As the largest cancer in the world, breast cancer has both benefits and risks from its diversified treatments. Shared decision-making can respect the patient's right to information and autonomy, consider their preferences and value orientations, and help patients obtain the most suitable treatment plan, it also can reduce their decision-making difficulties and improve their disease knowledge awareness and decision-making satisfaction. This paper reviews the definition of shared decision-making, the influencing factors, steps, tools and clinical effects of shared decision-making in the treatment decision-making of breast cancer patients, in order to provide reference for the research of shared decision-making in breast cancer patients in China.

OBJECTIVE To explore the material basis and potential mechanism of Kazakh classic prescription Wuzdekh （WZDK） in the treatment of enteritis. METHODS LC-MS/MS technology was used to analyze the chemical components in WZDK. Through network pharmacology and molecular docking technology， the main chemical components of WZDK were screened and the target was predicted； therapeutic effect and target of WZDK on acute enteritis were verified through in vivo experiments. The acute enteritis model of mice was induced by dextran sulfate sodium salt； the general condition of the mice was observed during administration and the disease activity index （DAI） score was calculated； pathological changes of the intestine and mRNA expression of core target were validated by HE staining and quantitative real-time PCR. RESULTS A total of 316 chemical components were obtained by LC-MS/MS. The core targets of network pharmacological analysis mainly included interleukin 1β（IL- 1β）， protein kinase B1 （AKT1）， tumor protein p53 （TP53）， IL-6， tumor necrosis factor （TNF） and so on. The results of molecular docking showed that chemical components such as mairin， lappadilactone， costunolide and dehydrocostus lactone were stable in binding to the core target. The results of in vivo experiment showed that， compared with model group， high dose （5.00 g/kg） of WZDK could significantly reduce the DAI score （P＜0.05）， improve inflammatory cell infiltration and mucosal tissue damage of colon tissue， and significantly down-regulated mRNA expressions of IL-6， TNF-α， IL-1β and TP53 in colon tissue（P＜ 0.05 or P＜0.01）. CONCLUSIONS Chemical components of WZDK such as mairin， lappadilactone， costunolide and dehydrocostus lactone may play the role of improving the imbalance of local inflammatory factors in the intestine and repairing damage of colonic mucosal tissue by down-regulating mRNA expressions of TNF-α， IL-6， IL-1β and TP53 in colon tissue.

Objective:To investigate the differential diagnostic value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) combined with serum indicators for prostate cancer.Methods:We recruited 97 patients with prostate diseases who received treatment in Zhuji People's Hospital from March 2018 to September 2020 for this study. Patients with prostate cancer were included in the study group ( n = 46) and patients with benign prostatic hyperplasia in the control group ( n = 51). All patients were subject to IVIM-DWI and serum early prostate cancer antigen-2 level detection alone or in combination. The sensitivity, specificity, accuracy, and diagnostic efficacy of IVIM-DWI and serum early prostate cancer antigen-2 level detection alone or in combination were compared between the two groups. Results:D and f values in the study group were (0.50 ± 0.14) × 10 -3 mm 2/s and (0.35 ± 0.11), respectively, which were significantly lower than those in the control group [(0.71 ± 0.12) × 10 -3 mm 2/s, (0.59 ± 0.08), t = 7.95, 12.37, both P < 0.001]. D* value and serum early prostate cancer antigen-2 level in the study group were (6.24 ± 1.90) × 10 -3 mm 2/s and (62.5 ± 18.3) μg/L, which were significantly higher than those in the control group [(4.08 ± 1.34) × 10 -3 mm 2/s, (17.3 ± 6.8) μg/L, t = -6.52, -16.43, both P < 0.001]. The overall detection rate, sensitivity, specificity, and accuracy of IVIM-DWI combined with serum early prostate cancer antigen-2 level detection for prostate cancer were 53.6% (52/97), 97.8% (45/46), 74.5% (38/51), and 85.6% (83/97), respectively. A receiver operating characteristic curve analysis showed that the sensitivity of IVIM-DWI combined with serum indicators in the diagnosis of prostate cancer and the area under the curve were greater than those produced by IVIM-DWI and serum early prostate cancer antigen-2 level detection alone (both P < 0.05). Conclusion:IVIM-DWI combined with serum early prostate cancer antigen-2 level detection has a higher sensitivity in the diagnosis of prostate cancer than monotherapy. The combined therapy provides a new perspective for the differential diagnosis of prostate cancer and has a certain clinical value.

