The incidence and mortality rates of lung cancer remain high, making it the leading cause of cancer-related deaths. In women, the predominant histological subtype is lung adenocarcinoma, commonly associated with epidermal growth factor receptor (EGFR) mutations, and EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can significantly improve patient prognosis. Metastasis of primary lung cancer to the endometrium is extremely rare and is often misdiagnosed as a primary reproductive system tumor, and its occurrence indicates poor prognosis. This article reports a case of an advanced lung adenocarcinoma patient with EGFR mutation, who developed abnormal vaginal bleeding after EGFR-TKIs treatment failure, and biopsy confirmed endometrial metastasis. A review of similar cases is also presented.
.
Humans ; Female ; ErbB Receptors/metabolism* ; Endometrial Neoplasms/genetics* ; Lung Neoplasms/genetics* ; Protein Kinase Inhibitors/therapeutic use* ; Adenocarcinoma of Lung/drug therapy* ; Treatment Failure ; Middle Aged ; Adenocarcinoma/genetics*

ObjectiveTo analyse the clinical characteristics of different traditional Chinese medicine （TCM） syndromes in patients with heart failure based on information from electronic medical record. MethodsA cross-sectional study was conducted to collect clinical data of all inpatients with heart failure in the Department of Cardiology， Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 1， 2019 to December 31， 2020. A database of clinical TCM data was established to explore the characteristics of clinical data of basic information， syndromes and syndrome element types， and biochemical indexes. The distribution of TCM syndromes and syndrome elements in heart failure patients were also analysed， and the basic information and biochemical indexes of the patients with top 7 different TCM syndrome types were compared. ResultsA total of 1676 inpatients with heart fai-lure were included. The top 7 TCM syndromes of heart failure were syndrome of phlegm turbidity and blood stasis （477 cases， 28.46%）， syndrome of qi deficiency and blood stasis （439 cases， 26.19%）， syndrome of qi deficiency and blood stasis with water retention （274 cases， 16.35%）， syndrome of yang deficiency with water retention （145 cases， 8.65%）， syndrome of qi and yin deficiency （104 cases， 6.21%）， syndrome of qi and yin deficiency with blood stasis （80 cases， 4.77%）， syndrome of heart yang deficiency （59 cases， 3.52%）. Among the 1676 patients， 6 syndrome elements accounted for more than 5%. Blood stasis accounted for the highest proportion of TCM syndrome element type （1292 cases， 77.09%）， followed by qi deficiency （919 cases， 54.83%）， phlegm （498 cases， 29.71%）， water retention （434 cases， 25.89%）， yang deficiency （215 cases， 12.82%） and yin deficiency （191 cases， 11.40%）. Among the 1676 patients， 1308 cases of acute heart failure mainly showed syndrome of phlegm turbidity and blood stasis （386 cases， 29.51%）， and 368 of chronic heart fai-lure mainly showed syndrome of qi deficiency and blood stasis （118 cases， 32.07%）. Patients with syndrome of phlegm turbidity and blood stasis had the shortest disease duration of 0.3 months， while those with syndrome of heart yang deficiency had the longest disease duration of 15 months. The proportion of syndrome of phlegm turbidity and blood stasis was the highest in patients with heart failure combined with coronary artery disease， the proportion of syndrome of qi deficiency and blood stasis with water retention was the highest in patients with heart failure combined with atrial fibrillation， and the proportion of patients with syndrome of qi deficiency and blood stasis with water retention and syndrome of yang deficiency with water retention in those applying diuretics during the hospital stay was the highest with more than 86%. The different 7 TCM syndromes showed statistically difference in patients with complications including coronary artery disease， old myocardial infarction， atrial fibrillation， pre and post-admission medication usage including intravenous vasodilators， cardiac stimulants， diuretics， and level of blood chloride， blood urea， blood creatinine， blood bicarbonate， blood albumin， and blood total bilirubin （P＜0.05）. ConclusionThe most common TCM syndromes in patients with heart failure are syndrome of phlegm turbidity and blood stasis and syndrome of qi deficiency and blood stasis. Different TCM syndromes have different characteristics in gender， disease complications， medication before and after admission， and blood indexes.

