OBJECTIVE To evaluate the efficacy and safety of Huoxue Xiaoyi Granule in inhibiting the recurrence of endometrio-sis(EMs)after conservative operation,and to provide evidence for Chinese medicine in inhibiting the recurrence of EMs.METHODS A total of 72 patients with qi-stagnation and blood-stasis after EMs operation were selected as the study objects and randomly divid-ed into the Chinese medicine group and the Western medicine group,36 cases in each group.The Chinese medicine group was treated with Huoxue Xiaoyi Granule,and the Western medicine group was treated with GnRH-α.The postoperative recurrence rate,TCM syn-drome score,carbohydrate antigen 125(CA125),dysmenorrhea score,pelvic pain score,pregnancy rate,serum sex hormones[estra-diol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)]and safety indexes of the two groups were observed.RE-SULTS At 9 months and 12 months after surgery,the total TCM syndrome scores of the two groups of patients were significantly re-duced(P<0.05),and the Chinese medicine group was better than the Western medicine group(P<0.05);12 months later,the TCM total clinical curative rate in the Chinese medicine group was better than that in the Western medicine group;after surgery,the serum CA125 levels,dysmenorrhea scores and pelvic pain severity of the two groups of patients were significantly reduced(P<0.05,P<0.01);during treatment,the total incidence of adverse reactions in the Chinese medicine group was lower than that in the Western medicine group(P<0.01);the recurrence rate of the Chinese medicine group was slightly lower than that of the Western medicine group,but there was no statistical difference(P>0.05).CONCLUSION Huoxue Xiaoyi Granule can significantly improve TCM syndromes in patients with qi-stagnation and blood-stasis after EMs surgery.It is safe and has equivalent efficacy to GnRH-α in pre-venting postoperative recurrence of EMs,and worthy of clinical promotion and application.

Objective To observe the value of CT radiomics nomogram for predicting Ki-67 expression of thymus epithelial tumors.Methods Totally 163 patients with thymus epithelial tumor,including 114 patients in training set and 49 patients in validation set were retrospectively enrolled.The patients were further divided into low expression(＜50％)and high expression(≥50％)subgroups according to Ki-67 index.Multivariate logistic regression analysis was performed to screen independent predicting factors of Ki-67 expression in thymus epithelial tumors,and clinical-CT model was constructed.The optimal radiomics features were extracted and screened based on chest plain and venous phase enhanced CT images,respectively.Then radiomics modelplain and radiomics modelenhanced were constructed,and Radscoreplain and Radscoreenhanced were calculated,respectively.The nomogram model was constructed based on clinical-CT model,Radscoreplain and Radscoreenhanced.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting Ki-67 expression of thymus epithelial tumors.Results Patient's gender and enhanced CT value of lesion were both independent predicting factors of Ki-67 expression in thymus epithelial tumors(both P＜0.05).The AUC of clinical-CT model,radiomics modelplain,radiomics modelenhanced and nomogram model for predicting Ki-67 expression was 0.736,0.814,0.836 and 0.857 in training set,which was 0.746,0.746,0.750 and 0.799 in validation set,respectively.Conclusion CT radiomics nomogram could be used to predict Ki-6 7 expression of thymus epithelial tumors.

BACKGROUND: Lung cancer has been the leading cause of cancer-related deaths worldwide for many years. This study aimed to investigate the global patterns and trends of lung cancer. METHODS: Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database. Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression, and average annual percent changes were calculated. The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression. RESULTS: An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020. The age-standardized incidence rate (ASIR) ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico. The age-standardized mortality rate (ASMR) varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico. Both ASIR and ASMR were approximately twice higher in men than in women. The ASIR of lung cancer showed a downward trend in the United States of America (USA) between 2000 and 2012, and was more prominent in men. The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women. CONCLUSIONS The burden of lung cancer is still unsatisfactory, especially in developing countries like China. Considering the effectiveness of tobacco control and screening in developed countries, such as the USA, there is a need to strengthen health education, accelerate the establishment of tobacco control policies and regulations, and improve early cancer screening awareness to reduce the future burden of lung cancer.
Male ; Humans ; Female ; United States ; Middle Aged ; Incidence ; Lung Neoplasms/epidemiology* ; Linear Models ; China/epidemiology*

