Objective:To investigate the risk factors for progression to castration-resistant prostate cancer (CRPC) in metastatic prostate cancer (mPCa) patients who underwent androgen deprivation therapy (ADT).Methods:One hunred mPCa patients underwent ADT were followed up from January 2014 to December 2020 in the Affiliated Central Hospital of Shenyang Medical University. Retrospective analyze the patient′s Gleason score, initial PSA value, minimum prostate specific antigen (nPSA) and time when PSA drops to the lowest point (TTN), and record the state of lymph node metastasis and bone metastasis. Single factor Kaplan-Meier analysis and multivariate Cox regression analysis were used to explore the related risk factors affecting the progress of CRPC.Results:A total of 82 cases (82%) of ADT patients progressed to CRPC. Univariate Kaplan-Meier analysis showed that Gleason score, PSA initial value, lowest nPSA and time to TTN, lymph node metastasis and bone metastasis are risk factors for CRPC ( P<0.01 or<0.05); Multivariate Cox regression analysis showed that Gleason score, initial PSA value, nPSA and TTN are independent risk factors for PCa patients to progress to CRPC ( P<0.01 or<0.05). Conclusions:This study demonstrated that Gleason score, lymph node metastasis, bone metastasis, initial PSA value, nPSA and TTN are risk factors for the progression of CRPC. Patients with higher Gleason grade, higher nPSA, shorter TTN, lymph node and bone metastasis have shorter PFS and higher risk of progression to CRPC.

Objective:To systematically understand the global research progress in the construction and validation of lung cancer risk prediction models.Methods:"lung neoplasms" , "lung cancer" , "lung carcinoma" , "lung tumor" , "risk" , "malignancy" , "carcinogenesis" , "prediction" , "assessment" , "model" , "tool" , "score" , "paradigm" , and "algorithm" were used as search keywords. Original articles were systematically searched from Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, Cochrane, and Web of Science) published prior to December 2018. The language of studies was restricted to Chinese and English. The inclusion criteria were human oriented studies with complete information for model development, validation and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese dissertation papers, and research materials such as reviews, letters, and news reports. A total of 33 papers involving 27 models were included. The population characteristics of all included studies, study design, predicting factors and the performance of models were analyzed and compared.Results:Among 27 models, the number of American-based, European-based and Asian-based model studies was 12, 6 and 9, respectively. In addition, there were 6 Chinese-based model studies. According to the factors fitted into the models, these studies could be divided into traditional epidemiological models (11 studies), clinical index models (6 studies), and genetic index models (10 studies). 15 models were not validated after construction or were cross-validated only in the internal population, and the extrapolation effect of models was not effectively evaluated; 8 models were validated in single external population; only 4 models were verified in multiple external populations (3-7); the area under the curve (AUC) of models ranged from 0.57 to 0.90.Conclusion:Research on risk prediction models for lung cancer is in development stage. In addition to the lack of external validation of existing models, the exploration of potential clinical indicators was also limited.

Objective:To develop a lung cancer risk prediction model for female non-smokers.Methods:Based on the Kailuan prospective dynamic cohort (2006.05-2015.12), a nested case-control study was conducted. Participants diagnosed with primary pathologically confirmed lung cancer during follow-up were identified as the case group, and others were identified as the control group. A total of 24 701 subjects were included in the study, including 86 lung cancer cases and 24 615 control population, respectively. Questionnaires, physical examinations, and laboratory tests were conducted to collect relevant information. Multivariable-adjusted logistic regressions were conducted to develop a lung cancer risk prediction model. Area Under the Curve (AUC) and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration, respectively. Ten-fold cross-validation was used for internal validation.Results:Two sets of models were developed: the simple model (including age and monthly income) and the metabolic index model [including age, monthly income, fasting blood glucose (FBG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C)].The AUC (95%CI) [0.745 (0.719-0.771)] of the metabolic index model was higher than that of the simple prediction model [0.688 (0.660-0.716)] ( P=0.004). Both the simple model ( PHL=0.287) and the metabolic index model ( PHL=0.134) were well-calibrated. The results of ten-fold cross-validation indicated sufficient stability, with an average AUC of 0.699 and a standard error (SD) of 0.010. Conclusion:By incorporating metabolic markers, accurate and reliable lung cancer risk prediction model for female non smokers could be developed.

