Objective To investigate the clinical significance of precursor of gastrin‐releasing peptide(ProGRP) for the differen‐tial diagnosis between small cell lung cancer (SCLC) and non‐small cell lung cancer(NSCLC) and efficacy assessment .Methods The levels of ProGRP were detected by ELISA in 210 healthy adults ,200 patients with lung benign disease ,260 patients with NSCLC and 182 patients with SCLC before treatment and after chemotherapy .Results The level of ProGRP in the SCLC group was significantly higher than that in the NSCLC group ,healthy control group and lung benign disease group(P<0 .01) .The sensi‐tivity of ProGRP for detecting SCLC was 56 .3% and the specificity was 92 .6% .When combination detection of ProGRP and NSE was used ,the sensitivity increased to 82 .6% ;the level of ProGRP in the patients with SCLC after 2‐cycle chemotherapy was signifi‐cantly lower than before treatment (P<0 .01) .Conclusion The tumor marker ProGRP has very important guidance significance to assisted diagnosis ,differential diagnosis and efficacy assessment of chemotherapy in the patients with SCLC .

Objective To evaluate the relationship between the CCNE1 or RIP2, identified at a single nucleotide poly?morphism, and the risk, clinic stage and pathological grade of bladder cancer. Methods Peripheral venous blood samples were obtained from 176 patients with bladder cancer and 210 controls without cancer. DNA was extracted. Polymerase chain reaction (PCR) method was used to detect CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism. According to the postoper?ative pathological results, patients with bladder cancer were determined the grading and staging. The genotype differences of medium gene and the distribution gene were analyzed and compared in bladder cancer group and control group. The relation?ship of CCNE1 (rs8102137) and RIP2 (rs42490) genotypes and clinical data of patients with bladder cancer was analyzed, and the relationship of them with the genetic susceptibility to bladder cancer was also analyzed. Results The genotype dis?tribution was with good group representative in control group. The frequency of CCNE1(rs8102137) variant allele was signifi?cantly higher in bladder cancer group (40.91%) than that of control group (30.95%,OR=1.54,95%CI:1.02-2.45, P<0.05). The frequency of RIP2 (rs42490) variant allele was significantly higher in bladder cancer group (72.73%) than that of control group (62.38%, OR=1.61, 95%CI:1.04-2.48, P<0.05). There were no significant differences in gene polymorphisms of CC?NE1(rs8102137) and RIP2 (rs42490) between different pathological grades and different clinical stages of bladder cancer. Conclusion The CCNE1 (rs8102137) and RIP2 (rs42490) polymorphism have interaction in occurrence of bladder cancer process. There is higher risk of bladder cancer in individuals carrying mutant alleles than that of individuals carrying wild type.

Objective To assess the value of preoperative neutrophil-lymphocyte ratio ( NLR) for predict the prognosis in patients with high grade T1 bladder.Methods From January 2004 to December 2014, the data of 307 patients diagnosed as bladder cancer of Stage 1 and high grade after undergoing TURBT were analyzed, including gender, age, smoking status, tumor number and size, hydronephrosis, intravesical instillations and preoperative blood transfusion of 307 patients diagnosed as bladder cancer of stage 1 and high grade after undergoing TURBT were analyzed retrospectively.All patients were primary urothelial carcinoma.According to preoperative NLR,patients were divided into the low NLR group( NLR≤2.42,n=197) and the high NLR group(NLR >2.42,n =110).Recurrence-free survival (RFS) and progression-free survival ( PFS) were calculated according to the Kaplan-Meier model and compared by the log-rank model.Cox regression models were used for multivariate analyses of the association between NLR and bladder cancer, then the prognostic factors affecting RFS and PFS were evaluated.Result of these 307 patients, the low NLR group accounted for 64.2%(197/307), and the high NLR group accounted for 35. 8%(110/307).The mean follow-up period was 71(range, 1-123)months.The recurrence rate in the low NLR group and the high NLR group recurrence rate were 19.2%( 38/197 ) and 34.5%( 38/110 ) respectively, RFS were 73.0(range, 2-123)months and 67.5(range, 1-122)months respectively.The progression rates were 4.1%(8/197) and 10.9%(12/110) respectively.The recurrence and progression rates in the high NLR group is higher than those in the low NLR group(P<0.01 and P=0.008), and RFS was shorter( P=0.002).Multivariable Cox regression analysis showed that NLR>2.42(P=0.007,HR=1.912)and hydronephrosis (P<0.01, HR =2.485 ) are associated with higher risk of recurrence.Conclusion Elevated preoperative NLR is an independent predictor of RFS and PFS in patients with high grade T1 bladder cancer.

