Clinical prognostic significance of xeroderma pigmentosum group C and IFN­Î³ in non­small cell lung cancer.

Lung cancer is the most common cancer in the world due to its high incidence and recurrence. Genetic instability is one of the main factors leading to its occurrence, development and poor prognosis. Decreased xeroderma pigmentosum group C (XPC) expression notably enhances the stem cell properties of lung cancer cells and increases their proliferation and migration. Additionally, patients with lung cancer and low XPC expression had a poor prognosis. The purpose of the present study was to analyze the effect of XPC and IFN-γ on the clinical prognosis of patients with non-small cell lung cancer (NSCLC). Lung adenocarcinoma specimens were collected from a total of 140 patients with NSCLC. Additionally, from these 140 patients, 48 paracarcinoma tissue specimens were also collected, which were later used to construct tissue microarrays. The expression of XPC and IFN-γ in cancer tissues and in paraneoplastic tissues was detected using immunohistochemistry. The prognosis and overall survival of patients were determined through telephone follow-up. The results showed a positive correlation between expression of XPC and IFN-γ in NSCLC. Additionally, high expression of both markers was associated with a favorable prognosis in patients with NSCLC. The aforementioned findings suggest that the expression of XPC and IFN-γ has prognostic value in clinical practice and is expected to become a marker for clinical application.

Comparison of the safety and effectiveness of the four-hook needle and hook wire for the preoperative positioning of localization ground glass nodules.

BACKGROUND: With the implementation of lung cancer screening programs, an increasing number of pulmonary nodules have been detected.Video-assisted thoracoscopic surgery (VATS) could provide adequate tissue specimens for pathological analysis, and has few postoperative complications.However, locating the nodules intraoperatively by palpation can be difficult for thoracic surgeons. The preoperative pulmonary nodule localization technique is a very effective method.We compared the safety and effectiveness of two methods for the preoperative localization of pulmonary ground glass nodules. METHODS: From October 2020 to April 2021, 133 patients who underwent CT-guided single pulmonary nodule localization were retrospectively reviewed. All patients underwent video-assisted thoracoscopic surgery (VATS) after successful localization. Statistical analysis was used to evaluate the localization accuracy, safety, information related to surgery and postoperative pathology information. The aim of this study was to evaluate the clinical effects of the two localization needles. RESULTS: The mean maximal transverse nodule diameters in the four-hook needle and hook wire groups were 8.97 ± 3.85 mm and 9.00 ± 3.19 mm, respectively (P = 0.967). The localization times in the four-hook needle and hook wire groups were 20.58 ± 2.65 min and 21.43 ± 3.06 min, respectively (P = 0.09). The dislodgement rate was significantly higher in the hook wire group than in the four-hook needle group (7.46% vs. 0, P = 0.024). The mean patient pain scores based on the visual analog scale in the four-hook needle and hook wire groups were 2.87 ± 0.67 and 6.10 ± 2.39, respectively (P = 0.000). All ground glass nodules (GGNs) were successfully resected by VATS. CONCLUSIONS: Preoperative pulmonary nodule localization with both a four-hook needle and hook wire is safe, convenient and effective.

Development and validation of a nomogram for predicting pulmonary complications after video-assisted thoracoscopic surgery in elderly patients with lung cancer.

