BackgroundCompared with adult-onset schizophrenia， patients with adolescent-onset schizophrenia experience a high genetic susceptibility， severe negative symptoms， high recurrence rate， poor prognosis and social function recovery. And clarifying the brain functional alterations in adolescent-onset schizophrenia is of great significance for further elucidating the pathogenesis of the disease and exploring personalized and precise treatment. ObjectiveTo investigate the altered functional and effective connectivity of bilateral precuneus in first-episode patients with adolescent-onset schizophrenia based on resting-state functional magnetic resonance imaging （rs-fMRI）， thus providing reliable imaging evidence in guiding the study on mechanism involved in adolescent-onset schizophrenia. MethodsTwenty-one drugnaïve first-episode patients with adolescent-onset schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） criteria for schizophrenia were enrolled， and another 21 psychiatrially healthy controls matched on age， educational background and gender were concurrently selected. The schizophrenic subjects were evaluated using the Psychotic Symptom Rating Scales （PSYRATS） and Positive and Negative Symptom Scale （PANSS）. All participants underwent rs-fMRI scans， and the whole-brain seed-based functional and effective connectivity analyses were conducted in bilateral cuneus region. Then the correlation between functional connectivity strength and clinical symptoms of patients was discussed. ResultsIn terms of functional connectivity， the functional connectivity of bilateral precuneus and left middle temporal gyrus was increased in patient group compared with healthy control group ［P<0.01， family-wise error （FWE） correction at cluster level， P<0.05］. In terms of effective connectivity， patient group responded to negative feedback with greater activation of seed region and left middle frontal gyrus than healthy control group. Correlation analysis within patient group denoted that the decreased effective connectivity of bilateral precuneus and left middle frontal gyrus was positively correlated with the total PANSS score （r=0.450， P<0.05）. ConclusionThe resting-state functional and effective connectivity of bilateral precuneus is abnormally alerted in drugnaïve first-episode patients with adolescent-onset schizophrenia， and the decreased effective connectivity of bilateral precuneus and left middle frontal gyrus may be related to the development of clinical symptoms. ［Funded by National Key Research and Development Program of China （number， 2022YFC2009901， 2022YFC2009900）］

OBJECTIVE To discuss medical insurance access and pricing methods for multi-indication drugs. METHODS The access situation of multi-indication drugs in China’s medical insurance negotiation over the years was sorted out. Referring to the economic theory of value-based pricing and the relevant experience of other countries， five applicable pricing methods of 3 categories for multi-indication drug in China were summarized. Taking ceftazidime-avibactam（CAZ-AVI） as an example， cost- utility analyses were performed for different indications， and appropriate pricing methods were applied. RESULTS & CONCLUSIONS All multi-indication drugs in China adopted a single pricing method. The pricing methods that could be explored include product-based pricing， such as single pricing based on the lower-value indication or mixed/weighted single pricing； indication-based pricing， such as developing a new agreement for single pricing under different discounts and listing with different brands and pricing of the same medicine for different indications； and compensation for access restrictions. Each method has its advantages and limitations. The case of CAZ-AVI showed that it is necessary to estimate the value of each indication for multi- indication drugs， and comprehensively consider appropriate access conditions and pricing methods based on value. Although single pricing is simple to operate， it is different to reflect the value entirely. The indication-based pricing and compensation for access restrictions all depend on the information collection system and the cooperation of multiple departments. China is supposed to carry out the value-based pricing of multi-indication drugs and constantly explore reasonable access methods to improve overall social welfare.

Objective:To provide references for standardizing the post-operative aeromedical assessment of heart valve disease of flying personnel by analyzing the pathogenesis characteristics and treatment.Methods:The case data of flying personnel with heart valve disease hospitalized in Air Force Medical Center from November of 2010 to December of 2021 were collected, which was called the clinical group; the relevant cases of heart valve disease in domestic flying personnel reported in the literature were retrieved, which was called the literature group. The retrospective study was carried out and the data was analyzed according to the aircraft type, lesion location, treatment method and identification results.Results:There were 20 cases in the clinical group. According to the number of detected cases, the valve positions order was the aortic valve (12 cases), the mitral valve (7 cases), the tricuspid valve (4 cases, all concomitant), and the pulmonary valve (1 case). The literature group had 11 cases, mainly were aortic valve disease (10 cases) and tricuspid valve (1 case). Most of these aortic valve lesions were based on the pathology of bicuspid aortic valve (BAV). Among the cases of aortic valve disease, 12 cases were flight-qualified, 1 case was restricted flight, 1 case of fighter aircraft was transferred to fly transporter, 3 cases were temporary unqualified for flight, 3 cases were unqualified for flight, and 2 cases were waivered. Among the cases of mitral valve disease, 3 cases were flight-qualified, 4 cases were temporary unqualified for flight, 1 case of tricuspid valve and 1 case of pulmonary valve were qualified for flight.Conclusions:The lesion site of valve is the main factor influencing the aeromedical assessment result. The aortic valve is the most common site of valve disease among flying personnel, and BAV is the most common pathologic type. It should be strengthened physical examination identification and prevention.

