Brain metastasis is the most common intracranial tumor in adults. Radiotherapy is one of the most important treatments, in addition to drugs, surgery, and other treatments. In recent years, rapid development of targeted therapy and radiosurgical technology has transformed the treatment mode of brain metastases, with increasing emphasis on individualized treatment. However, the mode of radiotherapy in patients with driver gene-positive remains controversial. In this article, the advances in the timing of radiotherapy for brain metastases were reviewed.

Cognitive impairment is a kind of senile disease that leads to the decline of personality and behavior ability of the elderly,which seriously affects the quality of daily life of patients.The prevalence rate of the disease increases year by year with the acceleration of the aging process of the society,and its incidence is affected by many risk factors.At this stage,the curative effect for middle and advanced patients is poor.So early identification and intervention to delay the progression of cognitive impairment have become the focus of relevant research.Blood pressure variability can lead to damage of target organs such as heart,brain tissue and kidney,which is closely related to cognitive impairment.In order to expand a new perspective of early intervention in cognitive impairment,this paper reviews the effects of blood pressure variability on different cognitive impairment and its possible pathogenic mechanism.

Objective To identify the main blood absorbed constituents from Youguiyin and elucidate the proliferative effect of Youguiyin and its main blood absorbed constituents on osteoblasts in rats.Methods Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technique was used to establish the analysis method for Youguiyin,individual herbal medicines and the medicated serum containing Youguiyin after oral administration in Sprague-Dawley rats.Osteoblasts of rats were isolated and cultured in vitro.The effect of Youguiyin,medicated serum,and its main blood absorbed components on osteoblast proliferation rate was evaluated by thiazole blue(MTT)assay.Results Ten components were detected in the blood serum of rats after oral administration of Youguiyin,namely aconitine,hypaconitine,mesaconitine,benzoylaconitine,benzoylhypaconitine,benzoylmesaconine from Aconiti Lateralis Radix Praeparata,cinnamic acid from Cinnamomi Cortex,morroniside,loganin from Corni Fructus,and pinoresinoldiglucoside from Eucommiae Cortex,respectively.Youguiyin decoction and seven components from Aconiti Lateralis Radix Praeparata and Cinnamomi Cortex showed a certain promoting proliferation effect on osteoblasts when the concentrations were 1 μg·mL-1,10 ng·mL-1,10 ng·mL-1,1 ng·mL-1,100 μg·mL-1,100 pg·mL-1,1 μg·mL-1 and 1 ng·mL-1,respectively.Besides,the effect onset was relatively rapid.The onset time of medicated serum containing Youguiyin was slow.Conclusions The ten chemical components absorbed in the blood from Youguiyin were identified.It was revealed that Youguiyin,medicated serum and the main components of Youguiyin absorbed in the blood can promote the proliferation of osteoblasts within a certain concentration range.

Objective To construct a perioperative exercise program for older frail patients with colorectal cancer,and to verify its effect.Methods Based on Goal-directed Theory and literature review,expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer.Then,from July to December 2022,the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application.It was divided in to the intervention group and the control group by the ward.The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing.The safety,feasibility and intervention effect of the program were evaluated.Results 15 experts were included for 2 rounds of expert consultations.The authority coefficient was 0.880;the coefficient of variation was＜0.250;the Kendall concordance coefficient was 0.167 and 0.224,respectively.The final program contained 4 stages:preoperative exercise,postoperative bed rest,sitting and standing exercise.In the end,54 specific interventions were constructed.During the preliminary application,all the patients completed the program.Generalized estimation equation showed that,on the interaction effect,there was no statistical difference(P=0.752);there were significant differences on the intervention effect and the time effect(P＜0.05).At discharge,there were significant differences in timed up and go test and Barthel Index between the 2 groups(P＜0.05).Only 2 patients experienced mild pain in the intervention group,and no other adverse events occurred.Conclusion The perioperative exercise program for older frail patients with colorectal cancer,based on Goal-directed Theory,is scientific,reliable and safe.It has been preliminarily verified in improving postoperative physical function,activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.

【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.