Background: Postoperative pulmonary complications (PPCs) significantly increase the morbidity and mortality in elderly patients with lung cancer. Considering the adverse effects of PPCs, we aimed to derive and validate a nomogram to predict pulmonary complications after video-assisted thoracoscopic surgery in elderly patients with lung cancer and to assist surgeons in optimizing patient-centered treatment plans. Methods: The study enrolled 854 eligible elderly patients with lung cancer who underwent sub-lobectomy or lobectomy. A clinical prediction model for the probability of PPCs was developed using univariate and multivariate analyses. Furthermore, data from one center were used to derive the model, and data from another were used for external validation. The model's discriminatory capability, predictive accuracy, and clinical usefulness were assessed using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis, respectively. Results: Among the eligible elderly patients with lung cancer, 214 (25.06%) developed pulmonary complications after video-assisted thoracoscopic surgery. Age, chronic obstructive pulmonary disease, surgical procedure, operative time, forced expiratory volume in one second, and the carbon monoxide diffusing capacity of the lung were independent predictors of PPCs and were included in the final model. The areas under the ROC curves (AUC) of the training and validation sets were 0.844 and 0.796, respectively. Ten-fold cross-validation was used to evaluate the generalizability of the predictive model, with an average AUC value of 0.839. The calibration curve showed good consistency between the observed and predicted probabilities. The proposed nomogram showed good net benefit with a relatively wide range of threshold probabilities. Conclusion: A nomogram for elderly patients with lung cancer can be derived using preoperative and intraoperative variables. Our model can also be accessed using the online web server https://pulmonary-disease-predictor.shinyapps.io/dynnomapp/. Combining both may help surgeons as a clinically easy-to-use tool for minimizing the prevalence of pulmonary complications after lung resection in elderly patients.

A comprehensive nomogram combining CT-based radiomics with clinical features for differentiation of benign and malignant lung subcentimeter solid nodules.

Objective: To establish a nomogram based on non-enhanced computed tomography(CT) imaging radiomics and clinical features for use in predicting the malignancy of sub-centimeter solid nodules (SCSNs). Materials and methods: Retrospective analysis was performed of records for 198 patients with SCSNs that were surgically resected and examined pathologically at two medical institutions between January 2020 and June 2021. Patients from Center 1 were included in the training cohort (n = 147), and patients from Center 2 were included in the external validation cohort (n = 52). Radiomic features were extracted from chest CT images. The least absolute shrinkage and selection operator (LASSO) regression model was used for radiomic feature extraction and computation of radiomic scores. Clinical features, subjective CT findings, and radiomic scores were used to build multiple predictive models. Model performance was examined by evaluating the area under the receiver operating characteristic curve (AUC). The best model was selected for efficacy evaluation in a validation cohort, and column line plots were created. Results: Pulmonary malignant nodules were significantly associated with vascular alterations in both the training (p < 0.001) and external validation (p < 0.001) cohorts. Eleven radiomic features were selected after a dimensionality reduction to calculate the radiomic scores. Based on these findings, three prediction models were constructed: subjective model (Model 1), radiomic score model (Model 2), and comprehensive model (Model 3), with AUCs of 0.672, 0.888, and 0.930, respectively. The optimal model with an AUC of 0.905 was applied to the validation cohort, and decision curve analysis indicated that the comprehensive model column line plot was clinically useful. Conclusion: Predictive models constructed based on CT-based radiomics with clinical features can help clinicians diagnose pulmonary nodules and guide clinical decision making.

Future time perspective and academic procrastination among nursing students: The mediating role of mindfulness.

AIM: To explore the relationship between university nursing students' academic procrastination, mindfulness, and future time perspective. DESIGN: A cross-sectional study. METHODS: A total of 343 university nursing students recruited from eight provinces in China have reported procrastination characteristics through fulfilling an online website link. The main instruments involved Mindfulness Attention Awareness Scale (MAAS), Zimbardo Time Perspective Scale, and Procrastination Assessment Scale (PASS). RESULTS: Participants who self-assessed higher frequency and degree of academic procrastination tended to possess lower future time consciousness, and lower mindfulness. Mindfulness served as a mediation effect between future time perspective and academic procrastination. The study indicates that weakening an individual's procrastination can be alleviated through future time awareness and mindfulness. Concentrating on influencing factors, strengthening nursing student's future time perspective, and practicing mindfulness training could assist educators to decrease students' procrastination intentions and behaviours.

Impact of the combination of sintilimab and chemotherapy on the tumor and paratumor PD-L1, IDO, TIM-3, FOXP3+ and CD8 expressions in patients with advanced esophageal squamous cell carcinoma.

