Objective To analyze the MRI imaging characteristics of brain metastases in non-small cell lung cancer(NSCLC)with different epidermal growth factor receptor(EGFR)mutation types and programmed cell death-ligand 1(PD-L1)expression,and to provide imaging diagnostic support for patients who can't undergo genetic and immunohistochemical testing.Methods A retrospec-tive selection was performed in 88 patients diagnosed with brain metastases of NSCLC,all patients were divided into EGFR mutation group and wild group according to the results of genetic testing,and patients with EGFR mutation group were divided into EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expression negative group according to whether the expression of PD-L1 was≥1％.The clinical data and MR image characteristics of brain metastases were compared in EGFR mutation group and wild group,as well as in EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expres-sion negative group.Results There were statistically significant differences in smoking history and intracranial symptoms between EGFR mutation group and wild group(P＜0.05).The edema diameter,edema index and enhancement ratio of EGFR mutation group and wild group were(0.67±1.10)cm,0.39±0.54,0.32±0.17 and(1.57±2.04)cm,1.05±1.21,0.53±0.27,respectively,and the differences were statistically significant(P＜0.05).There were 43 cases and 23 cases in EGFR mutation group and wild group with ≥2 metastases,respectively,and the difference was statistically significant(P＜0.05).Compared with＞60 years old,there were 15 patients(75％)of EGFR mutation with PD-L1 expres-sion positive in≤60 years old(P＜0.05).Conclusion Compared with EGFR wild patients,patients with EGFR mutation have more brain metastases(≥2),milder enhancement,less peritumoral edema,and fewer intracranial symptoms at initial diagnosis,and patients with EGFR mutation aged≤60 years are more likely to have PD-L1 expression positive.

Objective:To analyze the application of mobile application-based decision support tools in patient treatment decision-making both domestically and internationally, and to provide references and insights for future research in this area.Methods:A search was conducted in databases including China National Knowledge Infrastructure, VIP, Wanfang, China Biology Medicine disc, PubMed, Embase, CINAHL, and Web of Science for relevant studies on the application of mobile application-based decision support tools in patient treatment decision-making, with the search period extending from database inception to April 1, 2024. The scope review methodology by Arksey and O'Malley was used to guide the literature summary and analysis.Results:A total of 9 studies were included in the review. The main presentation forms of mobile application-based decision support tools in patient treatment decision-making were text, charts, and videos. The main contents included assessing patients' decision-making needs, providing informational support, and summarizing the decision-making process. The evaluation criteria focused on 2 areas: decision quality (preparedness for decision-making, self-efficacy, decision conflict, regret, actual participation, satisfaction, knowledge of the disease, and treatment choices) and psychological state.Conclusions:It is recommended that future researchers fully consider patients' treatment decision-making needs and preferences, provide a more diverse range of information presentation methods, and strengthen the comprehensiveness and scientific basis of the content. These improvements aim to enhance decision quality and, through multi-center, large-sample, high-quality studies, further explore the effectiveness of these tools in clinical applications, thereby providing more evidence for their widespread adoption.

Objective To analyze the MRI imaging characteristics of brain metastases in non-small cell lung cancer(NSCLC)with different epidermal growth factor receptor(EGFR)mutation types and programmed cell death-ligand 1(PD-L1)expression,and to provide imaging diagnostic support for patients who can't undergo genetic and immunohistochemical testing.Methods A retrospec-tive selection was performed in 88 patients diagnosed with brain metastases of NSCLC,all patients were divided into EGFR mutation group and wild group according to the results of genetic testing,and patients with EGFR mutation group were divided into EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expression negative group according to whether the expression of PD-L1 was≥1％.The clinical data and MR image characteristics of brain metastases were compared in EGFR mutation group and wild group,as well as in EGFR mutation with PD-L1 expression positive group and EGFR mutation with PD-L1 expres-sion negative group.Results There were statistically significant differences in smoking history and intracranial symptoms between EGFR mutation group and wild group(P＜0.05).The edema diameter,edema index and enhancement ratio of EGFR mutation group and wild group were(0.67±1.10)cm,0.39±0.54,0.32±0.17 and(1.57±2.04)cm,1.05±1.21,0.53±0.27,respectively,and the differences were statistically significant(P＜0.05).There were 43 cases and 23 cases in EGFR mutation group and wild group with ≥2 metastases,respectively,and the difference was statistically significant(P＜0.05).Compared with＞60 years old,there were 15 patients(75％)of EGFR mutation with PD-L1 expres-sion positive in≤60 years old(P＜0.05).Conclusion Compared with EGFR wild patients,patients with EGFR mutation have more brain metastases(≥2),milder enhancement,less peritumoral edema,and fewer intracranial symptoms at initial diagnosis,and patients with EGFR mutation aged≤60 years are more likely to have PD-L1 expression positive.

