Lung transplantation is currently the only recognized effective treatment for end-stage lung disease and has improved the quality of life for patients. However, lung transplantation still faces many challenges, including rejection, infection, post-transplant acute kidney injury, post-transplant diabetes mellitus, ischemia-reperfusion injury and donor shortage, etc. Chinese lung transplantation scholars made a series of important progress in the field of clinical research in 2024, focusing on the study and solution of the above problems, and providing new ideas for lung transplantation surgery. This article systematically reviews the clinical research and technological innovation in the field of lung transplantation in 2024, summarizes the achievements of clinical research in the field of lung transplantation in China in 2024, and aims to providing new directions and strategies for future research.

Lung transplantation is the optimal treatment for end-stage lung diseases and can significantly improve prognosis of the patients. However, postoperative complications such as infection, rejection, ischemia-reperfusion injury, and other challenges (like shortage of donor lungs) , limit the practical application of lung transplantation in clinical practice. Chinese research teams have been making continuous efforts and have achieved breakthroughs in basic research on lung transplantation by integrating emerging technologies and cutting-edge achievements from interdisciplinary fields, which has strongly propelled the development of this field. This article will comprehensively review the academic progress made by Chinese research teams in the field of lung transplantation in 2024, with a focus on the achievements of Chinese teams in basic research on lung transplantation. It aims to provide innovative ideas and strategies for key issues in the basic field of lung transplantation and to help China's lung transplantation cause reach a higher level.

Liver fibrosis is the common pathological process in the progression of various chronic liver diseases to liver cirrhosis， and it greatly affects the prognosis of patients with chronic liver diseases. As a novel adipokine， Chemerin participates in the metabolism of glucose and lipids and inflammation， and various studies have shown that the expression level of Chemerin is correlated with the degree of liver fibrosis， suggesting that Chemerin may be involved in the process of liver fibrosis by regulating metabolism and inflammation. Chemerin has shown certain potential in the auxiliary diagnosis of liver fibrosis and the intervention against the progression of liver fibrosis. This article reviews the potential role and mechanism of action of Chemerin in the process of liver fibrosis， in order to provide new ideas for the diagnosis and treatment of liver fibrosis.

Objective To compare the performance and efficacy of prognostic models constructed by different machine learning algorithms in predicting the survival period of lung transplantation (LTx) recipients. Methods Data from 483 recipients who underwent LTx were retrospectively collected. All recipients were divided into a training set and a validation set at a ratio of 7:3. The 24 collected variables were screened based on variable importance (VIMP). Prognostic models were constructed using random survival forest (RSF) and extreme gradient boosting tree (XGBoost). The performance of the models was evaluated using the integrated area under the curve (iAUC) and time-dependent area under the curve (tAUC). Results There were no significant statistical differences in the variables between the training set and the validation set. The top 15 variables ranked by VIMP were used for modeling and the length of stay in the intensive care unit (ICU) was determined as the most important factor. Compared with the XGBoost model, the RSF model demonstrated better performance in predicting the survival period of recipients (iAUC 0.773 vs. 0.723). The RSF model also showed better performance in predicting the 6-month survival period (tAUC _{6 months} 0.884 vs. 0.809, P = 0.009) and 1-year survival period (tAUC _{1 year} 0.896 vs. 0.825, P = 0.013) of recipients. Based on the prediction cut-off values of the two algorithms, LTx recipients were divided into high-risk and low-risk groups. The survival analysis results of both models showed that the survival rate of recipients in the high-risk group was significantly lower than that in the low-risk group (P<0.001). Conclusions Compared with XGBoost, the machine learning prognostic model developed based on the RSF algorithm may preferably predict the survival period of LTx recipients.

