Myelodysplastic syndrome (MDS), a myeloid tumor derived from the malignant clones of hematopoietic stem cells, has an annually increasing incidence. The contemporary research direction has shifted to analyzing the synergistic effect of immune surveillance collapse and abnormal bone marrow microenvironment in the pathological process of MDS. Against this backdrop, the immune checkpoint molecule TIM3 has emerged as a key target because of its persistently high expression on the surface of important immune cells such as T and NK cells. The abnormal activation of the TIM3 pathway is the mechanism by which solid tumors and hematological malignancies achieve immune escape and is a key hub in the formation of immune exhaustion phenotypes. This work integrates the original discoveries of our team with the latest international progress, systematically demonstrating the bidirectional regulatory network of TIM3 between the malignant clone proliferation of MDS and the immunosuppressive microenvironment. Integrating the evidence from emerging clinical trials allows us to consider the clinical significance of TIM3-targeted blocking for MDS, providing a transformative path to overcome the resistance of traditional treatments and marking a new chapter in the active immune reconstitution of MDS treatment.

Objective To explore whether or not the glioma U251 stem cell regulates its resistance to TMZ by the FOXO3a/β-catenin pathway.Methods The U251 stem cells were divided into the TMZ group(100 μmol/IL TMZ treated cells)and the control group.The Western blot and real-time quantitative reverse transcription-PCR(qRT-PCR)were used to detect the expression levels of FOXO3a,β-catenin,Nestin,CD133 and Sox2 under the TMZ action in the two groups.The stem cell pelletization experiment was used to verify the resistance of U251 stem cell on TMZ.Recombinant viral vectors pHY-FOXO3a,pHY-β-catenin-KD and PHy-β-Catenin-KD were constructed by embedding FOXO3a/β-catenin interference sequences into lentivirus pHY-LV-KD1.1 expression vector and transfected into U251 stem cells.The change of stem cell clone pellets number was measured under TMZ action.The effects of knockdown FOXO3a and β-catenin on the characteris-tics and drug resistance of U251 stem cells were observed.Results The Western blot and qRT-PCR results showed that compared with the control group,the expression levels of FOXO3a,β-catenin,Nestin,CD133 and Sox2 protein in the TMZ group were increased,the Nestin,CD133,Sox2 mRNA expression levels were in-creased(P＜0.05).The clone formation experiment results showed that the majority of survival cells on 5 d after TMZ treatment were the stem cells,indicating that the U251 stem cells could better tolerate TMZ.Knoc-king down FOXO3a and β-catenin could reduce the U251 stem cell populations number,indicating that its re-sistance to TMZ was weakened.Conclusion The FOXO3a/β-catenin pathway could regulates the characteris-tics of U251 stem cell and TMZ resistance.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To investigate the current situation of supportive care needs for patients with glioma after surgery and analyze its influencing factors.Methods:Using the convenient sampling method, a total of 168 postoperative patients with glioblastoma admitted to Beijing Tiantan Hospital Affiliated with Capital Medical University from January to May 2022 were selected as the research objects. The general information questionnaire, Supportive Care Need Survey-34-item Short Form (SCNS-SF34), M.D.Anderson Symptom Inventory Brain Tumor Module (MDASI-BT) and Cancer Fatigue Scale (CFS) were used to investigate them. The multiple linear regression analysis was used to explore the influencing factors of supportive care needs in patients with glioma after surgery.Results:The score for supportive care needs in 168 postoperative patients with glioblastoma was (71.68±25.28). The results of multiple linear regression analysis showed that place of residence, occupational status, degree of symptom distress and fatigue degree were the influencing factors for supportive care needs of glioma patients after surgery ( P<0.05) . Conclusions:Patients with glioma after surgery have unmet supportive care needs, which are influenced by their place of residence, work status, disease symptoms and fatigue levels. Medical staff provide personalized guidance to postoperative patients to help them cope with postoperative symptoms, reduce fatigue levels and meet their supportive care needs.

