OBJECTIVE To evaluate the clinical value of anlotinib in third-line treatment for patients with advanced non-small cell lung cancer （NSCLC） through real-world data. METHODS Clinical data of patients with advanced NSCLC who received treatment at the First Affiliated Hospital of Anhui University of Chinese Medicine from February 2021 to December 2024 were retrospectively collected. They were divided into anlotinib group （27 cases， receiving anlotinib therapy） and immunotherapy group （22 cases， receiving immunotherapy agents alone or in combination with chemotherapy drugs） according to treatment regimens. The progression-free survival （PFS） and overall survival （OS） of patients were compared between the two groups， and the occurrence of adverse drug reactions during the treatment period was recorded. Using a partitioned survival model， an economic evaluation of the two treatment regimens was conducted with a cost-utility analysis approach from the perspective of the healthcare system. RESULTS The median PFS and OS of patients in the anlotinib group were 5.93 months and 11.27 months， respectively； the median PFS and OS of patients in the immunotherapy group were 5.33 months and 9.77 months， respectively； the difference was not statistically significant （P＞0.05）. There was no statistical difference in the total incidence of adverse drug reactions and grade 3-4 serious adverse drug reactions between the two groups （P＞0.05）. Compared with the immunotherapy group， the incremental cost-effectiveness ratio of the anlotinib group was 1 806 724.60 yuan/quality-adjusted life year （QALY）， which was significantly higher than three times China’s per capita gross domestic product in 2024 （287 247 yuan/QALY）. CONCLUSIONS For third-line treatment of advanced NSCLC patients， the efficacy of anlotinib is no worse than that of immunotherapy alone or in combination with chemotherapy drugs， and the safety of the two groups is comparable. However， anlotinib is not cost-effective.

OBJECTIVE To establish a working model for the cough and asthma pharmaceutical care clinic and analyze the effects of outpatient pharmaceutical care interventions on patients. METHODS A pharmaceutical care clinic for cough and asthma was established in our hospital， with comprehensive regulations and rules， complete infrastructure and defined pharmaceutical care workflows. The demographic data of patients （gender， age， residence， disease duration and so on） were collected from May 2021 to December 2024. Indicators including health status， disease severity， inhalation technique， and medication adherence during visits and follow-up were collected and analyzed statistically， to assess the effects of pharmaceutical care interventions on patients. RESULTS The service procedure for the cough and asthma pharmaceutical care clinic in our hospital was established. A total of 215 patients’ basic information was collected. It was found that among the patients， males accounted for 55.35%， with an average age of （60.91±15.75） years old. Patients aged 60 to 69 constituted the largest proportion at 28.37%， and they exhibited relatively poor medication adherence [with an average score of （5.64±1.76）]. The majority of patients were diagnosed with chronic obstructive pulmonary disease （COPD） and prescribed budesonide/formoterol powder inhalers. In 68 follow-up cases， EQ-5D-5L scores increased by 5.81 points （P＜0.05）； COPD Assessment Test （CAT） scores decreased by 4.05 points （P＜0.05）， indicating reduced disease burden. Asthma Control Test （ACT） scores improved by 4.80 points， reaching partial control levels. Inhaler technique scores increased by 2.31 points （P＜0.05）. Medication adherence scores rose by 1.09 points （P＜0.05）. Patient satisfaction was over 90%. CONCLUSIONS After pharmaceutical care intervention， patients’ health status， disease severity， inhalant use technique， and compliance have all improved， and their satisfaction with the cough and asthma pharmaceutical care outpatient service is high. The pharmaceutical care intervention provided by the cough and asthma pharmaceutical care outpatient service can improve patients’ disease symptoms and medication compliance， and enhance the level of safe and rational drug use in the hospital.

