Imaging examination is a crucial part in diagnosis and treatment of central nervous system infection(CNSI),involving complex imaging sequences and parameters.This consensus was jointly written by multiple CNSI imaging experts in China,aimed to standardize imaging examination of CNSI.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Objective To establish the fingerprints and predict the quality markers of Sanqi Shenfeng oral liquid based on fingerprint and network pharmacology.Methods The fingerprints of 12 batches of Sanqi Shenfeng oral liquid were established by using HPLC,and their peaks were identified and assigned.The candidate components were selected by multiple statistical analysis methods such as similarity evaluation,hierarchical cluster analysis,principal component analysis and orthogonal partial least squares discrimination analysis(OPLS-DA).The"component-target-pathway"network diagram was constructed by network pharmacology,and the quality markers of Sanqi Shenfeng oral liquid were predicted.Results The 13 common peaks were identified from the established fingerprint.Compared with the reference material,eight common peaks were identified as 3(tetrahydroxystilbene glucoside),5(sodium benzoate),6(lobetyolin),7(notoginsenoside Ri),9(ginsenoside Rgi),10(ginsenoside Re),12(10-hydroxy-2-decenoic acid),13(ginsenoside Rb1).The similarity of 12 batches of Sanqi Shenfeng oral liquid samples was higher than 0.997,and 12 batches of samples were grouped into two categories.OPLS-DA analysis showed that peaks 2,3,4,7,9,10,11,12 were the main signature components affecting the quality of Sanqi Shenfeng oral liquid.Network pharmacology predicted that lobetyolin,notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Re and 10-hydroxy-2-decenoic acid were potential Q-markers of Sanqi Shenfeng oral liquid.The traditional functions are performed through STAT3/AKT1-Drp1,HIF-1 and PI3K-AKT signaling pathway.Conclusion The established fingerprint has good reproducibility,stability and feasibility.The six components have great influence on the quality of Sanqi Shenfeng oral liquid,which are transferable and traceable,and are closely related to the efficacy.They can be used as potential quality markers to provide a scientific basis for the quality control and evaluation of Sanqi Shenfeng oral liquid.

Imaging examination is a crucial part in diagnosis and treatment of central nervous system infection(CNSI),involving complex imaging sequences and parameters.This consensus was jointly written by multiple CNSI imaging experts in China,aimed to standardize imaging examination of CNSI.

Objectives:To investigate the imaging characteristics and incidence rate of nuchal ligament calci-fication in asymptomatic population.Methods:The clinical and imaging data of 318 asymptomatic volunteers were analyzed retrospectively,including the incidence,morphological classification,and segmental distribution of nuchal ligament calcification.The volunteers were divided into two groups based on the presence of nuchal ligament calcification,and differences in gender,age,body mass index(BMD,and lower cervical intervertebral parameters between the two groups were analyzed.Based on the Roussouly classification,differences in cervi-cothoracic parameters between the groups were analyzed.Finally,the correlation between the degree of nuchal ligament calcification and the aforementioned factors was studied to identify the risk factors for nuchal liga-ment calcification.Results:Among the 318 asymptomatic subjects,the incidence of nuchal ligament calcifica-tion was 23.27％.There were statistically significant differences in gender ratio,age,and BMI between the calcification of nuchal ligament group(ONL+)and non-calcification of nuchal ligament group(ONL-)(P＜0.001).The calcification of nuchal ligament was classified morphologically as follows:Local calcification 50.0％,con-tinuous calcification 27.0％,segmental calcification 7.0％,mixed calcification 9.0％and unclassified calcifica-tion 7.0％.The incidence of nuchal ligament calcification in each segment was as follows:C2/3 1.4％,C3/49.5％,C4/5 55.4％,C5/6 63.5％,and C6/7 18.9％.Compared with the ONL-group,the angular displacement(AD)and horizontal displacement(HD)of the ONL+group were significantly increased(P＜0.001).Based on the Roussouly classification,significant statistical differences in cervicothoracic parameters such as O-C2,C2-C7 SVA,and T1 slope(TS)were found between the ONL+group and the ONL-group(P＜0.05).Pearson correlation analysis showed that the degree of nuchal ligament calcification had a moderate correlation with AD,O-C2,and C2-C7 SVA,and a strong correlation with HD and TS.Multivariate logistic analysis revealed that HD was the most significant risk factor for nuchal ligament calcification,followed by O-C2,age,and AD.Conclusions:The incidence of nuchal ligament calcification was higher in asymptomatic men who were older and had a high body mass index.Cervicothoracic parameters(O-C2,C2-C7 SVA and TS)and segmental parameters(AD,HD)were significantly increased in the group of nuchal ligament calcification,and were correlated with the degree of nuchal ligament calcification.

