Objective:To explore the latent profiles of intellectual humility in primary colorectal cancer (CRC) postoperative patients and analyze the correlation between their intellectual humility and self-management.Methods:A total of 250 patients with primary CRC who underwent radical tumor surgery in anorectal department of Qinghai Provincial Hospital of Traditional Chinese Medicine from October 2021 to June 2023 were selected to accept a cross-sectional survey through convenient sampling method. They were surveyed by basic information questionnaire, comprehensive intellectual humility scale and cancer patient self-management assessment scale.Results:Finally, 243 valid questionnaires were obtained, it contained 125 males and 118 females with age 32- 68 (52.45 ± 10.24) years old. The score of primary CRC postoperative patients′intellectual humility was (67.59 ± 13.26) points, it could be divided into low-level intellectual humility type with 30 cases(12.34%), confident intellectual humility type with 36 cases (14.82%), mid-level intellectual humility type with 93 cases (38.27%), and high-level intellectual humility type with 84 cases (34.57%). Disordered multi-classes Logistic regression analysis showed that gender(female, OR=2.465), education level (high school or vocational school, OR=0.012) and diagnosis time(1-3 months, OR=15.289) were significant influencing factors to primary CRC postoperative patients from confident intellectual humility type (all P<0.05), gender (female, OR=5.354) and education level (high school or vocational school education, OR=0.012) were significant influencing factors to primary CRC postoperativepatients from mid-level intellectual humility type (both P<0.05), gender (female, OR=11.253), age (<45 years old, OR=7.532), education level (high school or vocational school, OR=0.017) and diagnosis time (<1 month, OR=0.054) were significant influencing factors to primary CRC postoperative patients from high-level intellectual humility type (all P<0.05). The score of primary CRC postoperative patients′self-management was (142.03 ± 19.83) points. There were statistically significant differences among scores of self-management, daily life management, symptom management and other six dimensions in patients from different categories of intellectual humility ( F values were 25.42-490.55, all P<0.05). There were positive correlation between the CRC patients′inteilectual humility and postoperatice self-managemeat ( r values were 0.373 - 0.749, all P<0.05). Conclusions:Primary CRC patients have a moderate level of knowledge humility and postoperative self-management. Their knowledge humility can be divided into low knowledge humility type, confident knowledge humility type, medium knowledge humility type, and high knowledge humility type. Knowledge humility can enhance postoperative self-management, and targeted interventions should be carried out for CRC patients with different types of knowledge humility to provide them with better cancer care and enhance their self-management level.

Objective:To analyze the regularity and related influencing factors of lateral cervical lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) with primary lesion > 1 cm, and to guide clinical diagnosis and treatment.Methods:The clinicopathological data of 155 PTC patients with primary lesion > 1 cm and LLNM who underwent radical surgery in Anhui Cancer Hospital from Jan. 2022 to Dec. 2022 were retrospectively analyzed. The observation indicators were as follows: gender, age, operation method, number of primary lesions, maximum diameter, location, Hashimoto's thyroiditis (HT), total number and positive number of lymph nodes in central and lateral cervical regions, proportion and rate of metastasis. The measurement data were analyzed by t test, and the count data were analyzed by χ2 test. Pearson correlation analysis and multivariate regression analysis were used to evaluate the influencing factors of lymph node metastasis. Results:The maximum diameter of PTC in 155 cases was (19.67±8.15) mm. A total of 1933 central lymph nodes were dissected, with metastasis ratio of 91.61% and average metastasis rate of 50.77%±29.14%. A total of 5371 lateral lymph nodes were dissected, with an average metastasis rate of 14.44%±9.89%. The proportion of LLNM in level III and level IV was 70.97% and 60.10% respectively, and the positive rate was 19.51% and 17.07% respectively. 43 cases were single-level LLNM, including 23 cases of single-level oligometastasis. There was a positive correlation between central lymph node metastasis (CLNM) rate and LLNM rate (Pearson=0.28, P=0.000). Gender ( P=0.022), age ( P=0.038), number of lesions ( P=0.025), maximum diameter of lesions ( P=0.002), and HT ( P=0.000) were independent factors of CLNM rate. Among the factors influencing the LLNM rate, only the maximum diameter of lesion showed statistical significance ( P=0.040). Single-level LLNM was only associated with HT ( P=0.034). HT ( OR=3.515, P=0.008) and single lesion ( OR=3.217, P=0.047) were independent factors for single-level oligometastasis. Conclusions:In PTC cases with primary lesion > 1 cm, LLNM rate is positively correlated with that of CLNM. LLNM occurres most frequently in level III and level IV. Single-level LLNM is more likely to occur in patients with HT, and when there’s a single focus, single-level oligometastasis is more likely to occur. Accurate preoperative evaluation should be emphasized for such patients.

