Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.

Objective:To deeply explore the decision-making experience of patients participating in clinical trials of neoadjuvant immunotherapy for lung cancer.Methods:Using the descriptive and qualitative research, 15 lung cancer patients who participated in clinical trials of neoadjuvant immunotherapy at the Cancer Hospital of the Chinese Academy of Medical Sciences were selected by purposive sampling from April 2021 to August 2022 for semi-structured in-depth interviews. Content analysis method was used for data analysis, summarization, and induction.Results:Three themes were extracted, namely decision-making information dilemma (insufficient or overloaded information, difficulty in understanding professional information, urgent need for decision-making information assistance), complex emotional experience (negative emotional experience, positive emotional experience), and hope for multi-party support (expecting psychological communication, hoping for family understanding, and longing for social recognition) .Conclusions:The decision-making experience of patients in clinical trials of neoadjuvant immunotherapy for lung cancer were summarized and described, which can help strengthen the understanding of the research team and medical and nursing staff on the live experience of such patients when making decisions, provide targeted decision support strategies, and promote good informed consent of patients.

Objective To deeply understand the psychological experience of patients with primary tumors participating in clinical trials,providing a reference basis for meeting the psychological needs of patients and improving the mental health level of patients with primary tumors.Methods From November 2021 to May 2022,13 patients with primary tumors participating in clinical trials were selected by target sampling method,semi-structured interviews were conducted,with Colaizzi 7-step analysis method was used to analyze the data.Results Four themes were extracted from the psychological experience of patients,namely the perception and attitudinal experience of clinical trials,complex and changeable emotional responses,experimental process adaptation,personal growth and transformation.Conclusion The psychological experience and related psychological problems of primary tumors patients participating in clinical trials cannot be ignored,the research team needs to help them complete role transformation and adaptation,pay attention to the experience of patients,improve mental health education programs according to the needs of this type of patients,and improve the quality of life of patients,then promote the development of cancer diagnosis and treatment in China.

Pediatric acute respiratory distress syndrome(PARDS) is a common clinical syndrome in pediatric intensive care unit, and a serious threat to children′s life health.The standardized diagnosis and management of PARDS is very important.Insufficient understanding of PARDS by clinical physician may delay diagnosis and treatment, worsen disease progression, and lead to serious consequences such as irreversible lung injury.The diagnosis and management guidelines for PARDS has been updated in The Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2). This article focuses on the definition, diagnosis, management strategies, and other aspects of PARDS in PALICC-2 for clinical reference, in order to improve the standardized diagnosis and management level of pediatric physicians for PARDS.

Objective:To evaluate the efficacy and mechanism of continuous blood purification(CBP) in the treatment of severe sepsis in children.Methods:A total of 42 patients with severe sepsis were enrolled in the study.According to the parents undefined desire to treatment, on the basis of the same treatment condition, 30 cases in the blood purification group were treated with CBP, and 12 cases in the control group were given the routine treatment without CBP treatment.The difference of each index between the two groups at the baseline(before treatment) and 72 hours after treatment were observed.Results:The differences of heart rate, mean arterial pressure and brain natriuretic peptide before and after treatment in the blood purification group were significantly higher than those in control group( P<0.05), and the differences of oxygenation index, 24-hour average urine volume, blood urea nitrogen, creatinine and Glasgow coma score in the blood purification group were significantly higher than those in control group( P<0.05). The difference of capillary refill time, lactic acid and central venous oxygen saturation in blood purification group were significantly higher than those in control group( P<0.05). The level of white blood cell count, C-reactive protein, procalcitonin and interleukin-6 in blood purification group were significantly higher than those in control group, with all significant difference( P<0.05). There was significant difference in critical illness score between two groups after treatment and before treatment.The mortality rate of the blood purification group was significantly lower than that in control group( P<0.01). Conclusion:CBP can improve cardiovascular function, brain function, renal function, tissue perfusion, inflammation index, internal environment, and improve the score of children with severe sepsis.

