ObjectiveTo compare the differences between the ultrafiltration method and the dextran gel filtration method during the purification of Tfn-modified PCL micelles by using purification efficiency and micelle purity as indicators. MethodsCoumarin-6 （C6） was used as a fluorescent probe and was loaded into HOOC-PEG-PCL to form PCL micelles by the film-dispersion method. Tfn was then conjugated to the surface of PCL micelles via an amidation reaction， resulting in two types of micelles： Tfn/PCL_H and Tfn/PCL_L. The pharmaceutical properties of the two types of micelles were characterized. The micelles were then purified through ultrafiltration method and dextran gel method respectively， and the efficiency of the two methods， along with the purity of the final micelles， was compared. The density of Tfn on the surface of PCL micelles was also calculated. ResultsThe hydrated diameter of PCL micelles was approximately 73 nm， and the C6 loading efficiency was around 0.046%. The size increased to 134 nm and 158 nm for Tfn/PCL_L and Tfn/PCL_H， respectively. The micelle population was monodisperse. The purification results showed that， for the ultrafiltration method， after two and one rounds of purification， the Tfn/C6 ratio stabilized at 23.6 and 3.4 for Tfn/PCL_H and Tfn/PCL_L， respectively. For the dextran gel filtration method， the Tfn/C6 ratio reached 23.7 for the Tfn/PCL_H group after two rounds of purification. However， for the Tfn/PCL_L group， the Tfn/C6 ratio increased during four rounds of dextran gel purification， and a significant difference （P = 0.042 4） was observed between the first and last filtrations. The density of Tfn in the final micelles were calculated. For the ultrafiltration method， the Tfn density of Tfn/PCL_H and Tfn/PCL_L were 94.9% and 13.8%， respectively. For the dextran gel filtration method， the density of the two micelles were 95.6% and 14.4%， respectively. For Tfn/PCL_L group， the density results revealing a statistically significant difference （P=0.000 2）. ConclusionThe purification efficiency of the two methods is comparable. However， the purity of the final micelles shows a significant difference， with the dextran gel filtration method resulting in higher purity， particularly for the Tfn/PCL_L micelles.

Objective To explore the clinical efficacy and safety of donepezil(DNPQ)combined with butylphthalide sequential therapy(BST)in the treatment of Parkinson's syndrome(PS).Methods In this study,104 patients with Parkinson's disease(PD)who were diagnosed and treated in the Department of Neurology of The Fourth Hospital of Changsha from January 2020 to November 2023 were randomly divided into a control group(butylphthalide softcapsule combined with DNPQ)and an observation group(BST combined with DNPQ).The main observation indicators of this study were the clinical efficacy and drug-related adverse reactions after 3 months of treatment.The secondary observation indicators were the cognitive function[Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)],overall condition[Unified Parkinson's Disease Rating Scale(UPDRS)],activity of daily living(ADL),and oxidative stress-related cytokines[recombinant human Parkinson's disease protein 7(PARK7),neurotrophic factor 3(NT3),and C-reactive protein(CRP)]improvement after treatment.Results There were 52 patients in the experimental group and 52 patients in the control group.The treatment efficacy rate in the experimental group was significantly higher than that in the control group(P<0.05),while the incidence of adverse reactions was significantly lower than that in the control group(P<0.05).Before treatment,there were no significant differences in MoCA scores,MMSE scores,UPDRS scores,ADL scores,serum NT3,CRP,and PARK7 levels between the two groups(P>0.05).After treatment,the MoCA score,MMSE score,and ADL score in the experimental group were higher than those in the control group(P<0.05),while the UPDRS score was lower than that in the control group(P<0.05).After treatment,the serum NT3 level in the experimental group was higher than that in the control group(P<0.05),while the serum CRP and PARK7 levels were lower than those in the control group(P<0.05).Conclusion The combination of DNPQ and BST has better clinical efficacy and safety,which can improve cognitive function,ADL and oxidative stress-related cytokine content in patients with PS.

