OBJECTIVE To evaluate the clinical value of anlotinib in third-line treatment for patients with advanced non-small cell lung cancer （NSCLC） through real-world data. METHODS Clinical data of patients with advanced NSCLC who received treatment at the First Affiliated Hospital of Anhui University of Chinese Medicine from February 2021 to December 2024 were retrospectively collected. They were divided into anlotinib group （27 cases， receiving anlotinib therapy） and immunotherapy group （22 cases， receiving immunotherapy agents alone or in combination with chemotherapy drugs） according to treatment regimens. The progression-free survival （PFS） and overall survival （OS） of patients were compared between the two groups， and the occurrence of adverse drug reactions during the treatment period was recorded. Using a partitioned survival model， an economic evaluation of the two treatment regimens was conducted with a cost-utility analysis approach from the perspective of the healthcare system. RESULTS The median PFS and OS of patients in the anlotinib group were 5.93 months and 11.27 months， respectively； the median PFS and OS of patients in the immunotherapy group were 5.33 months and 9.77 months， respectively； the difference was not statistically significant （P＞0.05）. There was no statistical difference in the total incidence of adverse drug reactions and grade 3-4 serious adverse drug reactions between the two groups （P＞0.05）. Compared with the immunotherapy group， the incremental cost-effectiveness ratio of the anlotinib group was 1 806 724.60 yuan/quality-adjusted life year （QALY）， which was significantly higher than three times China’s per capita gross domestic product in 2024 （287 247 yuan/QALY）. CONCLUSIONS For third-line treatment of advanced NSCLC patients， the efficacy of anlotinib is no worse than that of immunotherapy alone or in combination with chemotherapy drugs， and the safety of the two groups is comparable. However， anlotinib is not cost-effective.

OBJECTIVE To establish a working model for the cough and asthma pharmaceutical care clinic and analyze the effects of outpatient pharmaceutical care interventions on patients. METHODS A pharmaceutical care clinic for cough and asthma was established in our hospital， with comprehensive regulations and rules， complete infrastructure and defined pharmaceutical care workflows. The demographic data of patients （gender， age， residence， disease duration and so on） were collected from May 2021 to December 2024. Indicators including health status， disease severity， inhalation technique， and medication adherence during visits and follow-up were collected and analyzed statistically， to assess the effects of pharmaceutical care interventions on patients. RESULTS The service procedure for the cough and asthma pharmaceutical care clinic in our hospital was established. A total of 215 patients’ basic information was collected. It was found that among the patients， males accounted for 55.35%， with an average age of （60.91±15.75） years old. Patients aged 60 to 69 constituted the largest proportion at 28.37%， and they exhibited relatively poor medication adherence [with an average score of （5.64±1.76）]. The majority of patients were diagnosed with chronic obstructive pulmonary disease （COPD） and prescribed budesonide/formoterol powder inhalers. In 68 follow-up cases， EQ-5D-5L scores increased by 5.81 points （P＜0.05）； COPD Assessment Test （CAT） scores decreased by 4.05 points （P＜0.05）， indicating reduced disease burden. Asthma Control Test （ACT） scores improved by 4.80 points， reaching partial control levels. Inhaler technique scores increased by 2.31 points （P＜0.05）. Medication adherence scores rose by 1.09 points （P＜0.05）. Patient satisfaction was over 90%. CONCLUSIONS After pharmaceutical care intervention， patients’ health status， disease severity， inhalant use technique， and compliance have all improved， and their satisfaction with the cough and asthma pharmaceutical care outpatient service is high. The pharmaceutical care intervention provided by the cough and asthma pharmaceutical care outpatient service can improve patients’ disease symptoms and medication compliance， and enhance the level of safe and rational drug use in the hospital.

