Objective:To investigate the current status of application of stereotactic body radiation therapy (SBRT) in China, aiming to provide reference for promoting the development of this technology.Methods:From January to March 2024, a questionnaire was designed and distributed online, targeting member units of the Professional Committee of Stereotactic Radiosurgery Treatment, which covers 175 radiotherapy units in 30 provinces and regions nationwide. The survey focused on the current application of SBRT technology and its utilization in the treatment of early-stage non-small cell lung cancer (NSCLC). A statistical description of the survey results was presented.Results:Of 175 questionnaires distributed, a total of 130 valid responses were collected, with an effective response rate of 74.3%. A total of 81.5% (106/130) of the units had implemented SBRT technology, and 99.1% of the respondents believed it was necessary to further promote SBRT technology, yet the actual training rate was only 67.0%. SBRT equipment configuration: there were a total of 267 SBRT equipment, featuring a diverse range of types, with traditional linear accelerators as the mainstays, accounting for 76.0% ( n=203), followed by 12.0% ( n=32) for TOMO, 6.4% ( n=17) for Cyber knife, 3.7% ( n=10) for Gamma knife, and proton/heavy ion equipment at 1.5% ( n=4), respectively. The percentage of units with multi-leaf collimator leaf widths ≤0.5 cm was 93.4% (99/106). The application of SBRT: the first radiotherapy unit commenced SBRT in 2000, and this technology entered a period of rapid growth after 2015, sustaining a steady increase over the past decade; SBRT technology was mainly applied in the brain, lung, liver, bone, adrenal gland, and kidney, with application rates of 97.2%, 94.3%, 86.8%, 71.7%, 56.6%, and 27.4%, respectively, while the application rates for the pancreas, metastatic lymph nodes, and other parts were less than 5%. Current status of SBRT technology application in early-stage NSCLC: 90.6% (96/106) of units had implemented SBRT; pre-treatment multi-disciplinary diagnosis and treatment accounted for 77% (74/96); the proportion of application units for peripheral and central type lung cancer lesions both exceeded 57.3%, whereas the application rate for ultra-central type and lesions > 5 cm lung cancer was less than 30%; there was significant variability in the selection of reference guidelines, dose fractionation patterns, and the concept of central type among units. Conclusions:The development of SBRT technology in China is in a period of steady growth, but several issues such as low training rate and lack of standardization still exist. The survey results provide important reference for clinical training and promotion of SBRT technology in China.

Efficacy evaluation of TCM syndromes is a core aspect of validating the clinical effectiveness of TCM.However,consensus has yet to be established regarding its conceptual definition,measurement tools,and methodological framework.This article reviewed the current state of research in TCM syndrome efficacy evaluation:Conceptually,there is a need to clarify the distinction between broad(encompassing all outcome measures highlighting the efficacy of treatment based on syndrome differentiation)and narrow(limited to syndrome-related indicators)definitions;in terms of content and methodology,it is essential to integrate macro-and micro-level indicator systems,standardize evaluation models that either combine or separate disease and syndrome diagnosis,and address the characteristics of dynamism,individualization,and holism;regarding measurement,challenges such as interference from disease factors and insufficient indicator matching persist in the development of scales,objectification of the four diagnostic methods(inspection,listening and smelling,inquiry,pulse-taking),and construction of mathematical models still exist.Future research directions may focus on the following:Enhancing a people-centered evaluation process through"co-construction by practitioners and patients";Establishing a primary framework centered on"guiding disease treatment by syndrome differentiation"to promote the quantification and precision of syndrome indicators(e.g.,state-target syndrome differentiation);Integrating multiple data sources to construct an evidence-based comprehensive evaluation system.By standardizing definitions,innovating tools,and integrating methodologies,the standardization and precision of TCM pattern efficacy evaluation research can be advanced.

Objective:To analyze the operational effectiveness of a multi-medication management and consultation service platform for elderly patients based on quality function deployment (QFD) and “Internet+”.Methods:It was a non-randomized controlled trial. A total of 100 elderly patients were selected from the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University from September to November 2023 with convenience sampling method. The medication management was carried out through the multiple medication management and counseling service platform for the patients based on QFD and “Internet+”. The core modules included reminder module, evaluation module, consultation module and popularization module. A self-designed satisfaction questionnaire was used to collect the satisfaction scores of hospital service quality, medication adherence, medication knowledge, and medication safety before and one month after the platform was implemented. A total of 100 questionnaires were distributed, and 100 valid questionnaires (100%) returned. The t-test was used to analyze the differences between the satisfaction scores before and after the operation of the platform to evaluate the operation effects. Results:Among the 100 elderly patients with multiple medications included in the analysis, 65 were male and 35 were female, 84 patients had a combination of ≥2 chronic diseases. The patients aged (68.73±5.99) years, and the number of medications they were taking was (7.65±1.04). The scores of hospital service quality, medication adherence, medication knowledge, and medication safety after the application of the platform were all significantly higher than those before the launch of the platform [(3.66±0.48) vs (2.91±0.70) points, (3.90±0.30) vs (1.30±0.46) points, (3.39±0.49) vs (3.02±0.63) points, (3.75±0.44) vs (1.48±0.59) points](all P<0.05). Conclusion:The multiple medication management and consultation service platform for elderly patients based on QFD and “Internet+” can enhance the scientific management of multiple medication in elderly patients, reduce the burden of medication, improve the quality of medical services, and promote the development of intelligent elderly care services.

