Objective To investigate compliance of breast cancer patients with postoperative peripherally inserted central catheter (PICC) in terms of upper limb motion, to formulate practical plan of upper limb motion, and to improve the compliance in the patients with PICC catheter.Methods A total of 75 patients after breast cancer operation with PICC for chemotherapy were selected from Department of Thyroid and Breast Surgery for upper limb activity instructions.Plan-Do-Check-Act method was used to evaluate the feasibility and effectiveness.Two cycles were performed in two weeks.Patients' compliance was assessed by the inquiry method.Results After practicing and refining nursing process, perfecting the risk assessment table, adjusting the education time, etc., the cognition and acceptance of the significance of upper limb motion were improved in the patients.The compliance of the patients to the upper limb motion instructions was satisfactory.Conclusions The upper limb motion scheme in this study was modified and perfected through application, research, and practice.This scheme could enhance the compliance of patients in terms of upper limb motion.

Objective:To evaluate the application of PG-SGA,NRS 2002 and BIA in nutritional assessment and screening of patients with gynecologic cancers.Methods:118 patients were randomly selected.Nutritional status were evaluated by PG-SGA,NRS 2002 and BIA,and consistency between each tools were compared.Results:The prevalence of malnutrition or nutritional risk of patients were 64.4％ (PG-SGA),57.6％ (NRS 2002),and 33.9％ (BIA) respectively.In all patients,the consistency of PG-SGA and NRS 2002 was high (P ＜ 0.001),while there were not significantly consistent between BIA and PG-SGA,or between BIA and NRS 2002 (P ＜ 0.001).Conclusion:According to the evaluation of PG-SGA or NRS 2002 in gynecologic patients,the prevalence of malnutrition or nutritional risk is high,and these two scales are suitable for nutritional assessment and screening of gynecologic cancer patients,especially in ovarian cancer patients.In addition,BIA may be a promising tool to evaluate cervical cancer patients' nutritional status.

Objective To explore the correlation between serum uric acid ( SUA) and non alcohol fatty liver disease(NAFLD). Methods From October 2015 to December 2016,two hundred and forty?nine cases of NAFLD in Shengjing Hospital of China Medical University and 144 N?NAFLD patients were included in the study,to analyze their general data ( sex, height, weight, blood pressure ) , liver function, blood lipid and SUA. SUA was divided into four groups by four point method,group Q1 ( 99 cases) ,group Q2 ( 98 cases) ,group Q3 ( 98 cases ) , group Q4 ( 98 cases ) . The proportion of NAFLD in each group was compared and the relationship between SUA and NAFLD was analyzed by Logistic regression. Results There were statistically significant differences between the NAFLD group and the N?NAFLD group in gender,age,DBP,BMI,ALT,AST,γ?GT,SUA,TG,TC,HDL?C,LDL?C (P<0. 05),the differences in SBP,Tbil,Dbil and UDbil had no statistical significance ( P>0. 05);the proportion of NAFLD in group Q1,group Q2,group Q3 and group Q4 was 41. 41％(41/99),57. 14％(56/98),71. 43％(70/98),83. 67％(82/98),respectively,the differences between groups were statistically significant ( P=<0. 05); Logistic regression analysis showed that SUA was a risk factor for NAFLD (OR=1. 016,P<0. 05),after the adjustment of age,gender,BMI,diastolic blood pressure,TG,TC,HDL?C and LDL?C,OR=1. 008,P=0. 001. Conclusion SUA is an independent risk factor of NAFLD.

Cervical cancer is one of the most common gynecological malignancies, and its morbidity and mortality are among the highest. Persistent infection of high-risk types of HPV is the main reason for its onset, with types 16 and 18 being the most prevalent. Circular RNA (circRNA) is a single-stranded circular non-coding RNA formed by covalent end to end bonding of RNA precursors. It has functions such as miRNA sponge, binding RNA binding protein (RBP), and protein translation, and plays an important role in the occurrence and development of various diseases. At present, the research on circRNA in cervical cancer is still at an early stage. The latest progress of circRNA in high-risk HPV infection, occurrence and development of cervical cancer, and sensitivity to chemoradiotherapy is briefly reviewed.

Cervical cancer is one of the most common gynecological malignancies, and its morbidity and mortality are among the highest. Persistent infection of high-risk types of HPV is the main reason for its onset, with types 16 and 18 being the most prevalent. Circular RNA (circRNA) is a single-stranded circular non-coding RNA formed by covalent end to end bonding of RNA precursors. It has functions such as miRNA sponge, binding RNA binding protein (RBP), and protein translation, and plays an important role in the occurrence and development of various diseases. At present, the research on circRNA in cervical cancer is still at an early stage. The latest progress of circRNA in high-risk HPV infection, occurrence and development of cervical cancer, and sensitivity to chemoradiotherapy is briefly reviewed.

