Objective:To evaluate the value of shear wave elastography (SWE) and salivary gland ultrasound scoring(SGUS) system in the diagnosis of salivary glands lesions in patients with Sj?gren′s syndrome(SS) and to compare the diagnostic efficiency of the two methods.Methods:From June 2019 to November 2020, Fifty-eight patients with suspected SS were selected from the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University. According to the 2002 American-European Consensus Group classification standard, the enrolled patients were divided into two groups: SS group (47 cases) and non-SS group(11 cases). According to symptom duration, SS group was divided into the ≤5 years group (29 cases) and the >5 years group (18 cases). Meanwhile, 40 healthy volunteers were enrolled in this study as normal control group. The diagnostic value of salivary gland ultrasound scoring system and Young′s modulus in SS were analyzed.Results:The differences in Young′s modulus of parotid gland and submandibular gland between SS group and non-SS group (or control group) were statistically significant (all P<0.05). The ultrasound score of SS group was significantly higher than that of non-SS group and control group (all P<0.05). SGUS and Young′s modulus were not significantly different between different course groups (all P>0.05). The areas under ROC curve of the mean Young′s value in parotid and submandibular gland and the SGUS were 0.801, 0.829 and 0.676, respectively. The comparison of the area under the curve between the Young′s modulus of the parotid and submandibular glands and the ultrasound score was statistically significant (all P<0.05). Conclusions:SWE and Ultrasonography scoring system have certain value in the diagnosis of salivary gland lesions in SS, and can provide important reference information for clinical diagnosis from different perspectives. The diagnostic efficiency of SWE for salivary glands lesions in patients with SS is better than that of SGUS scoring system.

BACKGROUNDIt is well known that more than 40% patients were initially diagnosed with advanced non-small cell lung cancer (NSCLC) with intrapulmonary or/and distant metastasis. However, up to now, the reports about effects of different metastatic sites on survival were limited. The aim of this study is to investigate the clinicopathologic and survival difference by retrospective analysis among sole intrapulmonary metastasis, sole extrathoracic distant metastasis and simultaneous metastasis of lung and other extrathoracic organs for the patients with advanced NSCLC, and to analyze the prognosis-related factors of NSCLC with intrapulmonary metastasis.

METHODSOf the 425 patients with stage IV NSCLC diagnosed by pathology and through staging evaluation and treated at Beijing Cancer Hospital with long follow-up during Oct. 1995 to Dec. 2003, 81 cases had sole intrapulmonary metastasis, 98 cases had sole extrathoracic distant metastasis and 68 cases presented simultaneous lung metastasis and extrathoracic spread. Kaplan-Meier survival curve was performed to estimate the survival of patients with different metastasis, Log-Rank test was used to compare their survival difference, and univariate analysis was used to find prognostic related factors.

RESULTSMedian survival time (MST) and 1-, 2-, 3-year survival rate (SR) for patients with sole intrapulmonary metastasis were 13 months (95% CI: 11-15), 57%, 21%, 7%, respectively; MST was 22 months (95% CI: 18-26) for patients with N1 and/or N2 and 10 months (95%CI: 7-13) for patients with N3 (P=0.001). Among the patients with ipsilateral, contralateral and bilateral intrapulmonary metastasis, difference of MST and 1-, 2-, 3-year SR had no statistical significance (P > 0.05); Survival of patients with sole intrapulmonary metastasis was not significantly different from that of patients with sole brain or bone metastasis (P > 0.05), but was longer than that of patients with simultaneous lung and extrathoracic spread (P=0.021). One way analysis of variance showed that no significant association were found among age, pathologic subtype, differentiation degree or response of first-line chemotherapy and survival of the patients with sole intrapulmonary metastasis (P > 0.05), but sex and invasive status of lymph node (N1/N2 vs N3) were found to influence the survival of the patients (P= 0.018, P=0.001). Further stratified analysis by age showed that invasion of lymph node was independent prognostic factor (P=0.002); whereas for the patients with simultaneous metastasis of lung and distant organs, metastatic numbers (2 vs ≥3) of organ were independent prognostic factor (P=0.013).

