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.
.
Humans ; Small Cell Lung Carcinoma/therapy* ; Lung Neoplasms/therapy* ; Immunotherapy ; Neoplasm Staging ; Radiotherapy/methods* ; Combined Modality Therapy

Objective:To explore the factors influencing adherence to voice therapy among patients with voice disorders in China. Methods:Patients with voice disorders who visited the Voice Therapy Center at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from February to May 2022 were enrolled in the study. Adherence was assessed using the URICA-Voice scale, while influencing factors were assessed through the Voice Handicap Index（VHI） scale and a general information questionnaire. Correlation analysis was conducted using univariate and multivariate logistic regression analysis. Results:A total of 247 patients were included in the study, comprising 57 males（23.08%） and 190 females（76.92%）. The results revealed that: ①Female patients demonstrated higher likelihood of being in the contemplation stage（OR=0.22） compared to males. ②Patients with a monthly family income per capita>6 000 yuan were more likely to be in the contemplation stage than those with<3 000 yuan with an OR = 13.94. ③High vocal-demand occupations increased contemplation stage probability（OR=7.70） compared to moderate-demand occupations. ④Residence within 30-minute commute predicted action/maintenance stages（OR=7.14） versus≥60-minute commute. ⑤Patients whose occupations had high voice demands were more likely to be in the action and maintenance stages than those with average voice demands, with an OR of 16.20. Conclusion:Gender, monthly family income per capita, occupational voice demands, and distance to the hospital significantly impact the URICA-Voice compliance stages of patients. Patients who are female, have higher family income, have occupations with high voice demands, and live closer to the hospital exhibit higher compliance with voice training.
Humans ; Male ; Female ; Voice Disorders/therapy* ; Patient Compliance ; Voice Training ; Surveys and Questionnaires ; China ; Middle Aged ; Adult ; Voice Quality ; Logistic Models ; Aged

OBJECTIVE To investigate the acute lung injury effects of pulmonary phospholipids and their phospholipase A2(PLA2)decomposition products-lysophospholipids and fatty acids-on mice.METHODS Mice were randomly assigned to the following groups:① solvent control(PBS)and PLA2;② solvent control and glycerol phospholipid groups:1,2-dioleoyl-sn-glycero-3-phosphoserine(DOPS),1,2-dipalmitoyl-sn-glycero-3-phosphoserine(DPPS),1,2-dioleoyl-sn-glycero-3-phosphoethanol-amine(DOPE),1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine(DPPE),1,2-dipalmitoyl-sn-glycero-3-phosphocholine(DPPC),and 1-stearoyl-2-oleoyl-sn-glycero-3-phosphocholine(SOPC);③ solvent con-trol and fatty acid groups:palmitic acid(PA),oleic acid;④ solvent control and lysophospholipid groups:1-oleoyl-2-hydroxy-sn-glycero-3-phosphoserine(18∶1 LysoPS),1-stearoyl-sn-glycero-3-phosphoserine(18∶0 LysoPS),1-palmitoyl-sn-glycero-3-phosphoserine(16∶0 LysoPS),1-palmitoyl-sn-glycero-3-phos-phoethanolamine(16∶0 LysoPE),1-palmitoyl-sn-glycero-3-phosphocholine(16∶0 LysoPC);⑤ solvent control,PLA2,DPPC,PA,16∶0 LysoPC,16∶0 LysoPS,and 18∶1 LysoPS.Following anesthesia,mice were administered nebulized PBS in the solvent control group,2.1 ug·kg-1 PLA2 in PBS in the PLA2 group and 2.5 mg·kg-1 of the corresponding substance in PBS in other experimental groups.For group①,survival times were recorded and survival curves were plotted.At 1 h post-treatment,lung tissues from groups ①②③④ were collected,photographed to obtain white light images,and subjected to HE staining to assess histopathological changes and pathological scoring.At 2 h post-treatment,pulmonary blood flow in group ⑤ was assessed using laser speckle contrast imaging,arterial blood gas was analyzed with a blood gas analyzer,and lung function was evaluated using whole-body pleth-ysmography.At 6 hours post-treatment,blood cells from group ⑤ were analyzed using an automated hematology analyzer.RESULTS Compared with the solvent control group,severe pathological changes were observed in lung tissues of the PLA2 group,accompanied by extensive inflammatory infiltration and interstitial thickening,with all mice succumbing within 240 min.In mice treated with glyc-erol phospholipids,alveolar structures remained clear,alveolar walls were intact and continuous,and alveolar spaces were translucent,with only occasional minor inflammatory cell infiltration in the septa.No significant pathological alterations were detected in the fatty acid groups.Minor inflammatory cell infiltration was seen in the 16∶0 LysoPE and 16∶0 LysoPC groups.However,such pathological changes as patchy hemorrhage,alveolar interstitial edema,increased alveolar wall thickness,and elevated neutrophil counts were observed in the 18∶1 LysoPS,18∶0 LysoPS,and 16∶0 LysoPS groups.Pathological scores based on HE staining were significantly increased in the 16∶0 LysoPS and 18∶1 LysoPS groups com-pared with the solvent control.The percentage of the lung tissue injury area was also markedly higher in the 16∶0 LysoPS group.A significant decrease in the mean fluorescence intensity of blood flow was observed in the 16∶0 LysoPS group.Arterial partial pressure of oxygen(pO2)was significantly reduced in the PLA2 group,while arterial partial pressure of carbon dioxide(pCO2)was markedly elevated in the 16∶0 LysoPS and 18∶1 LysoPS groups.Lung function tests revealed that the 16∶0 LysoPS group exhibited significant increases in expiratory time,end-expiratory pressure,and enhanced pause,in contrast to significant decreases in tidal volume,expired volume,and minute volume.The 18∶1 LysoPS group also exhibited a significant decline in minute volume.No significant changes in inflammatory cell concentrations were detected in blood,with the exception of neutrophils in the 16∶0 LysoPS group,which showed a significant but physiologically normal increase.CONCLUSION Pulmonary phospholipids and their PLA2-derived fatty acid metabolites do not induce severe lung injury in mice while the lyso-phospholipid metabolites,particularly lysophosphatidylserine,are found to cause significant lung injury.

