Purpose: Numerous studies have produced conflicting findings regarding the efficacy of statins in prostate cancer treatment. Our objective was to examine the correlation between statin usage and clinical outcomes in Taiwanese men with de novo metastatic prostate cancer. Materials and Methods: We identified patients diagnosed with de novo metastatic prostate cancer from the Chang Gung Research Database spanning the years 2007 to 2020. To minimize confounding bias, we employed the inverse probability of treatment weighting (IPTW) method. Clinical outcomes were assessed using IPTW-adjusted Kaplan-Meier curves. Multivariate Cox proportional hazard regression analysis was utilized to evaluate the association between mortality and clinical factors. Results: The study cohort comprised 1,716 statin users and 276 non-users. Patients who used statins exhibited a longer median overall survival (85.4 months compared to 58.2 months; p=0.001) and cancer-specific survival (112.6 months compared to 75.7 months; p<0.001) compared to non-users. The median time to the development of castration-resistant status was similar between statin users and non-users (p=0.069). Multivariable Cox proportional hazards regression analysis, after IPTW adjustment, demonstrated that statin use was associated with improved overall survival. Conclusions Our study indicates that the use of statins following a de novo metastatic prostate cancer diagnosis enhances survival outcomes. However, statins did not appear to delay the onset of castration-resistant status. Further large-scale and long-term studies are warranted to investigate the biological effects of statins in men with prostate cancer.

Objective: To evaluate the degree of trust of patients in community traditional Chinese medicine(TCM)physicians, based on the TCM service capability promotion program, and to analyze the impacts by TCM prevention and health care service. Methods: 1 391 patients at 22 primary health service centers in 3 cities from Zhejiang province were investigated using the Chinese version of Wake Forest Physician Trust Scale(WFPTS)in September, 2017. Quantitative and qualitative variables were described by mean±SD, and ratio respectively. Differences were compared by t test, ANOVA and Kruskal-Wallis test. Results: Chinese version of WFPTS had good reliability and validity in measuring community TCM physicians. The average scoring of patients′ trust in community TCM physicians was 38.00±6.42, while their benevolence and competence were 19.14±3.41, 18.82±3.50 respectively.For patients with different demographic characteristics, their quantity and the way to acquire and utilize TCM prevention and health care service had different degrees of trust in community TCM physicians. Patients′ gender, age, awareness and utilization of TCM prevention and health care service, etc. affect the degree of trust in community TCM physicians. Conclusions Patients have higher degree of trust in community TCM physicians, and improving the rate of awareness and utilization of TCM prevention has positive impacts on the degree of trust in these physicians. It is proposed that health knowledge education be strengthened and skills of community TCM physicians′ capacity be enhanced through various ways.

Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.

Objective:To measure with Zhejiang province as an example the situation of the self-evaluation health management service capability of primary medical staff in county-level medical alliances.Methods:A self-evaluation scale for health management service capability by primary medical staff was customized, covering 5 dimensions of professional attitude, interpersonal communication ability, comprehensive knowledge integration ability, professional practice ability and professional development ability, as well as 29 items. In July-September 2019, medical alliances were selected from three counties/cities based on economic development as the survey targets, and a total of 264 primary medical staff were surveyed. Quantitative data were described in mean and standard deviation, while qualitative data were described in composition ratio, and the differences were compared by Kruskal-Willis test.Results:The self-evaluation scoring of health management service capability of the primary medical staff was (59.75±18.64) points, and the average scoring of the items was (2.06±0.64) points. The scoring of knowledge integration (1.98±0.70)and professional practical ability (2.03±0.67) were lower than the average scoring of the items; gender and occupation type of primary medical staff present statistical significances in the self-evaluation scoring of health management service capability.Conclusions:Given the health management service capabilities of primary medical staff, they still need to upgrade their knowledge integration and professional practice capabilities. County-level medical alliances should enhance their training of health management knowledge and skills, promote doctor-nurse collaboration in health management services to broaden the depth of primary health management services.

Objective To explore the effects of bundle airway management on the airway nursing in patients with severe inhalation injury. Methods Totally 32 patients with severe inhalation injury who were admitted and treated in the Department of Burns Surgery, the First Hospital of Jilin University between June 2013 and December 2014 were selected as a control group, who received conventional nursing, while another 35 patients with severe inhalation injury who were admitted and treated from January 2015 to June 2016 were selected as an observation group, who received nursing based on bundle airway management, including airway assessment and emergency treatment, diagnosis and treatment of suffocation, position management, sputum aspiration management, suction under glottis, airway humidification, aerocyst management, nursing with aircasing, nursing of incised part, nursing of breast and chest, mouth care, management of respiratory tube, and infection control in medical environment. Patients in the two groups were evaluated in arterial blood analysis indexes (pH, PaO2, PaCO2, Lac), oxygenation index and oxygen saturation (SaO2) at day 1, 6 and 12; sputum density in week 2 and 3; and the number of cases with positive results in sputum cultivation in week 2 and 3. Results There were statistically significant differences between the patients in the two groups in pH, PaO2, Lac,PaCO2and SaO2values at day 6 (P< 0.05); oxygenation index at day 12 (P< 0.05); and sputum density and the positive rate of sputum cultivation in week 2 and 3 (P<0.05). Conclusions Bundle airway management can effectively improve the oxygenation sputum density in patients with inhalation injury, and reduce their pulmonary infection.

