Endocrine therapy is mainly used as preoperative neoadjuvant therapy and postoperative adjuvant therapy for breast cancer patients and as salvage therapy for advanced breast cancer patients.Osteoporosis is the common adverse reaction of endocrine therapy for breast cancer,which seriously affects the quality of life of the patients.The theory of"liver and kidney sharing the common source"is closely related to the etiology,pathogenesis and therapeutic principle of osteoporosis.It is believed that the pathogenesis of endocrine therapy associated osteoporosis in breast cancer is most closely related to liver and kidney,and is characterized by deficiency in origin and excess in superficiality.Deficiency in origin manifests as deficiency of liver and kidney,and excess in superficiality manifests as blood stasis blocking collaterals.Chinese herbal medicine with the actions of nourishing liver and kidney can be used for interventions of various stages of endocrine therapy for breast cancer.In the stage of preoperative neoadjuvant therapy,Chinese herbal medicine intervention focuses on inhibiting cancer,so as to achieve synergistic anticancer actions with neoadjuvant therapy;the intervention can also be supplemented by medicine for supporting healthy qi with modified Liuwei Dihuang Pills,thus to reduce the incidence of adverse reactions.In the stage of postoperative adjuvant therapy,Chinese herbal medicine intervention focuses on supporting healthy qi,so as to promote the recovery of body functions and prevent the occurrence of osteoporosis,and modified treatment with Duhuo Jisheng Decoction or Zuogui Pills can be chosen.In the advanced stage of salvage treatment,Chinese herbal medicine intervention focuses on supporting healthy qi,and medicines for nourishing liver and kidney,strengthening muscles and bones,and activating qi and blood circulation to relieve pain can be chosen;in addition,medicinals with affinity to flesh and blood can be added to enhance the actions of nourishing liver and kidney.

Objective To investigate the correlation between indocyanine green(ICG)fluorescence imaging and lymph node metastasis of bladder cancer and its application value.Methods The clinicopathological data of 35 patients with bladder cancer(T1-T4aNxM0)treated in our hospital during Jun.2019 and Mar.2023 were collected.All patients underwent ICG submucous injection,and those with successful imaging received lymph node dissection under fluorescent guidance.After that,the remaining lymph tissue was cleared according to the standard lymph node dissection range,and the resected lymph tissue was subassembled for examination.Patients with non-imaging underwent standard pelvic lymph node dissection according to the routine procedure.Intraoperative lymph node imaging areas were recorded,and postoperative lymph node pathological data were collected.The correlation between fluorescence imaging patterns and lymph node metastasis in patients with different stages of bladder cancer was analyzed with correlation coefficients.Results The ICG fluorescence imaging rate was 91.43％(32/35),and there was no statistically significant difference in the imaging rate among patients with different stages of bladder cancer(P＞0.05).The fluorescence imaging range was significantly correlated with the stage(C=0.351,P=0.034).There was a significant correlation between the imaging range and lymph node metastasis in early-stage patients(C=0.619,P=0.022),but there was no significant difference in the lymph node metastasis rate in advanced patients with different imaging range(P＞0.05).In patients with full staging,the sensitivity of lymph nodes to predict metastasis was 60.00％(6/10),and the negative predictive value was 84.62％(22/26).In early-stage patients,the sensitivity and negative predictive value were 50.00％(1/2)and 93.75％(15/16),respectively.In advanced-stage patients,they were 62.50％(5/8)and 70.00％(7/10),respectively.Conclusion ICG fluorescence imaging rate of tracing lymph node metastasis is high,and the imaging range is significantly related to the tumor stage.For patients with early-stage(T1-T2)bladder cancer,the range of imaging helps to predict the risk of lymph node metastasis and guide the extent of lymph node dissection.Resection of multi-area imaged lymph nodes can comprehensively evaluate the lymphatic metastasis status of early-stage patients.