Objective:To investigate the factors influencing the decision to delivery interval (DDI) in emergency cesarean section in Guangzhou and the impact of DDI on maternal-infant outcomes.Methods:A retrospective study was conducted on clinical data of pregnant women who underwent emergency cesarean section at municipal and district maternal and child health hospitals in Guangzhou city in 2021. Per the classification method of emergency cesarean section and recommendations for DDI provided by National Institute for Health and Clinical Excellence guidelines, these subjects were classified into Category Ⅰ and Category Ⅱ cesarean sections. Each category was further divided into two subgroups based on DDI: the Category Ⅰ group into >30 min and ≤30 min subgroups, and the Category Ⅱ group into >75 min and ≤75 min subgroups. Chi-square test or Fisher's exact test, two independent samples t-test, Mann-Whitney U test, and logistic regression were used to analyze the potential factors influencing DDI and the impact of DDI on maternal-infant outcomes. Results:(1) Totally 502 women underwent urgent cesarean section, including 304 (60.6%) Category Ⅰ and 198 (39.4%) Category Ⅱ, were analyzed. Among the Category Ⅰ group, 30.3% (92/304) achieved a DDI of ≤30 min, while 37.4% (74/198) of Category Ⅱ cases had a DDI of ≤75 min. (2) For the Category Ⅰ cases, multivariate logistic regression showed that more patients under intravertebral anesthesia, than those under general anesthesia, had a DDI >30 min ( OR=14.04, 95% CI: 6.14-32.10) as well as more with ward-based emergencies than those with delivery room emergencies ( OR=3.21, 95% CI: 1.72-6.00, both P=0.001). Among the Category Ⅱ cases, logistic regression revealed that cesarean section during routine working hours was more likely to achieve DDI >75 min than that during resting hours ( OR=3.93, 95% CI: 2.03-7.63, P=0.001). The risk of DDI >75 min was higher in tertiary maternal and child health hospitals compared with secondary maternal and child health hospitals ( OR=2.45, 95% CI: 1.06-5.70, P=0.037). (3) Among the Category Ⅰ cases, compared with the DDI ≤30 min group, the DDI >30 min group had a lower risk of neonatal Apgar score ≤7 at 1 min ( OR=0.31, 95% CI: 0.14-0.69, P=0.004), but there was no significant difference in the risk of neonatal Apgar score ≤7 at 5 min ( OR=0.21, 95% CI: 0.04-1.17) or neonatal asphyxia ( OR=0.32, 95% CI: 0.07-1.44) between the two subgroups. In cases of Category Ⅱ cesarean sections, there was no significant difference in any maternal-infant outcomes between DDI ≤75 min and DDI >75 min subgroups. Conclusions:The location of emergency and types of anesthesia are the influencing factors of DDI for Category Ⅰ cesarean sections, while the operation time and level of maternal and child health hospital are the influencing factors of DDI for Category Ⅱ cesarean sections. We did not find any impact of DDI on maternal or infant outcome.

Objective:Analyze the operation mode of the valuation investment of scientific and technological achievements in hospitals, and provide a certain reference for other hospitals to carry out valuation investment in scientific and technological achievements.Methods:This paper analyzed the origin and current situation of the valuation investment of scientific and technological achievements. Taking Peking University Cancer Hospital as an example, it made an in-depth analysis of the valuation investment model of scientific and technological achievements.Results:The study found that the valuation investment of scientific and technological achievements in hospitals includes several key links such as signing the Valuation Investment Agreement, signing the Shareholder Agreement and the Articles of Association, the registration and identification of technical contracts, the issuance of invoices, and deferred taxation. And several suggestions on how to apply this model for the transformation of scientific and technological achievements were put forward.Conclusions:Although the implementation process of scientific and technological achievements is cumbersome, the operation mode is diverse, and the ownership of equity is difficult to distinguish, the advantages are extremely obvious. It can closely combine technological capital and industrial capital, form a strong and effective technological alliance and a community of multiple interests, better use the market-oriented motivation of scientific and technological innovation, and carry out cutting-edge research in line with market prospects.

OBJECTIVE To study the effects of transferrin-targeting peptide T7 （7pep） on intracellular transportation of polyethylene glycol-polycaprolactone （PEG-PCL） micelles in human cervical cancer HeLa cells. METHODS Using coumarin-6 （C6） as fluorescent indicator probe， both coumarin-6 （C6）-loaded PEG-PCL （PEG-PCL-C6） micelles and 7pep-modified PEG- PCL （7pep-PEG-PCL-C6） micelles were prepared by film-dispersion method. The particle size， polydispersity index and appearance morphology were compared between two types of micelles； the real-time uptake of two types of micelles by HeLa cells was compared， and the colocalization of two types of micelles with early endosomes （EE）， endocytic recycling compartments （ERC） and late endosomes （LE） after entry into the cells was observed. RESULTS The particle sizes of PEG-PCL-C6 and 7pep-PEG-PCL- C6 micelles were（75.0±2.3）and（82.0±1.5）nm； the polymer dispersity indexes were 0.17±0.20 and 0.17±0.32， respectively， with a regular spherical appearance. The colocalization results showed that entry speed and amount of 7pep-PEG-PCL-C6 micelles were significantly faster/more than those of PEG-PCL-C6 micelles. 7pep-PEG-PCL-C6 micelles entered EE faster than PEG-PCL-C6 micelles， while PEG-PCL-C6 micelles entered ERC at a faster rate than 7pep-PEG-PCL-C6 micelles， and both PEG-PCL-C6 micelles and 7pep-PEG-PCL-C6 micelles tended to accumulate gradually in LE； Pearson coefficient， signal overlap ratio， and colocalization ratio of 7pep-PEG-PCL-C6 micelles with LE were significantly lower 60 minutes after entering the cell than those 30 minutes after entering the cell （P＜0.05 or P＜0.01）. CONCLUSIONS Targeting 7pep modification can increase the entry speed and amount of PEG-PCL-C6 micelles， and also alter their intracellular transportation behavior.

