Objective To systematically evaluate the risk factors for persistent cough after lung resection, providing a theoretical basis for preventing persistent postoperative cough. Methods The Cochrane Library, Web of Science, EMbase, PubMed, Chinese Biomedical Literature Database, Wanfang, CNKI, and VIP databases were searched for studies related to risk factors for persistent cough after lung resection. The search period was from database inception to March 30, 2023. Two researchers independently screened the literature, extracted data, and performed quality assessment. RevMan 5.3 software was used for meta-analysis. Results A total of 17 articles with 3 698 patients were included. Meta-analysis results showed that females [OR=3.10, 95%CI (1.99, 4.81), P<0.001], age [OR=1.72, 95%CI (1.33, 2.21), P<0.001], right-sided lung surgery [OR=2.36, 95%CI (1.80, 3.10), P<0.001], lobectomy [OR=3.40, 95%CI (2.47, 4.68), P<0.001], upper lobectomy [OR=8.19, 95%CI (3.87, 17.36), P<0.001], lymph node dissection [OR=3.59, 95%CI (2.72, 4.72), P<0.001], bronchial stump closure method [OR=5.19, 95%CI (1.79, 16.07), P=0.002], and postoperative gastric acid reflux [OR=6.24, 95%CI (3.27, 11.91), P<0.001] were risk factors for persistent cough after lung resection, while smoking history was a protective factor against postoperative cough [OR=0.59, 95%CI (0.45, 0.77), P<0.001]. In addition, the quality of life score of patients with postoperative cough decreased compared with that before surgery [MD=1.50, 95%CI (0.14, 2.86), P=0.03]. Conclusion Current evidence suggests that females, age, right-sided lung surgery, lobectomy, upper lobectomy, lymph node dissection, bronchial stump closure method (stapler closure), and postoperative gastric acid reflux are independent risk factors for persistent postoperative cough in lung resection patients, while smoking history may be a protective factor against postoperative cough. This provides evidence-based information for clinical medical staff on how to prevent and reduce persistent postoperative cough in patients and improve their quality of life in the future.

ObjectiveTo explore the possible mechanisms of Shoutai Wan （寿胎丸） in treating recurrent miscarriage （RSA） from the perspective of immune tolerance under the acidic microenvironment at the maternal-fetal interface. MethodsFemale CBA/J mice were randomly divided into normal group， model group， progesterone group， and Shoutai Wan group， with 15 mice in each group. The mice in the normal group and model group were given 0.2 ml distilled water by gavage each day， the Shoutai Wan group given Shoutai Wan decoction 0.15 g/（10 g·d） by gavage， the progesterone group given progesterone tablets 0.44 mg/（10 g·d） by gavage. After gavage for 14 days， the mice were cohabited. Female CBA/J mice in the normal group were mated with male BALB/c mice at a ratio of 2∶1， and female CBA/J mice in the other groups were mated with male DBA/2 mice at a ratio of 2∶1 to establish the RSA mouse model. Vaginal smears were taken from the female mice the next morning， and the appearance of a large number of spermatozoa and the presence of a vaginal plug were considered as the first day of pregnancy. After the appearance of the plug， the mice were continued to be administered according to the previous method until the 10th day of pregnancy. On the 10th day of pregnancy， maternal-fetal interface tissues were collected from each group of mice， and lactate dehydrogenase colorimetric method was used to detect lactate （LA） content； qPCR method and Western blot method were used to detect the expression of immune-related factors interleukin-4 （IL-4）， interferon-gamma （IFN-γ）， transforming growth factor beta 1 （TGF-β1）， and forkhead box protein 3 （Foxp3） mRNA and protein； flow cytometry was used to detect the numbers of helper T lymphocyte 1 （Th1）， helper T lymphocyte 2 （Th2）， regulatory T cell （Treg）， classical macrophage （M1）， and alternative macrophage （M2）. The bivariate Pearson test was used to analyze the correlation between LA content and the numbers of Th1， Th2， Treg， M1， and M2 cells， as well as the correlation between LA content and the expression of IL-4， IFN-γ， TGF-β1， Foxp3 protein， and mRNA. ResultsOn the 10th day of pregnancy， compared with the normal group， the LA content decreased in the model group， and the expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues decreased， while the expression of IFN-γ protein and mRNA increased. The numbers of Th1 and M1 cells increased， while the numbers of Th2， Treg， and M2 cells decreased （P＜0.05 or P＜0.01）. Compared with the model group， the LA content increased in the Shoutai Wan group and progesterone group. The expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues increased， while the expression of IFN-γ protein and mRNA decreased. The numbers of Th1 and M1 cells decreased， while the numbers of Th2， Treg， and M2 cells increased （P＜0.05 or P＜0.01）. The LA content was positively correlated with the numbers of Th2， Treg， and M2 cells， and the expression of IL-4， TGF-β1， Foxp3 protein， and mRNA （P＜0.05 or P＜0.01）； the LA content was negatively correlated with the numbers of Th1， M1 cells， and the expression of IFN-γ protein and mRNA （P＜0.05 or P＜0.01）. ConclusionShoutai Wan may improve immune tolerance by regulating the expression of immune-related factors in the acidic microenvironment at the maternal-fetal interface of RSA model mice， thereby exerting its role in preventing miscarriage.

