OBJECTIVETo study the survival and prognostic factors of stage III N2 non-small cell lung cancer (NSCLC) after surgical treatment.

METHODS266 patients with stage III N2 NSCLC underwent operation from 1982 to 1996, with the 5-year survival rate compared with those of stage N0 and N1 patients who received operation in the same period. Histological classification, number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status, complete or incomplete operation, the procedure of operation were univariately and multivariately analyzed to determine their impact on the 5-year survival.

RESULTSThe 5-year survival rate of patients with stage III N2 non-small lung cancer after surgical treatment was 17.3%, which was significant lower than those with N0 (51.4%) and N1 (30.4%). Four prognostic factors significantly influenced the outcome: number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status and complete resection of the tumor.

CONCLUSIONPatients with stage III N2 NSCLC are candidates for surgical treatment if they have evidence of limited mediastinal lymph node metastasis and prospects of complete resection.

Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; mortality ; secondary ; surgery ; Female ; Humans ; Lung Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate

Objective To provide the evidence for the development of personalized health education courses for twin pregnant women.We explored the health education and psychosocial demand of twin pregnant women from the perspective of social ecosystem theory.Methods By purposive sampling,18 twin pregnant women hospitalized in the twin medical center of a tertiary A hospital in Shenyang from January to March 2023 to conduct for semi-structured interviews,and Colaizzi's 7-step analysis method was used to sort out and analyze the data.Results 3 themes were extracted from the health education and psychosocial needs of twin pregnant women.Microsystem:the content needs of twin pregnant women's health education(the guidance needs of nutrition intake and weight growth;the needs for fetus health monitoring guidance;the cognitive needs of twin pregnancy complications;the needs for health education knowledge related to puerperium and the diversification of the choice of teaching methods).Mesosystem:the emotional support needs of twin pregnant women during prenatal and puetperal(the needs of family support and peer education support).Macrosystem:seeking social support and network information support(the demand of community support;the needs of information related to twin pregnant women's hierarchical management system and maternal fetal medical referral process and the needs for network health education information).Conclusion The women with twin pregnancy have different needs for health education content in each stage of pregnancy and puerperium,and there are urgent needs for emotional support and social support.Clinical nurses should construct health education courses according to the needs of twin women,and innovate in content and form,so as to improve the self-care ability of twin pregnant women and the knowledge level of family caregivers,and improve the pregnancy outcome.

Objective:To implement a scoping review on prediction models for the outcome of the trial of labor after cesarean (TOLAC), providing a reference for the clinical application of the model.Methods:Literature on TOLAC outcome prediction models was searched in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to May 1, 2023. Two researchers independently screened literature and extracted data, and used the prediction model risk of bias assessment tool (PROBAST) to analyze the risk of bias and applicability of the included studies.Results:A total of 24 articles were included. The research design was mainly retrospective, with diverse model fitting methods and good predictive performance. The predictive factors of the TOLAC outcome prediction model especially included Bishop score, body mass index, mode of delivery, age, pregnancy days or weeks, and vaginal delivery history.Conclusions:In the future, research on the construction of TOLAC outcome prediction models may lean towards prospective research design, further improving research design, model fitting methods, model evaluation, and validation.

