Malignant tumors (commonly referred to as cancer) represent a major global public health challenge and contribute significantly to the worldwide disease burden. Early screening plays a critical role in improving detection rates, enabling timely intervention, and enhancing patient survival rates. However, current cancer screening guidelines primarily focus on site-specific screening, which may not fully address the need for comprehensive early detection. A scientifically rational, multi-cancer screening approach offers several advantages: it optimizes the use of biological samples, reduces time costs for participants, enhances the efficiency and comprehensiveness of screening, and minimizes overall expenses. Such an approach also facilitates the rational allocation of healthcare resources, ultimately helping to reduce the societal burden of cancer. To address this need, the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China. This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and international researches on cancer screening, early detection, and treatment for prevalent malignancies. Drawing upon China's unique demographic and healthcare context, as well as practical screening experiences, the consensus provides evidence-based recommendations on target populations, screening technologies, and procedural workflows for multi-cancer screening. These guidelines align with the principles and methodologies established by the World Health Organization (WHO), aiming to enhance the effectiveness of combined cancer screening in China, improve early detection rates, and provide a scientific foundation for national cancer prevention and control strategies.

Objective:To investigate the clinical characteristics and risk factors of airway mucus plugging in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:This was a retrospective cross-sectional study. A total of 322 hospitalized AECOPD patients admitted to the First Affiliated Hospital of Anhui Medical University from February 2023 to February 2025 were enrolled. Based on chest high-resolution computed tomography (HRCT) findings of airway mucus plugging, patients were classified into mucus plugging and non-mucus plugging groups. General and clinical data were collected, including age, sex, disease duration, smoking and alcohol history, comorbidities, number of acute exacerbations in the past year, routine blood tests, biochemical indices, pulmonary function, and pathogen detection. The incidence of airway mucus plugging in AECOPD patients was calculated, and differences in baseline characteristics, laboratory parameters, and pulmonary function between the two groups were compared. Logistic regression was used to identify independent risk factors for mucus plugging, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of relevant indicators.Results:Of the 322 enrolled patients, 87(27.02%) were found to have airway mucus plugging. Univariate analysis revealed statistically significant differences between the mucus plug group and the non-plug group in the following parameters (all P<0.05): body mass index (BMI), disease duration, smoking status, Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) score, frequency of acute exacerbations, neutrophil percentage, absolute lymphocyte count, lymphocyte percentage, albumin, C-reactive protein (CRP), activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, D-dimer, Aspergillus infection rate, percentage of forced expiratory volume in 1 second to predicted value (FEV 1%pred), ratio of FEV 1 to forced vital capacity (FEV 1/FVC), and percentage of maximal mid-expiratory flow to predicted value (MMEF 75/25%pred). Multivariate logistic regression analysis identified the following as independent risk factors for airway mucus plugs (all P<0.05): elevated CRP ( OR=1.022, 95% CI: 1.013-1.036), decreased albumin ( OR=0.891, 95% CI: 0.825-0.959), Aspergillus infection ( OR=1.774, 95% CI: 1.366-2.317), and reduced MMEF 75/25%pred value ( OR=0.978, 95% CI: 0.964-0.990). ROC curve analysis showed that the combined predictive model incorporating CRP, albumin, Aspergillus infection, and MMEF 75/25%pred had an area under the ROC curve (AUC) of 0.776(95% CI: 0.714-0.838), which was superior to each individual indicator alone, with AUCs of 0.721 for CRP, 0.687 for albumin, 0.579 for Aspergillus infection, and 0.631 for MMEF 75/25%pred. Conclusions:AECOPD patients with airway mucus plugging exhibit higher inflammatory markers, poorer nutritional status, a higher likelihood of Aspergillus infection, worse pulmonary function, and poorer prognosis. Aspergillus infection, elevated CRP, decreased albumin, and reduced MMEF 75/25%pred are independent risk factors for mucus plugs in AECOPD.

