OBJECTIVE To establish a pharmaceutical management system for externally dispensed medicines in medical institutions， so as to improve medication safety and regulatory efficiency. METHODS Based on policy analysis and hospital practice， a pharmaceutical management system for externally dispensed medicines was constructed by integrating institutional frameworks， an information‑based platform and management procedures， and the management effectiveness was evaluated. RESULTS Our hospital formulated the Regulations on the Management of Externally Dispensed Medicines ， which standardized catalogue selection， prescription issuance， acceptance and use， supervision and evaluation. An information‑based management platform for externally dispensed medicines was built relying on the hospital information system， enabling electronic prescription circulation， intelligent prescription review and whole‑process traceability. Institutional requirements and platform functions were embedded into three core management procedures， namely catalogue selection， prescription issuance， and medicine acceptance and use， forming a closed‑loop working mechanism. After the implementation of the management system， compared with pre‑implementation， the qualified rate of externally dispensed prescriptions increased from 85.2% to 99.3% （ P ＜0.001）， the automatic prescription review pass rate exceeded 95%， the prescription review duration shortened from 7.2 min to 1.8 min （ P ＜0.001）. All dimensional satisfaction scores of patients and medical staff were significantly improved， the standardization awareness of medical staff reached 100%. CONCLUSIONS The construction of a pharmaceutical management system for externally dispensed medicines with standardized institutional frameworks， informatized platforms and standardized procedures effectively enhances the rationality and management efficiency of externally dispensed prescription medicines， and provides a replicable practical pathway for the management of externally dispensed medicines in medical institutions.

Digital biopsy for liver diseases is characterized by the deep integration of artificial intelligence （AI） technologies and large-scale liver disease data， through which intelligent analytics are applied to support clinical decision-making and full-cycle management. This article reviews the AI technical framework based on standardized data governance and centered on multimodal large medical models， covering the application of natural language processing， knowledge map， generative AI， and large language models in the establishment of databases for specialty diseases， diagnosis， prognosis prediction， treatment， and automated medical documentation. This article also discusses the application prospects of this framework in medical education， scientific research， and healthcare management. Although this technique shows broad application potential， it still faces challenges in areas such as multi-center data integration， model interpretability， ethics， and data security. In the future， a smart ecosystem with closed-loop optimization and human-AI collaboration should be established to promote the comprehensive implementation of digital biopsy in the whole process of medicine， education， research， and management， thereby providing help for the precise prevention and control and holistic health management of liver diseases.

Microwave thermochemotherapy (MTC) has been applied to treat lip squamous cell carcinoma (LSCC), but a deeper understanding of its therapeutic mechanisms and molecular biology is needed. To address this, we used single-cell transcriptomics (scRNA-seq) and spatial transcriptomics (ST) to highlight the pivotal role of tumor-associated neutrophils (TANs) among tumor-infiltrating immune cells and their therapeutic response to MTC. MNDA⁺ TANs with anti-tumor activity (N1-phenotype) are found to be abundantly infiltrated by MTC with benefit of increased blood perfusion, and these TANs are characterized by enhanced cytotoxicity, ameliorated hypoxia, and upregulated IL1B, activating T&NK cells and fibroblasts via IL1B-IL1R. In this highly anti-tumor immunogenic and hypoxia-reversed microenvironment under MTC, fibroblasts accumulated in the tumor front (TF) can recruit N1-TANs via CXCL2-CXCR2 and clear N2-TANs (pro-tumor phenotype) via CXCL12-CXCR4, which results in the aggregation of N1-TANs and extracellular matrix (ECM) deposition. In addition, we construct an N1-TANs marker, MX2, which positively correlates with better prognosis in LSCC patients, and employ deep learning techniques to predict expression of MX2 from hematoxylin-eosin (H&E)-stained images so as to conveniently guide decision making in clinical practice. Collectively, our findings demonstrate that the N1-TANs/fibroblasts defense wall formed in response to MTC effectively combat LSCC.
Humans ; Neutrophils/metabolism* ; Single-Cell Analysis ; Lip Neoplasms/genetics* ; Hyperthermia, Induced/methods* ; Microwaves/therapeutic use* ; Transcriptome ; Carcinoma, Squamous Cell/immunology* ; Tumor Microenvironment

