Objective To investigate the effects of early pulmonary rehabilitation training on lung function recovery,complication rates,and quality of life in patients who undergo thoracoscopic surgery.Methods A ran-domized controlled trial was conducted involving 132 patients who underwent thoracoscopic surgery between June 2020 and June 2023.Participants were randomly allocated to either an early pulmonary rehabilitation program(n=72)or a conventional rehabilitation program(n=60).The early intervention group commenced a staged rehabilitation protocol—including respiratory training and physical exercise—within 24 to 72 hours following surgery,whereas the conventional group received standard postoperative nursing care only.Outcomes measured included postoperative pulmonary function(FEV1,FVC),incidence of postoperative complications,length of hospi-tal stay,and quality of life scores(maximum score:40).These outcomes were compared between the two groups.Results On postoperative days 3 and 7,the early group showed significantly higher FEV1 values compared to the conventional group[(1.6±0.17)L vs.(1.3±0.21)L;(1.9±0.20)L vs.(1.6±0.11)L,respectively],as well as improved FVC measurements[(2.5±0.20)L vs.(2.1±0.14)L;(2.9±0.25)L vs.(2.3±0.23)L(all P＜0.05)].The early intervention group also demonstrated a significantly lower overall complication rate(14.3％vs.33.3％,x2=6.79,P=0.009),including reduced incidences of atelectasis(6.9％vs.20.0％,P=0.031)and pulmonary infection(4.2％vs.13.3％,P=0.044).Additionally,patients in the early group had a shorter average hospital stay[(8.4±1.2)days vs.(10.9±2.3)days,P=0.018]and reported higher quality of life scores[(35.6±3.7)vs.(30.8±4.5),P=0.032].No significant difference was observed between the two groups in terms of the overall incidence of adverse events(23.6％vs.31.7％,x2=1.07,P=0.301).Conclusions Early pulmonary rehabilitation significantly facilitates the recovery of lung function,reduces the incidence of postoperative complica-tions,enhances quality of life,and demonstrates a favorable safety profile among patients undergoing thoracoscopic surgery.Therefore,this intervention should be more broadly implemented in clinical practice to optimize postop-erative recovery outcomes.

Objective To investigate the effects of early pulmonary rehabilitation training on lung function recovery,complication rates,and quality of life in patients who undergo thoracoscopic surgery.Methods A ran-domized controlled trial was conducted involving 132 patients who underwent thoracoscopic surgery between June 2020 and June 2023.Participants were randomly allocated to either an early pulmonary rehabilitation program(n=72)or a conventional rehabilitation program(n=60).The early intervention group commenced a staged rehabilitation protocol—including respiratory training and physical exercise—within 24 to 72 hours following surgery,whereas the conventional group received standard postoperative nursing care only.Outcomes measured included postoperative pulmonary function(FEV1,FVC),incidence of postoperative complications,length of hospi-tal stay,and quality of life scores(maximum score:40).These outcomes were compared between the two groups.Results On postoperative days 3 and 7,the early group showed significantly higher FEV1 values compared to the conventional group[(1.6±0.17)L vs.(1.3±0.21)L;(1.9±0.20)L vs.(1.6±0.11)L,respectively],as well as improved FVC measurements[(2.5±0.20)L vs.(2.1±0.14)L;(2.9±0.25)L vs.(2.3±0.23)L(all P＜0.05)].The early intervention group also demonstrated a significantly lower overall complication rate(14.3％vs.33.3％,x2=6.79,P=0.009),including reduced incidences of atelectasis(6.9％vs.20.0％,P=0.031)and pulmonary infection(4.2％vs.13.3％,P=0.044).Additionally,patients in the early group had a shorter average hospital stay[(8.4±1.2)days vs.(10.9±2.3)days,P=0.018]and reported higher quality of life scores[(35.6±3.7)vs.(30.8±4.5),P=0.032].No significant difference was observed between the two groups in terms of the overall incidence of adverse events(23.6％vs.31.7％,x2=1.07,P=0.301).Conclusions Early pulmonary rehabilitation significantly facilitates the recovery of lung function,reduces the incidence of postoperative complica-tions,enhances quality of life,and demonstrates a favorable safety profile among patients undergoing thoracoscopic surgery.Therefore,this intervention should be more broadly implemented in clinical practice to optimize postop-erative recovery outcomes.

