Objective To investigate the effects of hypoxia on the transcriptional phenotype and ultrastructure of tumor-associated macrophages(TAMs)in glioma.Methods CD14+monocytes were isolated from healthy human peripheral blood samples collected from the Blood Bank of the First Affiliated Hospital of Army Medical University,and the cells were induced to differentiate into TAMs through co-culture with glioma cell-conditioned medium.Hypoxic TAM models were established using varying concentrations of cobalt chloride hexahydrate(CoCl2,50～400 μmol/L)or hypoxic conditions(1%,5%,10%O2)for 48 h,while normoxic TAM models(21%O2)served as controls.RT-qPCR and transcriptome sequencing were employed to analyze transcriptional changes in TAMs under normoxic and hypoxic conditions.Gene set enrichment analysis(GSEA)was applied to compare the differences in angiogenesis,glycolysis and other hypoxia-responsive pathways between the 2 conditions.Transmission electron microscopy(TEM)or immunofluorescence staining was conducted to assess the ultrastructural alterations in cytoskeleton,endoplasmic reticulum(ER),and mitochondria in normoxic and hypoxic TAMs(1%O2).Results Hypoxic TAMs exhibited up-regulated transcription of hypoxia-responsive markers(oxygen transport,glycolysis,pro-angiogenesis),with the effects correlating with hypoxia severity(P<0.05).GSEA revealed significant up-regulation of hypoxia,angiogenesis regulation,glycolysis and gluconeogenesis,and starvation stress pathways,alongside down-regulation of innate immunity,macrophage activation,cytoskeleton,and protein maturation pathways in hypoxic TAMs(P<0.05).TEM and immunofluorescence staining demonstrated obvious ultrastructure changes,including disrupted cytoskeletal organization,shortened rough ER with reduced ribosomes,mitochondrial swelling with cristae damage,and diminished ER-mitochondria contacts in hypoxic TAMs.Conclusion CoCl2 and hypoxia induce a hypoxic transcriptional phenotype in TAMs,which may potentially associated with ultrastructural remodeling of the cytoskeleton,ER,and mitochondria.

As the core force in medical services,healthcare professionals are key stakeholders in implementing the Healthy China strategy,strengthening public health awareness,and improving national health literacy.They must actively shoul-der the social responsibility of science communication.In the face of the rising mortality rate of coronary heart disease(CHD),they are obligated to scientifically disseminate relevant health knowledge to the public.This article takes the Fifth Internal Medi-cine Party Branch of the Second Clinical General Party Branch at Guangdong Provincial Hospital of Traditional Chinese Medicine(Dade Road Main Campus)as a typical case to explore how Party building can create the"Heart-Shaping"science popularization brand for CHD.The Party branch plays a leading and exemplary role by organizing resources and uniting Party members.Through cross-media integration,innovative content formats,and other methods,it fosters a strong atmosphere of science popularization under Party leadership,encouraging medical staff to break away from tradition and pioneer a diversified model of CHD science communication,successfully establishing the"Heart-Shaping"brand.Additionally,it meticulously cultivates a professional sci-ence communication team,achieving synergistic progress in both Party building and CHD science popularization.This provides replicable and practical innovative experience for Party building-driven CHD science communication,highlighting the unique ad-vantages of Party building in enhancing the effectiveness of CHD science popularization and promoting the integration of Party work and professional services.

As the core force in medical services,healthcare professionals are key stakeholders in implementing the Healthy China strategy,strengthening public health awareness,and improving national health literacy.They must actively shoul-der the social responsibility of science communication.In the face of the rising mortality rate of coronary heart disease(CHD),they are obligated to scientifically disseminate relevant health knowledge to the public.This article takes the Fifth Internal Medi-cine Party Branch of the Second Clinical General Party Branch at Guangdong Provincial Hospital of Traditional Chinese Medicine(Dade Road Main Campus)as a typical case to explore how Party building can create the"Heart-Shaping"science popularization brand for CHD.The Party branch plays a leading and exemplary role by organizing resources and uniting Party members.Through cross-media integration,innovative content formats,and other methods,it fosters a strong atmosphere of science popularization under Party leadership,encouraging medical staff to break away from tradition and pioneer a diversified model of CHD science communication,successfully establishing the"Heart-Shaping"brand.Additionally,it meticulously cultivates a professional sci-ence communication team,achieving synergistic progress in both Party building and CHD science popularization.This provides replicable and practical innovative experience for Party building-driven CHD science communication,highlighting the unique ad-vantages of Party building in enhancing the effectiveness of CHD science popularization and promoting the integration of Party work and professional services.

