Objective:To develop a journey map for health management of patients with disability caused by accidental trauma from the social ecosystem theory perspective, so as to gain deeper insights into their actual needs during medical treatment and rehabilitation.Methods:The descriptive qualitative research was adopted. Purposeful sampling was employed to select patients with disability caused by accidental trauma admitted to the Trauma Center of the Department of Emergency and Critical Care Medicine at the First Affiliated Hospital with Nanjing Medical University between April and May 2024 for semi-structured interviews. Traditional content analysis method was employed to analyze the interview data.Results:From three dimensions of microsystem, mesosystem, and macrosystem, the needs and potential issues of medical treatment at different stages of the health management process for patients with disability caused by accidental trauma were analyzed, forming a patient journey map.Conclusions:Patients with disability caused by accidental trauma face prolonged periods of medical treatment, rehabilitation, and lifestyle readjustment, imposing significant burdens on themselves, their caregivers, and their families. Healthcare providers may proactively engage with patients based on their current and potential issues and needs, offer specialized guidance at critical junctures and meet the need of patients for continuity of care, thereby improving patients' quality of life and overall health outcomes.

Objective:To develop a journey map for health management of patients with disability caused by accidental trauma from the social ecosystem theory perspective, so as to gain deeper insights into their actual needs during medical treatment and rehabilitation.Methods:The descriptive qualitative research was adopted. Purposeful sampling was employed to select patients with disability caused by accidental trauma admitted to the Trauma Center of the Department of Emergency and Critical Care Medicine at the First Affiliated Hospital with Nanjing Medical University between April and May 2024 for semi-structured interviews. Traditional content analysis method was employed to analyze the interview data.Results:From three dimensions of microsystem, mesosystem, and macrosystem, the needs and potential issues of medical treatment at different stages of the health management process for patients with disability caused by accidental trauma were analyzed, forming a patient journey map.Conclusions:Patients with disability caused by accidental trauma face prolonged periods of medical treatment, rehabilitation, and lifestyle readjustment, imposing significant burdens on themselves, their caregivers, and their families. Healthcare providers may proactively engage with patients based on their current and potential issues and needs, offer specialized guidance at critical junctures and meet the need of patients for continuity of care, thereby improving patients' quality of life and overall health outcomes.

Background and objective Lung squamous cell carcinoma(LUSC)is a subtypes of non-small cell lung cancer(NSCLC).It has been reported that members of the protocadherin γ family can regulate tumor cell growth by inhibiting the Wnt signaling pathway.Protocadherin-gamma subfamily B4(PCDHGB4)as a family member in LUSC was rarely reported.The aim of this study was to investigate the role and potential prognostic value of PCDHGB4 in the development of LUSC us-ing bioinformatics methods.Methods The Cancer Genome Atlas(TCGA),cBioPortal and UALCAN databases were used to analyze the expression,prognosis,clinicopathological features,immune cell infiltration,immune regulatory genes,immune checkpoint inhibitors(ICIs),and methyltransferases of PCDHGB4 in LUSC.At the single cell level,we analyzed the clustering results of cell subtypes and the expression of PCDHGB4 in different immune cell subpopulations.In addition,we compared the promoter methylation levels of PCDHGB4 in LUSC tissues and normal tissues and performed protein-protein interaction and mutation analysis.Finally,enrichment analysis was performed based on the differentially expressed genes.Results Bioinformat-ics analysis results showed that the expression level of PCDHGB4 in LUSC tissues was lower than that in normal tissues.Sur-vival analysis showed that increased PCDHGB4 expression was associated with poor prognosis.Single-cell sequencing analysis showed that PCDHGB4 was expressed in T cells,monocytes or macrophages,and dendritic cells.It was further found that PCD-HGB4 played an important role in tumor immunity and confirmed that PCDHGB4 was associated with immune checkpoints,immune regulatory genes,and methyltransferases.Besides,enrichment analysis revealed that PCDHGB4 was involved in mul-tiple cancer-related pathways.Conclusion The expression of PCDHGB4 was low in LUSC.PCDHGB4 was related to the poor prognosis of patients,and PCDHGB4 was closely related to the infiltration and pathway of tumor immune cells.PCDHGB4 may be a potential prognostic marker and a new target for immunotherapy in LUSC.

