OBJECTIVE To evaluate the efficacy， safety and cost-effectiveness of serplulimab as a first-line treatment of small- cell lung cancer （SCLC）， and provide an evidence-based basis for drug selection in hospitals. METHODS Rapid health technology assessment was adopted； PubMed， Cochrane Library， Embase， CNKI， Wanfang， VIP and official websites of domestic and international health technology assessment agencies were systematically searched from the inception to Oct. 2024. Two reviewers independently screened the literature， assessed the quality of included studies and carried out the qualitative analysis according to the inclusion and exclusion criteria. RESULTS A total of 13 systematic reviews/meta-analyses and 9 economic studies were included， and the literature quality was generally good. In terms of effectiveness， compared with chemotherapy alone， serplulimab combined with chemotherapy significantly improved progression-free survival， overall survival， and objective response rate in patients with SCLC. In terms of safety， serplulimab combined with chemotherapy showed no significant difference in the incidence of ≥3 grade adverse events compared with chemotherapy alone in the treatment of SCLC， indicating a good safety profile； compared with combination therapies involving other immunosuppressive agents， the incidence rate of adverse events was also lower. In terms of cost-effectiveness， compared with chemotherapy alone， serplulimab combined with chemotherapy is not cost- effective， which may be related to the high price of serplulimab. CONCLUSIONS Serplulimab is effective and safe in the treatment of SCLC， but has no obvious advantage in terms of cost-effectiveness.

BACKGROUND:Platelet-rich fibrin(PRF)is a second generation platelet concentrate with the advantages of simple operation,no anticoagulant,and high bioactivity,which has been applied in the fields of trauma repair,bone defect repair,and tendon soft tissue repair,and has been proved to have a certain tissue repair-promoting effect. OBJECTIVE:To study the repair effect of PRF on articular cartilage tissue in rats with knee osteoarthritis. METHODS:Thirty-six Sprague-Dawley rats were randomly divided into normal group,model group,and PRF group,with 12 rats in each group.Rats in the normal group did not undergo any treatment.In the model group,animal models of knee osteoarthritis were prepared and rat models were then given physiological saline into the joint cavity once a week after surgery.Rat models of knee osteoarthritis were also prepared in the PRF group,and autologous PRF was injected into the joint cavity once a week after surgery.After 5 weeks of continuous treatment,tissue samples were taken.Hematoxylin-eosin staining was used to observe the morphology of cartilage tissue.Tunel staining was used to detect chondrocyte apoptosis,ELISA was used to detect inflammatory factor levels.Western blot and RT-PCR were used to detect Bcl-2,Bax,and Caspase-3 expression in protein and mRNA levels,respectively. RESULTS AND CONCLUSION:The model group had severe cartilage tissue damage,while the PRF group had significantly improved cartilage tissue morphology compared with the model group.The model group had more apoptotic chondrocytes.Compared with the model group,the mean absorbance of Tunel positive staining in the PRF group significantly decreased(P<0.01).The levels of interleukin-1β,interleukin-6 and tumor necrosis factor-α were significantly increased in the model group and PRF group compared with the normal group(P<0.01)and were significantly decreased in the PRF group compared with the model group(P<0.01).The relative expressions of Bax and Caspase-3 at protein and mRNA levels were significantly increased in the model group and PRF group compared with the normal group(P<0.01),while the relative expressions of Bcl-2 at protein and mRNA were significantly decreased(P<0.01).Compared with the model group,the relative expression of Bax and Caspase-3 at protein and mRNA levels were significantly decreased in the PRF group(P<0.01),while the relative expressions of Bcl-2 at protein and mRNA levels were significantly increased(P<0.01).To conclude,PRF can inhibit chondrocyte apoptosis by inhibiting the expression of pro-inflammatory factors,thereby promoting cartilage tissue repair in knee osteoarthritis rats.

Objective:To explore the perception and perceived characteristics of risk of diabetes in people at high risk of diabetes under different glycemic states, and to provide a reference for clinicians to develop targeted risk interventions.Methods:Descriptive phenomenology research method was used to conduct semi-structured interviews with 17 diabetes high-risk persons selected by purpose sampling from August 2020 to January 2022 in the Health Management Center of General Hospital of Northern Theater Command. Data was transcribed and analyzed using Colaizzi ′s method. Results:Different glycemic states led to different themes for extraction. Each distilled 3 themes, normoglycemia including ignoring the existence of risk and creating doubt, risk perception relies on individual feelings, and demonstrate a positive attitude towards their risk control capabilities; initial diagnosis of dysglycemia including perceive the severity of the risk and express fear, mediated by health professionals and a strong desire to learn, accept by high-risk status and self-reflection on lifestyle; persistent glycemic impairment including tend to ignore risks to avoid undue stress and anxiety, determined based on experience and information, laissez-faire attitude or positive change. The differences among the 3 categories were mainly reflected in attitudes, emotions, perceived predisposing factors and risk control.Conclusions:It is still necessary to strengthen the education on diabetes prevention awareness and risk factors. And blood glucose can be considered as a classification guideline for targeted education.

