Purpose: This study aimed to evaluate the safety and efficacy of gemcitabine and cisplatin (GP) regimen in combination with immune checkpoint inhibitor sintilimab as neoadjuvant therapy for muscle-invasive bladder cancer (MIBC) patients and the feasibility of the following selective bladder sparing surgery. Materials and Methods: Patients with histopathologically confirmed urothelial carcinoma without distant metastases (T2-4a, N ≤ 1, M0, American Joint Committee of Cancer 8th) and with adequate organ function will be enrolled. The therapeutic regimen was sintilimab 200 mg once on day 8, gemcitabine 1,000 mg/m2 and cisplatin 35 mg/m2 once on days 1 and 8, every 21 days for four cycles. The primary endpoint was pathologic complete response (pCR, pT0N0) rate. The secondary end points were ypT < 2 rate, R0 resection rate, event-free survival, and safety. Results: From May 4, 2020, to May 20, 2023, 55 patients were enrolled. Forty-six patients were evaluated for efficacy. Among the 42 patients who underwent surgery, 16 patients (38.0%) achieved pCR. Thirty-three patients (78.6%) achieved pT < 2. With a median follow-up of 15.7 months, the 1-year event-free survival was 91.3%. Notwithstanding the poor pathological baseline characteristic of a high T3-T4a proportion (39.1%), a promising bladder preservation (including 22 patients transurethral resection of bladder tumor, 5 patients partial cystectomy, and 4 surveillances) rate was achieved (67.4%). The most common grade ≥ 3 treatment-related adverse events was neutropenia (n=15, 27.3%), which was related to chemotherapy. There were no grade 3 immune-related adverse events. Conclusion Neoadjuvant GP plus sintilimab is a promising regimen for MIBC patients, with relatively high pT < 2 rate and triggering the emerging roles for the multi-disciplinary team decision-making for bladder sparing surgery.

Objective To investigate the current situation of the attitude and practical ability of hospice care in the terti-ary cancer hospital of Zhejiang Province,so as to provide reference for managers to explore more effective hospice care support.Methods Using convenience sampling selected 278 clinical nurses from Zhejiang Cancer Hospital.From June to August 2024,the general data questionnaire,hospice care attitude scale and self-assessment practice scale of hospice care were used to survey nurses with questionnaires,and the related factors affecting practical ability and the correlation between attitudes and practical a-bility were analyzed.Results The hospice attitude score of 278 nurses in the hospice co-photography mode was(88.43±12.01),and the average score of entries was(3.54±0.48).The total score of the hospice Practical ability scale was(61.87±12.42),and the average score of the items was(3.64±0.73).Nurses'age,education background,previous experience in ca-ring for end-stage patients and their families,and self-assessment of competence in hospice care were the main influencing factors of nurses'practical ability score(all P＜0.05).There was a positive correlation between clinical nurses'practice ability score and hospice attitude score,the correlation coefficient r=0.176,P＜0.05.Conclusion Under the mode of hospice co-care,the attitude of nurses in Zhejiang Province is above the middle level,and the practical ability of nurses needs to be further improved,the higher the attitude of nurses,and the nurses'practical ability of hospice care is strong.Nursing managers should carry out professional training to promote the attitude of nursing staff,so as to improve the practical ability of nurses in hospice care.

Objective To investigate the current situation of the attitude and practical ability of hospice care in the terti-ary cancer hospital of Zhejiang Province,so as to provide reference for managers to explore more effective hospice care support.Methods Using convenience sampling selected 278 clinical nurses from Zhejiang Cancer Hospital.From June to August 2024,the general data questionnaire,hospice care attitude scale and self-assessment practice scale of hospice care were used to survey nurses with questionnaires,and the related factors affecting practical ability and the correlation between attitudes and practical a-bility were analyzed.Results The hospice attitude score of 278 nurses in the hospice co-photography mode was(88.43±12.01),and the average score of entries was(3.54±0.48).The total score of the hospice Practical ability scale was(61.87±12.42),and the average score of the items was(3.64±0.73).Nurses'age,education background,previous experience in ca-ring for end-stage patients and their families,and self-assessment of competence in hospice care were the main influencing factors of nurses'practical ability score(all P＜0.05).There was a positive correlation between clinical nurses'practice ability score and hospice attitude score,the correlation coefficient r=0.176,P＜0.05.Conclusion Under the mode of hospice co-care,the attitude of nurses in Zhejiang Province is above the middle level,and the practical ability of nurses needs to be further improved,the higher the attitude of nurses,and the nurses'practical ability of hospice care is strong.Nursing managers should carry out professional training to promote the attitude of nursing staff,so as to improve the practical ability of nurses in hospice care.

