Objective To evaluate the efficacy and safety of intraoperative pleural irrigation with Nocardia rubra cell-wall skeleton (N-CWS) for reducing pleural effusion drainage after radical surgery for lung cancer. Methods A retrospective analysis was conducted on the clinical data of lung cancer patients who underwent lobectomy and mediastinal lymph node dissection at the First Affiliated Hospital of Xiamen University between December 2024 and May 2025. Patients were divided into a control group and an irrigation group based on the intraoperative use of N-CWS. Patients in the irrigation group received pleural irrigation with 800 μg of N-CWS diluted in 10 mL of normal saline. The following outcomes were compared between the two groups: pleural effusion drainage volume at 0-24 h, 24-48 h, and 48-72 h postoperatively, degree of air leak, chest tube duration, postoperative length of stay, and the incidence of adverse events (fever, chest pain, and nausea and vomiting). Results A total of 245 patients were included (97 males, 148 females) with a mean age of (61.28±6.26) years, with 205 in the control group and 40 in the irrigation group. Compared to the control group, the irrigation group showed significantly lower pleural effusion drainage volumes at 0-24 h, 24-48 h, and 48-72 h, as well as shorter chest tube duration and postoperative length of stay (all P<0.05). There was no statistical difference in the degree of postoperative air leak (P=0.661). No significant differences were observed between the two groups regarding the highest body temperature within 72 h post-surgery (P=0.130), fever grade (P=0.196), severity of chest pain (P=0.105), or the incidence of nausea and vomiting (P=0.376). Conclusion Intraoperative pleural irrigation with N-CWS in patients undergoing lobectomy and mediastinal lymph node dissection for lung cancer can significantly reduce postoperative pleural effusion drainage volume, shorten chest tube duration and length of hospital stay. The procedure is safe and feasible.

Objective:To explore the spatial clustering of the mortality rate of cervical cancer in different counties (cities, districts) in Shandong Province from 1970 to 2021 and its 50-year changing trend, so as to provide basis for the implementation and evaluation of prevention and control strategies and programs such as cervical cancer screening, early diagnosis and treatment, human papilloma virus (HPV) vaccination, etc.Methods:The mortality data of cervical cancer were obtained from the death registration system of Shandong Province and the data of three retrospective surveys of death causes. The mortality rate and age-standardized mortality rate (using the population composition of China in 1964) are used to describe the changing trend of cervical cancer in different years. The contribution values of population factors and non-population factors in cervical cancer mortality change are calculated by mortality differential decomposition method. ArcGIS 10.8 software is used for spatial distribution and spatial autocorrelation analysis.Results:From 1970 to 2021, the crude mortality rate and age standardized mortality rate of cervical cancer in Shandong Province showed a trend of first rapid decline and then slow increase. The crude mortality rate and standardized mortality rate of female cervical cancer in Shandong Province in 1970-1974 were the highest, reaching 17.22/10 5 and 13.17/10 5, respectively. In 2004-2005, it dropped to the lowest levels of 1.50/10 5 and 0.83/10 5. Subsequently, it slowly rose to 4.12/10 5 and 1.56/10 5 in 2020-2021. The differential analysis of cervical cancer mortality in different years found that the change of cervical cancer mortality was caused by the combined action of population factors and non-population factors. Among them, demographic factors (aging population) led to the increase of cervical cancer mortality, but non-demographic factors (early diagnosis and treatment, HPV infection level, medical technology level, etc) lead to the decrease of cervical cancer mortality. Compared with 1970-1974, with the passage of time, the absolute values of the contribution values of population factors and non-population factors showed an increasing trend, while the contribution of non-population factors was greater than that of population factors, which led to the decline of cervical cancer mortality. From the perspective of spatial distribution, there were great regional differences in the mortality rate of cervical cancer in different counties of Shandong Province. In 2020-2021, the mortality rate of cervical cancer in all counties decreased to a great extent compared with that in 1970-1974, and the high-high and low-low concentration areas of cervical cancer mortality in different years changed obviously. The high-aggregation areas of the cervical cancer mortality rate in Shandong Province from 2020 to 2021 were mainly distributed in some counties and districts of Linyi City, Zaozhuang City, and Heze City in the southwest. Conclusions:There are significant temporal and spatial changes in the mortality rate of cervical cancer in Shandong Province from 1970 to 2021. According to these trends and their geographical and spatial clustering, prevention and control strategies of cervical cancer in different regions should be further formulated and evaluated.