OBJECTIVE To learn from the self-medication tax system in Japan and improve over-the-counter drug cost sharing mechanism in China. METHODS By searching relevant policies and literature ，the evolution ，specific contents ，current situation and effects of Japanese self-medication tax system were summarized. Recommendations were put forward in the light of the actual situation of over-the-counter drug guarantee in China. RESULTS & CONCLUSIONS Japan has implemented the self-medication tax system since 2017. The Ministry of Health ， Labour and Welfare has made clear provisions on the preconditions for applying for the tax system and the deduction standards of the tax system ，and established a list of drugs to be responsible for the regular inclusion and discharge of the drugs under the tax system. The self- medication tax system has a remarkable effect in promoting the self-health management ，disease prevention and reducing medical expenses of Japanese residents. Our country can learn from the self-medication tax system in Japan and the experience of implementing the special deduction system for major medical conditions in China. To promote rational self-medication ，it is advisable to add a special deduction system for over-the-counter drugs into deductions in personal income tax and formulate the criteria and scope of application ，and establish a special list of over-the-counter drugs，thereby reducing the heavy burden of medical expenses of residents ，and exploring a new way to share the costs of over-the-counter drugs which is applicable to our national conditions.

Secondary hyperparathyroidism (SHPT) is a common and serious complication in long-term dialysis patients, who often experience multiple symptoms and a poor quality of life. Parathyroidectomy (PTX) is the best choice for severe SHPT patients with poor drug treatment. At present, the follow-up after PTX has not received sufficient attention, and the assessment of patients' clinical symptoms and quality of life is not yet adequate. In view of this, we systematically combed the changes and influencing factors of patients' quality of life and related symptoms after surgery, in order to provide reference for the practice and research of symptom management of such patients in the future.

Objective:To systematically understand the reform progress of disease prevention and control system in China.Methods:The literature regarding the reform of China′s disease prevention and control system was searched by using the keywords including disease prevention and control, center for disease prevention and control (CDC), disease control, reform, and system from 2003 to 2020 in China CNKI, Wanfang Data knowledge service platform, VIP information and China biomedical literature database. The language is limited to Chinese. A total of 25 studies were included to analyze the information about the organizational structure, functional orientation, financing mechanism and personnel system of China′s disease prevention and control system.Results:The 25 studies described the specific changes and reform suggestions of China′s disease prevention and control system, including key policies (7 studies), organizational structure transformation (4 studies), institutional function transformation (7 studies), financing mechanism transformation (5 studies), personnel system reform (2 studies), and performance-based salary system reform (4 studies). Meanwhile, the reform suggestions were concluded at the top-level design system reform (two aspects), organization structure (three aspects), functioning (four aspects), and personnel guarantee mechanism (three aspects).Conclusions:This study indicates that there is a lack of empirical evidence regarding specific reform effects and content analysis at the micro level of disease prevention and control system in China. Future study should strengthen the rigorousness of study design and focus on the quantitative impacts of reform implementation in China.

Objective:To systematically understand the reform progress of disease prevention and control system in China.Methods:The literature regarding the reform of China′s disease prevention and control system was searched by using the keywords including disease prevention and control, center for disease prevention and control (CDC), disease control, reform, and system from 2003 to 2020 in China CNKI, Wanfang Data knowledge service platform, VIP information and China biomedical literature database. The language is limited to Chinese. A total of 25 studies were included to analyze the information about the organizational structure, functional orientation, financing mechanism and personnel system of China′s disease prevention and control system.Results:The 25 studies described the specific changes and reform suggestions of China′s disease prevention and control system, including key policies (7 studies), organizational structure transformation (4 studies), institutional function transformation (7 studies), financing mechanism transformation (5 studies), personnel system reform (2 studies), and performance-based salary system reform (4 studies). Meanwhile, the reform suggestions were concluded at the top-level design system reform (two aspects), organization structure (three aspects), functioning (four aspects), and personnel guarantee mechanism (three aspects).Conclusions:This study indicates that there is a lack of empirical evidence regarding specific reform effects and content analysis at the micro level of disease prevention and control system in China. Future study should strengthen the rigorousness of study design and focus on the quantitative impacts of reform implementation in China.