The many-banded krait, Bungarus multicinctus, has been recorded as the animal resource of JinQianBaiHuaShe in the Chinese Pharmacopoeia. Characterization of its venoms classified chief phyla of modern animal neurotoxins. However, the evolutionary origin and diversification of its neurotoxins as well as biosynthesis of its active compounds remain largely unknown due to the lack of its high-quality genome. Here, we present the 1.58 Gbp genome of B. multicinctus assembled into 18 chromosomes with contig/scaffold N50 of 7.53 Mbp/149.8 Mbp. Major bungarotoxin-coding genes were clustered within genome by family and found to be associated with ancient local duplications. The truncation of glycosylphosphatidylinositol anchor in the 3'-terminal of a LY6E paralog released modern three-finger toxins (3FTxs) from membrane tethering before the Colubroidea divergence. Subsequent expansion and mutations diversified and recruited these 3FTxs. After the cobra/krait divergence, the modern unit-B of β-bungarotoxin emerged with an extra cysteine residue. A subsequent point substitution in unit-A enabled the β-bungarotoxin covalent linkage. The B. multicinctus gene expression, chromatin topological organization, and histone modification characteristics were featured by transcriptome, proteome, chromatin conformation capture sequencing, and ChIP-seq. The results highlighted that venom production was under a sophisticated regulation. Our findings provide new insights into snake neurotoxin research, meanwhile will facilitate antivenom development, toxin-driven drug discovery and the quality control of JinQianBaiHuaShe.

Objective:To analyze the current situation of researches on the fear of disease progression at home and abroad, and sort out the research hotspots and development context.Methods:The relevant literature about fear of disease progression published by China National Knowledge Infrastructure (CNKI) and Web of Science core collection database were systematiclly searched, and the search period was from January 1, 2002 to June 24, 2022. CiteSpace 5.8.R3 software was used for visual analysis of relevant literature.Results:A total of 340 articles were retrieved from CNKI and 1 199 articles were retrieved from Web of Science core collection database. The countries and institutions with the highest number of international publications were Germany, Technical University of Munich and The University of Sydney, with close cooperation among authors and poor inter-institutional cooperation. Domestic research focused on the influencing factors of fear of disease progression and its relationship with depression, anxiety, social support and quality of life, while foreign research focused on breast cancer and its survivors, depression, anxiety, quality of life, reliability and validity of the questionnaire and the feasibility of intervention.Conclusions:The number of articles published at home and abroad is generally on the rise. Compared with foreign countries, there is still a certain gap in the research on fear of progression in China. In the future, China should timely pay attention to the development trends and hot frontiers in this field internationally, so as to promote the research and development of fear of disease progression in China.

ObjectiveTo explore the research hotspots and development trends in the field of autism spectrum disorder (ASD) in the past ten years, the literatures of microglia-related neuroinflammation of ASD and the immune regulation and possible pathways of exercise ameliorating ASD symptoms were reviewed. MethodsArticles about microglia-related research in ASD during January, 2012 to December, 2021 were searched in the core collection database of Web of Science. The CiteSpace 5.8.R3 software was used to summarize the main findings, visualize and analyze the annual publication volume, high-frequency keywords and keyword clustering. Results and ConclusionA total of 783 papers were returned. The numbers of papers published increased with time. The neuroinflammation was a research hotspot in the pathogenesis of ASD, among which abnormal activation of microglia and the levels of inflammatory cytokines were important factors in the occurrence and development of ASD. Exercise was an important intervention to improve symptoms of ASD, which may associate with reducing neuroinflammation or regulating microglia-mediated inflammatory pathways.

Since the 18th National Congress of the Communist Party of China (CPC), the CPC Central Committee and the State Council have paid great attention to the prevention and control of endemic diseases. Through the implementation of the prevention and control measures of endemic diseases, especially the implementation of the "Six Major Actions" to tackle key problems in "three years' project", all kinds of diseases have met the relevant requirements. The prevention and control of endemic diseases in China has achieved remarkable results and made historic achievements. However, risk challenges remain. At present, there are still some problems in the management and treatment of patients with iodine deficiency disorders, water-borne iodine excess goiter, drinking water-borne endemic fluorosis and drinking tea-borne endemic fluorosis in China, which need to be solved by strengthening the prevention and control efforts.