Objective:To investigate the efficacy of different treatment modes for locoregional recurrence after nephrectomy in patients with renal cell carcinoma.Methods:A total of 106 patients with locoregional recurrence after nephrectomy without distant metastasis (77 males and 29 females) admitted to Sun Yat-sen University Cancer Center from October 2001 to July 2020 were retrospectively analyzed. The median age was 51 (40, 60) years old. Radical nephrectomy was performed in 90 patients with primary tumor and partial nephrectomy was performed in 16 patients. Pathological diagnosis showed that 54 cases were clear cell carcinoma and 52 cases were non-clear cell carcinoma. 53 cases were in stage T 1-2 and 53 cases in stage T 3-4. The median diameter of recurrent lesions was 3.2 (2.0, 6.3) cm, and the median number was 2 (1, 4). The recurrence sites were divided into renal fossa recurrence (33 cases), renal fossa±retroperitoneal lymph node recurrence (38 cases), and intra-abdominal spread (35 cases). The median duration from primary surgery to local recurrence was 14.8 (7.3, 35.8) months. Two treatment groups were identified as systemic therapy alone (Group A) and local therapy with or without systemic therapy (Group B). The Kaplan-Meier method was used to compare the progression free survival (PFS) and overall survival (OS) between Group A and Group B. The Cox model was used to perform univariate and multivariate analysis. Results:Of all the 106 patients, 33 patients were in Group A and 73 patients were in Group B. In Group A, 29 patients (87.9%) received targeted therapy, and 4 patients (12.1%) received targeted therapy combined with immunotherapy. In Group B, 34 patients (46.6%) received surgery or ablation and 39 patients (53.4%) received SBRT, of which 62 patients (84.9%) received concurrent systemic therapy. Among them, 58 patients (93.5%) received targeted therapy, and 4 patients (6.5%) received targeted therapy combined with immunotherapy. The median follow-up period was 29.0 (15.4, 45.9) months, 64 patients progressed on tumor including 28 patients died. The median PFS and OS were 15.6 (7.1, 35.2) months and 66.9 (37.8, not reached) months. The median PFS of Group A and Group B were 7.6(5.0, 17.2)months and 22.2(9.6, 63.9)months respectively ( P=0.001), median OS of Group A and Group B were 45.7 (23.4, 62.8)months and 71.0(50.6, not reached)months respectively, and the 2-year OS were 70.6% and 85.5% in Group A and Group B respectively ( P=0.023). The univariate analysis showed local therapy with or without systemic therapy was significantly reduced 56% risk of tumor progression ( HR=0.44, P=0.003) and reduced 60% risk of death ( HR=0.40, P=0.028). The multivariate analysis showed that the OS was associated with ECOG score( HR=10.20, 95% CI 4.13-25.30, P<0.001)and local therapy( HR=0.23, 95% CI 0.09-0.58, P=0.002). Conclusion:Compared with systemic therapy alone, local therapy with or without systemic therapy can effectively improve the PFS and OS of patients with locoregional recurrence after nephrectomy.

