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 compare the cost and efficacy of ambulatory versus hospitalized surgery for lung tumor patients. Methods Two researchers independently conducted a computer search on February 14, 2025, in databases including CNKI, PubMed, Web of Science, Ovid Medline, Cochrane Library, and Wanfang Database, with the search period covering from the inception of these databases to February 2025. The outcome indicators were postoperative complication rate, length of hospital stay, hospitalization costs, et al. For the included randomized controlled trials and non-randomized controlled trials, we used the Cochrane risk of bias assessment tool and the Newcastle Ottawa Scale (NOS) respectively to evaluate the quality of the literature, and extracted data from the included studies for meta-analysis using RevMan 5.4 and Stata 18.0. Results A total of 12 researches were ultimately included, consisting of 2 randomized controlled trials, 2 prospective cohort studies, and 8 retrospective cohort studies, involving a total of 76 403 patients. All researches were evaluated as high-quality. Meta-analysis showed that the ambulatory surgery group had advantages over the hospitalized surgery group in terms of operation time [MD=−21.07, 95%CI (−30.55, −11.58), P<0.001], length of hospital stay [MD=−2.17, 95%CI (−3.25, −1.09), P<0.001], hospitalization costs [SMD=−1.22, 95%CI (−2.18, −0.26), P=0.01], and overall postoperative complications [OR=0.48, 95%CI (0.32, 0.74), P<0.001]. There was no statistically significant difference between the two groups in terms of postoperative hoarseness [OR=0.62, 95%CI (0.24, 1.61), P=0.33] and postoperative chylothorax [OR=0.27, 95%CI (0.07, 1.07), P=0.06]. Conclusion Compared to conventional hospitalized lung tumor resection, ambulatory lung tumor resection can significantly reduce the patient’s surgery and hospital stay time, decrease hospitalization costs, and reduce the incidence of postoperative complications. Ambulatory surgery can improve hospital efficiency while reducing the economic burden on patients. It is worthy of further promotion and application.

Objective To explore the chain-mediating effect of anxiety and maladaptive coping strategies on perceived social support and post-traumatic stress disorder(PTSD)in primary caregivers of children with acute leukemia.Methods Two hundred primary care-givers of children with acute leukemia treated in the Pediatric Hematology Department of Shengjing Hospital of China Medical University between September 2022 and April 2023 were selected.A general information questionnaire,Perceived Social Support Scale,Self-Rating Anxiety Scale,Trait Coping Style Questionnaire,and Post-Traumatic Stress Disorder Checklist-Civilian Version were used for the survey.Pearson's correlation analysis was performed to determine the relationships between anxiety,maladaptive coping,perceived social sup-port,and PTSD.The chain-mediating effect was determined by structural equation modeling using Analysis of Moment Structures software and the Bootstrap method.Results PTSD was negatively correlated with perceived social support(r=-0.179,P＜0.05)and positively correlated with anxiety and maladaptive coping(r=0.762,P＜0.01;r=0.423,P＜0.01).Anxiety and maladaptive coping had chain-me-diating roles in the relationship between perceived social support and PTSD.Conclusion Perceived social support can indirectly affect the PTSD level of a caregiver through the chain-mediating effect of anxiety and maladaptive coping strategies.In clinical practice,enhancing caregivers perception of social support can alleviate anxiety,promote positive coping strategies,reduce negative coping strate-gies,and effectively reduce the risk of developing PTSD.

