Objective To understand the driver gene mutation status in patients with non-small cell lung cancer (NSCLC) in Xi'an City, and to analyze the association with environmental exposure factors. Methods A total of 305 NSCLC patients admitted to the First Affiliated Hospital of the Air Force Medical University from January 2019 to December 2023 were included. The driver gene mutation status was observed, and the relationship with environmental exposure factors was analyzed. Results The driver gene mutation rate of 305 patients was 46.89%, with EGFR gene mutation accounting for the highest proportion, and 4 cases of gene co-mutations were detected. There was a difference in gender among patients with different single drive gene mutations (P<0.05), and the proportion of EGFR in women was significantly higher (P<0.05). Univariate analysis showed that there were statistical differences in family history, smoking history, long-term cooking history, and fried smoked food intake between patients with driver gene mutation and patients without driver gene mutation (P<0.05). Logistic regression analysis suggested that long-term cooking history (OR=2.392), and fried smoked food intake (OR=2.849) were the environmental exposure factors affecting EGFR gene mutation (P<0.05), and smoking history (OR=1.377) was an environmental exposure factor of KRAS gene mutation (P<0.05). Conclusion EGFR gene mutation accounts for the highest proportion of NSCLC patients in Xi'an City, and is mainly female. Long-term cooking history, and fried smoked food intake are related to EGFR gene mutation. There is a certain association between smoking history and KRAS gene mutation.

Objective To investigate the efficacy of bevacizumab combined with raltitrexed in the treatment of unresectable hepatocellular carcinoma(HCC)and its effect on adverse reactions and survival rate.Methods A retrospective analysis was performed on 71 patients with unresectable hepatocellular carcinoma admitted to the oncology department of our hospital from February 2020 to June 2022.Among them,35 cases were treated with raltitrexed as control group,and 36 cases were treated with bevacizumab combined with raltitrexed as observation group.All patients received transcatheter arterial chemoembolization(TACE).After 1 month of treatment,the short-term treatment effect of the two groups was evaluated.The adverse reactions of the two groups were observed.Follow-up review was performed to record progression free survival(PFS)and overall survival(OS)in both groups.Results After 1 month of treatment,the disease control rate(DCR)and objective response rate(ORR)of control group were 74.29%and 45.71%respectively.The DCR and ORR of observation group were 83.33%and 55.56%respectively.There was no significant difference in short-term efficacy between the two groups(P>0.05).Following treatment,the vascular endothelial growth factor(VEGF)level in the observation group was considerably lower than in the control group(P<0.05).After treatment,18 months of follow-up,OS curve showed:observation group OS was 50.00%,control group OS was 31.40%;PFS curve showed:observation group PFS was 43.33%,control group PFS was 26.92%.Using the Log-rank test,between the two groups,there was a statistically significant difference in OS(χ2=4.381,P=0.036),although there was no statistically significant difference in PFS between the two groups(χ2=3.264,P=0.071).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Bevacizumab combined with raltitrexed can reduce tumor neovascularization,inhibit tumor growth and spread,prolong the survival time of patients,and do not increase adverse drug reactions.

Depression is a common cause of human disability and death.Some patients are not sensitive to antidepressants,and also the recurrence rate is very high.Unfortunately,there are many problems with existing antidepressants.So,it is urgent to find a new antidepressant aiming at multiple targets.Recently,researchers have found that soluble N-ethylmaleimide-sensitive factor attachment protein receptor(SNARE)complex is closely related to the progression of depression.This review discusses the potential mechanisms of the SNARE complex in glial cells,and hopes to contribute to the understanding of depression and provide new ideas for clinical development of novel antidepressant drugs.

Objective:To explore the mediating effect of attentional bias of negative information between fatalism and death anxiety in lung neoplasms patients.Methods:This study was a cross-sectional study. It was convenient to select 312 lung neoplasms patients treated in the Department of Oncology, First Affiliated Hospital and Second Affiliated Hospital of Air Force Military Medical University the Chinese People′s Liberation Army, from April 2021 to April 2022 as the research subjects. Questionnaires were conducted with Fatalism Scale, Attention to Negative Information Scale, and Templer′s Death Anxiety Scale. Structural equation model were constructed based on self-regulatory executive function models.Results:The total score of fatalism, attentional bias of negative information, and death anxiety of 312 lung neoplasms patients were (61.68 ± 11.92) points, (39.57 ± 5.19) points, and (61.23 ± 9.30) points, respectively. Attentional bias of negative information was significantly positively correlated with fatalism ( r = 0.594, P<0.01). Death anxiety was significantly positively correlated with fatalism and attentional bias of negative information ( r = 0.494, 0.558, both P<0.01). Attentional bias of negative information played a partial mediating role between fatalism and death anxiety, and the mediating effect accounted for 37.7% of the total effect. The value of each fitness index of the mediation effect model was within the acceptable range. Conclusions:Attentional bias of negative information is an intermediary variable between fatalism and death anxiety of lung neoplasms patients. Nursing staff should pay attention to the level of attentional bias of negative information of lung neoplasms patients and carry out targeted nursing interventions from the emotional processing process to reduce the level of death anxiety in patients with lung neoplasms.

