Background and objective Small cell lung cancer (SCLC) is a rapidly growing tumor with character-istic of neuroendocrine cellular function. Neuron speciifc enolase (NSE), pro-gastrin-releasing peptide (ProGRP) and lactic dehydrogenase (LDH) are valuable in diagnosis and treatment of SCLC. By analyzing the variation of NSE, ProGRP and LDH before and atfer treatment, the aim of this study is to investigate the effcacy of tumor markers in diagnostic staging, therapeu-tic evaluation and prediction of disease relapsing.Methods Patients with SCLC who receiving the ifrst line chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled and retrospectively analyzed. Clinical characteristic (includes NSE, ProGRP and LDH level before and atfer 2 cycles chemotherapy), effcacy evaluation, progression-free survival (PFS) were analyzed.Results Before treatment, Serum NSE, ProGRP and LDH in patients with extensive disease (ED) were signiifcantly higher than those with limited disease (LD)(allP<0.005); NSE level increased obviously accompanied by increase of lymph nodes stage in LD group (P=0.010); Patients with weight reduction when diagnosis had higher NSE and LDH than those without loss of weight (P=0.032,P=0.014). Atfer 2 cycles chemotherapy, decrease of NSE and ProGRP in effective group was higher than which in stable and ineffective groups (P=0.015,P=0.002). hTe relapse risk was lower in patients who accepted>4 cycles chemotherapy and with obvious decrease of ProGRP than those who accepted ≤4 cycles chemotherapy and with less obvious decrease of ProGRP in LD group; ED patients with no more than 2 distant metastasis, normal LDH level before treat-ment and obvious decrease of ProGRP atfer chemotherapy had lower short term relapse risk. In addition, the types of relapse (sensitive relapse, drug resistance relapse and refractory relapse) were negatively correlated with decrease of ProGRP (P=0.044). By multivariate analysis, numbers of chemotherapy cycle was independent prognostic factor for PFS in LD SCLC; numbers of distant metastasis and decrease of ProGRP were independent prognostic factors for PFS in ED SCLC.Conclusion Increase level of serum tumor markers is related to tumor burden. Decrease level of ProGRP atfer treatment may prognose effcacy and relapse risk.

Background and objective As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insuffcient clinical evidence for these patients. Lung squamous cell carcino-ma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients.Methods We retrospectively analyzed the clinical fea-tures of 38 elderly patients with lung squamous carcinoma and summarized the treatment under the clear diagnosis and clini-cal staging.Results Elderly patients with squamous cell carcinoma can choose surgery, radiotherapy and chemotherapy based on diagnosis and clinical staging when their physical condition is permitted.Conclusion Because of the short life expectancy of patients more than 80 years old, fewer of them could receive completed and effective treatment, comparing with patients between 70 and 80 years old.

Objective This study focuses on the construction and cultivation of young administrative management per-sonnel in Shanghai's public hospitals,aiming to provide scientific support for the development of high-quality young administra-tive management professionals in public hospitals.Methods Utilizing an anonymous online survey,this research collected data on the current state of subjective well-being and its influencing factors among the targeted groups from hospitals.Analysis of vari-ance and multivariate analysis were conducted to analyze potential factors affecting their sense of well-being.Results A total of 171 cases were included in the survey,with an average score of 80.37.This group of respondents exhibited a higher level of sub-jective well-being compared to the national norm.Notably,young administrative staff who had obtained Shanghai residency,had a surplus income,spent time with family after work,had career advancement opportunities,felt a strong connection to their work's value,and received affirmation from family members,demonstrated higher subjective well-being scores,with significant statisti-cal differences(P＜0.05).Conversely,those with an income ranging from 0 to 100 000,and those who felt overwhelmed by their current roles,scored lower on well-being,with significant statistical differences(P＜0.05).Conclusion This study sug-gests that by bolstering professional security and job stability,fostering a set of correct values and a sense of work identity,and improving job satisfaction and competence,the subjective well-being of this group can be further elevated.This,in turn,can in-ject new momentum into the high-quality development of public hospitals.

