Objective To explore the trend of lung cancer prevalence and influencing factors in a Hospital of Zigong from 2019-2023. Methods Select 2 835 lung cancer patients in Zigong region admitted to the Zigong Fourth People's Hospital from January 2019 to December 2023, and analyze the changes in the clinical characteristics and age strata of patients in different time periods in this group. Three thousand non-cancer respiratory patients in the same time period were included to compare the differences in patient data and to analyze the influencing factors affecting the changes in the characteristics of lung cancer in this region. Results There was an upward trend in the number of patients with pneumonia included between 2019 and 2023, with the highest volume of patients included in 2021 (609 cases). Over the 5-year period, the percentage of patients aged 0-39 years did not change significantly and accounted for a relatively low percentage. The proportion of patients aged 40-49 years increased (APC=0.69%, t=2.990, P<0.05), and the proportion of patients over 60 years old decreased, but to a lesser extent (APC=-0.25%, t=2.210, P<0.05). There were no significant differences in male percentage, lesion site, distant metastasis, smoking history and tumor diameter among patients in different years (all P>0.05). There were significant differences in TNM stage and lymphatic metastasis among patients in different years (all P<0.05). Compared with 2019, the proportion of early stage and patients with lymph node metastasis showed an upward trend within five years (χ²_{early stage}=9.153, P_{early stage}=0.002; χ²_{lymph node metastasis}=5.848, P_{lymph node metastasis}=0.016). The factor associated with the change in age of lung cancer patients in different years was family history of lung cancer (P<0.01). Factors associated with histologic changes in lung cancer patients in different years were age, family history of lung cancer and smoking history (all P<0.05). Factors associated with changes in TNM distribution in lung cancer patients in different years were age, tumor diameter, family history of lung cancer and lymph node metastasis (all P<0.05). Factors associated with changes in lymph node metastasis in lung cancer patients in different years were tumor diameter and TNM stage (all P<0.05). Conclusion From 2019 to 2023, the age of patients with lung cancer in a Hospital in Zigong area showed a decreasing trend, which may be influenced by family history of lung cancer.Patients with TNM early stage and lymph node metastasis increased respectively, which influenced each other and were interfered by factors of age, tumor diameter, and family history of lung cancer.

Objective To explore the trend of lung cancer prevalence and influencing factors in a Hospital of Zigong from 2019-2023. Methods Select 2 835 lung cancer patients in Zigong region admitted to the Zigong Fourth People's Hospital from January 2019 to December 2023, and analyze the changes in the clinical characteristics and age strata of patients in different time periods in this group. Three thousand non-cancer respiratory patients in the same time period were included to compare the differences in patient data and to analyze the influencing factors affecting the changes in the characteristics of lung cancer in this region. Results There was an upward trend in the number of patients with pneumonia included between 2019 and 2023, with the highest volume of patients included in 2021 (609 cases). Over the 5-year period, the percentage of patients aged 0-39 years did not change significantly and accounted for a relatively low percentage. The proportion of patients aged 40-49 years increased (APC=0.69%, t=2.990, P<0.05), and the proportion of patients over 60 years old decreased, but to a lesser extent (APC=-0.25%, t=2.210, P<0.05). There were no significant differences in male percentage, lesion site, distant metastasis, smoking history and tumor diameter among patients in different years (all P>0.05). There were significant differences in TNM stage and lymphatic metastasis among patients in different years (all P<0.05). Compared with 2019, the proportion of early stage and patients with lymph node metastasis showed an upward trend within five years (χ²_{early stage}=9.153, P_{early stage}=0.002; χ²_{lymph node metastasis}=5.848, P_{lymph node metastasis}=0.016). The factor associated with the change in age of lung cancer patients in different years was family history of lung cancer (P<0.01). Factors associated with histologic changes in lung cancer patients in different years were age, family history of lung cancer and smoking history (all P<0.05). Factors associated with changes in TNM distribution in lung cancer patients in different years were age, tumor diameter, family history of lung cancer and lymph node metastasis (all P<0.05). Factors associated with changes in lymph node metastasis in lung cancer patients in different years were tumor diameter and TNM stage (all P<0.05). Conclusion From 2019 to 2023, the age of patients with lung cancer in a Hospital in Zigong area showed a decreasing trend, which may be influenced by family history of lung cancer.Patients with TNM early stage and lymph node metastasis increased respectively, which influenced each other and were interfered by factors of age, tumor diameter, and family history of lung cancer.

