1.Brain and Meningeal Metastases of Lung Cancer Manifested as Brain Calcifications: A Case Report and Literature Review.
Deng ZHANG ; Yiru KONG ; Xiaohua LIANG ; Xinli ZHOU
Chinese Journal of Lung Cancer 2025;28(3):237-244
Lung cancer is still one of the most common malignant tumors in the world. With the increase of its incidence and the development of medical technology, the overall survival of lung cancer patients has significantly extended compared to before. The incidence of brain and meningeal metastases from lung cancer has also been rising year by year, but patients with brain and meningeal metastases from lung cancer have a poor prognosis and a very high mortality rate, and the diagnosis is mainly based on computed tomography (CT), magnetic resonance imaging (MRI) and other imaging examinations. However, the imaging features are diverse and the specificity is low, which makes it easy to be misdiagnosed and missed. Therefore, accurately identifying brain and meningeal metastases and timely targeted treatment is crucial for improving patient prognosis. This paper analyzed the diagnosis and treatment of a case of lung cancer with no obvious recurrence and metastasis in nearly 7-year long-term follow-up after radical lung cancer surgery, but the patient with abnormal behavior, impaired consciousness and epilepsy in the past 5 months, and multiple punctate calcifications in the brain found by head CT and MRI. This paper consider that the patient's mental and behavioral symptoms were caused by brain and meningeal metastasis of lung cancer after excluding infectious disease and ineffective treatment of autoimmune encephalitis, and further pathological biopsy and genetic detection confirmed the diagnosis of metastatic lung adenocarcinoma with epidermal growth factor receptor (EGFR) L858R gene mutation, and the patient's symptoms were significantly improved after targeted therapy by Osimertinib. This paper also searched the relevant literatures of brain calcifications in databases such as China National Knowledge Infrastructure (CNKI), Wanfang, UpToDate, PubMed, etc., and found that intracerebral calcifications exist in a variety of diseases, including infectious, genetic and neurodegenerative diseases, vascular diseases, metabolic diseases and tumors. However, brain calcification in brain and meningeal metastases are often underestimated, and the consequent risk is misdiagnosis and delayed treatment. Therefore, brain and meningeal metastases manifested as brain calcification should not be ignored in patients with a history of previous tumors.
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Humans
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Lung Neoplasms/pathology*
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Brain Neoplasms/diagnostic imaging*
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Meningeal Neoplasms/diagnostic imaging*
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Calcinosis/diagnostic imaging*
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Male
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Middle Aged
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Tomography, X-Ray Computed
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Magnetic Resonance Imaging
2.Research progress on rehabilitation motivation in cancer patients
Yiru WANG ; Hong WANG ; Xiao AN ; Zhicong ZHOU ; Xu SUN ; Xiaoyi LIU ; Ziwei TONG
Chinese Journal of Nursing 2025;60(12):1512-1517
Rehabilitation is an effective measure to improve the quality of life for cancer patients,and strong rehabilitation motivation is an important influencing factor for patients' compliance with rehabilitation.This paper mainly reviews the concepts,assessment tools,influencing factors,and intervention strategies of rehabilitation motivation in cancer patients,with the aim of providing references for medical staff to improve the level of rehabilitation compliance in cancer patients and develop targeted rehabilitation management strategies.