CONCLUSIONSNo statistical difference is found among survival of NSCLC patients with sole intrapulmonary metastasis and with sole brain, bone metastasis. Invasive status of lymph node and metastatic number of organ are important prognostic factors for patients with sole intrapulmonary metastasis and simultaneous metastasis of lung and extrathoracic organs, respectively.

Objective Aimed to develop the evaluation system and weight of hospital orientation training.Methods Literature review,Delphi,questionnaire,AHP to develop the evaluation system and determined the weight with Satty's method.Results The evaluation system includes 3 division's 13 items.Conclusions Course content,teaching method,course difficultness and occupational plan ning play the most important role,and should be paid more attention.

Background and objective Lacking of typical symptoms, more than 70% of patients with lung cancer are diagnosed as advanced-stage disease. Patients suffer from solid organs metastasis with different clinical features and prog-nosis. With development of new technology, more and more lung cancer patients are diagnosed with pancreatic metastasis. The aim of this study was to investigate clinicopathologic and survival difference by retrospective analysis among lung cancer patients with pancreatic metastases.Methods Of the patients with lung cancer diagnosed by pathology and thorough staging evaluation and treated at Beijing Cancer Hospital with long follow-up during July 1996 and June 2017, 35 cases had pancreatic metastases.Results There were 28 cases diagnosed as small cell lung cancer, 3 cases diagnosed as adenocarcinoma and 4 cases diagnosed as squamous cell carcinoma. There were 15 cases with pancreatic metastases in head of pancreas and 20 cases in body and tail of pancreas, 23 cases presented with isolated metastasis and 12 cases with multiple metastases. Pathological type was prognostic factor for lung cancer patients with pancreatic metastases.Conclusion Pancreatic metastases represents an uncommon site of extrathoracic spread of disease for part of patients with advanced lung cancer. Lung cancer with pancreatic metastases should be treated by combined therapy, especially by systemic chemotherapy. Pathological type was prognostic fac-tor for lung cancer patients with pancreatic metastases.

Intravascular large B-cell lymphoma(IVLBCL)is an aggressive extranodal large B-cell lymphoma,cocurrence in the same organ with other malignancies is very rare,especially in the lung.Here,we report a rare case of lung adenocarcinoma with IVLBCL.The patient was admitted to the hospital due to diarrhea associated with fever and cough.A computed tomography(CT)scan of the chest showed an irregular patchy high-density shadow in the upper lobe of the right lung with ground-glass opacity at the margin.After admission,the patient was given anti-infection treatment,but still had inter-mittent low fever(up to 37.5 oC).The pathological diagnosis of percutaneous lung biopsy(PLB)was lepidic-predominant ad-enocarcinoma with local infiltration,which was proved to be invasive nonmucinous adenocarcinoma of the lung with IVLBCL after surgery.This paper analyzed the clinicopathological characteristics and reviewed the relevant literature to improve the knowledge of clinicians and pathologists and avoid missed diagnosis or misdiagnosis.

Purpose/Significance To review digital health literacy assessment tools for the elderly,and to provide a theoretical basis for assessment,intervention and optimization.Method/Process A scoping review method is used to systematically review and evaluate digital health literacy assessment tools for the elderly.Result/Conclusion The 10 included assessment tools are generally applicable to the elderly population,but research targeting specific groups remains insufficient.These assessment tools should be further integrated in the future to promote the understanding and research of digital health literacy measurement methods.