Objective:To analyze the clinical characteristics of immune-related psoriasis caused by immune checkpoint inhibitors (ICIs).Methods:The patients with newly developed or worsening psoriasis after ICIs treatment in Department of Oncology, the Affiliated Hospital of Qingdao University from November 2019 to October 2023 were enrolled in this study. The patients′ gender, age, tumor type and stage, usage and dosage of ICIs, drugs applied in combination, history of psoriasis, the time of new onset or deterioration, clinical manifestations, intervention measures and outcomes were collected, and descriptive statistical analysis was performed.Results:A total of 13 patients were enrolled in the study, including 10 males and 3 females, with a median age of 66 years. The primary diseases included lung cancer (in 7 patients), gastric cancer (in 5 patients), and cholangiocarcinoma (in 1 patient). The tumor stage was Ⅳ in 12 patients and Ⅲ in 1 patient. Ten patients were treated with programmed cell death 1 receptor (PD-1) inhibitors, 2 with programmed cell death ligand 1 (PD-L1) inhibitors, and one with a PD-1/cytotoxic T-lymphocyte-associated antigen 4 combination antibody. All 13 patients were treated with other anti-tumor drugs at the same time. There were 10 patients with a history of psoriasis and 3 patients with newly developed psoriasis. The median time from the use of ICIs to the onset or deterioration of psoriasis was 54 days. Ten patients were plaque psoriasis and 3 were drip psoriasis. Among the 13 patients, 5, 5, and 3 patients were classified as mild, moderate, and severe, respectively. ICIs treatment was suspended in 11 patients and not stopped in 2 patients. After treatment with glucocorticoids, the skin lesions of 13 patients were improved and ICIs were restarted in 3 patients.Conclusions:ICIs-related psoriasis usually occurs within 2 months after the use of ICIs. The clinical types are plaque-like and drop-like, mostly mild or moderate. The prognosis is good after discontinuing ICIs or giving glucocorticoids and other drugs. Some patients can restart ICIs treatment.

Objective:To analyze the clinical characteristics of immune-related psoriasis caused by immune checkpoint inhibitors (ICIs).Methods:The patients with newly developed or worsening psoriasis after ICIs treatment in Department of Oncology, the Affiliated Hospital of Qingdao University from November 2019 to October 2023 were enrolled in this study. The patients′ gender, age, tumor type and stage, usage and dosage of ICIs, drugs applied in combination, history of psoriasis, the time of new onset or deterioration, clinical manifestations, intervention measures and outcomes were collected, and descriptive statistical analysis was performed.Results:A total of 13 patients were enrolled in the study, including 10 males and 3 females, with a median age of 66 years. The primary diseases included lung cancer (in 7 patients), gastric cancer (in 5 patients), and cholangiocarcinoma (in 1 patient). The tumor stage was Ⅳ in 12 patients and Ⅲ in 1 patient. Ten patients were treated with programmed cell death 1 receptor (PD-1) inhibitors, 2 with programmed cell death ligand 1 (PD-L1) inhibitors, and one with a PD-1/cytotoxic T-lymphocyte-associated antigen 4 combination antibody. All 13 patients were treated with other anti-tumor drugs at the same time. There were 10 patients with a history of psoriasis and 3 patients with newly developed psoriasis. The median time from the use of ICIs to the onset or deterioration of psoriasis was 54 days. Ten patients were plaque psoriasis and 3 were drip psoriasis. Among the 13 patients, 5, 5, and 3 patients were classified as mild, moderate, and severe, respectively. ICIs treatment was suspended in 11 patients and not stopped in 2 patients. After treatment with glucocorticoids, the skin lesions of 13 patients were improved and ICIs were restarted in 3 patients.Conclusions:ICIs-related psoriasis usually occurs within 2 months after the use of ICIs. The clinical types are plaque-like and drop-like, mostly mild or moderate. The prognosis is good after discontinuing ICIs or giving glucocorticoids and other drugs. Some patients can restart ICIs treatment.

