OBJECTIVES: This study aimed to explore the biological functions and clinical value of mothers against decapentaplegic homolog (SMAD) 7 in head and neck squamous cell carcinoma (HNSCC) through bioinformatics analysis and basic experiments. METHODS: The expression of SMAD7 in HNSCC in public databases was studied. Western blot was used to detect the expression of SMAD7 in HNSCC cell lines and normal epithelial cells. The SMAD7 highly expressed HNSCC cell line HSC-4 was silenced, and CCK-8, Transwell assays, and cell scratch experiments were conducted to study the effect of SMAD7 on the biological functions of HSC-4 cells. HNSCC expression profile data were obtained from UCSC xena, and genes related to SMAD7 were selected for gene ontology and Kyoto encyclopedia of genes and genomes gene enrichment analysis, construction of a co-expression gene interaction network, and screening of related cell signaling pathways. Western blot was used to detect the expression changes of proteins in the related cell signaling pathways in HNSCC cells with silenced SMAD7. cBioPortal was utilized to analyze the mutation rate of the SMAD7 gene, and the MethSurv database was used to analyze the methylation level of the SMAD7 gene and its correlation with prognosis. The receiver operating characteristic curve was used to assess the diagnostic value of SMAD7 for HNSCC. TIMER2.0 was used to analyze the correlation between SMAD7 expression and immune cell infiltration. RESULTS: SMAD7 was highly expressed in HNSCC tumor tissues and some cell lines. Silencing the expression of SMAD7 can significantly inhibit the proliferation, migration, and invasion of cancer cells. Silencing SMAD7 can induce the downregulation of vascular cell adhesion molecule 1 (VCAM-1). The bioinformatics analysis showed that the mutation rate of the SMAD7 gene and the methylation level were significantly correlated with the prognosis of patients with HNSCC. The expression of SMAD7 was related to the level of immune cell infiltration in HNSCC. CONCLUSIONS SMAD7 promotes the proliferation, migration, and invasion of HNSCC cells by regulating the expression of VCAM-1. It may be a potential tumor biomarker and therapeutic target for HNSCC.
Humans ; Smad7 Protein/metabolism* ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; Head and Neck Neoplasms/pathology* ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Signal Transduction ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Computational Biology

Objective To construct a surgical pharmaceutical risk management index system and then to enhance surgi-cal pharmaceutical service quality.Methods Literature research and consulting pharmaceutical experts were used to collect relevant data and construct initial scale items.The Delphi expert consultation method was used to revise and improve indicators with 20 experts,after 2 rounds of inquiry improvement.The analytic hierarchy process(AHP)was used to calculate the weight of each indicator,finally forming the surgical pharmaceutical risk management index system.Results The final construction of the scale entries includes four dimensions,14 second-grade indexes,and 71 third-grade indexes.The questionnaire response rates were 100.00％,while the authority coefficient of experts was 0.832.In the consultation,the harmony coefficients of the first,second,and third indicators were 0.743,0.491,and 0.277,respectively.The AHP was used to determine the weights of indicators,and the re-sult passed the consistency test.The professional factors and pharmacist factors of the first indicators are large in weight.Con-clusion The constructed surgical pharmaceutical risk management index system is scientific and practical,which can provide a reference for the clinical work of surgeons and maximize the risk of avoidance.

Objective To investigate the influencing factors and Traditional Chinese Medical(TCM)syndrome classification of skin pruritus in patients with maintenance hemodialysis(MHD).Methods A total of 174 hemodialysis patients who underwent regular dialysis in Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital from July to September 2024 were selected as study subjects.According to the presence or absence of uremic pruritus(UP),they were divided into pruritus group(n=66)and non-pruritus group(n=108).Both groups of patients were classified into TCM syndromes,and the factors affecting skin pruritus in MHD patients were analyzed by Logistic regression analysis and an evaluation model was established.The evaluation efficiency of the model was evaluated by receiver operating characteristic curve.The relationship between TCM syndromes and pruritus degree was analyzed.Results Both groups of patients were mainly characterized by spleen and kidney Qi deficiency,and the difference was statistically significant(P＜0.05).Logistic regression analysis showed that β2 microglobulin(β2-MG),blood phosphorus,hyper-sensitive C-reactive protein and parathyroid hormone(PTH)were all risk factors for skin pruritus in MHD patients.The area under the curve of skin pruritus in MHD patients was 0.962(95％CI:0.930-0.995).The underlying syndrome of UP patients was mainly spleen and kidney Qi deficiency,and marked syndrome was mainly blood deficiency and wind-dryness.Conclusion β2-MG,blood phosphorus,hyper-sensitive C-reactive protein and PTH are closely related to the occurrence of skin pruritus in MHD patients.The TCM syndrome of UP patients is mainly characterized by spleen and kidney Qi deficiency,and syndrome of blood deficiency and wind-dryness is mainly characterized by UP patients,and there is a certain correlation between TCM syndrome classification and the degree of skin pruritus.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

