Gastric cancer is a high-incidence malignancy that poses a serious threat to public health in China, ranking among the top three cancers in both incidence and mortality. The majority of patients are diagnosed at an advanced stage, resulting in limited treatment options and poor prognosis. To address key challenges in gastric cancer diagnosis and treatment, a research team led by Professor Jiafu Ji at Peking University Cancer Hospital has focused on the project "Development and Dissemination of Precision Medicine Approaches in Gastric Cancer Management". Through a series of high-quality multicenter clinical studies, the team established a set of new international standards in perioperative treatment, individua-lized drug selection, intelligent noninvasive diagnostics, and novel immunotherapy strategies. These advances have significantly improved treatment efficacy and reduced surgical trauma, achieving key technological breakthroughs in diagnosis, therapy, and mechanistic understanding, and systematically enhancing outcomes for gastric cancer patients. The project ' s findings had a broad international impact, including hosting China ' s first International Gastric Cancer Congress. Through nationwide dissemination, they have promoted the development of precision diagnosis and treatment of gastric cancer as a discipline, and led the formulation of the National Health Commission's guidelines for gastric cancer diagnosis and treatment. In recognition of its achievements, the project was awarded the First Prize of the 2024 Chinese Medical Science and Technology Award.
Stomach Neoplasms/genetics* ; Humans ; Precision Medicine/methods* ; China ; Immunotherapy/methods*

A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

Objective To develop a Discharge Readiness Scale for Patients with PICC and to test its reliability and validity.Methods Based on the Meleis transition theory,the initial version of the scale was formed through literature review,qualitative interview,expert enquiry and pre-investigation.Patients with PICC in 2 tertiary hospital in Hangzhou from December 2023 to March 2024 were selected to investigate the reliability and validity of the scale by convenience sampling.Results 352 questionnaires were distributed,and 340 valid questionnaires were recovered,and the validity recovery rate was 96.59％.The exploratory factor analysis extracted 4 common factors with the cumulative variance contribution rate of 80.568％.The confirmatory factor analysis showed that all evaluation indicators of the scale were within ideal standards.The item-level content validity index ranged from 0.79 to 1.00,and the scale-level content validity index was 0.96.The total Cronbach's α coefficient of the scale was 0.963,and the split-half reliability coefficient was 0.889.The Chinese version of the Discharge Readiness Scale was used as a calibration tool,and the correlation coefficients between the total score of the scale and the scores of each dimension and the calibration tool were 0.788 and 0.567～0.878,respectively(all P＜0.05).The Discharge Readiness Scale for Patients with PICC included 26 items in 4 dimensions including physiological and psychological status,knowledge of catheter maintenance,catheter maintenance capability and social support.Conclusion The Discharge Readiness Scale for Patients with PICC has good reliability and validity,and can be used to evaluate the level of discharge readiness among patients with PICC.

Objective:To analyze the efficacy and safety of 3D-printing-assisted anterolateral thigh perforator flap surgery for the treatment of complex soft tissue defects around the ankle joint.Methods:A total of 160 patients with skin and soft tissue defects around the ankle joint at the First People′s Hospital of Xiaoshan District, Hangzhou, from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a control group and an observation group according to the surgical approach, with 80 patients in each group. The control group underwent traditional anterolateral thigh perforator flap surgery, which included 43 males and 37 females, with an age of 21-62 (34.7±5.6) years. The observation group underwent 3D-printing-assisted anterolateral thigh perforator flap surgery, which included 45 males and 35 females, with an age of 20-66 (34.8±5.6) years. The operative time, flap healing time, and hospital stay duration were compared between the two groups. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF-α) were compared between the two groups before surgery and 3 days postoperatively. The ankle joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, the range of motion (ROM) was assessed using the ROM score, and the flap sensation was evaluated using the modified Highet grading system before surgery, 6 months postoperatively, and at the last follow-up. The incidence of adverse reactions such as arterial crisis, venous crisis, infection, and necrosis during the perioperative period was observed. Patient satisfaction was assessed 6 months after treatment.Results:All patients in both groups successfully completed the surgery, with no cases excluded. The operative time, flap healing time, and hospital stay duration were significantly shorter in the observation group than those in the control group (all P<0.001). Compared with preoperative levels, the levels of IL-6, IL-8, CRP, and TNF-α were significantly reduced in both groups 3 days postoperatively (all P<0.001), and these levels were significantly lower in the observation group than those in the control group at 3 days postoperatively (all P<0.001). Six months postoperatively and at the last follow-up, the AOFAS and ROM scores were significantly higher in the observation group than those in the control group (all P<0.05), and the flap sensation grading was significantly better in the observation group than that in the control group (all P<0.05). The incidence of adverse reactions was 7.5% (6/80) in the observation group, which was significantly lower than 18.8% (15/80) in the control group ( P=0.024). The patient satisfaction rate was 95.0% (76/80) in the observation group, which was significantly higher than 72.5% (58/80) in the control group ( P<0.001). Conclusion:3D-printing-assisted anterolateral thigh perforator flap repair for skin and soft tissue defects around the ankle joint can improve perioperative indicators, reduce the incidence of postoperative adverse reactions, promote the recovery of flap sensation and ankle function, attenuate the inflammatory response of the body, and enhance patient satisfaction.