Objective:To explore the barrier factors in the implementation of advance care planning for critically ill and end-life patients in China. Provide reference for the implementation of advance care planning in critically ill and end-life patients in China.Methods:The literature from CNKI, Chinese Biomedical Literature Database, Wanfang database, VIP, PubMed and Web of Science database on the implementation of advance care planning for critically ill and end-life patients in China were searched. The search deadline was from database establishment to January 15, 2023. To analyze the literature meeting the inclusion and exclusion criteria.Results:A total of 18 literatures were included, and the barrier factors to the implementation of advance care planning for critically ill and end-life patients in China included six categories (27 types): social and cultural factors (4 types), patient factors (4 types), family factors (5 types), medical staff factors (8 types), interpersonal interaction factors (4 types), policy and legal factors (2 types).Conclusions:The implementation of advance care planning for critically ill and end-life patients in China is affected by a variety of barrier factors. The improvement measures should be formulated according to the modifiable barrier factors to promote the implementation of advance medical care plan for critically ill and end-life patients in China.

Objective To investigate the identification of octreotide(OCT)modified chitosan(CS)miR-155 molecular beacon nanoparticles(CS-miR-155-MB-OCT)and imaging of lung cancer cells for the early screening of lung cancer.Methods A nude mouse model of lung transplantation tumor was established by injecting A549 lung cancer cells into tail veins to establish lung xenograft models.Cre adenovirus was injected through nasal cavity,and mice were killed at 4,6,8 and 12 weeks after adenovirus injection to establish lung cancer models of atypical hyperplasia,adenoma,carcinoma in situ and adenocarcinoma of lung in LSL K-ras G12D transgenic mice at different pathological stages.Lung tissue samples were taken and observed by HE staining.Immunohistochemistry were used to detect the expression of somatostatin receptor 2(SSTR2).Real-time fluorescence quantitative PCR was used to detect miR-155 expression levels in lung xenograft models and transgenic mice at different stages of lung cancer.Then CS-miR-155-MB and CS-miR-155-MB-OCT were injected via tail vein in lung xenograft models.CS-miR-155-MB-OCT was injected via tail vein in transgenic mice models.The fluorescence signals of lung in nude mice and transgenic mice at different disease stages were imaged by living imaging system.Frozen slices of lung tissue were made.The source of fluorescence signal was detected by laser confocal scanning microscope(CLSM).Results HE staining showed that lung transplantation tumor models and lung cancer models of atypical hyperplasia,adenoma,carcinoma in situ and lung adenocarcinoma at different pathological stages were successfully constructed.Immunohistochemical analysis showed somatostatin receptor 2(SSTR2)was expressed in transplanted lung tumor and tissue at different pathological stages.In transgenic mouse models,the expression of miR-155 was gradually increased as the disease progressed(P＜0.05).In lung xenograft models,the fluorescence signals were significantly higher in the CS-miR-155-MB-OCT group than those of the CS-miR-155-MB group(P＜0.05).In transgenic mouse models,the fluorescence signals gradually increased with the gradual progression of lesions(P＜0.05).After re-imaging the lung tissue,it was found that the fluorescence signal came from lung,and CLSM showed that the fluorescence signal came from cancer cells and some normal alveolar epithelial cells.Conclusion CS-miR-155-MB-OCT can dynamically reflect the occurrence and development of lung cancer according to changes of different fluorescence intensity,thus providing a new technology for the early diagnosis of lung cancer.

