OBJECTIVE To investigate the attenuation and synergism of Hugan buzure recipe （HBR） combined with oxaliplatin on hepatocellular carcinoma tumor bearing nude mice and its mechanism. METHODS Eight nude mice were selected from 40 nude mice as the blank group （normal saline）， and the remaining nude mice were inoculated with hepatoma cells Huh7 to establish the tumor-bearing model. The 32 modeled nude mice were randomly allocated to four groups： model group （normal saline， ig）， HBR group （0.69 g/kg， ig）， oxaliplatin group （10 mg/kg， ip）， and combination group （intraperitoneal injection of 0.69 g/kg HBR+intragastric administration of 10 mg/kg oxaliplatin）， with 8 mice in each group. Administer drug/normal saline once a day for 32 consecutive days； administer subcutaneous injection once every 7 days for a total of 5 times. During the experiment， the general condition of nude mice in each group was observed， and the tumor volume was measured every 4 days. On the 30th day of administration， the thermal stimulation paw withdrawal latency of nude mice in each group were detected. The tumor inhibition rate， spleen coefficient， the number of red blood cells， white blood cells and platelets in the whole blood of nude mice in each group， and the content of aspartate aminotransferase （AST） and creatinine in serum were detected after the end of administration. HE staining was used to observe the pathological changes in tumor tissues in nude mice in each group. The expression of microtubule-associated protein 1 light chain 3 （LC3），selective autophagy adaptor protein p62， B-cell lymphoma-2 （Bcl-2）， Bcl-2 associated X protein （Bax）， and Caspase-3 protein in tumor tissues. RESULT Compared with the model group， the tumor volume， tumor weight， white blood cells，red blood cells in the whole blood and spleen coefficients of nude mice in the oxaliplatin group were significantly decreased （P＜0.01）； the thermal stimulation paw withdrawal latency， AST and creatinine in serum were significantly increased （P＜0.05 or P＜0.01）. Compared with the oxaliplatin group， the tumor volume and tumor weight of nude mice in the combination group were significantly decreased （P＜0.01）； the white blood cells， red blood cells and platelets in the whole blood and spleen coefficients of nude mice were significantly increased （P＜0.05 or P＜0.01）； the thermal stimulation paw withdrawal latency， AST and creatinine in serum were significantly decreased （P＜0.01）； the expression levels of LC3， Bax and Caspase-3 proteins in tumor tissues of nude mice were significantly increased （P＜0.01）， and the expression levels of p62 and Bcl-2 proteins were significantly decreased （P＜0.01）. CONCLUSIONS HBR enhances the tumor inhibition rate of oxaliplatin by inducing apoptosis and autophagy， and can alleviate the peripheral neurotoxicity， hematological toxicity， hepatorenal toxicity， and immune organ toxicity caused by oxaliplatin in nude mice.

OBJECTIVE To establish anticoagulation pharmaceutical service model based on the integrated theory of health behavior change （ITHBC）， and analyze its effects. METHODS Referring to relevant literature and soliciting opinions from 8 experts from departments such as pharmacy， respiratory medicine， and vascular surgery， a anticoagulation pharmaceutical service model based on ITHBC was ultimately formed. VTE inpatients were selected from The First Affiliated Hospital of Shihezi University from December 2023 to June 2024 as the research subjects. They were randomly assigned into intervention group （58 cases） and control group （60 cases） using a random number table method. The intervention group implemented pharmacist-led anticoagulant pharmaceutical service model based on ITHBC， while the control group adopted a conventional anticoagulant pharmaceutical service model. The anticoagulation-related outcomes of two groups were compared after 3 months： anticoagulation compliance rate， the incidence of adverse drug reactions， the score of medication adherence and compliance rate of anticoagulant prescription； economic evaluation was conducted. RESULTS After implementing ITHBC-based anticoagulant pharmaceutical services for 3 months， the intervention group had higher anticoagulation compliance rate， score of medication adherence， and compliance rate of anticoagulant prescription than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups （P＞0.05）. For every 1% point increase in anticoagulant compliance rate， the hospital needed to invest 4.35 yuan additionally in anticoagulant pharmaceutical service fees. Compared with China’s per capita gross domestic product （GDP， 89 358 yuan） in 2023， the incremental cost-effectiveness ratio value that increased the anticoagulation compliance rate by 50% is far less than one time of per capita GDP. CONCLUSIONS The pharmacist- led anticoagulant pharmaceutical service model based on ITHBC can effectively improve the outcomes of anticoagulant therapy for VTE patients， enhance medication compliance， improve patients’ awareness and recognition of adverse drug reactions to anticoagulants， and has certain economic and social benefits.

