Objective To develop an Exercise Behavior Perception Scale for Lung Cancer Patients in China,and to test its reliability and validity.Methods According to the health belief model,the first draft of the scale was formed through literature review,semi-structured interview,research group discussion,2 rounds of expert correspondence and pre-survey.A total of 842 patients with lung cancer who received treatment in a tertiary A hospital in Zhengzhou City from October 2022 to April 2023 were selected for investigation,and item analysis,validity analysis,and reliability analysis were applied to adjust the items to form a formal scale.Results The Exercise Behavior Perception Scale for Lung Cancer Patients contained 24 items,and exploratory factor analysis generated 6 common factors,including physical rehabilitation benefits,emotional and mental benefits,information disorders,disease symptom disorders,condition disorders,and psychological disorders.The cumulative variance contribution rate reached 73.916％,and the results of confirmatory factor analysis showed that the model fit was good,the x2/df was 2.371,the root mean square error of approximation was 0.057,the normed fit index was 0.924,and the comparative fit index was 0.954,the scale score was moderately positively correlated with the total score of the Frenchay activities index(r=0.529,P＜0.001).The Cronbach's α,coefficient,half reliability,and retest reliability of the scale were 0.884,0.741,and 0.889,respectively.Conclusion The Exercise Behavior Perception Scale for Lung Cancer Patients had good reliability and validity,and it can be used to effectively evaluate the exercise behavior perception status of lung cancer patients.

Objective:To study the role of ML-SA5, an agonist of the lysosomal Ca 2+ channel transient receptor potential mucolipin 1 (TRPML1), in promoting lysosomal exocytosis to facilitate intracellular uranium removal and alleviate uranium-induced cellular damage for human renal proximal tubule epithelial cells (HK-2) exposed to uranyl acetate. Methods:HK-2 cells were divided into the following groups to be exposed to uranyl acetate at either 0 or 300 μmol/L for 24 h, followed by treatment with ML-SA5 and/or the lysosomal exocytosis inhibitor vacuolin-1 for 0.5 h: control group (Ctrl group), ML-SA5 group (M group), vacuolin-1 group (V group), ML-SA5 plus vacuolin-1 group (M+ V group), uranium exposure group (U group), uranium exposure plus ML-SA5 group (U+ M group), uranium exposure plus vacuolin-1 group (U+ V group), and uranium exposure plus ML-SA5 plus vacuolin-1 group (U+ M+ V group). We localized lysosome-associated membrane protein-1 (LAMP-1) on the plasma membrane (surface LAMP-1) by immunofluorescence assay; measured intracellular uranium content by inductively coupled plasma mass spectrometry; measured the level of kidney injury molecule-1 (KIM-1) by immunofluorescence assay; measured the rate of cell death with Calcein-AM/PI double staining; determined the subcellular localization of transcription factor EB (TFEB) and the levels of LAMP-1 and TRPML1 proteins by immunofluorescence assay; and measured the number of lysosomes using LysoTracker probes.Results:Compared with the Ctrl group, the U group showed significant increases in the surface LAMP-1 protein level ( t = 12.86, P < 0.05), KIM-1 protein level ( t = 18.86, P < 0.05), cell death rate ( t = 38.53, P < 0.05), TFEB nuclear translocation ( t = 9.12, P < 0.05), the protein expression levels of TFEB’s downstream target genes LAMP-1 ( t = 16.47, P < 0.05) and TRPML1 ( t = 32.33, P < 0.05), and the number of lysosomes labeled with LysoTracker probes ( t = 7.75, P < 0.05). Compared with the U group, the U+ M group showed a significantly increased surface LAMP-1 level ( t = 3.33, P < 0.05) and significant decreases in the intracellular uranium level ( t = 5.01, P < 0.05), KIM-1 protein expression level ( t = 3.81, P < 0.05), and cell death rate ( t = 3.24, P < 0.05); all these effects in the U+ M group could be neutralized by the lysosomal exocytosis inhibitor vacuolin-1; and in addition, ML-SA5 significantly increased TFEB nuclear translocation ( t = 9.20, P < 0.05), the protein expression levels of LAMP-1 ( t = 3.05, P < 0.05) and TRPML1 ( t = 3.17, P < 0.05), and the number of lysosomes labeled with LysoTracker probes ( t = 3.13, P < 0.05). Conclusions:The TRPML1 agonist ML-SA5 can promote lysosomal exocytosis to enhance intracellular uranium clearance and reduce uranium-induced cellular damage/death in uranium-loaded HK-2 cells, through activating TFEB to up-regulate lysosome biogenesis and TRPML1 protein expression.

