Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

Gongfa is an essential approach to prevent and treat diseases in traditional Chinese medicine(TCM),often used to prevent a disease before it arises.Guided by TCM and modern scientific theories,the Tuina(Chinese therapeutic massage)Gongfa prescription theory implements the principle,method,prescription,and form in clinical pattern-identified treatment to prescribe the corresponding Tuina Gongfa prescription,i.e.,to prescribe a basic Tuina Gongfa prescription,specifically for a systemic disease,and modify Gongfa forms based on the basic prescription according to different patterns.The Gongfa prescription for pulmonary diseases designs corresponding Gongfa forms from six perspectives:lifting Yang,securing the exterior,opening the orifices,soothing the chest,harmonizing the stomach,and regulating Qi to prevent and treat diseases.The application of the pulmonary Gongfa prescription indicates the potential to apply the Tuina Gongfa prescription theory for the clinical prevention,treatment,and rehabilitation of disorders of other systems,thereby fully realizing the unique role of TCM Gongfa.

Objective To construct a prognosis prediction model of primary liver cancer after surgical treatment based on synthetic minority over-sampling technique(SMOTE)algorithm and machine learning model.Methods A retrospective cohort study was conducted on 4 297 patients with primary liver cancer from the surveillance,epidemiology,and end results(SEER)database.One-Hot Encoding and Multiple Imputation were used to preprocess the collect data,and SMOTE algorithm was employed to solve the imbalance of data categories.The obtained clinical variables were included in the machine learning model.Based on decision tree(DT),random forest(RF),gradient boosting decision tree(GBDT)and eXtreme Gradient Boosting(XGBoost),a prognostic prediction model(SMOTE+DT/RF/GBDT/XGBoost)was build,and then the best prediction model was determined by comparing the performance of various models.Finally,a prognostic analysis system for primary liver cancer was developed based on the optimal model,which was then visualized.Results The combination model SMOTE+RF showed the best predictive performance,with higher area under the curve(0.895),accuracy(0.811)and precision(0.806)than those of other models in receiver operating characteristic curve(ROC)analysis.Conclusion The SMOTE+RF prognostic prediction model can effectively predict the survival outcome of patients with primary liver cancer.

Objective:To observe the clinical efficacy of neck Gongfa exercise in intervening people at high risk for cervical spondylosis. Methods:A total of 212 participants from 8 companies at high risk for cervical spondylosis were divided into two groups using the random number table method,with 105 participants in the control group receiving health education and 107 participants in the trial group receiving an additional neck Gongfa exercise.After successive 3-month interventions,the two groups were compared in terms of cervical soft tissue tension and neck disability index(NDI)score.The incidence of cervical spondylosis was observed 3 months later. Results:During the process,10 cases dropped out in the trial group,and the control group had 9 dropout cases.After the intervention,the cervical soft tissue tension value and NDI score improved in both groups(P<0.05)and showed significant differences between the two groups(P<0.05).At the 3-month follow-up,the trial group had a lower incidence rate of cervical spondylosis than the control group(P<0.05). Conclusion:For people at high risk for cervical spondylosis,neck Gongfa exercise can effectively improve cervical soft tissue tension and motor dysfunction and lower the incidence of cervical spondylosis in the short run.

As a novel and promising antitumor target, AXL plays an important role in tumor growth, metastasis, immunosuppression and drug resistance of various malignancies, which has attracted extensive research interest in recent years. In this study, by employing the structure-based drug design and bioisosterism strategies, we designed and synthesized in total 54 novel AXL inhibitors featuring a fused-pyrazolone carboxamide scaffold, of which up to 20 compounds exhibited excellent AXL kinase and BaF3/TEL-AXL cell viability inhibitions. Notably, compound 59 showed a desirable AXL kinase inhibitory activity (IC₅₀: 3.5 nmol/L) as well as good kinase selectivity, and it effectively blocked the cellular AXL signaling. In turn, compound 59 could potently inhibit BaF3/TEL-AXL cell viability (IC₅₀: 1.5 nmol/L) and significantly suppress GAS6/AXL-mediated cancer cell invasion, migration and wound healing at the nanomolar level. More importantly, compound 59 oral administration showed good pharmacokinetic profile and in vivo antitumor efficiency, in which we observed significant AXL phosphorylation suppression, and its antitumor efficacy at 20 mg/kg (qd) was comparable to that of BGB324 at 50 mg/kg (bid), the most advanced AXL inhibitor. Taken together, this work provided a valuable lead compound as a potential AXL inhibitor for the further antitumor drug development.

