Use of Chinese Herbal Medicine Therapies in Comprehensive Hospitals in Central China: A Parallel Survey in Cancer Patients and Clinicians

Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.

“Tasks”versus“Disciplines”:The Comprehensive Surveys of Natural Resources by the Chinese Academy of Sciences,and the Politics of Science Policy in the People’s Republic of China

As soon as the Chinese Academy of Sciences(CAS)was founded by the new government of the People’s Republic of China in 1949,the principles of“linking theory with practice”and“conducting research to serve the people”set the framework for its scientific studies.How to balance their obligations to facilitate national economic construction with their desires to advance disciplinary scientific developments posed a knotty problem that frustrated those who organized and engaged in scientific research across the country,and in the CAS in particular.Against this background,the slogan“let tasks lead disciplines”was proposed as an effective solution.However,how exactly to put this into practice became a pressing issue,as CAS scientists and scholars debated the relationship between tasks and advances within scientific disciplines.This paper examines these debates as they were carried out in the case of the comprehensive surveys of natural resources organized by the CAS,focusing especially on different understandings of the relationship between“tasks”and“disciplines”within the CAS in the early 1960s,and examining the impact and legacy of“letting tasks lead disciplinary developments,”with possible lessons for the formulation of scientific plans today.

Spectral purification improves monitoring accuracy of the comprehensive growth evaluation index for film-mulched winter wheat

In order to further improve the utility of unmanned aerial vehicle(UAV)remote-sensing for quickly and accurately monitoring the growth of winter wheat under film mulching, this study examined the treatments of ridge mulching,ridge–furrow full mulching, and flat cropping full mulching in winter wheat.Based on the fuzzy comprehensive evaluation (FCE) method, four agronomic parameters (leaf area index, above-ground biomass, plant height, and leaf chlorophyll content) were used to calculate the comprehensive growth evaluation index (CGEI) of the winter wheat, and 14 visible and near-infrared spectral indices were calculated using spectral purification technology to process the remote-sensing image data of winter wheat obtained by multispectral UAV.Four machine learning algorithms, partial least squares, support vector machines, random forests, and artificial neural network networks(ANN), were used to build the winter wheat growth monitoring model under film mulching, and accuracy evaluation and mapping of the spatial and temporal distribution of winter wheat growth status were carried out.The results showed that the CGEI of winter wheat under film mulching constructed using the FCE method could objectively and comprehensively evaluate the crop growth status.The accuracy of remote-sensing inversion of the CGEI based on the ANN model was higher than for the individual agronomic parameters, with a coefficient of determination of 0.75,a root mean square error of 8.40, and a mean absolute value error of 6.53.Spectral purification could eliminate the interference of background effects caused by mulching and soil, effectively improving the accuracy of the remotesensing inversion of winter wheat under film mulching, with the best inversion effect achieved on the ridge–furrow full mulching area after spectral purification.The results of this study provide a theoretical reference for the use of UAV remote-sensing to monitor the growth status of winter wheat with film mulching.

Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

A comprehensive survey of robust deep learning in computer vision

Deep learning has presented remarkable progress in various tasks.Despite the excellent performance,deep learning models remain not robust,especially to well-designed adversarial examples,limiting deep learning models employed in security-critical applications.Therefore,how to improve the robustness of deep learning has attracted increasing attention from researchers.This paper investigates the progress on the threat of deep learning and the techniques that can enhance the model robustness in computer vision.Unlike previous relevant survey papers summarizing adversarial attacks and defense technologies,this paper also provides an overview of the general robustness of deep learning.Besides,this survey elaborates on the current robustness evaluation approaches,which require further exploration.This paper also reviews the recent literature on making deep learning models resistant to adversarial examples from an architectural perspective,which was rarely mentioned in previous surveys.Finally,interesting directions for future research are listed based on the reviewed literature.This survey is hoped to serve as the basis for future research in this topical field.

