Objective:To analyze the clinicopathological characteristics and prognosis of patients with multilocular cystic renal neoplasm of low malignant potential and compare the clinicopathological charac-teristics of patients with multilocular cystic renal neoplasm of low malignant potential who underwent different surgical methods.Methods:Clinicopathological data and prognosis of patients admitted to Peking University Third Hospital from January 2010 to September 2023 were collected.Patients who underwent radical nephrectomy or nephron-sparing surgery and were pathologically diagnosed with multilocular cystic renal neoplasm of low malignant potential were identified.Based on the surgical methods,the patients were divided into radical nephrectomy group and nephron-sparing surgery group.The clinicopathological characteristics of the two groups were compared.Results:A total of 35 patients were enrolled in this study.The median age at diagnosis was 53.0(39.0-62.0)years.Among the 35 patients,23 were males(65.7％)and 12 were females(34.3％).Nine patients underwent radical nephrectomy(25.7％),while 26 patients underwent nephron-sparing surgery(74.3％).The clinical T-stage of 35 patients did not exceed T2a stage.The median operation time was 145.0 min,and the median estimated intraoperative blood loss was 20.0 mL.The median postoperative hospitalization days was 6.0 d.The postoperative pathological results did not indicate renal sinus invasion,sarcomatous change,adrenal invasion or lymph node invasion.Based on the surgical methods,the patients were divided into a radical nephrectomy group and a nephron-sparing surgery group.There was no significant difference in clinicopathological charac-teristics between the two groups.Except for one patient who was lost to the follow-up,all the other patients were followed up for 8-111 months,with a median follow-up time of 70.5 months.Only one patient died from non-cancer-specific reasons,other patients had no tumor metastasis or recurrence.Conclusion:Patients with multilocular cystic renal neoplasm of low malignant potential have a good prog-nosis.There is no significant difference in clinicopathological characteristics of patients between nephron-sparing surgery group and radical nephrectomy group for multilocular cystic renal neoplasm of low malig-nant potential.

Objective:To predict the 3-year cancer-specific survival(CSS)of patients with non-meta-static T3a renal cell carcinoma after surgery.Methods:A total of 336 patients with pathologically con-firmed T3a N0-1M0 renal cell carcinoma(RCC)who underwent surgical treatment at the Department of Urology,Peking University Third Hospital from March 2013 to February 2021 were retrospectively collect-ed.The patients were randomly divided into a training cohort of 268 cases and an internal validation co-hort of 68 cases at an 4∶1 ratio.Using two-way Lasso regression,variables were selected to construct a nomogram for predicting the 3-year cancer-specific survival(CSS)of the patients with T3aN0-1M0 RCC.Performance assessment of the nomogram included evaluation of discrimination and calibration ability,as well as clinical utility using measures such as the concordance index(C-index),time-dependent area un-der the receiver operating characteristic curve[time-dependent area under the curve(AUC)],calibra-tion curve,and decision curve analysis(DCA).Risk stratification was determined based on the nomo-gram scores,and Kaplan-Meier survival analysis and Log-rank tests were employed to compare progres-sion-free survival(PFS)and cancer-specific survival(CSS)among the patients in the different risk groups.Results:Based on the Lasso regression screening results,the nomogram was constructed with five variables:tumor maximum diameter,histological grading,sarcomatoid differentiation,T3a feature,and lymph node metastasis.The baseline data of the training and validation sets showed no statistical differences(P＞0.05).The consistency indices of the column diagram were found to be 0.808(0.708-0.907)and 0.903(0.838-0.969)for the training and internal validation sets,respectively.The AUC values for 3-year cancer-specific survival were 0.843(0.725-0.961)and 0.923(0.844-1.002)for the two sets.Calibration curves of both sets demonstrated a high level of consistency between the actual CSS and predicted probability.The decision curve analysis(DCA)curves indicated that the column dia-gram had a favorable net benefit in clinical practice.A total of 336 patients were included in the study,with 35 cancer-specific deaths and 69 postoperative recurrences.According to the line chart,the patients were divided into low-risk group(scoring 0-117)and high-risk group(scoring 119-284).Within the low-risk group,there were 16 tumor-specific deaths out of 282 cases and 36 postoperative recurrences out of 282 cases.In the high-risk group,there were 19 tumor-specific deaths out of 54 cases and 33 post-operative recurrences out of 54 cases.There were significant differences in progression-free survival(PFS)and cancer-specific survival(CSS)between the low-risk and high-risk groups(P＜0.000 1).Conclusion:A nomogram model predicting the 3-year CSS of non-metastatic T3a renal cell carcinoma patients was successfully constructed and validated in this study.This nomogram can assist clinicians in accurately assessing the long-term prognosis of such patients.

