Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To understand the current situation of reprocessing reusable sterilized items in the central sterile supply departments(CSSD)of hospitals and provide a scientific basis for further standardized management.Methods Using the convenience sampling method,a self-designed questionnaire on the current situation of reprocessing of reusable disinfection items in CSSDs was used to conduct a survey in 31 provinces(autonomous regions and municipalities)from June 11th to 23rd,2024.The questionnaire covered 2 aspects,including the basic situation of the hospital and the reprocessing of disinfection items.Results A total of 1 835 questionnaires were distributed,and 1 603 valid questionnaires were retrieved.Regarding the use of reusable disinfection items,with the most frequently used items being humidification bottles,tourniquets,breathing bags and their accessories,and ventilator tubing systems etc.Among them,1 558 hospitals(97.19％)established standardized disposal procedures,and 996 hospitals(62.13％)assigned dedica-ted personnel to be responsible.In terms of the reprocessing procedures of reusable disinfection items,all 1 603 hospitals carried out drying process for the items;the main packaging method was plastic self-sealing bags(59.95％),and 541 hospitals(33.75％)sterilized the packaging materials.Additionally,935 hospitals(58.33％)used oil-free air compressors;among them,51 hospitals(58.62％)installed activated carbon filters at the end of the compressors.Conclusion The current situation of reprocessing reusable sterilized items in CSSDs of nationwide hospitals needs improvement.It is recommended to strengthen the training of professional disinfection knowledge,unify the sterilization standards for plastic self-sealing bags,develop a storage management system,and adopt a medical air compressor system without oil and water to reduce the risk of hospital infections.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To understand the current situation of reprocessing reusable sterilized items in the central sterile supply departments(CSSD)of hospitals and provide a scientific basis for further standardized management.Methods Using the convenience sampling method,a self-designed questionnaire on the current situation of reprocessing of reusable disinfection items in CSSDs was used to conduct a survey in 31 provinces(autonomous regions and municipalities)from June 11th to 23rd,2024.The questionnaire covered 2 aspects,including the basic situation of the hospital and the reprocessing of disinfection items.Results A total of 1 835 questionnaires were distributed,and 1 603 valid questionnaires were retrieved.Regarding the use of reusable disinfection items,with the most frequently used items being humidification bottles,tourniquets,breathing bags and their accessories,and ventilator tubing systems etc.Among them,1 558 hospitals(97.19％)established standardized disposal procedures,and 996 hospitals(62.13％)assigned dedica-ted personnel to be responsible.In terms of the reprocessing procedures of reusable disinfection items,all 1 603 hospitals carried out drying process for the items;the main packaging method was plastic self-sealing bags(59.95％),and 541 hospitals(33.75％)sterilized the packaging materials.Additionally,935 hospitals(58.33％)used oil-free air compressors;among them,51 hospitals(58.62％)installed activated carbon filters at the end of the compressors.Conclusion The current situation of reprocessing reusable sterilized items in CSSDs of nationwide hospitals needs improvement.It is recommended to strengthen the training of professional disinfection knowledge,unify the sterilization standards for plastic self-sealing bags,develop a storage management system,and adopt a medical air compressor system without oil and water to reduce the risk of hospital infections.

Objective:To identify factors influencing orthostatic intolerance (OI) in patients during initial ambulation following minimally invasive lung surgery and develop and validate a risk prediction model to assist clinical practitioners in screening high-risk patients.Methods:Totally 1 000 patients who underwent minimally invasive lung surgery at the Department of Thoracic Surgery of Peking University Third Hospital from March 2022 to November 2023 were recruited by convenience sampling. Patients were randomly divided into a modeling group ( n=800) and an internal validation group ( n=200) in an 8∶2 ratio. Univariate analysis and logistic regression were applied to determine risk factors for OI in the modeling group. R software was utilized to construct a nomogram model. The model's predictive performance was assessed using the area under the ROC curve ( AUC) for both the modeling and validation groups. Calibration curves were plotted to evaluate consistency, and the Hosmer-Lemeshow test was conducted to confirm model fit. Results:The incidence of OI during initial ambulation was 37.2% (372/1 000). Logistic regression identified BMI, postoperative day 1 drainage volume, postoperative use of nonsteroidal anti-inflammatory drugs (NSAIDs), and initial ambulation pain score as independent risk factors for OI ( P<0.05). The AUC for the nomogram model in the modeling group was 0.645, and 0.694 in the validation group, indicating good predictive accuracy. Calibration curves showed strong agreement between predicted and observed outcomes ( P>0.05) . Conclusions:The constructed risk prediction model demonstrates good predictive ability for OI risk during initial ambulation following minimally invasive lung surgery, which can support clinical identification of high-risk patients. This tool may provide valuable guidance for implementing early, targeted preventive measures.

