Ferroptosis biomarkers predict tumor mutation burden's impact on prognosis in HER2-positive breast cancer.

BACKGROUND: Ferroptosis has recently been associated with multiple degenerative diseases. Ferroptosis induction in cancer cells is a feasible method for treating neoplastic diseases. However, the association of iron proliferation-related genes with prognosis in HER2+ breast cancer (BC) patients is unclear. AIM: To identify and evaluate fresh ferroptosis-related biomarkers for HER2+ BC. METHODS: First, we obtained the mRNA expression profiles and clinical information of HER2+ BC patients from the TCGA and METABRIC public databases. A four-gene prediction model comprising PROM2, SLC7A11, FANCD2, and FH was subsequently developed in the TCGA cohort and confirmed in the METABRIC cohort. Patients were stratified into high-risk and low-risk groups based on their median risk score, an independent predictor of overall survival (OS). Based on these findings, immune infiltration, mutations, and medication sensitivity were analyzed in various risk groupings. Additionally, we assessed patient prognosis by combining the tumor mutation burden (TMB) with risk score. Finally, we evaluated the expression of critical genes by analyzing single-cell RNA sequencing (scRNA-seq) data from malignant vs normal epithelial cells. RESULTS: We found that the higher the risk score was, the worse the prognosis was (P < 0.05). We also found that the immune cell infiltration, mutation, and drug sensitivity were different between the different risk groups. The high-risk subgroup was associated with lower immune scores and high TMB. Moreover, we found that the combination of the TMB and risk score could stratify patients into three groups with distinct prognoses. HRisk-HTMB patients had the worst prognosis, whereas LRisk-LTMB patients had the best prognosis (P < 0.0001). Analysis of the scRNA-seq data showed that PROM2, SLC7A11, and FANCD2 were significantly differentially expressed, whereas FH was not, suggesting that these genes are expressed mainly in cancer epithelial cells (P < 0.01). CONCLUSION: Our model helps guide the prognosis of HER2+ breast cancer patients, and its combination with the TMB can aid in more accurate assessment of patient prognosis and provide new ideas for further diagnosis and treatment.

Risk Factors of Serious Adverse Events for Geriatric Hip Fractures: Is it the Frailty or the Timing?

Objective: Preoperative frailty and surgical waiting times are associated with the occurrence of adverse outcomes in patients with hip fractures. Specifically, we aimed to investigate the influence of frailty status and surgical timing on the risk of serious adverse events during hospitalization. Methods: This study utilized an observational single cohort design and included patients aged ≥60 years with a primary diagnosis of hip fracture. Frailty was assessed using the chart-derived frailty index (CFI), which was calculated based on demographic and routine laboratory variables. The primary outcome of interest was the occurrence of in-hospital serious adverse events. A multivariate logistic regression model was utilized to examine the risk factors influencing outcomes. Results: The study included 427 participants, with a mean age of 80.28 ± 8.13 years and 64.2% of whom were female. Patients with high CFI have more comorbidities (P < .001), lower surgical rates (P = .002), and delayed surgical times (P = .033). A total of 239 patients (56.0%) experienced serious adverse events. The high CFI group had a significantly higher occurrence of serious adverse events compared to the low CFI group (73.4% vs 48.5%, P < .001). After adjusting for surgical timing and covariates, the multivariate logistic regression analysis revealed that high frailty significantly increased the risk for serious adverse events (OR = 2.47, 95% CI 1.398-4.412), infection (OR = 1.99, 95% CI 1.146-3.446), acute heart failure (OR = 3.37, 95% CI 1.607-7.045). However, the timing of surgery did not demonstrate any association with these outcomes. In addition, after adjusting for surgical factors, high CFI remains an independent risk factor for these complications. Conclusions: Frailty serves as a reliable predictor of the probability of encountering severe adverse events while hospitalized for elderly individuals with hip fractures. This method has the potential to pinpoint particular modifiable factors that necessitate intervention, whereas the impact of surgical timing remains uncertain and necessitates additional research.

Molybdate-Templated Luminescent Silver Alkynyl Nanoclusters: Total Structure Determination and Optical Property Analysis.