OBJECTIVE To explore the effects of narrative pharmacy management on medication compliance， negative emotions， and quality of life in patients with cardiovascular disease complicated with negative emotions. METHODS A total of 49 patients with drug use problems and negative emotions attending the cardiovascular pharmacy clinic of Wuhan First Hospital from February to August 2023 were selected as the study objects， narrative pharmacy model was applied for patient management during their visits； pharmaceutical care and emotional management were performed after 2 weeks of treatment and a follow-up visit was conducted to evaluate and record the management effect one month later. RESULTS Adopting a narrative pharmacy management model， 49 patients were involved in 114 drug related consultation questions. Compared with the visit， after one month of management， the number of medication types taken by patients significantly decreased [4.00 （2.00， 6.00） vs. 3.00 （1.50， 5.00）， P＜0.05]， the incidence of adverse reactions significantly decreased （32.65% vs. 2.04%， P＜0.001）， the rate of blood pressure and lipid compliance significantly increased （30.61% vs. 95.92%， P＜0.001）， and the score of the patient’s medication compliance significantly improved （[ 3.94±2.44） vs. （6.78±2.07）， P＜0.01]. The depression score significantly decreased [3.00 （2.00， 4.50） vs. 2.00 （0.00， 3.00）， P＜0.001]， the anxiety score significantly reduced [3.00 （2.00， 4.50） vs. 1.00 （0.00， 2.00）， P＜0.001]， quality of life score was significantly improved [22.00 （19.00， 22.00） vs. 23.00 （23.00， 24.50）， P＜0.01]. In the satisfaction survey， there was a slight increase in the overall satisfaction proportion （91.84% vs. 97.96%， P＞0.05）. CONCLUSIONS The application of narrative pharmacy in cardiovascular pharmacy clinic can improve patient compliance， reduce adverse drug reactions， enhance the effectiveness of drug treatment， avoid drug interactions， effectively improve the anxiety and depression， and ultimately improve the quality of life.

OBJECTIVE To investigate the role of clinical pharmacists in the treatment of a patient with Epstein-Barr （EB） virus encephalitis. METHODS Clinical pharmacist participated in drug diagnosis and therapy for a patient with EB virus encephalitis. According to the physiological characteristics of the disease and the pharmacokinetic-pharmacodynamic characteristics of antibiotics， clinical pharmacists suggested that the dose should be adjusted as ceftriaxone 2 g， q12 h+meropenem 2 g， q8 h. Based on the uncontrolled infection of the patient， pharmacists suggested that ceftriaxone should be stopped and vancomycin 1 million U and q12 h should be used as alternative therapy. According to the results of etiology， pharmacists suggested that acyclovir should be discontinued and replaced with ganciclovir 5 mg/kg， q12 h. The electrolyte disturbance of the patient may be adverse drug reactions caused by Mannitol injection， it was recommended to stop the drug. RESULTS The clinician followed the advice of the clinical pharmacists. After treatment， the patient improved and was discharged. CONCLUSIONS Clinical pharmacists can carry out pharmaceutical care for patients with EB virus encephalitis， assist physicians in optimizing the treatment plan of patients， and ensure the effectiveness and safety of drug treatment.

