Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.

Objective　To investigate the prognostic significance of N1 stage in non-small cell lung cancer (NSCLC) by comparing is survival with N0 and N2 stages. Methods　From Jan. 1982 to Dec. 1994, 138 NSCLC patients with surgical-pathological N1 stage had received complete mediastinal lymph node dissection. Two subgroups of N1 node were identified by using New Regional Lymph Node Classification for Lung Cancer Staging. Their prognostic significances were tested and 5-year survival rates were compared with those of surgical-pathological N0 (307 cases) and N2 (176 cases) patients received radical operation during the same period. Results　The overall 5-year suvival rate of N1 patients was 30.4 %. five-year survival was significantly better when N1 involvement was intralobar as compared with extralobar involvement, 50.3 % versus 26.5 % (P=0.001). Intralobar N1 5-year survival was similar to that of N0 (51.4 % vs 50.3 %), and extralobar N1 5-year survival was similar to that of N2 with singl focus (26.5 % vs 23.5 %). Conclusion　N1 stage in NSCLC is a compound with two subgroups; the prognostic significance of intralobar subgroup is related to N0 stage and extralobar subgroup is related to that of single focus N2.

Establishment of the “Happy Reading Club” was to create a personal reading space for undergraduates. The reading situation of undergraduates was analyzed with the creation processes of “Happy Reading Club” summa-rized.The reading popularizing activities were described, including questionnaire investigation of reading, sign of DIY “tree”, and recommendation of classic booklist, with the existing problems pointed out.

Objective To discuss the efficacy of tantalum rod implantation combined with bone transplantation in the treatment of early stage osteonecrosis of the femoral head.Methods Twenty-four male patients were re cruited.Twelve patients were allocated to the tantalum rod and bone implantation group.The mean age was 35.7 years.Twelve patients were allocated to the tantalum rod implantation group.The mean age was 33.2 years.All patients with stage Ⅱ osteonecrosis.Results All patients were followed up with an average of 42.5 ± 6.7 months.The final evaluation was made according to the last follow-up data.In the tantalum rod implantation group,the average score of pre-operation and post-operation were 65.3±6.3,82.6 ± 5.3 respectively with a statistic difference (P ＜ 0.05).Two of patients underwent total hip replacement before the end of this study,significant difference was observed in the aspect of radiographic progression (P ＜ 0.05).In the tantalum rod implantation combined with bone marrow stem cell transplantation group,the average score was 92.2 ± 1.0 with a statistic difference (P ＜ 0.05).There was no one of patients underwent total hip replacement before the end of this study.Significant difference was observed in the aspect of radiographic progression (P ＜ 0.05).Between the two groups,a significant difference was observed in clin ical symptoms in favor of the tantalum rod implantation combined with bone transplantation group(P ＜ 0.05).No significant difference was observed in the aspect of radiographic progression (P ＞ 0.05).Significant difference was observed in the aspect of survivorship of the femoral head(P ＜ 0.05).Conclusion Tantalum rod implantation combined with bone transplantation improves clinical symptoms and delay total hip arthoplasty than tantalum rod implantation.

BACKGROUNDTo investigate the role of interferon-alpha (IFN-α) in completely resected stage I and II non-small cell lung cancer (NSCLC) patients.

METHODSForty-four stageIand II NSCLC patients were randomized to two groups. Study group (surgery+IFN-α) received IFN-α injection, 3 million unit, every two days, with a period of treatment of 90 days. Control group (surgery only) received no adjuvant therapy until relapse or metastasis were detected. pTNM stage, histological types, relapse or metastasis, survival time were observed and evaluated.

RESULTSMedian follow-up was 49.9 months. The 1-, 2-, 3-, 4-year survival rates were 90.5%, 80.9%, 52.4%, 52.4% in the study group and 95.2%, 80.9%, 66.0%, 50.8% in the control group respectively. No significant statistic difference was found between the two groups ( P = 0.663 9 ). Kaplan-Meier and Cox Model analysis showed pTNM stage ( P =0.010 2), N status ( P =0.015) and weight loss ( P =0.030) were prognostic factors in completely resected stage I and II NSCLC.

