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KLKs have been proved to be key regulators of the tumor microenvironment. In this study, we explored the potential of Kallikrein-related peptidases (KLKs) as clinical diagnostic and prognostic markers in patients with kidney renal clear cell carcinoma (KIRC) as well as their relationship with common immuno-inhibitor and immune cell infiltration in the tumor microenvironment to provide new targets and novel ideas for KIRC therapy. Oncomine, Gene Expression Profiling Interactive Analysis (GEPIA), UCSC Xena, Genotype-Tissue Expression (GTEx), Kaplan-Meier plotter, cBioPortal, STRING, GeneMANIA, and TISIDB were used to analyze the differential expression, prognostic value, gene changes, molecular interaction, and immune infiltration of KLKs in patients with KIRC. From the gene expression level, it can be determined that KLK1, KLK6, and KLK7 are differentially expressed in KIRC and normal tissues. From the perspective of clinical prognosis, KLK1, KLK13, and KLK14 are highly correlated with the clinical prognosis of KIRC. The expression of KLKs is regulated by various immunosuppressive agents, with KDR, PVRL2, and VTCN1 being the most significant. The expression of KLKs is significantly correlated with the infiltration of various immune cells, of which Eosinophils and Neutrophils are the most significant. KLK1, KLK6, KLK7, KLK13, and KLK14 have potential as diagnostic and prognostic biomarkers, among which KLK1 is the most significant. This study may provide detailed immune information and promising targets for KIRC immunotherapy to assist in designing new immunotherapies.

Olfactory dysfunction (OD) is a common nasal disease, particularly prevalent among the elderly population, significantly impacting the affected individuals’ quality of life. This review focuses on the influence of aging and chronic inflammation on olfactory dysfunction, presenting insights from both the peripheral and central olfactory systems. By exploring the molecular mechanisms and pathological changes underlying the occurrence of olfactory dysfunction in relation to age-related diseases and chronic inflammation conditions, we aim to provide a comprehensive theoretical foundation for further research and offer valuable insights for more effective treatment of olfactory dysfunction.

To explored the anti-inflammatory mechanisms of total flavonoids of Hemsl. (PFHF) using network pharmacology, molecular docking, and cellular experiments. Key components, targets, and pathways of PFHF were identified via literature and network pharmacology, with molecular docking and dynamics simulations validating binding to therapeutic targets. RAW264.7 cells were treated with lipopolysaccharide (LPS) to establish inflammation, and groups included blank controls, LPS-induced models, prednisolone acetate, and low/high-dose PFHF. Cytokine levels (IL-6, TNF-α, IL-1β) were measured by ELISA, while immunofluorescence assessed protein expression post-PFHF treatment. Six major active components were identified, alongside 44 active components, 1,178 inflammatory genes, and 18 target genes. Core targets included IL-6, TNF, IL1B, INS, and CASP3. Gene Ontology (GO) analysis linked these targets to protein localization, membrane rafts, and receptor activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways highlighted IL-17, TNF, and NOD-like receptor signaling. Molecular docking confirmed rutin's strong binding to IL-6, TNF, IL-1β, INS, and CASP3. HPLC quantified rutin at 0.09 mg/mL. PFHF inhibited RAW264.7 proliferation with IC50 values of 206.32 µg/mL (24h) and 102.39 µg/mL (48h). High-dose PFHF reduced IL-6, TNF-α, and IL-1β (P<0.05) versus the model group. Immunofluorescence revealed elevated INS (P<0.05) and reduced CASP3 (P<0.01), iNOS, and Cox-2 (P<0.0001) in treated cells. PFHF exerts anti-inflammatory effects via IL-17 and TNF pathways, targeting IL-6, TNF-α, INS, IL-1β, and CASP3, mediated by rutin and other components.

The olfactory epithelium (OE) undergoes life-long renewal and regeneration. This process is supported by the globose basal cells (GBC) during the homeostatic state, as well as horizontal basal cells (HBC) during severe damage. Inflamm-aging refers to the low-grade, chronic and progressive state of heightened pro-inflammation associated with aging. However, the impact of inflamm-aging on OE homeostasis, regeneration, and the inflammatory microenvironment is not fully understood. In this study using mouse models, we elucidate the role of interleukin-17a (IL-17a) in OE regeneration and olfactory function. Our findings implicate that inflamm-aging in aged OE promotes the recruitment and activation of immune cells, accompanied by crosstalk between HBC and T cells. Elevated expression of IL-17a in aged OE triggers inflammatory signals and impairs olfactory function. Administration of IL-17a inhibitor Y-320 or neutralizing antibody promotes sensory neuronal regeneration and reverses age-related respiratory metaplasia in OE. Co-culturing mouse OE organoids with Th17 cells impairs neuronal generation and enhances the transformation towards respiratory cells, while neutralizing antibody against IL-17a alleviates neuronal loss and respiratory transformation. Additionally, conditional knockout of IL-17a in T cells facilitates OE regeneration by promoting HBC recruitment and differentiation into GBC. Collectively, our study identifies a function of IL-17a in OE regeneration and age-related deficits in olfactory function, providing evidence for further investigation of IL-17a as a possible therapeutic target against presbyosmia. The olfactory epithelium (OE) undergoes changes during aging and this may affect inflammatory responses and immune cell infiltration. Here the authors look at the effect of aging on OE and how this involves cross talk between T cells and horizontal basal cells involving Il17a expression in OE which is increased in aging and inhibition of IL-17a function reduces respiratory metaplasia.

