Cancer incidence in China has been rising steadily,with a particularly heavy burden from several high-prevalence malignancies.Medical examination for cancer plays a critical role in the early detection of cancer,precancerous lesions,and precursor conditions,thereby facilitating timely diagnosis and intervention.Such examination also addresses the growing demand for person-alized cancer screening services among diverse population groups.The development of evidence-based,context-specific cancer screening guidelines is essential to enhance the standardization,quality,and equity of preventive screening practices across the country,ultimately improving out-comes in early cancer detection and treatment.Guided by the Department of Medical Emergency Response of the National Health Commission,the Guidelines for Medical Examination for Cancer in Health Examination Agency(2025 Edition)were developed under the leadership of the National Cancer Center.A multidisciplinary panel of experts formulated the guidelines in accordance with the principles and methodology of the World Health Organization Handbook for Guideline Deve-lopment.The guidelines provide evidence-based recommendations on key clinical domains:target cancers and populations,overall screening workflow,screening protocols,diagnostic technolo-gies,result interpretation,follow-up procedures,and quality control.The primary objective is to standardize cancer screening practices in health examination agency and strengthen China's ca-pacity for prevention and control of high-burden cancers.

Objective To investigate the current status and barriers to implementing non-accompanied care services in medical institutions in Zhejiang Province,and to provide a basis for the improvement of standardized management of such services.Methods A self-designed questionnaire was conducted from September to October 2024 among all secondary and tertiary medical institutions in Zhejiang Province to assess the implementation status and barriers to non-accompanied care services.Results A total of 397 questionnaires were distributed,with 389 valid responses,yielding a valid response rate of 97.98％.Non-accompanied care services were implemented in 118 institutions(30.33％).Among these,90 institutions(76.27％)had established management systems for non-accompanied wards;71 institutions(60.17％)had a medical nursing assistant-to-bed ratio lower than 1∶5;41 institu-tions(34.75％)provided tiered training for medical nursing assistants;93 institutions(78.81％)required patients to bear the full cost of the service.Compared with secondary medical institutions,tertiary medical institutions have more complete management system for non-accompanied care services.The main obstacles hindering the development of non-accompanied care services include an imperfect management system for non-accompanied wards,a shortage of medical nursing assistants,a lack of standardized training for such assistants,inconsistent charging standards,and low acceptance among patients and their families.Conclusion The promotion of non-accompanied care services in medical institutions in Zhejiang Province has achieved initial success.However,challenges persist,including incomplete management systems,uneven development across hospital tiers,and imperfect charging mechanisms.It is recommended that relevant authorities strengthen policy support,enhance standardized training for healthcare nursing assistants,refine cost-sharing mechanisms,and improve the quality and sustainability of non-accompanied care services through multi-party collaboration.

