Background Volatile organic compounds (VOCs) in exhaled breath are closely associated with respiratory diseases and are linked to various metabolic reactions in the human body. A quantitative analytical method can provide technical support for studying VOCs related to various diseases. Objective To establish a thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) method for the determination of 27 VOCs in exhaled breath. Methods VOCs in exhaled breath were collected using a Bio-VOC sampler and enriched with Tenax TA thermal desorption tubes before TD-GC-MS analysis. Standards were collected using thermal desorption tubes and optimized for thermal desorption conditions as well as chromatographic and mass spectrometric conditions: The separation of the 27 VOCs was achieved by an optimized temperature program, the improvement of sensitivity by optimizing quantitative ions, and the increase of VOCs desorption efficiency by optimizing thermal desorption time and temperature. Limit of detection, limit of quantification, accuracy, precision, and stability of the proposed method were investigated by spiking with a blank gas bag, and exhaled breath samples from 20 healthy individuals were collected for an application study of the proposed method. Results The thermal desorption temperature was 280 ℃, and desorption time was 6 min. A VF-624ms chromatographic column was selected for the separation of target substances. The initial temperature of heating program was 35 ℃, maintained for 1 min, and then increased to 100 ℃ at a heating rate of 3 ℃·min⁻¹ for 1 min, followed by increasing to 210 ℃ at a heating rate of 28 ℃·min⁻¹ for 5 min. A quantitative analysis was conducted with a single ion monitoring (SIM) mode. Under these conditions, the 27 VOCs showed good linear relationships in their respective concentration ranges and the correlation coefficients were higher than 0.9990. The limits of detection of the method were in the range of 0.01-0.13 nmol·mol⁻¹, the limits of quantification were in the range of 0.02-0.44 nmol·mol⁻¹, and the spiked recoveries were in the range of 80.1%-120.5%, with intra-batch and inter-batch precision ≤ 18.8% and 17.9% respectively. All substances can be stored at room temperature (23-28 °C) for 7 d and at 4 °C for 14 d. The proposed method was applied to exhaled breath samples from 20 subjects with detection rates≥ 80% (except for trans-2-pentene and decane) and a concentration range of 0.00-465.50 nmol·mol⁻¹. Conclusion The established TD-GC-MS method for quantification of VOCs in exhaled breath is characterized by high sensitivity and good accuracy, and is suitable for quantitative determination of VOCs in exhaled breath, which can provide technical support for the study of exhaled breath VOCs.

Objective:To explore long-term outcome and risk factors of recurrence in stage Ⅲ gastric cancer patients who underwent radical gastrectomy and adjuvant chemotherapy.Methods:The clinical and pathological data of patients with stage Ⅲ (AJCC V8) gastric adenocarcinoma were analyzed retrospectively. All patients received radical gastrectomy and adjuvant chemotherapy consisting of oxaliplatin, fluoropyrimidines with or without docetaxel in our center during 2006 and 2011.Results:A total of 324 patients were enrolled into the study. With a median follow-up time of 108 months, 175 (54%) patients developed tumor recurrence. One hundred and eighty-three (56.5%) patients died, including 169 (52.2%) dying of gastric cancer recurrence. The median disease-free survival (DFS) was 35 months, and the median overall survival (OS) was 64 months. The 5-year OS rates were 58.2%, 51.5% and 25.6% in patients with stage ⅢA, ⅢB and ⅢC diseases, respectively ( P<0.01). Multivariate analysis revealed that T4b cancers ( P=0.02), higher lymph meta node ratio (LNR) ( P<0.01) and perineural invasion ( P=0.01) were independent negative prognostic factors, while more than 12 weeks of adjuvant chemotherapy may improve survival. Higher LNR was correlated with locoregional ( P<0.01), distant lymph node metastases ( P<0.01), and peritoneal metastases ( P=0.038). Perineural invasion ( P=0.047) was prone to peritoneal metastases. More than 12 weeks of adjuvant chemotherapy could reduce the risk of haematogenous metastases ( P=0.023). Conclusions:Outcomes were significantly different in subgroups of patients with stage Ⅲ gastric cancers after radical gastrectomy. Higher LNR and perineural invasion could predict poor prognosis and different recurrence patterns.

