177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective: To examine the effects of obesity and central obesity on hypertension, so as to provide insights into the prevention and control measures of hypertension. Methods: From September to December 2018, residents at ages of 35 to 75 years were sampled using the multi-stage random sampling method in Baiyin District, Baiyin City, Gansu Province, and subjected to questionnaire surveys and physical examinations. The interaction between obesity/central obesity and hypertension was evaluated using logistic regression analysis. The synergy index ( SI ), relative excess risk due to interaction ( RERI ) and attributable proportion due to interaction ( AP ) were calculated using Excel compiled by Andersson et al. Results: A total of 6 246 questionnaires were allocated and 6 169 valid questionnaires were recovered, with an effective recovery rate of 98.77%. The respondents included 3 038 men ( 49.25% ) and 3 131 women (50.75%), with a mean age of ( 52.05±8.78 ) years. There were 832 respondents with obesity ( 13.49% ) and 2 278 with central obesity ( 36.93% ). The crude and standardized prevalence rates of hypertension were 35.89% and 33.05%, respectively. Multivariable logistic regression analysis showed that obesity ( OR=2.020, 95%CI: 1.705-2.393 ) and central obesity ( OR=1.622, 95%CI: 1.433-1.836 ) were statistically associated with hypertension. There was no multiplicative interaction between obesity or central obesity and hypertension ( OR=1.011, 95%CI: 0.655-1.560 ), and no additive interaction was detected between obesity or central obesityand hypertension ( SI=1.405, 95%CI: 0.815-2.424; RERI=0.658, 95%CI: -0.298 to 1.614; AP=0.201, 95%CI: -0.075 to 0.476 ). Conclusions Obesity and central obesity increase the risk of hypertension; however, no interaction is detected between obesity or central obesity and hypertension.

Objective: To understand the awareness and influencing factors of medical healthcare APP among female college students in Weifang, and to provide references for healthy lifestyle and health literacy improvement. Methods: A total of 891 female college students were selected by stratified random sampling method, and were investigated regrading awareness on medical and health care APP and associated factors. Data were statistically analyzed by composition ratio, CHI-square test and binary Logistic regression. Results: There were 54.6% of the female college students who reported not aware of medical healthcare APP. The overall awareness rates of medical and health care APP for freshmen,sophomores, juniors, seniurs and above were 39.75%,45.59%,55.78% and 52.56%, respectively, and the difference was statistically significant(χ2=16.43，P<0.05). Logistic regression analysis showed that medical costs, medical healthcare information attention, medical health care information recognition, consulting the treatment scheme were positively associated with awareness of health care APP(OR=1.40,1.51,1.27,1.33,P<0.05). Conclusion The awareness rate of medical health care APP of female college students in Weifang is relatively low,and the difference between different groups is obvious. It is necessary to improve the scientific knowledge rate of the female college students to the APP, so as to influence the life style of the female college students.

Family physicians contracted service is an important choice to deepen the reform of China′s healthcare reform and achieve the strategic goal of " health for all" . In order to effectively promote the contracted service, the central government has successively issued a number of policy documents, which are echoed by the localities in their proactive explorations, achieving remarkable results. But there are also multiple roadblocks hindering the contracted service to progress. This article referred to the three-circle theory and studied policy implementation from the three dimensions of policy value, policy resources, and policy impetus. A thorough analysis of the problems in the implementation process revealed such main problems as insufficient family physicians, inadequacy of supporting policies and low level of policy acceptance among the young healthy age groups. The follow-up work will promote the long-term implementation of the family physicians contracted service policy by enriching the family physicians team, enriching supporting policies, and focusing on promotions to key age groups.

The healthcare plus aging care is a new type of aging care model that integrates medical services and aging care services. China has successively issued a series of policies, encouraging the localities to proactively explore such a model. The authors refer to the four dimensions of exchange and communication, policy resources, policy executor preferences and organizational structure in the Edwards policy execution model, for analyzing the implementation of such a policy. The study found such constraints for the policy as follows: unclear policy implementation standards, inadequate policy resources of manpower, financial and material resources, differences in preferences among local governments, general hospitals, primary medical institutions, and pension institutions, as well as decentralized and restricted organizational structures. At present, the policy of healthcare plus aging care remains in the stage of exploration and trial. The government should continue to define and revise the policy to ensure the smooth progress and long-term implementation of the policy of healthcare plus aging care.

