In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

Objective To investigate the impact of influence of personality traits of nurses as second victim and negative experience of nurses in adverse event and explore the intermediary roles of stress perception in influencing mechanism of negative experience.Methods Between March and April 2023,a convenience sampling method was employed to select 560 nurses from 3 general hospitals in Taiyuan City to conduct the study.The selected nurse all had experienced adverse events within last 3 months.The survey employed a general information questionnaire,Chinese big five personality questionnaire,second victim experience and support scale and Chinese version of stress perception scale.Pearson's correlation analysis was conducted to explore the correlation between the personality traits of nurses as second victim(specifically neuroticism),negative experiences and stress perception.The mediating role of stress perception between the neuroticism of nurses as second victim and negative experiences of nurses was analysed using PROCESS plug-in with the Bootstrap method.Results All of 560 distributed questionnaires were recovered,with a 100.00%of response rate.Personality traits of nurses as second victim were ranked in descending order with rigor,agreeableness,openness,neuroticism and extroversion.Both negative experiences and stress perception had higher scores(40.25±10.64 and 30.25±5.98,respectively).Neurotic personality in nurses as second victim was positively correlated with negative experience(r=0.528,P＜0.01)and stress perception(r=0.594,P＜0.01).Negative experiences showed a positive correlation with stress perception(r=0.339,P＜0.01).Neurotic personality of nurses as second victim had a significant direct impact on negative experiences[β=0.519,95%CI:0.318-0.720].As one of the stress perception dimensions,tension played a partial mediating role between neurotic personality in nurses as second victim and negative experience[β=0.148,95%CI:0.006-0.300],and a mediating effect percentage of 22.70%.Conclusions The neurotic personality of nurses as second victim can directly affect the negative experiences,either independently or in conjunction with tension.Nursing managers and nurses as second victims can reduce the negative experiences in adverse events by addressing higher neurotic personality and alleviating tension.

In recent years, the application of minimal residual disease (MRD) in solid tumors has gained widespread attention. MRD typically refers to the presence of residual cancer cells that remain undetectable by imaging after curative treatments, such as surgical resection. The presence of MRD post-surgery is significantly associated with an increased risk of tumor recurrence. In colorectal cancer, circulating tumor DNA (ctDNA) serves as an effective marker for assessing MRD, particularly in non-metastatic (stages I-III) colorectal cancer. As a real-time, accurate, and convenient biomarker, ctDNA can effectively predict tumor recurrence, guide postoperative adjuvant chemotherapy decisions, and provide crucial information for recurrence monitoring. The application prospects of ctDNA detection technology are vast, promising more precise and individualized treatment plans for colorectal cancer patients. This article comprehensively analyzes the progress in the application of ctDNA for detecting MRD in non-metastatic colorectal cancer patients, elaborates on its guiding role in clinical treatment decisions, and envisions the future development directions in this field.

Purpose: Oligometastatic non–small cell lung cancer (NSCLC) patients have been increasingly regarded as a distinct group that could benefit from local treatment to achieve a better clinical outcome. However, current definitions of oligometastasis are solely numerical, which are imprecise because of ignoring the biological heterogeneity caused by genomic characteristics. Our study aimed to profile the molecular alterations of oligometastatic NSCLC and elucidate its potential difference from polymetastasis. Materials and Methods: We performed next-generation sequencing to analyze tumors and paired peripheral blood from 77 oligometastatic and 21 polymetastatic NSCLC patients to reveal their genomic characteristics and assess the genetic heterogeneity. Results: We found ERBB2, ALK, MLL4, PIK3CB, and TOP2A were mutated at a significantly lower frequency in oligometastasis compared with polymetastasis. EGFR and KEAP1 alterations were mutually exclusive in oligometastatic group. More importantly, oligometastasis has a unique significant enrichment of apoptosis signaling pathway. In contrast to polymetastasis, a highly enriched COSMIC signature 4 and a special mutational process, COSMIC signature 14, were observed in the oligometastatic cohort. According to OncoKB database, 74.03% of oligometastatic NSCLC patients harbored at least one actionable alteration. The median tumor mutation burden of oligometastasis was 5.00 mutations/Mb, which was significantly associated with smoking, DNA damage repair genes, TP53 mutation, SMARCA4 mutation, LRP1B mutation, ABL1 mutation. Conclusion Our results shall help redefine oligometastasis beyond simple lesion enumeration that will ultimately improve the selection of patients with real oligometastatic state and optimize personalized cancer therapy for oligometastatic NSCLC.

