Objective:To analyze clinical characteristics of primary pancreatic lymphoma (PPL) patients.Methods:Clinical features of 22 patients diagnosed as PPL admitted to Peking Union Medical College Hospital from January 2002 to May 2023 were analyzed retrospectively.Results:The median age was 56.4±13.3 years. The median time from onset to diagnosis was 1.0 (1.0, 3.0) months. The main clinical manifestations were abdominal pain (15/22), weight loss (14/22) and jaundice (10/22). Elevated lactate dehydrogenase (LDH) was observed in 15/20 (75%) patients. Only 2 (2/9, 22.2%) patients had increased CA199 levels and 2 (2/9, 22.2%) patients had increased CEA levels. The maximum tumor diameter was 5.0 (3.8, 6.9) cm. Contrast-enhanced CT mostly showed low enhancement lesions. Major pancreatic duct dilatation were rare on CT scan (4/20). Fifteen patients were confirmed by pancreatic pathology, of which 8 were obtained by surgery, 4 were obtained by CT or ultrasound-guided percutaneous biopsy, and 3 were obtained by EUS-FNA. The main pathological type was diffuse large B-cell lymphoma (14/22). 19 patients received chemotherapy, and 6 patients died with a median follow-up of 5.0 (1.5, 35.5) months.Conclusions:PPL is rare and easy to be misdiagnosed. Elevated LDH levels, normal tumor markers, and non-dilatation of main pancreatic duct are important diagnostic clues. It is important to obtain pathology by EUS-FNA and other methods for definite diagnosis.

OBJECTIVE To explore the current status and challenges of informatization construction for clinical trial centralized pharmacy based on the relevant experience of The First Affiliated Hospital, Zhejiang University School of Medicine. METHODS Review the development of clinical trial drug management and informatization process, along with the management experience of the hospital where the author works, and then introduce the framework and specific operation details of the informatization system when conducting centralized management method, summarize the problems encountered at present and propose future prospects. RESULTS Informatization construction played a significant role in the management of central pharmacies in clinical trial, enabling them to adapt to the complex management needs of investigational products and meet the high standards and strict requirements of Good Clinical Practice(GCP) and related regulations. However, the development of the current information system was still not perfect, and there were problems that need to be solved. CONCLUSION Each hospital needs to pay attention to the informatization construction of the central pharmacy of the clinical trial, improve and perfect the centralized management method of the investigational products, and explore modern technologies and equipments, which are of immense importance for the construction of the clinical trial pharmacy management that conforms to the development trend of drug clinical trials and GCP.

Clinical trial management system is independently developed by our hospital, which basically realized the whole process management and data collection of clinical trials. Based on the platform, the functional architecture of data remote monitoring and auditing was established. By desensitizing and encrypting of data, the project and subject hologram were visualized to facilitate to review of data. The data remote monitoring and auditing cloud platform adopts the B/S architecture pattern. Users register to apply for an account through the cloud platform, and access to the account via HTTPS security protocol. The authorized users were able to view the relevant items online to ensure the secure data transmission and easy operating. The electronic management of data is the direction of future efforts. By compliance with laws and regulations, the remote monitoring/auditing can be realized, and the data security and personal privacy can be ensured with the application of information technology. In this paper, the feasibility of remote monitoring/auditing mode is explored, specific technical schemes and system functions are suggested, and the realization scenarios are conceived in case of major public health emergencies.

Objective: To investigate the correlation between damage to the dominant arcuate fasciculus (AF) and the occurrence of auditory comprehension dysfunction in post-stroke aphasia. Methods: Eighteen stroke survivors with non-fluent aphasia were recruited into the observation group, and nine healthy counterparts were chosen for the control group. All received diffusion tensor imaging (DTI) scans and fractional anisotropy (FA) values were measured. A Chinese aphasia battery was used to evaluate the aphasics′ language functioning, with the listening true or false, listening recognition and oral instruction auditory comprehension sub-scales used as the observation indices. Results: There were significant differences between the two groups in the FA value of the dominant AF. Spearman correlation showed that the FA value of the dominant AF was positively related to the listening recognition results. Conclusions Damage to the dominant AF may be one of the reasons for auditory comprehension dysfunction in post-stroke aphasia. It is significantly related to listening recognition.

