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Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To describe a grading system that can be used to evaluate core competency of clinical nurse specialists (CNSs) at different levels. Background: Evaluate core competence of CNSs at different levels reflects the quality of nursing and the development of the nursing profession. Design: This research employed the Delphi method. Methods: The STROBE checklist for observational cross‐sectional studies was followed to report this research study. This study consisted of two main phases: a literature review and semistructured interviews. Individual semistructured interviews were conducted with 11 healthcare experts and two patients. Two rounds of questionnaire surveys were administered to 21 nursing experts using the Delphi method. The CNSs were classified as primary, intermediate or advanced based on their years of work, professional titles and educational qualifications. Results: The graded competency evaluation system consisted of five first‐level indicators (clinical practice, consulting guidance and teaching, scientific research innovation, management and discipline development, and ethical decision‐making), 15 second level indicators, and 40 third‐level indicators. The authority coefficients (Cr) of the experts were.865 and.901. The Kendall's concordance coefficients of the three‐level indicators were.417,.289 and.316 for primary CNSs;.384,.294 and.337 for intermediate CNSs; and.489,.289 and.239 for advanced CNSs. Conclusion: The graded use evaluation system in clinical practice initially involves a comprehensive evaluation of the core abilities of CNSs. This is a tool for cultivating and grading the abilities of specialised nurses that can promote a practical upwards spiral. Relevance to Clinical Practice: The evaluation system can promote the scientific management and continuous improvement of CNSs in clinical nursing and can serve as a practical and objective reference for the effective management and development of CNSs. Patient or Public Contribution: Patients participated in the data collection process, during which they shared their health‐seeking experience with our research team. [ABSTRACT FROM AUTHOR]

With the development of intelligent products, products are increasingly able to provide personalised feedback to users. Product designs must meet users' emotional needs to deliver a positive experience. The current study examined emotional design, focusing on emotional arousal and methods for converting users from negative to positive emotional states. However, products are typically used in an emotional context with a specific usage scenario. Integrating emotional elements into a design can reveal users' concerns and needs, enabling user-centered emotional design. The current study examined the distribution of users' attention to product features under different emotional conditions. On the basis of the theory of visual attention, this study used emotional induction methodology and eye-tracking technology to observe users' attention to different product features after the induction of three different emotional states. We established a labeled product feature database and explored the influence of emotional scenes on user preferences. These research findings can provide theoretical support for emotional design of products under specific emotional scenarios and effectively guide designers to arrange design elements. [ABSTRACT FROM AUTHOR]

One central aim of disability studies is to shift understandings of disability, such that disability comes to be understood as about the social disadvantage/oppression that people face when society does not cater to impairment of body/mind. Nevertheless, there remains a need for more practical tools for disability advocacy, through which to transmit disability studies' ideas of disability to the general community. Drawing on a qualitative study of the perspectives of 23 people with physical and sensory impairments, this paper proposes virtual reality as an advocacy tool to communicate the principles and beliefs of disability studies. The findings highlight that, due to the nature of the technology, participants feel virtual reality has clear potential as a disability advocacy tool that can facilitate empathy, perspective-taking and positive social change, with a particular focus on how it