Malignant tumors(commonly referred to as cancer)represent a major global public health challenge and contribute significantly to the worldwide disease burden.Early screening plays a critical role in improving detection rates,enabling timely intervention,and enhancing pa-tient survival rates.However,current cancer screening guidelines primarily focus on site-specific screening,which may not fully address the need for comprehensive early detection.A scientifical-ly rational,multi-cancer screening approach offers several advantages:it optimizes the use of bio-logical samples,reduces time costs for participants,enhances the efficiency and comprehensive-ness of screening,and minimizes overall expenses.Such an approach also facilitates the rational allocation of healthcare resources,ultimately helping to reduce the societal burden of cancer.To address this need,the Cancer Epidemiology Committee of the Chinese Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers in China.This consensus integrates multidisciplinary expertise and synthesizes the latest domestic and interna-tional researches on cancer screening,early detection,and treatment for prevalent malignancies.Drawing upon China's unique demographic and healthcare context,as well as practical screening experiences,the consensus provides evidence-based recommendations on target populations,screening technologies,and procedural workflows for multi-cancer screening.These guidelines align with the principles and methodologies established by the World Health Organization(WHO),aiming to:enhance the effectiveness of combined cancer screening in China,improve early detec-tion rates,and provide a scientific foundation for national cancer prevention and control strategies.

Chimeric antigen receptor T-cell(CAR-T)therapy,as a revolutionary immunotherapy,has achieved significant clinical efficacy in the treatment of hematologic malignancies in recent years.However,its clinical application remains limited by associated toxicities.Bridging therapy,as a supplementary antitumor treatment administered between leukapheresis and CAR-T cell infusion,reduces tumor burden and modulates the immune microenvironment through chemotherapy,radio-therapy,targeted therapy,and immunotherapy.It not only delays disease progression but also sig-nificantly influences the toxicities associated with subsequent CAR-T therapy.This paper reviews the main types of toxicities and management strategies of CAR-T therapy,and analyzes the role of bridging therapy in managing these toxicities,conducting an in-depth analysis of the potential mechanisms by which different bridging therapy modalities influence these toxicities,to provide scientific basis and practical guidance for the clinical application of CAR-T therapy.

Malignant tumors(commonly referred to as cancers)represent a major global public health challenge and contribute substan-tially to the global disease burden.Early screening plays a crucial role in improving detection rates,enabling timely intervention,and enhan-cing patient survival.However,current cancer screening guidelines primarily focus on site-specific screening,which may not fully address the need for comprehensive early detection.A scientifically rational,multi-cancer screening approach offers several advantages:it optimizes the use of biological samples,reduces the time burden for participants,enhances the efficiency and comprehensiveness of screening,and min-imizes overall expenses.Moreover,this approach facilitates rational allocation of healthcare resources,ultimately helping to reduce the soci-etal burden of cancer.To address gap,the Cancer Epidemiology Committee of the China Anti-Cancer Association has developed the Expert Consensus on Combined Screening for Common Cancers.This consensus integrates multidisciplinary expertise and synthesizes the latest do-mestic and international researches on cancer screening,early detection,and treatment of prevalent malignancies.Drawing upon China's unique demographic and healthcare context and practical screening experiences,the consensus provides evidence-based recommendations on target populations,screening technologies,and procedural workflows for multi-cancer screening.These guidelines align with the prin-ciples and methodologies established by the World Health Organization(WHO),aiming to enhance the effectiveness of combined cancer screening in China,improve early detection rates,and provide a scientific foundation for national cancer prevention and control strategies.

OBJECTIVE: To analyze the clinical effectiveness of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in rescuing children with severe pulmonary contusion. METHODS: A retrospective analysis was conducted on the clinical data of four children with severe pulmonary contusion who were treated with VV-ECMO in the pediatric intensive care unit of Xi'an Children's Hospital from April 2021 to December 2024. The general data, laboratory indicators within 24 hours after admission, imaging features, bronchoscopic findings, diagnostic and treatment processes, as well as therapeutic outcomes of the children were analyzed. RESULTS: All four pediatric cases were male, aged 4 years and 9 months, 6 years and 5 months, 8 years and 10 months, and 9 years and 7 months, respectively. One case resulted from a high-altitude fall and three from traffic accidents, all presenting with multiple fractures. All four cases progressed to dyspnea within 1-4 hours post-injury and received endotracheal intubation with invasive ventilator support within 2-5 hours. Three cases exhibited tachycardia upon admission and were treated with norepinephrine, all four cases presented with fine moist rales in the lungs. Imaging studies revealed diffuse exudative changes in all four cases. Bronchoscopy identified diffuse pulmonary hemorrhage, with one case additionally showing rupture of the right intermediate bronchus. Conventional mechanical ventilation failed to correct oxygenation in all cases, prompting initiation of VV-ECMO therapy within 8-22 hours post-injury. One case underwent right thoracic exploration under ECMO support. Following treatment, all four cases demonstrated gradual reduction in bloody airway secretions, resolution of pulmonary exudative changes on imaging, and absence of hemorrhage on bronchoscopy. They were successfully weaned off ECMO and ultimately discharged as cured. CONCLUSIONS Severe pulmonary contusion rapidly leads to respiratory distress, requiring ventilator-assisted ventilation within hours of injury. When conventional ventilator support is ineffective, ECMO can be life-saving, with timely intervention yielding favorable prognosis.
Humans ; Extracorporeal Membrane Oxygenation/methods* ; Male ; Retrospective Studies ; Child, Preschool ; Child ; Contusions/therapy* ; Lung Injury/therapy* ; Treatment Outcome