Objective:To provide a reference for in-depth application and research in the field of coronary heart disease traditional Chinese medicine (TCM) nursing. Based on the CiteSpace software, the development trend and research hotspots of the literature are displayed and analyzed in this field.Methods:The China Knowledge Network (CNKI) database was used to retrieve the literature related to the research in this field published in the past 20 years from January 1st 2001 to October 5th 2021, and CiteSpace was used to visually analyze the number of articles, research institutions, authors and keywords, and to interpret its meaning in combination with the content of the atlas.Results:The amount of research literature in this field was generally on the rise, but the cooperation between various research institutions and authors needs to be strengthened. Research hotspots mainly focused on five areas: coronary heart disease-related symptom care, the application of characteristic TCM nursing techniques, the outcome indicators of the research, the TCM health management of patients with coronary heart disease, and the application model of TCM nursing.Conclusions:It is recommended to strengthen multidisciplinary and teamwork in this field, carry out high-quality randomized controlled studies, and focus on related research on multiple nursing models, evaluation tools, and symptom management.

Objective:To investigate the clinical characteristics, diagnosis and treatment of dermatomyositis with kidney neoplasm.Methods:The data of two patients with dermatomyositis complicated with kidney neoplasm in Tongji Hospital from January to February 2022 were retrospectively analyzed. The first case was a 55-year-old female, who was admitted with the chief complaints of recurrent erythema of upper extremities for 2 months and facial erythema for 1 month. Physical examination: erythema can be seen on upper limbs and face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Mi-2 antibody and anti-SSA /Ro-52 antibody were positive. Contrast CT showed nodular uneven enhancement in the right kidney with a size of 50 mm×41 mm. The second case was a 58-year-old female, who was admitted with the chief complaints of kidney occupying for a month. Physical examination: flaky erythema on face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Ro-52 antibody and anti-MDA5 antibody were positive. Contrast CT showed a significantly uneven enhanced mass with a size of about 50 mm×41 mm on left kidney. Both patients were diagnosed with kidney neoplasm before surgery and underwent laparoscopic partial nephrectomy in Tongji Hospital.Results:Both patients received regular oral prednisone after surgery. The pathological presentation of case 1 was papillary renal cell carcinoma, the facial erythema subsided 1 month after surgery, and there was no tumor recurrence for 13 months. The pathological presentation of case 2 was clear cell renal cell carcinoma, facial erythema subsided 2 weeks after surgery, and there was no tumor recurrence for 12 months.Conclusions:The diagnosis of dermatomyositis should be combined with clinical manifestations and laboratory examination, and the possibility of malignant tumor should be excluded due to the high likelihood of concomitant malignancy. For patients with dermatomyositis with kidney neoplasm, the main treatment is still surgery, and supplemented with glucocorticoid therapy.

Objective:Efficacy and safety of robot-assisted laparoscopic adrenalectomy as a treatment for large adrenal tumors.Three-dimensional(3D) reconstruction can effectively assist in preoperative planning of robotic adrenalectomy and reduce potential complications.Methods:We retrospectively reviewed the relevant information of patients who had a preoperative 3D reconstruction and underwent RA for adrenal masses larger than 10 cm. Thirteen male patients and sixteen female patients were included. The median(range) age was 43(25, 57) years old and the median tumor diameter was 12.1(10.3, 16.2) cm. The patients underwent preoperative CT enhancement scanning, and three-dimensional images were reconstructed based on the examination data. Robot-assisted laparoscopic adrenalectomy was performed under general anesthesia in 29 cases in this cohort.Results:All surgeries were completed successfully without major complications such as massive bleeding, secondary surgery, or even patient death. The median operative time was 131 (80, 245) min, and the median intraoperative bleeding was 330 (50, 2 200 ml) ml. 9 patients received blood transfusions. There were 11 cases of pheochromocytoma (37.9%), 10 cases of adenocarcinoma (34.5%) as well as 2 cases of teratoma (6.9%) and 6 cases of cortical carcinoma (20.7%). The patients were followed up for a median of 30 months after surgery. Except for 3 cases lost to follow-up and 2 patients with cortical cancer who developed recurrence or metastasis after surgery and died at 16 and 23 months after surgery, respectively, the remaining 24 cases have survived to date.Conclusions:RA is a safe and effective treatment for huge adrenal tumors. The 3D reconstruction could help the preoperative planning of RA and reduce potential complications.

