OBJECTIVE To explore the transformation of the dispensing and drug pickup process in traditional Chinese medicine pharmacy （TCM Pharmacy） in our hospital based on data-intelligence-driven， aiming to improve pharmacists’ work efficiency and patients’ drug pickup experience. METHODS Value stream mapping and journey mapping were used to systematically identify non-value-added links in pharmacists’ dispensing process and key pain points in patients’ drug pickup under the traditional process. An intelligent dispensing and drug pickup system for the TCM Pharmacy was developed based on the C# and Android television platforms， and a machine-learning model was adopted to predict patients’ drug pickup waiting time. A comprehensive evaluation was performed from three perspectives： system performance， prediction accuracy， and satisfaction of pharmacists and patients. RESULTS The system successfully streamlined non-value-added links such as “waiting for writing on the board” and “searching for drugs”， and realized multimodal dynamic prompts of dispensing status through auditory （number calling） and visual （television terminal） channels. The constructed model for predicting drug pickup waiting time exhibited good fitting degree and generalization ability （mean absolute error＝4.28 min， R 2 ＝0.882）. The comprehensive satisfaction scores of pharmacists and patients in the traditional mode were significantly increased from （70.99±1.74） and （73.58±1.98） to （90.02±1.30） and （88.61±2.08） in the new system， respectively （ P ＜0.01）. CONCLUSIONS The transformation of the intelligent drug dispensing and pickup system for TCM pharmacy based on data-intelligence-driven effectively improves the efficiency of pharmacists’ dispensing work， realizes process transparency and waiting time predictability， and significantly enhances patients’ drug pickup experience.

ObjectiveTo investigate the role of interleukin （IL）-17A in acute inhalational pneumonia induced by the highly drug-resistant and hypervirulent Staphylococcus aureus strain USA300-R in mice. MethodsAn acute inhalational pneumonia model was established in mice using an aerosolized pulmonary delivery technique. RNA sequencing （RNA-seq） and enzyme-linked immunosorbent assay （ELISA） were employed to examine the expression dynamics of Il17a mRNA and IL-17A protein， respectively， in the lungs of infected mice. Il17a knockout （Il17a^-/-） mice were generated using CRISPR/Cas9 gene editing technology. The survival rate， body weight， bacterial load in lung tissue， and histopathological changes were compared between Il17a^-/- and wild-type （WT） mice following inhalational infection with USA300-R. Results12 hours after USA300-R infection， compared to pre-infection， the expression level of Il17a mRNA in lung tissue and the level of IL-17A protein in bronchoalveolar lavage fluid （BALF） increased by approximately 50-fold （P<0.01） and 6-fold （P<0.001）， respectively. Compared to WT mice， Il17a^-/- mice exhibited approximately 10-fold higher bacterial loads in lung tissue at both 12 and 24 hours post-infection （P<0.001， P<0.05）. However， they showed significantly attenuated lung histopathological injury， reduced alveolar wall thickening， markedly decreased neutrophil infiltration， and an approximately 50% improvement in survival rate （P<0.05）. ConclusionIn acute Staphylococcus aureus USA300-R inhalational pneumonia， IL-17A contributes to bacterial clearance by recruiting neutrophils； however， excessive neutrophil infiltration exacerbates pulmonary inflammation and injury， reduces survival rates， and represents a potential therapeutic target.

Since the founding of the People’s Republic of China, remarkable achievements have been gained in infectious disease prevention and control, and rich practical experiences have been accumulated. If these experiences are shared with developing countries, it will greatly contribute to global infectious disease control and global health security. Under the framework of Forum on China-Africa Cooperation, a series of China-Africa public health capacity training programs have been recently held in China, in order to help improve the capability of infectious disease control in African countries. This article summarized and refined good design concepts and practices from these programs, so as to provide insights into sustainable optimization of China-Africa public health capacity training and improvements of the training effectiveness.

Objective:To construct an indicator system for entrustable professional activities (EPAs) in the general practice enhancement stage of pediatric specialist physician training.Methods:A draft indicator system for EPAs in the general practice enhancement stage of pediatric physician training was developed through core EPAs working group discussion, literature review, nominal group discussion, and expert consultation. Subsequently, the indicator system was preliminarily implemented and revised.Results:The core EPAs working group consisted of nine specialist physician trainers. In the initial brainstorming stage, a "potential list" of 30 activities was established. After literature review and collation, the draft indicator system included eight EPAs. Through nominal group discussion, the connotation of the draft was enriched, and the importance of the EPAs was ranked and modified. Finally, through expert consultation, the EPAs for the general practice enhancement stage of pediatric specialist physician training were determined. These included basic operations for the treatment of critically ill children, identification and management of critical illnesses, referral of critically ill children, perioperative management, in-hospital consultation, medical and teaching management and system improvement, doctor-patient communication and dispute handling, and response to public health events. During the preliminary implementation stage, a total of nine specialist physicians who participated in the training were evaluated. Based on the problems found in the pre-evaluation, the indicators of EPAs were revised, and a corresponding curriculum training system was developed.Conclusions:Through multiple rounds of nominal group discussion and expert consultation, the indicator system for EPAs in the general practice enhancement stage of pediatric specialist physician training was formulated. The system was preliminarily implemented and revised, and a curriculum system was constructed.