Objective:To evaluate the classification of petroclival meningiomas(PCM), proposed selection of microsurgical approach and therapeutic outcomes.Methods:Retrospectively analyzed clinical data of 179 cases of PCM from Department of Neurosurgery, Xiangya Hospital, Central South University between January 2011 and November 2020. There were 28 males and 151 females with an age of(49.9±10.2) years(range: 22 to 75 years) and the tumor size of(44.8±10.3)mm(range: 15 to 80 mm). The mean duration of symptom ( M( Q R)) was 18.0(40.6)months(range:1 week to 320 months) and the mean preoperative Karnofsky performance scale(KPS) was 78.6±13.3(range: 40 to 100). The PCM were classified into 5 types according to the difference in the origin of dural attachment, involvement of adjacent structures and growth patterns through preoperative MRI. The surgical approaches were selected based on the proposed classification, and the clinical characteristics, surgical record, and follow-up data of each type were reviewed. Results:The PCM were divided into clivus type(CV, 4 cases), petroclival type(PC, 60 cases), petroclivosphenoidal type(PC-S, 62 cases), sphenopetroclival type with 2 subtypes(S-PC, 50 cases) and central skull base type(CSB, 3 cases). All of 176 cases were obtained microsurgical treatment except CSB type. The gross total resection reached in 124 cases(70.5%) with 112 cases of retrosigmoid approach(RSA), 27 cases of subtemporal transtentorial transpetrosal approach, 13 cases of pretemporal trancavernous anterior transpetrosal approach(PTCA), 12 cases of extended pterional transtentorial approach(EPTA) and presigmoid combined supra-infratentorial approach, respectively. The RSA could be adopted in both of CV type and PC type and most of PC-S type(71.0%). S-PC subtype Ⅰ and subtype Ⅱ were mainly underwent EPTA(40.8%) and PTCA(52.2%), respectively. Seventy-two cases(40.9%) gained new neurological dysfunctions mainly with the cranial nerve paralysis. The postoperative morbidity and complications were recovered or improved with conservative and positive symptomatic and supportive treatment. There was no intraoperative and postoperative death case. One hundred and sixty four cases(93.2%) of operative patients were followed with the duration of 24(48)months(range:3 to 108 months). Tumor recurrence and progress were identified in 14 cases(10.4%) and 14 cases(28.6%), respectively. Compared with postoperative neurological status, 89 patients(54.3%) had improved and 38 patients(23.2%) were still suffering various degrees of neurological dysfunctions during the follow-up. The recent KPS was 84.2±11.4(range: 50 to 100) without statistical difference from preoperative KPS ( t=-1.356, P=0.125). As for each type, there were statistically significant differences in brain stem edema (χ 2=3.482, P=0.038), gross total resection (χ 2=9.127, P=0.001), surgical duration( F=8.954, P=0.013), postoperative length of stay( F=3.652, P=0.025), postoperative complications (χ 2=1.550, P=0.024), postoperative KPS( F=2.856, P=0.042) and tumor recurrence/progress (χ 2=4.824, P=0.013). Conclusion:The precise and comprehensive classification of PCM and specific individual treatment strategy are benefit to evaluate the diverse clinical prognosis, choose optimal surgical approaches, elevate gross total resection, diminish neurological dysfunctions and restraint tumor recurrence, so as to improve the quality of life for patients.