OBJECTIVES: The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups. METHODS: Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups. RESULTS: Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p<0.001) during follow-up and 1.40 (95% CI, 1.20 to 1.64; p<0.001) at the endpoint. The ORs in the high trajectory group were 1.94 (95% CI, 1.61 to 2.32; p<0.001) during follow-up and 2.04 (95% CI, 1.69 to 2.45; p<0.001) at the endpoint. CONCLUSIONS Cognitive function was better preserved in male participants and individuals with higher baseline cognitive function. A higher cognitive trajectory was associated with better physical performance over time.

ObjectiveTo investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) and related abnormal indicators among taxi drivers in Shenzhen, China, and to provide a basis for scientific prevention and treatment of fatty liver disease. MethodsA total of 1752 taxi drivers who underwent physical examination in Shenzhen Longhua District People’s Hospital from May 2018 to June 2019 were selected, and related indicators were measured, including body mass index (BMI), blood pressure, fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and uric acid (UA). Liver ultrasound examination was also performed. The association between the prevalence rate of NAFLD and various biochemical parameters was analyzed. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. ResultsThe prevalence rate of NAFLD among the taxi drivers was 51.66% (905/1752), and male drivers had a significantly higher prevalence rate than female drivers［57.94% (770/1329) vs 31.91% (135/423), χ2=9.209, P=0.027］. The taxi drivers with NAFLD had significantly higher abnormal rates of BMI, blood lipids, blood pressure, FPG, and UA than those without NAFLD (χ2=5.894, 7.126, 8.045, 8.909, and 10.373, P=0.047, 0.035, 0.030, 0.028, and 0.018). The taxi drivers with a BMI of ≥28 kg/m2 had a significantly higher prevalence rate of NAFLD than those with a BMI of 24.0-27.9 kg/m2 or a BMI of ＜24 kg/m2 (male: χ2=7.904 and 18.624, P=0.035 and 0.008; female: χ2=8.613 and 31.635, P=0.029 and 0.006). The taxi drivers with working years of ＞15 years had a significantly higher prevalence rate of NAFLD than those with working years of 11-15 years, 5-10 years, and ＜5 years (male: χ2=9.781, 13.546, and 18.052, P=0.024, 0.012, and 0.008; female: χ2=7.052, 9.847, and 12.157, P=0.036, 0.023, and 0.016). ConclusionThere is a high prevalence rate of NAFLD among taxi drivers in Shenzhen, and male drivers have a higher prevalence rate than female drivers. The prevalence rate of NAFLD is associated with the abnormal rates of hyperlipidemia, obesity, hyperglycemia, and hyperuricemia and the working years in driving.

