Objective To translate the Health Behavior Scale for Cancer Patients(HBSCP)into Chinese and conduct reliability and validity tests.The measurement invariance of the Chinese version of the scale among differ-ent cancer patients was measured to form a health behavior scale suitable for assessing cancer patients in China.Methods The original scale was translated and translated back according to the Brislin translation model.The Chinese version of the HBSCP was formed through cross-cultural adaptation and pre-test.A questionnaire survey was conducted on 600 cancer patients from 2 tertiary A hospitals in Tianjin and Nanchang from February to July 2024 by convenience sampling method to test the reliability,validity,and measurement invariance of the Chinese version of the HBSCP.Results 567 valid questionnaires were collected.The Chinese version of the HBSCP in-cludes 9 items with 2 factors.Confirmatory factor analysis supported the 2-factor model,and all indexes meet the ideal fitting standard.The factor load of each item on the scale ranged from 0.697 to 0.815.The composite relia-bility of the 2 dimensions was 0.815 and 0.874.Average variance extracted was 0.656 and 0.526.The Chinese version of the HBSCP was positively correlated with Health Promoting Lifestyle Profile-Ⅱ(r=0.760,P＜0.001).The con-tent validity index of items ranges of the scales from 0.930 to 1.000,and the content validity index/average of the scales was 0.993.The total Cronbach's alpha coefficient of the scale was 0.900,and the two-factor Cronbach's alpha coefficient was 0.849 and 0.873,respectively.The scale has measurement invariance in the equivalence test for 3 clusters of lung,gastrointestinal,and gynecologic cancers.Conclusion The Chinese version of the HBSCP has good reliability and validity and measurement invariance across cancer types,and can be used to measure the health behavior level of cancer patients.

Objective:To fine-tune the mT5 (massively multilingual pre-trained text-to-text transformer) large language model, automatically generate report conclusions for teaching purposes from chest CT image descriptions, and assess the quality of automatically generated conclusions.Methods:The training set included 3 000 high-quality physical examination chest CT reports from one hospital, and the external validation set consisted of 600 physical examination chest CT reports from two other hospitals. Experienced radiology teaching physicians assessed the consistency between the generated conclusions and the original physician-written conclusions in the external validation set using a 5-point Likert scale across five linguistic indicators (correctness of examination information, correctness of lesion detection, standardization of terminology, applicability of the conclusions, and simplicity of conclusions). Using the original report conclusions as the reference, the accuracy of the conclusions generated based on the external validation set in describing four major thoracic conditions (pulmonary nodules, pneumonia, emphysema, pleural effusion) was evaluated. Perform chi square test using SPSS 25.0.Results:In the external validation set, the mean consistency score between the generated conclusions and the original conclusions given by the radiology teaching physicians was >4 points, indicating agreement with the original conclusions. In the generated conclusions, the description of the four major thoracic conditions demonstrated 0.95-1.00 (95% CI=0.91-1.00) accuracy, 0.76-1.00 (95% CI=0.59-1.00) sensitivity, and 0.97-1.00 (95% CI=0.91-1.00) specificity. Conclusions:The chest CT report conclusion generation system based on the mT5 large language model demonstrated high accuracy and is expected to provide immediate and efficient automated guidance for standardized residency training.

Objective To systematically retrieve,assess and synthesise regarding the respiratory training for patients with spinal cord injury and to provide a reference for clinical practice.Methods According to the 6S Evidence Pyramid Model,following databases were searched for literature in relation to the respiratory training for patients with spinal cord injury:UpToDate,BMJ Best Practice,Joanna Briggs Institute Database of Systematic Reviews and Implementations,National Institute for Health and Clinical Excellence(NICE),National Guideline Clearinghouse(NGC),Registered Nurses'Association of Ontario(RNAO),Medlive,American Spinal Injury Association(ASIA),Physiotherapy Evidence Database(PEDro),The Cochrane Library,PubMed,Web of Science,CNKI,Wanfang Data,SinoMed and the websites of the Journals published by Chinese Medical Association.The types of literature included clinical decisions,practice guidelines,expert consensus,evidence summaries,systematic reviews/Meta-analyses,and original researches.The search period was from the inception of databases to 30th December,2023.Two researchers independently evaluated the quality of the literature and summarised the evidences.Results Fifteen studies were ultimately included,comprising 3 clinical decisions,3 guidelines,6 systematic reviews and 3 randomised controlled trials.A total of 21 best pieces of evidence were summarised,covering 5 aspects:pre-training assessment,training content,training equipment,training intensity and frequency,and effectiveness evaluation.Conclusion The best evidence of respiratory training for patients with spinal cord injury summarised in this study can provide the evidence-based support for healthcare professionals to formulate standardised respiratory training strategies.

