Objective:To evaluate the effects of sequential immunotherapy with radiotherapy on survival time and immune function in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a real-world study.Methods:Data of 84 patients with unresectable stage III NSCLC who were treated at the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to December 2022 (retrospective cohort) and from January 2023 to December 2023 (prospective cohort) were collected. The patients were divided into the combination group ( n=40) and radiotherapy group ( n=44) based on whether they received sequential immunotherapy or not. The progression-free survival (PFS) and overall survival (OS) between two groups were compared using standardized mortality ratio weighting (SMRW). Univariate Cox proportional hazards model, multivariate regression analysis, multi-model comparison of propensity score matching and subgroup analysis were emploed to analyze the robustness of clinical efficacy between two groups. E-value analysis was used to analyze the sensitivity of unmeasured confounding factors in observational studies. Additionally, the percentage of CD4 +T cells, CD8 +T cells and natural killer (NK) cells, and CD4 +/CD8 + T cell ratio before and after treatment between two groups were compared using analysis of covariance. Results:Among 84 patients, 77 (92%) cases were male and 7 (8%) were female. Among them, 42 (50%) were aged 65 years or older. The variables showed high homogeneity after SMRW, with a standardized mean difference of less than 0.1. In the combination group, the median PFS [17.0 months vs. 7.0 months, HR=0.260, 95% CI: 0.130-0.490, P<0.001] and OS [not reached vs. 24.0 months, HR=0.210, 95% CI: 0.070-0.590, P=0.002] were significantly longer compared to that in the radiotherapy group, with statistically significant differences. The study results were confirmed by robustness and sensitivity analyses. After treatment, patients in the combination group showed a statistically significant increase in the percentage of CD4 + T cells and NK cells, and CD4 +/CD8 + T cell ratio, as well as a decrease in the percentage of CD8 + T cells compared to those in the radiotherapy group (all P<0.05). Conclusions:Sequential immunotherapy following radiotherapy can significantly improve survival and prognosis of unresectable stage III NSCLC patients. The survival benefit is even greater when combined with chemotherapy. The main mechanism of the survival benefit may be the improvement of anti-tumor immune function.

Objective:It aims to deepen the understanding of the coupled and coordinated development of health investment and economic growth,and to provide a scientific basis for the development of health policies for China's ten largest urban ag-glomerations.Methods:Based on the provincial panel data of ten major urban agglomerations from 2013 to 2022,entropy weight method,coupled coordination degree model,spatial autocorrelation model and quantile regression model are used for analysis.Results:In observation period,the level of two-system coupling and coordination grows from 0.397 in 2013 to 0.645 in 2022;the global Moran's I decreases from-0.020 to-0.357.In the dynamic leapfrog analysis,22.2%of provinces and munici-palities experience positive leapfrogging,while 16.7%of provinces and municipalities show negative leapfrogging.Baesd on lo-calised Moran Index,the quantile regression results show that the proportion of the people in higher education,the level of ur-banization and the level of labor force have a positive influence on the level of coupling and coordination between these two sys-tems,with the β coefficient showing a tendency of increasing and then decreasing;medical research institutes have a negative influence on the level of coupling and coordination between these two systems on the 0.1-0.3 quantile;the level of foreign invest-ment has a positive influence on the 0.1 quantile,and the 0.6-0.8 quartile has a negative effect.GDP per capita has a weak ef-fect on the level of coordination between these two systems.Conclusion:The two-system coupling and coordination level of the ten major urban agglomerations shows an overall increase,but there are regional differences,and it is affected by the integra-tion of science and education,economic level and human resources.