Objective To investigate the health information literacy (HIL) conditions of patients after percutaneous coronary intervention (PCI) operation and to discuss the influence of HIL on the nursing knowledge acquisition behavior of the patients. Methods A total of 230 postoperative PCI patients who accepted treatment in Cardiology Department of our hospital were selected. General information questionnaire, 2012 National Residents Health Literacy Supervision Investigation Questionnaire-HIL part and nursing knowledge acquisition behavior questionnaire were adopted. Results In this investigation, 230 questionnaires were recovered and 216 of them were effective. HIL level of PCI postoperative patients was 24.1％ (52/216). Differences in HIL levels of patients of different ages, residential areas and educational degrees were of statistical significance (χ2=10.577, 12.657, 37.693, P<0.05). The scores of PCI postoperative exercise method and item analysis of PCI therapy institution and nursing knowledge obtained from medical care personnel, books, Internet and speeches in patients with HIL were 3.40±0.85, 3.35 ± 0.71, 3.37 ± 0.82, 3.75 ± 0.74, 3.54 ± 0.75 and 3.71 ± 0.82. They were significantly higher than the scores of 2.38±0.71, 2.40±0.76, 2.34±0.71, 2.48±0.75, 2.45±0.72 and 2.43±0.78 in the non HIL patients (t=6.657-9.000, P<0.05). The scores of nursing knowledge in coronary heart disease symptoms, PCI postoperative complications and aetiological agent of coronary heart disease,nursing knowledge sources of newspapers, TV and radio, relatives, and nursing knowledge acquisition barriers due to low educational level, incomprehension of terminology and lack of Internet knowledge of the patients with HIL were 2.37± 0.82, 2.63 ± 0.89, 2.42 ± 0.82, 2.37 ± 0.79, 2.50 ± 0.67, 2.48 ± 0.67, 2.46 ± 0.64, 2.46 ± 0.85, 2.54 ± 0.87 and 2.63±0.69. They were significantly lower than the scores of 3.43±0.78, 3.38±0.76, 3.45±0.74, 3.49±0.77, 3.32 ± 0.81, 3.41 ± 0.77 and 3.34 ± 0.83, 3.46 ± 0.70, 3.43 ± 0.74 and 3.41 ± 0.75 in the non HIL patients (t=-5.657-4.690, P<0.05). Conclusions HIL level of PCI postoperative patients is low, and patients in different HIL levels have different nursing knowledge acquisition behaviors.

Objective: To explore the preoperative anxiety and health information literacy of patients undergoing percutaneous coronary intervention (PCI), and to analyze the correlation between them, so as to provide reference for promoting psychological care of patients. Methods: A total of 221 PCI patients treated in our hospital were selected by convenience sampling, and the preoperative anxiety questionnaire and health information literacy questionnaire were used to investigate. Results: The score of health information literacy of PCI patients was (93.38±11.11) points. The score of information morality was the highest (79.1%) and the score of information acquisition and cognition was the lowest (59.3% and 59.9%). The score of anxiety was (27.07±3.96) points before operation, among them, uncertainty score was the highest with (9.73±1.47) points. The scores of all dimensions of health information literacy were negatively correlated with preoperative anxiety scores (r=-0.354~-0.133, P<0.05). Conclusions The preoperative anxiety level of PCI patients is relatively high, the higher the health information literacy level of patients, the lower the preoperative anxiety. Nurses should pay attention to improve the health information literacy of patients, reduce preoperative anxiety to improve the outcome of patients.

Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.