Objective To investigate the effects of inflammatory factors TNF-α, IL-1β, IL-6 on expression of mechano growth factor (MGF). Methods In the experimental group, TNF-α and IL-6 at concentration of 25, 50, 100 ng/mL, or IL-1β at concentration of 2.5, 5.0, 10 ng/mL were applied to fibroblast-like synoviocytes (FLSs) for 12 hours. The inhibitor groups were pretreated with PKA pathway inhibitor KT5720 at concentration of 1.0 mmol for 1 hour. The control group remained under the same culture condition as the experimental group, but without any growth factor. Real-time PCR was used to measure the gene expression of MGF. Results Treated with TNF-α at concentration of 25 ng/mL and IL-1β at concentration of 10 ng/mL, the MGF expression in FLSs was significantly increased (P＜0.05). IL-6 had no effect on MGF expression. A specific inhibitor of cAMP-dependent protein kinase, at concentration of 1.0 mmol significantly decreased the activation of MGF synthesis by TNF-α and IL-1β in FLSs (P＜0.05). Conclusions TNF-α at concentration of 25 ng/mL and IL-1β at concentration of 10 ng/mL significantly induce the MGF expression in FLSs, which activate MGF synthesis via the PKA pathway. This study is of significance in improving the application of MGF used in tissue repair area to make up the insufficient stress stimulation.

OBJECTIVETo compare the properties of water-absorption, water-locking, and air permeability among several foam dressings, and to provide references for clinician in choosing dressings for different types of wounds.

METHODSThe comparison was made among Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing that were commonly used in clinic. NaCl and CaCl2·H2O respectively in the weight of 8.3 g and 0.367 g were diluted with distilled water to the volume of 1 L to simulate wound exudation. The simulated wound exudation was used to test the water-absorbing rate of dressings at post immersion hour (PIH) 24, water-absorbing speed of dressings at post immersion minute (PIM) 1, 5, 10, and 20, the diffusion diameter of exudation dripped on the surface of dressings for 5 min to reflect the water-locking capacity of dressings, and the water evaporation capacity of exudation after being sealed up by dressings for 24 h to reflect the air permeability of dressings. Five samples of each dressing were used for each index. Data were processed with one-way analysis of variance and analysis of variance of repeated measurement, and LSD method was applied in paired comparison.

RESULTS(1) The water-absorbing rate at PIH 24 of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (646 ± 18)%, (616 ± 19)%, and (499 ± 11)% (F = 423.854, P < 0.01). The differences between each two dressings in water-absorbing rate were statistically significant (with P values all below 0.01). (2) The water-absorbing speed of Allevyn foam dressing at PIM 1, 5, 10, and 20 were (35.20 ± 2.31), (12.48 ± 0.37), (6.63 ± 0.23), and (3.39 ± 0.08) g×s(-1)×m(-2), which were obviously lower than those of Mepilex foam dressing [(119.68 ± 2.59), (24.39 ± 0.62), (12.33 ± 0.29), and (6.18 ± 0.13) g×s(-1)×m(-2)] and Biatain foam dressing [(121.09 ± 3.41), (24.73 ± 0.52), (12.37 ± 0.25), (6.18 ± 0.13) g×s(-1)×m(-2)], with P values all below 0.01. The water-absorbing speed of each dressing showed the trend of declination among three dressings with prolongation of time. The differences between two adjacent time points within each dressing in water-absorbing speed were statistically significant (with P values below 0.01). (3) Diffusion diameters of exudation dripped on the surface of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (5.66 ± 0.15), (4.84 ± 0.15), (3.94 ± 0.21) cm (F = 124.742, P < 0.01). The differences between each two of the three dressings in diffusion diameter were statistically significant (with P values all below 0.01). (4) The water evaporation capacity of exudation after being sealed up by each dressing for 24 h decreased in succession for Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing, which were respectively (31.2 ± 3.1), (29.7 ± 8.7), (5.6 ± 2.8) g×h(-1)×m(-2) (F = 24.324, P < 0.01). The water evaporation capacity of exudation sealed with Biatain foam dressing was significantly lower than that of exudation sealed with Allevyn foam dressing and Mepilex foam dressing (with P values below 0.01).

CONCLUSIONSAmong the three kinds of foam dressings, Allevyn performs best in water-absorbing rate, water-locking capacity, and air permeability, while Mepilex and Biatain perform best in water-absorbing speed. For selecting foam dressing in clinic, the properties of foam dressings and wound characteristics should be considered at the same time.