Two novel MoO42--templated luminescent silver alkynyl nanoclusters with 20-nuclearity ([(MoO42-)@Ag20(C≡CtBu)8(Ph2PO2)7(tfa)2]·(tfa-) (1)) and 18-nuclearity ([(MoO42-)@Ag18(C≡CtBu)8(Ph2PO2)7]·(OH) (2)) (tfa = trifluoroacetate) were synthesized with the green light maximum emissions at 507 and 516 nm, respectively. The nanoclusters were investigated and characterized by single-crystal X-ray crystallography, electrospray ionization mass spectrum (ESI-MS), X-ray photoelectron spectroscopy, thermogravimetry (TG), photoluminescence (PL), ultraviolet-visible (UV-vis) spectroscopy, and density functional theory calculations (DFT). The two nanoclusters differ in their structure by a supplementary [Ag2(tfa)2] organometallic surface motif, which significantly participates in the frontier molecular orbitals of 1, resulting in similar bonding patterns but different optical properties between the two clusters. Indeed, both nanoclusters show strong temperature-dependent photoluminescence properties, which make them potential candidates in the fields of optical devices for further applications.

Template-Free Synthesis of Two New Luminescent One-Dimensional High-Nuclearity Silver Polyclusters.

The metallophilic properties, spherical configuration, and flexible coordination of silver ions make them prone to create various coordination modes and structural features. Therefore, with the increase of the complexities of self-assembly, the effect of various synthetic conditions in the final structure of silver compounds becomes diverse and attractive. In this study, two new silver polyclusters, 16- and 21-nuclearity, protected by multiple ligands including alkynyl, trifluoroacetate, and diphenylphosphinate, were synthesized and characterized by single-crystal X-ray diffraction, powder X-ray diffraction, and Fourier transform infrared (FTIR) spectroscopy. The optical properties and thermal stability of the polyclusters were studied by solid-state ultraviolet-visible (UV-vis) absorption and solid UV-vis diffuse reflectance spectra and gravimetric analysis, respectively. The formation of the two polyclusters can be fine-controlled by simply adjusting the stoichiometric ratio of diphenylphosphinate ligands to silver precursors under the same synthetic condition, leading to the different coordination modes between ligands and Ag centers. This work shows a facile and template-free method to synthesize and control the silver polycluster assembly, encouraging further development of new polyclusters with the potential for various applications.

Monocarboxylate-protected two-electron superatomic silver nanoclusters with high photothermal conversion performance.

The first series of monocarboxylate-protected superatomic silver nanoclusters was synthesized and fully characterized by X-ray diffraction, fourier-transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), and electrospray ionization mass spectrometry (ESI-MS). Specifically, compounds [Ag16(L)8(9-AnCO2)12]2+ (L = Ph3P (I), (4-ClPh)3P (II), (2-furyl)3P (III), and Ph3As (IV)) were prepared by a solvent-thermal method under alkaline conditions. These clusters exhibit a similar unprecedented structure containing a [Ag8@Ag8]6+ metal kernel, of which the 2-electron superatomic [Ag8]6+ inner core shows a flattened and puckered hexagonal bipyramid of S6 symmetry. Density functional theory calculations provide a rationalization of the structure and stability of these 2-electron superatoms. Results indicate that the 2 superatomic electrons occupy a superatomic molecular orbital 1S that has a substantial localization on the top and bottom vertices of the bipyramid. The π systems of the anthracenyl groups, as well as the 1S HOMO, are significantly involved in the optical and photothermal behavior of the clusters. The four characterized nanoclusters show high photothermal conversion performance in sunlight. These results show that the unprecedented use of mono-carboxylates in the stabilization of Ag nanoclusters is possible, opening the door for the introduction of various functional groups on their cluster surface.

Construction and validation of a prognostic signature based on necroptosis-related genes in hepatocellular carcinoma.

