OBJECTIVE To upgrade the drug traceability code management system for a pediatric hospital under the “payment by code” background， aiming to comprehensively enhance traceability integrity， efficiency， and compliance. METHODS Taking Xiamen Children’s Hospital as the implementation setting， a before-and-after control design was adopted to construct an intelligent drug traceability code management system through systematic upgrades involving the technology platform， core mechanisms， and coordination with medical insurance. Key interventions included： upgrading a traceability code management platform and designing a dynamic code pool； innovating differentiated traceability mechanisms for routine， split-dose， and special drugs； establishing a tiered early-warning and emergency response system； and constructing a data coordination and quality control system. The drug traceability code upload rate served as the primary outcome. Process indicators such as the root causes distribution of failed uploads and the duration of medication returns， and a comprehensive outcome （the number of insurance-flagged abnormal prescriptions） were also analyzed. The data between the baseline period （April 2025） and the observation period （June-August 2025） were compared and evaluated. RESULTS After the upgrade， the overall upload rate of drug traceability codes increased from 9.21% （baseline） to 99.86% （August 2025）. The upload rate of traceability codes in previously unmanaged areas， such as the inpatient pharmacy and pharmacy intravenous admixture services， soared from 0 to nearly 100%. The proportion of non-uploads due to system issues fell from 66.44% （June 2025） to 2.62% （August Additionally， the number of insurance-flagged） abnormal prescriptions dropped sharply from 2 275.00 in the first “payment by code” policy month （July 2025） to 212.00 by the end of the observation period （August 2025）， a 90.70% decrease. CONCLUSIONS The developed management system effectively addresses complex scenario challenges such as high-frequency drug splitting. It significantly enhances traceability code upload performance and ensures a high degree of compliance with medical insurance data requirements. These outcomes contribute to proactive risk mitigation against insurance claim denials and demonstrate a concurrent optimization of pharmacy operations.

BACKGROUND:Traditional methods of urinary tract reconstruction are limited by donor scarcity,high complication rates,and suboptimal functional recovery.Tissue engineering strategies offer new directions in this field.Since the urinary tract is mainly composed of muscle tissue,the key is to find suitable seed cells and efficiently induce them to differentiate into smooth muscle cells.Comparative studies on the efficacy of different smooth muscle cell induction regimens are still lacking. OBJECTIVE:To isolate,culture,and identify human urine-derived stem cells,and to compare the effects of two different induction protocols. METHODS:Human urine-derived stem cells were isolated from urine samples of 11 healthy adult volunteers by multiple centrifugations.Surface markers were identified by flow cytometry.The multi-directional differentiation potential of human urine-derived stem cells was verified through osteogenic and adipogenic differentiation.Differentiation was induced by transforming growth factor-β1 or transforming growth factor-β1 combined with platelet derived growth factor for 14 days.Immunofluorescence staining and western blot assay were employed to compare the expression differences of smooth muscle-specific proteins(α-SMA and SM22). RESULTS AND CONCLUSION:(1)Urine-derived stem cells were successfully isolated from the eight urine samples of healthy people.These cells exhibit a"rice grain"-like morphology and possess a robust proliferative capacity.(2)Urine-derived stem cells exhibited high expression of mesenchymal stem cell surface markers(CD73,CD90,and CD44)and extremely low expression of hematopoietic stem cell surface markers(CD34 and CD45).These cells did not express CD19,CD105,and HLA-DR.(3)After osteogenic and adipogenic differentiation,the formation of calcium nodules and lipid droplets was observed,with positive staining results from Alizarin Red S and Oil Red O staining.(4)After 14 days of smooth muscle induction culture,immunofluorescence staining revealed that the smooth muscle differentiation rate of urine-derived stem cells treated with a combination of transforming growth factor-β1 and platelet derived growth factor was significantly higher compared to those treated with transforming growth factor-β1 alone(P<0.005).(5)After 14 days of smooth muscle induction culture,western blot assay further demonstrated that the expression levels of α-SMA and SM22 in the transforming growth factor-β1/platelet derived growth factor group were significantly elevated compared to those in the transforming growth factor-β1 only group(P<0.005).These findings confirm that urine-derived stem cells can be non-invasively isolated using multiple rounds of centrifugation.Compared with transforming growth factor-β1 alone,the combination of transforming growth factor-β1 and platelet derived growth factor can improve the efficiency of inducing urine-derived stem cells to differentiate into smooth muscle cells.