Abscopal effect (AE) is defined as the phenomenon that the non-irradiated lesions shrink in addition to the directly irradiated lesions when the tumors are treated with radiotherapy. With widespread application of programmed cell death receptor-1 (PD-1), programmed cell death ligand-1 (PD-L1), cytotoxic T-lymphocyte-associated protein 4 (CTL-4) antibody, the treatment of malignant tumors has entered the era of immunotherapy. With the increasing application of radiotherapy combined with immunotherapy, AE has received unprecedented attention from scholars. The combination of radiotherapy and immunotherapy can promote the occurrence of systemic immune response and enhance the anti-tumor response of radiotherapy, which has deepened the understanding of AE. In this article, the history of AE in different stages of radiotherapy was reviewed, and the factors, possible mechanisms and clinical research status affecting the incidence of AE were emphasized, aiming to increase the incidence of AE in the era of immunotherapy, promote the objective effectiveness of radiotherapy combined with immunotherapy in clinical application, and further improve clinical prognosis of patients with malignant tumors.

Objective To analyze the current situation of depressive symptoms among medical staff in Beijing City and its correlation with symptoms of anxiety, occupational stress and insomnia. Methods A total of 2 687 medical staff from 28 medical institutions in eight municipal districts of Beijing City were selected as study subjects using multi-stage sampling method. The basic situation, depression symptoms, anxiety symptoms, occupational stress and insomnia symptoms were investigated using the National Occupational Health Literacy Monitoring Questionnaire for Key Groups, Patient Health Questionaire-9, 7-item Generalized Anxiety Disorder Scale, Core Occupational Stress Scale, and Self-Sleep Management Questionnaire. Results The detection rate of depressive symptoms was 28.3%, and the detection rates of moderate, moderate-severe and severe depressive symptoms were 18.9%, 6.9% and 2.5%, respectively. The detection rate of anxiety symptoms was 41.3%, and the detection rates of mild, moderate and severe anxiety symptoms were 29.7%, 7.7% and 3.9%, respectively. The detection rate of occupational stress was 26.7%. The detection rate of insomnia symptoms was 36.6%. The results of multivariate logistic regression analysis showed that the risk of depressive symptoms in male medical staff was higher than that in female (P<0.05). The risk of depressive symptoms in night shift staff was higher than that in staff without night shift (P<0.05). The more severe the anxiety symptoms, the higher the risk of depressive symptoms (all P<0.01). The risk of depressive symptoms in medical staff with occupational stress was higher than those without occupational stress (P<0.01). The risk of depressive symptoms in medical staff with insomnia symptoms was higher than those without insomnia symptoms (P<0.01). Conclusion The detection rate of depressive symptoms among medical staff in Beijing City is relatively high. Gender, night shift, anxiety symptoms, occupational stress, and insomnia symptoms were independent risk factors of depressive symptoms.

Objective To establish a quality control method for Lvxintong Rugao. Methods Ketoconazole, Halcinonide and Neomycin sulfate were identified by TLC. The content of Ketoconazole and Halcinonide were determined by HPLC. The chromatographic column of Agilent ZORBAX SB-C₁₈ (4.6 mm×150 mm, 5 μm) column was used. Methanol-phosphate buffer (pH=7.40, 75:25) was applied as the mobile phase. The detection wavelength was 235 nm. The flow rate was 1.0 ml/min and the column temperature was set at room temperature. Neomycin Sulfate was determined by polarimetric analysis. Results The identification and determination methods showed good specificity. Ketoconazole and Halcinonide displayed good linearity within the range of 1.999~39.98 μg (r=0.999 9) and 0.400 8~8.016 μg (r=0.999 9), respectively. The average recoveries were 97.75% (RSD 0.77%) and 97.57% (RSD 0.84%), respectively. For the determination of Neomycin Sulfate, r=0.999 6 (n=6) in the range of 130.4~2 608 U/ml (n=6). The precision and repeatability of RSD were 1.1% and 1.6%, respectively. The solutions were stable in 6 h and the average recovery was 98.8% (RSD 2.6%). Conclusion The method could be used as the quality control method for Lvxintong Rugao.