Radiopharmaceuticals operate by combining radionuclides with carriers. The radiation energy emitted by radionuclides is utilized to selectively irradiate diseased tissues while minimizing damage to healthy tissues. In comparison to external beam radiation therapy, radionuclide drugs demonstrate research potential due to their biological targeting capabilities and reduced normal tissue toxicity. This article reviews the applications and research progress of radiopharmaceuticals in cancer treatment. Several key radionuclides are examined, including ²²³Ra, ⁹⁰Y, Lutetium-177 (¹⁷⁷Lu), ²¹²Pb, and Actinium-225 (²²⁵Ac). It also explores the current development trends of radiopharmaceuticals, encompassing the introduction of novel radionuclides, advancements in imaging technologies, integrated diagnosis and treatment approaches, and equipment-medication combinations. We review the progress in the development of new treatments, such as neutron capture therapy, proton therapy, and heavy ion therapy. Furthermore, we examine the challenges and breakthroughs associated with the clinical translation of radiopharmaceuticals and provide recommendations for the research and development of novel radionuclide drugs.
Humans ; Radiopharmaceuticals/therapeutic use* ; Neoplasms/radiotherapy* ; Radioisotopes/therapeutic use* ; Animals

Objective:To apply patent metrics to analyze the distribution, development trends, and characteristics of patents related to orthokeratology lenses for assisted wearing, providing a reference for the research and development of such patents.Methods:Patents related to orthokeratology lenses for assisted wearing were retrieved by computer from the China National Intellectual Property Administration database, incopat, Derwent Innovations Index, Free Patents Online, Organisation Africaine de la Propriété Intellectuelle, and IP Australia. The search timeframe was from the establishing of these databases until March 8, 2024. Patent metrics methods, word frequency analysis, and high-frequency word co-occurrence analysis were used for data analysis.Results:A total of 60 relevant patents were selected. The development of orthokeratology lens-assisted wearing patents began relatively late but has shown a strong growth trend, reaching a peak around 2015. Chinese patents accounted for the largest share (91.7%, 55/60) , with Zhejiang Province, Beijing City, Jiangsu Province, Guangdong Province, and Shanghai City having the highest number of patents. The majority of the applicants were enterprises. The research focus in this field is on mechanical assistance patents for lens wearing, with cutting-edge technologies focusing on monitoring the displacement of lenses relative to the pupil and providing timely feedback and guidance.Conclusions:This study, using patent metrics, word frequency analysis, and high-frequency word co-occurrence analysis, provides a reference for patent applications and product development in orthokeratology lens-assisted wearing in nursing.

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.

[Objective]To explore the value of the Model for End-Stage Liver Disease(MELD)3.0 in predicting survival outcomes for patients with alcoholic cirrhosis and to establish an effective mortality prediction model.[Methods]Clinical data of 788 hospitalized patients who were first diagnosed with alcoholic cirrhosis at the Third Affiliated Hospital of Sun Yat-sen University between January 1,2011 and December 31,2019 were analyzed.Patients were followed up until December 31,2023 and divided into survival and mortality groups based on the survival outcomes at 30 days,90 days,1 year,and 3 years after admission.The prognostic values of the MELD 3.0,MELD,MELD-Sodium(MELD-Na)for survival in alcoholic cirrhosis patients were assessed and compared by using the receiver operating characteristic(ROC)curve and the area under the curve(AUC).Additional risk factors associated with mortality in alcoholic cirrhosis patients were identified,and a novel mortality prediction model based on MELD 3.0 was developed.[Results]The AUC of the MELD 3.0 score in predicting 30-day,90-day,1-year,and 3-year survival was 0.823,0.730,0.686,and 0.658,respectively,which were superior to those of the MELD-Na(0.802,0.708,0.666,and 0.645,respectively)and MELD scores(0.698,0.668,0.654,and 0.633,respectively)(all P<0.05).MELD 3.0 demonstrated better performance at 30 and 90 days(AVC=0.823,0.730;both P<0.05)than at 1 year and 3 years(AVC=0.686,0.658;both P<0.05).Binary logistic regression combined with LASSO regression indicated that the independent risk factors associated with the 1-year outcome included MELD 3.0,baseline ascites and hepatocellular carcinoma.A survival prediction model was then established with AUC of 0.748,sensitivity of 0.695,and specificity of 0.775.[Conclusions]MELD 3.0 has a superior predictive ability for 30-day,90-day,1-year,and 3-year survival in patients with alcoholic cirrhosis than MELD-Na and MELD.The prediction model incorporating MELD 3.0,ascites and hepatocellular carcinoma improves the prediction of 1-year survival outcomes for alcoholic cirrhosis patients.

