To analyze the treatment strategy for a 78-year-old female patient with mismatch repair deficient (dMMR) gastric cancer who achieved long-term survival. After third-line chemotherapy failed, gene testing showed ARID1A p.Gln748fs, c.2733-1G＞T variation, with PD-L1 TPS 30%, CPS 60%. The nivolumab was employed, and two weeks later, the best response was partial response (PR). During the fourth-line immunotherapy maintenance treatment, progression of left adrenal metastasis was observed. The expression of human epidermal growth factor receptor-2 (HER-2) was positive, and the antibody drug conjugate disitamab vedotin (RC48) was chosen for treatment. After 10 months of treatment with nivolumab combined with RC48, the best efficacy was assessed as stable disease (SD), with a progression free survival (PFS) of up to 12 months. Radiotherapy was employed, and immunotherapy was maintained, allowing the patient to achieve a PFS of 18 months again. During immunotherapy, a clinical pharmacist developed a personalized pharmaceutical care plan for this patient. At the last follow-up, this patient achieved 78 months of long-term survival.

Objective: To explore the association of latent profiles of mobile phone dependence and self control with physical exercise among junior high school students, so as to provide references for the prevention of mobile phone dependence and the improvement of self control among junior high school students. Methods: From April to May 2024, a stratified random cluster sampling method was used to select a total of 2 311 students from grade 7 to grade 9 in three public junior high schools in Xiangxi Autonomous Prefecture, Hunan Province. Latent profile analysis was conducted to identify the latent profiles of mobile phone dependence and self control among junior high school students. Pearson correlation analysis was used to examine the correlation between mobile phone dependence and self control, and Chi square test was used to analyze the distribution differences of latent profiles of adolescents across different demographic characteristics. Multiple Logistic regression analysis was applied to explore the association between mobile phone dependence, self control, and physical exercise. Results: Four latent profiles of mobile phone dependence and self control were identified: low dependence-moderate self control group ( n =885, 38.3%), moderate dependence-low self control group ( n =910, 39.4%), high dependence-no self control group ( n =232, 10.0%), and no dependence-high self control group ( n =284, 12.3%). Significant differences were observed in the distribution of latent profiles across gender, grade and only child status ( χ 2=10.85, 35.72, 13.85， P <0.05). Logistic regression analysis showed that, after controlling for demographic variables, compared with the low dependence-moderate self control group, physical exercise was negatively associated with the moderate dependence-low self control group ( OR =0.79) and the high dependence-no self control group ( OR =0.81), while positively associated with the no dependence-high self control group ( OR =1.58) ( P <0.01). Conclusions The influence of physical exercise on junior high school students different potential profile types of mobile phone dependence and self control is different. Schools and families should adopt targeted physical exercise interventions based on the characteristics of different profiles to promote the physical and mental health of junior high school students.

Artificial intelligence(AI)has demonstrated great potential in the diagnosis and treatment of pancreatic cancer.It plays an important role in medical imaging analysis,pathological slide recognition,drug efficacy and prognosis prediction,as well as new drug development by leveraging deep learning algorithms.Despite challenges such as data acquisition and model interpretability,advancements in technology and data sharing are expected to further enhance its role in early screening,personalized treatment,and innovative drug discovery for pancreatic cancer,ultimately improving patient outcomes.

Artificial intelligence(AI)has demonstrated great potential in the diagnosis and treatment of pancreatic cancer.It plays an important role in medical imaging analysis,pathological slide recognition,drug efficacy and prognosis prediction,as well as new drug development by leveraging deep learning algorithms.Despite challenges such as data acquisition and model interpretability,advancements in technology and data sharing are expected to further enhance its role in early screening,personalized treatment,and innovative drug discovery for pancreatic cancer,ultimately improving patient outcomes.