Objective To evaluate the early stage effects of partial two?stage exchange (PTE) for infection after total hip arthroplasty (THA) in order to improve surgical treatment outcomes. Methods Twelve patients (7 males and 5 females) of infect?ed THA treated by PTE between September 2000 and February 2016 were included with an average of 59 years old (range, 40-74 years old). The femoral stem prosthesis was preserved when we ensured that it was not infected and with well fixation during opera?tion. The acetabular prosthesis was totally replaced. Furthermore, the secondary surgery was performed on patients who were free from infection for at least 3 months. At the follow?up duration, the pelvic X?ray was examined to access the presence of loosening of the prosthesis. The inflammatory index was recorded. Hip function was assessed by the Harris hip score, and the visual analogue score (VAS) and patient's subjective satisfaction were recorded by the questionnaire. Results All of the 12 patients were fol?lowed up for a mean of 33.3 months (range, 24-48 months). We achieved a 92% (11/12) success rate. One patient resuffered infec?tion, which was controlled after the second debridement. The preoperative Harris score of 12 patients was 23-57, with an average of 40.83±10.62. All patients had significant improvement in hip function after PTE. The Harris score reached 59.58±4.34 at one month after surgery, and reached 64.58±9.08 after three months and 86.75±4.58 at the last follow?up. There was significantly dif?ferent when compared with the preoperative Harris score. At the last follow?up, the length difference between the lower limbs was less than 1cm in all patients. Two patients did not complain of pain, while other 10 patients got a VAS score of less than 2 points. The patient's subjective satisfaction rating was 100%. Conclusion PTE could be a valuable alternative treatment for infection af?ter THA. The infection control rate and clinical outcomes are comparable to those of two?stage exchange.

Objective To investigate the diagnostic value of knee skin temperature and serum soluble intercellular adhesion molecule-1 (sICAM-1) level in peri-prosthetic infection after total knee arthroplasty (TKA).Methods Thirty patients (11 males and 19 females,aged 59.3±9.5 years old) underwent primary TKA during November 2012 and October 2015.Ten patients with peri-prosthetic infection (3 males and 7 females,aged 60.9±8.2 years old) underwent two-stage revision TKA from November 2012 to October 2015.The interleukin-6 (IL-6),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),sICAM-1 in serum and the skin temperature in knee joint were recorded preoperatively (revision patients on diagnosis),at days 1,7 and at 1,3,6,12 months post-operatively.Results All of the 40 patients were followed up for 12 months.The serum CRP,IL-6 and ESR levels in the primary TKA group were normal preoperatively and increased after operation,reaching their peaks at 1-7 days postoperatively.These indexes then returned slowly to the normal levels within 3 months.The serum sICAM-1 level in the primary TKA group did not change significantly during the follow up.The serum levels of CRP,IL-6,ESR,and sICAM-1 in the revision group were significantly higher than that in the primary TKA group preoperatively (P＜0.05),IL-6,CRP,ESR returned slowly to the normal levels within 3 months after the second-stage revision,while the level of sICAM-1 returned to normal within 3 months after the first-stage revision.During whole follow-up after the second-stage revision,the level of sICAM-1 didn't change significantly.The preoperative mean differential temperature (MDT) in the primary TKA group was 0.73±0.62 ℃ preoperatively and elevated to 4.37±1.06 ℃ at 7 days postoperatively,which returned to the baseline within 6 months after primary TKA.The preoperative MDT in the revision group was 5.03±0.81 ℃,which was significantly higher than that in the primary TKA group (P＜0.05).The MDT returned to the normal level within 6 months after the second-stage revision TKA.Conclusion The change of MDT is in accordance with serum CRP,IL-6,and ESR,which together may predict the occurrence of infection.Serum sICAM-1 level may also be valuable in the diagnosis of peri-prosthetic infection.