Objective This study aimed to provide an updated assessment of the clinical efficacy and safety of arthroscopic debridement combined with platelet-rich plasma injection for the treatment of knee osteoarthritis. Methods On 16 August 2025, we systematically searched multiple databases, including the Cochrane Library, Embase, Ovid Medline, PubMed, Web of Science, China Biology Medicine Disc, China National Knowledge Infrastructure, Wanfang, and VIP Chinese Science and Technology Journal Database (VIPC), for randomized controlled trials evaluating the efficacy of arthroscopic debridement combined with platelet-rich plasma injection in the management of knee osteoarthritis. Outcome measures included the following: (a) clinical response rate; (b) visual analog scale score; (c) Lysholm score; (d) Western Ontario and McMaster Universities Osteoarthritis Index score; and (e) adverse reactions. Data were recorded and analyzed using RevMan 5.4 software. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the research protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform (registration number: CRD420251127571). Results A total of 17 studies involving 1587 patients were included. Meta-analysis results showed that compared with the control group, the treatment group demonstrated a statistically significant difference in the overall clinical response rate: odds ratio = 5.38; 95% confidence interval: 3.45, 8.38; p < 0.00001. Subgroup analyses based on follow-up duration (3, 6, and 12 months) demonstrated a p value of 1.00 and I² value of 0%. Meta-analysis results for each subgroup were as follows: odds ratio = 5.66; 95% confidence interval: 2.14, 14.94; p = 0.0005 for 3 months; odds ratio = 5.68; 95% confidence interval: 2.87, 11.27; p < 0.00001 for 6 months; and odds ratio = 5.40; 95% confidence interval: 2.44, 11.96; p < 0.0001 for 12 months. The treatment group also exhibited a statistically significant reduction in visual analog scale scores: mean difference = −0.62; 95% confidence interval: −1.03, −0.20; p = 0.004. Lysholm scores increased significantly in the treatment group: mean difference = 5.07; 95% confidence interval: 2.99, 7.14; p < 0.00001. The Western Ontario and McMaster Universities Osteoarthritis Index score indicated statistically significant difference: mean difference = −8.65; 95% confidence interval: −11.13, −6.18; p < 0.00001. Adverse reaction rate demonstrated no statistically significant difference: odds ratio = 0.73; 95% confidence interval: 0.28, 1.89; P = 0.52. Conclusion The overall clinical response rate of arthroscopic debridement combined with platelet-rich plasma injection for knee osteoarthritis was significantly higher than that of the control group. The visual analog scale scores were lower, indicating effective pain relief in patients with knee osteoarthritis. The Lysholm scores were higher, demonstrating a significant improvement in knee function compared to the control group. The Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly lower than that of the control group, reflecting substantial efficacy of arthroscopic debridement combined with platelet-rich plasma injection in treating knee osteoarthritis by improving pain, stiffness, and functional impairment. The incidence of adverse reactions in the arthroscopic debridement combined with platelet-rich plasma injection group did not differ significantly from that in the control group, indicating that platelet-rich plasma injection does not increase the risk of adverse events.

Background Neutrophil-to-HDL-C ratio (NHR) has recently emerged as a composite biomarker integrating lipid metabolism and inflammatory status. Nevertheless, its potential association with the risk of gout or hyperuricemia remains inadequately explored. The present study aimed to examine the possible link between NHR and both conditions. Methods This study included 31,117 eligible adults from the 2007–2018 NHANES database in the United States. Participants were categorized into NHR quartiles, and weighted multivariate logistic regression along with restricted cubic spline (RCS) analyses was performed to assess its association with gout and hyperuricemia risk. Subgroup analyses were performed to assess the robustness and heterogeneity of the association across different subpopulations. All analyses were weighted to guarantee the generalizability of the findings to the national population. Results A positive correlation was observed between NHR and the risk of both gout and hyperuricemia. As NHR levels increased, the proportion of participants with gout or hyperuricemia rose significantly—specifically, the prevalence of gout was 2.46%, 3.69%, 4.24%, and 5.79% ( p  < 0.001), and for hyperuricemia, it was 13.63%, 17.38%, 20.65%, and 26.08% ( p  < 0.001), respectively. Multivariable logistic regression indicated that, in the unadjusted Model 1 analysis, each 1-unit increase in NHR was associated with a 5.1% higher risk of gout (OR = 1.051, 95% CI 1.036–1.069, p  < 0.001) and a 5.8% higher risk of hyperuricemia (OR = 1.058, 95% CI 1.051–1.066, p  < 0.001). The positive association remained stable and statistically significant after adjusting for potential confounding variables. Further RCS analysis revealed a nonlinear trend in the relationship between NHR and both conditions, with a potential risk threshold of approximately 16, beyond which the risk of disease increased substantially. Additionally, receiver operating characteristic (ROC) analysis showed that the NHR had better discriminatory performance than either HDL-C or NEU alone in predicting hyperuricemia (AUC = 0.682) and gout (AUC = 0.81). Conclusion NHR showed a significant association with the risk of gout and hyperuricemia, demonstrating a nonlinear dose–response pattern. NHR may serve as a promising inflammation–metabolism marker for the early identification of individuals at risk for uric acid-related disorders.