BACKGROUND: Anti-PD-1/PD-L1 therapeutics have been widely used in the clinic in various tumors, including advanced esophageal cancer, showing remarkable treatment efficacy. Factors determining the response to anti-PD-1/PD-L1 therapeutics are numerous, including the tumor microenvironment, such as CD8+ T cells and expression of PD-1/PD-L1. Our study aimed to explore the effect of chemoimmunotherapy on the expression of CD8+ T cells, TIM-3, and FOXP3+ in tumor, paratumor tissues, and the expression of PD-L1, IDO, in tumor, paratumor tissues, and lymph nodes, and analyze the correlation among these markers. METHODS: A total of 18 patients were allocated into two treatment groups: a treatment group and a concurrent control group. A total of 38 tissue samples, 114 slides (tumor, paratumor, and lymph node) were collected in the treatment group, and 37 tissue samples, 111 slides (tumor, paratumor, and lymph node) were collected in the concurrent control group. RESULTS: The expression of PD-L1, CD8+, FOXP3+, TIM-3, and IDO in tumors, paratumor tissues, but not lymph nodes, was significantly affected by chemoimmunotherapy. Compared with patients without chemoimmunotherapy, the expression of CD8+ T cells, IDO, and PD-L1 was significantly decreased in tumor and paratumor tissues after chemoimmunotherapy, while FOXP3+ expression was significantly decreased only in tumor tissues, and TIM-3 expression was significantly decreased only in paratumor tissues. Moreover, the correlation between these markers was also completely altered after chemoimmunotherapy. In addition, N staging was associated with high expression of CD8 in advanced esophageal squamous cell carcinoma in the concurrent control group. CONCLUSION: This study provides new insight into the effects of CI treatment on isolated CD8+ T cell infiltration, PD-L1, IDO, FOXP3+ and TIM-3 expression as well as their cross-talk in different tissues enabling a better understanding of the impact of CI treatment on the immune microenvironment.

Short-Term Surgical Outcomes for Lobectomy Between Robot-Assisted Thoracic Surgery and Uniportal Video-Assisted Thoracoscopic Surgery.

Objectives: To evaluate the short-term outcomes of uniportal video-assisted thoracoscopic surgery (UVATS) and Da Vinci robot-assisted thoracoscopic surgery (RATS) in lobectomy and lymph node (LN) dissection. Methods: The two groups of patients with primary non-small cell lung cancer (NSCLC; RATS group, UVATS group) were matched by the propensity score to compare LN dissection and recent clinical outcomes. The results were analyzed by univariate analysis. From November 2020 to November 2021, 412 NSCLC patients (54 RATS and 358 UVATS) from a single institution of the Provincial Hospital affiliated with Shandong First Medical University were included in the analysis. Age, sex, lung lobe, surgical resection scope, solid nodules, and core tumor ratios were matched according to different surgical methods. Results: From November 2020 to November 2021, 412 patients with NSCLC (54 RATS, 358 UVATS) from the Provincial Hospital affiliated with Shandong First Medical University were included in the analysis. According to our matching results, LN dissection was more thorough in the RATS group. Conclusion: RATS has potential advantages over UVATS in radical lung cancer surgery.

The influence of minimally invasive esophagectomy versus open esophagectomy on postoperative pulmonary function in esophageal cancer patients: a meta-analysis.

