Objective To investigate the current status of symptom burden and psychological distress among lung cancer patients in the diagnostic phase, and to explore the chain mediating role of social support and resilience between symptom burden and psychological distress. Methods The patients with lung cancer in the diagnostic phase who were treated in the Department of Thoracic Surgery of the Second Xiangya Hospital of Central South University from October 2022 to June 2023 were investigated by a general information questionnaire using the MD Anderson Symptom Inventory, the Social Support Rating Scale, the Connor-Davidson Resilience Scale, and the Distress Thermometer. The chain mediating role of social support and resilience between symptom burden and psychological distress was analyzed. Results A total of 413 lung cancer patients were enrolled, including 173 males and 240 females, aged (54.69±10.82) years. The detection rate of psychological distress among lung cancer patients in the diagnostic phase was 48.18%, and the average score was (3.84±2.50) points. Psychological distress was positively correlated with symptom burden (P<0.01), and negatively correlated with social support and resilience (P<0.01). The mediating effect of resilience between symptom burden and psychological distress was significant. The chain mediating effect of social support and resilience between symptom burden and psychological distress was also significant. Conclusion Lung cancer patients in the diagnostic phase have a high detection rate of psychological distress. Symptom burden can directly impact psychological distress, and can affect psychological distress through the indirect path of resilience as well as the chain mediating path between social support and resilience among lung cancer patients in the diagnostic phase.

This study was performed to investigate the therapeutic effect of oroxylin A(OA)on chicken type Ⅱcollagen-induced arthritis(CIA)in mice and observe the changes of immune cells.The CIA model was established,and 40 mg/kg OA was intraperitoneally injected for 10 consecutive days from the 28th day.The mice were sacrificed at three different times during the administration period,and the joints were scored at each time point.HE staining was used to observe the pathology of the mouse ankle joint;flow cytometry was used to detect the changes of Th17,Treg and macrophages in spleen and inguinal lymph nodes;ELISA was employed to detect the expression levels of IL-1β,IL-18 and IL-6 in serum;and qRT-PCR was used to detect the expression levels of IL-1β,IL-18,IL-6 and TNF-β in spleen of mice.Data showed that on the 34th day after OA administration,the joint swelling of CIA mice was significantly relieved,the pathological score was decreased,and the inflammatory cell infiltration was decreased.Flow cytometry results showed that the proportion of Th17 cells and macrophages in the spleen and inguinal lymph nodes of CIA mice in OA group decreased,while the proportion of Treg cells increased.The results of ELISA and qRT-PCR showed that OA could inhibit the level of inflammation in CIA mice.In conclusion,OA can regulate the proportion of immune cells,inhibit the level of inflammation in CIA mice,and then relieve the symptoms of CIA mice.

Background::Substantial progress in air pollution control has brought considerable health benefits in China, but little is known about the spatio-temporal trends of economic burden from air pollution. This study aimed to explore their spatio-temporal features of disease burden from air pollution in China to provide policy recommendations for efficiently reducing the air pollution and related disease burden in an era of a growing economy.Methods::Using the Global Burden of Disease method and willingness to pay method, we estimated fine particulate matter (PM 2.5) and/or ozone (O 3) related premature mortality and its economic burden across China, and explored their spatio-temporal trends between 2005 and 2017. Results::In 2017, we estimated that the premature mortality and economic burden related to the two pollutants were RMB 0.94 million (68.49 per 100,000) and 1170.31 billion yuan (1.41% of the national gross domestic product [GDP]), respectively. From 2005 to 2017, the total premature mortality was decreasing with the air quality improvement, but the economic burden was increasing along with the economic growth. And the economic growth has contributed more to the growth of economic costs than the economic burden decrease brought by the air quality improvement. The premature mortality and economic burden from O 3 in the total loss from the two pollutants was substantially lower than that of PM 2.5, but it was rapidly growing. The O 3-contribution was highest in the Yangtze River Delta region, the Fen-Wei Plain region, and some western regions. The proportion of economic burden from PM 2.5 and O 3 to GDP significantly declined from 2005 to 2017 and showed a decreasing trend pattern from northeast to southwest. Conclusion::The disease burden from O 3 is lower than that of PM 2.5, the O 3-contribution has a significantly increasing trend with the growth of economy and O 3 concentration.