SPF chickens were immunized with HN-mRNA vaccine by intramuscular injection.He-magglutination inhibition(HI)test,lymphocyte proliferation test,RT-qPCR and pathological sec-tions were used to evaluate the humoral and cellular immunity and protection against challenge in-duced by the candidate HN-mRNA vaccine.The results showed that 2.5,5.0,and 7.5 μg HN-mR-NA induced HI antibody antibodies in a dose-dependent manner.Among them,the Hi antibody in-duced by 7.5 μg HN-mRNA was slightly higher than that of the weak toxic vaccine(La Sota strain).In addition,in response to the stimulation of inactivated NDV virus,the proliferation and activation of lymphocytes in 2.5,5.0 and 7.5 μg HN-mRNA immunization groups and commercial vaccine group were observed.To further evaluate the antiviral protection provided by HN mRNA immunization,the 105 ELD50 NDV strong strain NA-1 was used to attack the 7.5 μg HN-mRNA immunised group and the commercial weakened vaccine(La Sota strain)and PBS groups using na-sal and ocular drops.The results showed that the survival rate of 7.5 μg HN-mRNA immunization group and commercial vaccine group was 100％,and these vaccines could protect tissues and or-gans from the damage caused by virus infection.At the same time,7.5 μg HN-mRNA and commer-cial vaccine could shorten the time of virus shedding in vitro and the viral load in vivo.This study provides a foundational framework for the clinical application of NDV HN mRNA candidate vac-cines and offers insights for the development of novel mRNA vaccines for poultry.

Objective The purpose of this study was to explore the application effect of BOPPPS combined with case simulation teaching method in nursing risk education of nursing students.By comparing the traditional teaching methods,the in-fluence of BOPPPS combined with case simulation teaching method on nursing students' occupational risk cognition ability,pa-tient safety perception ability and teaching satisfaction was evaluated.Methods 100 cases of nursing students in geriatric oncol-ogy department were divided into observation group and control group,50 cases in each group.The control group used traditional teaching methods;the observation group adopted the teaching mode of BOPPPS combined with case teaching method.The occu-pational risk cognition ability,patient safety perception ability and satisfaction with teaching mode were compared between the two groups.Results The occupational risk cognitive ability,patient safety perception ability and teaching satisfaction of the observa-tion group were better than those of the control group(P＜0.05).Conclusion The application of BOPPPS combined with case simulation teaching method in nursing risk teaching of nursing students can improve their occupational risk cognition ability,pa-tient safety perception ability and teaching satisfaction.

Objective To discuss the main pathological types and imaging characteristics of pulmonary nodules that are highly suspected to be malignant in clinical practice but are pathologically confirmed to be benign. Methods A retrospective analysis was performed on the clinical data of patients with pulmonary nodules who were initially highly suspected of malignancy but were subsequently pathologically confirmed to be benign. These patients were treated at the First Affiliated Hospital of Xiamen University from December 2020 to April 2023. Based on the outcomes of preoperative discussions, the patients were categorized into a benign group and a suspicious malignancy group. The clinical data and imaging characteristics of both groups were compared. Results A total of 232 patients were included in the study, comprising 112 males and 120 females, with a mean age of (50.7±12.0) years. Among these, 127 patients were classified into the benign group, while 105 patients were categorized into the suspicious malignancy group. No statistically significant differences were observed between the two groups regarding age, gender, symptoms, smoking history, or tumor history (P>0.05). However, significant differences were noted in nodule density, CT values, margins, shapes, and malignant signs (P＜0.05). Further analysis revealed that in the suspicious malignancy group, solid nodules were predominantly characterized by collagen nodules and fibrous tissue hyperplasia (33.3%), followed by tuberculosis (20.4%) and fungal infections (18.5%). In contrast, non-solid nodules were primarily composed of collagen nodules and fibrous tissue hyperplasia (41.2%) and atypical adenomatous hyperplasia (17.7%). Conclusion Benign pulmonary nodules that are suspected to be malignant are pathologically characterized by the presence of collagen nodules, fibrous tissue hyperplasia, tuberculosis, atypical adenomatous hyperplasia, and fungal infections. Radiologically, these nodules typically present as non-solid lesions and may exhibit features suggestive of malignancy, including spiculation, lobulation, cavitation, and pleural retraction.