CONCLUSIONSPostoperative low-dose IFN-α short-term therapy cannot significantly improve 3- and 4-year survival rates of patients with stage I and II completely resected NSCLC.

Objective Summarize and share the working practice of Investigator Research Ethics and Research Integrity Training conducted at Peking University Human Research Protection Program (PKU HRPP) ,to further explore continuing quality improvement of investigator ethical training at university level .Methods Conduct systematic review of the archiving files of PKU HRPP investigator training activities during 2012-2018 ,summarize feedback information from investigators to i-dentify possible experiences for sharing and space for improvement .Results There are some positive experiences for sharing a-bout the training mechanism and practices at PKU HRPP .Conclusions Based on the previous ethical training work and experi-ences at PKU HRPP ,possible proposals for continuing quality improvement may including :strengthening the requirements of ethical training of investigators ,encouraging and recognizing ethical training conducted by research teams ,emphasizing training Quality and the promotion of sharing and mutual recognition mechanisms for ethical training .

Insufficient bone quantity in the posterior region of the maxilla is one of the difficulties for dental implant placement. Maxillary sinus augmentation is considered to be a reliable treatment to solve the problem of insufficient bone quantity. With the increase of researches on maxillary sinus elevation, the debate over osteogenesis potential of Schneiderian membrane is getting more attention. Therefore, this article will review the current research on osteogenic potential of the Schneiderian membrane and its influence factors.

Esophageal squamous cell carcinoma is one of the most common cancer in China, and locally advanced stage remains a heterogeneous and complex disease. Its treatments are constantly evolving. To date, radiochemotherapy and surgery are involved in the comprehensive treatment of this disease. However, because of the specifical anatomical location of esophagus, its physiological function will be impaired after surgical resection. If similar survival is obtained in esophageal cancer, an organ preserving strategy without surgery is of great significance for improving the quality of life. As a non-invasive tumor treatment method, neoadjuvant therapy plays an important role in the comprehensive treatment of preserving the esophagus. Recently, there are studies investigating the role of organ preserving strategy in the comprehensive treatment of esophageal cancer with neoadjuvant therapy, and the recognition of these advances will provide reference value for the comprehensive treatment of esophageal cancer.

Hepatocellular carcinoma （HCC） is considered to be one of the most aggressive tumors. It often occurs in patients with chronic liver disease and liver cirrhosis. Although research achievements have been attained in the current treatment methods， the opportunity of radical hepatectomy or transcatheter arterial chemoembolization has been lost due to the unobvious progression and no obvious symptoms until the late stage， which results in the poor prognosis. Tumor cells need more energy than normal cells. They maintain their growth， proliferation， and metastasis through metabolic reprogramming. Therefore， metabolic reprogramming is one of the signs of tumorigenesis. Glucose metabolism， lipid metabolism， amino acid metabolism， and nucleotide metabolism are several common cellular metabolism modes. Because the liver is the main organ of lipid metabolism， the occurrence and development of HCC is often accompanied by abnormal lipid metabolism. A variety of enzymes， proteins， genes， signaling pathways， and metabolites are involved in the lipid metabolism reprogramming of HCC. Their abnormal expression can promote lipid synthesis and lipid droplet accumulation through a variety of mechanisms， and further affect the proliferation， migration， invasion， autophagy， apoptosis， and angiogenesis of HCC cells. In recent years， traditional Chinese medicine （TCM） has demonstrated great potential in the treatment of tumors， which has attracted wide attention of scholars. The effective components in Chinese herbal medicines and Chinese medicine compound prescriptions can inhibit the de novo synthesis of lipids， lower the level of lipid accumulation， and then inhibit the occurrence and development of HCC by regulating the lipid metabolism-related enzymes， proteins， and signaling pathways. This review summarizes the mechanism of the factors regulating lipid metabolism in HCC and the research progress in the TCM inhibition of HCC by regulating lipid metabolism reprogramming， and makes an outlook on the application prospect of lipid metabolism as a new target of TCM in the treatment of HCC， aiming to provide reference for the clinical treatment of HCC.