Objective:To analyze a Risk Scale for Emergence Agitation After General Anesthesia in Children (the EA risk scale) into simplified Chinese and evaluate the reliability and validity in children with strabismus correction surgery.Methods:After obtaining the authorization of the original author, the English version of the EA risk scale was translated, translated back and culturally debugged to form the Chinese version of the EA risk scale. Then 279 children with strabismus correction surgery were selected from a tertiary hospital of ophthalmology in Tianjin and were investigated to validate the scale.Results:The correlation coefficients of each item and the total score of the scale were respectively 0.768 (item 1) ,0.717(item 2), 0.676(item 3), 0.634(item 4) (all P < 0.01). Content validity index of the scale was 0.920, and each item was 0.80-1.00. One factors including 4 items were identified using exploratory factor analysis, accounting for 62.052% of the total variance. The optimal cut-off value for the EA risk in children was 10, with the AUG was 0.816, specificity of 0.704, and sensitivity of 0.839. The Cronbach α coefficient for the total scale was 0.819, and the intraclass correlation coefficient value between the scorers was 0.835. Conclusion:The Chinese version of the EA risk scale has good reliability and validity. The items are concise, clear, and easy to understand. It is suitable for clinical departments as a preliminary screening tool to identify emergence agitation after general anesthesia on children with strabismus correction surgery and to assess the risk of its occurrence.

Objective:To propose and verify a surgical classification system for the axial primary malignant and aggressive benign tumor.Methods:The CZH surgical classification system was originally developed for the axial primary malignant and aggressive benign tumor. The CZH surgical classification system includes seven types, according to the anatomic features and the extension of tumor violation. A total of 136 patients (79 males and 57 females) with axial primary malignant and aggressive benign tumor from multiple tertiary centers who received surgery from July 2006 to July 2019 were included. The average age was 44.40±17.55 years (8-83 years) old. There were 99 malignant tumors and 37 aggressive benign tumors included. The number of patients with each classification was presented as followed, Type I 13, Type II 15, Type IIIa 3, Type IIIb 20, Type IVa 43, Type IVb 12, Type Va 21, Type Vb 3, Type VI 2, Type VIIa 3 and Type VIIb 1. Surgical procedures were selected according to different types in classification. The inter- and intra-observer consistencies were evaluated by the Kendall's W test. The VAS, Frankel score, overall survival and recurrence free survival were recorded during the follow-up. Results:The inter- and intra-observer consistent coefficient was 0.973 and 0.996, respectively ( P<0.05). The single posterior approach was adopted for the Type II tumors. Other patients underwent surgery by the combined antero-posterior approach. The majority in anterior approach (113 cases) was the modified submandibular approach. The reconstruction modes included anterior "T" shape titanium mesh (112 cases) or the 3D printed prothesis (7 cases) combined with the posterior occipto-cervical fusion (92 cases) or the pedicle screw system (44 cases). The average surgical duration and the volume of intraoperative bleeding was 348.40±136.14 min (60-760 min) and 1 225.69±859.40 ml (80-4 000 ml), respectively. The operation duration and volume of intraoperative bleeding among each type were with statistical difference. The patients with Type IV, V tumors had longer operation duration than those with Type II tumors. Those with Type V and VII tumors had longer operation duration than those with Type I tumors. The patients with Type V tumors had more intraoperative bleeding than those with Type I-IV tumors. The average preoperative VAS score was 4.15±2.25 and then was reduced significantly to 0.62±0.71 and 0.38±0.59 at one and three months after operation, respectively. The Frankel score was also significantly ameliorated at one and three months postoperatively. There were 22 postoperative complications (16.2%). The complications included cerebral spinal fluid leak (12.5%), dysphagia and/or dysphonia (7.4%), dyspnea (5.1%), wound infection (3.7%), wound hemorrhage (2.2%) and pharyngeal dehiscence (1.5%). The incidence of postoperative complication was 25.9% in Type IV-VII tumors, while 11.8% in Type I-III tumors. Conclusion:CZH surgical classification system was verified with high observer consistency. This classification system could assist surgeons to select proper surgical approaches, resection modes and reconstruction modes, and thus ensure the safety of surgery and reduce the recurrence. The tumors in Type IV, V and VII may be with more challenging for surgeons. The incidence of postoperative complication in Type IV-VII tumors may be higher than that in Type I-III tumors.

