Objective To construct a postoperative lung infection preventive care program for lung cancer patients and carry out preliminary validation,so as to provide a reference basis that can be used in clinical practice.Methods Literature analysis was carried out to search domestic and international databases,guideline networks,and association websites,with a search timeframe of January 2011 to December 2021,to obtain relevant evidence,to construct a preliminary draft of a preventive care program for postoperative lung infections in patients with lung cancer,and to use the Delphi method of correspondence with experts from Guangdong Province,Henan Province,and Sichuan Province,September-December 2022,to determine the content of the program.Correspondence to determine the content of the program.In November-December 2023,15 thoracic surgery nurses and 15 lung cancer patients in a tertiary hospital in Shantou City were selected for the initial application of the program and evaluated the effectiveness of the program through the nurses'clinical significance,applicability,feasibility,and patient satisfaction.Results A total of 21 experts completed 2 rounds of correspondence.95.65％and 95.45％of questionnaires were retumed in the 2 rounds of correspondence;the authority coefficients of the experts were 0.941 and 0.948;the Kendall's harmony coefficients were 0.176 and 0.310;the coefficients of variation for each item in the 2nd round of correspondence were 0.04～0.25.The final draft of the program included 10 aspects and 37 measures,such as teamwork,health education,risk assessment,rehabilitation training,fluid management,oral manage-ment,airway management,nutritional management,pain management,line management,and other 10 areas with 37 measures.After the initial application of the program,100％of the nurses thought that the program was meaningful,87％of the nurses thought that the program was clinically applicable and feasible,and 100％of the patients indicated that they were satisfied with the program,of which 80％were very satisfied.Conclusion The constructed nursing program for preventing postoperative lung infection in lung cancer patients is scientific,relevant and feasible,and can provide references for clinical health care personnel to develop measures for preventing postoperative lung infection in lung cancer patients.

Rheumatic fever is an autoimmune disease characterized by recurring acute or chronic systemic connective tissue inflammation caused by group A streptococcal infection in the throat. Although rheumatic fever is common in China, there is a lack of standardized criteria for the diagnosis and treatment of this condition. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed standardized criteria for the diagnosis and treatment of this disease in China. The aim was to standardize rheumatic fever diagnosis methods, treatment opportunities, and strategies for both short-and long-term treatment, so as to reduce irreversible damage and improve prognosis.

Background::Pancreatic adenocarcinoma (PAAD) is an extremely lethal malignancy. Identification of the functional genes and genetic variants related to PAAD prognosis is important and challenging. Previously identified prognostic genes from several expression profile analyses were inconsistent. The regulatory genetic variants that affect PAAD prognosis were largely unknown.Methods::Firstly, a meta-analysis was performed with seven published datasets to systematically explore the candidate prognostic genes for PAAD. Next, to identify the regulatory variants for those candidate genes, expression quantitative trait loci analysis was implemented with PAAD data resources from The Cancer Genome Atlas. Then, a two-stage association study in a total of 893 PAAD patients was conducted to interrogate the regulatory variants and find the prognostic locus. Finally, a series of biochemical experiments and phenotype assays were carried out to demonstrate the biological function of variation and genes in PAAD progression process.Results::A total of 128 genes were identified associated with the PAAD prognosis in the meta-analysis. Fourteen regulatory loci in 12 of the 128 genes were discovered, among which, only rs4887783, the functional variant in the promoter of Ring Finger and WD Repeat Domain 3 ( RFWD3), presented significant association with PAAD prognosis in both stages of the population study. Dual-luciferase reporter and electrophoretic mobility shift assays demonstrated that rs4887783-G allele, which predicts the worse prognosis, enhanced the binding of transcript factor REST, thus elevating RFWD3 expression. Further phenotypic assays revealed that excess expression of RFWD3 promoted tumor cell migration without affecting their proliferation rate. RFWD3 was highly expressed in PAAD and might orchestrate the genes in the DNA repair process. Conclusions::RFWD3 and its regulatory variant are novel genetic factors for PAAD prognosis.

Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P＜0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P＜0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P＜0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P＜0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.

