Abstract: Inflammatory bowel disease (IBD), whose pathogenesis remains elusive, is a group of autoimmune diseases characterized by chronic, progressive, and lifelong inflammation of the digestive tract. The pathogenesis of IBD remains elusive. Although a number of drugs have been developed to treat IBD, their effects are merely anti-inflammatory. In addition, current treatments for IBD are easily susceptible to resistance in clinical practice. Mesenchymal stem cells (MSCs) have been reported to have the ability to migrate to the site of inflammation, with potent immunoregulatory effects, and to rebalance the immune microenvironment and restore the integrity of the epithelial barrier with significant value of application, particularly for patients who are refractory to classic medicines. In this paper, we reviewed the clinical applications, mechanisms and engineerable properties of MSC products and their exosomes to provide some reference for the use of MSCs and their exosomes in the treatment of IBD.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective To investigate the serum levels of soluble programmed death-1 (sPD-1) and soluble programmed death-ligand 1 (sPD-L1) in chronic hepatitis B (CHB) patients with clinical cure, the correlation between programmed death-1 (PD-1) and lymphocytes by flow cytometry, and the recovery of hepatitis B virus (HBV)-specific immunity. Methods A total of 26 CHB patients with clinical cure, 26 treatment-naïve CHB patients, and 26 healthy controls who were diagnosed at the outpatient service of Peking University First Hospital from January to May of 2022 were enrolled, and related clinical data and peripheral blood samples were collected. ELISA was used to measure the serum levels of sPD-1 and sPD-L1, and flow cytometry was used to measure the expression of PD-1 in peripheral blood lymphocytes. CHB patients with clinical cure were compared with the treatment-naïve CHB patients and the healthy controls. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups, and the chi-square test was used for comparison of categorical data between groups. The Pearson correlation analysis or the Spearman correlation analysis was used to investigate the correlation between two continuous variables. Results For the 26 CHB patients with clinical cure, the mean time of antiviral therapy was 8.33 years, with entecavir as the antiviral drug. The CHB patients with clinical cure had significantly higher levels of sPD-1 and sPD-L1 than the healthy controls ( P < 0.05) and significantly lower percentages of PD-1 + cells/lymphocytes and PD-1 + CD8 + T cells/lymphocytes than the treatment-naïve CHB patients ( P < 0.05). In the treatment-naïve CHB patients, the serum levels of sPD-1 and sPD-L1 were moderately negatively correlated with HBsAg level ( r =-0.524 and -0.583, both P < 0.05). The serum levels of sPD-1 and sPD-L1 were moderately positively correlated with PD-1 + CD8 + T cells/lymphocytes ( r =0.535 and 0.419, both P < 0.05). In the CHB patients with clinical cure, the serum levels of sPD-1 and sPD-L1 were not correlated with age, sex, alanine aminotransferase, T cells/lymphocytes, CD8 + T cells/lymphocytes, PD-1 + T cells/lymphocytes or PD-1 + CD8 + T cells/lymphocytes (all P > 0.05). Conclusion The serum levels of sPD-1 and sPD-L1 in treatment-naïve CHB patients are mainly associated with exhausted CD8 + T cells in peripheral blood, while there is no significant correlation between serum sPD-1/sPD-L1 and exhausted CD8 + T cells in peripheral blood in CHB patients with clinical cure.

Objective:To summarize the best evidence of thirst management in peripheral surgical patients in China, and to provide theoretical basis for clinical thirst management.Methods:According to the PIPOST model, research questions were raised. According to the "6S" model, literature published by various guide websites, evidence-based databases, original research databases and professional association websites at home and abroad from database establishment to January 30, 2022 were systematically retrieved. Two researchers independently evaluated the quality of the literature and extracted and integrated the evidence of the literature that met the quality standards. The research team graded the evidence and determined the recommendation level.Results:A total of 15 literatures were selected, including 2 systematic reviews, 3 clinical decisions and 10 randomized controlled trials (RCTS) . A total of 23 evidences were sorted out, including 8 aspects such as drug factors affecting thirst, thirst assessment tools, preoperative thirst intervention strategy, postoperative safe drinking water assessment, postoperative thirst intervention strategy, nursing observation, health education and precautions.Conclusions:In the absence of uniform standards for perioperative thirst management, the evidence summarized in this study can provide evidence-based evidence for clinical nursing work.

