BACKGROUND: Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide. Although the early stage non-small cell lung cancer (NSCLC) presents a relatively good prognosis, a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages. Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival. Following the standard methods of neoadjuvant therapy, perioperative management, postoperative adjuvant therapy, and other therapeutic strategies are important for improving patients' prognosis and quality of life. However, controversies remain over the perioperative management of NSCLC and presently consensus and standardized guidelines are lacking for addressing critical clinical issues in multimodality treatment. METHODS: The working group consisted of 125 multidisciplinary experts from thoracic surgery, medical oncology, radiotherapy, epidemiology, and psychology. This guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The clinical questions were collected and selected based on preliminary open-ended questionnaires and subsequent discussions during the Guideline Working Group meetings. PubMed, Web of Science, Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNKI) were searched for available evidence. The GRADE system was used to evaluate the quality of evidence and grade the strengths of recommendations. Finally, the recommendations were developed through a structured consensus-building process. RESULTS: The Guideline Development Group initially collected a total of 62 important clinical questions. After a series of consensus-building conferences, 24 clinical questions were identified and corresponding recommendations were ultimately developed, focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assement, and follow-up protocols for NSCLC. CONCLUSIONS This guideline puts forward reasonable recommendations focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assessment, and follow-up protocol of NSCLC. It standardizes perioperative multimodality treatment and provides guidance for clinical practice among thoracic surgeons, medical oncologists, and radiotherapists, aiming to reduce postoperative recurrence, improve patient survival, accelerate recovery, and minimize postoperative complications such as atelectasis.
Humans ; Carcinoma, Non-Small-Cell Lung/therapy* ; Lung Neoplasms/therapy* ; Combined Modality Therapy ; Perioperative Care

[Objective]To explore the mechanism of breast cancer occurrence,development and metastasis from the perspective of Qi-blood-colleteral transmission.[Methods]Starting from the classical Chinese medical texts and the etiology and pathogenesis of breast cancer,it analyses and elaborates the correlation between the metastasis of breast cancer and the transmission of Qi,blood and collaterals,and systematically analyses the treatment of breast cancer from the perspective of Qi,blood and collaterals,citing a clinical case to support it.[Results]Integrating antiquarian analysis,traditional meridian content and modern scholarly evidence-based surveys,it is found that breast cancer is located in the liver,Qi depression is the core factor of breast cancer,which produces toxin,caused by Qi and blood,mixed with phlegm and blood stasis,and finally reaches the deepest place of the body-collaterals.Therefore,for the treatment of breast cancer,depending on the stage of the disease,the diagnosis and treatment can be made based on the diagnosis and treatment.At the initial stage,the Qi should be adjusted to resolve the toxicity of depression,the blood should be dispersed to remove the toxicity of turbidity,and then gradually penetrate into the channels to remove the toxicity of stasis,and the medication should also be based on the three steps of Qi,blood,channels,and the treatment should be from shallow to deep.The syndrome differentiation of the attached case belonged to Qi deficiency and blood stasis,toxin and blood stasis blocking collaterals,with the method of supplementing Qi and activating blood circulation,detoxifying and removing blood stasis,searching collaterals and removing pathogens,finally the case achieved good effect and improved the lifequality.[Conclusion]The pathogenesis of breast cancer is preceded by Qi stagnation,the poison starts from Qi,enters the blood from Qi,the blood and the collaterals,and the collaterals'deficiency and toxicity are the important etiological mechanism for the emergence,development and metastasis of breast cancer.The treatment of breast cancer puts emphasis on clearing and resolving the toxicity of Qi,dispersing the turbid toxicity of blood,and searching and eliminating the toxicity of the stasis in the channel,which can provide new ideas for the treatment of breast cancer with traditional Chinese medicine.

