Chronic post-surgical pain (CPSP) is a common long-term complication following lung surgery. Its high incidence significantly impacts patients’ quality of life and functional recovery, and imposes a substantial socioeconomic burden. This consensus aims to systematically establish a standardized integrated Chinese and Western medicine diagnostic and treatment framework for chronic post-lung surgery pain (CPLSP). Based on the latest domestic and international evidence-based medical research and multidisciplinary clinical experience, the working group comprehensively elaborates on core issues regarding CPLSP, including its definition, epidemiology, pathogenesis, clinical assessment, Western medical treatment, traditional Chinese medicine (TCM) treatment, and integrated strategies. The consensus emphasizes a patient-centered approach, adhering to the principles of multimodality, individualization, and stepwise management, highlighting the synergistic advantages of integrating Chinese and Western medicine throughout the entire perioperative management cycle encompassing "perioperative anti-inflammation, acute analgesia, and chronic rehabilitation." Through systematic literature retrieval and evidence integration, a total of 9 core recommendations were established to provide scientifically sound and clinically practical guidance.

Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.

BACKGROUND: The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts. METHODS: Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts. RESULTS: In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use. CONCLUSIONS Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.
Humans ; Arthritis, Psoriatic/drug therapy* ; East Asian People ; Enthesopathy/complications* ; Registries ; Severity of Illness Index ; Spondylarthritis/epidemiology*

Environmental monitoring technologies competition can effectively improve the comprehensive quality and technical skills of technical personnel by means of professional theory exams and on-site practical assessment. In view of the undertaking work of the Second National Competition of Professional and Technical Personnel in Ecology and Environment Monitoring (special competition for radiation monitoring), this paper summarized the experience and gains in the aspects of preliminary preparation, field implementation, achievement generation, etc., analyzed the problems in national radiation environmental monitoring through the achievements of the special competition for radiation monitoring, and put forward recommendations for the next step, in order to provide reference for undertaking similar major events in the future and provide ideas and directions for national radiation environmental monitoring.

Objective To evaluate the clinical effect of immediate implant restoration in lower posterior teeth . Methods 31 XIVE implants were placed in lower posterior teeth of 31 patients.The temporary fixed resin crowns were fabricated immediately and final restorations were finished in 3~4 months.The control group used nonsub-merged implants and were restored with final crowns in 3~4 months.The tracking survey was taken from 12 to 24 months after final restoration .The patient satisfaction , papilla index score ( PIS ) and implant survival rate were eval-uated between the two groups .Results PIS of patients with immediate restoration reached (2.35 ±0.70) in aver-age compared(1.84 ±0.74) in control group.The patient satisfaction reached (91.5 ±7.5) with immediate resto-ration, compared with VAS score in average of(85.8 ±8.1) in control group.All implants in both groups achieved osseointegration and received 100% survival rate .Conclusion With proper technique in surgical and restoration procedure , immediate restoration after implant insertion in posterior madible has similar clinical success compared with delayed restoration .

OBJECTIVETo summarize and analyze the clinicopathological features and surgical management of patients with pathologic complete response (pCR) in the primary tumor after neoadjuvant chemotherapy for rectal cancer, and to explore the rational treatment of this entity.

METHODSClinical data of fifty-two patients with locally advanced mid-low rectal cancer admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from January 1994 to December 2013 were retrospectively analyzed. They were treated with neoadjuvant chemotherapy and achieved pathological complete response in the primary tumor. The preoperative clinical staging were stage II (cT3~4N0) in 10 cases and stage III (cT3~4N+) in 42 cases. After the neoadjuvant therapy, 10 cases achieved clinical complete response (cCR) (19.2%).

RESULTSRadical surgery was performed in 51 patients. Among them, five patients (9.8%) had pathological lymph node metastasis. One cCR patient underwent transanal local excision. The postoperative complication rate was 21.2%. During a median follow-up of 23.6 months, only one patient developed bone metastasis and another one had enlarged mesenteric and retroperitoneal lymph nodes detected by imaging. All the patients were alive by the last follow-up. The 2-year disease-free survival rate was 96.2% and overall survival rate was 100%.

CONCLUSIONSRadical surgery remains the standard therapy for cCR patients with rectal cancer after neoadjuvant chemotherapy. Local excision and "wait and see" should be recommended with great caution and limited to patients who cannot tolerate or refuse radical surgery with a strong demanding for sphincter saving, or applied in clinical trials.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; methods ; Disease-Free Survival ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neoadjuvant Therapy ; methods ; Neoplasm Staging ; Postoperative Complications ; Rectal Neoplasms ; drug therapy ; mortality ; pathology ; surgery ; Remission Induction ; Retrospective Studies ; Survival Rate

