Objective:To explore the value of lymphocyte subsets in predicting the efficacy and prognosis of non-small cell lung cancer(NSCLC)patients receiving programmed death receptor 1(PD-1)monoclonal antibody(mAb)combined with chemotherapy.Methods:A retrospective analysis was conducted on the clinical data of 50 NSCLC patients diagnosed and treated with PD-1 mAb combined with chemotherapy at the Second Hospital of Lanzhou University from January 2022 to December 2023.Peripheral blood lymphocyte subsets(including total T cells,CD4+T cells,CD8+T cells,NK cells,total B lymphocytes,and CD4+/CD8+T cell ratio)were collected before and after two cycles of treatment.After two cycles of treatment,imaging examination was performed to evaluate the therapeutic efficacy,dividing patients into disease control(DC)group and disease progression(PD)group.The relationship between lymphocyte subset levels and the short-term efficacy in NSCLC patients was analyzed using chi-square test,rank sum test,and Logistic regression analysis.The value of lymphocyte subsets in predicting patients'progression-free survival(PFS)was explored using Kaplan-Meier method.Results:PD-1 mAb combined with chemotherapy significantly influenced the immune status of NSCLC patients.After treatment,the peripheral blood CD4+T cells and CD4+/CD8+T cell ratio significantly increased(both P<0.01),while the level of CD8+T cells decreased.In terms of short-term efficacy,the proportion of CD4+T cells and the CD4+/CD8+T cell ratio in the DC group were significantly higher than those in the PD group(both P<0.01).Logistic multivariate analysis showed that the CD4+/CD8+T cell ratio was an independent factor affecting the efficacy of PD-1 mAb combined with chemotherapy.ROC curve analysis showed that the area under the curve(AUC)for CD4?/CD8? T cell ratio variation was 0.820(>0.5),with a cut-off value of 0.15.Patients with a the CD4+/CD8+T cell ratio increase of≥0.15 had a longer PFS.Conclusion:The proportion of CD4+T cells,CD8+T cells,and the CD4+/CD8+T cell ratio in peripheral blood can predict the efficacy and prognosis of PD-1 mAb combined with chemotherapy in advanced NSCLC patients.

Objective: To determine the levels of vitamin D in patients with pulmonary tuberculosis in Shenzhen and identify the influencing factors of vitamin D levels and key groups of vitamin D deficiency, so as to provide a scientific basis for tuberculosis- and nutrition-related health education and promotion in Shenzhen. Methods: Patients with smear-positive pulmonary tuberculosis who were diagnosed in 2016 were selected as the research subjects. Their relevant information and blood samples were collected, and the sample pool was established according to the inclusion criteria. One hundred and twenty patients were selected based on simple random sampling, including 84 men (70.0%) and 36 women (30.0%). Blood 25-hydroxyvitamin D [25(OH)D] concentrations were measured using chemiluminescence technology. Vitamin D statuses in patients were statistically described, and vitamin D levels in patients with different characteristics were compared. Multivariate linear regression analysis was performed to identify important factors influencing vitamin D levels in patients. Results: Mean serum concentration of 25(OH)D in 120 patients was (40.2±16.0) nmol/L. There were 2 cases of vitamin D sufficiency (1.7%), 28 cases of vitamin D insufficiency (23.3%), and 90 cases of vitamin D deficiency (75.0%), of which 23 cases (19.2%) were of severe deficiency. 25(OH)D concentrations in patients with different lifestyles (indoors; indistinguishable indoors or outdoors; outdoors) were significantly different (35.3 nmol/L vs. 40.6 nmol/L vs. 49.5 nmol/L, F=8.274, P<0.001). Mean concentration of 25(OH)D in patients with sun exposure time of >30 min/d was higher compared to that in those with sun exposure time <30 min/d in the last month (46.4 nmol/L vs. 36.7 nmol/L, t=3.342, P=0.001). Multivariate linear regression analysis showed that the risk factors for 25(OH)D with statistical significance were Han ethnicity or not (β=-11.576, t=-1.991, P=0.049), housekeeping (including unemployment and retirement) or not (β=-6.136, t=-1.998, P=0.048), sun exposure time<30 min/d or none (β=-9.644, t=-2.829, P=0.006), body mass index (β=-2.056, t=-3.439, P=0.001) , and indoor degree of lifestyles (β=-4.419, t=-2.155, P=0.033). Conclusion Level of vitamin D is generally insufficient in patients with pulmonary tuberculosis in Shenzhen. It is necessary to strengthen health education related to vitamin D in patients with tuberculosis, especially in the high-risk population of vitamin D deficiency, such as in those with a lack of exposure to sunlight or high BMI.