Objective To evaluate the current status in the implementation of GBZ/T 201.5-2015 Radiation shielding requirements for radiotherapy rooms-Part 5: Radiotherapy room of proton accelerators, identify issues in the application of its technical indicators, and provide a basis for the in-depth implementation and further revision of the standard. Methods In accordance with the Standardization Law of the People’s Republic of China and the Guidelines for Health Standards Tracking Evaluation (WS/T 536-2017), a combination of cluster sampling and stratified sampling methods was employed to select professionals involved in proton accelerator radiotherapy devices and facilities in three provinces (or municipalities directly under the central government) as the subjects of the survey. A questionnaire was developed to collect basic information about the subjects and their understanding and application of the technical indicators in the standard. A standard evaluation indicator system with a total score of 100 points was established to score the implementation of the standard (40 points), the technical content (30 points), and the effectiveness of the implementation (30 points). Results A total of 169 professionals from 107 institutions participated in the survey, with 79.88% of the respondents having at least 5 years of experience in radiation therapy and 74.56% holding intermediate or higher professional titles. The score of standard implementation was 18.3 points. The awareness rate exceeded 80%, indicating a high level of awareness about the standard. However, the scores for the dissemination and application of the standard were relatively low, accounting for 28% and 32% of their respective full marks. The technical content of the standard and the effectiveness of its implementation scored 27.0 and 26.6 points, respectively. The overall score in the evaluation of standard implementation was 72 points, with scores of 68.6, 72.3, and 75.0 for Beijing City, Shanghai City, and Jiangsu Province, respectively. Conclusion GBZ/T 201.5-2015 Radiation shielding requirements for radiotherapy rooms-Part 5: Radiotherapy room of proton accelerators is scientific and operable, and it is well-coordinated with relevant laws and standards. However, considering the development in FLASH technology and multi-chamber radiotherapy room, it is necessary to revise and improve the standard.

Objective To track and evaluate the implementation and application of the occupational health standard Radiation shielding requirements for radiotherapy room—Part 4: Radiotherapy room of ²⁵²Cf neutron afterloading (GBZ/T 201.4-2015) by radiation health technical service agencies, medical institutions, health supervision agencies, and radiotherapy facility design units, and to provide a scientific basis for the further revision and implementation of this standard. Methods Following the Guideline for health standards tracking evaluation (WS/T 536-2017) and the project implementation plan, relevant practitioners were randomly selected for a questionnaire survey. The survey primarily focused on their awareness, standard training, application, and revision suggestions of GBZ/T 201.4-2015. The results were summarized and analyzed. Results A total of 168 evaluation questionnaires were collected from relevant practitioners in 28 provinces. Only 31.6% of the respondents reported being “well familiar” or “ familiar” with the standard, 27.4% of the respondents believed that the standard was widely used, and 45.2% of the respondents believed that the standard could meet the needs of their work. Only 14.9% of the respondents had received relevant training on the standard, more than half of the respondents had not applied the standard within the past 10 years, and 45.2% of the respondents believed that the standard "needs to be revised". Conclusion Due to the small number of californium-252 neutron afterloading radiotherapy devices in operation on the market, the overall awareness of the standard is low, suggesting that relevant authorities need to strengthen training and publicity of the standard, and that certain sections of the standard need to be revised or merged.

Tumors pose a serious challenge to global public health. The sensitive and precise detection of tumor biomarkers is very important for early screening and diagnosis of cancers. DNAzymes with outstanding physical, chemical, and biological properties are widely applied in the design of biosensing strategies. By the use of sensing platforms such as fluorescence, electrochemistry, and surface-enhanced Raman scattering, DNAzymes facilitate the early screening and detection of tumors. This article summarizes the functional mechanism and common classifications of DNAzymes, and the updates of DNAzymes-based novel biosensing technologies within the field of liquid biopsy, expecting the technical challenges yet to be surmounted and future developmental directions.

Objective To explore the effects of two methods of video laryngoscope insertion on the success rate of tracheal intubation and postoperative pharyngeal complications.Methods We selected 80 elective surgerypatients with American Society of Anesthesiologists(ASA)classification Ⅰ to Ⅱ who had no difficult airway in preoperative assessment under general anesthesia with orotracheal intubation.They were aged 18 to 65 years old and there were no restrictions on height and weight.The patients were randomly divided into a group with laryngoscope inserted through the middle of the mouth(group M)and a group with laryngoscope inserted through the right corner of the mouth(group C),with 40 cases in each group.Observe the laryngoscope exposure grading,oropharyngeal mucosal bleeding,first-time intubation success rate,and occurrence of pharyngeal pain and hoarseness within 48 hours after surgery in both groups;record the patients'systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)among admission to the room(T0),after giving anesthesia drugs(T1),immediately after intubation(T2),1 min after intubation(T3),and 3 min after intubation(T4).Results The SBP of group M was lower than that of group C at T3(P＜0.05);There was no statistically significant difference in laryngoscope exposure grading between the two groups(P＞0.05).The intubation time,oropharynx mucosal bleeding and the cases of sore throat within 48 hours of group M were less than those in group C(P＜0.05).The success rate of primary intubation in group M was higher than that in group C(P＜0.05).Conclusion Inserting a video laryngoscope through the middle of the mouth can reduce oropharyngeal mucosal bleeding,improve the success rate of intubation,and reduce the incidence of postoperative pharyngeal complications.