Objective To establish the reference interval of urine Alzheimer-associated neuronal thread protein(AD7c-NTP)for healthy adults in Mianyang area using the indirect method.Methods The detection results of urine AD7c-NTP from 5 093 healthy in-dividuals were collected from the information management database of Medical Laboratory Department of Sichuan Science City Hospital from March 2017 to March 2022.Skewness-kurtosis and Kolmogorov-Smirnov tests were used to determine whether the data followed a normal distribution.After removing outliers using the Box Plots method,the enrolled subjects were grouped by gender and age.The Mann-Whitney U or Kruska-Wallis H tests were used to analyze the between-group differences of urine AD7c-NTP in healthy individu-als with different genders and ages.The adjacent age groups without statistically significant difference(P＞0.05)were combined,and the indirect method(non-parametric test method)was used to calculate the reference intervals for different gender and age groups.Results Skewness-kurtosis and Kolmogorov-Smirnov tests showed that the data followed a non-normal distribution.After removing 293 outliers using the Box Plots method,a total of 4 800 subjects,including 3 199 males and 1 601 females,were enrolled.The enrolled subjects were grouped by gender and age,and the non-parametric test method were used to establish the reference intervals of urine AD7c-NTP in healthy populations with different genders.The Mann-Whitney U test confirmed that urine AD7c-NTP levels existed gen-der differences(Z=14.09,P＜0.01),and the reference intervals for males and females were≤1.10 ng/mL and≤1.40 ng/mL,re-spectively.There were also statistical differences in urine AD7c-NTP levels among different age groups of the same gender.After combi-ning adjacent age groups without statistically significant difference(P＞0.05),the reference intervals of urine AD7c-NTP in healthy populations with different genders and ages were established by the non-parametric test method,which were≤1.00 ng/mL for male 20-39 years old group,≤1.10 ng/mL for male 40-79 years old group,≤1.60 ng/mL for male≥80 years old group,≤1.30 ng/mL for female 20-69 years old group,and≤1.60 ng/mL for female≥70 years old group,respectively.The established reference intervals of urine AD7c-NTP were further verified by healthy individuals,and the results met the standards.Conclusion The reference intervals of urine AD7c-NTP in healthy populations with different genders and ages in Mianyang area are established successfully using the indi-rect method,which may help to predict the risk of Alzheimer's disease in clinical practice and provide support for the diagnosis and treatment of the disease.

Objective To establish the reference interval of urine Alzheimer-associated neuronal thread protein(AD7c-NTP)for healthy adults in Mianyang area using the indirect method.Methods The detection results of urine AD7c-NTP from 5 093 healthy in-dividuals were collected from the information management database of Medical Laboratory Department of Sichuan Science City Hospital from March 2017 to March 2022.Skewness-kurtosis and Kolmogorov-Smirnov tests were used to determine whether the data followed a normal distribution.After removing outliers using the Box Plots method,the enrolled subjects were grouped by gender and age.The Mann-Whitney U or Kruska-Wallis H tests were used to analyze the between-group differences of urine AD7c-NTP in healthy individu-als with different genders and ages.The adjacent age groups without statistically significant difference(P＞0.05)were combined,and the indirect method(non-parametric test method)was used to calculate the reference intervals for different gender and age groups.Results Skewness-kurtosis and Kolmogorov-Smirnov tests showed that the data followed a non-normal distribution.After removing 293 outliers using the Box Plots method,a total of 4 800 subjects,including 3 199 males and 1 601 females,were enrolled.The enrolled subjects were grouped by gender and age,and the non-parametric test method were used to establish the reference intervals of urine AD7c-NTP in healthy populations with different genders.The Mann-Whitney U test confirmed that urine AD7c-NTP levels existed gen-der differences(Z=14.09,P＜0.01),and the reference intervals for males and females were≤1.10 ng/mL and≤1.40 ng/mL,re-spectively.There were also statistical differences in urine AD7c-NTP levels among different age groups of the same gender.After combi-ning adjacent age groups without statistically significant difference(P＞0.05),the reference intervals of urine AD7c-NTP in healthy populations with different genders and ages were established by the non-parametric test method,which were≤1.00 ng/mL for male 20-39 years old group,≤1.10 ng/mL for male 40-79 years old group,≤1.60 ng/mL for male≥80 years old group,≤1.30 ng/mL for female 20-69 years old group,and≤1.60 ng/mL for female≥70 years old group,respectively.The established reference intervals of urine AD7c-NTP were further verified by healthy individuals,and the results met the standards.Conclusion The reference intervals of urine AD7c-NTP in healthy populations with different genders and ages in Mianyang area are established successfully using the indi-rect method,which may help to predict the risk of Alzheimer's disease in clinical practice and provide support for the diagnosis and treatment of the disease.

