ObjectiveTo evaluate the effectiveness of Gandou decoction （GDD） by analyzing theclinical efficacy of GDD combined with speech training on the treatment of dysarthria with endoretention of damp-heat in Wilson's disease （WD）， so as to provide more clinical data and theoretical support for the selection of appropriate treatment schemes for WD patients with dysarthria with endoretention of damp-heat. MethodA total of 60 eligible WD patients with dysarthria with endoretention of damp-heat were selected and divided into a control group and a treatment group according to the random grouping method， with 30 cases in each group. The control group was treated with speech training + sodium dimercaptopropanesulfonate （DMPS）， and the treatment group was combined with GDD on the basis of the control group， with eight days as a course of treatment for 32 days. The total clinical effectiveness rate （Goldstein clinical classification）， dysarthria grading assessment from China Rehabilitation Research Center， TCM syndrome scores， 24-hour urine copper content， and modified Frenchay dysarthria rating scale scores of the two groups were compared before and after treatment. ResultAfter treatment， the total effective rate of the observation group was 90.0% （27/30）， and that of the control group was 70.0% （21/30）. The total effective rate of the observation group was significantly higher than that of the control group （Z=-1.986，P<0.05）. After treatment， the modified Frenchay dysarthria score， dysarthria grading assessment from China Rehabilitation Research Center， and 24-h urine copper in the two groups were significantly increased （P<0.05， P<0.01）， and the TCM syndrome score was significantly decreased （P<0.01）. Compared with the control group after treatment， except for the respiratory and jaw score， the modified Frenchay dysarthria score of the observation group was significantly increased （P<0.05， P<0.01）. The dysarthria grading from China Rehabilitation Research Center and 24-h urine copper content were significantly increased （P<0.01）， and the observation group had better efficacy. During the study period， there were no serious adverse reactions such as fever， rash， oral and eyelid mucosal swelling， exfoliative dermatitis， vomiting， diarrhea， or allergic shock during copper excretion treatment of DPMS and oral administration of GDD. ConclusionGDD combined with speech training can improve the symptoms and efficacy of WD patients with dysarthria with endoretention of damp-heat and enhance the patients' living standard to a certain extent， which can be widely used in clinics.

Objective To establish a safe disposal management program for home used sharps waste of insulin injection so as to provide a reference for the standardised management of sharps waste after insulin.injection.Methods Based on the model of information-motivation-behavioural skills,the safe disposal management program for insulin needles used at home was developed by literature reviews and semi-structured interviews to investigate the perceptions and requirements of patients.The program was then modified and refined by two rounds of expert consultation with Delphi method.Results The effective retrieval rates of questionnaire for two rounds of expert consultations were 88.89%and 93.75%,with an expert authority coefficient at 0.93.In the second round,the mean importance scores of the items were 4.40 to 5.00,with a coefficient of variation ranged from 0 to 0.168.The established program consisted of three primary items,six secondary items,and 20 tertiary items.Conclusion The safe disposal management program for home used sharps waste of insulin injection established from the perspectives of information,motivation and behavioural skills was scientific and practical,which offered a guidance to healthcare professionals in the clinical practices.

Objective In order to determine the incidence and mortality of uterine body cancer in Gansu province in 2019,the epidemic characteristics and the change trend of incidence and death from 2010 to 2019 were analyzed.Methods The quality control qualified data in Gansu province tumor registration center were used,uterine body cancer in urban and rural,age-specific inci-dence(mortality),the China standardized rate by Chinese population,the World standardized rate by World population,cumulative rate,crude incidence(mortality),composition ratio and rank,average annual percentage change(AAPC)and other indicators were calculated.Results In 2019,uterine body cancer in Gansu province ranked the seventh in the incidence of female malignant tumors,with a crude incidence of 4.43/100,000,the China standardized incidence was 3.28/100,000,and the World standardized incidence was 3.19/100,000.In 2019,uterine body cancer in Gansu province ranked the sixth among the mortality of female malignant tumors,with the crude mortality of 0.56/100,000,the China standardized mortality was 0.36/100,000,and the World standardized mortality was 0.35/100,000.The peak of morbidity(mortality)was in the age range of 50 to 54 years old.From 2010 to 2019,the incidence of uterine body cancer in Gansu province showed an overall upward trend.The China standardized incidence was AAPC=4.34%(95%CI:1.60%-7.15%),with a statistically significant trend(P<0.05);The mortality of uterine body cancer showed a fluctuating pat-tern of first rising,then decreasing,and increasing again,showing an overall downward trend.The China standardized mortality was AAPC=-11.35%(95%CI:-26.77%-7.32%),and the trend was not statistically significant(P>0.05).The incidence(mortali-ty)in rural areas was higher than that in urban areas.Conclusion The overall incidence of uterine body cancer in Gansu province is on the rise,and the death is on the decline.However,mortality in rural areas is on the rise.It is recommended to vigorously promote women′s health science popularization and education throughout the province,strictly implement the comprehensive measures of"early detection,early diagnosis,early treatment",and focus on the prevention and control of women aged 50-54,especially strengthening the early diagnosis and treatment of uterine body cancer in rural areas.

