Objective To reveal the scientific output and trends in pulmonary nodules/early-stage lung cancer prediction models. Methods Publications on predictive models of pulmonary nodules/early lung cancer between January 1, 2002 and June 3, 2023 were retrieved and extracted from CNKI, Wanfang, VIP and Web of Science database. CiteSpace 6.1.R3 and VOSviewer 1.6.18 were used to analyze the hotspots and theme trends. Results A marked increase in the number of publications related to pulmonary nodules/early-stage lung cancer prediction models was observed. A total of 12581 authors from 2711 institutions in 64 countries/regions published 2139 documents in 566 academic journals in English. A total of 282 articles from 1256 authors were published in 176 journals in Chinese. The Chinese and English journals which published the most pulmonary nodules/early-stage lung cancer prediction model-related papers were Journal of Clinical Radiology and Frontiers in Oncology, respectively. Chest was the most frequently cited journal. China and the United States were the leading countries in the field of pulmonary nodules/early-stage lung cancer prediction models. The institutions represented by Fudan University had significant academic influence in the field. Analysis of keywords revealed that multi-omics, nomogram, machine learning and artificial intelligence were the current focus of research. Conclusion Over the last two decades, research on risk-prediction models for pulmonary nodules/early-stage lung cancer has attracted increasing attention. Prognosis, machine learning, artificial intelligence, nomogram, and multi-omics technologies are both current hotspots and future trends in this field. In the future, in-depth explorations using different omics should increase the sensitivity and accuracy of pulmonary nodules/early-stage lung cancer prediction models. More high-quality future studies should be conducted to validate the efficacy and safety of pulmonary nodules/early-stage lung cancer prediction models further and reduce the global burden of lung cancer.

Objective To evaluate the effect of acupuncture at Yin Wei point on postoperative nausea and vomiting(PONV)in female patients undergoing abdominal surgery.The clinical efficacy of postoperative nausea and vomiting(PONV)and its impact on gut microbiota.Methods This study included 184 patients who underwent gynecological laparoscopic surgery in Jinhua Central Hospital from January 2021 to April 2024.They were randomly divided into control group(n=93)and acupuncture group(n=91)using a random number method.At the completion of surgery,the control group received intravenous injection of 5mg of tropisetron hydrochloride.In acupuncture group,on the basis of control group,intervention was performed by needling the palmar Yin Wei points of both forearms for 30 minutes before surgery.The incidence and severity of PONV were compared between two groups of patients.In addition,fecal samples were collected from two groups of patients before and after surgery,and differential analysis of gut microbiota community structure was performed using 16S amplicon absolute quantitative sequencing technology.Results In the 0-24 hours after surgery,40 cases of the acupuncture group and 56 cases of control group experienced PONV.The acupuncture group's PONV incidence was lower than control group's(P＜0.05).The nausea severity of acupuncture group after surgery was significantly lower than that of control groups.The proportion of patients taking antiemetic drugs after surgery in acupuncture group was also significantly lower than that in control group(P＜0.05).Before surgery,the two groups have no significant difference regarding Chao1,ACE,Shannon,and Simpson indices(P＞0.05).After surgery,the acupuncture group's Chao1,ACE,and Shannon indices were significantly higher than control group's(P＜0.05).The Simpson scores of two groups of patients were compared after surgery,and no significant difference was found(P＞0.05).The Observed,Chao1,ACE,and Shannon indices were significantly higher in the acupuncture group after surgery than before(P＜0.05).The incidence of adverse reactions in acupuncture group and control group were 8.8％and 8.6％,respectively,and there was no statistical significance(P＞0.05).Conclusion Acupuncture at Yin Wei point combined with intravenous injection of tropisetron can reduce the incidence of PONV in patients undergoing gynecological laparoscopic surgery.

