OBJECTIVE To address the management challenges encountered by inpatient pharmacy of our hospital in undertaking “internet-based medicine delivery” （IMD） services， and to improve service efficiency and medication safety. METHODS SWOT analysis method was applied to systematically examine both internal and external factors， formulate comprehensive management strategies， and restructure the service processes. Process optimization included： establishing a closed-loop process for dispensing and returning drugs based on the drug traceability codes； unifying the drug inventory of the inpatient pharmacy with that of IMD， optimizing the management of storage locations； improving the inventory management function of the hospital information system， and adjusting the inventory counting plan and shift scheduling rules. The indicators of the inpatient pharmacy， including inventory structure， dispensing efficiency， inventory checks accuracy rate， the rationality rate of prescription， and consistency rate of human-machine review， were compared before and after the implementation of the strategies to evaluate the implementation effects. RESULTS After implementation， the structure of the drug inventory was significantly optimized. The proportion of drugs approaching their expiration dates decreased by 35.55%， the proportion of unsold drugs decreased by 64.52%， and the proportion of drugs that had been accumulated for more than 4 weeks decreased by 33.26%. The speed of prescription dispensing increased by 34.92%， and the daily drug requisition time was shortened by 62.03%. The accuracy rate of inventory checks rose from 86.33% to 90.33%， while the rationality rate of prescriptions and the consistency rate of human-machine review rose from 86.00% and 89.33% to 95.00% and 97.00% respectively. Furthermore， the launch of the drug traceability system reduced external dispensing errors from 4 to 1. CONCLUSIONS The comprehensive management strategy based on SWOT analysis can effectively improve the quality of drug management in the inpatient pharmacy and the operational efficiency of IMD， ensuring timely and safe medication for patients.

The current transformation of the tripartite linkage of medical treatment has gradually shifted towards collaborative development and governance among medical care,medical insurance,and medicine,necessitating a clear understanding of the internal mechanisms underpinning this collaboration and governance to lay a theoretical foundation for practical exploration.Drawing on synergetics theory,it delves into the self-organizing characteristics of the collaborative development and governance among the tripartite system,grasping its fundamental operational laws.Through a questionnaire survey of the main functional departments in each field of the tripartite system to verify the rationality of the sequence parameters selected for the study.It ultimately identifies the order parameters as the value standard centered on health,the interest contract focused on public interest,new system for mobilizing resources nationwide,the innovative capacity of the pharmaceutical industry,and the rigorous accountability system.Furthermore,it systematically expounds on the self-organizing evolution process of the collaborative development and governance among the tripartite system,thereby revealing the inherent mechanisms of its collaborative development and governance.It proposes countermeasures and suggestions for establishing and improving diversified collaboration mechanisms,innovating monitoring and early warning mechanisms,and fostering positive feedback mechanisms,aiming to facilitate more scientific and efficient collaborative development and governance among the tripartite system.

Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.

This document targets digital human metabolic chamber platforms and specifies construction standards and testing protocols covering the full lifecycle of " build-test-operate." It encompasses chamber engineering and environmental control, digital platform and cybersecurity architecture, metabolic measurement and multimodal data acquisition, as well as quantitative system performance and data quality indicators with verifiable acceptance tests. By standardizing architecture, interfaces, and quality control, the specification enables multicenter data interoperability and harmonized quality management, providing high-quality, verifiable, and traceable infrastructure to support precision metabolism research and clinical translation in China.