is the environmental barriers and social attitudes around people that disables them. More practical advocacy or informal education tools are needed that align with the principles of disability studies. This research conducted in-depth interviews with 23 people with physical and sensory impairments. The research finds that virtual reality has clear potential as a disability advocacy tool. The participants reported that virtual reality can facilitate empathy, perspective-taking and positive social change. The research finds that virtual reality focuses on how environmental barriers and social attitudes around people with disability disable them, rather than focusing on impairment experiences. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most prevalent neurodegenerative and remains incurable. Aluminum is a potent neurotoxin associated with AD. The main pathological features of AD are extracellular amyloid-β protein deposition and intracellular hyperphosphorylated Tau protein. A body of evidence suggest that oxidative stress and autophagy are involved in the pathogenesis of AD. Andrographis paniculata (AP) is a native plant with anti-inflammatory, anti-oxidative stress, and regulation of autophagy properties. AP significantly alleviated cognitive impairments, reduced Aβ deposition and has neuroprotective effect. However, its effects on aluminum-induced AD model have not been studied much. In this study, we investigated whether AP protect against aluminum-induced neurotoxicity through regulation of p62-Kelch-like ECH-associated protein 1(Keap1)-Nuclear factor E2 related factor 2 (Nrf2) pathway and activation autophagy in vivo and in vitro. Methods: UPLC-ESI-qTOF-MS/MS was used to identify the chemical constituents of AP ethanol extract. The mice with cognitive deficit were established by injecting aluminum chloride and D-galactose, and treated with either AP extract (200, 400, or 600 mg/kg/d) or andrographolide (2 mg/kg/2d).The spatial memory ability was detected by Morris water maze, HE staining were used to detect in brain tissue,Oxidative stress indexs and SOD activity in both serum and brain tissue were detected by kit.The expression of p62-Nrf2 pathway proteins were measured via western blotting. Furthermore, the neurotoxicity model was induced by aluminum maltolate (700 µM) in PC12 cells. Following AP and andrographolide treatment, the cell viability was detected. The relevant mRNA and protein expressions were detected in cells transfected with the p62 siRNA. Results: The main active components of AP included andrographolide, neoandrographolide and deoxyandrographolide as identified. AP and andrographolide significantly improved the spatial memory ability of mice, attenuated pathological changes of hippocampal cells, reduced the level of malondialdehyde, and increased superoxide dismutase activity in serum or brain tissue as compared to model control. In addition, the Nrf2, p62 and LC3B-II proteins expression were increased, and p-Tau and Keap1 proteins were decreased in the hippocampus after AP and andrographolide treatment.Furthermore, AP increased aluminum maltolate-induced cell viability in PC12 cells. Silencing p62 could reverse the upregulation expression of Nrf2 and downregulation of Keap1 and Tau proteins induced by AP in aluminum maltolate-treated cells. Conclusions: AP had neuroprotective effects against aluminum -induced cognitive dysfunction or cytotoxicity, which was involved in the activation of the p62-keap1-Nrf2 pathway and may develop as therapeutic drugs for the treatment of AD. However, this study has certain limitations, further optimize the protocol or model and study the molecular mechanism of AP improving AD. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to evaluate the perioperative risks and outcomes of ultra-radical surgery in patients with extensive metastatic ovarian growing teratoma syndrome (GTS). Methods: We conducted a retrospective study of patients with extensive metastatic ovarian GTS treated in our hospital between 2000 and 2022. Patients' clinical characteristics, surgical treatment, and outcomes were evaluated. Results: Overall, 13 patients were identified, and the median age at diagnosis of ovarian immature teratoma (IT) was 24 years (range: 5–37). The median interval between IT diagnosis and presenting GTS was 8 months (range: 2–60), with a median surgery delay of 5 months (range: 3–300). Peritoneum and liver were the most commonly affected sites (100%), followed by bowel (12 patients, 92.3%), diaphragm (12 patients, 92.3%), adnexa (9 patients, 69.2%), omentum (8 patients, 61.5%), uterus (7 patients, 53.8%), in the descending order. The mean operation time was 316 min (range: 180–625), and the mean blood loss volume was 992 mL (range: 200–5,000). Peritoneal metastasectomy (13 patients, 100%), diaphragmatic metastasectomy (12 patients, 92.3%), metastasis removal from the bowel (8 patients, 61.5%), partial hepatectomy (4 patients, 30.8%), bowel excision and anastomosis (1 patient, 7.7%) were also applied to achieve optimal debulking. R0 was achieved in 9 (69.2%) patients. A high rate of intraoperative blood transfusion (8 patients, 61.5%) and admission to the intensive care unit (9 patients, 69.2%) were observed, and the median postoperative hospitalization time was 8 days (range: 4–22). After a median follow-up of 3.3 years, 9 patients were free of disease, and 4 were alive with stable residual diseases. Conclusion: The survival outcomes in extensive metastatic ovarian GTS were satisfactory after ultra-radical surgery, while a proper therapeutic plan should be established due to the high perioperative risks. [ABSTRACT FROM AUTHOR]

Background: Cyclic adenosine monophosphate (cAMP) levels are directly activated by adenylate cyclase (AC) and play an anti-inflammatory role in chronic obstructive pulmonary disease (COPD). Previously, we have shown that isoforskolin (ISOF) can effectively activate AC1 and AC2 in vitro, improve pulmonary ventilation and reduce the inflammatory response in COPD model rats, supporting that ISOF may be a potential drug for the prevention and treatment of COPD, but the mechanism has not been explored in detail. Methods: The potential pharmacological mechanisms of ISOF against COPD were analyzed by network pharmacology and multi-omics based on pharmacodynamic study. To use specific agonists, inhibitors and/or SiRNA for gene regulation function studies, combined qPCR, WB were applied to detect changes in mRNA and protein expression of important targets PIK3C3, AKT, mTOR, SPP1 and AQP4 which related to ISOF effect on COPD. And the key inflammatory factors detected by ELISA. Results: Bioinformatics suggested that the anti-COPD pharmacological mechanism of ISOF was related to PI3K-AKT signaling pathway, and suggested target protein like PIK3C3, AQP4, SPP1, AKT, mTOR. Using the AQP4 inhibitor,or inhibiting SPP1 expression by siRNA-SPP1 could block the PIK3C3-AKT-mTOR pathway and ameliorate chronic inflammation. ISOF showed cAMP-promoting effect then suppressed AQP4 expression, together with decreased level of IL-1β, IL-6, and IL-8. Conclusions: These findings demonstrate ISOF controlled the cAMP-regulated PIK3C3-AKT-mTOR pathway, thereby alleviating inflammatory development in COPD. The cAMP/AQP4/PIK3C3 axis also modulate Th17/Treg differentiation, revealed potential therapeutic targets for this disease. [ABSTRACT FROM AUTHOR]

Benign struma ovarii (SO) with synchronous ascites and elevated CA125 level is extremely rare that the incidence, clinical characteristics, and risk factors remain unclear. We conducted a retrospective study of patients with SO treated in our hospital between 1980 and 2022. Logistic regression was used to identify potential risk factors for SO patients presenting with ascites and elevated CA125 levels. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the identified risk factors. A total of 21 patients with synchronous ascites and elevated CA125 levels were identified in 229 patients with SO, the crude incidence rate was 9.17%, and four patients (1.75%) had pseudo-Meigs' syndrome. Ascites were completely involuted within 1 month postoperatively and the serum CA125 level decreased to normal between 3 d and 6 weeks after surgery. Multivariate logistic regression showed that age ≥49 years (OR 3.71, 95% CI 1.29 − 10.64, p = 0.015), tumor size ≥10.0 cm (OR 8.79, 95% CI 3.05 − 25.35, p < 0.001), and proliferative SO (OR 11.16, 95% CI 3.01 − 41.47, p < 0.001) were the independent risk factors for patients presenting ascites and elevated CA 125 level. The ROC curve revealed that the predictive performance for age and tumor size was unsatisfactory with an area under the curve (AUC) was 0.646 and 0.682, respectively. Linear regression demonstrated that the serum CA125 level has a moderate positive correlation with the volume of ascites (log2CA125 = 0.6272*log2ascites + 2.099, p = 0.0001, R2 = 0.5576). Less than one-tenth of patients with SO would present ascites and elevated CA125 levels, while age ≥49 years, tumor sizes ≥10 cm, and the presence of proliferative SO were the risk factors. [ABSTRACT FROM AUTHOR]