Comprehensive Evaluation of Flower Border Application Value of New and Superior Plants in Hefei Area

An analytic hierarchy process(AHP)was employed to assess the applicability of 18 new and superior varieties of flowers in Hefei City flower border applications.A total of 12 indicators were selected from three distinct aspects of adaptability,ornamental characteristics and use traits,in order to establish a comprehensive evaluation model.The results demonstrate that grade I(J≥2.685)exhibits excellent application value,encompassing six species of plants,such asHydrangeamacrophylla‘Endless Summer’;grade II(2.684≤J≤2.420)is also of notable application value,encompassing five species of plants,such asCallistemonrigidus;grade III(2.419≤J≤2.615)is of average application value,including five species of plants,such asCrocosmiacrocosmiflora;grade IV(J≤2.16)is of relatively poor application value.The evaluation results may be utilized as a theoretical reference for the promotion of new and superior varieties in the flower border of Hefei.

Enhancing landslide hazards survey and management to reduce the loss of human lives and properties

Landslides are pervasive geohazards that pose a serious threat to human lives,property,and crucial engineering constructions.Annually,landslides lead to tens of thousands of fatalities(see the paper of"List of typical catastrophic landslides from March 2004 to February 2024"in this issue,doi:10.31035/cg2024079)and cause economic damages amounting to billions of dollars around the world,as well as disrupting crucial infrastructures such as railways,highways。

Basic Survey Scheduling for the Wide Field Survey Telescope(WFST)

Aiming at improving the survey efficiency of the Wide Field Survey Telescope, we have developed a basic scheduling strategy that takes into account the telescope characteristics, observing conditions, and weather conditions at the Lenghu site. The sky area is divided into rectangular regions, referred to as “tiles,” with a size of2°. 577 × 2°. 634 slightly smaller than the focal area of the mosaic CCDs. These tiles are continuously filled in annulars parallel to the equator. The brightness of the sky background, which varies with the moon phase and distance from the moon, plays a significant role in determining the accessible survey fields. Approximately 50connected tiles are grouped into one block for observation. To optimize the survey schedule, we perform simulations by taking into account the length of exposures, data readout, telescope slewing, and all relevant observing conditions. We utilize the Greedy Algorithm for scheduling optimization. Additionally, we propose a dedicated dithering pattern to cover the gaps between CCDs and the four corners of the mosaic CCD array, which are located outside of the 3° field of view. This dithering pattern helps to achieve relatively uniform exposure maps for the final survey outputs.

Bilateral choroidal ganglioneuroma:a comprehensive analysis of vision decline in a 6-year-old boy

Dear Editor,We write to present a 6-year-old boy with bilateral choroidal ganglioneuroma(CG)by comprehensive multimodal imaging(MMI)in a duration of 6-year follow-up.To our knowledge,this is the first case report with elaborate data to delineate the natural history of visual function and MMI in a boy with rare bilateral CG,confirmed by choroid biopsy.

Spatial structural characteristics of the Deda ancient landslide in the eastern Tibetan Plateau:Insights from Audio-frequency Magnetotellurics and the Microtremor Survey Method

It is of crucial importance to investigate the spatial structures of ancient landslides in the eastern Tibetan Plateau’s alpine canyons as they could provide valuable insights into the evolutionary history of the landslides and indicate the potential for future reactivation.This study examines the Deda ancient landslide,situated in the Chalong-ranbu fault zone,where creep deformation suggests a complex underground structure.By integrating remote sensing,field surveys,Audio-frequency Magnetotellurics(AMT),and Microtremor Survey Method(MSM)techniques,along with engineering geological drilling for validation,to uncover the landslide’s spatial feature s.The research indicates that a fault is developed in the upper part of the Deda ancient landslide,and the gully divides it into Deda landslide accumulation zoneⅠand Deda landslide accumulation zoneⅡin space.The distinctive geological characteristics detectable by MSM in the shallow subsurface and by AMT in deeper layers.The findings include the identification of two sliding zones in the Deda I landslide,the shallow sliding zone(DD-I-S1)depth is approximately 20 m,and the deep sliding zone(DD-I-S2)depth is 36.2-49.9 m.The sliding zone(DD-Ⅱ-S1)depth of the DedaⅡlandslide is 37.6-43.1 m.A novel MSM-based method for sliding zone identification is proposed,achieving less than 5%discrepancy in depth determination when compared with drilling data.These results provide a valuable reference for the spatial structural analysis of large-deepseated landslides in geologically complex regions like the eastern Tibetan Plateau.

