Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Objective To develop the assessment scale of proactive health behavior ability for the disabled elderly in nursing homes and to test its reliability and validity.Methods The first draft of the scale was formed by literature review,qualitative interviews and Delphi method.From December 2023 to March 2024,525 disabled elderly people from 9 nursing homes in Sichuan Province and Chongqing City were selected as the survey subjects,and item analysis and reliability and validity test were carried out on the scale.30 disabled elderly people were re-investigated after 2 weeks to calculate the retest reliability of the scale.Results The scale consisted of 4 dimensions and 27 items.Exploratory factor analysis extracted 4 common factors,with the cumulative vanance contribution rate of 65.992％,and confirmatory factor analysis showed that the modified model fitting index was within acceptable range.The content validity index at item level was 0.917-1.000,and that at scale level was 0.997.The Cronbach's α coefficient,test-retest reliability and split-half reliability of the total scale were 0.944,0.997 and 0.882,respectively.Conclusion The scale has good reliability and validity,and it can be used to evaluate the proactive health behavior ability of the disabled elderly in nursing homes.

Objective:To assess the influence of age on the safety of propofol mono-sedation for adult patients undergoing painless gastroscopy.Methods:A retrospective study was conducted on data of 321 patients scheduled for painless gastroscopy with propofol mono-sedation. According to the age, patients were divided into youth group (116 cases, 18-44 years), middle-aged group (103 cases, 45-59 years) and elderly group (102 cases, 60-80 years). The procedure time, the total dosage of propofol, the occurrence of airway obstruction or hypoxemia, the use of airway interventions including airway opening maneuvers and facemask ventilation, lowest SpO 2, adverse cardiovascular events (including hypertension, hypotension, tachycardia, and bradycardia), and the use of ephedrine during painless gastroscopy were observed. Results:There was significant difference regarding the total dosage of propofol among youth group (173.2±47.0 mg), middle-aged group (158.8±41.3 mg) and elderly group (137.8±26.3 mg) ( F=21.761, P<0.001). The total dosage of propofol was significantly lower in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017), and that in the middle-aged group was significantly lower than that in the youth group ( P<0.017). The incidence of hypoxemia was 12.9% (15/116) in the youth group, 15.5% (16/103) in the middle-aged group and 25.5% (26/102) in the elderly group, with significant difference among three groups ( χ2=5.711, P=0.017). Moreover, the incidence of hypoxemia was significantly higher in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017). The incidences of hypotension, bradycardia and total adverse cardiovascular events were 5.2% (6/116), 4.9% (5/103) and 11.8% (12/102), 1.7% (2/116), 2.9% (3/103) and 7.8% (8/102), and 11.2% (13/116), 10.7% (11/103) and 20.6% (21/102) respectively in youth, the middle-aged and the elderly group. There were no significant differences in the above indicators among the three groups ( P>0.05). However, compared with those of the young and the middle-aged patients, the occurrence of hypotension, bradycardia and total adverse cardiovascular events in the elderly patients were on the rise. There were no significant differences among the three groups in other indices( P>0.05). Conclusion:Total dosage of propofol may need to be decreased gradually with the increase of age of patients undergoing gastroscopy with propofol mono-sedation. Compared with young and middle-aged patients, elderly patients have a significantly higher incidence of hypoxemia, with a tendancy of total adverse cardiovascular events increase, so the safety of painless gastroscopy is reduced for these patients.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To investigate the relationship of plasma concentration of NT-proBNP,copeptin and glasgow coma scale(GCS)scores,hematoma volumes in patients with acute cerebral hemorrhage.Methods 109 patients with acute cerebral hem-orrhage(the cerebral hemorrhage group)and 32 healthy individuals (the control group)admitted in our hospital from December 2011 to June 2013 were selected and detected for plasma NT-proBNP and copeptin.The levels of NT-proBNP,copeptin,glasgow co-ma scale(GCS)scores and hematoma volumes were compared between the two groups.Results The levels of plasma NT-proBNP and copeptin in the cerebral hemorrhage group were significantly higher than that in control group(P <0.05).The levels of plasma NT-proBNP and copeptin were significantly increased with the severity and the hematoma volume of the acute cerebral hemorrhage. The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes(r=0.63,r=0.58,P <0.01)and negative-ly correlated with Glasgow Coma Scale(GCS)scores(r=-0.52,r=-0.46,P <0.01).Conclusion The levels of NT-proBNP and copeptin are positively correlated with hematoma volumes and negatively correlated with glasgow coma scale(GCS)scores.They are important clinical parameters to reflect the severity and hematoma volumes of the acute cerebral hemorrhage.

Objective To study the risk factors of intracranial hemorrhage after endovascular therapy of cere-bral arteriovenous malformations embolization.Methods the clinical records and images of 230 patients with cAVMs were retrospectively reviewed.Patients with intracranial hemorrhage after endovascular therapy in 3 days were recorded and the risk factors of hemorrthage by using multivariate logistic regression for guiding the treatment strategy were studied.Results There were 15 patients occurred intracerebral hemorrhages.After treatment the area of cAVMs was significantly smaller than that before treatment[(2.18 ±0.91)cm vs (6.67 ±1.56)cm],the difference lvas a statis-tically significant (t =9.627,P <0.05).A partial AVM reduction of ≥36.5%(P =0.031)and hypertension(P =0.025)were considered as risk factors for hemorrhage after endovascular therapy of cAVWs.Conclusion Patients receives a partial AVMreduction of ≥36.5% or with hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.It's helpful for preventing intracerebral hemorrhage if the arterial blood pressure maintains after endovascular therapy.