Objective:To investigate the feasibility of multipoint core needle biopsy (CNB) at mid-stage to predict the treatment effect of neoadjuvant systemic therapy for breast cancer.Methods:A total of 67 breast cancer cases with indications of neoadjuvant systemic therapy were selected from Mar. 2021 to Nov. 2022.In the fourth cycle of neoadjuvant systemic therapy, core needle biopsy was performed at 3, 6, 9, 12 points of tumor bed and residual tumor foci of breast respectively.The results of CNB were compared with the results of routine pathology of surgery after the completion of neoadjuvant therapy. Matched biopsy and surgical specimens were compared to assess pCR. The accuracy and false negative rate (FNR) of interim pathological assessment were analyzed. The coincidence probability of interim biopsy pathology and pathology of standard surgical excision was verified.Results:The median age of enrolled patients was 49.2 years (21-69 years) .Median maximum tumor diameter before neoadjuvant systemic therapy and residual tumor diameter after neoadjuvant therapy were 40.4 mm (range 21-93mm) and 19.6 mm (range 0-41mm) respectively. A total of 28 patients achieved pCR, and the PCR rates of hormone receptor-positive and HER2-nagative,triple-negative,hormone receptor negative and HER2-positive and hormone receptor-positive and HER2-positive disease were 4/24 (16.7%) ,6/14 (42.9%) ,11/18 (61.1%) ,7/11 (63.6%), respectively. Two cases had no preoperative imaging abnormalities. The results of core needle biopsy pathology of residual tumor lesions in 55 patients were consistent with those of routine post-operation pathology.The results of core needle biopsy pathology of tumor bed of 56 patients was consistent with the routine pathology of surgery. The false negative rate of interim multipoint biopsy pathology of residual tumor foci was 17.9% (12/67). The false negative rate of tumor bed with core needle biopsy was 5.9% (4/67) .Conclusions:CNB guided under ultrasound is feasible in predicting tumor retreat situation in the tumor bed area and residual tumor foci at mid-stage of neoadjuvant therapy. Increasing the number of core needles and improving biopsy techniques may improve the accuracy of pathological evaluation of interim multipoint biopsy.

Objective:To observe the changes of serum C-terminal peptide of type Ⅰ collagen (CTX-1) and N-terminal lengthening peptide of type Ⅰ collagen (P1NP) in adult patients with skeletal fluorosis in the tea-drinking-borne endemic fluorosis area in Qinghai Province, and to find sensitive indicators for diagnosis of skeletal fluorosis.Methods:From April to August 2019, a case-control study was carried out in tea-drinking-borne endemic fluorosis area in Zhiduo County, Yushu Tibetan Autonomous Prefecture, and Gangcha County, Haibei Tibetan Autonomous Prefecture of Qinghai Province. According to the Diagnostic Standard for Endemic Skeletal Fluorosis (WS/T 192-2008), the clinical diagnosis and X-ray examination of skeletal fluorosis were carried out for permanent residents ≥25 years old and living for more than 10 years in the area, combined with face-to-face inquiry and investigation of past disease history, lifestyle and clinical manifestations. The patients with skeletal fluorosis and healthy people were selected as skeletal fluorosis group and control group, respectively. Randomized urine samples and fasting venous blood from the two groups were collected. The content of fluoride in urine was determined by ion selective electrode method, and the contents of CTX-1 and P1NP in serum were determined by enzyme-linked immunosorbent assay (ELISA).Results:A total of 127 people in the disease area were investigated, including 63 cases in skeletal fluorosis group and 64 cases in control group. There was no statistically significant difference in age and sex ratio between the two groups ( t = 0.42, χ 2 = 0.07, P > 0.05). The X-ray examination results showed that the patients with skeletal fluorosis were mainly mild, accounting for 71.43% (45/63); X-ray changes were mainly ossification of interosseous membrane and tendon. The urinary fluoride in control group and skeletal fluorosis group was 1.62 (1.12, 1.95) and 3.22 (2.38, 4.89) mg/L, respectively, with statistically significant difference between the two groups ( Z = 7.07, P < 0.001). The difference of serum CTX-1 and P1NP contents between the two groups was statistically significant ( Z = 2.00, 4.89, P < 0.05). Conclusions:The levels of serum CTX-1 and P1NP in patients with skeletal fluorosis are higher than those in healthy people. Serum CTX-1 and P1NP may be used as sensitive indicators for diagnosis of skeletal fluorosis.