Objective:It aims to deepen the understanding of the coupled and coordinated development of health investment and economic growth,and to provide a scientific basis for the development of health policies for China's ten largest urban ag-glomerations.Methods:Based on the provincial panel data of ten major urban agglomerations from 2013 to 2022,entropy weight method,coupled coordination degree model,spatial autocorrelation model and quantile regression model are used for analysis.Results:In observation period,the level of two-system coupling and coordination grows from 0.397 in 2013 to 0.645 in 2022;the global Moran's I decreases from-0.020 to-0.357.In the dynamic leapfrog analysis,22.2%of provinces and munici-palities experience positive leapfrogging,while 16.7%of provinces and municipalities show negative leapfrogging.Baesd on lo-calised Moran Index,the quantile regression results show that the proportion of the people in higher education,the level of ur-banization and the level of labor force have a positive influence on the level of coupling and coordination between these two sys-tems,with the β coefficient showing a tendency of increasing and then decreasing;medical research institutes have a negative influence on the level of coupling and coordination between these two systems on the 0.1-0.3 quantile;the level of foreign invest-ment has a positive influence on the 0.1 quantile,and the 0.6-0.8 quartile has a negative effect.GDP per capita has a weak ef-fect on the level of coordination between these two systems.Conclusion:The two-system coupling and coordination level of the ten major urban agglomerations shows an overall increase,but there are regional differences,and it is affected by the integra-tion of science and education,economic level and human resources.

Objective:To evaluate the effects of sequential immunotherapy with radiotherapy on survival time and immune function in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a real-world study.Methods:Data of 84 patients with unresectable stage III NSCLC who were treated at the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to December 2022 (retrospective cohort) and from January 2023 to December 2023 (prospective cohort) were collected. The patients were divided into the combination group ( n=40) and radiotherapy group ( n=44) based on whether they received sequential immunotherapy or not. The progression-free survival (PFS) and overall survival (OS) between two groups were compared using standardized mortality ratio weighting (SMRW). Univariate Cox proportional hazards model, multivariate regression analysis, multi-model comparison of propensity score matching and subgroup analysis were emploed to analyze the robustness of clinical efficacy between two groups. E-value analysis was used to analyze the sensitivity of unmeasured confounding factors in observational studies. Additionally, the percentage of CD4 +T cells, CD8 +T cells and natural killer (NK) cells, and CD4 +/CD8 + T cell ratio before and after treatment between two groups were compared using analysis of covariance. Results:Among 84 patients, 77 (92%) cases were male and 7 (8%) were female. Among them, 42 (50%) were aged 65 years or older. The variables showed high homogeneity after SMRW, with a standardized mean difference of less than 0.1. In the combination group, the median PFS [17.0 months vs. 7.0 months, HR=0.260, 95% CI: 0.130-0.490, P<0.001] and OS [not reached vs. 24.0 months, HR=0.210, 95% CI: 0.070-0.590, P=0.002] were significantly longer compared to that in the radiotherapy group, with statistically significant differences. The study results were confirmed by robustness and sensitivity analyses. After treatment, patients in the combination group showed a statistically significant increase in the percentage of CD4 + T cells and NK cells, and CD4 +/CD8 + T cell ratio, as well as a decrease in the percentage of CD8 + T cells compared to those in the radiotherapy group (all P<0.05). Conclusions:Sequential immunotherapy following radiotherapy can significantly improve survival and prognosis of unresectable stage III NSCLC patients. The survival benefit is even greater when combined with chemotherapy. The main mechanism of the survival benefit may be the improvement of anti-tumor immune function.

