Neuroendocrine carcinoma (NEC) represents a category of malignant tumors originating from neuroendocrine cells. Given that NEC cells exhibit characteristics of both neural and endocrine cells, they can hijack neuronal signaling pathways and dynamically regulate the expression of neuronal lineage markers during tumor metastasis, thereby constructing a microenvironment conducive to tumor growth and metastasis. Conversely, alterations in the tumor microenvironment can enhance the interactions between neurons and tumor cells, ultimately synergistically promoting the metastasis of NEC. This review highlights recent advancements in the field of cancer neuroscience, uncovering neuronal lineage markers in NEC that facilitate tumor dissemination through mediating crosstalk, bidirectional communication, and synergistic interactions between tumor cells and the nervous system. Consequently, the latest findings in tumor neuroscience have enriched our understanding of the biological mechanisms underlying tumor metastasis, opening new research avenues for a deeper comprehension of the complex biological processes involved in tumor metastasis, particularly brain metastasis. This review provides a comprehensive review of the crosstalk between tumor cells and neural signaling in the metastasis of NEC.
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Humans ; Carcinoma, Neuroendocrine/metabolism* ; Signal Transduction ; Animals ; Neoplasm Metastasis ; Neurons/pathology* ; Tumor Microenvironment ; Cell Communication

Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

Background and Aims:The incidence of intrahepatic cholangiocarcinoma(ICC)has been increasing in recent years.Due to its insidious onset and low rate of early diagnosis,radical resection remains the only potential curative treatment.Lymph node metastasis is a major adverse prognostic factor in ICC,but the scope and therapeutic value of lymphadenectomy remain controversial.Previous studies suggest that patients with central ICC may derive greater survival benefit from lymphadenectomy than those with peripheral ICC.Preoperative assessment of lymph node status mainly relies on imaging,but its accuracy is limited.This study aimed to investigate the prognostic impact of lymphadenectomy in ICC patients at different anatomical sites to inform surgical decision-making.Methods:A retrospective analysis was conducted on 220 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA from May 2016 to May 2021.The cohort included 126 males and 94 females,with a mean age of(56.76±13.15)years.Patients were categorized into peripheral ICC(n=144)and central ICC(n=76)groups.Clinical characteristics,albumin-bilirubin(ALBI)grade,preoperative risk of lymph node metastasis,number of lymph nodes dissected,lymph node metastasis status,and postoperative survival outcomes were compared.Subgroup analyses were conducted to assess the prognostic value of the number of lymph nodes dissected under different risk stratifications.Results:Significant differences were observed between peripheral and central ICC in ALBI grade(x2=9.952,P=0.002),preoperative lymph node metastasis risk(x2=6.166,P=0.014),number of lymph nodes dissected(x2=4.167,P=0.042),and lymph node metastasis rate(x2=7.331,P=0.007).The 3-year overall survival(OS)rate was higher in peripheral ICC(31.94％)than in central ICC(15.79％)(x2=13.890,P＜0.001).Among central ICC patients,those with ≥6 lymph nodes dissected had better 3-year OS than those with＜6(16.89％vs.13.04％,x2=3.894,P=0.048).In the high-risk subgroup of central ICC,≥6 lymph nodes dissected was also associated with improved 3-year OS compared with＜6(15.62％vs.11.11％,x2=3.962,P=0.047).In contrast,the number of lymph node dissections had no significant prognostic impact in peripheral ICC or in patients classified as low risk.Conclusion:Patients with peripheral ICC had a better prognosis than those with central ICC.Adequate lymphadenectomy(≥6 nodes)improved survival and enhanced staging accuracy in central ICC patients at high risk of lymph node metastasis,highlighting the importance of preoperative risk assessment for optimizing surgical strategies.

