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    25 December 2024, Volume 16 Issue 6 Previous Issue    Next Issue
    A new biological classification of tumor based on integrated medicine and its clinical application prospect 
    CAO Tianyu, WANG Yinge, LIU Yanxing, QIN Niping, WU Jian, KANG Xiaoyu, LIU Hao, GAO Xiaoliang, CHEN Jie, NIE Yongzhan, ZHAO Xiaodi, LU Yuanyuan, FAN Daiming
    2024, 16 (6):  633-637.  doi: 10.3969/j.issn.1674-5671.2024.06.01
    Abstract ( 193 )   PDF   Save
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    Chinese expert consensus on the localization of bioinformatics analysis for tumor genetic diagnosis using next⁃generation sequencing (2024 edition)
    Tumor Gene Diagnosis Committee of the China Anti⁃Cancer Association, Integrative Oncology Branch of the China Anti⁃Cancer Association
    2024, 16 (6):  638-649.  doi: 10.3969/j.issn.1674-5671.2024.06.02
    Abstract ( 265 )   PDF   Save
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    Chinese expert consensus on compensation management for research participants in clinical trials of cancer (2024 edition)
    The Society of Medical Ethics of China Anti⁃Cancer Association
    2024, 16 (6):  650-655.  doi: 10.3969/j.issn.1674-5671.2024.06.03
    Abstract ( 165 )   PDF   Save
    Compensation/allowance for research participants in clinical trials refers to economic or other forms of compensation provided by sponsors for any inconvenience, additional expenses, additional time, and provision of biological samples, associated with the participants. Good clinical practice and medical ethics guidelines, either domestic or international, allow the research participants to be provided with certain compensation. However, there is no clear regulation on the items, standards, methods, and means of compensation; in practice, a specific reference basis is lacking for determining whether or not compensation is appropriate. Therefore, experts and personnel are recruited from the Society of Medical Ethics of China Anti⁃Cancer Association to establish this expert consensus, aiming to provide a reference for determining compensation categories and cost standards for the subjects in clinical trials of premarket and registered anti⁃tumor drugs, and to propose ethical review suggestions for compensation and supervision measures for relevant personnel or departments.
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    Interpretation of 2024 ACG Clinical Guideline: Focal Liver Lesions 
    LIN Leipo, HUANG Zhihao, XIANG Bangde, MA Liang, LI Lequn, ZHONG Jianhong
    2024, 16 (6):  656-662.  doi: 10.3969/j.issn.1674-5671.2024.06.04
    Abstract ( 135 )   PDF   Save
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    Advances in tumor biomarkers in liquid biopsy of gastric cancer 
    FU Yifan, WANG Boda, HE Yangsong, LU Yuanyuan, WANG Xin
    2024, 16 (6):  673-680.  doi: 10.3969/j.issn.1674-5671.2024.06.06
    Abstract ( 155 )   PDF   Save
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    Correlation between blood lipid levels and survival prognosis of gastric cancer patients under operation: A retrospective cohort study
    GUO Zhiyu, CAO Tianyu, WANG Weidong, GUO Xingxian, MA Wanqi, LU Yuanyuan, ZHAO Xiaodi, JI Gang
    2024, 16 (6):  687-693.  doi: 10.3969/j.issn.1674-5671.2024.06.08
    Abstract ( 114 )   PDF   Save
    Objective To investigate the correlation between blood lipid levels and survival prognosis for the gastric cancer patients undergoing operation. Methods A total of 837 gastric cancer patients who underwent gastrointestinal surgery in department of Xijing Hospital, Air Force Medical University from May 2020 to May 2021 were selected as the study objects. The relationship between Serum levels of total cholesterol (TC), triglycerides (TG), high⁃density lipoprotein cholesterol (HDL⁃C), low⁃density lipoprotein cholesterol (LDL⁃C) and overall survival (OS) in patients with gastric cancer were analyzed by the Cox regression and the restricted cubic spine analysis. Results The survival analysis showed that the patients with TC≥5.2 mmol/L had a risk of death 56.8% higher than the patients with TC<5.2 mmol/L (HR=1.568, 95% CI:1.159~2.121), and the risk of death in patients with