Ferroptosis mechanisms and its novel potential therapeutic targets for DLBCL.

Diffuse large B-cell lymphoma (DLBCL), a heterogeneous lymphoid malignancy, poses a significant threat to human health. The standard therapeutic regimen for patients with DLBCL is rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), with a typical cure rate of 50-70%. However, some patients either relapse after complete remission (CR) or exhibit resistance to R-CHOP treatment. Therefore, novel therapeutic approaches are imperative for managing high-risk or refractory DLBCL. Ferroptosis is driven by iron-dependent phospholipid peroxidation, a process that relies on the transition metal iron, reactive oxygen species (ROS), and phospholipids containing polyunsaturated fatty acids-containing phospholipids (PUFA-PLs). Research indicates that ferroptosis is implicated in various carcinogenic and anticancer pathways. Several hematological disorders exhibit heightened sensitivity to cell death induced by ferroptosis. DLBCL cells, in particular, demonstrate an increased demand for iron and an upregulation in the expression of fatty acid synthase. Additionally, there exists a correlation between ferroptosis-associated genes and the prognosis of DLBCL. Therefore, ferroptosis may be a promising novel target for DLBCL therapy. In this review, we elucidate ferroptosis mechanisms, its role in DLBCL, and the potential therapeutic targets in DLBCL. This review offers novel insights into the application of ferroptosis in treatment strategies for DLBCL.

Effects of the low-speed continuous infusion catheter technique on double-lumen central venous catheters: A randomized controlled trial.

BACKGROUND: Central venous catheters are widely used in clinical practice, and the incidence of central venous catheter occlusion is between 25 % and 38 %. The turbulence caused by the pulsatile flushing technique is harmful to the vascular endothelium and may lead to phlebitis. The low-speed continuous infusion catheter technique is a new type of continuous infusion that ensures that the catheter is always in a keep-vein-open state by continuous low-speed flushing; hence, avoiding the problem of catheter occlusion. OBJECTIVE: To investigate the effectiveness of the low-speed continuous infusion catheter technique and the routine care of double-lumen central venous catheters. DESIGN: This was a prospective, randomized, controlled, open-label trial. SETTING: Patients were recruited from 14 medical institutions in China between February and June 2023. PARTICIPANTS: In total, 251 patients were recruited, with 125 in the intervention group and 126 in the control group. METHODS: Patients who used double-lumen central venous catheters for infusion treatment were selected, and those who met the sampling criteria were randomly divided into intervention and control groups using the random envelope method. The intervention group used the low-speed continuous infusion catheter technique to maintain catheter patency, whereas the control group used routine care with a trial period of 7 days. The primary outcome was the occlusion rate. The secondary outcomes included nursing satisfaction and complication rates of the two groups. RESULTS: After 7 days, the rate of catheter occlusion was 28.0 % (35/125, 95 % confidence interval (CI):0.203, 0.367) in the intervention group and 53.97 % (68/126, 95 % CI: 0.449-0.629) in the control group, with a statistically significant difference (χ2 = 17.488, p < 0.001); at 3 days of intervention, the rate of catheter blockage was 8.0 % (10/125, 95 % CI: 0.039-0.142) in the intervention group and 23.8 % (30/126, 0.167-0.322) in the control group, with a statistically significant difference (χ2 = 11.707, p < 0.001). Nurse satisfaction was significantly higher in the intervention group (115/125, 92.0 %, 95 % CI: 0.858-0.961) than in the control group (104/126, 82.54 %, 95 % CI: 0.748-0.887) (χ2 = 5.049, p = 0.025). There were no statistically significant complication rates in either group (p = 0.622). CONCLUSION: The low-speed continuous infusion catheter technique helps maintain catheter patency, improves nurse satisfaction, and provides a high level of safety. REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2200064007, www.chictr.org.cn). The first recruitment was conducted in February. https://www.chictr.org.cn/showproj.html?proj=177311.

Factors Associated With Infections From Peripheral Venous Catheters in Older Patients in the ICU and Exploration of Preventive Measures.