BACKGROUNDGensing Rg3 is an active component from ginseng. The aim of this study is to observe the clinical anticancer effect of Rg3 in combination with chemotherapy regimen NP (vinorelbine+cisplatin) in advanced non-small cell lung cancer (NSCLC).

METHODSStage III-IV NSCLC patients confirmed by pathology or cytology all received vinorelbine plus cisplatin for at least two cycles, and were randomized into two groups: patients in arm A also received placebo twice a day, while patients in arm B received two tablets of Rg3 twice a day for at least two months. The endpoints of the study were the efficacy, survival and tolerance of patients.

RESULTSFrom July 2000 to May 2002, 115 patients were enrolled into the trial. The patients' characteristics were well balanced in the two groups. Sex of patients: male, 79; female 36. Types of pathology: adenocarcinoma, 71; squamous cell carcinoma, 29; adenosquamous carcinoma, 8; others, 7. TNM stage: stage III, 45; stage IV, 70. Prior chemotherapy: with, 17; without, 98. Prior radiotherapy: with, 15; without, 100. Prior surgical treatment: with, 23; without, 92. Nine patients discontinued from the trial due to severe adverse effects (5) and other reasons (4), so there were 106 patients evaluable for clinical efficacy. The response rate was 14.5% (8/55) in arm A, and 33.3% (17/51) in arm B (P=0.011). The survival time in arm A was 9.7 months (mean) and 8.0 months (median), and 15.3 months (mean) and 10.0 months (median) in arm B (P=0.0088).

CONCLUSIONSPreliminary results show improvements in response rate and survival time (median and mean) in Rg3 arm compared with placebo arm. It is worthy to confirm the results in further clinical trials.

BACKGROUNDChemotherapy is the main treatment measure of advanced non-small cell lung cancer(NSCLC).The aim of this study is to explore the efficacy,toxicity,time to disease progression(TTP) and overall survival under the combined chemotherapy with gemcitabine(GEM) plus cisplatin(DDP) in the treatment of advanced NSCLC.

METHODSRetrospective review was conducted on 79 chemotherapy-naive cases of advanced NSCLC treated with GEM and DDP from October 1999 to November 2005.Among 79 patients,51 were male and 28 female;the median age was 53 years old(ranged from 21 to 74);there were 17 cases of squamous cell carcinoma,53 cases of adenocarcinoma,3 cases of large cell carcinoma,1 case of adeno-sqamous cell carcinoma,5 unidentified cases;there were 26 cases in IIIB stage and 53 cases in IV stage according to AJCC 1997 standard.All patients received GEM 800-1250 mg/m² on days 1 and 8 and DDP 75-80 mg/m² on day 1 or 30 mg/m² for three days by intravenous administration,with 21 days as one cycle.Each patient received 2-4 cycles chemotherapy.

RESULTSThe total clinical reponse rate(complete and partial response) was 31.6%,and clinical benefit rate(complete and partial response and stable disease) was 73.4%.1-year survival rate was 64.9%,2-year survival rate was 32%.After median follow-up of 2.33 years,median TTP was 5.06 months.The main toxicities were nausea,vomitting and hematological toxicities.The rates of grade III to IV leukopenia and thrombocytopenia were 25.4% and 31.6% respectively.Other toxicities were slight and tolerable.

CONCLUSIONSCombined chemotherapy with GEM plus DDP as first-line treatment to advanced NSCLC is an effective and feasible regimen,which is one of the standard regimens.For old patients,this regimen is a good choice.The fit dosage of GEM for Chinese is 1000 mg/m².

