As an important setting for the administration of vaccinations, the reasonable setting up and standardized management of vaccination clinics will enhance immunization service quality, public satisfaction, and improve the vaccination rate to protect people′s health. In recent years, various provinces in China are continuously promoting the standardized construction and management of vaccination clinics. However, the level of standardization management remains unbalanced, and the capacity of vaccination services needs to be further improved. This paper reviews the standardized management process of vaccination clinics, summarizes the practice and achievements in various regions, and analyzes the challenges and issues during these processes, to provide reference for improving the standardized management level of vaccination clinics in the future.

Objective To explore the identification method,pathogenesis,clinical characteristics and individualized pharmacotherapy of asymptomatic hyperuricemia after renal transplantation.Methods The pharmacist was on duty at the organ transplant outpatient clinic.During this time,they analyzed and sorted out the medications,identified and differentiated a case of asymptomatic hyperuricemia related to spironolactone in a patient who had undergone a renal transplant,and provided comprehensive care throughout the entire process.Results The asymptomatic hyperuricemia in this patient might be associated with spironolactone,and the adverse reactions of the patient were alleviated by pharmacists through optimizing clinical treatment.Up to now,no hyperuricemia occurred.Conclusions Pharmacists are required to collaborate closely with clinicians to establish medication profiles for patients under long-term follow-up and to closely monitor and evaluate drug-related adverse reactions.Additionally,they should assess the renal function and immune status of transplant recipients promptly and formulate individualized treatment plans in order to enhance the long-term survival of both the transplanted kidneys and the recipients.

Background and Aims:Pancreatic cancer is a highly aggressive malignancy that imposes a significant disease burden both in China and globally.It not only substantially increases healthcare expenditures but also profoundly influences health policy decisions.This study aims to systematically assess the disease burden of pancreatic cancer in China and worldwide over the past 30 years and to analyze future trends using a prospective predictive model,providing a scientific basis for the development of effective prevention and control strategies.Methods:Data on incidence,prevalence,mortality,and disability-adjusted life years(DALY)of pancreatic cancer,stratified by sex and standardized for age,were extracted from the Global Burden of Disease(GBD)database for the period 1990-2021.The autoregressive integrated moving average(ARIMA)model was used to predict the disease burden trends of pancreatic cancer for the next 15 years.Results:The results showed that from 1990 to 2021,the incidence,prevalence,mortality,and DALY rates of pancreatic cancer exhibited an increasing trend in both China and worldwide.Males had significantly higher incidence and mortality rates than females,with a faster growth rate.The highest incidence and mortality rates were observed in economically developed regions such as North America and Europe,while lower rates were noted in less developed regions such as Africa and South Asia.However,with economic development and lifestyle changes,the pancreatic cancer burden in these low-incidence regions is also gradually increasing.Over time,the growth rate of pancreatic cancer incidence and mortality in China has surpassed the global average,and with an aging population,the disease burden is expected to rise further in the future.Conclusion:There are significant variations in the pancreatic cancer burden across genders and regions.Strengthening health education and early screening for high-risk populations,optimizing personalized treatment strategies,and increasing investment in basic research on pancreatic cancer are essential to mitigating the growing disease burden.This study provides crucial scientific evidence for the formulation of pancreatic cancer prevention and control strategies,contributing to improved patient outcomes and reduced socioeconomic burden.

As an important setting for the administration of vaccinations, the reasonable setting up and standardized management of vaccination clinics will enhance immunization service quality, public satisfaction, and improve the vaccination rate to protect people′s health. In recent years, various provinces in China are continuously promoting the standardized construction and management of vaccination clinics. However, the level of standardization management remains unbalanced, and the capacity of vaccination services needs to be further improved. This paper reviews the standardized management process of vaccination clinics, summarizes the practice and achievements in various regions, and analyzes the challenges and issues during these processes, to provide reference for improving the standardized management level of vaccination clinics in the future.

