OBJECTIVE To evaluate the clinical value of anlotinib in third-line treatment for patients with advanced non-small cell lung cancer （NSCLC） through real-world data. METHODS Clinical data of patients with advanced NSCLC who received treatment at the First Affiliated Hospital of Anhui University of Chinese Medicine from February 2021 to December 2024 were retrospectively collected. They were divided into anlotinib group （27 cases， receiving anlotinib therapy） and immunotherapy group （22 cases， receiving immunotherapy agents alone or in combination with chemotherapy drugs） according to treatment regimens. The progression-free survival （PFS） and overall survival （OS） of patients were compared between the two groups， and the occurrence of adverse drug reactions during the treatment period was recorded. Using a partitioned survival model， an economic evaluation of the two treatment regimens was conducted with a cost-utility analysis approach from the perspective of the healthcare system. RESULTS The median PFS and OS of patients in the anlotinib group were 5.93 months and 11.27 months， respectively； the median PFS and OS of patients in the immunotherapy group were 5.33 months and 9.77 months， respectively； the difference was not statistically significant （P＞0.05）. There was no statistical difference in the total incidence of adverse drug reactions and grade 3-4 serious adverse drug reactions between the two groups （P＞0.05）. Compared with the immunotherapy group， the incremental cost-effectiveness ratio of the anlotinib group was 1 806 724.60 yuan/quality-adjusted life year （QALY）， which was significantly higher than three times China’s per capita gross domestic product in 2024 （287 247 yuan/QALY）. CONCLUSIONS For third-line treatment of advanced NSCLC patients， the efficacy of anlotinib is no worse than that of immunotherapy alone or in combination with chemotherapy drugs， and the safety of the two groups is comparable. However， anlotinib is not cost-effective.

To compare the effects of advanced bone flap and no bone flap on the healing of osteotomy gap in open-wedge high tibial osteotomy (OW-HTO) for the treatment of medial compartment osteoarthritis and knee inversion.Methods:A retrospective study was conducted to analyze the 85 patients who had undergone OW-HTO from March 2021 to December 2021 at Trauma Emergency Centre, The Third Hospital of Hebei Medical University for medial compartment osteoarthritis and knee inversion. The patients were divided into 2 groups according to whether bone flap was grafted. In group A of 42 patients who received advanced bone flap intraoperatively, there were 32 females and 10 males with an age of (63.7±6.6) years; in group B of 43 patients who received no advanced bone flap intraoperatively, there were 31 females and 12 males with an age of (63.2±9.4) years. The measures recorded and compared between the 2 groups included: osteotomy gap healing rates at 3, 6, 12, and 18 months postoperatively; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS) for pain, and Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 and 18 months postoperatively; medial proximal tibial angle (MPTA) and femorotibial angle at immediate postoperation and 18 months postoperation; postoperative complications.Results:The differences in preoperative general information between the 2 groups were not statistically significant, showing comparability ( P>0.05). The osteotomy gap healing rates at 3, 6, 12, and 18 months postoperatively in group A were significantly higher than those in group B ( P<0.05). The WOMAC (26.1±5.9), VAS (4.1±1.4), and KOOS (47.0±9.7) scores at 6 months postoperatively in group A were significantly lower than those in group B (31.3±8.3, 4.8±1.6, and 56.1±11.9) ( P<0.05), but the differences in the above indicators between the 2 groups at 18 months postoperatively were not statistically significant ( P>0.05). There was no statistically significant difference in MPTA or femorotibial angle at immediate postoperation between the 2 groups ( P>0.05). At 18 months postoperatively, the MPTA in group A (88.7°±1.1°) was significantly better than that in group B (87.7°±1.5°) ( P<0.05). The total complication rate in group B [27.9% (12/43)] was signifcantly higher than that in group A [2.4% (1/42)]( P<0.05). Conclusions:In the OW-HTO treatment of the patients with medial compartment osteoarthritis and knee inversion, application of an advanced bone flap to fill the osteotomy gap can accelerate the gap healing and reduces occurrence of delayed healing or non-healing of the osteotomy gap.

OBJECTIVE To provide a reference for the definition of the legal attributes of the provincial Chinese herbal pieces processing norms and the improvement of legal expression for the drug standards in Drug Administration Law. METHODS Based on the legal evolution of local drug standards in China， the composition of national drug standards for Chinese herbal pieces and the composition of current provincial Chinese herbal pieces processing norms were analyzed； at the same time， based on the method of legal interpretation， the legal connotation of the provincial Chinese herbal medicine processing norms in Drug Administration Law was investigated. RESULTS & CONCLUSIONS In the practice of drug supervision， the provincial Chinese herbal pieces processing norms are essentially local drug standards. The newly revised Drug Administration Law defines the drug standards specifically， but does not stipulate the legal attribute of drug standards for the provincial Chinese herbal pieces processing norms， and there are certain legislative technical defects. It is suggested that when amending the Drug Administration Law， the legal attributes of the drug standards of the provincial Chinese herbal medicine processing norms should be clarified.