Objective To investigate that the relationship of serum concentration of copeptin ,procalcitonin(PCT )and early diagnosis ,prognosis in patients with cerebral hemorrhage‐associated pulmonary infection .Methods One hundred and twenty pa‐tients with acute cerebral hemorrhage ,acute cerebral hemorrhage‐associated pulmonary infection and 60 healthy individuals (the control group) admitted in our hospital from January 2012 to December 2013 were selected and detected for serum copeptin and procalcitonin .The differences of serum copeptin ,procalcitonin levels were compared in controls ,in patients with cerebral hemor‐rhage and cerebral hemorrhage‐associated pulmonary infection and their correlation was analyzed .Results The levels of serum copeptin in the cerebral hemorrhage‐associated pulmonary infection were significantly higher than that in control group and the cer‐ebral hemorrhage (P<0 .05) .The levels of serum procalcitonin in control group and the cerebral hemorrhage were significantly lower than that in the cerebral hemorrhage‐associated pulmonary infection ,the levels of serum C‐reactive protein ,copeptin ,procalci‐tonin and the APACHEⅡ scores of the patients with survival group were significantly lower than those with non‐survival group (P<0 .05) .Conclusion The levels of serum copeptin and procalcitonin are correlated intimately with cerebral hemorrhage‐associat‐ed pulmonary infection .They are important clinical parameters to reflect the early diagnosis and prognosis of cerebral hemorrhage‐associated pulmonary infection .

PURPOSE: In the present study, we investigated the incidence of cardiotoxicity within 5 years of trastuzumab treatment and evaluated potential risk factors in clinical practice. METHODS: The study cohort included 415 patients diagnosed with early breast cancer (EBC). Cardiotoxicity incidence was evaluated in patients receiving trastuzumab and those who did not. Multivariate Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals of potential risk factors for trastuzumab-related cardiotoxicity after appropriate adjustments. RESULTS: Incidence of cardiotoxicity in patients treated with trastuzumab was significantly higher than that in controls (23.7% vs. 10.8%, p<0.001). This result was adjusted for factors that might increase the risk of cardiotoxicity, such as history of coronary artery diseases or the use of anthracyclines for more than four cycles. CONCLUSION: Our findings indicated that treatment with trastuzumab was strongly associated with cardiotoxicity in EBC patients.
Anthracyclines ; Breast Neoplasms* ; Cohort Studies ; Coronary Artery Disease ; Humans ; Incidence ; Observational Study* ; Prospective Studies* ; Risk Factors ; Trastuzumab

Objective To evaluate the expression of human kallikrein10 (KLK10) in different endometrioid tissues and analyse the relationship of KLK10 with ER and PR in endometrioid adenoearcinoma.Methods The expression of KLK10 protein in 12 normal endometria,19 endometrial hyperplasia and 34 endometrial carcinoma were detected by immunohistochemistry.The correlations of the expression of KLK10 protein,ER and PR were analyzed.Results The expression of KLK10 in stage Ⅰ,Ⅱ and Ⅲ were 64.3 ％(9/14),30.0 ％ (3/10),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in endometrial carcinoma,normal endometria,endometrial hyperplasia were 66.7 ％ (8/12),33.3 ％(4/12),10.0 ％ (1/10),and the difference was statistically significant (P ＜ 0.05).The expression of KLK10 in G1,G2,G3 were 66.7 ％,33.3 ％,10.0 ％,and the difference was statistically significant (P ＜ 0.05).The positive rate of KLK10 expression was 38.2 ％ and the positive rates of ER and PR expression were 67.6 ％and 55.9 ％,respectively,in 34 endometrial carcinoma.The expression of KLK10 was positively correlated with ER and PR expression (x2 =0.448,P ＜ 0.01).Conclusion Absence or down-regulated expression of KLK10 may play an important role in the formation and development of endometrioid adenocarcinoma.The low expression of KLK10 is correlated with low expression of ER and PR in endometrioid adenocarcinoma.The positive expression of KLK00,ER and PR predicts a better prognosis.

Objective To investigate the correlation between plasma homoeysteine (HCY) level and coronary-heart disease (CHD). Methods 117 patients with coronary heart disease (CHD group) and 50 healthy controls (control group) were involved in the investigation. Plasma total HCY level was measured with enzymatic cycling assay. According to the clinical types, CHD cases were divide dinto stable angina pectoris (SAP) group (n = 35), unstable angina pectoris (UAP) group (n = 39) and acute myocardial infarction (AMI) group (n=43). Based on coronary angiography, the CHD cases were further divided into single-vessel (n = 31 ), double-vessel (n = 40) and triple-vessel (n = 46) groups. Results 1 ) Plasma HCY level was significantly higher in CHD group than that in control group (P<0. 01). 2) Plasma HCY level was associated with clinical types, higherst in AMI group, followed by that of UAP group, SAP group, healthy control group. There was statistical difference of HCY level between SAP group and UAP group, SAP group and AMI group, UAP group and AMI group (P<0. 01). 3) Plasma HCY level was gradually elevated in single-vessel, double-vessel and tri- ple-vessel group. There was statistical difference of HCY level between single-vessel group or double- vessel group and triple-vessel group (P<0.01). There was significant difference between single-vessel group and double-vessel group (P>0.05). Conclusion Plasma HCY level is elevated in patients with CHD, and elevated HCY is associated with increased number of stenotic coronary arteries. As a risk factor for CHD, HCY is closely associated with the occurrence and development of CHD.