Objective The objective of this study was to analyze the incidence and mortality of female breast cancer in canc-er registration areas of Gansu province in 2019 and the change trend of female breast cancer incidence and mortality from 2010 to 2019,so as to provide data support for the prevention and treatment of breast cancer.Methods The incidence and mortality data of breast cancer and related demographic data in all cancer registration areas in Gansu province from 2010 to 2019 were collected.The incidence,mortality,age-standardized incidence by Chinese standard population(ASIRC),age-standardized mortality by Chinese standard population(ASMRC),age-standardized incidence by World standard population(ASIRW)and age-standardized mortality by World standard population(ASMRW),cumulative incidence and other key indicators of female breast cancer in each cancer registra-tion area were calculated according to urban and rural distribution and age groups.Joinpoint linear regression was used to analyze the annual change trend of incidence and mortality of female breast cancer in cancer registration areas in Gansu province from 2010 to 2019.Results In 2019,the number of new cases from female breast cancer in the cancer registration areas of Gansu province was 1,502 cases,accounting for 13.14%of all new malignant tumors in women.The incidence was 33.00/100,000,ASIRC and ASIRW were 23.83/100,000 and 23.81/100,000,respectively,and a cumulative rate of 0-74 years old was 2.34%.The incidence of breast cancer in urban and rural areas was 22.25/100,000 and 26.59/100,000,respectively.In 2019,the number of female breast cancer deaths in the cancer registration areas of Gansu province was 254,accounting for 5.61%of all female malignant tumor deaths.The crude mortality was 5.58/100,000,ASMRC and ASMRW were 3.70/100,000 and 3.90/100,000,respectively.The cumulative rate of 0-74 years old was 0.39%.The ASMRC of breast cancer in urban and rural areas was 3.63/100,000 and 3.79/100,000,respec-tively.The annual change trend in the ASIRC of female breast cancer in the province from 2010 to 2019 was not statistically significant(APC=-0.35%,P=0.81),while ASMRC decreased by an average of 9.85%per year(APC=-9.85%,P=0.03).Conclusion Breast cancer is a high incidence malignant tumor that threatens the physical and mental health of female residents in Gansu province,and it is a kind of cancer that women focus on.We should actively screen the risk group of women.

Objective To analyze the chemical constituents in the water extract of Bupleuri Radix and investigate the active ingredients of Bupleuri Radix for the treatment of depression.Methods The chemical constituents in the water extract of Bupleuri Radix were identified by Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS).CORT-induced poorly differentiated PC12 depression cell model was launched,and PC12 cells were pretreated with monomeric compounds from Bupleuri Radix for 24 h.The cell viability and LDH release rate were measured by CCK-8 assy kit and LDH assay kit,respectively.Results A total of 53 compounds were identified in the water extract of Bupleuri Radix,mainly including type Ⅰ,type Ⅱ and type Ⅲsaikosaponins.Among them,saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E,saikosaponin F and 6″-acetyl saikosaponin A contributed the most to the metabolite profile of Bupleuri Radix,and could improve the viability of CORT-induced PC12 cells(P<0.05,P<0.01).Furthermore,saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E and saikosaponin F could decrease the LDH release rate of CORT-induced PC12 cells(P<0.05,P<0.01).Conclusion The major anti-depression active ingredients in Bupleuri Radix may be Saikosaponin A,saikosaponin B2,saikosaponin C,saikosaponin E and saikosaponin F,which lays a foundation for the research of the quality control and pharmacodynamic material basis of Bupleuri Radix.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To retrieve and summarize the best evidence related to the management of insulin injection-related sharps waste disposal in diabetic patients at home and abroad, so as to provide reference for clinical healthcare professionals.Methods:This was a evidence-based research. Evidence on insulin injection-related sharps waste management in patients with diabetes, including guidelines, expert consensus, evidence summaries, best practice information sheet, recommended practices, clinical decisions and systematic reviews was systematically searched from domestic and international databases and professional websites, and the search time frame was from the establishment of the database to December 2021. Evidence was extracted and summarized following a quality evaluation of the literature that met the criteria.Results:A total of 15 papers were included, summarizing 25 pieces of best evidence on four areas including risk assessment and management of sharps waste associated with insulin injections, education and training, and the use of safe devices and sharps containers.Conclusions:Best evidence on the management of insulin injection-related sharps waste disposal provides evidence to support clinical practice for healthcare professionals to standardized sharps waste disposal practices in patients with diabetes.