Simple Summary: A systematic review and meta-analysis was performed to determine the role of adjuvant chemotherapy in FIGO stage IA G2-3 and stage IB-IC pure ovarian immature teratoma (POIT) and 15 studies with 707 patients were enrolled. Compared with surveillance, adjuvant chemotherapy significantly decreased the mortality rate (RR 0.31, 95% CI 0.11–0.88, p = 0.03), but not recurrence (p = 0.37), in the overall cohort. Subgroup analysis showed no statistical difference in the recurrence rate and mortality rate between patients who received adjuvant chemotherapy and surveillance in pediatric POIT, stage IA G2-3 POIT, stage IB-IC POIT, and stage IA-IC G3 POIT. Patients who received adjuvant chemotherapy appeared to have a lower risk of both recurrence (RR 0.17, 95% CI 0.03–0.83, p = 0.03) and death (p = 0.05) in adult POIT. Surveillance in stage I POIT over IA G1 should be applied cautiously, especially in adult patients. To determine the role of adjuvant chemotherapy in stage IA G2-3 and stage IB-IC pure ovarian immature teratoma (POIT), we performed a systematic review and meta-analysis by searching PubMed, Embase, Cochrane library, Web of Science, and ClinicalTrials.gov. Randomized controlled trials or cohort studies on stage IA G2-G3 or stage IB-IC POIT between 1 January 1970 and 15 December 2022 were enrolled. The recurrence rate and mortality rate were the primary outcomes, and subgroup analysis based on the tumor stage and grade was also conducted. In total, 15 studies with 707 patients were included. Compared with surveillance, adjuvant chemotherapy significantly decreased the mortality rate (RR 0.31, 95% CI 0.11–0.88, p = 0.03), but not recurrence (RR 0.74, 95% CI 0.39–1.42, p = 0.37), in the overall population. Subgroup analysis showed no statistical difference in the recurrence rate and mortality rate between patients who received adjuvant chemotherapy and surveillance in pediatric POIT, stage IA G2-3 POIT, stage IB-IC POIT, and stage IA-IC G3 POIT (all with p > 0.05). However, patients who underwent adjuvant chemotherapy appeared to have a lower risk of both recurrence (RR 0.17, 95% CI 0.03–0.83, p = 0.03) and death (RR 0.04, 95% CI 0.00–1.00, p = 0.05) in adult POIT. Adjuvant chemotherapy significantly decreased the mortality rate in patients with stage I POIT and lowered the risk of recurrence in the adult subgroup. Surveillance administered in stage I POIT over IA G1 should be cautious, especially in adult patients. [ABSTRACT FROM AUTHOR]

Background: Acupuncture effectively improves cognitive function in Alzheimer's disease (AD). Many neuroimaging studies have found significant brain alterations after acupuncture treatment of AD, but the underlying central modulation mechanism is unclear. Objective: This review aims to provide neuroimaging evidence to understand the central mechanisms of acupuncture in patients with AD. Methods: Relevant neuroimaging studies about acupuncture for AD were retrieved from eight English and Chinese medicine databases (PubMed, Embase, Cochrane Library, Web of Science, SinoMed, CNKI, WF, VIP) and other resources from inception of databases until June 1, 2022, and their methodological quality was assessed using RoB 2.0 and ROBINS - I. Brain neuroimaging information was extracted to investigate the potential neural mechanism of acupuncture for AD. Descriptive statistics were used for data analysis. Results: Thirteen neuroimaging studies involving 275 participants were included in this review, and the overall methodological quality of included studies was moderate. The approaches applied included task-state functional magnetic resonance imaging (ts-fMRI; n = 9 studies) and rest-state functional magnetic resonance imaging (rs-fMRI; n = 4 studies). All studies focused on the instant effect of acupuncture on the brains of AD participants, including the cingulate gyrus, middle frontal gyrus, and cerebellum, indicating that acupuncture may regulate the default mode, central executive, and frontoparietal networks. Conclusion: This study provides evidence of the neural mechanisms underlying the effect of acupuncture on AD involving cognitive- and motor-associated networks. However, this evidence is still in the preliminary investigation stage. Large-scale, well-designed, multimodal neuroimaging trials are still required to provide comprehensive insight into the central mechanism underlying the effect of acupuncture on AD. (Systematic review registration at PROSPERO, No. CRD42022331527). [ABSTRACT FROM AUTHOR]