Objective:To explore the effect of well-being therapy on fatigue and self-management efficacy of leukemia patients undergoing chemotherapy.Methods:From January 2018 to December 2019, totally 76 leukemia patients who undergoing chemotherapy were divided into experimental group and control group according to the enrolled time, with 38 cases in each group. Patients in the control group recieved routine nursing, the experimental group carried out well-being therapy. Before and after intervention, the effects were assessed by Cancer fatigue scale-Chinses version (CFS-C) and Strategies used by people to promote health-Chinses version (SUPPH-C), respectively.Results:After intervention, the physical fatigue, affective fatigue, cognitive fatigue, and total fatigue scores in CFS-C were 7.64±3.63, 7.28±1.60, 5.19±1.24 and 20.11±3.96 in the experimental group, significantly lower than those in the control group (9.57±3.52, 8.76±2.60, 6.08±1.62 and 24.41±3.86); the positive coping, stress reduction, making decisions, and total scores in SUPPH-C were 57.56±9.72, 40.11±5.99, 12.17±1.95 and 109.83±11.69 in the experimental group, significantly higher than in the control group (50.54±10.80, 36.70±7.62, 10.86±2.10 and 98.11±14.13), the difference was statistically significant ( t value was 2.119-3.856, P<0.05). Conclusion:Well-being therapy can effectively allivate cancer fatigue and promote self-management efficacy of leukemia patients undergoing chemotherapy.

Objective:To provide Parkinson's patients with health education consultation and personalized rehabilitation programs through the construction and standardized management of Parkinson's care and nursing studio, and to improve the quality of continuous rehabilitation of Parkinson's patients after discharge.Methods:Using the convenient sampling method, 168 patients who attended the Parkinson Care and Nursing Studio in Beijing Tiantan Hospital from April 2018 to June 2019 were selected as the subjects. Parkinson's care and nursing studio was set reasonably, a standardized management system was established, the service objects in the process of diagnosis and treatment were clarified, and the work content of the nursing studio was determined. The Parkinson's care and nursing studio team was led by the head nurse of the Department of Dyskinesia. Multidisciplinary collaboration was adopted, and there were 12 members in this team. An electronic file of the visited patient was established, and the patient's physical function and structure, the individual ability to complete tasks or actions, and the ability to participate in family and society were fully evaluated. Based on this, an objective and individualized rehabilitation training program was developed. Analyze studio workload and patients' satisfacation rate, comepare patient's medication compliance before and after intervention.Results:Since the opening of the Parkinson's Care Studio in April 2018, 12 members have been sent out in rotation, and a total of 168 patients have been treated. Parkinson's nursing care studio has a high evaluation and the very satisfied rate was 95.6%. After the intervention, the patient's medication compliance increased, and the difference was statistically significant before and after the intervention ( P<0.05) . Conclusions:The construction and standardized management of Parkinson's care and nursing studio will help improve the disease management and medication compliance of patients with Parkinson's disease, and it will be beneficial to the improvement of nurses' own value.

Objective: To investigate the impact of transitional care based on IMB model on caregivers of patients with hematological malignancies. Methods: A total of 200 patients with hematological neoplasms who were treated with chemotherapy in our hospital from May 2017 to September 2018 were selected, their caregivers were also selected as the research objects, and they were randomly divided into the study group with 82 cases and control group with 85 cases. The study group used a transitional care based on IMB model to intervene the patient caregivers, and the control group received routine nursing care. The general data questionnaire, the Caregiver Positive Feeling Scale (PAC), the Chinese version of Benefit Finding Scale (BFS), the nursing quality satisfaction questionnaire were used to investigate the caregivers. Results: After nursing intervention, the self-affirmation and self-expected dimension scores of PAC in the study group were 18.41±5.65, 18.87±4.23, which were higher than those in the control group (14.56±5.83, 15.24±4.59), the difference was statistically significant (t=2.476, 5.287, P<0.05 or 0.01). The acceptance, family relationship, personal growth, social relations and health behaviors dimension scores of BHS scale in the study group were 10.41±3.12, 9.87±3.93, 22.41±5.12, 10.22±3.52, 9.65±3.17, which were higher than those in the control group 9.06±3.87, 8.14±4.19, 19.51±5.24, 8.47±3.61, 7.52±3.74, the difference was statistically significant (t=2.476-3.963, P<0.05 or 0.01). The nursing satisfaction degree of caregivers in the study group was 75.61% (62/82), which was higher than that in the control group 42.35% (36/85), the difference was statistically significant (χ²=19.039, P < 0.01). Conclusions Transitional care based on the IMB model can improve the positive feelings in hematological neoplasms caregivers, enhance their benefit findings, and improve the quality of nursing care.

