Objective To determine the prognostic biomarkers and new therapeutic targets of the lung adenocarcinoma (LUAD), based on which to establish a prediction model for the survival of LUAD patients. Methods An integrative analysis was conducted on gene expression and clinicopathologic data of LUAD, which were obtained from the UCSC database. Subsequently, various methods, including screening of differentially expressed genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Set Enrichment Analysis (GSEA), were employed to analyze the data. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used to establish an assessment model. Based on this model, we constructed a nomogram to predict the probable survival of LUAD patients at different time points (1-year, 2-year, 3-year, 5-year, and 10-year). Finally, we evaluated the predictive ability of our model using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves. The validation group further verified the prognostic value of the model. Results The different-grade pathological subtypes' DEGs were mainly enriched in biological processes such as metabolism of xenobiotics by cytochrome P450, natural killer cell-mediated cytotoxicity, antigen processing and presentation, and regulation of enzyme activity, which were closely related to tumor development. Through Cox regression and LASSO regression, we constructed a reliable prediction model consisting of a five-gene panel (MELTF, MAGEA1, FGF19, DKK4, C14ORF105). The model demonstrated excellent specificity and sensitivity in ROC curves, with an area under the curve (AUC) of 0.675. The time-dependent ROC analysis revealed AUC values of 0.893, 0.713, and 0.632 for 1-year, 3-year, and 5-year survival, respectively. The advantage of the model was also verified in the validation group. Additionally, we developed a nomogram that accurately predicted survival, as demonstrated by calibration curves and C-index. Conclusion We have developed a prognostic prediction model for LUAD consisting of five genes. This novel approach offers clinical practitioners a personalized tool for making informed decisions regarding the prognosis of their patients.

Objective To investigate the incidence of central obesity and characteristics and changing trend of macronutrient energy supply in adult residents of Chongqing, and to analyze the relationship between carbohydrate energy supply and central obesity. Methods Using the longitudinal tracking data of China Health and Nutrition Survey project, combined with China food composition table , the energy and nutrient intake and macronutrient energy supply ratio were calculated. The association between carbohydrate energy supply and central obesity was analyzed by multi-level statistical model. Results In 2011, 2015 and 2018, the carbohydrate supply ratio of adult residents in Chongqing was 43.02%, 46.52%, and 46.07%, respectively, and the difference was statistically significant (F=18.699, P<0.001). The overweight rates in 2011, 2015, and 2018 were 29.2%, 36.7%, and 37.8%, while the obesity rates were 12.2%, 13.5%, and 19.5%, respectively, with statistically significant differences (χ²=41.416, P<0.001). The central obesity rates were 51.5%, 57.2%, and 62.8%, respectively (χ²=21.008, P<0.001). The carbohydrate supply ratio was positively correlated with waist circumference. Compared to the population with a carbohydrate to energy ratio of <55%, the risk of central obesity in the population with a carbohydrate to energy ratio of ≥ 65% was 1.63 times higher. Conclusion The ratio of carbohydrate to energy supply of adult residents in Chongqing has slightly increased. Rates of overweight, obesity and central obesity are on the rise. A high carbohydrate to energy supply ratio may be a risk factor for central obesity.

Ferroptosis is an iron-dependent form of regulated cell death,which is distinct from apoptosis,ne-crosis,and pyroptosis.Recent studies have found that activators of ferroptosis,such as Erastin,can activate autophagy-re-lated proteins,induce the formation of autophagosomes,and ultimately release ferric ions to mediate ferroptosis.This pro-cess,called ferritinophagy,is initiated by the binding of an autophagic cargo receptor protein,nuclear receptor coactivator 4(NCOA4),to iron-laden ferritin.The transfer of NCOA4-ferritin to the lysosome by ferritinophagy results in the proteoly-sis of ferritin,and,in turn,the release of its iron content and lipid-reactive oxygen species(ROS)accumulation.Ferritin-ophagy has been closely associated with central nervous system disorders,circulatory system diseases,and cancer.Fur-thermore,the regulation mechanism of ferritinophagy is also a hot topic in the study of iron-dependent cell death process.With the in-depth study of ferritinophagy,great progress has been made in the study of key components of ferritinophagy as well as its molecular mechanisms and processes.However,a comprehensive summary of the methods for detecting ferritin-ophagy is still unclear.To further deepen the understanding of ferritinophagy and its detection methods,this review focus-es on the concept,characteristics,methods,and precautions during detection of ferritinophagy.This review provided ex-perimental reference for subsequent researchers and promoting the progress of research related to ferritinophagy.

