Objective To construct early phase Ⅰ cardiopulmonary rehabilitation program for patients with Type A aortic dissection and to evaluate its clinical effects.Methods From January 2021 to October 2022,type A aortic dissection patients of a tertiary hospital in Beijing was selected by the destination sampling.They were divided into a control group and an intervention group.The intervention group was given early phase Ⅰcardiopulmonary rehabilitation program for patients with type A aortic dissection and the control group was given routine care.The 6-minute walking experiment(6MWT),Borg subjective fatigue score,the first time out of bed,the incidence of hypoxemia and related complications,and the incidence of adverse events related to rehabilitation nursing were compared between the 2 groups.Results A total of 130 cases were selected,among which 20 cases were excluded because of surgical complications and self-withdrawal.A total of 110 cases were finally included,with 57 cases in the intervention group and 53 cases in the control group.The results of walking distance of 6MWT,Borg subjective fatigue score and incidence of hypoxemia had statistical significance between the 2 groups(P＜0.05).The results of the time of the first time out of bed and the incidence of complications and the incidence of adverse events related to rehabilitation nursing had no statistical significance between the 2 groups(P＞0.05).Conclusion Early phase Ⅰ cardiopulmonary rehabilitation program for patients with type A aortic dissection benefits the improvement of the motor function,the reduction of incidence of hypoxemia.

Objective: To construct a competency evaluation model for health managers based on the grounded theory, so as to provide insights into the training and evaluation of health managers. Methods: From December 2022 to March 2023, health managers with three years and more of working from health management center of a tertiary hospital, a health management enterprise and a university with a top-tier ranking for the major of "Health Services and Management" were invited, and a semi-structured interview on competency was conducted based on grounded theory. Coding techniques were applied to analyze the interview data, including open coding, axial coding, selective coding and theoretical saturation testing using NVivo12 software. Based on the coding results and drawing inspiration from McClelland's "Iceberg Competency Model Structure", a competency evaluation model for health managers was formulated. Results: Twenty-one health managers participated in the study, including 8 participants from the hospital, 7 participants from the enterprise and 6 participants from the university, 14 females, 17 participants with 3-10 years of working, and 6 participants with the rank of associate senior professional title or above. The interview yielded 5 main categories, from which the competency evaluation model for health managers was developed with five dimensions: professional development, health management capability, communication and coordination, humanistic care, and personal traits. professional development and health management capability constituted the overt competencies of health managers, while communication and coordination, humanistic care, and personal traits formed their implicit competencies. Conclusions The competency evaluation model for health managers constructed in this study includes explicit competency and implicit competency, which is expected to serve as a reference for the effective selection and cultivation of health managers.

Objective To observe the effect of group biofeedback in patients with residual schiz-ophrenia(RS).Methods A total of 127 patients with RS were selected as study objects,and ran-domly divided into control group(n=63)and observation group(n=64).The control group re-ceived routine nursing,and the observation group received group biofeedback based on the control group.The Positive and Negative Symptom Scale(PANSS),Personal and Social Performance Scale(PSP)and Self-awareness Inventory(SAI)Questionnaire(treatment compliance)scores were com-pared between the two groups.Results After 12 weeks of intervention,the score of the positive symptoms,the score of negative symptoms and the total score of PANSS in the observation group were significantly lower than those in the control group(P＜0.05).The number of patients with PSP scores greater than 70 to 100 and greater than 30 to 70 in the observation group was significantly more than those in the control group,and the number of patients with PSP score of 0 to 30 was significantly less than that in the control group(P＜0.05).The SAI score of the observation group after interven-tion was significantly higher than that before intervention and control group,and the number of com-pleted biofeedback therapy in the observation group was significantly more than that in the control group(P＜0.05).Conclusion Group biofeedback can promote symptom relief and improve treat-ment compliance in patients with RS.