Objective To evaluate the current status in the implementation of GBZ/T 201.5-2015 Radiation shielding requirements for radiotherapy rooms-Part 5: Radiotherapy room of proton accelerators, identify issues in the application of its technical indicators, and provide a basis for the in-depth implementation and further revision of the standard. Methods In accordance with the Standardization Law of the People’s Republic of China and the Guidelines for Health Standards Tracking Evaluation (WS/T 536-2017), a combination of cluster sampling and stratified sampling methods was employed to select professionals involved in proton accelerator radiotherapy devices and facilities in three provinces (or municipalities directly under the central government) as the subjects of the survey. A questionnaire was developed to collect basic information about the subjects and their understanding and application of the technical indicators in the standard. A standard evaluation indicator system with a total score of 100 points was established to score the implementation of the standard (40 points), the technical content (30 points), and the effectiveness of the implementation (30 points). Results A total of 169 professionals from 107 institutions participated in the survey, with 79.88% of the respondents having at least 5 years of experience in radiation therapy and 74.56% holding intermediate or higher professional titles. The score of standard implementation was 18.3 points. The awareness rate exceeded 80%, indicating a high level of awareness about the standard. However, the scores for the dissemination and application of the standard were relatively low, accounting for 28% and 32% of their respective full marks. The technical content of the standard and the effectiveness of its implementation scored 27.0 and 26.6 points, respectively. The overall score in the evaluation of standard implementation was 72 points, with scores of 68.6, 72.3, and 75.0 for Beijing City, Shanghai City, and Jiangsu Province, respectively. Conclusion GBZ/T 201.5-2015 Radiation shielding requirements for radiotherapy rooms-Part 5: Radiotherapy room of proton accelerators is scientific and operable, and it is well-coordinated with relevant laws and standards. However, considering the development in FLASH technology and multi-chamber radiotherapy room, it is necessary to revise and improve the standard.

Gallbladder carcinoma(GBC)is one of the most common malignant tumors in the biliary system,which is difficult to diagnose in the early stage due to its high degree of malignancy,invasiveness and lack of specific clin-ical manifestations.In this paper,we summarize ultrasound,CT and other imaging manifestations in the early stage of GBC,and describe the role of protein markers and microRNA marker as biomarkers in the diagnosis of early GBC.The enhanced understanding of the relevant features might help to improve the accuracy of the diagnosis of early gallbladder carcinoma.

Objective To analyze the effects of arthroscopic meniscus treatment on knee osteoarthritis on the effective rate,VAS score,HSS score and TNF-α level.Methods We selected 86 patients with knee osteoarthritis caused by meniscus injury who were treated in our hospital from June 2019 to May 2020 as the research subjects.The treatment method was selected according to the patient's wishes,with 43 patients who chose conventional conservative treatment included in the control group and 43 patients who chose arthroscopic meniscus therapy included in the study group.The treatment effectiveness,visual ana-logue scale(VAS)score,HSS knee joint score and tumor necrosis factor-α(TNF-α)index levels were compared between the two groups of patients.Results The effective rate of treatment in the study group was significantly higher than that in the control group(P＜0.05);there was no significant difference between the study group and the control group in the VAS score,HSS score,and TNF-α level before treatment(P＞0.05).After treatment,the VAS score,HSS score and TNF-α level of the group were improved.The VAS score and TNF-α level of the study group after treatment were lower than those of the control group(P＜0.05),and the HSS score was higher than the control group.Group(P＜0.05).Conclusion The arthroscopic meniscus treatment for patients with knee osteoarthritis has a significant effect,which can effectively reduce the pain and inflammation of the patients and improve the function of the knee joint.

Objective To track and evaluate the implementation of the Radiation Shielding Requirements in Room of Radiotherapy Installations—Part 1: General Principle (GBZ/T 201.1–2007) among relevant personnel in medical radiation institutions, and to provide a scientific basis for revising the standard. Methods According to the Guidelines for Health Standards Tracking Evaluation (WS/T 536–2017) and the implementation protocol of standard evaluation, an online survey was conducted among 212 relevant workers from 146 medical radiation institutions across 18 provinces in China. The data were aggregated and analyzed with the use of Microsoft Excel 2010. Results A total of 215 questionnaires were returned, of which 212 were valid. Among the valid respondents, 77.8% believe that this standard is universally applied; 96.2% believe that this standard can meet work needs; 63.7% have participated in relevant training on this standard; 74.1% use this standard once or more per year; and 10.8% believe that this standard needs to be revised. Conclusion Medial radiation workers have a high rate of awareness of the basic information and content of the standard, but the understanding and application of the standard content need to be improved. We recommend that relevant departments further strengthen the promotion of and training on the standard, revise some content based on actual situation, and improve workers’ ability to use the standard.

