was used. From October to December 2023, a total of 12 patients with pulmonary hypertension attending the Department of Cardiology, Tianjin Medical University General Hospital, were selected as study participants and underwent semi-structured interviews. Colaizzi's phenomenological method was applied to analyze the data.Results:The facilitators of home-based pulmonary rehabilitation among patients with pulmonary hypertension included: capability factor (good exercise habits) ; opportunity factors (supervision and support from family members, professional guidance from medical staff) ; motivation factors (rehabilitation enthusiasm, perceived benefits of exercise). The barriers included: capability factors (obvious perception of physical symptoms, lack of knowledge about pulmonary rehabilitation, low level of e-health literacy) ; opportunity factors (unfavorable health environment, limited time) ; motivation factors (fear of exercise, lack of rehabilitation self-discipline) .Conclusions:Home-based pulmonary rehabilitation in patients with pulmonary hypertension is affected by multiple factors. Medical staff should adopt targeted interventions to promote patients' engagement in home-based pulmonary rehabilitation, with the aim of improving cardiopulmonary health, exercise endurance, and quality of life, thereby enhancing clinical prognosis.

Objective:To explore the facilitators and barriers of home-based pulmonary rehabilitation in patients with pulmonary hypertension, in order to provide a basis for medical staff to formulate precise pulmonary rehabilitation interventions.Methods:The maximum variation purposive sampling method was used. From October to December 2023, a total of 12 patients with pulmonary hypertension attending the Department of Cardiology, Tianjin Medical University General Hospital, were selected as study participants and underwent semi-structured interviews. Colaizzi's phenomenological method was applied to analyze the data.Results:The facilitators of home-based pulmonary rehabilitation among patients with pulmonary hypertension included: capability factor (good exercise habits) ; opportunity factors (supervision and support from family members, professional guidance from medical staff) ; motivation factors (rehabilitation enthusiasm, perceived benefits of exercise). The barriers included: capability factors (obvious perception of physical symptoms, lack of knowledge about pulmonary rehabilitation, low level of e-health literacy) ; opportunity factors (unfavorable health environment, limited time) ; motivation factors (fear of exercise, lack of rehabilitation self-discipline) .Conclusions:Home-based pulmonary rehabilitation in patients with pulmonary hypertension is affected by multiple factors. Medical staff should adopt targeted interventions to promote patients' engagement in home-based pulmonary rehabilitation, with the aim of improving cardiopulmonary health, exercise endurance, and quality of life, thereby enhancing clinical prognosis.

Objective:To investigate the effect of donor blood lipid levels and the degree of fat deposition on the pancreatic surface on the outcome of islet isolation.Method:A retrospective analysis was conducted on 171 cases of islet isolation data from organ donors between May 2015 and December 2024. According to the percentage of fat deposition area on the surface of the pancreatic capsule after trimming, the samples were divided into three groups: mild surface fat group (<30%, 60 cases) , moderate surface fat group (30%–70%, 55 cases) , and severe surface fat group (>70%, 56 cases). The modified Ricordi method was used to digest pancreatic tissue, and islets were purified by continuous density gradient centrifugation. The digestion efficiency, digestion time, islet yield (islet equivalent/quantity) , purity, score, and size were analyzed and compared among groups. One-way ANOVA was used for inter-group comparisons, and Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between blood lipid levels and islet isolation parameters.Result:The severe surface fat group had significantly higher pre-purification and post-purification islet equivalents, islet number, amount of digested pancreatic tissue, donor triglyceride levels, and low density lipoprotein (LDL) levels than the other groups (all P<0. 05) . Correlation analysis showed that LDL level was positively correlated with pre-purification islet equivalents (62 cases, r=0. 298, P=0. 019) and islet number (58 cases, r=0. 285, P=0. 030) . Donor high density lipoprotein (HDL) level was negatively correlated with post-purification islet equivalents (54 cases, r= – 0. 282, P=0. 039) ; donor triglyceride level was positively correlated with the amount of digested tissue (56 cases, r=0. 268, P=0. 046) and negatively correlated with purity (51 cases, r= - 0. 297, P=0. 035) ; donor very low density lipoprotein (VLDL) level was positively correlated with the amount of digested tissue (67 cases, r=0. 337, P=0. 005) and negatively correlated with purity (61 cases, r=- 0. 348 , P=0. 006) ; donor total cholesterol level was negatively correlated with pancreatic digestion efficiency (34 cases, r= - 0. 370, P=0. 032) , and the above differences were all statistically significant. Conclusion:Pancreata with heavier surface fat deposition can yield a higher number of islets. Meanwhile, donor blood lipid levels are correlated with islet isolation outcomes and can serve as important indicators for donor pancreas selection.