Objective　To explore the application of time series models based on meteorological factors in the population density of Aedes albopictus in Hainan Province, and to provide a scientific basis for the prevention and control of dengue fever in Hainan Province. Methods　The density of Aedes albopictus in different habitats in 18 cities and counties of Hainan Province from 2017 to 2022 was monitored monthly using the double-mosquito net trapping index and the Breteau index. Mann-Kendall trend test was used to analyze the temporal trends of the two density indices; Spearman's correlation analysis was employed to assess the correlation strength between each meteorological factor and the two indexes, eliminating unrelated variables, and further selecting the final variables through the full-subset regression method. Three time-series models were constructed for the two density indices, with root mean square error (RMSE), mean absolute error (MAE), and other accuracy metrics used to determine the optimal model; predictions for the density indices for 2023-2024 were made. All statistical analyses were performed in R (4.3.1). Results　The net trapping and Breteau indices showed an overall decrease over the years (Z-values of Mann-Kendall trend test were -6.15 and -4.03, respectively, and P<0.05). The meteorological factor most strongly associated with the trap index was the monthly average minimum temperature; monthly mean minimum temperature and monthly mean relative humidity were strongly correlated with the Breteau index. Based on various evaluation indicators, the multivariate time series model demonstrated the highest accuracy. The study predicts one to two peaks in both the trap index and Breteau Index for the years 2023 and 2024, with peak periods occurring between June to September and May to September, respectively. The predicted value for 2023 aligns with the measured value, demonstrating outstanding predictive accuracy. Conclusions　This study has introduced meteorological factors into the seasonal time series model, allowing for more accurate predictions of the density of Aedes albopictus in Hainan Province from 2023 to 2024, providing a model framework for the prevention and control of dengue fever in Hainan Province.

Objective: To explore the mediating effect of depressive symptom on the relationship between peer bullying patterns and suicidal ideation, and to provide suggestions for school bullying and suicide prevention for adolescents. Methods: A follow up cohort was established in a junior middle school in Suixi County, Anhui Province in September 2019 (T1). The first follow up was conducted in September 2020 (T2). A total of 1 687 junior high school students participated in this study. Self designed peer bullying questionnaire,center for Epidemiological Studies Depression Scale for children,and questions regarding suicide related behaviors were administered. Results: Prevalence of suicidal ideation, victimization and bullying were 28.3%, 27.0% and 24.4%, respectively. The latent class analysis(LCA) identified three heterogeneous peer bullying classes: low aggressive victims(71.4%), high aggressive victims(3.3%), high verbal and relational aggressive victims( 25.3 %). The low aggressive victims class was used as the reference group, T1 depressive symptom mediated the association between high aggressive victims(mediating effect=0.43, P < 0.05 ), high verbal and relational aggressive victims class (mediating effect= 0.29 , P <0.05) and T2 suicidal ideation. Conclusion Depressive symptom plays a mediating role in the relationship between peer bullying and suicidal ideation. In order to prevent peer bullying and suicide related psychological behaviors of adolescents, educators should pay attention to adolescents mental health when formulating corresponding measures.

Objective: To explore the relationship between different types of bullying behavior and depressive symptoms among adolescents, and to provide scientific basis for further prevention of peer bullying. Methods: Based on the follow up data of 1 687 adolescents from Huaibei City, Anhui Province in September 2019 (T1) and September 2020 (T2), the autoregressive cross lagged analysis was employed to explore the relationship between different types of peer bullying and depressive symptoms. Results: The scores of bullying behaviors (physical bullying, verbal bullying, relational bullying and cyber bullying) and depressive symptoms at T2 were lower than those at T1,and the differences were statistically significant ( t =13.60, 8.61,7.24,3.76,8.29, P <0.01). There was a positive correlation between bullying behavior and depressive symptoms ( P <0.01). The results from cross lagged regression analysis showed that physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β = 0.06 , 0.04, 0.12, 0.05), and physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β =0.07, 0.10, 0.13, 0.10) ( P <0.05). Conclusion There were bidirectional associations between adolescent peer bullying and depressive symptoms.

Depression is a common and recurrent mental disease, with complex etiology, which is mainly affected by genetic, metabolic and social factors. The specific pathogenesis is still unclear. In recent years, the hypothesis of inflammatory factors related to depression has attracted wide attention of researchers. A large number of clinical experimental studies have shown that depression is related to the increase of proinflammatory factors in central and peripheral blood. The inflammatory factors in peripheral blood can spread in the brain through the way of specific transporters across the blood-brain barrier, and activate or participate in the brain inflammatory response, and ultimately affect the neuronal activity and neurotransmitter release in the emotional regulation area of the brain, which in turn leads to depressive symptoms. This paper summarizes the relationship between inflammatory factors and depression and its possible mechanism, which provides reference for further prevention and control, clinical treatment and scientific research of depression.

Depression is a common and recurrent mental disease, with complex etiology, which is mainly affected by genetic, metabolic and social factors. The specific pathogenesis is still unclear. In recent years, the hypothesis of inflammatory factors related to depression has attracted wide attention of researchers. A large number of clinical experimental studies have shown that depression is related to the increase of proinflammatory factors in central and peripheral blood. The inflammatory factors in peripheral blood can spread in the brain through the way of specific transporters across the blood-brain barrier, and activate or participate in the brain inflammatory response, and ultimately affect the neuronal activity and neurotransmitter release in the emotional regulation area of the brain, which in turn leads to depressive symptoms. This paper summarizes the relationship between inflammatory factors and depression and its possible mechanism, which provides reference for further prevention and control, clinical treatment and scientific research of depression.

