Objective:To investigate the efficacy and safety of ixazomib combined with thalidomide and dexamethasone in the treatment of multiple myeloma(MM).Methods:The clinical data of 60 MM patients admitted to our center from January 2019 to June 2022 were analyzed retrospectively,including 43 newly diagnosed patients and 17 patients with recurrence and progression.All patients were treated with ixazomib combined with thalidomide and dexamethasone,and completed 2 to 7 treatment cycles.Results:The overall response rate(ORR)of all patients was 98.3％.Among them,53 patients completed 4 treatment cycles,and the ORR was 86.8％.Seventeen patients completed the whole treatment cycle,with curative effect reaching 88.2％achieving very good partial response and above,and 52.9％achieving complete response and above.Albumin and β2-microglobulin of all patients had been improved rapidly after treatment.The deadline was August 31,2022.The median follow-up time was 14(3-24)months,and overall survival(OS)rate was 86.67％.The OS rate of patients with recurrence and progression was significantly lower than that of newly diagnosed patients(P＜0.05).The most common adverse reaction of hematology was lymphopenia(53.3％),followed by anemia(33.3％).The most common non-hematological adverse reaction was fatigue(68.33％),followed by peripheral neuropathy(31.67％).Conclusion:Ixazomib combined with thalidomide and dexamethasone is effective in the treatment of MM,with good short-term efficacy,survival and safety.However,its long-term efficacy needs further observation.

Objective:This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies.Method:City A that has piloted DIP reform was set as the treatment group,and City B without reform was set as the control group.A total of 1 120 public medical institution samples from 2019 to 2022 were collected.The total medical expenses during hospitalization and some structural expenses were analyzed using DID method.Result:DIP had a significant inhibitory effect on the medical expenses,and the expenses of checkups and examinations during hospitalization in city A,but had no impact on the drug and the material expenses during hospitalization.Conclusion:DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization.The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient.DIP synergized with other supply-side policies to promote rational medical cost structure.It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

ObjectiveTo construct a quantitative prediction model of three indicators（moisture absorption rate， film thickness and coating weight gain） during the coating process of Vitamin C Yinqiao tablets（VCYT） by near-infrared spectroscopy（NIRS）， and to realize the endpoint judgment. MethodReal-time NIRS data of 4 batches of VCYT during the coating process were collected by diffuse reflection method. The coating method employed was the rolling coating method， and the samples were obtained at the spray stage from the coater's sampling port every 10 minutes， and 57 batches of samples（about 1 800 tablets） were collected at various coating times， the tablets were embedded in molten paraffin， cut longitudinally， and observed by stereomicroscope. The film thickness， with a target value of 38 μm， was then measured using Motic Images Advanced 3.2 software. Furthermore， the mositure absorption rate of samples， aiming for a target value of 3%， was determined in accordance with guiding principles for drug hygroscopicity testing in the 2020 edition of Chinese Pharmacopoeia， and 3 samples were randomly selected from each batch（10 tablets per batch）， and the coating weight gain was calculated（target value of 4%）. Partial least squares regression（PLSR） was used to construct a quantitative model of the 3 coating indicators， and the predicted values of the coating indicators were smoothed using the moving average method and used to determine the coating endpoints. ResultThe prediction determination coefficients（R_p²） for moisture absorption rate， film thickness and coating weight gain were 0.933 4， 0.932 6 and 0.965 9， the root mean square errors of prediction（RMSEP） were 0.163 5%， 1.870 9 μm and 0.240 3%， the relative percent deviations（RPD） were 3.711 0， 2.760 7 and 5.415 8， respectively. The results of the external validation set demonstrated that the real-time predicted values obtained by the models exhibited the same trend as the measured values， and the coating endpoint could be accurately predicted（with a prediction error of less than 7.32 min and a relative error of less than 5.63%）. ConclusionThe established NIRS model exhibits excellent predictive performance and can be used for quality control of VCYT during the coating process.

[Objective]To investigate the efficacy of a blended instruction model which incorporated preceptorship into the clinical anatomy course at Sun Yat-sen University and improve satisfaction and performance of medical students.[Methods]The study recruited participants including 375 Chinese students aged 20-24 years old,2 anatomy professors,49 surgeons and 7 lab technicians. The students were divided into 10 teams and each team was tutored by 1 anatomy professor,2 surgeons and 1 lab technician. After the course ended,the Course Experience Questionnaire (CEQ) and Student Experience in Education Questionnaire (SEEQ) were used in the survey to measure the quality of teaching and students' overall educational experience. Students' performance scores were collected and analyzed.[Results]The response rates for CEQ and SEEQ were 60.3％ (226/375) and 54.6％ (200/375),respectively. CEQ indicated a moderate level of overall satisfaction with 7.12 out of 10. Subscales like Clear Goals,Good Teaching and Generic Skills showed moderately positive reception of the course,while subscales like Appropriate Workload and Appropriate Assessment revealed students' concerns about heavy workload and difficult exam. There was no statistically significant difference in perceptions between male and female students. The students who are more satisfied with the quality of the course are also more satisfied with the way it is taught (P<0.01). SEEQ further confirmed the universal appeal of the course,with high scores in dimensions like Learning,Enthusiasm and Individual Rapport among the students. Qualitative responses highlighted areas of improvement,such as consistent teaching methods,practical hands-on experience for the students and alignment between what was taught and tested.The students after the preceptorship introduction achieved better academic performance than before.[Conclusions]The blended instruction model incorporating preceptorship enhances the student satisfaction and performance in clinical anatomy course,and also stimulates students' learning enthusiasm and group interaction. We need further improvement in the teaching quality control,syllabus contents and course assessment for teaching of clinical anatomy.