Objective To analyze the relationships between pulmonary ground-glass nodules(GGN)and bronchi and blood vessels and their diagnostic values for infiltrative lesions based on high-resolution computed tomography(HRCT)target scanning technology.Methods Patients with GGN detected by HRCT target scanning and complete pathological results were retrospectively selected as the research subjects.The relationships between GGN and bronchi and blood vessels in patients with different pathological types were analyzed,and the relationships for detecting infiltrative lesions were further analyzed,using pathological results as the gold standard.Results Three hundred patients were divided into 237 cases of pre-invasive lesions and 63 cases of infiltrative lesions according to pathological results.There were statistically significant differences in lesion properties and lesion morphology in patients with different types of GGN(P＜0.05).There were statistically significant differences in the relationships between GGN and bronchi and blood vessels in the pre-invasive lesions and the infiltrative lesions(P＜0.05).Based on the pathological results as the gold standard,the sensitivity of HRCT bronchial classification,vascular classification,and their combined detection of infiltrative lesions were 84.13％(53/63),95.24％(60/63),and 95.24％(60/63);specificity were 83.12％(197/237),87.34％(207/237),and 87.34％(207/237);accuracy were 83.33％(250/300),89.00％(267/300),and 89.00％(267/300).Conclusion Evaluating the classification of pulmonary GGN and bronchi and blood vessels by HRCT target scanning technology has good value in identifying infiltrative lesions.The combined diagnosis of the two signs can further improve the accuracy of detection.

Objective:To evaluate the practical value of ultrasound, ultrasound new technologies (ultrasound elastography, contrast enhanced ultrasound) and computed tomography (CT) examination alone or the combination of both of the four in the clinical diagnosis of lymph node metastasis of thyroid cancer by meta-analysis system.Methods:This study screened relevant literature on ultrasound, new ultrasound technologies, and CT in the diagnosis of lymph node metastasis of thyroid cancer by searching Chinese and English databases from January 2006 to August 2023. Two scholars independently assessed the quality of the literatures and scored them using the QUADAS scale. Then, the diagnostic ratio of single and combined examinations was analyzed by Meta-Disc software, and the heterogeneity test and meta-analysis were performed to calculate the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic ratio, accuracy, and area under curve (AUC). Finally, the diagnostic efficacies of different diagnostic techniques and their combination in identifying lymph node metastasis of thyroid cancer were assessed by calculating OR and P values by two-by-two comparisons. Results:Sixty-nine diagnostic studies totaling 30, 666 lesions were finally included. The meta-analysis study showed that contrast enhanced ultrasound had the highest sensitivity[0.83(0.77-0.87)], ultrasound specificity was the highest [0.84(0.79-0.88)], the highest AUC was for contrast enhanced ultrasound (0.90), and contrast enhanced ultrasound and ultrasound elastography had high accuracies (0.81, 0.80, respectively) both of them were higher than those of ultrasound (0.77) and CT (0.69). Contrast enhanced ultrasound and ultrasound elastography were both more sensitive than CT, with statistically significant differences between them ( P<0.01); contrast enhanced ultrasound + ultrasound elastography had the highest accuracy, while ultrasound + contrast enhanced ultrasound and contrast enhanced ultrasound + ultrasound elastography were both more sensitive, with no statistically significant differences between them ( P>0.05), but the latter had the highest specificity [0.90(0.88-0.92)], which were statistically significantly different from each other ( P<0.05), ultrasound+ contrast enhanced ultrasound and contrast enhanced ultrasound+ ultrasound elastography had higher sensitivities than ultrasound+ CT, which were statistically different from each other ( P<0.05), and ultrasound+ CT had the lowest specificity [0.76(0.70-0.81)]. Conclusions:The diagnostic efficacy of thyroid cancer lymph node metastasis is highest with contrast enhanced ultrasound. The new ultrasound technique for diagnosing thyroid cancer lymph node metastasis has a higher diagnostic value than CT, and it can be used as a complementary examination to conventional ultrasound.When the two techniques are used in combination, contrast enhanced ultrasound + ultrasound elastography has the highest accuracy, contrast enhanced ultrasound + ultrasound elastography and ultrasound + contrast enhanced ultrasound both have high sensitivity and specificity, and the diagnostic performance of both is higher than that of ultrasound + ultrasound elastography and ultrasound + CT, and in actual clinical practice when ultrasound elastography combined with contrast enhanced ultrasound is limited in the examination, ultrasound combined with contrast enhanced ultrasound can effectively serve as an alternative means to provide a good diagnostic support.