Objective The pathophysiological process of acute high-altitude hypoxia-induced lung injury affects protein expression levels,which are mainly evaluated by Western blot.No systematic study has investigated changes in internal control proteins as calibration loading amounts.Methods Lung injury at an altitude of 6000 m was induced in a low-pressure,low-oxygen chamber for 8,24,and 72 h using C57BL/6J mice.Establishment of the model was confirmed by hematoxylin and eosin staining.Expression levels of various internal control proteins,including vinculin,α-tubulin,eukaryotic translation initiation factor 5(EIF5),β-actin,and glyceraldehyde 3-phosphate dehydrogenase(GAPDH)were detected by Western blot,and total protein expression was detected by Coomassie blue staining.Furthermore,the lung injury model in vitro was establised by using,Bronchial epithelial cell(BZAS-2B)andhunman umbilical vein endothelial cells(HUVECS)confirmed by TUNEL staining.Expression levels of internal control proteins were detected by Western blot,and total protein expression was detected by Coomassie Blue staining.Results Acute 8,24,and 72 h hypoxic models were successfully established in lung tissue,demonstrating consistent total protein expression and stable levels of the internal reference proteins vinculin,α-tubulin,EIF5,andβ-actin.GAPDH expression was elevated in the HH8 h,HH24 h,and HH72 h groups compared with the normoxia(Nor)group,but only the increase at HH72 h groups was significant.Similarly,8,24,and 48 h hypoxic models were successfully established in BEAS-2B cells and HUVECs,with consistent total protein expression.In BEAS-2B cells,expression levels of the internal reference proteins β-actin and GAPDH were consistent with the normoxic control(NC)group,while vinculin,α-tubulin,and EIF5 expression levels were significantly reduced under hypoxic conditions for up to 24 h.In HUVECs,vinculin and α-tubulin expression levels were also consistent with the NC group,while EIF5,β-actin,and GAPDH expression levels were significantly reduced at 8 h and increased at 48 h.Conclusions Acute hypoxia induces lung tissue injury,and protein expression levels of the internal reference proteins vinculin,α-tubulin,EIF5,and β-actin are stable,making them suitable internal references for Western blot.Additionally,Western blot detected differential expression levels of the internal reference proteins vinculin,α-tubulin,EIF5,β-actin,and GAPDH in BEAS-2B cells and HUVECs,as the most important in vitro lung tissue models of hypoxia-induced injury.

Objective To investigate the imaging features of Langerhans cell histiocytosis(LCH)in the long bones of the limbs in children.Methods The clinical and imaging data of 23 children with long bones of the limbs were analyzed retrospectively.X-ray examinations were performed in 21 cases,CT scans in 16 cases,and MRI scans in 19 cases.Results The lesions were located in femur in 14 cases,tibia in 3 cases,fibula in 2 cases,humerus in 1 case,ulna in 2 cases,and both tibia and fibula in 1 case.Lesions were found in the diaphysis in 16 cases and the metaphysis in 7 cases(involving the epiphysis in 2 cases).Bone destruction appeared as oval,irregular,or eccentric shapes,with clear boundaries in 17 cases,blurred boundaries in 6 cases,and sclerosis in 6 cases.The average CT value was(48.27±8.20)HU,with"gear-like"changes in the axial view in 10 cases."Sleeve-like"periosteal reaction was observed in 14 cases,localized periosteal reaction in 5 cases,and no periosteal reaction in 4 cases.The lesions showed iso-or slightly hypointense signals on T1 WI,hyperintense signals on T2 WI,and hyperintense signals on diffusion weighted imaging(DWI),with an average apparent diffusion coefficient(ADC)value of(1.26±0.17)×10-3 mm2/s.Soft tissue masses were found in 7 cases.After enhancement,moderate to marked enhancement was observed in 9 cases,with lace-like enhancement in 6 cases.Among the 17 cases followed up,13 cases returned to normal or had only residual bone cortical thickening,3 cases showed a reduction in lesion size,and 1 case died.Conclusion The imaging features of LCH in the long bones in children have certain characteristics,but can still be easily confused with infections or malignant bone tumors.A comprehensive analysis combining clinical and imaging features is necessary to improve diagnostic accuracy.

