ObjectiveTo investigate the risk factors for liver cancer in patients with chronic hepatitis B （CHB） in the Qidong Chronic Hepatitis B cohort， and to construct a nomogram model for predicting the risk of liver cancer in CHB patients. MethodsA structured questionnaire survey was conducted among the CHB patients， aged ≥18 years， who attended the outpatient service of Qidong Third People’s Hospital from January 1 to December 31， 2016. The onset of liver cancer was defined as the primary outcome， and the outcomes of the cohort were obtained from Qidong Cancer Registry. Baseline clinical features were compared ；between the liver cancer group and the non-liver cancer group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Cox regression model was used to analyze the risk factors for liver cancer in CHB patients and calculate their hazard ratio （HR） and 95% confidence interval （CI）； the variables with statistical significance in the univariate Cox regression analysis were included in the LASSO regression analysis， and then the variables obtained were included in the multivariate Cox regression analysis to establish a predictive model. The nomogram was used to visualize the complex model. The receiver operating characteristic （ROC） curve， index of concordance （C-index）， and the calibration curve were used to assess the predictive efficacy of the model， and the decision curve was used to evaluate the clinical practicability of the nomogram. ResultsA total of 1 479 CHB patients were selected， among whom 58 patients with a confirmed diagnosis of liver cancer， 15 with missing data on testing indicators， and 164 with missing data on important information in the questionnaire were excluded， and finally 1 242 subjects were included in the study. Up to December 31， 2023， there were 67 new cases of liver cancer after a median follow-up time of 7.71 years， and the incidence density of liver cancer was 729.78/100，000 person-years. There were significant differences between the liver cancer group and the non-liver cancer group in age， sex， educational level， liver cirrhosis， duration of liver cirrhosis， history of diabetes mellitus， albumin， total bilirubin （TBil）， direct bilirubin， aspartate aminotransferase， aspartate aminotransferase， gamma-glutamyl transpeptidase （GGT）， and alkaline phosphatase （all P<0.05）. The multivariate Cox regression analysis showed that the increase in age （HR=1.07， 95%CI： 1.05‍ ‍—‍ ‍1.10， P<0.001）， a relatively high level of TBil （HR=1.98， 95%CI： 1.15‍ ‍—‍ ‍3.42， P=0.014）， a relatively high level of GGT （HR=2.41， 95%CI： 1.43‍ ‍—‍ ‍4.08， P=0.001）， and a long duration of liver cirrhosis （HR=1.09， 95%CI： 1.02‍ ‍—‍ ‍1.15， P=0.009） were independent risk factors for liver cancer in CHB patients. A nomogram prediction model was constructed based on the above four indicators， with an area under the ROC curve of 0.790， 0.845， and 0.829， respectively， in predicting the risk of liver cancer in CHB patients at 1， 3， and 5 years， and the bootstrap resampling method was used for internal validation and showed a C-index of 0. 778. The calibration curve showed that the prediction model had good stability， and the decision curve showed that it had certain clinical practicability. ConclusionThe increase in age， relatively high levels of TBil and GGT， and a long duration of liver cirrhosis are independent risk factors for liver cancer in CHB patients， and the nomogram model constructed based on these factors has a good predictive value and can be used in clinical practice to help develop strategies for the long-term monitoring of liver cancer.

Objective:Objective The inhibitory effect of Niuhuang Qinggan Capsule on 2019-nCoV virus was studied to provide experimental evidence for drug screening and treatment of 2019-nCoV acute respiratory disease.Methods:The 2019-nCoV virus GS048 strain was isolated and cultured by Vero-E6 cells. The solution of Niuhuang Qinggan capsule was incubated with virus in vitro to determine the change of virus titer. The effect of Niuhuang Qinggan capsule on the proliferation of 2019-nCoV virus was determined by cell culture medium method.Results:It was found that the concentration of 274.3 μg/ml was not toxic to the cells when the concentration of drugs was lower. When the drug was incubated with virus, the titer of virus decreased from 10 4.4TCID 50/ml to 10 2.8TCID 50/ml. In vitro 2019-nCoV virus culture experiment showed that the addition of the drugs reduced the cytopathy, and the logarithmic value of virus titer decreased by 40% -50%. Conclusion:In this study, in vitro inhibition experiments suggest that Niuhuang Qinggan capsule has the potential to inhibit the proliferation of 2019-nCoV. It can be used as a candidate drug to further verify the therapeutic effect of the 2019-nCoV acute respiratory disease.