Objective:To analyze the clinical features and diagnostic process of ring chromosome syndrome.Methods:Clinical data of 9 children with ring chromosome syndrome who were treated at the Children′s Medical Center of Peking University First Hospital from September 2009 to May 2025, were summarized and analyzed in a case series study. The data included clinical manifestations, types of epileptic seizures, genetic testing, treatment outcomes, and follow-up results, et al.Results:Among the 9 children with ring chromosome syndrome, there were 6 girls and 3 boys, including 4 children with ring chromosome 20 syndrome, 3 children with ring chromosome 14 syndrome, and 1 child each with ring chromosome 13 and 17 syndrome. All 9 children had de novo chromosomal variations. Among them, 3 children of ring chromosome 20 syndrome were mosaic, and the remaining 6 children were non-mosaic. All 9 children exhibited diverse clinical features, especially those with ring chromosome 20 syndrome, which presented with specific manifestations. The 4 children with ring chromosome 20 syndrome all had acute epileptic seizures as the initial symptom, with onset ages of 67, 39, 17, and 96 months, and all had focal seizures. One child with ring chromosome 20 syndrome had non-convulsive status epilepticus. Development of all 4 children with ring chromosome 20 syndrome was normal before seizure onset, but 3 children showed regression after onset. No physical deformities were observed in 4 children with ring chromosome 20 syndrome, and 2 children were misdiagnosed, 3 children underwent whole exome sequencing and copy number variation analysis in their families, with no abnormalities detected. All 4 children with ring chromosome 20 syndrome were diagnosed through chromosomal karyotype analysis, the intervals between onset and diagnosis were 2, 81, 19 and 13 months, respectively. Follow-up showed that epileptic seizures were not controlled in all 4 children with ring chromosome 20 syndrome. The other 5 children were characterized by developmental delay as the initial symptom, followed by epileptic seizures between 3 and 24 months of age. Developmental regression of the other 5 children did not occur after onset, 2 of them had microcephaly, and 3 had wide-set eyes. No misdiagnoses were reported in these 5 children, and the intervals between onset and diagnosis were 7, 3, 55, 3, and 106 months, respectively. Follow-up showed that epileptic seizures were controlled in these 5 children. Conclusions:Ring chromosome 20 syndrome typically manifest with epilepsy as the initial symptom and are refractory to drug treatment, their early development is entirely normal. Ring chromosome 13, 14, and 17 syndrome are characterized by developmental delay from an early age, followed by the onset of epileptic seizures, which are easily controlled. Conventional whole exome sequencing and copy number variation analysis in families rarely detect ring chromosome abnormalities. Early chromosomal karyotype analysis is essential for the diagnosis of ring chromosome syndrome.

Objective:To explore the genetic and clinical characteristics of epilepsy related with ATP6V1A gene heterozygous variants.Methods:A case series study was conducted. The clinical data of 10 children of epilepsy associated with ATP6V1A gene variants who were admitted to the Children′s Medical Center, Peking University First Hospital from January 2019 to December 2024 was collected. The characteristics of children′ gene variation, clinical phenotype, auxiliary examination results, treatment and prognosis were analyzed.Results:Among the 10 children, there were 4 boys and 6 girls. All 10 children with ATP6V1A gene variants were de novo heterozygous variants, including 1 case of mosaic variant. A total of 9 different variants were identified and 7 variants have not been reported previously. The age at epilepsy onset was 28 (9, 48) months. Five children experienced their first seizure as a fever induction. The types of epileptic seizures included focal seizures in 6 children, epileptic spasms in 5 children, tonic spasms and atonic seizures in 1 child respectively. Three children had 2 seizure types. Global developmental delays were exhibited in 8 children, 2 of whom manifested autism spectrum disorder phenotypes. Two children showed normal development. Electroencephalography revealed slowed background activity in 5 children. Interictal epileptiform discharges were recorded in 9 cases, including hypsarrhythmia, focal, multifocal or generalized discharges. Clinical seizures were captured in 4 children. Brain magnetic resonance imaging abnormalities were found in 4 children, including frontotemporal cortical dysplasia, prominent sulci, delayed myelination of white matter, dysplasia of the corpus callosum, bilateral ventricular enlargement, and cerebral atrophy. Five children were diagnosed with developmental and epileptic encephalopathy (DEE), and 4 of them were diagnosed with infantile epileptic spasms syndrome. At the last follow-up, the age was 78 (25, 120) months. Seizures were controlled in 6 children, while 4 children had uncontrolled seizures despite treatment with ≥3 anti-seizure medications. Conclusions:All children with ATP6V1A gene related epilepsy harbored de novo heterozygous missense variants, with few showing mosaic variants. Seizure onset age ranged widely from the neonatal period to childhood. The predominant seizure types were focal seizures and epileptic spasms. The phenotypic spectrum may exhibit DEE, while a minority maintain normal development.