Objective To investigate the relationship between impaired glucose regulation(IGR)and slow flow or no reflow(SF/NRF)during percutaneous coronary intervention(PCI)in patients with ST segment elevation myocardial infarction(STEMI).Methods Clinical materials of 80 STEMI patients with SF/NRF and 84 STEMI patients without SF/NRF in the hospital from October 2021 to October 2022 were retrospectively collected,including blood glucose,total cholesterol(TC),triglyc-eride(TG),cardiac troponin Ⅰ(cTn Ⅰ),fibrinogen,left ventricular ejection fraction(LVEF),D-dimer,uric acid,homocysteine,the ratio of absolute value of neutrophils to absolute value of lym-phocytes(NLR),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and 2 h postprandial blood glucose level.Logistic regression model was used to analyze the influencing factors of SF/NRF in STEMI patients with PCI;the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of fasting blood glucose and 2 h postprandial blood glucose levels for SF/NRF in STEMI patients with PCI.Results Compared with non-SF/NRF group,the levels of cTn Ⅰ,fibrinogen and HDL-C in SF/NRF group were significantly higher,while the levels of systolic blood pressure(SBP),diastolic blood pressure(DBP)and NLR were significant-ly lower(P＜0.05).Compared with non-SF/NRF group,the stent diameter,stent length and the time from chest pain to catheter room in SF/NRF group were significantly longer(P＜0.05).The levels of fasting blood glucose and 2 h postprandial blood glucose in SF/NRF group were significantly high-er than those in non-SF/NRF group(P＜0.05).Logistic regression analysis showed that fasting blood glucose and 2 h postprandial blood glucose were the influencing factors of SF/NRF in STEMI patients with PCI,and the area under the curve(AUC)of the combination of the two indicators for diagnosis of SF/NRF in STEMI patients during PCI was significantly higher than that by fasting blood glucose and 2 h postprandial blood glucose alone(Z=3.272,4.369,P＜0.001).Conclu-sion IGR is related to SF/NRF during PCI in STEMI patients,and fasting blood glucose and 2 h postprandial blood glucose levels are the influencing factors of SF/NRF in STEMI patients.

Objective To investigate the relationship between impaired glucose regulation(IGR)and slow flow or no reflow(SF/NRF)during percutaneous coronary intervention(PCI)in patients with ST segment elevation myocardial infarction(STEMI).Methods Clinical materials of 80 STEMI patients with SF/NRF and 84 STEMI patients without SF/NRF in the hospital from October 2021 to October 2022 were retrospectively collected,including blood glucose,total cholesterol(TC),triglyc-eride(TG),cardiac troponin Ⅰ(cTn Ⅰ),fibrinogen,left ventricular ejection fraction(LVEF),D-dimer,uric acid,homocysteine,the ratio of absolute value of neutrophils to absolute value of lym-phocytes(NLR),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and 2 h postprandial blood glucose level.Logistic regression model was used to analyze the influencing factors of SF/NRF in STEMI patients with PCI;the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of fasting blood glucose and 2 h postprandial blood glucose levels for SF/NRF in STEMI patients with PCI.Results Compared with non-SF/NRF group,the levels of cTn Ⅰ,fibrinogen and HDL-C in SF/NRF group were significantly higher,while the levels of systolic blood pressure(SBP),diastolic blood pressure(DBP)and NLR were significant-ly lower(P＜0.05).Compared with non-SF/NRF group,the stent diameter,stent length and the time from chest pain to catheter room in SF/NRF group were significantly longer(P＜0.05).The levels of fasting blood glucose and 2 h postprandial blood glucose in SF/NRF group were significantly high-er than those in non-SF/NRF group(P＜0.05).Logistic regression analysis showed that fasting blood glucose and 2 h postprandial blood glucose were the influencing factors of SF/NRF in STEMI patients with PCI,and the area under the curve(AUC)of the combination of the two indicators for diagnosis of SF/NRF in STEMI patients during PCI was significantly higher than that by fasting blood glucose and 2 h postprandial blood glucose alone(Z=3.272,4.369,P＜0.001).Conclu-sion IGR is related to SF/NRF during PCI in STEMI patients,and fasting blood glucose and 2 h postprandial blood glucose levels are the influencing factors of SF/NRF in STEMI patients.

