Objective:To explore the current status and influencing factors of family resilience in primary caregivers of advanced cancer patients.Methods:A convenience sampling method was used to select the primary caregivers of advanced cancer patients from the Department of Gastrointestinal Oncology at Beijing Cancer Hospital, between July 2023 and March 2024. A questionnaire survey was conducted using a general information survey, the Family Hardiness Index, the General Self-Efficacy Scale, and subscales for intimacy, emotional expression, and conflict in the Family Environment Scale.Results:A total of 130 questionnaires were distributed, and 120 valid questionnaires were returned, resulting in an effective response rate of 92.31%. The family Hardiness Index score of the 120 primary caregivers was (61.03±6.44) , with scores for the responsibility dimension at (29.35±3.32) , the control dimension at (16.97±2.78) , and the challenge dimension at (14.72±2.17) . The General Self-Efficacy Scale score was (2.60±0.57) , and the Family Environment Scale scores were as follows: intimacy (8.13±1.45) , emotional expression (5.40±1.71) , and conflict 2.00 (1.00, 3.00) . Multiple linear regression analysis showed that emotional expression in the family environment ( P=0.001) , self-efficacy ( P<0.001) , and marital status ( P=0.017) were significant factors influencing family resilience in primary caregivers, explaining 27.2% of the total variance. Conclusions:The family resilience of primary caregivers of advanced cancer patients is at a moderate to high level. Caregivers with spouses, better emotional expression among family members, and higher self-efficacy tend to have higher levels of family resilience.

OBJECTIVE Aimed to investigate the impact of comorbid asthma on chronic rhinosinusitis with nasal polyps(CRSwNP)and identify key proteins and signaling pathways.METHODS Proteomic methods were employed to analyze differentially expressed proteins(DEPs)in nasal lavage fluid(NLF)from control,CRSwNP,and CRSwNP with asthma groups.DIA quantitative analysis technology was used to assess the gradient changes of DEPs among the three groups to determine key proteins affected by comorbid asthma in CRSwNP.RESULTS Compared to the control group,1 377 and 1 006 DEPs were identified in the CRSwNP and CRSwNP with asthma groups,respectively.Peroxiredoxin-5(PRDX5),Ran-Binding Protein 1(RanBP1)(upregulated),and Keratin 9(KRT9)(downregulated)were identified as key proteins affecting CRSwNP with asthma.CONCLUSION Comorbid asthma may promote the occurrence and development of nasal polyps through specific key proteins and signaling pathways,providing new molecular insights into the interaction between CRSwNP and asthma.

Invasive angiomyxoma（AAM） is characterized by unclear boundaries, non enveloped glial growth, high recurrence rate, and belongs to a benign tumor, but it is invasive and grows slowly. A patient with recurrent left vestibular invasive angiomyxoma was admitted to the Otorhinolaryngology ward of Beijing Traditional Chinese Medicine Hospital Affiliated with Capital Medical University. The patient underwent two repeated surgeries and underwent a combined internal and external nasal approach for the removal of the nasal vestibular angiomyxoma. The patient recovered well after the surgery and has not recurred since follow-up.
Humans ; Myxoma/pathology* ; Neoplasm Recurrence, Local ; Nose Neoplasms/pathology*