OBJECTIVE: To compare the influence of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) on postoperative pulmonary function in patients with esophageal cancer. METHODS: Studies about the influence of MIE and OE on postoperative pulmonary function in esophageal cancer patients were searched from PubMed, EMBASE, the Cochrane Library, CNKI, Chinese Science and Technology Journal Database, CBM, and Wanfang Data from inception to March 18, 2021. Meta-analysis was performed using the RevMan 5.3. RESULTS: This analysis included eight studies, enrolling 264 patients who underwent MIE and 257 patients who underwent OE. The meta-analysis results showed that the MIE group had a higher outcome regarding the percent predicted vital capacity (%VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximum voluntary ventilation (MVV) 1 month after surgery than the OE group. In addition, those who underwent MIE had lower ΔVC%, ΔFVC, and ΔFEV1 between pre-operation and 1 month after surgery than those who underwent OE. There is no statistical difference between the two groups in ΔMVV. CONCLUSION: Compared with OE, MIE has a more protective effect on postoperative pulmonary function. However, due to the small number of included literature and all cohort studies, this finding needs to be validated with larger samples and higher quality RCT studies.

A nomogram for predicting postoperative pulmonary infection in esophageal cancer patients.

BACKGROUND: Although postoperative pulmonary infection (POI) commonly occurs in patients with esophageal cancer after curative surgery, a patient-specific predictive model is still lacking. The main aim of this study is to construct and validate a nomogram for estimating the risk of POI by investigating how perioperative features contribute to POI. METHODS: This cohort study enrolled 637 patients with esophageal cancer. Perioperative information on participants was collected to develop and validate a nomogram for predicting postoperative pulmonary infection in esophageal cancer. Predictive accuracy, discriminatory capability, and clinical usefulness were evaluated by calibration curves, concordance index (C-index), and decision curve analysis (DCA). RESULTS: Multivariable logistic regression analysis indicated that length of stay, albumin, intraoperative bleeding, and perioperative blood transfusion were independent predictors of POI. The nomogram for assessing individual risk of POI indicated good predictive accuracy in the primary cohort (C-index, 0.802) and validation cohort (C-index, 0.763). Good consistency between predicted risk and observed actual risk was presented as the calibration curve. The nomogram for estimating POI of esophageal cancer had superior net benefit with a wide range of threshold probabilities (4-81%). CONCLUSIONS: The present study provided a nomogram developed with perioperative features to assess the individual probability of infection may conducive to strengthen awareness of infection control and provide appropriate resources to manage patients at high risk following esophagectomy.

Prognostic factors for survival in esophageal squamous cell carcinoma (ESCC) patients with a complete regression of the primary tumor (ypT0) after neoadjuvant chemoradiotherapy (NCRT) followed by surgery.

BACKGROUND: There are also differences in survival prognosis among esophageal squamous cell carcinoma (ESCC) patients with a complete regression of the primary tumor (ypT0) after Neoadjuvant chemoradiotherapy (NCRT) followed by surgery. And the purpose of this study was to investigate influencing factors from these different prognostic outcomes and their possible causes. METHODS: The clinical data of 88 cases of ESCC patients with ypT0 after NCRT followed by surgery between 2011 and 2019 were retrospectively analyzed. The clinical and pathological prognostic factors that affect the survival were analyzed. RESULTS: Sex, number of lymph nodes dissected, and pathologic positivity of lymph nodes may be significant in univariate analysis (P<0.1). Further multivariate analysis suggested that the pathologic positivity of the lymph nodes was an independent factor affecting prognosis (HR: 4.757, 95% CI: 2.195-10.313, P=0.000). Subsequently, the whole group was divided into a positive lymph node group (group LN+) and a negative lymph node group (group LN-) for comparison. The overall survival (OS) of group LN+ was significantly worse (HR: 0.211, 95% CI: 0.0336-0.239; P<0.0001), and recurrence-free survival (RFS) was significantly poorer in the LN+ group (HR: 0.0679, 95% CI: 0.0239-0.1923, P<0.0001). There were 14 cases of recurrence and metastasis in the LN+ group (14/21, 66.7%) and 10 cases in the group LN- (10/67, 14.9%). Among the sites of recurrence and metastasis, there were 10 (10/14, 71.4%) and 4 (4/14, 28.6%) cases of distant metastasis, respectively, and 4 (4/14, 28.6%) cases of local metastasis in the LN+ group; meanwhile, there were 8 (8/10, 80.0%) cases of distant metastasis and 2 (2/10, 20.0%) cases of local metastasis in the LN- group. CONCLUSIONS: The independent risk factor for survival prognosis in ESCC patients with ypT0 after NCRT followed by surgery was positive postoperative pathological lymph nodes. The reason for the shortened survival time associated with this group of patients was their susceptibility to recurrence and metastasis.

