Objective: Sentinel lymph node biopsy (SLNB) has improved detection of low-volume node metastasis (LVNM) in endometrial cancer (EC), but its prognostic significance and the need for adjuvant therapy (AT) remain unclear. Methods: A comprehensive search was performed until August 31, 2024 in multiple databases and sources. From 21 studies, 65,228 apparent early-stage EC patients were identified: 370 with macrometastases (MAC), 526 with micrometastases (MM), 2,138 with isolated tumor cells (ITCs), and 62,194 with negative nodes. Results: Findings indicated: 1) The MM group had a lower risk of recurrence or progression (R/P) than the MAC group (risk ratio [RR]=0.49; 95% confidence interval [CI]=0.31–0.78;p=0.002), higher risk than the negative nodes group (RR=2.07; 95% CI=1.59–2.68; p<0.001), and similar risk to the ITC group (RR=0.67; 95% CI=0.44–1.02; p=0.060). 2) The MM group had higher 3-year progression-free survival (PFS) (RR=1.36; 95% CI=1.21–1.52; p<0.001) and overall survival (OS) (RR=1.22; 95% CI=1.09–1.37; p<0.001) than the MAC group, similar to the ITC and negative nodes groups. 3) The ITC group had a lower R/P risk and higher 3-year PFS/OS than the MAC group, similar to the negative nodes group. 4) AT reduced the R/P risk in the MM group (RR=0.41; 95% CI=0.22–0.76; p=0.005) and increased 3-year OS in the ITC group (RR=1.06; 95% CI=1.04–1.08; p<0.001). Conclusion Early-stage EC with LVNM had better prognostic outcomes than MAC, and AT may improve outcomes of LVNM patients. More evidence from prospective randomized controlled trials is needed to confirm these findings due to the inherent biases of retrospective studies.

OBJECTIVE To evaluate the economics of serplulimab combined with chemotherapy regimens for the first-line treatment of extensive-stage small cell lung cancer （ES-SCLC） from the perspective of health system in China. METHODS A partitioned survival model was constructed based on the ASTRUM-005 clinical trial and related literature data， with a model simulation time frame of 10 years and a 3-week cycle， and both cost and utility values were discounted using a 5% discount rate. The quality-adjusted life year （QALY） was used as a model output indicator and the incremental cost-effectiveness ratio （ICER） was calculated to evaluate the economics of serplulimab combined with chemotherapy regimens （serplulimab group） versus chemotherapy alone regimens （chemotherapy alone group） for the first-line treatment of ES-SCLC. One-way sensitivity analysis and probabilistic sensitivity analysis were used to verify the robustness of the results of the base-case analysis and to conduct a scenario analysis for the serplulimab patient assistance program. RESULTS The results of the base-case analysis showed that compared with chemotherapy alone group， ICER of serplulimab group was 758 690.27 yuan/QALY， which was higher than 3 times China’s per capita gross domestic product （GDP） in 2022 as the willingness-to-pay （WTP） threshold. The results of the scenario analysis showed that compared with chemotherapy alone group， the ICER of serplulimab group was 172 275.74 yuan/QALY， which was below above WTP threshold. The one-way sensitivity analysis showed that the progress-free survival utility value， serplulimab price and so on had a significant impact on the model results. The results of the probabilistic sensitivity analysis showed that the probability of the serplulimab group being economic was 0 when the serplulimab patient assistance program was not considered， but 100% when the patient assistance program was considered. CONCLUSIONS At a WTP threshold of 3 times China’s per capita GDP in 2022， the serplulimab group is no cost-effectiveness compared to the chemotherapy alone group； however， this result is reversed when the patient assistance program is taken into account.

Objective: To examine the status of bullying behaviors and psychological resilience of primary school students and the relationship between the two, and to provide references for related interventions. Methods: Olweus bullying questionnaire and adolescent psychological resilience scale were used to select students in grades 4-6 for questionnaire survey. Results: Primary school students who were bullied, bullied others, double-involved and uninvolved accounted 33.3%, 48.7%, 15.3%, and 2.7%. There were statistically significant differences in bullying in different dimensions of different genders, grades, and previous suicidal thoughts (P<0.05); there were statistically significant differences in the bullied status of only children, divorced parents, and different caregivers (t/F=3.64，2.65，6.62，P<0.05); The status of bullying behavior of students in the class was better than that of ordinary students (t=-2.18, P<0.05); senior students have a higher level of positive cognition (F=8.71, P<0.05); mental toughness of urban students better than rural areas (t=-2.20, P<0.05); students with divorced parents had poor levels of emotional control, family support, and psychological toughness (t=-4.60，-3.92，-3.44，P<0.05); class cadres focused on focus, positive cognition, family support, interpersonal assistance, and psychological resilience were better than ordinary students (t=5.19，6.43,5.64,4.13，6.58，P<0.05); students with parental care had better levels of target concentration, emotional control, family support, interpersonal assistance, and psychological resilience (t=4.59，8.68，8.76，12.35，13.45，P<0.05); the level of psychological resilience of students was low (t=15.90，P<0.05). Correlation analysis shows that there was a negative correlation between bullying behavior and psychological resilience of all pupils (P<0.01), regression analysis showed that bullying behavior may had a negative prediction of mental resilience (F=128.37, R2=0.12, P<0.01). Conclusion The current situation of bullying behavior and mental resilience of grade 4-6 students is worrisome, and it is urgent to improve the current situation of bullying and psychological resilience of primary school students.

Objective To explore the influence of social support and coping style on body and mind symptoms of patients with laryngeal carcinoma. Methods SCL-90, SSRS and MCMQ were used for the questionnaire survey of 168 patients with laryngeal carcinoma. Results The result of SCL-90 showed that all items were higher than those of norm in China, except the interpersonal relationship sensitivity and psychotic symptoms. The result of SSRS showed that the total score of social support was higher than that of norm, while the availability of support was obviously lower than that of norm. The result of MCMQ showed that avoidance and submissiveness were used frequently in patients, and avoidance was negatively correlat-ed with the factors of psychology. Conclusions Before the nursing plan and health consultation are set for patients with laryngeal carcinoma, the patients' social support should be used sufficiently, and the effect of coping style on patients' mental health should be evaluated.