Objective:To explore the relationship between irrational procrastination and compulsory citizenship behavior among clinical nurses,and to investigate the role of psychological entitlement in this relationship.Meth-ods:A sample of 413 clinical nurses from a tertiary hospital was selected for this study.The Irrational Procrastina-tion Scale(IPS),Compulsory Citizenship Behavior Scale(CCBS),and Psychological Entitlement Scale(PES)were used for evaluation.Results:The scores of IPS,CCBS and PES were positively correlated with each other(r=0.53,0.56,0.39,Ps＜0.01).Psychological entitlement partially mediated the relationship between compulsory citi-zenship behavior and irrational procrastination among clinical nurses,with an indirect effect of 0.17,accounting for 13.85％of the total effect.Conclusion:Psychological entitlement plays a partial mediating role in the relationship between compulsory citizenship behavior and irrational procrastination among clinical nurses.

Objective To construct a surgical pharmaceutical risk management index system and then to enhance surgi-cal pharmaceutical service quality.Methods Literature research and consulting pharmaceutical experts were used to collect relevant data and construct initial scale items.The Delphi expert consultation method was used to revise and improve indicators with 20 experts,after 2 rounds of inquiry improvement.The analytic hierarchy process(AHP)was used to calculate the weight of each indicator,finally forming the surgical pharmaceutical risk management index system.Results The final construction of the scale entries includes four dimensions,14 second-grade indexes,and 71 third-grade indexes.The questionnaire response rates were 100.00％,while the authority coefficient of experts was 0.832.In the consultation,the harmony coefficients of the first,second,and third indicators were 0.743,0.491,and 0.277,respectively.The AHP was used to determine the weights of indicators,and the re-sult passed the consistency test.The professional factors and pharmacist factors of the first indicators are large in weight.Con-clusion The constructed surgical pharmaceutical risk management index system is scientific and practical,which can provide a reference for the clinical work of surgeons and maximize the risk of avoidance.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

Objective:To explore the relationship between irrational procrastination and compulsory citizenship behavior among clinical nurses,and to investigate the role of psychological entitlement in this relationship.Meth-ods:A sample of 413 clinical nurses from a tertiary hospital was selected for this study.The Irrational Procrastina-tion Scale(IPS),Compulsory Citizenship Behavior Scale(CCBS),and Psychological Entitlement Scale(PES)were used for evaluation.Results:The scores of IPS,CCBS and PES were positively correlated with each other(r=0.53,0.56,0.39,Ps＜0.01).Psychological entitlement partially mediated the relationship between compulsory citi-zenship behavior and irrational procrastination among clinical nurses,with an indirect effect of 0.17,accounting for 13.85％of the total effect.Conclusion:Psychological entitlement plays a partial mediating role in the relationship between compulsory citizenship behavior and irrational procrastination among clinical nurses.

Objective To investigate the influencing factors and Traditional Chinese Medical(TCM)syndrome classification of skin pruritus in patients with maintenance hemodialysis(MHD).Methods A total of 174 hemodialysis patients who underwent regular dialysis in Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital from July to September 2024 were selected as study subjects.According to the presence or absence of uremic pruritus(UP),they were divided into pruritus group(n=66)and non-pruritus group(n=108).Both groups of patients were classified into TCM syndromes,and the factors affecting skin pruritus in MHD patients were analyzed by Logistic regression analysis and an evaluation model was established.The evaluation efficiency of the model was evaluated by receiver operating characteristic curve.The relationship between TCM syndromes and pruritus degree was analyzed.Results Both groups of patients were mainly characterized by spleen and kidney Qi deficiency,and the difference was statistically significant(P＜0.05).Logistic regression analysis showed that β2 microglobulin(β2-MG),blood phosphorus,hyper-sensitive C-reactive protein and parathyroid hormone(PTH)were all risk factors for skin pruritus in MHD patients.The area under the curve of skin pruritus in MHD patients was 0.962(95％CI:0.930-0.995).The underlying syndrome of UP patients was mainly spleen and kidney Qi deficiency,and marked syndrome was mainly blood deficiency and wind-dryness.Conclusion β2-MG,blood phosphorus,hyper-sensitive C-reactive protein and PTH are closely related to the occurrence of skin pruritus in MHD patients.The TCM syndrome of UP patients is mainly characterized by spleen and kidney Qi deficiency,and syndrome of blood deficiency and wind-dryness is mainly characterized by UP patients,and there is a certain correlation between TCM syndrome classification and the degree of skin pruritus.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.