Objective:To provide references for standardizing the post-operative aeromedical assessment of heart valve disease of flying personnel by analyzing the pathogenesis characteristics and treatment.Methods:The case data of flying personnel with heart valve disease hospitalized in Air Force Medical Center from November of 2010 to December of 2021 were collected, which was called the clinical group; the relevant cases of heart valve disease in domestic flying personnel reported in the literature were retrieved, which was called the literature group. The retrospective study was carried out and the data was analyzed according to the aircraft type, lesion location, treatment method and identification results.Results:There were 20 cases in the clinical group. According to the number of detected cases, the valve positions order was the aortic valve (12 cases), the mitral valve (7 cases), the tricuspid valve (4 cases, all concomitant), and the pulmonary valve (1 case). The literature group had 11 cases, mainly were aortic valve disease (10 cases) and tricuspid valve (1 case). Most of these aortic valve lesions were based on the pathology of bicuspid aortic valve (BAV). Among the cases of aortic valve disease, 12 cases were flight-qualified, 1 case was restricted flight, 1 case of fighter aircraft was transferred to fly transporter, 3 cases were temporary unqualified for flight, 3 cases were unqualified for flight, and 2 cases were waivered. Among the cases of mitral valve disease, 3 cases were flight-qualified, 4 cases were temporary unqualified for flight, 1 case of tricuspid valve and 1 case of pulmonary valve were qualified for flight.Conclusions:The lesion site of valve is the main factor influencing the aeromedical assessment result. The aortic valve is the most common site of valve disease among flying personnel, and BAV is the most common pathologic type. It should be strengthened physical examination identification and prevention.

BACKGROUND: Thoracoscopic surgery has gradually become the major procedure for lung cancer surgery in our department. Its characteristics are minimal trauma and quick recovery, which make approximately 90% of patients discharge from the hospital after surgery. However, the postoperative complications still happen now and then. We analyzed the patients who had been hospitalized for longer than 7 days after thoracoscopic lung cancer surgery, aiming to summarize the types and risk factors of complications, and improve postoperative safety of patients. METHODS: The data were come from the prospective database of Thoracic Surgery Unit One in Peking Cancer Hospital, and patients that underwent thoracoscopic pulmonary surgery between Jan. 2010 and Dec. 2014 with length of stay more than 7 days were included in the study. The classifications of the complications were investigated and graded as mild or severe complications according to modified Claviengrading, the relationship between clinical factors and degrees of complications was also analyzed. RESULTS: The hospitalization of 115 cases were longer than 7 days after surgery, accounting for 10.3% (115/1,112) of the whole patients that underwent surgery during the same period. Eighty-one cases had mild complications, accounting for 7.3% (81/1,112) of the whole cases that underwent surgery during the same period and 70.4% (81/115) of the cases with prolonged length of stay; the proportions of severe complications in both groups were 3.1% (34/1,112) and 29.6% (34/115), respectively; and the proportions of complications that caused perioperative deaths were 0.18% (2/1112) and 1.7% (2/115), respectively. Among all the postoperative complications, the most common was air leakage for more than 5 days after surgery, with a total of 20 cases (1.8% and 17.4%). The other common complications were: atelectasis (19 cases, 1.7% and 16.5%), pulmonary infection (18 cases, 1.6% and 15.7%), etc. The less common complications was bronchopleural fistula (4 cases, 0.36% and 3.5%) with very high risk, and 2 cases died perioperatively due to the combination of acute respiratory distresssyndrome (ARDS). In the clinical factors, only preoperative low pulmonary function (FEV1%<70%) was the potential risk factor for postoperative severe complications (45.8% vs 23.6%, P=0.038). There was no significant difference either regarding the 5 year disease free survival or the 5 year overall survival between mild complication group and severe complication group, with 5 year DFS being 52.2% and 51.9%, respectively (P=0.894) , and 5 year overall survival being 64.0% and 53.5%, respectively (P=0.673). CONCLUSIONS Continuous postoperative air leakage, atelectasis and pulmonary infections were the major causes for prolonged hospitalization after thoracoscopic surgery for lung cancer, and bronchopleural fistula was the most perilous complications. Patients with low preoperative pulmonary function were more likely to have severe postoperative complication, however, this would not influence the long term survival of the patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Hospitalization ; Humans ; Length of Stay ; Lung Neoplasms ; complications ; surgery ; therapy ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Postoperative Period ; Prospective Studies ; Thoracic Surgery, Video-Assisted