3.Rehabilitation effects based on immersive virtual reality as a treatment for peripheral vestibular dysfunction:a Meta-analysis
Xiaoyi LIU ; Hong WANG ; Zhicong ZHOU ; Xu SUN ; Yiru WANG ; Ziwei TONG ; Xiaoying LIU
Chinese Journal of Nursing 2025;60(9):1140-1146
Objective To systematically evaluate the rehabilitation effect of immersive virtual reality technology for patients with peripheral vestibular dysfunction,and to provide theoretical basis and practical guidance for the design of efficient rehabilitation training programs.Methods PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched for randomized controlled trials on the intervention effect of immersive virtual reality technology in patients with peripheral vestibular dysfunction from inception to February 2025.RevMan5.4 software was used to perform meta-analysis of the literature that met the quality standards.Results A total of 10 papers with 491 patients with peripheral vestibular dysfunction were included.Meta-analysis showed that immersive virtual reality technology improved vertigo symptoms in patients with peripheral vestibular dysfunction compared with conventional vestibular rehabilitation care[SMD=-1.41,95%CI(-1.58,-0.70),P<0.001],and subgroup analysis showed that the frequency of intervention was<5 times/week[SMD=-1.31,95%CI=(-1.96,-0.66),P<0.001],single intervention duration<30 min[SMD=-1.45,95%CI=(-2.21,-0.70),P<0.001],and intervention period≤7 weeks[SMD=-1.49,95%CI(-2.04,-0.94),P<0.001]were more significant.Immersive virtual reality technology reduced the risk of falls[MD=4.66,95%CI(3.84,5.48),P<0.001],and improved anxiety and depression[SMD=2.65,95%CI(1.98,3.33),P<0.001].Conclusion Immer-sive virtual reality technology improves vertigo symptoms,reduces the risk of falls,and improves anxiety and depres-sion symptoms in patients with peripheral vestibular dysfunction,in which the intervention period of ≤7 weeks,<5 training sessions per week,and each training session of<30 min are better for improving vertigo symptoms in patients with peripheral vestibular dysfunction.
4.Analysis of the Path to Improve the Efficiency of Medical Resource Allocation in Chinese Medicine Hospitals under the Perspective of fsQCA Configuration
Xueyun TIAN ; Zhixin WANG ; Yiru ZHOU ; Yan JIANG ; Liying ZHAO ; Jie ZHOU ; Zi YANG ; Xiaowei MAN
Chinese Hospital Management 2025;45(1):41-45
Objective To explore the optimisation path of medical resource allocation efficiency improvement in Traditional Chinese Medicine (TCM) hospitals under the synergistic effect of multiple factors,so as to provide powerful support for the balanced development of medical resources in TCM hospitals.Methods The comprehensive efficiency of resource allocation in TCM hospitals in 31 provinces (cities and districts) of China obtained by Data Envelopment Analysis was taken as the outcome variable,and with the help of Fuzzy-set Qualitative Comparative Analysis,it examined the configurations of efficient medical resource allocation,considering the following conditional variables:per capital Regional GDP,the proportion of fiscal allocation revenue to total income,the ratio of TCM practicing (assistant) physicians to all practicing (assistant) physicians,the average length of hospital stay for discharged patients,the number of total diagnosis and treatments per thousand population,and the number of hospital beds per thousand population.Results By analyzing the conditional patterns of efficient allocation of medical resources in TCM hospitals,three equivalent driving paths can be summarized,which are comprehensive service capacity,TCM advantage and hospitalization driving paths.Conclusion The overall level of medical resource allocation efficiency of TCM hospitals in China needs to be improved.In the future,efforts should be made to improve the comprehensive service capacity and operational efficiency of hospitals,give full play to the advantages of TCM,build a high-quality TCM talent team,reasonably shorten the average hospital stay,and improve the utilization efficiency of hospital beds.
5.Analysis of the Path to Improve the Efficiency of Medical Resource Allocation in Chinese Medicine Hospitals under the Perspective of fsQCA Configuration
Xueyun TIAN ; Zhixin WANG ; Yiru ZHOU ; Yan JIANG ; Liying ZHAO ; Jie ZHOU ; Zi YANG ; Xiaowei MAN
Chinese Hospital Management 2025;45(1):41-45
Objective To explore the optimisation path of medical resource allocation efficiency improvement in Traditional Chinese Medicine (TCM) hospitals under the synergistic effect of multiple factors,so as to provide powerful support for the balanced development of medical resources in TCM hospitals.Methods The comprehensive efficiency of resource allocation in TCM hospitals in 31 provinces (cities and districts) of China obtained by Data Envelopment Analysis was taken as the outcome variable,and with the help of Fuzzy-set Qualitative Comparative Analysis,it examined the configurations of efficient medical resource allocation,considering the following conditional variables:per capital Regional GDP,the proportion of fiscal allocation revenue to total income,the ratio of TCM practicing (assistant) physicians to all practicing (assistant) physicians,the average length of hospital stay for discharged patients,the number of total diagnosis and treatments per thousand population,and the number of hospital beds per thousand population.Results By analyzing the conditional patterns of efficient allocation of medical resources in TCM hospitals,three equivalent driving paths can be summarized,which are comprehensive service capacity,TCM advantage and hospitalization driving paths.Conclusion The overall level of medical resource allocation efficiency of TCM hospitals in China needs to be improved.In the future,efforts should be made to improve the comprehensive service capacity and operational efficiency of hospitals,give full play to the advantages of TCM,build a high-quality TCM talent team,reasonably shorten the average hospital stay,and improve the utilization efficiency of hospital beds.
