ObjectiveTo establish a narrative nursing program for patients with advanced liver cancer based on the framework of Snyder’s hope theory， and verify its effectiveness. MethodsThe Johns Hopkins evidence-based nursing model and the Delphi method were employed to construct the narrative nursing program for patients with advanced liver cancer. Utilizing the convenience sampling method， 70 patients with advanced liver cancer hospitalized in the department of hepatobiliary surgery from May 2024 to May 2025 were selected and divided into the control group and the intervention group using the random number table method， with 35 patients in each group. The control group received routine nursing care， while the intervention group received the narrative nursing program based on Snyder’s hope theory for patients with advanced liver cancer. The Herth Hope Index， Connor-Davidson Resilience Scale （CD-RISC）， Self-Rating Anxiety Scale （SAS）， and Morisky Medication Adherence Scale-8 （MMAS-8） were used to compare the hope level， psychological resilience， anxiety， and medication adherence between the two groups before and after the intervention. Furthermore， nursing satisfaction was also compared. ResultsThe Delphi expert consultation results demonstrated high consistency among expert opinions， with an expert positive coefficient of 100%. Meanwhile， the authority coefficients （0.902， 0.912） and Kendall’s concordance coefficients （0.260， 0.283） were all satisfactory. Ultimately， a narrative nursing program was established， consisting of 3 primary indicators， 10 secondary indicators， and 19 tertiary indicators. Compared with the control group， the intervention group exhibited significant improvements in scores of the three dimensions regarding the hope level， the total score of psychological resilience， medication adherence， and nursing satisfaction after the intervention， and the anxiety score was markedly reduced. All differences were statistically significant （P<0.05）. ConclusionThe narrative nursing program for patients with advanced liver cancer developed in this study is scientific and reliable. Its clinical application can effectively improve the psychological status and treatment behaviors of patients with advanced liver cancer， profoundly reflect the ethical care for the humanistic needs of patients， and provide an evidence-based basis for optimizing the psychological support for this population.

Objective To investigate the effects and mechanisms of silica dust on the apoptosis of alveolar epithelial cell (AEC) through in vitro and animal experiments. Methods i) In vitro experiment. A549 cells were stimulated with 100 mg/L silica suspension for 0, 12, 24 and 48 hours. The cell apoptosis rate was detected by flow cytometry. ii) Animal experiment. Specific pathogen-free male C57BL/6 mice were randomly divided into control, 14-day, 28-day, and 56-day groups, with five mice in each group. The mice in the control group were sacrificed at 56 days after being treated with 40.0 μL 0.9% sodium chloride solution, and the mice in the last three groups were sacrificed at 14, 28 and 56 days after being treated with 40.0 μL silica suspension with a mass concentration of 125 g/L via tracheal exposure method. The lung tissues of mice were collected to measure lung organ coefficients. Masson staining was used to detect the degree of pulmonary fibrosis, and Ashcroft scores were evaluated. The apoptosis of AEC in mice was observed by TUNEL immunofluorescence assay. iii) The mRNA relative expression of apoptosis-related genes in A549 cells and mouse lung tissue was detected using reverse transcription and real-time fluorescence quantitative polymerase chain reaction. Results i) In vitro experiment. The apoptosis rate of A549 cells increased with longer silica exposure (all P<0.05). The relative expression of B cell lymphoma-2 (BCL-2) mRNA in A549 cells in 24 h group and 48 h group decreased (both P<0.05), and the relative expression of BCL-2 associated X protein (BAX) mRNA increased (both P<0.05), compared with 0 h group. The mRNA relative expression of caspase (CASP) -3 and CASP-9 in A549 cells increased with longer silica exposure (all P<0.05). ii) Animal experiment. The lung organ coefficients and Ashcroft score in mice progressively increased (all P<0.05), the degree of pulmonary fibrosis was gradually aggravated, and TUNEL positive cells in lung tissue were gradually increased, while Bax, Casp-3 and Casp-9 mRNA relative expression increased with longer silica exposure (all P<0.05). Conclusion Silica dust may cause pulmonary fibrosis by inducing apoptosis of AEC, with a time-dependent effect. The mechanism may be related to the effect of silica dust on mitochondrial apoptosis through Bcl-2/Bax/Caspase-3 signaling pathway.

