BACKGROUND: This study aimed to investigate programmed death-ligand 1 tumor proportion score in predicting the safety and efficacy of PD-1/PD-L1 antibody-based therapy in treating patients with advanced non-small cell lung cancer (NSCLC) in a real-world setting. METHODS: This retrospective, multicenter, observational study enrolled adult patients who received PD-1/PD-L1 antibody-based therapy in China and met the following criteria: (1) had pathologically confirmed, unresectable stage III-IV NSCLC; (2) had a baseline PD-L1 tumor proportion score (TPS); and (3) had confirmed efficacy evaluation results after PD-1/PD-L1 treatment. Logistic regression, Kaplan-Meier analysis, and Cox regression were used to assess the progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) as appropriate. RESULTS: A total of 409 patients, 65.0% ( n = 266) with a positive PD-L1 TPS (≥1%) and 32.8% ( n = 134) with PD-L1 TPS ≥50%, were included in this study. Cox regression confirmed that patients with a PD-L1 TPS ≥1% had significantly improved PFS (hazard ratio [HR] 0.747, 95% confidence interval [CI] 0.573-0.975, P = 0.032). A total of 160 (39.1%) patients experienced 206 irAEs, and 27 (6.6%) patients experienced 31 grade 3-5 irAEs. The organs most frequently associated with irAEs were the skin (52/409, 12.7%), thyroid (40/409, 9.8%), and lung (34/409, 8.3%). Multivariate logistic regression revealed that a PD-L1 TPS ≥1% (odds ratio [OR] 1.713, 95% CI 1.054-2.784, P = 0.030) was an independent risk factor for irAEs. Other risk factors for irAEs included pretreatment absolute lymphocyte count >2.5 × 10 9 /L (OR 3.772, 95% CI 1.377-10.329, P = 0.010) and pretreatment absolute eosinophil count >0.2 × 10 9 /L (OR 2.006, 95% CI 1.219-3.302, P = 0.006). Moreover, patients who developed irAEs demonstrated improved PFS (13.7 months vs. 8.4 months, P <0.001) and OS (28.0 months vs. 18.0 months, P = 0.007) compared with patients without irAEs. CONCLUSIONS A positive PD-L1 TPS (≥1%) was associated with improved PFS and an increased risk of irAEs in a real-world setting. The onset of irAEs was associated with improved PFS and OS in patients with advanced NSCLC receiving PD-1/PD-L1-based therapy.
Humans ; Carcinoma, Non-Small-Cell Lung/metabolism* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Lung Neoplasms/metabolism* ; Aged ; B7-H1 Antigen/metabolism* ; Programmed Cell Death 1 Receptor/metabolism* ; Adult ; Aged, 80 and over ; Immune Checkpoint Inhibitors/therapeutic use*

Objective: To investigate the incidence of adverse event following immunization (AEFI) with 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) in Jiaxing City, Zhejiang Province, so as to provide insights into safety monitoring and evaluation of PCV13. Methods: Surveillance data of AEFI with PCV13 in Jiaxing City from 2020 to 2022 were collected from the AEFI Monitoring Information Management System of the Immunization Planning System of Chinese Disease Prevention and Control Information System, including demographic information, vaccination time, time of AEFI occurrence and clinical symptoms, and the reported incidence, population and district distribution, and clinical symptoms of AEFI with PCV13 were descriptively analyzed. Results: Totally 455 cases of AEFI with PCV13 were reported in Jiaxing City from 2020 to 2022, with a reported incidence rate of 232.33/105 doses. There were 431, 21 and 3 cases of general, abnormal, coincidence and psychogenic reactions, with reported incidence rates of 220.07/105 doses, 10.72/105 doses and 1.53/105 doses, respectively, and no reports of causal reaction, vaccine quality accident and vaccination accident. The AEFI cases included 258 boys and 197 girls, with a boy/girl ratio of 1.31∶1, and 288 children at ages of less than a year (63.30%). The largest number of AEFI was reported in Haining City (87 cases, 19.12%), and there were 349 AEFI cases (76.70%) within 24 hours following vaccination. The clinical symptoms mainly included redness and swelling, fever and induration, with reported incidence rates of 132.76/105 doses (260 cases), 109.27/105 doses (214 cases), and 55.66/105 doses (109 cases), respectively. There were 450 cases cured and 5 cases improved in 455 cases of AEFI. Conclusions General reaction is the predominant AEFI in Jiaxing City from 2020 to 2022, with mild symptoms. Most AEFI occurs within 24 hours following vaccination, and has a good prognosis.

