Patients with lung cancer experience a heavy symptom burden during the perioperative period, which seriously affects their recovery and quality of life. Traditional symptom management models rely mainly on scheduled ward rounds during hospitalization and outpatient follow-up after discharge. However, they have limitations such as delayed symptom recognition, lack of post-discharge monitoring, and non-quantitative symptom assessment, which often lead to delayed interventions and low patient satisfaction. In recent years, the symptom management model based on electronic patient-reported outcomes (ePRO) has been increasingly valued in clinical practice. Existing high-level evidence from both domestic and international studies indicates that, through proactive monitoring, real-time alerts, and remote interventions, this model enables dynamic and continuous symptom management and helps improve patient recovery and healthcare experience. As a supplement to routine medical care, the ePRO-based symptom management model aims to enhance the quality of care rather than replace existing medical processes. To promote the standardized application of this model in perioperative lung cancer care, this consensus integrates domestic and international evidence. After multiple rounds of voting by more than 50 experts, it formulates 12 consensus statements covering the three core components, symptom monitoring, alerting, and intervention, to provide scientific and practical recommendations for clinical practice.

Metabolic dysfunction-associated fatty liver disease （MAFLD） progresses to metabolic dysfunction-associated steatohepatitis （MASH） due to mitochondrial homeostasis imbalance and dysfunction in hepatocytes caused by various factors such as lipotoxicity and inflammatory infiltration. Recent studies have confirmed that mitochondrial injury is closely associated with chronic inflammation， with extracellular vesicle （EV） acting as a key mediator linking the two processes. This article systematically reviews the molecular mechanisms of hepatocyte mitochondrial dysfunction in MAFLD/MASH， highlights the regulatory role of hepatocyte-derived EV in intrahepatic inflammation， and discusses the potential application prospects of mitochondria-targeted therapies and intercellular communication interventions in MAFLD/MASH， in order to provide a theoretical basis for developing novel therapeutic strategies for these diseases.

Objective To investigate the value of serum miR-196b-5p and miR-199a-3p levels in the diagnosis of non-small cell lung cancer(NSCLC).Methods A total of 202 patients with NSCLC admitted to Nantong First People's Hospital from January 2022 to March 2024 were retrospectively selected as the study objects,and 195 healthy subjects in the same period were selected as the controls.General baseline data and pathological features of NSCLC patients were collected.The expression levels of serum miR-196b-5p and miR-199a-3p were analyzed by quantitative reverse transcription polymerase chain reaction.The cor-relation between the expression levels of miR-196b-5p and miR-199a-3p and the concentration of cytokeratin 19 fragment anti-gen 21-1(Cyfra21-1)was analyzed by Pearson's correlation analysis.According to the mean expression levels of miR-196b-5p and miR-199a-3p,NSCLC patients were divided into high and low expression groups,and their clinical baseline and pathological characteristics were analyzed.Receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic efficacy of se-rum Cyfra21-1,miR-196b-5p,miR-199a-3p and their combination in patients with NSCLC.Results Compared with the control group,the expression level of miR-196b-5p was increased and the expression level of miR-199a-3p was decreased in patients with NSCLC.Compared with stage Ⅰ/Ⅱ patients,the serum relative expression level of miR-196b-5p in stage Ⅲ/Ⅳ patients was significantly increased,and the relative expression level of miR-199a-3p was significantly decreased(all P＜0.01).Serum miR-196b-5p levels in NSCLC patients were positively correlated with Cyfra21-1,and serum miR-199a-3p levels were negatively correlated with Cyfra21-1(all P＜0.01).The expression differences of miR-196b-5p and miR-199a-3p were correlated with fam-ily history,pathological stage,tumor size,Cyfra21-1 level and lymph node metastasis of NSCLC patients(all P＜0.05).The are-a-under-the-curve(AUC)of serum miR-196b-5p level for the diagnosis of NSCLC was 0.882(sensitivity 75.25％,specificity 95.38％),and the AUC of serum miR-199a-3p level for the diagnosis of NSCLC was 0.857(sensitivity 68.32％,specificity 88.21％).The AUC of traditional biomarker Cyfra21-1 in the diagnosis of NSCLC patients was 0.818(sensitivity 63.86％,spe-cificity 87.18％).The diagnostic efficacy of the combined detection of miR-196b-5p and miR-199a-3p was significantly higher than that of serum Cyfra21-1(P＜0.01),miR-196b-5p(P＜0.01)and miR-199a-3p(P＜0.01)alone in patients with early stage(stage Ⅰ/Ⅱ)NSCLC.Conclusion The expression level of serum miR-196b-5p in NSCLC patients is significantly increased,and the expression level of miR-199a-3p is decreased,and the combined detection of miR-196b-5p and miR-199a-3p has a high effi-ciency in the diagnosis of NSCLC.