Objective:To investigate the application effect of a sequential clinical skill curriculum system in standardized residency training.Methods:A total of 300 residents who participated in the residency training of a clinical medical school from 2020 to 2022 were selected as the research subjects, among whom 46 residents in the experimental group had received the clinical skill training course of the clinical medical school in the undergraduate stage, and 254 in the control group had not received such training in the undergraduate stage. The teaching effect of the two groups was observed from the first year to the third year after they entered the residency training base and were trained together based on the curriculum system. SPSS 24.0 statistical software was used for data analysis, and the main statistical methods included descriptive analysis, the Kolmogorov-Smirnov test, the Mann-Whitney U test, and the chi-square test. Results:Before the residents entered the residency base, class 2020 [60.0(52.0,60.0) vs. 51.0(48.0,53.0)], class 2021 [54.0(52.0,56.0) vs. 51.0(48.0,53.0)] and class 2022 [53.0(51.0,55.0) vs. 50.0(47.0,51.0)] The difference between the entry base grades of the residents in the experimental group compared to the control group was statistically significant ( P<0.05). After 36 months of residency training, the difference between the residents in the trial group and the control group in the 2020 class was not statistically significant when it came to the passing rate of the final exam ( χ2=1.20, P=0.273). At the end of 12 months of residency training, there was a statistically significant difference ( P<0.05) between the scores of residents in the experimental group compared with the control group in the theoretical examination [124.0 (123.8,125.0) vs. 115.0 (101.0,125.0)] and medical history taking [92.0 (91.0,95.0) vs. 85.1 (79.3,94.5)]. The differences were not statistically significant ( P>0.05) at the end of 6, 18, and 24 months of residency training. At the end of 6 months [93.0(90.0,97.0) vs. 89.0(86.3,95.0)], 12 months [94.0(92.0,95.0) vs. 89.0(87.0,92.0)] and 18 months [90.0(86.5,93.5) vs. 81.0(69.0,91.0)] of residency training, residents in the experimental group Physical examination scores were statistically significant compared to the control group ( P<0.05). At the end of 24 months of residency training, there was no statistically significant difference ( P>0.05) between the physical examination scores of residents in the experimental group compared with the control group in the classes of 2020 [92.0(87.5,95.3) vs. 85.0(79.0,92.0)] and 2021 [94.0(87.0,96.0) vs. 90.0(84.0,95.0)]. Conclusions:The clinical skill curriculum system can help to improve the comprehensive clinical ability of residents, and the teaching contents and methods of physical examination should be further optimized, with a focus on the training of doctor-patient communication skills and humanistic literacy among residents in the future.

Objective:To study the levels and variation of equilibrium factor in indoor environment.Methods:A one-year continuous measurement of radon concentration and equilibrium equivalent radon concentration was carried out in an indoor office building of Nanning city. The effective data acquisition rates of radon gas and radon progeny were 99.9% and 86.7%, respectively.Results:The annual average activity concentration and equilibrium equivalent radon concentration in indoor environment were (50.9±20.7)and (15.5±10.1)Bq/m 3, both of which had the same diurnal and seasonal variation. The average annual value of equilibrium factor was 0.30±0.12, showing no obvious diurnal variation. The distribution of monthly mean value of equilibrium factor showed a similar trend to that of radon and radon progeny. The highest and the lowest value appeared in November and June, respectively, with 0.47±0.24 and 0.19±0.06. Conclusions:Due to the large variation range of monthly mean value of equilibrium factor in indoor environment, when annual effective dose of radon exposure was estimated based on radon gas concentration, attention should be paid to choose the quantity value of equilibrium factor and the uncertainty caused by the change of equilibrium factor should be considered.

Patient satisfaction is one of the core indicators to measure the service quality of medical institutions. To this end, a multi-campus public hospital in Shanghai constructed a management system of patient satisfaction evaluation. Since 2021, its call center has conducted a full coverage satisfaction assessment for discharged patients from its three campuses and collected dissatisfaction information feedback. The hospital organized relevant clinical departments and functional departments to fully communicate with the dissatisfied patients according to the feedback information, followed by a joint rectification. The hospital regularly conducts in-depth analysis of all complaints for timely discovery of common problems in different campuses for continuous improvement. This practice can provide reference for multi-campus hospitals to promote homogeneous management, to improve management efficiency, service quality and patient satisfaction.