Objective To investigate the value of parameters of MR diffusion kurtosis imaging(DKI)for predicting human epidermal growth factor receptor 2(HER2)-positive breast cancer(BC).Methods A total of 122 cases of BC diagnosed by pathology were retrospectively enrolled,including 37 cases of HER2-positive(HER2-positive group)and 85 cases of HER2-negative(HER2-negative group).Parameters obtained based on MR DKI(mean diffusivity[MD]and mean kurtosis[MK]values)and the results of immunohistochemical detection(expression of matrix metalloproteinase-2[MMP-2],vascular endothelial growth factor receptor 2[VEGFR-2])were compared between groups.Then maltivariable logistic regression was used to analyze the independent predictors of HER2-positive BC based on DKI parameters being statistically different between groups,and a combined model was constructed.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)were calculated to assess the efficacy of each single DKI parameter and their combined model for predicting HER2-positive BC,and the correlations of these DKI parameters with MMP-2 or VEGFR-2 expressions were analyzed.Results Compared with HER2-negative group,MD value,MK value,positive expression proportion of MMP-2 and VEGFR-2 increased in HER2-positive group(all P＜0.05).Both MD(OR=1.423)and MK(OR=1.624)values were independent predictors of HER2-positive BC(both P＜0.05),with AUC for predicting HER2-positive BC of 0.819 and 0.836,respectively,while the AUC of combined model of MD and MK values was 0.916.MD value of BC was positively correlated with MMP-2(rs=0.222)and VEGFR-2 expression(rs=0.232)(both P＜0.05),while MK value of BC was not significantly correlated with MMP-2 or VEGFR-2 expression(both P＞0.05).Conclusion As parameters of MR DKI,MD and MK values could be used to effectively predict HER2-positive BC.

The platelets play the important role in tumor angiogenesis,growth,and metastasis,in addition to coagulation.The interaction between tumors and platelets can produce"tumor-induced platelets",which leads various changes of platelet characteristics.In addition,activated platelets can also inhibit the effects of both chemotherapy and immunotherapy,therefore,both inhibiting platelet activation and depleting platelets can effectively improve tumor prognosis.In this review,we intro-duced the key role of platelets in the development of tumors,summarized their application in tumor diagnosis,monitoring,and treatment,and provid-ed our view on how to develop precise delivery strategies based on platelets for achieve efficient and safe tumor treatment.

Objective To explore the diagnostic value of MR in acute abdomen in pregnancy(AAP).Methods A total of 38 cases of acute abdominal pain pregnant patients who underwent pelvic MRI examinations were selected.The diagnoses made during surgery or at discharge were taken as the final diagnostic results.The MR imaging manifestations of various diseases were analyzed.Results The coincidence rate of MR diagnosis in 38 pregnant women with acute abdominal pain was 92.1%(35/38).Among them,19 cases were torsion of ovarian tumor pedicle,and 17 cases were correctly diagnosed by MR.The manifestations were adnexal tumors with spiral pedicle structures,the wall of the tumor near the pedicle were locally thickened,and there were exudative lesions around the tumor.There were 9 cases of hysteromyoma with degenerative hemorrhage,which showed mixed signal nodules or masses in the myometrium on the side of abdominal pain,and the boundaries were clear.Hemorrhagic focus with high signal intensity were found on T1WI.There were 7 cases of placental abruption,and 6 cases were correctly diagnosed by MR.The new mixed signal mass protruding from one side of the placenta into the uterine cavity.T2WI showed equal or slightly high signal,T1WI showed equal signal,diffusion weighted imaging(DWI)showed high signal,apparent diffusion coefficient(ADC)showed low signal,and the lesion were located under the placenta and tilted near the placenta edge.There were 3 cases of appendicitis with surrounding abscess formation.MR manifesta-tions included structural disorder of the right lower abdomen and turbid fat space,with peripheral exudative lesions visible.Round or irregular cystic masses could be seen,in which T2WI showed slightly high signal and T1WI showed equal signal,DWI showed high signal,and ADC showed low signal.In 2 cases,a slightly high T2WI signal focus was found in the curved blind tube with a diameter of＞6 mm.Conclusion MRI has differential diagnostic value for AAP,which can provide accurate diagnostic basis for clinic.

