Lung cancer is the leading cause of cancer-related deaths worldwide， and tumor metastasis is a key factor contributing to the mortality of most lung cancer patients. Aberrant activation of epithelial-mesenchymal transition （EMT） is a major driver of lung cancer progression and metastasis. EMT is characterized by the loss of apical-basal polarity and intercellular adhesion in highly differentiated， polarized， and organized epithelial cells， which acquire motility， migratory potential， and invasive properties. During this process， cells undergo cytoskeletal remodeling and transform into a mesenchymal phenotype， accompanied by associated changes in cellular markers. The EMT process is highly complex and is tightly regulated by intricate networks involving multiple transcription factors， post-translational controls， epigenetic modifications， and non-coding RNAs. Therefore， therapies targeting the mechanisms of malignant transformation and their associated pathways in lung cancer are of significant clinical importance. In recent years， EMT has attracted increasing attention as a potential target for cancer therapy. Chinese medicine， with its characteristics of multi-target action， low side effects， and good therapeutic efficacy， has demonstrated an important role in anticancer treatment. A series of studies have investigated the role of Chinese medicine in inhibiting EMT in lung cancer. Active ingredients of Chinese medicine， including flavonoids， glycosides， phenols， terpenoids， saccharides， and alkaloids， as well as Chinese medicine compound formulas， have shown significant regulatory effects on EMT. Their mechanisms mainly involve multiple pathways， targets， and links， including signaling pathways， exosomes， microRNAs （miRNAs）， and the tumor-associated immune microenvironment. This article summarizes the mechanisms by which EMT promotes malignant tumor progression and reviews the current research on how Chinese medicine active ingredients， monomers， and compound formulas inhibit EMT and suppress lung cancer cell migration and invasion. This study is expected to provide comprehensive theoretical information for basic and translational research on lung cancer.

OBJECTIVE: To investigate whether adding 1 transverse screw (TS) to the triangular parallel cannulated screw (TPCS) fixation has a mechanical stability advantage for Pauwels type Ⅲ femoral neck fractures by conducting finite element analysis on four internal fixation methods. METHODS: Based on CT data of a healthy adult male volunteer's femur, three Pauwels type Ⅲ femoral neck fracture models (Pauwels angle 70°, Pauwels angle 80°, and Pauwels angle 70° combined with bone defect) were constructed using Mimics 21.0 software and SolidWorks 2017 software. Four different internal fixation models were built at the same time, including TPCS, TPCS+TS, three cross screws (TCS), and TPCS+medial buttress plate (MBP). The mechanical stability of different models under the same load was compared by finite element analysis. RESULTS: The femoral model established in this study exhibited a maximum stress of 28.62 MPa, with relatively higher stress concentrated in the femoral neck. These findings were comparable to previous studies, indicating that the constructed femoral finite element model was correct. The maximum stress of internal fixation in finite element analysis showed that TCS was the lowest and TPCS+MBP was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. The maximum displacement of internal fixation in each fracture model was located at the top of the femoral head, with TCS having the highest maximum displacement of the femur. The maximum stress of fracture surface in finite element analysis showed that TCS was the lowest and TPCS was the highest in the Pauwels angle 70° model, while TPCS+MBP was the lowest and TPCS/TCS were the highest in the Pauwels angle 80° model and the Pauwels angle 70° combined with bone defect model, respectively. The maximum displacement of fracture surfece analysis showed that TPCS+MBP was the lowest and TCS was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the biomechanical stability of TPCS+TS was superior to that of TPCS alone and TCS, but it has not yet reached the level of TPCS+MBP.