Objective To investigate the mechanism of argon-helium cryotherapy in regulating the tyrosine-protein kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3)path-way,thereby inhibiting the inflammatory response in rats with atherosclerotic occlusive disease(ASO)of the lower extremities.Methods Forty rats were randomly divided into sham group,lower extremity ASO group,Ar-He Cryo group and Ar-He Cryo+p-JAK group,with 10 rats in each group.The average blood flow velocity of the lower extremity artery,lipid profile and inflammation levels were measured in each group.Hematoxylin-eosin(HE)staining was used to examine histopathologi-cal changes in arterial vessel tissues.Western blotting was performed to detect the expression levels of JAK2,p-JAK2,STAT3,p-STAT3 and suppressor of cytokine signaling 3(SOCS3)proteins in arterial vessel tissues.Results The average blood flow velocity of the lower extremity artery in the lower extremity ASO group was significantly lower than that in the sham group(P＜0.05).The average blood flow velocity in the Ar-He Cryo group was significantly higher than that in the ASO group(P＜0.05).The average blood flow velocity in the Ar-He Cryo+p-JAK group was significantly lower than that in the Ar-He Cryo group(P＜0.05).Serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)levels,tumor necrosis factor-alpha(TNF-α),interleukin-1 β(IL-1β),interleukin-6(IL-6)levels and endothelin-1(ET-1)content in the lower extremity ASO group were significantly higher than those in the sham group,while serum high-densi-ty lipoprotein cholesterol(HDL-C)levels and nitric oxide(NO)content were significantly lower than those in the sham group(P＜0.05).In the Ar-He Cryo group,serum TC,TG,LDL-C levels as well as TNF-α,IL-1β,IL-6 levels and ET-1 content were significantly lower than those in the lower extremity ASO group,while serum HDL-C levels and NO content were significantly higher(P＜0.05).In the Ar-He Cryo+p-JAK group,serum TC,TG,LDL-C levels as well as TNF-α,IL-1 β,IL-6 levels and ET-1 content were significantly higher than those in the Ar-He Cryo group,while HDL-C levels and NO content were significantly lower(P＜0.05).Compared with the sham group,the lower extremity venous vessels in the lower extremity ASO group showed significant steno-sis;compared with the lower extremity ASO group,the degree of stenosis in the lower extremity ve-nous vessels was significantly reduced in the Ar-He Cryo group;the degree of stenosis in the lower extremity venous vessels in the Ar-He Cryo+p-JAK group was similar to that in the lower extremity ASO group and significantly more severe than that in the Ar-He Cryo group.The ratios of p-JAK2/JAK2 and p-STAT3/STAT3 in arterial vessel tissues of the lower extremity ASO group were signifi-cantly higher than those in the sham group,and SOCS3 protein expression was significantly lower than that in the sham group(P＜0.05).In the Ar-He Cryo group,p-JAK2/JAK2 and p-STAT3/STAT3 in arterial vessel tissues were significantly lower than those in the lower extremity ASO group,and SOCS3 protein expression was significantly higher than that in the lower extremity ASO group(P＜0.05).In the Ar-He Cryo+p-JAK group,p-JAK2/JAK2 and p-STAT3/STAT3 in arte-rial vessel tissues were significantly higher than those in the Ar-He Cryo group,and SOCS3 protein expression was significantly lower than that in the Ar-He Cryo group(P＜0.05).Conclusion Ar-gon-helium cryotherapy can reduce lipid deposition in the arteries of rats with lower extremity ASO,inhibit inflammatory responses,and its mechanism may be related to the inhibition of activation of JAK2/STAT3 signaling pathway.

