To systematically synthesize evidence on multiple KRAS G12C inhibitors(KRAS G12C inhibitors, KRAS G12Ci) as monotherapy within a unified population and recommended-dose framework, establish a comparable benchmark range of efficacy and safety for previously treated patients with advanced or metastatic KRAS G12C-mutant non-small cell lung cancer(NSCLC), and explore potential effect modifiers.

In the past decade, real-world data (RWD) research has undergone significant transformations due to data aggregation and processing technologies. However, there is still a lack of consensus regarding the scope of RWD applications and the value of real-world evidence (RWE). This study briefly outlined the origins of the concept of RWD study and its early research scope to promote further development in this area. We also reviewed the understanding of RWD applications and research models from the five perspectives of healthcare professionals, medical institutions, decision-making departments, cross-regional cooperation model, and the practice of the One-Health model. Finally, we systematically summarized the renewed understanding of the value of RWE while looking ahead to the challenges and future developments in this field.

Objective Pre-packaged space scallion pancakes are prone to quality deterioration during storage due to starch retrogradation and lipid oxidation,which affects their food safety and sensory characteristics.Therefore,investigating their quality changes during storage and predicting shelf life are of great significance for ensuring the quality of space food.Methods study conducted accelerated shelf-life tests at(37±1)℃ and(47±1)℃ under simulated spacecraft food storage conditions.Comprehensive analyses were performed,including physicochemical properties(acid value,peroxide value,carbonyl value),microbiological indicators(total bacterial count,coliforms),color parameters(L*,a*,b*,c*,h°),and texture characteristics(hardness,adhesiveness,etc.).XRD and FTIR were employed to verify starch retrogradation and lipid oxidation.Results Physicochemical properties:The acid value gradually decreased and stabilized with prolonged storage.The peroxide value increased rapidly at 37℃and 47℃,with samples stored at 47℃approaching the safety limit(0.25 g/100 g)within 40 days,while the carbonyl value exhibited a decreasing trend.Microbiological indicators:All samples met the requirements of GJB 4992A-2012.No microbial contamination was detected initially,with only minor bacterial growth observed in later stages,and no coliforms were detected throughout the storage period.Color changes:During storage at 20℃,the a*value increased by 91.67%,while b* and c* values showed significant increases.Meanwhile,L* and h° values decreased by 7.42%and 8.75%,respectively.Texture deterioration:Overall texture characteristics declined,and XRD and FTIR analyses confirmed aggravated starch retrogradation.Shelf-life prediction:Correlation analysis identified peroxide value as the key factor.The established prediction model had an error margin of less than 10%,with predicted shelf lives of 236,121,and 57 days at 20℃,37℃,and 47℃,respectively.Conclusion This study reveals the quality change patterns of space scallion pancakes during storage.The established shelf-life prediction model provides theoretical and methodological support for quality monitoring of pre-packaged space foods.

Objective To investigate the effect of transcutaneous auricular vagus nerve stimulation(taVNS)on quality of early postoperative recovery in patients undergoing thoracoscopic lung resection.Methods A total of 168 patients scheduled for elective thoracoscopic lung resection(wedge resection,segmentectomy,lobectomy)under general anesthesia were enrolled and randomly assigned to active-taVNS group(group T)or sham-taVNS group(group S)(n=84).Participants received four consecutive 30-minute sessions of active stimulation or sham stimulation at four time points:(1)the afternoon prior to the surgery,(2)the morning of the surgery,(3)following extubation,and(4)the first afternoon post-surgery.The Quality of Recovery-15(QoR-15)scores of the patients,the Numerical Rating Scale(NRS)scores at rest and during cough at 24,48,and 72 hours after surgery were recorded;and the usage of opioids within 48 hours after surgery was recorded;the duration of chest tube indwelling,incidence of severe pulmonary complications,postoperative hospital stay and adverse reactions to the stimulation(such as nausea and vomiting,fever,constipation,dizziness and itching)were observed.Results Compared with group S,group T exhibited significantly higher QoR-15 scores at 24,48,and 72 h postoperatively,lower NRS pain scores during resting and coughing,and reduced opioid consumption within 48 hours postoperatively(P<0.05).There were no significant differences between the two groups in the duration of chest tube indwelling,incidence of severe pulmonary complications,hospital stay,and the incidence of adverse reactions to the stimula-tion(P>0.05).Conclusion TaVNS can significantly improve quality of early postoperative recovery in patients undergoing thoracoscopic lung resection,and provide more effective postoperative analgesia without increasing the risk of postoperative complications.

