Immune therapy has significantly improved the prognosis of patients with advanced non-small cell lung cancer. However, the associated immune-related adverse events directly affect the patients' survival benefits and quality of life. The occurrence of immune-related adverse events shows individual variability and is closely related to factors such as treatment cycles. Therefore, there is an urgent clinical need to implement individualized treatment and nursing interventions based on the specific types and severity of immune-related adverse events. Based on the latest domestic and international evidence-based medical evidence, this consensus systematically integrated relevant guidelines and literature, and elaborated in detail on the incidence rates, risk factors, hierarchical management strategies, and targeted nursing measures for various immune-related adverse events in the immunotherapy of advanced non-small cell lung cancer, as well as key points for guidance on home care, aiming to provide standardized and systematic scientific guidance for clinical nursing practice, enhance patients' self-management ability, and ensure treatment safety and continuity.

To analyze the clinical and pathological characteristics of children with lupus nephritis (LN) complicated by hyperuricemia (HUA), and to identify the factors influencing serum uric acid (SUA) levels.

SUA data of were collected from LN children admitted to the Children's Hospital Affiliated to Nanjing Medical University from January 2017 to December 2024, with healthy children enrolled as the control group. The incidence of HUA was compared between LN children and healthy children. Additionally, LN children were divided into a HUA group and a non-hyperuricemia (NHUA) group. Differences in clinical manifestations, pathological findings, and laboratory indicators between the two groups were compared, and independent factors influencing SUA were identified.

The incidence of HUA was 16.0% (17/106) in healthy children and 50.9% (54/106) in LN children. Compared with the NHUA group, the HUA group had significantly higher SLEDAI-2K scores (P＜0.001) and higher rates of serositis and hypertension (P=0.012 and P＜0.001, respectively) as clinical manifestations; higher acute activity index scores and a greater proportion of renal interstitial inflammatory cell infiltration (P=0.007 and P＜0.001, respectively) as pathological results; and poorer renal function-related indicators (P＜0.001), lower complement C3 levels (P=0.010), and more pronounced proteinuria (P＜0.05) as laboratory indicators. Multivariate Logistic regression analysis incorporating the above variables identified low complement C3 level as an independent factor influencing SUA.

The incidence of HUA is significantly higher in LN children than in healthy children. LN children complicated with HUA present more severe disease manifestations; therefore, SUA levels should be monitored in clinical practice. Furthermore, low complement C3 level is an independent factor influencing SUA, providing a useful reference for identifying high-risk children in the clinical setting.

To investigate the association of anti-Ro52 antibody with the clinical features and disease progression of anti-synthetase syndrome (ASS) associated interstitial lung disease (ILD).

Clinical data were obtained and reviewed from 90 patients with ASS-ILD. All patients were followed, and based on high-resolution computed tomography (HRCT) findings, they were divided into a disease progression group (n=23) and a stable group (n=67). According to serological results, the patients were further subdivided into an anti-Ro52 antibody positive group (n=76) and an anti-Ro52 antibody negative group (n=14). Clinical data were then compared between groups, and a Logistic regression model was used to analyze the risk factors affecting the progression of ASS-ILD.

Of the 90 ASS-ILD patients, 23 (25.6%) were in the progressive group and 67 (74.4%) in the stable group. The proprotion of patients with fever, baseline levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), troponin I (TnI), C-reaction protein (CRP), serum ferritin (sFe), and serum carbohydrate antigen 125 (CA125), as well as the positive rates of anti-Ro52 and anti-PL-7 antibodies and the proportion of patients with a high titer of anti-Ro52 antibody were significantly higher in the disease progression group than in the stable group (P＜0.05). Baseline forced vital capacity (FVC%) and diffusion capacity of carbonmonoxide (DLCO%) was significantly lower in the progression group, whereas the frequency of relapse and baseline glucocorticoid dose were significantly higher (P＜0.05). Multivariate logistic regression analysis identified fever, low baseline lung function, more relapses, and a high titer of anti-Ro52 antibody were risk factors for the progression of ASS-ILD (P＜0.05). Among the 90 patients, 76 (84.4%) were positive for anti-Ro52 antibodies, and 14 (15.6%) tested negative. Compared with the anti-Ro52 antibody-negative group, the positive group had a higher prevalence of Raynaud's phenomenon, a higher frequency of fever, elevated baseline levels of ESR, CRP, sFe, and CA125, and more frequent relapses (P＜0.05). In contrast, baseline FVC% and DLCO% were significantly lower in the anti-Ro52 antibody positive group (P＜0.05).

