Objective:To investigate the clinicopathological and genetic features of infantile rhabdomyofibrosarcoma (IRFS) with EGFR kinase domain duplication (EGFR-KDD).Methods:The clinical, morphological and immunohistochemical features of three IRFS with EGFR-KDD diagnosed from January 2022 to January 2024 at Department of Pathology, Foshan Traditional Chinese Medicine Hospital, Foshan, China were retrospectively analyzed using PCR or next generation sequencing technique; and related literature was reviewed.Results:There were 1 male and 2 females, aged at presentation ranging from 1 to 4 years. The tumor occurred in the left thigh, right maxillofacial region, and right popliteal space. The presenting symptom was a painless mass which was accidentally discovered. The maximum diameter of tumors ranged from 3 to 5 cm. Microscopically, the tumors were poorly defined and composed of relatively monomorphic spindle cells, arranged in diffuse, fascicular growth patterns, with moderate pale eosinophilic cytoplasm. Mitoses were abundant. A few round rhabdomyoblastic tumor cells with abundant eosinophilic cytoplasm were found. There was no evidence of hemorrhage or necrosis. The tumor cells expressed vimentin, SMA, MSA, desmin, MyoD1 and myogenin; and the Ki-67 proliferation index was 10%-60%. RT-PCR showed EGFR-KDD in all three cases. Gene fusion was detected in three cases based on next generation sequencing, but only one case had EGFR-KDD. Follow-up data for 12 to 36 months showed two patients died of the disease and one patient was alive without recurrences and metastasis.Conclusions:IRFS is a rare soft tissue tumor that resembles infantile fibrosarcoma but has immunohistochemical evidence of rhabdomyoblastic differentiation. It more commonly occurs in infants and tends to appear in limbs and torso with poor prognosis. Aggressive multimodality treatment is recommended for these patients. EGFR-KDD may be a genetic driver to IRFS. Clinical response to EGFR targeted therapy might be promising in the future.

Objective:To investigate the clinicopathological and genetic features of infantile rhabdomyofibrosarcoma (IRFS) with EGFR kinase domain duplication (EGFR-KDD).Methods:The clinical, morphological and immunohistochemical features of three IRFS with EGFR-KDD diagnosed from January 2022 to January 2024 at Department of Pathology, Foshan Traditional Chinese Medicine Hospital, Foshan, China were retrospectively analyzed using PCR or next generation sequencing technique; and related literature was reviewed.Results:There were 1 male and 2 females, aged at presentation ranging from 1 to 4 years. The tumor occurred in the left thigh, right maxillofacial region, and right popliteal space. The presenting symptom was a painless mass which was accidentally discovered. The maximum diameter of tumors ranged from 3 to 5 cm. Microscopically, the tumors were poorly defined and composed of relatively monomorphic spindle cells, arranged in diffuse, fascicular growth patterns, with moderate pale eosinophilic cytoplasm. Mitoses were abundant. A few round rhabdomyoblastic tumor cells with abundant eosinophilic cytoplasm were found. There was no evidence of hemorrhage or necrosis. The tumor cells expressed vimentin, SMA, MSA, desmin, MyoD1 and myogenin; and the Ki-67 proliferation index was 10%-60%. RT-PCR showed EGFR-KDD in all three cases. Gene fusion was detected in three cases based on next generation sequencing, but only one case had EGFR-KDD. Follow-up data for 12 to 36 months showed two patients died of the disease and one patient was alive without recurrences and metastasis.Conclusions:IRFS is a rare soft tissue tumor that resembles infantile fibrosarcoma but has immunohistochemical evidence of rhabdomyoblastic differentiation. It more commonly occurs in infants and tends to appear in limbs and torso with poor prognosis. Aggressive multimodality treatment is recommended for these patients. EGFR-KDD may be a genetic driver to IRFS. Clinical response to EGFR targeted therapy might be promising in the future.