Objective This study was to investigate the effects of Ginseng Astragalus Tumor Suppressor Formula combined with cisplatin on relevant immune genes and immune functions in mice modeled with hepatocellular carcinoma based on bioinformatics research.Methods Gene expression profiles and clinical data of hepatocellular carcinoma patients were downloaded from TCGA and GEO databases and screened for immune-expressed genes by taking intersections with immune-related genes downloaded from ImmPort database.Immune-related gene pair coefficients(IRGPI)were calculated to construct IRGP prognostic models.The optimal cut-off value of IRGPI for 1-year overall survival of hepatocellular carcinoma patients was determined based on ROC curve analysis,and hepatocellular carcinoma patients were divided into high and low immune risk groups,and the survival status of patients in the two groups was analyzed using the Kaplan-Meier method and the Log-Rank test.Then,we screened the active ingredients and gene targets of Ginseng Astragali Tumor Suppressor Formula for the treatment of hepatocellular carcinoma by network pharmacology,and obtained the intersection genes between Ginseng Astragali Tumor Suppressor Formula and disease,and then extracted the intersection of hepatocellular carcinoma-related immune genes and the intersection genes between Ginseng Astragali Tumor Suppressor Formula and disease through the"VennDiagram"software,and verified it through the animal model.The effects of Astragalus tumor-suppressing formula combined with cisplatin on the immunity genes and immune functions in the tumor tissues of mice with hepatocellular carcinoma were verified in animal models.Results Among 2483 relevant immune genes,84 pairs of immune-related genes were significantly associated with OS in the experimental group(P<0.001),and among the patients categorized into high and low immune risk groups by cut-off value-0.258,the overall survival rate of the high immune risk group was significantly lower than that of the low immune risk group(P<0.001).Univariate Cox analysis showed that IRGP model risk values and clinical characteristics of tumor T-staging had an impact on prognosis.Multifactorial Cox analysis showed that IRGP model risk value and tumor T-stage could be used as independent prognostic factors.266 genes intersecting with hepatocellular carcinoma were screened by network pharmacology technique for Ginseng Astragalus Tumor Suppressor Formula,and further 8 genes were obtained by taking the intersection with 84 pairs of immune-related genes.The experimental results showed that compared with the model group,the tumor mass of mice in each treatment group decreased(P<0.05);the spleen index and thymus index of mice increased(P<0.05);the CD4+/CD8+ratio in serum and spleen tissues of mice decreased;ICAM1,FABP5,IGF2,CDK4,NR1,ADRB2,AR,NR3C2 in tumor tissue of mice mRNA expression were all decreased(P<0.05),and the therapeutic effect of the combined group was significant(P<0.01).Conclusion This study predicted the key immune genes related to hepatocellular carcinoma as well as the prognostic analysis of immune-related genes,and the experimental study verified that Ginseng and Astragalus Tumor Suppressor Formula could effectively reduce the expression of related immune genes in tumor tissues,and improve the proportion of related immune cells in the splenic tissues of mice with hepatocellular carcinoma model as well as improve the immune function of mice.

Objective To investigate the current status and barriers to implementing non-accompanied care services in medical institutions in Zhejiang Province,and to provide a basis for the improvement of standardized management of such services.Methods A self-designed questionnaire was conducted from September to October 2024 among all secondary and tertiary medical institutions in Zhejiang Province to assess the implementation status and barriers to non-accompanied care services.Results A total of 397 questionnaires were distributed,with 389 valid responses,yielding a valid response rate of 97.98％.Non-accompanied care services were implemented in 118 institutions(30.33％).Among these,90 institutions(76.27％)had established management systems for non-accompanied wards;71 institutions(60.17％)had a medical nursing assistant-to-bed ratio lower than 1∶5;41 institu-tions(34.75％)provided tiered training for medical nursing assistants;93 institutions(78.81％)required patients to bear the full cost of the service.Compared with secondary medical institutions,tertiary medical institutions have more complete management system for non-accompanied care services.The main obstacles hindering the development of non-accompanied care services include an imperfect management system for non-accompanied wards,a shortage of medical nursing assistants,a lack of standardized training for such assistants,inconsistent charging standards,and low acceptance among patients and their families.Conclusion The promotion of non-accompanied care services in medical institutions in Zhejiang Province has achieved initial success.However,challenges persist,including incomplete management systems,uneven development across hospital tiers,and imperfect charging mechanisms.It is recommended that relevant authorities strengthen policy support,enhance standardized training for healthcare nursing assistants,refine cost-sharing mechanisms,and improve the quality and sustainability of non-accompanied care services through multi-party collaboration.