Objective To evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.Methods The data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan.2019 to Dec.2019 in Beijing United Family Hospital and other 18 medical centers,including 78 cases of renal tumor,2 cases of bladder cancer,2 cases of adrenal gland tumor,1 cases of renal cyst,1 case of prostate cancer,1 case of sweat gland carcinoma with lymph node metastasis,1 case of pelvic metastasis after radical cystectomy.All the patients underwent operations.In the laparoscopic surgery group,there were 27 cases of partial nephrectomy,1 case of radical prostatectomy,2 cases of radical cystectomy and 2 cases of adrenalectomy.In the da Vinci robotic surgery group of 54 cases,there were 51 cases of partial nephrectomy,1 case of retroperitoneal lymph node dissection,1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis.There were 41 partial nephrectomy patients with available clinical data for statistic,with a median age of 53.5 years (range 24-76),including 26 males and 15 females.The median R.E.N.A.L score was 7.8 (range 4-11).Before the operation,the engineers established the holographic image based on the contrast CT images and reports.The surgeon applied the holographic image for preoperative planning.During the operation,the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.Results All the procedures had been complete uneventfully.The holographic images helped surgeon in understanding the visual three-dimension structure and relation of vessels supplying tumor or resection tissue,lymph nodes and nerves.By manipulating the holographic images extracorporeally,the fused image guide surgeons about location vessel,lymph node and other important structure and then facilitate the delicate dissection.For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy,the median operation time was 140 (range 50-225) min,the median warm ischemia time was 23 (range 14-60) min,the median blood loss was 80(range 5-1 200) ml.In the robotic surgery group,the median operation time was 140 (range 50-215)min,the median warm i schemia time was 21 (range 17-40)min,the median blood loss was 150(range 30-1 200)ml.In the laparoscopic surgery group,the median operation time was 160(range 80-225)min,the median warm ischemia time was 25 (range 14-60)min,the median blood loss was 50 (range 5-1 200) ml.All the patients had no adjacent organ injury during operation.There were 2 cases with Clavien Ⅱ complications.One required transfusion and the other one suffered hematoma post-operation.However,the tumors were located in the renal hilus for these 2 cases and the R.E.N.A.L scores were both 11.Conclusions Holographic image navigation can help location and recognize important anatomic structures during the surgical procedures..This technique will reduce the tissue injury,decrease the complications and improve the success rate of surgery.

Objective To investigate the diagnostic value of lipocalin 2 (LCN2) combined with prostate-specific antigen (PSA) in prostate cancer (PCa).Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of serum LCN2 in patients with PCa (PCa group,n =82),patients with benign prostatic hyperplasia (BPH group,n =40) and healthy subjects (NC group,n =30).The levels of serum PSA were measured by chemiluminescence.The diagnostic value of LCN2 combined with PSA in PCa was analyzed by the receiver operating characteristic (ROC) curve.The relationship between the level of LCN2 and clinical parameters in PCa patients was analyzed.Results The levels of serum LCN2 in PCa group,BPH group and NC group were (88.97 ±40.83) pg/ml,(53.12 ±25.66) pg/ml,(13.34 ±4.86) pg/ml (F=61.306,P ＜0.001).The level of LCN2 in PCa group was significantly higher than that in BPH group and NC group (both P＜0.001).The levels of serum PSA in PCa group,BPH group and NC group were (17.65 ± 8.43) ng/ml,(11.27 ±3.56) ng/ml,(2.61 ±0.87) ng/ml (F=60.959,P＜0.001).The level of serum PSA in PCa group was significantly higher than that in BPH group and NC group (both P ＜0.001).There was positive correlation between serum LCN2 and PSA levels (r =0.360,P ＜ 0.001).The levels of serum LCN2 in PCa patients with different Gleason score,TNM stage and distant metastasis were significantly different (F =8.546,P ＜ 0.001;t =3.421,P =0.001;t =3.622,P =0.010).The area under the curve (AUC) of serum LCN2 was 0.763 (95％ CI:0.677-0.850,P ＜0.001).The sensitivity and specificity of serum LCN2 were 62.2％ and 85.0％.The AUC of PSA was 0.750 (95％ CI:0.665-0.836,P ＜ 0.001).The sensitivity and specificity of serum PSA were 51.2％ and 87.5％.The AUC of LCN2 combined with PSA was 0.822 (95％ CI:0.749-0.895,P ＜0.001).Conclusion Serum LCN2 level in the patients with PCa is significantly higher,which participates in tumor invasion.LCN2 may be a potential serum marker for the diagnosis of PCa.Combined detection of LCN2 and PSA contributes to the early diagnosis of PCa.

Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.

Objective To evaluate opioids utilization of cancer ached inpatients in the integrative traditional Chinese and western medicine hospital and provide suggestion for the rational utilization of opioids .Method DDDs ,DUI ,the distribution of cancer pain ,pain scores of the discharged patients and the utility of opioids were evaluated and analyzed by retrieving the medi-cal records from January in 2013 to December in 2014 .Results 292 medical records were selected and analyzed .Among them , 89 patients′pain score≥3 .The top opioids of DDDs were sufentanil citrate injection and fentanyl derivatives ,which is the main medication in treating the cancer pain patients .And the irrationaluseof fentanyl transdermal system was a common phenomenon among different departments .Conclusion Theutilization of opioids was basically rational ,but there still had some deficiencies . The intervention and management of narcotic drugs should be strengthened and deepened .

Objective To study the mediating effect of psychological defense mechanism between personality and depression or anxiety in postgraduate entrance re-examinee. Methods 496 examinee in entrance re-examination of medical postgraduate were investigated by applying Minnesota Multiphasic Personality Inventory(MMsion and anxiety(r=0. 107 ～0. 668, P＜0.05). Psychological defense mechanism was remarkably correlated with depression and anxiety(r= -0. 090 ～ -0.666, P＜0.05;r=0. 131 ～0. 663, P＜0.01). Personality was significantly correlated with psychological defense mechanism (r = - 0. 158 ～ - 0. 586, P ＜ 0.01;r = 0.125 ～ 0.532, Psion, anxiety factor, explicit anxiety, and fear (21.6%, 43.8%, 35.7%, 65.7%). Conclusion Personality is a remarkable predictor of depression and anxiety,and has indirect and direct influence on depression and anxiety through psychological defense mechanism.

OBJECTIVETo establish a HPLC fingerprint for quality evaluation of fructus Euodiae rutaecarpa, and to perform qualitative and quantitative analysis of its main constituents.

METHODThe 10 batches of samples were analyzed by HPLC linear gradient elution method and evaluated by similarity evaluation and system cluster analysis. The common peaks in chromatographic fingerprint were identified by LC-DAD-MS.

RESULTThe HPLC fingerprint of Euodiae Fructus showed 32 characteristic peaks, among them 13 peaks were identified, and 2 constituents were quantified.

CONCLUSIONThe HPLC fingerprint established could reflect the main constituents of Euodiae Fructus, and could combine with content determination to take an overall control of Euodiae Fructus.

Objective To study the socialization character of the examinee in entrance examination of medical postgraduate.Methods 48 examinee in physical fitness test and 496 examinee in entrance examination of medical postgraduate were investigated by applying minnesota multiphasic personality inventory ( MMPI ).Results ①Female postgraduate entrance examinee had higher scores of social responsibility and absence of social anxiety ( H1 ) than male ( 59.1 ± 9.0 vs 56.0 ± 8.5, 59.0 ± 10.1vs 57.3 ± 8.6, P ＜ 0.05 ).Graduates had higher scores of absence of social anxiety( H1 ) (58.3 ±9.4 vs 52.1 ± 11.5, P＜0.05 ), lower scores of alienation from the society(PD4A) and alienation from the society(S1 A) (44.2 ±7.6 vs 51.7 ±9.0, 39.6 ±7.4 vs 45.9 ±9.6,P＜0.05) than junior college graduates.The unmarried persons had higher scores of alienation from the society (PD4A) than the married persons (44.7±7.7 vs 42.9±7.1,P<0.05).②After controlling the effect of gender,marital status and education level, covariance analysis demonstrated that postgraduate entrance examinee had higher scores of S1A (40.0 ±7.5 vs35.2 ±6.8, P＜0.05).Conclusion There are significant differences of socialization character among postgraduate entrance examinee with the difference of genders, marital status and education level.Postgraduate entrance examinee prefers alienation from the society.

Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.