Objective: To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). Methods: Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p_(A-a) (O₂)]after anesthesia (T₁), after operation (T₂), at admission to intensive care unit (T₃) and before extubation (T₄) and complication rate between 2 groups were compared. Results: (1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ²=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P<0.01). (5)FPS-R scores at 1, 2, 3, 4 d postoperatively in the observation group were (4.02±0.41), (3.41±0.15), (2.55 ±0.20) and (1.16±0.27) points, while those in the control group were respectively (5.21±0.89), (5.02±0.63), (4.12±0.67) and (3.05±0.39) points, which differences were statistically significant (t=7.963, 16.302, 14.724, 26.128, all P<0.01). (6)There was no significant difference in p_(A-a) (O₂) and PIP between the two groups at T1, T2, T3 and T4 (all P>0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ²=0.000, P>0.05). Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate postoperative recovery of children, relieve postoperative pain, and reduce the financial burden of parents.Besides, intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery.

Objective To explore the effect of quality control circles (QCCs) in improving the delivery health checkup report.Methods QCC was founded with the theme of"improving the quality of health checkup report delivery."First,we planned an activity schedule and identified topics.We then set target focuses for service personnel,distribution modes,and operating environments;planned countermeasures;and selected optimal policies.Circle members implemented the optimal policies jointly.Reports of physical examinations by the Guoyu health management center were selected and analyzed.The total number of reports before improvement (January to December 2015) was 59 189 of which 34 549 (58.4％) were male patients and 24 640 (41.6％) were female patients;their average age was (37.7± 11.4) years.The total number of reports after improvement (December 2016 to January 2017) was 6 568,of which 3 881 (59.1％) were male patients and 2 687(40.9％) were female patients;their average age was (39.9± 11.7) years.We compared the quality indicators and evaluated the comprehensive quality of the patients before and after improvement.A total of 65 531 physical examination reports of subjects examined at the center between February and December 2017 were selected for effect tracking,including 39 230 (59.9％) men and 26 301(40.1％) women,aged (38.1±11.5).Results The on-time delivery rate of the health examination reports from rose from 51.4％ to 94.0％.The ratio of system leakage to sign for reports decreased from 14.5％ to 0.8％.The average time between the examination and when each report was handed over to for distribution decreased from 29.8 hours to 4.2 hours,and the average time between each report being distributed to the providers checking in dropped from 509.8 hours to 72.8 hours,while the average time for the preparation of each report for delivery decreased from 13.5 seconds to 3.1 seconds.The average time between delivery of a report and its being signed decreased from 4.3 seconds to 0.1 seconds.Before the improvement,the expected goals were not met.After improvement,the delivery rate of the health examination reports was 100.0％,the delivery intact rate of the group reports was 100.0％,and the satisfaction rate of the group reports was 99.4％.The comprehensive quality for the members was obviously higher after the improvement than before.After 11 months of tracking,the delivery accuracy rate of health examination report still failed to reach the target value of 100.0％,but all other indicators reached the target value,with good results.Conclusions Application of QCC not only improved the delivery the health checkup reports,but also promoted service quality after medical examinations and ended medical dispute caused by the loss of physical examination reports.

