Objective To explore the value of ovarian-adnexal reporting and data system(O-RADS)MRI score combined with tumor markers(CA125+HE4)in ovarian tumors.Methods Data from 223 patients with ovarian tumors confirmed by pathology were analyzed retrospectively,including 260 lesions.The Kappa test was used to assess the consistency of O-RADS MRI score between low and high seniority physician groups.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic effi-cacy of O-RADS MRI score combined with tumor markers(CA125+HE4)in ovarian tumors.Results The Kappa value of the O-RADS MRI score between low and high seniority physician groups was 0.803[95%confidence interval(CI)0.746-0.860].The sensitivity based on O-RADS MRI score for distinguishing benign and malignant ovarian tumors was 0.957 and 0.989,the specificity was 0.784 and 0.820,the accuracy was 0.846 and 0.881,the positive predictive value was 0.712 and 0.754,and the negative pre-dictive value was 0.970 and 0.993,and the area under the curve(AUC)was 0.871 and 0.905,respectively in the low and high senior-ity physician groups.Combined with tumor markers(CA125+HE4),the sensitivity and negative predictive value of both low and high seniority physician groups were 1.000.Conclusion The O-RADS MRI score has high diagnostic efficacy and good repeatability in ovarian tumors.Combined with tumor markers CA125 and HE4,the O-RADS MRI score can further improve the diagnostic sen-sitivity.

Objective To explore the value of ovarian-adnexal reporting and data system(O-RADS)MRI score combined with tumor markers(CA125+HE4)in ovarian tumors.Methods Data from 223 patients with ovarian tumors confirmed by pathology were analyzed retrospectively,including 260 lesions.The Kappa test was used to assess the consistency of O-RADS MRI score between low and high seniority physician groups.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic effi-cacy of O-RADS MRI score combined with tumor markers(CA125+HE4)in ovarian tumors.Results The Kappa value of the O-RADS MRI score between low and high seniority physician groups was 0.803[95%confidence interval(CI)0.746-0.860].The sensitivity based on O-RADS MRI score for distinguishing benign and malignant ovarian tumors was 0.957 and 0.989,the specificity was 0.784 and 0.820,the accuracy was 0.846 and 0.881,the positive predictive value was 0.712 and 0.754,and the negative pre-dictive value was 0.970 and 0.993,and the area under the curve(AUC)was 0.871 and 0.905,respectively in the low and high senior-ity physician groups.Combined with tumor markers(CA125+HE4),the sensitivity and negative predictive value of both low and high seniority physician groups were 1.000.Conclusion The O-RADS MRI score has high diagnostic efficacy and good repeatability in ovarian tumors.Combined with tumor markers CA125 and HE4,the O-RADS MRI score can further improve the diagnostic sen-sitivity.

Age-related macular degeneration(AMD)is a serious threat to the visual health of the elderly,and the dysfunction of retinal pigment epithelial cells(RPE)is a significant etiology risk.Aging process leads to RPE repli-cation senescence,and some environment factors like light exposure and cigarette exposure may lead to RPE stress premature aging,and the decreased lysosomal digestion ability of senescent RPE cells may lead to the accumulation of lipofuscin,triggering the occurrence of early AMD.A series of homeostatic imbalances in aging retina,such as cell senescence-renewal imbalance,oxidative stress-antioxidant imbalance,chronic inflammatory-anti-inflammatory imbalance,intestinal barrier and intestinal microbiota imbalance and pro-angiogenesis-antiangiogenic imbalance all contribute to the development of AMD.