Objective:To investigate the application of the decision-oriented context-input-process-product (CIPP) model combined with integrated teaching in standardized training of medical oncology.Methods:A total of 98 standardized training residents who participated in standardized training in Department of Oncology, Jiangsu Cancer Hospital, were enrolled as subjects, and they were divided into control group and observation group using a simple random number table, with 49 residents in each group. The residents in the control group received routine teaching, and those in the observation group received CIPP model combined with integrated teaching. The two groups were compared in terms of department examination score and assessment of subjective learning effect, and the observation group was assessed in terms of critical thinking ability before and after training. SPSS 22.0 was used for the t-test. Results:Compared with the control group, the observation group had significant increases in theoretical examination score ( t=2.95, P=0.004), practical operation score ( t=17.04, P<0.001), and total score ( t=3.55, P=0.001). After training, the observation group had significant increases in the scores of each dimension of critical thinking ability and the total score of critical thinking ability ( t=2.89, 3.55, 3.37, 3.20, 3.13, 2.67, 3.06, 3.13; P=0.005, 0.001, 0.001, 0.002, 0.002, 0.009, 0.003, 0.002). The observation group had significantly higher assessment scores of subjective learning effect than the control group ( t=3.46, 3.56, 2.83, 2.85, 2.57, 3.07; P=0.001, 0.001, 0.006, 0.005, 0.012, 0.003). Conclusion:The CIPP model combined with integrated teaching can improve the department examination score and critical thinking ability of standardized training residents in medical oncology, with good assessment results of subjective learning effect.

Objective:To explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC). Methods:From April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups. Results:Of 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm 3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm 3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences. Conclusions:Hypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective:To explore the clinical application value of general coagulation indices and neutrophil-to-lymphocyte ratio (NLR) for assessing coagulation status of patients with ovarian cancer.Methods:The data of 190 patients with ovarian cancer who were admitted to the Second Hospital of Shanxi Medical University from October 2019 to September 2022 were retrospectively analyzed. According to the International Federation of Gynecology and Obstetrics (FIGO) staging, the patients were divided into early (stage Ⅰ-Ⅱ) ovarian cancer group (70 cases) and advanced (stage Ⅲ-Ⅳ) ovarian cancer group (120 cases). Forty-four patients with benign ovarian tumors who were treated in the Second Hospital of Shanxi Medical University during the same period were selected. Plasma D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB) and thrombin time (TT) were tested. Platelet count (Plt), neutrophil count and lymphocyte count were measured by blood cell analyzer, and NLR was calculated. The receiver operating characteristic (ROC) curve was used to analyze the value of coagulation indices and NLR in the assessment of venous thromboembolism (VTE) in patients with ovarian cancer.Results:Compared with the benign ovarian tumor group, PT of patients in the early and advanced ovarian cancer groups was shorter (both P < 0.05), and D-D and Plt increased (both P < 0.05). Compared with the benign ovarian tumors group, TT of patients in the advanced ovarian cancer group decreased ( P < 0.05), and FIB and NLR increased (both P < 0.05). Compared with the early ovarian cancer group, PT and TT in the advanced ovarian cancer group were shorter (both P < 0.05), and FIB, D-D, NLR and Plt increased (all P < 0.05). The optimal cut-off values of FIB, D-D and NLR in stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ patients with VTE in ovarian cancer group were 3.165, 333.500 and 2.455, and the area under the curve (AUC) was 0.731, 0.837 and 0.759. Conclusions:The coagulation indices of patients with ovarian cancer are abnormal during treatment, suggesting that patients may produce active thrombosis, and the symptoms of patients in advanced stage are more serious.

Objective To investigate the current status of cytotoxicity and mechanical properties of the prosthetic liner on the market in China.Methods Six kinds of liner were collected, namely domestic 6 mm thick foam liner (A), domestic 5 mm thick EVA foam liner (B), German 5 mm thick EVA foam liner (C), Germany 12 mm thick PE foam liner (D), Iceland 3 mm thick silicone liner (E) and Germany 4 mm thick gel liner (F). Microscopic observation and thiazole blue colorimetry were used to detect the cytotoxicity. The content of small organic molecules was determined by the consumption of potassium permanganate. The tensile strength, elongation at break (%), and 100% tensile strength of the prosthetic liner were tested by material mechanics testing machine. The hardness was tested using the Shore hardness tester oo type.Results The cytotoxicity was grade 2 for prosthetic liners A, B, C and D, and was grade 0 for E and F. The redox substance content of prosthetic liners A、B、C exceeded 150 mg/kg. Except the prosthetic liner C, the hardness of the other products were all ≤ 70 HA. Except prosthetic liner D, the tensile strengths were > 1 MPa, breaking elongations were > 120.0%, 100% tensile strengths were > 0.9 MPa for other products.Conclusion Due to materials and production processes, the cytotoxicity and mechanical properties of the six samples are quite different.

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.