In recent years, research on stem cell therapy in the field of lung transplantation has gradually increased, demonstrating its potential in improving the outcomes of lung transplantation. As a treatment option for end-stage lung diseases, lung transplantation faces challenges such as scarcity of donor organs, postoperative complications and rejection. Stem cells, with their self-renewal and multi-directional differentiation capabilities, have emerged as strong candidates for alternative or adjunctive treatments. Current studies show that embryonic stem cells and umbilical cord mesenchymal stem cells play significant roles in lung tissue regeneration and immune regulation. However, stem cell therapy still needs to overcome issues such as the selection of cell sources, low survival rates after transplantation and unclear long-term efficacy in clinical applications. Future research should focus on exploring new stem cell sources, improving transplantation techniques and establishing efficacy evaluation systems.

Objective To investigate the association between physical activity levels and blood lipids among college freshmen, and to provide scientific evidence for the health management of college freshmen. Methods An electronic questionnaire survey on physical activity was conducted on freshmen of a university, and fasting blood biochemical indicators were detected. The International Physical Activity Questionnaire (IPAQ) short form was used to evaluate the physical activity levels of the participants. Dyslipidemia was defined as an abnormality in any one of the following serum lipid parameters: total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or non-high-density lipoprotein cholesterol. Binary logistic regression and stratified analyses were employed to explore the relationship between physical activity and blood lipids. Results A total of 3 401 participants were included, with an average age of 18.45 ± 0.92 years, and 60.5% were female. The prevalence of dyslipidemia was 17.7%, with a higher rate among males (22.1%) than females (14.8%). After adjusting for confounding factors related to blood lipids, high-intensity physical activity was negatively associated with the risk of elevated LDL-C among males (OR = 0.36, 95% CI: 0.13–0.99, P = 0.049). Conclusion Among freshmen at a medical college in Hubei Province, high-intensity physical activity is negatively associated with the risk of elevated LDL-C in males, but this association needs to be further confirmed by larger prospective cohort studies.

Objective: To systematically evaluate the application effectiveness of the full disinfection process in blood stations, identify key optimization links, and provide a scientific evidence for the formulation of specialized disinfection and hygiene standards for blood collection and supply institutions. Methods: On-site microbiological monitoring was conducted using techniques such as the plate settling method and cotton swab method. Stratified random sampling was performed on eight key control points: including evironmental air, hand hygiene, skin disinfection, blood transport boxes, pressure steam sterilization, sewage treatment, ultraviolet disinfection, and sterile swabs. Statistical analysis was performed using SPSS 20.0. Measurement data were expressed as mean ± standard deviation(x-±s), and inter-group comparisons were conducted using t-tests or analysis of variance (ANOVA). Count data were expressed as rates, and inter-group comparisons were conducted using the χ test. Trend analysis was performed using the Cochran-Armitage test, with a significance level of α=0.05. Results: The colony removal rate of plasma air disinfection machines (94.2%±0.8%) was significantly higher than that of the ultraviolet group (P<0.05). The qualification rate of quick-drying disinfectant hand was 100% within 30 days after opening the bottle, but decreased to 93.3% after 40 days (P<0.01). The qualification rate of disinfection for blood transport boxes using 500 mg/L chlorine-containing disinfectant (100%) was significant higher 75% alcohol (60%, P< 0.05). Skin disinfection with 2% alcoholic chlorhexidine gluconate balanced effectiveness and user experience (satisfaction score 4.8±0.3). The qualification rates for core procedures such as pressure steam sterilization and sewage treatment were both 100%. Conclusion: The current disinfection procedures in blood collection and supply institutions are reliable. The effective usage period of hand disinfectants, disinfection methods for transport boxes, and usage duration of sterile swabs are the main points for optimization. It is recommended that the opened hand disinfectants be used for ≤30 days and that chlorine-containing disinfectants be prioritized for wiping transport boxes, providing empirical support for the revision of protocols and the formulation of standards.