Objective:To explore the chain mediating effect of self-efficacy and positive coping styles between nurses′ adversity quotient on work engagement, so as to provide a theoretical reference for nursing managers to promote work engagement.Methods:A convenience sampling method was used to select 512 nurses from four tertiary hospitals in Shaanxi Province, and a cross-sectional study was conducted on them using the general information questionnaire, Adversity Response Profile, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Utrecht Work Engagement Scale-9.Results:The total scores of nurses' adversity response profile, self-efficacy, positive coping style and work engagement were 132.00(120.00, 139.00), 27.00(23.00, 29.00), 24.00(20.00, 25.00), 27.00(25.00, 35.00) points. Nurses' work engagement was significantly positively correlated with adversity quotient, self-efficacy and positive coping styles( r values were 0.523-0.614, all P<0.01). The independent mediation of self-efficacy or positive coping styles and the chain mediation of both accounted for 23.6%,40.9% and 15.9% of the total effect respectively. Conclusions:Nurses′ adversity quotient not only directly affected work engagemnet, but also indirectly affected work engagement through self-efficacy and positive coping style. The research suggested that managers should pay attention to the improvement of nurses′ self-efficacy and positive coping style, so as to promote nurses′ work engagement.

To summarize Professor ZHANG Zhiyuan's experience in treating leukorrheal diseases based on syndrome differentiation. It is believed that the main pathogenesis of leukorrheal diseases includes mainly depression， dampness and deficiency. Leukorrheal diseases can be classified into four syndrome types： syndrome of stagnation of liver qi and spleen deficiency， syndrome of internal retention of damp-heat， syndrome of cold-dampness invading downward， and syndrome of kidney yang deficiency. The treatment approach focuses on restoring the ascending and descending opening and closing of qi， regulating the liver and spleen to promote yang qi respectively. The four types of syndromes correspond to the application of four different herbal formulas： By using the combination of Danggui Shaoyao Powder （当归芍药散） from the Synopsis of Golden Chamber （《金匮要略》） with wind-dispelling herbs， adjustments are made to harmonize the liver and spleen； By applying modifications to the Baxian Drink （八仙饮） from the Obstetrics Enlightenment （《产科发蒙》） to clear heat and promote diuresis； A self-designed Shiwei Wendai Decoction （十味温带汤） is adjusted to warm the yang and dispel cold； The Baji Tusi Decoction （巴戟菟丝汤） from the New Compilation of Effective Recipes （《验方新编》） is adjusted to tonify and warm the kidney yang.

A large number of data show that the prevalence rate of alcoholic liver injury （ALI） is increasing year by year， and it has become one of the main causes of death due to chronic liver diseases such as liver cancer and liver cirrhosis. Quitting drinking is the main method for the prevention of ALI in modern medicine， and the main treatment methods include Western medicine with antioxidant and anti－fibrotic effects and nutritional support. However， Western medicine tends to have an unsatisfactory treatment effect and can only alleviate initial symptoms， and severe ALI still requires surgical treatment. Studies have shown that the monomers extracted from natural drugs and foods have obvious preventive and therapeutic effects on ALI， with high safety and easy access. Therefore， this article systematically summarizes the main natural drug and food monomers used for the prevention and treatment of ALI and proposes the idea of the combination of drug and food for the prevention and treatment of ALI from the perspective of paying attention to the whole process of health， in order to explore more effective prevention， health care， and treatment methods and provide ideas for research on the prevention and control of ALI.

Objective In order to obtain small molecule compounds with novel structure and good biological activity, the secondary metabolites of polar sponge-symbiotic Streptomyces sp. LHW11-07 were studied. Methods The fermentation product of Streptomyces sp. LHW11-07 was isolated and purified by gel column chromatography, silica gel column chromatography, reversed-phase medium pressure column chromatography and high performance liquid chromatography. The structures of the monomeric compound were identified by modern spectroscopic methods such as mass spectrometry, nuclear magnetic resonance and related literature reports. Results A total of nine compounds were isolated from the fermentation of this strain, which were cyclo-(L-Tyr-L-Trp) (1), cyclo-(L-Trp-L-Ser) (2), cyclo-(D-Tyr-D-Pro) (3), cyclo-(L-Tyr-L-Phe) (4), cyclo-(L-Tyr-L-Leu) (5), albaflavenol B (6), β-adenosine (7), N-formylantimyic acid methyl ester (8) and conglobatin A (9). Conclusion Compounds 1 and 2 were isolated from Streptomyces sp. for the first time.

Objective To evaluate the malnutrition status and analyze the changing trends of nutritional status among primary and middle school students in poor rural areas of Chongqing from 2013 to 2019, and to provide scientific bases for formulating measures to improve students' nutrition status. Methods In 12 poor rural areas in Chongqing, a random sampling was adopted. At least 10% of elementary and middle schools were randomly selected in each area each year. At least 40 students were sampled in each grade to measure their height and weight. The nutritional status of the students was evaluated and the changing trend of nutritional status in the five years from 2013 to 2019 was analyzed. Results From 2013 to 2019, the prevalence rate of malnutrition showed a downward trend. The prevalence rate of malnutrition of boys was higher than that of girls. The prevalence rate of growth retardation decreased more significantly than that of emaciation. Conclusion The status of malnutrition among students in poor areas of Chongqing had been improved, but had not been eliminated yet. Further attention should be paid to the changes of students' nutritional status and timely measures should be taken to improve the students' nutritional and health status.