Background: Ovarian strumal carcinoid is an extremely rare ovarian malignant tumor with limited data on clinical characteristics and survival outcomes.Methods: A retrospective study of 119 patients was conducted, including 98 cases identified from literature review, and their clinical characteristics were investigated. The overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and potential prognostic factors of these patients were also evaluated.Results: Lesions of 115 cases were confined to the ovarian while four patients presented with extra-ovarian disease upon initial diagnosis. Surgical treatment options performed in this cohort varied, 5.0% received ovarian cystectomy, 36.1% received unilateral salpingo-oophorectomy (USO), 7.6% received bilateral salpingo-oophorectomy (BSO), 42.0% received hysterectomy with BSO, and 8.4% underwent debulking surgery. Moreover, one patient did not undergo any surgery. No postoperative adjuvant therapy was administered in 89.9% patients, while 7.6% and 2.5% received adjuvant radiotherapy and chemotherapy, of which two patients received combined radiation and chemotherapy. At the final follow-up, 89.1% patients showed no evidence of the disease, and 5.0% were alive with the disease. Only seven deaths occurred, with two attributed to the tumor. The 5-year, 10-year, and 20-year OS rates were 96.0%, 85.0%, and 85.0%, respectively, with a 15-year recurrence rate of 4.4%. The 5-year and 20-year DSS rate were 98.5% and 95.9%. Multivariate Cox regression showed age ≥ 55 years was the only risk factor associated with the OS (P = 0.014, OR 7.988; 95% CI 1.519 - 42.004). However, the univariate and multivariate Cox regression showed no potential risk factor for RFS and DSS.Conclusion: Patients with ovarian strumal carcinoid have an excellent prognosis irrespective of the surgical option. Conservative surgery especially USO with individualized adjuvant therapy is recommended. [ABSTRACT FROM AUTHOR]

Study Question: Are taurine and its transporter TAUT associated with spermiogenesis and early embryo development?Summary Answer: Morphologically abnormal spermatozoa increased after local functional interference by intratesticular injection, and taurine depletion significantly reduced the normal embryo numbers in vivo and blastocyst formation rate in vitro.What Is Known Already: Taurine is one of the most abundant amino acids in the male reproductive system and it has been demonstrated that taurine can efficiently improve spermatogenic function in rat models of testicular injury. However, limited information is known about the role of taurine and its transporter TAUT in spermatogenesis and early embryo development.Study Design, Size, Duration: Clinical characteristics from 110 couples who have experienced recurrent pregnancy loss (RPL) were collected from December 2014 to March 2018. According to whether a fetal heartbeat was seen in the previous pregnancy under ultrasonic monitoring, patients with RPL were divided into two groups: an RPL without heartbeat (pregnancy with no fetal heartbeat, ROH) group, and an RPL with heartbeat (one or more pregnancies with fetal heartbeat, RWH) group. Semen samples (21 ROH and 20 RWH) were finally used for metabolomic analysis. Furthermore, semen samples were obtained from 30 patients with teratozoospermia (normal sperm morphology <4%) seeking evaluation for infertility and 25 age-matched control subjects with normal semen quality for western blotting. Animal experiments were performed in CD-1/ICR mice.Participants/materials, Setting, Methods: Metabolomics was performed to determine the metabolic changes between the ROH and RWH groups. Sperm proteins from patients with teratozoospermia and healthy controls were extracted for detecting TAUT expression using western blot analysis. Immunofluorescence was used to characterize the localization of TAUT in the testis and ejaculated spermatozoa. Functional analysis in mice was