Objective To investigate the genetic causes of auditory neuropathy with optic atrophy in a family.Methods The proband's medical history and family history were inquired in detail,and relevant clinical examina-tions were performed to confirm the diagnosis of auditory neuropathy with optic atrophy,and the genetic pedigree of the family was drawn.Peripheral blood of proband(Ⅲ-7)was collected for whole exome sequencing,and the patho-genicity of the detected mutations were interpreted.Blood samples of proband's wife(Ⅲ-8),eldest daughter(Ⅳ-7),second daughter(Ⅳ-9)and son(Ⅳ-10)were tested for mutation sites by Sanger sequencing.Combined with clinical manifestations and examination results,the family was studied.Results The genetic pattern of this family was autosomal dominant.The proband showed decreased visual acuity at the age of 19,bilateral sensorineural deaf-ness at the age of 30,and decreased speech recognition rate.Among 20 members of the family of 5 generations,10(2 deceased)showed similar symptoms of hearing and visual impairment.Proband(Ⅲ-7),eldest daughter(Ⅳ-7)and son(Ⅳ-10)underwent relevant examination.Pure tone audiometry showed bilateral sensorineural deafness.ABR showed no response bilaterally.The 40 Hz AERP showed no response in both ears.OAE showed responses in some or all of the frequencies.No stapedial reflex was detected.The eye movement of Ⅲ-7 and Ⅳ-10 were reasona-ble in all directions,and color vision was normal.Ocular papilla atrophy was observed in different degrees in fundus examination.OCT showed thinning of optic disc nerve fibers in both eyes,and visual evoked potential showed pro-longed P100 wave peak.They were diagnosed as hereditary auditory neuropathy with optic atrophy.A mutation of the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)at a pathogenic locus on chromosome 3 was detected by whole exon detection in Ⅲ-7.The results of generation sequencing analysis showed that the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)mutation of chromosome 3 was also found in Ⅳ-7 and Ⅳ-10.Meanwhile,the gen-otypes of Ⅲ-8 and Ⅳ-9 were wild homozygous,that is,no mutation occurred.Conclusion The OPA1 c.1334G＞A(p.Arg445His,NM_015560.2)mutation site might be the pathogenic mutation in this family.

Objective:The treatment of head and neck in plexiform neurofibroma (PNF) is a major clinical problem, lacking consensus on surgical treatment, classification, operation timing, and treatment method. The purpose of this study was to provide a basis for further consensus formation by analyzing the clinical manifestations, surgical conditions, tumor recurrence, post-operation satisfaction, and changes in quality of life of patients undergoing PNF surgery in head and neck.Methods:Through medical record review and telephone follow-up, a retrospective analysis was conducted on neurofibromatosis type 1 (NF1) patients admitted for surgical treatment for PNF patient in head and neck from May 2012 to July 2022 in Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Complete collection and statistical analysis of patients’clinical data, using telephone follow-up to investigate the immediate postoperative satisfaction and long-term surgical satisfaction of patients and/or their families, as well as standardized quality of life questionnaires HRQol(health related quality of life) and PlexiQol(plexiform neurofibroma quality of life). Based on the data about changes in quality of life before and after surgery and long-term surgical satisfaction, patients were divided into surgical benefit and non-benefit groups. Binary and multivariate logistic regression analysis were used to analyze the clinical characteristics of patients with long-term surgical benefit.Results:Totally 512 patients with head and neck NF1 were admitted for surgery with complete medical records. 121 patients were identified as NF1 related PNF diagnosed by medical history and radiological examination, and effective follow-up was obtained. There were 70 males and 51 females, aged (25.60±12.85) years old, ranging from 7 to 63 years old, with 41 patients who were ≤ 18 years old and 80 patients over 18 years old. 62.81%(76/121) of patients exhibiting clinical dysfunctions, and the tumor mass were mainly characterized by invasive growth. 41.32%(50/121) of patients underwent multiple surgical treatments, with a total of 215 surgeries performed on 121 patients. The surgical objective included appearance improvement and functional repair. The incidence of postoperative complications was 6.05%(13/215). The follow-up period after last operation was (51.41±27.66) months, and 42.15%(51/121) of patients reported postoperative tumor recurrence. 76.03%(92/121) of patients were satisfied with immediate postoperative result, while the rate decreased to 46.28%(56/121) during long-term follow-up. Family members of patients who were ≤ 18 years old had a higher proportion of dissatisfaction with the scars caused by surgery and a stronger willingness to undergo another surgery. The tumor recurrence was closely related to surgical benefits ( OR=2.32, P<0.05). Further analysis found that the gender and age of patients were the main risk factors for the recurrence. The recurrence risk in patients ≤ 18 years old was significantly higher than in that over 18 years old( OR=3.49, P=0.004), and the highest in the 7-12 year-old group, reaching 68.42%(13/19). The recurrence risk in male patients was significantly lower than that in females ( OR=0.40, P=0.026). Conclusion:The clinical manifestations of PNF patients in head and neck region are complex. Clinical diagnosis and treatment in PNF should focus on the applications in comprehensive method such as full preoperative evaluation, active multi-disciplinary treatment cooperation and combined therapies in order to improve the safety and effectiveness of treatment and reduce tumor recurrence.

