OBJECTIVE To systematically evaluate the correlation between dynamic changes in inflammatory markers during treatment with epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKIs） in non-small cell lung cancer （NSCLC） patients and therapeutic efficacy， with the aim of providing evidence-based support for clinical prognosis assessment and treatment strategy adjustment. METHODS Databases including PubMed， Embase， Cochrane Library， CNKI， Wanfang Data， and CBM were searched from the inception to July 20， 2025. Following literature screening， data extraction and quality assessment， descriptive analysis was conducted on the outcomes of included studies. RESULTS A total of eight studies were included to analyze the correlation of 6 inflammatory markers before and after treatment with EGFR-TKIs with therapeutic efficacy. The risk of bias assessment identified six high-quality studies and two moderate-quality studies. Among these studies， seven studies demonstrated that lower levels of neutrophil-to-lymphocyte ratio （NLR）， derived neutrophil-to-lymphocyte ratio （dNLR）， platelet-to-lymphocyte ratio （PLR）， and monocyte-to-lymphocyte ratio （MLR）， higher lymphocyte-to-monocyte ratio （LMR） before treatment， as well as decreased NLR and MLR and increased LMR after treatment were associated with longer median progression-free survival. Five studies indicated that lower levels of NLR， dNLR， PLR， and interleukin-6 （IL-6）， higher LMR before treatment as well as decreased NLR and dNLR and increased LMR were associated with longer median overall survival. Three studies indicated that lower levels of IL-6 were associated with a higher objective response rate， while the association of these markers after treatment remained controversial； another study showed that an early decline in NLR， MLR， and PLR after treatment may be associated with objective response benefit. CONCLUSIONS Lower inflammatory levels during EGFR-TKIs therapy correlate with better therapeutic efficacy in NSCLC patients.

Objective:To develop an indicator system for defining the health services provided by family doctors within the "Healthy Subdistrict" initiative in China.Methods:An initial set of indicators was developed through literature review and qualitative research, followed by the design of an expert consultation questionnaire. Twenty-one experts with extensive experience in community family doctor services in Beijing were selected. Two rounds of Delphi consultations were conducted via email between December 2024 and February 2025. Expert demographics and authority coefficients were collected and the indicator system was finalized.Results:The response rate was 100% for both rounds. The average expert authority coefficient ( Cr) was 0.860 (range: 0.700-1.000). Kendall′s W for importance and feasibility increased from 0.129 and 0.196 in the first round to 0.230 and 0.268 in the second round (all P<0.001), indicating strong consensus. The final system includes 5 first-level and 23 second-level indicators, categorized as: Integrated Preventive and Clinical Care Services, Healthy Community Promotion Services, Basic Medical Services, Public Health Services, and Services for Promoting Equity in Citizen Health and Well-being. The highest-weighted first-level indicators were Basic Medical Services (0.281) and Integrated Preventive and Clinical Care Services (0.281), followed by Services for Promoting Equity in Citizen Health and Well-being (0.191), Healthy Community Promotion Services (0.124), and Public Health Services (0.124). All indicators had importance and feasibility scores above 3.5. Conclusion:This study establishes a weighted indicator system to guide and evaluate the health services provided by family doctors within the "Healthy Subdistrict" initiative, clarifying key service priorities.

Objective:To evaluate the effectiveness of entrustable professional activities (EPAs) in the general practice internship of undergraduate clinical medicine students, identify issues that need improvement in the internship, and enhance medical students' competence.Methods:A total of 75 students in the five-year (English class) clinical medicine program enrolled in 2018 and 2019 who participated in general practice internship in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2021 to October 2023 were selected as study subjects. The design of core EPAs was adopted to assess the correlation among different EPA dimensions and to analyze the qualified rates.Results:The evaluation of EPAs showed that EPA2 (practicing respect, understanding and teamwork) had the highest mean score of 9.33, and EPA10 (chronic disease management and management of key populations) had the lowest mean score of 8.08. A supervision level of 3a and above was used as the criterion for qualification. The supervision levels of the students' EPAs were mostly concentrated at levels 3a and 3b. The highest qualified rate was for EPA2 (practicing respect, understanding and teamwork) at 85.33%, followed by EPA1 (complying with the rules of the profession and demonstrating professionalism) at 80.00% and EPA8 (reviewing information and solving clinical problems) at 72.00%. The lowest qualified rate was for EPA10 (chronic disease management and management of key populations) at 33.33%, followed by EPA4 (analyzing and interpreting test results) at 57.33%.Conclusions:EPAs concretize competency evaluation, which can effectively reflect the "competency-oriented" training objectives encompassing multiple elements such as knowledge, skills, values, and attitudes, while maintaining professional specificity. Undergraduates demonstrated strengths in professionalism and academics, but showed deficiencies in community chronic disease management and management of key populations. These findings suggest the need to strengthen the training in health and social care to better align with the competencies required during standardized residency training.