Objective:To translate the English version of the Attitude Tool of Delirium (ATOD) into Chinese and test the reliability and validity of its application in Chinese nurses, and to provide an assessment tool for assessing nurses ′ attitudes towards delirium patients. Methods:After obtaining authorization from the source scale developer, the English version of the ATOD scale was translated, back-translated, expert-consulte, pre-surveyed and cross-culturally adapted according to the Brislin translation model. A questionnaire survey was conducted among 298 nurses with experience in caring for patients with delirium in three tertiary hospitals in Jiangsu Province using a convenience sampling method. The critical ratio value and correlation coefficient were used to analyze the scale items. Exploratory factor analysis was used to evaluate the structural validity of the scale, and experts were invited to evaluate the content validity of the scale. Cronbach α coefficient and test-retest reliability were used to evaluate the reliability of the scale. Results:The Chinese version of the ATOD scale contains 3 dimensions of cognitive attitudes, behavioral attitudes, and emotional attitudes toward patients with delirium, with a total of 23 entries. The Cronbach α coefficient for the entire scale was 0.896, with each dimension′s Cronbach α coefficient ranging from 0.614 to 0.912. The retest reliability of the scale was 0.868, with each dimension ′s retest reliability ranging from 0.603 to 0.927. Exploratory factor analysis extracted three eigenvalues with common factors greater than 1, and the cumulative variance contribution rate was 63.812%. Conclusions:The Chinese version of the ATOD scale has good reliability and validity, and can be used as an evaluation tool for evaluating nurses ′ attitudes towards delirium patients in China, so as to provide an effective basis for the formulation of corresponding interventions.

AIM:To investigate the role of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)in hypoxia-induced autophagy and apopto-sis in endothelial cells.METHODS:Human umbili-cal vein endothelial cells(HUVECs)were exposed to hypoxia(1％O2)for varying durations(0,6,12,24 h)to evaluate autophagy and apoptosis levels.LOX-1 was further intervened to explore its effects on autophagy and apoptosis.GFP-LC3B adenovirus in-fection was observed under fluorescence microsco-py to assess LC3B expression.Autophagosomes were detected by transmission electron microscopy(TEM).LOX-1 mRNA levels were measured using re-al-time PCR.Protein expression of LOX-1,LC3Ⅱ/Ⅰ,Beclin-1,Atg5,cleaved-caspase 3,Bax,and Bcl-2 was analyzed by Western blot.Reactive oxygen spe-cies(ROS)levels were quantified using the DCFH-DA fluorescent probe.Apoptosis was assessed via Hoechst staining and flow cytometry(Annexin V-PI double staining).RESULTS:Hypoxia(1％O2,24 h)significantly increased LC3Ⅱ puncta under fluores-cence microscopy,upregulated LC3Ⅱ/Ⅰ protein ex-pression,and induced autophagosome formation observed by TEM.Hypoxia elevated ROS produc-tion and promoted apoptosis.LOX-1 mRNA and protein expression were upregulated in hypoxic HU-VECs.LOX-1 siRNA intervention markedly reversed hypoxia-induced autophagy,downregulating au-tophagy-related proteins(Beclin-1,Atg5,LC3Ⅱ/Ⅰ).LOX-1 siRNA also suppressed ROS generation and inhibited apoptosis,as evidenced by decreased ex-pression of cleaved-caspase 3 and Bax,and in-creased Bcl-2 levels.CONCLUSION:Hypoxia in-duced upregulation of LOX-1 expression to produce ROS,thereby promoting autophagy and apoptosis in endothelial cells.

