OBJECTIVE To systematically evaluate the correlation between dynamic changes in inflammatory markers during treatment with epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKIs） in non-small cell lung cancer （NSCLC） patients and therapeutic efficacy， with the aim of providing evidence-based support for clinical prognosis assessment and treatment strategy adjustment. METHODS Databases including PubMed， Embase， Cochrane Library， CNKI， Wanfang Data， and CBM were searched from the inception to July 20， 2025. Following literature screening， data extraction and quality assessment， descriptive analysis was conducted on the outcomes of included studies. RESULTS A total of eight studies were included to analyze the correlation of 6 inflammatory markers before and after treatment with EGFR-TKIs with therapeutic efficacy. The risk of bias assessment identified six high-quality studies and two moderate-quality studies. Among these studies， seven studies demonstrated that lower levels of neutrophil-to-lymphocyte ratio （NLR）， derived neutrophil-to-lymphocyte ratio （dNLR）， platelet-to-lymphocyte ratio （PLR）， and monocyte-to-lymphocyte ratio （MLR）， higher lymphocyte-to-monocyte ratio （LMR） before treatment， as well as decreased NLR and MLR and increased LMR after treatment were associated with longer median progression-free survival. Five studies indicated that lower levels of NLR， dNLR， PLR， and interleukin-6 （IL-6）， higher LMR before treatment as well as decreased NLR and dNLR and increased LMR were associated with longer median overall survival. Three studies indicated that lower levels of IL-6 were associated with a higher objective response rate， while the association of these markers after treatment remained controversial； another study showed that an early decline in NLR， MLR， and PLR after treatment may be associated with objective response benefit. CONCLUSIONS Lower inflammatory levels during EGFR-TKIs therapy correlate with better therapeutic efficacy in NSCLC patients.

Objective: To evaluate the methodological quality and reporting quality of clinical practice guidelines or expert consensus on blood transfusion and blood use (BTBU) in China (hereinafter referred to as "guidelines/consensus"), providing reference for the development and updating of future BTBU guidelines/consensus. Methods: A systematic search was conducted in Chinese databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Data-base, relevant guideline release platforms, and professional association websites. BTBU-related guidelines/consensus published between January 2006 and December 2025 were included. According to the inclusion and exclusion criteria, after completing literature screening and data extraction, three evaluators independently assessed the quality of the included literature using the Scientificity, Transparency, and Applicability of Guidelines Rating Tool (STAR), the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), and the International Practice Guideline Reporting Standards (RIGHT). Results: A total of 29 documents were included, including 5 guidelines, 22 consensus statements, and 2 protocols. The results of the STAR assessment showed that the total score was (21.7±8.8)%. The domain score ratios for registration, research protocol, funding, working group, conflict of interest, clinical question, evidence, consensus method, recommendation, accessibility and other domains were (2.2±12.1)%, 0, (36.7±25.1)%, (18.3±7.6)%, (19.2±15.3)%, (16.6±23.1)%, (15.1±6.3)%, (9.6±21.2)%, (54.3±18.4)%, (31.7±10.4)% and (10.3±31.0)%, respectively. For the AGREE Ⅱ assessment, the methodological quality of 26 articles was rated Grade B and 3 articles Grade C. The results of the RIGHT assessment indicated that the overall reporting rate of all guidelines/consensuses was (65.3±4.0)%. Conclusion: The methodological and reporting quality of current expert guidelines/consensus on BTBU in China still need improvement, and guidelines and consensus should be strictly formulated and standardized according to the standards of STAR, AGREE II and RIGHT.

Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

Objective To analyze the emergency testing results of a mixed poisoning incident involving methyl acetate and dimethyl carbonate in a composite fabric processing enterprise. Methods A mixed poisoning incident involving methyl acetate and dimethyl carbonate occurred at a composite fabric processing enterprise in a city of Guangdong Province. On-site occupational health investigation data and laboratory testing results related to this incident were collected, and an integrated analysis was conducted. Results The on-site occupational health investigation revealed inadequate ventilation and non-standard use of personal protective equipment. Volatile organic component analysis of raw and auxiliary materials showed that methyl acetate and dimethyl carbonate had relatively high percentages of peak area among all used volatile organic chemical agents in post-incident emergency testing, accounting for 65.10% and 38.25%, respectively. The exposure concentration of short term (C_STE) of methyl acetate in the production line air was 15.13 mg/m³. In the chemical storage area, C_STE of methyl acetate and methanol were 451.04 and <0.21 mg/m³, respectively, all below their respective occupational exposure limits (500.00 and 50.00 mg/m³). In the poisoned workers, blood methanol, blood formic acid, and urinary formic acid levels were 147, 414, and 4 389 mg/L, respectively. Conclusion Occupational exposure to methyl acetate and dimethyl carbonate may lead to acute occupational poisoning and cause health damage. Employers should fulfill their responsibilities for occupational disease prevention by ensuring proper operation of protective facilities, while workers should enhance awareness of occupational disease prevention and correctly use personal protective equipment.

Objective To develop a solvent desorption-gas chromatography method for quantifying malononitrile in workplace air. Methods Malononitrile in workplace air was collected using a silica gel tube and desorbed with methanol. Separation was performed using DB-FFAP capillary column, and detection was performed by hydrogen flame ionization detector. Results The linear ranges of malononitrile were 4.00-600.00 mg/L, with the correlation coefficient of 0.999 92. The detection limit was 0.54 mg/L. The minimum detection concentration was 0.36 mg/m³ (based on a collected air volume of 1.5 L). The average desorption efficiency was 95.0%-101.0%. The within-run and between-run relative standard deviations were 0.9%-5.3% and 1.0%-6.8%, respectively. The sampling efficiency was 100.0%. The samples were stable at 4 ℃ for at least 14 days. Conclusion The solvent desorption-gas chromatography method established in this study for the determination of malononitrile in workplace air is simple to use, with high accuracy and good precision, and is suitable for the determination of malononitrile in workplace air.

Dust and chemical substances are widely present occupational hazards in workplaces. Long-term exposure to dust and chemical substances can pose serious threats to workers′ health. Owing to their advantages in real-time detection, rapid response, and high accuracy, online monitoring technologies enable continuous measurement and analysis of the concentration and composition of dust and chemical substances in workplaces. These technologies provide timely and effective data support for the prevention and control of occupational diseases and have become an important protective tool in the field of occupational hazard. Current online monitoring technologies for workplace dust mainly include the tapered element oscillating microbalance method, light scattering method, β-ray method, triboelectric charging, video exposure monitoring, and ultrasonic methods. Online monitoring devices for workplace chemical substances are still in the early stages of development. However, this equipment has been partially applied in environmental monitoring, covering methods such as spectral analysis, electrochemical sensors, cataluminescence sensors, and intelligent sensing systems. In the future, the development of online dust monitoring technology should focus on overcoming technical bottlenecks to improve detection accuracy and exploring the synergistic effects of different technologies to compensate for the limitations of single methods. Meanwhile, online monitoring technologies for chemical substances should aim to develop integrated detection systems that combine high precision, real-time performance, low cost, and stability.

Triple-negative breast cancer (TNBC) is aggressive, with high recurrence rates and poor prognosis. Paclitaxel (PTX) remains a key chemotherapeutic agent for TNBC, but its efficacy diminishes due to the emergence of drug resistance, largely driven by cancer stem-like cells (CSCs), vasculogenic mimicry (VM) formation and tumor immunosuppressive microenvironment (TIME). Pyruvate kinase M2 (PKM2) is highly expressed in TNBC, and is a potential target for TNBC treatment. In this study, we developed a biomimetic codelivery system using albumin nanoparticles (termed S/P NP) to co-encapsulate PTX and shikonin (SHK), a natural inhibitor of PKM2. By inhibiting PKM2, SHK suppressed β-Catenin signaling, thereby reversing CSC stemness and preventing VM formation. The S/P NP system exhibited tumor-targeting delivery effect and significantly inhibited TNBC growth and lung metastasis. Mechanistically, the treatment reversed epithelial-mesenchymal transition (EMT) and stem-like properties of TNBC cells, suppressed VM formation, and remodeled the TIME. It reduced immunosuppressive cells (M2 macrophages, MDSCs) while promoting anti-tumor immunity (M1 macrophages, dendritic cells, cytotoxic T cells, and memory T cells). This dual-action strategy holds promise for improving TNBC therapy by targeting CSCs, VM, and the immune microenvironment, and for overcoming PTX resistance and reducing metastasis.