OBJECTIVE To investigate the improvement effects and its mechanism of Bazheng powder on chronic urinary tract infection （CUTI） induced by Escherichia coli in rats. METHODS The rats were divided into normal control group， model group， levofloxacin group （45 mg/kg） and Bazheng powder group （4.95 g/kg）， with 10 rats in each group. Except for the normal control group， other groups were administered an intravesical injection of Escherichia coli suspension （1×10⁸ cfu/mL） via the urethra to establish CUTI model； at the same time， rats in each group were administered the corresponding medicinal solution or water by gavage once a day for 4 consecutive weeks. After the last medication， blood routine tests （white blood cell count and lymphocyte percentage）， the levels of serum inflammatory factors [interleukin-1β （IL-1β）， IL-6， IL-8， tumor necrosis factor-α （TNF-α）]， and immune indicators [CD4， CD8， secretory immunoglobulin A （SIgA）]， renal function indicators [cystatin C （Cys-C）， α1- microglobulin （α1-MG）， urea and creatinine] were all determined； the pathological changes in renal and bladder tissues in rats were observed. The protein expressions of Toll-like receptor 4 （TLR4）， nuclear factor-κB （NF-κB）， and nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3） in rat bladder tissues were detected. RESULTS Compared with the normal control group， the levels of IL-1β， IL-6， IL-8， TNF-α， CD8， Cys-C， α1-MG， urea and creatinine in serum， as well as the protein expressions of TLR4， NF-κB and NLRP3 in bladder tissues， were significantly elevated in the model group （P＜0.05）. Conversely， the levels of CD4 and SIgA were significantly decreased （P＜0.05）. Pathological changes， such as extensive infiltration of inflammatory cells， were observed in both renal and bladder tissues. Compared with the model group， the above quantitative indicators in the Bazheng powder group were significantly improved （P＜0.05）， with no obvious inflammatory lesions observed in either renal or bladder tissues. CONCLUSIONS Bazheng powder can alleviate inflammatory reaction and improve the immune function of CUTI rats， and its mechanism may be related to the inhibition of TLR4/NF-κB/ NLRP3 signaling pathway.

Objective To explore the clinical application value of simple artery occlusion (SAO) in revealing intersegmental planes during thoracoscopic pulmonary segmentectomy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent thoracoscopic pulmonary segmentectomy at the First Affiliated Hospital of Xiamen University from February 2022 to December 2023. Patients were divided into a conventional group and a SAO group based on the method used to reveal the intersegmental plane during surgery. The two groups were compared in terms of intraoperative blood loss, operation time, postoperative drainage volume, time to intubation, postoperative pulmonary air leakage, and conversion to open thoracotomy rate. Results A total of 318 patients were included. There were 181 patients in the conventional group, including 86 males and 95 females, with an average age (53.35±9.20) years, and there were 137 patients in the SAO group, including 58 males and 79 females, with an average age (55.26±11.46) years. There were no statistical differences in general patient information between the two groups (P>0.05). The SAO group had less intraoperative blood loss [MD=17.568, 95%CI (9.968, 25.168), P<0.001] and postoperative drainage volume [MD=275.587, 95%CI (188.999, 362.175), P<0.001], shorter drainage tube duration [MD=1.000, 95%CI (1.000, 2.000), P<0.001] and operation time [MD=20.709, 95%CI (16.258, 25.159), P<0.001]. The incidence of postoperative pulmonary air leakage complications in the SAO group was lower than that in the conventional group [RR=0.361, 95%CI (0.181, 0.722), P=0.003]. Conclusion SAO can reduce surgical difficulty, shorten operation time, decrease the incidence of postoperative pulmonary air leakage, and enhance the safety of anatomical pulmonary segmentectomy, making it worthy of clinical promotion and application.

Objective:We aimed to analyze the spatio-temporal trend of breast cancer incidence and mortality in Shandong Province from 2012 to 2023 and predict the development trend from 2024 to 2030.Methods:Data on the incidence and mortality of breast cancer in Shandong Province from 2012 to 2023 were obtained from the Shandong Cancer Registry. The incidence, age-specific incidence, mortality, and age-specific mortality in different years, as well as in urban and rural areas, were calculated, and the rates were standardized based on the age composition of the Chinese standard population in 2000. The average annual percent change (AAPC) rate was calculated using Joinpoint 4.8.0.1 software. The global and local spatial autocorrelation analysis were performed using GeoDa 1.12 software. The Bayesian age-period-cohort model was used to predict the trend of breast cancer incidence and mortality from 2024 to 2030.Results:From 2012 to 2023, the breast cancer age-standardized incidence rate (ASIR) showed an increasing trend. The ASIR increased from 30.48/100 000 in 2012 to 39.94/100 000 in 2023 (AAPC=2.59%, P<0.001). The ASIR of urban and rural females also showed an upward trend. Additionally, the ASIR in rural areas (AAPC=3.33%, P<0.001) increased more than that in urban areas (AAPC=1.83%, P=0.002). The incidence peak of breast cancer mainly concentrated in population aged 45-64 years, and with the increase of years, the incidence peak gradually moved forward. The age-standardized mortality rate (ASMR) showed a downward trend. The ASMR decreased from 6.89/100 000 in 2012 to 4.93/100 000 in 2023 (AAPC=-3.12%, P<0.001). The ASMR of urban and rural females also showed a downward trend (urban: AAPC=-3.56%, P=0.007; rural: AAPC=-2.72%, P<0.001). The spatial analysis showed that from 2015 to 2023, the clustering areas of breast cancer incidence and mortality in Shandong had changed significantly. In 2015, the "High-high clusters" of ASIR mainly included Wendeng District in Weihai City, Dongying District, Kenli District, Lijin County, Guangrao County in Dongying City, Tianqiao District, Shizhong District in Jinan City; In 2023, the "High-high clusters" mainly included Jiaxiang County, Liangshan County, Jinxiang County, Wenshang County, Rencheng District in Jining City, Hedong District in Linyi City, Guangrao County in Dongying City. In 2015, the "High-high clusters" of ASMR only included Wenshang County in Jining City. In 2023, the "High-high clusters" mainly included Laizhou County in Yantai City, Junan County and Yishui County in Linyi City, Gaotang County in Liaocheng City, Dongping County and Ningyang County in Taian City. The Bayesian age-period-cohort model predicted that the ASIR trend of breast cancer in Shandong tended to be smooth (AAPC=0.33%, P=0.001). However, the ASMR remained decreasing (AAPC=-4.68%, P<0.001). Conclusions:The breast cancer incidence in Shandong showed an increasing trend, and it is expected to be smooth by 2030. However, the mortality showed a continuous downward trend. The incidence peak was mainly in the population aged 45-64 years, with obvious regional differences. Targeted prevention and control measures should be taken for high-risk groups and areas in Shandong Province.

