Objective:This study aimed to assess the effects of Peer Balint-style group on the empathy ability of third-year long-term medical students and to provide a theoretical and practical reference for effectively improving their humanistic quality.Methods:Ninety third-year Chinese long-term medicine students participated. Volunteers received either ten sessions of 1.5-h Peer Balint-style group which were led by specially trained peers from June 2019 to August 2019. The College Students' Empathy Ability Questionnaire was used before the experiment and the second day after the experiment. The total score of the scale from the pre-test and post-test and the scores of each dimension conformed to a normal distribution, with equal variance, describing in the form of ( x± s). Paired t-tests were performed to compare the total score and each dimension score before and after the intervention, using SPSS 22.0. Semi-structured interviews were conducted with 7 peer-group leaders and group members after the clinical practice period. The interview materials were analyzed by traditional content analysis. The content of the qualitative research was open-coded to obtain 10 categories, suggesting the role and inadequacy of Peer Balint-style groups. Results:A total of 63 valid samples were obtained. There was no significant difference of ( t=-0.44, P=0.661, P>0.05) between the total score of the post-test (118.00±11.98) and the total score of the pre-test (117.38±12.36). In each dimension, the reverse comprehension score of post-test (9.06±1.97) was significantly different ( t=-2.08, P=0.041, P>0.05) from the pre-test's (8.57±2.15), which increased compared to the pre-test score. Conclusions:Peer Balint-style group had a positive effect on improving empathy among medical students. Compared with the traditional Balint group, it has wider coverage, higher affinity and greater mobility. However, the design of the Peer Balint-style group still needs to be further improved.

Background::Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.Methods::The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case-control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group). Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed.Results::Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P < 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors ( P = 0.012), N2 tumors ( P = 0.001), and positive margin status ( P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors ( P < 0.001). Conclusion::HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high-volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option.

OBJECTIVE： To analyze the formulation regularity of Chinese patent medicines containing Paeonia lactiflora， and to provide evidence for modern clinical application and R&D of P. lactiflora. METHODS： The formulations of Chinese patent medicine containing P. lactiflora were collected from Chinese Materia Medica Preparation and 2015 edition of Chinese Pharmacopeia. Statistical analysis was performed on the frequency of medicinal material， channel tropism， distribution of attending syndromes and attending diseases， core medicine combination （support degrees were set as 10％， 20％， 30％ and confidence degree was 0.9） by using data mining methods such as descriptive statistics and association rule analysis in TCM Inheritance System V 2.5； the formulation regularity of common attending syndromes and attending diseases （support degrees were set as 20％， 30％， 40％ and confidence degree was 0.9） was analyzed. RESULTS： A total of 600 Chinese patent medicine formulations contained P. lactiflora， involving 673 ingredients. The main medicinal properties in Chinese patent medicines containing P. lactiflora were warm， followed by cold and neutral. The main medicinal flavor was sweet， followed by bitter and pungent. The main channel tropism was spleen， liver and heart channel. There were 165 kinds of main treatment diseases （menstrual disorder， dysmenorrhea， dizziness） and 159 main treatment syndromes （insufficiency of qi and blood， qi stagnation and blood stasis， liver and kidney deficiency）. Under the condition of 30％ support degree and 0.9 confidence degree， there were 20 core combination of Chinese patent medicine formulations containing P. lactiflora （Glycyrrhiza uralensis-P. lactiflora， Angelica sinensis-P. lactiflora， P. lactiflora-Poria cocos） and 19 association rules among drugs. Under the condition of 40％ support degree and 0.9 confidence degree， there were 8 core medicines in Chinese patent medicines containing P. lactiflora for menstrual disorders （such as P. lactiflora， Cyperus rotundus， A. sinensis）， 9 core medicines for dizziness （such as P. lactiflora， Rehmannia glutinosa， A. sinensis）， 9 core medicines for qi and blood deficiency （such as P. lactiflora， Atractylodes macrocephala， P. cocos）， and 10 core medicines for qi stagnation and blood stasis syndrome （such as P. lactiflora， Aucklandia lappa， G. uralensis）. CONCLUSIONS： In this study， data mining was used to analysis the main symptoms， compatibility characteristics and formulation rules of Chinese patent medicines containing P. lactiflora， which can provide a basis for the modern clinical application and new drug development of P. lactiflora.