Objective:To investigate the characteristics of multi-slice spiral CT images in lung cancer with cystic lesions and improve the accuracy of diagnosis.Methods:The clinical data of 27 cases of cystic lung cancer confirmed by pathological results of surgery or puncture who received treatment during 2012-2019 in Tongde Hospital of Zhejiang Province, China were collected. The clinical stages, pathological results and the characteristics of multi-slice spiral CT images were analyzed.Results:All 27 cases were diagnosed with peripheral lung cancer. Type VI peripheral lung cancer occurred in 12 (44.44%) cases, and adenocarcinoma in 17 (62.96%) cases. Stage Ia lung cancer occurred in 18 (66.67%) patients. Above 70% of CT images showed irregular cystic structure [70.37% (19/27)], polycystic structure [74.07% (20/27)], and vessels passing through the cysts [70.37% (19/27). Over 90% of CT images displayed unsmooth inner wall of the cysts [92.59% (25/27)] and fuzzy margin of the cysts [96.30% (26/27)].Conclusion:It is very difficult to diagnose lung cancer with cystic lesions. This kind of atypical lung cancer should be considered when the imaging features of peripheral lung cancer appear including thickened cystic wall, fuzzy cystic margin, vascular bundle sign and pleural indentation sign.

OBJECTIVETo compare the effects of acupuncture, electroacupuncture (EA) and moxibustion on functional constipation in rats.

METHODSSixty male Sprague-Dawley rats were divided into a control group (=8), a model group (=11), a medication group (=8), an acupuncture group (=11), an EA group (=11) and a moxibustion group (=11) by random number table. The rats in the model group, medication group, acupuncture group, EA group and moxibustion group were treated with intragastric administration of loperamide hydrochloride for 6 days continuously to establish the functional constipation models, while equal volume of drinking water was administrated to rats in the control group at the same time. The rats in the acupuncture group, EA group and moxibustion group were respectively treated with acupuncture, EA and moxibustion at "Tianshu" (ST 25) and "Shangjuxu" (ST 37) one hour after intragastric administration; rats in the medication group were treated with intragastric administration of cisapride suspension. All the treatment was given once a day for 6 days. At the last day of intervention, the 24-hour food intake, stool quantity and its water content were measured in each group; the pushing rate of intestine was measured; the structure of colon tissue and acidic mucus in its mucous layer were observed by hematoxylin-eosin dyeing and alcian blue dyeing; the expression of stem cell factor (SCF) and c-kit mRNA was detected by real-time PCR.

RESULTSCompared with the control group, the 24-hour food intake and stool quantity were reduced in the model group (both<0.01), and the water content of stool and pushing rate of intestine were reduced (both<0.01); compared with the model group, the stool quantity and its water content were increased in the medication group, acupuncture group, EA group (<0.05,<0.01), which were not significantly different from those in the moxibustion group (both>0.05). The pushing rate of intestine in each intervention group was increased (all<0.01). The 24-hour food intake and stool quantity in the medication group were not significantly different from those in the acupuncture group, EA group and moxibustion group (all>0.05), and the water content of stool was only reduced in the moxibustion group (<0.01). The pushing rate of intestine in the acupuncture group and moxibustion group was lower than that in the medication group (both<0.01), while that in the EA group was not significantly different from that in the medication group (>0.05). The water content of stool in the moxibustion group was lower than that in the acupuncture group and EA group (both<0.01). The pushing rate of intestine in the acupuncture group and moxibustion group was lower than that in the EA group (both<0.01). The HE staining result indicated the structure of colon tissue was normal, complete and similar in each group; the alcian blue staining indicated the acidic mucosubstance in the model group was lower than that in the control group; compared with the model group, the acidic mucosubstance in the medication group, acupuncture group, EA group and moxibustion group was all increased. Compared with the control group, the expression of SCF and c-kit mRNA was reduced in the model group (both<0.05); compared with the model group, the expression of SCF and c-kit mRNA was increased in the medication group, acupuncture group, EA group and moxibustion group (all<0.05); compared with the moxibustion group, the expression of c-kit mRNA was reduced in the acupuncture group and EA group (both<0.05).