【Objective】 To investigate the clinical characteristics and prognostic factors of small cell carcinoma of bladder (SCCB), and to explore the efficacy of neoadjuvant therapy. 【Methods】 Clinical information of 47 SCCB patients were retrospectively collected, and the clinical and pathological features were compared with those of urothelial carcinoma (UBC). The prognostic factors and efficacy of neoadjuvant therapy were also investigated. 【Results】 SCCB had higher baseline tumor staging, and was more likely to invade the muscle (100%) and metastasize distantly (21.3%). The overall survival was poor (median: 13.1 months, 1-year survival rate: 53.7%, 5-year overall survival rate: 15.4%). Tumor T staging was a risk factor for SCCB, while neoadjuvant therapy was an independent protective factor that significantly reduced the risk of recurrence and metastasis (HR: 0.189, 95%CI: 0.051-0.697, P=0.012) and death (HR: 0.177, 95%CI: 0.045-0.698, P=0.013), and significantly improved disease-free survival and overall survival. In addition, compared with neoadjuvant chemotherapy alone, neoadjuvant chemotherapy combined with immunotherapy could improve the pathological complete response rate. 【Conclusion】 SCCB is highly malignant and prone to metastasis, and has a poor prognosis. Neoadjuvant therapy combined with radical cystectomy is recommended as the first-line treatment.

Objective:To understand the identification value of pointing gestures in children with autism spectrum disorder(ASD) and its relationship with functional development.Methods:From December 2020 to November 2021, 1 099 children from Children’s Health Care Center of Beijing Children’s Hospital were tested by pointing gestures test, including 942 ASD children and 157 typical developed children.And the data of children's neuropsychological development scale from 800 children aged 1.0-5.9 were collected.SPSS 20.0 was used for statistical analysis. Trend test was used to analyze the distribution of pointing gestures test sensitivity in autistic children, and ANOVA was used to analyze the relationship between pointing gestures test scores and functional development fields.Results:The sensitivity of pointing gestures was 83.5% in children aged 1.0-10.0 years, 76.3%-93.1% in children aged 1.0-4.9 years, and 93.1%-95.1% in children aged 1.0-2.9.With the increase of age, the sensitivity of pointing gestures in autistic children (linear-by-linear association =164.889, P<0.001) and the Yoden index had a decreasing trend. The positive predictive value (91.53%-100.00%) and negative predictive value (75.36%-91.84%) were found in the children aged 1.0-10.0 years.The sensitivity of pointing gestures test was 44.9% in children with mild autism aged 1.0-10.0 years and 46.5%-65.9% in children with mild autism aged from 1.0-3.9 years. The sensitivity of pointing gestures test was 81.5% in children with moderate autism aged from 1.0-10.0 years and 87.3%-97.8% in children with moderate autism aged 1.0-3.9 years. The sensitivity of the pointing gestures test was 97.2% in children with severe autism aged 1.0-10.0 years, and 100.0% in children with severe autism aged 1.0-3.9 years. The sensitivity of the pointing gestures in mild, moderate and severe autism children decreased with age (linear-by-linear association values were 16.725, 64.232, 66.732 respectively, all P<0.001). The children with severe autism mainly scored 2 points (80.3%, 419/522) on the pointing gestures test , and children with moderate autism mainly scored 1 point(64.2%, 170/265) on the pointing gestures test. There were significant differences in functional development among different pointing gestures test groups.Functional development score in the autism children with 0 score of pointing gestures test was significantly higher than those with 1 score and 2 scores of pointing gestures test (all P<0.05). Conclusion:Pointing gestures has good sensitivity in children with autism (especially 1.0-4.9 years of age), and may serve as an objectively observable screening method. The better children with autism score on the pointing gestures, the better their functional development.