Objective:To identify factors influencing orthostatic intolerance (OI) in patients during initial ambulation following minimally invasive lung surgery and develop and validate a risk prediction model to assist clinical practitioners in screening high-risk patients.Methods:Totally 1 000 patients who underwent minimally invasive lung surgery at the Department of Thoracic Surgery of Peking University Third Hospital from March 2022 to November 2023 were recruited by convenience sampling. Patients were randomly divided into a modeling group ( n=800) and an internal validation group ( n=200) in an 8∶2 ratio. Univariate analysis and logistic regression were applied to determine risk factors for OI in the modeling group. R software was utilized to construct a nomogram model. The model's predictive performance was assessed using the area under the ROC curve ( AUC) for both the modeling and validation groups. Calibration curves were plotted to evaluate consistency, and the Hosmer-Lemeshow test was conducted to confirm model fit. Results:The incidence of OI during initial ambulation was 37.2% (372/1 000). Logistic regression identified BMI, postoperative day 1 drainage volume, postoperative use of nonsteroidal anti-inflammatory drugs (NSAIDs), and initial ambulation pain score as independent risk factors for OI ( P<0.05). The AUC for the nomogram model in the modeling group was 0.645, and 0.694 in the validation group, indicating good predictive accuracy. Calibration curves showed strong agreement between predicted and observed outcomes ( P>0.05) . Conclusions:The constructed risk prediction model demonstrates good predictive ability for OI risk during initial ambulation following minimally invasive lung surgery, which can support clinical identification of high-risk patients. This tool may provide valuable guidance for implementing early, targeted preventive measures.

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Objective: To study the efficacy and safety of sofosbuvir and daclatasvir regimens for patients who received kidney transplantation (KT) with hepatitis C virus (HCV) infection. Methods: This study enrolled a prospective cohort of consecutive KT patients with HCV infection from March 2016 to January 2018 in the hepatology Department of the Second Hospital of Shandong University. They were given sofosbuvir combined with daclatasvir, with or without ribavirin. The course of treatment was 12 weeks or 24 weeks. Clinical assessment, conventional liver and kidney biochemical parameters, hemoglobin, serum HCV RNA, as well as the types of immunosuppressive drugs and their doses were assessed routinely as follows: at the beginning of treatment; 2, 4, and 8 wk post treatment; at the end of treatment (EOT); and at 12, 24 wk after the therapy was completed. Adverse events and adjustment of anti-rejection drugs were surveilled during the treatment period. Results: A total of 13 patients were enrolled. All patients were naive to treatment. Their mean age was 46.84±7.79 years. There were 10 males and 3 females, 3 patients had cirrhosis (1 cases had decompensated cirrhosis), 10 patients had no cirrhosis. They were infected with HCV genotype 1 (6/13 GT1b), genotype 3 (2/13 GT3a) and genotype 6 (3/13 GT6a), and genotype 2 (2/13 GT2a). Twelve patients′ estimated glomerular filtration rate (eGFR) was > 30 ml/min per 1.73 m² at the beginning of treatment, 1 patient′s eGFR was <30 ml/min·1.73 m^2; 9 patients received 12 wk therapy, 4 patients received 24 wk therapy. Twelve patients had undetectable viral load by week 4 of treatment. All patients had undetectable HCV viral load at the end of treatment. Sustained virological response (SVR) 12 rate was achieved in 100% (13/13) of the recipients. The basic renal function remained stable during the course of treatment. No serious adverse events were observed during the treatment. Antiviral therapy was not discontinued due to side effects in any patient. Conclusions Sofosbuvir and daclatasvir for treatment of KT patients with HCV infection are highly effective and safe.