BACKGROUND: Currently, there is no consensus on the follow-up strategy (follow-up time interval and content) of non-small cell lung cancer (NSCLC) in the world, and the relevant clinical evidence is also very limited. In this study, we aimed to summarize the recurrence/metastasis sites and timings of stage I NSCLC patients based on their follow-up data, aiming to provide a basis of follow-up time interval and content for this group of patients. METHODS: We retrospectively analyzed the 416 stage I NSCLC patients that underwent continuous anatomic lobectomy between Jan. 2000 to Oct. 2013 in our prospective lung cancer database. According to the recurrence/metastasis sites and timings, the long term follow-up time interval and content were explored. RESULTS: The 5-yr disease free survival (DFS) and overall survival (OS) in the whole group were 82.4% and 85.4%, respectively. There were 76 cases (18.3%) had recurrence/metastasis during follow-up, among which the most frequent site was pulmonary metastasis (21 cases, 5.0%), followed by brain metastasis (20 cases, 4.8%), bone metastasis (12 cases, 2.9%), and mediastinal lymph node metastasis (12 cases, 2.9%). Among the factors that could influence recurrence/metastasis, patients with pT2a suffered from a higher recurrence/metastasis rate compared to patients with pT1 (P=0.006), with 5-yr DFS being 73.8% and 87.3%, respectively (P=0.002), and the 5-yr OS being 77.7% and 90.3%, respectively (P=0.011). CONCLUSIONS The commonest recurrence/metastasis sites of stage I NSCLC after anatomic lobectomy are lung, brain and mediastinal lymph nodes, the risk of recurrence/metastasis within 2 years were equal to that between 3 years and 5 years. The follow-up frequencies and content within 2 years could be adjusted according to T stages.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; Prospective Studies ; Retrospective Studies ; Young Adult

Objective: To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. Methods: The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (n=56) and traditional tube feeding group (n=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ² test, Fisher exact test and t test, respectively. Results: Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ²=2.393, P=0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (t=7.720, P=0.000); the general enteral complications were significantly lower (26/52 vs. 5/56, χ²=22.225, P=0.000), the nutritional support complete rate was significantly higher (23/52 vs. 55/56, χ²=39.167, P=0.000). Conclusions Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.

Objective To explore the relationship between the MRI enhancement ratios of liver parenchyma in hepatobiliary phase with gadobenate dimeglumine (Gd-BOPTA)and liver function.Methods Fifty-nine patients who underwent Gd-BOPTA-enhanced MRI were retrospectively enrolled in the study.The enhancement ratio of signal to noise ratio and enhancement ratio of the contrast ratio were calculated.The relationships between the enhancement ratio and CTP grading and MELD score were analyzed.Results The signal enhancement ratios in hepatobiliary phase in patients with CTP A classification were higher than those with CTP B classi-fication (P <0.01).Meanwhile,the ratios in patients with MELD scores less than 10 points were higher than those with MELD scores more than 10 points (P <0.01).Conclusion The MR enhancement degree of liver parenchyma in the hepatobiliary phase with Gd-BOPTA may reflect the liver function.

Interleukin-22 (IL-22) is a member of the IL-10 family, which exhibits a similar structure and immune function with IL-10. IL-22 is mainly secreted by Th22, Th1, and Th17 cells, innate lymphoid cells (ILCs), and γδT and NKT cells. IL-22 is mainly in-volved in autoimmune diseases, malignant tumors, and infective diseases. As such, studies have focused on the function of IL-22 cyto-kine in the pathogenesis of various malignant tumors. Studies revealing the expression and pathogenesis of IL-22 in malignant tumors possibly provide a new method to treat and prevent malignant tumors. In our study, the discovery, structural characteristics, and func-tions of IL-22 in malignant tumors are reviewed.

OBJECTIVE: To study the effect of anti-tumor peptide of tumstatin on tumor growth of human laryngeal squamous carcinoma in nude mice and the underlying mechanism. METHOD: Nude mice model bearing laryngocarcinoma were established by using human laryngeal squamous carcinoma cell line (Hep-II). The animals were given tumstatin or PBS for 10 consecutive days. The volumes of the subcutaneous tumor were observed. The microstructure in which the general 2-step immunohistochemical examination was adopted and ultra-micro-structural changes of carcinoma after administration of tumstatin were observed under light and electron microscopes for pathology examination. RESULT: The differences was statistically significant in the net mice weight, tumor weight, tumor volume and tumor weight/net mice weight between the treatment group and the control group (P<0.01). The restrained percentage of tumor was 51.58%. The necrosis and apoptosis of the tumor cells and the angiogenesis reduction were found under light and electron microscope in the treatment group. MVD of the treatment group was lower than that of the control group (P<0.01). CONCLUSION Tumstatin can significantly restrain the development of laryngocarcinoma.
Animals ; Apoptosis ; drug effects ; Autoantigens ; pharmacology ; Carcinoma, Squamous Cell ; pathology ; Cell Line, Tumor ; Collagen Type IV ; pharmacology ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Peptides ; pharmacology ; Xenograft Model Antitumor Assays