Objective:To develop a suitable scale for assessing the public health safety literacy in residents in China.Methods:The initial scale of Chinese public health safety literacy was developed through theoretical conceptualization, item pooling, field verifying and item inclusion and exclusion. Then the initial scale was converted into an electronic questionnaire. A total of 2 809 residents from 4 provinces were randomly selected for field testing. Classical test theory (CTT) and item response theory (IRT) were used for item reduction. SPSS 23.0 was used for exploratory factor analysis (EFA) and unidimensional testing. Package R 4.1.1 ltm and mirt were used for the analysis of the psychometric properties of items and generate the ICC, IIC and TIF.Results:The initial scale had 30 items (B1-B30), and the test took 9.8 s to complete one item averagely. According to the CTT, B2 was deleted due to coefficient of total correlation (CITC) <0.3 and the item-dimension correlation coefficient (IDCC) <0.4. B23 was deleted due to CITC<0.3, IDCC<0.4 and difficulty index ( W) <0.2. B30 was deleted due to CITC<0.3 and W<0.2. The total Cronbach's α of the scale was 0.923 after deletion. EFA indicated that 14 items should be deleted due to lower factor loadings <0.7. EFA was conducted for remaining 13 items and 2 common factors were extracted, the factor loadings of all items were >0.7, the accumulated variance contribution of the 2 common factors was 63.361%, and the total Cronbach's α was 0.891, showing unidimensionality, IRT was used to test the remaining items. B14 and B20 were deleted due to discrimination coefficient ( a) <0.3, difficulty threshold coefficient ( b) ?[-3,3], the small amount of information and the flat, crowded, non-monotonic ICC, and IIC. Finally, the Cronbach's α of the 11-itemed scale was 0.936 with TLI=0.97, CFI=0.99, and RMSEA =0.03. Conclusion:The final scale has good reliability, validity, discrimination, difficulty level and feasibility, and can be applied for the rapid assessment of public health safety literacy in China.

Objective:To investigate the pathological change mechanism of patients with chronic active Epstein-Barr virus infection (CAEBV).Methods:The clinical manifestations, laboratory examinations, diagnosis and treatment of one CAEBV patient in Suzhou Hongci Hematology Hospital of Jiangsu Province were retrospectively analyzed with review of related literature.Results:Combined with the results of laboratory, lymph node biopsy and bone marrow tests in different periods, the patient initially showed lymphoproliferative disease, and gradually transformed into lymphoma with the diagnosis results of EB virus-related lymphocyte clones in different periods. The patient received the corresponding treatment plan in different periods, but eventually died due to hemophagocytic syndrome and rapid progress of the disease.Conclusion:CAEBV may cause lymphocytes to gradually evolve from polyclonal to monoclonal state.

Objective: To explore the effect of aerobic plus resistance training on the intervention of adolescents with moderate mental retardation and to provide reference for healthy development among specific need population. Methods: Totally 29 adolescents with moderate mental retardation, aged 12-17 years from one middle school in Shunde district of Foshan, were divided into intervention group and control group (16/13) with random number table. The intervention group was subjected to aerobic combined resistance exercise for 11 weeks. The control group maintained the original activities. The changes in body composition, muscle strength, cardiorespiratory endurance and balance ability of the two groups of subjects before and after intervention were compared. Results: After the intervention, the intervention group s skeletal muscle (22.90±3.63)kg, muscle mass (39.75±5.57)kg, lean body mass (41.52±6.79)kg, sitting arm support (49.19±35.28)s, standing timing test (22.13±6.01)s, half crunches (20.12±6.48), grip strength [left (15.98±4.86)kg; right (16.37±5.46)kg], heart rate immediately after 2 min stepping exercise (91.43±13.44)frequency/min, Standing on one foot with eyes closed [left (5.82±5.20)s; right (6.02±5.56)s] compared with before exercise, the body fat decreased(t=2.57,2.72,2.07,2.10,3.31,2.92,2.76,3.44, 2.86,2.04,2.38, -2.92,P<0.05); after the intervention, the sitting arm support and closed eyes standing(right) improved(P<0.05). Conclusion Aerobic combined resistance exercise can improve muscle strength and endurance, aerobic endurance and balance ability in adolescents with moderate mental retardation and adaptability of teenagers with moderate mental retardation.