Currently, histological and molecular methods are considered for the treatment of advanced non-small cell lung cancer (NSCLC). Single-agent epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKIs) and anaplastic lymphoma kinase in-hibitors (ALK-TKIs) have been used as standard first-line therapies for patients with active EGFR mutation and ALK rearrangement, re-spectively. However, to date, the single-agent EGFR-TKIs as the first-line therapy for patients with known EGFR mutations has been demonstrated to provide a prolonged progression-free survival but does not affect overall survival (OS). Physicians these days focus on improving the OS of patients with advanced NSCLC. To patients with EGFR mutation, combining and maintaining EGFR-TKIs with chemotherapy could be a promising approach. In this article, various ways of combining EGFR-TKIs with chemotherapy were explored.

Objective To apply the virtual reality in balance function training for Parkinson's Disease (PD). Methods From October, 2013 to January, 2016, 31 patients with balance disorders after PD were divided into two groups:the treatment group (n=17) received virtual reality balancing games training, while the control group (n=14) received routine balance training. They were assessed with Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), static fall index (SFI), limits of stability (LOS), dynamic fall index (DFI) and modified Barth-el Index (MBI) before and four weeks after treatment. The frequency of falls in the next six weeks was recorded. Results The scores of BBS, TUGT, SFI, LOS, DFI and MBI improved significantly in both groups after treatment (P<0.05), and improved more in scores of BBS (t=2.095), TUGT (t=-2.091), DFI (t=-2.182), LOS scores (t=2.202) and MBI (t=3.036) in the treatment group than in the control group (P<0.05). There was positive correlation between scores of BBS and MBI (r=0.899, P<0.001). The frequency of falls was less in the treatment group than in the control group (P<0.05). Conclusion Virtual reality balance training can improve the balance function for PD.

Objective:To screen the biomarkers in the exhaled breath of mice exposed to benzene by using exhaled breath online analysis system.Methods:Thirty 8-week-old male C57BL/6 mice were randomly divided into six groups (0, 3, 32, 324, 648, and 1 296 mg/m 3) and treated with benzene vapour for 28 days. At the end of the exposure, the peripheral blood cell counts and blood glutathione (GSH) were detected. The content of malondialdehyde (MDA) in HL60 cells treated by mice plasma was examined. Exhaled breath data from mice were collected by Secondary electrospray ionization source high resolution mass spectrometry (SESI-HRMS). Targeted analysis underlying benzene metabolites and oxidative stress metabolites was performed to screen the biomarkers in exhaled breath. Results:After benzene exposure, the number of peripheral blood cells was decreased in different degrees, particularly in the white blood cells (WBC) number. The WBC in 32 and 324 mg/m 3 groups was declined by 27.76% and 52.87%, respectively compared to that in control group ( P<0.05). Meanwhile, compared with the control group, the GSH content of peripheral blood cells from 324 mg/m 3 group decreased by 13.16% ( P<0.05). In addition, MDA content was increased by 18.11% in HL60 cells treated with plasma from 324 mg/m 3 group mice ( P<0.05). The phenol, hydroquinone/catechol, benzenetriol and trans, trans-Muconic acid ( t,t-MA) in the exhaled gas of mice could be used as biomarkers for benzene exposure ( R 2>0.8, P<0.001). The peak intensity of five small molecular metabolites related to oxidative stress (ω-carboxylic fatty acid C 5H 10O 3, ω-carboxylic fatty acid C 6H 12O 3, glutamate, cysteine and MDA) increased with the increase of benzene concentration ( P<0.05), which was negatively correlated with WBC decline ( P<0.001), suggesting that these molecules mignt be used as biomarkers of benzene-induced toxicity. Conclusions:Phenol, hydroquinone/catechol, benzenetriol and trans, trans-Muconic acid ( t,t-MA) in exhaled breath of mice could be used as biomarkers for benzene exposure; ω-carboxylic fatty acid C 5H 10O 3, ω-carboxylic fatty acid C 6H 12O 3, glutamate, cysteine and MDA might be used as markers of benzene-induced toxicity.

Objective Ti explire the treatment appriach if irganiphisphirus pesticide piisining and ti ibserve its clinical effect and ti explire the methids if clinical nursing.Methods 60 patients with irganiphisphirus pesticide piisining were randimly divided inti ibservatiin griup with 32 patients and the cintril griup with 28 patients.The cintril griup was given riutine gastric lavage,atripinizatiin,pralidixime injectiin,rehydratiin,symptimatic treatment and nursing while the ibservatiin griup was injected pralidixime and mannitil in the lavage tube (ir Pyridinealdixime methichliride)based in the treatment if cintril griup.The treatment effect if twi griups were cimpared.Results Atripine disage and biunce in the ibservatiin griup was ib-viiusly less than that in the cintril griup (P <0.01).Effectivness time if atripine,hispitaliza-tiin time and curative rate were better than that in the cintril griup (P <0.05).Conclusion Early lavage tube injectiin if pralidixime and mannitil (ir Pyridinealdixime methichliride)can significantly imprive success rate if irganiphisphirus pesticide piisining if patients.

