From the perspective of palliative care， focusing on the entire process surrounding the death of terminally ill children， with an emphasis on the value of death for children. It explores the children’s understanding of death and the process of self-value pursuit， elucidating the construction of the value of death. Furthermore， it interprets the multifaceted implications of the value of death for children from three dimensions： terminally ill children， caregivers， and society. Additionally， it explores the role of the construction of the value of death in achieving a good death for terminally ill children， optimizing care models， and accelerating the formation of a societal environment of good death， as so to enhance contemporary society’s understanding and appreciation for the value of death for children， bridging the gap in pediatric palliative care and providing a theoretical basis for improving the quality of life for terminally ill children.

OBJECTIVES: To evaluate the value of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). METHODS: This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET/CT imaging at our hospital from August, 2020 to March, 2023, including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment. GEP-NEN were classified into G1, G2, and G3 neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC) based on pathological typing. The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers: ⁶⁸Ga-DOTATATE>¹⁸F-FDG (A); ⁶⁸Ga-DOTATATE=¹⁸F-FDG (B); ⁶⁸Ga-DOTATATE<¹⁸F-FDG (C); and complementation (D). The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis. RESULTS: In the 49 patients with GEP-NEN, ⁶⁸Ga-DOTATATE PET/CT was superior to ¹⁸F-FDG PET/CT for detecting systemic tumor lesions (P<0.001) and more sensitive for detecting primary/recurrent lesions, lymph node metastasis, liver metastasis, and bone metastasis (P<0.05), while ¹⁸F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis (P<0.05). In terms of the detection efficiency, Pattern A was found in 46.9% (23/49) patients, Pattern B in 38.8% (19/49), Pattern C in 12.2% (6/49), and Pattern D in 2.0% (1/49). The complementary value of ¹⁸F-FDG PET/CT to ⁶⁸Ga-DOTATATE PET/CT was 0% in G1 NET patients (0/13), 8.3% in G2 NET patients (2/24), 50% in G3 NET patients (3/6), and 33.3% in NEC patients (2/6). 12.2% (6/49) of the patients had their staging confirmed or changed due to additional lesions detected by ¹⁸F-FDG PET/CT imaging, resulting subsequently in establishment or adjustment of their treatment plans. CONCLUSIONS ⁶⁸Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients. Additional ¹⁸F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2, G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.
Humans ; Positron Emission Tomography Computed Tomography/methods* ; Neuroendocrine Tumors/therapy* ; Pancreatic Neoplasms/therapy* ; Retrospective Studies ; Organometallic Compounds ; Stomach Neoplasms/therapy* ; Neoplasm Staging ; Fluorodeoxyglucose F18 ; Intestinal Neoplasms/therapy* ; Female ; Male ; Middle Aged ; Aged ; Adult

Objective To compare the results of accumulation and continuation methods in indoor radon measurement. Methods The radon concentrations in 30 households in 7 provincial capital cities of China were simultaneously measured using both accumulation and continuation methods. Results The radon concentration measured by accumulation method in 30 households ranged from 21 to 323 Bq/m³, with a median M(P₂₅, P₇₅) of 70.5 (43.8, 111). The radon concentration measured by the continuation method ranged from 16.1 to 258 Bq/m³, with a median M(P₂₅, P₇₅) of 100 (51.3, 141). The average relative percent deviation between the two measurement methods was 41.8%. There were significant differences among the measurement results at 8, 16, and 24 h by the continuation method. Pairwise comparisons showed there were statistical diffferences between 8 h and 16 h, as well as between 8 h and 24h; however, no statistical significance was found (P < 0.05), between 16 h and 24 h. Conclusion The overall continuous measurement results of the 30 households were higher than those of cumulation method. The comparison between accumulation and continuation measurement results did not show a high level of correlation (r=0.49). The continuation method is significantly affected by environmental factors, and the length of the measurement period can affect the measurement results. The selection of indoor radon measurement methods should consider the purpose, sample size, and environmental conditions.