Human epidermal growth factor receptor 2 (HER2)-targeted therapy has greatly improved the prognosis of HER2-positive breast cancer. HER2-targeted therapy combined with chemotherapy dominated by trastuzumab+ pertuzumab is important in the neoadjuvant therapy, postoperative adjuvant therapy and late-stage standard treatment for HER2-positive breast cancer. Antibody-drug conjugates (ADCs) and tyrosine kinase inhibitors (TKIs) have further improved the efficacy of therapy. However, advanced breast cancer will eventually get a recurrence or drug resistance. HER2-positive breast cancer is characterized by moderate immunogenicity with the presence of large tumor-infiltrating lymphocytes (TILs), which provides a theoretical basis for immunotherapy. The application of HER2-targeted cancer vaccines and immune checkpoint inhibitors is promising and would offer more treatment options for the patients.

Objective To investigate the relationships of serum levels of human fractalkine(CX3CL1)and chitinase-3-like protein 1(YKL-40)with early cognitive impairment in elderly patients with Alzheimer's disease(AD).Methods A total of 110 AD patients in the Second Affiliated Hospital of Xinxiang Medical University from February 2021 to December 2023 were selected as AD group,and 50 healthy individuals with physical examination during the same period were selected as control group.Clinical materials and serum levels of CX3CL1 and YKL-40 were compared between the two groups,and multivariate Logistic regression models were used to analyze the influencing factors of cognitive im-pairment in AD patients.Based on the Mini-Mental State Examination(MMSE)score,the 110 AD patients were divided into mild cognitive impairment group(n=47),moderate cognitive impairment group(n=36),and severe cognitive impairment group(n=27).Spearman correlation analysis was performed to explore the relationships of serum CX3CL1 and YKL-40 with MMSE score,Addenbro-oke's Cognitive Examination-Ⅲ(ACE-Ⅲ)score,and Montreal Cognitive Assessment(MoCA)score.Results The AD group had higher proportions of patients aged over 80 years,with an edu-cation level of primary school or below,smoking history,alcohol consumption history,diabetes mel-litus,hypertension,AD family history,and living alone as well as higher serum levels of CX3CL1 and YKL-40 compared to the control group;conversely,the AD group had a lower proportion of pa-tients engaging in no physical exercise/labor,and lower MMSE,ACE-Ⅲ,and MoCA scores,with significant between-group differences(P＜0.05).Advanced age,diabetes mellitus,and high ser-um levels of CX3CL1 and YKL-40 were independent risk factors for cognitive impairment in AD pa-tients(P＜0.05),while an education level of college or above was a protective factor(P＜0.05).Compared with the mild cognitive impairment group,the moderate and severe cognitive impairment groups had higher serum levels of CX3 CL1 and YKL-40,and the severe cognitive impairment group had higher serum levels of CX3 CL1 and YKL-40 than the moderate group,with significant between-group differences(P＜0.05).Spearman correlation analysis revealed that serum CX3CL1 and YKL-40 were negatively correlated with MMSE,ACE-Ⅲ,and MoCA scores(P＜0.05).Conclu-sion Serum CX3CL1 and YKL-40 are highly expressed in elderly AD patients,and are closely re-lated to early cognitive impairment in elderly AD patients.

Objective To investigate the relationships of serum levels of human fractalkine(CX3CL1)and chitinase-3-like protein 1(YKL-40)with early cognitive impairment in elderly patients with Alzheimer's disease(AD).Methods A total of 110 AD patients in the Second Affiliated Hospital of Xinxiang Medical University from February 2021 to December 2023 were selected as AD group,and 50 healthy individuals with physical examination during the same period were selected as control group.Clinical materials and serum levels of CX3CL1 and YKL-40 were compared between the two groups,and multivariate Logistic regression models were used to analyze the influencing factors of cognitive im-pairment in AD patients.Based on the Mini-Mental State Examination(MMSE)score,the 110 AD patients were divided into mild cognitive impairment group(n=47),moderate cognitive impairment group(n=36),and severe cognitive impairment group(n=27).Spearman correlation analysis was performed to explore the relationships of serum CX3CL1 and YKL-40 with MMSE score,Addenbro-oke's Cognitive Examination-Ⅲ(ACE-Ⅲ)score,and Montreal Cognitive Assessment(MoCA)score.Results The AD group had higher proportions of patients aged over 80 years,with an edu-cation level of primary school or below,smoking history,alcohol consumption history,diabetes mel-litus,hypertension,AD family history,and living alone as well as higher serum levels of CX3CL1 and YKL-40 compared to the control group;conversely,the AD group had a lower proportion of pa-tients engaging in no physical exercise/labor,and lower MMSE,ACE-Ⅲ,and MoCA scores,with significant between-group differences(P＜0.05).Advanced age,diabetes mellitus,and high ser-um levels of CX3CL1 and YKL-40 were independent risk factors for cognitive impairment in AD pa-tients(P＜0.05),while an education level of college or above was a protective factor(P＜0.05).Compared with the mild cognitive impairment group,the moderate and severe cognitive impairment groups had higher serum levels of CX3 CL1 and YKL-40,and the severe cognitive impairment group had higher serum levels of CX3 CL1 and YKL-40 than the moderate group,with significant between-group differences(P＜0.05).Spearman correlation analysis revealed that serum CX3CL1 and YKL-40 were negatively correlated with MMSE,ACE-Ⅲ,and MoCA scores(P＜0.05).Conclu-sion Serum CX3CL1 and YKL-40 are highly expressed in elderly AD patients,and are closely re-lated to early cognitive impairment in elderly AD patients.

