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Project-based learning (PBL) is a transformative approach to college education with the potential to develop comprehensive skills such as critical thinking, problem-solving, and teamwork. This study explores factors influencing the effectiveness of PBL and proposes strategies for its enhancement among Chinese college students. Utilizing the Input-Environment-Output (IEO) model as a theoretical framework, we conducted an empirical analysis of PBL outcomes and their determinants. The study employed advanced data analysis techniques, including structural equation modeling (SEM), to demonstrate the positive impact of PBL on knowledge integration, project skills, and self-efficacy. The effectiveness of PBL, however, is influenced by various factors, including instructional design, teacher guidance, student participation, and the disciplinary and institutional contexts. Based on a survey of 553 Chinese college students, the findings suggest that targeted improvements in these areas can optimize PBL to better meet students' educational needs. The results provide actionable insights for educators and policymakers on enhancing PBL strategies to foster a more engaging and effective learning environment.

Background: Atezolizumab may provide clinical benefits to patients with advanced non-small cell lung cancer (NSCLC). However, the price of atezolizumab is relatively high, and its economic outcomes have remained unclear. In this study, we used two models to examine the cost-effectiveness of initial atezolizumab monotherapy versus chemotherapy for patients with PDL1 high-expressing EGFR and ALK wild-type advanced NSCLC in the context of the Chinese healthcare system. Methods: Partitioned Survival model and Markov model were performed to evaluate the cost-effectiveness of first-line single-agent atezolizumab versus platinum-based chemotherapy for patients with advanced NSCLC with PD-L1 high-expressing EGFR and ALK wild-type disease. Clinical outcomes and safety information were obtained from the most recent data from the IMpower110 trial, while cost and utility values were obtained from Chinese hospitals and relevant literature. Total costs, life years (LYs), quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed to explore model uncertainty. Scenario analyses were also conducted for the Patient Assistance Program (PAP) and various provinces in China. Results: In the Partitioned Survival model, the total cost of atezolizumab was $145,038, providing 2.92 LYs and 2.39 QALYs, while the total cost of chemotherapy was $69,803, providing 2.12 LYs and 1.65 QALYs. The ICER for atezolizumab versus chemotherapy was $102,424.83/QALY; in the Markov model, the ICER was $104,806.71/QALY. Atezolizumab was not cost-effective at the WTP threshold of three times China's per capita gross domestic product (GDP). Sensitivity analysis showed that the cost of atezolizumab, the utility of PFS, and the discount rate had a significant impact on ICER; PAP significantly reduced ICER, but atezolizumab was still not cost-effective in China. Conclusion: First-line monotherapy with atezolizumab for patients with PD-L1 high-expressing EGFR and ALK wild-type advanced NSCLC was estimated to be less cost-effective than chemotherapy in terms of the Chinese healthcare system; offering PAP increased the likelihood that atezolizumab would be cost-effective. In some areas of China with higher levels of economic development, atezolizumab was likely to be cost-effective. To improve the cost-effectiveness of atezolizumab, drug prices would need to be reduced. [ABSTRACT FROM AUTHOR]

Corona virus disease 2019 (COVID-19) infection has become a major public health issue affecting human health. The main goal of epidemic prevention and control at the current stage in China is to "protect people's health and prevent severe cases". Patients with lung cancer who receive antitumor therapy have low immunity, and the risk of severe illness and death once infected is much higher than healthy people, so they are vulnerable to COVID-19 infection. At present, less attention has been paid to the prevention and treatment of COVID-19 infection in patients with lung cancer in domestic guidelines and consensus. Based on the published data in China and abroad, we proposed recommendations and formed expert consensus on the vaccination of COVID-19, the use of neutralizing antibodies and small molecule antiviral drugs for patients with lung cancer, for physician's reference. [ABSTRACT FROM AUTHOR]