OBJECTIVE： To investigate the effects of Buyang huanwu decoction on endothelial-mesenchymal transformation （EndMT） of lung tissue in idiopathic pulmonary fibrosis （IPF） model rats， and to explore its potential mechanism. METHODS： Male SD rats were randomly divided into normal group， model gorup， dexamethasone group [0.405 mg/（kg·d）]， Buyang huanwu decoction low-dose， medium-dose and high-dose groups [6.435， 12.87， 25.74 g/（kg·d）， by raw material]， with 8 rats in each group. Except for normal group， other groups were given endotracheal injection of bleomycin to induce IPF model. On the second day after modeling， normal group and model group were given water intrgastrically [10 mL/（kg·d）]； administration groups were given relevant medicine intragastrically， once a day， for consecutive 28 days. 24 h after last medication， the expression of endothelial cell markers [platelet endothelial cell adhesion molecule 1， vascular endothelial cell cadherin] and interstitial cell markers [α-smooth muscle actin， fibroblast specific protein 1] were detected by immunohistochemistry method. The expression of Notch4 and DLL4 in lung tissue of rats were detected by Western blotting assay. RESULTS： Compared with normal group， the expression of endothelial cell markers were decreased significantly in lung tissue of model group， while the expressipon of interstitial cell markers， Notch4 and DLL4 were increased significantly （P＜0.01）. Compared with model group， the expression of endothelial cell markers in lung tissue of rats were increased significantly in administration groups， while Buyang huanwu decoction low-dose group was significantly lower than dexamethasone group； the expression of interstitial cell markers， Notch4 and DLL4 were decreased significantly， while Buyang huanwu decoction low-dose group was significantly higher than dexamethasone group （P＜0.05 or P＜0.01）. CONCLUSIONS： Buyang huanwu decoction can relieve IPF of model rats by intervening in EndMT， the mechanism of which may be associated with inhibiting DLL4/Notch4 singaling pathway.

Objective To investigate the effect of saw palmetto extract (SR) on GL261 glioma in rats and immune system.Methods The 40 rats were divided into 4 groups randomly,one was the control group without tumor (n =10),the other 30 rats were given subcutaneous inoculation of tumor cells and then divided into 3 groups:tumor-bearing group (n =10),low dose SR group (n =10),and high dose SR group (n =10).After 1 weeks feeded,the rats of SR groups were given the saw palmetto extract,low dose group 50 mg/kg once a day every other day and 300 mg/kg of high dose group every other day.The tumor-bearing groups received the same dose of distilled water.After 4 weeks feeding,we measured the tumor weight and the inhibition rate was calculated.The tumor cell apoptosis was detected by TdT mediated dUTP nick-end labeling (TUNEL) staining.The splenic T lymphocyte proliferation was tested by methyl thiazolyl tetrazolium (MTF).Results (1) The SR groups compared to tumor group,the tumor weight was significantly reduced (F =62.678,P =0.000).The tumor inhibition rate was significantly higher in high dose group.(2) The apoptosis of tumor cells in tumor-bearing group was significantly less than SR groups and the apoptosis was significantly increased after treatment with SR,especially in high dose SR group (F =1.287E3,P =0.000).(3) Compared to SR groups and control group,T lymphocyte proliferation of tumor-bearing group reduced obviously.After treated with SR,T lymphocyte proliferation significantly increased and was higher in high-dose group (F =103.565,P =0.000).Conclusions Saw palmetto extract can activate T lymphocytes and induce apoptosis to tumor cells.Its function was related to SR concentration.

Objective To investigate the effect of supportive nursing intervention on treatment adherence of patients with schizophrenia and caregivers′anxiety.Methods A total of 72 schizophrenia patients and their caregivers were randomly divided into observation group and control group,with 36 patients in each group.Two group both received routine therapy and nursing care,meanwhile the observation group received an extra 3 months supportive nursing intervention.Medication adherence scale was used to evaluate treatment adherence of patients;self-rating anxiety scale (SAS)was used to evaluate mental health of caregivers,and nursing satisfaction scale was used to evaluate the satisfaction of nursing care.Results After 3 months intervention,treatment compliance (12 cases fully compliance, 18 cases partially compliance,6 cases noncompliance)and nursing care compliance (11 cases fully compliance,15 cases partially compliance, 10 cases noncompliance)of the observation group were obviously higher than those of the control group(χ2 =13.461,17.537;P <0.01 ).After intervention,SAS scores of the observed caregivers(37.51 ±5.93)were lower than that before intervention(43.11 ±4.98)and that of the control group(42.08 ±5.64)(t =4.283, 4.040;P <0.01 ).In the observation group,nursing care satisfaction of caregivers was markedly improved, including 29 cases (82.6%)satisfied,with 5 cases(14.2%)somewhat satisfied,1 case(2.9%)unsatisfied;while in the control group,15 cases (41.7%)satisfied,11 cases (30.6%)somewhat satisfied,9 cases (25%) unsatisfied,and the difference was statistically significant(χ2 =13.105,P <0.01).Conclusions Supportive nursing intervention can significantly improve the treatment and nursing adherence of schizophrenia patients, alleviate caregivers′anxiety,and promote their satisfaction of nursing care.