Objective:To research on the application effect of the supply-processing-distribution (SPD) model based on risk perspective in the management of low-value medical consumables of clinical departments in hospital,so as to improve management efficiency of hospital for low-value medical consumables. Methods:Risk points in the management of low-value medical consumables were identified based on a risk perspective,and the SPD mode was adopted to conduct collaborative management for low-value medical consumables in the hospital. Low-value medical consumables were used in clinical departments of the Hospital of Chengdu University of Traditional Chinese Medicine from October 2021 to November 2023 were selected. According to random number table,885 medical consumables were used from October 2021 to October 2022 were managed by using the conventional management model,and another 885 medical consumables were used from November 2022 to November 2023 were managed by using the SPD model based on a risk perspective. The management effect scores,performance evaluation results,management efficiency,and incidence of adverse situations of low-value medical consumables were compared between the two management modes. Results:The average scores of occurring problems and operation cost of low-value medical consumables in the SPD model group were respectively (15.14±2.06) and (20.44±3.16),which were lower than those in the conventional management model group,with statistically significant differences (t=84.009,92.863,P<0.05). The average scores of delivery timeliness,work efficiency,standardization,traceability of consumables,waste recycling of consumables,delivery satisfaction,and demand forecasting were respectively (97.14±10.11),(95.25±10.85),(89.65±12.54),(88.25±9.14),(94.14±10.22),(88.14±9.22),and (95.84±10.33) in the SPD model group,which were higher than those in the conventional management model group,with statistically significant differences (t=78.169,77.874,75.326,68.557,35.288,25.422,102.959,P<0.05). The average issuance time and replenishment time of low-value medical consumables in the SPD model group were respectively (6.11±0.72) min and (12.58±2.35) h,which were shorter than those in the conventional management model group,with statistically significant differences (t=54.129,122.343,P<0.05). The issuance accuracy rate and proportion of saved amount of low-value medical consumables in the SPD model group were respectively 98.76％ and 3.16％,which were higher than those in the conventional management model group,with statistically significant differences (x2=159.178,5.618,P<0.05). The number of issuance error and the proportion of expired consumables,invalid consumables or damaged consumables in the SPD model group were respectively 1.24％ and 0.90％,which were lower than those in the conventional management model group,with statistically significant differences (x2=159.178,23.792,P<0.05). The average time consuming of daily and monthly of low-value medical consumables in the SPD model group were respectively (0.29±0.02) h and (1.14±0.25) h,which were shorter than those in the conventional management model group,and the average number of monthly inventory backlog and average circulation time in the SPD model group were respectively (33.19±4.25) and (26.14±3.18) d,which were lower than those in the conventional management model group,with statistically significant differences (t=412.428,122.343,114.555,39.848,P<0.05). The incidence rates of unregistered use,unskilled operation,failure to enter data into the computer,carelessness during shift handovers,and loss of consumables of low-value medical consumables in the SPD model group were respectively 6.21％,7.12％,2.03％,2.26％ and 1.92％,which were lower than those in the conventional management model group,with statistically significant differences (x2=28.882,15.225,22.824,12.683,16.893,P<0.05). Conclusion:The application of the SPD model based on a risk perspective in the management of low-value medical consumables in clinical departments of hospital can reduce operating costs of hospital,and increase procurement efficiency for them,and enhance the level of refined management for low-value medical consumables.

Bispecific antibodies(BsAbs),as an important recent innovation in the field of tumor immunotherapy in recent years,can simultaneously or sequentially target different antigens or two different epitopes of the same antigen.Compared with traditional monoclonal antibodies,they can produce superior therapeutic effects.This article reviews the progress in clinical applications and safety research of BsAbs in cancer therapy,revealing that they(such as blinatumomab,glofitamab,teclistamab,amivantamab,etc.)exhibit significant therapeutic efficacy against hematological malignancies,lung cancer,cervical cancer,melanoma,and other cancers.For cytokine release syndrome(CRS)induced by BsAbs,prophylactic or pre-emptive medication is commonly administered in clinical practice;for neurotoxicity and infections triggered by BsAbs,clinical practice necessitates rigorous monitoring of patients'vital signs and the provision of essential treatments.In addition,different BsAbs exhibit variations in escalation dose,infusion rate,storage duration,and equipment requirements.Therefore,strict adherence to the instructions in the drug package inserts is essential during clinical operations to ensure safety and therapeutic efficacy.In the future,more multicenter trials need to be conducted to validate the efficacy and safety of BsAbs across different tumor types and patient populations,and long-term follow-up data should be accumulated to optimize treatment cycles and dosage regimens.