6.Research progress on rehabilitation motivation in cancer patients
Yiru WANG ; Hong WANG ; Xiao AN ; Zhicong ZHOU ; Xu SUN ; Xiaoyi LIU ; Ziwei TONG
Chinese Journal of Nursing 2025;60(12):1512-1517
Rehabilitation is an effective measure to improve the quality of life for cancer patients,and strong rehabilitation motivation is an important influencing factor for patients' compliance with rehabilitation.This paper mainly reviews the concepts,assessment tools,influencing factors,and intervention strategies of rehabilitation motivation in cancer patients,with the aim of providing references for medical staff to improve the level of rehabilitation compliance in cancer patients and develop targeted rehabilitation management strategies.
7.Rehabilitation effects based on immersive virtual reality as a treatment for peripheral vestibular dysfunction:a Meta-analysis
Xiaoyi LIU ; Hong WANG ; Zhicong ZHOU ; Xu SUN ; Yiru WANG ; Ziwei TONG ; Xiaoying LIU
Chinese Journal of Nursing 2025;60(9):1140-1146
Objective To systematically evaluate the rehabilitation effect of immersive virtual reality technology for patients with peripheral vestibular dysfunction,and to provide theoretical basis and practical guidance for the design of efficient rehabilitation training programs.Methods PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,Wanfang Database,VIP Database,and China Biomedical Literature Database were searched for randomized controlled trials on the intervention effect of immersive virtual reality technology in patients with peripheral vestibular dysfunction from inception to February 2025.RevMan5.4 software was used to perform meta-analysis of the literature that met the quality standards.Results A total of 10 papers with 491 patients with peripheral vestibular dysfunction were included.Meta-analysis showed that immersive virtual reality technology improved vertigo symptoms in patients with peripheral vestibular dysfunction compared with conventional vestibular rehabilitation care[SMD=-1.41,95%CI(-1.58,-0.70),P<0.001],and subgroup analysis showed that the frequency of intervention was<5 times/week[SMD=-1.31,95%CI=(-1.96,-0.66),P<0.001],single intervention duration<30 min[SMD=-1.45,95%CI=(-2.21,-0.70),P<0.001],and intervention period≤7 weeks[SMD=-1.49,95%CI(-2.04,-0.94),P<0.001]were more significant.Immersive virtual reality technology reduced the risk of falls[MD=4.66,95%CI(3.84,5.48),P<0.001],and improved anxiety and depression[SMD=2.65,95%CI(1.98,3.33),P<0.001].Conclusion Immer-sive virtual reality technology improves vertigo symptoms,reduces the risk of falls,and improves anxiety and depres-sion symptoms in patients with peripheral vestibular dysfunction,in which the intervention period of ≤7 weeks,<5 training sessions per week,and each training session of<30 min are better for improving vertigo symptoms in patients with peripheral vestibular dysfunction.