Objective:To investigate the efficacy of neutrophil elastase inhibitor in children with acute respiratory distress syndrome（ARDS）.Methods:A total of 168 children with moderate to severe ARDS who were hospitalized in the Department of Pediatric Intensive Care Unit，the Affiliated Children′s Hospital of Xi′an Jiaotong University and Children's Emergency Center of Gansu Provincial Central Hospital from January 2022 to December 2023 were selected. Eighty-seven children receiving neutrophil elastase inhibitors were treated as the treatment group and 81 children receiving conventional treatment as the control group. The dynamic changes of general data，clinical indicators and ventilator parameters at 24 h，48 h and 72 h were compared between the two groups. Mortality at 28 days was the primary endpoint. Kaplan-Meier curve and Log-Rank test were used to evaluate cumulative survival.Results:There was no significant difference in general information and clinical characteristics between the two groups.Compared with the control group，arterial partial pressure of oxygen（PaO 2）/fraction of inspired oxygen（FiO 2）in the treatment group increased significantly at 48 h［（160.28±5.90）mmHg（1 mmHg=0.133 kPa）vs（141.04±4.01）mmHg， P<0.05］and 72 h［（227.58±6.85）mmHg vs（180.86±4.08）mmHg， P<0.05］，and the differences were statistically significant.The platform pressure in the treatment group were lower than that of the control group at 24 h［（28.18±3.95）cmH 2O（1cmH 2O=0.098 kPa）vs（30.15±7.75）cmH 2O， P<0.05］，48 h［（25.56±4.06）cmH 2O vs（29.07±5.01）cmH 2O， P<0.05］，72 h［（24.95±2.82）cmH 2O vs（27.12±6.51）cmH 2O， P<0.05］，and the differences were statistically significant. IL-8 in the treatment group were lower than that of the control group at 48 h［（78.26±14.05）ng/L vs（86.02±15.01）ng/L， P<0.05］and 72 h［（58.38±15.56）ng/L vs（68.68±18.05）ng/L， P<0.05］，and the differences were statistically significant.The survival curve showed that the cumulative survival rate of the treatment group was higher than that of the control group，the difference between the two groups was statistically significant（ χ2=4.549， P=0.033）. Conclusion:Neutrophil elastase inhibitors can reduce the lung injury of ARDS patients by inhibiting the inflammatory response induced by neutrophils，and ultimately improve the prognosis of the disease.

Objective:To evaluate the safety and efficacy of immunoadsorption with protein A column(PA-IA) in refractory anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children.Methods:The clinical data of 8 children with anti-NMDAR encephalitis who failed to receive first-line treatment from January 2022 to June 2023 in PICU of Xi'an Children's Hospital were retrospectively collected.Clinical features,modified Rankin score (mRS),anti-NMDAR antibody titers in serum and cerebrospinal fluid(CSF),cells count in CSF,protein level in CSF,serum IgG,complement C3,C4 level were analyzed before and after immunoadsorption therapy. All adverse events that occurred during treatment were recorded in detail.Result:Among the 8 children,there were 5 males and 3 females,aged 5 to 12 years old,and each patient was immunized 6 to 10 times,and 75 times of PA-IA treatment were performed. The mRS score decreased in 8 children after PA-IA treatment. Blood IgG level,CSF cell number,protein level in CSF,blood complement C3 and C4 levels,and antibody titers related in blood and CSF were all lower than those before PA-IA treatment. The differences were all statistically significant ( P<0.001).During 75 times of treatment,only 1 case of membrane rupture occurred during treatment,the treatment was stopped and continued after the plasma separator was replaced,with no other adverse reactions. Conclusion:PA-IA could effectively improve the clinical symptoms and neurological function of children with refractory anti-NMDAR encephalitis with good safety,but its exact efficacy in children with anti-NMDAR encephalitis needs to be verified by prospective studies with larger samples.