Fever, low baseline lung function, more relapses, and a high titer of anti-Ro52 antibody are risk factors for the progression of ASS-ILD. Patients with anti-Ro52 antibody positive ASS-ILD exhibit more pronounced inflammation and worse baseline lung function. Therefore, closer monitoring of inflammatory markers and pulmonary function should be implemented in this patient population.

To compare the clinical efficacy of arthroscopic hamstring tendon reconstruction versus artificial ligament reconstruction in the treatment of anterior cruciate ligament (ACL) injuries by evaluating sports performance and joint functional recovery to inform clinical decision-making.

A retrospective analysis was conducted on 80 patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction at our institution between June 2023 and June 2025. Based on the type of graft used, the patients were divided into two groups: an autograft group (n=43) and an artificial ligament group (n=37). Knee function was assessed preoperatively and at 8 weeks, 3 months, and 6 months postoperatively using the Lysholm score and the International Knee Documentation Committee (IKDC) score. Additionally, the time to return to sports, the activity level at the aforementioned time points (measured by the Tegner Activity Scale), and the incidence of complications at 9 months postoperatively were compared between the two groups.

At eight weeks, three months, and six months postoperatively, the Lysholm and IKDC scores of both groups were significantly higher than the preoperative values (P＜0.001). Repeated-measures analysis of variance (ANOVA) revealed a statistically significant main effect of time in both groups (Lysholm: F=1548.57, P＜0.001; IKDC: F=3394.49, P＜0.001), while no statistically significant main effect of group was found (Lysholm: F=0.904, P=0.345; IKDC: F=1.22, P=0.273). A significant time-by-group interaction effect was present in both groups (Lysholm: F=14.72, P＜0.001; IKDC: F=4.98, P=0.003). However, there were no statistically significant differences in Lysholm and IKDC scores between the two groups at each individual time point (P＞0.05). The time to return to sports was shorter in the artificial ligament group than in the autologous tendon group (P＜0.05). At eight weeks, three months, and six months postoperatively, the Tegner scores of both groups were significantly higher than the preoperative scores (P＜0.001), and the scores of the artificial ligament group were significantly higher than those of the autologous tendon group at each postoperative time point (P＜0.05). No statistically significant difference was noted in the complication rates between the two groups (P＞0.05).

Both arthroscopic hamstring tendon reconstruction and artificial ligament reconstruction can effectively improve knee joint function in patients with ACL injuries and demonstrate comparable safety profiles. However, artificial ligament reconstruction is associated with faster recovery of joint function and a shorter time to return to sports in the early postoperative period, making it a more suitable option for young and middle-aged patients with high demands for rapid rehabilitation and sports resumption.

To evaluate the value of oral-intravenous dual-contrast gastrointestinal ultrasound in the diagnosis of early gastric cancer.

A total of 65 patients suspected of having early gastric cancer who underwent oral-intravenous dual-contrast gastrointestinal ultrasound were included. Pathological examination confirmed early gastric cancer in 48 cases. The diagnostic accuracy of oral contrast-enhanced ultrasound alone was compared with that of dual-contrast ultrasound, using pathological findings as the reference standard. Furthermore, by evaluating lesion location, extent, alterations in the layered structure of the gastric wall, and blood flow perfusion characteristics, the accuracy and clinical significance of dual-contrast ultrasound in preoperative T-staging of early gastric cancer were analyzed.

After oral gastrointestinal contrast-enhanced ultrasound alone, early gastric cancer lesions appeared as hypoechoic protrusions or localized thickening of the gastric wall. With dual-contrast ultrasound (combined oral and intravenous contrast), the lesions demonstrated hyperenhancement in the arterial phase with rapid washout in the venous phase. The detection rate for oral contrast-enhanced ultrasound alone and dual-contrast ultrasound was 55.39% and 70.77%, respectively; the sensitivity was 75.00% and 95.83%; the specificity was 70.59% and 88.24%; the accuracy was 73.85% and 93.85%; and the missed diagnosis rate was 25.00% and 4.17%, respectively. All these differences were statistically significant (P＜0.05). The positive predictive value was 87.81% and 95.83%, respectively, and this difference was not statistically significant (P＞0.05). The accuracy of T-staging by dual-contrast ultrasound was 97.92%.

Dual-contrast ultrasound can clearly delineate the location, extent, layer invasion depth, and blood perfusion characteristics of early gastric cancer, playing a significant role in improving the detection rate and preoperative T-staging accuracy of early gastric cancer.