Tumor metastasis is one of the important biological characteristics of malignant tumor,which is closely related with the prognosis of the cancer patients.High expression of ADAM8 in varieties of tumors was revealed in many recent studies,and such aberrant expression played a crucial role in regulating of tumor metastasis.Studies showed that overexpression of ADAM8 attenuated the intercellular adhesion effect,promoted tumor angiogenesis,and enhanced the degradation of ECM as well as the releasing of cytokines.Therefore,suppression of ADAM8 may lead to inhibition of tumor metastasis,which makes ADAM8 a particular attractive target as it can be used as a prognostic indicator and a potential therapeutic target of malignant tumor.A review about the relations between ADAM8 protein′s abnormal expression and tumor occurrence was discussed in this paper,also include discussion about the mechanisms of ADAM8 protein′s disorder-induced tumor formation,as well as therapeutic strategies based on ADAM8-targeted,which may provide references for follow-up research and clinical treatment.

Objective To propose a new N staging system for nasopharyngeal carcinoma based on intensity-modulated radiotherapy (IMRT) and Radiation Therapy Oncology Group (RTOG) guidelines for cervical lymph node levels.Methods A retrospective analysis was performed in 324 patients with newly diagnosed nasopharyngeal carcinoma who had no distant metastasis confirmed by pathology and received IMRT in the Department of Radiation Oncology in The First Affiliated Hospital of Guangxi Medical University from January 2010 to December 2011.They were restaged according to the 7thedition of UICC/AJCC staging system for nasopharyngeal carcinoma.The survival rates were estimated using the Kaplan-Meier method and the log-rank test was used for univariate prognostic analysis.The Cox proportional hazards model was used for multivariate prognostic analysis.Results Of 324 patients,269(83.0%) had lymph node metastasis.The median follow-up was 58 months (6-77 months).The 5-year overall survival,disease-free survival,relapse-free survival,and distant metastasis-free survival rates were 84.8%,77.1%,92.7%,and 80.5%,respectively.Univariate and multivariate analyses of patients with positive cervical lymph nodes revealed that retropharyngeal lymph node status,cervical lymph node level,and laterality were evaluated as independent prognostic factors for nasopharyngeal carcinoma.According to the hazard ratio calculated,the N staging system was revised as follows:N0:no regional lymph node metastasis;N1:VⅡ a or/and unilateral levels (I,Ⅱ,Ⅲ,Va) involvement;N2:bilateral levels (I,Ⅱ,Ⅲ,Va) involvement;N3:levels IVa,Vb,and IVb+Vc involvement.Conclusions The proposed N staging system is based on IMRT and RTOG guidelines for lymph node levels and more practical,and can provide highly objective prediction of outcome and guide treatment in nasopharyngeal carcinoma.

Aim To discuss the impact of important ac-tive ingredient of garlic diallyl sulfide———DATS on platelet activating factor (PAF ) mediated melanoma metastasis and its mechanisms.Methods ①MTT was used to test the effect of different concentrations of DATS on B16F10 and A375 melanoma cell growth number;②Scratch test and transwell were employed to test the effect of different concentrations of DATS on B16F10 and A375 melanoma cell migration;③ West-ern blot was used to test the effect of DATS on expres-sion of MMP-2,ERK,p38 induced by PFA;④Intrave-nous injection of tumor metastasis model was used to check the inhibition of DATS in PAF-mediated melano-ma metastasis.Results B16F10 cells relative growth rate fell to 73.21% and 48.78%,respectively,when DATS concentration reached 50 and 100 μmol·L-1 . DATS inhibited the levels of PAF-induced migration of melanoma cells B16F10 and vertical migration signifi-cantly,and inhibited B16F10 cells migration induced by PAF through inhibiting the expression of MMP-2, paxillin protein,FAK and other proteins.Conclusion DATS can significantly inhibit PAF-induced tumor metastasis, which is related to the inactivation of MAPKs.