Objective:To construct a standard index system for the outpatient job competency of midwife, and to clarify the midwives' abilities when providing outpatient services, so as to improve the midwives' core competencies and service satisfaction.Methods:A research group was established in December 2018. On the basis of literature review and survey of midwives' outpatient needs in the early stage, referring to expert opinions, and taking job competency theory as the theoretical framework, the standard index system for the outpatient job competency of midwife were initially constructed. From December 2018 to March 2019, convenience sampling was used to select 24 experts from different ClassⅢ Grade A hospitals of Beijing, and the Delphi method was used to conduct 2 rounds of expert consultations.Results:Among 2 rounds of expert consultations, the effective recovery rates of the questionnaires were all 100.0% (24/24) , the positive coefficient of experts was 100.0%, and the coefficient of authority of experts was 0.786. The Kendall coordination coefficients of the 2 rounds of correspondence were 0.030 and 0.400, respectively ( P<0.05) . The final construction of standard index system for the outpatient job competency of midwife included 4 first-level indicators, 9 second-level indicators and 24 third-level indicators of knowledge and skills, professional quality, health education ability, and ability to improve the quality of professional services. Conclusions:The standard index system for the outpatient job competency of midwife is scientific and reasonable, comprehensive in content, and strong in specialty, which can provide a reference for the training and assessment of midwife.

OBJECTIVEBy analysing the defect of control design in randomized controlled trials (RCTs) of simple obesity treated with acupuncture and using acupuncture as the contrast, presenting the essential factors which should be taken into account as designing the control of clinical trial to further improve the clinical research.

METHODSSetting RCTs of acupuncture treating simple obesity as a example, we searched RCTs of acupuncture treating simple obesity with acupuncture control. According to the characteristics of acupuncture therapy, this research sorted and analysed the control approach of intervention from aspects of acupoint selection, the penetration of needle, the depth of insertion, etc, then calculated the amount of difference factor between the two groups and analyzed the rationality.

RESULTSIn 15 RCTs meeting the inclusion criterias, 7 published in English, 8 in Chinese, the amount of difference factors between two groups greater than 1 was 6 (40%), 4 published in English abroad, 2 in Chinese, while only 1 was 9 (60%), 3 published in English, 6 in Chinese.

CONCLUSIONControl design of acupuncture in some clinical RCTs is unreasonable for not considering the amount of difference factors between the two groups.

To explore the expressive elements for the clinical randomized controlled trials of acupuncture and moxibustion so as to provide reference for them, taking peptic ulcer as an example. Sixty-six papers from 1996 to 2015 were collected in domestic and overseas databases, including China National Knowledge Infrastructure (CNKI), WANFANG, VIP, China Biology Medicine (CBM), PubMed, Web of Science, Sciencedirect, Springer, Wiley. The expression qualities were evaluated according to the Consolidated Standards of Reporting Trials (CONSORT) and the Standards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA). We consider that the reports are not sound, especially their preface, trial design and intervention.

OBJECTIVETo explore the acupoints selection rules on peptic ulcer treated with acupuncture and moxibustion,so as to provide references for acupoints clinical selecting.

METHODSLiterature on clinical report and clinical study for peptic ulcer treated with acupuncture and moxibustion was retrieved in CNKI, WANFANG, VIP, CBM, PubMed, Web of Science and other databases from January 1, 2003 to August 31, 2014,and acupoints selecting rules were summarized according to syndromes and symptoms.

RESULTSOne hundred and ten articles were acquired, and acupoints the first to the fifth used were Zhongwan (CV 12), Zusanli (ST 36), Weishu (BL 21), Pishu (BL 20) and Neiguan (PC 6). The main acupoints were Zhongwan (CV 12) and Zusanli (ST 36). As to acupoints mainly selected in accordance with different syndromes: (1)Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6) were matched for the syndrome of deficiency cold in the spleen and the stomach. (2) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Geshu (BL 17) were combined for the syndrome of qi stagnation and blood stasis. (3) Weishu (BL, 21), Pishu (BL 20), Qimen (LR 14) for the syndrome of qi stagnation induced by liver depression. (4) Neiguan (PC 6) and Taichong (LR 3) for the syndrome of liver qi invading the stomach. (5) Weishu (BL 21) and Pishu (BL 20) for the syndrome of weakness of the spleen and the stomach. (6) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Gongsun (SP 4) for the syndrome of cold in the stomach. (7) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), San yinjiao (SP 6) for the syndrome of yin deficiency in the stomach. (8) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Yinlingquan (SP 9), Ganshu (BL 18) for the syndrome of phlegm and dampness stagnation. As for acupoints majorly selected according to different symptoms, (1) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Taichong (LR 3) were combined for acid regurgitation. (2) Weishu (BL 21), Neiguan (PC 6), Tianshu (ST 25), Gongsun (SP 4) were selected for abdominal distension. (3) Weishu (BL 21), Neiguan (PC 6), Liangqiu (ST 34), Gongsun (SP 4) for unbearable stomach pain. (4) Weishu (BL 21), Pishu (BL 20), Neiguan (PC 6), Qihai (CV 6), Gongsun (SP 4) for lacking in strength.