Objective:Based on the perspective of status-seeking, to clarify the status quo of rural doctors′ subjective social status, and put forward countermeasures and suggestions to improve the subjective social status of rural doctors.Methods:By investigating 1 395 rural doctors in both 2015 and 2017 to clarify the status quo of rural doctors′ subjective social status through descriptive analysis, we compared the subjective social status of rural doctors with different characteristics by using differential analysis.Results:The overall subjective social status scoring of rural doctors was 3.17±0.48, including decision participation scoring(3.30±0.82), income scoring(2.19±0.80), social relationship scoring(4.05±0.61), career reputation scoring(3.09±0.84), career promotion scoring(2.38±0.67), and career value scoring(4.04±0.63). Rural doctors with middle or above academic titles, high-performance levels, as well as those comparable to doctors in township hospitals and self-employed clinics were found with higher subjective social status.Conclusions:Rural doctors held their subjective social status to be at an intermediate level, with higher ratings for interpersonal relationships and professional values and lower ratings for salary and training mechanisms. Positive feedback on the status-seeking behavior of rural doctors is recommended to improve village clinic services and reshape the image of rural doctors.

Objective: To investigate the usage of medical and health care APP among female college students, and to understand possible influencing factors, so as to provide reference for medical health care behaviors and personal health among college students. Methods: A stratified random sampling method was used to select 891 female college students from 3 colleges in Weifang. A questionnaire survey on their concentration on their own health, the knowledge, cognition and behavior of medical and health care APP, and Logistic regression analysis was used to analyze the influencing factors. Results: There were 55.4% female college students who had used medical and health care APP, and most of them (290) had used fitness and weight loss APP. There was statistical significance of the different usages of students of different degrees, majors and grades(χ2=26.55, 7.72, 13.96, P<0.05). Logistic regression analysis showed that educational background, annual medical costs, awareness of medical and health care APP and attitude towards APP prospect were the factors influencing the utilization of medical and health care APP (OR=0.44，0.69，1.36，1.23，P<0.05). Conclusion The usage rate of medical and health care APP is general, and sustained utilization rate is low, the APP should enrich menstrual period consumption and figure report, add video recommendation, interactive dating, and other functions, improve female students medical and health care APP cognition, female college students to change health care APP attitude.

Objective: To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation. Method: Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests; Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups. Results: The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38%(1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups. Conclusions The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.

Objective To evaluate the changes of hypoxic conditions in non-small cell lung cancer (NSCLC) patients before and after radiotherapy and assess the value of 18F-fluoromisonidzaole (FMISO)PET/CT for radiotherapy efficacy evaluation.Methods A total of 21 NSCLC patients (15 males,6 females,age 30-74 years) from January 2014 to October 2016 were prospectively enrolled.18F-FMISO PET/CT was performed before and after radiotherapy,and all patients underwent 18F-fluorodeoxyglucose (FDG)PET/CT before radiotherapy.Routine chest CT was performed at the 3rd and 6th month after radiotherapy.The maximum standardized uptake value (SUVmax) of tumor and muscle,tumor volume and hypoxic volume (HV) were measured.Tumor-to-muscle (T/M) value of 18F-FMISO was calculated,and T/M ≥ 1.3 was considered as the hypoxia cut-off value.Data were analyzed using Pearson correlation,paired t test,signed rank sum test and Wilcoxon rank sum test.Results Totally 81.0％(17/21) of NSCLC patients had hypoxia.There were significant positive correlations between 18F-FMISO T/M value and tumor volume or 18F-FDG SUVmax(r:0.72,0.60,both P＜0.05).The T/M value after radiotherapy was significantly lower than that before radiotherapy (1.42± 1.12 vs 2.08±0.71;t =3.62,P＜0.05),and median HV was also significantly lower than that before radiotherapy (6.53 vs 12.41 cm3;z =-3.83,P＜0.05).The median T/M values of effective group (n =14) and ineffective group (n =7) before radiotherapy were significantly different (2.14 vs 2.87;z=-2.27,P＜0.05),and the median HV of 2 groups before radiotherapy was also significantly different (6.43 vs 10.20 cm3;z=-2.14,P＜0.05).Conclusions Most NSCLC patients have hypoxia before radiotherapy.The larger tumor volume,the higher degree of hypoxia.Radiotherapy can alleviate the hypoxia of tumors.18F-FMISO PET/CT imaging before radiotherapy can be used to predict the efficacy of patients with NSCLC.