Objective:To analyze the health development plans of the provinces in China during the " 14th Five-Year Plan" , and explore the key tasks, similarities and differences of health informatization construction in each province.Methods:Using the website of local people′s government and the official website of the provincial Health Commission, 27 copies of health development plans of various provinces during the " 14th Five-Year Plan" period were retrieved and collected from February 16 to June 5, 2022. The relevant statements of health information in the plan were extracted, content analysis was used to reveal the structural characteristics of the policy in the form of word frequency statistics, and discourse analysis was used to study the policy content.Results:The health information policies of 27 provinces during the " 14th Five-Year Plan" period could be summarized as 10 major themes, such as accelerating the construction of hierarchical diagnosis and treatment system, promoting the high-quality development of public hospitals, and deepening the reform of medical security system. The health information policy in the eastern, central and western regions was relatively clear, and there were certain differences in the construction points according to their own characteristics.Conclusions:During the " 14th Five-Year Plan" period, the policies of each province around the field of health information are well defined, and the core structure and content are similar. The distribution of key points in the eastern region is relatively balanced; the construction of health information in the central region is more prioritized and prominent; the construction of health information in the western region is focused on complementing the weak links and weaknesses.

Objective:To explore whether autophagy is involved in dysfunction of vascular endothelial induced by sodium arsenite (NaAsO 2). Methods:Human primary umbilical vein endothelial cells were isolated and cultured. The cells were treated with different levels of NaAsO 2 [0 (control)), 2, 5, 10, 20, 30, 50 μmol/L] for 24 h, and cell viability was determined using CCK8. According to the results of CCK8, the levels of arsenite used in subsequent experiments were determined, intracellular nitric oxide (NO) content (incubated by NaAsO 2 for 4 h) was detected by flow cytometry, LC3 levels (incubated by NaAsO 2 for 0, 6, 12 and 24 h) was detected using Western blotting, and autophagosome (incubated by NaAsO 2 for 12 h) was observed by electron microscope. At the same time, human primary umbilical vein endothelial cells were pretreated with 0.1 mmol/L 3-MA (autophagy inhibitor) for 2 h, and induced by 30 μmol/L NaAsO 2, and the above detection indicators were compared with those of the 30 μmol/L NaAsO 2 group. Results:Human primary umbilical vein endothelial cells were successfully isolated and cultured. Compared with the control group [cell viability: (99.97 ± 5.33)%, NO content: 42 048.34 ± 789.61], the cell viability [(73.00 ± 0.86)%] and NO content (23 353.97 ± 971.85) of 30 μmol/L NaAsO 2 group were remarkably lower, and the differences were statistically significant ( P < 0.01). Incubated with 30 μmol/L NaAsO 2 at different time points 6, 12, 24 h, LC3Ⅱ levels (5.782 ± 2.789, 9.692 ± 2.222, 5.573 ± 2.941) were significantly elevated than those of control group (1.000 ± 0.383, P < 0.05), and the LC3 Ⅱ level was the highest at 12 h. After treatment with 30 μmol/L NaAsO 2 for 12 h, the number of autophagosome in cells observed under electron microscope was significantly higher than that of the control group. Compared with 30 μmol/L NaAsO 2 group [cell viability: (68.78 ± 1.55)%, LC3 Ⅱ level: 5.680 ± 0.545, NO content: 13 025.78 ± 962.61], cell viability [ (79.54 ± 4.99) %] in 3-MA+ NaAsO 2 group was increased, the LC3Ⅱ level (3.956 ± 0.398) was decreased, and the differences were statistically significant ( P < 0.05); intracellular NO content (13 988.51 ± 1 671.07) increased, whereas the difference was not statistically significant ( P > 0.05). Conclusion:Autophagy is involved in the vascular endothelial dysfunction induced by arsenic.