CONCLUSIONSAcupuncture, EA and moxibustion all can play a positive regulative role on functional constipation in rats, in which EA has the best efficacy, followed by acupuncture.

Combining with the data based on data mining,to collect the clinical experimental research ralating to thermal moxibustion from June 2010 to March 2015, and extract the representative clinical experimental research of clinical diseases. To summarize advances in clinic study of Thermal Moxibustion in recent five years.

There have been many reports of clinical and experimental researches of microacupuncture therapy, the relevant systematic works, teaching materials and national standards in recent decades. It shows that microacupuncture system has been formed and its influence has been promoted. While the rapid development of microacupuncture therapy, there are the problems and contradictions on nomenclature, explanation of theoretical basis, optimal indications, and multiple systems and schools, etc. All the above have blocked the clinical application and development. It is considered that we need to unify the nomenclature, condense the theoretical basis, clear the optimal indications, promote the exchange and blend among different schools and sum up the outcomes by systematic review and data mining technique.
Acupuncture Therapy ; instrumentation ; methods ; trends ; Humans ; Needles

OBJECTIVETo analyze the diseases and effects of the manipulations to promoteby filiform needles, with the help of data mining technique.

METHODSLiterature about different manipulations to promoteby filiform needles in recent 60 years was collected in China National Knowledge Infrastructure(CNKI). Then databases were established to mine the relativities among the diseases, subjects, acupoints selection law,routes and directions of meridianand effects.

RESULTS①Total 489 articles were included. The basic manipulations with the frequency of 630 were on the top. The auxiliary and four methods ofrespectively appeared 70 times. The diseases in the internal medicine were treated with the basic and auxiliary methods of the higher frequencies, 311 and 44 times separately. While the four methods ofwere mostly used in the surgical area, 37 timestotally. ②The diseases treated from high to low by lifting, thrusting and twirling represented retention of urine, sequelae of stroke, pain in waist and lower limbs, of which the effect for retention of urine was better than those of the other two, and the lifting and thrusting method was superior to twirling. ③As for the auxiliary methods, 25 times were found about vibration needling; 18 times, twisting. The highest frequency of 6 times for the vibration needling was on the sequelae of stroke; while 4 times for the twisting, stranguria. ④As to the four methods of,was most frequently applied, and its highest frequency of 18 was onsyndrome.

CONCLUSIONSManipulations to promoteby filiform needles are crucial to achieving the effects of acupuncture. The basic methods are widely used in clinic and have been seen good efficacy. While the auxiliary means assist to promoteto stimulate the body,among which the four methods ofare mainly to smooth the meridians and driveof patients with surgical diseases and take meridian blocking the priority.

