Effective symptom management can alleviate the physical and psychological distress experienced by patients with cancer, improve quality of life, and contribute to treatment adherence and improve clinical outcomes. However, most existing guidelines are developed for healthcare professionals, and patients and the public have limited access to standardized and comprehensible guidance on symptom management. To address this gap and to facilitate effective communication and shared decision-making, this study proposes the development of a patient version of the cancer symptom management guideline. The development process will adhere to the methodological framework recommended by the Guidelines International Network and the World Health Organization. The GRADE approach will be employed to assess the certainty of evidence and to formulate recommendations. In addition, the process will be informed by the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) instrument and the Reporting Items for Practice Guidelines in Healthcare-Public or Patient Versions of Guidelines (RIGHT-PVG). This protocol outlines the establishment of the guideline working group, the identification and prioritization of key questions, evidence retrieval and appraisal, and the formulation of recommendations, with the aim of ensuring methodological rigor and transparency in the development of the patient guideline and providing methodological reference for similar guideline initiatives.

Objective To evaluate answers to typical clinical questions related to neuro-ophthalmology generated by Artificial Intelligence(AI)Large Language Models(LLM)and to explore the performance of neuro-ophthalmology-related questions on LLM in a multidimensional manner using objective and expert assessment.Methods Multicenter,random-ized,cross-sectional pilot study.Thirty typical questions related to neuro-ophthalmology were selected based on four per-spectives:definition,etiology,clinical manifestations and signs,and treatment and prognosis,and were analyzed quantita-tively using Deepseek,Wenxin Yiyin 4.0,Doubao,and Kimi 1.5,which are four open-source LLMs in China,and quantita-tively analyzed with objective assessment;and quantitatively rated by three ophthalmologists using expert assessment for 120 answer texts.Three ophthalmology experts quantitatively scored the 120 answer texts.Three ophthalmologists quantita-tively scored the 120 answer texts.Level 3,5,and 4 Likert scales were developed according to the completeness,accura-cy,professionalism,relevance,and criticality of the question texts,respectively.The best-performing LLM was selected,and its performance was observed across the four types of questions.Additionally,three other experts assessed whether the best-performing one could be evaluated as a substitute for real-world doctor-patient communication.Results In the objective Chinese text reading difficulty analysis,the differences in total word count among the four LLMs were statistically significant(all P＜0.001).Of the four LLMs,Kimi 1.5 performed the best,with frequencies of 61％,29％,and 41％for the highest scores in completeness(3),accuracy and professionalism(5),and relevance and usefulness(4),respective-ly.Kimi 1.5 performed more consistently on the questions on the four areas of neuro-ophthalmologic disorders:definition,etiology,clinical manifestations and signs,treatment,and prognosis,with no between-group differences(P＞0.05).Con-clusion Chinese language LLMs have great potential in the clinical application of neuro-ophthalmology.Kimi 1.5 outper-forms other LLMs in terms of completeness,accuracy,professionalism,relevance,and usefulness,but it still cannot re-place real-world doctor-patient communication.There is a need to explore new diagnostic and therapeutic model of AI+physician in the future.