Field survey and analysis on near-fault severely damaged high-speed railway bridge in 2022 M6.9 Menyuan earthquake

The 2022 M6.9 Menyuan earthquake caused severe damage to a high-speed railway bridge,which was designed for high-speed trains running at speeds of above 250 km/h and is located right next to the fault.Bridges of this type have been widely used for rapidly constructing the high-speed railway network,but few bridges have been tested by near-fault devastating earthquakes.The potential severe impact of the earthquake on the high-speed railway is not only the safety of the infrastructure,trains and passengers,but also economic loss due to interrupted railway use.Therefore,a field survey was carried out immediately after the earthquake to collect time-sensitive data.The damage to the bridge was carefully investigated,and quantitative analyses were conducted to better understand the mechanism of the bridge failure.It was found that seismic action perpendicular to the bridge’s longitudinal direction caused severe damage to the girders and rails,while none of the piers showed obvious deformation or cracking.The maximum values of transverse displacement,out-of-plane rotation and twisting angle of girders reached 212.6 cm,3.1 degrees and 19.9 degrees,respectively,causing severe damage to the bearing supports and anti-seismic retaining blocks.These observations provide a basis for improving the seismic design of high-speed railway bridges located in near-fault areas.

Socio-scientific quantification of the comprehensive benefits of debris flow mitigation measures for villages in western Sichuan, China

Debris flow hazards seriously threaten thesafety and sustainable development of mountainousareas. Numerous debris flow mitigation measures havebeen implemented worldwide;however, acomprehensive assessment of the specific disasterreduction effects of these measures and their economic,social and ecological benefits is yet to be performed.The western region of Sichuan Province frequentlysuffers from geohazards such as debris flow, and thegovernment has adopted many mitigation measures.This study assessed the benefits of debris flowmitigation measures and identified the key influencingfactors via a field-based study conducted in 81 villagesin western Sichuan province, China. A framework forthe evaluation of the benefits of rural debris flowmitigation measures was constructed andquantitatively evaluated using a survey. Snowballsampling was performed to recruit 81 village leadersand 468 farmers. The results showed that managementand engineering measures were the main methodsused to mitigate debris flow;ecological measures wereauxiliary. The average satisfaction scores of farmers forthese three types of measures were 4.07, 3.90, and 3.56,respectively (as measured on a five-point Likert scale).In contrast, in terms of the benefits of these mitigationmeasures, only a small proportion of villages (11.11%)obtained a high level of comprehensive benefits fromthe debris flow mitigation measures, while the majority(88.89%) received medium to low-level benefits. Toimprove this situation, we further studied and foundthat the main factors that restricted villages fromachieving high-level comprehensive benefits were theunpredictable nature of debris flows, labour forceoutflow and remoteness. Effective control measures, agood economic environment and strong governmentassistance were reported as crucial factors forimproving these comprehensive benefits. This studyprovides socio-scientific references for decisionmakingon rural debris flow mitigation measures while keeping villages at the centre of economic development.

Survey on performance of vertical slot and nature-like fishways at Angu hydropower station, Southwest China

To restore dam-blocked natural fish migratory passages,a growing number of artificial fishways have been built in water conservancy and hydropower projects in China.The Angu hydropower station involved diverse important fish habitats in the lower reaches of the Daduhe River in Southwest China.Therefore,a vertical slot fishway(VSF)and a nature-like fishway(NLF)were built near the backwater area of the reservoir to connect the upstream and downstream habitats.Hydrodynamic and aquatic ecological surveys were conducted after the completion of the project to estimate the fish passing effect of the two fishways.The results indicated that both fishways were in effective operation and could maintain the desired hydrodynamic conditions and be used by several local fish species.During the survey,149 fish from 15 species and 111 fish from 17 species were captured by the traps in the VSF and NLF,respectively,while 1263 fish from 27 species were found in the downstream area.Some species captured in the VSF were not found in the NLF,and vice versa,which implied the different preferences of fish.Meanwhile,3789 signals including 2099 upward ones and 1690 downward ones were monitored with an ultrasonic fish detector at the inlet of the VSF.These findings revealed the characteristics of fish species observed in and near the fishways and provided valuable insights into the different fish passing capabilities of VSFandNLF.