The scientific rigor and efficacy of methodologies employed in drafting emergency health systems guidance documents （HSGs） are paramount in guaranteeing the quality， reliability， and applicability of HSGs. According to the Appraisal of Guidelines for Research and Evaluation- Health Systems （AGREE-HS）， we demonstratively assessed both global coronavirus disease-2019 （COVID-19） emergency HSGs and World Health Organization （WHO） standard HSGs to uncover the core attributes of methods employed in the development of emergency HSGs. Our evaluation findings revealed that across the five assessment items of AGREE-HS， methods in the 34 emergency HSGs evaluated ranked third， trailing behind topic and recommendations. Notably， criterion 2 （the best available and most contextually relevant evidence is considered） received the highest score， whereas criterion 5 （evidence of cost and cost-effectiveness of the potential options is described） scored the lowest. Compared with the WHO standard HSGs， the COVID-19 emergency HSGs exhibited low scores in methods （P<0.05）， which was reflected in nine criteria （P<0.05）， especially in criteria 1 （systematic and transparent methods are used to identify and review the evidence） and 9 （systematic and transparent methods are used to agree upon the final recommendations）. Among the COVID-19 emergency HSGs， that developed by the WHO achieved higher scores in eight out of all nine criteria， excluding criterion 8 （P<0.05）. The clinically relevant emergency HSGs had higher scores in the criteria 3 （the evidence base is current） and 8 （the rationale behind the recommendations is clear） than other types of emergency HSGs. Collectively， the methodology for developing emergency HSGs， represented by the COVID-19 emergency HSG， underscores evidence orientation and integrates expert consensus. It is characterized by adaptable evidence synthesis strategies， streamlined evidence review protocols， and contextual relevance， all of which are influenced by external， internal， and implementation-specific factors.

Objective To develop a training curriculum for specialist nurses in oral implantology and to provide a theoretical basis for professional development.Methods In September 2022,based on literature reviews,interviews and group discussions were conducted to formulate an preliminary draft of the"Training Curriculum for Nursing Specialists in Oral Implantology",which included 6 primary domains and 23 secondary items.Between October and November 2022,Delphi method was employed to conduct 2 rounds of expert consultations with 17 dentists and nursing specialists in oral implantology.The initial draft was improved based on the results of consultation and a final version of the curriculum was concluded.Results The response rate of the two rounds of expert consultation was both of 100%with an expert authority coefficient at 0.873.The importance scores for the items in the two rounds of expert correspondence ranged from 4.31 to 5.00 and 4.47 to 5.00,respectively,with the coefficients of variation ranged from 0 to 0.16 and 0 to 0.14,respectively.The proportion of maximum scores in the two rounds of expert consultation ranged from 43.75%to 100.00%and 47.10%to100.00%,respectively,with Kendall W coefficients of 0.196 and 0.310,respectively,indicating statistically significant differences(all P<0.001).The finalised curriculum encompassed 6 primary domains and 30 secondary items.The primary domains included basic knowledge about oral implantation,perioperative care of oral implantation,care during restoration period of oral implantation,infection management of oral implantation,emergency management of oral implantation,and nursing management in oral implantation.Conclusion The curriculum developed for training of specialist nurses in oral implantology is scientifically valid and reliable.It is in line with the training requirements for the specialists in oral implantology and provides guidance for the professional training.

Objective To develop a training curriculum for specialist nurses in oral implantology and to provide a theoretical basis for professional development.Methods In September 2022,based on literature reviews,interviews and group discussions were conducted to formulate an preliminary draft of the"Training Curriculum for Nursing Specialists in Oral Implantology",which included 6 primary domains and 23 secondary items.Between October and November 2022,Delphi method was employed to conduct 2 rounds of expert consultations with 17 dentists and nursing specialists in oral implantology.The initial draft was improved based on the results of consultation and a final version of the curriculum was concluded.Results The response rate of the two rounds of expert consultation was both of 100%with an expert authority coefficient at 0.873.The importance scores for the items in the two rounds of expert correspondence ranged from 4.31 to 5.00 and 4.47 to 5.00,respectively,with the coefficients of variation ranged from 0 to 0.16 and 0 to 0.14,respectively.The proportion of maximum scores in the two rounds of expert consultation ranged from 43.75%to 100.00%and 47.10%to100.00%,respectively,with Kendall W coefficients of 0.196 and 0.310,respectively,indicating statistically significant differences(all P<0.001).The finalised curriculum encompassed 6 primary domains and 30 secondary items.The primary domains included basic knowledge about oral implantation,perioperative care of oral implantation,care during restoration period of oral implantation,infection management of oral implantation,emergency management of oral implantation,and nursing management in oral implantation.Conclusion The curriculum developed for training of specialist nurses in oral implantology is scientifically valid and reliable.It is in line with the training requirements for the specialists in oral implantology and provides guidance for the professional training.