BACKGROUND: Necroptosis is a necrotic programmed cell death with potent immunogenicity. Due to the dual effects of necroptosis on tumor growth, metastasis and immunosuppression, we evaluated the prognostic value of necroptosis-related genes (NRGs) in hepatocellular carcinoma (HCC). METHODS: We first analyzed RNA sequencing and clinical HCC patient data obtained to develop an NRG prognostic signature based on the TCGA dataset. Differentially expressed NRGs were further evaluated by GO and KEGG pathway analyses. Next, we conducted univariate and multivariate Cox regression analyses to build a prognostic model. We also used the dataset obtained from the International Cancer Genome Consortium (ICGC) database to verify the signature. The Tumor Immune Dysfunction and Exclusion (TIDE) algorithm was used to investigate the immunotherapy response. Furthermore, we investigated the relationship between the prediction signature and chemotherapy treatment response in HCC. RESULTS: We first identified 36 differentially expressed genes out of 159 NRGs in hepatocellular carcinoma. Enrichment analysis showed that they were mainly enriched in the necroptosis pathway. Four NRGs were screened by Cox regression analysis to establish a prognostic model. The survival analysis revealed that the overall survival of patients with high-risk scores was significantly shorter than that of patients with low-risk scores. The nomogram demonstrated satisfactory discrimination and calibration. The calibration curves validated a fine concordance between the nomogram prediction and actual observation. The efficacy of the necroptosis-related signature was also validated by an independent dataset and immunohistochemistry experiments. TIDE analysis revealed that patients in the high-risk group were possibly more susceptible to immunotherapy. Furthermore, high-risk patients were found to be more sensitive to conventional chemotherapeutic medicines such as bleomycin, bortezomib, and imatinib. CONCLUSION: We identified 4 necroptosis-related genes and established a prognostic risk model that could potentially predict prognosis and response to chemotherapy and immunotherapy in HCC patients in the future.

What role do extracellular vesicles play in developing physical frailty and sarcopenia? : A systematic review.

BACKGROUND: Frailty and sarcopenia are typical geriatric conditions with a complex pathophysiology. Extracellular vesicles (EVs) are key regulators of age-related diseases, but the mechanisms underlying physical frailty, sarcopenia, and EVs are not well understood. METHODS: A systematic literature review was conducted to examine the evidence supporting an association between EVs and physical frailty and/or sarcopenia by searching the electronic databases, including the Cochrane Library, PubMed, and Embase, from January 2000 to January 2021. RESULTS: A total of 216 cross-sectional studies were retrieved, and after the removal of 43 duplicate records, the title and abstract of 167 articles were screened, identifying 6 relevant articles for full-text review. Of the studies five met the inclusion criteria, and heterogeneity among studies was high. There is controversy regarding whether frailty and/or sarcopenia are related to circulating EV levels; however, the cargo of EVs has been associated with frailty and sarcopenia in various ways, such as microRNAs, mitochondrial-derived vesicles (MDVs), and protein cargoes. CONCLUSION: Recent studies, although limited, depicted that EVs could be one of the underlying mechanisms of frailty and/or sarcopenia. There is a possibility that physical frailty and sarcopenia may have specific EV concentrations and cargo profiles; however, further research is required to fully understand the mechanisms and identify potential biomarkers and early preventative strategies for physical frailty and sarcopenia.

Synthesis of Two Neutral Silver Alkynyl Nanoclusters by a Single Divalent Tetrahedral Anion Template and a Study of Their Optical Features.

The synthesis of nanoclusters from simple structural units is usually a challenging process because of the complexity and unpredictability of the self-assembly process of these types of compounds. Herein, two new neutral 19-nuclearity silver nanoclusters based on alkynyl ligands with the formulas [(CrO4)@Ag19(C≡CtBu)8(Ph2PO2)6(tfa)3(CH3OH)2] (1) and [(SO4)@Ag19(C≡CtBu)8(Ph2PO2)6(tfa)3(CH3OH)2] (2), in which tfa = trifluoroacetate, were synthesized, and their structures were investigated by single-crystal and powder X-ray diffraction, electrospray ionization mass spectrometry, elemental analyses, and Fourier transform infrared spectroscopy. The surface ligands of Ph2PO2H and trifluoroacetate were assembled through hydrogen bonding, metal-aromatic interactions, and coordination bonding around 19 silver atoms as the metal skeletons of the nanoclusters. Sulfate and chromate anions, as a template within the metal skeleton of clusters through bonding with silver atoms, stabilized the structure. In addition, the UV-vis absorption spectroscopy, luminescence properties, and thermal stability of the nanoclusters were investigated.

Tumor radiomics signature for artificial neural network-assisted detection of neck metastasis in patient with tongue cancer.