Objective:Based on latent profile analysis, the category characteristics of decisional dilemma of participating in thrombolysis decision-making agents of patients with acute myocardial infarction (AMI) are analyzed to reduce the decision-making difficulties of decision-making agents in AMI patients.Method:The 292 cases of decision-making agents of patients with AMI and treated by intravenous thrombolysis in emergency department of Xinjiang Uygur Autonomous Region People's Hospital were selected as respondents From January 2022 to June 2023.A cross-sectional survey was conducted using General Information Questionnaire, Perceived Social Support Scale, State-Trait Anxiety Inventory, Control Preference Scale, Wake Forest Physician Trust Scale and Decisional Conflict Scale.Selected Mplus 8.3 software to conduct potential profile analysis on the survey data.Results:The 281 valid questionnaires were ultimately collected, with 146 males and 135 females aged 35-72(55.61 ± 9.05) among 281 AMI patients; 135 acting decision-makers from the south, 146 females, aged 30-72(55.52 ± 6.74).The score of decisional dilemma of participating in thrombolysis of decision-making agents of patients with AMI was 45(41, 46). LPA analysis showed that decisional dilemma of participating in thrombolysis of decision-making agents can be divided into 4 latent profiles which were low-level decisional dilemma profile accounts for 16.01% (45/281), high-level decisional dilemma profile accounts for 16.38% (46/281), extra high-level decisional dilemma profile with social support restricting accounts for 35.23% (99/281) and extra high-level decisional dilemma profile with information restricting accounts for 32.28% (91/281). Multiple logistic regression analysis showed represented patients with AMI history, decision-making agent ′s age, gender, educational level, decision-making role, decision-making participation type were significant influencing factors of decisional dilemma of participating in thrombolysis of high-level decisional dilemma profile (all P<0.05);represented patients with AMI history, decision-making agent ′s age, gender, education level, decision-making role, assuming patient ′s treatment payment role, assuming patient ′s care role, perceived social support level, state anxiety level, decision-making participation type and trust doctors level were significant influencing factors of decisional dilemma of participating in thrombolysis of extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting(all P<0.05). Conclusions:The level decisional dilemma of participating in thrombolysis of decision-making agents for intravenous thrombolysis treatment of AMI patients were high, and their decisional dilemma can be divided into low-level decisional dilemma profile, high-level decisional dilemma profile, extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting.They should be purposively intervened based on their corresponding decisional dilemma profile.