To investigate the effect of multisensory stimulation intervention in improving anxiety and depression levels in patients with hematological tumors undergoing peripherally inserted central catheter (PICC) placement.

One hundred patients with hematological tumors who underwent PICC placement at the PICC intravenous therapy clinic of a tertiary hospital in Inner Mongolia Autonomous Region, China from November 2024 to August 2025 were randomly divided into an experimental group and a control group. Both groups received routine negative psychological intervention, and the experimental group additionally received multisensory stimulation intervention. Anxiety and depression levels were compared between the two groups before and after intervention.

After intervention, the experimental group had lower anxiety and depression scores than the control group, indicating that this intervention effectively alleviates patients' anxiety and depression.

Multisensory stimulation intervention can alleviate anxiety and depression levels in patients with hematologic malignancies undergoing PICC placement.

To explore the perceptions, attitudes, and recommendations of healthcare personnel in primary healthcare institutions toward granting prescribing authority to public health physicians, aiming to provide theoretical support for the subsequent formal nationwide implementation of such authority.

A self-designed questionnaire was used to conduct a survey among various medical personnel in primary healthcare institutions in Jiangsu Province, selected via convenience sampling. Quantitative data were analyzed using SPSS 27.0 software for descriptive statistics, and qualitative data were analyzed using Nvivo 20.0 software.

A total of 564 valid questionnaires were collected, yielding a response effectiveness rate of 94%. The sample consisted of 149 public health physicians, 292 other physicians, and 133 other healthcare personnel. Overall, attitudes toward granting prescription authority to public health physicians were positive across all groups. Specifically, 96% of public health physicians, 96.2% of other physicians, and 98.4% of other healthcare personnel expressed support.

Healthcare professionals across all categories in primary healthcare institutions in Jiangsu Province demonstrate strong support for granting prescription authority to public health physicians. Empowering public health physicians with prescription rights may facilitate the integration of medical and preventive services and enhance the capacity of primary healthcare. To ensure the safe and effective implementation of these rights, it is necessary to improve the relevant legal framework, clarify the role and scope of prescription authority for public health physicians, and intensify both the depth and breadth of prescription training.

Primary hyperparathyroidism is a common endocrine metabolic disorder that can lead to multisystem target-organ damage, substantially impairing patients' quality of life and long-term prognosis. In recent years, ultrasound-guided thermal ablation has emerged as a minimally invasive treatment option for primary hyperparathyroidism and has demonstrated reliable efficacy with an acceptable safety profile in multiple studies. This review summarizes the research background, technical aspects, therapeutic outcomes, and complication management of thermal ablation in the treatment of primary hyperparathyroidism, with the goal of informing clinical practice and guiding future investigations.

One-carbon metabolism is a fundamental intracellular pathway responsible for methyl donor transfer, governing essential processes such as epigenetic regulation and neurotransmitter synthesis, and thus plays a pivotal role in brain health and disease. Dysregulation of this metabolic pathway is increasingly linked to cognitive disorders like Alzheimer's disease and vascular cognitive impairment, where it contributes to pathology by disrupting epigenetic programming, neuroenergetics, and synaptic transmission. This review synthesizes current evidence to elucidate the mechanistic connections between one-carbon metabolism and cognitive function, focusing on its metabolic pathways, key pathogenic mediators, such as homocysteine, and potential therapeutic interventions targeting these pathways.

Kidney stones are a common urological condition, with calcium oxalate stones accounting for more than 75% of cases. Their pathogenesis is closely associated with metabolic imbalance in the body. The gut-kidney axis, as a key pathway for material exchange and signal transmission between the intestine and the kidney, plays a central role in regulating renal calcium metabolism, oxidative stress, and crystal adhesion. However, the regulatory function of the gut-kidney axis does not operate independently; rather, it relies on the synergistic effect of various active substances, among which fat-soluble vitamins are key regulatory factors. Fat-soluble vitamins can directly regulate the intestinal absorption efficiency of stone-related substances such as calcium and oxalic acid. They can also indirectly interfere with kidney stone formation by affecting renal oxidative stress levels, the activity of ion transporters, and the function of vitamin-dependent proteins, thus serving as an important link connecting the gut-kidney axis to the pathogenesis of kidney stones. This article systematically reviews the metabolic characteristics of four fat-soluble vitamins (A, D, E, and K), their roles in the "intestinal absorption-material transport-renal effect" process via the gut-kidney axis, and the mechanisms by which they regulate kidney stone formation. In addition, it highlights the limitations of current research and suggests future research directions, providing a theoretical basis for the prevention and precise intervention of kidney stones.