Objective To investigate the clinical significance of H2A histone family member(H2AX)gene in human lung adenocarcinoma,and to explore its biological role in lung adenocarcinoma.Methods The tran-scriptome data of lung adenocarcinoma were downloaded from the Cancer Genome Atlas and Gene Expression database.The expression of H2AX mRNA in lung adenocarcinoma tissues and adjacent normal lung tissues was extracted by R 4.3.1 software,and the relationship between the expression of H2AX and the clinicopath-ological parameters of the patients was analyzed.Kaplan-Meier and Cox regression analysis were used to ana-lyze the prognostic value of H2AX gene expression.The expression of H2AX gene in lung adenocarcinoma cell lines and normal bronchial epithelial cells was verified by quantitative real-time PCR(qPCR).Gene set enrich-ment analysis,gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were used to explore the biological role of H2AX gene.Results The expression of H2AX mRNA in lung adenocarcinoma tissues was significantly higher than that in adjacent normal tissues(P<0.001).qPCR results showed that compared with normal bronchial epithelial cells,the expression levels of H2AX mRNA in lung adenocarcinoma cell lines A549 and SPC-A1 were significantly increased(P<0.05).H2AX expression was associated with tumor stage(P=0.029)and N stage(P=0.016).Kaplan-Meier curve analysis showed that high expression of H2AX was associated with a lower overall survival rate of patients(P<0.001).Cox regression analysis showed that H2AX was an independent prognostic factor for lung adenocarcinoma patients(HR=1.011,95%CI 1.003-1.020,P=0.006).The results of functional enrichment analysis showed that H2AX gene was involved in molecular functions such as cell cycle,DNA replication,mismatch repair,and P53 signaling pathway.Conclusion H2AX gene is highly expressed in human lung adenocarcinoma,which is relat-ed to the malignant progression of tumor patients.H2AX gene can affect the progression of lung adenocarcino-ma through a variety of pathways,and may be used as a molecular marker for lung adenocarcinoma patients.

Objective To systematically review and quantitatively analyze the safety of biologic agents for the clinical treatment of psoriasis during pregnancy and lactation.Methods The literature from start of database to June 27,2023,was searched in MEDLINE(PubMed),Embase,Cochrane Library,and Web of Science by two researcher.Quality of included studies was assessed by the quality evaluation tool of case series from Australian JBI Evidence Based Healthcare Centre.According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA),a systematic review and was conducted to assess pregnancy or breastfeeding outcomes in psoriasis patients exposed to biologics within 3 months prior to pregnancy,during pregnancy or breastfeeding.Data on pregnancy and exposure characteristics were pooled,and the prevalence of adverse pregnancy outcome was summarized using a random effects model.Results A total of 54 studies involving 1206 pregnancies in 1177 female patients with psoriasis exposed to biologic agents were included in the analysis.Systematic review results demonstrated that the majority of the exposures were limited to early pregnancy,with pooled spontaneous abortion rates,elective abortion rates,overall mortality,preterm birth rates,incidence of low birth weights,and congenital anomalies similar to those of general population(P>0.05).Furthermore,no serious adverse reactions were reported during lactation.Conclusions The use of biologic agents in pregnant and breastfeeding women with psoriasis does not significantly increase the risk of adverse pregnancy outcomes and does not affect neonatal health or growth.However,the limited available safety data underscores the necessity of further studies to establish the relationship between psoriasis,biologic agents,and pregnancy/lactation outcomes,thereby providing comprehensive guidance for clinical practice.

Objective To comparatively analyze the clinical characteristics of primary bilateral macronodular adrenal hyperplasia(PBMAH)and adrenal cortisol-producing Adenoma(CPA),and enhance the understanding of two diseases.Methods The clinical data of 85 PBMAH patients(PBMAH group)and 195 CPA patients(CPA group)diagnosed at Department of Endocrinology,the First Medical Center of Chinese PLA General Hospital,from September 2014 to August 2024 were retrospectively analyzed.The demographic characteristics,comorbidities,biochemical indicators,adrenocorticotropic hormone-cortisol(ACTH-F)levels,and adrenal imaging features and treatment conditions were compared between the two groups.Results(1)General characteristics:Compared with CPA group,PBMAH group had older age at diagnosis and a higher proportion of male patients.(2)Clinical characteristics:Compared with CPA group,PBMAH group had a longer disease duration,a higher proportion of subclinical Cushing's syndrome(CS),and a higher proportion of hypertension,impaired glucose tolerance/diabetes,bone mass reduction or osteoporosis,with higher serum potassium levels,and the differences were statistically significant(P<0.01).(3)Hormone levels:Both PBMAH and CPA groups showed ACTH-F rhythm disorder,significantly increased cortisol levels and suppressed ACTH.Compared with PBMAH group,CPA group had stronger autonomous cortisol secretion ability,manifested by increased midnight serum cortisol(F0:00),16:00 serum cortisol(F16:00),24-hour urinary free cortisol(24 h UFC)levels and lower 8:00 serum ACTH(ACTH8:00)and 16:00 serum ACTH(ACTH16:00)(P<0.01).After low-dose dexamethasone suppression test(LDDST),CPA group showed lower suppression rates of ACTH and cortisol,and higher proportions of paradoxical elevation in serum cortisol and 24 h UFC compared with PBMAH(P<0.01).Conclusions PBMAH has a longer disease course and higher proportions of comorbid metabolic disorders than CPA,mostly manifested as subclinical Cushing's syndrome.CPA has stronger autonomous cortisol secretion ability,with cortisol less likely to be suppressed after LDDST and more obvious paradoxical elevation of cortisol and 24 h UFC.