Objective: To understand the incidence risk and risk factors of tuberculosis (TB) among middle school students in Chongqing, so as to provide a basis for formulating TB prevention and control strategies. Methods: From September to December 2022, 32 181 middle school students were selected as the study cohort from 15 administrative districts in Chongqing by using the stratified cluster random sampling method. All cohort members were screened with the tuberculin skin test (TST), and relevant information was collected from January 1, 2023 to December 31, 2024. On the basis of active screening, the follow up data of the participants were compared with the National Tuberculosis Management Information System to obtain the incidence status of the study subjects. The Log rank test was used to compare the TB incidence rates among students with different characteristics, and a Cox proportional hazards model was established to analyze the incidence risk and risk factors of TB. Results: The TST screening rate of the cohort members was 93.0%. During the 2 year follow up period, a total of 36 TB cases occurred, with a cumulative incidence rate of 111.87/100 000 and an incidence density of 55.95/100 000. Among them, the cumulative incidence rate of students from public schools (170.44/ 100 000 ) was higher than that of students from private schools (41.16/100 000), the cumulative incidence rate of students in schools located in high epidemic areas (153.95/100 000) was higher than that in medium epidemic areas (69.00/100 000), and the difference was statistically significant ( χ 2=11.49, 4.73, both P <0.05). The Log-rank test for different TST results showed that the difference in TB comulative incidence rate between students with strongly positive TST results (216.55/ 100 000 ) and those with negative TST results (81.40/100 000) was statistically significant ( χ 2=5.85, P <0.05). Univariate analysis using the Cox proportional hazards model revealed that the risk of TB was lower in students from private schools ( HR=0.25, 95% CI = 0.10-0.59) and students in medium epidemic areas ( HR=0.46, 95%CI =0.23-0.94); whereas the risk of TB was increased in students with strongly positive TST results ( HR=1.39, 95%CI =1.05-1.84) (all P <0.05). Multivariate Cox regression analysis showed that the risk of TB in students from private schools was lower than that of students from public schools ( HR=0.23, 95%CI=0.08-0.62, P <0.05). Conclusions The annual average incidence rate of TB among middle school students in Chongqing is at a relatively high level. It is necessary to strengthen the management and intervention for student groups, including those in public schools, those in schools located in high epidemic areas, and those with strongly positive TST results, so as to reduce the incidence rate of TB.

Objective To analyze the monitoring data of cardio-cerebrovascular diseases prevention and control system in Yichang in 2022, and to provide data support and experience for the precise prevention and treatment of cardio-cerebrovascular diseases. Methods Acute cardiovascular and cerebrovascular event data were collected from the Yichang Cardio-cerebrovascular Events Monitoring System from January 1, 2022 to December 31, 2022. Descriptive analysis was conducted for the data collected. Statistical analysis was performed using SPSS 20.0 software, and a chi-square test was used to analyze the count data. Results A total of 37,217 cases of cardio-cerebrovascular events were monitored in Yichang in 2022. The crude incidence and the standardized incidence were 983.84/100,000 and 541.55/100,000, respectively. The incidence in males was higher than females (554.93/100,000 vs 428.91/100,000，χ² =464.52，P＜0.05). The top three diseases were cerebral infarction, acute myocardial infarction, and cerebral hemorrhage. The incidence of events increased with age, and 79.80% of the cases were over 60 years old. The main onset time was from May to August. Conclusion The use of the cardio-cerebrovascular events monitoring system in Yichang and the implementation of ^“mandatory reporting card^” monitoring can timely obtain the epidemic characteristics of the diseases, provide support for the precise formulation of prevention and control strategies and measures, reduce underreporting rates, and improve the monitoring system, which is worthy of reference and promotion.

Objective:To investigate the application effect of problem-based learning (PBL) combined with scenario simulation in nursing teaching of needlestick injuries.Methods:A total of 123 undergraduates majoring in nursing were selected as research subjects from the classes of 2020 and 2021 in a medical university. The 60 undergraduates in the class of 2020 were established as control group and were given PBL teaching, and the 63 undergraduates in the class of 2021 were established as experimental group and were given PBL combined with scenario simulation. The two groups were compared in terms of theoretical score, skill examination score, and knowledge-attitude-practice (KAP) score of needlestick injury knowledge. SPSS 25.0 was used to perform the t-test, the chi-square test, and the rank sum test. Results:Compared with the control group, the experimental group had significantly higher scores of theoretical examination [(84.43±5.03) vs. (80.30±4.81), P<0.001] and skill examination [(88.40±4.26) vs. (83.55±5.84), P<0.001], as well as significantly higher scores of knowledge [(14.46±1.03) vs. (13.18±1.23), P<0.001], attitude [(52.59±3.09) vs. (48.05±3.06), P<0.001], and practice [(67.37±4.28) vs. (62.17±3.92), P<0.001] in KAP questionnaire. Conclusions:PBL combined with scenario simulation teaching can effectively improve the knowledge of protection against needlestick injuries and related skills in nursing students, enhance their awareness of needlestick injuries, and promote the protective behavior against needlestick injuries.