Objective:To analyze long-term outcomes and prognostic factors of gastric cancer patients after robotic radical total gastrectomy.Methods:A retrospective case-control study was conducted. Inclusion criteria: (1) receiving robotic radical total gastrectomy; (2) gastric adenocarcinoma was confirmed by postoperative pathology; (3) no previous history of other malignant tumors; (4) no preoperative chemotherapy or radiation therapy performed. Exclusion criteria: (1) age <18 years old or age >80 years old;(2)distant metastasis before surgery, or palliative surgery; (3) conversion to laparotomy;(4) R1 or R2 resection; (5)emergency surgery; (6) remnant gastric cancer or recurrence; (7)died of severe complications during hospitalization or within 1 month after surgery. Overall survival rates (OS) and disease-free survival rates (DFS) were evaluated using the Kaplan-Meier method. Cox regression analysis was used to identify prognosis factors for overall survival.Results:According to the above criteria, 166 gastric cancer patients who underwent robotic radical total gastrectomy between March 2010 and November 2018 were included in this study. Roux-en-Y reconstruction was performed in all patients. Reconstruction were achieved using extracorporeal method through a minilaparotomy in 149 case and intracorporeal anastomosis in 17 cases. The number of harvested lymph nodes was (34.8±17.5), and the number of harvested lymph nodes at group 2 was (10.1±6.7). The number of patients with lymph node metastasis of group 2 was 73 (44.0%). The median follow-up time was 25 months (range 2-109). There were 55 (33.1%) cases of recurrence during follow-up. The 3- and 5-year overall survival rates were 55.8% and 46.2% respectively. The 3- and 5-year disease-free survival rates were 53.4% and 45.4% respectively. The 5-year overall survival rates grouped based on TNM stage were 78.9% for stage I, 58.5% for stage II, and 37.1% for stage III. The 5-year disease-free survival rates grouped based on TNM stage were 78.9% for stage I, 59.2% for stage II, and 34.6% for stage III. Univariate analysis suggested that TNM stage, the number of harvested lymph nodes and number of harvested lymph nodes at group 2 were associated with overall survival rates (all P<0.05). Multivariate analyses revealed that TNM stage ( P<0.001; stage IIIB: HR=5.357, 95%CI:1.182 to 24.275; stage IIIC: HR=11.937, 95%CI: 2.677 to 53.226) and number of harvested lymph nodes at group 2 ( P=0.034; 6-10: HR=0.562,95%CI:0.326 to 0.969; >10: HR=0.388, 95%CI: 0.176 to 0.857) were independent prognostic factors for overall survival. Conclusion:The long-term outcomes of robotic radical total gastrectomy were satisfactory. TNM stage and number of harvested lymph nodes at group 2 were independent prognostic factors for overall survival.

Objective:To analyze long-term outcomes and prognostic factors of gastric cancer patients after robotic radical total gastrectomy.Methods:A retrospective case-control study was conducted. Inclusion criteria: (1) receiving robotic radical total gastrectomy; (2) gastric adenocarcinoma was confirmed by postoperative pathology; (3) no previous history of other malignant tumors; (4) no preoperative chemotherapy or radiation therapy performed. Exclusion criteria: (1) age <18 years old or age >80 years old;(2)distant metastasis before surgery, or palliative surgery; (3) conversion to laparotomy;(4) R1 or R2 resection; (5)emergency surgery; (6) remnant gastric cancer or recurrence; (7)died of severe complications during hospitalization or within 1 month after surgery. Overall survival rates (OS) and disease-free survival rates (DFS) were evaluated using the Kaplan-Meier method. Cox regression analysis was used to identify prognosis factors for overall survival.Results:According to the above criteria, 166 gastric cancer patients who underwent robotic radical total gastrectomy between March 2010 and November 2018 were included in this study. Roux-en-Y reconstruction was performed in all patients. Reconstruction were achieved using extracorporeal method through a minilaparotomy in 149 case and intracorporeal anastomosis in 17 cases. The number of harvested lymph nodes was (34.8±17.5), and the number of harvested lymph nodes at group 2 was (10.1±6.7). The number of patients with lymph node metastasis of group 2 was 73 (44.0%). The median follow-up time was 25 months (range 2-109). There were 55 (33.1%) cases of recurrence during follow-up. The 3- and 5-year overall survival rates were 55.8% and 46.2% respectively. The 3- and 5-year disease-free survival rates were 53.4% and 45.4% respectively. The 5-year overall survival rates grouped based on TNM stage were 78.9% for stage I, 58.5% for stage II, and 37.1% for stage III. The 5-year disease-free survival rates grouped based on TNM stage were 78.9% for stage I, 59.2% for stage II, and 34.6% for stage III. Univariate analysis suggested that TNM stage, the number of harvested lymph nodes and number of harvested lymph nodes at group 2 were associated with overall survival rates (all P<0.05). Multivariate analyses revealed that TNM stage ( P<0.001; stage IIIB: HR=5.357, 95%CI:1.182 to 24.275; stage IIIC: HR=11.937, 95%CI: 2.677 to 53.226) and number of harvested lymph nodes at group 2 ( P=0.034; 6-10: HR=0.562,95%CI:0.326 to 0.969; >10: HR=0.388, 95%CI: 0.176 to 0.857) were independent prognostic factors for overall survival. Conclusion:The long-term outcomes of robotic radical total gastrectomy were satisfactory. TNM stage and number of harvested lymph nodes at group 2 were independent prognostic factors for overall survival.