Objective:To investigate the current status of knowledge, attitude and practice regarding perioperative lung rehabilitation for lung cancer among nurses of Thoracic Surgery Department, and explore its influencing factors, so as to provide a basis for promoting clinical lung rehabilitation training.Methods:This study was a cross-sectional survey. From May to August 2022, 513 nurses of Thoracic Surgery Department from 10 ClassⅢ hospitals in Henan Province were selected as survey subjects using convenience sampling. Nurses were surveyed using a self-designed Thoracic Surgery Nurses' Perioperative Lung Rehabilitation Knowledge, Attitude, and Practice Questionnaire for Lung Cancer. Multiple linear regression was used to analyze the influencing factors of nurses' knowledge, attitude, and practice. A total of 485 valid questionnaires were collected, with an effective response rate of 94.54% (485/513) .Results:The total score, knowledge dimension score, attitude dimension score, and practice dimension score of knowledge, attitude, and practice of perioperative lung rehabilitation for lung cancer among 485 nurses of Thoracic Surgery Department was (186.25±33.55), (76.36±16.44), (43.27±6.39), and (66.62±15.71), respectively. The results of multiple linear regression analysis showed that the influencing factors of the total score of knowledge, attitude, and practice of perioperative lung rehabilitation for lung cancer among nurses of Thoracic Surgery Department were their post, whether they understood the content of lung rehabilitation, the times they participated in lung rehabilitation training, and whether they implemented lung rehabilitation for patients ( P<0.05) . Conclusions:Thoracic Surgery Department nurses have a positive attitude in perioperative lung rehabilitation for lung cancer, but their knowledge and behavior urgently need to be improved. Nursing managers should actively carry out perioperative lung rehabilitation training, encourage Thoracic Surgery Department nurses to update their self-knowledge system, strengthen their lung rehabilitation execution ability, and further promote the development of lung rehabilitation related work.

Objective:To explore the mechanism of lysosomal membrane permeabilization(LMP)inuranyl acetate-induced death of human kidney proximal tubular epithelial HK-2 cells.Methods:HK-2 cells were exposed to uranyl acetate at concentrations of 100, 300 and 600 μmol/L for 24 h, then in tracellular reactive oxygen species (ROS)and mitochondrial superoxide were measured by DCFH-DA and MitoSOX probe, respectively. HK-2 cells were divided into four groups: blank control group, NAC or CA-074 Me group, uranyl acetate exposure group and uranyl acetate exposure plus NAC or CA-074 Me group. Two-color immune of luorescence staining was used to detect the co-localization of galectin-1 and lysosomal associated membrane protein-1 (LAMP-1) to measure the extent of LMP, and to detect the non- co-localization of cathepsin B and LAMP-1 to reflect the release of cathepsin B in lysosomes. Calcein-AM/PI double staining method was used to detect cell death. One-color immune of luorescence staining of cleaved-caspase-3 expression was used to detect apoptosis. Results:Intracellular ROS and mitochondrial superoxide levels were significantly increased in HK-2 cells after exposure with 100, 300 and 600 μmol/L uranyl acetate for 24 h, about 1.1-2.5 times or 4.0-28 times, respectively( tROS=17.98, 11.84, 11.75, P< 0.05; tmitochondrial superoxide=6.14, 16.02, 13.06, P< 0.05), and they also increased with uranyl acetate concentrations ( tROS=10.10, 10.37, 5.59, P< 0.05; tmitochondrial superoxide=21.50, 15.16, 5.93, P< 0.05). The percentage of co-localization of galectin-1 and LAMP-1 and the percentage of non- co-localization of cathepsin B and LAMP-1 were markedly increased in HK-2 cells after exposure with 600 μmol/L uranyl acetate for 24 h, 5.4-6.7 times or 1.5-2.1 times, respectively ( tGalectin-1=15.85, 12.70, P< 0.05; tCathepsin B=5.95, 6.69, P< 0.05), but these increases were inhibited by NAC ( tGalectin-1=4.74, P<0.05; tCathepsin B=4.51, P< 0.05). Moreover, the cell death rate and the cleaved-caspase-3 expression level were also significantly increased in HK-2 cells after exposure with 600 μmol/L uranyl acetate for 24 h, about 28-47 times or 2.4-6.0 times, respectively( tPI=30.40, 10.34, P<0.05; tCleaved-caspase-3=18.49, 9.52, P<0.05), and these increases were obviously diminished by CA-074 Me ( tPI= 6.76, P<0.05; tCleaved-caspase-3=13.47, P<0.05). Conclusions:Exposure to uranyl acetate induces a burst of intracellular ROSthat leads to LMP and consequently causes leakage of cathepsin B from lysosomes to cytoplasm, in turn triggering the lysosomal-dependent cell death and mitochondrial-regulated apoptosis of HK-2 cells.