To investigate the role of clinical pharmacists in the treatment team for acute drug poisoning,the pharmaceutical prac-tice of clinical pharmacists involved in the treatment of acute metronidazole poisoning was reported in the present paper. Clinical phar-macists assisted physicians in developing blood perfusion regimen on the basis of drug characteristics. Referring to the related guide-lines and evidence-based medicine, clinical pharmacists optimized the drug treatment programs to avoid drug-induced liver injury and stress ulcer. Meanwhile,clinical pharmacists provided an individualized heparin regimen and pharmaceutical care for the patient. With the close collaboration with physicians,the patient obtained perfect medicine therapy and pharmaceutical care. It is suggested clinical pharmacists play an active role in the rescue of acute drug poisoning patient by providing poisoning drug information for physicians time-ly and participating in the design of drug treatment programs using professional knowledge.

Objective To explore the reaction time and attention bias characteristics of patients with first-episode depressive disorder.MethodsTotally 32 patients with first-episode depressive disorder (MD group) and 24 non-depression control participants(NC group) matched with MD group on age,gender and education level were enrolled in the study.The clinical symptoms were assessed by Beck Depression Inventory(BDI).All participants completed a dot-probe task to assess attentional preference for facial stimuli with varying valence (happy,sad and neutral facial expressions).ResultsThe reaction times(RTs) of MD group was longer than that of NC group in the dot-probe task ((468.6±87.7)ms,(451.7±82.5)ms,P<0.01).The four-way ANOVA revealed a significant main effect of prime duration,indicating overall shorter RTs on primes with longer duration ((476.9±88.4)ms vs (456.2±82.7)ms vs (447.7±83.9)ms,P<0.01).Compared with NC group,the scores of attention bias for sad faces were decreased in MD group ((7.43±26.4)ms vs (-4.97±19.5)ms,P<0.05).With the longer duration of presentation,the score of attention maintenance of emotional facies for MD group were increased (happy faces: (-11.0±4.8)ms,(2.2±6.9)ms,(6.1±8.5)ms;angry faces:(-1.6±7.5)ms,(6.5±8.6)ms,(14.9±6.7)ms).The adherence score of attention to happy faces were decreased ((1.8±5.6)ms,(-8.2±6.7)ms,(-8.7±7.1)ms),while the score of adherence score towards sad faces were increased ((-7.6±7.2)ms,(-2.6±8.5)ms,(1.5±6.2)ms) with increasing prime duration.ConclusionPatients with first-episode depressive disorder have slower response to emotional faces and associated with attentional bias for sad faces.With the increasing prime duration,it is more and more obvious to attentional bias in the two aspects of allocation and adherence.

BACKGROUND:In order to overcome the shortcomings of single materials, antibiotics-loaded hydroxyapatite/titanium composites have attracted people’s attentions.
OBJECTIVE:To evaluate the biocompatibility of vancomycin/hydroxyapatite/titanium nanotubes.
METHODS:Mouse osteoblasts, MC-3T3-E1, were co-cultured with titanium (Cp-T), TiO2nanotubes, and vancomycin/hydroxyapatite/titanium nanotubes, respectively. Cel morphology and growth were observed after 1, 3 and 5 days of co-culture under inverted microscope and scanning electron microscope. The cel proliferation was detected by AO-EB method. The total protein, calcium and alkaline phosphatase levels were detected at 7 and 14 days of co-culture.
RESULTSAND CONCLUSION:The MC-3T3-E1 cels with good viability and morphology adhered wel on the surface of vancomycin/hydroxyapatite/titanium nanotubes compared with those on the surface of pure titanium and TiO2nanotubes under the scanning electron miscroscope. Moreover, there were a large amount of pseudopodia on the surface of composite nanotubes. Compared with the other two groups, the cel number on the surface and the levels of intracelular calcium and alkaline phosphatase were al higher in the vancomycin/hydroxyapatite/titanium nanotubes group. These findings suggest that the vancomycin/hydroxyapatite/titanium nanotubes have good biocompatibility and no cytotoxicity.