Objective:To systematically understand the global research progress in the construction and validation of lung cancer risk prediction models.Methods:"lung neoplasms" , "lung cancer" , "lung carcinoma" , "lung tumor" , "risk" , "malignancy" , "carcinogenesis" , "prediction" , "assessment" , "model" , "tool" , "score" , "paradigm" , and "algorithm" were used as search keywords. Original articles were systematically searched from Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, Cochrane, and Web of Science) published prior to December 2018. The language of studies was restricted to Chinese and English. The inclusion criteria were human oriented studies with complete information for model development, validation and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese dissertation papers, and research materials such as reviews, letters, and news reports. A total of 33 papers involving 27 models were included. The population characteristics of all included studies, study design, predicting factors and the performance of models were analyzed and compared.Results:Among 27 models, the number of American-based, European-based and Asian-based model studies was 12, 6 and 9, respectively. In addition, there were 6 Chinese-based model studies. According to the factors fitted into the models, these studies could be divided into traditional epidemiological models (11 studies), clinical index models (6 studies), and genetic index models (10 studies). 15 models were not validated after construction or were cross-validated only in the internal population, and the extrapolation effect of models was not effectively evaluated; 8 models were validated in single external population; only 4 models were verified in multiple external populations (3-7); the area under the curve (AUC) of models ranged from 0.57 to 0.90.Conclusion:Research on risk prediction models for lung cancer is in development stage. In addition to the lack of external validation of existing models, the exploration of potential clinical indicators was also limited.

Objective:To develop a lung cancer risk prediction model for female non-smokers.Methods:Based on the Kailuan prospective dynamic cohort (2006.05-2015.12), a nested case-control study was conducted. Participants diagnosed with primary pathologically confirmed lung cancer during follow-up were identified as the case group, and others were identified as the control group. A total of 24 701 subjects were included in the study, including 86 lung cancer cases and 24 615 control population, respectively. Questionnaires, physical examinations, and laboratory tests were conducted to collect relevant information. Multivariable-adjusted logistic regressions were conducted to develop a lung cancer risk prediction model. Area Under the Curve (AUC) and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration, respectively. Ten-fold cross-validation was used for internal validation.Results:Two sets of models were developed: the simple model (including age and monthly income) and the metabolic index model [including age, monthly income, fasting blood glucose (FBG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C)].The AUC (95%CI) [0.745 (0.719-0.771)] of the metabolic index model was higher than that of the simple prediction model [0.688 (0.660-0.716)] ( P=0.004). Both the simple model ( PHL=0.287) and the metabolic index model ( PHL=0.134) were well-calibrated. The results of ten-fold cross-validation indicated sufficient stability, with an average AUC of 0.699 and a standard error (SD) of 0.010. Conclusion:By incorporating metabolic markers, accurate and reliable lung cancer risk prediction model for female non smokers could be developed.

Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia.Methods Eighty-threepatients with adult umbilical hernia admitted to People's Hospital of Beijing Daxing District from Feb.2008 to Jan.2017 were randomly divided into laparoscopic umbilical hernia repair group (n =38) and open umbilical hernia repair group (n =45).Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n =38),while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time,hospital stay,blood loss,seroma/hematoma formation,wound infection,incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0.The outpatient consultation was performed at 2 weeks,1 month,3 months,and 6 months after operation.The follow-up contents were wound condition,pain,and whether there were any masses in the umbilicus.After every 3 months of telephone follow-up or outpatient review,whether there were any masses in the umbilicus,the average follow-up time was 14 months.Results All operations were successfully completed.The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31 ± 8) min vs (48 ± 10) min,P ＜ 0.01],and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P ＜ 0.05).The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40 ± 18) ml vs (62 ± 25) ml,P ＜ 0.01].The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P ＜ 0.05).The postoperative complications include seroma,wound infection and incomplete bowel obstruction.There were no significant differences between the two groups of seroma,incision infection and recurrence (P ＞ 0.05).The difference of the incidence of incomplete bowel obstruction between the two groups was statistically significant (P =0.019) . The total postoperative complication rate was significantly lower in laparoscopic umbilical hernia repair group than in open umbilical hernia repair group(x2 =5.328,P =0.021).Conclusions Laparoscopic umbilical hernia repair has short operation time,less bleeding,and satisfactory postoperative pain.It is worthy of advocacy for umbilical hernia patients who can tolerate general anesthesia.