Objective:To systematically evaluate the methodology and reporting quality of colorectal cancer (CRC) screening guidelines/consensus and provide lights for drafting CRC screening guidelines in China.Methods:The literature retrieval for all the Chinese and English guidelines published before September 1 st, 2020 was conducted by using Chinese/English databases, such as China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, Guideline International Network, and supplement with the official website of multiple regions, such as the U.S. Preventive Services Task Force and American Cancer Society. We utilized The Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) approaches to assess the quality of CRC screening guidelines/consensus comprehensively. Results:After quality control, a total of 19 guidelines/consensus released by the United States, China, Australia, Canada, Britain, South Korea, and International organizations are successfully included, and strikingly, most of those belong to the United State(7). The results of the AGREE Ⅱ quality evaluation show that the average scores of scope and purpose (87.5%) and clarity of presentation (89.6%) are high. In contrast, there are deficient in stakeholder involvement (47.0%), the rigor of development (42.3%), applicability (47.5%), and editorial independence (50.2%). Among all the guidelines, there are 12 with an overall score of 50 or more, 13 with a recommendation level of "A", 2 with a rating of "B" and 4 with a rating of "C". Additionally, the RIGHT evaluation revealed that the average report rate in each field is necessary information (76.3%), background (77.0%), evidence (55.8%), recommendations (59.4%), review and quality assurance (26.3%), funding and declaration and management of interests (43.4%), other information (49.1%). Among all the guidelines, six have good reporting quality, whereas the additional 13 have general or weak evidence. Furthermore, subgroup analysis indicates that the quality of guidelines in developed countries is superior to that of China.Conclusion:The number of CRC screening guidelines/consensus is increasing gradually, and the overall quality of those is high, but the normative nature is warranted to be strengthened.

Objective To investigate the value of preoperative platelet count (Plt) in predicting prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy. Methods Clinical data of 399 patients who underwent hepatic resection for HCC in Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center from January 1987 to December 1994 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. Of the 399 patients, 356 cases were male, and 43 cases were female with age ranging from 21 to 78 years old and a median age of 48 years old. The relations between preoperative Plt and patients' gender, age, gamma-glutamyl transpeptidase (GGT), hepatitis B surface antigen (HBsAg), alpha fetal protein (AFP), cirrhosis, tumor encapsulation, tumor diameter, tumor number, vascular invasion and histological differentiation were observed. Patients were divided into 3 groups according to the level of preoperative Plt:group 1 (<100×109/L, n=41), group 2 (100×109/L-300×109/L, n=321), group 3 (>300×109/L, n=37). Survival analysis of patients in 3 groups was conducted. The relations between preoperative Plt and clinicopathological parameters were compared using t test. Survival analysis was conducted using Kaplan-Meier method and Log-rank test. Survival prognosis was analyzed using Cox's proportional hazard model. Results Preoperative Plt was associated with HBsAg, AFP, and tumor diameter (t=2.069, 2.222,-3.911;P<0.05). The 5-, 10-, 15-year cumulative survival rates were 41.2%, 25.2%, 11.8%in group 1, 33.7%, 23.0%, 18.1%in group 2, and 11.4%, 8.6%, 5.7%in group 3 respectively. The survival rate in group 3 was signiifcantly lower than those in group 1 and group 2 (χ2=5.706, 11.361;P<0.05). Increasing preoperative Plt was an independent risk factor for postoperative prognosis. The prognosis in group 3 was poorer than those in group 1 and group 2 (HR=1.761, 1.845;P<0.05). Conclusions Increasing preoperative Plt is an independent risk factor for postoperative prognosis of patients with HCC after hepatectomy. Patients with increasing preoperative Plt have poor prognosis.