OBJECTIVE To evaluate the efficacy and safety of apatinib combined with PD-1/PD-L1 inhibitors in the treatment of malignant solid tumors. METHODS Randomized controlled trials （RCTs） on apatinib combined with PD-1/PD-L1 inhibitors （combination group） versus monotherapy （apatinib or PD-1/PD-L1）combined with （or） chemotherapy/other treatments （control group） in the treatment of malignant solid tumors were collected from PubMed， Web of Science， Embase， Cochrane Library， CNKI， VIP， Wanfang Data and China Biomedical Literature Database. The search time limit was from the establishment of the databases to May 2025. After literature screening， data extraction and literature quality evaluation， meta-analysis was performed using RevMan 5.3 and Stata 14.0. RESULTS A total of 28 RCTs involving 2 974 patients were included. The objective response rate [RR＝1.639， 95%CI（1.452，1.851）， P＜0.000 01]， disease control rate [RR＝1.284， 95%CI（1.178，1.399）， P＜0.000 01] and CD3+， CD4+， CD4+/CD8+ as well as the incidence of ADR such as hypertension， fatigue， proteinuria， thrombocytopenia were significantly higher in the combination group than control group （P＜0.05 or P＜0.000 01）. The progressive disease rate [RR＝ 0.497， 95%CI（0.437， 0.566）， P＜0.000 01] and serum tumor + marker levels and CD8 were significantly lower in the combination group than control group （P＜0.05 or P＜0.000 01）. Subgroup analysis results of different types of tumors showed that the objective response rate and disease control rate were significantly higher in the combination group than control group （P＜0.05）. The results of sensitivity analysis showed that the stability of this study was good. The results of publication bias analysis showed that there was a high possibility of publication bias in this study. CONCLUSIONS Apatinib combined with PD-1/ PD-L1 inhibitors has a significant efficacy in the treatment of different types of tumors， but attention should be paid to the occurrence of hypertension， fatigue， proteinuria and thrombocytopenia.

BACKGROUND: Despite some studies identifying a potential association between obesity and chronic obstructive pulmonary disease (COPD) risk, previous research had overlooked the dynamic nature of body weight over time, leading to inconsistent findings. The purpose of this study is to elucidate the relationship between adult weight change and COPD risk by adjusting for potential confounding factors. METHODS: We conducted a retrospective analysis using data from ten NHANES cycles (1999-2018), including adults aged 40-74 years. Weight change patterns were assessed using BMI at three time points and classified into five categories per period. Absolute weight change was also grouped into five levels. Multivariate logistic regression models, incorporating sampling weights, were used to examine associations between weight change and COPD, adjusting for demographic and lifestyle covariates. RESULTS: Compared with participants who maintained normal weight, stable obesity participants had increased risk of COPD from age 25 years to 10 years before the survey (OR = 1.45, 95% CI = 1.15 to 1.83), in the 10 years period before the survey (OR = 1.75, 95% CI = 1.47 to 2.08), and from age 25 years to survey (OR = 1.84, 95% CI = 1.46 to 2.31). Three periods indicate that weight gain in adulthood was associated with risk of COPD. In addition, substantial weight gain of more than 20 kg was associated with a higher risk of COPD. In stratified analyses, we also observed a more significant association between weight change and the risk of COPD in never smokers compared to former smokers. CONCLUSIONS Our study suggested that stable obesity and weight gain in adulthood were associated with an increased risk of COPD compared to those who maintain a normal weight, and that the association between weight gain and the incidence of COPD appears closer in patients who have never smoked.
Humans ; Pulmonary Disease, Chronic Obstructive/etiology* ; Middle Aged ; Male ; Female ; Adult ; Aged ; Retrospective Studies ; Weight Gain ; Obesity/complications* ; Risk Factors ; United States/epidemiology* ; Nutrition Surveys ; Body Mass Index

Heart development protein with EGF-like domains 1 (HEG1) is a novel mucin-like membrane protein with a long O-glycosylation region and EGF domain. HEG1 plays critical roles in embryo development and cardiogenesis, and is closely related to the occurrence and progression of malignant tumors. Here this article demonstrates the research progress on HEG1 in cardiovascular formation and tumor development in recent years, to inspire new ideas for the pathogenesis, diagnosis and treatment of related diseases.

Objective To analyze the situation and study trend of large-scale nurses'health cohort studies based on Web of Science,to help design clinical guidelines and scientific research for nursing staff in China.Methods Articles of large nurses'health cohort studies published from 1993 to 2023 were retrieved from Web of Science(WOS)Core Collection.Citespace and Bibilometrix were used to perform the bibliometric analysis.Results 2882 studies were included in this study.Total volume of papers was enlarging by year.Clustering results showed that the main keywords could be divided into 3 categories:risks of women's health,risks of cardiovascular disease and reproducibility.Results of keywords burst showed that lifestyle,cardiovascular disease,women reproductive health and mental health were the highlights of studies in recent 5 years.Conclusion Research on large-scale nurse health cohorts holds significant scientific significance.It is recommended to establish a nationwide large-scale nurse health cohort as soon as possible.In the study,appropriate exposure factors should be selected,with reproductive health,mental health,and psychiatric disorders being the primary outcome measures,and chronic physical illnesses being the secondary outcome measures.By systematically describing the factors influencing the physical and mental health of nurses in China,we can better safeguard their well-being and promote the development of the nursing discipline.

