Objective To explore the prevalence of depressive symptoms in postoperative patients with ovarian cancer and to analyze its influencing factors from multiple dimensions, including clinical characteristics, psychological factors, and laboratory indicators. Methods A cross-sectional study was conducted, which enrolled 235 postoperative patients with ovarian cancer. Depressive status was assessed using the patient health questionnaire, and the demographic, pathological, and medical record data of the patients were collected using the generalized anxiety disorder scale, Pittsburgh sleep quality index, European organization for research and treatment of cancer quality of life questionnaire core 30, and ECOG performance status score. Peripheral blood tumor marker (CA125), routine blood test, lymphocyte subsets, and serum cytokine levels were measured. Univariate and multivariate binary logistic regression analysis were used for statistical analysis. Results The prevalence of depression in postoperative patients with ovarian cancer was 39.15% (92/235). Univariate analysis showed that ECOG score ≥ 2 points, pain, anxiety, poor sleep quality, low quality of life, low life satisfaction, tumor recurrence, six or more cycles of chemotherapy, as well as higher levels of CA125, NLR, and NAR, and lower hemoglobin levels were significantly associated with depression (all P<0.05). Multivariate binary Logistic regression analysis showed that anxiety (OR=1.975, 95%CI: 1.231-3.170), sleep efficiency (OR=4.181, 95%CI: 1.211-14.43), sleep latency (OR=34.806, 95%CI: 4.258-284.542), ECOG performance status score, cognitive function (OR=0.918, 95%CI: 0.868-0.97), and life satisfaction were independent risk factors for depression (all P<0.05). Laboratory indicators were not independent influencing factors in the multivariate Logistic regression model. Conclusion Depression in postoperative patients with ovarian cancer is influenced by physiological, psychological, and social factors. Clinical management should focus on patients with anxiety, sleep disorders, poor physical condition, and low life satisfaction, and a comprehensive prevention and treatment strategy centered on psychological intervention and taking into account symptom management and social support should be implemented.

Objective: Blood safety surveillance is a critical measure for the objective assessment of blood quality and enhancing transfusion safety. This study aims to comprehensively understand the current status of blood safety surveillance and management in blood collection and supply institutions in Sichuan Province, systematically analyze existing problems and vulnerabilities, and provide a basis for optimizing management strategies and improving capabilities to ensure blood safety. Methods: The Blood Safety Surveillance questionnaire was designed, covering adverse donor reaction reporting, management of adverse events, and transfusion adverse reaction feedback. An online survey was conducted via Questionnaire Star platform among 21 blood collection and supply institutions in the province, gathering information on management systems, process implementation, and utilization of monitoring data. The collected data were organized and statistically analyzed using Excel. Results: The questionnaire response rate and validity rate were both 100%. Blood collection and supply institutions in Sichuan Province have generally established a blood safety surveillance system and achieved positive outcomes. Regarding adverse events in blood collection and supply, 95.24% (20 institutions) have established reporting procedures, and 66.67% (14) collect information through multiple channels such as internal reports, external reports, and statistical trend feedback. A total of 90.48% (19) institutions regularly summarize and analyze adverse event data, and 85.71% (18) produce reports with improvement recommendations based on this analysis.71.43% (15) institutions implement reward and penalty measures, and 71.43% (15) report underreporting or omission due to accountability or performance concerns. In terms of monitoring adverse blood donation reactions, all blood collection and supply institutions have established full-process management systems.76.19% (16) collect data through multiple approaches, including on-site donation records, voluntary donor reports, and donor follow-ups. Adverse reactions were followed up in 95.24% (20) of institutions with 65% (13) completing follow-ups within 24 hours.80.95% (17) have established investigation procedures, while 66.67% (14) believe underreporting or omission still occurs. All blood collection and supply institutions regularly compile statistics on adverse donation reactions. Of these, 85.71% (18) institutions providing feedback to management departments and 90.48% (19) analyzing the data and making recommendations.76.19% (16) institutions use monitoring data for return donor management and targeted care, and 71.43% (15 stations) incorporate it into management reviews. Regarding adverse transfusion reactions, 95.24% (20) institutions have established and implemented procedures for isolating, recalling, and tracing of problematic blood units. However, only 42.86% (9) have established feedback mechanisms of adverse transfusion reaction with hospitals, and only 19.05% (4) support direct reporting via information systems.47.62% (10) institutions regularly analyze adverse transfusion reaction data, and 19.05% (4) provide feedback and recommendations to relevant hospitals. All blood collection and supply institutions reported challenges in collecting hospital feedback, citing complexities in data collection and reporting processes. Conclusion: Blood safety surveillance systems have been preliminarily established in Sichuan Province. However, further strengthening is still required, including conducting in-depth data analysis and utilization, standardizing the configuration of emergency medications and equipment, and improving feedback mechanisms for adverse transfusion reactions. To improve the overall level of blood safety management, it is recommended to strengthen closed-loop data management, improve feedback mechanisms between blood collection and supply institutions and hospitals, foster a non-punitive reporting culture, and systematically advance the regionalization and standardization of the monitoring system. These efforts will contribute to sustainably improving the overall effectiveness and sustainability of blood safety management.