Objective To explore the correlation between polycystic ovary syndrome(PCOS)and periodontitis in light of cytokines levels,sex hormone levels and metabolism-related indicators and their changes during progression of the two diseases.Methods Twenty healthy subjects and 40 patients diagnosed with PCOS underwent full-mouth periodontal examinations to obtain full-mouth plaque score(FMPS),gingival bleeding index of probing(BOP),probing depth(PD),and clinical attachment level(CAL).The participants were divided into Group A without periodontitis or PCOS(n=15),Group B with PCOS but without periodontitis(n=28),Group C with periodontitis but without PCOS(n=5),and Group D with both diseases(n=12).Serum levels of luteinizing hormone/follicle stimulating hormone(LH/FSH),testosterone,prolactin,progesterone and estradiol,and the levels of interleukin 6(IL-6),IL-17A,tumor necrosis factor α and matrix metalloproteinase 8(MMP-8)in both serum and saliva samples were measured at the time of enrolment and at 3 and 6 months after enrolment and compared among the 4 groups.Results Serum MMP-8 level was significantly higher in Group B than in Group A(P<0.05).Salivary MMP-8 level was significantly higher in Group D than in Group B(P<0.05).Salivary MMP-8,LH,and LH/FSH levels and serum and salivary IL-6 and progesterone levels all tended to increase in the 6 months after enrollment(OR>1,P<0.05).During the follow-up period,serum IL-6 levels differed significantly between the non-PCOS groups(A and C)and PCOS groups(B and D)(P<0.05);serum IL-6 and salivary MMP-8 levels differed significantly between the non-periodontitis groups(A and B)and periodontitis groups(C and D)(P<0.05).Spearman correlation analysis indicated positive correlations of LH and LH/FSH with PD(P<0.05);testosterone and LH/FSH were positively correlated with serum MMP-8 levels(P<0.05),and PD,BOP and FMPS were positively correlated with salivary MMP-8 levels(P<0.01).Conclusion There is a correlation between PCOS and periodontitis,and their progression is accompanied by changes in serum and salivary levels of pro-inflammatory cytokines and serum sex hormones.

Objective To explore the correlation between polycystic ovary syndrome(PCOS)and periodontitis in light of cytokines levels,sex hormone levels and metabolism-related indicators and their changes during progression of the two diseases.Methods Twenty healthy subjects and 40 patients diagnosed with PCOS underwent full-mouth periodontal examinations to obtain full-mouth plaque score(FMPS),gingival bleeding index of probing(BOP),probing depth(PD),and clinical attachment level(CAL).The participants were divided into Group A without periodontitis or PCOS(n=15),Group B with PCOS but without periodontitis(n=28),Group C with periodontitis but without PCOS(n=5),and Group D with both diseases(n=12).Serum levels of luteinizing hormone/follicle stimulating hormone(LH/FSH),testosterone,prolactin,progesterone and estradiol,and the levels of interleukin 6(IL-6),IL-17A,tumor necrosis factor α and matrix metalloproteinase 8(MMP-8)in both serum and saliva samples were measured at the time of enrolment and at 3 and 6 months after enrolment and compared among the 4 groups.Results Serum MMP-8 level was significantly higher in Group B than in Group A(P<0.05).Salivary MMP-8 level was significantly higher in Group D than in Group B(P<0.05).Salivary MMP-8,LH,and LH/FSH levels and serum and salivary IL-6 and progesterone levels all tended to increase in the 6 months after enrollment(OR>1,P<0.05).During the follow-up period,serum IL-6 levels differed significantly between the non-PCOS groups(A and C)and PCOS groups(B and D)(P<0.05);serum IL-6 and salivary MMP-8 levels differed significantly between the non-periodontitis groups(A and B)and periodontitis groups(C and D)(P<0.05).Spearman correlation analysis indicated positive correlations of LH and LH/FSH with PD(P<0.05);testosterone and LH/FSH were positively correlated with serum MMP-8 levels(P<0.05),and PD,BOP and FMPS were positively correlated with salivary MMP-8 levels(P<0.01).Conclusion There is a correlation between PCOS and periodontitis,and their progression is accompanied by changes in serum and salivary levels of pro-inflammatory cytokines and serum sex hormones.