Objective To clarify the role of syk kinase in inflammasome activation in mouse peritoneal macrophages during Listeria monocytogenes (LM) infection. Methods Murine peritoneal macrophages were randomly divided into BAY treatment group, SB treatment group, WO treatment group, no treatment group and negative control group (NI). There were three wells in each group. The syk inhibitor BAY 117082, P38MAPK inhibitor SB203580 and PI3K inhibitor wotamine were used to treat murine peritoneal macrophages for 1h in BAY treatment group, SB treatment group and WO treatment group. Murine peritoneal macrophages were infected with LM for 24 h except NI group. The protein level of interleukin (IL)-18 in the supernatant was detected by ELISA kit. The activation condition of key molecule ASC in the infected-macrophages cyto-plasm was observed under fluorescence microscope. The phosphorylation levels of syk protein kinase at different time points during LM infection were determined by Western blot assay. Results There was no significant difference in IL-18 protein level before and after BAY treatment in NI group (P>0.05). The IL-18 protein level was significantly lower after LM infec-tion in BAY treatment group compared with that in no treatment group (P<0.05). In contrast, there was no significant differ-ence in IL-18 production between SB treatment group, WO treatment and no treatment group (P>0.05). Meanwhile, the per-centage of ASC-speck positive cells was obviously diminished in BAY treatment group compared with that in no treatment group (P<0.01). The phosphorylation levels of syk were significantly increased in 5 min, 15 min and 30 min post-infection. Conclusion Syk kinase signaling is involved in the inflammasomes activation upon Listeria monocytogenes infection in mu-rine macrophages.

Objective To clarify the relationship of p63 and CD44 expressions with age and ultraviolet irradiation in the process of skin aging.Methods Full-thickness skin samples were obtained from the normal skin at different sites,including 44 sun-exposed sites(face,neck,dorsal aspect of the forearm),46 sun-protected sites(abdomen,thigh),and 31 semi-exposed sites(back,flexor aspect of the forearm,upper arm,leg),of 121 volunteers(63 males and 58 females).Of all the volunteers,55 were 10 t0 30 vears of age (young),41 were 31 to 50 years of age(adult),and 25 were 51 to 79 years of age(old).Immunohistochemisty using antibodies to p63 and CD44 was applied to detect the expression of p63 and CD44 in these specimens.Imaging analysis software was utilized to calculate the percentage of p63-expressing cells in basal layer as well as the expression level of p63 and CD44.Results In stratum basale,the percentage of p63-expressing cells decreased with age(r=-0.218,P＜0.05),but showed no significant difference among sun-exposed skin,semi-exposed skin and sun-protected skin(P＞0.05).The correlation between the expression intensity of epidermal p63 and age was negative in sun-exposed sites(r=-0.389,P=0.010),positive in sun-protected sites(r=0.341,P＜0.05).but non-significant in semi-exposed sites(P＞0.05).With regard to the expression of epidermal p63,no significant difference was observed among sun-exposed sites,sun-protected sites and semi-exposed sites in volunteers aged from 10 to 30 years.while in those aged from 31 to 50 years and from 51 to 79 years.sun-protected sites was significantly higher than semi-exposed sites followed by sun-exposed sites(all P＜0.05).There was a weak correlation between the expression intensity of epidermal CD44 and age(r=-0.083,P＜0.05),but no significant difierence was noted among the three kinds of sites(P＞0.05).Conclusions In stratum basale,the percentage of p63.expressing cells and the expression intensity Of CD44 negatively correlate with age,but have no correlation with ultraviolet irradiation.In individuals aged from 31 to 50 years and from 51 t0 79 vears.the expression of epidermal p63 decreases with the accumulation of sun-exposure.