Objective To develop a Discharge Readiness Scale for Patients with PICC and to test its reliability and validity.Methods Based on the Meleis transition theory,the initial version of the scale was formed through literature review,qualitative interview,expert enquiry and pre-investigation.Patients with PICC in 2 tertiary hospital in Hangzhou from December 2023 to March 2024 were selected to investigate the reliability and validity of the scale by convenience sampling.Results 352 questionnaires were distributed,and 340 valid questionnaires were recovered,and the validity recovery rate was 96.59％.The exploratory factor analysis extracted 4 common factors with the cumulative variance contribution rate of 80.568％.The confirmatory factor analysis showed that all evaluation indicators of the scale were within ideal standards.The item-level content validity index ranged from 0.79 to 1.00,and the scale-level content validity index was 0.96.The total Cronbach's α coefficient of the scale was 0.963,and the split-half reliability coefficient was 0.889.The Chinese version of the Discharge Readiness Scale was used as a calibration tool,and the correlation coefficients between the total score of the scale and the scores of each dimension and the calibration tool were 0.788 and 0.567～0.878,respectively(all P＜0.05).The Discharge Readiness Scale for Patients with PICC included 26 items in 4 dimensions including physiological and psychological status,knowledge of catheter maintenance,catheter maintenance capability and social support.Conclusion The Discharge Readiness Scale for Patients with PICC has good reliability and validity,and can be used to evaluate the level of discharge readiness among patients with PICC.

A 36-year-old male presented to the Department of Neurosurgery of the Second People′s Hospital of Hunan Province on February 12, 2024, due to "10 days of aggravated paroxysmal headache and 1 day of mental abnormality". Ten days ago, after catching a cold, the patient developed persistent low fever and paroxysmal headache. On February 12, 2024, acuted mental and behavioral abnormalities developed, including slow response, self-talk, defecation and urination, no sense of shame and other mental and behavioral abnormalities. On February 22nd, metagenomic next-generation sequencing (mNGS) in cerebrospinal fluid confirmed feline rickettsia infection. One week after doxycycline anti-rickettsia treatment, cerebrospinal fluid mNGS results indicated that the etiology turned negative, and the clinical symptoms improved. Mental disorders caused by rickettsial encephalitis in cats are rare but clinically significant. This case highlights the diagnostic value of mNGS in critical and difficult cases, and supports its integration with traditional diagnostic techniques to achieve precision medicine.