Schimke immuno-osseous dysplasia (SIOD)caused by SMARCAL1 gene mutations is a rare genetic disorder characterized by multi-system involvement, including T-cell dysfunction, skeletal dysplasia, disproportionate short stature, nephrotic syndrome, and kidney failure. This multidisciplinary consultation involved a 9-year-old boy with intrauterine growth retardation, presenting with short stature, T-cell lymphopenia, proteinuria, and degenerative bone and joint disease. Treatment primarily focused on symptomatic and supportive care. Through the multidisciplinary rare disease consultation, holistic support was provided to the patient, offering comprehensive care from various specialtiesx.We also aim to use this case report to enhance clinicians′ under-standing of SIOD and improve the management and treatment of rare diseases.

Objective:To explore the microbiological characteristics of donor blood culture and donor liver perfusion culture and summarize the clinical experiences to provide basic rationales for preventing donor-derived infections.Methods:From August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020 at First Affiliated Hospital, Zhengzhou University, culture results of donor blood and donor liver perfusate were retrospectively reviewed.According to whether or not donor liver was obtained without breaking diaphragm, removing gallbladder intraoperatively and flushing bile through cystic duct, two stages were assigned: before and after improvement measures of liver donor, i.e.August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020.The culture results of donor blood samples and donor liver perfusion fluid samples in two stages of liver transplantation were statistically analyzed and infection preventing measures during donor liver maintenance and obtaining donor liver examined.Results:A total of 486 cases of blood culture from potential donors and 478 cases of liver perfusion culture were analyzed.The results showed that the incidence of blood culture infection was 4.5% and 4.3% before and after improvement measures( χ2=0.008; P=0.927)while the incidence of perfusion fluid infection was 56.8% and 46.2%( χ2=4.569; P=0.031); Klebsiella pneumoniae was a major pathogen cultured in perfusion solution before improvement measures and Staphylococcus epidermidis after improvement measures. Conclusions:Before organ donation, infection screening and prevention of potential donors and corresponding measures during donor liver acquisition can reduce donor source infection and effectively lower the mortality of recipients.

【Objective】 To investigate the establishment of a competitive performance evaluation management program for blood centers to ensure the blood supply. 【Methods】 A competitive performance evaluation system for Blood Donor Service Department of blood centers in eastern Shenzhen was established. The data concerning blood collection after (May to October 2021, the experiment group) and before (the corresponding period in 2020, the control) the launch of evaluation system was compared, including the proportion of total/novel blood donors in fixed donation sites, the donation rate of 400 mL and pre-collection deferral rate; collected units per shift, the average collection volume of staff, and the growth rate of per capita donation; the proportion of first-time/repeated/double-dose platelet apheresis donors; the proportion of transfer-in/transfer-out of red blood cells; the ratio of group to street blood donors. 【Results】 The proportion of total/novel blood donors in fixed donation sites(81.13% vs 75.87%), the donation rate of 400 mL(58.14% vs 57.91%) and pre-collection deferral rate(76.55% vs 65.92%) in the experimental group was higher than that of the control, while the proportion of pre-collection deferral was lower(18.87% vs 24.13%) (P<0.05). Compared by the control, the units collected per shift, the average collection volume of staff and the blood donation per capita at fixed sites in the experiment group increased by 54.29%, 52.21%, and 3.36% (P<0.05). The proportion of first-time platelet donors was greater than that in the control(43.90% vs 19.61%), while the proportion of repeated platelet donors was lower (56.10% vs 80.39%). The proportion of double-dose platelet donors was lower than that in the control(12.62% vs 22.19%) (P<0.05). The amount of red blood cells transfer-in was 0%, lower than 2.38% in the control group(P<0.05), while the amount of red blood cell transfer-out was 1.86%, higher than 0% in the control group (P<0.05). The proportion of group blood donors decreased from 24% to 15.19%, while street blood donors increased from 76% to 84.81% (P<0.05). 【Conclusion】 Proper competitive performance evaluation system can effectively mobilize employee motivation, improve the efficacy of blood collection and internal management, and ensure clinical blood supply.

