Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Health service is an important part of the integrated development of the Yangtze River Delta. Taking the cooperation practice between Shanghai Tenth People′s Hospital and Suzhou Yinshanhu Hospital as an example, this article introduced the multi-agent cooperation mode of the loose medical alliance including the government, urban hospitals and cross provincial grassroots medical institutions. Among them, the local government provided policy, fund guarantee and guidance, the urban hospital exported management ideas, medicine talents and technologies, and the primary hospital conducted dual training by inviting in and going out to achieve double growth. Through the high gap cooperation between tertiary hospital and primary hospital, Yinshanhu hospital had been comprehensively developed. The loose medical alliance with multi subject coordination and cross region could give full play to the advantages of the loose healthcare alliance mode, achieve multi-win, and have reference significance for promoting the regional integration of medical and health services in the Yangtze River Delta.

Objective:To analyze the association between the Charlson Comorbidity Index(CCI)and the risk of early in-hospital death in cerebral hemorrhage inpatients.Methods:Basic personal and medical information about sex, age, surgery, frequency of hospitalization, days of hospitalization, and ICD-10 diagnosis code was collected for intracerebral hemorrhage patients aged 60 or above admitted to a tertiary general hospital from January 1, 2017 to December 31, 2019.The CCI score was calculated based on diagnoses at the time of discharge.Using the CCI score as the dependent variable and in-hospital death as the independent variable, univariate and multiple logistic regression analysis was conducted to examine the association between CCI and in-hospital death.The receiver operator characteristic curve(ROC)was used to assess the value of CCI in predicting death.Results:A total of 504 cerebral hemorrhage inpatients were included in the study, with an average age of 69.48±7.55 years, and 52 died during the period.Univariate Logistic regression showed that, compared with inpatients with CCI=3, the OR values(95% CI)for inpatients with CCI=4 and CCI≥5 were 2.145(1.056-4.355)and 4.769(2.168-10.494), respectively.Multiple Logistic regression showed that, compared with inpatients with CCI=3, the OR(95% CI)for inpatients with CCI≥5 was 4.453(1.474-13.456), The area under the ROC curve was 0.718, with 95% CI at 0.642-0.793( P<0.001). Conclusions:The CCI score was associated with the risk of early in-hospital death in elderly patients with cerebral hemorrhage and can be used to assess and predict the risk of early in-hospital death for these patients.

Objective To explore the status of emotional-social loneliness including emotional isolation,social isolation,emotional and social loneliness in patients with acute cerebral infraction,and to analyze the related factors.Methods A total of 122 patients with acute cerebral infraction admitted to the neurology department of 5 third-grade class-A hospitals from Jan.2017 to Oct.2017 were enrolled.Data was collected by self-reported questionnaires including patients' general data and the emotional-social loneliness questionnaire data.Results Among 122 patients with acute cerebral infraction,emotional isolation,social isolation,emotional loneliness and social loneliness were found in 48 cases(39.3％),60 cases(49.2％),40 cases(32.8％)and 36 cases(29.5％),respectively.The total average score for emotional isolation,social isolation,emotional loneliness and social loneliness were 8.3 ± 5.2,8.6 ± 5.1,7.5 ± 6.1,and 7.4 ± 5.5,respectively.The scores for emotional-social loneliness were associated with education level,monthly family income,occupations and the emotion state before disease,and were not associated with gender,marriage status and stroke history.Conclusions The prevalence of emotional-social loneliness is high in patients with acute cerebral infraction.Especially careful attention should be paid to patients with higher education level and retired with monthly family income ≥5 000 RMB.

Objective To explore the effect of different blood glucose monitoring frequency on blood glucose fluctuation and control in type 2 diabetes mellitus patients with intensive insulin therapy .Methods One hundred and twenty type 2 diabetes mellitus patients with intensive insulin therapy were chosen and randomly divided into three groups .The three times group received 3 times monitoring including fasting , after breakfast and bedtime , and the five times group received 5 times monitoring including fasting , after breakfast , before supper , bedtime and before dawn , and the eight times group received the 8 times monitoring including before and after every meal , bedtime and before dawn , and the changes of the hemoglobin A 1 c ( HbA1 c) were observed for 4 weeks before and after the treatment .Results The average levels of HbA 1 c in the three groups were decreased 4 weeks after treatment in the three groups , and the difference was not statistically significant ( F=0.301, P>0.05).No difference was found in the fasting blood glucose and blood glucose before supper in the three groups (F=1.450, t=1.760;P>0.05).The levels of blood glucose after breakfast were respectively (8.78 ±0.90), (9.08 ±0.63), (7.49 ±1.01) mmol/L in the three groups, and the level of blood glucose in the eight times group was better than those of the three and five times groups , and the difference was statistically significant (F=23.340,P<0.05).The levels of bedtime blood glucose were respectively (8.07 ±0.59), (8.32 ±0.75), (7.28 ±0.54) mmol/L in the three groups, and the blood glucose fluctuation range in the eight times group was lowest, and the difference was statistically significant (F=32.880, P<0.05).The level of blood glucose before dawn in the eight times group was (6.68 ±0.59) mmol/L, and was better than (7.75 ±0.77) mmol/L in the five times group, and the difference was statistically significant (t=4.170, P<0.01).The average levels of 24 h blood glucose in the three groups were respectively (8.33 ±1.20), (8.26 ± 0.97), (7.84 ±1.15) mmol/L, and the blood glucose control in the eight times group was best , and the difference was statistically significant (F=22.36, P<0.05), and the detection rate of hypoglycemia was 33.3%in the small hours.Conclusions The blood glucose fluctuation range in the eight times group is minimum.The many times blood glucose monitoring in type 2 diabetic patients with intensive insulin therapy , at least 3 times daily, can reduce and prevent the incidence of hypoglycemia .

Objective To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78. 57e, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P=0.204), but greater than that of residents (P<0.001). Conclusion Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.