Objective Against the backdrop of the Medical Humanistic Care Enhancement Action Plan(2024-2027),this study aims to explore the pathways through which medical institutions can promote cultural construction by leveraging Red Cross initiatives.Methods Taking Hospital P in Shanghai as a case study,participatory observation,document analysis,and in-depth interviews were conducted.Based on Schein's three-level model of organizational culture,the hospital's Red Cross prac-tices were analyzed.Results The study summarizes the implementation process,outcomes,and challenges of Red Cross initia-tives at Hospital P.Reflections and recommendations are provided.Conclusion It is recommended to strengthen communication to deepen recognition of Red Cross culture,enhance teamwork to foster the development of Red Cross teams,and promote volun-teer services to implement Red Cross practices,thereby comprehensively elevating the hospital's cultural construction.

Objective To optimized the ultrasonic-assisted extraction process of methyl geniposide from Mussaenda pu-bescens and investigated its antioxidant activity in vitro.Methods The yield of shanzhiside methyl ester from Mussaenda pu-bescens was used as an indicator.The optimal extraction process of shanzhiside methyl ester from Mussaenda pubescens w as ex-plored using single factor experiments and response surface methodology.The factors included methanol concentration,extrac-tion time,extraction temperature,and liquid-solid ratio.The in vitro antioxidant activity of Shanzhiside methyl ester from Mus-saenda pubescens was evaluated by the scavenging rate of DPPH free radical,hydroxyl radical,and superoxide anion free radi-cal.Results The optimal process for extracting glycosides from Mussaenda pubescens using ultrasound assisted method is meth-anol with a mass concentration of 55%,53℃extraction temperature,32∶1 liquid to material ratio,and extraction time of 98 mi-nutes.The yield of methyl ester of shanzhiside was(9.516±1.66)mL/g,and the yield of mountain hawthorn glycoside by re-gression model was 9.532 mg/g,with a relative error of less than 0.2%.After 5.5 hours of antioxidant testing reaction,4 μmol/L of geniposide methyl ester showed significant effects on DPPH·and the clearance rates of ABTS·were 95.18%and 98.75%,respectively,and the total antioxidant capacity of FRAP was 1.054 mmol/L Vc equivalent.Conclusion Response sur-face methodology can optimize the extraction process of shanzhiside methyl ester from Mussaenda pubescens,and the obtained Shanzhiside methyl ester exhibits excellent antioxidant activity in vitro.

Objective Against the backdrop of the Medical Humanistic Care Enhancement Action Plan(2024-2027),this study aims to explore the pathways through which medical institutions can promote cultural construction by leveraging Red Cross initiatives.Methods Taking Hospital P in Shanghai as a case study,participatory observation,document analysis,and in-depth interviews were conducted.Based on Schein's three-level model of organizational culture,the hospital's Red Cross prac-tices were analyzed.Results The study summarizes the implementation process,outcomes,and challenges of Red Cross initia-tives at Hospital P.Reflections and recommendations are provided.Conclusion It is recommended to strengthen communication to deepen recognition of Red Cross culture,enhance teamwork to foster the development of Red Cross teams,and promote volun-teer services to implement Red Cross practices,thereby comprehensively elevating the hospital's cultural construction.

Objective To optimized the ultrasonic-assisted extraction process of methyl geniposide from Mussaenda pu-bescens and investigated its antioxidant activity in vitro.Methods The yield of shanzhiside methyl ester from Mussaenda pu-bescens was used as an indicator.The optimal extraction process of shanzhiside methyl ester from Mussaenda pubescens w as ex-plored using single factor experiments and response surface methodology.The factors included methanol concentration,extrac-tion time,extraction temperature,and liquid-solid ratio.The in vitro antioxidant activity of Shanzhiside methyl ester from Mus-saenda pubescens was evaluated by the scavenging rate of DPPH free radical,hydroxyl radical,and superoxide anion free radi-cal.Results The optimal process for extracting glycosides from Mussaenda pubescens using ultrasound assisted method is meth-anol with a mass concentration of 55%,53℃extraction temperature,32∶1 liquid to material ratio,and extraction time of 98 mi-nutes.The yield of methyl ester of shanzhiside was(9.516±1.66)mL/g,and the yield of mountain hawthorn glycoside by re-gression model was 9.532 mg/g,with a relative error of less than 0.2%.After 5.5 hours of antioxidant testing reaction,4 μmol/L of geniposide methyl ester showed significant effects on DPPH·and the clearance rates of ABTS·were 95.18%and 98.75%,respectively,and the total antioxidant capacity of FRAP was 1.054 mmol/L Vc equivalent.Conclusion Response sur-face methodology can optimize the extraction process of shanzhiside methyl ester from Mussaenda pubescens,and the obtained Shanzhiside methyl ester exhibits excellent antioxidant activity in vitro.