Finite Element Analysis ; Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Screws ; Fracture Fixation, Internal/instrumentation* ; Male ; Bone Plates ; Stress, Mechanical ; Biomechanical Phenomena ; Tomography, X-Ray Computed ; Adult ; Femur Neck/surgery*

ObjectiveTo observe the effects of Tongmai Kaiqiao pills on AMP-activated protein kinase （AMPK）/peroxisome proliferator-activated receptor gamma coactivator-1α （PGC-1α） signaling pathway and mitochondrial biogenesis in hippocampal tissue of rats with vascular cognitive impairment （VCI） and to investigate the potential mechanism of Tongmai Kaiqiao pills in improving cognitive impairment in rats with VCI. MethodsTwelve of 72 male SD rats were selected as the sham operation group， and the remaining rats were modelled using the modified 2VO method. The rats that were successfully modelled were divided into the model group， the high-dose group of Tongmai Kaiqiao pills （27.6 g·kg^-1）， the low-dose group of Tongmai Kaiqiao pills （13.8 g·kg^-1）， the combination group （27.6 g·kg^-1 Tongmai Kaiqiao pills + 25 mg·kg^-1 dorsomorphin）， and the donepezil hydrochloride group （0.45 g·kg^-1） according to the random number table method. After four weeks of continuous intraperitoneal injection of the corresponding drugs， the Morris water maze test was used to test the learning and memory ability of rats. Hematoxylin-eosin （HE） staining and Nissl staining were used to detect pathological changes in the hippocampus of the rats. The content of mitochondrial adenosine triphosphate （ATP） in the brain hippocampus was detected by colorimetry， and reactive oxygen species （ROS） level was detected in rat mitochondria by MitoSOX Red assay. Mitochondrial DNA copy number was detected by real-time fluorescent quantitative PCR （Real-time PCR）. Pathological changes in mitochondria were observed by transmission electron microscopy （TEM）， and AMPK， PGC-1α， phosphorylated AMP-activated protein kinase （p-AMPK）， nuclear respiratory factor 1 （Nrf1）， and mitochondrial transcription factor A （TFAM） protein expression in the hippocampus of the rats were detected by Western blot. ResultsCompared with those in the sham operation group， rats in the model group had a reduced number of platform crossings （P<0.01）， significantly prolonged evasion latency （P<0.01）， disorganized neuronal arrangement in the hippocampal region， widened gaps， and blurred nucleus membrane and nucleolus boundaries. The emergence of necrotic cells was visible. The color of the nissl bodies was light， and the number was reduced with severe loss. Mitochondria were atrophied， and cristae were lost. Severe damage was observed. The content of ROS was increased， and the level of ATP was decreased. mtDNA copy number decreased significantly （P<0.01）， and the protein expression of p-AMPK， PGC-1α， Nrf1， and TFAM decreased （P<0.05， P<0.01）. Compared with those in the model group， rats in the high-dose group of Tongmai Kaiqiao pills and donepezil hydrochloride group showed a shorter time to find the platform （P<0.01）， increased number of platform crossings （P<0.01）， restored mitochondrial morphology and structure of the hippocampal neurons， alleviated neuronal death， increased number of nissl bodies， weaken degree of injury， lower content of ROS， and significantly increased levels of ATP and number of copies of mtDNA （P<0.05， P<0.01）. In addition， there was increased protein expression of p-AMPK， PGC-1α， Nrf1， and TFAM （P<0.05， P<0.01）. Compared with the model group， the evasion latency was shortened in the low-dose group of Tongmai Kaiqiao pills （P<0.01）， and the number of platform crossings was increased， but the difference was not statistically significant. The mitochondria were swollen and deformed， and the cristae became shorter and partially disappeared. The degree of damage did not improve significantly， and the number of nissl bodies was increased but not statistically significant. The ROS content decreased （P<0.01）， but there was no significant difference in ATP level and mtDNA copy number. The protein expression of PGC-1α was increased （P<0.05）， but there was no significant difference in the protein expression of p-AMPK， Nrf1， and TFAM， and the results were not statistically significant. Compared with the donepezil hydrochloride group， there was no significant change in the results of each assay in the high-dose group of Tongmai Kaiqiao pills， and the difference was not statistically significant. Compared with the high-dose group of Tongmai Kaiqiao pills， rats in the combination group had a significantly lower number of platform crossings （P<0.01）， a significantly longer evasion latency （P<0.01）， a reduced number of neuronal cells， disorganized tissue structure， swollen and blurred cell outlines， a significant reduction in the number of nissl bodies. Moreover， there was an increase in the content of ROS， a decrease in the level of ATP and the number of mtDNA copies （P<0.01）， and a decrease in the expression of p-AMPK， PGC-1α， Nrf1， and TFAM （P<0.05）. ConclusionTongmai Kaiqiao pills is able to improve cognitive function in rats by activating the AMPK/PGC-1α signaling pathway， promoting mitochondrial biogenesis， and attenuating pathological damage to neurons in the hippocampal region， thereby demonstrating its therapeutic potential.