Objective This study was to investigate the effects of Ginseng Astragalus Tumor Suppressor Formula combined with cisplatin on relevant immune genes and immune functions in mice modeled with hepatocellular carcinoma based on bioinformatics research.Methods Gene expression profiles and clinical data of hepatocellular carcinoma patients were downloaded from TCGA and GEO databases and screened for immune-expressed genes by taking intersections with immune-related genes downloaded from ImmPort database.Immune-related gene pair coefficients(IRGPI)were calculated to construct IRGP prognostic models.The optimal cut-off value of IRGPI for 1-year overall survival of hepatocellular carcinoma patients was determined based on ROC curve analysis,and hepatocellular carcinoma patients were divided into high and low immune risk groups,and the survival status of patients in the two groups was analyzed using the Kaplan-Meier method and the Log-Rank test.Then,we screened the active ingredients and gene targets of Ginseng Astragali Tumor Suppressor Formula for the treatment of hepatocellular carcinoma by network pharmacology,and obtained the intersection genes between Ginseng Astragali Tumor Suppressor Formula and disease,and then extracted the intersection of hepatocellular carcinoma-related immune genes and the intersection genes between Ginseng Astragali Tumor Suppressor Formula and disease through the"VennDiagram"software,and verified it through the animal model.The effects of Astragalus tumor-suppressing formula combined with cisplatin on the immunity genes and immune functions in the tumor tissues of mice with hepatocellular carcinoma were verified in animal models.Results Among 2483 relevant immune genes,84 pairs of immune-related genes were significantly associated with OS in the experimental group(P<0.001),and among the patients categorized into high and low immune risk groups by cut-off value-0.258,the overall survival rate of the high immune risk group was significantly lower than that of the low immune risk group(P<0.001).Univariate Cox analysis showed that IRGP model risk values and clinical characteristics of tumor T-staging had an impact on prognosis.Multifactorial Cox analysis showed that IRGP model risk value and tumor T-stage could be used as independent prognostic factors.266 genes intersecting with hepatocellular carcinoma were screened by network pharmacology technique for Ginseng Astragalus Tumor Suppressor Formula,and further 8 genes were obtained by taking the intersection with 84 pairs of immune-related genes.The experimental results showed that compared with the model group,the tumor mass of mice in each treatment group decreased(P<0.05);the spleen index and thymus index of mice increased(P<0.05);the CD4+/CD8+ratio in serum and spleen tissues of mice decreased;ICAM1,FABP5,IGF2,CDK4,NR1,ADRB2,AR,NR3C2 in tumor tissue of mice mRNA expression were all decreased(P<0.05),and the therapeutic effect of the combined group was significant(P<0.01).Conclusion This study predicted the key immune genes related to hepatocellular carcinoma as well as the prognostic analysis of immune-related genes,and the experimental study verified that Ginseng and Astragalus Tumor Suppressor Formula could effectively reduce the expression of related immune genes in tumor tissues,and improve the proportion of related immune cells in the splenic tissues of mice with hepatocellular carcinoma model as well as improve the immune function of mice.

Cancer incidence in China has been rising steadily,with a particularly heavy burden from several high-prevalence malignancies.Medical examination for cancer plays a critical role in the early detection of cancer,precancerous lesions,and precursor conditions,thereby facilitating timely diagnosis and intervention.Such examination also addresses the growing demand for person-alized cancer screening services among diverse population groups.The development of evidence-based,context-specific cancer screening guidelines is essential to enhance the standardization,quality,and equity of preventive screening practices across the country,ultimately improving out-comes in early cancer detection and treatment.Guided by the Department of Medical Emergency Response of the National Health Commission,the Guidelines for Medical Examination for Cancer in Health Examination Agency(2025 Edition)were developed under the leadership of the National Cancer Center.A multidisciplinary panel of experts formulated the guidelines in accordance with the principles and methodology of the World Health Organization Handbook for Guideline Deve-lopment.The guidelines provide evidence-based recommendations on key clinical domains:target cancers and populations,overall screening workflow,screening protocols,diagnostic technolo-gies,result interpretation,follow-up procedures,and quality control.The primary objective is to standardize cancer screening practices in health examination agency and strengthen China's ca-pacity for prevention and control of high-burden cancers.

