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Thyroid cancer is the most common malignant neoplasm within the endocrine system and the field of head and neck surgery. Although the majority of thyroid cancers, more than 90%, are well-differentiated thyroid carcinomas with a favourable prognosis, the escalating incidence of this disease has contributed to an increasing number of patients with a propensity for recurrent disease, rapid disease progression, and poor or no response to conventional treatments. These clinical challenges are commonly attributed to alterations in key thyroid oncogenes or signaling pathways, thereby initiating tumour cell dedifferentiation events, accompanied by reduced or virtually absent expression of the sodium/iodine symporter (NIS). As a result, the disease evolves into iodine-refractory differentiated thyroid cancer (RAIR-DTC), an entity that is insensitive to conventional radioiodine therapy. Despite being classified as a differentiated thyroid cancer, RAIR-DTC has an extremely poor clinical prognosis, with a 10-year survival rate of less than 10%. Therefore, it is of paramount importance to comprehensively elucidate the underlying pathogenesis of RAIR-DTC and provide specific targeted interventions. As the pathogenic mechanisms of RAIR-DTC remain elusive, here we aim to review recent advances in understanding the pathogenesis of RAIR-DTC and provide valuable insights for the development of future molecularly targeted therapeutic approaches.

Abstract Background Disturbance of the intestinal flora is a pathogenic factor for chronic atrophic gastritis (CAG). Hua-Zhuo-Jie-Du (HZJD) has been shown to be an effective Chinese herbal preparation for treating CAG. However, the effects of HZJD on the intestinal flora of CAG is unclear. In this study, we probed the regulating effects of HZJD on intestinal microbes in CAG rats using 16S rRNA gene sequencing. Methods High-performance liquid chromatography (HPLC) analysis was used to perform quality control of HZJD preparations. We then administered 1-methyl-3-nitro-1-nitrosoguanidine (200 μg/ml) to Sprague–Dawley rats to establish a CAG model. HZJD and vitacoenzyme were administered orally to these rats over a 10 week period. Hematoxylin and eosin (H&E) staining was performed to observe the histopathology of CAG rats. A rarefaction curve, species accumulation curve, Chao1 index, and ACE index were calculated to assess the alpha diversity. Principal component analysis (PCA), non-metric multi-dimensional scaling (NMDS), and unweighted pair group method with arithmetic mean (UPGMA) were conducted to examine the beta diversity. The LEfSe method was used to identify differential bacteria. Differential function analysis used PCA based on KEGG function prediction. Results HPLC showed that our HZJD preparation method was feasible. H&E staining showed that HZJD significantly improved the pathological state of the gastric mucosa in CAG rats. The rarefaction curve and species accumulation curve showed that the sequencing data were reasonable. The Chao1 and ACE indices were significantly increased in CAG rats compared to the N group. Following HZJD and vitacoenzyme treatment, the Chao1 and ACE indices were decreased. PCA, NMDS, and UPGMA results showed that the M group was separated from the N, HZJD, and V groups, and LEfSe results showed that the relative abundance of Akkermansia, Oscillospira, Prevotella, and CF231 were significantly higher in the N group. Proteobacteria and Escherichia were significantly enriched in the M group, Allobaculum, Bacteroides, Jeotgalicoccus, Corynebacterium, and Sporosarcina were significantly enriched in the V group, and Firmicutes, Lactobacillus, and Turicibacter were significantly enriched in the HZJD group. Conclusion HZJD exhibited a therapeutic effect on the intestinal flora of CAG rats.