Objective: To explore the causal link of cumulative ecological risk and future orientation with health risk behaviors among higher vocational college students, so as to provide reference for reducing and preventing health risk behaviors among higher vocational college students. Methods: A longitudinal follow up study was conducted on 612 students using convenience sampling from 2 vocational colleges in Hunan Province. The Cumulative Ecological Risk Scale, Future Orientation Scale, and Health Risk Behavior Scale were used during three follow up visits (T1: September 2022, T2: June 2023, T3: March 2024), and a cross lagged panel model was constructed to examine the longitudinal causal relationship of cumulative ecological risk, future orientation and health risk behaviors. Analysis of longitudinal intermediary effect between variables by Bootstrap. Results: The cumulative ecological risk scores of T1, T2 and T3 among higher vocational college students were (2.94±1.44,2.99±1.63,3.02±1.54), future orientation scores (40.49±4.71,41.51±5.72,41.06±4.35) and health risk behavior scores (3.73±2.01,3.49±2.00,3.23±2.00). The results of repeated measures ANOVA showed that the future orientation score of T2 was higher than that of T1, and the main effect of measurement time was statistically significant ( F=5.09，P＜0.01,η 2=0.02). The health risk behavior score of T1 was higher than that of T2, and the health risk behavior score of T2 was higher than that of T3, and the main effect of measurement time was statistically significant ( F=10.12，P＜0.01,η 2=0.03).The cross lagged model showed good adaptability, with χ 2/df =7.20 ( P <0.01), relative fitting indicators GFI=0.98, CFI=0.99, TLI=0.96, IFI=0.99, NFI =0.99, and absolute fitting indicator RMSEA =0.06. Among them, the T1, T2 cumulative ecological risk showed negatively predictive effects on T2, T3 future orientation ( β =-0.24, -0.47 ), and T1, T2 cumulative ecological risk positively predicted T2, T3 health risk behavior ( β =0.20, 0.24), while T1, T2 future orientation negatively predicted T2, T3 health risk behavior ( β =-0.25, -0.18) ( P ＜0.01). Bootstrap test analysis found that T2 future orientation had a longitudinal mediating effect ( β=0.04, P ＜0.01) on the T1 cumulative ecological risk and T3 health risk behavior. Conclusions The accumulation of ecological risk among higher vocational college students can positively predict health risk behaviors, while future orientation can negatively predict healthrisk behaviors. Moreover, future orientation plays a longitudinal mediating role between accumulated ecological risks and health risk behaviors.

Objective:To survey the status quo of the provision of palliative care services by community health service centers in Shanghai and to investigate the related influencing factors.Methods:This was a cross-sectional survey. The status quo of the provision of palliative care services in all community health service centers (249 in total) in 16 districts of Shanghai were surveyed in December 2022. The Evaluation Form for the Quality Management of Hospice Care Work in Shanghai Community Health Service Center was used for survey, which included basic information, talent team, related department, medical services, research and training, and health education, etc. The data were collected up to November 30, 2022. The 16 districts were divided into three areas: central city (80 centers), suburb (92 centers) and exurb (77 centers). The scores of different districts were compared and the influencing factors were analyzed.Results:The average self-evaluation score of community hospice care service in 16 districts was 69.42 points. Changning District in the central city had the highest self-evaluation score (87.32 points) and Fengxian District in the exurb had the lowest self-evaluation score (44.59 points). The total scores of hospice service in central urban area and suburban area [(73.99±16.96) and (75.61±10.69) points] were higher than those in the exurbs [(56.81±20.82) points], and the scores in central urban area and suburban area were also higher than those in the exurbs ( P<0.05). Multivariate regression analysis showed that the community location, the registration status of hospice department, inpatient ward facilities, and availability of hospice information platform were independent influencing factors of community self-rating scores ( P<0.05). Conclusion:Hospice care services have been fully covered in Shanghai community health service centers, and the current situation of community hospice care services in the central city and the suburbs is better than that in the exurbs.