Background and objective Lung cancer is the most common type of cancer,accounting for more than half of all cancer cases,with lung adenocarcinoma(LUAD)representing over half of lung cancer patients.Currently,the 5-year survival rate for metastatic LUAD patients remains low and there is an urgent need for new biomarkers as targets for targeted therapy.Go-Ichi-Ni-San 1(GINS1),an important member of the GINS family,is closely related to the occurrence and devel-opment of human malignant tumors.This study aims to explore the role of GINS1 in glycolysis,proliferation,and metastasis of LUAD cells and the related molecular mechanisms.Methods The expression of GINS1 was analysed using bioinformatics between LUAD patients and healthy controls.The expression levels of GINS1 in LUAD and adjacent tissues were detected by immunohistochemistry and Western blot.Western blot and real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)were used to detect the expression of GINS1 in LUAD cell lines A549,SK-LU-1,Calu-3,H1299 and BEAS-2B.Stably knockdown GINS1 in A549 cells and its negative control cell line,as well as stably overexpress GINS1 in H1299 cells and its negative control cell line,were constructed by lentiviral transduction.Colony formation test was used to detect cell proliferation.Scratch test was used to detect cell migration.Transwell test was used to detect cell invasion,and the test kits were used to detect glucose consumption and lactate production.The expression levels of glycolysis-related proteins,Notch signaling pathway proteins and phosphatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)signaling pathway proteins were detected by Western blot.The Notch receptor agonist Jagged1 was added to cells from the shGINS1-A549 group and the Notch receptor inhibitor LY3039478 was added to cells from the GINS1-OE-H1299 group for the regression assay.Results The expression of GINS1 was up-regulated in LUAD patients,tissues and cell lines,and corre-lated with overall survival(P＜0.05).Knockdown of GINS1 significantly inhibited the proliferation,migration and invasion of A549 cells(P＜0.05),while overexpression of GINS1 significantly enhanced the proliferation,migration and invasion of H1299 cells(P＜0.05).Furthermore,knockdown of GINS1 resulted in reduced glucose consumption,reduced lactate production,and reduced expression levels of glycolytic-related proteins in A549 cells(P＜0.05);overexpression of GINS1 enhanced glycolytic level in H1299 cells(P＜0.05).The expression levels of Notch1,Notch3,phosphorylated-PI3K(p-PI3K),phosphorylated-AKT(p-AKT)and phosphorylated-mTORC1(Ser2448)[p-mTORC1(Ser2448)]in A549 cells were significantly decreased by GINS1 knockdown(P＜0.05),while the expression levels of P13K,AKT,mTOR and p-mTORC2(Ser2481)were not significantly changed(P＞0.05).Overexpression of GINS1 increased the levels of Notch1,Notch3 and PI3K/AKT/mTORC1 pathway phosphorylated proteins in H1299 cells(P＜0.05).Jagged1 significantly reversed the inhibition of glycolysis,prolif-eration and metastasis induced by GINS1 knockdown in A549 cells(P＜0.05),and LY3039478 significantly inhibited the en-hancement of glycolysis,proliferation and metastasis induced by GINS1 overexpression in H1299 cells(P＜0.05).Conclusion The expression of GINS1 enhances the expression of Notch1 and Notch3 receptors,and then phosphorylates and activates the downstream PI3K/AKT/mTORC1 signaling pathway to enhance the glycolysis,proliferation and metastasis of LUAD cells.