Background and objective Bone metastases are the most common metastases of the non-small cell lung cancer (NSCLC). It can lead to bone ache and pathology fracture, deteriorate the quality of life. Methods We retrospec-tively investigated the characteristics, diagnosis and prognosis factors of bone metastases in NSCLC. All of the 600 patients are from department of thoracic oncology in recently 5 years. Emission computed tomography (ECT) was used to screen the bone metastases and the diagnosis of bone metastases was conifrmed by computed tomography (CT)/magnetic resonance imaging (MRI)/X-ray or pathology. Results Among the total 322 bone metastases patients, subtype of adenocarcinoma had the most opportunity to occur bone metastases, and we found that vertebrae, pelvis and femora et al were the most frequently involved metastases sites. Patients who had more than 3 high 18F-FDG uptake sites of ECT, could be conifrmed bone metasta-ses by CT/MRI/X-ray than those with 1-2 high 18F-FDG uptake sites [80.6%(203/252) vs 50.79%(32/63), P<0.001]. hTe patients with bone metastases who had non-SRE had longer survival than that of SRE [1-yr survival 44.75%(non-SRE) vs 36.17%(SRE);median survival 14.74 mo (non-SRE) vs 12.25 mo (SRE)]. Multivariables analysis showed the pathology were non-adnocarcinoma, bone metastases less than 3 sites and bone metastases without other organs metastases would have good prognosis. Conclusion hTere were relations between the numbers of abnormal dense sites of ECT and the diagnosis of skeletal metastases, non-adnocarcinoma bone metastases less than 3 sites and bone metastases without other organs metastases were the independent prognosis factors.

Background and objective Epidermal growth factor receptor (EGFR) mutations occur more frequently in non-small cell lung cancer (NSCLC) of women, never smokers, Asian population and those with adenocarcinoma. Short in-frame deletion in exon 19 and L858R substitution are the most common mutations, which are closely associated with EGFR tyrosine kinase inhibitors (TKIs) treatment response. However, the therapeutic effects of EGFR-TKIs on NSCLC with uncom-monEGFR mutation subtypes remain unclear. hTe aim of this study is to investigate the clinicopathologic feature of uncom-monEGFR mutations and the outcomes of these patients.Methods Twenty-four patients that harbored uncommonEGFR mutations were included in this study. Clinicopathologic features of uncommonEGFR mutations and the outcomes of these patients were analyzed.Results Of the 24 patients, 13 received EGFR-TKIs treatment. hTe response rate of EGFR-TKIs treat-ment was 46.1%, and the median progression-free survival (PFS) was 7.4 months. Mutations on S768I and L861Q composed a major part (8 of 24) of uncommon mutations.Conclusions UncommonEGFR mutations constituted a unique part of the whole group ofEGFR mutations. hTeir composition and sensitivity to EGFR-TKIs were heterogeneous, which requires further assessment in a prospective study.

ObjectiveTo investigate the current situation of rehabilitation therapists' work, and analyze the factors related to their career development and transformation. MethodsFrom September, 2022 to January, 2023, 153 rehabilitation therapists in Weifang were investigated with a cross-sectional questionnaire, using general questionnaire, Job Satisfaction Scale for Grassroots Health Technicians, Social Responsibility Scale, Job Role and Identity Inventory, and Employee Turnover Scale. ResultsThe majority of rehabilitation therapists interviewed were male (52.28%), under 35 years old (88.24%), with a bachelor's degree (77.78%), income less than 5 000 yuan a month (46.40%), and less than five years of service (48.36%). The work time was (7.78±0.84) hours a day, (5.39±0.51) days a week. The favorable rate of the physical environment of work was 67.32%, and the favorable rate of the interpersonal relationship environment of work was 80.39%. The score of professional identity was (3.61±0.84), the score of job satisfaction was (3.62±0.97), the score of social responsibility was (3.53±0.79), and the score of turnover was (2.39±1.10). Education level, job satisfaction, and social responsibility were the main factors related to the employee turnover (P < 0.05). ConclusionThe overall educational level of rehabilitation therapists is relatively low, and the human resource structure needs to be optimized. There is a significant difference between academic education and continuing education, and career development needs to be improved. The main factors related to career development and transformation are education level, job satisfaction, and social responsibility.