Objective:To evaluate the efficacy and safety of angiogenesis inhibitor combined with erlotinib versus erlotinib alone in the targeted treatment of epidermal growth factor receptor(EGFR)-mutated advanced non-small cell lung carcinoma. Methods:A computer-based online search was performed using PubMed,Cochrane Library,Excerpta Medica Database(Embase),Web of Science,VIP,China National Knowledge Infrastructure(CNKI),and WANFANG databases.The retrieval time is from the establishment of the database to March 2022.After literature screening and rigorous data extraction,Meta-analysis was performed using RevMan 5.4 software.The primary endpoints of this study were median progression free survival(mPFS),median overall survival(mOS),objective response rate(ORR)and safety. Results:A total of 11 articles containing data of 3 805 patients was included in this study.Meta-analysis results showed that compared with the treatment of erlotinib alone(control group),the treatment of angiogenesis inhibitors combined with erlotinib(experimental group)could effectively improve the mPFS[hazard ratio(HR)=0.64,95％confidence interval(CI)=0.58-0.70,P＜0.000 01]and ORR[odds ratio(OR)=1.2 5,95％CI=1.02-1.54,P=0.03]in advanced non-small cell lung cancer patients,while it did not show an advantage in improving mOS(HR=0.91,95％CI=0.78-1.07,P=0.26)and the difference was not statistically significant.In terms of safety,adverse events(AE)of grade 3 and above are higher in experimental group than that in control group(OR=2.09,95％CI=1.70-2.58,P＜0.00001),the experimental group had a higher rate of hypertension(OR=5.48,95％CI=2.78-1 0.8,P＜0.000 01),dermatitis acneiform and rash(OR=2.27,95％CI=1.33-3.89,P=0.003),diarrhea(OR=3.78,95％CI=2.13-6.69,P＜0.000 01),and proteinuria(OR=5.71,95％CI=1.73-18.82,P=0.004).There was no statistically significant difference in bleeding events(OR=1.37,95％CI=0.79-2.38,P=0.26)or hepatic injury(OR=1.08,95％CI=0.77-1.52,P=0.65)between the 2 groups. Conclusion:Compared with erlotinib alone,the combination of angiogenesis inhibitors could effectively improve the ORR and mPFS in patients with EGFR-mutated advanced non-small cell lung cancer.However,the combination of angiogenesis inhibitors with erlotinib increased the incidence of several grade 3 treatment-related AE,such as hypertension,dermatitis acneiform and rash,diarrhea,and proteinuria,compared to erlotinib treatment alone.

Objective:To evaluate the usability of gamification coronary heart disease health management platform based on WeChat, so as to provide support for self-management of coronary heart disease patients.Methods:From November to December 2022, 10 patients with coronary heart disease who were treated at Dongzhimen Hospital of Beijing University of Chinese Medicine were selected using convenience sampling. The research subjects registered for the health management platform by scanning the QR code and underwent a 2-month trial experience. Two months later, researchers collected data from the platform and used a combination of questionnaire surveys and qualitative interviews to investigate the user's experience and feedback of the research subjects, in order to evaluate the usability of the platform.Results:Within two months, the health management platform had 226 visits, an average visit time of 26 minutes, and an availability questionnaire score of (71.8±2.8). The research subjects had an acceptable attitude towards the usability of this platform, had a good overall user experience, and had also provided improvement suggestions for the platform while they gained beneficial experiences.Conclusions:The gamification coronary heart disease health management platform based on WeChat has good usability, providing a feasible means for the health management of heart disease patients, and also providing reference for other chronic disease health management projects involving lifestyle changes and incentives.