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective:To explore the current status and influencing factors of family resilience in primary caregivers of advanced cancer patients.Methods:A convenience sampling method was used to select the primary caregivers of advanced cancer patients from the Department of Gastrointestinal Oncology at Beijing Cancer Hospital, between July 2023 and March 2024. A questionnaire survey was conducted using a general information survey, the Family Hardiness Index, the General Self-Efficacy Scale, and subscales for intimacy, emotional expression, and conflict in the Family Environment Scale.Results:A total of 130 questionnaires were distributed, and 120 valid questionnaires were returned, resulting in an effective response rate of 92.31%. The family Hardiness Index score of the 120 primary caregivers was (61.03±6.44) , with scores for the responsibility dimension at (29.35±3.32) , the control dimension at (16.97±2.78) , and the challenge dimension at (14.72±2.17) . The General Self-Efficacy Scale score was (2.60±0.57) , and the Family Environment Scale scores were as follows: intimacy (8.13±1.45) , emotional expression (5.40±1.71) , and conflict 2.00 (1.00, 3.00) . Multiple linear regression analysis showed that emotional expression in the family environment ( P=0.001) , self-efficacy ( P<0.001) , and marital status ( P=0.017) were significant factors influencing family resilience in primary caregivers, explaining 27.2% of the total variance. Conclusions:The family resilience of primary caregivers of advanced cancer patients is at a moderate to high level. Caregivers with spouses, better emotional expression among family members, and higher self-efficacy tend to have higher levels of family resilience.

The Multi-Attribute Utility Instrument (MAUI) is currently a common method for health utility measurement. It converts scores from multiple dimensions of health status into a single utility value through the construction of utility value set,which is then used for the calculation of Quality-Adjusted Life Years (QALYs). Selecting an appropriate method for constructing the value set of MAUI is crucial for accurately measuring health utility values. The Multi-Attribute Utility Function (MAUF),as an important method for constructing the utility value set,has been widely applied internationally. It focuses on introducing the theoretical basis of the application of MAUF,the construction methods in different MAUI,and their application situations,aiming to provide references and insights for the methodological research on the construction of the utility value set for the MAUI in China.

Objective To investigate the clinical effect of transhepatic arterial chemoembolization(TACE)combined with tyrosine kinase inhibitors(TKIs)and programmed death receptors-1(PD-1)inhibitors(TACE+TKIs+PD-1 antibody)in the treatment of moderate advanced unresectable hepatocellular carcinoma(HCC).Methods The clinical data of 65 patients with moderate advanced unresectable hepatocellular carcinoma admitted to the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2022 were analyzed retrospectively.65 patients were treated with TACE+TKIs+PD-1 antibody.The observation indexes were tumor response,objective response rate(ORR),disease control rate(DCR),total survival time,progression free survival time,conversion operation rate and adverse drug reaction.Results The ORR of 65 p-atients with hepatocellular carcinoma was 49.2％(32/65),and the DCR was 89.2％(58/65).Among them,there were 2 patients with complete remission(CR),30 patients with partial remission(PR),26 patients with stable disease(SD),and 7 patients with progression disease(PD).Among 65 patients with hepatocellular carcinoma,18 patients were transformed into resectable hepatocell-ular carcinoma and underwent RO surgery.The conversion rate was 27.6％(18/65).65 patients were followed up for 3 to 22.4 months,The median follow-up time was 16.5 months.The median overall survival time and median disease progression free survival time of 65 patients were 14.5 months(95％CI:12.3～16.6 months)and 8.8 months(95％CI:6.9～10.6 months),respectively.After treatment,65 patients all had post embolism syndrome(abdominal pain,fever,nausea,vomiting and other symptoms),and some patients had transient abnormal liver function.Adverse drug reactions below grade 3 recovered within a few days.Some patients were associated with multiple adverse drug reactions.1 patient(1.5％)stopped using TACE because of stubborn vomiting,and 5 patients(7.6％)stopped using Lenvatinib because of severe liver function damage during treatment,2 patients(3％)stopped using Camrelizumab because of severe reactive capillary hyperplasia,one patient(1.5％)stopped using Tislelizumab because of severe hypothyroidism,one patient(1.5％)stopped the treatment of Lenvatinib and Sintilimab due to severe gastrointestinal bleeding.The adverse drug reactions of grade 3～4 occurred in other patients were alleviated after drug reduction,symptomatic treatment and hormone treatment.Conclusion TACE+TKIs+PD-1 antibody can obtain reliable clinical efficacy and anti-tumor activity in the treatment of moderate advanced unresectable hepatocellular carcinoma.