[Objective]To explore the mechanism of breast cancer occurrence,development and metastasis from the perspective of Qi-blood-colleteral transmission.[Methods]Starting from the classical Chinese medical texts and the etiology and pathogenesis of breast cancer,it analyses and elaborates the correlation between the metastasis of breast cancer and the transmission of Qi,blood and collaterals,and systematically analyses the treatment of breast cancer from the perspective of Qi,blood and collaterals,citing a clinical case to support it.[Results]Integrating antiquarian analysis,traditional meridian content and modern scholarly evidence-based surveys,it is found that breast cancer is located in the liver,Qi depression is the core factor of breast cancer,which produces toxin,caused by Qi and blood,mixed with phlegm and blood stasis,and finally reaches the deepest place of the body-collaterals.Therefore,for the treatment of breast cancer,depending on the stage of the disease,the diagnosis and treatment can be made based on the diagnosis and treatment.At the initial stage,the Qi should be adjusted to resolve the toxicity of depression,the blood should be dispersed to remove the toxicity of turbidity,and then gradually penetrate into the channels to remove the toxicity of stasis,and the medication should also be based on the three steps of Qi,blood,channels,and the treatment should be from shallow to deep.The syndrome differentiation of the attached case belonged to Qi deficiency and blood stasis,toxin and blood stasis blocking collaterals,with the method of supplementing Qi and activating blood circulation,detoxifying and removing blood stasis,searching collaterals and removing pathogens,finally the case achieved good effect and improved the lifequality.[Conclusion]The pathogenesis of breast cancer is preceded by Qi stagnation,the poison starts from Qi,enters the blood from Qi,the blood and the collaterals,and the collaterals'deficiency and toxicity are the important etiological mechanism for the emergence,development and metastasis of breast cancer.The treatment of breast cancer puts emphasis on clearing and resolving the toxicity of Qi,dispersing the turbid toxicity of blood,and searching and eliminating the toxicity of the stasis in the channel,which can provide new ideas for the treatment of breast cancer with traditional Chinese medicine.

Objective:To validate and compare the value of the Status Epilepticus in Pediatric Severity Score (STEPSS) versus PEDSS in assessing the short-term prognosis of children with status epilepticus (SE).Methods:Clinical data of 152 children with SE hospitalized at the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were retrospectively analyzed.According to the STEPSS and PEDSS scores, children with SE were scored and their prognosis was predicted.Receiver operating characteristic (ROC) curves of the 2 scales in assessing the short-term prognosis of SE in children were plotted, and the area under the curve (AUC), optimal cut-off, sensitivity and specificity were calculated, thus validating and comparing the value of the STEPSS versus PEDSS in assessing the short-term prognosis of children with SE.Results:Of the 152 children with SE, 90 were male and 62 were female, with the age of (5.8±3.9) years (1 month to 15 years). There were 112 cases with good prognosis and 40 cases with poor prognosis, involving 13 deaths.The AUC of STEPSS and PEDSS scores in predicting the death in children with SE were 0.908(95% CI: 0.848-0.967) and 0.887(95% CI: 0.831-0.942), respectively, both with the optimal cut-off value of 4.The sensitivity of STEPSS and PEDSS scores in predicting the death in children with SE were 0.740 and 0.846, respectively, and the specificity were 0.745 and 0.835, respectively.There was no significant difference in predicting the death in children with SE between the 2 scales ( P>0.05). In predicting adverse outcomes, the AUC of the STEPSS and PEDSS scores were 0.869(95% CI: 0.800-0.937) and 0.926(95% CI: 0.873-0.979), respectively, both with the optimal cut-off value of 3.The sensitivity of STEPSS and PEDSS scores in predicting adverse outcomes in children with SE were 0.827 and 0.900, respectively, and the specificity were 0.732 and 0.866, respectively.There was significant difference in predicting the adverse outcomes in children with SE between the 2 scales ( P<0.05). Conclusions:Compared with the STEPSS, the PEDSS has a higher application in predicting the short-term treatment outcome of children with SE, which can be used as a routine method to assess the prognosis of children with SE.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

OBJECTIVETo determine the nature of genomic copy number variations (CNVs) in two fetuses with congenital heart defects (CHD) and explore the correlation between 3q microdeletions and CHD.

METHODSGenomic DNA was extracted from fetal umbilical cord tissue, and chromosome copy number variations were detected by low coverage whole genome sequencing.

RESULTSBoth fetuses had microdeletions of the long arm of chromosome 3. Fetus 1 had ventricular septal defect, cleft lip and palate, and a 1.66 Mb deletion on 3q29. The deleted region encompassed all of the critical genes for 3q29 microdeletion syndrome. Fetus 2 had overriding aorta, ventricular septal defect, and a novel 240 kb deletion on 3q28.

CONCLUSION3q29 microdeletion may result in CHD in combination with cleft lip and palate. Genomic CNVs can be detected by low coverage whole genome sequencing.