Objective:The treatment of head and neck in plexiform neurofibroma (PNF) is a major clinical problem, lacking consensus on surgical treatment, classification, operation timing, and treatment method. The purpose of this study was to provide a basis for further consensus formation by analyzing the clinical manifestations, surgical conditions, tumor recurrence, post-operation satisfaction, and changes in quality of life of patients undergoing PNF surgery in head and neck.Methods:Through medical record review and telephone follow-up, a retrospective analysis was conducted on neurofibromatosis type 1 (NF1) patients admitted for surgical treatment for PNF patient in head and neck from May 2012 to July 2022 in Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Complete collection and statistical analysis of patients’clinical data, using telephone follow-up to investigate the immediate postoperative satisfaction and long-term surgical satisfaction of patients and/or their families, as well as standardized quality of life questionnaires HRQol(health related quality of life) and PlexiQol(plexiform neurofibroma quality of life). Based on the data about changes in quality of life before and after surgery and long-term surgical satisfaction, patients were divided into surgical benefit and non-benefit groups. Binary and multivariate logistic regression analysis were used to analyze the clinical characteristics of patients with long-term surgical benefit.Results:Totally 512 patients with head and neck NF1 were admitted for surgery with complete medical records. 121 patients were identified as NF1 related PNF diagnosed by medical history and radiological examination, and effective follow-up was obtained. There were 70 males and 51 females, aged (25.60±12.85) years old, ranging from 7 to 63 years old, with 41 patients who were ≤ 18 years old and 80 patients over 18 years old. 62.81%(76/121) of patients exhibiting clinical dysfunctions, and the tumor mass were mainly characterized by invasive growth. 41.32%(50/121) of patients underwent multiple surgical treatments, with a total of 215 surgeries performed on 121 patients. The surgical objective included appearance improvement and functional repair. The incidence of postoperative complications was 6.05%(13/215). The follow-up period after last operation was (51.41±27.66) months, and 42.15%(51/121) of patients reported postoperative tumor recurrence. 76.03%(92/121) of patients were satisfied with immediate postoperative result, while the rate decreased to 46.28%(56/121) during long-term follow-up. Family members of patients who were ≤ 18 years old had a higher proportion of dissatisfaction with the scars caused by surgery and a stronger willingness to undergo another surgery. The tumor recurrence was closely related to surgical benefits ( OR=2.32, P<0.05). Further analysis found that the gender and age of patients were the main risk factors for the recurrence. The recurrence risk in patients ≤ 18 years old was significantly higher than in that over 18 years old( OR=3.49, P=0.004), and the highest in the 7-12 year-old group, reaching 68.42%(13/19). The recurrence risk in male patients was significantly lower than that in females ( OR=0.40, P=0.026). Conclusion:The clinical manifestations of PNF patients in head and neck region are complex. Clinical diagnosis and treatment in PNF should focus on the applications in comprehensive method such as full preoperative evaluation, active multi-disciplinary treatment cooperation and combined therapies in order to improve the safety and effectiveness of treatment and reduce tumor recurrence.

Objective To explore and analyze the therapeutic effect of cryotherapy in the removal of granulation tissue under electronic bronchoscope,and find an efficient and safe auxiliary treatment technique for patients undergoing granulation tissue removal surgery.Method A clinical practice study was conducted on 41 patients who underwent granulation tissue removal surgery from June 2021 to June 2022.Patients were divided into groups using single and double numbers,with 21 patients assigned to single numbers included in the control group and 20 patients assigned to double numbers included in the observation group.Both groups underwent electronic bronchoscope granulation tissue removal surgery.During the surgery,the control group received argon-plasma coagulation(APC),while the observation group received cryotherapy.The levels of immune function indicators(including CD4+,CD8+and CD4+/CD8+),postoperative recovery related indicators,and effective rate of the two groups of patients were compared before and after treatment.Result Before treatment,there was no statistically significant difference in CD4+and CD4+/CD8+between the two groups of patients(P>0.05).After treatment,CD4+and CD4+/CD8+in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05);Before treatment,there was no statistically significant difference in CD8+between the two groups of patients(P>0.05).After treatment,the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05);The effective rate of the observation group was 95.00%,higher than 80.95%of the control group.The postoperative pain visual analogue scale(VAS)of the observation group was(2.14±0.18)points,significantly lower than the control group's(6.09±0.95)points,and the differences were statistically significant(P<0.05);The first postoperative feeding time of the observation group was(6.08±0.76)hours,and the hospital stay was(5.12±0.68)days,which were shorter than the control group's(15.39±2.97)hours and(7.08±0.93)days;The treatment cost of the observation group was(10 500.60±80.70)yuan,which was lower than the control group's(19 800.00±126.00)yuan,and the differences were statistically significant(P<0.05);The incidence of postoperative complications in the observation group was 5.00%,lower than the control group's 23.81%,and the difference was statistically significant(P<0.05).Conclusion The application of cryotherapy in the removal of granulation tissue under electronic bronchoscope has a significant therapeutic effect.It can not only improve the surgical treatment effect of patients,improve their immune index levels,but also alleviate their postoperative pain,reduce the incidence of postoperative complications,and shorten their postoperative pre-and post cycle.Moreover,the treatment cost is low,and it is worthy of clinical application and promotion.

