Objective The aim of this study was to analyze the relationship between polymorphism of epidermal growth factor(EGF)gene and sensitivity of concurrent chemoradiotherapy(CCRT)regimen containing cisplatin in esophageal cancer patients.Methods A prospective cohort study was conducted in 112 esophageal cancer patients who underwent CCRT treatment in Tianchang City People's Hospital and Haimen People's Hospital from March 2020 to February 2024 as the research subjects.All patients under-went EGF gene polymorphism detection and pathological features were analyzed at admission.The genotypes and alleles of EGF G-61A locus were counted.All patients were evaluated for the effect at 4 cycles of CCRT treatment.According to the pathological evalua-tion criteria established by Becker et al.the patients were divided into the CCRT-tolerant group and CCRT-sensitive group.The EGF G-61A locus gene polymorphism and clinicopathological features were compared between the two groups,and the relationship between EGF G-61A locus polymorphism and CCRT sensitivity of esophageal cancer was analyzed.Results A total of 112 patients with e-sophageal cancer were enrolled in this study,of which 106 patients were followed up.The results of EGF G-61A locus genotype detec-tion showed that among the 106 patients,33 cases had GG genotype,45 cases had GA genotype,and 28 cases had AA genotype.The results of allele detection showed that 73 cases had G allele and 33 cases had A allele.The results of CCRT treatment showed that 28 patients were tolerant to CCRT treatment and 78 patients were sensitive to CCRT treatment.The proportion of TNM stage Ⅳa,poor dif-ferentiation and CCRT tolerance in patients with EGF G-61A GG genotype was higher than that in patients with GA and AA geno-types.The proportion of TNM stageⅣa,low differentiation and CCRT tolerance in patients with EGF G-61A G allele was higher than that in patients with A allele.The difference was statistically significant(P<0.05).The proportion of TNM stage Ⅳa and low differen-tiation in the CCRT tolerance group was higher than that in the CCRT sensitive group,and the proportion of EGF G-61A GG genotype and G allele was higher than that in the CCRT treatment sensitive group,with significant differences(P<0.05).Logistic regression a-nalysis showed that TNM stage Ⅳa,poor differentiation,EGF G-61A GG genotype,and G allele were risk factors for CCRT tolerance in esophageal cancer(P<0.05).Conclusion The sensitivity of patients with esophageal cancer to CCRT regimen containing cisplatin is related to EGF G-61A gene polymorphism,and the EGF G-61A GG genotype and G allele may increase the risk of CCRT toler-ance.

Objective The aim of this study was to analyze the relationship between polymorphism of epidermal growth factor(EGF)gene and sensitivity of concurrent chemoradiotherapy(CCRT)regimen containing cisplatin in esophageal cancer patients.Methods A prospective cohort study was conducted in 112 esophageal cancer patients who underwent CCRT treatment in Tianchang City People's Hospital and Haimen People's Hospital from March 2020 to February 2024 as the research subjects.All patients under-went EGF gene polymorphism detection and pathological features were analyzed at admission.The genotypes and alleles of EGF G-61A locus were counted.All patients were evaluated for the effect at 4 cycles of CCRT treatment.According to the pathological evalua-tion criteria established by Becker et al.the patients were divided into the CCRT-tolerant group and CCRT-sensitive group.The EGF G-61A locus gene polymorphism and clinicopathological features were compared between the two groups,and the relationship between EGF G-61A locus polymorphism and CCRT sensitivity of esophageal cancer was analyzed.Results A total of 112 patients with e-sophageal cancer were enrolled in this study,of which 106 patients were followed up.The results of EGF G-61A locus genotype detec-tion showed that among the 106 patients,33 cases had GG genotype,45 cases had GA genotype,and 28 cases had AA genotype.The results of allele detection showed that 73 cases had G allele and 33 cases had A allele.The results of CCRT treatment showed that 28 patients were tolerant to CCRT treatment and 78 patients were sensitive to CCRT treatment.The proportion of TNM stage Ⅳa,poor dif-ferentiation and CCRT tolerance in patients with EGF G-61A GG genotype was higher than that in patients with GA and AA geno-types.The proportion of TNM stageⅣa,low differentiation and CCRT tolerance in patients with EGF G-61A G allele was higher than that in patients with A allele.The difference was statistically significant(P<0.05).The proportion of TNM stage Ⅳa and low differen-tiation in the CCRT tolerance group was higher than that in the CCRT sensitive group,and the proportion of EGF G-61A GG genotype and G allele was higher than that in the CCRT treatment sensitive group,with significant differences(P<0.05).Logistic regression a-nalysis showed that TNM stage Ⅳa,poor differentiation,EGF G-61A GG genotype,and G allele were risk factors for CCRT tolerance in esophageal cancer(P<0.05).Conclusion The sensitivity of patients with esophageal cancer to CCRT regimen containing cisplatin is related to EGF G-61A gene polymorphism,and the EGF G-61A GG genotype and G allele may increase the risk of CCRT toler-ance.

