Objective: To investigate the trend of gastric cancer disease burden in Wenzhou City, Zhijiang Province from 2014 to 2023, so as to providing evidence for prevention and control strategies. Methods: Data on incidence and mortality of gastric cancer among household registered residents in Wenzhou City from 2014 to 2023 were collected through the Wenzhou Chronic Disease Monitoring and Management Information System, and the crude incidence and crude mortality were calculated. The disease burden of gastric cancer was evaluated by calculating years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) using the World Health Organization's disease burden methodology. Trends in YLL rate, YLD rate and DALY rate of gastric cancer from 2014 to 2023 were analyzed using the average annual percent change (AAPC). Results: A total of 28 122 cases of gastric cancer and 17 080 deaths were reported in Wenzhou City from 2014 to 2023. The crude incidence and crude mortality were 34.13/105 and 20.73/105, respectively. The YYL, YLD and DALY caused by gastric cancer were 181 816.78, 53 198.41, and 235 015.198 person-years, and the YLL rate, YLD rate and DALY rate were 2.21, 0.64 and 2.85 person-years per 1 000 people, respectively. The YLL rate and DALY rate showed a downward trend (AAPC=-4.608% and -2.552%,both P<0.05), while the YLD rate showed an upward trend (AAPC=4.657%, P<0.05). The DALY rate of gastric cancer in men was 3.82 person-years per 1 000 people, and that in women was 1.83 person-years per 1 000 people, with a downward trend (AAPC=-2.924% and -1.647%, both P<0.05). The DALY rate of gastric cancer was relatively low in the 15 to <45 years age group, increased starting from the age of 45 years, and peaked in the ≥70 years age group, reaching 14.09 person-years per 1 000 peoples. The DALY rate of gastric cancer among residents aged 15 to <45 years, 45 to <70 years and ≥70 years showed a downward trend (AAPC=-3.626%, -5.450% and -4.404%, all P<0.05). Conclusions From 2014 to 2023, the DALY rate of gastric cancer in Wenzhou City demonstrated a sustained decline, primarily driven by a the loss of life years due to premature death. Males and older people continue had a heavier disease burden. It is recommended to implement targeted prevention and control measures to reduce the disease burden of gastric canceron among residents.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.

Diseases of glucose and lipid metabolism disorder,presented rather complicated pathological mechanism,often with clinical pattern of multiple concurrent diseases.Therefore,the traditional single-disease based on treatment methods need improving.In view of plenty of clinical practice,theatrical and fundamental researches,the pathological mechanisms of some chronic disorders,such as hyperlipidemia,nonalcoholic fatty liver disease,type 2 diabetes,hypertension,atherosclerosis and severe cardiovascular complications,resulted from the impairment in the metabolism of glucose and lipid were investigated using the method of integrated Chinese and western medicine.Overall,the features of these diseases and their common characteristics were discovered,and accordingly we defined the new concept of glucolipid metabolic disease (GLMD) and put forward the concept of pivot liver of metabolic regulation system.In addition,we developed the therapeutic strategy of modulating liver,starting pivot and cleaning turbidity,for the comprehensive and integrated treatment and prevention of these diseases.The theory of GLMD shared the critical characteristics with precision medicine,taking its own specialty.Finally,the content and approaches for the research of GLMD were proposed,and some essential and core fields in the precision medical research for GLMD were profoundly analyzed and prospected.

OBJECTIVE:To establish a method for the residues determination of Pb,Cd,Cu,As and Hg in Codonopsis pilo-sula,and evaluate the quality evaluation of C. pilosula of Pingshun County in Shanxi province. METHODS:Microwave diges-tion-inductively coupled plasma mass spectrometry was adopted with KED scanning model,RF power was 1 550 W,sampling depth was 5.0 mm,plasma gas(argon)flow rate was 16.0 L/min,helium partial pressure was 0.1 mbar,argon gas was 0.6 mbar, the vacuum degree of 5×10-8 mbar,branch turbopump speed was 1 000 hz,sampling cone aperture was 1.0 mm,skimmer aperture was 0.5 mm,the spray chamber temperature was 2.7 ℃,the data collection was repeated 3 times. RESULTS:The linear range was 0-20 ng/ml for Pb(r=0.999 3),0-10 ng/ml for Cd(r=0.998 5),0-250 ng/ml for Cu(r=0.998 8),0-20 ng/ml for As(r=0.999 0) and 0-1.0 ng/ml for Hg(r=0.997 9);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recoveries were 95.80%-100.20%(RSD=1.85%,n=6),94.50%-98.00%(RSD=1.26%,n=6),98.52%-102.43%(RSD=1.60%,n=6), 94.90%-98.70%(RSD=2.29%,n=6)and 96.00%-101.00%(RSD=1.84%,n=6);the limits of detection were 0.021 0,0.003 4, 0.043 7,0.115 6 and 0.005 6 ng/kg,respectively. Pb,Cd,Cu,and As were detetcted,and Hg was not detected,the range of total contents was 7.185 2~12.558 0 mg/kg. CONCLUSIONS:The method is simple with good precision,stability and reproducibility, and can be used for the residues determination of Pb,Cd,Cu,As and Hg in C. pilosula;heavy metal residues in C. pilosula in Shanxi Pingshun county does not exceed limit values of national and industry standards.

PurposeTo evaluate the feasibility and clinical values of CT scan with iterative reconstruction and low radiating dose in craniocerebral trauma.Material and Methods 120 patients suffered from craniocerebral trauma were randomly assigned. All the subjects underwent CT scan using route dose of filtered back projection (FBP) and low dose of iDose (? dose and ? dose), respectively. The quartering were used to subjectively evaluate noise of imaging, skull base artifact, contrast of gyrus-white matter and lesion display in each group. Imaging noise, signal and noise rate (SNR), contrast and noise rate (CNR) of gyrus-white matter and dose length product (DLP) were compared.Results The image quality of both? iDose and ? iDose groups were lower than that of FBP group, but still met the requirement of diagnosis. The image noise of both? iDose and ? iDose groups were higher than that of FBP group (P<0.05). The SNR and CNR of both? iDose and ? iDose groups were lower than those of FBP group (P<0.05). The DLP of both? iDose and ? iDose groups were lower than that of FBP group. There was statistical difference between iDose groups and FBP group (F=2751.46,P<0.05).Conclusion Application of iDose could effectively decrease radiation dose in craniocerebral trauma. Although iDose technique has higher noise level and lower SNR and CNR, the imaging qualities and capability of displaying abnormity meet diagnosis requirement. So that iDose has clinical significance.