LDL⁃C≥3.4 mmol/L was 95.7% higher than that in patients with LDL⁃C<3.4 mmol/L (HR=1.957, 95% CI: 1.440~2.660). However, TG and HDL⁃C were not associated with OS (P>0.05). The restricted cubic spine analysis showed that there was a U⁃shaped relationship between TC and OS. When TC level was less than 4.36 mmol/L, the survival risk of patients decreased with the increase of TC level, and the lowest risk was reached at TC=4.36 mmol/L. The risk increased with the increase of TC level at > 4.36 mmol/L (P for nonlinear=0.006). There was a J⁃shaped relationship between LDL⁃C and OS. When LDL⁃C level was in the low range, the risk was relatively stable, and the risk increased rapidly until LDL⁃C=2.57 mmol/L (P for nonlinear=0.024), and no correlation was found between TG and HDL⁃C level and OS (P>0.05 for both). Subgroup analysis showed that TC and LDL⁃C were more significantly associated with OS in male patients, age>50 years old, BMI<18.5 kg/m2, smoking history, no history of coronary heart disease and alcohol consumption (all P<0.05), except for the association between TG and OS observed in gastric cancer patients with a smoking history, there was no significant correlation between TG and HDL⁃C levels and OS in other subgroups (all P>0.05). Conclusions High levels of LDL⁃C and TC are closely associated with poor clinical prognosis in gastric cancer patients, which can be used as an important indicator for postoperative prognostic assessment of patients with gastric cancer.
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    Incidence,mortality,and disease burden of cervical cancer in China,1990—2021: trends over the past  30 years and future prediction
    XUAN Wenzhen, GONG Jianmin, LI Na
    2024, 16 (6):  694-700.  doi: 10.3969/j.issn.1674-5671.2024.06.09
    Abstract ( 243 )   PDF   Save
    Objective To analyze the incidence, mortality and disease burden of cervical cancer in China from 1990 to 2021, and to provide evidence for the prevention of cervical cancer. Methods Based on the 2021 Global Burden of Disease Study database, the standardized incidence, standardized mortality and disability⁃adjusted life years (DALY ) rate of cervical cancer were analyzed using the Joinpoint regression model. Based on the age⁃period⁃cohort model, the age, period and cohort effects of cervical cancer were investigated. The grey prediction model GM (1, 1) was used to predict the standardized incidence, standardized mortality and disease burden of cervical cancer from 2022 to 2036. Results From 1990 to 2021, the standardized incidence of cervical cancer in China showed an annually increasing trend [average annual percentage change (AAPC)=0.39%]. The standardized mortality rate and standardized DALY rate showed a decreasing trend (AAPCstandardized mortality=-1.34%, AAPCstandardized DALY rate=-1.32%). The results of age⁃period⁃cohort effect showed that from 1990 to 2021, the incidence of cervical cancer in China peaked twice in the 55-59 age group and 70-74 age group, respectively; the DALY rate peaked once in the 50-54 age group; the mortality rate increased annually with the increase of age. The period effect analysis showed that the relative risk (RR) value of incidence of cervical cancer fluctuated with time, and the RR value of mortality and DALYs rate decreased with time. Cohort effect analysis showed that with the change of time, the RR value of incidence showed an upward trend, and the RR value of mortality and DALY rate decreased. The predicted results showed that the standardized incidence of cervical cancer in China will increase from 14.04/105  in 2022 to 16.03/105 in 2036, the standardized mortality will decrease from 4.64/105  in 2022 to 4.03/105 in 2036, and the DALY rate will decrease from 149.99 /105  in 2022 to 129.80 /105  in 2036. Conclusions The standardized incidence of cervical cancer in China is increasing annually, while the standardized mortality rate and DALY rate will decrease year by year in the future. The trend of change is affected by age, period and cohort to varying degrees. In the future, prevention and control strategies should continue to strengthen the coverage of vaccination and screening measures to cope with the challenges brought by the increasing incidence.
