Objective To analyze the incidence and disease burden of substance use disorder(SUD)in China from 1990 to 2019,to evaluate the impact of different ages,periods and birth cohorts on the disease burden of SUD,and to predict disease burden of SUD from 2020 to 2034,so as to provide strategies for the prevention of SUD.Methods Based on the Global Burden of Disease Study 2019(GBD 2019)database,the disease burden was described by incidence,years of life lost(YLLs),years lived with disability(YLDs)and disability-adjusted life years(DALYs).The Joinpoint regression model was used to analyze the trend of standardized incidence and standardized DALYs rate of SUD.Based on the age-period-cohort model,the age,period and cohort effects of SUD were discussed.The grey prediction model GM(1,1)was used to fit the trend of the incidence and standardized incidence of SUD and the trend of disease burden,and to predict the incidence and disease burden of SUD in 2020-2034.Results From 1990 to 2019,the standardized incidence of SUD of amphetamines[average annual percentage change(AAPC)=-0.9％]and cocaine(AAPC=-0.5％)in China showed a downward trend(P＜0.001),and the standardized incidence of SUD of cannabis(AAPC=0.9％)showed an increasing trend year by year(P＜0.001).The trend of standardized incidence of opioid abuse disorders was not obvious(P＞0.05).The DALYs rate caused by the 4 SUD showed a decreasing trend year by year(AAPCamphetamines=-2.2％,AAPCcocaine=-1.5％,AAPCcannabis=-1.0％,AAPCopioids=-1.0％,P＜0.001).The results of age-period-cohort effect showed that the peak incidence of amphetamine,cocaine,cannabis and opioid use disorders was in the 25-30 age group.The DALYs rate caused by cannabis SUD increased with age,while the DALYs rates of amphetamines,cocaine and opioids SUD reached the peak in the 25-29,30-34 and 35-39 age groups,respectively.The results of period effect showed that the risk of SUD in propylamines,cocaine and cannabis decreased first and then increased,while the risk of SUD in opioids increased and then decreased and increased again.The results of birth cohort effect showed that the risk of SUD of amphetamines,cocaine and opioids showed a decreasing trend as a whole except for a small fluctuation in individual birth cohorts.The risk of DALYs rate caused by SUD of amphetamines,cocaine and opioids showed a decreasing trend as a whole,while the risk of DALYs rate caused by SUD of cannabis showed an increasing trend year by year.The prediction results showed that the incidence of SUD of amphetamines,cocaine and opioids showed a downward trend from 2020 to 2034,and the incidence of SUD of cannabis showed a fluctuating upward trend.The DALYs attributed to SUD of amphetamines,cocaine,cannabis and opioids showed a decreasing trend year by year.Conclusion The disease burden of SUD in China is decreasing year by year in the future.The incidence and disease burden are affected by age effect,period effect and cohort effect to varying degrees.Early prevention and effective intervention are the key measures to control SUD.

Objective To investigate the antithrombotic therapy for acute myocardial infarction patients after PCI stenting combined with tricuspid valve repair. Methods The risk of bleeding and embolization was evaluated, relevant data were reviewed, professional knowledges of pharmacy were utilized through the whole treatment process, individualized medication plan for patients was designed and used. Results A better therapeutic effect was achieved through the implementation of pharmaceutical care and medication education to the patients. Conclusion Clinical pharmacists carry out pharmaceutical care in antithrombotic drugs utilities，which could improve the safety level of drug use and provide basis for clinical rational drug use.

Objective:To investigate the research competence and training needs of young general practitioners (GPs) in Guangdong province.Methods:A questionnaire survey on research competence and training needs was conducted in December 2020 among GPs from one selected economically developed area and one selected less developed area in Guangdong Province.Results:A total of 172 young GPs were included in the study. The survey showed that 75.6% (130/172) and 76.2% (131/172) respondents thought that participation in scientific research and research literacy were important, but only 11.9% (21/172) had participated in research project, among whom 81.0% (17/21) undertook data collection. The basic score of evidence-based medicine was 24.00(21.00, 28.00), and 55.2% respondents (95/172) were able search literature when they encountered problems and 43.7% (77/172) used domestic databases. The self-assessment score of scientific research ability was 14.00(12.00, 17.00), the score of research training needs was 41.00(31.00, 49.50), and the scores of "scientific research topic selection, scientific research design, statistical analysis, organization and implementation, and paper writing" were generally high. There was significant difference in the total scores of the two scales of evidence-based medicine basis and scientific research ability self-assessment among respondents with different educational background ( P<0.05). The basic score of evidence-based medicine of orientation-trained GPs was higher than that of non-orientation-tranined GPs; the average score of research training needs in female respondents was higher than that in males ( P<0.05). Conclusions:The study suggests that young general practitioners have inadequate experience in research participation and organization, and low self-ratings of research competence, but generally high personal efficacy in research. It is recommended that appropriate training content and well-organized intervention should be developed for young GPs.