Epidural labor analgesia aims to provide effective medical services to alleviate labor pain in parturients, while adhering to the principles of voluntary participation and clinical safety. In 2018, Peking Union Medical College Hospital(PUMCH)became one of the first pilot units for labor analgesia in China, and has achieved satisfactory results in high-quality development of labor analgesia. This article mainly introduces the achievements and experience of labor analgesia at PUMCH, including: (1) prioritizing maternal and infant safety, arranging personnel rationally, and developing standardized treatment processes through multidisciplinary collaboration to ensure safe and comfortable childbirth; (2) leveraging the hospital's comprehensive capabilities in emergency treatment, and improving collaborative rescue plans for critically ill parturients and newborns; (3) implementing advanced teaching methods to effectively train and conduct simulated drills for labor analgesia and rescue of critically ill parturients; (4) conducting patient education and informative lectures to help parturients acquire a scientific understanding of labor analgesia. We hope that this experience can provide reference and inspiration for other hospitals.

Objective:To evaluate the safety and feasibility of robot assisted total gastrectomy plus hand-sewn esophagojejunostomy.Methods:The clinical data of 72 patients diagnosed with gastric cancer and undergoing total gastrectomy at the First Affiliated Hospital of Ningbo University from Nov 2021 to May 2024 were retrospectively analyzed. They were divided into two groups: robot-assisted total gastrectomy (RATG) group, consisting of 30 patients, and laparoscopic assisted total gastrectomy (LATG) group, consisting of 42 patients . In the RATG group, the digestive tract was reconstructed by manual suture under the robot scope and Roux-Y reconstruction was performed . In LATG group, digestive tract reconstruction was performed using an in vitro stapler and Roux-Y. The clinicopathological data, perioperative indexes, and postoperative follow-up data of both groups were observed and analyzed.Results:All 72 patients successfully completed the operation without conversion to open laparotomy. The total operation time in RATG group was longer than that in LATG group [(235.2±25.8) min vs. (200.7±40.6) min, t=4.099, P<0.05)].RATG was superior to LATG group in terms of digestive tract reconstruction time, postoperative fluid intake time and hospitalization days,the difference was statistically significant [(36.9±3.0) min vs.(39.4±4.5) min, (4.2±0.5) d vs. (5.2±0.6) d、(9.5±1.6) d vs. (10.8±2.4)d, t=-2.554,-7.135,-2.595, all P<0.05]; In terms of postoperative pathology, the number of lymph node dissection in RATG group was higher than that in LATG group [(29.8±6.2) vs. (26.3±7.5), t=2.197, P<0.05]. Conclusion:The application of delayed disconnection hand-sewn esophagojejunostomy in Da Vinci robot total gastrectomy is safe and feasible for cure-intent total gastrectomy in patients of gastric carcinoma.

The high incidence of complications in preterm infants has a serious negative impact on neonatal health.Therefore,the discovery of predictors of complications in preterm infants has a positive clinical value.Umbilical cord blood is rich in various biomarkers and has the advantages of easy access and no harm to the infants,making it an ideal specimen for testing.A number of studies had explored the predictive value of de-tecting markers in umbilical cord blood,either alone or in combination with other assays,for various types of preterm complications,in order to facilitate earlier intervention for preterm complications and to improve the prognosis of the disease.This paper reviews the recent development of cord blood testing for predicting com-plications in various types of preterm infants.

Objective To investigate the effect of bone marrow mesenchymal stem cells(BMSC)transplantation on rats with painful diabetes peripheral neuropathy(PDPN).Methods Fourteen SPF grade male GK rats were randomly divided into model group and treat-ment group,with 7 rats in each group.Seven Wistar rats of the same-sex and same-age were used as the normal group.The treatment group received intraperitoneal injection of BMSC for 6 weeks of treatment.Detection of thermal pain threshold;take the sciatic nerve and observe the pathological morphological changes of the sciatic nerve using hematoxylin-eosin(HE)staining and Masson staining;Western blot was used to detect the expression of JAK2/STAT3 signaling pathway related proteins p-JAK2 and p-STAT3.Results After treat-ment with BMSC,the thermal pain threshold of rats increased slightly;the sciatic nerve injury was repaired,the infiltration of inflammato-ry cells was alleviated,and the phenomenon of demyelination was improved;the expression of pathway related proteins p-JAK2 and p-STAT3 decreased.Conclusion BMSC transplantation can alleviate inflammatory response,repair sciatic nerve,and alleviate pain by in-hibiting the JAK2/STAT3 signaling pathway.