BACKGROUND AND PURPOSE: To determine the neck management of tongue cancer, this study attempted to construct an artificial neural network (ANN)-assisted model based on computed tomography (CT) radiomics of primary tumors to predict neck lymph node (LN) status in patients with tongue squamous cell carcinoma (SCC). MATERIALS AND METHODS: Three hundred thirteen patients with tongue SCC were retrospectively included and randomly divided into training (60%), validation (20%) and internally independent test (20%) sets. In total, 1673 feature values were extracted after the semiautomatic segmentation of primary tumors and set as input layers of a classical 3-layer ANN incorporated with or without clinical LN (cN) status after dimension reduction. The receiver operating characteristic (ROC) curve, accuracy (ACC), sensitivity (SEN), specificity (SPE), area under curve (AUC) and Net Reclassification Index (NRI), were used to evaluate and compare the models. RESULTS: Four models with different settings were constructed. The ACC, SEN, SPE and AUC reached 84.1%, 93.1%, 76.5% and 0.943 (95% confidence interval: 0.891-0.996, p<.001), respectively, in the test set. The NRI of models compared with radiologists reached 40% (p<.001). The occult nodal metastasis rate was reduced from 30.9% to a minimum of 12.7% in the T1-2 group. CONCLUSION: ANN-based models that incorporated CT radiomics of primary tumors with traditional LN evaluation were constructed and validated to more precisely predict neck LN metastasis in patients with tongue SCC than with naked eyes, especially in early-stage cancer.

[Association of body fat ratio with precocious puberty in girls].

OBJECTIVE: To study the association of body fat ratio with precocious puberty in girls. Previous studies have shown that body mass index (BMI) is associated with the girls' age of puberty but have not revealed the association of body fat ratio with age of puberty. METHODS: Based on the consensus on the diagnosis and treatment of central precocious puberty (CPP), 128 children with precocious puberty who were admitted to the hospital from July to August, 2017, were divided into a CPP group with 87 children and a peripheral precocious puberty (PPP) group with 41 children. A total of 51 girls without any puberty development signs were enrolled as the control group. Dual-energy X-ray absorptiometry was used to measure the body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body. The association between body fat ratios and precocious puberty was analyzed with reference to age, BMI, BMI-Z score, bone age, ovarian volume, and hormone levels. RESULTS: Compared with the control group, the CPP and PPP groups had significantly higher body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body, legs/whole body fat ratio, and (upper limbs+legs)/trunk fat ratio (P<0.05), while there were no significant differences in the above body fat ratios and fat distribution indicators between the CPP and PPP groups (P>0.05). For the girls with precocious puberty, the high body fat ratio group had significantly higher luteinizing hormone (LH) base value, luteinizing hormone releasing hormone (LHRH)-stimulated LH peak value, and LH/follicle-stimulating hormone peak value than the low body fat ratio group (P<0.05). Compared with the control group, both the high body fat ratio and low body fat ratio groups had a significantly higher LH base value (P<0.05). CONCLUSIONS: The increase in body fat may be a factor inducing precocious puberty in girls, but further studies are needed to determine the mechanism.

Neuroprotective mechanism of L-cysteine after subarachnoid hemorrhage.

Hydrogen sulfide, which can be generated in the central nervous system from the sulfhydryl-containing amino acid, L-cysteine, by cystathionine-ß-synthase, may exert protective effects in experimental subarachnoid hemorrhage; however, the mechanism underlying this effect is unknown. This study explored the mechanism using a subarachnoid hemorrhage rat model induced by an endovascular perforation technique. Rats were treated with an intraperitoneal injection of 100 mM L-cysteine (30 µL) 30 minutes after subarachnoid hemorrhage. At 48 hours after subarachnoid hemorrhage, hematoxylin-eosin staining was used to detect changes in prefrontal cortex cells. L-cysteine significantly reduced cell edema. Neurological function was assessed using a modified Garcia score. Brain water content was measured by the wet-dry method. L-cysteine significantly reduced neurological deficits and cerebral edema after subarachnoid hemorrhage. Immunofluorescence was used to detect the number of activated microglia. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the levels of interleukin 1ß and CD86 mRNA in the prefrontal cortex. L-cysteine inhibited microglial activation in the prefrontal cortex and reduced the mRNA levels of interleukin 1ß and CD86. RT-PCR and western blot analysis of the complement system showed that L-cysteine reduced expression of the complement factors, C1q, C3α and its receptor C3aR1, and the deposition of C1q in the prefrontal cortex. Dihydroethidium staining was applied to detect changes in reactive oxygen species, and immunohistochemistry was used to detect the number of NRF2- and HO-1-positive cells. L-cysteine reduced the level of reactive oxygen species in the prefrontal cortex and the number of NRF2- and HO-1-positive cells. Western blot assays and immunohistochemistry were used to detect the protein levels of CHOP and GRP78 in the prefrontal cortex and the number of CHOP- and GRP78-positive cells. L-cysteine reduced CHOP and GRP78 levels and the number of CHOP- and GRP78-positive cells. The cystathionine-ß-synthase inhibitor, aminooxyacetic acid, significantly reversed the above neuroprotective effects of L-cysteine. Taken together, L-cysteine can play a neuroprotective role by regulating neuroinflammation, complement deposition, oxidative stress and endoplasmic reticulum stress. The study was approved by the Animals Ethics Committee of Shandong University, China on February 22, 2016 (approval No. LL-201602022).