Objective:To explore the application effect of hydration therapy in patients with intermittent claudication (IC) of peripheral arterial disease, and to provide reference for clinical application.Methods:A randomized controlled trial method was used to select 86 patients with IC of peripheral arterial disease who attended the Department of Vascular Surgery of Shanxi Bethune Hospital from June to September 2023 as the study subjects by convenience sampling method, and they were divided into the control group and the intervention group by using the method of randomized numerical table, each group had 43 cases. In the control group, routine care was provided, and in the intervention group, hydration therapy was implemented on the basis of the control group. Ankle-brachial index, transcutaneous partial pressure of oxygen, and claudication distance were assessed in both groups 1d before and 6 months after the intervention.Results:Forty-two patients in each group completed the study, 21 males and 21 females, aged (61.33 ± 8.93) years in the intervention group; 24 males and 18 females, aged (61.33 ± 9.01) years in the control group. Compared with the ankle-brachial index, transcutaneous oxygen partial pressure and limp distance of the 2 groups 1 d before intervention, the differences were not statistically significant (all P>0.05), and 6 months after the intervention, the transcutaneous oxygen partial pressure of the patients in the intervention group was (37.69 ± 8.86) mmHg (1 mmHg=0.133 kPa), and that of the control group was (29.69 ± 7.79) mmHg, and the differences between the 2 groups were statistically significant ( t=4.40, P<0.05). The differences in patients′ transcutaneous partial pressure of oxygen and limp distance before and after intervention in the intervention group were -7.00 (-13.00, -1.75) mmHg and -50.00 (-100.00, 0.00) m, respectively, and in the control group were 0.01 (-1.00, 1.00) mmHg and 0.01 (-1.25, 20.00) m, respectively, and the differences between the 2 groups were statistically were statistically significant ( Z=5.59, 4.33, both P<0.05). Conclusions:Hydration therapy improves transcutaneous oxygen partial pressure values and claudication distance in patients with peripheral arterial disease IC, and improves microcirculation of the affected limbs in patients.

Aim To observe whether the mechanosensitive ion channel Piezo1 was involved in the senescence of atrial fibroblasts by activating β-catenin based on our previous study which found marked increase of Piezo1 mRNA in senescent atrial fibroblasts. Methods Primary mouse atrial fibroblasts (MAFs) were isolated from male C57BL/6 mice (3-4 weeks) by enzyme digestion, and tert-butyl hydroperoxide (TBHP) was used to induce the senescence of cells. The ratio of senescent cells was detected by senescence-associated β-galactosidase (SA-β-Gal) staining. The protein levels of Piezo1, β-catenin/p-β-catenin, senescence-associated proteins p53 and p21 in the cells treated with TBHP (100 μmol · L

Five new flavonoid derivatives, cajavolubones A-E (1-5), along with six known analogues (6-11) were isolated from Cajanus volubilis, and their structures were elucidated by spectroscopic analysis and quantum chemical calculations. Cajavolubones A and B (1 and 2) were identified as two geranylated chalcones. Cajavolubone C (3) was a prenylated flavone, while cajavolubones D and E (4 and 5) were two prenylated isoflavanones. Compounds 3, 8, 9 and 11 displayed cytotoxicity against HCT-116 cancer cell line.
Flavonoids/chemistry* ; Cajanus ; Molecular Structure ; Chalcones/chemistry*

Objective:To investigate the feasibility of blue velvet arena test (BVAT) in evaluating spatial memory function in patients with chronic insomnia disorder (CID).Methods:From June 1, 2021 to May 31, 2022, 62 CID outpatients or inpatients were enrolled continuously in the Department of Sleep Disorders, the Affiliated Chaohu Hospital of Anhui Medical University, and 56 good sleepers in the same period were enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. Montreal Cognitive Assessment Scale (MoCA), nine box maze test (NBMT), and BVAT were used to assess general cognition and memories.Results:Compared to the controls, the CID patients had increased PSQI score [15.0 (12.8, 16.0) vs 0 (0, 1.0); Z=-9.47, P<0.001], and decreased MoCA score [24.5 (21.5, 27.0) vs 27.0 (26.0, 28.0); Z=-4.18, P<0.001]; increased numbers of errors in the spatial working [1.0 (0.8, 2.0) vs 1.0 (0, 1.0); Z=-2.24, P<0.05], object working [1.5 (0.8, 3.0) vs 0 (0, 1.0); Z=-4.36, P<0.001] and object recognition [0 (0, 0) vs 0 (0, 0); Z=-2.10, P<0.05] memories in NBMT; and increased average erroring distance in BVAT [23.0 (16.4, 27.2) cm vs 18.7 (16.6, 20.7) cm; Z=-3.30, P<0.01]. Partial correlation analysis showed that in the CID patients, the average erroring distance in BVAT was positively correlated with erroneous numbers in spatial working memory in NBMT ( r=0.54, P<0.001). Principal components analysis showed that the average erroring distance of BVAT (load=0.844) and the errors of spatial working memory in NBMT (load=0.801) were jointly attributed to the first factor. Receiver operating characteristic curve analysis showed that the sensitivity of BVAT was higher than that of NBMT (0.575 vs 0.250, P<0.05) for spatial memory detection in total sample. Conclusion:The BVAT has a higher reliability in the functional assessment of spatial memory in CID patients.