Objective:To retrieve, evaluate and integrate the evidence related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, so as to provide reference for clinical implementation of extracorporeal cardiopulmonary resuscitation.Methods:According to the evidence-based nursing method and the 6S evidence model, guidelines, clinical decisions, expert consensus, systematic review and other literatures related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital were searched from National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, and other websites, UpToDate, The Cochrane Library, PubMed, Embase, CNKI, Wanfang and other databases. The retrieval date limit was from the establishment of the database to May 20, 2023. Researchers assessed the quality of the included articles, and extracted and summarized the evidence that met the quality standards.Results:A total of 11 articles were included, including 2 guidelines, 6 expert consensuses, 1 systematic review and 2 quasi-experimental studies. A total of 18 pieces of evidences were summarized from 6 aspects, including medical conditions, team building, materials management, operation mechanism, pre-initiating treatment and initiating judgment.Conclusions:This study summarizes the evidence of preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, which can provide reference for promoting the implementation of extracorporeal cardiopulmonary resuscitation. Future studies still need to focus on team building, personnel training and assessment, and optimisation of the management system, so as to improve the efficiency and readiness of treatment.

Objective:To examine the impact of berberine on polycystic ovary syndrome (PCOS) in mice, and to investigate the effects of berberine on the intestinal flora and the intestinal flora on PCOS.Methods:A mouse model of PCOS was established by administering dehydroepiandrosterone in combination with high fat diet, and the mouse model was given a berberine treatment. The study consisted of a blank control group (C group), a PCOS model group (M group) and a berberine treatment group (T group). During the experiment, the mice were closely monitored through timed body weight measurements and estrous cycle monitoring; intraperitoneal glucose tolerance test and insulin tolerance test were done. Upon completion of the pharmacological intervention, the wet weights of liver, ovary and fat deposits of mice were assessed and subjected to HE staining to confirm the success of PCOS modeling and the efficacy of berberine. Additionally, fecal samples were analyzed for intestinal flora through 16S rRNA analysis.Results:The PCOS model was established successfully, berberine alleviated the disturbance of estrous cycle in mice, and significantly alleviated fat accumulation and metabolic abnormalities of glucose in mice. The cross-sectional area of fat pad cells in T group was (2 858±146) μm2, which was significantly lower than that in M group [(9 518±347) μm2], and the difference was statistically significant ( P<0.001). The blood glucose levels in T group were significantly lower than those in M group ( P<0.05). The composition and structure of intestinal flora in mice of M group with PCOS (compared with C group) and in mice of T group after berberine intervention (compared with M group) were significantly altered. However, alpha diversity did not change significantly among three groups ( P>0.05). Conclusion:Berberine could alleviate PCOS by intervening in the alterations of gut microbiota.

In order to investigate the enzyme production mechanism of yak rumen-derived anaerobic fungus Orpinomyces sp. YF3 under the induction of different carbon sources, anaerobic culture tubes were used for in vitro fermentation. 8 g/L of glucose (Glu), filter paper (Flp) and avicel (Avi) were respectively added to 10 mL of basic culture medium as the sole carbon source. The activity of fiber-degrading enzyme and the concentration of volatile fatty acid in the fermentation liquid were detected, and the enzyme producing mechanism of Orpinomyces sp. YF3 was explored by transcriptomics. It was found that, in glucose-induced fermentation solution, the activities of carboxymethyl cellulase, microcrystalline cellulase, filter paper enzyme, xylanase and the proportion of acetate were significantly increased (P < 0.05), the proportion of propionate, butyrate, isobutyrate were significantly decreased (P < 0.05). The results of transcriptome analysis showed that there were 5 949 differentially expressed genes (DEGs) between the Glu group and the Flp group, 10 970 DEGs between the Glu group and the Avi group, and 6 057 DEGs between the Flp group and the Avi group. It was found that the DEGs associated with fiber degrading enzymes were significantly up-regulated in the Glu group. Gene ontology (GO) function enrichment analysis identified that DEGs were mainly associated with the xylan catabolic process, hemicellulose metabolic process, β-glucan metabolic process, cellulase activity, endo-1,4-β-xylanase activity, cell wall polysaccharide metabolic process, carbohydrate catabolic process, glucan catabolic process and carbohydrate metabolic process. Moreover, the differentially expressed pathways associated with fiber degrading enzymes enriched by Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were mainly starch and sucrose metabolic pathways and other glycan degradation pathways. In conclusion, Orpinomyces sp. YF3 with glucose as carbon source substrate significantly increased the activity of cellulose degrading enzyme and the proportion of acetate, decreased the proportion of propionate, butyrate and isobutyrate. Furthermore, the degradation ability and energy utilization efficiency of fungus in the presence of glucose were improved by means of regulating the expression of cellulose degrading enzyme gene and participating in starch and sucrose metabolism pathway, and other glycan degradation pathways, which provides a theoretical basis for the application of Orpinomyces sp. YF3 in practical production and facilitates the application of Orpinomyces sp. YF3 in the future.
Animals ; Cattle ; Neocallimastigales/metabolism* ; Anaerobiosis ; Rumen/microbiology* ; Propionates/metabolism* ; Isobutyrates/metabolism* ; Cellulose/metabolism* ; Fungi ; Starch/metabolism* ; Glucose/metabolism* ; Acetates ; Sucrose/metabolism* ; Cellulases ; Cellulase