Objective:To investigate the efficacy of nafamostat mesylate in traumatic extracorporeal membrane oxygenation (ECMO) therapy.Methods:Patients admitted to the intensive care units of Children's Hospital Affiliated to Xi'an Jiaotong University and Gansu Provincial Maternal and Child Health Hospital for ECMO-assisted cardiopulmonary support due to trauma from January 2021 to December 2024 were selected as the study subjects. Based on different anticoagulation strategies, patients were divided into the nafamostat mesylate group( n=11) and the common heparin group( n=10). The general conditions of the two groups were compared. In addition, differences in various clinical indicators during the ECMO-assisted process were compared, including white blood cell count (WBC), platelet count (PLT), hemoglobin level (Hb), hematocrit (HCT), prothrombin time(PT), activated partial thromboplastin time (APTT), thrombin time(TT), fibrinogen(FIB) and D-dimer. Furthermore，the differences in the total volume of component blood transfusions, coagulation substances, complications and prognosis between the two groups were compared. Results:No statistically significant differences were observed between the two groups regarding age, gender, weight, type of ECMO support, type of trauma, presence of active bleeding, or rate of surgical intervention. There were no statistically significant differences in WBC, PLT, Hb, HCT, PT, APTT, TT, FIB, and D-dimer between the two groups of patients prior to the initiation of ECMO support (all P>0.05). Compared with the common heparin group, children in the nafamostat mesylate group had lower PT[(21±6)s vs. (27±3)s; (20±4) vs. (28±5)], APTT[(68±8)s vs. (89±12)s; (64±15)s vs. (85±21)s], TT [(25±11)s vs. (31±13)s; (24±8)s vs. (35±6)s], and D-dimer[(5.8±1.1) μg/mL vs. (11.5±5.6) μg/mL; (4.2±1.8) μg/mL vs. (14.6±2.5) μg/mL],and higher FIB[(2.1±0.5) g/L vs. (1.6 ± 0.3) g/L; (2.4 ± 0.4) g/L vs. (1.3 ± 0.6) g/L] when ECMO assisted for 24 h and 72 h,the differences were all statistically significant(all P<0.05). Compared to the nafamostat mesylate group, the common heparin group exhibited significantly higher total cumulative infusion amounts of red blood cell suspension, plasma, platelet, FIB, hemocoagulase, and thromboplastin complex during the ECMO-assisted process, and the differences were statistically significant (all P<0.05). There was no statistically significant difference between the two groups of children in terms of time to ECMO assistance, membrane lung failure, loop thrombosis, embolism, and successful withdrawal rate (all P>0.05). Conclusion:Nafamostat mesylate can effectively reduce the risk of bleeding and minimize the requirement for blood product and coagulation substance infusions during traumatic ECMO assistance.

Objective:To evaluate the safety and efficacy of immunoadsorption with protein A column(PA-IA) in refractory anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in children.Methods:The clinical data of 8 children with anti-NMDAR encephalitis who failed to receive first-line treatment from January 2022 to June 2023 in PICU of Xi'an Children's Hospital were retrospectively collected.Clinical features,modified Rankin score (mRS),anti-NMDAR antibody titers in serum and cerebrospinal fluid(CSF),cells count in CSF,protein level in CSF,serum IgG,complement C3,C4 level were analyzed before and after immunoadsorption therapy. All adverse events that occurred during treatment were recorded in detail.Result:Among the 8 children,there were 5 males and 3 females,aged 5 to 12 years old,and each patient was immunized 6 to 10 times,and 75 times of PA-IA treatment were performed. The mRS score decreased in 8 children after PA-IA treatment. Blood IgG level,CSF cell number,protein level in CSF,blood complement C3 and C4 levels,and antibody titers related in blood and CSF were all lower than those before PA-IA treatment. The differences were all statistically significant ( P<0.001).During 75 times of treatment,only 1 case of membrane rupture occurred during treatment,the treatment was stopped and continued after the plasma separator was replaced,with no other adverse reactions. Conclusion:PA-IA could effectively improve the clinical symptoms and neurological function of children with refractory anti-NMDAR encephalitis with good safety,but its exact efficacy in children with anti-NMDAR encephalitis needs to be verified by prospective studies with larger samples.