Objective To observe the effect of group biofeedback in patients with residual schiz-ophrenia(RS).Methods A total of 127 patients with RS were selected as study objects,and ran-domly divided into control group(n=63)and observation group(n=64).The control group re-ceived routine nursing,and the observation group received group biofeedback based on the control group.The Positive and Negative Symptom Scale(PANSS),Personal and Social Performance Scale(PSP)and Self-awareness Inventory(SAI)Questionnaire(treatment compliance)scores were com-pared between the two groups.Results After 12 weeks of intervention,the score of the positive symptoms,the score of negative symptoms and the total score of PANSS in the observation group were significantly lower than those in the control group(P＜0.05).The number of patients with PSP scores greater than 70 to 100 and greater than 30 to 70 in the observation group was significantly more than those in the control group,and the number of patients with PSP score of 0 to 30 was significantly less than that in the control group(P＜0.05).The SAI score of the observation group after interven-tion was significantly higher than that before intervention and control group,and the number of com-pleted biofeedback therapy in the observation group was significantly more than that in the control group(P＜0.05).Conclusion Group biofeedback can promote symptom relief and improve treat-ment compliance in patients with RS.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Immune checkpoint inhibitors are able to reactivate the immune system therefore enhance the anti-tumor effects. However, over-activated T cells may induce immune related adverse events (irAEs). Hematological irAEs are rarely reported, which mainly represent as mono-lineage cytopenia or pancytopenia, including autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), neutropenia and aplastic anemia, sometimes even lethal, such as hemophagocytic lymphohistiocytosis. The clinical manifestations of hematological irAEs will be summarized and recommendations of diagnosis and treatment are proposed.

Immune checkpoint inhibitors (ICIs) have made remarkable breakthroughs in cancer treatment. However, the widely use of ICIs is associated with a spectrum of immune-related adverse events (irAEs). These adverse events can affect any organ system. In this article, we have made a systemic review about the clinical characteristics of rheumatic irAEs, and also summarized irAEs in patients with pre-exsiting rheumatic disease. We also focus on the management of rheumatic irAEs.

Immune checkpoint inhibitors (ICIs) have been widely used in management of malignant tumor. Programmed death ligand 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have been introduced to treat non-small cell lung cancer (NSCLC) in recent years. Currently, PD-1/PD-L1 inhibitors are considered to have minor side effects and do not independently increase the risk of infection. However, they may cause immune-related adverse events (irAEs) that can require immunosuppressive therapy with corticosteroids and/or immunosuppressants, leading to opportunistic infections. Furthermore, there were reports about reactivation of chronic/latent infections without irAEs. Thus, immune checkpoint inhibitor related infections have drawn more and more attention in the world. In this paper, we described the potential mechanism, available clinical data and recommendation of diagnosis and management for PD-1/PD-L1 inhibitor related infections.

Immunotherapy for malignant tumors is a hot spot in current research and treatment of cancer. The activation of programmed cell death receptor-1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA)-4 relevant signaling pathway can inhibit the activation of T lymphocytes. Tumor cells can achieve immune escape by activating this signaling pathway. By inhibiting this signaling pathway, immune-checkpoint inhibitors (ICIs) activate T lymphocytes to clear the tumor cells. Therefore, the adverse effects of ICIs are mainly immune-related adverse events (irAEs). The digestive system, including gastrointestinal tract and liver are vital organs of digestion and absorption, metabolism and detoxification, as well as important immune related organs, which are the commonly affected system of irAEs. This review separately explains the incidence, clinical features, diagnosis and treatment of liver and gastrointestinal adverse events in ICIs.

The increasing use of target therapy and immunocheckpoint inhibitors in cancers has brought new hope of survival to patients with advanced tumors. However, more and more adverse side-effects and toxicities of these medications had been reported, affect almost all human organs including the eye. These adverse effects may affect the entire ocular tissues, like eyelid, eye lashes, conjunctiva, cornea, uvea, retina, optic nerve and so on, which are always been ignored by patients and doctors. In this paper we will summarize the characteristics of the related ocular diseases and give our advice on how to diagnose and manage these diseases.