Objective To investigate the weight loss efficacy and mechanisms of oligopeptide-herbal medicine composite,and to provide new approaches for obesity treatment.Methods Twenty-three SPF female SD rats were randomly divided into control group(n=3)and modeling group(n=20).The control group was fed an ordinary diet for 6 consecutive weeks,and the modeling group was fed a high-fat diet for 6 consecutive weeks to establish a simple obesity rat model.After successful modeling,the modeling group was randomly divided into model group(n=10)and treatment group(n=10).The treatment group started anoint-and-massage therapy with oligopeptide-herbal medicine composite(3 g per rat per time,once a day,20 min each time),which was recorded as day 1.The control group and model group were not treated with oligopeptide-herbal medicine composite but received the same massage,and continued to be fed ordinary feed and high-fat feed respectively.Ten rats in the model group and ten in the treatment group were each divided into 3 groups,with 3,3,and 4 rats in each group.On days 3,6,and 9 after treatment,the rats in the three groups were weighed and cardiac blood collection was performed after isoflurane respiratory anesthesia.After euthanasia by cardiac bloodletting,abdominal subcutaneous adipose tissue(aSAT)and perirenal white adipose tissue(pWAT)samples were collected and weighed.Serum triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)levels were measured.Image J software was used to measure aSAT thickness and the diameter and area of perirenal white adipocytes and abdominal subcutaneous adipocytes.Immunofluorescence technique was used to observe the number of telocytes(TCs),cell junctions and exosomes per unit area of aSAT.Transmission electron microscopy was used to measure the length of telopodes(Tps)of dermal and subcutaneous TCs in abdominal skin,and to observe the distribution of exosome vesicles,rough endoplasmic reticulum,mitochondria,and cell junctions.Results Compared with the control group,the body weight of rats in the modeling group increased significantly(P＜0.05).Compared with the control group,rats in the model group showed a significant increase in serum TG level,a significant decrease in HDL-C level,and a significant increase in pWAT mass(all P＜0.05).Compared with the model group,the treatment group showed a significantly increased rate of body weight reduction,significantly decreased pWAT mass,significantly decreased serum TG level,and significantly increased HDL-C level(all P＜0.05).Compared with the model group,the treatment group showed significant reductions in aSAT thickness,as well as cell diameter and area in both aSAT and pWAT(all P＜0.05).Compared with the model group,the treatment group showed significantly increased number of TCs per unit area of aSAT,number of exosomes from TCs in aSAT,and Tps length(all P＜0.05).The treatment group showed an increasing trend in the numbers of mitochondria,rough endoplasmic reticulum,and cell junctions in TCs.Conclusion Oligopeptide-herbal medicine composite applied via anoint-and-massage therapy effectively improves obesity-related symptoms such as dyslipidemia and fat accumulation in obese rats by regulating TCs and their intercellular communication.