Objective:To analyze the application of mobile application-based decision support tools in patient treatment decision-making both domestically and internationally, and to provide references and insights for future research in this area.Methods:A search was conducted in databases including China National Knowledge Infrastructure, VIP, Wanfang, China Biology Medicine disc, PubMed, Embase, CINAHL, and Web of Science for relevant studies on the application of mobile application-based decision support tools in patient treatment decision-making, with the search period extending from database inception to April 1, 2024. The scope review methodology by Arksey and O'Malley was used to guide the literature summary and analysis.Results:A total of 9 studies were included in the review. The main presentation forms of mobile application-based decision support tools in patient treatment decision-making were text, charts, and videos. The main contents included assessing patients' decision-making needs, providing informational support, and summarizing the decision-making process. The evaluation criteria focused on 2 areas: decision quality (preparedness for decision-making, self-efficacy, decision conflict, regret, actual participation, satisfaction, knowledge of the disease, and treatment choices) and psychological state.Conclusions:It is recommended that future researchers fully consider patients' treatment decision-making needs and preferences, provide a more diverse range of information presentation methods, and strengthen the comprehensiveness and scientific basis of the content. These improvements aim to enhance decision quality and, through multi-center, large-sample, high-quality studies, further explore the effectiveness of these tools in clinical applications, thereby providing more evidence for their widespread adoption.

The proportion of the elderly population in China is increasing.How to truly achieve elderly care and medical services through medical-nursing combined care is an important problem that urgently needs to be solved.Taking Beijing as an example,this paper analyzed the development situation of medical-nursing combined care in Beijing,conducted field research on the three main models of medical-nursing combined care in Beijing,as well as summarized the difficulties and challenges faced by different models from the perspective of organizations and institutions.It suggested to further integrate and coordinate the Beijing-Tianjin-Hebei policies of medical-nursing combined care,accelerate the implementation of long-term care insurance,strengthen the professional training of elderly care talent teams,enhance the standardized construction and supervision of elderly care institutions,and vigorously develop technological and intelligent elderly care.

Objective To explore the CT finding of inflammatory myofibroblastic tumor (IMT)in the rare abdominal or pelvic, and compare their pathologies,to improve the accuracy of diagnosis and understanding of the disease.Methods The imaging,clinical and pathological data of 1 7 cases with IMT in the rare abdominal or pelvic were analyzed retrospectively.1 1 cases were performed with plain and enhanced scan,3 cases had plain scan only,and 3 cases had enhanced scan only.Results Among the 1 7 cases,8 cases were male,9 cases were female;1 5 cases were single,2 cases were multiple;4 cases were located in the stomach,colon or bladder,3 cases located in spleen,1 case located in kidney or urachus.Among those,2 lesions located in the colon cavity presented as soft tissue, it was difficult to distinguish the lesion from the adjacent intestinal contents since the small intestinal hypotonic CT examination was not performed and the intestinal filling was poor,thus those lesions were missed diagnosed with CT plain scan.The remaining 15 cases presented as soft tissue density as well,among those,9 cases presented with clear border while 6 cases with blurred border;the peripheral fat space of 4 cases were blurred and presented as infection and exudation,5 cases were accompanied with lymph node enlargement around the lesion;the density of 10 cases were uneven,among those,1 IMT lesion in bladder presented with linear calcification,1 IMT lesion in gastric antrum presented with nodular ossification in the center,9 cases showed obvious necrosis and cystic degeneration;5 cases showed even.After contrast administration,the lesions were enhanced mildly,moderately or significantly.The enhancement type were various,presented as uniform or nonuniform delayed enhancement.Vessel shadow was observed in 10 cases during arterial phase.All of the 17 lesions were primary, and no recurrence was found during follow-up.Conclusion The feature of IMT in the abdominal or pelivic including the following:the peripheral area of the lesion presenting as infection or exudation,the lesion showing uniform or nonuniform delayed enhancement, and vessel shadow observed in the lesion during arterial phase;in addition,calcification of the edge or central of the lesion occasionally happens,while ossification of the lesion is quite rare.