The seventh article of Measures for the Ethical Review of Biomedical Research Involving Humans (2016) stipulated that medical and health institutions without an ethics committee shall not carry out biomedical research involving Humans. The Opinions on Strengthening the Governance of Ethics in Science and Technology, issued in March 2022, clearly stated that the institutions that do not meet the conditions for establishing a scientific and technological ethics (review) committee should entrust other institutions to conduct the review. The fourteenth article of Measures for Ethical Review of Life Science and Medical Research Involving Humans (2023) proposes that if an institution, which carries out life science and medical research involving humans, has not established an ethics committee or its ethics committee is not competent for ethics review, it can entrust a competent ethics committee or regional ethics committee in writing to carry out ethical review. Most medical institutions at or above the second level in China have set up ethics committees. While most universities and colleges, scientific research institutions, enterprises and grass-roots medical and health institutions have not set up ethics committees, which lack a working system to protect the safety and interests of the participants, and is difficult to conduct life sciences and medical research involving humans. At present, there is a need for some research institutions that do not have the conditions to establish ethics committees to entrust their projects of life science and medical research involving humans to other institutions for ethical review. The entrusted review is still in the exploratory stage, and there is no relevant specification. The hasty implementation of entrusted review may not achieve the goal of effectively protecting the safety and interests of the participants, and even cause legal disputes. Based on the thematic discussion, with reference to the relevant laws and regulations, departmental rules, ethical standards, and the experience of the ethics committees of some domestic institutions in implementing the entrusted review, the guideline was formulated for the reference of the current entrusted review to ensure the safety and interests of the participants.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Background The community is the main place for people's daily activities. A livable environment will improve the subjective well-being of residents. Objective To understand the current status of subjective well-being of residents in Pudong, Shanghai, and explore the impact of community environmental factors on residents' subjective well-being. Methods Using quota sampling, 6000 permanent residents from 12 sub-districts or towns in Pudong, Shanghai were selected to participate in an questionnaire survey. The questionnaire included three parts: participants' basic information, community environmental factors (neighborhood aesthetics, fitness environment, public service and security, natural environment), and subjective well-being. Using a multiple regression model, the influence of community environmental factors on the subjective well-being of residents was analyzed. Results A total of 5887 questionnaires were recovered, and the valid recovery rate was 98.1%. The subjective well-being score of the survey respondents was (7.03±1.61) points. There was no statistical difference in the subjective well-being score of study subjects of different gender and marital status groups; while those with different ages, education levels, occupations, and self-evaluated economic status showed statistical differences in their subjective well-being score (P<0.05). The multiple logistic regression analysis results showed that after controlling general demographic characteristics, with the low level as the control group (according predetermined cut-off values of 33.3% and 66.7%, the community environmental factors were divided into high-, medium-, and low-level groups), the OR values of subjective well-being of the high- and medium-level neighborhood aesthetics groups were 1.393 (95%CI: 1.173-1.654) and 1.235 (95%CI: 1.080-1.412); the OR values of the high- and medium-level fitness environment groups were 2.297 (95%CI: 1.929-2.734) and 1.349 (95%CI: 1.166-1.560); the OR values of the high- and medium-level public service and security groups were 1.101 (95%CI: 0.943-1.285) and 1.039 (95%CI: 0.905-1.193); the OR values of the high- and medium-level natural environment groups were 4.248 (95%CI: 3.321-5.434) and 1.652 (95%CI: 1.374-1.986), respectively. Conclusion Community environment factors could affect residents' subjective well-being, and good neighborhood aesthetics, fitness environment, natural environment have positive effects.