Adamantinomatous craniopharyngioma (ACP) is an epithelial tumor originating from remnants of Rathke's pouch. A highly inflammatory microenvironment and histological presence of the senescence-associated secretory phenotype (SASP) are key pathological features of ACP. Pyroptosis, an inflammatory form of programmed cell death, forms a positive feedback loop with SASP, mutually promoting their effects. This review summarizes the current research progress on regulatory mechanism of SASP and pyroptosis in ACP so as to further understand the pathophysiological mechanisms underlying ACP development.

Adamantinomatous craniopharyngioma (ACP) is an epithelial tumor originating from remnants of Rathke's pouch. A highly inflammatory microenvironment and histological presence of the senescence-associated secretory phenotype (SASP) are key pathological features of ACP. Pyroptosis, an inflammatory form of programmed cell death, forms a positive feedback loop with SASP, mutually promoting their effects. This review summarizes the current research progress on regulatory mechanism of SASP and pyroptosis in ACP so as to further understand the pathophysiological mechanisms underlying ACP development.

Objective To investigate the distribution of B cells in both tumor and non-tumor tissues of gastric cancer patients,analyze their phenotypic characteristics and explore the impact on T cell proliferation.Methods Immunohistochemical staining was utilized to detect the expression of B cell surface marker CD 19 in tumor and non-tumor tissues from 33 gastric cancer patients.The expression levels of chemokine receptors and immunoglobulin molecules on B cells in both tumor and non-tumor tissues were measured using flow cytometry.Chemotaxis experiments were conducted to examine the role of the CXCL12-CXCR4 axis in B cell chemotaxis.B cells isolated and purified from both tissue types were co-cultured with autologous peripheral T cells to assess their effect on T cell proliferation.Results There were significantly more B cells infiltrated in tumor tissues than those infitrated in the non-tumor tissues of gastric cancer patients(P＜0.01),and CXCR4 was highly expressed on tumor-infiltrating B cells compared with B cells derived from non-tumor tissues(P＜0.05).The Cancer Genome Atlas(TCGA)analysis indicated that the expression level of CXCL12 in tumor tissues was positively correlated with the expression level of CD19 in gastric cancer patients(r=0.15,P＜0.01).And the expression level of CXCL12 in tumor tissues of the gastric cancer patients was also positively correlated with the number of B cells infiltrated in tumor tissues.Chemotaxis experiments confirmed that the CXCL12-CXCR4 axis was involved in promoting B cell chemotaxis(P＜0.05).Although B cells in tumor and non-tumor tissues had similar levels of IgM,IgG,and IgA expression,tumor-infiltrating B cells significantly inhibited the proliferation of T cells when compared with B cells derived from non-tumor tissues(P＜0.01).Conclusion There are more B cells infiltrated in gastric cancer tissues,which may be recruited to tumor tissues through the CXCL12-CXCR4 axis,and then inhibit T cell proliferation to promote the progression of gastric cancer.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans ; Brain Neoplasms/pathology* ; Neoplasm Recurrence, Local/metabolism* ; Glioma/pathology* ; Neural Stem Cells/pathology* ; Oligodendrocyte Precursor Cells/pathology* ; Tumor Microenvironment

INTRODUCTION: The burden of frequent attenders (FAs) of emergency departments (EDs) on healthcare resources is underestimated when single-centre analyses do not account for utilisation of multiple EDs by FAs. We aimed to quantify the extent of multiple ED use by FAs and to characterise FAs. METHODS: We reviewed nationwide ED attendance in Singapore data from 1 January 2006 to 31 December 2018 (13 years). FAs were defined as patients with ≥4 ED visits in any calendar year. Single ED FAs and multiple ED FAs were patients who attended a single ED exclusively and ≥2 distinct EDs within the year, respectively. Mixed ED FAs were patients who attended a mix of a single ED and multiple EDs in different calendar years. We compared the characteristics of FAs using multivariable logistic regression. RESULTS: We identified 200,130 (6.3%) FAs who contributed to1,865,704 visits (19.6%) and 2,959,935 (93.7%) non-FAs who contributed to 7,671,097 visits (80.4%). After missing data were excluded, the study population consisted of 199,283 unique FAs. Nationwide-linked data identified an additional 15.5% FAs and 29.7% FA visits, in addition to data from single centres. Multiple ED FAs and mixed ED FAs were associated with male sex, younger age, Malay or Indian ethnicity, multiple comorbidities, median triage class of higher severity, and a higher frequency of ED use. CONCLUSION A nationwide approach is needed to quantify the national FA burden. The multiple comorbidities and higher frequency of ED use associated with FAs who visited multiple EDs and mixed EDs, compared to those who visited a single ED, suggested a higher level of ED burden in these subgroups of patients. The distinct characteristics and needs of each FA subgroup should be considered in future healthcare interventions to reduce FA burden.
Comorbidity ; Emergency Service, Hospital ; Ethnicity ; Humans ; Logistic Models ; Male ; Retrospective Studies ; Triage

Objective To investigate the correlation between incidence rate of tinnitus and noise exposure time,age,hearing condition in noise exposure workers.Methods A total of 1 985 noise exposure workers (age between 20～60 years old;working length between 1 ～30 years) in a large dockyard were randomly selected as the subject of this study with 1 831 male workers and 154 female workers in average 36.3±8.25 years old.The average noise exposure time was 9.1±6.50 years and pure tone threshold of final candidates in sound-proofed environment was evaluated (at 0.25～8 kHz).The subjects were divided into four groups according to the subjective tinnitus level:mild tinnitus,moderate tinnitus,severe tinnitus and no tinnitus to analysis the correlation among incidence rate of tinnitus and noise exposure time,age,hearing condition,etc.Results Among all 1 985 subjects enrolled the occurrence rate of tinnitus was 20.55％ (408/1 985),with 367 acquired mild tinnitus(89.95％),39 acquired moderate tinnitus (9.56％) and 2 for severe tinnitus (0.49％).Mild tinnitus and moderate tinnitus showed a multi-step raising according to noise exposure time.Mild tinnitus increased continually with age while moderate tinnitus showed an accumulation in age group over 55 years old.Female was less likely to be annoyed by tinnitus than male.Conclusion Tinnitus can be early warning of auditory damage by noise exposure;older male group with longer noise exposure time is more vulnerable to tinnitus.Tinnitus acquired in noise environment is more likely to be mild.

Objective To investigate and analyze the characteristics and stratified influencing factors of self-directed learning of nursing college students.Methods In November 2016,a total of 304 students from three nursing colleges in Sichuan province were investigated with self-rating scale of self-directedness learning (SRSSDL).304 copies of the questionnaires were issued and recovered.Using SPSS 13.0,the independent sample t test and variance analysis were used to compare the differences between groups.Pearson correlation test and multiple linear regression were used to analyze the influencing factors.Results The average SRSSDL score of key undergraduate students of nursing college was (220.27 ± 30.16),the score of general undergraduate students was (212.37 ± 25.01),the score of Junior college students was (205.26 ± 29.84),The score difference has statistical significance (F=6.191,P=0.002).Students from key undergraduate had the highest self-directed learning ability,and students from general undergraduate and Junior college had the medium self-directed learning ability.The factors such as different levels,whether the one-child,self-study time every day,team learning experience affect students' self-directed learning ability.Conclusions We should create conditions for students to study independently,cultivate professional identity and independent spirit under the premise of clear educational objectives to improve their SDL ability.