Objective: To understand the needs of primary and secondary school students, parents and teachers for comprehensive sexuality education content, and to explore the applicability of comprehensive sexuality education content in China. Methods: By using the method of stratified cluster sampling, 5 571 primary and middle school students and 4 835 parents from Beijing, Chongqing, Heilongjiang (Harbin and Jiamusi) and Hubei (Wuhan and Xiaogan) were selected for questionnaire survey. Depending on the physical health monitoring points of various provinces and cities, 176 sexuality education related teachers in nine regions were surveyed. The development of the questionnaire was based on the content framework of comprehensive sexuality education proposed in the International Technical Guidelines for Sexuality Education. Results: Students had a higher demand for knowledge on the concepts of "relationship" (53.4% for primary school students, 57.6% for junior high school students) and "health and well-being skills" (71.1% for primary school students, 55.9% for junior high school students). Parents had higher demand for most comprehensive sexuality education content with the exception of lower need for "sex and sexual behavior (74.7% of primary school parents, 80.8% of junior high school parents)" and "sexual and reproductive health (primary parents 74.3%, junior high school parents 75.8%)". Teachers had a high demand for most comprehensive sexuality education content, but primary school teachers had a lower need for "values, rights, culture and sex(65.9%)", "sex and sexuality(60.1%)" and "sexual and reproductive health(66.8%)". The results of correspondence analysis showed that junior middle school teachers had the highest demand for comprehensive education content, followed by primary school parents, junior middle school parents, primary school teachers, junior middle school students and primary school students. Conclusion Teachers and parents have a higher demand for most comprehensive sexuality education content, while lower demand for some relatively sensitive content. Students have a relatively low demand for comprehensive sexuality education content. It is recommended to further improve the content of school sexuality education based on the actual needs of China.

Objective: To understand the awareness of sexual knowledge among primary and secondary school students, as well as their attitudes towards school sex education and to provide a reference for school-based sex education. Methods: A total of 5 531 primary and secondary school students were selected from Beijing, Chongqing, Heilongjiang (Harbin and Jiamusi) and Hubei (Wuhan and Xiaogan) by stratified cluster sampling and were investigated with self-reported questionnaire. Results: Sex-related knowledge scored 62.33±19.35, with a pass rate of 61.9%, and the excellent rate 17.5%. Sexual knowledge of junior high school students scored 64.30±19.07, with the pass rate of 64.7%, and the excellent rate 22.0%. A large proportion of primary students reported unaware of pubertal growth and HIV/AIDS-related knowledge, and a large proportion of junior high students unaware of reproductive physiology. Multivariate Logistic regression analysis showed region, grade, gender, and suburban areas were related to the level of sexual knowledge(P<0.05). More than 76.0% primary students and 85.9% middle school students agreed on the importance of school sexuality education. 59.7% of primary school students and 73.3% of junior high school students hoped to include school sexuality education in compulsory education courses; 59.8% of primary school students and 68.3% of junior high school students felt that school sexuality education should be equipped with specialized teachers. Conclusion Chinese primary and secondary school students are lack of sexual knowledge. As students have strong wills to get more information on sexual knowledge, schools should provide them with more comprehensive and effective sex education through appropriate courses and activities.