[Objective] To analyze the effects of different factors and red blood cell transfusion thresholds on the efficacy of neonatal red blood cell (RBC) transfusion, in order to provide more references for neonatal transfusions to better achieve rational and effective blood use. [Methods] A retrospective collection of data from 282 neonates who received RBC transfusions at our hospital from 2022 to 2023 was conducted, including birth weight, gestational age, number of blood transfusions, length of hospital stay, assisted ventilation during RBC transfusion, and laboratory test results before and after transfusion. SPSS software was used for statistical analysis to comprehensively analyze the impact of different factors on the efficacy of RBC transfusion in neonates. [Results] The results showed that the gestational age and weight of newborns at birth were negatively correlated with their length of hospital stay and the number of RBC transfusions during hospitalization. Newborns with younger gestational age and lower weight had longer hospital stays and more RBC transfusions during hospitalization. After administering RBCs according to the standard of 15 mL/kg, there was a statistically significant difference in the efficacy of RBC transfusion at different transfusion thresholds. In non-critical situations, RBC transfusions were ineffective when the pre-transfusion hemoglobin (Hb) level was >120 g/L. When the pre-transfusion Hb level was ≤70 g/L, RBC transfusions achieved higher efficacy in both critical and non-critical situations. [Conclusion] In critical situations, the group with pre-transfusion Hb values ≤ 70 g/L has the best RBC transfusion effect, while in non-critical situations, the group with pre-transfusion Hb levels between 81 and 90 g/L has the best RBC transfusion effect. Overall, the efficacy of RBC transfusion in non-critical situations is higher than that in critical situations.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective:To compare the effects of different appointment regimens on the daily waiting time, fixedness of treatment time and lateness rate of radiotherapy patients.Methods:Medical records of 5488 radiotherapy from 332 patients on the same linear accelerator in West China Hospital of Sichuan University from March to June 2022 were selected. Based on the radiotherapy information integration platform of MOSAIQ, all patients were randomly assigned to the morning class, afternoon class and evening class. Traditional manual appointment regimen was adopted for the morning class, 30 min appointment regimen for the afternoon class, and 15 min appointment regimen for the evening class, respectively. The differences in patient waiting time for treatment, fixedness of treatment time, and lateness rate under different appointment regimens were compared. The fixedness of treatment time and waiting time was determined by one-way ANOVA, and the 2×3 Chi-square test was adopted for the lateness rate. Results:The waiting time in the 15 min appointment, the 30 min appointment and manual appointment groups were (27.08 ± 17.21), (34.57± 19.12) and (41.50 ±20.94) min, respectively. There was statistical significance among three appointment regimens ( F=254.97, P<0.001). The waiting time was the shortest in the 15 min appointment group, followed by the 30 min appointment group, and the manual appointment group (all P<0.001 for two-group comparison). The fixedness of treatment time in the 15 min appointment, the 30 min appointment and the manual appointment groups were (15.60±7.87), (18.69±8.94) and (24.30±15.10) min, respectively. There was statistical significance among three groups ( F=25.23, P<0.001). Among them, the fixedness of treatment time in the 15 min appointment group was the highest, followed by the 30 min appointment group, and the manual appointment group (all P<0.001). The lateness rates in the 15 min appointment, the 30 min appointment and the manual appointment groups were 5.7%, 6.2% and 9.6%, respectively. The lateness rate in the manual appointment group was higher than those in the 15 min appointment and the 30 min appointment groups ( χ2=19.24、14.90, both P<0.001), but there was no statistical significance in the lateness rate between the 15 min appointment and 30min appointment groups ( χ2=0.39, P=0.535). Conclusion:In the clinical practice of conventional intensity-modulated radiotherapy technology carried out by conventional linear accelerator, the 15 min appointment regimen can shorten the waiting time for radiotherapy and improve the fixedness of daily radiotherapy time, which is worthy of clinical promotion.