Objective:To analyze the differential expression of silent information regulator transcript-1 (SIRT1) in tissues and cells of nasopharyngeal carcinoma (NPC), to explore the effects of SIRT1 on the proliferation and migration of NPC cells, as well as the effects on and mechanisms of lipid metabolism in NPC cells.Methods:Experimental subjects: In this study, tissue specimens were obtained from patients who visited the Department of Otolaryngology and performed nasopharyngeal tissue biopsy in the Affiliated Hospital of Nantong University from 2019 to 2020. Among them, 6 cases were male, 6 cases were female, age range: 27-72 years old, including 7 cases of NPC diagnosed by pathology and 5 cases of normal nasopharyngeal mucosa. Experimental methods and outcome measures: Western Blot and quantitative real time polymerase chain reaction (qRT-PCR) were used to detect the protein and mRNA levels of SIRT1. CNE2 cell line was selected for subsequent experiments. Cell viability and migratory ability were evaluated by CCK8, wound healing and Transwell assays respectively. Animal xenograft tumor model was used to explore the role of SIRT1 inhibitor Ex527 on tumor growth in nude mice. Oil red and Bodipy were used to stain intracellular lipids. For the mechanical investigation, the interactions between SIRT1 and hypoxia inducible factor-1α (HIF-1α) were analyzed by immunoprecipitation (IP) and chromatin immunoprecipitation (ChIP). Finally, statistical analysis was performed by SPSS 26.0 software, P<0.05 was considered statistically significant. Results:The levels of SIRT1 protein (1.005±0.168) and mRNA (5.829±2.395) in NPC tissues were higher than those in normal nasopharyngeal mucosa (0.181±0.042,1.995±1.605). Differences were statistically significant ( t values were 6.438 and 2.759, both P<0.05). The mRNA and protein levels of CNE1, CNE2, 5-8F and 6-10B cell lines were also higher than those in normal nasopharynx epithelial cell line NP69. Besides, overexpression of SIRT1 correlated with the proliferation and migration of NPC cells. The tumorigenesis ability of nude mice in the Ex527 group was lower than that in the control group. The low SIRT1 expression reduced the protein level of the key enzymes of liposynthesis in NPC cells, improved the expression of lipolysis enzymes, while HIF-1α overexpression promoted lipid synthesis enzymes in NPC cells. SIRT1 inhibited HIF-1α transcription by enhancing deacetylation levels. The binding ability of HIF-1α to SIRT1 promoter regions decreased when NPC cells were hypoxic. Conclusions:SIRT1 promotes the proliferation, migration and lipid metabolism of nasopharyngeal carcinoma cells, which might be expected to provide new theoretical basis for prognosis judgment and gene therapy.

Objective : To analyze interacting proteins of tropomodulin1 (TMOD1 ) in Raw264．7 mouse monocyte macrophage line by mass spectrometry and GeneCards database． Methods : Immunoprecipitation combined with mass spectrometry was used to find interacting proteins of TMOD1 after overexpress TMOD1 in Raw264．7 cells. GeneCards database was used to search for known genes for macrophage migration．Bioinformatics ＆ Systems Biolo- gy was used to analyze correlation between known targets and mass spectrometry proteins to find common differenti- ally expressed proteins( CO-DEPs) ．WoLF PSORT was used to predict subcellular localization of CO-DEPs．Egg- NOG databasewas used to analyze eukaryotic orthologous group(KOG) of CO-DEPs．DAVID database was used to analyze gene ontology( GO) enrichment kyoto encyclopedia of genes and genomes( KEGG) pathway of CO-DEPs. String database was used to analyze protein interaction network and CytoScape software drawing. Results : There were 41 CO-DEPs in mass spectrometry and GeneCards database．Subcellular localization of CO-DEPs was mainly distributed in cytoplasm，nucleus and mitochondria．KOG notes were mainly O : post-translational modification，Z : cytoskeleton and J : translation．GO enrichment found that CO-DEPs was mainly involved in poly (A) RNA bind- ing，protein folding and focal adhesion．KEGG was mainly enriched in arrhythmogenic right ventricular cardiomyop- athy (ARVC) and tight junction．ACTB was a protein with large protein interaction． Conclusion The proteins in- teracting with TMOD1 in macrophages mainly include myosin heavy chain-9 (MYH9) ，α-actinin 1 (ACTN1) and β-actin (ACTB) ，etc，suggesting that TMOD1 is related to macrophages migrate.

Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 10⁸ μm³, 0.44 × 10⁸ μm³ and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 10⁸ μm³, 0.38 × 10⁸ μm³ and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.