Objective: To investigate the characteristics, temporal trend of silicosis, and provide basis for risk assessment and precise prevention and control of occupational diseases. Methods: Using descriptive statistics to analyze the reported cases of silicosis by SPSS 20.0 software. Reported silicosis cases, the constituent ratio, the incidence age and the working age at onset were analyzed by a linear trend test. Analyzing the variation trends of regional, industry, economic type and enterprise scale distributions by the chi-square trend test. Moreover, using Moran's I method for spatial autocorrelation analysis and trend-surface analysis. Results: (1) During 2006 to 2015, Guangdong province had reported 1, 428 cases of silicosis, mainly gathered in Foshan, Zhongshan, Guangzhou, Shenzhen, which included 1391 male cases accounting for 97.41%. And the average incidence age was 45 (39, 51) . The average working age of onset was 9 (5.5, 15) . In economic type distribution, the private economy took the main part, accounting for 59.1%. In enterprise scale distribution, it was dominated by small and medium enterprises (SMEs) , accounting for 32.4% and 37.3% respectively. In industry distribution, most cases were gathered in materials and mining industry, accounting for 32.1% and 22.9% respectively. (2) The number of silicosis cases, the incidence age and the working age of onset showed a rising trend (P<0.01) . Meanwhile, the constituent ratios of medium-sized enterprises and building materials industry were increasing (P<0.05) . The annual variation trends of regional, economic type and age distributions were not statistically significant (P> 0.05) . (3) The spatial distribution trend showed an inverted U type, which was firstly raised and then declined from south to north and from east to west. The distribution characteristic demonstrated some high-high cluster areas, including Chancheng, Nanhai, Shunde, Panyu, Dongguan, Pengjiang, and Zhongshan. While Wuhua showed a high-low outlier form (P<0.01) . Conclusion Silicosis cases, age and working age of onset were on the rise, as well as the industry and enterprise scale distributions of occupational diseases presented a certain trend in Guangdong province from 2006 to 2015. There were high-high cluster and high-low outlier phenomena in spatial distribution with spatial correlation. Therefore, our work of silicosis epidemic trend and distribution may provide some bases for the occupational disease risk assessment and control.

OBJECTIVE: To explore the application of the autoregressive integrated moving average model( ARIMA model)in predicting incidence of occupational noise-induced deafness( ONID). METHODS: The ARIMA model was established and validated based on the number of new onset ONID cases in Guangdong Province from 2006 to 2015. Then the ARIMA model was used to predict the trend of new onset ONID cases from 2016 to 2020. RESULTS: The number of new ONID cases in Guangdong Province from 2006 to 2015 showed an exponential growth trend. The optimal model fitted with the number of new onset ONID cases from 2006 to 2015 was the ARIMA( 2,2,2) model,which better match the number of new onset ONID cases from 2008 to 2015. According to the ARIMA( 2,2,2) model,the number of new onset ONID cases in Guangdong Province will continue to have a rapidly increasing trend from 2016 to 2020. CONCLUSION: The ARIMA model based on time series matches the time trend of ONID onset,and it can be used for the prediction of ONID incidence trend.

OBJECTIVE: To analyze the epidemiological characteristics and predict epidemiological trends of occupational chemical poisoning,based on directly reported data during 2006-2015 in Guangdong Province. METHODS: The data of patients with occupational chemical poisoning reported from National Information Surveillance System for Occupational Disease and Occupational Health from 2006 to 2015 in Guangdong Province were collected. The epidemiological characteristics were retrospectively analyzed. The autoregressive integral moving average model( ARIMA model) was established and validated based on the number of the new onset cases and was used to predict the trends of occupational chemical poisoning from 2017 to 2020 in Guangdong Province. RESULTS: From 2006 to 2015,1 288 new cases of occupational chemical poisoning were reported in Guangdong Province,which accounted for 24. 4% of the total number of new cases of occupational diseases in the province( 5 283 cases). Among the new cases,the percentage of acute and chronic poisoning was 21. 7%( 279/1 288) and 78. 3%( 1 009/1 288). There was 74. 7%( 962/1 288) of organic solvent poisoning. Five kinds of new occupational chemical poisoning were found. Most of the new cases were male,accounting for 56. 7%( 729/1 288). They were mainly distributed and concentrated in Pearl River Delta Region,accounting for 95. 9%(1 235/1 288). Shenzhen,Dongguan and Guangzhou were the most three cities which had 425,325 and 209 cases respectively,all of them accounted for 74. 4%( 959/1 288). The new cases of poisoning mainly distributed in medium and small enterprises( 72. 0%),private economic enterprises( 50. 9%) and manufacturing industries(70. 5%). The number of occupational chemical poisoning diseases decreased first,and increased,and the proportion to the total number of occupational diseases in Guangdong Province showed a straight downward trend(P < 0. 01). The median age at diagnosis was 35 years old and the median work year at diagnosis was 2. 0 years,and both of them showed an increasing trend( P < 0. 01). CONCLUSION: Occupational chemical poisoning in Guangdong Province has certain characteristic of crowd aggregation and epidemic trends.