Objective:To screen the biomarkers in the exhaled breath of mice exposed to benzene by using exhaled breath online analysis system.Methods:Thirty 8-week-old male C57BL/6 mice were randomly divided into six groups (0, 3, 32, 324, 648, and 1 296 mg/m 3) and treated with benzene vapour for 28 days. At the end of the exposure, the peripheral blood cell counts and blood glutathione (GSH) were detected. The content of malondialdehyde (MDA) in HL60 cells treated by mice plasma was examined. Exhaled breath data from mice were collected by Secondary electrospray ionization source high resolution mass spectrometry (SESI-HRMS). Targeted analysis underlying benzene metabolites and oxidative stress metabolites was performed to screen the biomarkers in exhaled breath. Results:After benzene exposure, the number of peripheral blood cells was decreased in different degrees, particularly in the white blood cells (WBC) number. The WBC in 32 and 324 mg/m 3 groups was declined by 27.76% and 52.87%, respectively compared to that in control group ( P<0.05). Meanwhile, compared with the control group, the GSH content of peripheral blood cells from 324 mg/m 3 group decreased by 13.16% ( P<0.05). In addition, MDA content was increased by 18.11% in HL60 cells treated with plasma from 324 mg/m 3 group mice ( P<0.05). The phenol, hydroquinone/catechol, benzenetriol and trans, trans-Muconic acid ( t,t-MA) in the exhaled gas of mice could be used as biomarkers for benzene exposure ( R 2>0.8, P<0.001). The peak intensity of five small molecular metabolites related to oxidative stress (ω-carboxylic fatty acid C 5H 10O 3, ω-carboxylic fatty acid C 6H 12O 3, glutamate, cysteine and MDA) increased with the increase of benzene concentration ( P<0.05), which was negatively correlated with WBC decline ( P<0.001), suggesting that these molecules mignt be used as biomarkers of benzene-induced toxicity. Conclusions:Phenol, hydroquinone/catechol, benzenetriol and trans, trans-Muconic acid ( t,t-MA) in exhaled breath of mice could be used as biomarkers for benzene exposure; ω-carboxylic fatty acid C 5H 10O 3, ω-carboxylic fatty acid C 6H 12O 3, glutamate, cysteine and MDA might be used as markers of benzene-induced toxicity.

Objective Ti explire the treatment appriach if irganiphisphirus pesticide piisining and ti ibserve its clinical effect and ti explire the methids if clinical nursing.Methods 60 patients with irganiphisphirus pesticide piisining were randimly divided inti ibservatiin griup with 32 patients and the cintril griup with 28 patients.The cintril griup was given riutine gastric lavage,atripinizatiin,pralidixime injectiin,rehydratiin,symptimatic treatment and nursing while the ibservatiin griup was injected pralidixime and mannitil in the lavage tube (ir Pyridinealdixime methichliride)based in the treatment if cintril griup.The treatment effect if twi griups were cimpared.Results Atripine disage and biunce in the ibservatiin griup was ib-viiusly less than that in the cintril griup (P <0.01).Effectivness time if atripine,hispitaliza-tiin time and curative rate were better than that in the cintril griup (P <0.05).Conclusion Early lavage tube injectiin if pralidixime and mannitil (ir Pyridinealdixime methichliride)can significantly imprive success rate if irganiphisphirus pesticide piisining if patients.

Objective:To investigate the status quo of knowledge, attitude and practice of enterostomal therapists (ET) in chronic wound pain management and analyze its influencing factors, so as to provide references and suggestions for continuous improvement of wound pain management.Methods:The convenient sampling method was used to investigate 260 ET objects. The survey tools were a self-designed General Information Questionnaire and questionnaires on knowledge, attitude and practice of ET on chronic wound pain.Results:A total of 260 questionnaires were distributed and 238 were valid. The score of ET on chronic wound pain knowledge questionnaire was (5.90±1.49) , the score of ET on chronic wound pain attitude questionnaire was (25.74±3.57) and the score of ET on chronic wound pain management practice questionnaire was (53.28±12.52) . The results of multiple linear regression showed that professional title, working years in wound care and working experience in relevant departments of oncology were the influencing factors of knowledge, attitude and practice of ET in chronic wound pain management ( P<0.05) . Conclusions:ET lacks knowledge of chronic wound pain and has acceptable attitudes, and his practical behaviors need to be strengthened urgently.Hospital administrators vigorously develop full-time ET and implement multidisciplinary collaboration to manage wound pain. When selecting ET training personnel, it is recommended that nurses at or above the intermediate level be the target of training. For ET, it is necessary to continuously improve professional titles and re-learn, and continuously accumulate experience in practice. For ET schools, a wound pain training knowledge system based on job competence should be established, and corresponding training should be carried out for wound specialist nurses.