In the past decade, real-world data (RWD) research has undergone significant transformations due to data aggregation and processing technologies. However, there is still a lack of consensus regarding the scope of RWD applications and the value of real-world evidence (RWE). This study briefly outlined the origins of the concept of RWD study and its early research scope to promote further development in this area. We also reviewed the understanding of RWD applications and research models from the five perspectives of healthcare professionals, medical institutions, decision-making departments, cross-regional cooperation model, and the practice of the One-Health model. Finally, we systematically summarized the renewed understanding of the value of RWE while looking ahead to the challenges and future developments in this field.

Objective To investigate the effect of transcutaneous auricular vagus nerve stimulation(taVNS)on quality of early postoperative recovery in patients undergoing thoracoscopic lung resection.Methods A total of 168 patients scheduled for elective thoracoscopic lung resection(wedge resection,segmentectomy,lobectomy)under general anesthesia were enrolled and randomly assigned to active-taVNS group(group T)or sham-taVNS group(group S)(n=84).Participants received four consecutive 30-minute sessions of active stimulation or sham stimulation at four time points:(1)the afternoon prior to the surgery,(2)the morning of the surgery,(3)following extubation,and(4)the first afternoon post-surgery.The Quality of Recovery-15(QoR-15)scores of the patients,the Numerical Rating Scale(NRS)scores at rest and during cough at 24,48,and 72 hours after surgery were recorded;and the usage of opioids within 48 hours after surgery was recorded;the duration of chest tube indwelling,incidence of severe pulmonary complications,postoperative hospital stay and adverse reactions to the stimulation(such as nausea and vomiting,fever,constipation,dizziness and itching)were observed.Results Compared with group S,group T exhibited significantly higher QoR-15 scores at 24,48,and 72 h postoperatively,lower NRS pain scores during resting and coughing,and reduced opioid consumption within 48 hours postoperatively(P<0.05).There were no significant differences between the two groups in the duration of chest tube indwelling,incidence of severe pulmonary complications,hospital stay,and the incidence of adverse reactions to the stimula-tion(P>0.05).Conclusion TaVNS can significantly improve quality of early postoperative recovery in patients undergoing thoracoscopic lung resection,and provide more effective postoperative analgesia without increasing the risk of postoperative complications.

Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.

BACKGROUND:Studies have found that glucagon-like peptide-1 and its analogues have a significant neuroprotective effect,and some drugs have been applied to the clinical stage Ⅲ study of Alzheimer's disease.However,the mechanism of its neuroprotective effect is still unclear,which needs to be further explored and clarified. OBJECTIVE:To screen out the genes related to the pathogenesis of Alzheimer's disease and the related targets of semaglutide for the treatment of Alzheimer's disease based on bioinformatics and network pharmacology analyses,to identify the potential target genes by comprehensive analysis of the two and to verify them at the cellular level. METHODS:Using DisGeNET database,differentially expressed genes between Alzheimer's disease patients and healthy population were screened out.The chemical structure formula and two-dimensional structure diagram of semaglutide were obtained using PubChem online database.GO/KEGG enrichment analysis was performed using DAVID online database.A protein-protein interaction network was constructed by using the STRING database.The HPA database was used to determine the distribution characteristics of the target proteins in various human tissues.Finally,western blot was used to detect relevant protein expression in HT22 cells after semaglutide intervention. RESULTS AND CONCLUSION:With the dataset in DisGeNET database,3 374 differentially expressed genes between Alzheimer's disease patients and healthy people were obtained,and meanwhile,101 target genes of semaglutide potential drugs were obtained.There were 23 intersection genes between them.Ten key genes were identified based on the protein-protein interaction network,which were silent information regulator 1(SIRT1),CASP9,CCND1,CASP1,KEAP1,DLG4,CASP4,GRB2,GRIA1,and EDNRA.The results of GO gene functional annotation analysis of key genes showed that the positive regulatory activity of cysteine endopeptidase,the positive regulation of proteolysis,and the positive regulation of cysteine endopeptidase involved the cytoplasmic part of the apoptotic activity process;AMPA glutamate receptor complex,inflammatory complex,CARD domain binding,cysteine endopeptidase activity,and cysteine endopeptidase activity were involved in the apoptotic process.The results of KEGG signaling pathway analysis indicated that colorectal cancer,non-small cell carcinoma,and endometrial carcinoma were related to immune infiltration,inflammation and autophagic apoptosis.In addition,according to the association ranking of key genes and their distribution in different tissues of HPA online database,SIRT1 was identified as the most significant differential gene.The expression level of SIRT1 protein was significantly down-regulated in HT22 cells after β-amyloid protein 1-42 treatment,but it could be significantly increased after being treated with semaglutide.To conclude,SIRT1 may be a target gene for semaglutide in the treatment of Alzheimer's disease.