Objective To comapre and analyze the differences and commonalities of expression profiles of serum exosomal microRNA between patients with thyroid nodules and healthy persons at different iodine levels,and then provide evidence for screening early diag-nostic markers of thyroid nodules at different iodine levels.Methods The peripheral blood samples from 10 patients with thyroid nod-ules and healthy volunteers at different iodine levels were collected.Their serum iodine levels were measured by the arsenic cerium cat-alytic spectrophotometry.Serum exosomal microRNA were extracted and the expression levels of microRNA were determined by the high-throughput sequencing technology.The differential target genes were predicted and further performed Gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Results Compared with healthy volunteers,there were 6 downreg-ulated miRNAs in the patients with thyroid nodules at different iodine levels,namely miR-324-5p,miR-6511b-3p,miR-9903,miR-550a-3p,miR-5001-3p,and miR-3688-3p.Differentially expressed exosomal microRNA could regulate the MAPK signaling path-way,PI3K-AKT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.Conclusion Six differentially expressed microRNAs is identified,which may serve as biological markers for the early diagnosis of thyroid nodules at different iodine levels.

【Objective】 To investigate the effects of formononetin (FMN) on cardiomyocyte apoptosis and HSP90/AKT in rats with dilated cardiomyopathy-mediated heart failure. 【Methods】 Echocardiography, ELISA, histological staining, and TUNEL staining were used to observe the protective effect of different doses of FMN on dilated cardiomyopathy-mediated heart failure in rats and the apoptosis of cardiomyocytes. The potential targets of formononetin on dilated cardiomyopathy-mediated heart failure were obtained from TCMSP, DisGeNet, GeneCards, and other databases, the key targets were obtained according to the protein-protein interaction (PPI) network, and the key targets were verified by molecular docking. Western blotting was used to further verify the regulatory role of key targets in the treatment of dilated cardiomyopathy-mediated heart failure with formononetin. 【Results】 Formononetin could reduce the levels of LVIDS, LVIDD, NT-pro BNP, cTn-T, CK, CK-MB, and LDH in rats with dilated cardiomyopathy-mediated heart failure, increase the levels of EF and FS, and reduce the apoptosis of cardiomyocytes. FMN had a strong binding effect on 10 key targets (AKT1, HSP90AA1, CASP3, MAPK1, MMP9, SRC, ALB, HRAS, IGF1, and EGFR) screened by network pharmacology, with HSP90AA1 and AKT1 having the strongest binding effect. Formononetin decreased the expression of HSP90, AKT and downstream CASP3 protein, but increased the expression of p-AKT in myocardial tissue. 【Conclusion】 Formononetin may inhibit the expression of HSP90, promote phosphorylation of AKT to p-AKT, and inhibit the expression of CASP3, thereby reducing the apoptosis of cardiomyocytes and improving myocardial tissue damage, so as to achieve the purpose of treating dilated cardiomyopathy-mediated heart failure.

Objective:To investigate the risk factors of depression in patients with lacunar cerebral infarction 3 months after discharge, and build a risk prediction model.Methods:The clinical data of 237 patients with lacunar cerebral infarction diagnosed and treated in the Second Affiliated Hospital of Wannan Medical College from January 1, 2021 to January 1, 2022 were retrospectively analyzed. Demographic data, laboratory indicators and risk factors of cardiovascular disease were collected when the patients were admitted to hospital. The patient health questionnaire-9 (PHQ-9) score was used to assess the risk of post-stroke depression (PSD) 3 months after discharge. Univariate and multivariate logistic regression analyses were used to identify independent risk factors of depression. A predictive model was constructed based on the above risk factors. The predictive efficacy was evaluated by receiver operating characteristic (ROC) curve, and the clinical applicability of the predictive model was measured by calibration curve and decision curve.Results:Fifty-four patients with lacunar infarction (22.80%) showed symptoms of depression at 3 months after discharge. Multivariate logistic regression showed that women ( OR=2.952, 95% CI: 1.403-6.213, P=0.004), cystatin C ( OR=2.964, 95% CI: 1.222-7.191, P=0.016), apolipoprotein B ( OR=4.836, 95% CI: 1.533-15.258, P=0.007) were the independent risk factors for PSD in patients with lacunar infarction. Activity of daily living (ADL) score ( OR=0.939, 95% CI: 0.915-0.964, P<0.001) was a protective factor for PSD in patients with lacunar infarction. The area under the curve (AUC) of the prediction model was 0.779 (95% CI: 0.703-0.855, P<0.001), which was better than other predictors. Hosmer-Lemeshow H test showed that the model was well calibrated ( P=0.588). In addition, the prediction model of decision curve analysis had a good clinical applicability. Conclusions:The predictive model based on gender, laboratory indicators and daily life ability score can evaluate the risk of PSD in patients with lacunar infarction 3 months after discharge. It is good predictive efficacy and clinical applicability which worth clinical promotion and application.