ObjectiveTo determine the trend in diabetes-related death and probability of premature mortality among residents in Yangpu District of Shanghai and provide evidence for the formulation of relevant intervention strategies. MethodsMortality and demographic data were collected among residents in Yangpu District of Shanghai from 2002 to 2020. Statistical analysis was conducted using chi-square test with SPSS 21.0 and Excel 2010. Joinpoint regression was used to determine annual percent change （APC）. The mortality was standardized by utilizing the world standard population in 2000. ResultsA total of 25 091 cases of diabetes-related deaths were reported in Yangpu District， Shanghai from 2002 to 2020. The average annual crude mortality of diabetes-related diseases was 122.10/10⁵， which was 116.13/10⁵ in males and 128.23/10⁵ in females. The difference between males and females in crude mortality was statistically significant （P<0.05）. Moreover， primary causes of diabetes-related deaths were diabetes， cardiovascular and cerebrovascular diseases， and tumors. Among diabetic deaths， peripheral circulatory complications accounted for 50.79%， followed by renal complications （16.05%）. The crude mortality in males， females， and total of diabetes-related diseases showed an upward trend， while the standardized mortality remained stable with an upward trend in male and a downward trend in female. Furthermore， the crude mortality in males， females， and total of diabetes complicated with cardiovascular and cerebrovascular diseases showed an increasing trend. In contrast， both the standardized mortality in males and in total showed an increasing trend， while that in females remained stable. The overall crude mortality of diabetes was on the rise， which was increasing in males and stable in females. The overall standard mortality of diabetes was on the decline， which was increasing in males while declining in females. In addition， the probability of premature mortality caused by diabetes-related diseases， cardiovascular and cerebrovascular diseases complicated with diabetes， and diabetes decreased from 2002 to 2020 with no statistical significance. Males showed an upward trend while females showed a downward trend. ConclusionThe mortality of diabetes-related diseases， cardiovascular and cerebrovascular diseases complicated with diabetes， and diabetes among residents in Yangpu District of Shanghai is on the rise. Similarly， standardized mortality and probability of premature mortality in males for all three diseases are also on the rise. It warrants more attention to the health of male diabetes patients and targeted measures to reduce the disease burden.

In November 2019, we received and treated a patient with MTSCC of the left kidney. The tumor was located at the upper pole of the left kidney, with a size of 23.3 cm×18.0 cm×21.8 cm. She underwent transperitoneal radical nephrectomy. There was no local recurrence or distant metastasis during the follow-up of 3 years and 2 months. MTSCC of the kidney is a rare subtype of renal carcinoma, with slower disease progression, a clear and smooth rim, and fewer invasion or metastasis. Its final diagnosis should depend on pathology examination. Surgical treatment is the only effective intervention for this disease at present.

Objective:To compare the consistency of preoperative frailty assessment in elderly colorectal cancer patients using Frailty Phenotype (FP), FRAIL Scale (FS), Clinical Frailty Scale (CFS), and Edmonton Frailty Scale (EFS), and their predictive performance in predicting the postoperative complication, so as to provide reference for nurses to choose appropriate frailty assessment tools.Methods:From December 2020 to October 2021, 207 elderly patients who underwent radical surgery for colorectal cancer at the General Surgery of the First Affiliated Hospital of Soochow University were selected as the study subject by convenience sampling. FP, FS, CFS, and EFS were used to assess patients' frailty. Taking postoperative complications as the outcome indicator, the predictive performance of four frailty assessment tools was compared using the receiver operating characteristic (ROC) curve and Bayes discriminant analysis.Results:The frailty detection rates of FP, FS, CFS, and EFS in 207 elderly colorectal cancer patients were 19.8% (41/207), 11.6% (24/207), 22.2% (46/207), and 10.1% (21/207), respectively. The areas under the ROC curves of FP, FS, CFS, and EFS were 0.714, 0.643, 0.737, and 0.665, respectively, with statistically significant differences (all P<0.01). Pairwise comparison found that there were statistically significant differences in the area under the ROC curve between FP and FS, FS and CFS, CFS and EFS ( P<0.05). The cross validation accuracy of FP, FS, CFS and EFS in predicting the postoperative complication in elderly colorectal cancer patients was 78.7%, 68.6%, 76.3%, and 75.8%, respectively. Conclusions:FP and CFS have moderate predictive performance for postoperative complications in elderly colorectal cancer patients, and there is no difference in predictive performance between the two. Both CFS and FP can be used for the assessment of preoperative frailty in elderly colorectal cancer patients, but considering clinical applicability, CFS is recommended.

Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

Monkeypox， a zoonotic disease caused by monkeypox virus， can be transmitted among humans. The etiology and the clinical symptoms of monkeypox are analogous to smallpox. Before 2022， monkeypox was mainly reported in central and west Africa as an endemic. Since May 2022， the outbreak of monkeypox has been reported in many non-endemic countries and regions. Now， the number of new cases of monkeypox is increasing rapidly. The pattern of monkeypox transmission is significantly different from that in previous outbreaks， and many studies have proposed the possible influence of genetic evolution on the virulence and host range of monkeypox virus in the incident. Given its similarity to smallpox， the outbreaks of monkeypox have attracted wide international attention. In order to provide a scientific basis for the formulation of specific measures of prevention and control， we reviewed the characteristics of etiology and epidemiology of monkeypox， and made primary analysis of the global epidemic of monkeypox.