Objective:To study the spatiotemporal heterogeneity of the incidence rate of pulmonary tuberculosis and its macro influencing factors in China, so as to provide a reference for the relevant departments to formulate prevention and control policies.Methods:In virtue of the complexity of influencing factors, a new method combining principal component analysis (PCA) with geographically and temporally weighted regression (GTWR) was proposed to analyze the spatiotemporal heterogeneity of influencing factors for pulmonary tuberculosis. Using the data of incidence rate of pulmonary tuberculosis and gross regional product (secondary indicators) of 31 provinces (excluding Hong Kong, Macao, and Taiwan) in China from 2010 to 2019, a macro influencing factor indicator system was established by the PCA scores of 21 secondary indicators quantified to determine four primary indicators: comprehensive economy, medical security, cultural and educational transportation, and resources and environment. Based on the indicator system, PCA-ordinary least squares (PCA-OLS) model, PCA-geographically weighted regression (PCA-GWR) model, and PCA-GTWR model were constructed.Results:Three models passed F-test with F-values of 58.74, 196.62, and 1 202.90 respectively (all P < 0.05), indicating that the impact of the primary indicators on the incidence of tuberculosis is statistically significant. The mean squared error (0.01), the mean absolute error (0.08), the mean absolute percentage error (0.02), and the corrected Akaike information criterion (-358.76) of PCA-GTWR were lower than those of PCA-OLS (0.13, 0.28, 0.07, 258.38) and PCA-GWR (0.06, 0.15, 0.03, 23.41). Meanwhile, the determination coefficient (0.95) of PCA-GTWR was higher than that of PCA-OLS (0.44) and PCA-GWR (0.77), indicating the goodness of fit of the model is the best. And the PCA-GTWR model showed that the comprehensive economy, medical security, cultural and educational transportation, and resources and environment had significant spatiotemporal heterogeneity on the incidence rate of pulmonary tuberculosis according to the distribution of regression coefficients. Conclusion:It is necessary to comprehensively consider various factors and formulate detailed and overall prevention and control measures for pulmonary tuberculosis according to local conditions.

ObjectiveTo analyze the production of Poria in 5 major producing areas and the problems through field investigation and literature review and thus to lay a foundation for healthy development of Poria industry. MethodEach production process of Poria in Anhui， Hubei， Hunan， Yunnan， and Sichuan was probed and related research was retrieved for the analysis. ResultSichuan， Guangxi， Guizhou， and other areas have been the emerging producers of Poria. However， a few Poria cocos lines were used and the variety breeding lagged behind. Different cultivation techniques were adopted in different production areas. For example， the "induction" method failed to be widely used. Moreover， the harvest time was mainly dependent on the market demand not matter it was suitable or not. Furthermore， steaming has replaced the traditional diaphoretic processing in the processing of this medicinal material in production areas. In addition， fumigation with sulphur was still used in the processing of Poria. ConclusionAn excellent variety is the key to the quality of Poria. Efforts should be made to strengthen the evaluation of the germplasm resources of P. cocos and variety breeding and standardize the processing in production areas， thereby ensuring the safety and effectiveness of Poria and the decoction pieces. In addition， the contradiction between artificial cultivation and woodland ecology should be fully coordinated to ensure the sustainable development of Poria industry in China.

【Objective】 To investigate the clinical features and gene analysis of one pedigree with multiple endocrine neoplasia type 2A （MEN2A） so as to clarify the diagnosis and classification of the disease， guide treatment and prevention， and improve prognosis. 【Methods】 The clinical data of a 36-member MEN2A family， including 6 probands， with medullary thyroid carcinoma， were investigated， and the peripheral blood genomic DNA of 28 family members （blood sample of one proband was not collected） was extracted. PCR amplification was performed on exons 8， 10， 11， 13， 14， 15 and 16 of the RET gene， and the products were directly sequenced. 【Results】 Review of the medical history showed that two probands with medullary thyroid carcinoma were accompanied with hyperparathyroidism， and one family member had pheochromocytoma. The RET gene mutation test confirmed that 13 family members， consisting of 5 probands and 8 family members， had the RET proto-oncogene exon 10 missense mutation. The heterozygous missense had mutation c.1852T>A， leading to the conversion of cysteine （TGC） at position 618 to serine （AGC） （Cys618Ser）. All subjects carrying RET gene Cys618Ser mutation had abnormal thyroid ultrasound change， accompanied with elevated calcitonin levels. Subjects carrying wild type of RET gene had normal calcitonin levels. The family was finally diagnosed with MEN2A by RET gene detection. 【Conclusion】 RET gene detection plays key role in the diagnosis and treatment of patients with MEN2A family and has guiding value in the follow-up and prognosis of asymptomatic carriers. There is a positive correlation between calcitonin level and the RET protooncogene mutation Cys618Ser. Patients suspected of MEN2A should be screened in time.