Objective:To explore the application of sound thinking combined with Sandwich teaching in oncology nursing practice teaching.Methods:A total of 68 nursing students who were interns in the Department of Oncology, The First Affiliated Hospital of Air Force Medical University from 2020 to 2021 were included in the study, and they were divided into a control group ( n=34) and an observation group ( n=34). The control group took routine teaching for interns, while the observation group took sound thinking combined with Sandwich teaching. The examination results, critical thinking abilities, and the evaluation of nursing teaching effectiveness of the two groups of nursing interns were evaluated. SPSS 22.0 was used for Chi-square test and t-test. Results:The examination scores of nursing students in the observation group were higher than those in the control group ( t=3.44, 2.87, 3.45, P<0.05). Compared with those before training, the scores of critical thinking ability of nursing interns in both groups increased after the training, and the observation group was better than the control group ( t=0.180, 3.64, 0.61, 2.92, 0.31, 2.74, 0.45, 2.65, 0.25, 3.58, 1.16, 2.85, 0.36, 3.20, 0.33, 2.38, P<0.05). The scores of autonomous learning ability, communication and collaboration ability, independent thinking ability, clinical reasoning ability, and problem-analyzing and -solving ability in the observation group were higher than those in the control group ( t=2.82, 3.46, 2.68, 3.29, 2.44, P<0.05). Conclusion:Combining sound thinking with Sandwich teaching in nursing clinical practice teaching in department of oncology can improve the examination scores of nursing students, improve their critical thinking abilities, and enable them to give a high evaluation of nursing teaching effectiveness.

Frailty and trauma are closely related, and together affect the health outcomes of elderly trauma patients. However, insufficient attention has been paid to the frailty of elderly trauma patients in China. This paper reviews the relationship between frailty and trauma, assessment tools and management of frailty in elderly trauma patients, in order to provide a new perspective of nursing care for elderly trauma patients in China and to provide references for carrying out research on frailty in elderly trauma patients.

Objective: To investigate the current status of knowledge and attitudes of oncology nursing staffs on pain management in cancer patients. Methods: A total of 232 oncology nursing staffs from 7 Grade III-A Hospitals in 4 provinces and municipalities were surveyed using General Information Questionnaire and knowledge and attitudes survey regarding pain (KASRP) (2014) questionnaire (Chinese version). Results: The results of this survey showed that the average score of knowledge and attitude about pain management of 232 oncology nursing staffs was (21.56±4.01) points, and the average correct rate was 52.59%. There were no significant differences in the scores of different education background, years of nursing work, years of cancer clinical nursing care, and the nature of the hospital they worked in(P>0.05). However, there was a difference in the score of nursing staffs with different professional titles (F=5.885, P=0.003). Besides that, difference also showed in scores of nursing staffs with different experiences in caring cancer pain patients (F=3.216, P=0.024). Conclusion The knowledge and attitude of pain management in oncology nursing staffs are in low level, the command of knowledge is not enough, meanwhile, the pain management ability is insufficient. Therefore, it is necessary to strengthen the training of pain related knowledge of nursing staffs and improve their pain management ability.

Objective To evaluate the relationship between proton pump inhibitor (PPI) and the risk of spontaneous bacterial peritonitis (SBP) in cirrhosis patients systematically.Methods The literature on the related databases as of February 2019 was searched.Case-control studies,cohort studies,and randomized controlled studies (RCT),which set the theme as the relationship between PPI and SBP in cirrhosis patients,whose main outcome indicator was SBP incidence,and which had high quality assessed by Newcastle-Ottawa Scale or modified Jadad scoring method,were collected.The meta-analysis was performed using Rev Man 5.3 software.Results A total of 18 studies were enrolled in the meta-analysis.Of the 18 studies,8 were case-control studies,9 were cohort studies,and 1 was RCT;6 were prospective studies and 12 were retrospective studies;13 were single-center studies and 5 were multi-center studies.A total of 6 961 patients were included,3 353 in the trial group and 3 608 in the control group.The patients in the trial group received PPI alone and the patients in the control group did not receive any acid-suppressing drug.Overall analysis of the 18 studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.83,95％ CI:1.43-2.33,P ＜ 0.001).The results of subgroup analysis for 8 case-control studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group(OR =2.38,95％ CI:1.69-3.36,P ＜ 0.001).The results of subgroup analysis for 9 cohort studies showed that the risk of SBP of patients in the trial group was markedly higher than that in the control group (OR =1.27,95％ CI:1.04-1.55,P =0.020).The results of subgroup analysis for 12 retrospective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.81,95％CI:1.34-2.45,P=0.001).The results of subgroup analysis for 6 perspective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.88,95％ CI:1.27-2.79,P =0.002).The results of subgroup analysis for 13 single-center studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.97,95％ CI:1.41-2.76,P ＜ 0.001).The results of subgroup analysis for 5 multicenter studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.69,95％CI:1.33-2.13,P＜0.001).Conclusions PPI can increase the risk of SBP in patients with liver cirrhosis.It is suggested that PPI be used cautiously in patients with liver cirrhosis.