Objective:To summarize the risk prediction models for postoperative hypoxemia and provide a reference for clinical nursing practice and future research on hypoxemia risk prediction models for postoperative patients.Methods:A systematic literature search was conducted in CNKI, CBM, Wanfang, PubMed, Web of Science Core Collection, Cochrane Library, Embase, and CINAHL databases, covering publications up to January 31, 2024. Two researchers independently screened the literature, extracted data, performed integrative analysis, and evaluated the risk of bias in the included studies.Results:Seventeen studies were included, involving 17 different prediction models. The study populations were primarily adult patients, with hypoxemia incidence rates ranging from 2.40% to 49.30%. Modeling methods included Logistic regression and decision tree algorithms. The presentation formats of the models included risk scoring formulas, nomograms, decision tree diagrams, and web calculators. The five most frequently identified predictive factors were body mass index, age, comorbidities, duration of intraoperative cardiopulmonary bypass, and preoperative white blood cell count. Sixteen models reported the area under the receiver operating characteristic curve ranging from 0.667 to 0.916. All 17 studies exhibited varying degrees of bias risk.Conclusions:Existing risk prediction models for postoperative hypoxemia demonstrate good performance; however, the bias risk level of all studies was high. Future research should standardize the model development process according to bias risk assessment checklists to establish models with low bias risk and strong clinical applicability.

This article provides an overview of ecological momentary assessment based on mobile information devices. It reviews the design frameworks, domestic and international research progress, and the challenges associated with its application. The study aims to offer insights and reference methods for developing electronic ecological momentary assessment platforms in China.

Objective:To evaluate the effectiveness of entrustable professional activities (EPAs) in the general practice internship of undergraduate clinical medicine students, identify issues that need improvement in the internship, and enhance medical students' competence.Methods:A total of 75 students in the five-year (English class) clinical medicine program enrolled in 2018 and 2019 who participated in general practice internship in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2021 to October 2023 were selected as study subjects. The design of core EPAs was adopted to assess the correlation among different EPA dimensions and to analyze the qualified rates.Results:The evaluation of EPAs showed that EPA2 (practicing respect, understanding and teamwork) had the highest mean score of 9.33, and EPA10 (chronic disease management and management of key populations) had the lowest mean score of 8.08. A supervision level of 3a and above was used as the criterion for qualification. The supervision levels of the students' EPAs were mostly concentrated at levels 3a and 3b. The highest qualified rate was for EPA2 (practicing respect, understanding and teamwork) at 85.33%, followed by EPA1 (complying with the rules of the profession and demonstrating professionalism) at 80.00% and EPA8 (reviewing information and solving clinical problems) at 72.00%. The lowest qualified rate was for EPA10 (chronic disease management and management of key populations) at 33.33%, followed by EPA4 (analyzing and interpreting test results) at 57.33%.Conclusions:EPAs concretize competency evaluation, which can effectively reflect the "competency-oriented" training objectives encompassing multiple elements such as knowledge, skills, values, and attitudes, while maintaining professional specificity. Undergraduates demonstrated strengths in professionalism and academics, but showed deficiencies in community chronic disease management and management of key populations. These findings suggest the need to strengthen the training in health and social care to better align with the competencies required during standardized residency training.

Objective:To summarize the risk prediction models for postoperative hypoxemia and provide a reference for clinical nursing practice and future research on hypoxemia risk prediction models for postoperative patients.Methods:A systematic literature search was conducted in CNKI, CBM, Wanfang, PubMed, Web of Science Core Collection, Cochrane Library, Embase, and CINAHL databases, covering publications up to January 31, 2024. Two researchers independently screened the literature, extracted data, performed integrative analysis, and evaluated the risk of bias in the included studies.Results:Seventeen studies were included, involving 17 different prediction models. The study populations were primarily adult patients, with hypoxemia incidence rates ranging from 2.40% to 49.30%. Modeling methods included Logistic regression and decision tree algorithms. The presentation formats of the models included risk scoring formulas, nomograms, decision tree diagrams, and web calculators. The five most frequently identified predictive factors were body mass index, age, comorbidities, duration of intraoperative cardiopulmonary bypass, and preoperative white blood cell count. Sixteen models reported the area under the receiver operating characteristic curve ranging from 0.667 to 0.916. All 17 studies exhibited varying degrees of bias risk.Conclusions:Existing risk prediction models for postoperative hypoxemia demonstrate good performance; however, the bias risk level of all studies was high. Future research should standardize the model development process according to bias risk assessment checklists to establish models with low bias risk and strong clinical applicability.