Objective:To explore the current status and influencing factors of knowledge, attitude and practice of nurses in Thoracic Surgery Department on thoracic drainage tube nursing after pneumonectomy, aiming to provide a basis for the training of clinical thoracic surgery specialist nursing personnel.Methods:Using the convenient sampling method, a total of 319 nurses in Henan Province were selected as research objects from August 13 to November 13, 2020, and self-designed questionnaire on knowledge, attitude and practice of thoracic drainage tube nursing after pneumonectomy was used to investigate. A total of 319 questionnaires were issued and 300 valid questionnaires were returned, with an effective recovery rate of 94.04%.Results:The total score of knowledge, attitude and practice of 300 Thoracic Surgery Department nurses on thoracic drainage tube nursing after pneumonectomy and scores of knowledge, attitude and behavior dimensions were respectively (72.09±6.65) , (7.96±2.51) , (26.04±2.24) and (38.09±4.78) . The results of multiple linear regression analysis showed that main influencing factors of nursing knowledge of Thoracic Surgery Department nurses on thoracic drainage tube after pneumonectomy were education level, professional title and position ( P<0.05) . The influential factor of attitude was working years ( P<0.05) . The influencing factors of behavior were knowledge, attitude, position and whether participated a thoracic drainage training or not ( P<0.05) . The influencing factor of total score of knowledge, attitude and practice was professional title ( P<0.05) . Conclusions:Thoracic Surgery Department nurses have a positive attitude towards thoracic drainage tube nursing after pneumonectomy, but their knowledge and behavior level need to be improved. Nursing leaders should carry out thoracic drainage tube nursing training according to the different characteristics of nurses. At the same time, they need to encourage nurses to actively learn new knowledge and constantly update their own knowledge system, so as to change nursing behavior and improve the quality of thoracic surgery.

Low targeting efficiency limits the applications of nanoparticles in cancer therapy. The fact that mesenchymal stem cells (MSC) trapped in the lung after systemic infusion is a disadvantage for cell therapy purposes. Here, we utilized MSC as lung cancer-targeted drug delivery vehicles by loading nanoparticles (NP) with anti-cancer drug. MSC showed a higher drug intake capacity than fibroblasts. In addition, MSC showed predominant lung trapping in both rabbit and monkey. IR-780 dye, a fluorescent probe used to represent docetaxel (DTX) in NP, delivered MSC accumulated in the lung. Both MSC/A549 cell experiments and MSC/lung cancer experiments validated the intercellular transportation of NP between MSC and cancer cells. assays showed that the MSC/NP/DTX drug delivery system exerted primary tumor inhibition efficiency similar to that of a NP/DTX drug system. Collectively, the MSC/NP drug delivery system is promising for lung-targeted drug delivery for the treatment of lung cancer and other lung-related diseases.