Objective To explore the chain-mediating effect of anxiety and maladaptive coping strategies on perceived social support and post-traumatic stress disorder(PTSD)in primary caregivers of children with acute leukemia.Methods Two hundred primary care-givers of children with acute leukemia treated in the Pediatric Hematology Department of Shengjing Hospital of China Medical University between September 2022 and April 2023 were selected.A general information questionnaire,Perceived Social Support Scale,Self-Rating Anxiety Scale,Trait Coping Style Questionnaire,and Post-Traumatic Stress Disorder Checklist-Civilian Version were used for the survey.Pearson's correlation analysis was performed to determine the relationships between anxiety,maladaptive coping,perceived social sup-port,and PTSD.The chain-mediating effect was determined by structural equation modeling using Analysis of Moment Structures software and the Bootstrap method.Results PTSD was negatively correlated with perceived social support(r=-0.179,P＜0.05)and positively correlated with anxiety and maladaptive coping(r=0.762,P＜0.01;r=0.423,P＜0.01).Anxiety and maladaptive coping had chain-me-diating roles in the relationship between perceived social support and PTSD.Conclusion Perceived social support can indirectly affect the PTSD level of a caregiver through the chain-mediating effect of anxiety and maladaptive coping strategies.In clinical practice,enhancing caregivers perception of social support can alleviate anxiety,promote positive coping strategies,reduce negative coping strate-gies,and effectively reduce the risk of developing PTSD.

Objective To analyze the global burden of disease and cross-national imbalances of tracheal,bronchial and lung cancer from 1990-2021 and to further predict changes up to 2040.Methods Age-standardised incidence rate(ASIR),prevalence rate(ASPR),mortality rate(ASMR),disability-adjusted life years rate(ASDR)and 95%confidence interval(95%UI)were extracted from GHDx.The official data platform of the institute for health metrics and evaluation(IHME)and the source of data were the Global Burden of Disease Study 2021(GBD 2021)for global burden of disease of trachea,bronchus and lung cancer.The estimated annual percentage change(EAPC)was calculated to describe the prevalence at global,regional and national levels,to understand the differences in diseases at different gender,age and socio-demographic index(SDI)levels,and to explore the overall situation through cluster analysis,cross-country health inequality analysis and to predict the future prevalence up to 2040 through Nordpred model.Results Globally,the ASIR for tracheal,bronchial and lung cancer fluctuated slightly from 1990 to 2009,and began to decline rapidly after 2009,with an ASIR of 26.42/100 000 in 2021.ASPR showed an increasing and then decreasing trend,reaching a peak in 2011,with a peak of 37.28/100 000 in 2021,while the ASMR and the ASDR showed a general decreasing trend.Tracheal,bronchial and lung cancer diseases showed the highest disease burden in men,those aged 65-74 and in countries and regions with high SDI.ASDR burden showed significant inequalities globally,with a significant positive correlation between ASDR and SDI,mainly concentrated in countries and regions with high SDI,and the unequal burden of ASDR for tracheal,bronchial and lung cancer decreases over time.Predictive analyses found that the number of new cases,current cases,deaths and disability-adjusted life years(DALY)for tracheal,bronchial and lung cancer were expected to increase through 2040,whereas ASIR,ASPR,ASMR and ASDR were projected to decrease each year.Conclusion The overall burden of tracheal,bronchial and lung cancer has declined globally from 1990 to 2021,but with demographic and regional differences.The actual number of cases will continue to climb in the future,despite the continuing decline in age-specified rates,and disease prevention and control will need to focus on growth trends and equity in resource allocation.