Strategies for improving crop comprehensive benefits via a decision-making system based on machine learning in the rice‒rape,rice‒wheat and rice‒garlic rotation systems in Southwest China

Rice‒rape,rice‒wheat and rice‒garlic rotations are common cropping systems in Southwest China,and they have played a significant role in ensuring ecological and economic benefits(EB)and addressing the challenges of China’s food security in the region.However,the crop yields in these rotation systems are 1.25‒14.73%lower in this region than the national averages.Intelligent decision-making with machine learning can analyze the key factors for obtaining better benefits,but it has rarely been used to enhance the probability of obtaining such benefits from rotations in Southwest China.Thus,we used a data-intensive approach to construct an intelligent decision‒making system with machine learning to provide strategies for improving the benefits of rice-rape,rice-wheat,and rice-garlic rotations in Southwest China.The results show that raising the yield and partial fertilizer productivity(PFP)by increasing seed input under high fertilizer application provided the optimal benefits with a 10%probability in the rice-garlic system.Obtaining high yields and greenhouse gas(GHG)emissions by increasing the N application and reducing the K application provided suboptimal benefits with an 8%probability in the rice-rape system.Reducing N and P to enhance PFP and yield provided optimal benefits with the lowest probability(8%)in the rice‒wheat system.Based on the predictive analysis of a random forest model,the optimal benefits were obtained with fertilization regimes by reducing N by 25%and increasing P and K by 8 and 74%,respectively,in the rice-garlic system,reducing N and K by 54 and by 36%,respectively,and increasing P by 38%in rice-rape system,and reducing N by 4%and increasing P and K by 65 and 23%in rice-wheat system.These strategies could be further optimized by 17‒34%for different benefits,and all of these measures can improve the effectiveness of the crop rotation systems to varying degrees.Overall,these findings provide insights into optimal agricultural inputs for higher benefits through an intelligent decision-making system with machine learning analysis in the rice-rape,rice‒wheat,and rice-garlic systems.

Nationwide questionnaire survey on pediatric pancreatic tumors in Japan

BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pediatric pancreatic tumors,no comprehensive treatment plans for pediatric pancreatic tumors have been developed.AIM To compared the clinical features,treatment methods,and prognosis of pediatric pancreatic tumors in Japan with those in other countries.METHODS Questionnaires were sent to 213 pediatric surgical units in Japan.Pancreatic tumors that were not surgically treated were excluded from the survey.The primary survey investigated the number of patients aged 0-18 years who underwent pancreatic tumor surgery and the type of tumors managed during the 22-year study period(from January 1,2000 to December 31,2021)by post card.The secondary survey assessed the clinical images,treatment methods,and tumor outcomes via email.RESULTS The primary survey enrolled 228 patients.In the secondary survey,213 patients were eventually enrolled.The most common type of pancreatic tumor was solid pseudopapillary neoplasm(SPN)[n=164(77.0%)],followed by pancreatoblastoma[n=16(7.5%)],pancreatic endocrine tumor[n=14(6.6%)],non-epithelial tumor[n=9(4.2%)],pancreatic tumor[n=7(3.3%)],and metastatic pancreatic tumor[n=3(1.4%)].Overall,123(57.7%)patients underwent distal pancreatectomy,of whom 49 underwent laparoscopic surgery.Forty-four(20.7%)patients underwent enucleation,of whom eight underwent laparoscopic surgery.Thirty-two(15.0%)patients underwent pancreaticoduodenectomy,of whom one underwent laparoscopic surgery.All patients with SPN,including those with distant metastases and recurrent disease,survived.CONCLUSION SPN was more common in Japan than in other countries.Regardless of the histological type,resection is the most effective treatment for pediatric pancreatic tumors.