Background: Early identification of the malignant propensity of pulmonary ground-glass nodules (GGNs) can relieve the pressure from tracking lesions and personalized treatment adaptation. The purpose of this study was to develop a deep learning-based method using sequential computed tomography (CT) imaging for diagnosing pulmonary GGNs. Methods: This diagnostic study retrospectively enrolled 762 patients with GGNs from West China Hospital of Sichuan University between July 2009 and March 2019. All patients underwent surgical resection and at least two consecutive timepoint CT scans. We developed a deep learning-based method to identify GGNs using sequential CT imaging on a training set consisting of 1524 CT sections from 508 patients and then evaluated 256 patients in the testing set. Afterwards, an observer study was conducted to compare the diagnostic performance between the deep learning model and two trained radiologists in the testing set. We further performed stratified analysis to further relieve the impact of histological types, nodule size, time interval between two CTs, and the component of GGNs. Receiver operating characteristic (ROC) analysis was used to assess the performance of all models. Results: The deep learning model that used integrated DL-features from initial and follow-up CT images yielded the best diagnostic performance, with an area under the curve of 0.841. The observer study showed that the accuracies for the deep learning model, junior radiologist, and senior radiologist were 77.17%, 66.89%, and 77.03%, respectively. Stratified analyses showed that the deep learning model and radiologists exhibited higher performance in the subgroup of nodule sizes larger than 10 mm. With a longer time interval between two CTs, the deep learning model yielded higher diagnostic accuracy, but no general rules were yielded for radiologists. Different densities of components did not affect the performance of the deep learning model. In contrast, the radiologists were affected by the nodule component. Conclusions: Deep learning can achieve diagnostic performance on par with or better than radiologists in identifying pulmonary GGNs. [ABSTRACT FROM AUTHOR]

Background and Objective Mortality of lung cancer can be decreased by early screening effectively. However, consistent and proficient standards & methods have not been established in China. This study was based on pulmonary nodules/lung cancer comprehensive management platform established by West China Hospital, Sichuan University. Early screening of pulmonary nodules was integrated into standard healthcare of lung cancer system, aiming to improve survivals of lung cancer patients. Methods Three cohorts were established: healthy populations, pulmonary nodules cohort and lung cancer patients cohort, and related clinical data will be collected and analyzed. Preliminary plan includes verifying effect of pulmonary nodules screening module. Results Pulmonary nodules screening was performed in 2,836 employers (>40 years old) of West China Hospital. Lung cancers were diagnosed in 66 participants, all receiving surgery to remove the lesions. 65 of them were with early stage diseases, 1 with lung cancer and brain metastasis. Conclusion Proficient screening, follow-up and healthcare can be achieved via pulmonary nodules/lung cancer comprehensive management mode, which will be extended all over west China region in future. [ABSTRACT FROM AUTHOR]

The NE–striking Jiamusi–Yitong fault zone (JYFZ) is the most important branch in the northern segment of the Tancheng–Lujiang fault zone. The precise shearing time of its large–scale sinistral strike–slip has yet to determined and must be constrained. Detailed field investigations and comprehensive analyses show that strike–slip faults or ductile shear belts exist as origination structures along the western region of Yitong Graben. The strike of the shear belts trend to the NE–SW with steep mylonitic foliation. The zircon U–Pb dating result for the granite was 264.1±1 Ma in the ductile shear belt of the JYFZ. The microstructural observation (rotated feldspar porphyroclasts, S–C fabrics, and quartz c–axis fabrics, etc.) demonstrated the sinistral shearing of the ductile shear zones. Moreover, the recrystallized quartz types show a transitional stage of the subgrain rotation toward the recrystallization of the grain boundary migration (SR–GBM). Therefore, we suggest that the metamorphic grade of the shear zone in the ductile shear zones should have reached high greenschist facies conditions, and the deformation temperatures should approximately 450–500°C, which is obviously higher than the blocking temperature of muscovite (300–400°C). Hence, the 40Ar /39Ar isochron age of muscovite from ductile shear zones should be a cooling age (162.7±1 Ma). We infer that the sinistral strike–slipping event at the JYFZ occurred in the late Jurassic period, and it was further inferred from the ages of the main geological events in this region that the second sinistral strike–slip age of the Tancheng–Lujiang fault zone occurred during the period of tectonic movements in the Circum–Pacific tectonic domain. This discovery also indicates the age of the Tancheng–Lujiang fault zone that stretches to northeastern China. The initiation of the JYFZ in the late Jurassic is related to the speed and direction of oblique subduction of the west Pacific Plate under the Eurasian continent and is responsible for collision during the Jurassic period. [ABSTRACT FROM AUTHOR]