Objective To explore the effect and factors of patellofemoral arthroplasty (PFA) for isolated patellofemoral osteoarthritis.Methods Data of 18 patients (3 males,15 females) with isolated patellofemoral osteoarthritis underwent PFA from March 2006 to December 2014 were retrospectively analyzed.There were 3 males and 15 females with a mean age of 54 years (range,46-74 years).It was strict to grasp the surgical indications according to the clinical symptoms,signs and imaging data preoperatively.11 patients were operated with AVON patellofemoral prosthesis (Stryker Inc.) and the other 7 patients were operated with the Gender Solutions patellofemoral prosthesis (Zimmer Inc.).Active and passive functional rehabilitation exercise was encouraged at the early stage after operation.Visual analogue scale (VAS) was 5.33±0.99 (range,4-7) and hospital for special surgery knee score (HSS) was 53.28±5.71 (range,44-63) before operation.Results The mean duration of follow-up was 63.98 months (range,6-104 months).VAS after operation for 1 and 3 months were 1.17±0.79 (range,0-3) and 0.72±0.67 (range,0-2),and the pain was almost relieved after 9 months.HSS after operation for 1,3,9 months were 70.06±6.33 (range,61-80),86.06±5.12 (range,77-95) and 91.39±4.83 (range,82-97).HSS score of the latest follow-up was 92.06±4.05 (range,84-97),which was improved obviously from the preoperative ones.The excellent and good rate was 100％ (excellent 15 cases,good 3 cases).The satisfactory rate was 94.4％ (17/18).Only one case got slightly knee pain when walking up and down the stairs after 2 years,and the pain was relieved after being administered with NSAIDs and rest.No incision infection,rupture,prosthesis supported bone fracture,prosthesis loosening and other complication was occurred during the follow-up period in the other patients.Conclusion The clinical outcomes of PFA are strictly related to surgical indications,implant design and appropriate surgical technique.Therefore,based on the appropriate PFA implants,strict surgical indications,appropriate patients,excellent operation skills and actively functional rehabilitation exercise,PFA could treat the isolated patellofemoral osteoarthritis effectively.

BACKGROUNDThe initial osteoblastic adhesion to materials characterizes the first phase of cell-material interactions and influences all the events leading to the formation of new bone. In a previous work, we developed a novel amorphous calcium phosphate (ACP)/poly(L-lactic acid) (PLLA) material that demonstrated morphologic variations in its microstructure. The aim of this study was to investigate the initial interaction between this material and osteoblastic cells. Cellular attachment and the corresponding signal transduction pathways were investigated.

METHODSA porous ACP/PLLA composite and PLLA scaffold (as a control) were incubated in fetal bovine serum (FBS) containing phosphate-buffered saline (PBS), and the protein adsorption was determined. Osteoblastic MG63 cells were seeded on the materials and cultured for 1, 4, 8, or 24 hours. Cell attachment was evaluated using the MTS method. Cell morphology was examined using scanning electron microscopy (SEM). The expression levels of the genes encoding integrin subunits α1, α5, αv, β1, focal adhesion kinase (FAK), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were determined using real-time reverse transcription polymerase chain reaction (RT-PCR).

RESULTSThe ACP/PLLA material significantly increased the protein adsorption by 6.4-fold at 1 hour and 2.4-fold at 24 hours, compared with the pure PLLA scaffold. The attachment of osteoblastic cells to the ACP/PLLA was significantly higher than that on the PLLA scaffold. The SEM observation revealed a polygonal spread shape of cells on the ACP/ PLLA, with the filopodia adhered to the scaffold surface. In contrast, the cells on the PLLA scaffold exhibited a spherical or polygonal morphology. Additionally, real-time RT-PCR showed that the genes encoding the integrin subunits α1, αv, β1, and FAK were expressed at higher levels on the ACP/PLLA composite.

CONCLUSIONSThe ACP/PLLA composite promoted protein adsorption and osteoblastic adhesion. The enhanced cell adhesion may be mediated by the binding of integrin subunits α1, αv, and β1, and subsequently may be regulated through the FAK signal transduction pathways.

Biocompatible Materials ; chemistry ; Calcium Phosphates ; chemistry ; Cell Adhesion ; physiology ; Cells, Cultured ; Focal Adhesion Protein-Tyrosine Kinases ; metabolism ; Humans ; Integrin alpha1 ; metabolism ; Integrin alpha5 ; metabolism ; Integrin alphaV ; metabolism ; Integrin beta1 ; metabolism ; Integrins ; genetics ; metabolism ; Lactic Acid ; chemistry ; Osteoblasts ; cytology ; Porosity ; Tissue Engineering ; methods