Objective:To investigate the effects of body habitus and gender on radiation dose assessment methodologies in low-dose chest CT, with particular emphasis on clarifying discrepancies among various dose quantification approaches and their associations with patient characteristics.Methods:Imaging data from 19 371 patients who underwent low-dose chest CT at the First Affiliated Hospital of Chongqing Medical University between January 2021 and January 2024 were retrospectively analyzed. Patients were categorized into eight groups based on water-equivalent diameter (WED) and gender: Group A (150 mm≤WED<210 mm; 71 males, 1 032 females), Group B (210 mm≤WED<260 mm; 4 525 males, 8 005 females), Group C (260 mm≤WED<300 mm; 4 234 males, 1 105 females), and Group D (WED≥300 mm; 357 males, 42 females). WED, size-specific dose estimate (SSDE), and organ dose-based effective dose(ED Radimetrics)were calculated using Radimetrics software. Scanner-reported dose metrics, including volume CT dose index (CTDIvol), dose-length product (DLP), and DLP-derived effective dose(ED DLP), were recorded. The ratios of SSDE/CTDIvol and ED Radimetrics/ED DLP were used to quantify discrepancies between dose evaluation methods. The Kruskal-Wallis test was employed to analyze dose metric differences across WED groups within the same gender, while the Wilcoxon rank-sum test compared gender-based differences within each WED group. Results:All dose metrics significantly increased with WED for both genders (all P<0.05). Within the same WED group, ED Radimetrics was significantly higher in females ( P<0.05), whereas ED DLP was higher in males ( P<0.05). The SSDE/CTDIvol ratio decreased with increasing WED, declining from 1.74 in Group A to 1.16 in Group D for females and from 1.68 to 1.12 for males. The ED Radimetrics/ED DLP ratio exhibited a decreasing trend with WED in females (1.82 to 1.30) but showed an initial increase in males (1.29 in Group A to 1.31 in Group B) before decreasing to 0.94 in Group D (all intergroup P<0.05). SSDE/CTDIvol and ED Radimetrics/ED DLP ratios of females were consistently higher than that of males within each WED group (all P<0.05). Conclusions:Patient body habitus and gender significantly influence radiation dose distribution in low-dose chest CT. Larger body habitus is associated with higher radiation doses, while females receive greater ED Radimetrics than males within comparable body habitus. Traditional dose metrics (CTDIvol and ED DLP) were underestimated for patients with small body sizes and female individuals.

Objective To evaluate the frailty status and risk factors among hospitalized elderly patients after percutaneous coronary intervention(PCI),and to provide a reference for improving and delaying their frailty.Methods From March to August 2024,using convenience sampling,patients aged over 75 years who underwent PCI in a tertiary cardiovascular disease specialist hospital in Beijing were selected as the survey participants.Patient-related informations were collected through a self-designed general information questionnaire.The Fried Phenotype Frailty Scale,the Katz Activities of Daily Living,Lawton Instrumental Activities of Daily Living(IADL)scale,the Charlson Comorbidity Index,the Morse Fall Scale,the Mini Nutritional Assessment-Short Form(MNA-SF),and the 15-item Geriatric Depression Scale(GDS-15)were evaluated postoperatively until discharge.Univariate and multivariate logistic analyses were conducted to identify factors associated with frailty among patients after PCI.Results A total of 278 patients were included.The incidence of frailty after PCI was 52.16％.Based on Fried Phenotype scores,patients were divided into a non-frail group and a frail group.Univariate analysis showed statistically significant differences between the 2 groups in terms of age,gender,hemoglobin,NT-ProBNP,LVEF,IADL scores,living alone status,nutrition status,falls risk,and depression level(P＜0.05).Multivariate logistic regression analysis revealed that age,Lawton IADL scores,falls risk,nutrition status,depression level were factors influencing frailty,with odds ratios of 1.167,0.575,1.597,0.399,and 3.610,respectively(P＜0.05).Conclusion The incidence of frailty is high among patients aged over 75 years after PCI,and there are multiple risk factors affecting their frailty status.Clinical healthcare providers should prioritize long-term management of these patients and implement comprehensive interventions with the consideration of their physiological,psychological,and social conditions.