OBJECTIVE To explore the therapeutic effect and safety of Maiwei Yangfei Decoction(MWYF)in the treatment of idiopathic pulmonary fibrosis of qi-yin deficiency type.METHODS A total of 58 patients with idiopathic pulmonary fibrosis of qi-yin deficiency type were randomly divided into an experimental group and a control group with 29 cases in each group according to a 1:1 ratio.Two cases dropped out of the experimental group and three cases dropped out of the control group.The control group received standardized treatment of Western medicine,and the experimental group received MWYF on the basis of the treatment of the control group.The treatment course of both groups was 3 months.The TCM syndrome score,lung function,6-minute walking distance(6MWD),transcutaneous blood oxygen saturation(SpO2),high-resolution computed tomography(HRCT)score,St.George's respir-atory questionnaire(SGRQ)score and serum sialoglycoprotein antigen(KL-6)level of the two groups were compared before and after treatment.Blood routine and liver and kidney function of the two groups were detected before and after treatment,and the occurrence of adverse reactions during treatment was recorded.RESULTS After treatment,the total score of TCM syndrome of the two groups was significantly improved(P<0.01),and the experimental group was better than the control group(P<0.01);the DLCO%of the experi-mental group increased(P<0.05),and the experimental group was higher than the control group(P<0.05).The experimental group showed significant improvement in 6MWD,HRCT grid shadow,SGRQ symptom score and total score,and serum KL-6 level(P<0.05,P<0.01),which was better than the control group(P<0.05,P<0.01).No serious adverse events occurred in either group dur-ing the treatment.CONCLUSION MWYF combined with standardized Western medicine treatment can effectively improve the clini-cal symptoms of patients with idiopathic pulmonary fibrosis of qi-yin deficiency type,reduce the expression level of serum KL-6,and has a definite effect and good safety.

Objective To screen differentially-expressed circRNA in plasma exosomes of patients with non-small cell lung cancer(NSCLC)and verify its diagnostic value for NSCLC.Methods The plasma exosomes of six patients with NSCLC and six healthy people were analyzed by circRNA sequencing.The expression of hsa_circ_0052513 in plasma exosomes of 60 NSCLC patients and 60 healthy controls was detected by qRT-PCR.The expression level of hsa_circ_0052513 in plasma exosomes of NSCLC patients before and after surgery was detected by qRT-PCR.The correlation between the expression of plasma exosomal hsa_circ_0052513 and clinical data of patients with NSCLC was statistically analyzed.Results Sequencing results showed that the expression of hsa_circ_0052513 in the plasma exosomes of NSCLC patients was higher than that of healthy controls,and the results were confirmed by qRT-PCR.Hsa_circ_0052513 was decreased in patients with NSCLC after tumor resection(P<0.05).The high expression of plasma exosomal hsa_circ_0052513 in patients with NSCLC was correlated with tumor size,distant metastasis,and TNM stage of NSCLC(all P<0.05).The area under the curve of plasma exosomal hsa_circ_0052513 in the diagnosis of patients with NSCLC was 0.7904(P<0.0001).Conclusion Hsa_circ_0052513 is highly expressed in the plasma exosomes of patients with NSCLC and is related to tumor size,metastasis,and TNM stage.Hence,Hsa_circ_0052513 could be a new diagnostic marker for NSCLC.

Objective To explore the effectiveness of Guasha therapy with Fufu Tongbian in treating cancer-related insomnia(CRI)and seek a new approach to managing CRI.Methods Sixty patients with CRI who were admitted to the oncology department of our hospital from July 2021 to July 2022 were engaged in the study.The patients were randomly divided equally into two groups by using the PROCPLAN process in SAS software.The patients in the control group were given conventional symptomatic treatment and the patients in the trial group were managed with Guasha therapy with Fufu Tongbian in addition to the conventional symptomatic treatment.The two groups were compared in terms of clinical efficacy as well as scores by the Pittsburgh sleep quality index(PSQI),Hamilton depression scale(HAMD),and Hamilton anxiety scale(HAMA)were compared after 2 courses of treatment.Results All patients had completed the study.The trial group exhibited significantly higher total effective rate and presented significantly lower scores on PSQI,HAMD and HAMA compared to the control group(all P＜0.001).Conclusion Guasha therapy with Fufu Tongbian can improve sleep condition of CRI patients and alleviate their depression and anxiety,thus improving sleep quality of CRI patients.