Objective To translate the Health Behavior Scale for Cancer Patients(HBSCP)into Chinese and conduct reliability and validity tests.The measurement invariance of the Chinese version of the scale among differ-ent cancer patients was measured to form a health behavior scale suitable for assessing cancer patients in China.Methods The original scale was translated and translated back according to the Brislin translation model.The Chinese version of the HBSCP was formed through cross-cultural adaptation and pre-test.A questionnaire survey was conducted on 600 cancer patients from 2 tertiary A hospitals in Tianjin and Nanchang from February to July 2024 by convenience sampling method to test the reliability,validity,and measurement invariance of the Chinese version of the HBSCP.Results 567 valid questionnaires were collected.The Chinese version of the HBSCP in-cludes 9 items with 2 factors.Confirmatory factor analysis supported the 2-factor model,and all indexes meet the ideal fitting standard.The factor load of each item on the scale ranged from 0.697 to 0.815.The composite relia-bility of the 2 dimensions was 0.815 and 0.874.Average variance extracted was 0.656 and 0.526.The Chinese version of the HBSCP was positively correlated with Health Promoting Lifestyle Profile-Ⅱ(r=0.760,P＜0.001).The con-tent validity index of items ranges of the scales from 0.930 to 1.000,and the content validity index/average of the scales was 0.993.The total Cronbach's alpha coefficient of the scale was 0.900,and the two-factor Cronbach's alpha coefficient was 0.849 and 0.873,respectively.The scale has measurement invariance in the equivalence test for 3 clusters of lung,gastrointestinal,and gynecologic cancers.Conclusion The Chinese version of the HBSCP has good reliability and validity and measurement invariance across cancer types,and can be used to measure the health behavior level of cancer patients.

BACKGROUND: Lung adenocarcinoma (LUAD) is the predominant subtype of non-small cell lung cancer (NSCLC). Damage-specific DNA binding protein 1 (DDB1), as a core protein of the CUL4-DDB1 ubiquitin ligase complex, is involved in the regulation of DNA damage repair, epigenetic modification, and cell cycle checkpoint activation. While the involvement of DDB1 in tumour progression through DNA repair and RNA transcriptional regulation has been reported, its expression and role in LUAD remain to be elucidated. This study aims to investigate the expression and role of DDB1 in LUAD. METHODS: The expression, clinicopathological features and prognosis of DDB1 in LUAD were analysed using databases such as UALCAN, Kaplan-Meier Plotter and GEPIA; The interaction network and enriched functional pathways were constructed by GeneMANIA and Metascape; the correlation between DDB1 and immune cells by combining with TISIDB infiltration was evaluated, and the clustering results of cell subtypes and the expression of DDB1 in different immune cell subpopulations were analysed by single-cell sequencing; finally, tissue microarrays were used to further verify the expression and prognostic value of DDB1 in LUAD. RESULTS: The mRNA and protein expression of DDB1 in LUAD tissues were significantly higher than those in normal tissues (P<0.01), and the high expression correlated with later clinical stage (P<0.001), lymph node metastasis (P<0.001) and poor prognosis (P<0.001). Functional enrichment showed that DDB1 was involved in DNA repair and RNA transcriptional regulation, and TISIDB evaluation revealed that DDB1 was negatively correlated with the expression level of immune cells, suggesting the potential regulation of the immune microenvironment. Single cell analysis showed that DDB1 was mainly expressed in T cells, alveolar macrophages and dendritic cells. Tissue microarrays confirmed that overall survival was shorter in the DDB1 high expression group (P<0.001), and Cox multifactorial analysis showed that DDB1 was an independent predictor of LUAD prognosis. CONCLUSIONS DDB1 is highly expressed in LUAD, which is associated with poor prognosis, and is closely related to tumor immune cell infiltration, and is involved in tumourigenesis and development through DNA repair and RNA transcriptional regulation. DDB1 can be used as a potential prognostic marker and therapeutic target for LUAD.
Humans ; Adenocarcinoma of Lung/immunology* ; DNA-Binding Proteins/metabolism* ; Lung Neoplasms/diagnosis* ; Gene Expression Regulation, Neoplastic ; Prognosis ; Male ; Female ; Middle Aged

