Dormant tumor cells (DTCs) serve a crucial role in the pathogenesis of metastasis and may compromise the efficacy of existing therapeutic modalities aimed at fully eradicating cancer. However, the mechanisms underlying the dormant-to-proliferating switch of DTCs remain largely unknown. The lung is one of the most common sites of metastatic recurrence. The transdifferentiation of alveolar epithelial cells II (AEC IIs) to AEC Is is a hallmark of alveolar epithelial stimulation. However, the role of AEC II transdifferentiation during the reactivation of DTCs has not been fully elucidated. In the present study, we found that tumor cells promoted the transdifferentiation of AEC IIs. Furthermore, the supernatant of the transdifferentiation of AEC IIs to AEC Is (Super-TDA) promoted the dormant-to-proliferating switch of DTCs via the autocrine effect of TGF-β1 on the 3D BME culture system in vitro. Monensin and LY2109761 blocked the dormant-to-proliferating switch of DTCs induced by Super-TDA. Although lipopolysaccharide did not directly stimulate the reactivation of DTCs, it promoted DTC reactivation by increasing the secretion of TGF-β1 in the Super-TDA. We further demonstrated that the upregulation of SNAI2 expression was required for Super-TDA facilitating the DTC dormant-to‑proliferating switch. Taken together, our findings demonstrated that tumor cells may promote AEC II transdifferentiation. Furthermore, the transdifferentiation of AEC IIs may, in turn, induce the reactivation of 3D-established DTCs by promoting TGF-β1/SNAI2 signaling. Targeting this process may provide novel therapeutic strategies for the inhibition of the dormant‑to-proliferating switch.

Objective To investigate the willingness of nurses in Yichang to participate in “Internet plus nursing services” and analyze the influencing factors in order to provide reference for the implementation of “Internet plus nursing services”. Methods Using the “Internet plus Nursing Service” questionnaire, a cross-sectional survey was conducted among 1447 nurses in Yichang by convenience sampling from July to September in 2022, and the related influencing factors were analyzed. The questionnaire was composed of two parts: the demographic characteristics and the questionnaire of nurses’ willingness to participate in “Internet plus nursing service”, including 4 dimensions: awareness, promoting factors, concern factors and training needs. Likert 5-point scoring method was used for scoring. Binary logistic regression was used to screen the variables, and the ROC curve and Nomogram risk prediction model were drawn. Results A total of 1233 valid questionnaires were collected. It shows that 76.07% of nurses in Yichang are willing to participate in “Internet plus nursing services”. Among them, education background, specialist nurses, awareness, promotion factors, concerns and training needs are the independent influencing factors (all P < 0.05). The area under the ROC curve (AUC) of the prediction model is 0.802, and the consistency index (c-index) of nomogram is 0.800. The average absolute error of internal calibration is 0.014, and the model has good accuracy and discrimination. Conclusion Nurses in Yichang have a high willingness to participate in “Internet plus nursing services”, a low awareness of the program and a high demand for relevant professional training. It is suggested that the government and hospitals should strengthen the publicity of “Internet plus nursing services”, improve relevant laws and regulations and strengthen the construction of specialist nurses’ team, so as to provide a good practice environment for nurses’ door-to-door service.

Background: With the increasing pace of China's aging population, the growing demand for public health services and the shortage of nursing human resources have become more prominent. The “Internet+ Nursing Services” have received more attention. Exploring the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services” and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services”, and to test the validity and reliability of the scale. Methods: A preliminary scale was developed through literature review, theoretical research, semi-structured qualitative interviews, and two rounds of Delphi expert inquiry. A convenience sampling method was used for the questionnaire survey. Likert 5-point scoring was used to assign importance to the items. The survey data of 659 clinical nurses from February to March 2023 were used for item analysis, exploratory factor analysis, and reliability and validity tests of the pre-test scale. The survey data of 538 clinical nurses in April 2023 were used for confirmatory factor analysis of the formal scale. Results: The final scale consisted of 25 items and 4 dimensions (performance expectation, perceived risk, professional knowledge training needs, and non-professional knowledge training needs). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the KMO value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The content validity index of the scale (S-CVI) was 0.914. The confirmatory factor analysis model fit indices were good: χ2/df=4.234, RMSEA=0.078, NFI=0.940, IFI=0.953, TLI=0.947, and CFI=0.953. Conclusion: The scale for assessing the obstacles and promoting factors of nurses' willingness to participate in “Internet+ Nursing Services” has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in “Internet+ Nursing Services”.

Diesel poisoning is a rare clinical condition. On September 27, 2021, a 55-year-old male who mistakenly inhaled 20 mL of diesel through a siphon was admitted to our hospital. The main symptoms were cough and asthma. Chest computed tomography (CT) showed both lungs scattered with patchy consolidation, ground-glass shadow, exudation, and pleural effusion. After 61 days of lung rehabilitation training and other supportive treatment, including oxygen therapy, postural drainage, ventilator support, bronchoalveolar lavage, hemoperfusion, continuous renal replacement therapy (CRRT), hormones, and antibiotics, the patient’s condition improved, and the patient was discharged. Through literature review, we found that lung consolidation, ground-glass shadow, nodular lesions, and pleural effusion can be observed on chest images of patients with lipoid pneumonia, with severe cases showing diffuse lesions involving both lungs, possibly secondary to respiratory failure. Children with acute critical illness deteriorates rapidly and have poor prognosis, whereas adults or patients with chronic poisoning have better prognosis after active treatment.