Nursing care,as an important part of the healthcare system,is vital to promoting people's health and improving the level of medical and healthcare services.At present,nursing in China faces challenges such as talent shortage,uneven service quality and insufficient service supply,as well as opportunities such as growing demand for nursing services and diversification of service modes.To better address the challenges and seize the opportunities,the National Health Commission and the State Administration of Traditional Chinese Medicine have jointly issued the"Action Plan for Further Improving Nursing Services(2023-2025)"(hereinafter referred to as the"Action Plan").The article discusses how the Action Plan should be implemented from 3 aspects:focusing on the overall development and scientific management of nursing personnel,enhancing the level of humanisation and personalisation of nursing services,strengthening the intelligent construction of nursing services,and promoting the socialisation and universality of services,so as to provide an opportunity for comprehensively promoting the construction of nursing personnel and the quality development of nursing work in the new era,and improving people's health.It discusses how to implement the Action Plan and put forward ideas to comprehensively promote the construction of the nursing team and nursing work in the new era,and improve people's health and quality of life.

Objective To construct an evidence-based practice model for nurses in preventing deep vein thrombosis(DVT)and provide a scientific and targeted theoretical basis for nurses to carry out evidence-based nursing practice in DVT prevention.Methods Based on the previous evidence-based nursing practice project on DVT prevention after hip and knee arthroplasty,the research team used theoretical analysis and brainstorming to develop a draft of the work model.Expert meetings were organized to validate the content of the draft using the Delphi method,leading to the finalization of the evidence-based practice model for nurses in preventing DVT.Results The Knowledge-to-Action(KTA)framework was selected as the basic framework for constructing the evidence-based nursing practice model for preventing DVT.Theoretical Domain Framework,Theory of Planned Behavior,and Social Cognitive Theory were chosen to explore the influencing factors of nurses'behavior change in preventing DVT through evidence-based practice.The authority coefficient of the participating experts was 0.904,indicating high reliability.The final model consisted of 6 key components:knowledge generation,problem identification,localization and adaptation,knowledge application,sustained knowledge use,and conceptual framework for behavior change through evidence-based practice.Conclusion Based on theoretical analysis and clinical practice,this study developed an evidence-based practice model for nurses in preventing DVT using the expert meeting.The research methodology was scientific,and the content was reliable,providing a theoretical basis for nurses to engage in evidence-based nursing practice for DVT prevention.

Objective To investigate influential factors of spontaneous passage of common bile duct stones(CBDS)leading to unnecessary endoscopic retrograde cholangiopancreatography(ERCP).Methods We retrieved 432 cases undergoing ERCP for CBDS from January 2023 to February 2024 through our hospital's electronic medical record system.After screening according to exclusion criteria,a total of 393 cases were included.According to the presence or absence of CBDS during ERCP,they were divided into two groups:the spontaneous stone passage group and the confirmed CBDS group.We evaluated 26 variables to determine influential factors of spontaneous stone passage through both univariate and multivariate analyses.Results Out of the 393 patients[42.7％female(168/393);mean age,63.9 years old],stones were not found in 76 patients(19.3％)during the ERCP procedure.After excluding 2 false positives,74 case were included in the spontaneous stone passage group and 317 case in the confirmed CBDS group.In univariate analysis,7 factors were found potentially associated with spontaneous passage(P＜0.05),including age,vomiting,elevation of asperate aminotransferase,elevation of blood amylase,common bile duct dilation,diameter of CBDS ≤5 mm,and single CBDS.Significant associations with spontaneous CBDS passage were identified as vomiting(OR=3.432,95％CI:1.271-9.272,P=0.015)and diameter of CBDS ≤ 5 mm(OR=4.835,95％CI:2.720-8.595,P=0.000)in multivariate analyses.Conclusions Spontaneous CBDS passage occurs more frequently in patients with small stones(≤5 mm)and presence of vomiting.For patients with such characteristics,clinical physicians should consider the patient's situation and,if necessary,review endoscopic ultrasound or magnetic resonance cholangiopancreatography before ERCP for avoiding unnecessary ERCP.

Indocyanine Green/therapeutic use* ; Photochemotherapy ; Combined Modality Therapy ; Anti-Infective Agents

Objective:To evaluate the effectiveness of remote pulmonary rehabilitation in the elderly COPD patients in order to provide evidence-based basis for the clinical practice and promotion of remote pulmonary rehabilitation.Methods:We searched databases including Web of Science, PubMed, Cochrane Library, Embase, CINAHL,China Biology Medicine disc, China National Knowledge Internet, VIP, and Wanfang and selected all randomized controlled trials (RCTs) that reported the effects of telerehabilitation on the elderly patients with COPD. The retrieval time was from the establishment of the database to April 26, 2023. Meta-analysis was performed by RevMan 5.3.Results:A total of 24 RCTs involving 2 980 patients with COPD were finally included. Meta-analysis results showed that telerehabilitation in the elderly patients with COPD can improve the lung function (FEV 1/FVC) ( MD=2.09, 95% CI 0.30-3.89, P<0.05), quality of life ( MD=-0.66, 95% CI -1.05--0.26, P<0.05), anxiety ( MD=-0.69, 95% CI -1.32--0.05, P<0.05) and depression ( MD=-0.81, 95% CI -1.59--0.04, P<0.05), and the subgroup for the lung function (FEV 1/FVC) of the elderly patients with COPD emphasized that physical activity, intervention time ≤24 weeks, intervention frequency 1-3 times per week, and use of network platform, there were significant differences between those subgroups (all P<0.01). But there was no statistically significant difference in improving the exercise capacity ( MD=-1.54, 95% CI -14.83-11.75, P>0.05). Conclusions:Telerehabilitation in pulmonary can be considered a supplementary intervention for improving the lung function (FEV 1/FVC), the quality of life and the psychological condition on the elderly patients with COPD.