Objective To investigate the clinical and pathological characteristics of adrenal cortical carcinoma(ACC),compare differences between hypercortisolism and non-functional ACC,and assess the diagnostic value of indicators such as Ki-67 index.Methods The clinical data of 57 ACC patients admitted to the First Medical Center of Chinese PLA General Hospital from January 2015 to March 2025 were retrospectively analyzed.According to the results of endocrine function assessment,47 of these patients were divided into hypercortisolism group(n=19)and non-functional group(n=28).The differences in clinical and pathological characteristics between the two groups were compared,and non-parametric tests and Spearman correlation analysis were used to explore the relationship between Ki-67 index and tumor stage as well as imaging features.Results Among the 57 patients,there were 20 males and 37 females,with a male-to-female ratio of 1:1.85.The age ranged from 16 to 76 years,and the age at diagnosis was(48.7±13.3)years.The tumor diameter was(10.53±4.14)cm.The tumors were located on the right side in 12 cases(21.1%),on the left side in 34 cases(59.6%),and bilaterally in 11 cases(19.3%).Among them,16 cases(28.1%)were complicated with glucose metabolism disorders,31 cases(54.3%)had hypertension,and 20 cases(35.1%)had hypokalemia.According to ENSAT staging,there were 0 cases in stage Ⅰ,15 cases(26.3%)in stage Ⅱ,24 cases(42.1%)in stage Ⅲ,and 18 cases(31.6%)in stage Ⅳ.Endocrine function assessment was completed in 47 of the 57 patients,including 28 cases(59.6%)of non-functional ACC and 19 cases(40.4%)of hypercortisolism(including 1 case of hypercortisolism combined with increased sex hormone secretion).Compared with non-functional group,hypercortisolism group had a significantly higher prevalence of hypertension(P=0.014),later ENSAT stage(P=0.010),and a higher proportion of hypervascularization(P=0.048).The median Ki-67 index was 20%(10%-40%),showing no significant correlation with either the maximum tumor diameter or SUVmax value,but it was related to ENSAT staging,with Ki-67 index in stageⅣ patients being significantly higher than that in stage Ⅱ(P=0.032).Immunohistochemistry results showed that the positive rate of Inhibin-α was 84.8%,and the positive rate of Melan-A was 40.9%.Conclusions ACC is a rare malignant endocrine tumor.ACC patients with hypercortisolism are more likely to be complicated with hypertension,have later staging,and more common hypervascular manifestations.Clinically,their endocrine function should be prioritized for assessment,and more active treatment strategies should be adopted.Diagnosis should be combined with imaging characteristics(such as hypervascularization)and immunohistochemical indicators(Ki-67,Inhibin-α,Melan-A).The significant increase in Ki-67 is in the advanced stage can serve as an important prognostic indicator to guide individualized treatment.