Objective:To extract and summarize the best evidence of early ambulation after anterior cervical surgery, so as to provide practical basis for early ambulation of clinical patients.Methods:The research questions were proposed based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model. According to the "6S" model, the clinical guidelines, expert consensus, clinical decision-making, evidence summary, systematic reviews and randomized controlled trials related to "early postoperative activities of patients undergoing anterior cervical surgery" in databases such as UpToDate, British Medical Journal (BMJ) Best Practice website, Cochrane Library, China National Knowledge Infrastructure and WanFang Data were systematically retrieved. The retrieval time was from the establishment of the database to February 1, 2022. Two researchers independently evaluated the quality of the articles, and extracted and integrated the evidence of the articles meeting the quality standards.Results:A total of 10 articles were included, including two guidelines, three expert consensus, three systematic reviews, and two randomized controlled trials. It is summarized into 28 pieces of evidence and 7 dimensions, including multidisciplinary team cooperation, optimization of preoperative health education, preparation before ambulation, content of ambulation, multimodal analgesia management, nausea and vomiting management, and safety management of ambulation.Conclusions:The evidence included in this study provides a series of information for early ambulation after anterior cervical surgery. The medical and nursing staff should combine the evidence with the actual clinical situation, consider the value and expectation of the patient, comprehensively and individually evaluate the patient, and then make an early ambulation plan.

Objective:To retrieve and summarize the best evidence on non-pharmacological interventions for pain management in knee osteoarthritis.Methods:The literatures related to non-pharmacological intervention in pain management for knee osteoarthritis were searched on UpToDate, BMJ Best Practice, Australia Joanna Briggs Institute evidence-based healthcare center database, Cochrane Library, National Institute for Health and Clinical Excellence, Guidelines International Network, Medlive, Medline, PubMed, Wanfang database and China National Knowledge Infrasructure. The evidences were extracted after quality evaluation of the included literature.Results:A total of 11 references were included, including 6 guidelines, 2 expert consensuses, 2 systematic evaluations and 1 randomized controlled trial. Finally, 22 pieces of best evidences were summarized from 6 aspects, including health education, pain assessment, referral, psychological intervention, exercise intervention and physical therapy.Conclusions:Summary of the best evidence for non-pharmacological intervention in pain management for patients with knee osteoarthritis can provide evidence-based evidence for clinical healthcare professionals and knee osteoarthritis patients to undergo non-pharmacological pain intervention.

Objective:To compile Pressure Injury Prevention Behavior Assessment Scale (Patient Version) and conduct reliability and validity test.Methods:Guided by the theory of "patient participation in patient safety" , an item pool was initially constructed through literature review and patient interview, and Delphi expert consultation method was used to evaluate and screen items. From October to November 2021, the convenient sampling method was adopted to select 160 inpatients of Orthopedics Department of West China Hospital of Sichuan University as research objects for questionnaire survey, project analysis, reliability and validity test.Results:The formed Pressure Injury Prevention Behavior Assessment Scale (Patient Version) contained 21 items in 3 dimensions. The Cronbach 's α coefficient was 0.947, and the broken half reliability coefficient was 0.873. The content validity index at scale level was 0.958, and the content validity index at item level was 0.909-1.000. Exploratory factor analysis showed that the cumulative variance contribution rate of the three common factors was 61.931%. Conclusions:It is preliminarily verified that Pressure Injury Prevention Behavior Assessment Scale (Patient Version) has good reliability and validity, which can be used to evaluate the current situation of orthopaedic patients participating in the prevention of stress injury behavior and provide a basis for the corresponding intervention measures.