Risk factors for lymph node metastasis and surgical methods in patients with early-stage peripheral lung adenocarcinoma presenting as ground glass opacity.

BACKGROUND: It is difficult to predict lymph node metastasis in patients with early lung cancer. Pure ground glass opacity (GGO) on computed tomography indicates an early-stage adenocarcinoma that can be removed by limited resection or lobectomy without the need for mediastinal lymph node dissection or sampling, and lung adenocarcinoma with GGO therefore has a good prognosis. We examined the incidence and risk factors of lymph node metastasis in patients with clinical stage IA lung adenocarcinoma. METHODS: We retrospectively analyzed clinical data for 327 patients with stage IA peripheral lung cancer treated in our hospital from March 2014 to December 2018. The patients were divided into four groups according to computed tomography signs. Lobectomy and systematic lymph node dissection were performed in all patients. Correlations between lymph node metastasis and clinical pathological factors were analyzed by logistic regression. RESULTS: Among the 327 patients, 26 (7.95%) had lymph node metastasis. No patients with pure GGO or GGO-dominant types had lymph node metastasis. Logistic regression identified tumor diameter, solid content, plasma carcinoembryonic antigen (CEA) level, pathological type, lymphovascular invasion, and pleural invasion as factors related to the presence of lymph node metastasis. CONCLUSIONS: Tumor diameter, solid component ratio, plasma CEA level, pathological type, vascular tumor thrombus, and pleural invasion are possible independent risk factors for lymph node metastasis in patients with stage IA lung adenocarcinoma. In contrast, lymph node metastasis is rare in patients with pure GGO or GGO-dominant lung adenocarcinoma.

Enhanced Recovery after Surgery for Lung Cancer Patients.

BACKGROUND: Enhanced recovery after surgery (ERAS) is a perioperative treatment intended to speed up recovery of surgical patients. Pulmonary lobectomy is a high-risk procedure, which ERAS is intended to address. OBJECTIVE: We evaluated the application of ERAS to patients with lung cancer. INTERVENTIONS/METHODS: Of 337 patients who underwent pulmonary lobectomies for lung cancer at our hospital, 168 received traditional perioperative nursing, and 169 received ERAS. Their complication rates, numerical rating scale of pain (NRS), satisfaction with care, demographics and some inpatient indices before and after surgery were compared. RESULTS: The two groups did not significantly differ in general data or NRS score at 6 post-operative hours (P = 0.214) and 1 post-operative day (POD; P = 0.027). The ERAS group had lower incidence of postoperative lung complication (P = 0.008), shorter length of stay (P < 0.001), shorter enterokinesia recovery times (P < 0.001), lower hospitalization costs (P < 0.001), lower NRS scores at POD 2-5 (P < 0.001), higher nursing satisfaction (P < 0.001), and higher postoperative pulmonary function indices of maximal voluntary ventilation (MVV; P < 0.001), forced vital capacity (FVC; P = 0.002), and forced expiratory volume in 1 second (FEV1; P = 0.002) than did the traditional group. CONCLUSION: ERAS is applicable to lung surgery patients. IMPLICATIONS FOR PRACTICE: Applying ERAS to thoracic surgery patients can alleviate their postoperative pain, shorten enterokinesia recovery, lower postoperative complication incidence, reduce hospitalization expenses, and raise nursing satisfaction, thereby expediting recovery.

Clinical characteristics and management of cardiac and/or pulmonary cement embolus after percutaneous vertebroplasty: a single center experience.