Metastasis is a pivotal and intricate process in the progression of malignant tumors,strongly correlating with poor prognosis.Approximately 90%of cancer-related mortality is attributed to metastasis,with the five-year survival rate for patients with metastatic solid tumors ranging from 5%to 30%.Consequently,a comprehensive understanding of the underlying biological mechanisms driving metastasis is essential for unraveling its core processes and developing novel therapeutic strategies.The metastatic cascade involves tumor cells navigating numerous biological barriers,including detachment from the primary tumor,invasion of blood vessels or lymphatics,survival in circulation,extravasation into distant organs and subsequent adaptation to the microenvironment.To surmount these challenges,tumor cells undergo phenotypic changes,genetic mutations and dysregulating signaling pathways.Additionally,microenvironmental factors(such as angiogenesis,matrix remodeling and immune evasion)play a critical role,orchestrating the initiation and growth of metastatic lesions in an interdependent manner.Organ-specific metastasis,a distinct subset of metastasis,involves dynamic bidirectional interactions between tumor cells and the microenvironment of target organs.These interactions determine the selectivity of metastatic spread and drive the adaptive evolution of both the tumor and the organ,which encompasses multiple layers of cellular interactions,including cell-cell and cell-matrix signaling.Tumor cell mutations,the release of specific signaling molecules,the capacity to withstand circulatory pressures,and signaling exchanges with target organs collectively govern the selective nature of organ-specific metastasis.Furthermore,factors intrinsic to the target organ-such as its regenerative potential,metabolic profile,immune surveillance mechanisms and matrix stiffness-further facilitate the adaptive remodeling of metastatic cells within these environments.Thus,the bidirectional selection and adaptation between tumor cells and target organs form a dynamic,complex system that reshapes our understanding of metastatic tumor development.While current research emphasizes shared biological features in metastasis,the successful formation of metastatic tumors depends not only on these common mechanisms but also on the unique characteristics governing organ-specific metastasis.The interplay between generalizable and organ-specific mechanisms profoundly influences the metastatic outcome.This review aimed to consolidate our current knowledge of these shared and distinct processes,analyze the evolving understanding of the bidirectional selection between tumor cells and target organs,and assess the current status of metastatic risk prediction models for patients without metastasis.Furthermore,the paper discussed the challenges and opportunities in managing advanced-stage metastatic tumors,offering new insights and potential clinical strategies to improve prognosis and treatment outcomes.

Objective:To develop a rapid assessment scale for healthy aging suitable for the Chinese population.Methods:Based on existing healthy aging assessment scales, national standards, and expert consensus, an initial Healthy Aging Rapid Assessment Scale was drafted through two rounds of expert consultation. A pre-survey was conducted with 3 220 subjects recruited from Guangzhou between July 2023 and July 2024. Items were screened through item analysis and exploratory factor analysis to form the final scale. Reliability and validity of the final scale were validated across five cities: Guangzhou, Dongguan, Shenzhen, Baoding, and Chuxiong.Results:The initial version comprised 36 items, while the finalized scale contained 18 items across three dimensions: metabolic health, mental health, and cognitive health. Test-retest reliability ranged from 0.71 to 0.81 across all study sites. The Spearman-Brown coefficient varied between 0.91-0.96, Cronbach′s α between 0.77-0.83, comparative fit index (CFI) between 0.90-0.98, goodness-of-fit index (GFI) between 0.90-0.99, and root-mean-square error of approximation (RMSEA) between 0.03-0.09. For the three dimensions, reliability and validity metrics demonstrated consistency: Spearman-Brown coefficients 0.87-0.99, Cronbach′s α 0.77-0.83, CFI 0.90-0.98, GFI 0.90-0.99, and RMSEA 0.03-0.09 across four regions.Conclusion:The developed Healthy Aging Rapid Assessment Scale for the Chinese population exhibits robust reliability and validity.