Objective:To explore the symptom clusters, core symptoms and bridging symptoms in the symptom network of early postoperative patients with laryngeal cancer.Methods:From January 2021 to April 2024, convenience sampling was used to select early postoperative patients with laryngeal cancer admitted to the Department of Otolaryngology at the First Affiliated Hospital of the University of Science and Technology of China as participants. The General Information Questionnaire and M.D. Anderson Symptom Inventory-Head & Neck were used for the survey. R language software was used to analyze symptom clusters, core symptoms, and bridging symptoms in early postoperative patients with laryngeal cancer.Results:A total of 300 questionnaires were distributed and 287 valid questionnaires were collected, with a valid response rate of 95.7%. Network analysis extracted three symptom clusters (oropharyngeal specific symptom cluster, shortness of breath and fatigue symptom cluster, and sleep emotion symptom cluster), among which the oropharyngeal specific symptom cluster was the most severe. Symptom network analysis showed a strong correlation between oropharyngeal pain and swallowing difficulties, distress and fatigue, and restless sleep and sadness. Shortness of breath exhibited the highest intensity centrality ( rs=1.29) and mediation centrality ( rb=96) in the symptom network. It was the core symptom and bridging symptom in the symptom network of early postoperative patients with laryngeal cancer. Conclusions:Early postoperative patients with laryngeal cancer have a severe oropharyngeal-specific symptom cluster, with shortness of breath being the core symptom and bridging symptom in the symptom network. Medical and nursing staff should focus on the mutual influence between early symptoms of patients after laryngectomy and correctly identify core symptoms and bridging symptoms to improve symptom management accuracy.

Objective:To explore the symptom clusters, core symptoms and bridging symptoms in the symptom network of early postoperative patients with laryngeal cancer.Methods:From January 2021 to April 2024, convenience sampling was used to select early postoperative patients with laryngeal cancer admitted to the Department of Otolaryngology at the First Affiliated Hospital of the University of Science and Technology of China as participants. The General Information Questionnaire and M.D. Anderson Symptom Inventory-Head & Neck were used for the survey. R language software was used to analyze symptom clusters, core symptoms, and bridging symptoms in early postoperative patients with laryngeal cancer.Results:A total of 300 questionnaires were distributed and 287 valid questionnaires were collected, with a valid response rate of 95.7%. Network analysis extracted three symptom clusters (oropharyngeal specific symptom cluster, shortness of breath and fatigue symptom cluster, and sleep emotion symptom cluster), among which the oropharyngeal specific symptom cluster was the most severe. Symptom network analysis showed a strong correlation between oropharyngeal pain and swallowing difficulties, distress and fatigue, and restless sleep and sadness. Shortness of breath exhibited the highest intensity centrality ( rs=1.29) and mediation centrality ( rb=96) in the symptom network. It was the core symptom and bridging symptom in the symptom network of early postoperative patients with laryngeal cancer. Conclusions:Early postoperative patients with laryngeal cancer have a severe oropharyngeal-specific symptom cluster, with shortness of breath being the core symptom and bridging symptom in the symptom network. Medical and nursing staff should focus on the mutual influence between early symptoms of patients after laryngectomy and correctly identify core symptoms and bridging symptoms to improve symptom management accuracy.