Objective: To explore the relationships between the characteristics of childhood sexual abuse and non-suicidal self-injury in nursing female college students. Methods: Two medical colleges and junior colleges were selected in Anhui province. A total of 2 549 female nursing students in grade 1 to 3 were asked to fill a questionnaire regarding sociodemographic information,childhood sexual abuse and non-suicidal self-injury. Results: The reported rate of non-suicidal self-injury among female nursing students in the past six months was 8.2%. Sexual abuse at any time during childhood (primary school or earlier,middle school and high school) increased the risk of non-suicidal self-injury among female nursing students (P<0.05). Exposure to sexual abuse in all three periods was associated with 5.04(95%CI=1.73-14.62) times odds ratio than that of those who not exposed to sexual abuse (P<0.01). Only contact sexual abuse and both contact and non-contact sexual abuse in childhood were correlated with nonsuicidal selfinjury among female nursing students [OR(95%CI)=2.21(1.48-3.29), 3.56(2.13-5.96)] (P<0.05). Two patterns of sexual abuse experiences were identified,including persistent sexual abuse (3.1%) and the other group is occasional sexual (96.9%). Persistent sexual abuse in childhood was correlated to higher risk of non-suicidal self-injury compared with occasional sexual abuse (OR=2.61,95%CI=1.35-5.05,P<0.01). Conclusion The occurrence periods,types and patterns of sexual abuse in childhood are closely related to non-suicidal self-injury in female nursing students.

Objective: To investigate the correlation between childhood maltreatment and quality of life (QOL) in nursing girls in Anhui Province, so as to provide reference for improving QOL of nursing girls. Methods: The stratified cluster sampling method was used to select students of grade 1 to 3 in nursing major from 2 colleges and 2 specialized colleges by self-administered questionnaire in Anhui province. The questionnaire was conducted to analyze the relationship between childhood abuse and neglect and QOL of female nursing students. Multiple linear regression model was used to assess the associations between childhood maltreatment and QOL. Results: Among 2 549 female nursing students, the mean scores of 4 dimensions of QOL were physical (12.85±2.01), psychological (13.86±2.40), social relationship (12.83±2.84) and environment (13.37±2.21). The scores of QOL among college students were higher than specialized college students, high grade students were higher, and those who have a good relationship with their parents were higher(P<0.01). The prevalence rates of childhood physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect were 4.9%, 10.6%, 7.3%, 6.7% and 4.1%, respectively. The scores of QOL were lower among female nursing students with childhood maltreatment than those without childhood maltreatment(P<0.01). The results of multiple linear regression analysis showed that the number of childhood abuse and neglect were negatively correlated with physical, psychological and environmental dimension of QOL, and the number of childhood maltreatment were significantly dose-responsive to quality of life(P<0.05). Conclusion The female nursing students are still greatly neglected, and the experience of childhood maltreatment is negatively related to the quality of life among female nursing students.

Objective: To explore the relationship between childhood sexual abuse (CSA) experience and sexual behavior among female nursing students and to provide a scientific reference for intervening sexual behavior for female nursing students. Methods: A cross-sectional study was conducted among 2 549 female students majoring nursing from four medical schools (one is a medical college and the other is medical junior college) by self-administered questionnaire. A questionnaire survey regarding demographic information, childhood sexual abuse, sexual behavior was conducted and multi-factor Logistic regression method was used to analyze the effect of childhood sexual abuse in different stages made on their sexual behavior. Results: Among 2 549 female nursing students, 143(5.6%) reported having had sexual intercourse, 141 reported having had sexual intercourse with the opposite sex, 6 reported having had sexual intercourse with the same sex, and 4 reported having sexual intercourse with both sexes. The report rate of sexual behavior of nursing students in undergraduate colleges (6.8%) was lower than that of junior college (3.9%), the second-grade nursing students reported the highest rate of sexual behavior (7.8%), the lowest in first grade (4.0%). Nursing students in good relationship with parents reported lowest rate of sexual behavior(P<0.05). Compared to those who had not experienced CSA, students who had experienced contacting or no-contacting CSA reported a higher percentage engaged in sexual intercourse(P<0.05). CSA in all types and different stages in childhood associated with higher risk of sexual intercourse among nursing students(P<0.05). Conclusion Childhood sexual abuse shows significant impacts on sexual behaviors during young adulthood, which warrants further attention to promote physical and mental health of college students.