BACKGROUND: Cardiac and/or pulmonary cement embolus (CPCE) caused by the leakage of bone cement after percutaneous vertebroplasty (PVP) are rare but are lethal complications in patients with vertebral compression fracture (VCF). Literature in this field is limited, and guidelines for the management of such complications are unclear. This study aimed to review our center's experience. METHODS: Medical records (clinical characteristics and management) and imaging data (X-ray findings, CT findings, and fluoroscopic findings) of 12 patients with CPCE after PVP between October 2015 and July 2018 at our hospital were collected and examined retrospectively. Their health conditions were also evaluated through a telephone follow-up survey. RESULTS: Twelve patients with an average age of 76.8±8.5 years were included in our study. One patient who had a cardiac cement embolus and one patient who suffered from an inferior vena cava (IVC) cement embolus were successfully treated via percutaneous retrieval. Ten asymptomatic patients with pulmonary cement embolus (PCE) were managed with conservative observation. All of the patients were alive and remained asymptomatic during the follow-up period (median time, 6.5 months; range, 1-50 months). CONCLUSIONS: More attention should be paid to the possibility of development of CPCE. For patients with cardiac cement embolus, open heart surgery should be considered as a preferred treatment, and percutaneous procedure could be used as an alternative treatment for patients with surgical contraindication or other surgical high-risk factors. For patients with an IVC cement spike, percutaneous retrieval could be recommended. Careful observation and clinical follow-up could be recommended for patients with asymptomatic peripheral or central PCEs.

The influence of adjuvant radiation therapy after endoscopic resection on survival for early stage EC: an analysis of the surveillance epidemiology and end results (SEER) database.

BACKGROUND: Endoscopic resection (ER) followed by radiation therapy (RT) is a treatment option for early stage esophageal cancer (EC). We used the surveillance epidemiology and end results (SEER) database to investigate the influence of adjuvant RT after ER on survival for early stage EC. METHODS: The SEER database [1998-2013] was queried for locoregional cases of EC. Tumor staging was redefined with the 8th Edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control tumor-node-metastasis (TNM) staging system. The T1-2 stage EC cases in which ER were followed by radiation or observation were included. Kaplan-Meier methods were performed to compare overall survival (OS) and cancer-specific survival (CSS) between the patients who received radiation and those who did not. Subgroup analysis was made according to AJCC stage. A multivariate Cox proportional-hazards regression model was used to identify independent covariates which may influence survival. RESULTS: The median survival of the no-radiation group was significantly longer than that of the radiation group [74 vs. 31 months; hazard risk (HR), 2.39; 95% confidence interval (CI), 1.782-3.197; P<0.001]. In T1a stage subgroup, patients who did not receive RT had significantly better OS and CSS outcomes (OS: 90 vs. 31 months; HR, 2.90; 95% CI, 1.766-4.773; P<0.001; CSS: 105 vs. 48 months; HR, 5.40; 95% CI, 2.636-8.226; P<0.001). In the T1b and T2 subgroup analyses, both the OS and CSS were not significantly different between the radiation group and the no-radiation group (all P>0.05). In multivariate regression analysis, radiation was not a significant factor for OS and CSS after adjustment for confounding factors (P>0.05). CONCLUSIONS: Using SEER data, we revealed that RT after ER did not improve survival in early stage EC patients; specifically, RT did not benefit T1b and T2 patients and may lead to poorer survival in T1a patients. Our findings do not support the addition of RT after ER for early stage EC, especially T1a EC.

Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery.