ObjectiveTo study the accumulation and absorption of dry matter and nutrients in Curcuma phaeocaulis from Sichuan， the origin of Curcumae Radix （tuber） and Curcumae Rhizoma （rhizome）， to explore the growth and development laws and nutrient demand characteristics of the medicinal species， and thus to lay a theoretical basis for rational fertilization. MethodThe plant growth indexes， dry matter accumulation， and nutrient content of C. phaeocaulis at different growth stages in Sichuan were measured and analyzed. ResultThis medicinal species featured the dominant growth of aboveground leaves and stems before October and growth of underground part （particularly the rhizomes and tubers） from October. During the whole growth period， the accumulation of nitrogen， phosphorus， potassium， calcium， magnesium， iron， manganese， zinc， and copper per plant was 2 450.31， 907.09， 3 171.18， 625.94， 493.38， 14.53， 2.24 ， 2.93， 0.46 mg， respectively， with the order of potassium > nitrogen > phosphorus > calcium > magnesium > iron > zinc > manganese > copper. ConclusionThe species needs sufficient potassium and nitrogen， appropriate amount of phosphorus， calcium， and magnesium， a small amount of iron， and very little zinc， manganese， and copper for growth， and potassium is particularly important. Nitrogen， phosphorus， and potassium fertilizers supply macroelements and nitrogen fertilizer should be supplemented at seedling stage， leafy stage， early rhizome expansion stage， tuber expansion stage， and the second expansion stage of rhizome. Phosphorus and potassium fertilizers should be applied at seedling stage， tuber expansion stage， secondary expansion stage of rhizome， and dry matter accumulation stage of tuber and rhizome. At seedling stage， leafy stage， early rhizome expansion stage， tuber expansion stage， and the second expansion stage of rhizome， a variety of medium and trace elements-containing foliar fertilizers should be used.

Genomic instability remains an enabling feature of cancer and promotes malignant transformation. Alterations of DNA damage response (DDR) pathways allow genomic instability, generate neoantigens, upregulate the expression of programmed death ligand 1 (PD-L1) and interact with signaling such as cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling. Here, we review the basic knowledge of DDR pathways, mechanisms of genomic instability induced by DDR alterations, impacts of DDR alterations on immune system, and the potential applications of DDR alterations as biomarkers and therapeutic targets in cancer immunotherapy.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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The medical fungus Hirsutella sinensis has been used as a Chinese folk health supplement because of its immunomodulatory properties. Our previous studies established the antifibrotic action of Hirsutella sinensis mycelium (HSM) in the lung. The epithelial-mesenchymal transition (EMT) is involved in the pathogenesis of idiopathic pulmonary fibrosis. The present study investigates the role of HSM in mediating EMT during the development of pulmonary fibrosis. HSM significantly inhibits bleomycin (BLM)-induced pulmonary fibrosis by blocking the EMT. In addition, the expression levels of midkine are increased in the lungs of the BLM-induced group. Further analysis of the results indicates that the mRNA level of midkine correlated positively with EMT. HSM markedly abrogates the transforming growth factor β-induced EMT-like phenotype and behavior in vitro. The activation of midkine related signaling pathway is ameliorated following HSM treatment, whereas this extract also caused an effective attenuation of the induction of EMT (caused by midkine overexpression) in vitro. Results further confirm that oral medication of HSM disrupted the midkine pathway in vivo. Overall, findings suggest that the midkine pathway and the regulation of the EMT may be considered novel candidate therapeutic targets for the antifibrotic effects caused by HSM.
Bleomycin ; Epithelial-Mesenchymal Transition ; Humans ; Midkine ; Mycelium ; Pulmonary Fibrosis/drug therapy*