Objective: To evaluate the efficacy of the left spermatic vein transposition to the great saphenous vein in treating left varicocele (VC) secondary to nutcracker syndrome (NCS). Methods: Clinical data of 8 patients treated during Feb.2020 and Feb.2023 in our hospital were retrospectively analyzed.A meticulous preoperative evaluation of the vascular status of the spermatic vein and the great saphenous vein was performed using color Doppler ultrasound.A spermatic vein-great saphenous vein shunt surgery was performed in patients who were strictly selected.The clinical symptoms and hemodynamics of renal vein were compared before and after operation. Results: The median age of patients was 23.5(18-33) years.There was a notable reduction in post-exercise scrotal and lower back pain in all patients，and the score of scrotal pain decreased to 0 in 7 patients. The median quantification of urinary protein was 352.8(54.4-687.3) mg prior to surgical intervention，which significantly diminished to 125.5(25.9-255.1) mg 6 months after operation.Notably，3 cases of preoperative positive urine occult blood tests were undetectable in the subsequent postoperative assessments.The median peak blood flow velocity at the site of stenosis in the left renal vein measured at 74.4(48.7-117.6) cm/s preoperatively，subsequently reduced to 45.1(25.5-61.2) cm/s postoperatively.During the 6-month follow-up，no recurrence of varicocele，vascular anastomotic stenosis or thrombosis were observed. Conclusion: Our research indicates that spermatic vein to great saphenous vein bypass is safe and feasible in the treatment of left varicocele secondary to nutcracker syndrome for strictly selected patients，which can effectively alleviate renal vein congestion without significant complications.

Objective:To investigate the anatomic origin of juvenile nasopharyngeal angiofibroma（JNA） through radiologic analysis of tumor invasion patterns, providing insights into tumor etiology and surgical recurrence prevention. Methods:This retrospective cohort study included primary JNA cases at the Department of Otorhinolaryngology, Eye and ENT Hospital of Fudan University from March 2015 to September 2024. All patients underwent preoperative high-resolution CT（HRCT） scans, and some underwent enhanced magnetic resonance imaging. The study retrospectively analyzed the patients' imaging data to examine tumor invasion into the pterygopalatine fossa and the vidian canal. These sites were categorized into non-invaded, partially invaded, and completely invaded for the pterygopalatine fossa and the vidian canal. The study analyzed the proportions of invasion at these sites to further speculate on the origin of JNA. Results:A total of 105 JNA patients were included in the study. Among them, 100% of the patients had complete tumor invasion in the pterygopalatine fossa. For the vidian canal, the proportions of complete invasion, partial invasion, and non-invasion were 54.3%, 27.6%, and 18.1%, respectively. As the staging of JNA tumors increased, the proportion of vidian canal invasion also increased. Conclusion:Our evidence suggests that the pterygopalatine fossa, rather than the vidian canal, might be the likely origin of JNA, which is enlightening for the study of the etiological mechanisms of JNA.
Humans ; Nasopharyngeal Neoplasms/pathology* ; Retrospective Studies ; Angiofibroma/pathology* ; Neoplasm Invasiveness ; Pterygopalatine Fossa/pathology* ; Female ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Adolescent