ObjectiveTo observe the effect of ginsenoside Rg₁ （G-Rg₁） on the biological activity of cryopreserved Schwann cells （SCs） of the rat sciatic nerve and explore the feasibility of G-Rg₁ in reducing the cryopreservation-induced injury in SCs. MethodBilateral sciatic nerves of SD rats were randomly divided into a fresh group， a blank group， and five G-Rg₁ groups of different doses （1×10^-7， 1×10^-6， 1×10^-5， 1×10^-4， and 1×10^-3 mol·L^-1）. The nerves in the blank group and the G-Rg₁ groups were preserved in liquid nitrogen solutions containing 0， 1×10^-7， 1×10^-6， 1×10^-5， 1×10^-4， and 1×10^-3 mol·L^-1 G-Rg₁ for four weeks. The apoptosis of SCs was detected by TdT-mediated dUTP-biotin nick end labeling （TUNEL）/S100 immunofluorescence staining. The expression of cysteinyl aspartate-specific protease （Caspase）-9， Caspase-3， major histocompatibility complex （MHC）-Ⅰ， and MHC-Ⅱ was detected by Western blot. Subsequently， all nerves were cultured in the incubator at 37 ℃ with 5% CO₂ for 7 days. The expression of glial cell line-derived neurotrophic factor （GDNF） and nerve growth factor （NGF） was detected by Western blot. In addition， the above cryopreserved nerves in the blank group and the 1×10^-6， 1×10^-5， and 1×10^-4 mol·L^-1 G-Rg₁ groups were transplanted to the Wistar rats by allografting （blank transplantation group and the 1×10^-6， 1×10^-5， and 1×10^-4 mol·L^-1 G-Rg₁ transplantation groups）， and fresh sciatic nerve allograft and isograft control group were set up. Sixteen weeks after transplantation， compound muscle action potential （CMAP） and nerve conduction velocity （NCV） were measured by electrophysiology. Nerve filament （NF）200 immunofluorescence staining， transmission electron microscopy， and toluidine blue staining were used to analyze the histology of the regenerated nerves. ResultCompared with the fresh group， the blank group and the G-Rg₁ groups showed increased expression of Caspase-9， Caspase-3， and the apoptosis of SCs （P<0.05，P<0.01） and decreased expression of GDNF， NGF， MHC-Ⅰ， and MHC-Ⅱ （P<0.01）. Compared with the results in the blank group， the expression of Caspase-9 and Caspase-3 decreased in the 1×10^-7， 1×10^-6， 1×10^-5，1×10^-4 mol·L^-1 G-Rg₁ groups （P<0.01）， and the apoptosis of SCs was reduced in the 1×10^-7-1×10^-4 mol·L^-1 G-Rg₁ groups（P<0.05，P<0.01） and increased in the 1×10^-3 mol·L^-1 group （P<0.05）， while the expression of GDNF and NGF increased in the 1×10^-7， 1×10^-6， 1×10^-5，1×10^-4 mol·L^-1 G-Rg₁ groups and decreased in the 1×10^-3 mol·L^-1 group （P<0.05）. There was no statistical significance in the expression of MHC-Ⅰ and MHC-Ⅱ between the blank group and the G-Rg₁ groups. Compared with the 1×10^-7 mol·L^-1 and 1×10^-3 mol·L^-1 G-Rg₁ groups， the 1×10^-6 1×10^-5， 1×10^-4 mol·L^-1 G-Rg₁ groups showed decreased expression of Caspase-3 and the apoptosis of SCs （P<0.05，P<0.01） and increased expression of GDNF and NGF （P<0.05，P<0.01）. There was no statistical significance in MHC-Ⅰ and MHC-Ⅱ expression among G-Rg₁ groups. Sixteen weeks after transplantation， compared with the isograft group， the blank transplantation group and the G-Rg₁ transplantation groups showed decreased CMAP， NCV， myelin sheath thickness， and number of myelinated nerve fibers （P<0.01）， and the 1×10^-6 and 1×10^-4 mol·L^-1 G-Rg₁ transplantation groups showed decreased NF200 （P<0.01）. Compared with the allograft group， the blank transplantation group and the G-Rg₁ transplantation groups showed increased CMAP， NCV， NF200， myelin sheath thickness， and number of myelinated nerve fibers （P<0.05，P<0.01）. Compared with the blank transplantation group， the G-Rg₁ transplantation groups showed increased CMAP， NCV， NF200， myelin sheath thickness， and number of myelinated nerve fibers （P<0.05，P<0.01）. Among all groups of G-Rg₁ transplantation， each index of the 1×10^-5 mol·L^-1 G-Rg₁ transplantation group was superior to that of the 1×10^-4 and 1×10^-6 mol·L^-1 G-Rg₁ transplantation group （P<0.05）. ConclusionG-Rg₁ at a certain centration can maintain the biological activity of cryopreserved SCs of rat sciatic nerve， alleviate the cryopreservation-induced injury of rat sciatic nerve， and promote nerve regeneration after allograft.

Objective:To explore the influencing factors of teaching quality in standardized training of psychiatry specialists, and to provide evidence for improving the training quality.Methods:Both qualitative and quantitative methods were combined in the study. First, information was collected by stratified random sampling and individual interviews, and NVivo 11.0 was used in coding the information and reducing the information to the main concepts. Then, the qualitative research results were compiled into a questionnaire Investigation on Influencing Factors of Standardized Training of Specialists to investigate and analyze all previous specialized training doctors and teaching teachers. SPSS 23.0 was used to perform Mann-Whitney U test. Results:①The teaching abilities of teachers, the attitudes on study and work of the specialists, the teaching initiative of teachers were found to be the important influencing factors of teaching quality. The recognition degree of the specialists was 89.5%, 57.9% and 55.3%, while that of the teachers was 68.4%, 66.7% and 52.6%. ②The teachers' attitudes, the busy degree of the teachers' work and policy orientation were found to be the important influencing factors of teaching initiative. The recognition degree of the specialists was 68.4%, 57.9% and 47.7%, while that of the teachers was 68.4%, 59.6% and 47.4%. ③The mentors' reserve of professional knowledge and skills, the reserve of educational knowledge and skills and the study and exploration in education were found to be the important influencing factors of teaching ability. The recognition degree of the specialists was 89.5%, 81.6% and 57.9%, while that of the teachers was 82.5%, 82.5% and 68.4%.Conclusion:The early cultivation of teaching attitude should be emphasized; the workload of the teachers should be distributed reasonably; the training on both the teaching ability and professional ability should be paid attention to.

