Objective To explore the clinical value of preoperative Glasgow-Blatchford score(GBS)and AIMS65 score in predicting the prognosis of patients with non-variceal upper gastrointestinal bleeding after receiving interventional treatment.Methods The clinical data of 59 patients with non-variceal upper gastrointestinal bleeding,who received transcatheter arterial embolization(TAE)at the Department of Interventional Vascular Surgery,Shanghai Tenth People's Hospital of China between 2018 and 2021,were collected.The clinical value of GBS and AIMS65 score in predicting patient's outcome was analyzed.Results With the preoperative GBS and AIMS65 scores increasing,the mortality also increased.Compared with AIMS65 score(AUC=0.630,0.95％CI:0.494-0.752),GBS(AUC=0.823,95％CI:0.702-0.910)had a higher predictive value for postoperative in-hospital death in patients with non-variceal upper gastrointestinal bleeding after receiving interventional treatment.With a GBS cutoff＞9 points,the Youden index for predicting in-hospital death was 0.54.Conclusion In predicting the postoperative in-hospital death for patients with non-variceal upper gastrointestinal bleeding after receiving TAE,the clinical value of the preoperative GBS score is higher than that of AIMS65 score.

In April 2022,an epidemic occurred in Gongshu District,Hangzhou,where Zhejiang Cancer Hospital is loca-ted.And the hospital was confronted with the most extensive,the most unusual and the most urgent public health emergency crisis since its establishment.Taking patients as the core and proceeding from the public perspective,an authoritative voice of a hospital was conveyed in a timely and accurate manner,which demonstrated the hospital's resolution and executive power in the crisis.Based on Malcolm Gladwell's"tipping point"theory,the paper reveals the situation of online public opinion caused by the sudden epidemic and its response,discusses the hospital's communication practices in handling public health emergencies and provides hospitals with practical reference for brand promotion and operation.

Objective:To compare the distribution differences of serum protein electrophoresis (SPE) among different gender and age individuals, and to explore the clinical application of SPE screening monoclonal gammopathy.Methods:A retrospective analysis was conducted based on the SPE results obtained from 533 989 cases enrolled from January 2018 to December 2019 at Zhongshan Hospital Affiliated to Fudan University. Among these patients, 435 479 inpatients were from departments of hematology, nephrology, spinal surgery, endocrinology, and rheumatology and immunology; and 98 510 were apparently healthy individuals. The distributions of albumin, α1 globulin, α2 globulin, β1 globulin, β2 globulin and γ globulin in different gender and age groups (≤20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, ≥91 years old) were compared. A total of 10 014 cases were selected by immunofixation electrophoresis (IFE). The positive detection rates of different SPE bands and IFE bands were analyzed. The sensitivity and specificity of SPE methods were determined according to IFE results as the gold standard.Results:No significant difference was examined in the proportion of SPE bands between different genders ( P>0.05). There were statistically significant differences in the proportion of albumin bands between apparently healthy individuals and hospitalized patients at different ages (apparently healthy individuals: F=5.12, P<0.05, inpatients: F=4.18, P<0.05), and all of them decreased with the increase of age. The proportion of γ globulin bands increased with age (apparently healthy individuals: F=1.34, P<0.05; inpatients: F=1.24, P<0.05). The sensitivity of SPE was 69% (2 098/3 051), and the specificity was 97% (6 721/6 963). Compared with IFE method, the positive detection rate of monoclonal gammopathy was significantly different (χ2=5 049.94, P<0.05). The positive rate of monoclonal gammopathy in γ globulin region (21.11%, 2 114/10 014) was higher than that in β globulin region (3.28%, 328/10 014) (χ2=90.74, P<0.05) and β-γ globulin region (1.63%, 163/10 014) (χ2=44.34, P<0.05). IgG and IgM bands are common in γ globulin region. Among them, IgG-κ type accounted for 94.1% (995/1 058), IgG-λ type accounted for 94.8% (690/728), IgM-κ type accounted for 89.2% (222/249), IgM-λ accounted for 83.8% (62/74). IgA bands are common in β region, of which IgA-κ accounted for 49.8% (103/207) and IgA-λ accounted for 51.6% (149/289). The positive rate of monoclonal gammopathy of IgG-κ type was the highest (10.57%, 1 058/10 014), and the positive rate of monoclonal gammopathy of IgM-λ type was the lowest (0.74%, 74/10 014). Conclusions:With increasing age, the proportion of albumin band in SPE decreased and the proportion of γ globulin band increased. IgG and IgM type monoclonal gammopathy is mostly found in the gamma region, with a higher detection rate in IgG type. IgA type monoclonal gammopathy is mostly found in the β region, with a lower detection rate.