Cultivating innovative medical talents is a key strategy for enhancing a hospital's core competitiveness.Taking Zhejiang Cancer Hospital as a case study,this paper constructs a lifelong training system for innovative medical talents based on the"Triple-Phase Cultivation Framework(three stages,four integrations,five mechanisms)".This system delineates the cultivation cycle in-to three stages aligned with talent development trajectories:the"30s Start-up Phase"(young talents under 35),the"40s Growth Phase"(core professionals under 45),and the"50s Breakthrough Phase"(academic leaders under 50).It implements a four-dimensional cultivation model integrating medicine with research,education,engineering/informatics,and industry.Furthermore,a com-prehensive guarantee mechanism is established,encompassing policies & systems,platform re-sources,project drivers,financial investment,and talent teams.Practice demonstrates that this system has significantly enhanced talent development effectiveness.Over the past five years,the hospital has established 2 academician workstations and recruited 10 academician teams.The annual number of postdoctoral researchers has surged from 4 in 2020 to 58 in 2024.A total of 71 innova-tive talents have been selected across three batches,with 69 recognitions in provincial/ministerial-level talent programs,placing the hospital among the leaders within hospitals directly under the Zhejiang Provincial Health Commission.Notably,the hospital achieved a"zero breakthrough"in in-dependently cultivating national-level talents,including recipients of the National Ten-Thousand Talent Program(Young Top Talents)and the Postdoctoral Innovative Talent Support Program.The"Triple-Phase Cultivation Framework"establishes a replicable paradigm for nurturing innovative medical talents through its full-career-cycle approach,multidisciplinary integration,and systematic support mechanisms,offering valuable insights for talent strategies in specialized cancer hospitals.

AIM:To investigate the role of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)in hypoxia-induced autophagy and apopto-sis in endothelial cells.METHODS:Human umbili-cal vein endothelial cells(HUVECs)were exposed to hypoxia(1％O2)for varying durations(0,6,12,24 h)to evaluate autophagy and apoptosis levels.LOX-1 was further intervened to explore its effects on autophagy and apoptosis.GFP-LC3B adenovirus in-fection was observed under fluorescence microsco-py to assess LC3B expression.Autophagosomes were detected by transmission electron microscopy(TEM).LOX-1 mRNA levels were measured using re-al-time PCR.Protein expression of LOX-1,LC3Ⅱ/Ⅰ,Beclin-1,Atg5,cleaved-caspase 3,Bax,and Bcl-2 was analyzed by Western blot.Reactive oxygen spe-cies(ROS)levels were quantified using the DCFH-DA fluorescent probe.Apoptosis was assessed via Hoechst staining and flow cytometry(Annexin V-PI double staining).RESULTS:Hypoxia(1％O2,24 h)significantly increased LC3Ⅱ puncta under fluores-cence microscopy,upregulated LC3Ⅱ/Ⅰ protein ex-pression,and induced autophagosome formation observed by TEM.Hypoxia elevated ROS produc-tion and promoted apoptosis.LOX-1 mRNA and protein expression were upregulated in hypoxic HU-VECs.LOX-1 siRNA intervention markedly reversed hypoxia-induced autophagy,downregulating au-tophagy-related proteins(Beclin-1,Atg5,LC3Ⅱ/Ⅰ).LOX-1 siRNA also suppressed ROS generation and inhibited apoptosis,as evidenced by decreased ex-pression of cleaved-caspase 3 and Bax,and in-creased Bcl-2 levels.CONCLUSION:Hypoxia in-duced upregulation of LOX-1 expression to produce ROS,thereby promoting autophagy and apoptosis in endothelial cells.

Objective:To fine-tune the mT5 (massively multilingual pre-trained text-to-text transformer) large language model, automatically generate report conclusions for teaching purposes from chest CT image descriptions, and assess the quality of automatically generated conclusions.Methods:The training set included 3 000 high-quality physical examination chest CT reports from one hospital, and the external validation set consisted of 600 physical examination chest CT reports from two other hospitals. Experienced radiology teaching physicians assessed the consistency between the generated conclusions and the original physician-written conclusions in the external validation set using a 5-point Likert scale across five linguistic indicators (correctness of examination information, correctness of lesion detection, standardization of terminology, applicability of the conclusions, and simplicity of conclusions). Using the original report conclusions as the reference, the accuracy of the conclusions generated based on the external validation set in describing four major thoracic conditions (pulmonary nodules, pneumonia, emphysema, pleural effusion) was evaluated. Perform chi square test using SPSS 25.0.Results:In the external validation set, the mean consistency score between the generated conclusions and the original conclusions given by the radiology teaching physicians was >4 points, indicating agreement with the original conclusions. In the generated conclusions, the description of the four major thoracic conditions demonstrated 0.95-1.00 (95% CI=0.91-1.00) accuracy, 0.76-1.00 (95% CI=0.59-1.00) sensitivity, and 0.97-1.00 (95% CI=0.91-1.00) specificity. Conclusions:The chest CT report conclusion generation system based on the mT5 large language model demonstrated high accuracy and is expected to provide immediate and efficient automated guidance for standardized residency training.