AIM: To explore symptom clusters experienced by patients with oesophageal cancer 3 months after surgery and examine whether symptom clusters are related to demographic, clinical and quality of life variables. BACKGROUND: There are multiple symptoms in patients with oesophageal cancer after surgery, which seriously affect their quality of life. Exploring the mechanics of concurrent symptoms such as symptom clusters may facilitate the development of strategies to reduce the impact of these symptoms and improve quality of life. DESIGN: Cross-sectional survey. The STROBE Statement was chosen as the EQUATOR checklist. METHODS: A convenience sample of 128 oesophageal cancer patients was followed up at 3 months after surgery. Participants completed the demographic questionnaire, the M. D. Anderson Symptom Inventory for Gastrointestinal Cancer, the Functional Assessment of Cancer Therapy-General and the Connor-Davidson Resilience Scale. Exploratory factor analysis, stepwise regression and correlation analysis were applied. RESULTS: Four symptom clusters were identified: dysphagia-psychological, chemoradiotherapy side-effect, digestive tract reconstruction and fatigue-sleep. Gender, stage of disease and resilience influenced the dysphagia-psychological symptom cluster. Gender, stage of disease, resilience and treatment were significant factors affecting the chemoradiotherapy side-effect and fatigue-sleep symptom clusters. Gender, stage of disease, resilience and anastomotic position were significant factors influencing the digestive tract reconstruction symptom cluster. The correlations between symptom clusters and quality of life were significant, with the highest correlation between the dysphagia-psychological cluster and quality of life. CONCLUSIONS: Nurses should pay more attention to symptom management in patients with oesophageal cancer 3 months after surgery by focusing on four symptom clusters. It is necessary to implement individualised care depending on the influence factors including gender, stage of disease, resilience, treatment and anastomotic position. RELEVANCE TO CLINICAL PRACTICE: These findings will help develop targeted interventions to facilitate further symptom management for transitional nursing from the peri-operative phase to long-term rehabilitation.

Emotional intelligence a academic procrastination among junior college nursing students.

AIMS: To explore nursing students' academic procrastination and its relationship with emotional intelligence (EI) and self-efficacy, and self-efficacy's mediation of the relationship between EI and academic procrastination. BACKGROUND: Academic procrastination can lead to a range of negative outcomes. Previous researches have suggested EI and self-efficacy are associated with academic procrastination, but the underlying mechanism of the relationships between them is not clear. Therefore, it is important to determine how these two factors affect academic procrastination. DESIGN: A cross-sectional survey. METHODS: A convenience sample of 347 nursing students was recruited from two junior colleges in Jinan City, Shandong Province, China. RESULTS: Emotional intelligence and self-efficacy were negatively associated with academic procrastination. Furthermore, self-efficacy mediated the relationship between EI and academic procrastination. CONCLUSIONS: Students who report lower EI and self-efficacy may be at a higher risk of academic procrastination. One way of weakening individuals' procrastination is to strengthen their EI. Another is to help them believe in their abilities rather than fear failure in achieving their goal. Focusing more on these influencing factors can help nursing educators develop intervention measures aimed at decreasing students' procrastination behaviour, such as through EI and self-efficacy training. IMPACT: The findings from the current study could have important implications for nursing education. That is, students who report lower EI and self-efficacy may be at a higher risk of academic procrastination. A larger focus on these influencing factors can help nursing educators and consultants develop intervention measures aimed at decreasing students' procrastination behaviour.

Effectiveness of honey dressing in the treatment of diabetic foot ulcers: A systematic review and meta-analysis.

OBJECTIVE: Honey dressing has been applied in the treatment of diabetic foot ulcers (DFUs). However, there is a lack of research showing ample evidence that honey dressing is more effective in the treatment of DFUs than other dressings. This study aimed to examine the effects of honey dressing on wound-healing process for DFUs. METHOD: We searched for evidence regarding honey dressing used in the treatment of DFUs in various databases. We selected randomized controlled trials (RCTs) and quasi-experimental studies for meta-analysis. RESULTS: The meta-analysis showed that honey dressing effectively shortened the wound debridement time, wound healing time, and bacterial clearance time; it increased the wound healing rate and bacterial clearance rate during the first one to two weeks of use. CONCLUSION: Our findings suggest that honey dressing effectively promotes healing in DFUs. Further research is needed to elucidate these findings so that this form of treatment can be widely applied.