OBJECTIVE To investigate the effects of clopidogrel on the pharmacokinetics and pharmacodynamics of ciprofol in rats.METHODS Eighteen male SD rats were randomly divided into control group,clopidogrel normal-dose group and clopidogrel high-dose group,with 6 rats in each group.Among them,rats in the normal-dose group and high-dose group were given 7.5 mg/kg and 15 mg/kg clopidogrel by gavage,respectively,and rats in the control group were given the same volume of 0.5％sodium carboxymethyl cellulose solution,once a day,for 14 consecutive days.Afterward,2.4 mg/kg ciprofol was injected by tailvein and blood samples were collected from the inner canthus of the eye at 2,4,8,12,16,20,30,45 and 60 min after the end of the administration.During this period,the duration of the loss of righting reflex(LORR)in rats was counted.After the proteins were precipitated by acetonitrile,the rat plasma sample was analyzed by LC-MS/MS using deuterated ciprofol as the internal standard,Symmetry C18 as the chromatographic column,and acetonitrile-0.01％ammonia solution containing 5 mmol/L ammonium acetate(gradient elution)as the mobile phase to detect the concentration of ciprofol in the plasma.The pharmacokinetic parameters in rats were calculated by using DAS 2.0 software.RESULTS Compared with control group,area under the drug concentration-time curve and mean residence time of ciprofol increased or prolonged significantly,while plasma clearance decreased significantly in clopidogrel normal-dose and high-dose groups;the duration of LORR in rats was prolonged by 19.5％and 23.9％,with statistical difference(P＜0.05).However,there was no statistically significant difference in the pharmacokinetic parameters or LORR duration of ciprofol between the different dose groups of clopidogrel(P＞0.05).CONCLUSIONS Clopidogrel could inhibit the metabolism of ciprofol in rats and prolong the duration of LORR.

Cognitive frailty, as one of the independent dimensions of frailty syndrome, has received increasing attention from researchers in recent years. Cognitive frailty not only reduces the quality of life for elderly people, but also increases the risk of adverse outcomes such as falls, disabilities, hospitalization, dementia, and death. This article introduces the concept, assessment methods, influencing factors, and intervention measures of cognitive frailty, emphasizing the important role of general practitioners in screening and management of cognitive frailty.

Background and Aims:Pancreatic cancer is a highly aggressive malignancy that imposes a significant disease burden both in China and globally.It not only substantially increases healthcare expenditures but also profoundly influences health policy decisions.This study aims to systematically assess the disease burden of pancreatic cancer in China and worldwide over the past 30 years and to analyze future trends using a prospective predictive model,providing a scientific basis for the development of effective prevention and control strategies.Methods:Data on incidence,prevalence,mortality,and disability-adjusted life years(DALY)of pancreatic cancer,stratified by sex and standardized for age,were extracted from the Global Burden of Disease(GBD)database for the period 1990-2021.The autoregressive integrated moving average(ARIMA)model was used to predict the disease burden trends of pancreatic cancer for the next 15 years.Results:The results showed that from 1990 to 2021,the incidence,prevalence,mortality,and DALY rates of pancreatic cancer exhibited an increasing trend in both China and worldwide.Males had significantly higher incidence and mortality rates than females,with a faster growth rate.The highest incidence and mortality rates were observed in economically developed regions such as North America and Europe,while lower rates were noted in less developed regions such as Africa and South Asia.However,with economic development and lifestyle changes,the pancreatic cancer burden in these low-incidence regions is also gradually increasing.Over time,the growth rate of pancreatic cancer incidence and mortality in China has surpassed the global average,and with an aging population,the disease burden is expected to rise further in the future.Conclusion:There are significant variations in the pancreatic cancer burden across genders and regions.Strengthening health education and early screening for high-risk populations,optimizing personalized treatment strategies,and increasing investment in basic research on pancreatic cancer are essential to mitigating the growing disease burden.This study provides crucial scientific evidence for the formulation of pancreatic cancer prevention and control strategies,contributing to improved patient outcomes and reduced socioeconomic burden.

Objective:To construct a hierarchical training course system for neonatal nurses based on core competencies, to provide a reference for meeting the training needs of neonatal nurses under the new situation.Methods:Through literature review, questionnaire survey on training needs, and focus group interviews, a preliminary hierarchical training curriculum system for neonatal nurses was developed. Two rounds of Delphi correspondence were conducted with 19 domestic experts to finalize the system.Results:The effective questionnaire recovery rates of the two rounds of expert consultation were 95.00% and 100.00%, and the expert authority coefficient was 0.916, the Kendall harmony coefficient of the first round of expert opinions was 0.351 ( P<0.001), and the Kendall harmony coefficient of the second round of expert opinions was 0.463 ( P<0.001). The hierarchical training course structure and course training content are formed, including N0: 3 first-level items, 9 second-level items, 80 third-level items, N1: 3 first-level items, 9 second-level items, 91 third-level items, N2: 3 first-level items, 9 second-level items, 86 third-level items, N3: 3 first-level items, 10 second-level items, 81 third-level items, N4: 3 first-level items, 10 second-level items, 76 third-level items. Conclusions:The hierarchical training course system for neonatal nurses based on the core competence of nurses is scientific and practical, which can provide a reference for the hierarchical training of neonatal nurses.