Objective To discuss the necessity of closing the peritoneum during the operation of ileal conduit after the radical cystectomy.Methods We retrospectively analyzed the clinical data of 395 patients with bladder cancer who received radical cystectomy from Jan.2014 to Sep.2016.The amount of male was 327,female was 68.The mean age was (65.8 ± 9.7) years old.Patients were divided into four groups according to the surgical method of cystectomy and urinary diversion.In group A,patients,including 78 males and 9 females,were received open radical cysectomy (ORC) with extraperitoneal ileal conduit.The mean age was (67.8 ± 9.2) years old.In the preoperative clinical staging,66 cases were less than T2 and 21 cases were more than T2.Preoperative pathological grade in 83 cases and low grade in 4 cases.In group B,patients,including 31 males and 2 females,were accepted ORC with ileal conduit without peritoneum closure.The mean age was (67.3 ± 8.7) years old.Preoperative clinical staging showed less than T2 in 25 cases,more than T2 in 8 cases,The preoperative pathological grade showed high grade in 33 cases.In group C,patients,including 112 males and 27 females,were accpeted LRC with ileal conduit without peritoneum closure.The mean age was (64.3 ± 10.5)years old.The preoperative clinical staging showed less than T2 in 107 cases and more than T2 in 32 cases.The preoperative pathological grade showed high grade in 135 cases and low grade in 4 cases.In group D,patients,including 106 males and 30 females,were accepted RARC with ileal conduit without peritoneum closure.The mean age was (65.9 ±10.0)years old.Preoperative clinical staging showed less than T2 in 103 cases and more than T2 in 33 cases.The preoperative pathological grade showed high grade in 132 cases and low grade in 4 cases.Ileal conduit without peritoneum closure means completely open the peritoneum after anastomosis of the ureter and intestine in the urinary diversion surgery without shutting down the peritoneum,which is different from the extraperitoneal ileal conduit.The operating time,blood loss,blood transfusion rate,recovery time of intestinal function and perioperative complications and rate of hydronephrosis were analyzed.Results The 395 cases completed operation successfully,no LRC or RARC had been converted to ORC.The operative time was (280.1 ± 92.3) min,(233.6 ± 99.4) min,(304.8 ± 108.9) min,(364.6 ± 86.4) min in four groups,respectively (P ＜ 0.05).The blood loss in four groups were (489.1 ± 285.6) ml,(431.8 ± 233.1) ml,(373.0 ±213.7) ml,(205.6 ± 137.8) ml,respectively (P ＜0.05).The transfusion rate in four groups were 18 (20.7％),16 (48.0％),15 (10.8％),14 (10.3％),respectively (P ＜ 0.05).The mean time to flatus in four groups were (3.7 ±1.8)d,(3.6±1.0)d,(3.5±1.2)d,(2.2±1.7)d,respectively (P ＜ 0.05).While ileal obstruction rate had no statistical difference in four groups [group A 17 cases(19.5％),group B 6 cases(18.2％),group C 27 cases(19.4％),group D 19 cases(14.0％),P =0.678].Urine leakage,intestinal leakage,lymphocyst were only occurred in group A [7 cases (8.0％),2 cases (2.3％),2 cases (2.3％)].Pyelonephritis was noticed in each group,including 14 cases(16.1％)in group A,2 cases(6.1％)in group B,9 cases (6.5％)in group C,6 cases(4.4％)in group D (P ＜ 0.05).Hydronephrosis 6 months after surgery was observed in four groups,including 15 cases(17.2％)in group A,3 cases(9.1％)in group B,7 cases(5.0％)in group C,5 cases(3.7％)in group D (P ＜ 0.05).Conclusions Ileal conduit without peritoneum closure would not increase the incidence of complications,on the contrary,it would relieve the tension of anastomosis,and reduce the occurrence of complications such as urine leakage.

Objective To investigate the expression of c-Myc in gastric mucosa associated lymphoid tissue (MALT) lymphoma and its implications on prognosis.Methods The clinical data of 79 patients hospitalized in our hospital from 2009 to 2015 were retrospectively analyzed.In these patients,38 patients were low-grade MALT lymphoma,20 patients were high-grade MALT lymphoma,21 patients were diffused large B cell lymphoma (DLBCL).Real-time PCR was used to detect the levels of c-Myc expression in gastric MALT tissues and pair-matched adjacent normal tissues.The relationship between the expression of c-Myc and prognosis of patients was evaluated combing with the clinical data.Results Compared with the normal tissues,the expression levels of c-Myc protein were 15.7％ (6/38),25％ (5/20) and 28.5％ (6/21)in patients with low-grade MALT lymphoma,high-grade MALT lymphoma,and DLBCL.The relative expression levels of cMyc mRNA were gradually elevated in low-grade MALT lymphoma,high-grade MALT lymphoma and DLBCL.The tumor size and depth of invasion can influence the expression level of c-Myc.Survival analysis found that the overall survival rates and relapse-free survival rates were lower in patients with c-Myc positive expression than those of patients with negative expression (P ＜ 0.05).Conclusion C-Myc plays a key role in the malignant transformation of gastric MALT lymphoma.