Objective To evaluate the efficacy and safety of preoperative bladder artery embolization followed by transurethral resection of bladder tumor(TURBt)in treating bladder cancer.Methods A retrospective analysis was conducted on the clinical data of 129 bladder cancer patients treated at the Fourth Affiliated Hospital of Soochow University from January 2021 to June 2024.Exclusions included 2 cases of acute bleeding with shock,3 cases requiring staged surgery due to poor intraoperative visualization,7 cases with other malignancies,12 cases without TURBt performed within 24 hours after embolization,and 1 case where selective bladder artery embolization failed.Patients were divided into two groups based on whether they underwent pre-TURBt embolization.Group A(n=61)underwent TURBt alone,while Group B(n=43)underwent TURBt within 24 hours after bladder artery embolization.There were no statistically significant differences in gender composition,tumor size,or other clinical characteristics between the two groups(P＞0.05).Statistical comparisons were made between the two groups regarding operation time,intraoperative blood loss,postoperative hospital stay,duration of postoperative catheterization,and incidence of adverse reactions.Results In Group A,the mean operation time was(67.9±14.2)min,intraoperative blood loss was(80.7±24.7)mL,postoperative hospital stay was(8.5±1.6)days,and catheterization duration was(6.9±1.1)days.In Group B,the mean operation time was(54.0±12.6)min,intraoperative blood loss was(58.6±27.3)mL,postoperative hospital stay was(7.3±1.4)days,and catheterization duration was(6.4±0.9)days.Operation time,intraoperative blood loss,postoperative hospital stay,and catheterization duration were significantly lower in Group B compared to Group A(P＜0.05).There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups(P＞0.05).Conclusion Preoperative bladder artery embolization followed by TURBt for bladder cancer reduces tumor blood supply,thereby decreasing intraoperative bleeding.This approach effectively minimizes surgical bleeding,shortens operation time and postoperative hospital stay,with minimal side effects.It represents a safe and effective combined treatment method worthy of clinical promotion and application.

Objective To observe the effects of Ditan Yizhi Decoction on Wnt/β-catenin signaling pathway and mitochondrial autophagy in vascular dementia(VD)rats.Methods Totally 70 male SD rats were randomly selected as the sham-operation group,with only the common carotid artery isolated and not ligated,and the rest of the rats were used to prepare a rat model of VD by the modified bilateral common carotid artery permanent ligature method.The successfully modeled rats were randomly divided into model group,donepezil group,agonist group and Ditan Yizhi Decoction low-,medium-and high-dosage groups and were given corresponding interventions for 4 weeks.Morris water maze experiment was used to assess the learning and memory ability of rats,HE staining and Nissl staining were used to observe the morphology of hippocampal tissue,transmission electron microscopy was used to observe the ultrastructure of hippocampal neuron,Western blot was used to detect the expressions of PINK1,Parkin,p62,Beclin-1,LC3BⅡ/Ⅰ,β-catenin,GSK-3β,p-GSK-3β protein.Results Compared with the sham-operation group,rats in the model group had a prolonged escape latency(P<0.01),a reduced number of crossing platforms(P<0.01);neuronal gaps in the CA1 area of the hippocampus were enlarged,with irregular cell morphology and blurred borders,neuronal solidification,Nissl bodies dissolution and fragmentation,reduced quantity,mitochondrial cristae disorder,and disruption of the structure of the bilayer membrane,with a greater number of autophagosomes in the surroundings;the expressions of PINK1,Parkin,Beclin-1,LC3BⅡ/I,β-catenin,p-GSK-3β/GSK-3β protein were significantly increased(P<0.01),and p62 protein expression was significantly decreased(P<0.01).Compared with the model group,the escape latency of rats in donepezil group,agonist group and Ditan Yizhi Decoction low-,medium-and high-dosage groups were significantly shortened(P<0.01),and the number of crossing platforms significantly increased(P<0.05,P<0.01);the number of neurons in the hippocampal CA1 region increased,with normal morphology and orderly arrangement,Nissl bodies were abundant,and transmission electron microscopy showed that mitochondrial morphology recovered,rupture decreased,and autophagosomes around mitochondria decreased,the protein expressions of PINK1,Parkin,Beclin-1,LC3BⅡ/Ⅰ,β-catenin and p-GSK-3β/GSK-3β in hippocampal tissue were significantly decreased(P<0.01),the protein expression of p62 significantly increased(P<0.05,P<0.01).Conclusion Ditan Yizhi Decoction can improve learning memory ability and neuronal morphology in VD rats,and its mechanism may be related to the activation of Wnt/β-catenin signaling pathway to inhibit mitophagy.

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.