Objective To evaluate answers to typical clinical questions related to neuro-ophthalmology generated by Artificial Intelligence(AI)Large Language Models(LLM)and to explore the performance of neuro-ophthalmology-related questions on LLM in a multidimensional manner using objective and expert assessment.Methods Multicenter,random-ized,cross-sectional pilot study.Thirty typical questions related to neuro-ophthalmology were selected based on four per-spectives:definition,etiology,clinical manifestations and signs,and treatment and prognosis,and were analyzed quantita-tively using Deepseek,Wenxin Yiyin 4.0,Doubao,and Kimi 1.5,which are four open-source LLMs in China,and quantita-tively analyzed with objective assessment;and quantitatively rated by three ophthalmologists using expert assessment for 120 answer texts.Three ophthalmology experts quantitatively scored the 120 answer texts.Three ophthalmologists quantita-tively scored the 120 answer texts.Level 3,5,and 4 Likert scales were developed according to the completeness,accura-cy,professionalism,relevance,and criticality of the question texts,respectively.The best-performing LLM was selected,and its performance was observed across the four types of questions.Additionally,three other experts assessed whether the best-performing one could be evaluated as a substitute for real-world doctor-patient communication.Results In the objective Chinese text reading difficulty analysis,the differences in total word count among the four LLMs were statistically significant(all P＜0.001).Of the four LLMs,Kimi 1.5 performed the best,with frequencies of 61％,29％,and 41％for the highest scores in completeness(3),accuracy and professionalism(5),and relevance and usefulness(4),respective-ly.Kimi 1.5 performed more consistently on the questions on the four areas of neuro-ophthalmologic disorders:definition,etiology,clinical manifestations and signs,treatment,and prognosis,with no between-group differences(P＞0.05).Con-clusion Chinese language LLMs have great potential in the clinical application of neuro-ophthalmology.Kimi 1.5 outper-forms other LLMs in terms of completeness,accuracy,professionalism,relevance,and usefulness,but it still cannot re-place real-world doctor-patient communication.There is a need to explore new diagnostic and therapeutic model of AI+physician in the future.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective:To assess the feasibility of shear wave elastography (SWE) in differentiating inflammatory and fibrotic strictures in Crohn's disease (CD) .Methods:A cross-sectional survey study was conducted. The patients with stricture-type CD who underwent SWE examination at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to June 2023 were continuously collected. The general data, laboratory examination indicators, and ultrasound examination indicators were collected. Laboratory examination indicators included C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Ultrasound examination indicators included intestinal wall thickness, proximal bowel dilation, intestinal wall layer structure, Limberg grading, and the elasticity indicator SWE value. Patients were divided into inflammatory stricture group and fibrotic stricture group by using a modified fibrosis score of the narrowed intestine. Statistical analysis was performed to compare the differences in clinical data between the two groups, and Spearman correlation analysis was used to evaluate the correlation between ultrasound indicators and fibrosis score. Receiver operating characteristic (ROC) curves were plotted, and the diagnostic efficacy of SWE for inflammatory stricture and fibrotic stricture was calculated.Results:A total of 60 CD patients [44 men, 16 women; mean age, 34.3 ± 11.1 years; mean disease duration 60 (24, 117) months] were included. There were 43 patients in the inflammatory stricture group and 17 in the fibrotic stricture group. The differences in CRP ( P = 0.049), intestinal wall thickness ( P = 0.020), intestinal wall layer structure ( P = 0.001), and SWE value ( P < 0.001) between the two groups were statistically significant, but the differences in other indicators were not statistically significant (all P > 0.05). Intestinal wall thickness, intestinal wall layer structure, and SWE value were all positively correlated with fibrosis scores (all r s >0.3). In distinguishing inflammatory stricture from fibrotic stricture, a cut-off value of 15.9 kPa for SWE value yielded a sensitivity of 0.824, a specificity of 0.791, and the area under curve was 0.850 (95% CI: 0.740~0.952, P<0.001) . Conclusion:SWE examination can be used for the differential diagnosis of inflammatory and fibrotic strictures in CD, providing more diagnostic evidence for patients with stricture-type CD.

Objective:To assess the feasibility of shear wave elastography (SWE) in differentiating inflammatory and fibrotic strictures in Crohn's disease (CD) .Methods:A cross-sectional survey study was conducted. The patients with stricture-type CD who underwent SWE examination at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to June 2023 were continuously collected. The general data, laboratory examination indicators, and ultrasound examination indicators were collected. Laboratory examination indicators included C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Ultrasound examination indicators included intestinal wall thickness, proximal bowel dilation, intestinal wall layer structure, Limberg grading, and the elasticity indicator SWE value. Patients were divided into inflammatory stricture group and fibrotic stricture group by using a modified fibrosis score of the narrowed intestine. Statistical analysis was performed to compare the differences in clinical data between the two groups, and Spearman correlation analysis was used to evaluate the correlation between ultrasound indicators and fibrosis score. Receiver operating characteristic (ROC) curves were plotted, and the diagnostic efficacy of SWE for inflammatory stricture and fibrotic stricture was calculated.Results:A total of 60 CD patients [44 men, 16 women; mean age, 34.3 ± 11.1 years; mean disease duration 60 (24, 117) months] were included. There were 43 patients in the inflammatory stricture group and 17 in the fibrotic stricture group. The differences in CRP ( P = 0.049), intestinal wall thickness ( P = 0.020), intestinal wall layer structure ( P = 0.001), and SWE value ( P < 0.001) between the two groups were statistically significant, but the differences in other indicators were not statistically significant (all P > 0.05). Intestinal wall thickness, intestinal wall layer structure, and SWE value were all positively correlated with fibrosis scores (all r s >0.3). In distinguishing inflammatory stricture from fibrotic stricture, a cut-off value of 15.9 kPa for SWE value yielded a sensitivity of 0.824, a specificity of 0.791, and the area under curve was 0.850 (95% CI: 0.740~0.952, P<0.001) . Conclusion:SWE examination can be used for the differential diagnosis of inflammatory and fibrotic strictures in CD, providing more diagnostic evidence for patients with stricture-type CD.