Objective:To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH).Methods:Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021.Results:The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days).Conclusions:Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.

Objective:To summarize the experience of surgical treatment of prosthetic valve dysfunction and evaluate the safety of operation.Methods:The clinical data of 142 patients admitted by the same cardiovascular surgeon from January 2015 to December 2019 at the first medical center of Chinese People's Liberation Army General Hospital. The clinical data were retrospectively analyzed, including 60 males (42.25%) and 82 females (57.75%), with an average age of 59.4 years old. Inclusion criteria: patients received redo-valvuloplasty or valve replacement after valvuloplasty or replacement, excluding mitral balloon dilatation and tricuspid valvuloplasty without implantation of annuloplasty ring.Results:The reasons of redo heart valve surgery in the same valve position including: bioprosthetic valve failure, mechanical prosthetic valve dysfunction, valve dysfunction after valvuloplasty, prosthetic valve infectious endocarditis, perivalvular leakage. There was 2 death in 142 cases, and the operative mortality rate was 1.41%. The reasons of the perioperative period death include cerebral hemorrhage, coagulation dfsfunction; perioperative complications include low cardiac output syndrome (LCOS), hypoxic-ischemic encephalopathy, respiratory failure, tracheal re-intubation, re-thoratomy for hemaostsis.Conclusion:There are many reasons for reoperation of prosthetic valve dysfunction, and the reoperation surgery is a difficult procedure. However, choosing the suitable surgical option, strengthening the perioperative management of such patients can effectively reduce the incidence of postoperative mortality and complications, minimally invasive surgery can reduce the mortality and complications.

Objective:The aim of this study was to compare the perioperative outcomes of a totally thoracoscopic repeat mitral valve surgery under hypothermic ventricular fibrillation with those of a conventional median sternotomy approach for repeat mitral valve surgery and to explore the safety of the totally thoracoscopic repeat mitral valve surgery under hypothermic ventricular fibrillation.Methods:Patients requiring repeat mitral valve surgery admitted by the same surgeon at Cardiovascular Surgery, First Medical Center, Chinese PLA General Hospital from January 2018 to January 2022 were retrospectively enrolled. The patients were divided into the totally thoracoscopic group under hypothermic ventricular fibrillation and the conventional median sternotomy group according to the procedure, and the preoperative baseline data and perioperative outcomes were collected and statistically analyzed using SPSS 22.0.Results:A total of 91 patients matched the criteria for study enrollment, 25 in the totally thoracoscopic group and 66 in the median sternotomy group. There was no statistical difference in the preoperative baseline data between the two groups. The totally thoracoscopic group has advantages in mitral valvuloplasty rate(32.0% vs. 7.6%, P=0.008), transfusion rate(72.0% vs. 98.5%, P<0.001), mechanical ventilation time [(19.0±27.8)h vs.(43.3±58.3)h, P=0.009], chest drainage tube time [(2.2±1.9)days vs.(3.7±2.4)days, P=0.004], postoperative chest drainage volume [(489.6±319.1)ml vs.(913.6±568.4)ml, P=0.001], postoperative discharge time[(8.0±2.7)days vs.(13.9±12.8)days, P=0.026]. The totally thoracoscopic group had a longer cardiopulmonary bypass time [(180.8±41.7)min vs.(143.2±39.7)min, P<0.001], and it had an intraoperative ventricular fibrillation time of(100.2±42.5)min. There were no statistically significant differences in the postoperative complication rate(12.0% vs. 21.2%, P=0.481) and mortality(4.0% vs. 4.5%, P=1.000) between the two groups. Conclusion:The totally thoracoscopic approach has the characteristics of less invasion and faster recovery compared with the median sternotomy approach. Hypothermic ventricular fibrillation simplifies the procedure at the ascending aorta while reducing myocardial injury than conventional occlusion of the ascending aorta. Totally thoracoscopic mitral valve surgery under hypothermic ventricular fibrillation is a safe minimally invasive technique.