Objective To investigate the clinical features of multiple primary malignancies ( MPM) in patients with kidney malignancy .Methods The clinical data of 111 patients suffered from MPM associated with kidney malignant tumor in Yantai Yuhuangding Hospital and Affiliated Yantai Hospital of Binzhou Medical College from April 1984 to December 2014 were retrospectively analyzed .Results Among the 111 cases,there were 100 cases with two primary malignancies ,9 with three cancers and 2 cases with four or five cancers.Synchronous MPM were 37 cases,and metachronous 74 cases.The interval between the first and the second primary malignancy was between 0 and 348 months,with average of 46 months and median of 16 months.One hundred and seventy-two cases were treated by operation , and 64 cases by conservative therapy.The proportion of operation from the first to the fifth cancers were 89.2%(99/111),59.5%(66/111),54.5%(6/11),50.0%(1/2),0%(0/1),respectively,with the trend of declining.Finally 95 cases (85.6%) were followed up ,with 53 cases survived and 42 cases died.From the diagnostic date of the first primary cancer,overall survival in 1 year,3 years,5 years,10 years were 97.2%,77.2%,67.8%,48.4%, respectively.Median survival time was 120 months.From the diagnostic date of the last primary cancer , overall survival in 1 year,3 years,5 years were 81.4%,53.4%,48.2%,respectively.Median survival was only 48 months.Univariate analysis showed that the cumulative survival rate was higher in patients with operation than conservative therapy ( P =0.000 ) , in metachronous group than synchronous group ( P =0.009).COX proportional hazard model showed metachronous MPM (OR=3.870,95%CI 1.702-8.801,P=0.001),aggressive operation of the first primary cancer (OR=0.107,95%CI 0.018-0.647,P=0.015) and the second cancer (OR=0.313,95%CI 0.131 -0.750, P=0.009) were independent prognostic factors. Conclusions The main treatment of MPM associated with kidney malignancy is aggressive operation, radiotherapy, chemotherapy and biological therapy are adjuvant .Early detection and early operation for MPM are beneficial for increasing the survival of the patients .

Objective To summarize and analyze the clinicopathological features and surgical management of patients with pathologic complete response ( pCR ) in the primary tumor after neoadjuvant chemotherapy for rectal cancer, and to explore the rational treatment of this entity. Methods Clinical data of fifty?two patients with locally advanced mid?low rectal cancer admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from January 1994 to December 2013 were retrospectively analyzed. They were treated with neoadjuvant chemotherapy and achieved pathological complete response in the primary tumor. The preoperative clinical staging were stage Ⅱ ( cT3~4N0) in 10 cases and stage Ⅲ( cT3~4N+) in 42 cases. After the neoadjuvant therapy, 10 cases achieved clinical complete response (cCR) (19.2%). Results Radical surgery was performed in 51 patients. Among them, five patients (9.8%) had pathological lymph node metastasis. One cCR patient underwent transanal local excision. The postoperative complication rate was 21. 2%. During a median follow?up of 23. 6 months, only one patient developed bone metastasis and another one had enlarged mesenteric and retroperitoneal lymph nodes detected by imaging.All the patients were alive by the last follow?up. The 2?year disease?free survival rate was 96.2%and overall survival rate was 100%. Conclusions Radical surgery remains the standard therapy for cCR patients with rectal cancer after neoadjuvant chemotherapy. Local excision and “wait and see” should be recommended with great caution and limited to patients who cannot tolerate or refuse radical surgery with a strong demanding for sphincter saving, or applied in clinical trials.

Objective To summarize and analyze the clinicopathological features and surgical management of patients with pathologic complete response ( pCR ) in the primary tumor after neoadjuvant chemotherapy for rectal cancer, and to explore the rational treatment of this entity. Methods Clinical data of fifty?two patients with locally advanced mid?low rectal cancer admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from January 1994 to December 2013 were retrospectively analyzed. They were treated with neoadjuvant chemotherapy and achieved pathological complete response in the primary tumor. The preoperative clinical staging were stage Ⅱ ( cT3~4N0) in 10 cases and stage Ⅲ( cT3~4N+) in 42 cases. After the neoadjuvant therapy, 10 cases achieved clinical complete response (cCR) (19.2%). Results Radical surgery was performed in 51 patients. Among them, five patients (9.8%) had pathological lymph node metastasis. One cCR patient underwent transanal local excision. The postoperative complication rate was 21. 2%. During a median follow?up of 23. 6 months, only one patient developed bone metastasis and another one had enlarged mesenteric and retroperitoneal lymph nodes detected by imaging.All the patients were alive by the last follow?up. The 2?year disease?free survival rate was 96.2%and overall survival rate was 100%. Conclusions Radical surgery remains the standard therapy for cCR patients with rectal cancer after neoadjuvant chemotherapy. Local excision and “wait and see” should be recommended with great caution and limited to patients who cannot tolerate or refuse radical surgery with a strong demanding for sphincter saving, or applied in clinical trials.

Objective To investigate the relationship among HbA1c、urine microalbuminuria (UmAlb)and blood lipids in pa-tients type 2 diabetes mellitus.Methods 120 patients with type 2 diabetes in the hospital were enrolled in the study in 2012.Ac-cording to the test results of HbA1c,the people enrolled in the study were divided into two groups,group A:HbA1c <6.5%,60 cases totally;group B:HbA1c≥6.5%,60 cases totally.UmAlb and blood lipids were measured.Results Compared with group A, UmAlb、TC、TG and LDL-C concentrations increased significantly in group B(P <0.05),while HDL-C decreased significantly(P <0.05).Conclusion In type 2 diabetic patients whose HbA1c≥6.5%,UmAlb,TC,TG and LDL-C concentrations increased obvi-ously and the risk of diabetic complications increase.