Objective:To compare the clinical effects of endoscopic thyroidectomy with different approaches on patients with thyroid cancer.Methods:A prospective study was conducted on 96 patients with thyroid cancer who underwent complete endoscopic thyroidectomy (CET) by the same experienced surgical team in the Head and Neck Surgery Department of Shanxi Cancer Hospital from Jan. 2020 to Jan. 2023. The patients were randomly divided into a trans-subclavian approach group of 48 cases and a transoral vestibular access group of 48 cases using a random number table method. The trans-subclavian approach group underwent CET via the subclavian approach, while the transoral vestibular access group underwent CET via the oral vestibular approach. The surgical and postoperative rehabilitation conditions, complications, and cosmetic satisfaction scores were compared between the two groups. The immune indicators (T lymphocyte subsets (CD3 +, CD4 +), CD4 +/CD8 +), serum soluble interleukin 2 receptor (SIL-2R), tissue kallikrein 11 (KLK11), midkine (MK) levels were measured before surgery. At 1 d, 3 d, and 7 d postoperatively, neck function was assessed using the visual analog scale (VAS), neck injury index, and dysphagia index. Results:The operation time of the transoral vestibular access group and the Trans-subclavian approach group were (117.58±10.87) min and (101.84±11.35) min, respectively ( P<0.001), and the hospitalization time was (4.31±0.86) d and (5.12±0.91) d, respectively ( P<0.001). The drainage volume was (65.13±12.49) mL and (78.65±15.32) mL, respectively ( P<0.001). At 1, 3, and 7 days after surgery, the CD3 + levels in the transoral vestibular access group and the trans-subclavian approach group were (41.53±3.86) % and (38.29±3.51) %, respectively ( P<0.001), (46.21±4.35) % and (42.81±4.06) %, respectively ( P=0.001), and (48.23±4.47) % and (45.10±4.23) %, respectively ( P<0.001). The CD4 + levels were (33.27±3.90) % and (30.18±3.45) %, respectively ( P<0.001), (36.28±4.15) % and (33.46±3.87) %, respectively ( P=0.001), and (38.69±4.22) % and (35.17±4.10) %, respectively ( P<0.001). The CD4 +/CD8 + levels were (1.31±0.22) and (1.16±0.21), respectively ( P=0.001), (1.40±0.23) and (1.20±0.22), respectively ( P<0.001), and (1.58±0.24) and (1.45±0.25), respectively ( P=0.011). There was no significant difference in the levels of serum SIL-2R, KLK11, MK, VAS scores, cervical injury index, or swallowing dysfunction index between the transoral vestibular access group and the trans-subclavian approach group on postoperative day 1, 3, and 7 ( P>0.05). The incidence of complications in the transoral vestibular access group and the trans-subclavian approach group was 8.33% (4/48) and 22.92% (11/48), respectively ( P=0.049), and the cosmetic satisfaction rate was 95.83% (46/48) and 81.25% (39/48), respectively ( P=0.025) . Conclusions:Both the transoral vestibular approach and the subclavian approach for CET treatment of thyroid cancer can cause damage to cervical function. The former can reduce immune function damage, help with early postoperative recovery, and improve safety and patient satisfaction with cosmetic appearance, but it can prolong the operation time.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the indoor radon concentrations and to analyze their seasonal variations in urban and rural residential dwellings in Ningxia province.Methods:From March 2022 to March 2023, based on the administrative region division and population distribution in Ningxia, a total of 143 typical residential dwellings, including 82 urban houses and 61 rural houses, were selected to measure indoor radon concentration by CR-39 solid nuclear track detectors for 1 year in Ningxia, with detectors changed every 3 months.Results:The annual average indoor radon concentration in Ningxia was 88 Bq/m 3, range 39-226 Bq/m 3. The annual average indoor radon concentration was below 100 Bq/m 3 for 69.9% of the measured dwellings, and below 300 Bq/m 3 for all of surveyed dwellings. Indoor radon concentrations in rural areas were much higher than those in urban areas ( Z=5.85, P<0.05). Indoor radon concentration varied significantly with the seasons, higher in autumn and winter, but lower in spring and summer, in total ( χ2=63.97, P<0.05), urban ( χ2=24.74, P<0.05), and rural ( χ2=43.15, P<0.05). Conclusion:The annual average indoor radon concentrations in all the measured dwellings are below the reference level of 300 Bq/m 3 recommended by Indoor Air Quality Standard (GB/T 18883-2022) in China.