Objective:To investigate the interventional and protective effect of low-dose L-carnitine(LC)against reproductive system damage in male Wistar rats during acute exposure to simulated high-altitude environment.Methods:A total of 24 specific pathogen-free male Wistar rats,aged 12 weeks,were randomly divided into control group,high-altitude model group,and LC intervention group[intraperitoneal injection of LC at a dose of 50 mg/(kg·d)],with 8 rats in each group.The rats in the control group were fed under normal conditions(at an altitude of approximately 1 500 m),those in the high-altitude model group,and those in the LC intervention group were fed in a hypobaric oxygen chamber(at a simulated alti-tude of 6 000 m).The rats were sacrificed after 3 days.The testis was collected to calculate testicular index;the semen was collected from the epididymis,and the Weili sperm quality analysis system was used to assess sperm quality;blood samples were collected from the abdominal aorta,and ELISA kits were used to measure the serum levels of testosterone(T),luteinizing hormone(LH),and follicle-stimulating hormone(FSH);testicular tissue samples were collected,and biochemical kits were used to measure the activity of reactive oxygen species(ROS),malondialdehyde(MDA),and superoxide dismutase(SOD);testicular tissue was collected to prepare HE and electron microscopy sections,and a light microscope and a transmission electron microscope were used for observation.Results:Com-pared with the blank control group,the high-altitude model group had significant increases in the levels of T,LH,and FSH(P<0.01),testicular tissue damage under the light microscope,and changes in the morphology of spermatogenic cells,including mitochondrial al-terations,membrane edema,loss of cristae,swelling of the matrix,and local dissolution,as well as significant increases in the levels of ROS and MDA(P<0.01)and a significant reduction in SOD activity(P<0.01).Compared with the high-altitude model group,the LC intervention group had a significant increase in the level of T(P<0.01),significant reductions in the levels of FSH and LH(P<0.01),and significant improvements in the pathological changes of testicular tissue,with no marked mitochondrial injury,and there were sig-nificant reductions in the levels of ROS and MDA(P<0.01)and a significant increase in SOD activity(P<0.01).There was no signifi-cant difference in testicular index between groups(P>0.05).The high-altitude model group had a significantly lower sperm count than the blank control group(P<0.05),while there was no significant difference in sperm count between the LC intervention group and the blank control group(P>0.05);there was no significant difference in sperm motility between groups(P>0.05).Conclusion:Low-dose LC can improve reproductive system damage in rats during acute exposure to simulated high-altitude environment,possibly by alleviat-ing oxidative stress response.

Objective:To observe the effects of Alpiniae Oxyphyllae Fructus-Linderae Radix on miR-155-5p/SOCS1/inflammatory factor axis and cell apoptosis in hippocampus of depressed rats.Methods:A total of 60 SPF male Wistar rats were divided into six groups: control group, model group, fluoxetine group and Alpiniae Oxyphyllae Fructus-Linderae Radix low-, middle- and high-dosage groups, with 10 rats in each group. Except for the control group, all other groups used chronic mild unpredictable stimuli combined with solitary confinement to construct a depression rat model. Following an 8-week modeling period, the fluoxetine group received oral administration of 2 mg/kg Fluoxetine liquid daily and the Alpiniae Oxyphyllae Fructus-Linderae Radix groups received oral administration of 1 g/kg, 2 g/kg and 4 g/kg Alpiniae Oxyphyllae Fructus-Linderae Radix liquid daily, whereas the control group and model group were given an equivalent volume of distilled water for continuous drug intervention over a span of 3 weeks. The rats' behavioral variations were assessed through an open field test; miR-155-5p expression in the hippocampus was determined via RT-PCR; SOCS1 protein expression in the hippocampus was evaluated by Western Blot; TNF-α, IL-6 and IL-1β levels in the serum were quantified using ELISA; hippocampal cell apoptosis was examined through HE staining.Results:Compared with the model group, the fluoxetine group and Alpiniae Oxyphyllae Fructus-Linderae Radix middle- and high-dosage groups showed an increase in open field test scores ( P<0.05), a decrease in miR-155-5p expression in the hippocampus ( P<0.05), an increase in SOCS1 protein expression in the hippocampus ( P<0.05), a decrease in serum TNF-α, IL-1β, IL-6 levels ( P<0.05), and a reduction in apoptosis of hippocampal CA3 cells ( P<0.05). Conclusion:Alpiniae Oxyphyllae Fructus-Linderae Radix probably amplifies the indirect negative regulation of SOCS1 protein on inflammatory factors by suppressing miR-155-p expression in the hippocampus of depressed rats, thereby ameliorating cell apoptosis in the hippocampal area and manifesting antidepressant properties.

Objective: To investigate the effects of plateau environment exposure on the reproductive system of male rats, so as to provide the reference for mechanisms of reproductive damage in plateau environment. Methods: Sixty SPF-grade 12-week-old male Wistar rats were randomly divided into the plain-exposed group, the 1 day-, 3 day-, 7 day-, 14 day- and 28 day- plateau-exposed groups. The rats in the plain-exposed group were raised under normal conditions for 28 days, while the rats in the plateau-exposed groups were raised in a simulated high-altitude plateau chamber. After the completion of the designated feeding periods, the rats were sacrificed under anesthesia, and testicular tissue and abdominal aortic blood were collected to detect the testicular index and evaluate sperm quality. Histological and cellular morphologies of the testicular tissue were analyzed. Additionally, the levels of malondialdehyde (MDA), superoxide dismutase (SOD) and reactive oxygen (ROS) in the testicular tissue were determined, along with serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T). Conclusions Plateau environment may cause a decrease in testicular index and sperm quality, impair mitochondrial function, induce oxidative stress, and thus affect reproductive system of male rats. However, there are signs of self-repair in the reproductive system with the increase of exposure duration.