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    Analysis of the incidence and mortality of malignant tumors in tumor registration areas of Shanxi Province,2020
    PAN Hongxin, CUI Wangfei, LYU Licheng, WANG Xinzheng, CAO Ling, ZHANG Yongzhen
    2024, 16 (6):  700-706.  doi: 10.3969/j.issn.1674-5671.2024.06.10
    Abstract ( 352 )   PDF   Save
    Objective To analyze the incidence and mortality of malignant tumors in the tumor registration areas of Shanxi Province in 2020. Methods Based on the data reported by the tumor registration areas in Shanxi Province in 2020, the crude incidence rate, crude mortality rate and age⁃standardized rate by the Chinese standard population (ASRC rate) of the incidence/mortality of malignant tumors in Shanxi Province in 2020 were calculated after stratifying data by urban and rural areas and gender. Results In 2020, the number of new cases of malignant tumors in the tumor registration areas of Shanxi Province was 14,052, the crude incidence was 263.25/105, and the ASRC rate of incidence was 157.67/105. The number of mortality was 8,316, the crude mortality was 155.79/105, and the ASRC rate of mortality was 87.61/105 The incidence rate and mortality rate of malignant tumors increased from the ages of 35 and 40, respectively, showing a characteristics that rural areas were higher than urban areas, and male higher than female. In 2020, the top 10 types of malignant tumors in Shanxi Province were lung cancer, breast cancer, stomach cancer, cervical cancer, colorectal cancer, esophageal cancer, liver cancer, thyroid cancer, kidney cancer and bladder cancer, accounting for 77.02% of all malignant tumors; the top 10 types of malignant tumor mortality in Shanxi Province were lung cancer, stomach cancer, esophageal cancer, liver cancer, colorectal cancer, cervical cancer, breast cancer, pancreatic cancer, brain cancer and gallbladder cancer accounting for 84.06% of all malignant tumors. Conclusions The key cancer types in Shanxi Province Lung cancer include upper digestive tract cancer, cervical cancer, colorectal cancer, liver cancer and breast cancer. The high⁃risk groups of malignant tumors are male population, people over 40 years old and urban population in Shanxi Province, to which attention should pay attention to, and prevention and treatment work should be carried out as soon as possible.
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    Down⁃regulation of α2⁃macroglobulin expression activates TGF⁃β/SMADs signaling pathway to induce cisplatin resistance in ovarian cancer
    LU Tingting, SHI Lijun, LIU Yingzhao, LIANG Huiting, WANG Qi
    2024, 16 (6):  707-714.  doi: 10.3969/j.issn.1674-5671.2024.06.11
    Abstract ( 136 )   PDF   Save
    Objective To investigate the relationship between the expression levels of alpha⁃2⁃macroglobulin (A2M) in ovarian cancer patients and their prognosis and platinum resistance, and to analyze the regulation of A2M on the TGF⁃β/SMADs signaling pathway and its impact on the apoptosis of tumor cells induced by Cisplatin (DDP). Methods The Western blot was used to detect A2M expression in xenogeneic subcutaneous tumor models of ovarian cancer treated by DDP in nude mice, and the relationship between A2M expression and DDP resistance was analyzed. Immunohistochemistry was used to detect the expression of A2M in 129 ovarian cancer tissues and analyze its relationship with prognosis. ELISA was used to detect A2M content and analyze its relationship with  DDP resistance in serum samples of 103 cases of ovarian cancer. The 0, 0.5, 1.0, 2.0, 4.0 μmol/L A2M protein was added to drug⁃resistant ovarian cancer cells SKOV3/DDPⅡ, A2M content in co⁃culture system was detected by ELASA and analyzed its relationship with cytokines, and the apoptosis of DDP drug⁃resistant ovarian cancer cells was detected by flow cytometry.  