Chromosome Deletion ; Chromosomes, Human, Pair 3 ; DNA Copy Number Variations ; Female ; Genetic Testing ; Heart Defects, Congenital ; genetics ; Humans ; Pregnancy ; Prenatal Diagnosis

Objective To investigate the clinical efifcacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of liver metastasis of colon cancer. Methods A total of 68 patients with liver metastasis of colon cancer in the Sixth Affiliated Hospital of Sun Yat-sen University from June 2007 to May 2011 were enrolled in this prospective study. The informed consents of all patients were obtained and local ethical committee approval had been received. There were 43 males and 25 females with a mean age of (59±4) years old. The patients were divided into RFA group and Control group with 34 cases in each group according to random number table method. Patients in both groups underwent TACE ifrstly and patients in RFA group underwent RFA 3 weeks after TACE treatment. Cluster of differentiation (CD) 3+, CD4+, CD8+positive cell percentage and CD4+/CD8+ratio were deifned by flow cytometry before and after treatments in two groups. The tumor diameter after treatments and general efifcacy were observed. The patients were followed up and the tumor recurrence and survival of the patients were observed. The comparisons of tumor diameter and immune function between two groups were conducted using t test. The comparison of efifcacy between two groups was conducted using rank sum test. The survival analysis was conducted using Log-rank test and Z test. Results The CD4+, CD8+percentage and CD4+/CD8+ratio were (42±4)%, (13±3)%, 2.9±0.9 in RFA group after treatment and were (33±4)%, (17±3)%, 2.3±0.9 in Control group, where signiifcant differences were observed (t=5.483,-6.488, 9.321;P<0.05). The tumor diameter in RFA group after treatment [(0.9±0.1) cm] was significantly smaller than that in Control group [(1.9±0.2) cm] (t=-4.573, P<0.05). The total effective rate in RFA group was 62%(21/34) and was 35%(12/34) in Control group. The treatment efifcacy of RFA group was better than that of Control group (Z=4.769, P<0.05). The 2-, 3-year survival rates in RFA group (38.2%, 23.5%) were significantly higher than those in Control group (14.7%, 5.9%) (Z=4.836, 4.221; P<0.05). Conclusions TACE combined with RFA is a safe and effective regimen in treating liver metastasis of colon cancer. The efifcacy may be associated with the improvement of the body’s immune function.

OBJECTIVE: To study on relationship between diverse handling time following onset and clinical prognosis of cases with Bell palsy. METHOD: Two hundred and sixteen cases with Bell palsy, who were admitted in our department between Jun. 2006 and Dec. 2009, were collected and divided into 6 groups according to disease time: 1-2 months, > 2 - 3 months, > 3 - 4 months, > 4 - 5 months, > 5 - 6 months, and > 6 months. Cases in all groups received subtotal course decompression of facial nerve and other compound treatment, and the relationship between handling timing and clinical prognosis were compared. RESULT: It was found that the difference of prognosis and handling timing was statistically significant, after comparison between all groups with Facial Grading Standards (H-B) as the standard to assess prognosis. CONCLUSION Clinical prognosis of cases with Bell palsy was related to alternative handling time, and subtotal course decompression of facial nerve was recommended to be performed as early as possible for those cases who were irresponsive after conservative treatment for one month.
Adolescent ; Adult ; Bell Palsy ; surgery ; Decompression, Surgical ; methods ; Facial Nerve ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Treatment Outcome ; Young Adult

Aim To investigate the protective effect of catechin on cerebral ischemia-reperfusion injury in rats and its mechanism.Methods 40 rats were randomly divided into 5 groups:sham operation group,model group and 50,100 and 200 mg·kg~(-1) catechin groups,with 8 rats in each group.The model of focal cerebral ischemia-reperfusion in rats was established with modified sutured-occluded method.The rats in catechin groups were injected with catechin at the matched concentration.The rats in sham operation group and model group were injected with saline.And all rats were given more time in 2 hours after ischemia.Rats were sacrificed for histologic examination after the behavioral test,and their brains were taken to assay the activities of MPO and NOS.Results Catechin at different dosages(50,100 and 200 mg·kg~(-1))could obviously decrease neurological deficit score,repair histological injury,and reduce the activities of MPO and NOS in rats of focal cerebral ischemia-reperfusion injury.Conclusions Catechin can relieve the cerebral ischemia reperfusion injury,and its mechanism may be partly related to the effects of its antiinflammation and antioxidation.

Strict regulation of HIV-1 PR function is critical for efficient production of mature viral particles. During viral protein expression and viral assembly, HIV-1 PR located within Gag-Pol precursor must be inactive to prevent premature cytoplasmic processing of the viral Gag and Gag-Pol precursors. Premature activation of HIV-1 precursors leads to major defects in viral assembly and production of viral particles. A cell-level premature activation of HIV-1 precursors assay using bioluminescence resonance energy transfer (BRET) was established. Three thousand compounds were screened to evaluate this assay. The results showed that the assay is sensitive, specific and stable (Z' factor is 0.905).