Context: Intensive care units (ICUs) have the highest incidence of hospital-acquired infections. An in-depth understanding of the factors associated with PVIN infections may be the best way to prevent and control PVIN infections. Objective: The study aimed to investigate the factors associated with peripheral venous indwelling needle (PVIN) infections in older patients in the intensive care unit (ICU) and to use the findings to develop targeted preventive-care measures. Design: The research team conducted a prospective observational study of factors influencing PVIN infections and a prospective randomized controlled study of targeted nursing care. Setting: The studies took place at the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. Participants: For the first study, participants were 121 patients admitted to the hospital's ICU between April 2018 and June 2020, and for a second analysis, participants were 92 ICU patients admitted between December 2020 and March 2022. The first group took part in an analysis of the factors influencing PFIN infections and the second in a comparison of a targeted nursing intervention and routine care. Groups: For the first analysis, the research team divided the 121 participants into two groups: (1) a control group with 69 participants who didn't develop a PVIN infection and (2) an observation group with 52 participants who developed a PVIN infection. For the second analysis, the team randomly assigned the 92 participants to one of two groups: (1) 46 participants to a targeted nursing group who received care focused on preventing PVIN infections, and (2) 46 participants to a conventional group receiving routine care. Outcome Measures: For the first analysis, the research team carried out logistic regression analysis to assess the factors related to PVIN infections, including the incidence of PVIN infections, durations of PVIN retention, ICU stays, and lengths of hospital stay (LOS). For the second analysis, the research team: (1) measured changes in blood glucose and inflammatory factor levels at baseline and postintervention and (2) conducted a nursing satisfaction survey upon patients' discharges. Results: For the first study, logistic multiple regression analysis revealed that the durations of catheter retention of ≥7d, a number of punctures ≥2 times, a duration of antibiotic administration of ≥14d, and Acute Physiology and Chronic Health Evaluation (APACHE II) scores were independent risk factors for PVIN infections in older patients in an ICU (all P < .001). After implementing targeted nursing strategies for the second study, the targeted care group had a significantly lower incidence of PVIN infections (P < .001), shorter duration of PVIN retention (P < .001), shorter ICU stay (P < .001), and shorter LOS (P < .001) compared to those of the conventional group. Additionally, the intervention group showed significantly lower fasting plasma glucose (FPG) and 2h postprandial plasma glucose (2hPG) levels, with P < .001 and P = .002, respectively; significantly lower interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) levels, with P < .001, P < .001, and P = .001, respectively; and significantly higher nursing satisfaction postintervention (P = .036). Conclusions: The duration of catheterization, antibiotic administration, and APACHE II scores were independent risk factors for PVIN infections in older patients in the ICU. Implementing targeted care based on those factors can effectively prevent PVIN infections in ICU patients and improve patient satisfaction, demonstrating high clinical practicality.

The potential of targeting cuproptosis in the treatment of kidney renal clear cell carcinoma.

Renal cell carcinoma (RCC) is one of the top ten malignancies and tumor-related causes of death worldwide. The most common histologic subtype is kidney renal clear cell carcinoma (KIRC), accounting for approximately 75% of all RCC cases. Early resection is considered the basic treatment for patients with KIRC. However, approximately 30% of these patients experience recurrence post-operation. Cuproptosis, an autonomous mechanism for controlling cell death, encompasses various molecular mechanisms and multiple cellular metabolic pathways. These pathways mainly include copper metabolic signaling pathways, mitochondrial metabolism signaling pathways, and lipoic acid pathway signaling pathways. Recent evidence shows that cuproptosis is identified as a key cell death modality that plays a meaningful role in tumor progression. However, there is no published systematic review that summarizes the correlation between cuproptosis and KIRC, despite the fact that investigations on cuproptosis and the pathogenesis of KIRC have increased in past years. Researchers have discovered that exogenous copper infusion accelerates the dysfunction of mitochondrial dysfunction and suppresses KIRC cells by inducing cuproptosis. The levels of tricarboxylic acid cycle proteins, lipoic acid protein, copper, and ferredoxin 1 (FDX1) were dysregulated in KIRC cells, and the prognosis of patients with high FDX1 expression is better than that of patients with low expression. Cuproptosis played an indispensable role in the regulation of tumor microenvironment features, tumor progression, and long-term prognosis of KIRC. In this review, we summarized the systemic and cellular metabolic processes of copper and the copper-related signaling pathways, highlighting the potential targets related to cuproptosis for KIRC treatment.

Effects of group psychological counselling on transition shock in newly graduated nurses: A quasi-experimental study.

AIM: This study examined the effects of group psychological counselling on transition shock in newly graduated nurses. BACKGROUND: Newly graduated nurses are often faced with transition shock as they enter the workforce. Helping them adapt to the new work environment and role as quickly as possible is an important goal for nursing managers. METHOD: This prospective, parallel-group, quasi-experimental trial enrolled 71 newly graduated nurses who were randomly assigned to the intervention (n = 38) or control (n = 41) group. In addition to routine hospital training, the intervention group received psychological counselling. Participants were evaluated with the Transition Shock Scale of Newly Graduated Nurses before (pre) and after (post) the training with or without intervention. RESULTS: The total score and score on each dimension of the scale were decreased after the intervention (P < .05); control subjects showed no difference between pre- and post-scores. The total score and score on each dimension were higher in the control group than in the intervention group (P < .05). CONCLUSION: Psychological counselling alleviates transition shock in newly graduated nurses entering the workforce. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can introduce group psychological counselling into their training programmes to increase the job readiness of newly graduated nurses.