The polyfoliate perforator flap is a new type of flap that was developed on the basis of the traditional polyfoliate myocutaneous flap, polyfoliate fascial flap and perforator flap. It overturns the traditional idea that the deep fascial vascular network is the fundamental for a survival of the flap, and enables the flaps to achieve the best profile and function of the recipient areas with minimal damage to the donor area. In order to improve the understanding of the polyfoliate perforator flap and further standardise its clinical application, this paper forms a consensus on the definition, classification, indications, operative points and precautions of the polyfoliate perforator flap, so as to provide references in diagnosis and treatment process and practical application for the surgeons.

Objective To investigate the effects of urinary ostomy bag connected with disposable drainage bag on drainage of abdominal cavity after surgery on gastrointestinal tumor.Methods A total of 82 patients carried out drainage of the abdominal cavity after surgery on gastrointestinal tumor in Cancer Hospital of Jiangxi Province from January to December 2015 were selected and divided into control group (n=40) and observation group (n=42).During the period of abdominal cavity drainage,the control group was given routine dressing change.In addition to the conventional treatment of the drainage incision,the observation group utilized urinary ostomy bag connected with disposable drainage bag for drainage.The incidence rates of leakage and irritable dermatitis around abdominal drainage mouth,dressing times of drainage incision,healing time of drainage incision and patient comfort in drainage were compared between the two groups.Results At the end of abdominal cavity drainage,the incidence rates of leakage and irritable dermatitis around abdominal drainage mouth of the observation group were significantly lower than those of the control group (x2 =5.550,6.717;P=0.043,0.010);the dressing times of drainage incision in the observation group was significantly less than that in the control group (t=13.840,P=0.000);the healing time of drainage incision in the observation group was significantly shorter than that in the control group (t=6.854,P=0.000);the comfort in the observation group was significantly higher than that in the control group 0=7.429,P=0.000).Conclusion Urinary bag connected with disposable drainage bag for drainage after surgery on gastrointestinal tumor can effectively reduce the occurrence of leakage and irritable dermatitis around abdominal drainage mouth,improve patient comfort,it is worthy of clinical promotion.

The effects of tanshinone IIA on the proliferation of the human non-small cell lung cancer cell line A549 and its possible mechanism on the VEGF/VEGFR signal pathway were investigated. The exploration of the interaction between tanshinone IIA and its target proteins provides a feasible platform for studying the anticancer mechanism of active components of herbs. The CCK-8 assay was used to evaluate the proliferative activity of A549 cells treated with tanshinone IIA (2.5-80 μmol/L) for 24, 48 and 72 h, respectively. Flow cytometry was used for the detection of cell apoptosis and cell cycle perturbation. VEGF and VEGFR2 expression were studied by Western blotting. The binding mode of tanshinone IIA within the crystal structure of the VEGFR2 protein was evaluated with molecular docking analysis by use of the CDOCKER algorithm in Discovery Studio 2.1. The CCK-8 results showed that tanshinone IIA can significantly inhibit A549 cell proliferation in a dose- and time-dependent manner. Flow cytometry results showed that the apoptosis rate of tested group was higher than the vehicle control, and tanshinone IIA-treated cells accumulated at the S phase, which was higher than the vehicle control. Furthermore, the expression of VEGF and VEGFR2 was decreased in Western blot. Finally, molecular docking analysis revealed that tanshinone IIA could be stably docked into the kinase domain of VEGFR2 protein with its unique modes to form H-bonds with Cys917 and π-π stacking interactions with Val848. In conclusion, tanshinone IIA may suppress A549 proliferation, induce apoptosis and cell cycle arrest at the S phase. This drug may suppress angiogenesis by targeting the protein kinase domains of VEGF/VEGFR2.

Objective To study the effect of a new mucA gene mutation on the biofilm formation process and the morphology of matured biofilm of Pseudomonas aeruginosa. Methods The mucA gene of PAO1 was cloned into the Pseudomonas aeruginosa expression plasmid pUCP20. The recombinant plasmid was transformed to mucoid PA17 which contained a new mucA mutation. Positive clones of the plasmids were identified by enzyme digestion and sequencing. The expression levels of algD in the positive clones were assessed by semi-quantitative RT-PCR. The modified plate culture method was used to establish the biofilm models of PA17, PA17 with recombinant plasmid and PAO1 in vitro. Results Transformation was identified by the decreased expression of algD in positive clones. The rate of biofilm formation of the positive clones was between those of PAO1 and PA17. The irreversible adhesion occurred after 8 h and the matured biofilm was observed on day 6. The morphologies of PA17, PAO1 and PA17 with recombinant plasmid were the same. Conclusion The mucA gene mutation of PA17 delays the formation of irreversible adhesion of PA17 biofilm, but it has no effect on the morphology of matured biofilm.