Objective To provide the supporting evidence for the separation policy between medicine and pharmacy by investigating the effect of the policy on pharmacy administration in four three grade hospitals.Methods The drug supply chain management was researched in 4 pilot hospitals.Specifically, the difference between Shanghai Sixth People′s Hospital and the Sixth People′s Hospital East Campus was compared.Changes of rational drug use index before and after the separation policy were documented for the Sixth People′s Hospital East Campus.Results ① 4 pilot hospitals with professional management of hospital drug supply chain achieved savings in staff, equipment and drug inventory.② The Sixth People′s Hospital East Campus has higher out of stock rate than Shanghai Sixth People′s Hospital.③ The rational drug use indicators were ameliorated after implementation of the separation policy in the Sixth People′s hospital East Campus.Conclusions The separation policy between medicine and pharmacy not only reduces hospital cost, but also improves hospital pharmacy management.

Infective endocarditis(IE)is an infectious disease on the endocardial surface,which is usually divided into acute(symptoms last for 6 weeks),sub-acute(symptoms last for 6 weeks to 3 months),and chronic(symptoms last for more than 3 months).IE is a systemic disease,which not only affects the heart itself,but also affects the function of multiple organs throughout the body.Therefore,the treatment of IE requires multidisciplinary involvement,especially the department of cardiothoracic surgery,infection department and imaging department.This study reviews the current research progress on the diagnosis and treatment of IE at home and abroad,in order to provide reference for the diagnosis and treatment of IE.

Elucidation of the signaling pathway mechanisms related to the mechanical stress-mediated bone regeneration is of great significance for improvement of bone regeneration and clinical treatment of bone-related diseases such as bone defects and bone elongation. Mechanical stress transmits mechanical stimuli into cells through the piezo channels and integrins, causing a variety of signaling pathway responses, which in turn changes transcription factor translocation, gene expression, and osteoblast differentiation to promote bone regeneration ultimately. This article reviews the research progress concerning the mechanisms related to mechanical stress-mediated bone tissue regeneration.

Almost 50% myelodysplastic syndromes (MDS) patients have different splicing factor mutations, including SF3B1, SRSF2, U2AF1. Different splicing factor mutations cause the various mechanisms of slicing abnormality and eventually lead to the similar MDS phenotypes, indicating that splicing factor mutations might generate the common pathopoiesia pathway different from slicing abnormality. Recent studies have shown that SF3B1, U2AF1 and SRSF2 mutations could contribute to the accumulation of R-loop, cause DNA damage and repair abnormality, activate ATR-Chk1 pathway and finally promote apoptosis and tumorigenesis. This paper reviews the role of R-loop in the pathogenesis of MDS and the progress of related targeted drugs.

Cataract extraction is often combined with the implantation of intraocular lens (IOL) with the diopter matching the operated eye to restore optimal visual function after surgery.However, there are often errors between the actual refractive power of the operated eye and the predicted value.One of the major causes of postoperative refractive error is the change in IOL position compared with the expected position.In order to improve the accuracy of postoperative refraction prediction, Holladay proposed to introduce the concept of effective lens position (ELP) into the IOL diopter calculation formula.The differences in the parameters and algorithms incorporated in the calculation of ELP lead to differences in the accuracy of IOL calculation formulas.With the application of multi-parameter calculation methods, especially the formula based on the artificial intelligence algorithm, the accuracy of IOL calculation formula has been significantly improved.ELP is also affected by various factors such as differences in ocular anatomy, IOL design and material, and surgical procedures, especially the factors affecting the stability of the capsular bag that increase the difficulty of accurately predicting ELP.Therefore, the changes in postoperative ELP need to be further discussed in order to obtain more accurate postoperative refraction.This article aimed to give a review of the development of calculation formulas and the influencing factors of ELP.

Myopic traction maculopathy (MTM) is a general term for multiple pathological changes such as myopic retinoschisis (MRS), macular hole (MH), and macular detachment (MD) in highly myopic eyes.The new MTM classification methods based on optical coherence tomography, the size and the location of the outer MRS, the relationship of MTM with posterior staphyloma, occurrence of MH and MD deepen the understanding of the disease and effectively assess the condition and prognosis of the disease.The pathogenesis of MTM may be related to the perpendicular and tangential traction produced by vitreoretinal adhesion, internal limiting membrane, and the posterior staphyloma.In the natural course of MTM, the morphology and visual function of most patients with MRS remain stable, and the progression of MRS is related to the severity of schisis and damage to the outer retinal microstructure.Surgical treatment is effective for advanced MTM with significantly impaired visual function.Vitrectomy is the main treatment method for MTM.Macular buckling or combined surgery can be chosen for MRS with MH and/or MD, and posterior scleral reinforcement is also an option for the treatment of MTM with long axial length, posterior staphyloma and poor results of vitrectomy to achieve the goal of relieving internal and external traction and repositioning the retina.The effectiveness of the surgery is also related to a variety of factors.Enzymatic vitreolysis and scleral cross-linking techniques have also provided new ideas for the treatment of MTM.This article summarized the clinical features and treatment strategies of MTM to guide its diagnosis and treatment.