Objective To investigate the effects of garlicin capsule on immune function in patients with breast cancer undergoing chemotherapy??Methods Form April 2018 to October 2018,62 patients with breast cancer were treated by operation in Tangshan People′s Hospital and pathologically diagnosed as breast cancer??Random number table method was used to divide the patients into treatment group and control group, with 31 cases in each group??The treatment group was given garlicin capsule combined with EC regimen( the first day( epirubicin hydrochloride injection 90 mg／m2+ cyclophosphamide 90 mg／m2 ) ,21 days for one cycle,four consecutive cycles), while the control group was given EC regimen alone for 4 courses??The occurrence of adverse reactions was recorded??T lymphocyte subsets were detected before and after treatment to evaluate the immune function of the body??Results There was no significant difference in the number of adverse reactions between the two groups after treatment ( Seventy in the treatment group and 69 in the control group) ( P＞0??05)??The levels of CD3+, CD4+, CD8+ and CD4+／CD8+ were ( 53??76 ± 4??29)%, (40??19 ±3??71)%,( 28??61 ± 2??75)% and ( 1??41 ± 0??16) in the treatment group before chemotherapy, respectively??While after chemotherapy were ( 52??41 ± 4??44)%, ( 39??49 ± 4??06)%, ( 28??70 ± 2??76)% and (1??35± 0??94), respectively??The levels of CD3+, CD4+, CD8+ and CD4+／CD8+ were ( 54??35 ± 4??09)%, (40??70± 4??09 )%, ( 27??62 ± 3??60 )% and ( 1??49 ± 0??24 ) in the control group before chemotherapy, respectively??While after chemotherapy were ( 44??27 ± 6??67)%, ( 35??39 ± 4??96)%, ( 30??48 ± 3??43)% and (1??17±0??20)??After treatment,the levels of CD3+,CD4+,CD4+／ CD8+ decreased and CD8+ increased,but there had no significant difference( P＞0??05)??After treatment,CD3+( decreased from( 54??35 ± 4??09)% to (44??27 ± 6??67 )%), CD4+( decreased from ( 40??70 ± 4??09 )% to ( 35??39 ± 4??96 )%), CD4+／CD8+ ((decreased from (1??49±0??24) to (1??17±0??20)),the difference was statistically significant( t value was 7??17,4??60,5??71,－3??02,P value was 0??000,0??000,0??002,0??000)??Compared with control group,the levels of CD3+、CD4+、CD4+／ CD8+in treatment group increased and CD8+decreased significantly (all P＜0??01)??Conclusion Garlicin capsule can improve the depression of immune function caused by chemotherapy??

Objective To detect patients with cancer of the stomach cancer tissue and serum Periostin protein expression of the situation,the preliminary explore its clinical significance.Methods Selected 60 cases of our hospital diagnosed as gastric carcinoma patients with carcinoma tissue samples,tissue adjacent to carcinoma specimens and serum,and choose 60 cases of healthy check-up serum specimens at the same time.Classified all patients according to clinical classification factors,inclu-ding age,sex,TNM stage,degree of infiltration,lymph node metastasis and pathological grading,immunohistochemical meth-od determination of Periostin in gastric cancer and adjacent tissue protein expression,enzyme-linked immunoassay detection in patients with gastric cancer patients and normal serum Periostin protein content.Results The method of ELISA to detect gastric cancer patients serum Periostin protein level was 46.76.4 ng/ml,and healthy crowd Periostin protein levels was 23.1 ±4.5 ng/ml,statistically significant difference (t= 7.34,P<0.05).Immunohistochemical methods showed that Periostin in patients with cancer of the stomach cancer tissue protein positive rate was (73.2±5.4)%,positive rate of (33.4±6.5)%in the tissue adjacent to carcinoma,statistically significant difference (t=8.52,P<0.05).Ⅲ~Ⅳ period patients serum Periostin protein level was 64.9±6.3 ng/ml,Ⅰ~Ⅱ period patients serum Periostin protein level was 41.6±4.1 ng/ml, statistically significant difference (t=9.17,P< 0.05).Periostin protein inⅢ~Ⅳ positive rate was 67.8% in patients with carcinoma tissue,Ⅰ~ phase Ⅱ positive rate was 52.9%,statistically significant difference (t=9.64,P<0.05).According to infiltrate the classification:T3,T4 patients serum Periostin protein level was 61.9±6.6 ng/ml,T1 and T2 patients serum Periostin protein level was 44.6±3.7 ng/ml,statistically significant difference (t=8.24,P<0.05).Periostin protein in T3 and T4 positive rate was 6 6.2% in patients with carcinoma tissue,T1 and T2 positive rate was 5 1.4%,statistically signifi-cant difference (t=7.58,P<0.05).Lymph node metastasis patients serum Periostin protein level was 65.2±4.3 ng/ml, without metastasis in patients with serum Periostin protein level was 42.6±3.2 ng/ml,statistically significant difference (t=7.63,P<0.05).Periostin protein in the tissue of carcinoma patients with lymph node metastasis group positive rate was 60.8%,no transfer of positive rate was 37.5%,statistically significant difference (t=8.56,P<0.05).Conclusion Periostin protein expression in patients with gastric cancer tissue and serum was significantly higher than that of healthy people,and to a certain extent is proportional to the illness,Periostin protein is a predictable stomach occurrence,lesion degree of poten-tial biological indicators.