Objective:To evaluate the performance differences of three common novel quantitative ultrasound（QUS）imaging methods-Nakagami-Gamma parametric imaging，ultrasound attenuation intercept imaging，and weighted Shannon entropy imaging-in monitoring high-intensity focused ultrasound（HIFU）therapy.Methods:On a clinical HIFU therapy system， ex vivo pork loin tissue and in vivo rabbit leg tissue were treated with HIFU at different acoustic power levels（77-174 W）. Ultrasound monitoring radiofrequency（RF）data were acquired online，and the three QUS images were reconstructed based on identical raw data. Performance was compared through quantitative analysis of tissue damage contrast-to-noise ratio（CNR）and damage area assessment relative to true histological damage. Results:During HIFU therapy，all three QUS imaging methods outperformed B-mode ultrasound in characterizing HIFU-induced damage，with significantly higher CNR values. Among the images，Nakagami-Gamma images showed the highest increase in CNR values before and after treatment，with an improvement of 22.5%- 60.3%；meanwhile，the damage area assessed by weighted Shannon entropy images exhibited the highest correlation with the true damage area（ r=0.81， P<0.000 1）. Conclusions:By characterizing tissue microstructure features，QUS imaging can more reliably monitor HIFU thermal damage than conventional B-mode ultrasound. Among the methods，Nakagami imaging was the most sensitive to damage characterization，entropy parameter imaging showed the strongest correlation with the true damage area，and attenuation intercept imaging achieved the best damage area matching. This study may provide references for developing next-generation clinical HIFU therapy monitoring systems.

The Kirsten rat sarcoma viral oncogene homolog ( KRAS ) mutation is one of the most prevalent activating alterations in cancer. It indicates a poor overall prognosis due to its highly invasive nature. Although several KRAS inhibitors have been developed in recent years, a significant clinical challenge has emerged as a substantial proportion of patients eventually develop resistance to these therapies. Therefore, identifying determinants of drug resistance is critical for guiding treatment strategies. This review provides a comprehensive overview of the mutation landscape and molecular mechanisms of KRAS activity in various cancers. Meanwhile, it summaries the progress and prospects of small molecule KRAS inhibitors undergoing clinical trials. Furthemore, this review explores potential strategies to overcome drug resistance, with the ultimate goal of steering toward patient-centric precision oncology in the foreseeable future.
Humans ; Drug Resistance, Neoplasm/drug effects* ; Proto-Oncogene Proteins p21(ras)/metabolism* ; Mutation/genetics* ; Neoplasms/genetics* ; Antineoplastic Agents/therapeutic use*

Objective:To investigate the effects of miR-7-5p on the proliferation,apoptosis,and immune escape of esophageal squamous cell carcinoma(ESCC)KYSE-150 cells by regulating forkhead box M1(FOXM1).Methods:The targeted binding sites of miR-7-5p and FOXM1 were verified by the dual-luciferase reporter gene assay.The cancer tissues and adjacent paracancerous tissues as well as the basic clinical data of 56 ESCC patients hospitalized at Changzhou Geriatric Disease Hospital affiliated to Soochow University between January 2022 and October 2024 were collected.qRT-PCR was used to detect the expression levels of miR-7-5p and FOXM1 in ESCC tissues,and analyze the relationship between their expressions and clinicopathological characteristics.Normal cultured KYSE-150 cells were selected as the Control group Plasmids were transfected into KYSE-150 cells using Lipofectamine 3000 transfection reagent,and the cells were assigned into the Mimic-NC group,the miR-7-5p mimic group,the miR-7-5p mimic+OE-NC group,and the miR-7-5p mimic+OE-FOXM1 group.EdU staining and CCK-8 assay were used to detect the proliferation ability of KYSE-150 cells.Flow cytometry was performed to detect the apoptosis of KYSE-150 cells and CD8+T cells.Western blot assay was performed to detect the expression levels of PD-L1,FOXM1,BAX,and PCNA proteins in KYSE-150 cells.A nude mouse transplanted tumor model of KYSE-150 cells was established to observe the effects of miR-7-5p overexpression on the growth of the transplanted tumors and the expressions of Ki-67 and FOXM1 in the tissues.Results:miR-7-5p could target and negatively regulate FOXM1(P<0.05).miR-7-5p expression was low and FOXM1 expression was high in ESCC tissues(both P<0.05).The expressions of miR-7-5p and FOXM1 were significantly correlated with TNM stage and differentiation degree,respectively(all P<0.05).The rates of EdU-positive cells,cell proliferation ability,CD8+T cell apoptosis rate,as well as PD-L1,PCNA,and FOXM1 mRNA and protein in the miR-7-5p overexpression group were significantly reduced(all P<0.05),while the apoptosis rate,miR-7-5p,and BAX increased significantly(all P<0.05).Meanwhile,overexpression of FOXM1 could reverse the above effects(all P<0.05).Overexpression of miR-7-5p decreased the mass and volume of transplanted tumors,and the expressions of Ki-67 and FOXM1 proteins in transplanted tumor tissues(all P<0.05).Conclusion:Overexpression of miR-7-5p can significantly inhibit the proliferation and immune escape of KYSE-150 cells and promote cell apoptosis,which may be achieved by targeted negative regulation of FOXM1.