Objective:To investigate the inhibitory effect of tripartite motif-containing 25 (TRIM25) on the replication of Japanese encephalitis virus (JEV) in cells and its molecular mechanism.Methods:Human glioma cells (U251 cells) and Kunming mice were infected with JEV, and then the cells and brain tissue samples were collected. The transcription levels of six TRIM genes were detected by real-time PCR, and the expression of TRIM25 in cells was detected by Western blot. U251 and A549 cells overexpressed with TRIM25 and U251 cells knocked out with TRIM25 gene were constructed. Cells were infected with JEV, and the replication of JEV was detected by viral plaque assay, real-time PCR and Western blot. The interaction of TRIM25 with viral proteins was investigated by co-immunoprecipitation (Co-IP) and indirect immunofluorescence assay. The expression of IFN-β in overexpressed TRIM25 cells was detected by real-time PCR and ELISA.Results:JEV infection promoted the expression of TRIM25 in cells and mouse brain tissues. TRIM25 overexpression restricted JEV replication in U251 and A549 cells, while TRIM25 knockout enhanced JEV replication. TRIM25 overexpression upregulated the level of IFN-β in cells. TRIM25 interacted with JEV capsid protein and promoted the degradation of capsid protein.Conclusion:TRIM25 can inhibit the replication of JEV in cells by upregulating IFN-β and promoting the degradation of JEV C protein.

Lactate, the end product of glycolysis within the central nervous system (CNS), functions not only as a crucial neuronal energy source but also as a potent signaling molecule. Recently, lactate-mediated protein lactylation has been recognized as a novel post-translational modification influencing CNS pathophysiology. Lactate-mediated protein lactoylation modification regulates key pathological processes such as neuroinflammation and oxidative stress by modulating the structure and function of histones and non-histones, thereby influencing the occurrence and development of CNS diseases. This article reviews the research progress on mechanism of lactylation modification in CNS diseases, aiming to explore the regulatory potential of lactylation modification in CNS diseases and provide new ideas for the study of CNS diseases.

Objective To investigate the drug resistance of Mycobacterium tuberculosis(MT)in Shaanxi Province in the past five years.Methods A total of 744 patients with culture-positive sputum specimens at the former Shaanxi Provincial Institute for Tuberculosis Control and Prevention from January 2019 to December 2023 were selected as the study subjects,and the results of their strain identification and drug susceptibility tests were collected to analyze the resistance to six antituberculosis drugs.Results The overall resistance rate of the MT complex of 726 strains was 33.33%(242/726).The rates of mono-resistance,multi-resistance,multi-drug resistance and extensive resistance were 12.95%(94/726),7.44%(54/726),12.95%(94/726)and 0.41%(3/726).The resistance rate was 31.73%(204/643)in primaries and 45.78%(38/83)in retreatment patients,and the difference between the resistance rates of primaries and retreatment patients was statistically significant(χ2=6.536,P=0.011).The resistance rates of the 6 antituberculosis drugs,in descending order,were as follows:streptomycin(SM)22.87%(166/726),isoniazid(INH)22.73%(165/726),rifampicin(RFP)15.15%(110/726),ofloxacin(OFX)9.09%(66/726),ethambutol(EMB)7.30%(53/726),kanamycin(KM)2.89%(21/726).The resistance rates for each year from 2019～2023 were 39.61%(61/154),33.33%(44/132),34.47%(81/235),24.54%(40/163)and 38.10%(16/42),respectively,and the difference in resistance rates between years was not statistically significant(χ2=8.967,P=0.062).Conclusion The burden of drug-resistant tuberculosis remains heavy in Shaanxi,and the situation of multidrug-resistant tuberculosis,in particular,is more serious,and control measures need to be strengthened and improved to reduce the incidence and spread of drug-resistant tuberculosis.