Objective To evaluate the benefits of physical activity on the physical health,mental health and health behaviors related to physical activity in obese and overweight children and adolescents.Methods Following the PRISMA guidelines,a systematic search was conducted in Web of Science,PubMed,Scopus,PsycINFO,Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals,related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents.They were assessed using AMSTAR 2 tool to en-sure that the methodological quality was medium to high.Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included.Six studies were of high quality,and two were of moderate quality.In terms of physical health,combined aerobic and resis-tance exercise interventions demonstrated the most significant improvements in reducing body mass index(BMI)and body fat percentage.Moderate-to-high-intensity exercise performed three times per week,at least 60 minutes per session,over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and over-weight children while improving cardiorespiratory endurance and muscular strength.In terms of mental health,physical activity was positive in reducing depression and anxiety,and improving self-esteem in children and ado-lescents.Activities such as dance,outdoor adventure programs and team sports notably enhanced social skills and emotional well-being.For neurodevelopmental disorders,low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities.In terms of health-related behaviors,physi-cal activity interventions promoted the development of exercise habits,improved social interaction skills,in-creased physical activity participation,reduced sedentary behavior,and enhanced health and physical activity knowledge.In terms of multi-modal interventions,programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interven-tions.Health-promoting schools(HPS)approach,integrating school,family and community involvement,effec-tively increased students'physical activity levels,reduced obesity rates,and improved mental health outcomes.Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents.Moderate-to-high-intensity aerobic and resistance training,dance,and outdoor activities are effective interven-tions for improving body composition and mental health.Multi-modal interventions and HPS strategies can yield sustained health benefits.

Objective To analyze the research hotspots and trends of invasive fungal infections(IFIs)in China over the past 24 years,and provide references and suggestions for future research.Methods Literatures on IFIs re-search in China from 2000 to 2024 were retrieved from China National Knowledge Infrastructure(CNKI)and Web of Science(WOS).CiteSpace software was employed to conduct collaboration network analysis on authors' institu-tions,and co-occurrence,clustering,and burst analyses were conducted on key words.Results A total of 2 479 li-teratures retrieved from CNKI and 1 149 from WOS were included in the analysis,involving 295 research institu-tions,with no core research team identified having a intermediary centrality＞0.1.Institutions with intermediary centrality＞0.1 included Chinese Academy of Sciences,Peking University,Fudan University,Sun Yat-sen Univer-sity and Zhejiang University.Key words with high centrality included"diagnosis""risk factor""voriconazole"and"Candida albicans".Clustering analysis grouped the co-occurrence network of key words into 6 clusters,mainly covering fungal diagnosis,treatment,and susceptible factors.Since 2020,focuses on the safety of antifungal treat-ment agents and primary prevention have emerged,with hot topics including pharmacokinetics,children,clinical features,and risk factors.Conclusion Currently,research teams are dispersed with insufficient interdisciplinary collaboration.Research topics are relatively simple.It is necessary to strengthen research on fungal resistance and healthcare-associated infection prevention and control.Risk factors and prevention measures for IFIs may be the fo-cus of future research.