Hungary, as the first European country to legislate TCM, its legislation experience has significant implications for the international development of TCM. This article reviewed the historical process of TCM legislation in Hungary, summarized its legislative achievements, and analyzed the problems encountered during the implementation process. It was found that the current challenges faced by TCM legislation in Hungary mainly include constraints from the dominance of modern medicine, restrictions from strict qualification requirements, insufficient public awareness, difficulties in TCM registration, and challenges in policy coordination and cooperation. Based on these findings, the article proposed countermeasures such as improving the legal framework, strengthening educational cooperation, enhancing public awareness, promoting the mutual recognition of standards between China and Europe, and deepening China-Hungary collaboration. These measures aim to further improve the legislation and implementation of TCM in Hungary, thereby promoting the healthy development of TCM in Hungary and the global service trade of TCM.

Objective:To explore the clinical features and prognostic factors of lymphoma-associated hemophagocytic lymphohistiocytosis (LAHS).Methods:A retrospective cohort study was conducted. The clinical data of 44 LAHS patients who diagnosed at the Second Hospital of Shanxi Medical University from September 2016 to September 2022 were retrospectively analyzed. All patients were divided into B cell LAHS (B-LAHS) group (19 cases) and NK/T cell LAHS (NK/T-LAHS) group (19 cases) according to the lymphoma types, except for 4 cases of classic Hodgkin lymphomas and 2 cases of splenic lymphoma lymphomas. The clinical features and the factors influencing the prognosis of both groups were compared. According to whether lymphoma treatment were included in the initial treatment regimen, the patients were divided into the group with lymphoma treatment and the group without lymphoma treatment, and the objective response rate (ORR) of both groups was compared. Kaplan-Meier method was used to analyze the overall survival (OS), the log-rank method was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis.Results:Among 44 LAHS patients, 26 cases were male and 18 cases were female, with the age of (69±7) years. Most of them were secondary to diffuse large B-cell lymphoma (DLBCL), and 17 out of 44 patients were secondary to DLBCL. All patients had fever, lymphadenopathy, and ferritinemia. The differences in red blood cells (RBC), hemoglobin (Hb), activated partial thromboplastin time (APTT), peripheral blood Epstein-Barr virus DNA (EBV DNA) load, positive rate of Epstein-Barr virus-encoded small RNA (EBER) in tissues, triglycerides (TG), aspartate aminotransferase (AST) and fibrinogen between NK/T-LAHS patients and B-LAHS patients were statistically significant (all P<0.05). The ORR of 44 patients with LAHS was 52.3% (23/44); the median OS time of LAHS patients was 157 d, and that of NK/T-LAHS patients was 110 d; the median OS time of B-LAHS was 135 d; and the difference was statistically significant ( χ2 = 7.47, P = 0.024). The median OS was not reached in patients receiving initial treatment regimen containing lymphoma, while the median OS time was 65 d in patients receiving treatment without containing lymphoma, and the difference was statistically significant ( χ2 = 3.97, P = 0.046). The results of multivariate Cox proportional hazards model showed that age ≥ 70 years ( HR = 2.502, 95% CI: 1.047-5.978, P = 0.039), serum ferritin (SF) ≥ 1 500 μg/L( HR=0.521,95% CI:0.282~0.960, P=0.037), soluble CD25 ≥ 7 800 U/ml ( HR = 0.536, 95% CI: 0.348-0.828, P = 0.005), interleukin (IL)-10≥100 ng/L ( HR = 0.532, 95% CI: 0.33-0.85, P = 0.009), interferon (IFN)-γ≥5.0 ng/ L ( HR = 0.554, 95% CI: 0.32-0.95, P = 0.033), Th (CD3 + CD4 + T cells)/ Ts (CD3 + CD8 + T cells) < 2 ( HR = 1.731, 95% CI: 1.005-2.982, P = 0.048), and hepatomegaly ( HR = 2.581, 95% CI: 1.059-6.289, P = 0.037) were independent factors influencing the poor outcome of LAHS patients. Conclusions:LAHS is mostly secondary to DLBCL. The early clinical manifestations lack specificity and the prognosis is generally poor, and the worst prognosis occurs in patient with NK/T-LAHS. The initial treatment with lymphoma can prolong OS time in patients with LAHS.

