OBJECTIVE To establish a pharmaceutical management system for externally dispensed medicines in medical institutions， so as to improve medication safety and regulatory efficiency. METHODS Based on policy analysis and hospital practice， a pharmaceutical management system for externally dispensed medicines was constructed by integrating institutional frameworks， an information‑based platform and management procedures， and the management effectiveness was evaluated. RESULTS Our hospital formulated the Regulations on the Management of Externally Dispensed Medicines ， which standardized catalogue selection， prescription issuance， acceptance and use， supervision and evaluation. An information‑based management platform for externally dispensed medicines was built relying on the hospital information system， enabling electronic prescription circulation， intelligent prescription review and whole‑process traceability. Institutional requirements and platform functions were embedded into three core management procedures， namely catalogue selection， prescription issuance， and medicine acceptance and use， forming a closed‑loop working mechanism. After the implementation of the management system， compared with pre‑implementation， the qualified rate of externally dispensed prescriptions increased from 85.2% to 99.3% （ P ＜0.001）， the automatic prescription review pass rate exceeded 95%， the prescription review duration shortened from 7.2 min to 1.8 min （ P ＜0.001）. All dimensional satisfaction scores of patients and medical staff were significantly improved， the standardization awareness of medical staff reached 100%. CONCLUSIONS The construction of a pharmaceutical management system for externally dispensed medicines with standardized institutional frameworks， informatized platforms and standardized procedures effectively enhances the rationality and management efficiency of externally dispensed prescription medicines， and provides a replicable practical pathway for the management of externally dispensed medicines in medical institutions.

The emerging paradigm of tumor microecology has reshaped our understanding of carcinogenesis. Colorectal cancer（CRC），a prevalent malignancy worldwide，is not only associated with gut microbial dysbiosis but is also linked to the oral microbiome. Notably， Fusobacterium nucleatum（Fn）can translocate from the oral cavity to the colon via cross-organ migration，colonize tumor tissues，and promote CRC initiation，progression，and therapeutic resistance. This review synthesizes evidence on the association between Fn and CRC，focusing on its promise as a biomarker for early detection，risk stratification，and disease monitoring，to provide novel insights for developing Fn-based strategies for the prevention，diagnosis，and management of CRC.

Objective:To investigate the relationships among coping styles,negative life events,meaning in life,and psychological resilience in adolescents.Methods:A total of 1 434 adolescents aged 13 to 17 years comple-ted online questionnaire survey.The Simplified Coping Style Questionnaire(SCSQ),Adolescent Self-Rating Life E-vents Checklist(ASLEC),Chinese Meaning in Life Questionnaire(C-MLQ),and Connor-Davidson resilience scale(CD-RISC)were used to assess coping styles,perceived impact of negative life events,experience and pursuit of meaning in life,and ability to cope with and adapt to adversity,respectively.Logistic regression was used to explore the associations among these variables.Results:A total of 723 students(50.4％)tended to adopt negative coping styles when facing adverse events.Positive coping styles were negatively associated with being in senior high school(OR=0.62,P＜0.05)and impact of life events(OR=0.97,P＜0.001),while positively associated with sense of meaning in life(OR=1.04,P＜0.001)and psychological resilience(OR=1.04,P＜0.001).Conclusion:Among adolescents,positive coping styles are inversely associated with impact of negative life events,and positively associ-ated with both the sense of life meaning and psychological resilience.

Objective To evaluate the efficacy and safety of using stent semi-retrieval technique during mechanical thrombectomy(MT)for acute anterior cerebral artery(ACA)occlusion.Methods We made a retrospective analysis of 38 patients with acute ACA occlusion treated by stent semi-retrieval technique at Tangdu Hospital and Xi'an No.1 Hospital from June 2019 to September 2023.The successful recanalization,first-pass effect(FPE),perioperative complications and postoperative recovery of all the patients were analyzed.Modified thrombolytic test in cerebral infarction(mTICI)was used to evaluate the recanalization(unsuccessful recanalization,mTICI 0-2a;successful recanalization,mTICI 2b-3).FPE was defined as mTICI 3 after one thrombectomy.The clinical outcome was evaluated by modified Rankin Scale(mRS)3 months postoperatively.A good prognosis was defined as a mRS 0-2.Results Of the 38 patients,36(94.7％)got successful recanalization(mTICI 2b-3),with an FPE of 73.7％(28/38).Two cases of mild vascular spasm(5.3％)occurred during the mechanical thrombectomy,which completely relieved without further treatment.None of the 38 patients experienced vascular rupture or dissection,and no thrombus escaped during the thrombus removal process.There was no subarachnoid hemorrhage or parenchymal hemorrhage in the area related to ACA occlusion.Ninety days after operation,14 cases(36.8％)reached good outcome(mRS 0-2),18 cases(47.4％)reached mRS 3-5,and 6 cases(15.8％)died.Conclusion Our preliminary experience suggests that the stent semi-retrieval technique may be a safe and effective method for treating acute anterior cerebral artery occlusion.

