Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the main pathological subtype of lung cancer. On April 13, 2023, the National Comprehensive Cancer Network (NCCN) released the third edition of the 2023 NCCN Oncology Clinical Practice Guidelines: Non-small Cell Lung Cancer, which reflects the latest advances in international lung cancer research. This article will interpret the main updated contents of the new edition of the guidelines, and compare it with the third edition of the NCCN guidelines in 2022, so as to provide references about the diagnosis and treatment of NSCLC for clinical medical personnel in China.
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Humans ; Carcinoma, Non-Small-Cell Lung ; China ; Lung Neoplasms ; Thorax

Objective:To investigate the clinical manifestations of population following COVID-19 by using questionnaires.Methods:COVID-19 among anesthesia workers and the surrounding population was investigated between 11 November 2022 and 31 December 2022 in China.The Tencent electronic questionnaire(ID.11492813) was sent to different WeChat groups of the Association of Anesthesiologists or Society of Anesthesiologists via the WeChat platform of the medical personnel in China. The survey was conducted between January 7 and January 15, 2023. Results:A total of 17 000 questionnaires were issued for this survey, 11 060 valid questionnaires from 31 provinces and autonomous regions were collected all over the country, with a recovery rate of 65.059%.There were 10068 (91.037%) participants diagnosed as having COVID-19, and among of them, 47.606% were male and 52.394% were female. The main post-COVID-19 clinical manifestations included fever (85.777%), cough (83.731%), fatigue (75.338%), parasomnia (64.352%), limb soreness (58.890%), dizziness, headache, tinnitus (38.617%), loss or abnormality of taste (37.763%), and loss or abnormality of smell (30.960%); peripheral neuralgia was usually found within 3 days after positive nucleic acid test or positive antigen test; there were 2 963 cases accompanied with sweating, and among of them, 47.25% were male and 52.75% were female, and 37.80% of these participants continued to sweat after the nucleic acid test or antigen test became negative. There were 1 151 cases with premature heart beats among the study population, and the symptoms aggravated following COVID-19 were found in 34.32% of these patients.Conclusions:In addition to the respiratory system, the central and peripheral nerves of patients are also affected following COVID-19, and the peripheral and central nerve disorders last until several days after negative nucleic acid test or antigen test, suggesting that anesthesiologists should pay more attention to monitoring of various nerve function and impact of surgery and anesthetic drugs on the stress response of the body in such patients.

Gastric cancer with hemorrhage and cerebral infarction is a serious complica-tion with poor prognosis in clinic. Although the incidence rate is extremely low, the fatality and disability rates are very high. In addition, the opposition in treatment between the two complica-tions increases the difficulty of clinical diagnosis and treatment. The authors report the diagnosis and treatment of a gastric cancer patient with hemorrhage and new cerebral infarction, in order to to provide reference for related treatments.