Objective To analyze the global burden of disease and cross-national imbalances of tracheal,bronchial and lung cancer from 1990-2021 and to further predict changes up to 2040.Methods Age-standardised incidence rate(ASIR),prevalence rate(ASPR),mortality rate(ASMR),disability-adjusted life years rate(ASDR)and 95%confidence interval(95%UI)were extracted from GHDx.The official data platform of the institute for health metrics and evaluation(IHME)and the source of data were the Global Burden of Disease Study 2021(GBD 2021)for global burden of disease of trachea,bronchus and lung cancer.The estimated annual percentage change(EAPC)was calculated to describe the prevalence at global,regional and national levels,to understand the differences in diseases at different gender,age and socio-demographic index(SDI)levels,and to explore the overall situation through cluster analysis,cross-country health inequality analysis and to predict the future prevalence up to 2040 through Nordpred model.Results Globally,the ASIR for tracheal,bronchial and lung cancer fluctuated slightly from 1990 to 2009,and began to decline rapidly after 2009,with an ASIR of 26.42/100 000 in 2021.ASPR showed an increasing and then decreasing trend,reaching a peak in 2011,with a peak of 37.28/100 000 in 2021,while the ASMR and the ASDR showed a general decreasing trend.Tracheal,bronchial and lung cancer diseases showed the highest disease burden in men,those aged 65-74 and in countries and regions with high SDI.ASDR burden showed significant inequalities globally,with a significant positive correlation between ASDR and SDI,mainly concentrated in countries and regions with high SDI,and the unequal burden of ASDR for tracheal,bronchial and lung cancer decreases over time.Predictive analyses found that the number of new cases,current cases,deaths and disability-adjusted life years(DALY)for tracheal,bronchial and lung cancer were expected to increase through 2040,whereas ASIR,ASPR,ASMR and ASDR were projected to decrease each year.Conclusion The overall burden of tracheal,bronchial and lung cancer has declined globally from 1990 to 2021,but with demographic and regional differences.The actual number of cases will continue to climb in the future,despite the continuing decline in age-specified rates,and disease prevention and control will need to focus on growth trends and equity in resource allocation.

Objective:To systematically integrate the real experiences of self-management in breast cancer-related lymphedema (BCRL) patients and provide evidence for optimizing home self-management support strategies.Methods:A computer-based search was conducted in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, and VIP Database for qualitative studies on self-management experiences in BCRL patients, with the search period extending from the inception of each database to November 30, 2023. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the results were synthesized using an integrative approach.Results:A total of 20 articles were included, with 87 research findings extracted and summarized into 11 new categories, which were integrated into 4 main outcomes: the psychological, family function, and social adaptation associated with lymphedema symptoms; the multiple factors affecting patients' self-management of lymphedema; varied levels of self-management participation and coping behaviors; diverse self-management support needs.Conclusions:Healthcare professionals need to address the barriers and needs of patients performing self-management of lymphedema at home. By integrating coping resources and enhancing self-regulation and self-management capabilities, healthcare providers can help patients adapt to and cope with lymphedema more effectively.

Objective To explore the clinical characteristics,antimicrobial resistance,virulence and molecular epi-demiology characteristics of carbapenem-resistant hypervirulent Klebsiella pneumoniae(CR-hvKP).Methods Car-bapenem-resistant Klebsiella pneumoniae(CRKP)strains isolated from clinical specimens in a tertiary first-class teaching hospital from 2018 to 2021 were collected.ST1 1 CR-hvKP strains were screened through the detection of antimicrobial resistance genes and virulence genes as well as multilocus sequence typing(MLST).Basic clinical in-formation,antimicrobial resistance genes and virulence genes were analyzed.Twenty-three strains of ST1 1 CR-hvKP were randomly selected for virulence phenotype analysis;45 strains of CR-hvKP were randomly selected for homology analysis by pulsed-field gel electrophoresis(PFGE).Results There were a total of 124 clinically isolated strains of ST11 CR-hvKP from 2018 to 2021,mainly from the department of neurosurgery(33.87％).The major specimen source was sputum(56.45％),the average age of infected patients were(55.2±16.4)years old,and the majority were male patients(77.42％).Antimicrobial susceptibility testing results showed these strains were resis-tant to most clinically commonly used antimicrobial agents.Virulence detection showed that virulence varied among these strains,but most of them were hypervirulence strains.PFGE analysis results showed that the strains were mainly subtype A1(63.4％).Conclusion ST1 1 CR-hvKP presents multidrug resistance and hypervirulence.Clonal transmission of some strains exists in this hospital,which poses great challenges for clinical anti-infection treatment as well as prevention and control.It is necessary to strengthen the prevention and control of healthcare-associated infection.