Hepatocellular carcinoma has a high morbidity and mortality, which has seriously harmed human health. Several targeted therapies have been approved for the first- and second-line treatment of advanced hepatocellular carcinoma. The emergence of immunotherapy has brought the treatment of hepatocellular carcinoma into a new era. Targeted and immunotherapeutic agents have synergistic effects in mechanism, also the combination of these two therapies has been clinically beneficial to patients with advanced hepatocellular carcinoma. At the same time, in addition to the systemic therapy of targeted combined immunological, applying appropriate local therapy can provide a longer survival period or even a chance of cure for that some patients. The authors introduce the diagnosis and treatment of a case of advanced hepatocellular carcinoma who achieved pathological complete remission by first-line immunotherapy combined with anti-angiogenesis targeted therapy.

Objective To study the prevalence of cigarettes and e-cigarettes, and to analyze its influencing factors among high school students in Wenzhou. Methods:A self-administered questionnaire survey was conducted among a total of 3 785students from senior high schools and vocational high schools in Wenzhou from September to November in 2020, who were selected by stratified cluster sampling. Their demographic information and the use of tobacco [including the use of cigarettes, e-cigarettes (currently smoking and smoking attempt), and the dual use of them] were asked in the questionnaire of “Global Youth Tobacco Survey”(GYTS). Proportion and rate were used to describe their demographic characteristics and smoking prevalence. Chi-square test was used to compare the difference in smoking prevalence of the high school students with selected characteristics. Multinomial logistic regression was used to analyze the influencing factors of tobacco use among the participants.Results:Among the 3 785 questionnaires, 3 740 were completed, and effective rate was 98.80%. The smoking attempt rate, current smoking rate, e-cigarette attempt rate, e-cigarette using rate, and dual using rate of the high school students in Wenzhou were 11.79% (441/3 740), 2.57% (96/3 740), 10.00% (374/3 740), 2.86% (107/3 740), 0.99% (37/3 740), respectively. Male students, vocational high school students, the students whose parents smoking showed higher smoking attempt rate, current smoking rate, e-cigarette attempt rate than female student, senior high school students and those parents who don′t smoke, respectively (all P<0.05). Best friend smoking [6.076 (2.872-12.855); 4.630 (2.656-8.071)], vocational high school [3.226 (1.877-5.546); 2.238 (1.432-3.496)] were risk factors for e-cigarette and the cigarettes use, belief that whether smoking or not does not make any difference in social activities [0.160 (0.077-0.331); 0.193 (0.096-0.387)], or smoking in social activities makes people more uncomfortable [0.037 (0.018-0.077); 0.155 (0.083-0.288)] were protective factors of e-cigarette and the cigarettes use. Additionally, passive smoking in past week [2.194 (1.129-4.262)], free tobacco products received [2.836 (1.018-7.905)], seeing smoking in campus [2.072 (1.111-3.863)] were all risk factors, while belief that smoking makes young people less attractive [0.280 (0.116-0.676)], not having been to tobacco retail outlets and unexposed to tobacco advertising or promotion [0.241 (0.123-0.473)] can protect senior middle school student away from cigarette. As to e-cigarette, boys were the risk factors [1.831 (1.100-3.050)]; as opposed to being a risk factor for cigarette use [1.942 (1.084-3.478)], rural area was a protective factor for e-cigarette use [0.639 (0.410-0.994)] among high school students in Wenzhou. Conclusions:High school students have relatively low rates of smoking cigarettes and e-cigarette in Wenzhou. Vocational students, best friend smoking are risk factors of e-cigarette and the cigarettes, beliefs that whether smoking or not does not make any difference or smoking makes people more uncomfortable in social activities are protective factors.