Objective:To investigate the predictive value of neutrophil extracellular traps (NETs) on the prognosis of patients with epidermal growth factor receptor (EGFR) wild-type lung adenocarcinoma.Methods:A total of 132 surgical paraffin specimens of EGFR wild-type lung adenocarcinoma diagnosed at the Tumor Hospital Affiliated to Xinjiang Medical University from January 2016 to December 2023 and 12 pairs of cancer and paracancerous fresh tissues from patients with EGFR wild-type lung adenocarcinoma diagnosed in March-July 2024 were collected with their clinical information. Western blotting and immunofluorescence were used to detect the expression levels of citrullinated histone H3 (CitH3) and myeloperoxidase (MPO) in cancerous and paraneoplastic tissues. Immunohistochemistry was used to detect the infiltration of PD-L1, CD4 + T cells and CD8 + T cells in the tumors. The clinical and prognostic correlations between NETs and EGFR wild-type lung adenocarcinoma patients were analyzed. Results:The expression of MPO ( P＜0.001) and CitH3 ( P=0.009) was significantly increased in the tumors compared with the paracancerous tissues. The rate of high expression of NETs in cancer tissues was higher in patients with EGFR wild-type lung adenocarcinoma who were in stage Ⅲ and Ⅳ, with lymph node metastasis, distant metastasis, pleural invasion, high expression of Ki-67, low expression of CD8 + T, and lowered lymphocyte counts when compared to paraneoplastic tissues ( P＜0.05). Patients were stratified based on TNM stage Ⅱb for prognostic analysis. Kaplan-Meier univariate analysis showed that the median overall survival (OS) (stage Ⅰ to Ⅱb: 47 vs 87 months; stage Ⅲ to Ⅳ: 27 months vs not reach) and the median disease-free survival (DFS) (stage Ⅰ to Ⅱb: 42 vs 78 months; stage Ⅲ to Ⅳ: 18 vs 39 months) of patients with high expression of NETs in stage Ⅰ to II b and stage Ⅲ to Ⅳ were lower than those with low expression (stage Ⅰ to Ⅱb: OS, P＜0.001; DFS, P＜0.001; stage Ⅲ to Ⅳ: OS, P=0.001; DFS, P=0.022). The OS (stage Ⅰ to Ⅱb: HR=3.513, 95% CI: 1.966-6.277, P＜0.001; stage Ⅲ to Ⅳ: HR=3.215, 95% CI: 1.324-7.806, P=0.010) and the DFS (stage Ⅰ to Ⅱb: HR=2.478 ,95% CI: 1.396-4.400, P=0.002; stage Ⅲ to Ⅳ: HR=2.248, 95% CI: 1.089-4.638, P=0.028) in the group with high expression of NETs in either stage Ⅰ to Ⅱb or stage Ⅲ to Ⅳ were significantly shorter than those in the group with low expression. Conclusion:The EGFR wild-type lung adenocarcinoma patients with high expression of NETs have relatively shorter DFS and OS, which are independent risk factors for the prognosis of patients with EGFR wild-type lung adenocarcinoma, and are likely to be the potential biomarkers for the diagnosis and treatment of EGFR wild-type lung adenocarcinoma.

This study aims to establish an efficient protoplast-mediated genetic transformation sys-tem for Pochonia chlamydosporia(P.chlamydosporia)to facilitate gene transformation,genetic modification,and subsequent biological function research.Through orthogonal testing,the study systematically optimized key factors influencing electroporation,including voltage,osmotic stabi-lizer,pulse time,nucleic acid concentration,and protoplast concentration.The results showed that the optimal electroporation conditions were:voltage of 250 V,osmotic stabilizer as 0.6 mol/L su-crose solution,pulse time of 10 ms,plasmid concentration of 1％,and protoplast concentration of 1×107 protoplasts/mL,yielding a transformation efficiency of 0.4 × 103 CFU/pg.The interaction analysis revealed that the five factors affected transformation efficiency in the following order:plasmid concentration＞protoplast concentration＞pulse time＞osmotic stabilizer type＞voltage.Based on the positive transformants,the study further evaluated their colony morphology,growth rate,conidial yield,mycelial dry weight,and the ability to infect the eggs of three types of animal gastrointestinal nematodes.The results indicated that the electroporation process did not signifi-cantly affect the biological functions of P.chlamydosporia.The transformants successfully ex-pressed enhanced green fluorescent protein(EGFP),and PCR analysis confirmed the successful in-tegration of the thiostrepton resistance gene.In conclusion,this study successfully established a protoplast-based electroporation-mediated genetic transformation system for P.chlamydosporia,providing a valuable foundation for further research into the mechanism of egg parasitism and the underlying genes involved in its biocontrol activity.

