Objective To investigate the relationship between thyroid carcinoma and psychosocial risk factors.Methods A hospital based case-controlled study of thyroid carcinoma was conducted.Cases were path-ologically confirmed as primary papillary thyroid carcinoma.Both 102 cases and 114 controls were tested by the PSSG scale.Results Multivariate conditional logistic regression analysis showed that overworking,children′s fu-ture,depress,anxiety,and like to suppress their emotions could increase the risk of thyroid carcinoma,pleasing e-motion and forget unhappy as soon as possible might prevent the thyroid carcinoma.Conclusion Psychosocial risk factors are important in the onset and progression of the thyroid carcinoma.

Objective To observe the effect of advanced oxidation protein products (AOPPs) on articular and synovial in a rabbit model of osteoarthritis (OA).Methods 48 male New Zealand rabbits were randomly divided into 3 groups:AOPPs group,PBS group and sham-operated group.OA model were created in AOPPs group and PBS group by anterior cruciate ligament transection and medial meniscus resection (ACLT+MMx).then intra-articular injection of 1 ml AOPPs or PBS were performed once every other day in AOPPs group and PBS group,respectively.In sham-operated group,the anterior cruciate ligament was just exposed without transection,and then the incision was sutured.All rabbits were saerificed after 4 and 8 weeks of intervention,respectively.Results The India ink seore of 4 and 8 weeks were 4.19±0.60,5.75±0.60 in AOPPs group,and 1.06±0.18,1.38±0.60 in sham-operated group,2.50±0.46、3.06±0.62 in PBS group,respectively.In addition,the differences were statistically significant among the three groups.The Mankin score of 4 and 8 weeks were 8.19±0.70,11.94±0.90 in AOPPs group,and 0.75±0.53,1.06± 0.73 in sham-operated group,4.25± 1.46、4.50±0.89 in PBS group,respectively.The differences were statistically significant among the three groups.Meanwhile,the protein expression level of matrix metalloproteinases (MMP)-3 on synovial at 4 and 8 weeks in AOPPs group were 1.006±0.080,1.098±0.088;0.065±0.006,0.053±0.011 in sham-operated group;and 0.552±0.024,0.839±0.084 in PBS group,respectively.The proteiu expression level of MMP-13 on synovial at 4 and 8 weeks in AOPPs group were 0.966±0.080,1.621 ±0.041;0.101±0.022,0.367±0.033 in sham-operated group;and 0.564±0.030,1.322±0.085 in PBS group,respectively.The differences were statistically significant among the three groups at two times.Conclusion AOPPs participate in the occurrence and development of artieular cartilage by upregulating the protein expression of MMP-3 and MMP-13 on synovial.

Objective To explore oropharyngeal swallowing disorders with videofluoroscopic swallowing study (VFSS). Methods 16 patients with dysphagia accepted VFSS with 10 ml of thin barium meal (50% w/v), thick barium meal (270% w/v), biscuit coated with thick barium meal in single swallow. Their swallowing function was observed on the lateral and anterior/posterior planes, including: symmetry of pyriform sinuses, oral transit time, presence of pharyngeal delay, pharyngeal transit time, oral and pharyngeal residue, and presence of aspiration.Results 5 patients demonstrated oral swallowing disorder. 3 patients demonstrated pharyngeal swallowing disorders, that was pharyngeal delay which caused in aspiration after swallowing. 8 patients demonstrated oropharyngeal swallowing disorders, and 3 of them presented aspiration,2 patients were silent aspirators, 1 was aspiration before and 1 after swallowing. The aspiration time could not be judged from the videofluoroscopy in the other one. For 4 patients with aspiration, 3 were severe, with more than 25% of the bolus aspirated, and 1 aspirated less than 5%. Conclusion VFSS can be helpful to plan individual rehabilitation.

OBJECTIVE To analyze the implementation experience of France’s additional list system for innovative medical products， and to provide reference for China to support medical institutions to use innovative medical products. METHODS Taking France as a case study， using policy analysis method， this paper systematically studied the practice of establishing additional list system to compensate for innovative medical products in France under diagnosis-related group （DRG） payment， including the establishment background， selection procedure and implementation effect. The suggestions were provided on the medical insurance payment methods for innovative medical products in China. RESULTS & CONCLUSIONS The additional list system established a compensation and payment system for innovative medical products with significant clinical efficacy but high treatment cost， covering four stages： application， evaluation， payment and adjustment， which effectively reduced the drug burden on medical institutions， promoted the use of innovative pharmaceutical products by medical institutions， and stimulated the innovation drive of the pharmaceutical industry， but at the same time brought payment pressure to the medical insurance fund. With the rapid spread of our DRG/diagnosis-intervention packet payment reform of China， some regions have also explored the establishment of a compensation and payment mechanism for innovative medical products， but there are still imperfections. We can refer to the implementation experience of the French additional list system and establish an effective compensation and payment system for innovative medical products starting from the establishment of selection criteria， the selection of compensation mode and the implementation of dynamic adjustment.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.