Objective:To survey the status quo of the provision of palliative care services by community health service centers in Shanghai and to investigate the related influencing factors.Methods:This was a cross-sectional survey. The status quo of the provision of palliative care services in all community health service centers (249 in total) in 16 districts of Shanghai were surveyed in December 2022. The Evaluation Form for the Quality Management of Hospice Care Work in Shanghai Community Health Service Center was used for survey, which included basic information, talent team, related department, medical services, research and training, and health education, etc. The data were collected up to November 30, 2022. The 16 districts were divided into three areas: central city (80 centers), suburb (92 centers) and exurb (77 centers). The scores of different districts were compared and the influencing factors were analyzed.Results:The average self-evaluation score of community hospice care service in 16 districts was 69.42 points. Changning District in the central city had the highest self-evaluation score (87.32 points) and Fengxian District in the exurb had the lowest self-evaluation score (44.59 points). The total scores of hospice service in central urban area and suburban area [(73.99±16.96) and (75.61±10.69) points] were higher than those in the exurbs [(56.81±20.82) points], and the scores in central urban area and suburban area were also higher than those in the exurbs ( P<0.05). Multivariate regression analysis showed that the community location, the registration status of hospice department, inpatient ward facilities, and availability of hospice information platform were independent influencing factors of community self-rating scores ( P<0.05). Conclusion:Hospice care services have been fully covered in Shanghai community health service centers, and the current situation of community hospice care services in the central city and the suburbs is better than that in the exurbs.

Objective To identify the characteristics and research status of symptom clusters in patients with lung cancer patients during chemotherapy.Methods This scoping review was conducted under the Joanna Briggs Institute guidelines.A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Scopus,CNKI,Wanfang,and CBM databases to identify relevant studies about symptom clusters in patients with lung cancer from inception until December 31,2023.The included studies were summarized and analyzed.Results 19 papers were included and 22 symptom clusters were extracted,mainly including psychological,gastrointestinal,lung cancer-specific,fatigue-related,and respiratory symptom clusters.There are 6 symptom cluster assessment tools,of which 4 were M.D Anderson Symptom Inventory in different version;the symptom clusters were dynamically changing during chemotherapy in patients with lung cancer,with variations in core symptom clusters at different stages.Conclusion Multiple symptom clusters exist during chemotherapy in lung cancer patients,and the naming of symptom clusters and attribution of symptoms need to be further standardized.The assessment tools for symptom clusters in patients undergoing chemotherapy for lung cancer are mainly based on the Anderson Symptom Assessment Scale and other language versions.Symptom clusters in patients with lung cancer during chemotherapy show dynamic changes,and there are differences in core symptom groups at different stages.

Neonatal hyperbilirubinaemia, clinically presenting as jaundice, is a ubiquitous and commonly a benign metabolic condition in newborn infants.It is a leading cause of hospitalization of neonates in the first week of life.Serum bilirubin has been considered as the most potent superoxide with the peroxyl radical scavenger activity.However, uncontrolled hyperbilirubinaemia or rapidly rising bilirubin can reach a neurotoxic concentration, potentially leading to central nervous system sequelae.Thus, the health status of jaundiced newborn infants is dependent on striking an appropriate balance between the protective effects of serum bilirubin and the risk of bilirubin neurotoxicity.In order to standardize the management of neonatal hyperbilirubinemia (jaundice), many countries have developed clinical practice management guidelines.This review sorted out and briefly interpreted the main contents of clinical management guidelines for neonatal hyperbilirubinemia drafted by the American Academy of Pediatrics and other countries, aiming to provide references of clinical diagnosis and treatment practice to domestic pediatrician.

Objective:To construct the evaluation index system of core competence of specialized gynecological nurses, and to provide reference for the curriculum setting and effect evaluation of standardized training for specialized gynecological nurses.Methods:The draft evaluation index system was prepared through literature research and group discussion. From May to June 2021, two rounds of Delphi letter consultation was used among 18 experts, to complete the selection and modification of evaluation index, and to determine the index weight.Results:The effective response rate of the two rounds of Delphi expert consultation was 100%, the expert authority coefficient was 0.938, and the Kendall harmony coefficient of the two rounds of expert letter consultation was 0.117 and 0.304, respectively (both P<0.01). Finally, the evaluation index system of core competence of specialized gynecological nurses was formed, including 4 first-level indexes, 11 second-level indexes and 48 third-level indexes. Conclusions:The evaluation index system of core competence of specialized gynecological nurses established in this study is scientific and reliable, which can provide reference for the curriculum setting and effect evaluation of standardized training for specialized gynecological nurses.

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.