performed by intratesticular injection of siRNAs or antagonist (β-alanine) and 5% β-alanine was provided in drinking water to 3-week-old male mice for 5 weeks with the aim of depleting taurine. Murine epididymal spermatozoa were stained with hematoxylin and eosin for morphological assessment. IVF and mating tests were performed in mice for assessing fertility.Main Results and the Role Of Chance: Metabolomic analysis demonstrated that the taurine content was lower in spermatozoa but higher in seminal plasma from the ROH than the RWH group. TAUT expression was lower in spermatozoa from patients with teratozoospermia than controls. Immunofluorescence showed that TAUT was localized to the manchette in mouse elongated spermatids functional analysis showed that morphologically abnormal spermatozoa increased after interference, and this defect increased after supplementation with 5% β-alanine but was improved by 5% taurine supplementation. Supplementation with 5% β-alanine significantly reduced the normal embryo number in the mouse uterus as well as blastocyst formation rate in vitro.Large Scale Data: N/A.Limitations, Reasons For Caution: The sample size was low and larger cohorts are needed to confirm the positive effect of taurine on human sperm quality. A comprehensive safety examination should be performed to evaluate whether taurine is a possible treatment for teratozoospermia. Furthermore, the specific molecular mechanism of TAUT involvement in spermiogenesis remains to be clarified.Wider Implications Of the Findings: The study provides new insights into the role of taurine and its transporter TAUT in male reproduction and embryo development. The results also indicate that TAUT is a promising molecular candidate for the assessment of sperm quality, which may contribute to the diagnosis and treatment for teratozoospermia.Study Funding/competing Interest(s): This work was supported by grants from the National Natural Science Foundation of China (no. 81774075, 31900605, 81971451), Jiangsu Science and Technology Program Grant (BK20190654) and Maternal and child health scientific research of Jiangsu Province (F202121). The authors declare no competing financial interests. [ABSTRACT FROM AUTHOR]

Background: The significance of human epidermal growth factor receptor 2 (Her2) and nucleus-associated antigen Ki-67 expression remains controversial in gastric adenocarcinoma (GaC). The aim of this study was to investigate the expression and clinicopathologic and prognostic significance of Her2 and Ki-67 in resected GaC without distant metastasis.Methods: Malignant tissues and clinicopathologic data were obtained from 195 patients with resected non-metastatic GaC. Immunohistochemistry staining was performed to examine the expression of Her2 and Ki-67; their association with clinicopathologic factors were investigated using logistic regression, and their association with survival was explored using Kaplan-Meier analysis and Cox proportional hazards regression.Results: Her2 was majorly expressed in cell membrane and Ki-67 in cell nucleus in non-metastatic GaC. Stronger Her2 expression was significantly associated with better tumor differentiation, neurovascular invasion, less advanced pathological tumor (pT) stage, and more advanced pathological node (pN) stage; while Ki-67 expression was not significantly associated with any investigated clinicopathologic factors. Patients with both negative Her2 and negative Ki-67 expression had poorer tumor differentiation, and more advanced pT and pathological tumor-node-metastasis (pTNM) stages; the association with pT and pTNM stages were further confirmed by multivariable analyses, especially in node-negative disease. Her2 or Ki-67 alone was not significantly associated with pTNM stage. A strongly positive (+++) Her2 expression was associated with poorer survival in multivariable analysis only (P = 0.047); while Ki-67 or combined expression was not significantly associated with prognosis.Conclusions: In non-metastatic GaC, Her2 expression and combined expression of Her2 and Ki-67 were associated with several clinicopathologic factors including tumor differentiation and stage, and only a +++ Her2 expression was associated with poorer prognosis in multivariable analysis with marginal significance in this study; while Ki-67 alone had both limited clinicopathologic and prognostic values. [ABSTRACT FROM AUTHOR]