Objectives: To develop a Brief Adolescent Respiratory System Health Assessment Scale-Student Version (BARSHAS-SV) and test the validity and reliability of the scale.Methods: Considering common respiratory system diseases and respiratory system symptoms as a theoretical basis, researchers developed a Brief Adolescent Respiratory System Health Assessment Scale-Student Version-I (BARSHAS-SV-I). After six medical experts reviewed the BARSHAS-SV-I, and six adolescents tested the BARSHAS-SV-I, researchers developed an updated BARSHAS-SV-II. Researchers randomly selected two middle schools in Baoding, China. Thousand twenty nine valid questionnaires were recovered. Researchers evaluated the validity and reliability of the scale and obtained the final version of the scale (BARSHAS-SV). The exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) were used to evaluate the construct validity of the scale. The content validity index (CVI) was used to evaluate the content validity of the scale. The Cronbach's α coefficient and the mean inter-item correlation coefficient (MIIC) were used to assess the reliability of the scale.Results: BARSHAS-SV Cronbach's α = 0.910, content validity = 0.941, and factor cumulative variance contribution rate = 64.047% conducting EFA. Conducting CFA, Chi square value (χ2) = 233.806, degrees of freedom (df) = 106, Chi square value/degree of freedom (χ2/df) = 2.206, root-mean-square error of approximation (RMSEA) = 0.063, normed fit index (NFI) = 0.922, goodness of fit index (GFI) = 0.917, Tueker-Lewis index (TLI) = 0.942, comparative fit index (CFI) = 0.955, incremental fit index (IFI) = 0.956. BARSHAS-SV consisted of 4 dimensions and 17 items. Four factors were as follows: Factor 1, mild respiratory system diseases (Cronbach's α coefficient = 0.781); Factor 2, severe respiratory system diseases (Cronbach's α coefficient = 0.829); Factor 3, respiratory system symptoms (Cronbach's α coefficient = 0.835); Factor 4, treatment and recovery of respiratory system diseases (Cronbach's α coefficient = 0.845).Conclusions: BARSHAS-SV is a valid and reliable method that can be applied to assess adolescent respiratory system health status. BARSHAS-SV may help teachers and medical staff in schools to quickly and conveniently evaluate the adolescent respiratory system health status and identify respiratory issues.

Objectives: To develop a Brief Haze Weather Health Protection Behavior Assessment Scale-Adolescent Version (BHWHPBAS-AV).Methods: Considering primary prevention, secondary prevention and tertiary prevention as a theoretical basis, researchers developed a Brief Haze Weather Health Protection Behavior Assessment Scale-Adolescent Version-I(BHWHPBAS-AV-I). After performing 6 reviews by related experts, and after conducting six adolescent tests for BHWHPBAS-AV-I, researchers developed an updated BHWHPBAS-AV-II. Out of the 20 districts in Baoding, two districts were randomly selected; moreover, two middle schools from these two districts were also randomly selected. Considering one class as a unit, researchers subsequently randomly selected 22 classes by using stratified sampling. In the end, 1,025 valid questionnaires were used as part of the study. At which point, researchers investigated the validity and reliability of the scale and obtained the final scale (BHWHPBAS-AV).Results: BHWHPBAS-AV Cronbach's α = 0.878, content validity = 0.948, and factor cumulative contribution rate = 54.058% using exploratory factor analysis. By confirmatory factor analysis, Chi square value (χ2) = 271.791, degrees of freedom (df) = 94, Chi square value/degrees of freedom (χ2/df) = 2.891, root-mean-square error of approximation (RMSEA) = 0.051, normed fit index (NFI) = 0.930, incremental fit index (IFI) = 0.953, goodness of fit index (GFI) = 0.955, Tueker-Lewis index (TLI) = 0.940, comparative fit index (CFI) = 0.953. BHWHPBAS-AV was composed of 16 items as well as 3 dimensions.Conclusions: A BHWHPBAS-AV scale that has an acceptable reliability and validity can be applied to assess adolescent haze weather health protection behavior, and can also help school teachers, as well as medical staff working in community health care institutions, to perform targeted behavioral interventions and deliver health education programs to adolescents.

Objective: This study aimed to investigate the level of haze-related knowledge adolescents have and to explore relevant influencing factors.Methods: From June 2015 to January 2016, researchers randomly selected 2 districts from the 20 districts of Baoding, China. Then, researchers randomly selected two middle schools from two districts. By conducting a stratified cluster sampling and considering one class as a unit, researchers randomly selected, from the other middle school, five first-grade classes, five second-grade classes, five third-grade classes from the one middle school, and three first-grade classes, two second-grade classes, and two third-grade classes. Finally, 1,100 adolescents were investigated by using the demographic questionnaire and the Adolescent Haze-Related Knowledge Awareness Assessment Scale (AHRKAAS). Multiple linear regressions were conducted to explore factors affecting the adolescent haze-related knowledge. Sensitivity analysis was used to confirm associations between influencing factors and AHRKAAS scores.Results: The AHRKAAS score rate was 69.9%. The dimension of human factors of haze formation was the highest (score rate = 85.6%). The dimension of haze harms on the human body was the lowest (score rate = 57.1%). Compared with the group (monthly expenses