Objective To understand the HPV vaccination situation in the vaccination clinic of Shaanxi Provincial Center for Disease Control and Prevention, and to guide the rational use of the vaccine. Methods The vaccination information and the information on HPV vaccine inoculated subjects in the clinic of Shaanxi Provincial Center for Disease Control and Prevention from 2018 to 2019 were analyzed. Results A total of 5 714 HPV vaccination subjects were analyzed, among which the largest proportion (48.97%) was in the 20-26.5 years old group, and the smallest proportion (1.12%) was in the 9-15 years old group. The 9-valent HPV vaccination accounted for 98.72% of the 20-26.5-year-old group. There were statistically significant differences in the distribution of vaccination populations between the bivalent and quadrivalent HPV vaccines (P＜0.01，χ²=252.85), and between the bivalent and 9-valent HPV vaccines (P＜0.01，χ²=258.15). The vaccination rate of the bivalent HPV vaccine was 88.25% (894/1 013), and the vaccination rate of the quadrivalent HPV vaccine was 94.43% (1 915/2 028). The difference was statistically significant (Z=-2.02, P=0.043). Conclusion Vaccination subjects tend to choose high-valent HPV vaccines, and the proportion of HPV vaccination in the younger age group is seriously insufficient. Both bivalent and quadrivalent HPV vaccines have relatively high overall vaccination rates. The next step should be to strengthen the vaccination publicity for younger age groups.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective:To compare and analyze the ultrasonic images between intestinal involvement in Kawasaki disease (IIKD) and abdominal type allergic purpura (ATAP), so as to improve the understanding of IIKD.Methods:From July 2014 to January 2020, the ultrasonographic images of 21 children with IIKD and 24 children with ATAP in Tianjin Children′s Hospital were collected and analyzed.Results:Univariate analysis showed that there were significant differences between IIKD group and ATAP group in non stratified thickening of intestinal wall, decreased echo of serosa and adjacent mesentery (irregular shape), thickening of peripheral fat tissue and abnormal shape of adjacent lymph nodes (all P<0.05); Multivariate analysis showed that decreased echo of serosa and adjacent mesentery (irregular shape) were independent influencing factors of IIKD. The area under ROC curve was 0.914(95% CI=0.819-1.000, P<0.001). The sensitivity and specificity of IIKD were 95.2% and 87.5%, respectively. Conclusions:The ultrasonographic images of intestinal involvement in IIKD and ATAP have certain specificity. Decreased echo of serosa and adjacent mesentery (irregular shape) can effectively distinguish IIKD and ATAP.

Objective: To report the experience on the multi-disciplinary management of metastatic renal cell (mRCC) patients in a single center. Methods: Data of 168 mRCC patients treated by multi-disciplinary team (MDT) at Sun Yat-sen University Cancer Center from December 2007 to February 2019 was retrospectively analyzed.Three treatment groups were identified, including 76 patients with 55 males and 21 females, received anti-angiogenic agents alone (Group A), 66 patients with 55 males and 11 males, received anti-angiogenic agents plus local therapy (Group B)and 26 patients, with 19 males and 7 females, received anti-angiogenic agents plus immunotherapy and local therapy (Group C). The Sunitinib, Sorafenib, Axitinib were chosen for the TKI. The Pembrolizumab was used for immunotherapy. The stereotactic body radiation therapy and surgical excision were considered as the local therapy. The study aims to compare the age, gender, IMDC score, pathology, nbephrectomy, adverse events, progression-free survival and overall survival (OS). Results: Of all patients, the median follow-up duration was 23 months (ranging 6-117 cmonths). The PFS was 18.3 months and median OS was 33.5 months. The 2 years and 5 years survival rate was 66% and 35%, respectively. The median OS of Group A, B and C were 29.8 months, 44.6 months and not reached. 2y-OS was 58%, 67% and 89%, while 5y-OS 12%, 46% and 57%.There was no difference in age, gender, IMDC score, pathology, synchronous metastases or nephterectomy between the three groups. The prognostic result in TKI based combination therapy was superior to TKI therapy alone, which the 5y-OS was 51% and 11%, respectively. The prognostic result in group C's moderate-high risk mRCC patients was superior to group A and B. The median OS in TKI+ DC and CIK+ Pembrolizumab was 49.1 months and 53.1 months. On univariate analyses, IMDC score, nephrectomy and treatment group was associated with OS (P<0.05). On multivariate analyses, treatment group, nephrectomy was associated with OS (P<0.05). The risk of death of Group C decreased about 60% [HR 0.39 (0.17, 0.89), P=0.026]. 78 (46.4%) patients on TKI alone and 16 (61.5%) patients treated with TKI plus immunotherapy had Grade 3 or 4 adverse events. 16 (20.3%) patients had Clavien Ⅲ-Ⅳ toxicity after surgical procedures. 6 (5.7%) patients had Grade 3 toxiciy after SBRT. Conclusions Patients treated with combined therapy had better survival than those treated with anti-angiogenic agents alone. MDT approach could bring survival benefit to mRCC patients.