Objective:To develop Insulin Pen Waste Needles Disposal Behavior Scale for Diabetic Patients and test its reliability and validity.Methods:Using the model of information, motivation and behavior skills as the theoretical framework, the item pool was constructed by literature review, semi-structured interview and expert consultation, and the test scale was formed after a small sample pre-survey. In July 2022, 158 and 204 diabetes patients who self-injected insulin in Endocrinology Outpatient Department of a general hospital in Shanghai were selected by the convenient sampling method. Two questionnaires were conducted to test the reliability and validity of the scale.Results:Insulin Pen Waste Needles Disposal Behavior Scale for Diabetic Patients included four dimensions, such as disposal behavior cognition, disposal behavior motivation, disposal behavior skills, and safe disposal behavior, with a total of 16 items. Four common factors were extracted from exploratory factor analysis, and the cumulative variance contribution rate was 73.80%. Content validity index was 0.98 at the average scale level, 0.88 at the level of unanimity scale, and 0.83-1.00 at the level of each item. The results of confirmatory factor analysis showed that the scale structure was stable. The Cronbach's α coefficient of the scale was 0.908, the Cronbach's α coefficient of the four factors was 0.858-0.901, the split half reliability coefficient was 0.941, and the retest reliability coefficient was 0.819.Conclusions:The scale constructed in this study has good reliability and validity, which can provide a scientific and effective assessment tool for medical staff to evaluate the disposal behavior of discarded needles used for insulin pens in diabetic patients.

Objective To investigate the clinical effectiveness and adverse events of domestic programmed cell death -1 (PD-1) inhibitor in the treatment of advanced non-HBV non-HCV-related hepatocellular carcinoma (NBNC-HCC). Methods A totals of 31 patients with advanced NBNC-HCC who received domestic PD-1 inhibitor in the Affiliated Hospital of Xuzhou Medical University from June 2019 to February 2022 were retrospectively enrolled and their clinicopathological data were retrieved from their medical records and analyzed, i.e., the time to disease progression (TTP), disease control rate (DCR), objective response rate (ORR), and adverse events were recorded and statistically analyzed. The Kaplan-Meier method was used for survival analysis. Results Among these 31 patients, only one achieved the complete response and four achieved the partial response, and six had the stable disease, but 20 showed a disease progression, resulting in an ORR of 16.1% and a (DCR of 35.5%. The median TTP was 7.2 months [95% confidence interval: 6.4-8.0) months]. The incidence of adverse events was 61.30% and the common adverse events were skin rash (29.03%) and hypertension (22.58%). However, there was no grade 4 adverse reactions or related death in these patients. Conclusion Advanced NBNC-HCC patients had a relative weak response to the PD-1 inhibitor although the adverse events were controllable. Future multi-center prospective clinical trials are needed to validate the data.

Objective:To understand the causes of improper disposal of discarded insulin pen needles at home in diabetic patients.Methods:Using descriptive phenomenological research method, semi-structured interviews were conducted in November 2021 with 18 patients with diabetes from the outpatient department of Shanghai University of Medicine & Health Sciences Affiliated Sixth Peoples Hospital South Campus (Shanghai Fengxian District Central Hospital), and Colaizzi seven-step analysis method was used to extract the themes.Results:The reasons for improper disposal of discarded insulin pen needles at home by diabetic patients included misconceptions about methods for safe disposal of needles, low awareness of safe disposal of needles, fear of needle stick injuries, lack of social support, time and distance conflict and economic burden.Conclusions:Medical staff should pay attention to health education to increase patients′ knowledge about safe disposal of needles. The collection program was optimized to alleviate patients′ fear of safe disposal of needle. At the same time, multiple support should be given to improve patients′ compliance with safe disposal of needle.