Objective:To investigate the status of nursing practice and organizational management for reperfusion therapy in ischemic stroke across medical institutions in Beijing.Methods:In June 2023, a survey was conducted among nursing managers from 62 medical institutions under the jurisdiction of the Beijing Stroke Treatment Quality Control and Improvement Center. The survey aimed to assess the current nursing practices and organizational management for reperfusion therapy in ischemic stroke.Results:Among the 62 medical institutions, 16.13% (10/62) had dedicated reperfusion therapy nurses for stroke, and 87.10% (54/62) had established specific nursing protocols and procedures for stroke reperfusion therapy within their departments. However, 27.42% (17/62) of these institutions based the development and updates of their protocols on experiential summaries rather than standardized guidelines. In terms of nursing practice, there was room for improvement in emergency identification and triage of suspected stroke patients, assistance with intravenous thrombolysis, patient condition monitoring, early rehabilitation, and related health education. Regarding nursing quality control, significant differences were observed between institutions that regularly conducted quality control of stroke reperfusion therapy nursing and those that organized regular training sessions for nurses in this area ( P<0.05) . Conclusions:While nursing practices and quality for stroke reperfusion therapy in Beijing are progressing, there are disparities in regional development. There is a high demand for specialized stroke nursing and targeted technical training.

Objective To investigate the effects of Yitangkang on browning of white adipose and PINK1/Parkin pathway of mitophagy in adipose tissue of db/db mice.Methods Totally 30 six-week db/db mice were randomly divided into model group,Yitangkang Group(30 g/kg)and liraglutide group(200 μg/kg),and another 10 C57BL/6 mice of the same age were set as normal group.All groups were treated with corresponding drugs or normal saline for 5 weeks.During the period of administration,the body mass and fasting blood glucose(FBG)of mice in each group were detected regularly,the samples of liver,white and brown adipose of mice were weighed,the contents of serum triglyceride cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were detected by biochemical analyzer,HE staining was used to observe the pathological changes of inguinal white adipose tissue(iWAT),immunohistochemical staining was used to detect the expression of browning marker protein uncoupling protein-1(UCP1)in iWAT,Western blot was used to detect the expressions of browning-related proteins UCP1,PRDM16,PGC-1α and mitophagy-related proteins PINK1,Parkin,Beclin-1,p62 in iWAT.Results Compared with the normal group,the body mass,liver,white adipose and brown adipose mass of the model group significantly increased(P<0.01),the FBG and serum TG,TC and LDL-C contents significantly increased(P<0.01),and the content of HDL-C significantly decreased(P<0.01);large vacuoles in iWAT adipocytes,the diameter of adipocytes increased obviously,some adipocytes were extruded and deformed,and the edge of adipocytes was not clear,the expressions of iWAT UCP1,PRDM16,PGC-1α and p62 proteins decreased(P<0.01),while the expressions of PINK1,Parkin and Beclin-1 proteins increased(P<0.01).Compared with the model group,the body mass,liver and white adipose mass significantly decreased in Yitangkang group and the liraglutide group(P<0.01),FBG and serum contents of TC,TG and LDL-C were significantly decreased(P<0.05,P<0.01),while HDL-C content significantly increased(P<0.01);the diameter of iWAT adipocytes decreased,the number increased,and the morphology was regular,the expressions of iWAT UCP1,PRDM16,PGC-1α and p62 proteins increased(P<0.01),while the expressions of PINK1,Parkin and Beclin-1 proteins decreased(P<0.05,P<0.01).Conclusion Yitangkang can improve glucose and lipid metabolism and promote browning of white adipose in db/db mice,which may be related to mitophagy mediated by PINK1/Parkin pathway.

Ferroptosis is a novel iron-dependent mode of programmed cell death characterized by iron deposition and accumulation of lipid peroxidation. More and more studies have found that ferroptosis is closely related to the pathogenesis of type 2 diabetes mellitus （T2DM）. The yin-fire theory is an important part of LI Gao's spleen-stomach theory， and it is believed that qi-fire imblance and yin-fire internal generation is the main pathogenesis of T2DM. Abnormal iron metabolism may be an important prerequisite for T2DM yin-fire internal generation， while oxidative stress is the specific manifestation of T2DM qi-fire imbalance. Reactive oxygen species （ROS） is the end product of qi-fire imbalance， and lipid peroxide is the pathological products of T2DM yin-fire internal generation. This study intends to explore the pathological mechanism of qi-fire imbalance and yin-fire internal generation from the perspectives of iron metabolism， oxidative stress and lipid peroxidation， enriching the modern connotation of yin-fire theory， and benefiting traditional Chinese medicine to target against ferroptosis， and prevent and treat T2DM precisely.