Objectives:To examine the prognosis factors of recurrence of esophageal carcinoma within 6 months after neoadjuvant therapy followd by surgery.Methods:The clinical data of 187 patients with esophageal squamous cell carcinoma who underwent neoadjuvant therapy followed by curative esophagectomy between January 2018 and April 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital were analyzed retrospectively. There were 160 males and 27 females, aging (63.0±7.1) years (range:43 to 76 years). The t test, χ 2 test and rank-sum test were used for univariate analysis of the prognosis factors for recurrence within 6 months postoperative, while the Logistic regression was used for multivariate analysis. Results:There were 30 patients (16.0%) developed recurrence within 6 months after operation, including local recurrence in 1 case, regional recurrence in 11 cases, hematogenous recurrence in 13 cases, and combined recurrence in 5 cases. Univariate analysis suggested that there was a significant difference in T staging of tumor before neoadjuvant therapy (cT), tumor regression grade, circumferential resection margin, pathological T stage (ypT) and pathological N stage (ypN) between the recurrence patients and non-recurrence patients (all P<0.05). Logistic regression analysis suggested that the cT3-4 ( OR=2.701, 95% CI: 1.161 to 6.329, P=0.021) and ypN(+)( OR=1.654, 95% CI: 1.045 to 2.591, P=0.032) were the independent prognosis factors for recurrence within 6 months. Conclusion:The combination of neoadjuvant therapy and surgery is not effective in reducing early postoperative recurrence in patients who have invaded the epineurium before treatment, and still have positive lymph nodes after neoadjuvant therapy.

Objective:To examine the safety and short-term outcomes of prone position thoracoscopic esophagectomy.Methods:Clinical data of consecutive thirty patients who accepted prone position thoracoscopic esophagectomy at Department of Thoracic Surgery, Shanghai Chest Hospital between July and December 2020 was analyzed retrospectively. There were 25 males and 5 females, aging 65.5(29.0) years ( M( Q R))(range: 48 to 82 years). Patients with cT3-4a accounted for 73.3%(22/30) and cN(+) accounted for 43.3%(18/30). All the patients in this study had no serious comorbidity, accepted prone position thoracoscopic esophagectomy. Results:No conversion to thoracotomy occurred. The overall time of operation was 210 (105) minutes (range: 130 to 268 minutes), the time of thoracic procedures was 92 (46) minutes (range: 72 to 136 minutes), the time of abdominal procedures was 32 (14) minutes (range: 20 to 48 minutes), respectively. R0 resection accounted for 93.3%(28/30), the negative ratio of circumferential margin was 96.7%(29/30). The number of lymph nodes dissection was 21.5(7.2) (range: 16.0 to 28.0) in total, 12.0(6.5) (range: 9.0 to 18.0) in thoracic lymph nodes, 2.0(1.5) (range: 1.0 to 5.0) in left recurrent laryngeal nerve lymph nodes, and 1.0(1.0) (range: 1.0 to 3.0) in right recurrent laryngeal nerve lymph nodes, respectively. There was no perioperative death, and the overall postoperative complication rate was 43.3%(13/30). The incidence of anastomotic leakage was 10.0%(3/30), recurrent laryngeal nerve paralysis was 26.7%(8/30), and respiratory complication was 6.7%(2/30). The postoperative hospital stay was 10 (9) days (range: 5 to 42 days).Conclusion:Prone position thoracoscopic esophagectomy is safe and feasible, and the short-term outcomes is satisfactory.

Objectives:To examine the prognosis factors of recurrence of esophageal carcinoma within 6 months after neoadjuvant therapy followd by surgery.Methods:The clinical data of 187 patients with esophageal squamous cell carcinoma who underwent neoadjuvant therapy followed by curative esophagectomy between January 2018 and April 2020 at Department of Thoracic Surgery, Shanghai Chest Hospital were analyzed retrospectively. There were 160 males and 27 females, aging (63.0±7.1) years (range:43 to 76 years). The t test, χ 2 test and rank-sum test were used for univariate analysis of the prognosis factors for recurrence within 6 months postoperative, while the Logistic regression was used for multivariate analysis. Results:There were 30 patients (16.0%) developed recurrence within 6 months after operation, including local recurrence in 1 case, regional recurrence in 11 cases, hematogenous recurrence in 13 cases, and combined recurrence in 5 cases. Univariate analysis suggested that there was a significant difference in T staging of tumor before neoadjuvant therapy (cT), tumor regression grade, circumferential resection margin, pathological T stage (ypT) and pathological N stage (ypN) between the recurrence patients and non-recurrence patients (all P<0.05). Logistic regression analysis suggested that the cT3-4 ( OR=2.701, 95% CI: 1.161 to 6.329, P=0.021) and ypN(+)( OR=1.654, 95% CI: 1.045 to 2.591, P=0.032) were the independent prognosis factors for recurrence within 6 months. Conclusion:The combination of neoadjuvant therapy and surgery is not effective in reducing early postoperative recurrence in patients who have invaded the epineurium before treatment, and still have positive lymph nodes after neoadjuvant therapy.