Background and purpose:Colorectal cancer(CRC)is one of the major malignant tumors threatening human health worldwide,with long-term high incidence and mortality rate.Potassium channel modulatory factor 1(KCMF1)is a member of the E3 ubiquitin ligase family.It binds to target proteins through the RING domain and participates in the regulation of a variety of biological processes in vivo.However,the function of KCMF1 in CRC remains unclear.This study aimed to investigate the expression level of E3 ubiquitin ligase KCMF1 in colorectal tumor,and to explore the effects of KCMF1 on the proliferation of CRC cells and its underlying molecular mechanism.Methods:The The Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)databases were used to analyze the expression level of KCMF1 in CRC tissues and adjacent tissues and the association between the KCMF1 expression and the prognosis of CRC patients.Furthermore,immunohistochemical staining was performed to detect the protein level of KCMF1 in 90 paired human CRC tissues and adjacent non-tumor tissues.Lentiviral shRNA delivery system was employed to specifically target the KCMF1 gene(shKCMF1)in HCT116 and HCT15 CRC cell lines.The effects of KCMF1 knockdown on cell proliferation,apoptosis and cell cycle distribution were assessed by methyl thiazoyl terazolium(MTT)assay,colony formation assay,Western blot and flow cytometry.Changes in the transcriptional profile in HCT116 cells upon KCMF1 knockdown were identified by RNA sequencing(RNA-Seq),and the affected signaling pathways were evaluated by bioinformatics analysis.Real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR),Western blot,luciferase reporter assay and cell immunofluorescence assay were utilized to validate the alteration of the affected signaling pathway.Results:The TCGA and GTEx databases and IHC results showed that the mRNA and protein expression levels of KCMF1 in CRC tissues were significantly upregulated compared with adjacent tissues(P＜0.01).KCMF1 expression level was negatively correlated with the survival time of patients with CRC(P＜0.01),and was positively associated with CRC clinical stage(P＜0.05).Compared with control cells,KCMF1 knockdown significantly inhibited the proliferation of HCT116 and HCT15 cells(P＜0.001),induced cell apoptosis(P＜0.001),and led to cell cycle arrest in G1 phase(P＜0.01).RNA-Seq analysis showed that KCMF1 was involved in the regulation of several signaling pathways,including nuclear factor-κB(NF-κB)signaling pathway.KCMF1 knockdown reduced the transcription levels of the target genes of NF-κB signaling pathway,including BCL-XL,XIAP and CIAP(P＜0.05),and suppressed the expression of phosphorylated p65 and nuclear translocation of p65(P＜0.01).Meanwhile,the activity of NF-κB reporter was reduced in tumor cells upon KCMF1 knockdown(P＜0.01).Conclusion:The expression of KCMF1 is significantly upregulated in human CRC tissues and positively associated with advanced clinical stage and poor prognosis.KCMF1 may promote the proliferation of CRC cells by activating the NF-κB signaling pathway.KCMF1 may be a potential new therapeutic target for CRC.