The expression of A2M gene in sensitive cells SKOV3 was knocked down by the RNA interference technology, CCK⁃8 assay was used to detect the cell activity of each group after treated exogenous A2M and knocking down A2M, and the half maximal inhibitory concentration (IC50) of DDP was calculated; The Western blot was used to detect the key nodes of TGF⁃β/SMADs signal transduction, TGF⁃β1, TGFβR2, SMAD2/3, and their phosphorylated expression, and the expression of cell apoptosis⁃related proteins BCL⁃2 and PARP1. A xenograft model of ovarian cancer in nude mice was used to compare the effect of DDP treatment on the tumorigenesis volume of SKOV3 cells with A2M gene knockdown and control cells. Results The expression of A2M protein in xenografts of drug⁃resistant mice decreased with the increase of DDP treatment, whereas the expression of PARP1 protein was up⁃regulated. A2M protein expression was positively correlated with overall survival and progression⁃free survival in ovarian cancer patients (all P<0.05), and the serum A2M content in platinum⁃resistant ovarian cancer patients decreased (P=0.031). Exogenous addition of A2M protein could significantly decrease the cytokine contents of TGF⁃β1, MMP1, MMP2, MMP7 and MMP9 compared with those without A2M protein (all P<0.05), and the total apoptosis rates of SKVO3/DDP Ⅱ cells and A2780/DDP Ⅱ cells increased and the IC50 of DDP decreased (P<0.0001). At the same time, the expression of TGF⁃β1 and PKCa were decreased, the phosphorylation levels of TGFβR2 and SAMD2/3 in SKVO3/DDP Ⅱ cells were down⁃regulated, and TGF⁃β1⁃SMAD2/3 complex was inhibited to play the role of transcription factor, thereby inhibited the phosphorylation of apoptosis⁃related protein BCL⁃2 and induced the inactivation of PARP1 protein, and promoted the apoptosis of ovarian cancer cells. However, the results of DDP IC50 and TGF⁃β1, SMAD2/3, PKCa, BCL⁃2, PARP1 protein expression in SKVO3 cells with A2M gene knockdown were opposite. The tumor volume of the established mouse xenograft model was significantly higher than the control group after 8 DDP treatments. Conclusions A2M is involved in the sensitivity of ovarian cancer cells to DDP treatment by negatively regulating the TGF⁃β/SMADs signaling pathway, and its knockdown can activate the BCL⁃2 dependent cell anti⁃apoptotic pathway, which leads to platinum resistance and poor prognosis of ovarian cancer.
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    Effects of lncRNA PSMA3-AS1 on proliferation,migration and invasion of neuroblastoma cells by regulating the miR-186?5p/SOX4 axis
    AN Yanxiao, JIAO Hanliang, QI Yanwei, ZHONG Zhiyong
    2024, 16 (6):  715-721.  doi: 10.3969/j.issn.1674-5671.2024.06.12
    Abstract ( 101 )   PDF   Save
    Objective To investigate the effects of long non⁃coding RNA human proteasome α subunit type 3 antisense RNA1 (lncRNA PSMA3⁃AS1) on the proliferation, migration and invasion of neuroblastoma cells and the regulation mechanism of microRNA⁃186⁃5p (miR⁃186⁃5p)/sex⁃determining region Y box protein 4 (SOX4) axis. Methods si⁃PSMA3⁃AS1 and miR⁃186⁃5p inhibitor as well as their negative controls were transfected, respectively, into human neuroblastoma cells SH⁃SY5Y with LipofectamineTM 3000 reagent. The cells were randomly divided into the Control group (untransfected plasmid), the si⁃NC group (transfected with PSMA3⁃AS1 negative control), the si⁃PSMA3⁃AS1 group (transfected with si⁃PSMA3⁃AS1), the si⁃PSMA3⁃AS1+miR⁃NC group (co⁃transfected with si⁃PSMA3⁃AS1 and miR⁃186⁃5p inhibitor negative control), the si⁃PSMA3⁃AS1+miR⁃186⁃5p inhibitor group (co⁃transfected with si⁃PSMA3⁃AS1 and miR⁃186⁃5p inhibitor). The expression levels of PSMA3⁃AS1, miR⁃186⁃5p and SOX4 mRNA in each group were detected by qRT⁃PCR. The expression of SOX4 protein in each group were detected by Western blot. CCK⁃8 method and Transwell assay were used to detect the proliferation, migration and invasion ability of transfected cells in each group. The targeting relationship between miR⁃186⁃5p and PSMA3⁃AS1 and SOX4 was predicted by bioinformatics method and was verified by double luciferase reporter gene assay. Results Compared with the Control group and si⁃NC group, the si⁃PSMA3⁃AS1 group had a decreased PSMA3⁃AS1 expression level, cell survival rate, number of migration and invasion cells (all P<0.001). The results of double luciferase reporter gene assay showed that PSMA3⁃AS1 could target and negatively regulate miR⁃186⁃5p, while miR⁃186⁃5p could target and negatively regulate SOX4. After knocking down PSMA3⁃AS1, the expression level of miR⁃186⁃5p was increased, while the expression levels of SOX4 mRNA and protein were decreased (all P<0.001). In the recovery experiment, compared with the si⁃PSMA3⁃AS1+miR⁃NC group, the expression levels of SOX4 mRNA and protein, the cell survival rate, the number of migration and invasion cells in the si⁃PSMA3⁃AS1+miR⁃186⁃5p inhibitor group were increased (all P<0.001), and the expression level of miR⁃186⁃5p was decreased (all P<0.001). Conclusions Knockdown of PSMA3⁃AS1 can inhibit the proliferation, migration and invasion of neuroblastoma cells by regulating the miR⁃186⁃5p/SOX4 axis.