Objective : To observe the brain tissue injury during hypoxia-ischemia, as well as the pathological changes and the expression of ferroptosis-related factors after the use of Shenfu injection(SFI), and to explore the protective effect of SFI on hypoxic-ischemic brain injury(HIBD) by inhibiting ferroptosis. Methods : An animal model of HIBD in SD rats was constructed and intervened with SFI. Pathologic changes in brain tissue were observed by HE staining methods. Nissen staining was used to observe neuron survival. Glutathione Peroxidase 4(GPX4) and Divalent Metal Transporter 1(DMT1) expression were detected in brain tissue by Western blot, immunohistochemistry and immunofluorescence. Reduced Glutathione(GSH), Lactate Dehydrogenase(LDH), Malondialdehyde(MDA), Superoxide Dismutase(SOD) and tissue iron content were determined with the kits. BV-2 microglial cell line(BV2) cells were culturedin vitroand divided into control group(Ctrl group), oxygen-glucose deprivation group(OGD group), iron ferroptosis-inducing group(Erastin group), iron ferroptosis-inhibiting group(Fer-1 group), Shenfu injection group(SFI group), and Erastin+Shenfu injection group(Erastin+SFI group). 2′,7′-Dichlorodihydrofluorescein diacetate(DCFH-DA) reactive oxygen species(ROS) fluorescent probe was used to detect the ROS release level; Immunofluorescence was used to observe intracellular GPX4, DMT1 expression. Results : Compared with the Sham group, rats in the HIBD group showed significant neuronal cell damage in brain tissue, decreased GPX4 expression(P<0.01), increased DMT1 expression(P<0.01), decreased GSH and SOD levels(P<0.01), and increased LDH, MDA and tissue iron levels(P<0.05,P<0.05,P<0.01). In contrast, after the intervention of SFI, GPX4 expression was elevated(P<0.01), DMT1 expression decreased(P<0.01), GSH and SOD levels were elevated(P<0.01), and LDH, MDA, and tissue iron levels decreased(P<0.05,P<0.05,P<0.01). The cells experiments showed that compared with the Ctrl group, the OGD group had a significantly higher ROS content and a decrease in the expression of GPX4 fluorescence intensity, and an increase in the fluorescence intensity of DMT1(P<0.01), compared with the OGD group, the ROS content was reduced in the SFI group, while the expression of GPX4 was elevated and the expression of DMT1 was reduced(P<0.01). Conclusion Hippocampal and cortical regions are severely damaged after HIBD in neonatal rats, and their brain tissues show decreased expression of GPX4 and increased expression of DMT1. The above suggests that ferroptosis is involved in HIBD brain injury in neonatal rats. In contrast, Shenfu injection has a protective effect on HIBD experimental animal model and BV2 cell injury model by reducing iron aggregation and ROS production.

Objective To investigate the expression and significance of heat shock protein 70(HSP70),apoptosis-associated speck-like protein(ASC),and vitamin D in children with febrile seizures(FS).Methods A total of 200 children with FS admitted to our hospital from June 2022 to December 2023 were selected as FS group,including 158 cases of simple FS and 42 cases of complex FS.Another 200 febrile children without FS were selected as fever group,and 50 healthy children were selected as control group.The differences in HSP70,ASC mRNA,and vitamin D expression a-mong the three groups were compared.The differences in HSP70,ASC mRNA,and vitamin D ex-pression at different time points in children with different types of FS were compared.The influencing factors and predictive value of complex FS were analyzed.Results At admission,the expression lev-els of HSP70 and ASC mRNA gradually decreased,while the vitamin D levels gradually increased in the FS group,fever group,and control group,with statistically significant between-group differences(P＜0.01).One hour after admission,the levels of HSP70 and ASC mRNA in both the complex FS group and the simple FS group were lower than those at admission(P＜0.01).The levels of HSP70 and ASC mRNA in the complex FS group at admission and 1 hour after admission were higher than those in the simple FS group,while the vitamin D level was lower(P＜0.01).Multivariate Logistic regression analysis showed that elevated HSP70 and ASC mRNA levels at admission were independ-ent risk factors for complex FS(P＜0.001),while elevated vitamin D level was an independent protective factor for complex FS(P＜0.001).The area under the curve(AUC)for HSP70,ASC mRNA,and vitamin D in assessing complex FS were 0.785(95％CI,0.721 to 0.840),0.766(95％CI,0.701 to 0.823),and0.760(95％CI,0.695 to 0.817),respectively.The combined AUC of HSP70,ASC mRNA,and vitamin D for assessing complex FS was 0.915,with a sensitivity of 90.48％and a specificity of 81.65％.The AUC of combined assessment of complex FS by vari-ous factors was greater than that of HSP70,ASC mRNA,and vitamin D alone(Z=2.743,2.749,3.086,P=0.006,0.006,0.002).Conclusion The levels of HSP70 and ASC mRNA are elevat-ed,while the vitamin D level is reduced in children with complex and simple FS.The combined as-sessment of HSP70,ASC mRNA,and vitamin D at admission has high value in assessing complex FS.