Objective To explore the effect of Traditional Chinese Medicine's five-element music therapy com-bined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver de-pression and spleen deficiency type.Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects,and they were divided into an experimental group and a control group by a random number table with 37 cases in each group.The control group was given routine treatment and nursing care,as well as Traditional Chinese Medicine's emotional nursing.The experimental group received Tradi-tional Chinese Medicine's five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care,with an intervention period of 4 weeks.The Generalized Anxiety Disorder Scale(GAD-7),Patient Health Questionnaire Depression Scale(PHQ-9)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention.Results A total of 72 patients completed the study,with 36 in the experimental group and 36 in the control group.Before and after intervention,the scores of GAD-7,PHQ-9,and PSQI in the experimental group were compared,and the dif-ferences were statistically significant(P＜0.001).After the intervention,the GAD-7 score in the experimental group was(7.89±3.15),which was lower than(10.14±4.41)in the control group.The PHQ-9 score was(12.33±4.08)in the ex-perimental group,which was lower than(14.64±5.34)in the control group.The PSQI score was(12.39±3.06)points,which was lower than(14.22±3.37)in the control group,and the differences were statistically significant(P＜0.05).Conclusion The application of Traditional Chinese Medicine's five-element music therapy combined with individual-ized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease.

OBJECTIVE: We aimed to analyze the current indoor radon level and estimate the population risk of radon-induced lung cancer in urban areas of China. METHODS: Using the passive monitoring method, a new survey on indoor radon concentrations was conducted in 2,875 dwellings across 31 provincial capital cities in Chinese mainland from 2018 to 2023. The attributable risk of lung cancer induced by indoor radon exposure was estimated based on the risk assessment model. RESULTS: The arithmetic mean (AM) and geometric mean (GM) of indoor radon concentrations were 65 Bq/m³ and 55 Bq/m³, respectively, with 13.6% of measured dwellings exceeding 100 Bq/m³ and 0.6% exceeding 300 Bq/m³. The estimated number of lung cancer deaths induced by indoor radon exposure was 150,795, accounting for 20.30% (95% CI: 20.21%-20.49%) of the lung cancer death toll. CONCLUSION This study provided the most recent data on national indoor radon levels in urban areas and the attributable risk of lung cancer. These results served as an important foundation for further research on the disease burden of indoor radon exposure and radon mitigation efforts.
Radon/analysis* ; China/epidemiology* ; Air Pollution, Indoor/analysis* ; Lung Neoplasms/etiology* ; Humans ; Cities/epidemiology* ; Air Pollutants, Radioactive/adverse effects* ; Neoplasms, Radiation-Induced/etiology* ; Risk Assessment ; Radiation Monitoring

Objective To primarily investigate the indoor radon concentrations in the urban and rural dwellings in Yinchuan, China, and to estimate the effective dose. Methods A total of 67 dwellings, which included 49 urban households and 18 rural households in Yinchuan, were selected to cumulatively measure the indoor radon concentrations for more than 3 months using solid state nuclear track detection. Results The arithmetic mean, geometric mean, median, and range of indoor radon concentrations in urban and rural areas in Yinchuan were 64 Bq/m³, 59 Bq/m³, 57 Bq/m³, and 25-172 Bq/m³, respectively. Surveillance sites with an indoor radon concentration higher than 100 Bq/m³ accounted for 7.5%. Indoor radon concentrations in rural areas were higher than those in urban areas. Indoor radon concentrations were highest in winter and lowest in summer. The effective dose of indoor radon exposure among residents in Yinchuan was 1.86 mSv/a. Conclusion The results of indoor radon concentrations measured in this investigation in Yinchuan are significantly higher than those measured in the 1990s. The annual effective dose is higher than the mean levels in the world and China.

Long non-coding RNAs (lncRNAs) are a group of non-coding RNAs with a length of over 200 nucleotides. Recently, studies have shown that lncRNAs can regulate gene expression at the epigenetic, transcriptional, and post-transcriptional levels, affect the proliferation, migration, and infiltration of tumor cells, and participate in the occurrence and development of benign and malignant proliferative skin diseases, such as keloids, hemangioma, squamous cell carcinoma and melanoma. This review summarizes roles of lncRNAs in the pathogenesis of benign and malignant proliferative skin diseases.