Objective To compare the preparation efficiency of mouse pox and mouse hepatitis antibodies between two substrains of BALB/c and Big-BALB/c (B-BALB/c) mice, and to provide a theoretical basis and reference for the selection of laboratory animals in the preparation of monoclonal antibodies inducedin vivo through hybridoma.Methods Individuals weighing more than 5% of the weight of normal animals at 4 weeks of age (the criterion for late selection is more than 10%) were selected from a population of conventionally bred BALB/c mice and bred individually, and a subline of B-BALB/c mice was prepared after 10 generations of selection. A total of 40 BALB/c mice and 40 B-BALB/c mice aged 10 to 11 weeks, half male and half female, were selected and inoculated with the mousepox monoclonal antibody hybridoma cell line G23 or the murine hepatitis monoclonal antibody hybridoma cell line Y15 pre-treated with liquid paraffin, respectively. Mice ascites containing monoclonal antibodies were obtained by in vivo induction. The antibody titer was tested by indirect ELISA. The mice were grouped based on the sub-strains, gender and inoculation type of hybridoma to analyze the ascites production, antibody titer and antibody production, and to evaluate the antibody preparation efficiency of the two BALB/c mouse sub-strains.ResultsAfter 10 generations of breeding, the body weight of 10-week-old male and female B-BALB/c mice increased by 22.3% and 12.8%, respectively, compared with BALB/c mice of the same age. Compared with BALB/c mice, B-BALB/c mice had better tolerance and adaptation to secondary ascites collection. Compared with BALB/c mice, the ascites production and antibody titer during the preparation of antibodies in B-BALB/c mice were significantly increased, especially in the hybridoma cell line G23 vaccination group (both P＜0.000 1) . After inoculation with the hybridoma cell lines G23 or Y15, the average antibody production of B-BALB/c mice (14.99×10⁴ U and 33.22×10⁴ U) was higher than that of BALB/c mice (5.33×10⁴ U and 19.31×10⁴ U) (both P＜0.01). After inoculation with hybridoma cell line G23, the average antibody production per unit body weight of B-BALB/c mice (0.55×10⁴ U/g) was higher than that of BALB/c mice (0.23×10⁴ U/g) (P＜0.000 1). And the antibody production per unit body weight of female B-BALB/c or BALB/c mice was higher than that of male B-BALB/c or BALB/c mice (bothP＜0.01).Conclusion B-BALB/c mice can be used as an alternative to BALB/c mice in the in vivo induction of monoclonal antibody preparation, which can achieve the purpose of reducing the number of experimental animals used, lowering the labor cost, and improving the efficiency of antibody preparation.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective: To investigate the current status and influencing factors of occupational stress among couriers. Methods: Couriers (n=925) were selected on this study used cluster sampling method from January to March 2018. They were from SF and Zhongtong Express Co., Ltd., on the Wechat platform, and surveyed by a job stress questionnaire based on a job demand-control model.Valid questionnaires(n=617) were obtained. Results: A total of 418 workers were occupational stress positive (67.7%). The results of Chi-square analysis showed that there were significant differences in occupational stress among workers categorized by job position, working years, mealtime, sleeping time, and weekly work time (P<0.05). The multivariate logistic analysis indicated that non-regular meals, short-term sleep and less than 0.5 working years were risk factors for occupational stress(P<0.05). Conclusion Couriers generally have occupational stress. The main influencing factors are job position, working years mealtime, sleeping time, and weekly work time. It is necessary to guide healthy lifestyle, rationally organize labor and assign tasks, and improve working environment to relieve their occupational stress.

Objective To explore the relationship of Crohn's disease (CD) susceptibility to aryl hydrocarbon receptor (AhR) polymorphisms and haplotypes in Han population in Wenzhou city, China. Methods A total of 310 CD patients and 573 age-and sex-matched healthy controls were enrolled in our study. Three single nucleotide polymorphisms (SNPs) of AhR(rs10249788,rs2158041,rs2066853) were determined by the improved multiple ligase detection reaction technique. Unconditional logistic regression analyses was applied to analyze the allelic and genotypic differences of each SNP between CD patients and controls, as well as their influence on the clinicopathologic characteristics in CD patients. Analyses of linkage disequilibrium and haplotype were performed by Haploview 4.2 software in all study subjects. Results Compared with the controls, the variant allele (T) and genotype (CT+TT) of (rs2158041) were evidently decreased among CD patients (19.52% vs. 25.04%, P=0.009; 34.19% vs. 44.68%, P=0.003). According to"the Montreal Classification Standards", CD patients were divided into different subgroups. The variant allele(T)and genotype(CT+TT)of(rs2158041)were significantly lower in patients with terminal ileum CD than in controls (16.79% vs. 25.04%, P=0.005; 28.24% vs. 44.68%, P=0.001). Similar conclusions were also drawn in patients with constricting disease when compared with the controls(15.20%vs.25.04%,P=0.003;28.43% vs.44.68%,P=0.003).The three SNPs above were shown to be in a linkage disequilibrium.Compared with the controls respectively,the frequency of haplotype(CCG)was increased in CD patients (44.73% vs. 39.60%, P=0.039), whereas that of haplotype (CTG) was decreased (18.02% vs. 22.78%, P=0.047). Conclusions AhR (rs2158041) variation might influence the risk as well as the location and behavior of CD. The haplotype (CCG) possibly increase the risk of CD development, whereas haplotype(CTG)might decrease it.

