OBJECTIVE To explore a model for constructing a platform for medical institution formulation and provide insights for promoting their development. METHODS By systematically reviewing the development status and challenges of medical institution preparations in China， and based on the theory of industry-university-research collaborative innovation， the organizational structure， collaborative processes， and safeguard mechanisms of the platform were designed. RESULTS & CONCLUSIONS Medical institution formulations in China mainly faced challenges such as weak research and development （R&D） capacity， uneven quality standards， and blocked transformation pathways. This study established a full-chain， whole- industry collaborative innovation network covering the government， medical institutions， universities/research institutes， pharmaceutical enterprises， and the market， forming a new “government-industry-university-research-application” five-in-one platform model for medical institution formulations. By establishing mechanisms such as multi-entity collaborative cooperation， full- chain intellectual property management， contribution-based benefit distribution， staged risk-sharing， and third-party evaluation， the model clarified the responsibilities and collaborative pathways of all parties. The new model highlights the whole-process transformation of clinical experience-based prescriptions， enabling precise alignment between clinical needs and technological R&D， as well as between preparation achievements and industrial transformation. While breaking down the barriers of traditional platform construction， it effectively achieves optimal resource allocation and complementary advantages， addresses problems emerging in the development of medical institution preparations， and provides reference value for the formulation of relevant systems.

The underlying cause of low response rates to existing immunotherapies is that tumor cells dominate tumor immune escape through surface antigen deficiency and inducing tumor immunosuppressive microenvironment (TIME). Here, we proposed an in situ tumor cell engineering strategy to disrupt tumor immune escape at the root by restoring tumor cell MHC-I/tumor-specific antigen complex (MHC-I/TSA) expression to promote T-cell recognition and by silencing tumor cell CD55 to increase the ICOSL⁺ B-cell proportion and reverse the TIME. A doxorubicin (DOX) and dual-gene plasmid (MAC pDNA, encoding both MHC-I/ASMTNMELM and CD55-shRNA) coloaded drug delivery system (LCPN@ACD) with tumor targeting and charge/size dual-conversion properties was prepared. LCPN@ACD-induced ICD promoted DC maturation and enhanced T-cell activation and infiltration. LCPN@ACD enabled effective expression of MHC-I/TSA on tumor cells, increasing the ability of tumor cell recognition and killing. LCPN@ACD downregulated tumor cell CD55 expression, increased the proportion of ICOSL⁺ B cells and CTLs, and reversed the TIME, thus greatly improving the efficacy of αPD-1 and CAR-T therapies. The application of this in situ tumor cell engineering strategy eliminated the source of tumor immune escape, providing new ideas for solving the challenges of clinical immunotherapy.

Objective To investigate the application value of B/M ultrasonic measurement in patients with dysphagia caused by lateral medullary syndrome.Methods Twenty patients suffered from lateral medullary syndrome with pharyngeal dysphagia and completely depended on tube feeding were selected.Before and after treatment,the swallowing function was evaluated by functional oral intake scale(FOIS),7 pharyngeal indicators in videofluoroscopic dysphagia scale(VDS)and ultrasonic measurement.Results There was significant difference in FOIS rating before and after treatment(Z=-3.998,P<0.000).Compared with those results before treatment,the VDS score was significantly decreased,and the motion amplitude of geniohyoid muscle,hyoid displacement and hyoid-larynx approximation shortening rate(ASR)were significantly increased after treatment(all P<0.01).Conclusion Ultrasound detection of geniohyoid muscle movement distance,hyoid displacement and ASR can evaluate the damage of hyoid and laryngeal lifting function in patients with lateral medullary syndrome,and indirectly reflect the changes in swallowing function before and after treatment.