This study aims to establish an efficient protoplast-mediated genetic transformation sys-tem for Pochonia chlamydosporia(P.chlamydosporia)to facilitate gene transformation,genetic modification,and subsequent biological function research.Through orthogonal testing,the study systematically optimized key factors influencing electroporation,including voltage,osmotic stabi-lizer,pulse time,nucleic acid concentration,and protoplast concentration.The results showed that the optimal electroporation conditions were:voltage of 250 V,osmotic stabilizer as 0.6 mol/L su-crose solution,pulse time of 10 ms,plasmid concentration of 1％,and protoplast concentration of 1×107 protoplasts/mL,yielding a transformation efficiency of 0.4 × 103 CFU/pg.The interaction analysis revealed that the five factors affected transformation efficiency in the following order:plasmid concentration＞protoplast concentration＞pulse time＞osmotic stabilizer type＞voltage.Based on the positive transformants,the study further evaluated their colony morphology,growth rate,conidial yield,mycelial dry weight,and the ability to infect the eggs of three types of animal gastrointestinal nematodes.The results indicated that the electroporation process did not signifi-cantly affect the biological functions of P.chlamydosporia.The transformants successfully ex-pressed enhanced green fluorescent protein(EGFP),and PCR analysis confirmed the successful in-tegration of the thiostrepton resistance gene.In conclusion,this study successfully established a protoplast-based electroporation-mediated genetic transformation system for P.chlamydosporia,providing a valuable foundation for further research into the mechanism of egg parasitism and the underlying genes involved in its biocontrol activity.

Objective:To explore the clinical features and prognostic factors of lymphoma-associated hemophagocytic lymphohistiocytosis (LAHS).Methods:A retrospective cohort study was conducted. The clinical data of 44 LAHS patients who diagnosed at the Second Hospital of Shanxi Medical University from September 2016 to September 2022 were retrospectively analyzed. All patients were divided into B cell LAHS (B-LAHS) group (19 cases) and NK/T cell LAHS (NK/T-LAHS) group (19 cases) according to the lymphoma types, except for 4 cases of classic Hodgkin lymphomas and 2 cases of splenic lymphoma lymphomas. The clinical features and the factors influencing the prognosis of both groups were compared. According to whether lymphoma treatment were included in the initial treatment regimen, the patients were divided into the group with lymphoma treatment and the group without lymphoma treatment, and the objective response rate (ORR) of both groups was compared. Kaplan-Meier method was used to analyze the overall survival (OS), the log-rank method was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis.Results:Among 44 LAHS patients, 26 cases were male and 18 cases were female, with the age of (69±7) years. Most of them were secondary to diffuse large B-cell lymphoma (DLBCL), and 17 out of 44 patients were secondary to DLBCL. All patients had fever, lymphadenopathy, and ferritinemia. The differences in red blood cells (RBC), hemoglobin (Hb), activated partial thromboplastin time (APTT), peripheral blood Epstein-Barr virus DNA (EBV DNA) load, positive rate of Epstein-Barr virus-encoded small RNA (EBER) in tissues, triglycerides (TG), aspartate aminotransferase (AST) and fibrinogen between NK/T-LAHS patients and B-LAHS patients were statistically significant (all P<0.05). The ORR of 44 patients with LAHS was 52.3% (23/44); the median OS time of LAHS patients was 157 d, and that of NK/T-LAHS patients was 110 d; the median OS time of B-LAHS was 135 d; and the difference was statistically significant ( χ2 = 7.47, P = 0.024). The median OS was not reached in patients receiving initial treatment regimen containing lymphoma, while the median OS time was 65 d in patients receiving treatment without containing lymphoma, and the difference was statistically significant ( χ2 = 3.97, P = 0.046). The results of multivariate Cox proportional hazards model showed that age ≥ 70 years ( HR = 2.502, 95% CI: 1.047-5.978, P = 0.039), serum ferritin (SF) ≥ 1 500 μg/L( HR=0.521,95% CI:0.282~0.960, P=0.037), soluble CD25 ≥ 7 800 U/ml ( HR = 0.536, 95% CI: 0.348-0.828, P = 0.005), interleukin (IL)-10≥100 ng/L ( HR = 0.532, 95% CI: 0.33-0.85, P = 0.009), interferon (IFN)-γ≥5.0 ng/ L ( HR = 0.554, 95% CI: 0.32-0.95, P = 0.033), Th (CD3 + CD4 + T cells)/ Ts (CD3 + CD8 + T cells) < 2 ( HR = 1.731, 95% CI: 1.005-2.982, P = 0.048), and hepatomegaly ( HR = 2.581, 95% CI: 1.059-6.289, P = 0.037) were independent factors influencing the poor outcome of LAHS patients. Conclusions:LAHS is mostly secondary to DLBCL. The early clinical manifestations lack specificity and the prognosis is generally poor, and the worst prognosis occurs in patient with NK/T-LAHS. The initial treatment with lymphoma can prolong OS time in patients with LAHS.

