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Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is an uncommon subtype of lung cancer with bleak prognosis. Its optimal treatment remains undetermined due to its malignancy. A 66-year-old man diagnosed with unresectable locally advanced LCNEC exhibited partial radiographic response to chemo-immunotherapy. He underwent salvage surgery after 4 rounds of docetaxel/nedaplatin (DP) regimen plus sintilimab, a highly selective monoclonal antibody which targets human anti-programmed death-ligand 1 (PD-L1). In addition, the pathologic examination of the excision demonstrated that there were no viable residuary tumor cells. This case indicates that neoadjuvant chemo-immunotherapy might benefit patients with locally advanced LCNEC, which deserves further investigation.

BackgroundFatigue is a common source of distress for cancer survivors. The severity of cancer-related fatigue varies significantly, which may be due to individual differences in host factors.AimThis cross-sectional study aims to explore how demographic, oncological, sociological, psychological, and stress-related hormones levels interact to influence the distinct experiences of fatigue (Cancer-related fatigue [CRF] occurrence and fatigue degree).MethodsA cross-sectional study carried out at the oncology outpatient and ward department of Xiyuan Hospital of China Academy of Chinese Medical Sciences recruited 306 cancer patients between January 2021 to December 2021. General information, fatigue, psychological factors was evaluated by general information questionnaire, the Revised Piper’s Fatigue Scale-Chinese Version (RPFS-CV), and the self-report Hospital Anxiety and Depression Scale (HADS). Stress-related hormones were measured with chemiluminescent enzyme immunoassay (Zhengzhou Antobio).Results306 patients were included, 229 (74.8%) were diagnosed with CRF, including 94 (41.0%) with mild fatigue, 121 (52.8%) with moderate fatigue, and 14 (6.1%) with severe fatigue. Multivariate regression analysis showed that higher depression scores, aldosterone levels may increase the risk of CRF. Patients who are obese (Body mass index ≥ 28 kg/m2) may help to reduce the risk of CRF. Other contributing factors for increased levels of fatigue (p< 0.05) include being female, having anxiety, depression and high aldosterone levels.ConclusionThe research suggested that CRF was a common symptom in cancer survivors and pay attention to these influencing factors may help to better identify patients susceptible to fatigue and provide long-term, targeted interventions.

With the normalization of the COVID-19 epidemic, online learning has gained prominence in the post-epidemic era. Gaining a comprehensive understanding of how online learning influences learning outcomes is essential for the success of large-scale online education initiatives. This study proposed a conceptual model based on an ecosystem theory to investigate the impact of K-12 online learning on academic achievement. A survey was conducted among 1,625 K-12 school students in Shenzhen, China, utilizing Structural Equation Modeling (SEM) for data analysis. The results indicate the following: (1) online learning engagement directly predicts academic achievement and mediates personal and environmental factors; (2) Family involvement and school support have similar impacts, with family involvement slightly stronger; (3) The Big Five Personality, especially conscientiousness, openness, and emotional stability, mediate the influence of family and school investment; and (4) School support affects academic achievement through online learning engagement, with emotional engagement being most significant. Our model illuminates the mediating role of online learning engagement, the impact of family involvement and school support, and the significance of Big Five Personality traits in K-12 online learning. This study contributes to the theoretical and practical understanding of the online learning ecosystem in the post-pandemic era, seldom explored in K-12 settings.

This qualitative research investigated the applicability of teacher leadership, a notion mostly grounded in the Western literatures, to the educational settings in China. The current research focused on the Chinese lead teachers, backbone teachers (BTs), their experiences, and perspectives of teacher leadership. As a program designed to increase school capacity, the BT system has left its delivery of the promises largely to the local context. The BTs' boundary expanding into other leadership domains traditionally considered as remote from the core of teaching and learning was at the mercy of the principal's leadership and support. [ABSTRACT FROM AUTHOR]