Professor JIA Chunsheng believes that "Dongyuan's acupuncture therapy" proposed by GAO Wu could not entirely reflect LI Dongyuan's academic thought of acupuncture and moxibustion. Hence, we collected all of the academic works of LI Dongyuan and extracted the texts relevant with acupuncture-moxibustion therapy, titled as Dongyuan's acupuncture-moxibustion therapy. This process contributed to the deeper study on Dongyuan's acupuncture and moxibustion academic thought. By the influence of Dongyuan's acupuncture-moxibustion academic thought, in association with his clinical experience for dozens of years, Professor JIA Chunsheng proposed that acupuncture and moxibustion should pay attention to the regulation and tonification of spleen and kidney. In clinical practice, Zhongwan (CV 12), bilateral Tianshu (ST 25), Qihai (CV 6) and Guanyuan (CV 4) are commonly selected to consolidate the root, cultivate the primary and treat the spleen and kidney simultaneously. The locations of the above selected points are distributed like a star. This "star-like point selection method" points to the importance of the spleen and kidney (the primary qi). For many diseases, especially the disorders of internal injury, the star-like acupuncture therapy is commonly used and the relevant acupoints are supplemented. The good clinical efficacy has been achieved.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, Ancient ; Humans ; Moxibustion ; history ; methods

OBJECTIVETo investigate the levels and influencing factors of phthalate internal exposure in pregnant women (gestation age ≤ 16 weeks).

METHODSDuring April to June in 2013, 1 020 pregnant women (gestation age ≤ 16 weeks) who had established the maternal care manual were recruited in maternal and child health hospital of Siming District, Xiamen city. Participators were asked to complete a questionnaire to obtain information on socio-demographic characteristics, lifestyle behaviors, and antenatal examination and to provide a urine sample. Finally, 998 pregnant women who provided a urine sample and completed the questionnaire were enrolled. Adopting systematic sampling method, 100 ones were selected randomly among 998 pregnant women. High performance liquid chromatography-electrospray ionization-tandern mass was used to determine the concentration of five phthalate monoesters in each urine, including mono-n-methyl phthalate (MMP), mono-ethyl phthalate (MEP), mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), mono-ethylhexyl phthalate (MEHP). Based on the measurements and questionnaire data, multivariate logistic regression was used to analyze the association between the phthalate monoester levels and potential influential factors.

RESULTSThe detection rates of MMP, MEP, MBP, MBzP and MEHP in 100 pregnant urine samples were 94%, 93%, 87%, 83%, 99%, respectively. And the urinary median uncorrected concentrations of MMP, MEP, MBP, MBzP and MEHP in 100 urine samples were 20.56, 17.62, 10.15, 2.03, and 5.12 ng/ml, respectively. Specific gravity-corrected concentration were 20.81, 20.36, 12.88, 2.58, 5.00 ng/ml, respectively. The results of multivariate logistic regression analysis indicated that: education degree was negatively associated with urinary concentration of MMP, MEP, MBP, MBzP and MEHP, OR (95% CI) were 0.495 (0.253-0.966), 0.380 (0.191-0.755), 0.379 (0.186-0.774), 0.401 (0.196-0.819), 0.373(0.183-0.762), respectively. Participants who had hair permed and dyed during pregnancy had higher urinary level of MBP and MBzP, OR (95% CI) were 12.867 (1.240-133.525), 15.982 (1.367-186.911), respectively; Participants who use cosmetics during pregnancy had higher urinary level of MEP and MBP, OR (95% CI) were 2.977 (1.012-8.757), 4.440 (1.485-13.272), respectively; plastic bottled water consumption was positively associated with urinary concentrations of MEP and MEHP, OR (95% CI) were 3.780 (1.417-10.083), 2.699 (1.039-7.010), respectively; annual household income was negatively associated with urinary concentration of MMP, OR (95% CI) was 0.597 (0.372-0.959); individuals who took medications during pregnancy had higher urinary level of MEHP than non-takers, OR (95% CI) was 4.853 (1.084-21.732).

CONCLUSIONPregnant women whose gestation age was less than 16 weeks are generally exposed to phthalate. Phthalate internal exposure levels are significantly associated with most measured factors and the influencing factors with different phthalates internal exposure levels are different.

Chromatography, High Pressure Liquid ; Dibutyl Phthalate ; urine ; Female ; Humans ; Life Style ; Maternal Exposure ; Phthalic Acids ; urine ; Pregnancy ; Surveys and Questionnaires ; Tandem Mass Spectrometry