Polyphyllin Ⅰ(PPⅠ)and polyphyllin Ⅱ(PⅡ)are the main active substances in the Paris polyphylla.However,liver toxicity of these compounds has impeded their clinical application and the potential hepatotoxicity mechanisms remain to be elucidated.In this work,we found that PPⅠ and PⅡ exposure could induce significant hepatotoxicity in human liver cell line L-02 and zebrafish in a dose-dependent manner.The results of the proteomic analysis in L-02 cells and transcriptome in zebrafish indicated that the hepa-totoxicity of PPⅡ and PⅡwas associated with the cholesterol biosynthetic pathway disorders,which were alleviated by the cholesterol biosynthesis inhibitor lovastatin.Additionally,3-hydroxy-3-methy-lglutaryl CoA reductase(HMGCR)and squalene epoxidase(SQLE),the two rate-limiting enzymes in the choles-terol synthesis,selected as the potential targets,were confirmed by the molecular docking,the over-expression,and knockdown of HMGCR or SQLE with siRNA.Finally,the pull-down and surface plasmon resonance technology revealed that PPⅠ could directly bind with SQLE but not with HMGCR.Collectively,these data demonstrated that PPⅠ-induced hepatotoxicity resulted from the direct binding with SQLE protein and impaired the sterol-regulatory element binding protein 2/HMGCR/SQLE/lanosterol synthase pathways,thus disturbing the cholesterol biosynthesis pathway.The findings of this research can contribute to a better understanding of the key role of SQLE as a potential target in drug-induced hepatotoxicity and provide a therapeutic strategy for the prevention of drug toxic effects with similar structures in the future.

Objective:To analysis the clinical features and prognosis in oropharyngeal carcinoma with secondary primary tumor. Methods:A retrospective analysis was performed on 468 pathologically confirmed oropharyngeal cancer as the primary tumor patients with p16 status, excluded distant metastasis, and admitted to the Chinese Academy of Medical Sciences from January 2010 to December 2020. The clinical features and prognosis of the secondary primary tumor were analyzed. Results:Among 468 patients with oropharyngeal cancer treated at initial diagnosed, 222 cases were P16-negative. With a median follow-up time of 64.3 months, 66 cases developed second primary cancer, with an incidence of 29.3%, among which 63.6%（42/66） were synchronous and 36.4%（24/66） were heterochronous, esophagus was the most commonly involved site. The 5-year OS of p16-negative oropharyngeal carcinoma with synchronous second primary cancer, without second primary cancer and with heterogeneous second primary cancer were 26.3% and 57.3% and 73.2%（P=0.001）; The second primary cancer accounted for 11.2%（12/107） of the deaths in the whole group, among them, the heterochronous second primary accounted for 75.0%（9/12）. There were 246 patients with p16 positive, with a median follow-up time of 52.4 months, 20 patients developed second primary cancer（8.1%）. Among them, 65.0%（13/20） were synchronous and 35.0%（7/20） were heterochronous. Esophagus was the most commonly involved site. The 4-year OS of p16-positive with synchronous, heterochronous and non-second primary cancer group were 51.9%, 80.7% and 83.3%. Secondary primary cancer accounted for 3.8%（2/52） of all deaths in p16 positvie group. Conclusion:The incidence of second primary cancer of p16 positive and negative oropharyngeal carcinoma were different. The esophagus was the most commonly involved site regardless of p16 status. Regardless of p16 status, the survival of patients with synchronous second primary cancer was worse than those without second primary cancer. For p16-negative oropharyngeal carcinoma, the prognosis was better in patients with heterogeneous second primary cancer, the second primary cancer is one of the main causes of death.
Humans ; Carcinoma/diagnosis* ; Oropharyngeal Neoplasms/diagnosis* ; Retrospective Studies ; Neoplasms, Second Primary/diagnosis*