Background and objective The Expand Access Program (EAP) of Iressa(gefitinib, ZD1839) in China was initiated in 2001 with the aim of providing gefitinib to non-small cell lung cancer (NSCLC) patients who failed to respond to standard treatment or who could not tolerate chemotherapy. The primary objective was to describe the quality of life (QoL), tumor control status, drug safety, and clinical/genomic features of active long-term survivors enrolled in the EAP. The secondary objective was to determine the clinical characteristics of long-term survivors in the EAP program. Methods In this descriptive observational study, data were collected based on epidemiological research methods. The data of patients who were actively participating in the EAP and still undergoing gefitinib treatment were collected in a cross-sectional manner to reflect the current status of each patient. Meanwhile, the data of patients who had been on gefitinib treatment for more than three years and had already been terminated from the EAP or those who were fast progressors were collected retrospectively. Results A total of 934 patients were screened in the EAP database. Among these patients, 25 were active long-term survivors still enrolled in the EAP and 34 were long-term survivors who had been terminated from the program. These 59 patients were enrolled in 15 different centers in China, and the remaining 875 patients were fast progressors. The median scores for the Functional Assessment of Cancer Therapy-Lung (FACT-L), Trial Outcome Index (TOI), and Lung Cancer Subscale (LCS) of the 25 long-term survivors were 64.5, 37 and 12.5, respectively. The performance status 0-1 accounted for 91.6% of the data observed during the cross-sectional survey. For active long-term survivors, the objective response rate was 37.5%, the disease control rate was 87.5%, and the median duration of response time was almost 68 months. In the long-term survivor group, no serious and new adverse events were reported. Patients who were aged under 65 years (68.5%), affected with adenocarcinoma (81.4%), female (55.9%), or had never smoked (71%) accounted for majority of the long-term survivors. The percentage of females was significantly higher in the long-term survivor group than in the fast progressor group (P=0.02). Three tissue samples were collected from each of the 24 active long-term survivors, and one patient was found to be positive of EGFR mutation. Twenty-two blood samples were also collected, and one patient tested positive for EGFR mutation. The Ki67 protein expression was also tested in three tissue samples, and two of these were found positive for Ki67 protein expression, with a response duration time of over 73 months. Conclusion A 250 mg dose of gefitinib offers good QoL and is safe for advanced NSCLC long-term survivors even after more than three years of treatment. According to the evaluation of the current tumor control statuses of patients, gefitinib demonstrates good efficacy in these active long-term survivors. [ABSTRACT FROM AUTHOR]

Purpose: To review the results of endovascular treatment of acute aortic dissections with domestic stentgrafts at a single center. Methods: Data from all 51 patients who presented with acute aortic dissections (ADs, Stanford B type) between April 2004 and May 2009 and underwent endovascular interventions with domestic stent grafts were retrospectively reviewed. Of these patients 50 had primary ADs and 1 had a traumatic AD. All patients were followed up for from 1 to 48 months (average, 15.11 ± 10.93 months). Results: There was no strut failure or surgical conversion in any of the patients. Intraoperative angiography documented the complete seal of the primary entry. Two deaths occurred during hospitalization. One patient died due to aortic rupture 24 h after the procedure, and the other died of myocardial infarction 3 days later. Two patients (4.1%) died during the follow-up period. A Kaplan-Meier analysis revealed a 4-year survival rate of 92.16%. Conclusions: Endovascular treatment for acute Stanford B-type ADs with domestic stent grafts is both safe and effective, while also demonstrating an acceptable survival rate and mid-term clinical outcomes. [ABSTRACT FROM AUTHOR]

Background and objective In the previous studies, we have designed the Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer. In order to make a better understanding of the status of risk factors of lung cancer for residents in Chengdu, we carried out the investigation from June 2009 to December 2009. Methods With the stratified random sampling method, eligible residents were included and their risk factors of lung cancer were collected with the Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer. Results According to the criteria of the questionnaire, 21.34% of the population were at high risk of lung cancer. The smoking rate for male was 48.58%, higher than that of 2.65% for female. About 5.39% of male smokers began smoking before 15 years old. The average daily tobacco consumption in the most population was less than 20 pieces, with a duration between 20 to 40 years. However, there were 11.34% of all women suffered from passive smoking, and another 15.30% and 5.86% of residents were exposed to cooking fumes, minerals or asbestos. As for the previous illness history, 0.77%-18.08% of individuals have connective tissue diseases, pulmonary tuberculosis, emphysema and others. Finally, 4.91% of residents endured the long-term mental depression, and 7.24% had a positive family history of tumors. Conclusion The status of risk factors for lung cancer among residents in Chengdu was not optimistic. It should be paid more attention to tobacco control and environmental improvement to improve people's health. [ABSTRACT FROM AUTHOR]