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    Summary of the best evidence for blood glucose management in cancer patients with immune checkpoint inhibitors inducing hyperglycemia
    JIANG Yuan, WANG Xiaoyan, LEI lei, LIU Lihua, WU Danfeng, ZHANG Siqi, TANG Dairong, FAN Lingli, FENG Gang, XUE Xiaojing
    2024, 16 (6):  722-728.  doi: 10.3969/j.issn.1674-5671.2024.06.13
    Abstract ( 98 )   PDF   Save
    Objective To investigate the occurrence of symptoms in patients with intermediate and advanced hepatocellular carcinoma after hepatectomy, to construct a symptom network for these patients, identify symptom clusters and core symptoms, and provide a basis for formulating targeted symptom management strategies. Methods A total of 299 patients with intermediate and advanced hepatocellular carcinoma who underwent hepatectomy in department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital from September 2019 to December 2021 were selected by a convenience sampling method. A cross⁃sectional study was conducted using general demographic questionnaires, the Chinese version of the M.D. Anderson Symptom Inventory, The Symptom Module Specific to Primary Liver Cancer, and the Hospital Anxiety and Depression Scale. Symptom clusters were extracted by exploratory factor analysis , symptom cluster networks were constructed with R Programming Language, and core symptoms and symptom clusters were identified by analyzing the centrality indicators of the networks, including strength, tightness and mediation. Results The top 5 symptoms in patients with intermediate and advanced hepatocellular carcinoma after surgery were dry mouth (89.30%), abdominal distension (86.29%), pain (80.26%), fatigue (79.26%), and sleep disturbance (78.60%). A total of 3 symptom clusters were identified: a neuropsychological symptom cluster, a weakness⁃gastrointestinal symptom cluster, and a pain⁃sleep symptom cluster, with a cumulative variance contribution of 55.54%. In the symptom network, distress (rs=1.65), nausea (rs=0.96), and pain (rs=0.36) were the core symptoms of the neuropsychological symptom cluster, the weakness⁃gastrointestinal symptom cluster, and the pain⁃sleep symptom cluster, respectively, with the neuropsychological symptom cluster being the central symptom cluster. Distress (rbS=1.095), lack of appetite (rbS=1.039), sleep disturbance (rbS=0.746) were the bridging symptoms. Conclusions Patients with intermediate and advanced hepatocellular carcinoma after surgery experience multiple symptoms. Healthcare providers can strengthen the understanding and assessment of symptom clusters according to the results of network analysis, pay attention to the core symptoms, and provide timely and precise interventions for patients.