Objective:To retrospectively compare the clinical effects of the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the European Kidney Function Consortium (EKFC) equation based on creatinine to estimate glomerular filtration rate (eGFRcr) in a Chinese population.Methods:Patients and healthy individuals who visited the Zhongshan Hospital, Fudan University, between January 1, 2023, and December 31, 2023, were enrolled. The exclusion criteria were age<18 years, amputees, pregnant women, patients with muscle-related diseases, and patients who had undergone ultrafiltration or dialysis. The final study population included 660 078 individuals with a median age of 58 years (44, 68), 56.51% (372 987/660 078) of them were men. eGFRcr was calculated using the 2021 CKD-EPI, EKFC equations and initial 2009 CKD-EPI equation. Results were compared by differences (P 10), charges in population distribution and impact on staging of chronic kidney disease (CKD) by gender, age and creatinine results. Results:Compared with the results of 2009 and 2021 CKD-EPI eGFRcr, the P 10was 99.99% ( R 2=0.997). When applying the 2021 CKD-EPI eGFRcr equation, there was a slight overestimation of 3.77 (2.92, 4.47) ml/(min×1.73 m 2). 86.42% (570 455/660 078)participants had higher eGFRcr owing to the utilization of the 2021 CKD-EPI equation, which did not cause CKD stage change. A total of 12.35% (81 514/660 078) of subjects had different CKD stage with the higher 2021 CKD-EPI eGFRcr. 1.23% (8 109/660 078) had lower eGFRcr but no change in the CKD stage with the 2021 equation. Compared to the 2009 CKD-EPI eGFRcr results, the EKFC eGFRcr demonstrates P 10 values of 89.79%, with a correlation coefficient of R 2=0.976. The overall eGFRcr values using the EKFC equation were decreased by 4.63(-2.22, -7.04) ml/(min×1.73 m 2). There were 75.14% (495 992/660 078) individuals whose eGFRcr results were lower in EKFC equation, which did not cause CKD stage change. There were 15.63% (103 161/660 078) leading to a different CKD stage. Additionally, 8.80% (58 077/660 078) individuals with a higer eGFRcr result did not change CKD stage, while 0.43% (2 848/660 078) experienced a change in CKD staging due to the overestimation. Conclusions:Compared with the 2009 CKD-EPI eGFRcr results, the 2021 CKD-EPI eGFRcr results were slightly higher and had good consistency in different genders and ages. However, the EKFC eGFRcr was generally lower than 2009 CKD-EPI eGFRcr, showing poor consistency. The differences between eGFR equations should be considered when judging the CKD stage of patients.

Objective To qualitatively analyze the main chemical components in compound Jinqiancao granules by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Methods XBridge BEH C₁₈ column (2.1 mm×100 mm, 2.5 µm) was used for chromatographic separation. The mobile phase was composed of 0.1% formic acid water and 0.1% formic acid-acetonitrile, gradient elution, and the flow rate was 0.4 ml/min. Mass spectrometry was characterized by Quadrupole time-of-flight mass spectrometry (Q-TOF/MS) and positive ion mode scanning. Results Under the optimized LC/MS condition, 47 components in compound Jinqiancao granules were identified. The isomers were distinguished by software calculation. The source of medicinal materials was assigned. Conclusion A rapid and efficient analytical method was established for the identification of chemical components in compound Jinqiancao granules by UHPLC-Q-TOF/MS.