Objective To analyze the research hotspots and trends of invasive fungal infections(IFIs)in China over the past 24 years,and provide references and suggestions for future research.Methods Literatures on IFIs re-search in China from 2000 to 2024 were retrieved from China National Knowledge Infrastructure(CNKI)and Web of Science(WOS).CiteSpace software was employed to conduct collaboration network analysis on authors' institu-tions,and co-occurrence,clustering,and burst analyses were conducted on key words.Results A total of 2 479 li-teratures retrieved from CNKI and 1 149 from WOS were included in the analysis,involving 295 research institu-tions,with no core research team identified having a intermediary centrality＞0.1.Institutions with intermediary centrality＞0.1 included Chinese Academy of Sciences,Peking University,Fudan University,Sun Yat-sen Univer-sity and Zhejiang University.Key words with high centrality included"diagnosis""risk factor""voriconazole"and"Candida albicans".Clustering analysis grouped the co-occurrence network of key words into 6 clusters,mainly covering fungal diagnosis,treatment,and susceptible factors.Since 2020,focuses on the safety of antifungal treat-ment agents and primary prevention have emerged,with hot topics including pharmacokinetics,children,clinical features,and risk factors.Conclusion Currently,research teams are dispersed with insufficient interdisciplinary collaboration.Research topics are relatively simple.It is necessary to strengthen research on fungal resistance and healthcare-associated infection prevention and control.Risk factors and prevention measures for IFIs may be the fo-cus of future research.

Objective To evaluate the benefits of physical activity on the physical health,mental health and health behaviors related to physical activity in obese and overweight children and adolescents.Methods Following the PRISMA guidelines,a systematic search was conducted in Web of Science,PubMed,Scopus,PsycINFO,Cochrane Library and CNKI for systematic reviews or meta-analyses published between 2016 and 2024 in Science Citation Index Q4 or higher journals,related to physical activity or exercise for physical and mental health in obese and overweight children and adolescents.They were assessed using AMSTAR 2 tool to en-sure that the methodological quality was medium to high.Results A total of eight systematic reviews and meta-analyses involving 24 567 participants were included.Six studies were of high quality,and two were of moderate quality.In terms of physical health,combined aerobic and resis-tance exercise interventions demonstrated the most significant improvements in reducing body mass index(BMI)and body fat percentage.Moderate-to-high-intensity exercise performed three times per week,at least 60 minutes per session,over twelve weeks or longer significantly reduced BMI and body fat percentage in obese and over-weight children while improving cardiorespiratory endurance and muscular strength.In terms of mental health,physical activity was positive in reducing depression and anxiety,and improving self-esteem in children and ado-lescents.Activities such as dance,outdoor adventure programs and team sports notably enhanced social skills and emotional well-being.For neurodevelopmental disorders,low-intensity activities like aquatic walking and yoga significantly improved self-regulation and social interaction abilities.In terms of health-related behaviors,physi-cal activity interventions promoted the development of exercise habits,improved social interaction skills,in-creased physical activity participation,reduced sedentary behavior,and enhanced health and physical activity knowledge.In terms of multi-modal interventions,programs combining aerobic exercise with nutrition education or psychological counseling were more effective in improving overall health compared to single-modal interven-tions.Health-promoting schools(HPS)approach,integrating school,family and community involvement,effec-tively increased students'physical activity levels,reduced obesity rates,and improved mental health outcomes.Conclusion Physical activity is benefit in physical and mental health for obese and overweight children and adolescents.Moderate-to-high-intensity aerobic and resistance training,dance,and outdoor activities are effective interven-tions for improving body composition and mental health.Multi-modal interventions and HPS strategies can yield sustained health benefits.