Objective:To investigate the predictive value of neutrophil extracellular traps (NETs) on the prognosis of patients with epidermal growth factor receptor (EGFR) wild-type lung adenocarcinoma.Methods:A total of 132 surgical paraffin specimens of EGFR wild-type lung adenocarcinoma diagnosed at the Tumor Hospital Affiliated to Xinjiang Medical University from January 2016 to December 2023 and 12 pairs of cancer and paracancerous fresh tissues from patients with EGFR wild-type lung adenocarcinoma diagnosed in March-July 2024 were collected with their clinical information. Western blotting and immunofluorescence were used to detect the expression levels of citrullinated histone H3 (CitH3) and myeloperoxidase (MPO) in cancerous and paraneoplastic tissues. Immunohistochemistry was used to detect the infiltration of PD-L1, CD4 + T cells and CD8 + T cells in the tumors. The clinical and prognostic correlations between NETs and EGFR wild-type lung adenocarcinoma patients were analyzed. Results:The expression of MPO ( P＜0.001) and CitH3 ( P=0.009) was significantly increased in the tumors compared with the paracancerous tissues. The rate of high expression of NETs in cancer tissues was higher in patients with EGFR wild-type lung adenocarcinoma who were in stage Ⅲ and Ⅳ, with lymph node metastasis, distant metastasis, pleural invasion, high expression of Ki-67, low expression of CD8 + T, and lowered lymphocyte counts when compared to paraneoplastic tissues ( P＜0.05). Patients were stratified based on TNM stage Ⅱb for prognostic analysis. Kaplan-Meier univariate analysis showed that the median overall survival (OS) (stage Ⅰ to Ⅱb: 47 vs 87 months; stage Ⅲ to Ⅳ: 27 months vs not reach) and the median disease-free survival (DFS) (stage Ⅰ to Ⅱb: 42 vs 78 months; stage Ⅲ to Ⅳ: 18 vs 39 months) of patients with high expression of NETs in stage Ⅰ to II b and stage Ⅲ to Ⅳ were lower than those with low expression (stage Ⅰ to Ⅱb: OS, P＜0.001; DFS, P＜0.001; stage Ⅲ to Ⅳ: OS, P=0.001; DFS, P=0.022). The OS (stage Ⅰ to Ⅱb: HR=3.513, 95% CI: 1.966-6.277, P＜0.001; stage Ⅲ to Ⅳ: HR=3.215, 95% CI: 1.324-7.806, P=0.010) and the DFS (stage Ⅰ to Ⅱb: HR=2.478 ,95% CI: 1.396-4.400, P=0.002; stage Ⅲ to Ⅳ: HR=2.248, 95% CI: 1.089-4.638, P=0.028) in the group with high expression of NETs in either stage Ⅰ to Ⅱb or stage Ⅲ to Ⅳ were significantly shorter than those in the group with low expression. Conclusion:The EGFR wild-type lung adenocarcinoma patients with high expression of NETs have relatively shorter DFS and OS, which are independent risk factors for the prognosis of patients with EGFR wild-type lung adenocarcinoma, and are likely to be the potential biomarkers for the diagnosis and treatment of EGFR wild-type lung adenocarcinoma.