ObjectiveIn the context of COVID-19 prevention and control， to summarize the current situation of the public health personnel team development against the pandemic at a county-level center for disease control and prevention （CDC） in Shanghai’s extra-large urban area， to analyze and summarize the current situation and existing problems of the public health personnel team of the district and county-level CDCs， and to propose measures to strengthen and improve the development. MethodsTaking the Shanghai Pudong New Area Center for Disease Control and Prevention， which serves a population of 5.68 millions， as an example， through information access， individual interviews， questionnaires， holding symposiums， etc.， combined with the deployment of personnel in the handling of the COVID-19， we described the Pudong New Area CDC’s talent team characteristics， personnel recruitment and loss， and investigated the factors affecting the construction of talent team. ResultsFrom 2014 to 2020， Pudong CDC recruited 115 people， and 65.71% of them chose to work there. 68 people resigned， with an average of 6.8 people leaving every year， with a fluctuating upward trend in resignation rate （χ²=0.158，P<0.05）. Since we entered the phase of regular COVID-19 prevention and control in 2020， the staff have been overloaded with work， based on the number of hours spent dealing with the pandemic on the spot and the number of people on the job. In 2017 to 2019， the salary of staff was basically maintained at the level of 2016 （average annual growth of about 2.5%）； it lacked targeted talent recruitment （one-time resettlement fee， etc.） and talent retention incentives （monthly housing subsidy for new employees， etc.）. According to the questionnaire’s results， 79.23% of the respondents believed that the talent incentive mechanism needs to be improved， 73.43% believed that a good environment for talent growth needs to be created， and 50.24% thought that the employment mechanism needs to be reformed. It is difficult to meet the needs of pandemic prevention and control under the new situation with the current number of public health personnel， the recruitment of talents is insufficient， the turnover is too high， and there is a gap between the ability of some public health personnel and what is required of them under the new situation and new tasks. ConclusionThe quantity and quality of public health personnel for disease control in Shanghai can hardly meet the needs of pandemic prevention and control under the new situation. The pertinence and systematization of public health talent training urgently need to be strengthened， and the incentive mechanism needs to be improved.

Identification of the risk factors for conversion to cesarean section during labor can significantly improve the mother and infant outcomes. Though advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), intrapartum ultrasound is not widely practiced in managing labor progress. The Obstetrics and Gynecology Center of Zhujiang Hospital of Southern Medical University has carried out intrapartum ultrasound in recent years. We summarize the clinical key point and the significance of measuring the major sonographic parameters during labor and illustrate the role of occiput-spine angle, a new sonographic index, in predicting fetal head descent during the first stage of labor.

Objective To optimize the extraction process of the compound herba lysimachiae by orthogonal experiment and response surface method. Methods The sum of the peak areas of multiple representative components in the compound herba lysimachiae was used as the evaluation index. The ultrasonic extraction time, ultrasonic temperature and ethanol ratio were analyzed to optimize the extraction process conditions by orthogonal experiment and Box-Behnken response surface analysis method. Results Ultrasonic extraction time and ethanol ratio are important factors in the extraction process of the compound herba lysimachiae. The effect of ultrasonic temperature in the extraction process is not significant. The optimal extraction condition for compound herba lysimachiaeare is 10 min ultrasonic extraction time at 55 ℃ with 55% ethanol. Conclusion The optimal extraction process parameters obtained by combining orthogonal experiment and Box-Behnken response surface method can be used for the extraction of representative components from the compound herba lysimachiae and pharmaceutical research in the future.

Apoptosis has been considered as the only form of regulated cell death for a long time. However, a novel form of programmed cell death called necroptosis was recently reported. The process of necroptosis is regulated and plays a critical role in the occurrence and development of multiple human diseases. Thus, the study on the molecular mechanism of necroptosis and its effective inhibitors has been an attractive field for researchers. Herein, we introduce the molecular mechanism of necroptosis and focus on the literature about necroptosis drug screening in recent years. In addition, the identification of the critical drug targets of the necroptosis is also discussed.

Objective To investigate the molecular mechanism of solanine-induced apoptosis of prostate cancer cells Du145 and LNCaP.Methods The effects of solanine on the viability of Du145 and LNCaP cells were evaluated by MTT assay.The generation of intracellular reactive oxygen species (ROS) and solanine-induced apoptosis were measured by flow cytometry.The protein levels of p38 and p-p38 expressions were examined by Western blot.Results Solanine significantly inhibited the viability of Du145 and LNCaP cells in a dose-dependent manner (P＜0.01).The inhibition of solanine on cell viability was suppressed by the ROS scavenger NAC.ROS generation,apoptosis and phosphorylation of p38 were induced by treatment with solanine at 40 μmol/L for 24 h.The expression of p38 and solanine-induced apoptosis were suppressed by NAC and SB203580.Conclusion Solanine induces the apoptosis of human prostate cancer cell via the RO.S-p38 signaling pathway.