Objective To investigate the correlation between indocyanine green(ICG)fluorescence imaging and lymph node metastasis of bladder cancer and its application value.Methods The clinicopathological data of 35 patients with bladder cancer(T1-T4aNxM0)treated in our hospital during Jun.2019 and Mar.2023 were collected.All patients underwent ICG submucous injection,and those with successful imaging received lymph node dissection under fluorescent guidance.After that,the remaining lymph tissue was cleared according to the standard lymph node dissection range,and the resected lymph tissue was subassembled for examination.Patients with non-imaging underwent standard pelvic lymph node dissection according to the routine procedure.Intraoperative lymph node imaging areas were recorded,and postoperative lymph node pathological data were collected.The correlation between fluorescence imaging patterns and lymph node metastasis in patients with different stages of bladder cancer was analyzed with correlation coefficients.Results The ICG fluorescence imaging rate was 91.43％(32/35),and there was no statistically significant difference in the imaging rate among patients with different stages of bladder cancer(P＞0.05).The fluorescence imaging range was significantly correlated with the stage(C=0.351,P=0.034).There was a significant correlation between the imaging range and lymph node metastasis in early-stage patients(C=0.619,P=0.022),but there was no significant difference in the lymph node metastasis rate in advanced patients with different imaging range(P＞0.05).In patients with full staging,the sensitivity of lymph nodes to predict metastasis was 60.00％(6/10),and the negative predictive value was 84.62％(22/26).In early-stage patients,the sensitivity and negative predictive value were 50.00％(1/2)and 93.75％(15/16),respectively.In advanced-stage patients,they were 62.50％(5/8)and 70.00％(7/10),respectively.Conclusion ICG fluorescence imaging rate of tracing lymph node metastasis is high,and the imaging range is significantly related to the tumor stage.For patients with early-stage(T1-T2)bladder cancer,the range of imaging helps to predict the risk of lymph node metastasis and guide the extent of lymph node dissection.Resection of multi-area imaged lymph nodes can comprehensively evaluate the lymphatic metastasis status of early-stage patients.

Objective To investigate the clinical value of fiber nasopharyngoscope applied in adenoid hypertrophy(AH)combined with allergic rhinitis(AR)in children.Methods Clinical data of 174 pediatric patients from January 2021 to March 2024 was collected and analyzed.Among them,129 cases were diagnosed with AH via fiber nasopharyngoscope examination(79 cases with AR were assigned to the AH with AR group,the remaining 50 cases of simple AH without AR were assigned to the AH group),and 45 cases of simple AR without AH through fiber nasopharyngoscope examination were assigned to the AR group.And 25 healthy children who came to our pediatric health department for health examinations during the same period were selected as the healthy control(HC)group.On the day of admission,all subjects underwent lateral X-ray examination of the nasopharynx,and the ratio of the maximum thickness of adenoids to the anterior posterior diameter of the nasopharynx cavity(A/N ratio)was calculated.Meanwhile their of peripheral blood eosinophil(EOS)percentage,serum interleukin-17(IL-17),and tumor necrosis factor-α(TNF-α)levels were tested.The A/N ratio,peripheral blood EOS percentage,serum IL-17 and TNF-α levels were compared among the AH with AR group,AH group,AR group,and HC group.The A/N ratio,peripheral blood EOS percentage,serum IL-17 and TNF-α levels of children with different degrees of adenoid obstruction under fiber nasopharyngoscope were compared in AH and AR group.Spearman correlation coefficient was used to analyze the correlation between the degree of adenoid obstruction under fiber nasopharyngoscope and the levels of peripheral blood EOS percentage,serum IL-17 and TNF-α in children from AH and AR group.Result A/N ratio:the value in AH with AR group was higher than that in AH group(P＜0.05),the value in AH group was higher than that in AR group(P＜0.05),and the value in AR group was higher than that in HC group(P＜0.05).Peripheral blood EOS percentage,serum IL-17 and TNF-α levels:AH with AR group had higher levels than those in AR group(P＜0.05),AR group had higher levels than those in AH group(P＜0.05),and AH group had higher levels than those in HC group(P＜0.05).The A/N ratio,peripheral blood EOS percentage,serum IL-17 and TNF-α levels in children with adenoid obstruction degree Ⅲ～Ⅳ under fiber nasopharyngoscope in the AH group were significantly higher than those in children with degree Ⅰ～Ⅱ(P＜0.05).Spearman correlation analysis showed that the degree of adenoid obstruction under fiber nasopharyngoscope in children with AH accompanied by AR significantly positively correlated with peripheral blood EOS percentage,serum IL-17 and TNF-α levels(r values were 0.527,0.451,and 0.402 respectively,P＜0.05).Conclusion Fiber nasopharyngoscope can be used for the diagnosis of AH with AR in children,and can be positive in determining severity of the patient's condition when combined with peripheral blood EOS percentage,serum IL-17 and TNF-α levels.