Objective:To evaluate the efficacy and safety of nimotuzumab in the treatment of advanced head and neck tumors by using meta-analysis.Methods:Randomized controlled trials (RCT) of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) treated with nimotuzumab were searched from databases (Cochrane Library, PubMed, Embase, Wanfang Data and CNKI) for meta-analysis. The efficacy evaluation indexes included overall survival, progression-free survival, disease-free survival, objective response rate, and complete response rate. Adverse reactions were analyzed for safety evaluation. The heterogeneity results were evaluated by Chi-square test, the degree of heterogeneity was evaluated by I2, and the literature was statistically analyzed by random effects model. Results:A total of 11 RCT were included, consisting of 1 202 patients (602 in the intervention group and 600 in the control group). Compared with the control group, the overall survival was significantly prolonged, death risk was decreased by 22% ( HR=0.78, 95% CI=0.63-0.95, P=0.014), the progression-free survival was prolonged and the risk of disease progression was declined by 35% ( HR=0.65, 95% CI=0.53-0.81, P<0.01), and the disease-free survival was prolonged and the risk of recurrence was decreased by 29% ( HR=0.71, 95% CI=0.55-0.91, P<0.01), the objective response rate ( RR=1.37, 95% CI=1.20-1.55, P<0.01) and complete response rate ( RR=1.30, 95% CI=1.15-1.46, P<0.01) were significantly improved in the intervention group. In addition, adding nimotuzumab did not increase the incidence of adverse reaction ( RR=0.98, 95% CI=0.93-1.03, P=0.41). Conclusion:Nimotuzumab can significantly prolong long-term survival and improve short-term efficacy with high safety in LA-HNSCC patients.

Dyslipidemia is an important risk factor of atherosclerotic cardiovascular disease (ASCVD). Statins delay the occurrence and development of ASCVD, and reduce the risk of cardiovascular events and death. Due to safety concerns, there exist insufficient use of lipid-lowering agents and a high withdrawal rate of the agents in the elderly. To promote the prevention and treatment of ASCVD, this expert consensus is issued and focuses on the management of dyslipidemia of Chinese elderly basing on the clinical evidence of the use of lipid-lowering drugs by the elderly, and the lipid management guidelines and expert consensus recommendations at home and abroad.

Objective To observe the pathological change of visceral pleura in patients with chronic obstructive pulmonary disease (COPD), and to discuss the relationship between the changes and COPD airflow limitation. Methods A total of 70 patients received the pulmonary lobectomy or partial resection because of lung tumor in Tianjin Chest Hospital from May 2014 to August 2015 were selected in this study. According to the results of pulmonary function test, the patients were divided into COPD group [forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) <70%,n=40] and control group (FEV1/FVC≥70%,n=30). The lung tissues, which was not the lesion areas, were used to make tissue sections. The Elastica Van Gieson (EVG) method was used to stain the sections. The thickness of visceral pleural and the proportion of elastic fibers in visceral pleural were observed and calculated under a microscope in the two groups. Results The specimens were derived from upper and middle lobes in 22 cases of COPD group, and from lower lobe in 18 cases. Specimens were derived from upper and middle lobes in 17 cases of control group, and from lower lobe in 13 cases. There were no statistical differences in sampling sites between two groups (χ2=0.019,P>0.05). The visceral pleural thickness and the proportion of elastic fibers in visceral pleural were significantly thinner in COPD group than those of control group ( P<0.01). In both COPD group and control group, visceral pleural thickness was significantly thinner in upper and middle lobes than that of lower lobe (P<0.05), but the proportion of elastic fibers in visceral pleural of upper, middle lobes showed no statistical difference compared with that of the lower lobe (P>0.05). Conclusion The thinner visceral pleural and the reduction of elastic fibers in visceral pleural are one of the causes of expiratory airflow limitation in COPD patients.

AIM To study the pharmacodynamics of Baijin Granules [Mallotus apelta (lour.) Muell.Arg.,Smilax china L.],Zhuang medicine,on model rats with sequelae of pelvic inflammatory disease.METHODS The rat model for sequelae of pelvic inflammatory disease was built with mixed bacteria (Escherichia coli and Staphylococcus aureus) and mechanical injury.Subsequently,the rats were randomly divided into eight groups,including model,Baijin Granules low-,middle-,high-dose,positive control (dexamethasone and Huahong Granules),blank control and sham operation groups,with ten rats in each group.After 14 days of successive administration,the hemorheology and blood routine in rats' abdominal aorta were measured by collecting blood in 24 hours of last administration.The pathological morphology of uterine tissue was observed.RESULTS The hemorheology indexes,WBC count and neutrophil percentage were significantly decreased in the model rats,and the pathological morphology of uterine tissue was markedly improved.CONCLUSION Baijin Granules have good therapeutic effects on sequelae of pelvic inflammatory disease in rats.