Objective: To establish an assessment model for predicting the aggressiveness of papillary thyroid microcarcinoma(PTMC) and to provide a theoretical basis for actively monitoring the same. Methods: 264 PTMC patients were included from October 2017 to January 2021. All patients were confirmed by postoperative pathology. 154 cases collected from October 2017 to April 2019 were included in the model group while 110 cases collected from May 2019 to January 2021 were included in the validation group. We analyzed the clinical data, ultrasound characteristics, and BRAF V600 E gene status of 154 patients in the model group with confirmed PTMC based on pathological examination. Single factor regression was used to screen out risk factors for PTMC invasion, and these factors were then included in a multivariate logistic regression analysis to establish a risk prediction model; the established model was used to evaluate the diagnostic efficacy of 110 PTMC patients in the validation group. Results: Multivariate analysis showed that male sex, age<45 years, microcalcification, tumor diameter>5 mm, suspected extraglandular invasion and lymph node metastasis on ultrasound, and BRAF V600 E gene mutation were all risk factors for PTMC invasion. A scoring model was established according to risk factors, and the higher the score, the higher the risk. In the 110-case verification group, the area under the predictive performance curve of the evaluation prediction model was 0.774(95%CI: 0.685-0.848), the cut-off value was 0.450 2, the sensitivity was 83.3%, and the specificity was 62.9%. The model therefore had good diagnostic efficacy. Conclusion Ultrasound combined with BRAF V600 E gene detection model can predict the aggressiveness of PTMC to a certain extent, which can provide reference for the selection of clinical treatment options.

Struma ovarii is a highly specialized form of monoderal ovarian teratoma, in which thyroid tissue has exceeded all other tissues or only thyroid tissue malignant struma ovarii is a very rare disease. Studies have confirmed that the pathogenesis is basically consistent with primary thyroid cancer. Preoperative diagnosis is difficult and the diagnosis should be based on postoperative paraffin pathology. It’s important to emphasize that the histologic malignance does not represent malignant ovarian behavior. Transabdominal hysterectomy+bilateral salpingo-oophorectomy has a better prognosis, and there are different opinions on the management of the mainstream thyroid. Most patients take active thyroid excision followed by chemotherapy and radiotherapy and 131I for postoperative follow-up in accordance with the principle of primary thyroid cancer.

Objective:To observe and evaluate the effect of health education on drinking brick-tea type fluorosis in Zhiduo County, Qinghai Province, so as to provide basis for further formulating health education strategies.Methods:From April 2019 to April 2020, according to the historical prevalence of drinking brick-tea type fluorosis in Zhiduo County, Qinghai Province, 3 townships (towns) were selected to carry out the health education activities on drinking brick-tea type fluorosis for students of grade 4 - 6, village doctors, adults and monks in each township (town). We carried out a one-year publicity on the prevention and treatment of drinking brick-tea type fluorosis, distributed health education materials and organized health education activities. Before and after the intervention, we conducted a questionnaire survey on health education among the target population (grade 4 - 6 students, village doctors, adults and monks), to evaluate the awareness rate and behavior formation rate of fluorosis prevention and control, and to evaluate the intervention effect.Results:A total of 86 students of grade 4 - 6, 40 village doctors, 42 adults and 20 monks were investigated, after the intervention, the awareness rates of prevention and treatment of drinking brick-tea type fluorosis in grade 4 - 6 students, village doctors, adults and monks were 87.98% (227/258), 96.67% (116/120), 81.75% (103/126), 83.33% (50/60), respectively, which were significantly higher than those before the intervention [38.38% (76/198), 83.33% (100/120), 15.45% (19/123), 28.89% (13/45), P < 0.05]. After the intervention, the behavior formation rates of prevention and treatment of the drinking brick-tea type fluorosis in grade 4 - 6 students, village doctors, adults and monks were 74.42% (128/172), 72.50% (58/80), 52.38% (44/84), 60.00% (24/40), respectively, which were significantly higher than those before the intervention [14.39% (19/132), 38.75% (31/80), 3.66% (3/82), 0(0/28), P < 0.05]. Conclusion:The comprehensive intervention measures based on health education can significantly improve the knowledge of local residents, and improve their bad drinking habits of drinking tea, which is of great significance to the prevention and treatment of drinking brick-tea type fluorosis.