Objective To investigate the clinical efficacy of low-frequency transcranial magnetic stimulation (rTMS) on post-stroke upper limb spasticity and its mechanism. Methods From September, 2015 to December, 2017, 23 patients with post-stroke upper limb paralysis were randomly divided into control group (n=13) and experimental group (n=10). Both groups received routine rehabilitation, and the experimental group received 1 Hz rTMS at primary motor area (M1) for eight weeks. They were assessed with modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after treatment, while the activation under fMRI in the task state was observed and the laterality index (LI) was calculated. Results The scores of MAS, FMA-UE and MBI improved after treatment in both groups (Z>2.121, t=6.248, P<0.05), and improved more in the experimental group than in the control group (Z>2.084, t=-2.095, P<0.05). The ipsilateral M1, ipsilateral sensory motor cortex and bilateral supplementary motor area were activated more in the control group than in the experimental group during the movement of affected hand. LI in the M1 increased after treatment in both groups (Z>2.366, P<0.05), and was more in the experimental group than in the control group (Z=-2.430, P<0.05). There was a positive correlation between the change of LI in the M1 and the improvement of the MAS and FMA-UE (r>0.612, P<0.05). Conclusion Low-frequency rTMS may improve the motor function and spasticity of upper limb after stroke by promoting reorganization of the cortex and inducing normalization of cortical function.

Objective To analyze the genetic quality of 24 domestic inbred strains mice using microsatellite loci panel.Methods Previously selected 30 microsatellite loci of mouse with high polymorphism and more allele numbers were used to synthesize corresponding fluorescently-labeled primers.Then the genomic DNA samples of each mouse were amplified by PCR and the products were analyzed by STR scanning to genotype the inbred strains of mice.Results Out of the 24 inbred strains, 15 inbred strains showed the same genotype within one strain at 30 loci.Among different strains, microsatellite loci indicated polymorphism which could be used to distinguish different strains.However, the rest 9 strains demonstrated polymorphism within strains.Conclusions Our stuoly provides a useful microsatellite panel to detect genetic quality of inbred mice and distinguish different strains with the optimized microsatellite loci.

BACKGROUND:Previous studies have found that electroacupuncture can delay articular cartilage degeneration mediated by JAK-STAT signaling pathway through upregulating the expression level of transforming growth factor β1 as well as mRNA expression levels of STAT3, Smad3 and LepR. In the meanwhile, electroacupuncture can inhibit the mRNA expression of p38 and Fas mRNA mediated by MAPK signaling pathways, further inhibiting the apoptosis of chondrocytes. OBJECTIVE: To explore the effect of electroacupuncture on the degeneration of articular cartilage in rats with knee osteoarthritis based on Ras-Raf-MEK1/2-ERK1/2 signaling pathway. METHODS:120 male healthy Sprague-Dawley rats aged 2 months olds were selected and randomly divided into normal, model, 15-minite electroacupuncture and 30-minute electroacupuncture groups (n=30 per group). The rats in the latter three groups received the intra-articular injection of 4% papain bilaterally, and the remaining rats received no intervention. At 2 weeks after modeling, the latter two groups were respectively given 15- and 30-minute electroacupuncture, five times weekly for consecutive 12 weeks. The morphology of the cartilage was observed by hematoxylin-eosin staining, the expression level of interleukin-1β in the synovium was detected by ELISA assay, and the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were detected by western blot analysis. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that: in the model group, the cartilage surface was rough, the cartilage layer became thinner, and the cartilage structure was damaged with incomplete tidal line; in the 15- and 30-minute electroacupuncture groups, the cartilage structure was complete with clear layers and complete tidal line. ELISA showed that the expression level of interleukin-1β in the model group was significantly higher than that in the normal group (P< 0.01), and the level in the 15- and 30-minute electroacupuncture groups was significantly lower than that in the model group (P < 0.05). Western blot assay found that compared with the normal group, the protein expression levels of Ras, Raf, MEK1/2, ERK1/2, C-MYC, C-FOS, and C-JUN were increased in the model group. However, all above protein levels except ERK1/2 in the 15- and 30-minute electroacupuncture groups were significantly lower than those in the model group (P < 0.01,P < 0.05). To conclude, electroacupuncture inhibits the degeneration of articular cartilage in osteoarthritisvia Ras-Raf-MEK1/2-ERK1/2 signaling pathway and downregulating the expression level of interleukin-1β.