Objective:To construct an evaluation index system for community hospice comfort care.Methods:This was a cross-sectional study. Two rounds of expert consultations were conducted using modified Delphi method from June to September 2023, 14 experts in the field of palliative care nursing were invited to participate in the consultations. Based on the consultation results, an evaluation index system for comfort care of community hospice was preliminarily developed.Results:All consultation experts were females, with an average age of (48±8) years; 9 held senior professonal titles, and 12 had more than 5 years of palliative care-related working experiencs. The positive coefficient of correspondence in two rounds of consultations was 100%, and the degree of authority was 0.841 and 0.834, respectively. The expert coordination coefficients for the importance of secondary indicators were 0.281 (χ 2=182.65) and 0.284 (χ 2=132.98), and the expert coordination coefficients for the operability of secondary indicators were 0.231 (χ 2=150.12) and 0.252 (χ 2=118.01), respectively. The constructed evaluation index system of hospice comfort care consisted of 5 primary indexes and 32 secondary indexes. The five primary indexes were environmental comfort, physiological comfort, psychological comfort, spiritual comfort and social comfort with a weight coefficient of 0.202 3, 0.205 3, 0.205 3, 0.199 4 and 0.187 7, respectively. Conclusion:An evaluation index system for comfort care in community hospice has been preliminarily developed in this study, after validation it would provide a reference for assessing the comfort needs of patients with palliative care.

Objective:To evaluate the effect of workshop-based incontinence associated dermatitis (IAD) training course for geriatric nurse specialists, and to provide references and evidence for the application of workshop teaching model in specialized nursing training.Methods:The convenience sampling method was used to select 40 participants in the 9th Chongqing Geriatric Nurse Specialist Training Program in May 2021 as the intervention group, and IAD training was conducted using the workshop method. The 42 participants in the 8th Chongqing Geriatric Nurse Specialist Training Program in May 2020 were selected as the control group, who received IAD training through traditional teaching methods. After the training, the achievement of teaching objectives and teaching satisfaction were compared between the two groups using questionnaire survey, and IAD nursing knowledge and attitudes were compared using scales. SPSS 27.0 was used for the t-test and chi-square test. Results:The questionnaire survey showed that the intervention group achieved higher teaching objectives in all dimensions compared to the control group ( P<0.05). Compared with the control group, the intervention group had higher scores in teaching satisfaction regarding teaching format, interest in learning, practical skills, theoretical understanding, integration of theory and practice, and problem-solving abilities ( P<0.05). Compared with the control group, the intervention group demonstrated significantly higher scores in IAD nursing knowledge [(11.32±1.56) vs. (9.02±2.26), P<0.05] and attitudes [(37.63±3.54) vs. (32.81±2.97), P<0.05]. Conclusions:The workshop training has been highly recognized by the trainees, contributing to improved implementation effectiveness of teaching, enhancing the scores of IAD nursing knowledge and attitudes. This approach offers a new perspective for training with a practical focus in the specialized nursing field.

Objective:To evaluate the efficacy of 6% hydroxyethyl starch (HES) 130/0.4 electrolyte solution for fluid therapy in the patients undergoing meningioma resection.Methods:Ninety-two American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, with body mass index of 18-30 kg/m 2, with expected operation duration>3 h, undergoing elective meningioma resection, were divided into 2 groups ( n=46 each) using a random number table method: lactated Ringer′s solution (LR) group and HES group. LR was infused throughout operation in group LR, and 6% HES was intravenously infused in group HES, with the maximum dose not exceeding 50 ml/kg, and the excess part was supplemented with LR. Goal-directed fluid therapy was used to maintain stroke volume variation<13% and mean arterial pressure 70-90 mmHg. Arterial blood gas analysis was performed immediately before anesthesia induction (T 0), when 1 000 and 2 000 ml of fluid were infused (T 1, 2), and at the end of surgery (T 3) to record electrolyte and acid-base balance indexes. Thromboelastogram was simultaneously monitored. The occurrence of electrolyte disorder, acid-base imbalance and abnormal coagulation function and consumption of norepinephrine were recorded. Patients were followed up at 3 and 7 days after surgery, and the Chinese quality of recovery-15 scores were recorded. The hospitalization time and occurrence of brain edema, pulmonary edema, nausea and vomiting were recorded. Results:In group L and group H, 4 cases and 6 cases were excluded due to prolonged operation time, and 42 cases and 40 cases were finally included, respectively. Compared with LR group, the plasma Na + concentration was significantly increased at T 3, the plasma Cl - concentration and pH value were increased at T 1-3, the plasma Ca 2+ concentration was decreased at T 2, 3, reaction time was increased at T 3, coagulation time was increased and maximum amplitude was decreasedat T 2, 3, and coagulation Angle was decreased at T 1-3( P<0.05). No electrolyte disorder and abnormal coagulation function was found in the two groups. There was no statistically significant difference in the consumption of norepinephrine, postoperative Chinese quality of recovery-15 score, length of hospital stay and incidence of alkalosis, pulmonary edema, brain edema, and nausea and vomiting between the two groups ( P>0.05). Conclusions:The efficacy of liquid therapy is comparable between HES and LR in the patients undergoing meningioma resection.