Objective To clarify the status of tobacco exposure and identify risk factors of smoking among smear-positive pulmonary tuberculosis patients in Shenzhen,in order to provide a scientific basis for the formulation of tuberculosis-tobacco control strategy in Shenzhen.Methods From January to December 2016,a special survey was carried out in 8 districts in Shenzhen.A unified questionnaire was used to make face to face interviews for 958 smear-positive pulmonary tuberculosis patients registered in 2016.Descriptive statistics was conducted to analyze the status of tobacco exposure.Single factor analysis and multiple logistic regression were used to identify the important risk factors of smoking.Results Among smear-positive pulmonary tuberculosis patients in Shenzhen,the rates of general smoking,current smoking,regular smoking were 40.9％,34.2％ and 30％,respectively.All smoking rates were higher among male than female participants (x2=255.226,197.463 and 162.707,respectively,and the P values were all＜0.001);164cases of heavy smokers accounted for 50.0％ of current smokers.Among 392 smokers,64 had quitted smoking,and the rate of smoking cessation was 16.3％.Among 566 nonsmokers,the rate of passive smoking from cohabiting smokers was 17.8％ (101/566),and it was higher in female than male participants (23.1％ vs.12.3％,x2=11.219,P=0.001).In single factor analysis,gender,work or living environment,age,education level,marital status,and body mass index were closely related to smoking (x2=255.226,28.375,40.922,29.585,9.117,and 7.052,respectively,and the P values were all＜0.05).In multiple logistic regression,the major risk factors for smoking included in the model were gender (x2=120.797,P＜0.001),age (x2=5.728,P=0.017),education level (x2=17.159,P＜0.001),mode of case-finding (x2=3.670,P=0.055),work or living environment (x2=6.039,P=0.049),and marital status (x2=5.091,P=0.078).Conclusion The smoking status of smear-positive pulmonary tuberculosis patients was serious in Shenzhen.Tuberculosis patients were the key smokers.We should provide accurate intervention and health guidance for patients,such as,macro policy guidance,instillation of knowledge,mental health intervention,and smoke-free environment.

Objective To explore the effects of mindfulness training in pain management for patients with lumbar disc herniation.Methods From June to October 2017, a total of 64 patients with lumbar disc herniation were selected by purposive sampling method, and received mindfulness training. The Oswestry Pain & Disability Index (ODI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) were applied to investigate patients before and after training.Results After six weeks of training, the score of ODI was (6.63±1.13), which was lower than that before the intervention (14.21±1.06), and the difference was statistically significant (t=8.779,P<0.01). The scores of SAS and SDS decreased after six weeks of training, and the differences were statistically significant (t=11.326, -9.563;P<0.01).Conclusions Mindfulness training can effectively alleviate the pain, anxiety and depression in patients with lumbar disc herniation, so as to improve patients' rehabilitation.

Internal mammary nodes are part of the first stop of mammary gland lymphatic drainage.It plays an important role in the process of occurrence and development of breast cancer.Whether irradiation internal mammary nodes or not is still a larger controversy.At present,for the early stage patients,the efficacy of internal mammary lymph node irradiation is not clear.For the patients with positive axillary lymph nodes,inboard or central quadrant lesions,postoperative radiotherapy of internal mammary nodes has a certain value.