CONCLUSIONWe treating peptic ulcer with acupuncture and moxibustion mainly choose Zhongwan (CV 12) and Zusanli (ST 36), and attach importance to acupoints selection based on syndrome and symptom differentiation.

Objective Through summaring all the randomized controlled trials published in Chinese Acupuncture & Moxibustion during the last 30 years,to investigate clinical researching situation of acupuncture in home and to provide objective and reliable data for other researchers.Methods All clinical research papers published in Chinese Acupuncture & Moxibustion from 1981-2010 was categorized and scored accordingto the size of sample,methods of grouping,and having or not having international or national diagnostic criteria,and then made a comprehensive analysis and comparison.Results ① RCT articles published in Chinese Acupuncture & Moxibustion has increased annually.②The methods of grouping has become more and more normative,which indicates that the level of RCT has been elevated.Of them,randmon digital table has been put into use the most frequently.Conclusion The quality of acupuncture clinical research papers are improving continuously,but the descriptions of the process need to be standardized.

Objective To define the patterns of local extension and nodal involvement in patients with early stage nasal NK/T-cell lymphoma, and to improve the delineation of clinical target volume.Methods Two hundred and twenty-two patients consecutively diagnosed with nasal NK/T-cell lymphoma were reviewed.All patients had stage Ⅰ E/Ⅱ E diseases.CT/MRI images were reviewed to determine the local invasion of adjacent organs or structures and involvement of lymph node.Results 143 of 222(64%) patients had primary tumor extended into adjacent organs or structures from nasal cavity.According to the incidence rates of tumor extension, the involved organs or structures were subclassified into three subgroups:high risk (≥40%):ethmoid sinus (60%) and maxillary sinus (55%);intermediate risk (5%-40%):nasopharynx (39%), skin (22%), oropharynx (12%), orbit (10%), and hard palate (10%);and low risk (≤5%):sphenoid sinus (3%), soft plate (3%),frontal sinus (3%) and skull base (1%).Cervical lymph node metastasis occurred in 16%(36/222) of the patients and these patients were staged as Ⅱ E.Thirty-three patients with stage Ⅱ E disease had available images and were analyzed for the pattern of nodal involvement.Submandibular or submental (57%) and the upper cervical lymph nodes (57%) were the most commonly involved sites of nodal region.For the 24 patients with primary tumor located in the unilateral nasal cavity, 54% presented with contralateral cervical lymph node metastasis.Whereas for the 9 patients with primary tumor located in the bilateral nasal cavity, 57% had bilateral cervical lymph node metastasis.For the 88 patients with extensive stage Ⅰ E disease who did not receive irradiation to the cervical lymph node, only one patient (1%) had disease relapse in cervical lymph node.Furthermore, all patients with disease extended to nasopharynx (n= 23) or oropharynx (n= 8) did not receive prophylactic cervical lymph node irradiation, and none of them developed cervical lymph node relapse.Conclusions The delineation of clinical target volume for early stage nasal NK/T-cell lymphoma should be determined by the risk of involvement of paranasal structures and cervical lymph node.Prophylactic neck irradiation is not recommended for patients with stage Ⅰ disease.