Teaching clinics represent a unique form of outpatient training of resident physicians and serve as a crucial instrument and core component of standardized training of general practice residents. This article reviews the common model and innovations of teaching clinics of general practice in China, and analyzes their reported effectiveness in enhancing the capabilities of consultation of resident physicians, the teaching capabilities of general practice trainers, as well as satisfaction levels of involved participants. It outlines the challenges encountered in implementing teaching clinics, including inadequate teaching facilities and equipment, incomplete incentive system for teaching, difficulties in patient recruitment, and weaknesses in the teaching capabilities of trainers. To address these challenges, this article proposes corresponding strategies based on realistic needs, including the improvement of facilities and equipment in teaching clinics, the establishment of incentive systems for teaching clinics, the expansion of patient recruitment channels for teaching clinics, and the enhancement of training for trainers' teaching capabilities. This is envisaged to provide both theoretical bases and practical guidance for the effective execution and standardized development of teaching clinics in general practice residency training bases.

Chemoimmunotherapy has been approved as standard treatment for triple-negative breast cancer (TNBC), but the clinical outcomes remain unsatisfied. Abnormal epigenetic regulation is associated with acquired drug resistance and T cell exhaustion, which is a critical factor for the poor response to chemoimmunotherapy in TNBC. Herein, macrophage-camouflaged nanoinducers co-loaded with paclitaxel (PTX) and decitabine (DAC) (P/D-mMSNs) were prepared in combination with PD-1 blockade therapy, hoping to improve the efficacy of chemoimmunotherapy through the demethylation of tumor tissue. Camouflage of macrophage vesicle confers P/D-mMSNs with tumor-homing properties. First, DAC can achieve demethylation of tumor tissue and enhance the sensitivity of tumor cells to PTX. Subsequently, PTX induces immunogenic death of tumor cells, promotes phagocytosis of dead cells by dendritic cells, and recruits cytotoxic T cells to infiltrate tumors. Finally, DAC reverses T cell depletion and facilitates immune checkpoint blockade therapy. P/D-mMSNs may be a promising candidate for future drug delivery design and cancer combination therapy in TNBC.

Chemotherapy is currently the main clinical treatment method for malignant tumors， and chemotherapy resistance is the main factor leading to chemotherapy failure and malignant tumor recurrence and metastasis. The cha-racteristics of malignant tumors formation were regarded as similar to the “Yin Fire” theory， manifested that deficiency of original qi as the foundation of malignant tumors， imbalance of original qi and yin fire as the internal cause of malignant tumor progression， and the internal environment of phlegm-blood stasis-toxicity-deficiency caused by yin fire promoted the formation of chemoresistance. In the treatment of chemoresistance of malignant tumors， traditional Chinese medicine should focus on treating disease before its onset by tonifying the spleen and strengthening the middle， nou-rishing the original qi， and reinforcing healthy qi and anti-cancer； during the treatment， the clinicians should regulate the qi and detoxify to clear yin fire， and improve the internal environment. Summarily， the strategies were adjusting the balance of internal environment of original qi and yin fire， and conducting a comprehensive treatment during the whole process， to provide new ideas for the treatment of chemoresistance of malignant tumors with traditional Chinese medicine.

Objective To label granulocytes in a state of differentiation in mouse bone marrow (BM) with EdU (5-ethynyl-2′-deoxyuridine) for further understanding the changes in granulocyte produc-tion at different stages of differentiation during inflammation. Methods C57BL/6 mice were intraperitoneal-ly (i.p.) injected with EdU and heat-inactivated Escherichia coli(HI E.coli). BM cells were harvested at different time points after HI E.coli injection and then stained with fluorescent-conjugated antibodies(Abs). Myeloblasts,promyelocytes,myelocytes, metamyelocytes and band and segmented neutrophils were identi-fied by fluorescence-activated cell sorting(FACS). The percentage of EdU-positive cells in each population was recorded. Results The percentage of EdU-positive myeloblasts in mice increased by 10.0% at 24 h af-ter intraperitoneal injection with HI E.coli,but decreased by 75.0% and 23.0% at 48 h and 72 h,respec-tively. The percentage of EdU-positive promyelocytes declined by 23.0%,54.5%,64.3% and 77.8% at 24 h,48 h,72 h and 96 h,respectively. The percentage of EdU-positive myelocytes increased by 60.0% and 10.0% at 24 h and 48 h,but decreased by 80.0% and 90.0% at 72 h and 96 h. The percentage of EdU-positive metamyelocytes increased by 50.0% at 24 h,but decreased by 33.3%,61.5% and 66.7% at 48 h,72 h and 96 h. The percentage of EdU-positive band and segmented cells increased by 14.0% at 24 h,but decreased by 50.0%, 77.8% and 88.0% at 48 h, 72 h and 96 h. Conclusion Emergency granulopoiesis occurred 24 h after the establishment of HI E.coli-induced model of acute peritonitis, which meant that the proliferation of myeloid precursor cells,especially that of myelocytes and metamyelocytes,was accelerated and resulted in increasing number of mature neutrophils immigrating to sites of inflammation.