Objective To evaluate the diagnostic value of ischemia-modified albumin(IMA)and the crea-tine kinase(CK)index in acute ischemic stroke(AIS).Methods According to the inclusion and exclusion cri-teria,totally 149 newly diagnosed and untreated AIS patients hospitalized in Henan Provincial People's Hospi-tal from October 2021 to October 2022 were selected as the AIS group.Additionally,156 healthy people who underwent the physical examination during the same period were selected as the control group.Activity levels of IMA,CK,creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)and hydroxybutyrate-dehydrogen-ase(HBDH)were measured using the Abbott C1600 biochemical analyzer,and the CK index(ratio of CK-MB to CK)was calculated.Relative risk factors were analyzed,receiver operating characteristics(ROC)curve was constructed,data were analyzed using SPSS27.0.1,graphs were plotted using GraphPad Prism 9.4.1,and differences in area under the curve(AUC)were compared using MedCalc(version 20.0.22).Results The AIS group exhibited significantly higher levels of IMA,CK-MB,and the CK index,and significantly lower levels of CK compared to the control group(all P＜0.05).Univariate logistic regression analysis revealed that both IMA and the CK index were risk factors for AIS(both P＜0.001).After adjusting for gender and age in a multivariate binary logistic regression analysis,IMA emerged as an independent risk factor for AIS(OR=1.901,95％CI:1.649-2.190,P＜0.001).IMA,CK-MB and CK index in the AIS group were significantly higher than those in the control group,and CK levels were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).Univariate Logistic regression analysis showed that IMA and CK index were risk factors for AIS(P＜0.001).After adjusting for sex and age in multivariate binary Logistic regression analysis,IMA was an independent risk factor for AIS(OR=1.901,95％CI:1.649-2.190,P＜0.001).The ROC curve demonstrated that AUC,the sensitivity and the specificity of sin-gle detection for IMA were 0.922,81.2％,and 90.4％,respectively.There was no significant difference compared to combined detection using IMA+CK index or IMA+CK index+CK(all P＞0.05).Conclusion IMA is an independent risk factor for AIS,which has strong diagnostic value and is worthy of clinical application.

Objective To explore the effect of multiparameter electroencephalogram(EEG)-guided anesthesia management on EEG burst suppression(BS)and postoperative delirium(POD)in elderly patients undergoing lower abdominal laparoscopic surgery.Methods A total of 100 elderly patients,48 males and 52 females,aged 65-85 years,BMI 18.5-28.0 kg/m2,and ASA physical status Ⅱ or Ⅲ,were enrolled for lower abdominal surgery under general anesthesia.Patients were randomly divided into two groups:multiparameter group and single parameter group,50 patients in each group.In multiparameter group,multiparameter EEG monitoring with patient statu index(PSI),spectral edge frequency(SEF),burst suppression ratio(BSR)and density spectral array(DSA)were used to guide the depth management of anesthesia.In single parameter group,single parameter PSI was used to guide the depth management of anesthesia.The total area under the hypotensive threshold of MAP(AUTMAP)was calculated,and the amount of anesthetic used during the operation and the use of vasoactive drugs,duration of anesthesia,extu-bation time,duration of PACU stay,and postoperative hospitalisation days were recorded.HR,MAP,PSI,and SEF were recorded before the induction of anesthesia,5 minutes after induction of anesthesia,5,30,and 60 minutes after incision,and at the end of surgery.The incidence,duration,and maximum BSR of in-traoperative BS,as well as the incidence of POD 1,2,and 3 days after surgery were recorded.Results There was no significant difference in AUTMAP values between the two groups.Compared with single parame-ter group,intraoperative propofol and remifentanil dosage were significantly decreased(P＜0.05),awak-ening time,PACU stay,and postoperative hospitalization time were significantly shorter in multiparameter group(P＜0.05),the PSI was significantly increased 5,30,and 60 minutes after incision and at the end of surgery,and the SEF was significantly increased 5 minutes after induction of anesthesia,5,30,and 60 minutes after induction and the end of surgery(P＜0.05).Compared with single parameter group,inci-dence of intraoperative BS was significantly decreased,duration of BS was significantly shorter,smaller maximum BSR was significantly decreased,and incidence of POD on 1 day after surgery in multiparameter group(P＜0.05).Conclusion Anesthesia management guided by multiparameter EEG can inhibit the oc-currence of BS,mitigate the degree of BS,and reduce the incidence of POD in elderly patients undergoing abdominal surgery.

Objective:To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes.Methods:The clinical data of children with septic shock in children′s PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results:A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs ( OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions:The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.