Objective:To summarize the evidence of cold therapy for patients after knee joint replacement, so as to provide theoretical support for the practical implementation of cold therapy in patients after knee joint replacement in clinical practice.Methods:The literature on cold therapy for patients after knee joint replacement was systematically searched in relevant databases and websites at home and abroad. The search period was from database establishment to September 2022. The evaluation of literature quality and evidence extraction were independently completed by two researchers.Results:A total of 17 articles were included, including two clinical practice guidelines, five systematic reviews, six randomized controlled trials, and four expert consensuses. After independent evaluation and evidence extraction by two researchers, a total of 19 pieces of evidence were collected from 5 aspects: evaluation and education, observation of cold therapy, cold therapy tools, cold therapy parameters, and cold therapy effects. Among them, 8 pieces of A-level recommended evidence and 11 pieces of B-level recommended evidence.Conclusions:Cold therapy for patients after knee joint replacement is widely accepted and applied. Medical and nursing personnel should prioritize patient safety and formulate scientific cold therapy plans based on various factors such as individual differences, patient preferences, actual clinical scenarios, differences in medical equipment, medical and nursing personnel technical level, and cost-effectiveness, in order to maximize patient benefits.

Objective To investigate the influencing factors for direct-acting antiviral agent (DAA) therapy failure in the treatment of hepatitis C by comparing baseline clinical data and resistance-associated substitution (RAS) in sequencing data between the patients with HCV RNA reactivation after DAA therapy and the patients with successful DAA treatment. Methods A total of 13 patients from multiple centers who failed DAA therapy from November 2019 to October 2021 were enrolled as treatment failure group, and sequencing was performed for their positive serum samples. A total of 51 patients with successful DAA treatment were enrolled as control group, and baseline clinical data and sequencing results were compared between the treatment failure group and the control group. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; univariate and multivariate logistic regression analyses were performed to calculate odds ratio ( OR ) and investigate the influencing factors for treatment failure. Results All 12 patients with complete treatment data experienced recurrence within 1 year after the end of medication. The male patients with treatment failure had significantly higher baseline total bilirubin, direct bilirubin, and creatinine than their female counterparts ( Z =-2.517, -2.440, and -2.132, P =0.010, 0.010, and 0.038), and the patients with an age of ≤55 years ( OR =5.152, 95% confidence interval [ CI ]: 1.116-23.790, P =0.036) or genotype 3b ( OR =9.726, 95% CI : 1.325-71.398, P =0.025) had a higher probability of treatment failure. There were differences in the incidence rates of major RAS mutations on three gene fragments between the treatment failure group and the treatment success group, and the common RAS mutations detected in the treatment failure group were not detected in the treatment success group. Conclusion Age, genotype, and RAS in serum virus gene sequence are influencing factors for DAA treatment failure.

[摘 要] 目的：探讨PD-1抗体联合化疗对比抗血管生成药物联合化疗在晚期驱动基因阴性肺腺癌一线治疗中的疗效和安全性。方法：收集2018年3月至2021年8月河北医科大学第四医院收治的141例不可手术切除的ⅢB/ⅢC和Ⅳ期驱动基因阴性肺腺癌患者，回顾性分析PD-1抗体联合化疗对比抗血管生成药物联合化疗在一线治疗中的疗效与安全性。主要研究终点为无进展生存期（PFS），次要终点为客观缓解率（ORR）、疾病控制率（DCR）和不良反应。结果：141例患者均纳入生存分析，中位随访时间为13.0个月（95% CI：12.0～14.0）。PD-1抗体联合化疗组（A组）和抗血管生成药物联合化疗组（B组）的ORR分别为33.33%和27.38%，DCR分别为98.25%和89.29%，差异均无统计学意义。A组和B组的中位PFS分别为8.4个月（95% CI: 7.3～9.9）和6.9个月（95% CI: 6.1～7.7），差异无统计学意义。亚组分析结果显示，ⅢB/ⅢC期、肝或脑转移患者中，A组中位PFS较B组均延长（均P<0.01）。A组和B组不良反应发生率分别为26.32%和14.29%，多数为1~2级。结论：PD-1抗体联合化疗对比抗血管生成药物联合化疗一线治疗晚期驱动基因阴性肺腺癌疗效相当，不良反应可耐受，可成为晚期驱动基因阴性肺腺癌标准一线治疗。