One-day-old AA broilers were divided into five groups(15 chickens each,5 replicates per group):control(basic diet),three groups with low,medium,and high doses of crude extract of Flos sophorae and Fructus sophorae(100,150,200 mg/kg),and one group with Macleaya cordata extract(300 mg/kg).The 42-day trial measured intestinal enzyme activity,morphology,antioxidant and immune capacity,barrier function,and microbiota structure and diversity.Compared to the control and Macleaya cordata groups,the high-dose crude extract of Flos sophorae and Fructus sophorae group significantly increased trypsin activity in the duodenum,jejunum,and ileum(P＜0.05).It also reduced reactive oxygen species and malondialdehyde levels,increased glu-tathione peroxidase activity,reduced tumor necrosis factor-α,increased interleukin-10,and elevated mRNA expression of tight junction protein-1 and mucin-2 in the jejunum(P＜0.05).Microbial di-versity analysis showed higher Shannon index,increased Firmicutes and Bacteroidetes,decreased Proteobacteria,and more beneficial bacteria in the high-dose group(P＜0.05).Supplementing 200 mg/kg of crude extract of Flos sophorae and Fructus sophorae enhances intestinal morpholo-gy and function,and promotes intestinal health,thereby increasing farming efficiency.

In order to investigate the effects of Fuzi Lizhong Oral liquid on immune function and in-testinal health of chicks,185 1-day-old healthy chicks were randomly divided into 4 groups.The blank control group(CG group)was given normal tap water;the high,medium and low dose groups(FZH group,FZM group and FZL group)were given tap water containing 5.00,2.50 and 1.25 g/L of Fuzi Lizhong Oral liquid,respectively.Starting from the first day of age,the drug was administered continuously for 5 d,and the blood was collected from the subwing vein on the sixth day of the test.The results showed that compared with CG group,thymus index in FZH group was significantly increased(P＜0.05).Compared with CG group,serum IgM,IgG and sIgA in FZH group were significantly increased(P＜0.05),and serum IgG and sIgA in FZM group were signifi-cantly increased(P＜0.05).Compared with CG group,the relative expression of Occludin and Claudin-1 mRNA in FZH group was significantly increased(P＜0.05),and the relative expression of ZO-1 mRNA in FZM and FZH groups was significantly increased(P＜0.05).Compared with CG group,Shannon index of FZH group was significantly increased(P＜0.05),Simpson index of FZH group was significantly decreased(P＜0.05),and many beneficial bacteria such as Strepto-coccus spinosus,Eubacillus spinosus and Lactobacillus spinosus played a synergistic role.The results showed that adding 5.00 g/L Fuzi Lizhong Oral liquid in drinking water could improve the immunity of chicks,maintain the intestinal barrier function of chicks,increase the intestinal flora richness and promote the intestinal health of chicks.

Objective:To construct and validate a predictive model for postoperative recurrence in early non-small cell lung cancer patients.Methods:The clinical data of 252 patients with early non-small cell lung cancer admitted to the 926th Hospital of Joint Logistic Support Force of PLA from January 2016 to January 2018were retrospectively collected. All of the patients underwent surgical treatment and they were followed up for 5 years after surgery, according the recurrence after surgery, they were divided into the recurrence group (103 cases) and non- recurrence group (149 cases). The risk factors for postoperative recurrence in early non-small cell lung cancer patients were analyzed. A predictive model for postoperative recurrence in early non-small cell lung cancer patients was constructed and validated.Results:The results of Logistic regression analysis showed that tumor long diameter≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction were independent risk factors for postoperative recurrence in early non-small cell lung cancer patients ( P<0.05). Using R4.0.3 statistical software, the dataset was randomly divided into a training set and a validation set, with a sample size of 176 cases in the training set and 76 cases in the validation set. A prediction model was constructed, with thearea under the curve (AUC) of the receiver operating characteristic (ROC) curve of 0.754 (95% CI 0.679 - 0.828) in the training set and AUC of 0.749 (95% CI 0.634 - 0.864) in the validation set. The model was subjected to a Hosmer-Lemeshow Goodness-of-Fit Test in the validation set, χ2 = 11.31, P = 0.185. Conclusions:The predictive model base on tumor long diameter ≥ 3 cm, lymph node metastasis, low differentiation, spicules and pleural traction can identify patients at high risk of postoperative recurrence in early non-small cell lung cancer effectively.