Objective:To analyze the efficacy and safety of 3D-printing-assisted anterolateral thigh perforator flap surgery for the treatment of complex soft tissue defects around the ankle joint.Methods:A total of 160 patients with skin and soft tissue defects around the ankle joint at the First People′s Hospital of Xiaoshan District, Hangzhou, from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a control group and an observation group according to the surgical approach, with 80 patients in each group. The control group underwent traditional anterolateral thigh perforator flap surgery, which included 43 males and 37 females, with an age of 21-62 (34.7±5.6) years. The observation group underwent 3D-printing-assisted anterolateral thigh perforator flap surgery, which included 45 males and 35 females, with an age of 20-66 (34.8±5.6) years. The operative time, flap healing time, and hospital stay duration were compared between the two groups. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF-α) were compared between the two groups before surgery and 3 days postoperatively. The ankle joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, the range of motion (ROM) was assessed using the ROM score, and the flap sensation was evaluated using the modified Highet grading system before surgery, 6 months postoperatively, and at the last follow-up. The incidence of adverse reactions such as arterial crisis, venous crisis, infection, and necrosis during the perioperative period was observed. Patient satisfaction was assessed 6 months after treatment.Results:All patients in both groups successfully completed the surgery, with no cases excluded. The operative time, flap healing time, and hospital stay duration were significantly shorter in the observation group than those in the control group (all P<0.001). Compared with preoperative levels, the levels of IL-6, IL-8, CRP, and TNF-α were significantly reduced in both groups 3 days postoperatively (all P<0.001), and these levels were significantly lower in the observation group than those in the control group at 3 days postoperatively (all P<0.001). Six months postoperatively and at the last follow-up, the AOFAS and ROM scores were significantly higher in the observation group than those in the control group (all P<0.05), and the flap sensation grading was significantly better in the observation group than that in the control group (all P<0.05). The incidence of adverse reactions was 7.5% (6/80) in the observation group, which was significantly lower than 18.8% (15/80) in the control group ( P=0.024). The patient satisfaction rate was 95.0% (76/80) in the observation group, which was significantly higher than 72.5% (58/80) in the control group ( P<0.001). Conclusion:3D-printing-assisted anterolateral thigh perforator flap repair for skin and soft tissue defects around the ankle joint can improve perioperative indicators, reduce the incidence of postoperative adverse reactions, promote the recovery of flap sensation and ankle function, attenuate the inflammatory response of the body, and enhance patient satisfaction.

Objective:The study aimed to quantify the contents of peimine and peiminine in huangshi xiangsheng pills using a nano quantity analyte detector(NQAD)and compare the results with the evaporative light scattering detector(ELSD).Methods:Analytical separation was conducted utilizing a CAPCELL PAK MG Ⅲ C18 column(4.6 mm ×250 mm,5 μmi)as the stationary phase.The mobile phase consisted of a mixture of acetonitrile-water-diethylamine(65∶35∶0.03),with a flow rate set at 1.0 mL·min-1 and the column maintained at a temperature of 25℃.Results:NQAD analysis revealed a robust linear correlation between the concentration and the peak area for peimine within a concentration range of 2.450 to 1.470 μg·mL-1,achieving a correlation coefficient of 0.999 3.The limit of detection(LOD)and recovery rate for peimine were determined to be 14.70 ng and 99.50％(n=9),respectively.Similarly,a linear relationship was observed for peiminine between the concentration and the peak area,spanning a range of 3.657 to 1.170 μg·mL-1,with a correlation coefficient of 0.999 1.The LOD and recovery rate for peiminine were 21.94 ng and 100.5％(n=9),respectively.In contrast,ELSD yielded LOD of 24.50 ng for peimine and 36.57 ng for peiminine,with linear range of double logarithmic fitting was 4.900 to 490.0 μg·mL-1 and 7.314 to 585.1 μg·mL-1,respectively.Conclusion:NQAD outperforms ELSD in the quantification of peimine and peiminine,offering superior accuracy,precision,and sensitivity,along with an extended dynamic linear range.By enabling direct content calculation via linear regression,it streamlines the process,bypassing the complex double logarithmic calculations.This approach not only boosts the efficiency of data handling but also substantially simplifies the computational steps,addressing the detection and analysis needs for peimine and peiminine in huangshi xiangsheng pills.