Objective:To investigate an association between glycosylated hemoglobin(HbA1c)level and non-alcoholic fatty liver(NAFL)in the elderly.Methods:In this retrospective case-control study, 5 186 elderly individuals aged 65 years and over meeting the inclusion conditions via health physical examination were successively selected from January to December 2018.They were divided into NAFL group(n=1 731)and non-NAFL group(n=3 455). Waist circumference, body mass index, smoking history, diastolic blood pressure, glomerular filtration rate, serum levels of triglyceride, low density lipoprotein cholesterol, alanine aminotransferase, aspartic aminotransferase, fasting blood glucose and HbA1c were compared between the two groups, and their correlations with NAFL were analyzed.Results:The prevalence of NAFL was 33.4%(1, 731/5, 186). The values of waistline, body mass index, smoking history, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterol, glomerular filtration rate, alanine aminotransferase, aspartate aminotransferase, fasting glucose and HbA1c were higher in the NAFL group than in non-NAFL group(all P<0.05). While levels of creatinine, urea nitrogen and age were lower in the NAFL group than in non-NAFL group( P<0.05). According to the quartile of HbA1c level, these subjects were divided into Q1 to Q4 groups(HbA1c<5.7%, 5.7≤HbA1c<6.0%, 6.0%≤HbA1c<6.5%, HbA1c≥6.5%), and the prevalence of NAFL in the Q1 to Q4 were 22.8%(225/1 120), 27.9%(398/1 429), 36.5%(514/1 409), 45.9%(564/1 228)respectively.The prevalence of NAFL was increased along with the increase in the level of HbA1c( P<0.01). Multivariate Logistic regression analysis showed that after adjusting for age, gender and metabolic components, the risk for developing NAFL was gradually increased in Q2 group, Q3 group, Q4 group versus Q1 group as the following OR value: OR=1.274, 95% CI: 1.004-1.616; OR=1.639, 95% CI: 1.294-2.077; OR=1.787, 95% CI: 1.337-2.389, respectively, all P<0.01. Conclusions:The prevalence of NAFL is positively associated with HbA1c levels in the elderly and HbA1c is an independent risk factor for NAFL disease.

Objective:To explore the application value of enhanced recovery after surgery (ERAS) in colorectal cancer patients.Methods:From January 2017 to December 2018, 60 patients with colorectal cancer who admitted to the Second People′s Hospital of Lianyungang were selected and divided into ERAS group and control group according to the random digital table method, with 30 patients in each group.The inflammation, nutritional indicators, immune indicators and clinical manifestations before and after surgery in the two groups were compared.Results:At 1 d and 3 d after surgery, the C-reactive protein (CRP) levels in the ERAS group were (70.2±10.3)mg/L, (82.5±8.2)mg/L, respectively, which were lower than those in the control group [(81.5±9.9)mg/L, (110.2±12.9)mg/L] ( t=4.324, 9.911, all P<0.05). On the third day after operation, the levels of albumin and prealbumin in the ERAS group were (31.6±4.8)g/L, (196.8±40.6)g/L, respectively, which were higher than those in the control group [(28.0±5.8)g/L, (172.1±38.8)g/L]( t=2.621, 2.409, all P<0.05). The immune parameters(IgA, IgM, IgG, CD 4+, CD 4+ /CD 8+) in the ERAS group were higher than those in the control group( t=2.132, 2.223, 6.063, 4.253, 2.828, all P<0.05). The number of cases with thirsty and hunger on the day of surgery in the ERAS group was 3 cases and 7 cases, respectively, which were less than 21 cases and 25 cases of the control group(χ 2=22.500, 21.696, all P<0.05). The first exhaust time, defecation time and hospital stay time in the ERAS group were (36.2±12.1)h, (63.4±13.4)h and (9.5±3.2)d, respectively, which were shorter than those in the control group [(54.7±13.8)h, (96.5±18.8)h and (12.1±4.0)d] ( t=5.513, 7.845, 2.761, all P<0.05). The incidence of complications between the two groups had no statistically significant difference ( P>0.05). Conclusion:ERAS can significantly reduce the physical and psychological traumatic stress of patients with colorectal cancer, achieve rapid recovery, improve the treatment effect, shorten the length of hospital stay, reduce social and family burden, and provide a basis for the choice of clinical treatment program.