OBJECTIVES: Peripheral whole blood cell counts have been used as prognostic indicators for various cancers, but their predictive value in nasopharyngeal carcinoma remain unclear. This study aims to evaluate the prognostic significance of the pretreatment hemoglobin×lymphocyte/monocyte ratio (HLMR) in non-recurrent, non-metastatic NPC patients undergoing definitive radiotherapy. METHODS: Clinical and follow-up data from 805 NPC patients who completed definitive radiotherapy or chemoradiotherapy were retrospectively analyzed. Pretreatment hemoglobin, lymphocyte count, and monocyte count were collected to calculate HLMR. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off value of HLMR. Patients were then classified into high and low HLMR groups. The association between HLMR and clinicopathological characteristic was assessed using chi-square tests. Independent prognostic factors for overall survival (OS) and progression-free survival (PFS) were identified using Cox proportional hazards models. A nomogram was constructed based on the independent predictors to estimate patient survival rates, and internal validation was performed using a validation cohort. RESULTS: The ROC curve identified 605.5 as the optimal HLMR cut-off value for predicting 5-year survival. Multivariate Cox regression analysis revealed that T stage (HR=1.886, 95% CI 1.331 to 2.673, P<0.001), N stage (HR=2.021, 95% CI 1.267 to 3.225, P=0.003), Eastern Cooperative Oncology Group (ECOG) score (HR=3.991, 95% CI 1.257 to 12.677, P=0.019), concurrent chemoradiotherapy regimen (HR=0.338, 95% CI 0.156 to 0.731, P=0.006), and HLMR (HR=0.648, 95% CI 0.460 to 0.912, P=0.013) were independent prognostic factors for OS. A nomogram including T stage, N stage, and HLMR in the training cohort was constructed to predict 3-, 5-, and 7-year OS, with a C-index of 0.713. The area under the curves for predicting 3-, 5-, and 7-year OS were 0.744, 0.665, and 0.682, respectively. Calibration curves showed good agreement between predicted and observed survival rates. The above results were further confirmed in the validation cohort. CONCLUSIONS Pretreatment HLMR may serve as a promising prognostic biomarker for patients with nasopharyngeal carcinoma.
Humans ; Nasopharyngeal Carcinoma/mortality* ; Prognosis ; Hemoglobins/analysis* ; Nasopharyngeal Neoplasms/pathology* ; Monocytes/cytology* ; Female ; Male ; Retrospective Studies ; Middle Aged ; Adult ; Aged ; Nomograms ; Chemoradiotherapy ; ROC Curve

In this paper, the differences between air probe and filled probe for measuring high-frequency dielectric properties of biological tissues are investigated based on the equivalent circuit model to provide a reference for the methodology of high-frequency measurement of biological tissue dielectric properties. Two types of probes were used to measure different concentrations of NaCl solution in the frequency band of 100 MHz-2 GHz. The results showed that the accuracy and reliability of the calculated results of the air probe were lower than that of the filled probe, especially the dielectric coefficient of the measured material, and the higher the concentration of NaCl solution, the higher the error. By laminating the probe terminal, liquid intrusion could be prevented, to a certain extent, to improve the accuracy of measurement. However, as the frequency decreased, the influence of the film on the measurement increased and the measurement accuracy decreased. The results of the study show that the air probe, despite its simple dimensional design and easy calibration, differs from the conventional equivalent circuit model in actual measurements, and the model needs to be re-corrected for actual use. The filled probe matches the equivalent circuit model better, and therefore has better measurement accuracy and reliability.
Reproducibility of Results ; Sodium Chloride ; Calibration

BACKGROUND: Lung cancer is the most common malignant tumor in China, lung adenocarcinoma (LUAD) is the main type of lung cancer, which is a serious threat to people's life and health. At present, there are fewer studies on the role of Dikkopf1 (DKK1) in lung adenocarcinoma. The aim of this study was to investigate the role and potential prognostic value of DKK1 in the development of lung adenocarcinoma by bioinformatics methods. METHODS: Several databases, such as genotype-tissue expression (GTEx), The Cancer Genome Atlas (TCGA) and tumor-immune system interactions database (TISIDB), were used to analyze the expression, clinicopathological features, immune cell infiltration, prognosis and methylation of DKK1 in lung adenocarcinoma. Then, linked immune cell infiltration Omics database was used to analyze the co-expressed genes of DKK1 and their functional enrichment. Finally, 59 pathological samples of paraffin-embedded lung adenocarcinoma patients who underwent surgery at the Affiliated Cancer Hospital of Xinjiang Medical University between 2016 and 2017 were collected for the validation of the prognostic value of expression by immunohistochemistry (IHC) test. RESULTS: The results of bioconfidence analysis showed that the expression level of DKK1 in lung adenocarcinoma tissues was higher than that in normal tissues, the expression in advanced cancers was higher than that in early stages, and the experimental validation revealed that among 59 cases of lung adenocarcinoma, there were 15 cases of negative expression (25.4%), 18 cases of weakly positive expression (30.5%), and 26 cases of strongly positive expression (44.1%). The different expression of DKK1 is related to methylation, prognosis and the activities of various immune cells. Functional enrichment shows that DKK1 may be involved in skin development and cell-substrate junction, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis shows that DKK1 is related to ABC transporters. Bioinformatics analysis and clinical case specimens showed that high DKK1 expression was associated with poorer prognosis in patients with lung adenocarcinoma. CONCLUSIONS High expression of DKK1 in lung adenocarcinoma is associated with poor prognosis. DKK1 is closely associated with tumor immune cell infiltration and pathways. DKK1 can be considered as a potential prognostic marker and a novel target for immunotherapy of lung adenocarcinoma.