Although immunotherapy has made a breakthrough in the treatment of cancer,the emergence of drug resistance has limited be-nefits in most patients,and reversing immunotherapy resistance remains a hotly debated and unresolved issue.The tumor microenviron-ment(TME)comprises a large number of T lymphocytes.During the biological processes of proliferation,activation,and the effect of tumor-infiltrating lymphocytes(TILs),TILs face severe local metabolic stress,resulting in metabolic reprogramming to meet the markedly increased energy demand and biosynthesis requirements.This process of adaptive changes in the metabolic pattern is closely related to the pheno-type and function of TILs,affecting immunotherapy efficacy and mediating immunotherapy resistance.In recent years,with the study of TIL metabolism and the search for specific metabolic regulatory points,targeting the TIL metabolic pathway could restore the tumor-killing func-tion and reverse immunotherapy resistance.This review explores the relationship between the metabolic reprogramming of TILs and im-mune resistance,and provides a new strategy for reversing immune resistance.

Objective:To investigate the efficacy of fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog-Bone titanium plate for acute Rockwood Ⅲ acromioclavicular dislocation in comparison with open reduction and fixation with a clavicular hook plate.Methods:A retrospective study was conducted to analyze the data of the 60 patients with acute type Ⅲ acromioclavicular dislocation who had been treated at Department of Orthopedics, Liaocheng People's Hospital from February 2019 to May 2022. There were 35 males and 25 females with an age of (43.2±8.0) years, and 34 left sides and 26 right sides affected. According to different surgical methods, they were divided into a double titanium plates group of 32 cases who had been treated by fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog Bone titanium plate and a hook plate group of 28 cases who had been treated by open reduction and internal fixation with a clavicle hook plate. The time from injury to operation was (2.1±1.3) d. The 2 groups were compared in terms of incision length, operation time, intraoperative bleeding, and visual analogue scale (VAS) pain score, Constant-Murley shoulder function score and the coracoclavicular distance on the affected side which were recorded preoperatively and at the last follow-up. Complications such as infection, loosening of internal fixation or secondary fracture were observed.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). All patients were followed up for (11.2±2.1) months. The incision length in the double titanium plates group [(3.5±0.3) cm] was significantly shorter than that in the hook plate group [(6.2±0.7) cm], and the intraoperative bleeding [(45.3±7.5) mL] in the former was significantly less than that in the latter [(64.1±6.2) mL] ( P < 0.05). However, there was no statistically significant difference in the operation time between the 2 groups ( P > 0.05). The VAS score [0.5 (0, 1.0) points] and Constant-Murley shoulder function score [(95.1±2.1) points] in the double titanium plates group were significantly better than those in the hook plate group [0.8 (0, 1.0) points, (86.0±4.4) points] at the last follow-up ( P < 0.05). However, there was no statistically significant difference between the 2 groups in the coracoclavicular distance on the affected side ( P > 0.05). Good acromioclavicular joint repositioning and fixation were achieved in all patients. There were no surgery-related complications except for sinus tract formation in one patient in the double titanium plates group. Conclusion:In the treatment of acute Rockwood Ⅲ acromioclavicular dislocation, fixation through dual minimally invasive incisions and dual osseous channels with a loop titanium plate combined with a Dog-Bone titanium plate is superior to open reduction and internal fixation with a clavicular hook plate, showing advantages of minimal invasion, better safety, less intraoperative bleeding, and faster joint function recovery.

Objective To analyze the effects of arthroscopic meniscus treatment on knee osteoarthritis on the effective rate,VAS score,HSS score and TNF-α level.Methods We selected 86 patients with knee osteoarthritis caused by meniscus injury who were treated in our hospital from June 2019 to May 2020 as the research subjects.The treatment method was selected according to the patient's wishes,with 43 patients who chose conventional conservative treatment included in the control group and 43 patients who chose arthroscopic meniscus therapy included in the study group.The treatment effectiveness,visual ana-logue scale(VAS)score,HSS knee joint score and tumor necrosis factor-α(TNF-α)index levels were compared between the two groups of patients.Results The effective rate of treatment in the study group was significantly higher than that in the control group(P＜0.05);there was no significant difference between the study group and the control group in the VAS score,HSS score,and TNF-α level before treatment(P＞0.05).After treatment,the VAS score,HSS score and TNF-α level of the group were improved.The VAS score and TNF-α level of the study group after treatment were lower than those of the control group(P＜0.05),and the HSS score was higher than the control group.Group(P＜0.05).Conclusion The arthroscopic meniscus treatment for patients with knee osteoarthritis has a significant effect,which can effectively reduce the pain and inflammation of the patients and improve the function of the knee joint.