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    Network analysis of concurrent symptoms and core symptom identification in patients with intermediate and advanced hepatocellular carcinoma after surgery
    HUANG Shihuan, LAN Huiyu, NONG Xiaolian, LI Fanrong, ZHAO Fengjuan, YOU Xuemei
    2024, 16 (6):  729-735.  doi: 10.3969/j.issn.1674-5671.2024.06.14
    Abstract ( 116 )   PDF   Save
    Objective To investigate the occurrence of symptoms in patients with intermediate and advanced hepatocellular carcinoma after hepatectomy, to construct a symptom network for these patients, identify symptom clusters and core symptoms, and provide a basis for formulating targeted symptom management strategies. Methods A total of 299 patients with intermediate and advanced hepatocellular carcinoma who underwent hepatectomy in department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital from September 2019 to December 2021 were selected by a convenience sampling method. A cross⁃sectional study was conducted using general demographic questionnaires, the Chinese version of the M.D. Anderson Symptom Inventory, The Symptom Module Specific to Primary Liver Cancer, and the Hospital Anxiety and Depression Scale. Symptom clusters were extracted by exploratory factor analysis , symptom cluster networks were constructed with R Programming Language, and core symptoms and symptom clusters were identified by analyzing the centrality indicators of the networks, including strength, tightness and mediation. Results The top 5 symptoms in patients with intermediate and advanced hepatocellular carcinoma after surgery were dry mouth (89.30%), abdominal distension (86.29%), pain (80.26%), fatigue (79.26%), and sleep disturbance (78.60%). A total of 3 symptom clusters were identified: a neuropsychological symptom cluster, a weakness⁃gastrointestinal symptom cluster, and a pain⁃sleep symptom cluster, with a cumulative variance contribution of 55.54%. In the symptom network, distress (rs=1.65), nausea (rs=0.96), and pain (rs=0.36) were the core symptoms of the neuropsychological symptom cluster, the weakness⁃gastrointestinal symptom cluster, and the pain⁃sleep symptom cluster, respectively, with the neuropsychological symptom cluster being the central symptom cluster. Distress (rbS=1.095), lack of appetite (rbS=1.039), sleep disturbance (rbS=0.746) were the bridging symptoms. Conclusions Patients with intermediate and advanced hepatocellular carcinoma after surgery experience multiple symptoms. Healthcare providers can strengthen the understanding and assessment of symptom clusters according to the results of network analysis, pay attention to the core symptoms, and provide timely and precise interventions for patients.
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    Application and management of midline intravenous catheters in secondary or above hospitals in Hunan Province
    LIU Hanqing, HU Yonghong, LIN Qin, WEI Tao, YUAN Zhong, LI Xuying
    2024, 16 (6):  736-740.  doi: 10.3969/j.issn.1674-5671.2024.06.15
    Abstract ( 98 )   PDF   Save
    Objective To investigate the application and the management issues of midline intravenous catheters in secondary or above hospitals in Hunan Province, and to provide a basis for standardizing the usage of midline catheters. Methods A cross⁃sectional survey was conducted using a self⁃designed "Survey on the Application and Management of Midline Catheters". The survey was distributed  to relevant coordinators in 89 secondary or above hospitals across 14 cities in Hunan Province, time range was from August 2023 to October 2023. Results A total of 78 hospitals (out of 89 hospitals) introduced midline catheters, most of which introduced midline catheters due to difficult peripheral venous access (83.33%, 65/78), followed by long⁃term continuous infusion therapy (75.64%, 59/78) and the application of chemotherapeutic drugs (26.92%, 21/78). In terms of evaluating the insertion length of catheters, 55 hospitals (70.51%, 55/78) used the distance of “the pre⁃puncture site along the vein to the ipsilateral clavicular line” as the predicted length for catheter insertion; 27 hospitals (34.62%, 27/78) performed catheter tip positioning; 69 hospitals (88.46%, 69/78) had a specified dwell time for midline catheters, with 62 hospitals believing the dwell time could exceed 4 weeks. A total of 28 hospitals (35.89%, 28/78) had incomplete clinical application standards and protocols for midline catheters, with 21 hospitals lacked standard operating procedures for catheter removal, 16 hospitals lacked health education protocols, and 14 hospitals lacked procedures for managing complications. A total of 66 hospitals (84.62%, 66/78) implemented quality control measures, while 12 hospitals (15.38%, 12/78) did not adopt any quality control measures. Conclusions The application of midline catheters have been popularized in secondary or above hospitals in Hunan Province, but the indications for catheter insertion are not sufficiently rational. The standard procedures for catheter insertion and maintenance need to be improved, and the quality management system requires further development and standardization.
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    ESMO 2024: new breakthroughs and future trends in hepatocellular carcinoma treatment
    WANG Jinming, LI Yaojie, QIU Guogao, LIU Shaoping, LIU Jie, YOU Xuemei, MA Liang, ZHONG Jianhong
    2024, 16 (6):  741-746.  doi: 10.3969/j.issn.1674-5671.2024.06.16
    Abstract ( 138 )   PDF   Save
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