Objective:To investigate the clinical value of adjuvant therapy after conversion resection for pancreatic cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 173 patients with pancreatic cancer who underwent surgical resection after neoadjuvant and/or induction therapy in The First Affiliated Hospital of Naval Medical University from January 2019 to December 2021 were collected. There were 107 males and 66 females, aged (59±9)years. Observation indicators: (1) comparison of clinicopathological data between patients with and without adjuvant therapy after conversion resection for pancreatic cancer; (2) analysis of influencing factors for prognosis of pancreatic cancer after conversion resection; (3) follow-up and prognosis; (4) survival benefit of adjuvant therapy in subgroup populations. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the non-parameter rank sum test. The Graphpad prism 8 software was used to draw survival curves, the Kaplan-Meier method was used to calculate survival time and survival rates, and the Log-Rank test was used for survival analysis. The COX proportional hazards regression model was used for univariate and multivariate analyses. Interaction analysis was used to determine the benefit of adjuvant therapy in subgroup populations. Results:(1) Comparison of clinicopathological data between patients with and without adjuvant therapy after conversion resection for pancreatic cancer. Of the 173 pancreatic cancer patients, there were 108 cases with adjuvant therapy after conversion resection and 65 cases without adjuvant therapy after conversion resection, respectively. Age and body mass index were (58±9)years and (23.2±2.8)kg/m 2 in patients with adjuvant therapy, versus (61±8)years and (22.2±2.8)kg/m 2 in patients without adjuvant therapy, showing significant differences in the above indicators between them ( t=-2.036, 2.200, P<0.05). (2) Analysis of influencing factors for prognosis of pancreatic cancer after conversion resection. Results of multivariate analysis showed that CA19-9 normalization, pathological N staging, degree of tumor differentiation and postoperative adjuvant therapy were independent factors influencing overall survival time in pancreatic cancer patients receiving conversion resection ( hazard ratio=1.598, 1.541, 2.004, 2.571, 95% confidence interval as 1.041-2.453, 1.021-2.327, 1.288-3.118, 1.721-3.843, P<0.05). (3) Follow-up and prognosis. All 173 patients were followed up for 24.5(5.0,52.0)months. The postoperative median overall survival time of 173 patients was 28.9(5.7,51.9)months, and the 1-, 2-, 3-year overall survival rates were 90%, 59%, 40%, respectively. Of 2019, 2020, 2021, the proportions of patients receiving adjuvant therapy after conversion resection were 62.8%(27/43), 57.7%(30/52) and 65.4%(51/78) respectively. The postoperative median overall survival time was 42.2(8.8,49.7)months in patients with adjuvant therapy after conversion resection, versus 20.4(5.7,51.9)months in patients without adjuvant therapy after conversion resection, showing a significant difference between them ( χ2=29.893, P<0.05). (4) Survival benefit of adjuvant therapy in subgroup populations. Results of interaction analysis showed that in subgroup populations with CA19-9 normalization, pathological stage N0, pathological stage N1-2, moderate to well differentiated tumors, adjuvant therapy after conversion resection can bring a better survival benefit for patients with pancreatic cancer ( adjustment hazard ratio=0.220, 0.300, 0.410, 0.340, 95% confidence interval as 0.120-0.400, 0.170-0.560, 0.240-0.690, 0.210-0.690). Conclusions:Postoperative adjuvant therapy is an independent factor influencing overall survival time in pancreatic cancer patients receiving conversion resection. Adjuvant therapy after conversion resection can bring additional survival benefits for pancreatic cancer, particularly for patients who respond favorably to neoadjuvant and/or induction therapy.

ObjectiveTo explore the efficacy and safety of Lianhua Qingwen preparation in the treatment of community-acquired pneumonia （CAP）. MethodThe PubMed，Embase，Cochrane Collaboration，CNKI，VIP，and Wanfang Medical Network database （CBM） were systematically searched for all the randomized controlled clinical trials （RCTS） of Lianhua Qingwen Preparation in the treatment of CAP from the establishment of the databases to February 2023. The inclusion criteria were established， and the search results were screened. The risk assessment tool （ROB） scale was used to evaluate the methodological quality of the final included studies， and the R software was used for data integration and meta-analysis. ResultA total of 30 pieces of literature were included，involving 2 800 patients. The combined use of Lianhua Qingwen preparation on the basis of antibiotics and other conventional treatments showed that Lianhua Qingwen preparation could improve the cure rate ［relative risk（RR）=1.32，95% confidence interval（95% CI）［1.23，1.42］，P<0.000 1）］ and shorten the time of fever remission ［Mean difference（MD）=-1.45，95% CI ［-1.93，-0.97］，P<0.000 1］，and the duration of fever reduction was divided into general population and special population subgroups. The results showed that Lianhua Qingwan preparation could shorten the duration of fever reduction （general population MD=-1.51，95%CI ［-2.07，-0.94］，P<0.000 1， special population MD=-1.22，95% CI ［-2.16，-0.29］，P=0.010 6）and does not increase the incidence of adverse reactions（RR=0.85，95%CI ［0.62，1.15］，P<0.000 1）. After nine pieces of virtual literature with negative results were supplemented by the shear compensation method，the cure rate of CAP by Lianhua Qingwan preparation was still improved （RR=1.20，95%CI ［1.13，1.29］，P<0.000 1）. ConclusionThe application of Lianhua Qingwen preparation on the basis of antibiotics in the treatment of CAP can improve the cure rate and shorten the time of fever reduction.

Pulmonary Arterial Hypertension(PAH)is a chronic progressive cardiopulmonary disease.The main pathological changes are vasoconstriction and pulmonary artery proliferative remodeling and right ventricular hypertrophy.Further exploration of the pathogenesis of PAH can reveal that its related pathways include vascular proliferation,vascular wall remodeling,oxidative stress,inflammatory response and gene regulation.Although great progress has been made in the treatment of PAH in recent years,the mortality rate is still high,current clinical treatments have not effectively improved the prognosis,and the disease has great impact on the physical,social,work and emotional aspects of patients.This article will review the latest research on the treatment of PAH,aiming to provide new clues for the clinical treatment of PAH.

Objective: To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students. Methods: Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors. Results: The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05. Conclusion Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.