Myelodysplastic syndrome (MDS) is a heterogeneous group of clonal diseases originating from hematopoietic stem cells. Various types of gene mutations have been found in MDS in recent years with the advance in high-throughput sequencing. Among the genes related to transcription factors, the mutation rate of RUNX1 is higher. RUNX1, a member of the core-binding factor family of transcription factors, is a critical regulator of normal hematopoiesis. RUNX1 mutation can lead to the decrease in the activity of transcription and the binding barrier of DNA. Recent studies have shown that RUNX1 mutation is an independent risk factor for the poor prognosis of MDS. Patients with RUNX1 mutation have a higher risk of transformation to leukemia and a shorter overall survival time. This review mainly discusses the mechanisms of pathogenesis, clinical features and the treatment of MDS patients with RUNX1 mutation.

N6-methyladenosine(m6A)is the most prevalent modification that regulates gene expression in eukaryotes.It regulates splicing,degradation,stability,and translation of RNA.Numerous studies have demonstrated the close association between m6A methylation and tumor development,highlighting its crucial role in regulating tumor immune response.The m6A modification actively participates in governing immune cell differentiation and maturation as well as modulating anti-tumor immune responses.Within the tumor microenvironment,m6A modification can also impact the recruitment,activation,and polarization of immune cells,thereby either promoting or inhibiting tumor cell proliferation and metastasis.Consequently,it plays a pivotal role in reshaping the tumor immune microenvironment.In recent years,immunotherapy for tumors has been increasingly applied to clinical practice with notable success achieved through approaches such as immune checkpoint inhibitor therapy and adoptive cell immunotherapy.Targeting m6A modifications to interfere with the immune system,such as targeting dysregulated m6A regulators through small molecule inhibitors and inducing immune cell reprogramming,can improve anti-tumor immune response and strengthen immune cells' ability to recognize and kill tumor cells.The m6A modification represents a novel avenue for potential clinical application within tumor immunotherapy.This review provides a comprehensive summary of the regulatory impact of m6A methylation modification on immune cells in the context of cancer,while also delving into novel targets for tumor immunotherapy.

BACKGROUND:Although nerve conduits provide an effective treatment approach for nerve repair,traditional nerve conduits merely serve as mechanical channels in the repair process.The therapeutic effect still needs to be improved.Carbon nanomaterials have good physicochemical properties and hold great potential in fields such as electrochemistry and tissue engineering.Nerve conduits loaded with carbon nanomaterials,after appropriate functional modifications,are expected to further enhance the quality of nerve repair. OBJECTIVE:To review the recent research progress of carbon nanomaterial-loaded nerve conduits/scaffolds for peripheral nerve repair. METHODS:PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),and Wanfang databases were searched for the literature on the application of carbon nanomaterial catheters in peripheral nerve regeneration.English keywords were"carbon nanomaterials,carbon-based nanomaterials,nerve conduit,nerve guidance conduit,scaffold,nerve regeneration,peripheral nerve repair,peripheral nerve injury"and Chinese keywords were"carbon nanomaterials,carbon materials,graphene,carbon nanotubes,nerve conduits,nerve scaffolds,nerve repair,nerve regeneration,peripheral nerve injury".Finally,69 articles were selected for this review. RESULTS AND CONCLUSION:(1)Carbon nanomaterials primarily restore damaged neural bioelectric signal conduction by activating calcium ion channels and inducing intracellular calcium activity.The application of various nerve conduit design strategies has improved the effectiveness of nerve repair.(2)Successful intraneural vascularization is the prerequisite for repairing peripheral nerve injuries.Reactive oxygen species and reactive nitrogen species generated by carbon nanomaterials trigger subsequent signaling pathways that promote intraneural vascularization.(3)The ratio of M1 to M2 macrophages affects the repair of peripheral nerve injuries.Carbon nanomaterials promote the polarization of macrophages into the M2 phenotype,thereby exerting their anti-inflammatory and regenerative effects.(4)Some carbon nanomaterials may induce excessive generation of reactive oxygen species intracellularly,potentially exhibiting cytotoxicity detrimental to nerve repair.However,appropriate functional modifications can improve the adverse effects caused by carbon nanomaterials.(5)Although carbon nanomaterials can restore the microenvironment of peripheral nerve injuries and play a positive role in promoting peripheral nerve regeneration,their inherent cytotoxicity and unclear in vivo degradation pathways still pose challenges for clinical application.However,by employing methods such as functional modification,it is possible to enhance the biocompatibility of carbon nanomaterials.Modified carbon nanomaterials have promising prospects in the field of neural tissue engineering.