Objective:To investigate the characteristics of attention bias to aggressive information under self-threat priming in college students with different types of high self-esteem.Methods:A total of 650 college students were selected,and high self-esteem participants were selected through the Self Esteem Scale(SES).Then,43 partic-ipants were selected from different types of high self-esteem(fragile and safe)groups through the Implicit Associa-tion Test(IAT).Each group participated in Raven's Standard Progressive Matrices(SPM)with different difficulty levels to complete self-threat priming,and then completed the spatial cue experiment.When the cue was invalid,the attention bias was obtained according to the variation of the reaction time difference(RTI)between the subjects're-sponses to aggressive words and neutral words.Results:The RTI values of the fragile high self-esteem group were higher under high self-threat priming than that of the secure high self-esteem group(P＜0.01).Under low self-threat priming,there was no significant difference in RTI values among different types of high self-esteem groups(P＞0.05).Conclusion:Fragile high self-esteem group are more likely to develop attention bias towards aggressive words under high self-threat priming than that of secure high self-esteem group.

Objective:To compare the clinical efficacy of fluorescent laparoscopy versus conventional laparoscopy for living-donor hepatectomy and explore the application value of fluorescent cholangiography in pediatric living donor liver transplantation (LT) using left lateral lobe.Methods:From October 2016 to August 2023, retrospective analysis was conducted for the relevant clinical data from 302 recipients of laparoscopic left lateral lobe donor hepatectomy. There were 90 cases in conventional laparoscopy group and 212 cases in fluorescent laparoscopy group. After propensity score matching (PSM), 88 patients were enrolled into each group. The perioperative data such as operative duration, donor liver thermal ischemic time, number of graft bile duct openings, liver function parameters and complication rates at Day 1/3 postoperation of donors and recipients were compared between two groups. SPSS 27.0 statistical software was utilized for analysis. Independent sample t, Mann-Whitney U and chisquare tests were utilized for examining the inter-group differences. Results:In fluorescent laparoscopy group, the proportion of grafts with a single open left hepatic duct was 84.1 %(74/88) versus 70.5% (62/88) in conventional laparoscopy group with statistically significant difference ( P=0.031). No statistically significant inter-group differences existed in postoperative liver function recovery or short-term postoperative complications ( P>0.05 ). No statistically significant inter-group differences existed in short-term postoperative liver function recovery or hospitalization length ( P> 0.05). In terms of biliary complications, fluorescent laparoscopy group had no biliary complications while the incidence of biliary complications was 3.4% (3/88) in conventional laparoscopy group. However, inter-group difference was statistically insignificant ( P>0.05 ) . Conclusions:Living-donor LT using left lateral lobe under fluorescent laparoscopy may enhance the surgical safety for both donors and recipients.

Objective:To recognize the overall situation of the core competency of medical professional postgraduate, analyze the advantages and disadvantages of the training process, and provide basis for better optimization and revision of training objectives and training plans.Methods:An anonymous online questionnaire was conducted among 264 postgraduates majoring in clinical medicine to recognize the cognition and self-evaluation of core competence, and analyze the differences in scores of different grades and types. SPSS 23.0 was used for independent-samples t test; and one-way analysis of variance to analyze categorical variables. Results:The doctoral degree students' core competency results were higher than those of master degree students, and those of the senior students were higher than junior students ( P<0.05). "System Improvement Ability" [master degree students (2.94±1.07), first-year students (2.82±0.97)], "Patient Management" [(first-year students (2.77±1.22)], "Academic Research" [first-year students (2.90±1.03)], and 4 other indicators were the weakness of students (all less than 3 scores). Conclusion:The students have a good sense of professional identity for doctors. The different depth of the clinical practice education is the possible cause which brings about the differences among students with different degrees. We should focus on strengthening the training for the "shortcomings" in the core competence of students.

Objective:To analyze the situation of doctoral enrollment work in Peking Union Medical College Hospital after the change of enrollment mode from "unified enrollment examination" to "application-assessment" system, and summarize the enrollment work.Methods:The information of candidates in two different enrollment methods of the unified enrollment examination in 2016 and the application-assessment system in 2017 and 2018 was collected and compared. The opinions of doctoral candidates in 2018 on the application-assessment system were collected by questionnaires. Excel 2016 was used to input data for descriptive statistical analysis and SPSS 20.0 was used to analyze the quantitative data by chi-square tested and t-tested.Results:Since 2016, the total number of candidates applying for Peking Union Medical College Hospital has shown a downward trend, and the age of candidates has shown a trend towards younger age. However, there was no statistical difference in candidate's gender, source of students, and their Master's Graduation Schools. Only among the 2017 and 2018 academic degree candidates, there was a statistical difference in scores between the freshman and the previous student ( P=0.025). The results of the questionnaire showed that students were highly satisfied with "application-audit" system of Peking Union Medical College Hospital (82.54%, 52/63). More than 90.00% of the students agreed with the evaluation indexes. Additionally, 85.71%(54/63) of students suggested that professional and academic types use different enrollment evaluation indicators, which could fully reflect the quality of professionalism and the training potential of cultivation. Conclusion:The change of enrollment model from "unified admission examination" to "application-audit" system has little impact on the candidates of Peking Union Medical College Hospital. In the process of implementing the "application-assessment" system, the Educational Management Department of Peking Union Medical College Hospital has actively explored the system construction and standardization process, and supervised the whole enrollment process, which has gained the trust and recognition of candidates as well as high student satisfaction.