Infection with non-tuberculous mycobacteria (NTM) is relatively rare in areas that are high-endemic for tuberculosis. We identified 126 strains of NTM in respiratory specimens collected by the Chinese Nationwide Survey in 2000, the Beijing Tuberculosis and Thoracic Tumour Institution, and the Guangzhou Thoracic Hospital. Species diagnosis was attained by sequencing of 16S-rDNA complemented by phenotypic characterization when necessary. Mycobacterium avium-intracellulare-complex – well known as a potential pulmonary pathogen – was diagnosed in all 3 surveys. Potentially pathogenic rapid growing strains of M. abscessus, M. chelonae and M. fortuitum were also detected. Moreover, species non-pathogenic in the airways such as M. nonchromogenicum, M. terrae and M. gordonae were encountered. Also, single strains of rare NTM species were isolated. Thus, several potentially pathogenic species of NTM were isolated from pulmonary specimens in China, and molecular techniques made possible exact species diagnosis. [ABSTRACT FROM AUTHOR]

Background: Angiopoietin-2 (Angpt2) is associated with the progression of coronary artery disease (CAD). This research aimed to investigate the possible association between single nucleotide polymorphisms (SNPs) of ANGPT2 and CAD. Methods: This research was performed in a hospital from the eastern region of China. From February 2019 to June 2019, 222 patients with CAD were newly diagnosed and 403 healthy controls were confirmed by physical examinations. The distribution frequency of five SNPs of the ANGPT2 (rs11137037, rs2442598, rs12674822, rs1823375, and rs734701) in all participants was analyzed by real-time polymerase chain reaction (PCR) with SNP locus-specific probes. Results: Our data showed that the participants with the TT genotype of rs2442598 were at reduced risk of CAD compared with wild-types (adjusted odds ratio [AOR] = 0.511, 95% CI: 0.283-0.923). The participants with the AC and AC+CC genotypes of rs11137037 were at greater risk of CAD compared to wild-types (AOR = 1.754, 95% CI: 1.140-2.699; AOR = 1.731, 95% CI: 1.165-2.573, respectively). In addition, carriers of the GG+TT genotypes of rs12674822, showed more significant high-density lipoprotein than those of GG genotype, in addition, carriers of the GG+TT genotypes of rs12674822, showed more significant high-density lipoprotein than those of GG genotype (P=0.037). Conclusion: These findings, as well as analysis of the haplotype, clearly indicate that ANGPT2 SNPs were highly correlated with susceptibility to CAD among the Han Chinese population. [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate the association of serum 25-hydroxyvitamin D (25(OH)D) with skeletal muscle mass (SMM) and function among the elderly in an urban area in northern China.Methods and Study Design: A total of 912 participants (316 men, 596 women) aged more than 60 years from 4 communities in Beijing were enrolled. Serum concentrations of 25(OH)D were measured through radioimmunoassay. SMM was assessed through bioelectrical impendence analysis, whereas skeletal muscle function was assessed through grip strength and 4-m regular gait speed measurements. On the basis of expert consensus of the Asian Working Group for Sarcopenia, low muscle mass was defined as relative skeletal mass index (RSMI) <7.0 kg/m2 for men and <5.7 kg/m2 for women. A noncondition logistical regression model was employed to explore the association between vitamin D and both muscle mass and function.Results: Serum 25(OH)D was positively associated with grip strength (β=0.16, SE=0.05). The upper quartile of 25(OH)D was negatively associated with loss of grip strength (OR=0.05, 95% CI: 0.01-0.48) in men but not in women. No significant associations were noted between 25(OH)D and appendicular skeletal muscle mass, RSMI, and gait speed.Conclusions: The present study demonstrated a positive association between vitamin D and skeletal muscle strength in elderly Chinese men but not women. [ABSTRACT FROM AUTHOR]