Objective:To investigate the orthodontic needs and to analyze the influencing factors of orthodontic treatment of university students in Xi'an.Methods:The orthodontic questionnaire survey was conducted in university students by stratified cluster random sampling,the Dental health component(DHC)and aesthetic component(AC)in the orthodontic treatment needs index were used as the objective indicators of orthodontic treatment needs,and the self-perceived aesthetic component(SAC)of the subjects was used as the subjective indicator of the need for orthodontic treatment.Univariate and multivariate logistic regression analysis were used to determine the influencing factors of university students'willingness to orthodontic treatment.Results:A total of 1135 university students were sur-veyed,including 578 males and 557 females.There were 224(19.74％),184(16.21％)and 120(10.57％)university students who required orthodontic treatment by DHC,AC and SAC analysis,respectively.Among the 224 university students who needed orthodontic treatment by DHC,68(30.36％)were willing to undergo orthodontic treatment,and 156(69.64％)were unwilling.Univariate and multivariate logistic regression analysis showed that gender,malocclusion,cognitive situation and social environment were independent influencing factors affecting the treatment intention.Conclusion:The objective orthodontic demand of Xi'an university students is high,but the demand for subjective orthodontic treatment is low.Gender,malocclusion,cognitive situation and social environment are the in-dependent influencing factors of university students'orthodontic treatment intention.

Objective:To explore the efficacy and safety of immunoneoadjuvant therapy with pembrolizumab combined with chemotherapy in locally advanced resectable hypopharyngeal squamous cell carcinoma patients.Methods:This study was a prospective, single arm, single center clinical study that was opened for enrollment in April 2021. Patients who met the inclusion criteria at the Cancer Hospital of the Chinese Academy of Medical Sciences were treated with neoadjuvant therapy of pembrolizumab combined with cisplatin and paclitaxel, and after treatments, received surgery and postoperative adjuvant therapy. The main endpoint of this study was postoperative pathological complete response (pCR), and other observations included adverse reactions and long-term prognoses of patients after neoadjuvant therapy.Results:By September 2023, a total of 23 patients who underwent neoadjuvant therapy and surgery were enrolled in the study and all patients were males aged 49-74 years. All patients were locally advanced stage, including 3 patients in stage Ⅲ and 20 patients in stage Ⅳ. There were 12 cases of primary lesions with posterior ring involvement accompanied by fixation of one vocal cord and 20 cases of regional lymph node metastases classified as N2. Eighteen cases received a two cycle regimen and 5 cases received a three cycle regimen for neoadjuvant therapy. The postoperative pCR rate was 26.1% (6/23), with no surgical delay caused by adverse drug reactions. The laryngeal preservation rate was 87.0% (20/23). Pharyngeal fistula was the main surgical complication, with an incidence of 21.7% (5/23). The median follow-up time was 15 months, and 3 patients experienced local recurrence.Conclusions:The immunoneoadjuvant therapy of pembrolizumab combined with chemotherapy has a high pCR rate in locally advanced resectable hypopharyngeal squamous cell carcinoma, with increased laryngeal preservation rate and no significant impact on surgical safety.