ObjectiveTo investigate the possible mechanism of Buzhong Yulin Decoction （补中愈淋汤） in the prevention and treatment of recurrent urinary tract infection. MethodsThe mouse models of recurrent urinary tract infection were established by uropathogenic Escherichia coli （UPEC） strain UTI89 by bladder perfusion， and the successful mouse models were randomly divided into a model group， an antibiotic group， and a low- and high-dose Buzhong Yulin Decoction group， with six mice in each group. In addition， 5 C57BL/6 mice without modelling were taken as blank group. The low- and high-dose Buzhong Yulin Decoction groups received 0.1 ml/10 g of decoction by gavage， with concentrations of 1.3 g/ml and 5.2 g/ml， respectively； the antibiotic group received 0.1 ml/10 g of levofloxacin hydrochloride solution with 5 mg/ml by gavage； the blank and model groups received 0.1 ml/10 g of distilled water by gavage. Each group was gavaged once a day for 7 consecutive days. The total number of urine marks， the number of central urine marks， and the total urine volume of the urine marks were observed by the urine marking test； HE staining was used to observe the histopathological changes in the bladder of mice； serum levels of the inflammatory factors interleukin 1β （IL-1β）， interleukin 6 （IL-6） and tumour necrosis factor α （TNF-α） were detected by ELISA； the morphology of the epithelial cells of bladder was observed by scanning electron microscopy； immunofluorescence assay to detect bladder tissue anti-UroPlakin 3A protein level and UPEC bacterial load； the spread plate method to detect urinary bacterial load and bacterial load of bladder epithelial cells； RT-PCR method to detect Ras-related protein Rab-11A （RAB11A） and Ras-related protein Rab-27B （RAB27B） mRNA level in bladder tissue； immunoblotting to detect microtubule-associated protein 1 light chain3 （LC3） and P62 protein levels in bladder tissue. ResultsCompared with the blank group， the bladder epithelial cell layers were lost and showed abnormal morphology in mice of the model group； bladder tissue UroPlakin 3A protein and RAB11A and RAB27B mRNA levels reduced， the total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and LC3 and P62 protein levels in bladder tissue all elevated （P＜0.05 or P＜0.01）. Compared with the model group， the bladder epithelial cell layers were intact and the morphology of epithelial cells were regular in the low- and high-dose Buzhong Yulin Decoction groups； the average surface area of bladder epithelial cells reduced， the levels of UroPlakin 3A protein and RAB11A and RAB27B mRNA in bladder tissues elevated， and total number of urine marks， the number of central urine marks， bladder tissue UPEC bacterial load， urinary bacterial load， bacterial load in bladder epithelial cells， serum IL-1β， IL-6， and TNF-α levels， and P62 protein levels in bladder tissue all reduced （P＜0.05 or P＜0.01）， but LC3 protein levels showed no statistically significant （P＞0.05）. In the antibiotic group， the bladder epithelial cells were partially missing and the morphology of epithelial cells was abnormal. Compared with the antibiotic group， the average surface area of the bladder epithelial cells in the mice increased in the low- and high-dose Buzhong Yulin Decoction groups， the bacterial load of the bladder epithelial cells decreased， and the P62 protein level of the bladder tissue decreased （P＜0.05）. When comparing between the low- and high-dose Buzhong Yulin Decoction groups， the differences in each index were not statistically significant （P＞0.05）. ConclusionBuzhong Yulin Decoction may prevent and treat recurrent urinary tract infection by repairing the bladder mucosal barrier， increasing RAB11A and RAB27B level and enhancing autophagy in bladder tissues， thereby facilitating bacterial clearance from bladder epithelial cells and reducing the bacterial load of bladder epithelial cells.

Objective:The study aimed to quantify the contents of peimine and peiminine in huangshi xiangsheng pills using a nano quantity analyte detector(NQAD)and compare the results with the evaporative light scattering detector(ELSD).Methods:Analytical separation was conducted utilizing a CAPCELL PAK MG Ⅲ C18 column(4.6 mm ×250 mm,5 μmi)as the stationary phase.The mobile phase consisted of a mixture of acetonitrile-water-diethylamine(65∶35∶0.03),with a flow rate set at 1.0 mL·min-1 and the column maintained at a temperature of 25℃.Results:NQAD analysis revealed a robust linear correlation between the concentration and the peak area for peimine within a concentration range of 2.450 to 1.470 μg·mL-1,achieving a correlation coefficient of 0.999 3.The limit of detection(LOD)and recovery rate for peimine were determined to be 14.70 ng and 99.50％(n=9),respectively.Similarly,a linear relationship was observed for peiminine between the concentration and the peak area,spanning a range of 3.657 to 1.170 μg·mL-1,with a correlation coefficient of 0.999 1.The LOD and recovery rate for peiminine were 21.94 ng and 100.5％(n=9),respectively.In contrast,ELSD yielded LOD of 24.50 ng for peimine and 36.57 ng for peiminine,with linear range of double logarithmic fitting was 4.900 to 490.0 μg·mL-1 and 7.314 to 585.1 μg·mL-1,respectively.Conclusion:NQAD outperforms ELSD in the quantification of peimine and peiminine,offering superior accuracy,precision,and sensitivity,along with an extended dynamic linear range.By enabling direct content calculation via linear regression,it streamlines the process,bypassing the complex double logarithmic calculations.This approach not only boosts the efficiency of data handling but also substantially simplifies the computational steps,addressing the detection and analysis needs for peimine and peiminine in huangshi xiangsheng pills.