This article provides an overview of ecological momentary assessment based on mobile information devices. It reviews the design frameworks, domestic and international research progress, and the challenges associated with its application. The study aims to offer insights and reference methods for developing electronic ecological momentary assessment platforms in China.

Objective:To develop an indicator system for defining the health services provided by family doctors within the "Healthy Subdistrict" initiative in China.Methods:An initial set of indicators was developed through literature review and qualitative research, followed by the design of an expert consultation questionnaire. Twenty-one experts with extensive experience in community family doctor services in Beijing were selected. Two rounds of Delphi consultations were conducted via email between December 2024 and February 2025. Expert demographics and authority coefficients were collected and the indicator system was finalized.Results:The response rate was 100% for both rounds. The average expert authority coefficient ( Cr) was 0.860 (range: 0.700-1.000). Kendall′s W for importance and feasibility increased from 0.129 and 0.196 in the first round to 0.230 and 0.268 in the second round (all P<0.001), indicating strong consensus. The final system includes 5 first-level and 23 second-level indicators, categorized as: Integrated Preventive and Clinical Care Services, Healthy Community Promotion Services, Basic Medical Services, Public Health Services, and Services for Promoting Equity in Citizen Health and Well-being. The highest-weighted first-level indicators were Basic Medical Services (0.281) and Integrated Preventive and Clinical Care Services (0.281), followed by Services for Promoting Equity in Citizen Health and Well-being (0.191), Healthy Community Promotion Services (0.124), and Public Health Services (0.124). All indicators had importance and feasibility scores above 3.5. Conclusion:This study establishes a weighted indicator system to guide and evaluate the health services provided by family doctors within the "Healthy Subdistrict" initiative, clarifying key service priorities.

AIM:To investigate the effects of overexpressing α-Klotho(KL)in RAW264.7 cells stimulated by oxidative stress on the proliferation, migration, tube-formation and tight junction of human umbilical vein endothelial cells(HUVECs).METHODS:RAW264.7 cells were categorized into control, 4-hydroxynonenal(4HNE), and 4HNE+KL groups, with F4/80 expression assessed via immunofluorescence staining. Three groups of conditional media were prepared for HUVECs and culture divided into Mø-NC, Mø-4HNE, and Mø-4HNE+KL groups. Cell proliferation was evaluated using CCK8 assay, while scratch test and Transwell assays were employed to measure cell migration. Additionally, tube-formation assay was conducted to assess cell tubule formation, and Western blot assay was utilized to detect the protein expression levels of Claudin 5, Occludin and ZO 1.RESULTS:The results of immunofluorescence staining showed that the fluorescence intensity of F4/80 of RAW264.7 cells in the 4HNE group was significantly enhanced compared with the control group, while that of F4/80 in the 4HNE+KL group was significantly decreased compared with the 4HNE group(all P<0.05). The CCK8 assay results revealed a significant increase in the proliferation of HUVECs in the Mø-4HNE group compared with the Mø-NC group. Conversely, the proliferation of the Mø-4HNE+KL group exhibited a significant decrease compared with that in the Mø-4HNE group(all P<0.01). The results of scratch test and Transwell assays demonstrated a significant increase in the migration of HUVECs in the Mø-4HNE group compared with the Mø-NC group, while the migration of the Mø-4HNE+KL group exhibited a significant decrease compared with the Mø-4HNE group(all P<0.01). In the tube-formation assay, it was observed that the number of tubes formed by HUVECs in the Mø-4HNE group was significantly increased compared with the Mø-NC group, while that of tubes formed in the Mø-4HNE+KL group was significantly decreased compared with the Mø-4HNE group(all P<0.01). Additionally, the Western blot results revealed a significant decrease in the relative expression levels of Claudin 5, Occludin, and ZO 1 in the Mø-4HNE group compared with the Mø-NC group. Conversely, in the Mø-4HNE+KL group, there was a significant increase in the relative expression levels of Claudin 5, Occludin, and ZO 1 compared to the Mø-4HNE group(all P<0.01).CONCLUSIONS: KL inhibits the proliferation, migration, and tube-formation of HUVECs while enhancing the tight junction by changing the activation state of macrophages in the diabetic oxidative stress environment.