Objective:To explore the mediating effect of job embeddedness and job satisfaction on psycholog-ical capital and organizational silence in clinical nurses.Methods:Totally 412 clinical nurses(145 males and 267 females)were selected and assessed with the Nurse Organizational Silence Assessment Questionnaire(NOSAQ),Psychological Capital Questionnaire-24(PCQ-24),Job Embedding Scale(JES)and Nurses Job Satisfaction Scale(NJSS).SPSS macro program PROCESS and Bootstrap method were used to explore the role of mediation.Results:The NOSAQ scores were negatively correlated with the scores of PCQ-24,JES and NJSS(r=-0.55,-0.59,-0.51,Ps＜0.01).Job embeddedness and job satisfaction played a chain mediating role between psychological capital and organizational silence of clinical nurses(95％CI:-0.26--0.04),and the mediating effect accounted for 14.7％of the total effect.Conclusion:It suggests that organizational silence is closely related to psychological capital,job embeddedness and job satisfaction in clinical nurses.

Objective To explore the diagnostic value of MR in acute abdomen in pregnancy(AAP).Methods A total of 38 cases of acute abdominal pain pregnant patients who underwent pelvic MRI examinations were selected.The diagnoses made during surgery or at discharge were taken as the final diagnostic results.The MR imaging manifestations of various diseases were analyzed.Results The coincidence rate of MR diagnosis in 38 pregnant women with acute abdominal pain was 92.1%(35/38).Among them,19 cases were torsion of ovarian tumor pedicle,and 17 cases were correctly diagnosed by MR.The manifestations were adnexal tumors with spiral pedicle structures,the wall of the tumor near the pedicle were locally thickened,and there were exudative lesions around the tumor.There were 9 cases of hysteromyoma with degenerative hemorrhage,which showed mixed signal nodules or masses in the myometrium on the side of abdominal pain,and the boundaries were clear.Hemorrhagic focus with high signal intensity were found on T1WI.There were 7 cases of placental abruption,and 6 cases were correctly diagnosed by MR.The new mixed signal mass protruding from one side of the placenta into the uterine cavity.T2WI showed equal or slightly high signal,T1WI showed equal signal,diffusion weighted imaging(DWI)showed high signal,apparent diffusion coefficient(ADC)showed low signal,and the lesion were located under the placenta and tilted near the placenta edge.There were 3 cases of appendicitis with surrounding abscess formation.MR manifesta-tions included structural disorder of the right lower abdomen and turbid fat space,with peripheral exudative lesions visible.Round or irregular cystic masses could be seen,in which T2WI showed slightly high signal and T1WI showed equal signal,DWI showed high signal,and ADC showed low signal.In 2 cases,a slightly high T2WI signal focus was found in the curved blind tube with a diameter of＞6 mm.Conclusion MRI has differential diagnostic value for AAP,which can provide accurate diagnostic basis for clinic.

Objective To investigate the value of parameters of MR diffusion kurtosis imaging(DKI)for predicting human epidermal growth factor receptor 2(HER2)-positive breast cancer(BC).Methods A total of 122 cases of BC diagnosed by pathology were retrospectively enrolled,including 37 cases of HER2-positive(HER2-positive group)and 85 cases of HER2-negative(HER2-negative group).Parameters obtained based on MR DKI(mean diffusivity[MD]and mean kurtosis[MK]values)and the results of immunohistochemical detection(expression of matrix metalloproteinase-2[MMP-2],vascular endothelial growth factor receptor 2[VEGFR-2])were compared between groups.Then maltivariable logistic regression was used to analyze the independent predictors of HER2-positive BC based on DKI parameters being statistically different between groups,and a combined model was constructed.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)were calculated to assess the efficacy of each single DKI parameter and their combined model for predicting HER2-positive BC,and the correlations of these DKI parameters with MMP-2 or VEGFR-2 expressions were analyzed.Results Compared with HER2-negative group,MD value,MK value,positive expression proportion of MMP-2 and VEGFR-2 increased in HER2-positive group(all P＜0.05).Both MD(OR=1.423)and MK(OR=1.624)values were independent predictors of HER2-positive BC(both P＜0.05),with AUC for predicting HER2-positive BC of 0.819 and 0.836,respectively,while the AUC of combined model of MD and MK values was 0.916.MD value of BC was positively correlated with MMP-2(rs=0.222)and VEGFR-2 expression(rs=0.232)(both P＜0.05),while MK value of BC was not significantly correlated with MMP-2 or VEGFR-2 expression(both P＞0.05).Conclusion As parameters of MR DKI,MD and MK values could be used to effectively predict HER2-positive BC.