Exfoliative cytology is a simple and non-invasive examination method that is easily accepted by the patient. A number of new techniques are used to further increase the accuracy of sample collecting. It is widely used in the detection of cervical, oral cavity and various coelom exfoliated cells. This article reviews the development of exfoliative cytology in oral cancer diagnosis. It is realized that the qualitative and quantitative analysis of cancer and precancerous lesions, through DNA quantitative analysis to calculate DNA index (DI value), multiple parameter analysis and statistical modeling calculation to evaluate oral cancer risk index (OCRI) of the patient has great significance in cancer screening, early diagnosis and prognosis review, especially in the field of oral cancer.

BACKGROUND:Chronic ankle instability can cause traumatic joint disease and secondary adhesive capsulitis, and even result in permanent dysfunction.
OBJECTIVE: To explicit the forming reason of chronic ankle instability and to investigate the diagnosis and treatment methods of chronic ankle instability based on the biomechanical analysis of the ankle joint.
METHODS: PubMed and Wanfang databases were retrieved for review and basic research papers about the anatomy, biomechanics, diagnosis and treatment of chronic ankle instability published from January 1990 to December 2014. The keywords were “chronic ankle instability, anatomy of ankle joint, biomechanics, therapy, research” in English and Chinese, respectively. After screening, 40 papers were included to summarize the anatomical structure of the ankle joint, mechanism and classification, diagnostic methods, and treatment methods of chronic lateral ankle instability.
RESULTS AND CONCLUSION:Diagnostic methods of chronic ankle instability include ankle varus stress test, ankle anterior drawer test, ultrasonic test, modern imaging detection; and therapeutic methods for chronic ankle instability can be divided into conservative treatment and surgical treatment, and the surgical treatment can be subdivided into non-anatomic reconstruction and anatomical repair of the damaged ligament. Early diagnosis and effective treatment are recommended for patients with chronic ankle instability, and the treatment programs should be determined based on comprehensive analysis of ankle anatomical structure, biomechanical characteristics, pathogenesis, and diagnostic results.

BACKGROUNDQuantitative dynamic contrast enhancement MR imaging (DCE-MRI), used to measure properties of tissue microvasculature and tumor angiogenesis, is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment. The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area, which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.

METHODSOne hundred and forty-three patients with sinonasal tumors, including 78 malignant tumors and 65 benign tumors and tumor-like lesions, underwent clinically used DCE-MRI. Parametric maps were obtained for quantitative parameters including K(trans), kep and ve. Two radiologists reviewed these maps and measured K(trans), kep and ve in the tumor tissue. Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.

RESULTSK(trans), kep and ve showed significant differences between benign and malignant tumors in the sinonasal area (P = 0.000 1). The accuracy of K(trans), kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0%, 76.2% and 67.1%, respectively. There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas (P < 0.05). Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3%, sensitivity of 88.2%, specificity of 68.0%, positive predictive value of 66.7%, and negative predictive value of 90.9%. However, no significant difference in K(trans) and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area (P > 0.05).

CONCLUSIONSIt is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region. Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.

Contrast Media ; Female ; Humans ; Image Enhancement ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; diagnosis