[Community Structure Characteristics of nirS Denitrifying Bacteria of Spring Typical Parkland Waterbodies in Shijiazhuang City].

Four typical park water bodies located in the main urban area of Shijiazhuang city were selected to study the relationships between water quality and the community structure and diversity of nirS denitrifying bacteria. The results showed that the nitrogen concentration ranged from 4.43 to 13.83 mg·L-1 in four park water bodies, which exhibited notable nitrogen pollution characteristics. Based on the characteristic index analysis of three-dimensional fluorescence spectra, the four park water bodies all exhibited strong autochthonous components and low humus characteristics. The results of Illumina high-throughput sequencing indicated that most of the nirS denitrifying bacteria showed significant differences in dominant genus. The unclassified_Bacteria (53.52%), Pseudomonas (60.48%), and Rhodobacter (46.94%) were the dominant bacteria in Yuxi park, Shuishang park, and Chang'an park, respectively. In comparison, unclassified_Bacteria (36.19%) and unclassified_Proteobacteria (23.44%) were the dominant bacteria in Shiji park. Redundancy analysis showed that denitrification bacteria in Yuxi park were mainly affected by nitrate, total nitrogen, and dissolved oxygen; denitrification bacteria in Shuishang park were greatly affected by total phosphorus; denitrification bacteria in Chang 'an park were mainly affected by ammonia and nitrous nitrogen; and denitrification in Shiji park were mainly affected by total phosphorus, nitrite, and ammonia. Overall, the water quality and the community structure of nirS denitrification bacteria exhibited significant differences in park water bodies. Further research could contribute to the understanding of water quality characteristics and the denitrifying community structure of urban water systems, and develop efficient denitrifying bacterial agents.

[Inhibitory effect of BF523 from Ilex hainanensis on ox LDL-induced foam cells formation].

Cardio-cerebral vascular disease induced by atherosclerosis is a serious cause of human health. The pathogenesis of AS is very complex,and the oxidized low-density lipoprotein( ox LDL) induced foam cells formation is considered to be the most important cytological change in AS. Based on the definition of " TCM chemical biology",we clarified the chemical composition of Ilex hainanensis,the effective substances of I. hainanensis on the activity of anti-AS were screened. Then we found that saponin BF523 had the good inhibitory effect on foam cell formation. In this research,we studied the BF523 as the research object to clarify the molecular target of the active compound of I. hainanensis by foam cell formation model. The results showed that BF523 significantly inhibited the oxidation of ox LDL-induced macrophage foaming and decreased the lipid content in macrophages. BF523 had inhibited the phagocytosis of ox LDL in macrophages by reducing the mRNA and protein levels of scavenger receptor CD36,thereby inhibiting the occurrence and development of AS. These findings not only clarified the mechanism of the inhibition of foam cell formation by saponin BF523,but also provided a useful exploration for the enrichment of the theory of " TCM chemical biology".

The association of different types of cerebral infarction with post-stroke depression and cognitive impairment.

The aim of this study was to investigate post-stroke depression (PSD) and cognitive impairments in patients with different types of cerebral infarction.A total of 110 patients with cerebral infarction treated in our hospital from January 2015 to February 2016 were included in present study. Forty-seven patients were PSD patients and 63 patients were non-PSD patients. The Hamilton Depression Rating Scale (HAMD) and Mini-Mental State Examination (MMSE) were employed to assess depression and cognition of patientsAmong PSD patients, the proportion of patients with partial anterior circulation infarction (PACI, 68.75%) was significantly higher than patients with lacunar circulation infarction (LACI, 29.17%) and posterior circulation infarction (POCI, 26.67%) (P < .05). No significant difference was found in PSD patients with LACI and POCI (P > .05). The MMSE score of patients with PACI (18.05 ±â€Š2.61) was lower than patients with POCI and LACI (P < .05), however, no significant difference was found in patients with LACI and POCI (P > 0.05). The incidences of cognitive impairment in patients with PACI, LACI, and POCI were 12.50%, 14.58%, and 13.33%, respectively. The MMSE score of PSD patients (21.23 ±â€Š2.12) was significantly lower than non-PSD patients (P < .05).Compared with LACI and POCI patients, PACI patients had a higher incidence of PSD and impaired cognitive functions. In addition, affective disorders such as depression may be correlated with cognitive impairment in patients with cerebral infarction.