OBJECTIVE: To analyze the core acupoint selection rules and syndrome-based compatibility patterns of acupuncture for autism spectrum disorder (ASD) using data mining techniques. METHODS: Relevant literature of acupuncture for ASD was retrieved from CNKI, Wanfang, VIP, PubMed, and Web of Science. After applying inclusion and exclusion criteria, a prescription database was established based on the extracted effective data. Descriptive analysis was conducted on the frequency, meridian tropism, anatomical distribution, and specific point. High-frequency acupoints were visualized using Origin software. The Apriori algorithm in IBM SPSS Modeler 18.0 was used for association rule analysis of acupoint combinations. Cluster analysis of high-frequency acupoints was performed using IBM SPSS Statistics 26.0. The relationships between high-frequency syndromes and acupoints were visualized using Cytoscape 3.10.0. RESULTS: A total of 223 studies and 452 prescriptions were included, among which 223 were based on syndrome differentiation. A total of 205 acupoints were included with a cumulative frequency of 4 067. The top five most frequently used acupoints were Baihui (GV20), Sishenzhen, Zhisanzhen, Niesanzhen, and Neiguan (PC6). Acupoints were primarily from Jin's three-needle therapy, the governor vessel, scalp acupuncture, and the foot-taiyang bladder meridian, with a high proportion of acupoints located on the head and neck and the limbs. Among specific point, five-shu points, yuan-source points, and back-shu points were most frequently used. Association rule analysis revealed that the core acupoint group was Sishenzhen-Dingshenzhen-Zhisanzhen-Niesanzhen. Cluster analysis divided the top 20 high-frequency acupoints into four categories: governor vessel activation and brain awakening group, spleen strengthening and heart nourishing group, Jin's three-needle spirit-regulating group, and kidney-reinforcing and marrow-filling group. Clinically, the main syndrome patterns were kidney essence deficiency, hyperactivity of heart and liver fire, phlegm obstructing the heart orifices, dual deficiency of heart and spleen, and liver qi stagnation. CONCLUSION The core acupoint prescriptions of acupuncture for ASD are Sishenzhen, Dingshenzhen, Zhisanzhen, and Niesanzhen. The treatment emphasizes spirit regulation and mental tranquility, guided by the principles of harmonizing multiple zang-fu organs, regulating qi and blood, unblocking qi movement, and balancing yin and yang. Syndrome-based acupoint compatibility is recommended in clinical practice.
Humans ; Acupuncture Points ; Acupuncture Therapy ; Autism Spectrum Disorder/therapy* ; Data Mining ; Meridians

Objective:To explore changes in immune status in patients with cervical intraepithelial neoplasia(CIN)after cer-vical conization and its relationship with prognosis of high-risk human papilloma virus(HR-HPV).Methods:A total of 227 patients with CINⅡ～Ⅲ admitted to Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian Campus)from January 2019 to November 2022 were included to analyze HPV typing situation of different patients.Patients were divided into conversion group and persistent infection group according to postoperative conversion status.Different patients'postoperative immune indexes and regression were observed,and relationship between HPV types and immune indexes and postoperative regression was analyzed.Results:HPV types 16,33,52 and 58 were predominant in CINⅡ patients;HPV types 16 and 58 were predominant in CINⅢ patients.Differences between conversion and persistent infection groups were statistically significant regarding time to surgery,IL-10,TGF-β,TNF-α,CD4+T and CD4+T/CD8+T(P<0.05).After surgery,patients'CD8+T level decreased with time,CD4+T and CD4+T/CD8+T levels showed an increasing trend with time,and HPV types 16,33,52 and 58 were significantly correlated with immune indicators.Generalized linear mixed-effects models showed that CD8+T was a risk factor for patient regression,CD4+T and CD4+T/CD8+T were protective factors for patient regression.Generalized multifactor downscaling model interaction analysis showed that CD4+T,CD8+T,CD4+T/CD8+T and HPV typing were interactive on postoperative regression.Conclusion:Postoperative patients of cervical conization have decreased level of CD8+T and increased levels of CD4+T and CD4+T/CD8+T,CD8+T is risk factor for patient regression,while CD4+T and CD4+T/CD8+T are protective factors for patient regression.