Background Nursing students encounter various stressors during their clinical practicum; however, the stressors are not the same during different periods. At present, studies on the stressors and coping styles of nursing students in the middle period of their clinical practicum are rare. Aims The current study aimed to explore the stressors and coping styles of nursing students in the middle period of their clinical practicum. Methods A qualitative study with a descriptive phenomenological method was conducted to collect data from 10 nursing students undergoing the middle period of their clinical practicum from December 2020 to February 2021. The data were collected by semistructured interviews using interview outlines prepared in advance. The data were analyzed by Colaizzi’s analysis method. Results The stressors experienced by nursing students in the middle period of their clinical practicum mainly included personal reasons, teaching arrangements, interpersonal relationships, occupational particularity and career planning. Additionally, nursing students coped with the stressors that they face in the clinical practicum by eliminating stressors and regulating emotions. Conclusions Nursing students experienced various stressors and used a variety of coping styles in the middle period of their clinical practicum, which was different from what occurred in the early and late periods. Targeted interventions should be formulated and implemented to relieve nursing students’ stress and guide them to adopt effective coping styles.

Background Nursing is a stressful profession that can impact the physical and mental health of nurses as well as the safety of patients. Furthermore, various factors may affect the job stress of nurses. However, recent studies mainly focused on the overall level of job stress and its related factors, ignoring the population heterogeneity of nurses’ job stress. Methods A total of 440 nurses participated in the questionnaire survey between March 2023 and April 2023. Data were collected using the Demographic Characteristics Questionnaire, the Nursing Job Stressor Inventory, the Generalized Anxiety Disorder 7-item Scale, and the Nurse Job Performance Scale. A latent profile analysis was used to identify the latent profiles of job stress. Kruskal-Wallis H test and ordinal logistic regression were used to explore the predictors of different profiles. Results The job stress of nurses could be classified into four profiles: relatively low job stress, relatively high job stress, high job stress, and the highest job stress. Generalized anxiety disorder, job performance, health status, and dislike of nursing as a career were predictors of different profiles. Conclusions The majority of nurses were classified into profile 2, and their job stress was relatively high. Lowering anxiety levels, enhancing job performance, improving nurses’ health status, and changing professional attitudes toward nursing may be effective ways to reduce nurses’ job stress.

Background Due to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP). Methods A cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP. Results The item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity. Conclusion The 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.

Background Developing a strong professional identity is crucial to helping nursing students pursing nursing career. Stress and coping are two factors that may influence professional identity. The relationship between nursing interns’ professional identity, coping, and perceived stress, however, has not received much attention in the literature. This study aimed to examine the role of coping as a mediator in the relationship between perceived stress and professional identity among nursing interns. Methods In September 2020, a cross-sectional study was done at a Chinese medical university. Data were collected online from 213 nursing interns via convenience sampling using the personal characteristics questionnaire, the professional identity scale for nursing students, the stress rating scale for nursing students in practice and the simplified coping style questionnaire. Multiple regression analysis, and a bootstrap approach with SPSS Process macro were adopted to examine the mediating role of coping on perceived stress and professional identity. Results The overall mean score for nursing interns’ professional identity was 3.30 ± 0.51. Perceived stress was negatively correlated with professional identity ( r = -0.217, p  < 0.01), and positively correlated with positive coping style ( r  = 0.168, p  < 0.05). Positive coping style was positively correlated with professional identity ( r  = 0.177, p  < 0.01). Positive coping style acted as a mediator between perceived stress and professional identity among nursing interns. Conclusion This study showed that nursing interns had a medium level of professional identity and the negative influence of stress perceived by nursing interns on their professional identity might be buffered by the increased use of positive coping style. Therefore, coping training programs should be developed to help mitigate the negative impact of stress on the professional identity of nursing interns in clinical practicum.