Objective:To evaluate the classification of petroclival meningiomas(PCM), proposed selection of microsurgical approach and therapeutic outcomes.Methods:Retrospectively analyzed clinical data of 179 cases of PCM from Department of Neurosurgery, Xiangya Hospital, Central South University between January 2011 and November 2020. There were 28 males and 151 females with an age of(49.9±10.2) years(range: 22 to 75 years) and the tumor size of(44.8±10.3)mm(range: 15 to 80 mm). The mean duration of symptom ( M( Q R)) was 18.0(40.6)months(range:1 week to 320 months) and the mean preoperative Karnofsky performance scale(KPS) was 78.6±13.3(range: 40 to 100). The PCM were classified into 5 types according to the difference in the origin of dural attachment, involvement of adjacent structures and growth patterns through preoperative MRI. The surgical approaches were selected based on the proposed classification, and the clinical characteristics, surgical record, and follow-up data of each type were reviewed. Results:The PCM were divided into clivus type(CV, 4 cases), petroclival type(PC, 60 cases), petroclivosphenoidal type(PC-S, 62 cases), sphenopetroclival type with 2 subtypes(S-PC, 50 cases) and central skull base type(CSB, 3 cases). All of 176 cases were obtained microsurgical treatment except CSB type. The gross total resection reached in 124 cases(70.5%) with 112 cases of retrosigmoid approach(RSA), 27 cases of subtemporal transtentorial transpetrosal approach, 13 cases of pretemporal trancavernous anterior transpetrosal approach(PTCA), 12 cases of extended pterional transtentorial approach(EPTA) and presigmoid combined supra-infratentorial approach, respectively. The RSA could be adopted in both of CV type and PC type and most of PC-S type(71.0%). S-PC subtype Ⅰ and subtype Ⅱ were mainly underwent EPTA(40.8%) and PTCA(52.2%), respectively. Seventy-two cases(40.9%) gained new neurological dysfunctions mainly with the cranial nerve paralysis. The postoperative morbidity and complications were recovered or improved with conservative and positive symptomatic and supportive treatment. There was no intraoperative and postoperative death case. One hundred and sixty four cases(93.2%) of operative patients were followed with the duration of 24(48)months(range:3 to 108 months). Tumor recurrence and progress were identified in 14 cases(10.4%) and 14 cases(28.6%), respectively. Compared with postoperative neurological status, 89 patients(54.3%) had improved and 38 patients(23.2%) were still suffering various degrees of neurological dysfunctions during the follow-up. The recent KPS was 84.2±11.4(range: 50 to 100) without statistical difference from preoperative KPS ( t=-1.356, P=0.125). As for each type, there were statistically significant differences in brain stem edema (χ 2=3.482, P=0.038), gross total resection (χ 2=9.127, P=0.001), surgical duration( F=8.954, P=0.013), postoperative length of stay( F=3.652, P=0.025), postoperative complications (χ 2=1.550, P=0.024), postoperative KPS( F=2.856, P=0.042) and tumor recurrence/progress (χ 2=4.824, P=0.013). Conclusion:The precise and comprehensive classification of PCM and specific individual treatment strategy are benefit to evaluate the diverse clinical prognosis, choose optimal surgical approaches, elevate gross total resection, diminish neurological dysfunctions and restraint tumor recurrence, so as to improve the quality of life for patients.

Objective: To explore the risk factors for hyperlipidemic acute pancreatitis (HTGP). Methods: The clincial data of 169 HTGP cases admitted in Capital Medical University Attached Xuanwu Hospital from September 2012 to December 2018 were retrospectively analyzed. Patients were divided into severe HTGP group (n=63) and mild or moderately severe HTGP group (n=106). Clinical data were compared between two groups and variables with statistically significance and clinical values were chosen and included for binary logistic regression to explore the independent risk factors for severe HTGP. Results: Severe HTGP patients′ heart beat and respiratory rate were significantly higher than moderately severe or mild HTGP cases, while the percentage of patients with previous AP history in severe HTGP group was obviously lower than moderately severe or mild HTGP cases. There were no statistically significant differences on other baseline data and previous history. Severe HTGP patients had significantly higher white blood cell, mean platelet volume, erythrocyte sedimentation rate, total protein, C-reaction protein on first day, C-reaction protein on third day, amylase, lipase, triacylglycerol, prothrombin time, D-dimer, fibrinogen, CTSI, APACHEⅡ score and Ranson score than those in moderately severe or mild HTGP cases; the lymphocyte count, albumin-globulin ratio, uric acid, apolipoprotein-A1, blood calcium, prothrombin activity were obviously lower than those in moderately severe or mild HTGP cases; and all the differences were statistically significant. Triglyceride and CRP on the first and third day, CTSI, APACHEⅡ score and Ranson score were included for binary logistic regression model, and the results showed that triglyceride on the first day (OR=1.08, 95% CI 1.02-1.14, P=0.01), C-reaction protein on the third day (OR=1.01, 95% CI 1.00-1.01, P<0.01), CTSI score(OR=1.51, 95% CI 1.06-2.13, P=0.02), APACHEⅡ score(OR=1.22, 95% CI 1.07-1.40, P<0.01)were the risk factors of severe HTGP, while triglyceride on the third day (OR=0.8, 95% CI 0.69-0.91, P=0.00)was the protective factor of severe HTGP. Conclusions Triglyceride on the first day, C-reaction protein on the third day, CTSI score and APACHEⅡ score were the risk factors of severe HTGP, which deserve special attention.