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Objective:To explore the expression and clinical significance of long non-coding RNA colorectal neoplasia differentially expressed (lncRNA CRNDE), microRNA-181a-5p (miR-181a-5p) and autophagy related 5 (ATG5) in the peripheral blood of patients with gouty arthritis (GA) patients.Methods:The clinical data, laboratory parameters and peripheral blood samples were collected from 40 patients with acute gout (AG), 40 patients with intermittent gout (IG) and 50 healthy subjects (HC). The expression levels of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA were detected by real-time fluorescence quantification (RT-qPCR) and the expression level of ATG5 protein was detected by Western-blot. The expression levels of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA were compared among the three groups and correlated with clinical indices, and a subject operating characteristic curve (ROC) was constructed to assess the value of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA in the diagnosis of gout. Measurements conforming to normal distribution were analyzed using t test or ANOVA, data with non-normal distribution was analyzed using Mann-Whitney U test or Kruskal-Wallis H test, correlation analysis between variables was analyzed using Spearman's analysis, and the diagnostic value of each indicator was analyzed using ROC curve. Results:① The differences in the expression of lncRNA CRNDE, miR-181a-5p, and ATG5 mRNA between the three groups were statistically significant ( H=32.12, 57.73, 68.32, all P<0.001). Among them, lncRNA CRNDE expression level in the AG group was significantly higher than that in the IG group and healthy control group [61.95(11.39, 108.30)×10 -3, 25.71(15.40, 38.40)×10 -3, 13.80(3.97, 23.99)×10 -3; Z=-3.24, P=0.001; Z=-5.03, P<0.001], and the expression level of IG group was higher than that of healthy control group( Z=-3.56, P<0.001); miR-181a-5p and ATG5 mRNA expression levels in AG group were significantly lower than those in IG group and healthy control group [miR-181a-5p: 39.81(31.22, 69.38)×10 -3, 60.74(44.19, 90.35)×10 -3, 121.30(101.50, 316.90)×10 -3; Z=-3.01, P=0.030; Z=-6.93, P<0.001. ATG5 mRNA: 4.52(2.31, 26.63)×10 -3, 43.63(13.72, 102.70)×10 -3, 153.90(66.62, 365.80)×10 -3; Z=-5.47, -7.36, all P<0.001)], which were expressed at lower levels in the IG group than in the healthy controls ( Z=-5.25, -4.47, all P<0.001). The difference of ATG5 protein expression level among the three groups expressed was statistically significant ( F=6.24, P=0.030), and the AG group was higher than the healthy control group, and the difference was statistically significant [(0.96±0.13) vs.(0.61±0.04), t=4.25, P=0.013], but the difference between the IG group (0.78±0.15) and the AG group and the HC group was not statistically significant ( t=1.51, P=0.206; t=1.85, P=0138). ② Spearman correlation analysis showed that lncRNA CRNDE was negatively correlated with the expression levels of miR-181a-5p and ATG5 mRNA in gout patients ( r=-0.49, P<0.001; r=-0.35, P=0.002); miR-181a-5p was positively correlated with ATG5 mRNA expression levels ( r=0.64, P<0.001); lncRNA CRNDE expression level was positively correlated with ESR and WBC ( r=0.49, P<0.001; r=0.43, P=0.001); miR-181a-5p expression level was negatively correlated with ESR and WBC ( r=-0.29, P=0.009; r=-0.35, P=0.002), and ATG5 mRNA expression levels were negatively correlated with ESR, WBC, and GR ( r=-0.26, P=0.021; r=-0.26, P=0.024; r=-0.27, P=0.021). In the AG group lncRNA CRNDE was positively correlated with ESR and WBC ( r=0.36, P=0.022; r=0.36, P=0.026) and miR-181a-5p was negatively correlated with WBC ( r=-0.34, P=0.038) ③ ROC curve showed that the areas under ROC curve of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA expression levels to predict gout were 0.764, 0.875 and 0.864, respectively. The area under ROC curve of gout predicted by the three combined was 0.928. Conclusion:lncRNA CRNDE, miR-181a-5p, and ATG5 may be involved in the pathoge-nesis of primary gouty arthritis, and are potential biological parameters for studying the pathogenesis of gout.