Objective To compare the colonoscopy results of patients with positive fecal SDC2,ADHFE1,and PPP2R5C gene methylation tests to those with positive fecal occult blood tests,and analyze the effectiveness of colorectal cancer(CRC)screening.This study aims to provide a scientific basis for risk assessment in CRC screening.Methods From December 2023 to May 2024,9 284 combined test kits for SDC2,ADHFE1,and PPP2R5C gene methylation were distributed to high-risk individuals aged 40～80 years.Among them,841 patients(9.1％)tested positive.These patients were encouraged via telephone to undergo colonoscopy,with colonoscopy combined with pathological diagnosis as the gold standard,a total of 495 positive patients completed electronic colonoscopy.Among them,the 251 patients who tested positive for fecal SDC2,ADHFE1,and PPP2R5C gene methylation and completed electronic colonoscopy were the observation group;concurrently,244 patients who tested positive for fecal occult blood tests and underwent electronic colonoscopy were selected as the control group.Compare two groups of patients with polyp,number,shape,pathological changes and pathological types.Results There was no statistically significant difference in number and lesion location of polyps between the two groups of patients(P>0.05).The proportion of Yamada type Ⅰ in the observation group was lower than that in the control group,while the proportion of Yamada type Ⅱ was higher than that in the control group.The difference was statistically significant(P<0.05).In the observation group,1 case(0.4％)of CRC,62 cases(24.7％)of advanced adenomas,78 cases(31.1％)of non-advanced adenomas,20 cases(8.0％)of hyperplastic polyps,and 90 cases(35.9％)with no dysplastic lesions were identified.In the control group,6 cases(2.5％)of CRC,38 cases(15.6％)of advanced adenomas,53 cases(21.7％)of non-advanced adenomas,19 cases(7.8％)of hyperplastic polyps,and 128 cases(52.5％)with no dysplastic lesions were identified.The proportions of non-advanced adenomas and advanced adenomas were lower in the control group than those in the observation group,while the no dysplastic lesions rate was higher in the control group,the differences were statistically significant(P<0.05).Conclusion The detection rate of colorectal non-advanced adenomas and advanced adenomas is higher with fecal SDC2,ADHFE1,and PPP2R5C gene methylation testing compared to the fecal occult blood test.

Objective To compare the colonoscopy results of patients with positive fecal SDC2,ADHFE1,and PPP2R5C gene methylation tests to those with positive fecal occult blood tests,and analyze the effectiveness of colorectal cancer(CRC)screening.This study aims to provide a scientific basis for risk assessment in CRC screening.Methods From December 2023 to May 2024,9 284 combined test kits for SDC2,ADHFE1,and PPP2R5C gene methylation were distributed to high-risk individuals aged 40～80 years.Among them,841 patients(9.1％)tested positive.These patients were encouraged via telephone to undergo colonoscopy,with colonoscopy combined with pathological diagnosis as the gold standard,a total of 495 positive patients completed electronic colonoscopy.Among them,the 251 patients who tested positive for fecal SDC2,ADHFE1,and PPP2R5C gene methylation and completed electronic colonoscopy were the observation group;concurrently,244 patients who tested positive for fecal occult blood tests and underwent electronic colonoscopy were selected as the control group.Compare two groups of patients with polyp,number,shape,pathological changes and pathological types.Results There was no statistically significant difference in number and lesion location of polyps between the two groups of patients(P>0.05).The proportion of Yamada type Ⅰ in the observation group was lower than that in the control group,while the proportion of Yamada type Ⅱ was higher than that in the control group.The difference was statistically significant(P<0.05).In the observation group,1 case(0.4％)of CRC,62 cases(24.7％)of advanced adenomas,78 cases(31.1％)of non-advanced adenomas,20 cases(8.0％)of hyperplastic polyps,and 90 cases(35.9％)with no dysplastic lesions were identified.In the control group,6 cases(2.5％)of CRC,38 cases(15.6％)of advanced adenomas,53 cases(21.7％)of non-advanced adenomas,19 cases(7.8％)of hyperplastic polyps,and 128 cases(52.5％)with no dysplastic lesions were identified.The proportions of non-advanced adenomas and advanced adenomas were lower in the control group than those in the observation group,while the no dysplastic lesions rate was higher in the control group,the differences were statistically significant(P<0.05).Conclusion The detection rate of colorectal non-advanced adenomas and advanced adenomas is higher with fecal SDC2,ADHFE1,and PPP2R5C gene methylation testing compared to the fecal occult blood test.