Association of body mass index and outcomes following lobectomy for non-small-cell lung cancer.

BACKGROUND: Obesity and overweight have become increasingly prevalent, but no consensus has been reached regarding the effect of body mass index (BMI) on surgical outcomes. In this study, we sought to examine the influence of BMI on perioperative outcomes in a large cohort of patients with non-small-cell lung cancer (NSCLC) who underwent lobectomy. METHODS: A retrospective study was conducted in 1198 patients who underwent lobectomy for primary NSCLC at Shandong Provincial Hospital between November 2006 and January 2017. BMI was calculated using measured height and weight on admission and categorized as obese (≥ 30 kg/m2), overweight (25 to 29.9 kg/m2), normal (18.5 to 24.9 kg/m2), or underweight (< 18.5 kg/m2). Patients' baseline characteristics and outcomes were abstracted from medical records following institutional review board approval. Endpoints included operative mortality, perioperative complications, and length of stay (LOS). Complications were divided into four groups as respiratory, cardiovascular, other, and overall. Logistic regression models were constructed to assess the association between BMI and adverse outcomes. RESULTS: When compared with normal BMI, obesity and overweight did not increase the risk of complications in any category, operative mortality, or prolonged LOS. In fact, the incidence of operative mortality and respiratory complications tended to be lower in overweight patients than in normal weight patients (P = 0.047 and P = 0.041, respectively). Conversely, underweight patients experienced significantly more operative mortality, respiratory complications, and prolonged LOS (P = 0.004, P = 0.011, and P = 0.003, respectively). CONCLUSIONS: Obesity and overweight did not confer adverse surgical outcomes. Underweight patients presented increased risk of respiratory complications, perioperative death, and prolonged LOS. Thus, overweight and obesity should not be a relative contraindication for lobectomy. Meanwhile, nurses and surgeons should focus on perioperative management of underweight patients.

The long noncoding RNA LINC01207 promotes proliferation of lung adenocarcinoma.

Lung adenocarcinoma (LAD) and lung squamous cell cancer (LSCC) are two most common histological types of lung cancer, while they differ in many aspects. Recent evidence shows that long non-coding RNAs (lncRNAs) play an important role in the process of cancer initiation and progression. Thus, characterization of LAD and LSCC associated lncRNAs may help understand the difference between LAD and LSCC. Here, we analyzed three sets of RNA-seq data, including LAD RNA-seq data from TCGA project. We identified a novel lncRNA, long intergenic non-protein coding RNA 1207 (LINC01207) which was significantly up-regulated in LAD tissues compared with paired non-tumor tissues (5.78 fold increase, P<0.05), while there was no significant differences between LSCC tissues and adjacent non-tumor tissues. The expression level of LINC01207 was associated with TNM stage of LAD patients, and higher LINC01207 level indicated advanced TNM stage (P<0.05) and shorter survival (HR=2.53, P<0.05). By small interfering RNA (siRNA) mediated knockdown of LINC01207, we determined the biological function of LINC01207 in A549 cell line. After knockdown of LINC01207, cell proliferation ability was inhibited. Further analysis showed that after silence of LINC01207, the percentage of apoptotic cells significantly increased. By RNA immunoprecipitation and Chromatin immunoprecipitation assay, we demonstrated that LINC01207 could bind with EZH2 and mediated trimethylation of histone 3 lysine 27 at the promoter region of Bad, an important pro-apoptotic gene. Finally, we developed xenograft tumor models in nude mice and xenograft tumors derived from A549 cells transfected with siRNA-LINC01207 had significantly lower tumor weight and smaller tumor volume. In summary, the novel lncRNA, LINC01207 is specifically up-regulated in LAD but not in LSCC; and LINC01207 could promote LAD cell growth both in vivo and in vitro.

A comparison of postoperative early enteral nutrition with delayed enteral nutrition in patients with esophageal cancer.

We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3) based on whether they received EN within 48 h, 48 h-72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.