Objective:To investigate and explore the clinical significance of the expression levels and differences of autophagy related genes ATG3, ATG5, ATG12, ATG16, LC3 and Beclin-1 in peripheral blood mononuclear cells of patients with refractory moderate-to-severe rheumatoid arthritis (RA), who were treated with abatacept.Methods:Peripheral blood samples of 30 patients admitted to the affiliated hospital of North Sichuan Medical College from June 2020 to June 2022 were collected before and after abatacept treatment. Autophagy associated genes were detected by RT-qPCR and, autophagy associated proteins were detected by Western Blot. Correlation analysis with clinical parameters was performed. SPSS26.0 and GraphPad Prism 9.0 were used for statistical analysis, Independent sample t-test was used for comparison between groups, and non-normal distribution data were expressed as M ( Q1, Q3), Spearman correlation analysis was used to analyze the correlation between variables, and P<0.05 was considered statistically significant. Results:①Compared with the mRNA expression levels of ATG12(0.007 6±0.005 9), ATG16(0.003 1±0.002 2) and LC3(0.038 2±0.017 1) before treatment, after 24 weeks treatment with abatacept, the mRNA expression levels of ATG12 (0.011 4±0.003 1) and ATG16 (0.004 2±0.000 7) increased ( t=-2.49, P=0.042; t=-2.15, P=0.038), and the mRNA expression level of LC3 (0.022 6±0.008 3) was decreased ( t=3.28, P=0.003) after 24 weeks of abatacept treatment.②After 24 weeks, the expression level of ATG16 mRNA in the remission group (0.004 8±0.000 8) was higher than that in the non-remission group (0.003 8±0.000 3) ( t=-3.41, P=0.003). The expression level of LC3 mRNA in remission group (0.027 3±0.007 3) was lower than that in non-remission group (0.017 9±0.006 5) ( t=3.69, P=0.017). ③ATG5 mRNA expression level was positively correlated with TJC, ESR and anti-CCP antibody ( r=0.75, P=0.049; r=0.43, P=0.044; r=0.97, P=0.011). The expression level of ATG12 mRNA was negatively correlated with DAS28, ESR and hsCRP ( r=-0.46, P=0.025; r=-0.51, P=0.026; r=-0.41, P=0.031). The expression level of ATG16 mRNA was positively correlated with ESR and hsCRP ( r=0.50, P=0.030; r=0.40, P=0.024). The expression level of Beclin-1 mRNA was significantly higher than TJC, RF-IgG and anti-CCP antibody were negatively correlated ( r=-0.51, P=0.025; r=-0.42, P=0.035; r=-0.81, P=0.043). The expression level of LC-3 mRNA was positively correlated with ESR and hsCRP ( r=0.55, P=0.028; r=0.56, P=0.024). ④Compared with the protein expression level before the treatment, of ATG12 (0.675 3±0.036 3), which (1.547 7±0.080 5) increased after 24 weeks of treatment ( t=-7.80, P=0.001). Compared with the protein expression levels of ATG16 (0.817 1±0.089 0), LC3Ⅱ (0.807 1±0.072 1) and IL-1β (1.129 7±0.118 9) before treatment, 24 weeks after, the protein expression levels of ATG16 (0.424 6±0.103 5), LC3Ⅱ (0.353 7±0.056 9) and IL-1β (0.346 7±0.050 8) decreased ( t=2.62, P=0.042; t=2.88, P=0.045; t=2.25, P=0.038) 24 weeks after treatment. Conclusion:Autophagy related genes is associated with several clinical presentations and disease activity. The results of this study suggest that autophageius are involved in the pathogenesis of RA. Abatacept may be a potential autophage modulator by regulating autophagy related genes including ATG12、ATG16 and LC3.