Objective:To explore the mediating chain effect between attachment and coping style of disease perception and hope in patients with advanced lung cancer, and to provide theoretical basis for improving coping style in patients with advanced lung cancer.Methods:From October 2021 to June 2022, 354 patients with advanced lung cancer in the First and Second Affiliated Hospitals of Anhui Medical University were selected by convenience sampling. The general information questionnaire, the Experiences in Close Relationships Inventory, the Brief Illness Perception Questionnaire, the Herth Hope Index, and the Medical Coping Modes Questionnaire were used to conduct cross-sectional questionnaire survey. SPSS 25.0 software and Bootstrap method were used to construct and verify the chain mediation model.Results:Finally, 336 patients with advanced lung cancer were included, including 214 males and 122 females, aged 27-79(59.43 ± 8.61) years old. Attachment avoidance score was (3.31 ± 1.01) points, attachment anxiety score was (3.86 ± 1.17) points, illness perception score was (40.07 ± 12.01) points, hope score was (34.05 ± 5.87) points, and face coping score was (18.75 ± 5.34) points in patients with advanced lung cancer. The avoidance coping score was (15.47 ± 1.97) points, and the yielding coping score was (9.62 ± 3.85) points. In patients with advanced lung cancer, attachment avoidance and attachment anxiety were positively correlated with yield coping ( r=0.448, 0.747, both P<0.01), positively correlated with illness perception ( r=0.356, 0.627, both P<0.01), and negatively correlated with hope ( r=-0.406, -0.670, both P<0.01). Illness perception was positively correlated with yield coping ( r=0.744, P<0.01), and negatively correlated with hope ( r=-0.628, P<0.01). Hope was negatively correlated with yield response ( r=-0.769, P<0.01). The mediation model showed that the chain mediating effect of attachment avoidance, illness perception, hope and yield coping was significant in patients with advanced lung cancer, with an effect value of 0.009 and an effect size of 13.95%. The chain mediating effect of attachment anxiety, illness perception, hope and yield coping were significant, with an effect value of 0.010 and an effect size of 8.27%. Conclusions:Attachment can not only directly predict submission coping in advanced lung cancer patients, but also indirectly predict submission coping through the chain mediation of illness perception and hope.

Objective:To explore the efficacy and safety of ibrutinib for the treatment of newly treated and relapsed refractory (R/R) lymphoplasmacytic lymphoma (LPL) /Waldenstr?m macroglobulinemia (WM) .Methods:Retrospectively collected clinical data of 98 cases of newly treated and R/R LPL/WM patients who received ibrutinib treatment at the Hematology & Blood Diseases Hospital of the Chinese Academy of Medical Sciences from March 2016 to June 2023, and analyzed their efficacy and safety.Results:A total of 98 LPL/WM patients were included, which consisted of 45 newly treated patients and 53 R/R patients. Of these, 74 were males (75.5%) and the cohort had a median age of 64 (42-87) years. Eighty-eight patients were eligible for efficacy evaluation with a median treatment time of 20.8 (2.1-55.0) months, a major remission rate (MRR) of 78.4%, and an overall response rate (ORR) of 85.2%. The MRR and ORR of the newly treated patients were 78.4% and 86.5%, respectively, whereas the MRR and ORR of the R/R patients were 78.4% and 84.3%, respectively. There were no statistically significant differences in MRR and ORR between the initial treatment and R/R patients (all P values >0.05) . The median follow-up period was 29.1 (2.9-50.3) months and the median overall survival time for newly treated and R/R patients was not reached. The median progression-free survival time was 23.5 (95% CI 10.5-36.5) months and 45.0 (95% CI 34.0-56.0) months, respectively, with no statistically significant differences (all P values >0.05) . There were 25 deceased patients and no deaths were related to ibrutinib treatment. The main adverse reactions of ibrutinib were thrombocytopenia (5.1%) , pneumonia (8.1%) , and hyperuricemia (21.4%) . The incidence of atrial fibrillation was 2.0%. Conclusion:Ibrutinib exhibits good efficacy and safety for newly treated and R/R LPL/WM patients.