In this paper, the differences between air probe and filled probe for measuring high-frequency dielectric properties of biological tissues are investigated based on the equivalent circuit model to provide a reference for the methodology of high-frequency measurement of biological tissue dielectric properties. Two types of probes were used to measure different concentrations of NaCl solution in the frequency band of 100 MHz-2 GHz. The results showed that the accuracy and reliability of the calculated results of the air probe were lower than that of the filled probe, especially the dielectric coefficient of the measured material, and the higher the concentration of NaCl solution, the higher the error. By laminating the probe terminal, liquid intrusion could be prevented, to a certain extent, to improve the accuracy of measurement. However, as the frequency decreased, the influence of the film on the measurement increased and the measurement accuracy decreased. The results of the study show that the air probe, despite its simple dimensional design and easy calibration, differs from the conventional equivalent circuit model in actual measurements, and the model needs to be re-corrected for actual use. The filled probe matches the equivalent circuit model better, and therefore has better measurement accuracy and reliability.
Reproducibility of Results ; Sodium Chloride ; Calibration

【Objective】 To compare the current standards and explore the influencing factors for hemolysis rate of leukocyte-reduced red blood cells at the end of the preservation period, in order to formulate reasonable internal control indicators. 【Methods】 A retrospective analysis was performed on hemolysis rate of 427 samples of leukocyte-reduced red blood cells at the end of the preservation period in Nanning Blood Center from 2015 to 2022. Compared with the current standard for hemolysis rate at the end of the preservation period (GB 18469-2012 Quality Requirements for Whole Blood and Component Blood), the differences were analyzed, and the factors influncing the hemolysis rate were analyzed in terms of different blood donor groups. 【Results】 1) Among the 427 samples, the hemolysis rate of 418 (97.89%) did not exceed 0.4%, all lower than 0.8%; 2)the hemolysis rate of the male group was higher than that of the female group; 3) the hemolysis rate of the 18-29 years old group was lower than that of the 30-39 year old group and the 40-60 year old group, with statistically significant difference; 4) in terms of occupation, the hemolysis rate of students was the lowest, and the differences between groups were statistically significant; 5) no statistical significance was found in ethnicity and blood type. 【Conclusion】 Statistics indicated that gender, age, blood donation volume and occupation of blood donors were the influencing factors of hemolysis rate. The current standard is obviously higher in the qualified range of blood quality control in Nanning. It is advisable to formulate a reasonable quality control strategy with internal control index of hemolysis rate set <0.4%, which is conducive to making accurate evaluation of internal quality control and ensuring blood safety.