Objective:To evaluate the performance differences of three common novel quantitative ultrasound（QUS）imaging methods-Nakagami-Gamma parametric imaging，ultrasound attenuation intercept imaging，and weighted Shannon entropy imaging-in monitoring high-intensity focused ultrasound（HIFU）therapy.Methods:On a clinical HIFU therapy system， ex vivo pork loin tissue and in vivo rabbit leg tissue were treated with HIFU at different acoustic power levels（77-174 W）. Ultrasound monitoring radiofrequency（RF）data were acquired online，and the three QUS images were reconstructed based on identical raw data. Performance was compared through quantitative analysis of tissue damage contrast-to-noise ratio（CNR）and damage area assessment relative to true histological damage. Results:During HIFU therapy，all three QUS imaging methods outperformed B-mode ultrasound in characterizing HIFU-induced damage，with significantly higher CNR values. Among the images，Nakagami-Gamma images showed the highest increase in CNR values before and after treatment，with an improvement of 22.5%- 60.3%；meanwhile，the damage area assessed by weighted Shannon entropy images exhibited the highest correlation with the true damage area（ r=0.81， P<0.000 1）. Conclusions:By characterizing tissue microstructure features，QUS imaging can more reliably monitor HIFU thermal damage than conventional B-mode ultrasound. Among the methods，Nakagami imaging was the most sensitive to damage characterization，entropy parameter imaging showed the strongest correlation with the true damage area，and attenuation intercept imaging achieved the best damage area matching. This study may provide references for developing next-generation clinical HIFU therapy monitoring systems.

Objective:To develop a rapid assessment scale for healthy aging suitable for the Chinese population.Methods:Based on existing healthy aging assessment scales, national standards, and expert consensus, an initial Healthy Aging Rapid Assessment Scale was drafted through two rounds of expert consultation. A pre-survey was conducted with 3 220 subjects recruited from Guangzhou between July 2023 and July 2024. Items were screened through item analysis and exploratory factor analysis to form the final scale. Reliability and validity of the final scale were validated across five cities: Guangzhou, Dongguan, Shenzhen, Baoding, and Chuxiong.Results:The initial version comprised 36 items, while the finalized scale contained 18 items across three dimensions: metabolic health, mental health, and cognitive health. Test-retest reliability ranged from 0.71 to 0.81 across all study sites. The Spearman-Brown coefficient varied between 0.91-0.96, Cronbach′s α between 0.77-0.83, comparative fit index (CFI) between 0.90-0.98, goodness-of-fit index (GFI) between 0.90-0.99, and root-mean-square error of approximation (RMSEA) between 0.03-0.09. For the three dimensions, reliability and validity metrics demonstrated consistency: Spearman-Brown coefficients 0.87-0.99, Cronbach′s α 0.77-0.83, CFI 0.90-0.98, GFI 0.90-0.99, and RMSEA 0.03-0.09 across four regions.Conclusion:The developed Healthy Aging Rapid Assessment Scale for the Chinese population exhibits robust reliability and validity.