Background and objective Epidermal growth factor receptor (EGFR) and KRAS gene are important driver genes of non-small cell lung cancer (NSCLC).The studies are mainly focused on detection ofEGFR gene for advanced NSCLC,and the mutation feature of EGFR and KRAS gene in early NSCLC tissue is unknown.This study aims to investigate the mutations of EGFR and KRAS gene in NSCLC,and the relationship between the genotype and clinicopathologic features.Methods The hotspot mutations in EGFR and KRAS gene in 754 tissue samples of stage Ⅰ-Ⅲa NSCLC from Department of Pathology,Peking Union Medical College Hospital were detected by modified amplification refractory mutation system (ARMS) real-time PCR kit,and analyzed their correlation with clinical variables.Results The hotspot mutation rates in EGFR and KRAS were 34.5％ and 13.1％ respectively,and there were EGFR-KRAS double mutations in 3 samples.The mutation rate of EGFR was higher in females than that in males (39.5％ vs 29.4％,P=0.076),significantly increased in adenocarcinomas (38.7％) compared to that in the other forms of NSCLC (P＜0.01),but still lower than that reported in some Asian studies of advanced adenocarcinoma (-50％).Meanwhile,the mutation rate of KRAS was remarkably higher in males than that in females (16.6％ vs 9％,P=0.048),increased in adenocarcinomas compared to that in the other forms of NSCLC,but the difference was not significant (P=0.268).Samples harbored EGFR mutation were younger than those harbored KRAS mutation (P=0.031,5),and had significant difference in gender between the two groups (P＜0.01).Conclusion The mutation rate of EGFR in stag Ⅰ-Ⅲa NSCLC patients was lower than that in advanced NSCLC patients.And the percentage of the NSCLC patients with EGFRKRAS double mutations is 0.9％.

Objective To study the clearance of high risk human papillomavirus(HPV)infection among the women with normal cervical pathologic diagnosis.Methods One hundred and seventy.two HPV-positive cases with normal cervical pathologic diagnosis were enrolled in the study.The infection status of HPV was monitored during follow-up from Aug 2006 to Aug 2008.The time of HPV infection spontaneous clearance,as well as effect factors,were analyzed.Results During follow-up,there were 62.2%(107 cases,107/172) of the HPV infection cleared.The medium clearance time was 11.3 months(95% CI:10.6-16.6 months).The medium clearance time of aged<30 years,30-39 years,40-49 years and>49 years were 11.3,12.0,10.9 and 8.5 months.respectively.There were not significant difference among aged intervals (P=0.384).The virus copies of HPV-clearance cases and persistent-infection were 22.6 and 95.0,respectively.There was not significant difference between groups(P=0.061).Conclusions Most of the high risk HPV infection with normal cervical pathologic diagnosis would spontaneously cleared.Age and HPV copies may play little role in the HPV clearance.