Implementing a pain management nursing protocol for orthopaedic surgical patients: Results from a PAIN OUT project.

AIMS AND OBJECTIVES: To investigate the effect of introducing a standardised pain management nursing protocol in orthopaedic patients undergoing surgery. BACKGROUND: Postoperative pain is a common phenomenon but is still undertreated in hospitalised patients. Nurses' lack of sufficient knowledge and skills about pain management may be a contributing factor to poor outcomes. DESIGN: An interventional, separate sample pre- and post-test. METHODS: A pain management nursing protocol was introduced and a handbook and training sessions regarding management of postsurgical pain were provided to the nurses on a Joint Orthopaedic ward at a university-affiliated general hospital in Guangzhou, China. Before and after the intervention, nurses' knowledge about pain management and attitudes were assessed, and perioperative management practices and pain-related patient-reported outcomes were evaluated. RESULTS: Sixteen and 15 registered nurses, and 77 and 71 patients participated in the study before and after the intervention, respectively. Nurses' scores related to knowledge and skills increased significantly after the protocol was introduced but were still insufficient with regard to pharmacological-related items. The proportion of patients receiving a combined opioid and nonopioid increased after the intervention. Clinically significant changes were observed in some patient-reported outcomes, such as worst pain since surgery, percentage of time experiencing severe pain, and pain interference with activities out of bed. There were significant changes in nonpharmacological methods administered by nurses to patients or used by patients to relieve pain. CONCLUSIONS: Implementation of a pain management nursing protocol combined with education in one surgical ward was associated with nurses' increased knowledge and attitudes regarding pain, a change in some management practices, and improvement in a number of pain-related patient-reported outcomes. RELEVANCE TO CLINICAL PRACTICE: It was feasible to develop and implement a standardised pain management nursing protocol and use it in the clinical routine. The intervention had an effect on changing some features of care, with an improvement in patient-reported outcomes. Support by leaders and medical team facilitated the process of the implementation.

Synthesis and biological evaluation of substituted 4-(thiophen-2-ylmethyl)-2H-phthalazin-1-ones as potent PARP-1 inhibitors.

We have developed a series of substituted 4-(thiophen-2-ylmethyl)-2H-phthalazin-1-ones as potent PARP-1 inhibitors. Preliminary biological evaluation indicated that most compounds possessed inhibitory potencies comparable to, or higher than AZD-2281. Among these compounds, 18q appeared to be the most notable one, which displayed an 8-fold improvement in enzymatic activity compared to AZD-2281. These efforts lay the foundation for our further investigation.

Is comprehensive geriatric assessment recognized and applied in Southwest China? A survey from Sichuan Association of Geriatrics.

OBJECTIVES: To investigate how health care providers in Southwest China conducted comprehensive geriatric assessment (CGA) in their clinical practices. METHODS: One hundred twenty-two medical care providers who attended the 2012 Sichuan Association of Geriatrics (SAG) Continuing Medical Education participated in this cross-sectional survey. The instrument was divided into 2 parts, including respondents' demographics and information on their application of CGA. RESULTS: Of the total 122 participants, 120 (73 physicians and 47 nurses) responded. Three-quarters of the respondents reported that they evaluated at least 1 item of CGA separately. Among them, 30/32 respondents from university-affiliated hospitals reported having performed CGA compared with 18/22 from community hospitals or retirement/nursing facilities and 42/66 from provincial or county hospitals (P < .001), respectively. Respondents who attended the SAG Continuing Medical Education were more likely to complete the CGA (86.5% vs 66.2%, P = .011) and the integrated CGA (48.9% vs 20.0%, P < .001). Physicians were more likely to assess the instrument daily living capacity and communication capacity. Nurses were more focused on the basic activities of daily living, economic support, and caregiver. CONCLUSIONS: These findings showed that the application of CAG in the mainland of China is not adequate. The training program related to CGA held by the SAG was helpful in improving the proportion of effective use of CGA. More efforts should be made in the future to build the CGA work team.