Objective Based on the background of disease diagnosis related groups(DRGs)in public hospitals to construct the nursing quality evaluation index system for percutaneous radiofrequency ablation(PRFA)of liver cancer so as to improve the nursing quality for PRFA of liver cancer.Methods Using three-dimensional quality model and through interview,literature analysis,two rounds of Delphi expert letter inquiry and analytic hierarchy process,the evaluation standard of PRFA nursing quality of liver cancer was established,and its effect was validated in clinical practice.Results The evaluation index system of PRFA nursing quality for liver cancer was constructed,which included 3 first-level indexes,9 second-level indexes and 22 third-level indexes.After clinical application,the incidence of intraoperative and postoperative moderate-severe pain,the incidence of high fever,and the 24-hour number of times required care in the intervention group were lower than those in the control group(P＜0.05),the incidence of postoperative Ⅲ degree vomiting in the intervention group was remarkably lower than that in the control group(P＜0.01),and the average hospitalization days in the intervention group were less than those in the control group(P＜0.05),and the average hospitalization expense in the intervention group was lower than that in the control group,but the difference was not statistically significant(P＞0.05).Conclusion The PRFA nursing quality evaluation index system for liver cancer is scientific and practical,which is helpful for improving the outcome of patients and promoting the quality of nursing.

Animal surgery courses are a critical component of medical training;however,teaching practices have demonstrated problems,such as the difficulty of interdisciplinary teaching,students' weak concepts of sterility,poor clinical thinking,insufficient teamwork,shallow emotional investment,and ineffective value guidance.By integrating the characteristics of student learning and utilizing virtual simulation experiments alongside peer role models,an emotional-guidance teaching model has been established to enhance the effectiveness of"life education",through strengthened emotional identification and improved value guidance.The result indicate that this teaching model forms a closed-loop teaching process,aligns with students' cognitive patterns and cultivates their comprehensive abilities,and enhances teaching effectiveness.

Objective:To compare the clinical efficacy of laparoscopic-assisted, totally laparoscopic, and robotic radical gastrectomy (for total or distal gastrectomy) in real-world practice, clarify the advantages and disadvantages of each approach, and provide evidence for clinical surgical selection.Methods:A retrospective analysis was conducted on 225 patients who underwent radical gastrectomy for gastric cancer at the Zhejiang Provincial People′s Hospital from January 2022 to September 2023, including 100 cases of total gastrectomy and 125 cases of distal gastrectomy. Patients were divided into three groups based on the surgical approach: laparoscopic-assisted group, totally laparoscopic group, and robotic group. Perioperative indicators (operation time, intraoperative blood loss, number of lymph nodes dissected, etc.), inflammatory and nutritional indicators (C-reactive protein, white blood cell count, albumin, etc.), and postoperative recovery indicators (time to oral feeding, time to first flatus, length of hospital stay, etc.) were compared among the three groups.Results:In total gastrectomy, there were statistically significant differences among the three groups in C-reactive protein ( P<0.001), operation time ( P=0.002), time to oral feeding ( P<0.001), and intraoperative blood loss ( P<0.001). In distal gastrectomy, significant differences were observed in C-reactive protein ( P<0.001), operation time ( P<0.001), time to oral feeding ( P=0.002), and length of hospital stay ( P<0.001). No statistically significant differences were found in the incidence of postoperative complications or the number of lymph nodes dissected among the three groups (all P>0.05). Conclusions:Each of the three surgical approaches has its own advantages and disadvantages. The laparoscopic-assisted approach has low hardware requirements and shorter hospital stay after distal gastrectomy, making it suitable for widespread application. The robotic approach causes less trauma and milder inflammatory response but has high equipment and maintenance costs, requiring selection based on actual clinical conditions.