N⁶-甲基腺苷(N⁶-methyladenosine, m⁶A)修饰是真核生物信使 RNA中最丰富的表观遗传修饰,其失调会导致mRNA异常生物学行为如翻译和降解紊乱,从而调控肿瘤发生发展。近期研究表明m⁶A在免疫调控过程中可发挥重要作用,其不仅可调节免疫细胞的活化,还在肿瘤微环境中免疫应答发挥重要调控作用,从而影响免疫治疗效果。越来越多的证据表明m⁶A修饰可能是肿瘤免疫治疗的重要潜在干预靶点。本文阐述了免疫细胞中m⁶A修饰调控及其在肿瘤免疫微环境中相关调节作用,并进一步探讨了靶向m⁶A调控蛋白在肿瘤免疫治疗中的干预策略及潜在治疗价值。

N⁶-methyladenosine (m⁶A) modification is the most abundant epigenetic modification in eukaryotic messenger RNA (messenger RNA). Its dysregulation drives abnormal transcription and translation processes, which promotes the occurrence and development of tumors. Studies have shown that m⁶A modification can regulate the activation of immune cells and their infiltration into the tumor microenvironment (TME), which may affect the efficiency of immunotherapy. Therefore, m⁶A modification may be a potential target for tumor immunotherapy. This paper describes the modification of m⁶A in immune cells and the antitumor immune response associated with TME, and explores the potential therapeutic value of targeting m⁶A regulators in tumor immunotherapy.

目的 观察LACE风险模型下的护理干预策略在心脏瓣膜置换术后患者中的应用效果。方法 选取我院2021年3月—2022年3月心脏瓣膜置换术后患者82例作为研究对象,以患者入院顺序编号分为对照组、观察组,各41例。对照组予以常规护理,观察组予以LACE风险模型下的护理干预。比较2组出院时、干预后的自我管理能力及负性情绪;干预期间的术后并发症发生率、再入院率、用药依从性。结果 干预后观察组自我管理环境、自我管理行为、自我管理认知评分高于对照组（P<0.05）;观察组术后并发症发生率7.32%（3/41）、再入院率4.88%（2/41）均低于对照组24.39%（10/41）、21.95%（9/41,P<0.05）;观察组用药依从率97.56%（40/41）高于对照组78.05%（32/41,P<0.05）;干预后观察组汉密尔顿抑郁量表评分、汉密尔顿焦虑量表评分低于对照组（P<0.05）。结论 心脏瓣膜置换术后患者进行LACE风险模型下的护理干预后,患者的自我管理能力及用药依从性明显改善,同时其并发症发生率和再入院率有效降低,焦虑、抑郁等负性情绪得到缓解,具有良好护理效果。

Objective To observe the effect of nursing intervention strategy under LACE risk model in patients after heart valve replacement．Methods From March 2021 to March 2022,82 patients with heart valve replacement were enrolled as the study objects．The patients were divided into control group and observation group according to the order of admission,with 41 patients in each group．The control group was given routine nursing,and the observation group was given nursing intervention under LACE risk model．The self-management ability and negative emotions at discharge and after intervention were compared between the two groups．The incidence of postoperative complications,readmission rate and medication compliance during the intervention period were also compared．Results After intervention,the scores of self-management environment,self-management behavior and self-management cognition in the observation group were higher than those in the control group（P<0.05）．The postoperative complication rate of 7.32%（3/41）and readmission rate of 4.88%（2/41）in the observation group were lower than those of 24.39%（10/41）and 21.95%（9/41）in the control group（P<0.05）．The compliance rate of the observation group（97.56%）was higher than that of the control group（78.05%,P<0.05）．After intervention,the scores of Hamilton Depression Scale and Hamilton Anxiety Scale in the observation group were lower than those in the control group（P<0.05）．Conclusions After nursing intervention under LACE risk model for patients after heart valve replacement,the self-management ability and medication compliance of patients have been significantly improved,the incidence of complications and readmission rate have been effectively reduced,and negative emotions such as anxiety and depression have been alleviated,which has good nursing effect．