Objective To investigate the therapeutic effect of different combination regimens on patients with high-frequency sudden sensorineural hearing loss(SSNHL). Methods 82 patients with high-frequency SSNHL from December 2013 to May 2017 were enrolled. The control group was treated with hormone,lidocaine, and genetein combination therapy,while the observation group received systemic hormones,and local hormones combined with hyperbaric oxygen therapy,the average frequency of pure tone valve improvement,complications and adverse reactions in two groups were compared.Results After the treatment,the average pure tone of the two groups was significantly improved than pretherapy(tcontrol group = 10.28,P = 0.00;tobservation group = 11.06, P=0.00),but there was no significant difference in hearing improvement between the two groups(t=0.680,P=0.698),the total effective rate in the control group was 63.41%,in which the observation group was 68.29%,the difference was not statistically significant(χ2=0.230,P=0.816),but the cure rate was 26.83% in the observa-tion group which was higher than that in the control group(7.32%)(χ2=2.05,P=0.040).There was no signifi-cant difference in improvement of complication(tinnitus and ear nausea)between the two groups(χ2Tinnitus =0.000,P=1.000;χ2Aurussion=0.000,P=1.000),and there was no obvious adverse reaction in both groups. Conclusions Treatment of high-frequency SSNHL,hormone and hyperbaric oxygen therapy is good and safe, which can effectively improve the patient′s complication(tinnitus and ear nausea).

OBJECTIVE:To develop the drug traceability management system in outpatients of medical institutions,and gradu-ally improve its traceability management. METHODS:Based on barcode technology,drug traceability management system in outpa-tients of medical institutions was independently developed,introducing it from system environment,framework design and system function,and the application results were evaluated in terms of differences in dispensing time,deployment error,drug withdrawal treatment and applicability investigation. RESULTS:The system was developed on hospital information system network environ-ment,which was designed by combination of client/server(C/S)network system(B/S)and set function modules as follows as role rights management,data extraction,information control,data acquisition and data query. The system can match with drug electron-ic surveillance code,commodity code and other traceable barcodes,achieve drug tracing from hospitals to users through software interaction,as well as the computer-aided calibration in dispensing to effectively reduce outpatient's dispensing error. The average time for each outpatient prescription prolonged 9 s after using the system;24 dispensing errors and 4 non-normal withdrawals were prevented within 1 month;100% surveyed pharmacists expressed approval for the system's applicability. CONCLUSIONS:The system can achieve the drug suitability management in outpatients,which has shown good applicability and further improved drug safety management and control capabilities in medical institutions.

Hepatitis B virus ( HBV) is an important pathogen threatening to human health. Up to date, various of cell infection models and animal models for HBV and the host are widely used in the exploring research of infection mechanism, new drug development and effective therapeutic method for HBV. However, these models have some defects, such as low infection rate, rather short infective stage, and comparatively large species differences with human, and so on. Among them, the biggest problem is that these models cannot completely simulate HBV infection process and pathological changes naturally occurred in human. Herein, the major HBV infection models developed in the past fifteen years, as well as the latest research progress, are presented as a brief review, to provide a reference for constructing novel HBV infection models in the future.

Objective To observe the dynamic changes of endothelial progenitor cells (EPC)and vascular endothelial growth factor (VEGF) in the patients with acute myocardial infarction (AMI)after percutaneous transluminal coronary intervention (PCI). Methods The level of VEGF before and after PCI in 50 cases with AMI were determined by fluorescence immunoassay and enzyme-linked immunosorbnent assay (ELISA),and the ratio of EPC in flood was checked by flow cytometry.Results The level of EPC was higher after PCI than before PCI [(4.15 ± 0.22)％ vs.(0.59 ±0.02) ％,P＜0.01],and there were positive correlations between EPC and number of coronary artery disease (r=0.45,P ＜ 0.05 ),coronary artery lesions ( r =0.76,P ＜ 0.01 ),left ventricular enddiastolic diameter (r=0.68,P＜0.01),ejection fraction (r=0.75,P＜0.01).The VEGF levels after PCI was increased [(506± 120)μg/L vs.(204±98)μg/L,P＜0.01],and its level was positively related with coronary lesions (r=0.66,P＜0.01),left ventricular ejection fraction(r=0.90,P＜0.01).There was association between rising rates of EPC and VEGF in a short time after PCI within 24 h period (r=0.56,P＜0.01). Conclusions The clinical efficacy and prognosis can be assessed by the changes of VEGF level and EPC ratio before and after PCI operation in AM1 patients.

To divide the lung from the original X-ray image, the maximum classes square error is employed in finding the threshold. Then the thorax is ascertained according to the edge-detection and tracking-bug method, and the lung is divided from the thorax by the thresholding segmentation method. The gray mean in the lung is regarded as the eigenvalue to identify the image, but it doesn not work well. In view of the dosage of the X-ray exposure and the difference between persons, a new method that adopts the ratio of the gray in lungs to the gray in bones as the eigenvalue is brought forward to identify the image. And the two methods are compared by using the distance between classes. The result shows that the second method is more effective.
Humans ; Lung ; diagnostic imaging ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Respiration