OBJECTIVE: To screen the optimal regimen of acupuncture and moxibustion for obstructive sleep apnea hypopnea syndrome (OSAHS), so as to provide the evidences for clinical decision-making. METHODS: From 7 databases in Chinese and English i.e. the Full-Text Database of China Journal Network (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), VIP Information Chinese Journal Service Platform (VIP), Chinese Biomedical Literature Database (SinoMed), PubMed, Web of Science (WOS) and Cochrane Library, randomized controlled trial (RCT) articals of OSAHS treated with acupuncture and moxibustion were searched. The quality of evidence was evaluated with the modified Jadad scale, the evaluation index was established and the optimal regimen of acupuncture and moxibustion for OSAHS was screened by multi-index decision analysis. RESULTS: A total of 10 RCTs were included, and the filiform needling therapy was optimal in treatment of OSAHS. The acupoints included Lianquan (CV23), Danzhong (CV17), Zhongwan (CV12), and bilateral Kongzui (LU6), Pishu (BL20), Fenglong (ST40), Zusanli (ST36), Yinlingquan (SP9) and Zhaohai (KI6). Zusanli (ST36) received the reinforcing method, Pishu (BL20) and Fenglong (ST40) were stimulated with the reducing technique, and the rest acupoints with the uniform reinforcing-reducing. Each acupoint was manually manipulated once every 10 min during the needle retention for 30 min. Acupuncture was delivered once a day, 5 times a week and for consecutive 4 weeks. Among the included literature, the severity of disease was not reported in detail, the filiform needling was the dominant intervention, the local acupoints such as Lianquan (CV23) and Panglianquan (Extra) were mainly selected. The apnea-hypopnea index and the minimum oxygen saturation were taken as the evaluation indexes, and the effect was evaluated in reference to the generally accepted standards. The attention to safety evaluation was insufficient, the report on methodology was not adequate and the quality was low. CONCLUSION Filiform needling is the dominant therapy of acupuncture and moxibustion for OSAHS, and the local acupoints are considered specially. But the quality of clinical research should be improved.
Humans ; Moxibustion ; Acupuncture Therapy ; Sleep Apnea, Obstructive/therapy* ; Acupuncture Points ; Randomized Controlled Trials as Topic

Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

N6-methyladenosine(m6A)is the most common mRNA modification in eukaryotes,and fat mass and obesity-related protein(FTO),are its demethylases,which efficiently remove the modification of m6A mRNA,and is strongly associated with obesity.Atherosclerosis is a chronic inflammatory lesion of the blood vessel wall driven by lipids.It was found that FTO-mediated m6A may influence the process of atherosclerosis through lipid metabolism,oxidative stress,mitochondrial dysfunction,and macrophage foaminess.

OBJECTIVE To explore the clinical value of metagenomic next generation sequencing(mNGS)in detec-tion of pathogens from the patients with pulmonary infection.METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People's Hospital from Jun.2021 to Jun.2023.The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid(BALF)and traditional cultures(including sputum culture and BALF culture).The positive rates,consistency,distribution,efficacy and curative effects were observed and sys-tematically compared between the two detection methods.RESULTS Totally 122 strains of bacteria,47 strains of fungi,94 strains of viruses,3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 pa-tients by mNGS,as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the tra-ditional culture method.The positive rate of detection of pathogens was 89.32％by mNGS,higher than 38.83％of the traditional culture method(P＜0.001).There was certain difference in the distribution of pathogens be-tween the two detection method,the two detection method showed the poor consistency of detection efficacy,and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy(P＜0.001).In addition,some of drug resistance genes could be detected by mNGS.CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pul-monary infections than the traditional culture method and can detect various types of pathogens.The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable.It plays an imorptant role in guid-ing the clinical diagnosis and treatment of the patients with pulmonary infections.

Objective:To investigate the interaction of risk factors for diabetic retinopathy (DR) occurrence.Methods:A cross-sectional study was performed.A total of 6 783 diabetic patients with complete survey data from 2005 to 2018 in the National Health and Nutrition Survey database were enrolled, among which 4 426 patients were included according to inclusion criteria and were divided into non-DR diabetes group of 3 491 cases and DR group of 935 cases.The related risk factors were collected, including age, gender, race, residential status, education, annual household income, body mass index (BMI), fasting glucose, glycosylated hemoglobin, duration of diabetes, family history of diabetes, comorbidities, smoke, alcohol use, sleep, physical activity.Patient Health Questionnaire (PHQ-9) was used to assess the psychological status.After the categorization of all variables, risk factors of DR were analyzed by logistic regression, and the interaction between factors was further analyzed.Results:Multivariate analysis showed that female[odds ratio ( OR)=1.33, 95% confidence interval ( CI): 1.02-1.72], duration of diabetes ≥10 years ( OR=1.03, 95% CI: 1.02-1.04), insulin therapy ( OR=2.38, 95% CI: 1.87-3.05), urinary albumin creatinine ratio (UACR) ≥30 mg/g ( OR=1.55, 95% CI: 1.22-1.96) and depression ( OR=1.44, 95% CI: 1.13-1.83) were risk factors for DR, and BMI≤28 kg/m 2 ( OR=0.70, 95% CI: 0.55-0.89) was a protective factor for DR.Furthermore, interaction analysis revealed additive interaction between UACR ≥30 mg/g and insulin therapy [relative excess risk due to interaction ( RERI)=2.46, 95% CI: 0.84-4.09, attributable proportion due to interaction ( AP)=0.44, 95% CI: 0.26-0.63, synergy index ( S)=2.16, 95% CI: 1.37-3.41).The UACR ≥30 mg/g and longer diabetic duration ≥10 years had both multiplicative ( OR=1.67, 95% CI: 1.00-2.76) and additive interactions ( RERI=2.02, 95% CI: 0.79-3.25, AP=0.47, 95% CI: 0.27-0.66, S=2.53, 95% CI: 1.37-4.68). Conclusions:Patients with diabetes treated with insulin, with a duration of diabetes ≥10 years and accompanied by UACR ≥30 mg/g are at higher risk of developing DR than those with a single risk factor.