Comprehensive reutilization of herbal waste:Coproduction of magnolol,honokiol,and β-amyrin from Magnolia officinalis residue

Herbal extraction residues(HERs)cause serious environmental pollution and resource waste.In this study,a novel green route was designed for the comprehensive reutilization of all components in HERs,taking Magnolia officinalis residues(MOR)as an example.The reluctant structure of MOR was first destroyed by alkali pretreatment to release the functional ingredients(magnolol and honokiol)originally remaining in MOR and to make MOR more accessible for hydrolysis.A metal–organic frame material MIL-101(Cr)with a maximum absorption capacity of 255.64 mg g^(-1)was synthesized to absorb the released honokiol and magnolol from the pretreated MOR solutions,and 40 g L^(-1)reducing sugars were obtained with 81.8%enzymatic hydrolysis rate at 10%MOR solid loading.Finally,382 mg L-1β-amyrin was produced from MOR hydrolysates by an engineered yeast strain.In total,1 kg honokiol,8 kg magnolol,and 7.64 kg β-amyrin could produce from 1 ton MOR by this cleaner process with a total economic output of 170,700 RMB.

Intervention package on stress management: Improving comprehensive well-being among nurses

Objective:The main objective of this study is to investigate the effectiveness of the stress management intervention package in improving stress-related burnout.Materials and Methods:An experimental study was done on 300 nurses selected by a nonprobability convenience sampling technique and a quasi-experimental one-group pre-and posttest research design was utilized.Modified expanded nurses stress scale and self-structured three-point Likert scale on the challenges that nurses may face following stressful life events utilized to collect information.The nurses signed up for six interactive sessions on various stress-coping methods by utilizing a variety of teaching strategies such as lecture cum discussion,video slides,group work,and direct interaction with the experts to explore stress-related issues.Results:Continuous stress affects both the body and the mind,causing psychosomatic symptoms.Data found that 2%to 10%of nurses frequently suffered with physical symptoms such as exhaustion,backache,acidity,headache,shoulder stiffness,and insomnia.Following the intervention,the number of nurses who had these symptoms frequently and sometimes decreased.Previously,10%of nurses experienced emotional symptoms frequently;however,after intervention,this figure was reduced to<2%.The greatest proportion of nurses(18%)reported frequently worrying,while 1.3%expressed frequent worrying after intervention.Maximum(5%)of nurses had a tendency to eat too little or too much;this has been reduced to 0.3%after the intervention.The intervention package on stress management significantly improved nurses’Conclusion:An intervention package for stress management was helpful in lowering physical,emotional,psychological,and behavioral stress-related symptoms among nurses.

Comprehensive analysis of gene mutations and mismatch repair in Chinese colorectal cancer patients

BACKGROUND RAS,BRAF,and mismatch repair(MMR)/microsatellite instability(MSI)are crucial biomarkers recommended by clinical practice guidelines for colorectal cancer(CRC).However,their characteristics and influencing factors in Chinese patients have not been thoroughly described.AIM To analyze the clinicopathological features of KRAS,NRAS,BRAF,and PIK3CA mutations and the DNA MMR status in CRC.METHODS We enrolled 2271 Chinese CRC patients at the China-Japan Friendship Hospital.MMR proteins were tested using immunohistochemical analysis,and the KRAS/NRAS/BRAF/PIK3CA mutations were determined using quantitative polymerase chain reaction.Microsatellite status was determined using an MSI detection kit.Statistical analyses were conducted using SPSS software and logistic regression.RESULTS The KRAS,NRAS,BRAF,and PIK3CA mutations were detected in 44.6%,3.4%,3.7%,and 3.9% of CRC patients,respectively.KRAS mutations were more likely to occur in patients with moderate-to-high differentiation.BRAF mutations were more likely to occur in patients with right-sided CRC,poorly differentiated,or no perineural invasion.Deficient MMR(dMMR)was detected in 7.9% of all patients and 16.8% of those with mucinous adenocarcinomas.KRAS,NRAS,BRAF,and PIK3CA mutations were detected in 29.6%,1.1%,8.1%,and 22.3% of patients with dMMR,respectively.The dMMR was more likely to occur in patients with a family history of CRC,aged<50 years,right-sided CRC,poorly differentiated histology,no perineural invasion,and with carcinoma in situ,stage I,or stage II tumors.CONCLUSION This study analyzed the molecular profiles of KRAS,NRAS,BRAF,PIK3CA,and MMR/MSI in CRC,identifying key influencing factors,with implications for clinical management of CRC.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention

BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.