Objective To evaluate the relationship between proton pump inhibitor (PPI) and the risk of spontaneous bacterial peritonitis (SBP) in cirrhosis patients systematically.Methods The literature on the related databases as of February 2019 was searched.Case-control studies,cohort studies,and randomized controlled studies (RCT),which set the theme as the relationship between PPI and SBP in cirrhosis patients,whose main outcome indicator was SBP incidence,and which had high quality assessed by Newcastle-Ottawa Scale or modified Jadad scoring method,were collected.The meta-analysis was performed using Rev Man 5.3 software.Results A total of 18 studies were enrolled in the meta-analysis.Of the 18 studies,8 were case-control studies,9 were cohort studies,and 1 was RCT;6 were prospective studies and 12 were retrospective studies;13 were single-center studies and 5 were multi-center studies.A total of 6 961 patients were included,3 353 in the trial group and 3 608 in the control group.The patients in the trial group received PPI alone and the patients in the control group did not receive any acid-suppressing drug.Overall analysis of the 18 studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.83,95％ CI:1.43-2.33,P ＜ 0.001).The results of subgroup analysis for 8 case-control studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group(OR =2.38,95％ CI:1.69-3.36,P ＜ 0.001).The results of subgroup analysis for 9 cohort studies showed that the risk of SBP of patients in the trial group was markedly higher than that in the control group (OR =1.27,95％ CI:1.04-1.55,P =0.020).The results of subgroup analysis for 12 retrospective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.81,95％CI:1.34-2.45,P=0.001).The results of subgroup analysis for 6 perspective studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.88,95％ CI:1.27-2.79,P =0.002).The results of subgroup analysis for 13 single-center studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.97,95％ CI:1.41-2.76,P ＜ 0.001).The results of subgroup analysis for 5 multicenter studies showed that the risk of SBP in patients in the trial group was markedly higher than that in the control group (OR =1.69,95％CI:1.33-2.13,P＜0.001).Conclusions PPI can increase the risk of SBP in patients with liver cirrhosis.It is suggested that PPI be used cautiously in patients with liver cirrhosis.

Objective To explore the changes of programmed death receptor-1 (PD-1) in chronic hepatitis B (CHB) patients with different baseline of hepatitis B virus (HBV) DNA levels after treatment with adefovir dipivoxil (ADV).Methods One hundred CHB patients with positive hepatitis B e antigen (HBeAg),1 × 104 copy/mL≤HBV DNA≤1 × 107 copy/mL,and positive human leukocyte antigen-A2 were divided into two groups according to the baseline HBV DNA level:47 cases in low virus load group whose HBV DNA level was ≤1 × 105 copy/mL; 53 cases in high virus load group whose HBV DNA level was＞1 × 105 copy/mL.Both groups were treated with ADV 10 mg/d.Serum HBV DNA,HBeAg seroconversion rate,alanine aminotransferase (ALT) and total bilirubin (TBil) levels of both groups before treatment and 12 months after treatment were compared.Flow cytometry was used to test peripheral blood HBV-specific cytotoxic T lymphocyte (CTL) surface PD-1 and peripheral blood HBV-specific CTL level.Categorical data were tested by x2 test; quantitative data was compared with t-test.Results Peripheral blood HBV-specific CTL surface PD-1 of CHB patients in low virus load group was 20.17 ％±1.69％,which was lower than that in high virus load group (41.38％±2.30％,t =53.02,P＜0.01) ; peripheral blood HBV specific CTL levels in two groups were 0.37％±0.02％ and 0.17％± 0.02％,respectively (t=50.47,P＜0.01) ; ALT and TBil levels in low virus load group were both lower than those of high virus load group (t=13.07,P＜0.01; t=5.06,P＜0.01).Twelve months after treatment,HBV DNA of 25 cases (53.2％) in low virus load group and 10 cases (18.9％) in high virus load group were lower than the detectable level (HBV DNA＜500 copy/mL,x2 =12.89,P＜0.01);HBeAg seroconversion was achieved in 15 cases(31.9％) and 1 case (1.9％),respectively (x2 =16.72,P＜0.01) ; peripheral blood HBV-specific CTL surface PD-1 expression levels were 9.00 ％ ±1.38 ％ and 29.40 ％ ± 3.76 ％,respectively (t =36.80,P＜ 0.01) ; peripheral blood HBV-specific CTL levels were 0.65％±0.10％ and0.48％±0.07％,respectively (t=9.61,P＜0.01).Conclusions After treatment with ADV,along with the decrease of HBV DNA load,HBV-specific CTL surface PD-1 expression decreases,while HBV-specific CTL level increases.The changes in low virus load group are much more remarkable.