Paraneoplastic neurological syndromes (PNS) are a rare group of immune-mediated disorders that affect the central and peripheral neuromuscular system in association with cancer.If the limbal lobe system of the brain is involved,it will show paraneoplastic limbal encephalitis(PLE).The discern of patients with PNS is challenging since tumors causing paraneoplastic neurologic disorders are often asymptomatic and sometimes occult.We report a case of PLE with double positive anti-Hu and Yo antibodies,and further analyze and discuss it in conmbination with relevant literature to improve the understanding of the disease.

Objective:To explore the association between sibling violence experience and emotional and behavioral problems.Methods:A Multistage stratified cluster sampling was used in Hunan province, 1735 participants from multiple-child family were recruited to survey the prevalence of sibling violence and the occurrence of emotional and behavioral problems with the Strength and Difficulties Questionnaires (SDQ).Results:According to SDQ total score, the rate of abnormal emotion and behavior in children and adolescents involved in sibling violence was higher than that in students who were not experienced sibling violence [45.6％ (236/518) vs.26.8％ (326/1217) ], the rate in bully-victim was higher than that in pure-victim and pure-bully [52.8％ (132/250) vs.37.9％ (74/195) vs.41.1％ (30/73) ].The rates in children and adolescents who were bullied and perpetrated more than 4 sub-types of sibling violence were 63.4％ (53/93) and 76.9％ (60/78).Conclusion:There is an association between sibling violence experience and emotional and behavioral problems among children and adolescents in rural areas.

OBJECTIVE: To review the clinical features of a male twin affected with glutaric academia type I (GA-I) and analyze the variations of glutaryl-CoA dehydrogenase (GCDH) gene. METHODS: Clinical data of the pair of twins and their parents were collected. Genomic DNA was extracted from peripheral blood samples, and variants of GCDH genes were detected by capture sequencing using a customized panel. Variants of the twins and their parents were verified by Sanger sequencing. RESULTS: The level of glutaric acyl carnitine (C5DC + C6OH) was 3.26 μmol/L in the male twin. The relative level of glutaric acid in urine was 547.51 by gas chromatography mass spectrometry analysis. Cerebral ultrasonography showed that the patient had subependymal hemorrhage, but no serious clinical manifestation was noted. After treating with special formula milk powder and L-carnitine, the boy showed good growth and development. Two heterozygous variants of the GCDH gene were detected in the patient, among which c.416C>G was suspected to be pathogenic, while c.109_110delCA was unreported. The variants were respectively inherited from his parents. The twin girl only carried the c.416C>G variant. CONCLUSION GA-I can be diagnosed by mass spectrometry, urine gas chromatographic mass spectrometry, imaging as well as genetic diagnosis. Early diagnosis and intervention is important.
Amino Acid Metabolism, Inborn Errors ; genetics ; Brain Diseases, Metabolic ; genetics ; Female ; Glutaryl-CoA Dehydrogenase ; deficiency ; genetics ; Humans ; Male ; Mutation ; Phenotype

Recently,an unconventional T cell population (collectively designated as Vδ2 -γδT cell ) has been characterized during the anti-cytomegalovirus immune response in all organ transplant recipients,neo-nates,and healthy individuals.These cytomegalovirus-induced Vδ2 -γδT cells undergo a dramatic and stable ex-pansion after cytomegalovirus infection,in a conventional adaptive way.Similarly,as cytomegalovirus-specific CD8 +αβT cells,they exhibit an effector/memory TEMRA phenotype and cytotoxic effect or functions.This paper reviews the researchs and reports about cytomegalovirus induced-Vδ2 -γδT cell,including its location,phe-notype,and activation,as well as its immunologic mechanism in cytomegalovirus infection,acute or chronic re-jection,and anti-cancer function.

Cytomegalovirus is a DNA virus that has the potential to latent-reactivation in human body with immune deficiency.CMV infection is usually asymptoatic in an immunocompetent host,but it may attack immunocompromised population.IL-10 is an important immunoregulatory cytokine,it can attenuate and terminate viral response by multiple immunosuppressive ways:affecting the expression of pro-inflammatory cytokines and chemokines,regulating antigen presenting cells,and restraining effector cell and NK cell responses.Currently,many researchers report that IL-10 has close relationtship with immunologic mechanism of cytomegalovirus in host.This paper reviews the biological effect of IL-10 and effect of IL-10 in cytomegalovirus infection.