Objective:To develop and evaluate the Self-rating Identification Scale for Common Syndromic Elements of Coronary Heart Disease.Methods:The item pool of the Self-rating Identification Scale for Common Syndromic Elements of Coronary Heart Disease was formed through literature review and expert consultation. Items were screened by combining frequency, correlation coefficient, Cronbach's α coefficient and factor analysis. Subjective and objective weighting was used to determine the weight of items, and diagnostic threshold was determined by receiver operator characteristic curve. Cronbach's α coefficient and factor analysis were used to test the reliability and validity of the scale.Results:The Self-rating Identification Scale for Common Syndromic Elements of Coronary Heart Disease had a total of 6 syndrome elements and 36 items. It included 3 items of blood stasis, 9 items of phlegm, 7 items of Qi stagnation, 5 items of Qi deficiency, 6 items of Yin deficiency, and 6 items of Yang deficiency, and the diagnostic thresholds were 1.000, 45.300, 36.400, 66.600, 33.900, and 30.500 respectively. The test-retest reliability coefficients of each dimension of the scale were all greater than 0.7, and the internal consistency reliability coefficients of each dimension were 0.540 to 0.848. In the factor analysis, each variable with a common factor load coefficient greater than 0.4 was extracted, and the results were completely consistent with the scale entry settings. The cumulative variance contribution rate was 53.822%.Conclusions:The reliability and validity of the Self-rating Identification Scale for Common Syndromic Elements of Coronary Heart Disease are good, and it has scientific research and clinical application value.

Objective:To investigate the use intention of patients with coronary heart disease for mobile health and understand needs of patients for gamification design of mobile health platform, in order to improve the self-management level of patients with coronary heart disease by building a gamified mobile health platform.Methods:Using the convenient sampling method, a total of 181 hospitalized patients with coronary heart disease (CHD) in Department of Cardiology from July to September 2020 (3 hospitals in Beijing and 1 hospital in Heilongjiang Province) were selected as research objects. Questionnaire on the usage needs of mobile health platform for coronary heart disease was used to investigate them.Results:Only 8 of the 181 patients (4.42%) used cardiac mobile health, and 113 (62.43%) patients never used cardiac mobile health but would consider using it. But 60 (33.15%) patients never used cardiac mobile medical experience and said that they won' t use it in the future, and the reasons included operation, language, safety, need awareness and health concerns. Among 121 patients with coronary heart disease, the top three requirements for gamification design were human-computer interaction encouragement and company (32.23%) , completion of tasks to exchange for real prizes (30.58%) and health ranking (28.10%) .Conclusions:Based on needs of patients, an easy-to-use, scientific and readable gamified mobile health platform for coronary heart disease should be built, mobile health publicity should be increased, and the continuous use rate of the mobile health platform and the self-management of patients should be improved.

Objective:Through the analysis of the ancient books for pectoral stuffiness pain, to explore the relevant Chinese herbal medicine prescriptions, the main syndrome factors corresponding to the prescriptions and the content of medication nursing.Methods:We used the database of Chinese Medical Code (5th Edition) as the data source, and established a database, extracted relevant contents. In the end we carried out statistical analysis and discussion.Results:Four main syndrome factors were extracted from the 102 kinds of prescriptions, which were cold coagulation, qi stagnation, blood stasis and turbid phlegm. The corresponding medication nursing measures mainly contained five aspects, including the temperature, time, frequency, solution of taking medicine and medication taboo. Among them, the temperature of taking medicine was mainly warm and hot; the time of taking medicine was mainly before eating, after eating, empty stomach, before breakfast, at noon, Before sleep and regardless of the time; the frequency of taking medicine was mainly two times a day, three times a day, three times a day and once a night; the solution of taking medicine was mainly wine, porridge, ginger decoction, orange peel decoction, Chen-pi decoction, vinegar decoction and so on; the medication taboo was mainly onions, pork, cold, cabbage, mutton and so on.Conclusion:The study of medication nursing for pectoral stuffiness pain based on the theory of syndrome factors is beneficial to promote the theoretical and clinical research for the disease. It can promote the standardization of medication nursing, improve the nursing staff's ability of syndrome differentiation nursing, and provide a reference for clinical medication nursing of Traditional Chinese Medicine.