Objective:To prepare domestic 64Cu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE), and to verify its distribution and preliminary diagnostic value in neuroendocrine tumors (NETs). Methods:DOTATATE was labeled with the domestic 64Cu to obtain 64Cu-DOTATATE. The lipophilicity, in vitro stability, and pharmacokinetics were studied. Biodistribution experiments and microPET imaging were performed on NCI-H727 (somatostatin receptor (SSTR)2 positive expression) tumor-bearing nude mice. The preliminary clinical applications were conducted on 10 NETs patients (5 males, 5 females; age (58.5±13.0) years) from Chinese PLA General Hospital between May 2023 and April 2024. Data were analyzed by using independent-sample t test. Results:64Cu-DOTATATE was successfully prepared with the radiochemical purity greater than 98%, log P of -2.609±0.051 and good stability. Pharmacokinetic experiments in BALB/c mice suggested rapid blood clearance of the drug (elimination half-time of 22.78min). Biodistribution results in tumor-bearing mice showed that 64Cu-DOTATATE was mainly metabolized through the liver and kidneys, with significant tumor uptake at 1h ((2.519±0.273) percentage activity of injection dose per gram of tissue (%ID/g)) and sustained high uptake at 24h ((4.331±0.549)%ID/g). MicroPET imaging of tumor-bearing mice showed a slight increase in uptake and good retention at 24h, with a significant statistical difference compared to the blocked group ((2.197±0.250) vs (0.985±0.064) % ID/g; t=6.40, P=0.008). The tumor/liver ratios were 0.075±0.007, 0.083±0.011, 0.118±0.005, 0.263±0.031 at 1, 2, 6 and 24h, respectively. Preliminary clinical application indicated that 64Cu-DOTATATE exhibited good targeting in patients, and the liver radioactivity distribution was moderate (SUV max=10.62±3.46), providing good image quality. Conclusion:Domestic 64Cu-DOTATATE PET/CT imaging is a promising imaging evaluation method in NETs with the value for further clinical research.

Objective:To analyze the quality level of maternal mid-trimester serum prenatal screening in China from 2019 to 2023.Methods:A questionnaire survey was conducted to collect information from laboratories participating in the National Health Commission′s Clinical Laboratory Center inter-laboratory quality assessment program for prenatal screening from 2019 to 2023. The collected data included screening protocols, detection methods, testing systems, and monthly laboratory screening quality indicators. The Chi-square test was used to compare the initial screening positive rates among different screening protocols, provinces, detection methods, and testing systems. A log-transformed linear regression analysis was performed to evaluate the relationship between the average annual sample size and the out-of-control rate of various median multiple of the median (mMoM) values.Results:This study included 806 laboratories from 29 provinces (including autonomous regions and municipalities). The five-year average out-of-control rates for mMoM values across indicators ranged from 15.8% to 31.3%. The initial positive rates of dual, triple, and quadruple screening protocols were statistically different ( χ2=760.2, P<0.001). The initial positive rates across different provinces ranged from 4.7% to 10.3%, with statistically significant differences ( χ2=35 388.0, P<0.001). There were also statistically significant differences in initial positive rates between different testing systems ( χ2=2 493.2, P<0.001). Testing systems using chemiluminescence methods had significantly higher initial positive rates compared to systems using time-resolved fluorescence methods (7.2% vs. 6.5%, χ2=533.6, P<0.001). Log-linear regression analysis showed that testing systems with larger annual average sample sizes had lower out-of-control rates for mMoM values (AFP: β=-0.100, P=0.005; hCG: β=-0.123, P=0.008; uE3: β=-0.139, P=0.007). Conclusion:There are significant differences in the quality of maternal mid-trimester serum screening across different detection methods, testing systems and provinces in China.