Objective:To systematically review the predictive model for de novo stress urinary incontinence (de novo SUI) after pelvic organ prolapse (POP) surgery, with the aim of providing reference for preventing the occurrence of de novo SUI.Methods:Literature on the prediction model of de novo SUI after POP surgery was electronically retrieved in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang, and VIP. The search period was from the establishment of the database to December 31, 2023, and the language was limited to Chinese and English. Two researchers independently screened literature, extracted data, and used the prediction model risk of bias assessment tool (PROBAST) to evaluate the quality of the models.Results:A total of 13 articles were included, including 13 de novo SUI risk prediction models. One literature was a prospective study, one literature was a secondary analysis of data, and the rest were retrospective studies. The area under the receiver operating characteristic curve in nine models ranged from 0.595 to 0.842, and the C-index of three models ranged from 0.710 to 0.738. Five models were not validated or only internally validated after construction. Six models were validated in one external population. The predictive performance of one model was validated in six external populations. The overall applicability of the 13 prediction models was good, but there was a certain risk of bias in all of them. Conclusions:There is a significant difference in the predictive performance of the de novo SUI risk prediction model after POP surgery, and the number is relatively small, indicating that it is still in the development stage. Future research should continuously optimize existing models and conduct external validation, and construct predictive models suitable for postoperative de novo SUI in POP patients in China.

Objective:To identify the risk factors and to construct a predictive model for early postnatal mortality (with the first 7 days of life) in extremely preterm infants.Methods:This retrospective study involved 244 extremely preterm infants with a gestational age of 22 to 27 weeks and 6 days, born at the Affiliated Hospital of Jining Medical College from January 2017 to December 2022. They were divided into an early survival group ( n=140) and an early mortality group ( n=84), based on survival for ≥7 days after birth. LASSO and logistic regression were used to select risk factors for early mortality. A nomogram predictive model was constructed using the R software program. The goodness-of-fit tests, area under the curve (AUC), calibration curves, and decision curves were used to evaluate its performance and clinical usefulness. Results:LASSO regression and multivariate logistic regression analyses showed that breech delivery ( OR=3.055, 95% CI: 1.125-8.296), intubation in the delivery room ( OR=4.320, 95% CI: 1.328-14.053), diagnosis of grade Ⅲ-Ⅳ neonatal respiratory distress syndrome within 6 h after birth ( OR=11.552, 95% CI: 3.056-43.677), and use of adrenaline in the delivery room ( OR=10.706, 95% CI: 1.454-78.816) were risk factors for early mortality in extremely preterm infants. Conversely, large gestation age ( OR=0.234, 95% CI: 0.125-0.436), antenatal administration of corticosteroids to promote fetal lung maturity ( OR=0.046, 95% CI: 0.014-0.145), and the use of pulmonary surfactant within 6 h after birth ( OR=0.021, 95% CI: 0.004-0.122) were protective factors against mortality. The goodness of fit test of the early death risk nomogram prediction model for extremely preterm infants indicates a good fit ( P=0.702). The AUC of the model was 0.963 (95% CI: 0.943-0.983), with a sensitivity of 0.904 (95% CI: 0.806-0.949), specificity of 0.892 (95% CI: 0.829-0.938), and accuracy of 0.880. Decision curve analysis indicated that a threshold probability>2% would yield a net benefit. Conclusions:Breech delivery, intubation in the delivery room, use of adrenaline in the delivery room, and the diagnosis of grade Ⅲ-Ⅳ neonatal respiratory distress syndrome within 6 h post-birth are independent risk factors for early mortality in extremely preterm infants. Large gestational age, antenatal administration of corticosteroids to promote fetal lung maturity and use of pulmonary surfactant within 6 h after birth are protective factors. The constructed prediction model based on the aforementioned factors can quantitatively, conveniently, and intuitively assess the risk of early mortality in extremely preterm infants.