Background::As erythropoietin (EPO) has been used to treat anemia in cancer patients, negative controversy has continued. Unfortunately, its effects on non-small-cell lung carcinoma (NSCLC) cell lines are uncertain and the phenomenon of inducing immune escape of tumor cells remains to be explored. This study aimed to provide an important basis for the application of exogenous EPO in the treatment of tumor-associated anemia.Methods::Cells were cultured in 1% O 2, 5% CO 2, and 94% N 2 to simulate a hypoxic environment of the tumor. A549 cell line (lower expression EPOR) and NCI-H838 cell line (higher expression EPOR) were treated with 2 and 8 U/ml recombinant human EPO (rhEPO). CCK-8 method was used to determine the logarithmic growth phase of the cells and to detect cell proliferation. The expression levels of VEGF, HIF-1α, and PD-L1 were determined by western blot. One-way ANOVA was used for statistical analysis between groups, with p < 0.05 indicating a significant difference. Results::Hypoxia itself could decrease the survival rate of NSCLC cells. Under the hypoxic condition, rhEPO induced tumor cells proliferation, especially in the NCI-H838 cell line, where 2 U/ml rhEPO increased the total number of surviving cells (Hypoxia + rhEPO 2 U/ml vs. Hypoxia, p < 0.05). Western blot analysis showed that hypoxia upregulated the expression of VEGF, HIF-1α, and PD-L1 in NSCLC cell lines (Normoxia vs. Hypoxia, p < 0.05), but may not be dependent on the expression levels of EPOR. RhEPO decreased the expression levels of VEGF and HIF-1α. In the A549 cell line, it depended on the concentration of rhEPO and was particularly obvious in HIF-1α (Hypoxia vs. Hypoxia + rhEPO 2 U/ml vs. Hypoxia + rhEPO 8 U/ml, p < 0.05). A low concentration of rhEPO may not reduce VEGF expression. In the NCI-H838 cell line, the effect of rhEPO on VEGF was more obvious, but it may be independent of rhEPO concentrations. The downregulation of PD-L1 expression by rhEPO was only presented in the A549 cell line and required higher rhEPO concentrations (Hypoxia + rhEPO 8 U/ml vs. Hypoxia&Hypoxia + rhEPO 2 U/ml, p < 0.05). Conclusion::The effect of prolonged high concentrations of rhEPO under hypoxic conditions resulted in accelerated cells proliferation of non-small-cell lung cancer and was independent of EPOR expression levels on the cell lines surface. Hypoxia resulted in increased expression of VEGF, HIF-1α, and PD-L1 on the NSCLC cell lines. Under normoxic conditions, rhEPO did not affect the expression of VEGF, HIF-1α, and PD-L1; but under hypoxic conditions, the application of rhEPO reduced the expression of VEGF, HIF-1α, and PD-L1, producing an impact on the biological behavior of tumor cells.