OBJECTIVE To explore the clinical value of metagenomic next generation sequencing(mNGS)in detec-tion of pathogens from the patients with pulmonary infection.METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People's Hospital from Jun.2021 to Jun.2023.The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid(BALF)and traditional cultures(including sputum culture and BALF culture).The positive rates,consistency,distribution,efficacy and curative effects were observed and sys-tematically compared between the two detection methods.RESULTS Totally 122 strains of bacteria,47 strains of fungi,94 strains of viruses,3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 pa-tients by mNGS,as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the tra-ditional culture method.The positive rate of detection of pathogens was 89.32％by mNGS,higher than 38.83％of the traditional culture method(P＜0.001).There was certain difference in the distribution of pathogens be-tween the two detection method,the two detection method showed the poor consistency of detection efficacy,and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy(P＜0.001).In addition,some of drug resistance genes could be detected by mNGS.CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pul-monary infections than the traditional culture method and can detect various types of pathogens.The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable.It plays an imorptant role in guid-ing the clinical diagnosis and treatment of the patients with pulmonary infections.

Objective: To investigate whether fibroblast growth factor 18(FGF18) can induce human gingival fibroblasts(HGFs) isolatedin vitroto differentiate into osteoblast-like cells, and to explore the mechanism of osteogenesis. Methods : HGFs were isolated, cultured and identified by tissue block method. The third generation of HGFs were divided into experimental group and control group. FGF18 and L-DMEM was added to the experimental group while L-DMEM was added to the control group.The effects of different concentrations of FGF18(0, 0.01, 0.02, 0.04, 0.06 mg/L) on proliferation of HGFs were detected by Methylthiazolyldiphenyl-tetrazolium bromide(MTT) assay. Alkaline phosphatase(ALP) and alizarin red staining were used to detect the osteogenesis and mineralization ability of the cells after induction. RT-PCR, immunocytochemistry staining, and Western blot were used to detect the expression of genes and proteins related to osteogenesis and BMP2 in the BMP signaling pathway. Results: Compared with the control group, the experimental group could promote the proliferation of HGFs at 3, 5, 7, 9, and 11days(P<0.05),ALP activity and mineral salt deposition increased after induction at 14 and 21 days(P<0.05), and the expressions of ALP, OPN, OCN mRNA and BMP2 mRNA in BMP signaling pathway significantly increased(P<0.01). The expressions of OPN, OCN and BMP2 protein at 21 days were significantly higher than those at 14 days(P<0.01). Conclusion FGF18 can promote the proliferation of HGFs, and induce the differentiation of HGFs into functional osteoblasts. The osteogenic mechanism is related to the upregulation of BMP2.

Objective To explore the application value of targeted next-generation sequencing(tNGS)in the detection of influenza A virus.Methods A retrospective analysis was conducted on the clinical data of 116 patients suspected of having influenza A at our hospital from October 2024 to February 2025.All patients underwent sputum tNGS and throat swab influenza nucleic acid tests due to fever and pulmonary infection,and the diagnostic efficacy of the two methods was compared.Results Among 116 patients,93 were diagnosed with influenza A.Among these 93 influenza A patients,the detection rate of tNGS was higher than that of in-fluenza nucleic acid testing(P<0.05).The results of tNGS and influenza nucleic acid testing for influenza A showed significant consistency with the confirmed diagnosis(P<0.05).There was a statistically significant difference in tNGS sequence counts between the influenza nucleic acid-positive and negative groups(P<0.05).Twenty-three patients excluded from influenza A diagnosis served as the control group.Comparisons of white blood cell(WBC)counts among the influenza nucleic acid-positive group,negative group,and control group showed statistically significant differences(P<0.05),whereas comparisons of C-reactive protein(CRP)and serum amyloid A(SAA)showed no statistically significant differences(P>0.05).Conclusion tNGS demonstrates significant advantages in detecting influenza A virus.Combined with peripheral blood infection-related in-dicators for comprehensive diagnosis,it may provide a more effective approach for early diagnosis and treatment of influenza virus infectious diseases.