Discipline construction is the power source to realize the high quality development of public hospitals,and high quality scientific research management is the inevitable path to realize the connotative development of public hospitals.The quality improvement of scientific research project process management is step-by-step,and mid-term inspection is a representative work.This paper applies PDCA cycle theory to the mid-term inspection of scientific research projects,analyzes the problems encountered in the mid-term inspection of scientific research projects from the four stages of plan,implementation,check and act,and develops effective intervention measures.The mid-term inspection mode,which combines publicity activities of scientific research norms with self-examination by researchers and on-the-spot inspection by the scientific research department,should be carried out to standardize the process of mid-term inspection of scientific research projects and promote the high-quality development of scientific research in hospitals.

In recent years， the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine （TCM） in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine， the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances， TCM theories of etiology and pathogenesis， the role and advantages of TCM in the whole course management of pulmonary nodules， contents and methods of research on pulmonary nodules， and science popularization work， aiming to provide a reference for clinical practice and scientific research. After discussion， the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness， blood stasis， and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules， improving physical constitution， ameliorating multi-system nodular diseases， reducing anxiety and avoiding excessive diagnosis and treatment， and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present， the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed， which needs to be further studied from multiple perspectives such as clinical epidemiology， biology， and evidence-based medicine. The primary task of current research is to find out the advantages， effective prescriptions， and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time， basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized， scientific， and accurate effective diagnosis and treatment.

Objective To investigate whether chemokine CCL2(also known as monocyte chemotactic protein 1 or MCP-1)has a causal relationship with lung cancer.Methods Genetic data of chemokine CCL2 and different pathological subtypes of lung cancer were extracted from genome-wide association studies(GWAS),and inverse-variance weighted(IVW)analysis was used as main analysis,while weighted median,simple model,MR-Egger regression,and weighted model were chosen as supplementary analyses.Sensitivity analyses were performed to verify the reliability of the data.Results The result of IVW analysis on chemokine CCL2 to lung adenocarcinoma was OR = 1.065,95%CI(0.919～1.234),P = 0.401.The result of IVW analysis on chemokine CCL2 to squamous cell lung carcinoma was OR = 1.059,95%CI(0.931～1.205),P = 0.381.The result of IVW analysis on chemokine CCL2 to small cell lung carcinoma was OR = 0.959,95%CI(0.760～1.208),P = 0.720.Conclusions There is no direct causal relationship between chemokine CCL2 and lung cancer.

The discussion and research on the clinical dominant diseases of traditional Chinese medicine （TCM） have attracted increasing attention. Through approaches including modern technology， evidence-based medical methods， and multi-disciplinary treatment， we should construct a sound TCM inheritance and innovation system， establish a collaborative innovation mechanism， and integrate major research projects， striving to make breakthroughs in TCM theory， methodology， standards， and regulation system， promoting the scientific and technological progress of TCM， and thereby improving its curative effect. The China Association of Chinese Medicine （CACM） carried out a series of youth salon seminars for clinical dominant diseases in TCM， discussing and sorting out the advantages of the dominant diseases in clinical diagnosis and treatment of TCM and integrated traditional Chinese and western medicine in specific diseases or fields. Authoritative experts in the industry were invited to give comment and guidance to form a report. Centering on clinical research of dominant diseases， thematic research was carried out in the aspects of practice， human experience-based evidence， and transformation path. Through the systematic study of the dominant diseases， the advantages of TCM in different stages of disease treatment were excavated to constantly improve the prevention and treatment ability of TCM and carry forward the advancement of TCM theory and practice. At the same time， the communication and understanding between traditional Chinese and western medicine were improved， laying the foundation for the further formation of industry guidelines or consensus and comprehensive promotion. These seminars are expected to provide references for the development of policy planning， clinical diagnosis and treatment， health economy， and social services in TCM and lay the foundation for the formation of a new modern diagnosis and treatment system with Chinese characteristics.