Objective:To investigate the correlation between specific expression of serum micro ribonucleic acid (miRNA) and dilated cardiomyopathy (DCM) in children.Methods:Sixteen children diagnosed with DCM in Pediatric Heart Center of Beijing Anzhen Hospital from November 2013 to March 2016 were enrolled in the DCM group.Meanwhile, 12 age- and gender-matched healthy children who underwent medical examinations at the same time in the same hospital were selected as the healthy control group.Their serum was collected and miRNA sequencing was performed.The sample size was expanded at the later stage (the DCM group included 30 cases, and the healthy control group included 16 cases). The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) verification experiment was conducted on 11 miRNAs with statistically significant sequencing results.Results:Serum miRNA sequencing showed that 172 miRNAs were up-regulated but no miRNAs were down-regulated in the DCM group, compared with the healthy control group (fold change>2, P<0.001). Top 11 significantly up-regulated miRNAs were verified by qRT-PCR, and it was found that 8 of the 11 miRNAs (let-7f, let-7g, miR142-5p, miR143-3p, miR26a, miR27a-3p, miR27b-3p, and miR126-3p) in the DCM group were significantly up-regulated (all P<0.05). In the receiver operating characteristic (ROC) curves of DCM patients, the area under the curves of serum miR142-5p, miR143-3p, miR27b-3p, and miR126-3p were 0.983, 0.992, 0.915 and 0.950, respectively, which were statistically significantly different from those of the healthy control group (all P<0.05). Conclusions:Four serum miRNAs (miR-142-5p, miR-126-3p, miR-143-3p and miR-27b-3p) can distinguish children with DCM from healthy children.Circulating miRNAs are effective in screening DCM children.

Objective:To retrieve the relevant guidelines and expert consensus on self-management of patients with high-risk foot diabetes, and analyze the content of high-quality guidelines and expert consensus recommendations, so as to provide a reference for the construction of a guidance program for self-management of patients with high-risk foot diabetes.Methods:Computer-retrieved clinical practice guidelines and expert consensus for self-management of patients with high-risk foot for diabetes from databases, guideline networks, and related professional websites. The search period was from January 1, 2012 to June 5, 2022. The quality of the included literature was evaluated and the evidence was extracted and integrated by 2 researchers. Experts were invited to evaluate the summarized evidence.Results:According to the quality of literature, a total of 12 guidelines (10 at level A and 2 at level B) and 3 expert consensus (expert discussion and decision) were included, and 8 themes were defined as regular follow-up, self-assessment, foot and decompression management, exercise management, nutrition management, indicator management, psychological management, and health education, a total of 28 recommendations. Among them, there were 23 A-level recommendations and 5 B-level recommendations.Conclusions:The quality of the guidelines and expert consensus included in this study is high,the recommended level of the summarized evidence is high. This study provides the reference and basis for the clinical staff to construct and guide the clinical practice of self-management of high-risk diabetic foot patients.

To evaluate the clinical value of a new method of guide wire extraction and single reverse-α fixation with short nasobiliary duct for oronasal conversion and fixation, patients who underwent endoscopic nasobiliary drainage in Shanghai East Hospital, Tongji University from January to August 2022 were selected. They were randomly divided into guide wire extraction and single reverse-α fixation with short nasobiliary duct group (the observation group, n=145) and guide wire taking and reverse-α fixation group (the control group, n=71). The operation time, one-time operation success rate, adverse events, comfort and satisfaction between the two groups were compared. The operation time in the observation group was significantly shorter than that in the control group [102 ( 91, 117) s VS 136 (127, 145) s, Z=-9.639, P<0.001]. The one-time operation success rate in the observation group was significantly higher than that in the control group [88.28% (128/145) VS 67.61% (48/71), χ2=13.496], the nasopharynx stimulation score [1 (1, 2) VS 2 (1, 2), Z=-4.457] and adverse events incidence [4.14% (6/145) VS 15.49% (11/71), χ2=8.475] in the observation group were significantly lower than those in the control group ( P<0.05). During the indwelling of nasobiliary duct, the bile drainage volume (179.45±81.54 mL VS 142.89±55.69 mL, t=3.407) and nursing satisfaction score (7.72±0.99 VS 6.06±1.07, t=11.337) in the observation group were higher than those in the control group, and the comfort score (3.00±1.01 VS 4.83±0.99, t=-12.642) and incidence of adverse events [3.45% (5/145) VS 14.08% (10/71), χ2=8.344] in the observation group were lower than those in the control group ( P<0.05). The operation time of nasobiliary duct removal in the observation group was significantly shorter than that in the control group (9.00±1.14 s VS 11.93±1.36 s, t=-16.616, P<0.001). In conclusion, the guide wire extraction and single reverse-α fixation with short nasobiliary duct for nasobiliary oronasal conversion and fixation in endoscopic nasobiliary drainage has the advantages of simple operation, small irritation response and low complication incidence, which is worth of clinical promotion.