Background and objectiveSmall cell lung cancer combined with squamous cell carcinoma are rare. hTe aim of this study was to analyze the clinicopathological characteristics and treatment, and explored the prognostic factors of this disease.MethodsBetween January 2004 and December 2012, 58 patients with cytopathologically conifrmed small cell lung cancers combined with squamous cell carcinoma were retrospectively analyzed.Kaplan-Meier methods were used to calculate the survival rate, andLog-rank test was used to examine differences between arms. hTeCox regression model was used to analyze the independent factors affecting the overall survival (OS).Results hTe OS of the 58 patients was 22.7 months with a range of 0.3 to 124.3 months. In univariate analysis, Karnofsky performance score before treatment, extensive disease, tumor stage were the considered prognostic factors affecting the OS rate (P<0.05).Cox multivariate analysis showed that only the tumor-node-metastasis (TNM) stage was the independent prognostic factor (P=0.019). hTe majority of the patients received multimodality therapy and chemotherapy was the main treatment. Distant metastasis was the main reasonfor the treatment failure.ConclusionCombined therapy with chemotherapy as the main treatment should be adopted in therapeutic regimen of the patients with small cell lung cancers combined with squamous cell carcinoma. TNM stage was the independent prognos-tic factor inlfuencing the OS.

Background and objective Epidermal growth factor receptor (EGFR) is commonly overexpressed in lung squamous cell carcinoma and has been associated with impaired prognosis. hTe aim of this study was to observe the ef-ifcacy and safety of nimotuzumab, a anti-EGFR monoclonal antibody, combined with chemotherapy as second- or later-line in the treatment of advanced lung squamous cell carcinoma.Methods A retrospective analysis of clinical data was conducted in 13 patients with advanced lung squamous cell carcinoma, who were administered with nimotuzumab combined with chemo-therapy as second-line or later-line treatment. hTe effcacy of therapy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and safety by National Cancer Institute Common Toxicity Criteria (NCI-CTC) 4.0.Results Of the 13 advanced squamous-cell lung cancer patients, one patient had complete response (CR), 2 patients had partial re-sponse (PR), 4 cases had stable disease (SD), and 6 patients had progressive disease. hTe overall response rate (ORR) was 23.1% and clinical beneift rate (CBR) was 53.8%. EGFR expression were detected by immunohistochemistry in 6 patients and the results showed 5 patients were EGFR 3+ and the other was EGFR 2+. Of these 6 EGFR positive patients, 1 case had CR, 1 case had PR and 4 cases had SD; ORR was 33.3% and CBR was 100.0%. Grade 3/4 hematological toxicities were observed in 3 (23.1%) patients, and non-hametological toxicities were mild. Nimotuzumab-associated skin rash was found in 2 (15.4%) patients.ConclusionNimotuzumab combined with chemotherapy as second- or later-line therapy for advanced squamous cell lung carcinoma was active and well-tolerated, especially for those patients with EGFR positive.

Background and objective Squamous cell carcinoma (SCC) is a common pathological type of non-small cell lung cancer, and advanced lung SCC is incurable. Chemotherapy combined with anti-angiogenesis agents can pro-long the patients’ survival time. hTe aim of the study was to analyze the effcacy and safety of recombinant human endostatin (Endostar) in treating advanced lung SCC.Methods We retrospectively analyzed the short-term efficacy and toxicity of recombinant human endostatin combined with traditional chemotherapy regimens in treating 15 advanced lung squamous cell carcinoma patients in Department of Medical Oncology retrospectively, Cancer Hospital, Chinese Academy of Medical Sciences from November 2011 to May 2015. Treatment-related survival was also analyzed.Results Among the evaluble 14 patients, the best overall response was partial response in 5 patients (35.7%), stable disease in 7 patients (50.0%), and progres-sive disease in 2 patients (14.3%). hTe objective response rate (ORR) was 35.7%, and disease control rate (DCR) was 85.7%. hTe median progression-free survival (PFS) was 9.3 months. hTe main grade 3 toxicity was neutropenia (2/15, 13.3%) and vomitting (1/15, 6.7%).Conclusion Chemotherapy combined with recombinant human endostatin enabled good objective response in advanced SCC patients and had well security.