Objective:To explore the potential relationship between sugar metabolism,acid production and cariogenicity of Prevotella denticola.Methods:Morphological features of Prevotella denticola were observed and respectively cultured under incubation conditions with and without sugar and at different pH values.The growth characteristics of Prevotella denticola were detected by UV-Vis spectro-photometer and pH meter,the organic acid content in the culture supernatants of the cultures was detected by HPLC.Dentin slices were divided into control group,phosphoric acid group and the Prevotella denticola group and cultured in the corresponding mediu for 1 and 2 weeks respectively,the degree of demineralization of the samples was examined SEM and VHM.Results:Prevotella denticola fermen-ted sucrose and glucose,produced acids with its final pH values as low as 4.7,Succinic acid and acetic acid were its main metabolites.Prevotella denticola was moderately acid-tolerant.Furthermore,Prevotella denticola was able to cause dentin demineralization,and the Vickers hardness value of dentin samples in the Prevotella denticola group was significantly decreased compared with the control group(P＜0.05).Conclusion:The cariogenic capacity of Prevotella denticola may be related to its sugar metabolism and acid production.

Objective:To analyze the satisfaction of elderly outpatient experience, based on a satisfaction questionnaire survey of outpatients in public hospitals, for references to improve the medical experience of elderly patients.Methods:This study extracted the satisfaction survey questionnaires for outpatients in second level and above public hospitals nationwide from the National Health Commission′s satisfaction survey platform from 2019 to 2022. The questionnaire content included six dimensions: registration experience, doctor-patient communication, nurse-patient communication, environment and labeling, privacy protection, and medical staff response, as well as overall satisfaction. The satisfaction, relative satisfaction, and dissatisfaction rates of elderly outpatients were analyzed using standardized assignment of question options, etc; T-test was used for inter group comparison.Results:A total of 10.095 7 million outpatient satisfaction questionnaires were included in this study, including 0.576 3 million questionnaires for elderly outpatients. From 2019 to 2022, the overall satisfaction of outpatients had been increasing year by year, and the overall satisfaction scores of elderly patients were significantly higher than that of non-elderly patients( P<0.01). The satisfaction scores of elderly patients in the nurse communication dimension(86.55 to 91.03 points) and relative satisfaction(1.000) were the higher in each year, while the satisfaction scores in the environment and identification dimension(81.05 to 86.03 points) and relative satisfaction(0.935 to 0.955) were lower. In 2019 and 2022, elderly patients had higher dissatisfaction rates in the two dimensions of registration experience(2.26%, 1.91%) and doctor communication(0.80%, 0.53%). Conclusions:From 2019 to 2022, the overall satisfaction of elderly patients in secondary and above public hospitals in China was relatively higher with a steady increasing tendency. However, there was still room for further improvement in the environment and labeling, cultural construction, and registration experience for elderly patients.