Objective:To explore the selection criteria of the donor for islet transplantation of Chinese people by analyzing the correlation between pancreas characteristics and success rate of islets isolation.Methods:Data from 113 cases of human islet isolation were collected. According to the result of islet isolation, the donors were divided into two groups, the success group(IEQ≥250 000, purification≥30%, and viability≥80%), and the failure group(IEQ<250 000, or purification<30%, or viability<80%). The modified Ricordi method was used to digest pancreas tissue, and the continuous density gradient method was performed to purify islets. The islets were identified by staining with the Dithizone(DTZ), the islets were analyzed for cell viability and purity.Results:The donor age in success group was significantly younger than failure group in the range of age eligible for this study( t=2.479, P=0.015). Pearson correlation showed that donor age was positively corelated with islet yield( r=-0.214, P=0.047). There was more fat on the pancreas surface in the successful islet isolation group( z=-2.007, P=0.045). The digestibility( t=2.133, P=0.035) and recovery rate( t=5.912, P=0.001) were elevated in success group. Conclusion:The pancreases from younger donors could obtain the higher-yielding islet, the pancreas with more surface fat or with higher weight was associated with islet isolation success in the scope covered by the inclusion criteria of this study.

Objective:To investigate the correlations of β cell dedifferentiation in non-diabetic subjects with risk factors for type 2 diabetes mellitus(T2DM).Methods:Immunofluorescence staining with insulin and β cell dedifferentiated marker ALDH1A3 was used to evaluate the β cell dedifferentiation levels in 38 non-diabetic and 23 T2DM. Correlation analyses were performed between β cell dedifferentiation levels and available clinical parameters including age, body mass index, HbA 1C level, triglycerides, and cholesterol levels in non-diabetic subjects. Results:β cell dedifferentiation level defined by the positive expression of ALDH1A3 in β cells(ALDH1A3 + INS + cell proportion) was significantly elevated in T2DM subjects( P<0.001). In PreD subjects, ALDH1A3 + INS + cells proportion were decreased( P=0.050) and negatively correlated with HbA 1C( r=-0.44, P=0.006), but not with age and body mass index. The analysis of correlation with lipidemic parameters showed that ALDH1A3 + INS + cells proportion was positively correlated with plasma total cholesterol level( r=0.39, P=0.045), but not plasma total triglyceride. Conclusion:ALDH1A3 + INS + cells were found to be decreased in prediabetes, suggesting that there may be enhanced β-cell identity in prediabetes to compensate for insulin secretion requirements; ALDH1A3 + INS + cells were elevated in people with high plasma total cholesterol levels, suggesting that total cholesterol may be one of the factors that induce β-cell dedifferentiation.

Background and Objectives: Adipose tissue-derived mesenchymal stem cells (ASCs) are recognized as an advantaged source for the prevention and treatment of diverse diseases including type 2 diabetes mellitus (T2DM). However, alterations in characteristics of ASCs from the aforementioned T2DM patients are still obscure, which also hinder the rigorous and systematic illumination of progression and pathogenesis. Methods: and Results: In this study, we originally isolated peripancreatic adipose tissue-derived mesenchymal stem cells from both human type 2 diabetic and non-diabetic donors (T2DM-ASCs, ND-ASCs) with the parental consent, respectively. We noticed that T2DM-ASCs exhibited indistinguishable immunophenotype, cell vitality, chondrogenic differentiation and stemness as ND-ASCs. Simultaneously, there’s merely alterations in migration and immunoregulatory capacities in T2DM-ASCs. However, differing from ND-ASCs, T2DM-ASCs exhibited deficiency in adipogenic and osteogenic differentiation, and in particular, the delayed cell cycle and different cytokine expression spectrum. Conclusions The conservative alterations of T2DM-ASCs in multifaceted characteristics indicated the possibility of autologous application of ASCs for cell-based T2DM treatment in the future.

Objective: To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. Methods: 16 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. Results: Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. Conclusions The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure.