Small cell lung cancer (SCLC) is the thoracic malignant tumor and accounts for about 15% of lung malignancies and transfer often occurs by the time of diagnosis. Extensive stage-small cell lung cancer (ES-SCLC) accounts for about 2/3 of all SCLC. For many years, radiotherapy has occupied an important position in the treatment of SCLC, especially in the treatment of ES-SCLC, because SCLC is more sensitive to radiotherapy. However, in recent years, immune checkpoint inhibitor has shown more excellent antitumor activity in the treatment of ES-SCLC and become the mainstream argument for the treatment of ES-SCLC. However, will radiotherapy be buried by the times among the therapeutic approaches for ES-SCLC? In this article, we will review the clinical progress of radiotherapy, immunotherapy and combination therapy for ES-SCLC.
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Humans ; Small Cell Lung Carcinoma/therapy* ; Lung Neoplasms/therapy* ; Immunotherapy ; Neoplasm Staging ; Radiotherapy/methods* ; Combined Modality Therapy

Objectives:To investigate the relationship between QRS duration and its changes during hospitalization and long-term all-cause mortality in patients with chronic heart failure.Methods:A total of 3 580 patients who attended three tertiary hospitals in Shanxi Province(First Hospital of Shanxi Medical University,Shanxi Cardiovascular Hospital,Shanxi Bethune Hospital)and were diagnosed with chronic heart failure from March 2014 to November 2021,were enrolled in this study.QRS duration at admission and discharge were collected,and the changes in QRS duration during hospitalization(ΔQRS)and the ΔQRS ratio(ΔQRS/admission QRS duration×100% )were calculated.Patients were divided into three group according to tertiles of ΔQRS:the group with decreasing QRS duration(n=1 364),the group with stable QRS duration(n=1 248),and the group with progressing QRS duration(n=968).Telephone follow-up was conducted at months 1,3,6,12,and every 6 months thereafter after discharge till May 1,2023,long-term all-cause mortality was the primary endpoint.Survival curves were plotted using the Kaplan-Meier method,and comparisons between groups were made using the log-rank method.Cox proportional risk regression model was used for prognostic analysis,and restricted cubic spline curves were calculated to evaluate QRS duration-related variables during hospitalization and the risk of long-term all-cause mortality in patients with chronic heart failure.Results:The median follow-up was 71(56,92)months,and all-cause mortality occurred in 502(14.0% )patients.Long-term all-cause mortality was lower in the group with decreasing QRS duration and the group with stable QRS duration compared with the progressing QRS duration group(13.9% vs.10.7% vs.18.6%,χ2=28.607,P<0.001).Multifactorial Cox regression analysis showed that admission QRS duration(HR=1.005,95% CI:1.002-1.009,P=0.003)and higher ΔQRS ratio during hospitalization(HR=2.071,95% CI:1.247-3.440,P=0.005)were independent influencing factors of long-term all-cause mortality in chronic heart failure patients.Restricted cubic spline curves showed that when the admission QRS duration was>96.36 ms,the longer the QRS duration,the higher the risk of all-cause mortality;when the admission QRS duration fluctuated from 89.32-96.36 ms,the QRS duration was a protective factor for long-term all-cause mortality in patients with chronic heart failure;and when the ΔQRS ratio during hospitalization was≥3.40%,higher ΔQRS ratio was linked with increased risk of all-cause mortality.Conclusions:QRS duration and ΔQRS ratio during hospitalization are independent predictors of long-term all-cause mortality in patients with chronic heart failure.Admission QRS duration>96.36 ms and ΔQRS ratio during hospitalization≥3.40% are associated with increased risk of long-term all-cause mortality in patients with chronic heart failure.

Objective To analyze the effects and differences of two veno-arterial extracorporeal membrane oxygenation(VA-ECMO)cannulation methods and subsequent left ventricular unloading on cardiac function and hemodynamics.Methods The lumped parameter model(LPM)of VA-ECMO integrated with the cardiovascular system in the MATLAB/Simulink environment was extended to simulate and analyze the changes in ventricular function and blood flow in the heart failure patient model under central VA-ECMO or peripheral VA-ECMO support.The effects of using arterial vasodilators or a left atrial drainage cannula on left ventricular function under central VA-ECMO support at a pump flow rate of 3 L/min were compared.Results Under central VA-ECMO or peripheral VA-ECMO support,left ventricular pressure and volume increased,and stroke volume and ventricular work decreased.Both arterial vasodilators and the left atrial drainage cannula could reduce left ventricular pressure and volume.Arterial vasodilators additionally increased stroke volume and improved left ventricular ejection fraction from 11.6％to 19.5％.Conclusions Both VA-ECMO cannulation methods provide effective circulatory support in the heart failure patient model,with similar effects on ventricular function.Under central VA-ECMO support,arterial vasodilators can improve left ventricular function more effectively than the left atrial drainage cannula.

The Yi Ethnic group's medical culture boasts a profound heritage and a long-standing history.Despite enduring the ravages of war,it has consistently served as a vital healthcare resource in the southwestern region,safeguarding the reproduction,well-being,and prosperity of the Yi people and other ethnic groups residing there.From the perspective of intangible cultural heritage,this paper expounds on the modern-day value and notable achievements of the inheritance and innovation of Yi Ethnic medicine in contemporary society,while also analyzing the existing problems.It puts forward countermeasures and suggestions for the inheritance and innovation of Yi Ethnic medicine under the framework of intangible cultural heritage from the following four aspects:firstly,strengthening scientific and standardized research on Yi Ethnic medicine to establish its inheritance status within the modern pharmaceutical industry;Secondly,intensifying efforts in the cultivation and recognition of diverse talents in Yi Ethnic medicine,and establishing a modern safeguard system for a workforce of compound professionals;Thirdly,actively integrating into the development of the bio-pharmaceutical and big health industries to enhance the inheritance and innovation capabilities of the Yi Ethnic medicine sector;and fourthly,improving digital management capabilities,reinforcing financial support and supply,and ensuring the recognition and widespread education of Yi Ethnic medicine.

Objectives:To investigate the relationship between QRS duration and its changes during hospitalization and long-term all-cause mortality in patients with chronic heart failure.Methods:A total of 3 580 patients who attended three tertiary hospitals in Shanxi Province(First Hospital of Shanxi Medical University,Shanxi Cardiovascular Hospital,Shanxi Bethune Hospital)and were diagnosed with chronic heart failure from March 2014 to November 2021,were enrolled in this study.QRS duration at admission and discharge were collected,and the changes in QRS duration during hospitalization(ΔQRS)and the ΔQRS ratio(ΔQRS/admission QRS duration×100% )were calculated.Patients were divided into three group according to tertiles of ΔQRS:the group with decreasing QRS duration(n=1 364),the group with stable QRS duration(n=1 248),and the group with progressing QRS duration(n=968).Telephone follow-up was conducted at months 1,3,6,12,and every 6 months thereafter after discharge till May 1,2023,long-term all-cause mortality was the primary endpoint.Survival curves were plotted using the Kaplan-Meier method,and comparisons between groups were made using the log-rank method.Cox proportional risk regression model was used for prognostic analysis,and restricted cubic spline curves were calculated to evaluate QRS duration-related variables during hospitalization and the risk of long-term all-cause mortality in patients with chronic heart failure.Results:The median follow-up was 71(56,92)months,and all-cause mortality occurred in 502(14.0% )patients.Long-term all-cause mortality was lower in the group with decreasing QRS duration and the group with stable QRS duration compared with the progressing QRS duration group(13.9% vs.10.7% vs.18.6%,χ2=28.607,P<0.001).Multifactorial Cox regression analysis showed that admission QRS duration(HR=1.005,95% CI:1.002-1.009,P=0.003)and higher ΔQRS ratio during hospitalization(HR=2.071,95% CI:1.247-3.440,P=0.005)were independent influencing factors of long-term all-cause mortality in chronic heart failure patients.Restricted cubic spline curves showed that when the admission QRS duration was>96.36 ms,the longer the QRS duration,the higher the risk of all-cause mortality;when the admission QRS duration fluctuated from 89.32-96.36 ms,the QRS duration was a protective factor for long-term all-cause mortality in patients with chronic heart failure;and when the ΔQRS ratio during hospitalization was≥3.40%,higher ΔQRS ratio was linked with increased risk of all-cause mortality.Conclusions:QRS duration and ΔQRS ratio during hospitalization are independent predictors of long-term all-cause mortality in patients with chronic heart failure.Admission QRS duration>96.36 ms and ΔQRS ratio during hospitalization≥3.40% are associated with increased risk of long-term all-cause mortality in patients with chronic heart failure.

Objective:To retrieve, evaluate and summarize the best evidence on the use of bedside ultrasound by ICU nurses to assess the lungs of adult critically ill patients, and to provide a reference for clinical practice and the construction of related processes and protocols.Methods:Based on the "6S" pyramid model, a computer-based search was conducted on relevant computer decision support system, guideline networks, professional associations, and domestic and international databases, the search time limit was from the establishment of the database to June 5, 2024. The panel members who had been trained in the evidence-based course evaluated the included literature with corresponding tools, extracted evidence according to the theme.Results:Twenty-five papers were finally included, including 6 guidelines, 8 expert consensus, 2 expert opinion, 3 clinical decision-making, 3 systematic evaluation, and 3 randomized controlled trials. A total of 35 pieces of evidence were formed from 4 aspects, including personnel training, operation specifications, clinical application (including dyspnea screening, intervention implementation, efficacy evaluation, diaphragm function evaluation) and precautions.Conclusions:The best evidence for lung assessment and intervention in adult critically ill patients based on bedside ultrasound can provide a reference for the adjustment and decision-making of nursing measures for adult critically ill patients. In the subsequent process of evidence transformation, attention should be paid to combining clinical practice and the joint cooperation of medical staff.

Objective To analyze the effects and differences of two veno-arterial extracorporeal membrane oxygenation(VA-ECMO)cannulation methods and subsequent left ventricular unloading on cardiac function and hemodynamics.Methods The lumped parameter model(LPM)of VA-ECMO integrated with the cardiovascular system in the MATLAB/Simulink environment was extended to simulate and analyze the changes in ventricular function and blood flow in the heart failure patient model under central VA-ECMO or peripheral VA-ECMO support.The effects of using arterial vasodilators or a left atrial drainage cannula on left ventricular function under central VA-ECMO support at a pump flow rate of 3 L/min were compared.Results Under central VA-ECMO or peripheral VA-ECMO support,left ventricular pressure and volume increased,and stroke volume and ventricular work decreased.Both arterial vasodilators and the left atrial drainage cannula could reduce left ventricular pressure and volume.Arterial vasodilators additionally increased stroke volume and improved left ventricular ejection fraction from 11.6％to 19.5％.Conclusions Both VA-ECMO cannulation methods provide effective circulatory support in the heart failure patient model,with similar effects on ventricular function.Under central VA-ECMO support,arterial vasodilators can improve left ventricular function more effectively than the left atrial drainage cannula.

The Yi Ethnic group's medical culture boasts a profound heritage and a long-standing history.Despite enduring the ravages of war,it has consistently served as a vital healthcare resource in the southwestern region,safeguarding the reproduction,well-being,and prosperity of the Yi people and other ethnic groups residing there.From the perspective of intangible cultural heritage,this paper expounds on the modern-day value and notable achievements of the inheritance and innovation of Yi Ethnic medicine in contemporary society,while also analyzing the existing problems.It puts forward countermeasures and suggestions for the inheritance and innovation of Yi Ethnic medicine under the framework of intangible cultural heritage from the following four aspects:firstly,strengthening scientific and standardized research on Yi Ethnic medicine to establish its inheritance status within the modern pharmaceutical industry;Secondly,intensifying efforts in the cultivation and recognition of diverse talents in Yi Ethnic medicine,and establishing a modern safeguard system for a workforce of compound professionals;Thirdly,actively integrating into the development of the bio-pharmaceutical and big health industries to enhance the inheritance and innovation capabilities of the Yi Ethnic medicine sector;and fourthly,improving digital management capabilities,reinforcing financial support and supply,and ensuring the recognition and widespread education of Yi Ethnic medicine.

Objective:To evaluate the effect of lifestyle interventions based on mobile health technolo-gy on gestational weight gain among overweight or obese pregnant women,to explore the influencing fac-tors of the intervention effect,and to provide scientific evidence for weight management during pregnan-cy.Methods:The randomized controlled trial(RCT)design was used.From April 2024 to August 2024,200 singleton overweight or obese pregnant women aged 18-40 years in early pregnancy were re-cruited and stratified block-randomized according to body mass index(BMI)categories,age,and parity.The control group received routine prenatal care,while the intervention group received lifestyle interven-tions based on mobile health technology,which included biweekly face-to-face or telephone sessions;weekly recording of dietary behavior goals with personalized feedback on WeChat public account;6 000 steps per day and 150 minutes of brisk walking per week;and weekly weight recording with personalized feedback.Based on the intention-to-treat principle,generalized linear mixed models were used to analyze the effects on weight gain and weight gain rate up to 24-28 gestational weeks,gestational diabetes melli-tus(GDM),and dietary and physical activity behaviors.Additionally,subgroup analysis and interaction analysis were conducted to explore whether intervention effects on weight gain varied by different maternal characteristics.Results:The mean age of the women in the intervention and control groups was(30.49±3.99)years and(29.83±3.95)years,respectively,with gestational weeks at enrollment being(11.35±1.61)weeks and(11.26±1.52)weeks.No statistically significant differences were observed in the baseline characteristics between the two groups(P＞0.05).In the study,10 and 12 participants were lost to the follow-up in the intervention and control groups,respectively,with 178 women comple-ting the midterm follow-up.At the midterm follow-up(24-28 weeks),the weight gain in the interven-tion and control groups was(5.00±3.72)kg and(6.57±4.28)kg,respectively.After adjusting for age,parity,gravidity,region,pre-pregnancy BMI categories,and socioeconomic status,the between-group difference was-1.63 kg(95％CI:-2.80 to-0.46;P=0.007).The adjusted between-group difference in weight gain rate was-0.07 kg/week(95％CI:-0.11 to-0.02;P=0.005).Com-pared with the control group,the intervention group had lower fasting blood glucose at the oral glucose tolerance test(OGTT)by 0.19 mmol/L(95％CI:0.04 to0.33;P=0.013).No significant difference was observed in GDM incidence between the two groups.Among different subgroups based on characteris-tics,such as age,region,socioeconomic status,and parity,there was no statistically significant dif-ference in the effect on weight gain.Conclusion:The lifestyle interventions based on mobile health tech-nology effectively controlled weight gain up to 24-28 gestational weeks among overweight or obese women and improved fasting blood glucose level.This has significant public health implications for impro-ving the health of overweight or obese pregnant women in China.

Objective To investigate the correlation between physical activity duration,sleep quality,weight control,and PRO(patient-reported outcomes)in individuals with hypertension,providing effective information for enhancing patient-reported outcomes in this population.Methods A total of 625 hypertensive patients were randomly selected from four counties in Yunnan Province from April to June 2020 to participate in a field survey.The questionnaire included patients'basic information,lifestyle,health status and the PRO Scale for Hypertension-PROISCD-HY(V1.0).Statistical analyses including t-tests,one-way ANOVA,and multivariate linear regression were conducted to investigate the relationships between physical activity duration,sleep quality,weight control,and PRO,with the Bootstrap method used to examine potential mediating effects.Results After adjusting for potential covariates,the multiple linear regression model indicated a significant association between a physical activity duration of≥2 hours with PRO[B=6.551,95%CI(2.611,10.491)].Stratified analysis showed that this association was only present among males,females,and younger adults,but not in older adults.Additionally,a positive correlation was found between good sleep quality and PRO[B=1.870,95%CI(0.449,3.291)],with this association being consistent across all populations after stratification.Patients who managed their condition through exercise and diet had higher PRO scores[B=1.904,95%CI(0.383,3.424)],while those controlling weight through diet and other methods exhibited a decrease in PRO scores[B=-4.873,95%CI(-7.860,-1.887);B=-7.105,95%CI(-12.211,-1.999)],with variations among different groups.The bootstrap method revealed that physical activity duration had both direct and indirect effects on PRO,with sleep quality acting as a partial mediator between physical activity duration and PRO.Conclusion A Physical activity duration of at least 2 hours,good sleep quality,and weight control have been shown to improve PRO in individuals with hypertension.