Objective To explore the value of low contrast dose and low flow rate one-stop craniocervical CT angiography(CT A)-cerebral CT perfusion(CTP)for detecting carotid atherosclerosis(CAS).Methods Totally 117 CAS patients were prospectively enrolled and divided into group A(n=19),B(n=52),C(n=46),and low contrast dose and low flow rate one-stop craniocervical CTA-brain CTP scanning,low contrast dose and low flow rate craniocervical CT A scanning,as well as conventional craniocervical CT A scanning were performed,respectively.Virtual monoenergetic images(VMI)of 40,50 and 60 keV were reconstructed in group A and B.The subjective and objective evaluations of image quality were compared among 3 groups.Results Subjective scores of image quality and diagnostic confidence of 40 and 50 keV VMI,and the diagnostic confidence of 60 keV VMI in group A and B were not significant different compared with those in group C(all P＞0.05).Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each segment of craniocervical blood vessels at 40 and 50 keV VMI in group A and B were all higher than those in group C(all P＜0.05).CNR of cavernous sinus segment of internal carotid artery(C5 segment),horizontal segment of middle cerebral artery(MCA)(A1 segment),lateral sulcus segment of MCA(M2 segment)and basilar artery(BA)segment in group A at 60 keV VMI were all higher than those in group C(all P＜0.05).SNR of C5 segment,A1 segment and BA segment,as well as CNR of BA segment of 60 keV VMI in group B were all higher than those in group C(all P＜0.05).Conclusion Low contrast dose and low flow rate one-stop craniocervical was feasible for detecting CAS.

Objective:To understand spatial aggregation of lung cancer mortality and its changing trends over the past fifty years in different counties and districts of Shandong Province from 1970 to 2021.Methods:The mortality data of lung cancer were obtained from the death registration system of Shandong province and three retrospective surveys of death cause. The mortality rate and age-standardized mortality rate were used to describe the changing trend of lung cancer in different years, and the contribution value of population factors and non-population factors in lung cancer mortality change was calculated by the mortality differential decomposition method. GeoDa 1.20 and ArcGIS 10.8 software were used for spatial autocorrelation analysis and visualization map display.Results:The crude mortality rate of lung cancer in Shandong Province showed a significant upward trend from 1970 to 2021, rising from 7.22 per 100 000 in 1970-1974 to 62.73 per 100 000 in 2020-2021, with an increase of 7.69 times. Meanwhile, the standardized mortality rate of lung cancer exhibited a trend of increasing first and then decreasing. The differential analysis of lung cancer mortality in different years revealed that changes in crude mortality rates were the result of the combined effects of demographic and non-demographic factors. The proportion of population factors (aging population) leading to an increase in lung cancer mortality rate rose from 2.12% in 1990-1992 to 40.20% in 2020-2021. From a spatial distribution perspective, there were significant regional differences in lung cancer mortality rates among counties (cities, districts) in Shandong Province across different eras. Compared to the period of 1970-1974, the lung cancer mortality rates in all counties and districts in 2020-2021 showed a considerable increase, and there were noticeable changes in the areas of high-high and low-low clustering of lung cancer mortality rates across different eras.Conclusion:There have been significant temporal and spatial changes in the mortality rate of lung cancer in Shandong Province from 1970 to 2021. The crude mortality rate has shown an upward trend, while the standardized mortality rate increases first and then decreases. The concentration of lung cancer mortality rates in counties and districts has also undergone significant changes.