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.

Objective To investigate the weight loss efficacy and mechanisms of oligopeptide-herbal medicine composite,and to provide new approaches for obesity treatment.Methods Twenty-three SPF female SD rats were randomly divided into control group(n=3)and modeling group(n=20).The control group was fed an ordinary diet for 6 consecutive weeks,and the modeling group was fed a high-fat diet for 6 consecutive weeks to establish a simple obesity rat model.After successful modeling,the modeling group was randomly divided into model group(n=10)and treatment group(n=10).The treatment group started anoint-and-massage therapy with oligopeptide-herbal medicine composite(3 g per rat per time,once a day,20 min each time),which was recorded as day 1.The control group and model group were not treated with oligopeptide-herbal medicine composite but received the same massage,and continued to be fed ordinary feed and high-fat feed respectively.Ten rats in the model group and ten in the treatment group were each divided into 3 groups,with 3,3,and 4 rats in each group.On days 3,6,and 9 after treatment,the rats in the three groups were weighed and cardiac blood collection was performed after isoflurane respiratory anesthesia.After euthanasia by cardiac bloodletting,abdominal subcutaneous adipose tissue(aSAT)and perirenal white adipose tissue(pWAT)samples were collected and weighed.Serum triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)levels were measured.Image J software was used to measure aSAT thickness and the diameter and area of perirenal white adipocytes and abdominal subcutaneous adipocytes.Immunofluorescence technique was used to observe the number of telocytes(TCs),cell junctions and exosomes per unit area of aSAT.Transmission electron microscopy was used to measure the length of telopodes(Tps)of dermal and subcutaneous TCs in abdominal skin,and to observe the distribution of exosome vesicles,rough endoplasmic reticulum,mitochondria,and cell junctions.Results Compared with the control group,the body weight of rats in the modeling group increased significantly(P＜0.05).Compared with the control group,rats in the model group showed a significant increase in serum TG level,a significant decrease in HDL-C level,and a significant increase in pWAT mass(all P＜0.05).Compared with the model group,the treatment group showed a significantly increased rate of body weight reduction,significantly decreased pWAT mass,significantly decreased serum TG level,and significantly increased HDL-C level(all P＜0.05).Compared with the model group,the treatment group showed significant reductions in aSAT thickness,as well as cell diameter and area in both aSAT and pWAT(all P＜0.05).Compared with the model group,the treatment group showed significantly increased number of TCs per unit area of aSAT,number of exosomes from TCs in aSAT,and Tps length(all P＜0.05).The treatment group showed an increasing trend in the numbers of mitochondria,rough endoplasmic reticulum,and cell junctions in TCs.Conclusion Oligopeptide-herbal medicine composite applied via anoint-and-massage therapy effectively improves obesity-related symptoms such as dyslipidemia and fat accumulation in obese rats by regulating TCs and their intercellular communication.

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.

[Objective]To explore the value of the Model for End-Stage Liver Disease(MELD)3.0 in predicting survival outcomes for patients with alcoholic cirrhosis and to establish an effective mortality prediction model.[Methods]Clinical data of 788 hospitalized patients who were first diagnosed with alcoholic cirrhosis at the Third Affiliated Hospital of Sun Yat-sen University between January 1,2011 and December 31,2019 were analyzed.Patients were followed up until December 31,2023 and divided into survival and mortality groups based on the survival outcomes at 30 days,90 days,1 year,and 3 years after admission.The prognostic values of the MELD 3.0,MELD,MELD-Sodium(MELD-Na)for survival in alcoholic cirrhosis patients were assessed and compared by using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Additional risk factors associated with mortality in alcoholic cirrhosis patients were identified,and a novel mortality prediction model based on MELD 3.0 was developed.[Results]The AUC of the MELD 3.0 score in predicting 30-day,90-day,1-year,and 3-year survival was 0.823,0.730,0.686,and 0.658,respectively,which were superior to those of the MELD-Na(0.802,0.708,0.666,and 0.645,respectively)and MELD scores(0.698,0.668,0.654,and 0.633,respectively)(all P<0.05).MELD 3.0 demonstrated better performance at 30 and 90 days(AVC=0.823,0.730;both P<0.05)than at 1 year and 3 years(AVC=0.686,0.658;both P<0.05).Binary logistic regression combined with LASSO regression indicated that the independent risk factors associated with the 1-year outcome included MELD 3.0,baseline ascites and hepatocellular carcinoma.A survival prediction model was then established with AUC of 0.748,sensitivity of 0.695,and specificity of 0.775.[Conclusions]MELD 3.0 has a superior predictive ability for 30-day,90-day,1-year,and 3-year survival in patients with alcoholic cirrhosis than MELD-Na and MELD.The prediction model incorporating MELD 3.0,ascites and hepatocellular carcinoma improves the prediction of 1-year survival outcomes for alcoholic cirrhosis patients.