Objective:To investigate the correlation between serum SET domain bifurcated 1 (SETDB1), cyclooxygenase-2 (COX-2) levels and bone metabolism indexes in perimenopausal osteoporosis patients.Methods:71 patients with perimenopausal osteoporosis admitted to Haining Maternal and Child Health Hospital from Aug. 2018 to Aug. 2021 were selected as the study group, and 50 healthy subjects were selected as the control group. The general data, bone mineral density and bone metabolism of the two groups were determined. The concentrations of SETDB1 and COX-2 in serum were determined by ELISA. Correlation analysis was performed to determine the correlation between serum SETDB1 and COX-2 levels and bone metabolism indexes. ROC curve was used to analyze the value of serum SETDB1 and COX-2 levels in the diagnosis of perimenopausal osteoporosis.Results:Compared with the control group, bone mineral density, PINP and osteocalcin levels were decreased in the study group, but CTX levels were increased (all P<0.05). In addition, compared with the control group (52.85±7.96) (4.88±1.00), the concentration of SETDB1 in the study group was decreased (40.25±7.08), but the concentration of COX-2 was increased (7.28±2.09) ( t=9.16, P<0.001; t=5.62, P<0.001). SETDB1 concentration was positively correlated with PINP and osteocalcin, and negatively correlated with CTX concentration ( r=0.36, -0.40, 0.34, P<0.001). However, COX-2 concentration was negatively correlated with PINP and osteocalcin, and positively correlated with CTX concentration ( r=-0.35, 0.42, -0.37, P<0.001). Serum SETDB1 and COX-2 were both effective indicators for the diagnosis of perimenopausal osteoporosis (AUC=0.81, P<0.01; AUC=0.79, P<0.001) . Conclusion:Serum SETDB1 and COX-2 levels can be used as diagnostic indexes for perimenopausal osteoporosis patients, and they are correlated with bone metabolism indexes.

Objective:To explore the application effect of continuous quality improvement based on trauma team activation model in emergency triage.Methods:This study is a historical controlled study. A total of 12 215 trauma patients receiving initial treatment in the Emergency Department of the First Affiliated Hospital with Nanjing Medical University from January 2020 to June 2021 were selected as the research objects by the convenience sampling method, and 3 896 trauma patients from January to June 2020 were enrolled as the baseline group, and 4 054 patients from July to December 2020 were enrolled as the phaseⅠ improvement group, and 4 265 patients from January to June 2021 were enrolled as the phaseⅡ improvement group. The baseline group adopted the one-tiered trauma team activation model, which was evaluated and decided by the first-visiting doctor. The phaseⅠ improvement group received the one-tiered trauma team activation model, which was evaluated and decided by pretest triage nurses. The stageⅡ improvement group conducted the two-tiered trauma team activation model, which was evaluated and decided by pretest triage nurses. The trauma team activation time, overtriage rate and undertriage rate were compared between the three groups.Results:The trauma team activation time of the phaseⅠ improvement group and phaseⅡ improvement group was shorter than that of the baseline group, and the difference was statistically significant ( P<0.05). The overtriage rate of the phaseⅡ improvement group was lower than that of the baseline group and the phaseⅠ improvement group, and the differences were statistically significant ( P<0.05). The underage rate of the three groups were <5%, and the differences were not statistically significant ( P>0.05) . Conclusions:The two-tiered activation of trauma team mode led by nurses can shorten the trauma team activation time, reduce the overtriage rate and undertriage rate, improve the quality of trauma team activation.

Objective:To investigate the status quo of organizational silence behavior of nurses in Emergency Department, and analyze the influence of working environment and psychological capital on organizational silence.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 232 emergency department nurses from 5 ClassⅢ Grade A hospitals in Jiangsu Province were selected as the research objects from April to June 2022. The research objects were surveyed using the general information survey questionnaire, Nurse Organization Silence Assessment Questionnaire, Nurse Work Environment Scale and Nurse Psychological Capital Scale. Pearson correlation was used to analyze the correlations among organizational silence, work environment and psychological capital. The mediation model was modeled using AMOS 24.0 software, and the Bootstrap method was used to verify the mediating effect of psychological capital between work environment and organizational silence. A total of 232 questionnaires were sent out in this study, and 210 were effectively received with effective recovery of 90.5% (210/232) .Results:The organizational silence score of 210 emergency department nurses was (54.70±15.02), The working environment score was (80.72±11.07), and the psychological capital score was (71.59±11.57). Organizational silence was negatively correlated with work environment and psychological capital scores ( r=-0.309, -0.670, respectively; P<0.05) ; Working environment was positively correlated with psychological capital score ( r=0.266, P<0.05). The mediating effect analysis showed that psychological capital had a partial mediating effect between working environment and organizational silence (β=-0.311, P<0.05). The direct effect size of working environment on organizational silence was -0.241 ( P<0.05) . Conclusions:The organizational silence of nurses in emergency department is at a medium high level, and the working environment can indirectly affect the organizational silence through psychological capital. Nursing managers can improve organizational silence by creating a healthy working environment, cultivating nurses' psychological capital and creating more opportunities to communication.