Objective To analyze the impact of medical insurance payment method reform on the efficiency of health services in China and provide empirical evidence for optimizing payment policies.Methods Using panel data from 31 Chinese provinces from 2012 to 2022,it measured health service efficiency with super-efficiency SBM model,assessed the effects of payment reforms using a staggered DID model,and analyzed the heterogeneous impacts of health informatization levels and health resources.Results DRG payment method reform increased health service efficiency,while no evidence was found that DIP payment method reform improved efficiency.Heterogeneity analysis showed that DRG payment method reform effects were not significantly influenced by health informatization levels or bed resource distribution,where as DIP payment method reform's negative effects were positively moderated in regions with higher informatization or abundant bed resources.Conclusion DRG payment method reform can improve the efficiency of healthcare services.It is recommended to accelerate the promotion of the DRG payment method system.Regarding the reform of the DIP payment system,it is recommended to improve the DIP scoring settlement mechanism,strengthen refined disease management,optimize hospital information system construction,enhance the medical insurance information platform and medical record quality control system,in order to improve hospital management levels and service efficiency.

Recently, photodynamic therapy (PDT) has gained considerable attention as a promising therapeutic approach for the treatment of psoriasis. Unfortunately, the activation of high mobility group box 1 protein (HMGB1) by PDT triggers innate and adaptive immune responses, which exacerbate skin inflammation. Herein, we combined glycyrrhizic acid (GA), a natural anti-inflammatory compound and immunomodulator derived from the herb Glycyrrhiza uralensis Fisch., with PDT actuated by the photosensitizer chlorin e6 (Ce6) by co-loading them in GA-based lipid nanoparticles coated with a catechol-modified quaternary chitosan salt (GC NPs/QCS-C). GC NPs/QCS-C exhibited high drug loading efficacy, uniform size distribution, an ideal topical adhesive property, enhanced skin retention and penetration in psoriasis-like lesions, and high intracellular uptake in epidermal cells compared with the counterparts. Subsequently, the transdermal administration of GC NPs/QCS-C followed by near-infrared laser radiation in an imiquimod-induced psoriasis-like mouse model significantly ameliorated psoriasis symptoms, promoted the apoptosis of hyperproliferative epidermal cells, and alleviated the inflammatory cascade. The significant therapeutic outcomes of GC NPs/QCS-C were attributed to the synergistic effects of GA and PDT on modulating immune cell recruitment and inhibiting dendritic cell maturation. Our results demonstrated that the topical bio-adhesive nanosystem that combines GA and Ce6 offers a synergistic chemo-phototherapeutic strategy for psoriasis treatment.

Objective:To investigate the current status of preimplantation genetic testing for aneuploidies (PGT-A) in China in 2024 and to provide recommendations for ensuring the consistency of PGT-A results.Methods:This study was a nationwide external quality assessment research. The National Center for Clinical Laboratories of the National Health Commission conducted two surveys in June and December 2024, with participation from 31 laboratories across China. During each survey, quality control samples of varying concentrations were distributed: the first survey distributed 6 samples (Batch Nos. 202401-202406) and the second survey distributed 3 samples (Batch Nos. 202431-202433). Participating laboratories were required to submit information including detection platforms, single-cell amplification methods, library construction methods, sequencing instruments, and test results. Collected data were statistically analyzed using Microsoft Excel to evaluate laboratories' PGT-A testing capabilities and determine whether results met predefined quality control requirements.Results:All 31 laboratories submitted results for both surveys. In the first survey, 90.3% (28/31) met qualification criteria with a 9.7% failure rate (3/31). For individual batches, pass rates were 90.3% (28/31) for batches 202401-202403 and 100% (31/31) for batches 202404-202406. The second survey achieved 100% (31/31) compliance across all three batches (202431-202433), with each batch maintaining a 100% pass rate.Conclusion:The detection quality of PGT-A in China is generally good, but with differences, and factors such as sample concentration, transportation conditions and detection methods affect the consistency of the results. The study highlights the urgent need for nationwide external quality assessment of PGT-A in China. This will help identify issues in laboratories in a timely manner and ensure the consistency of PGT-A test results.