With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Living systematic review (LSR) is a systematic review methodology that incorporates regular updates to integrate new evidence, aiming to rapidly reflect the latest research findings. Although LSRs are increasingly adopted in clinical fields, their reporting quality remains inconsistent and lack of standardized guidelines. To standardize LSR reporting, the PRISMA 2020 statement has released an extension checklist (PRISMA-LSR). This paper describes the background of PRISMA-LSR release and main revisions, and interprets it with examples, with the goal of guiding future LSR research and enhancing reporting quality.

Objective To investigate an automated pretreatment technology for detecting levels of free silica in workplace dust. Methods An fully automated pretreatment workstation for detecting free silica levels in workplace dust was developed by integrating graphite-controlled digestion temperature, online-controlled dilution of digestion solutions, and filtration endpoint recognition based on monitoring technology, combined with multi-channel synchronous measurements. Results The fully automatic pretreatment workstation was used to digest and filter 14 standard samples of free silica produced by three institutions, and then detected by pyrophosphate method. The result range of high-, medium-, and low-level free silica standard samples detection was 66.5%-84.8%, 40.0%-44.5%, and 2.1%-24.8%, respectively. The mean relative standard deviations were 3.9%, 1.4% and 1.5%. Conclusion The fully automated pretreatment workstation produced results that met relevant requirements. It can effectively replace the manual digestion and filtration steps of the pyrophosphate method to measure free silica levels in workplace dust and enable rapid detection of free silica in dust samples.

Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.

Objective:To construct a comprehensive evaluation index system for the clinical usability of clinical nursing information systems from the perspective of nurses, providing a basis for the improvement of clinical nursing information systems.Methods:Using an integrated model, this study employed both quantitative research through systematic reviews and qualitative research via Meta-integration methods to preliminarily construct the index system. Expert consultations were conducted to modify and refine the index system. The final version of the evaluation index system for clinical nursing information systems' usability, based on the users' perspective, was established.Results:A total of 20 experts in the field of nursing information were included in this study. The response rates for the two rounds of expert consultation were 100% and 85%, respectively. The authority coefficients were 0.878 and 0.886, and the Kendall harmony coefficients for the importance and rationality scores of the indices in the two rounds of expert consultation ranged from 0.182 to 0.231 ( P<0.05). The final evaluation index system included four primary indicators, 10 secondary indicators, and 37 tertiary indicators. Conclusions:The developed evaluation index system for the clinical usability of clinical nursing information systems from the user's perspective is scientific, reliable, advanced, and practical. It effectively reflects the key aspects of nurses' evaluations of clinical nursing information systems and provides a foundation for promoting the high-quality and sustainable development of clinical nursing information systems.

Objective:To investigate the correlation between graduate students' source information and their destinations as well as the potential influencing factors, and to provide a reference for employment guidance for graduate students.Methods:A total of 9 599 entries of 2019-2023 graduate students' source information and destinations were exported from the Chongqing smart employment platform for college graduates. With the use of SPSS software, we performed chi-square tests for contingency tables, and further confirmed the detected statistically significant factors through multinomial logistic regression analysis.Results:There were significant differences in the destinations of graduate students of different ages, training types, and source origins (all P<0.001). Students from the western region accounted for 80.82%(7 758/9 599) of the whole population, indicating that the western region was the major student source of the university. The destinations of the graduate students were concentrated in the western region [82.32% (7 902/9 599)], radiating to the eastern region [10.77% (1 034/9 599)] and central region [6.02% (578/9 599)]. According to the multinomial logistic regression analysis, compared with the students aged 21-25 years, the likelihoods of those aged 26-30 years choosing the central region and the eastern region as their destinations were 0.631 times and 0.813 times, respectively; and the likelihood of the students aged 31-35 years choosing the eastern region was 0.633 times. Professional graduate students were 0.678, 0.806, 0.257, and 0.447 times as likely as academic graduate students to choose the central region, the eastern region, the northeastern region, and Hong Kong, Macao, Taiwan, and other regions, respectively. Conclusions:The destinations of graduate students differ regionally by source origin and age bracket. Compared with academic graduate students, professional graduate students have greater regional mobility.