8.Preliminary exploration on the ethical governance path of internet medicine from the perspective of medical equity
Rui ZHANG ; Yiru LU ; Ruixuan ZHU ; Luojing ZHOU
Chinese Medical Ethics 2024;37(1):54-60
Economic development drives the increase of endogenous demand,and Internet medicine integrates regional medical resources,expanding the fairness of the public's access to medical and health services.However,it is also accompanied an ethical crisis with the development of technology,which requires continuous standardization and practice.Starting from the principle of medical fairness,this paper sorted out the main advantaged characteristics of the development of Internet medicine from the aspects of data fairness,cost equity,opportunity equity,and educational equity.The existing ethical problems of Internet medicine were explored including unfair protection of ethical review mechanisms,unfair data collection of scientific and technological subjects,unfair distribution of benefits and risks,and unfair utilization of Internet medical resources.It also proposed the governance paths of compacting the subject responsibility,perfecting review and supervision,improving the sharing mechanism,bridging the digital divide,strengthening risk prevention,protecting the citizens'rights and interests,strengthening education and guidance,and increasing grassroots investment.
9.Research on the optimization countermeasures of the transformation policy of medical science and technology achievements in China: Based on policy tools
Yiru LU ; Ruixuan ZHU ; Luojing ZHOU
Chinese Journal of Medical Science Research Management 2024;37(3):216-223
Objective:This study aimed to analyze the focuses and shortcomings of the current medical achievements transformation policy, and to put forward references and suggestions for the subsequent formulation of medical science and technology innovation achievement transformation policy.Methods:46 policy texts were retrieved from Peking University Magic Treasure, Law Star, and other related websites of the State Council, the National Health Commission, the State Administration of Traditional Chinese Medicine, and other relevant ministries and commissions, and the policy clauses were systematically quantitatively analyzed from three dimensions of supply, demand, and environment using policy tool theory.Results:The number of policy documents issued from 2015 to 2022 showed a fluctuating increase. There were 25 normative policies, accounting for 54.3%, and 21 guiding and operational policies, accounting for 45.7%. Environmental policies accounted for 74.9%, while demand-oriented policies accounted for 3.1% among the 587 codes.Conclusions:It is suggested to reduce the dependence on environment-based policy tools, optimize the distribution structure of sub-categories such as tax incentives and financial support, strengthen the support of supply-based policy tools to promote the high-quality development of the transformation of medical scientific and technological achievements, increase the driving role of demand-based policies to enhance the appropriate allocation of clinical demand, further optimize the policy system for the transformation of medical scientific and technological achievements, and strengthen the supporting measures of relevant special policies.
10.Analysis of the Institutional Distribution of Curative Care Expenditure for the Elderly Population before and after the Comprehensive Reform of Medical-pharmaceutical Separation and Linkage of Medical Con-sumption in Beijing
Yan JIANG ; Yiru ZHOU ; Xiaowei MAN ; Liying ZHAO ; Wei CHENG
Chinese Hospital Management 2024;44(1):31-35
Objective By studying the changes in the institutional distribution of curative care expenditure(CCE)of the elderly population before and after the comprehensive reform medical-pharmaceutical separation and linkage of medical consumption,it provided data reference for the next step of accurately optimizing the elderly patients flow.Methods A multi-stage stratified whole-group sampling survey was used to select the sample.A System of Health Accounts 2011 was used to calculate the CCE of elderly patients in medical institutions.Results The CCE of medical institutions for the elderly population in Beijing increased from 60.457 billion yuan to 797.54 billion yuan,with an average annual growth rate of 6.83%,the fastest growth rate of 24.04%for community-based health treat-ment center.The percentage of CCE in the community increased from 11.31%to 17.71%,while the percentage of CCE in tertiary hospitals decreased by 4.39 percentage points.The flow of CCE for outpatient patients was obviously opti-mized.Younger elderly outpatient patients are more willing to seek treatment in the community,but the flow di-rection of outpatient treatment for elderly patients is more optimized.The CCE fpr elderly outpatient patients with chronic diseases such as endocrine,nutritional and metabolic diseases and nervous system diseases have been substantially transferred to the community-based health center.Conclusion The reform has different impacts on the treatment of elderly patients with different genders,ages and diseases.It is necessary to strengthen the service capacity building of primary medical institutions,highlight the development characteristics of secondary hospitals,and accurately improve the hierarchical diagnosis and treatment system for elderly patients.

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