Objective To compara the postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) and open transinguinal preperitoneal (TIPP).Methods Retrospective analysis of clinical data of 180 patients with inguinal hernia admitted to the Daxing District People's Hospital of Capital Medical University from January 2016 to January 2018,male 158 cases,female 22 cases,average age 56 years old,age range 23-80 years old.Including 110 patients in the TAPP group and 70 patients in the TIPP group,patients in the TAPP group were treated with laparoscopic TAPP,and patients in the TIPP group were treated with open TIPP.Pain degree was assessed with pain visual analogue scale (VAS) postoperatively at 3 weeks,3 months and 6 months.The incidence of chronic pain was measured at 3 weeks,3 months,and 6 months after surgery,and the incidence of foreign body sensation at 3 months was recorded.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;Chi-square test was used for compare the count data between groups.Results At 3 weeks,3 months,and 6 months after surgery,the mean value of pain VAS in the TAPP group was lowerthan in the TIPP group [(0.07 ± 0.40) scores vs (0.37 ± 0.94) scores,(0.03 ± 0.16) scores vs (0.24 ± 0.69) scores,(0.01 ± 0.10) scores vs (0.14 ± 046) scores],and the difference was statistically significant (P =0.004,0.002,0.004).The incidence of pain in the TAPP group was 3.6％,2.7％,and 0.9％ at 3 weeks,3 months,and 6 months after surgery,respectively.The incidence of pain in the TIPP group was 14.3％,11.4％,and 10.0％,respectively.The difference was statistically significant (P =0.021,0.040,0.012).At 3 months postoperatively,there were 2 cases (1.8％) in the TAPP group and 12 cases (17.1％) in the TIPP group with the foreign body sensation.The difference between the two groups was statistically significant (x2 =14.006,P =0.000).Conclusion Compared with the open TIPP,the laparoscopic TAPP is used to repair the inguinal hemia,The postoperative pain is milder,and the incidence of chronic pain and foreign body sensation was lower.

Based on the developing situation of Computer Aided Diagnosis/Detection (CAD) software, considering the domestic and international regulation of CAD software, according to current Medical Device Classification Catalog and related laws of China Food and Drug Administration (CFDA), this paper investigated and analyzed the classification of CAD software, and provided technical suggestion on classifying principle of CAD software applying Artificial Intelligence (AI) or other advanced technology from medical device regulation scope, for the reference of regulatory and technical departments.
Artificial Intelligence ; China ; Diagnosis, Computer-Assisted ; Radiographic Image Interpretation, Computer-Assisted ; Software

The prevalence of various types of mental illness has reached 17.5％, and the current treatment of mental illness generally includes western medicine, psychotherapy and physical therapy. Due to the high disability rate, low cure rate and easy recurrence, mental illness has become a major public health problem that seriously affects human health and social stability. And it has attracted the attention of the government and society. At present, the typical western medicine for treating mental illness has serious side effects, while new types of medicine for treating mental illness has a slow efficacy. Physical therapy has an unstable effect, and the side effects of drugs for treating mental illness lack effective method. These problems are expected to be successfully solved through traditional Chinese medicine, acupuncture and acupoint stimulation. This paper puts forward the integrated traditional Chinese and western medicine for the treatment of mental illness, and strives to build a technical system for the treatment of mental illness with integrated Chinese and Western medicine through the organic combination of multidisciplinary and multi-technology.Meanwhile, it lists some classic cases of treatment in order to provide reference for those who are keen on the integrated Chinese and western medicine in the treatment of mental disease.

Objective: To summarize and analyze the clinical data of hepatic venous pressure gradient (HVPG) and to explore the application value of HVPG in the diagnosis, evaluation and clinical treatment of portal hypertension in cirrhosis. Methods: The patient data of HVPG measurement performed in Shandong Provincial Hospital from April 2010 to November 2017 were collected. Results: A total of 633 patients with 833 times of HVPG measurements were included. There was significant difference in HVPG between patients with different etiologies, different Child-pugh grades and different degrees of decompensated cirrhosis. Conclusion The HVPG test is suitable for the diagnosis and evaluation of portal hypertension. The HVPG of patients with different severity of liver cirrhosis can guide the choice of the treatment plan, and the HVPG measurement should also be strictly standardized and quality control.