Objective:To investigate the correlation between graduate students' source information and their destinations as well as the potential influencing factors, and to provide a reference for employment guidance for graduate students.Methods:A total of 9 599 entries of 2019-2023 graduate students' source information and destinations were exported from the Chongqing smart employment platform for college graduates. With the use of SPSS software, we performed chi-square tests for contingency tables, and further confirmed the detected statistically significant factors through multinomial logistic regression analysis.Results:There were significant differences in the destinations of graduate students of different ages, training types, and source origins (all P<0.001). Students from the western region accounted for 80.82%(7 758/9 599) of the whole population, indicating that the western region was the major student source of the university. The destinations of the graduate students were concentrated in the western region [82.32% (7 902/9 599)], radiating to the eastern region [10.77% (1 034/9 599)] and central region [6.02% (578/9 599)]. According to the multinomial logistic regression analysis, compared with the students aged 21-25 years, the likelihoods of those aged 26-30 years choosing the central region and the eastern region as their destinations were 0.631 times and 0.813 times, respectively; and the likelihood of the students aged 31-35 years choosing the eastern region was 0.633 times. Professional graduate students were 0.678, 0.806, 0.257, and 0.447 times as likely as academic graduate students to choose the central region, the eastern region, the northeastern region, and Hong Kong, Macao, Taiwan, and other regions, respectively. Conclusions:The destinations of graduate students differ regionally by source origin and age bracket. Compared with academic graduate students, professional graduate students have greater regional mobility.

Objective:To construct a comprehensive evaluation index system for the clinical usability of clinical nursing information systems from the perspective of nurses, providing a basis for the improvement of clinical nursing information systems.Methods:Using an integrated model, this study employed both quantitative research through systematic reviews and qualitative research via Meta-integration methods to preliminarily construct the index system. Expert consultations were conducted to modify and refine the index system. The final version of the evaluation index system for clinical nursing information systems' usability, based on the users' perspective, was established.Results:A total of 20 experts in the field of nursing information were included in this study. The response rates for the two rounds of expert consultation were 100% and 85%, respectively. The authority coefficients were 0.878 and 0.886, and the Kendall harmony coefficients for the importance and rationality scores of the indices in the two rounds of expert consultation ranged from 0.182 to 0.231 ( P<0.05). The final evaluation index system included four primary indicators, 10 secondary indicators, and 37 tertiary indicators. Conclusions:The developed evaluation index system for the clinical usability of clinical nursing information systems from the user's perspective is scientific, reliable, advanced, and practical. It effectively reflects the key aspects of nurses' evaluations of clinical nursing information systems and provides a foundation for promoting the high-quality and sustainable development of clinical nursing information systems.

Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.

Objective To explore the relationship between androgen level and adverse pregnancy outcome of pregnant women at advanced maternal age.Methods A total of 192 pregnant women who were admitted to Changzhou Maternal and Child Health Care Hospital for delivery from May to October 2022 were selected as the study objects.According to guidelines for diagnosis and treatment of hypertensive disorder complicating pregnancy and maternal age,the study objects were divided into simple pregnant women at advanced maternal age group,pregnant women at advanced maternal age complicated with hypertensive disorder complicating pregnancy,healthy control group and age-appropriate pregnant women complicated with hypertensive disorder complicating pregnancy group.Serum levels of five androgens[total testosterone(TT),sex hormone binding globulin(SHBG),free testosterone index(FTI),dehydroepiandrosterone sulfate(DHEAS)and androstendi-one(A2)]in each group were detected by chemiluminescence method.Results Compared with the healthy control group,TT,A2,FTI were significantly increased and SHBG was significantly decreased in the age-ap-propriate pregnant women complicated with hypertensive disorder complicating pregnancy group,the level of DHEAS was decreased in the simple pregnant women at advanced maternal age group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that TT was negatively correla-ted with age(P＜0.05),positively correlated with systolic blood pressure,diastolic blood pressure and body mass index(P＜0.05),and had no correlation with offspring sex and offspring weight(P＞0.05).Multivari-ate Logistic regression analysis showed that TT and body mass index were independent risk factors for hyper-tensive disorder complicating pregnancy in pregnant women(P＜0.05).Conclusion The level of androgen in pregnant women at advanced maternal age is related to the occurrence of hypertensive disorder complicating pregnancy.