Objective To investigate the clinical and epidemiological characteristics of crayfish associated rhabdomyolysis syndrome in Baiyun District, Guangzhou, and explore the related factors, and to provide evidence for the prevention of crayfish rhabdomyolysis syndrome. Methods The cases of crawfish associated rhabdomyolysis syndrome were found through the foodborne disease surveillance and reporting system, and a field epidemiological investigation was carried out to analyze the clinical and epidemiological characteristics of the cases. Results A total of 25 cases of crayfish associated rhabdomyolysis syndrome occurred in 2020. The intake of crayfish of the cases ranged from 5 to 25, the incubation period was 1 to 9.5h, and the interval from onset to medical treatment was 0.17 to 9h. All the cases had muscle pain, and the content of creatine kinase (CK) in the cases increased to varying degrees (128-17851 U/L). Retrospective cohort analysis of 10 crayfish events found no correlation between the consumption of different parts of crayfish and the incidence of crayfish-related rhabdomyolysis syndrome. Conclusion The incidence of rhabdomyolysis syndrome reported in Baiyun District of Guangzhou is related to the consumption of crayfish, but the pathogenic factors need to be further studied. It is suggested to strengthen the supervision of crayfish breeding, transportation, sales, and processing to ensure the health of consumers.

Professor , as the famous and veteran physician of TCM, has practiced TCM for more than 50 years, and had unique experience for the treatment of encephalopathy. Professor applied the theory of skin to guide the treatment of shoulder-hand syndrome after stroke. On the basis of the ancient acupuncture method of , combined with modern acupuncture method and new materials, with characteristics of shoulder-hand syndrome after stroke at different time points, he proposed to use floating needling and acupoint catgut embedding to treat patients with stageⅠ, and to use picking therapy and penetration needle to treat patients with stageⅡ, and to use fire needles, penetration needle and acupoint catgut embedding to treat patients with stageⅢ, combined with conventional acupuncture and rehabilitation treatment. As a result, the superior efficacy was achieved.

Objective To assess the structure validity of application of sub-health measurement scale version 1.0(SHMS V1.0)in college students in Guangzhou City to lay a foundation for further analyzing the healthy status in this group and its influen-cing factors.Methods Nine hundreds college students were selected by adopting the stratified random sampling method for conduc-ting the questionnaire survey.The SPSS20.0 and AMOS21.0 were adopted to conduct the exploratory factor analysis(EFA)and confirmatory factor analysis(CFA)respectively.Results EFA obtained 7 factors with eigenvalue more than 1,the cumulative vari-ance contribution rate was 56.766%,moreover 7 factors were basically consistent with the theoretical structure of SHMS V 1.0. CFA conducted the model fitting for 3 total scales and 3 subscales,the results showed that the fitting of 3 subscales was good,the fitting result of total scale could be accepted,but did not reach the desired effect.Therefore,five times modification was applied in the total scale,and the fitting indexes after modification were CMIN/DF=2.723,GFI=0.907,IFI=0.917,TLI= 0.905,CFI=0.917,RMSEA=0.046,the fitting effect was comparatively excellent.Conclusion The dimension division of sub-health measure-ment scale is basically reasonable,and using this scale for measuring the sub-health status of college students in Guangzhou City has a better structure validity.

Objective To establish the norms of Self-rated Health Measurement Scale Version 1. 0 ( SRHMS V1.0) for urban residents in Guangdong. Methods We used regional stratified random sampling method to select 6000 urban residents of 5 cities in Guangdong ( including Guangzhou, Maoming, Shantou, Shaoguan and Shenzhen) for a questionnaire investigation with SRHMS V1. 0, and establish the norms of mean,percentile and threshold based on characteristics of SRHMS V1.0 scores. Results The residents can be divided into 8 groups on the basis of gender and cut-off point of age 40,50 and 60. The mean norms of SRHMS V1.0 total scores were:(78.57±10.10),(76.93±9.90),(75.33±10.66),(69.45±13.90)for males under age40,40-50,50-60 and above 60 respectively;(77.03±10.00),(74.55±10.27),(72.24±11.76), (66.48±14.37)for females under age40,40-50,50-60 and above 60 respectively. The percentile norms of SRHMS V1.0 from 5 percent to 95 percent were established with 5% as interval. The norms of cutting off scores were established as five states according to the scores of TS,namely severe poor health,poor health,gen-eral health,good health and fairly good health,with( x-s),( x-0.5s),( x+0.5s),( x+s) as cutting off scores. Conclusion The study established the SRHMS V1.0 norms for urban residents of Guangdong preliminarily,which provides reference for further research of the population''s health status and its impacting factors.