Objective To study the values of quantitative parameters of DCE-MRI in diagnosis of benign and malignant liver tumors and to explore its diagnostic efficacy.Methods Consecutive 25 patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MRI,and total 28 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters (Ktrans ,Kep ,Ve and iAUC)of the lesions and the surrounding normal liver tissue were acquired.The inde-pendent sample t test was used to compare the quantitative parameters between different tumors.The optimal parameters values of benign and malignant liver tumors were determined by plotting ROC curves.Results The mean quantitative parameters of HCC and benign lesions were larger than those of the surrounding normal liver tissue.Ktrans ,Kep and iAUC between HCC and surrounding nor-mal liver tissue had significant differences (P <0.05),Ktrans and iAUC between benign lesions and surrounding normal liver tissue had a significant difference (P <0.05).Ktrans ,Kep and iAUC between HCC and benign lesions had significant differences (P <0.05). The diagnostic effectiveness of Ktrans = 0.21 5 min-1 ,with sensitivity of 81.3% and specificity of 66.7%,was greater than that of Kep =0.477 and iAUC=24.706.Conclusion The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors.

OBJECTIVETo perform a sampling survey of occupational hazard in typical industrial enterprises in Guangzhou, China, by means of sentinel surveillance, to understand the classification, distribution, and concentration/intensity of occupational hazard as well as the characteristics and development of occupational health management in Guangzhou, and to provide a scientific basis for occupational health supervision.

METHODSFifteen enterprises in information technology (IT), shipbuilding, chemical, leather and footwear, and auto repair industries were enrolled as subjects. Dynamic surveillance for occupational hazard and occupational health management was performed in workplaces of those enterprises.

RESULTSThe overall overproof rate of occupational hazard in the 15 sentinel enterprises from 2012 to 2014 was 6.16% (45/731). There was no significant difference in the overproof rate between the three years (P > 0.05). During the three years, enterprises in shipbuilding industry had significant higher overproof rates than those in other industries (P < 0.05). According to the results of occupational health management questionnaire, the overall coincidence rate of survey items was 57.88% (393/679); enterprises in IT industry had significant lower coincidence rates than those in other industries in 2012 and 2014 (47.62%, 29.63%; P < 0.05), while enterprises in leather and footwear industry had significant lower coincidence rates than those in other industries in 2013 (40.63%; P < 0.05).

CONCLUSIONThe enterprises in shipbuilding industry are the key to the prevention and control of occupational hazard in Guangzhou. To strengthen surveillance for occupational health in workplaces in Guangzhou, it is important to enhance occupation health supervision among small and micro enterprises and develop continuous sentinel surveillance for occupational hazard in key industries.

China ; Humans ; Industry ; Occupational Health ; statistics & numerical data ; Sentinel Surveillance ; Surveys and Questionnaires ; Workplace

OBJECTIVETo investigate noise hazard and its influence on hearing loss in workers in the automotive component manufacturing industry.

METHODSNoise level in the workplace of automotive component manufacturing enterprises was measured and hearing examination was performed for workers to analyze the features and exposure levels of noise in each process, as well as the influence on hearing loss in workers.

RESULTSIn the manufacturing processes for different products in this industry, the manufacturing processes of automobile hub and suspension and steering systems had the highest degrees of noise hazard, with over-standard rates of 79.8% and 57.1%, respectively. In the different technical processes for automotive component manufacturing, punching and casting had the highest degrees of noise hazard, with over-standard rates of 65.0% and 50%, respectively. The workers engaged in the automotive air conditioning system had the highest rate of abnormal hearing ability (up to 3.1%).

CONCLUSIONIn the automotive component manufacturing industry, noise hazard exceeds the standard seriously. Although the rate of abnormal hearing is lower than the average value of the automobile manufacturing industry in China, this rate tends to increase gradually. Enough emphasis should be placed on the noise hazard in this industry.

Automobiles ; China ; Hearing Loss, Noise-Induced ; epidemiology ; Hearing Tests ; Humans ; Manufacturing Industry ; Noise, Occupational ; adverse effects ; Occupational Exposure ; Occupations ; Workplace