Background::As erythropoietin (EPO) has been used to treat anemia in cancer patients, negative controversy has continued. Unfortunately, its effects on non-small-cell lung carcinoma (NSCLC) cell lines are uncertain and the phenomenon of inducing immune escape of tumor cells remains to be explored. This study aimed to provide an important basis for the application of exogenous EPO in the treatment of tumor-associated anemia.Methods::Cells were cultured in 1% O 2, 5% CO 2, and 94% N 2 to simulate a hypoxic environment of the tumor. A549 cell line (lower expression EPOR) and NCI-H838 cell line (higher expression EPOR) were treated with 2 and 8 U/ml recombinant human EPO (rhEPO). CCK-8 method was used to determine the logarithmic growth phase of the cells and to detect cell proliferation. The expression levels of VEGF, HIF-1α, and PD-L1 were determined by western blot. One-way ANOVA was used for statistical analysis between groups, with p < 0.05 indicating a significant difference. Results::Hypoxia itself could decrease the survival rate of NSCLC cells. Under the hypoxic condition, rhEPO induced tumor cells proliferation, especially in the NCI-H838 cell line, where 2 U/ml rhEPO increased the total number of surviving cells (Hypoxia + rhEPO 2 U/ml vs. Hypoxia, p < 0.05). Western blot analysis showed that hypoxia upregulated the expression of VEGF, HIF-1α, and PD-L1 in NSCLC cell lines (Normoxia vs. Hypoxia, p < 0.05), but may not be dependent on the expression levels of EPOR. RhEPO decreased the expression levels of VEGF and HIF-1α. In the A549 cell line, it depended on the concentration of rhEPO and was particularly obvious in HIF-1α (Hypoxia vs. Hypoxia + rhEPO 2 U/ml vs. Hypoxia + rhEPO 8 U/ml, p < 0.05). A low concentration of rhEPO may not reduce VEGF expression. In the NCI-H838 cell line, the effect of rhEPO on VEGF was more obvious, but it may be independent of rhEPO concentrations. The downregulation of PD-L1 expression by rhEPO was only presented in the A549 cell line and required higher rhEPO concentrations (Hypoxia + rhEPO 8 U/ml vs. Hypoxia&Hypoxia + rhEPO 2 U/ml, p < 0.05). Conclusion::The effect of prolonged high concentrations of rhEPO under hypoxic conditions resulted in accelerated cells proliferation of non-small-cell lung cancer and was independent of EPOR expression levels on the cell lines surface. Hypoxia resulted in increased expression of VEGF, HIF-1α, and PD-L1 on the NSCLC cell lines. Under normoxic conditions, rhEPO did not affect the expression of VEGF, HIF-1α, and PD-L1; but under hypoxic conditions, the application of rhEPO reduced the expression of VEGF, HIF-1α, and PD-L1, producing an impact on the biological behavior of tumor cells.

Objective:To explore the serum cyclic polypeptide biomarkers for ovarian cancer diagnosis.Methods:A total of 54 patients with epithelial ovarian cancer confirmed by pathology in Cancer Hospital, Chinese Academy of Medical Sciences from March 2018 to September 2018 were selected as the study subjects, and 40 healthy women with normal examination results in the cancer screening center were selected as the control. All of the samples were randomly divided into training set and validation set at the ratio of 1∶1 with a random number. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with magnetic bead technology was used for detecting peptide profiling in serum samples to screen significantly differently expressed peptides between ovarian cancer group and control group of the training set (score>5). Receiver operating characteristic (ROC) curve analysis was used to screen differential peptide peaks with area under curve (AUC) ≥0.8, sensitivity and specificity>90% in the training set and validation set. Liquid chromatography-mass spectrometry (LC-MS/MS) was further used to determine the composition of differentially expressed peptides.Results:By comparing the peptide profiles of the two groups, 102 differential peptide peaks were initially detected in the mass-to-charge ratio range of 1 000 to 10 000. ROC curve analysis showed that there were 42 differential peptide peaks with AUC ≥0.8 in both training set and validation set, 19 of which were highly expressed in ovarian cancer group, and 23 were lowly expressed. There were 15 different peptide peaks in highly expressed ovarian cancer group with sensitivity and specificity over 90%. The mass-to-charge ratios were 7 744.27, 5 913.41, 5 329.87, 4 634.21, 4 202.02, 3 879.26, 3 273.35, 3 253.79, 3 234.34, 2 950.33, 2 664.51, 2 018.38, 1 893.37, 1 498.69 and 1 287.55. There were 15 different peptide peaks in lowly expressed ovarian cancer group with sensitivity and specificity over 90%, the mass-to-charge ratios were 9 288.46, 7 759.77, 5 925.24, 4 652.77, 4 210.42, 3 887.02, 3 279.90, 3 240.82, 2 962.15, 2 932.70, 2 022.42, 1 897.16, 1 501.69, 1 337.38 and 1 290.13. No protein composition was identified in 15 different peptide peaks in lowly expressed ovarian cancer group. The two protein compositions identified in 15 different peptide peaks in highly expressed ovarian cancer group were recombinant serglycin (SRGN) and fibinogen alpha chain (FGA), the mass-to-charge ratios of which were 1 498.696 and 5 913.417, respectively. The sensitivity and specificity of the two proteins for ovarian cancer diagnosis were 100%, 100% and 90.9%, 100%, respectively.Conclusion:SRGN and FGA are highly expressed in the serum of ovarian cancer patients, which may be potential diagnostic markers for ovarian cancer.