Objective To investigate the weight loss efficacy and mechanisms of oligopeptide-herbal medicine composite,and to provide new approaches for obesity treatment.Methods Twenty-three SPF female SD rats were randomly divided into control group(n=3)and modeling group(n=20).The control group was fed an ordinary diet for 6 consecutive weeks,and the modeling group was fed a high-fat diet for 6 consecutive weeks to establish a simple obesity rat model.After successful modeling,the modeling group was randomly divided into model group(n=10)and treatment group(n=10).The treatment group started anoint-and-massage therapy with oligopeptide-herbal medicine composite(3 g per rat per time,once a day,20 min each time),which was recorded as day 1.The control group and model group were not treated with oligopeptide-herbal medicine composite but received the same massage,and continued to be fed ordinary feed and high-fat feed respectively.Ten rats in the model group and ten in the treatment group were each divided into 3 groups,with 3,3,and 4 rats in each group.On days 3,6,and 9 after treatment,the rats in the three groups were weighed and cardiac blood collection was performed after isoflurane respiratory anesthesia.After euthanasia by cardiac bloodletting,abdominal subcutaneous adipose tissue(aSAT)and perirenal white adipose tissue(pWAT)samples were collected and weighed.Serum triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)levels were measured.Image J software was used to measure aSAT thickness and the diameter and area of perirenal white adipocytes and abdominal subcutaneous adipocytes.Immunofluorescence technique was used to observe the number of telocytes(TCs),cell junctions and exosomes per unit area of aSAT.Transmission electron microscopy was used to measure the length of telopodes(Tps)of dermal and subcutaneous TCs in abdominal skin,and to observe the distribution of exosome vesicles,rough endoplasmic reticulum,mitochondria,and cell junctions.Results Compared with the control group,the body weight of rats in the modeling group increased significantly(P＜0.05).Compared with the control group,rats in the model group showed a significant increase in serum TG level,a significant decrease in HDL-C level,and a significant increase in pWAT mass(all P＜0.05).Compared with the model group,the treatment group showed a significantly increased rate of body weight reduction,significantly decreased pWAT mass,significantly decreased serum TG level,and significantly increased HDL-C level(all P＜0.05).Compared with the model group,the treatment group showed significant reductions in aSAT thickness,as well as cell diameter and area in both aSAT and pWAT(all P＜0.05).Compared with the model group,the treatment group showed significantly increased number of TCs per unit area of aSAT,number of exosomes from TCs in aSAT,and Tps length(all P＜0.05).The treatment group showed an increasing trend in the numbers of mitochondria,rough endoplasmic reticulum,and cell junctions in TCs.Conclusion Oligopeptide-herbal medicine composite applied via anoint-and-massage therapy effectively improves obesity-related symptoms such as dyslipidemia and fat accumulation in obese rats by regulating TCs and their intercellular communication.

Objective:To translate and adapt the Apathy Evaluation Scale-Clinician (AES-C) into Chinese and test its reliability and validity in patients with Alzheimer 's disease (AD). Methods:Following Brislin′s translation model, the English version of the AES-C was translated, back-translated, cross-culturally adapted, and pre-surveyed, ultimately forming the Chinese version of the AES-C. Clinical data were prospectively collected from October 2022 to April 2024 for AD patients aged 55-85 years who were treated at the outpatient and inpatient psychiatric departments of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. A total of 111 AD patients were recruited. Two weeks later, using systematic sampling, one patient was randomly selected from the first three cases as the starting point, followed by selecting patients at intervals of 3 and 4 alternately until 30 cases were selected. Item analysis of the scale was conducted using the critical ratio(CR) method. Content validity was assessed by calculating the item-level content validity index(I-CVI) and the scale-level content validity index (S-CVI). Structural validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was examined by internal consistency reliability (Cronbach′s α coefficient) and test-retest reliability.Results:The CR values of each item analysis were>3.000 ( P<0.01). Low-relevant entries were deleted after a unanimous expert discussion of content validity, and the I-CVI and S-CVI were both 1.000. The Kaiser-Meyer-Olkin (KMO) value was 0.722, Bartlett′s test of spherical χ 2=621.286 ( df=55), P<0.01. Four common factors were extracted, with variance contribution rate of 33.0%, 15.3%, 15.1%, 15.1%, and 14.9%, for a cumulative variance contribution of 78.4%. CFA showed χ2/ df=1.778, Root Mean Square Error of Approximation (RMSEA)=0.084, Tucker-Lewis Index (TLI)=0.928, Goodness-of-Fit Index (GFI)=0.906, Comparative Fit Index (CFI)=0.950, and Incremental Fit Index (IFI)=0.952, and all the indexes of the model were in line with the model fit standards. Cronbach′s coefficient α was 0.809, and the retest reliability coefficient was 0.928. Conclusion:The Chinese version of the Apathy Evaluation Scale-Clinician (AES-C) demostrates good reliability and validity in AD patients.