ObjectiveTo observe the effect of the Fangfeng Tongshengsan on post-chemoembolization syndrome with primary liver cancer or postoperative liver metastases of colorectal cancer. MethodSeventy-two patients suffered from post-chemoembolization syndrome after transcatheter hepatic arterial chemoembolization were randomly divided into 2 groups， including a Fangfeng Tongshengsan group and a control group， with 36 patients in each group. The patients in Fangfeng Tongshengsan group orally took the decoction for consecutive 7 d. The patients in the control group were physically cooled down with alcohol rub bath and ice pack for consecutive 7 d. Furthermore， the difference of fever， Karnofsky performance status （KPS）， pain in the liver region， nausea vomiting， constipation， and liver function between these two groups were observed. ResultCompared with the control group， Fangfeng Tongshengsan significantly relieved fever， reduced the body temperature （P<0.05）， and shortened the duration of fever （P<0.05）， indicating that Fangfeng Tongshengsan remarkably improved the KPS （P<0.05）. Meanwhile， Fangfeng Tongshengsan obviously alleviated nausea， vomiting， and constipation status and shortened the duration time compared with the control group （P<0.05）. In addition， the parameters of liver function including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ-glutamyl transpeptidase （GGT）， and total bilirubin （TBIL） were significantly decreased in the Fangfeng Tongshengsan group （P<0.05）， which indicated that Fangfeng Tongshengsan alleviated liver dysfunction of patients with post-chemoembolization syndrome. ConclusionFangfeng Tongshengsan can be used to treat post-chemoembolization syndrome with primary liver cancer and postoperative liver metastases of colorectal cancer.

Objective To clarify the distribution of etiological factors in elderly versus non-elderly outpatients with vertigo/dizziness for optimizing the diagnosis and therapy. Methods We retrospectively analyzed data of outpatients with vertigo/dizziness in Shaanxi Provincial People's Hospital from April 2015 to April 2017 and conducted diagnoses in accordance with the currently wide-accepted diagnostic criteria. Results A total of 3 356 patients with chief complains of vertigo/dizziness were recruited ,and their top seven etiological factors were benign paroxysmal positional vertigo (n＝ 1 320 ,39.3%) ,chronic subjective dizziness(n＝680 ,20.3%) ,vestibular migraine(n＝386 ,11.5%) ,posterior circulation ischemia (n＝213 ,6.4%) ,Meniere's disease (n ＝ 138 ,4.1%) ,vestibular neuritis (n＝ 121 ,3.6%) ,and vestibular paroxysmia(n＝76 ,2.3%). The top four etiological factors for the elderly patients (n＝1 255)were benign paroxysmal positional vertigo (n＝ 498 ,39.7%) ,chronic subjective dizziness (n＝ 279 ,22.2%) ,posterior circulation ischemia(n＝161 ,12.8%) ,and vestibular migraine(n＝73 ,5.8%) ;while the top four etiological factors for non-elderly patients (n＝ 2 101)were benign paroxysmal positional vertigo (n＝ 822 ,39.1%) , chronic subjective dizziness(n＝401 ,19.1%) ,vestibular migraine(n＝313 ,14.9%) ,and vestibular neuritis(n＝105 ,5.0%). The detection rate in elderly patients versus non-elderly patients was significantly higher in chronic subjective dizziness (22.2% vs.19.1%,P＝ 0.032 )and in posterior circulation ischemia (12.8%vs.2.5%,P＝0.000) ,and was significantly lower in vestibular neuritis (1.3% vs.5.0%,P＝ 0.000 ) ,in vestibular migraine(5.8% vs.19.4%,P ＝ 0.000)and in other causes (1.0% vs.2.7%,P ＝ 0.002) . Conclusions The ratio of posterior circulation ischemia is markedly higher in elderly outpatients than in non-elderly outpatients ,whereas the ratios of vestibular migraine and vestibular neuritis in elderly patients are lower than in non-elderly outpatients.