BACKGROUND: Present studies have proved that titanium coating nanotubes cannot only promote the biological activity of the material itself, but also be used as a drug carrier loading antibiotics and growth factors. OBJECTIVE: To investigate the antibacterial properties of vancomycin/hydroxyapatite/titanium dioxide nanotubes in vitro and in vivo. METHODS: The releasing property in vitro of vancomycin/hydroxyapatite/titanium dioxide nanotubes and vancomycin/titanium dioxide nanotubes were detected. And 1010/L Staphylococcus aureus dilution was put onto the commercial titanium, titanium dioxide nanotube and vancomycin/hydroxyapatite/titanium dioxide nanotube, respectively. Twenty-four hours later, the bacterial growth and activity was observed by scanning electron microscope and confocus scanning electron microscope, respectively. RESULTS AND CONCLUSION: Scanning electron microscope showed: the number of Staphylococcus aureus was the least on the vancomycin/hydroxyapatite/titanium dioxide nanotube, and the bacterial morphology was destroyed. Confocus scanning electron microscope observed: the number of bacteria and viable bacteria was the least on the vancomycin/hydroxyapatite/titanium dioxide nanotube, and the most on the commercial titanium. Besides, the releasing time of vancomycin from the hydroxyapatite/titaniumdioxide nanotube was up to 18 days, but the releasing time of vancomycin was only 4 hours from the titanium dioxide nanotube. In conclusion, the vancomycin/hydroxyapatite/titanium dioxide nanotube has good antibacterial property and slow-releasing performance.

Objective To compare the knee function in patients with intraoperative medial collateral ligament(MCL)injury treated with or with?out increased prosthetic constraint. Methods The records of 19 cases who encountered with iatrogenic injury to the MCL during total knee arthro?plasty(TKA)between January 2005 and December 2010 were retrospectively reviewed. Eight patients(LCCK group)were treated with increased prosthetic constraint;the remaining 11 patients(LPS group)received increased prosthetic constraint between January 2005 and December 2010 served as controls. The MCL was repaired after TKA. The complications were observed after operation. Knee society scores(KSS)subjective knee scores were used to assess the knee function. No patient was lost for follow?up. The mean follow?up was 5 years. Results Until last follow?up(60 months),The KSS subjective score was 87.4 for LCCK group compared with 93.3 for the LPS group. No revisions for knee instability were per?formed in the 11 patients treated with non?prosthetic constraint;however,2 patients treated with increased prosthetic constraint were revised due to joint loosening. Conclusion The MCL tear should be repaired during TKA;the type of the prosthesis should not be increased when MCL injury is recognized during TKA.

Objective To investigate the molecular mechanism of the glucocorticoid?induced osteoblasts apoptosis,and to develop the effective intervention measures. Methods The MC3T3?E1 cells were treated with different concentrations of dexamethasone for 24 hours,then the apoptosis rate was detected with TUNEL analysis,the intracellular expression of Bim and Bax were determined by Westen blot. In addition,MC3T3?E1 cells were randomly divided into Bim?siRNA group,negative control siRNA group and control group. Twenty?four hours after transfection,10-4mmol/L dexamethasone was added to each group of cells for another 24 hours administration. The apoptosis rate was analyzed using the TUNEL,the mito?chondrial transmembrane electric potential was detected by flow cytometry after JC?1 staining,the expression of Bax,Bcl?2 in mitochondrial and Cyt?C,AIF in cytosolic were determined by Western blot. Results The rate of osteoblast apoptosis and Bim expression in cells were both significantly in?creased with the dosage of dexamethasone,there was no significant difference between the groups in the expression of Bax;the rate of osteoblast apop?tosis after the expression of silence Bim was significantly lower than the negative control siRNA group and control group,the expression of Bax and Cyt?C,AIF in cytosolic were significantly reduced,and the mitochondrial transmembrane electric potential was increased. Conclusion Bim is the key molecules in hormone?induced apoptosis of osteoblasts ,the expression of silence Bim can inhibit dexamethasone induced osteoblasts apoptosis through the mitochondrial pathway.