Objective To explore the application value of stepped screening on hypertension with self-report health measurement questionnaire by comparing the accuracy of the different levels of screening. Methods A total of 6 715 subjects with hypertension (average age of 53.47 ± 11.07 years) were selected from those who completed the physical examination in the department of health management in the Third Xiangya Hospital of Central South University for questionnaire survey, routine inspection and special inspection for hypertension. And the patients were divided into four groups based on their hypertension risk levels: the questionnaire survey group, routine inspection group, questionnaire + routine inspection group and questionnaire+routine inspection+special inspection group. The results were compared respectively to calculate the sensitivity, specificity, positive predictive value and coincidence rate of single inspection and joint inspection. Results Nearly 90.00%of the subjects had hypertension associated with the risk factors, while 20.83% of the subjects had hypertension associated with other clinical diseases (the highest percentage was seen in hypertension with diabetes as 14.88%). According to the guidelines of stratification, 3.41% of the patients were at low risk, 23.78% at moderate risk, 47.85% at high risk, and 24.96% at extremely high risk. Sensitivity and specificity of routine inspection were 95.56%and 45.51%in judgment of moderate risk, which became 100.00%and 45.51%after addition of questionnaire survey;as a result, thesensitivity increased. Sensitivity and specificity of routine inspection were 15.03%and 96.28%in judgment of high risk, which became 30.03% and 99.14% after addition of questionnaire survey; as a result, the sensitivity doubled. Sensitivity and specificity of routine inspection were 15.03%and 100.00%in judgment of extremely high risk, and the sensitivity increased to 94.45%after addition of questionnaire survey, while the specificity remained unchanged. Conclusion Addition of questionnaire on the basis of routine physical examination could greatly increase the detection rate of hypertension patients at different risk levels, and increase the sensitivity as well as specificity for detection of moderate risk, high risk and extremely high risk. Therefore, health information and data acquired from the questionnaire and data obtained from the medical inspection equipment are equally important and suggest health management (physical examination) institutions to take questionnaire as a necessary and primary screening in physical examination and chronic disease screening.

Objective To establish a new T staging system for nasopharyngeal carcinoma ( NPC) based on magnetic resonances imaging ( MRI) and intensity?modulated radiotherapy ( IMRT) . Methods A retrospective analysis was performed on the clinical data of 608 patients who were newly diagnosed with non?metastatic NPC by MRI and treated with IMRT in our hospital from 2008 to 2010. All patients were staged according to the 7th edition of the UICC/AJCC staging system for NPC. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The Cox regression model was used for multivariate analyses. To deal with the deficiency in the current UICC/AJCC staging system, a new T staging system for NPC was established and systematically evaluated. Results The 5?year follow?up rate was 94?5%. The 5?year overall survival (OS), disease?free survival, local relapse?free survival (LRFS), and distant metastasis?free survival rates were 81?5%, 80?1%, 86?0%, and 81?1%, respectively. The univariate and multivariate analyses showed that the anatomic structures of nasopharynx, parapharyngeal space, and skull base were influencing factors for the OS rate (P=0?000?0?045). New T staging criteria were proposed based on the risk differences and survival curves:stage T1:invasion of the nasopharynx, parapharyngeal space, oropharynx, nasal cavity, skull base, and internal pterygoid muscle;stage T2:invasion of the external pterygoid muscle, paranasal sinus, intracalvarium, infratemporal fossa, and cranial nerves. The proposed T staging system achieved a good separation in both OS and LRFS curves. Conclusions The proposed new T staging system gives an objective prognostic prediction in patients with NPC, which provides an exploratory attempt toward a new clinical staging system for NPC.

The study on tumor metabolism has been gradually be-come a hot spot in recent years .A lot of proteins involved in the regulation of tumor metabolism especially the glucose transporter protein 1(GLUT1).As a key regulatory factor mediating energy metabolism within tumor cells , GLUT1 can regulate the glucose intake and maintain the basic level of metabolism in tumor cells . More importantly, the abnormal expression of GLUT1 was asso-ciated with many kinds of tumors , of which GLUT1 was used to meet the energy requirement for the fast growth of tumor .Thus GLUT1 also played a crucial role in growth , differentiation and metastasis of tumor cells and prognosis of tumors .Meanwhile , as three-dimensional crystal structure of GLUT 1 was determined , it is possible to design the small molecular inhibitors of GLUT 1, which can realize “starve to death” tumor cells.GLUT1 can be a particularly attractive target for tumor treatment and interfer-ence.The relationship between abnormal expression of GLUT 1 protein and tumor metabolism was reviewed . Moreover , the mechanism of tumor metabolism regulated by GLUT 1 protein ex-pression and treatment of cancers were discussed , which may provide references for future research and clinical treatment .