OBJECTIVE To investigate the effects of brusatol on the malignant biological behavior of ovarian cancer cells by regulating the sphingosine kinase 1 （SPHK1）/sphingosine-1-phosphate （S1P）/sphingosine-1-phosphate receptor 3 （S1PR3） signaling pathway. METHODS Human ovarian cancer cell strain SKOV-3 were randomly divided into control group， brusatol group， SPHK1 overexpression group， brusatol+blank load group， brusatol+SPHK1 overexpression group. The cell viability， colony formation rate， the number of migration and invasion， apoptosis rate， the expressions of cell proliferation-related proteins [myelocytomatosis viral oncogene homolog （C-myc）]， apoptosis-related proteins [B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）]， epithelial mesenchymal transition （EMT）-related proteins （E-cadherin， N-cadherin） and SPHK1， S1P， S1PR3 proteins were all detected in each group. Transplanted tumor model of nude mice was constructed by using SKOV-3 cells and randomly separated into control group， brusatol low-dose， medium-dose and high-dose groups， SPHK1 overexpression group， high- dose brusatol+blank load group， and high-dose brusatol+SPHK1 overexpression group； the growth of transplanted tumors were detected. The nude mice model of SKOV-3 transplantation tumor was randomly divided into control group， brusatol group， SPHK1 overexpression group， brusatol+blank load group， and brusatol+SPHK1 overexpression group； the proliferation and apoptosis of transplanted tumor tissue， the expressions of EMT-related Δ 基金项目江西省中医药管理局科技计划项目（No.2023B0762） ＊第一作者 副主任药师 。研究方向 ：药学研究及药理学 。E- proteins and SPHK1/S1P/S1PR3 signaling pathway proteins mail：jsgj2023@126.com were detected in each group. RESULTS Cell experiments in # 通信作者 主任医师，硕士。研究方向：妇科及妇科肿瘤学。E- vitro had shown that compared with the control group， the cell mail：11638199@qq.com viability， clone formation rate， migration number， invasion 中国药房 2024年第35卷第16期 China Pharmacy 2024 Vol. 35 No. 16 · 1991 · number， protein expressions of C-myc， Bcl-2， N-cadherin， SPHK1， S1P and S1PR3 were decreased significantly in brusatol group （P＜0.05）， while the apoptosis rate， protein expressions of Bax and E-cadherin were increased significantly （P＜0.05）； overexpression of SPHK1 could weaken the effects of brusatol on the above indicators in SKOV-3 cells. Mice experiments in vivo had shown that compared with the control group， the transplanted tumor volumes of nude mice in the brusatol low-dose， medium- dose and high-dose groups were decreased significantly in a dose-dependent manner after 21 days of intervention （P＜0.05）. Brusatol of high dose could also significantly reduce the protein expressions of C-myc， Bcl-2， N-cadherin， SPHK1， S1P and S1PR3 in transplanted tumor tissue of nude mice （P＜0.05）， and significantly increase the protein expressions of Bax and E- cadherin （P＜0.05）； overexpression of SPHK1 could weaken the effects of brusatol on the above indicators in transplanted tumor tissue of nude mice. CONCLUSIONS Brusatol can inhibit the proliferation， cloning， EMT， migration and invasion of ovarian cancer cells， and induce their apoptosis by down-regulating the expression of SPHK1/S1P/S1PR3 signaling pathway. It can also inhibit the growth of ovarian cancer cells in nude mice， ultimately suppressing their malignant biological behavior and exerting significant anti-cancer effects on ovarian cancer.

By reviewing the relevant literature of ancient herbal works and modern codices， this paper sorted out the historical evolution and developmental venation of processing of Notoginseng Radix et Rhizoma. On this basis， the modern research of processed products of Notoginseng Radix et Rhizoma was used as the breakthrough point to analyze the literature in terms of processing technology， chemical composition changes and changes in pharmacological effects before and after processing. According to the research status of processing of Notoginseng Radix et Rhizoma， some existing problems were analyzed in this paper， such as not many ancient processing methods used in modern time， lack of standardized research on processing technology. And saponins， polysaccharides， amino acids， flavonoids and other chemical components in Notoginseng Radix et Rhizoma may change to different degrees before and after processing， which was the main reason for the difference of efficacy before and after processing. However， the current research on the pharmacological effects of Notoginseng Radix et Rhizoma mainly focuses on raw products， resulting in a lack of in-depth research on the transformation mechanism of Notoginseng Radix et Rhizoma in processing difference， and the scientific connotation of "Shengxiao Shubu" has not been clearly elaborated， which is not conducive to the standardized clinical use of drugs. Therefore， it is necessary to further analyze the material basis of Notoginseng Radix et Rhizoma and its processed products， and to explore the change rule of chemical components before and after processing and its correlation with pharmacodynamic activity， so as to clarify the processing mechanism for providing scientific basis for its standardized processing， quality control and clinical rational use.