Fetal malformation of cortical development(MCD)is a group of structural neurological disorders caused by abnormalities in development of cortical layer during embryogenesis,characterized by significant heterogeneity and diversity,which may lead to adverse clinical outcomes such as epilepsy and intellectual disabilities.The progresses in prenatal evaluation on fetal MCD were reviewed in this article.

INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Objective:This study aimed to investigate the characteristic expression of programmed death-ligand 2(PD-L2)and epithelial-mesenchymal transition(EMT)-related biomarkers in head and neck squamous cell carcinoma(HNSCC)and their mechanism of action in HNSCC metastasis.Methods:Tumor tissue samples from 94 patients with HNSCC were collected from Tianjin Medical University Cancer Hos-pital from January 2018 to July 2023,and their correlation with clinicopathological parameters,including lymph node metastasis,was statist-ically assessed.Western blot was used to detect PD-L2 expression in HNSCC tumor tissues.PD-L2 overexpression and knockdown stably-transfected monoclonal cell lines were generated using lentiviral vectors.Transwell assays were performed to explore the effect of PD-L2 on the invasive migration of the HNSCC cell lines.Additionally,RNA sequencing was used to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined by Western blot to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through EMT pathway activation.Additionally,RNA sequencing was employed to identify downstream target genes regulated by PD-L2.The expression levels of key EMT markers,including E-cadherin,N-cadherin,and Vimentin,were examined with Western blot analysis to elucidate the molecular mechanism by which PD-L2 promotes tumor cell metastasis through the EMT pathway activation.Results:High expression of PD-L2 is positively correlated with N staging(P<0.05),and elevated PD-L2 expression predicts a poor prognosis in HNSCC patients.Conclusions:PD-L2 regulates the EMT pathway to promote HNSCC metastasis.Targeting PD-L2 is expected to provide a new strategy for the treatment of metastatic HNSCC.

Objective:To analyze the operational effectiveness of a multi-medication management and consultation service platform for elderly patients based on quality function deployment (QFD) and “Internet+”.Methods:It was a non-randomized controlled trial. A total of 100 elderly patients were selected from the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University from September to November 2023 with convenience sampling method. The medication management was carried out through the multiple medication management and counseling service platform for the patients based on QFD and “Internet+”. The core modules included reminder module, evaluation module, consultation module and popularization module. A self-designed satisfaction questionnaire was used to collect the satisfaction scores of hospital service quality, medication adherence, medication knowledge, and medication safety before and one month after the platform was implemented. A total of 100 questionnaires were distributed, and 100 valid questionnaires (100%) returned. The t-test was used to analyze the differences between the satisfaction scores before and after the operation of the platform to evaluate the operation effects. Results:Among the 100 elderly patients with multiple medications included in the analysis, 65 were male and 35 were female, 84 patients had a combination of ≥2 chronic diseases. The patients aged (68.73±5.99) years, and the number of medications they were taking was (7.65±1.04). The scores of hospital service quality, medication adherence, medication knowledge, and medication safety after the application of the platform were all significantly higher than those before the launch of the platform [(3.66±0.48) vs (2.91±0.70) points, (3.90±0.30) vs (1.30±0.46) points, (3.39±0.49) vs (3.02±0.63) points, (3.75±0.44) vs (1.48±0.59) points](all P<0.05). Conclusion:The multiple medication management and consultation service platform for elderly patients based on QFD and “Internet+” can enhance the scientific management of multiple medication in elderly patients, reduce the burden of medication, improve the quality of medical services, and promote the development of intelligent elderly care services.

Objective:To investigate the effects of methylphenidate combined with exercise intervention on at-tention,self-awareness and problem behaviors in children with attention deficit hyperactivity disorder(ADHD).Methods:A retrospective analysis was conducted on 106 children with ADHD receiving methylphenidate treat-ment.Based on whether exercise intervention was applied,participants were divided into the joint intervention group(n=49)and the control group(n=57).The Integrated Visual and Auditory Continuous Performance Test,Piers-Harris Children's Self-Concept Scale,and Conners Parent Symptom Questionnaire(PSQ)were used to measure children's attention,self-awareness,and problem behaviors.Results:After intervention,children in the joint inter-vention group had shorter reaction time,fewer omissions and errors,and lower PSQ scores(in all dimensions except anxiety and depession)than those in the control group.Additionally,their scores on the full response control quo-tient,full attention quotient,auditory response control quotient,visual response control quotient,auditory attention quotient and visual attention quotient,and Piers-Harrisscores in each dimension were higher than those in the control group(Ps＜0.05).Conclusion:Methylphenidate combined with exercise intervention could effectively enhance at-tention and self-awareness of children with attention deficit hyperactivity disorder,and reduce problem behaviors.

Fetal malformation of cortical development(MCD)is a group of structural neurological disorders caused by abnormalities in development of cortical layer during embryogenesis,characterized by significant heterogeneity and diversity,which may lead to adverse clinical outcomes such as epilepsy and intellectual disabilities.The progresses in prenatal evaluation on fetal MCD were reviewed in this article.

Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279 743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2 500 g),normal birth weight(2 500-3 999 g),and macrosomia(≥4 000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.