kV X-ray radiotherapy was the primary mode of radiotherapy widely used to treat many types of cancer, including deep tumors, before the invention of the Co-60 therapy machine and the electron linear accelerator, which gradually replaced kV X-ray radiotherapy. kV X-ray radiotherapy equipment requires less space and shielding, and still has application value in the treatment of skin lesions and superficial tumors. Especially in recent years, kV X-ray has been used in the treatment of keloid, and electronic brachytherapy equipment has been used in intracavitary, intraoperative, and superficial radiotherapy. Therefore, kV X-ray radiotherapy has seen renewed application. The quality control of kV X-ray radiotherapy equipment is the key to ensure the treatment effect and safety of patients. This paper reviews the current status of quality control of kV X-ray radiotherapy equipment and provides a reference for the formulation of quality control assessment standards for kV X-ray radiotherapy equipment.

Objective To compare the morphology differences in small shadows of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") between computed tomography (CT) and digital radiography (DR) imaging. Methods A total of 1 010 pneumoconiosis patients were selected as the research subjects using a judgment sampling method. Chest DR imaging and CT imaging were performed on patients, and the differences in small shadow morphology between the two images were compared. Results In both DR and CT images of patients, circular small shadows identified as p, q, and r shapes accounted for 76.2%, 11.5%, and 1.3%, respectively, while irregular small shadows were identified in 1.8% of cases. There was medium high consistency between DR and CT in detecting these four types of small shadow morphology (Kappa=0.72, P<0.01). The detection rate of irregular small shadows (including interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema) by CT images was 54.0% (545/1 010), with 88.6% (483/545) of these cases also showing small circular shadows. Irregular small shadows in CT images were mostly identified as p small circular shadows in DR images, accounting for 88.8% (484/545). The results of DR and CT images for p/p, p/q, q/p, q/q, q/r, r/q and r/r in small circular shadows showed medium high consistency (Kappa =0.52, P<0.01). Conclusion The results of CT and DR imaging for pneumoconiosis with small shadow were of medium high consistency, with CT demonstrating advantages in detecting irregular small shadow morphology of pneumoconiosis. CT images can be used to describe the shape of circular small shadow as DR images, and irregular small shadow can be described as interlobular septal thickening, ground-glass opacity, and/or centrilobular emphysema.

Traditional antibody drug conjugates(ADC)combine monoclonal antibodies with cytotoxic drugs to accurately strike cancer cells,but there are still many shortcomings in stability,targeting,efficacy,and safety.Novel ADC,such as bi-specific,site-specific,dual-payload,and pro-drug type ADC,can be optimized by simultaneously binding 2 different antigens or epitopes,selecting more stable linkers,coupling with specific amino acid sites of antibodies,carrying different drug payloads,and adopting prodrug strategies,while retaining the characteristics of traditional ADC.Significantly improving the stability,targeting,efficacy and safety of drugs can better meet the needs of clinical treatment.Novel ADC will play a more important role in cancer treatment in the future.Discussing the progress of novel ADC in cancer treatment and analyzing their advantages and challenges can provide theoretical support for the development of anti-cancer strategies and provide directions for drug research and development.

Although immunotherapy has made a breakthrough in the treatment of cancer,the emergence of drug resistance has limited be-nefits in most patients,and reversing immunotherapy resistance remains a hotly debated and unresolved issue.The tumor microenviron-ment(TME)comprises a large number of T lymphocytes.During the biological processes of proliferation,activation,and the effect of tumor-infiltrating lymphocytes(TILs),TILs face severe local metabolic stress,resulting in metabolic reprogramming to meet the markedly increased energy demand and biosynthesis requirements.This process of adaptive changes in the metabolic pattern is closely related to the pheno-type and function of TILs,affecting immunotherapy efficacy and mediating immunotherapy resistance.In recent years,with the study of TIL metabolism and the search for specific metabolic regulatory points,targeting the TIL metabolic pathway could restore the tumor-killing func-tion and reverse immunotherapy resistance.This review explores the relationship between the metabolic reprogramming of TILs and im-mune resistance,and provides a new strategy for reversing immune resistance.