OBJECTIVE To provide a basis for the rational use of nonsteroidal anti-inflammatory drugs （NSAIDs） in the perioperative period， and provide practical methods and technical references for the evaluation and selection of NSAIDs in medical institutions. METHODS Initiated by the Affiliated Hospital of Qingdao University， Clinical Pharmacy Professional Committee of the Shandong Pharmacists Association， Clinical Individualised Drug Testing and Guidance Branch of the Shandong Medical Association， Comprehensive Clinical Medication Evaluation Working Committee of the Shandong Pharmacists Association， Pain Branch of the Shandong Medical Association in conjunction with several medical institutions in Shandong Province organized 22 pharmaceutical experts and medical experts from 17 hospitals in Shandong Province to form a consensus on the rational use and comprehensive clinical evaluation of NSAIDs in the perioperative period through the literature research method， expert interview method and questionnaire survey method based on evidence-based medicine. A comprehensive clinical evaluation was also conducted on a total of 13 specifications of 9 commonly used clinical drug varieties in Shandong Province， including celecoxib， etoricoxib， imrecoxib， ibuprofen （containing reference/original drugs and national/Shandong Province’s centralized volume-based procurement varieties）. RESULTS & CONCLUSIONS A consensus opinion was formed on preoperative prophylactic use and postoperative use of NSAIDs， as well as contraindications， digestive tract risk， cardiovascular system risk， bleeding risk and kidney injury risk in the perioperative period. The evaluation and selection criteria of perioperative use of NSAIDs were established， involving 6 dimensions of safety， efficacy， economy， innovation， appropriateness， and accessibility. The results of comprehensive clinical evaluation showed that the top 6 drugs （scores over 70） were Celecoxib capsules （Celebrex） and Celecoxib capsules （Naiqi）， Diclofenac sodium sustained-release tablets，Etocoxib tablets （Arcoxia） and Etocoxib tablets （Qimingshu）， and Parecoxib sodium for injection. With the progress of clinical research， this consensus will be further updated and adjusted， and medical institutions can combine with the practice to develop a comprehensive clinical evaluation system of NSAIDs suitable for their institutions.

Boccia is a targeted sport that has been devised in Europe for people with severe cerebral palsy (CP) or similar severe limbs dysfunction. In the target sport, it is important that the parasympathetic nerve becomes dominant during the competition, and it is said that the parasympathetic nerve activity tends to become dominant by training to raise the heart rate. The training protocol incorporates a rolling movement, which is an Activities of Daily Living (ADL) that can be performed even with severe CP. The purpose of this study is to verify whether interval rolling movement (IR), which repeats rolling movement at the maximum speed, is effective as training for increasing heart rate associated with effort exercise for people with severe CP. One workout consisted of 1minute rolling movement and 30seconds of rest, and three times of this workout were as 1set of IR. Subjects performed 3sets of IR with a 5minutes rest and performed this training for 6months. Six severe CP boccia players were divided into two groups, 1/week group and 1/month group, depending on the frequency of intervention. As a result, the post-exercise heart rate and the number of turns per minute increased significantly in the weekly group, and no significant change was observed in the monthly group. For severe CP boccia players, it was suggested that conducting IR at least once a week is an effective method of training aimed at increasing heart rate associated with effort exercise.

Objective: In 2020, coronavirus disease-2019 (COVID-19) became the cause of a pandemic. In response, the Japan Sports Agency issued warnings about secondary damage to health, such as the threat to physical and mental well-being due to the lack of exercise in this situation. In this study, we report on cross-sectional and longitudinal examinations of standing trunk flexion to evaluate how temporary long-term school closures affected musculoskeletal function in elementary school students.Patients and Methods: All children in one public elementary school in T-city during the school years 2019 and 2020 were included in this study. A digital forward flexion meter was used to measure standing trunk flexion.Results: In this study, 284 (284/289: 98.3%) and 266 (266/274: 97.1%) children in school years 2020 and 2019, respectively, were found to have valid data for cross-sectional analysis. The standing trunk flexion did not show significant differences between grades or sexes. In the longitudinal analysis, the results of the comparison of standing trunk flexion in children for two consecutive years revealed significant differences only between grades 3 and 4 (P<0.05) and between girls in grades 3 and 4 (P<0.01), but no significant differences in other grades or among boys or girls were observed.Conclusion: Initially, we expected that there would be a difference in the results of functional assessment using standing trunk flexion depending on the period of absence from school. However, the results of this study showed no significant changes in standing trunk flexion. Moreover, since children’s musculoskeletal functions may be affected by various factors during the COVID-19 pandemic, they should be carefully monitored in the future.

OBJECTIVE To evaluate the cost-utility of benmelstobart combined with anlotinib and chemotherapy as first-line treatment for extensive-stage small cell lung cancer （ES-SCLC） from the perspective of China’s healthcare system. METHODS Based on the data from the ETER 701 study， a partitioned survival model was constructed with a cycle of 3 weeks to simulate the total cost， quality-adjusted life years （QALY）， and incremental cost-effectiveness ratio （ICER） over 10 years for patients with ES- SCLC treated with benmelstobart plus anlotinib and chemotherapy， or chemotherapy alone. One-way sensitivity analysis and probability sensitivity analysis were performed to verify the robustness of the simulation results. The willingness-to-pay （WTP） threshold was set at 3 times the per capita gross domestic product （GDP） of China in 2023， which amounted to 268 074 yuan/QALY. RESULTS Compared with chemotherapy alone， benmelstobart combined with anlotinib and chemotherapy gained 0.438 QALY more at the cost of 403 505.55 yuan more， with an ICER of 922 031.37 yuan/QALY， which was higher than the WTP threshold set in this study. One-way sensitivity analysis showed that benmelstobart’s cost and utility value of the progression-free survival state had a greater impact on the ICER value； probabilistic sensitivity analysis confirmed the robustness of the model； only when the price of benmelstobart was reduced by 75.4%， the combined regimen would be cost-effective. CONCLUSIONS The first-line treatment of ES-SCLC with benmelstobart combined with anlotinib and chemotherapy is not cost-effective from the perspective of China’s healthcare system at present.

Objective: To evaluate the efficacy of fan therapy for the relief of dyspnea in patients with chronic progressive disease. Methods: A systematic electronic database search of all available articles published before October 23, 2019 was conducted using Ichushi-Web of the Japan Medical Abstract Society databases, CENTRAL, EMBASE, and MEDLINE. In addition, a hand-search for updates was performed using PubMed on June 30, 2020 and December 7, 2021. The inclusion criteria were: 1) any RCTs comparing the effect of fan therapy with any other intervention, and 2) patients aged ≥18 years. Exclusion criteria were: 1) duplicate references, and 2) conference presentations. Results: We identified 110 studies, of which 10 met our criteria for inclusion. Finally, five studies were used in the meta-analysis. Fan therapy significantly improved dyspnea in patients with chronic progressive disease compared to control groups with a standardized mean difference of −1.43 (95% confidence interval: −2.70 to −0.17, I2=94%, p<0.0001). Conclusion: Fan therapy was found to be effective in reducing dyspnea in chronic progressive disease.