Abstract Background The evaluation of respiratory system health status in hospitalized patients is usually based on many laboratory examinations and imaging examinations. Medical examinations require a lot of manpower, material resources, financial resources, and may cause a certain degree of mechanical damage and radiation damage. It is not easily used widely and economically to assess the respiratory health status of community adults. Therefore, researchers developed a brief adult respiratory system health status scale-community version (BARSHSS-CV) and tested its reliability and validity. Methods Using clinical characteristics and pathogenic factors of respiratory system diseases as a theoretical basis and through reference to relevant literature, researchers developed an initial scale. A randomized cluster sampling strategy was used to recruit adults in the communities of Baoding City, Shijiazhuang City, Cangzhou city and Chifeng City in China. Researchers randomly selected 1 district from each city. Subsequently, 4 communities were respectively randomly selected from 4 districts. Then, researchers conducted the questionnaire survey in 4 communities. Finally, researchers investigated 615 community adults. 584 valid questionnaires were recovered. By applying exploratory factor analysis, confirmatory factor analysis, content validity index, Cronbach’s α coefficient, mean inter-item correlation coefficient and test-retest reliability, researchers tested the reliability and validity of scale and created the final BARSHSS-CV. Results BARSHSS-CV Cronbach’s α=0.951, content validity = 0.933, test-retest reliability = 0.963 and factor cumulative contribution rate = 67.168% by exploratory factor analysis. By confirmatory factor analysis, Chi square value (χ2) was 442.117, degrees of freedom (df) was 161, Chi square value/degrees of freedom (χ2 /df) was 2.746, root-mean-square error of approximation (RMSEA) was 0.065, goodness of fit index (GFI) was 0.902, incremental fit index (IFI) was 0.955, comparative fit index (CFI) was 0.955, normed fit index (NFI) was 0.931, Tueker-Lewis index (TLI) was 0.947. BARSHSS-CV consisted of 20 items and 3 dimensions. Conclusions BARSHSS-CV with good test-retest reliability and content/construct validity is a brief and economical tool for assessing the state of respiratory system amongst adult communities. BARSHSS-CV may help medical staff in community primary medical institutions quickly, conveniently and economically assess the status of respiratory system and the main problems of respiratory system in community adults.

Abstract Background Haze leads to many direct serious public health impacts. Understanding haze related knowledge can not only help adolescents organize health protection awareness to prevent the harmful effects that haze has on the body, but also promote their normal growth and development. Methods By considering, as the theoretical basis, the reasons behind the formation of haze and the underlying mechanisms of the diseases that it causes, in addition to also investigating extensive literature references, our research team developed the Adolescent Haze Related Knowledge Awareness Assessment Scale (AHRKAAS-I). After 6 experts reviewed AHRKAAS-I, and 6 adolescents tested the scale, the research team further revised and improved AHRKAAS-I to form AHRKAAS-II. After which, researchers randomly selected 2 districts from the 20 districts of Baoding, and subsequently randomly selected 2 middle schools from these 2 districts. Conducting a stratified cluster sampling method, considering class as a unit, the research team randomly selected 22 classes. Finally, a total of 1100 adolescents were investigated and 1034 valid questionnaires were recovered. By analyzing the data of 1034 valid questionnaires, the researchers tested the reliability and validity of the scale and obtained the final scale (AHRKAAS). Results AHRKAAS Cronbach’s α=0.923, content validity = 0.940, criterion validity = 0.444, and factor cumulative contribution rate = 66.178% by exploratory factor analysis. Using confirmatory factor analysis, Chi square value = 662.780, degrees of freedom = 242, Chi square value/degrees of freedom = 2.739, root-mean-square error of approximation = 0.049, goodness of fit index = 0.929, adjusted goodness of fit index = 0.905, comparative fit index = 0.964, normed fit index = 0.944, and Tueker-Lewis index = 0.955. AHRKAAS consisted of 25 items and 4 dimensions. Conclusion AHRKAAS with a good reliability and validity can be used to assess the cognition level of haze related knowledge among the adolescents, help medical workers and coordinators in schools when conducting targeted behavior interventions. Furthermore, it can be used for health guidance for adolescents relating to the health prevention of haze.