Objective:To construct a quality assessment indicator system for undergraduate clinical medicine courses, and to provide scientific guidance for the assessment and improvement of the courses.Methods:The CIPP model was used as the research framework to determine the indicator system through two rounds of expert consultations based on the Delphi method, and the weights of the indicators were assigned using the analytic hierarchy process.Results:The quality assessment system for undergraduate clinical medicine courses comprised 4 primary indicators, 12 secondary indicators, and 43 tertiary indicators. Regarding the primary indicators, high weights were assigned to process assessment (0.398 8) and outcome assessment (0.336 1). Regarding the secondary indicators, the top three weights were assigned to capacity enhancement (0.193 0), teaching staffing (0.122 8), and course content (0.121 5).Conclusions:The assessment system constructed based on the CIPP model covers all aspects of background, input, process, and result. It takes into account the characteristics of clinical medicine courses that emphasize both theory and practice, making the indicators scientific and systematic.

Objective To establish a method for the simultaneous determination of peimine,peiminine,and hupehenine in Juhong pills,to investigate the raw material usage of Fritillaria thunbergii Miq.,and to preliminarily develop a detection approach for identifying adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia.Methods The high-performance liquid chromatography-triple quadruple mass spectrometry(HPLC-MS/MS)was performed on an Agilent Poroshell 120 SB C18 column(2.1 mm×100 mm,2.7 μm)with a mobile phase consisting of acetonitrile-methanol(1∶1)and 0.1%formic acid under gradient elution.The flow rate was set at 0.3 mL·min-1.The column temperature was maintained at 35℃,and the injection volume was 2 μL.Electrospray ionization(ESI)in positive ion mode and multiple reaction monitoring were employed to quantify the three components in 170 batches of Juhong pills.Simulated positive samples with varying adulteration ratios of Fritillaria hupehensis Hsiao et K.C.Hsia were prepared to establish a simple yet efficient detection limit for adulteration.Results Three components showed good linear correlation within their ranges(r≥0.997 5),and the averaged recoveries ranged from 92.0%-106.2%.A total of 61 batches were suspected of Fritillaria thunbergii Miq.adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia in raw material inputs,with the peimine to peiminine ratio below 1.15.Among these samples,27 batches were large honey-bound pills with hupehenine levels of 2.636-9.939 μg·g-1;34 batches were water-honeyed pills showing significantly higher hupehenine contamination at 6.752-48.137 μg·g-1.Conclusion The established method is simple,reliable,and accurate for the quality control of Fritillaria thunbergii Miq.adulteration in Juhong pills without imposing significant additional costs.

Objective To establish a method for the simultaneous determination of peimine,peiminine,and hupehenine in Juhong pills,to investigate the raw material usage of Fritillaria thunbergii Miq.,and to preliminarily develop a detection approach for identifying adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia.Methods The high-performance liquid chromatography-triple quadruple mass spectrometry(HPLC-MS/MS)was performed on an Agilent Poroshell 120 SB C18 column(2.1 mm×100 mm,2.7 μm)with a mobile phase consisting of acetonitrile-methanol(1∶1)and 0.1%formic acid under gradient elution.The flow rate was set at 0.3 mL·min-1.The column temperature was maintained at 35℃,and the injection volume was 2 μL.Electrospray ionization(ESI)in positive ion mode and multiple reaction monitoring were employed to quantify the three components in 170 batches of Juhong pills.Simulated positive samples with varying adulteration ratios of Fritillaria hupehensis Hsiao et K.C.Hsia were prepared to establish a simple yet efficient detection limit for adulteration.Results Three components showed good linear correlation within their ranges(r≥0.997 5),and the averaged recoveries ranged from 92.0%-106.2%.A total of 61 batches were suspected of Fritillaria thunbergii Miq.adulteration with Fritillaria hupehensis Hsiao et K.C.Hsia in raw material inputs,with the peimine to peiminine ratio below 1.15.Among these samples,27 batches were large honey-bound pills with hupehenine levels of 2.636-9.939 μg·g-1;34 batches were water-honeyed pills showing significantly higher hupehenine contamination at 6.752-48.137 μg·g-1.Conclusion The established method is simple,reliable,and accurate for the quality control of Fritillaria thunbergii Miq.adulteration in Juhong pills without imposing significant additional costs.

Objective:To investigate the relationship among social support, anxiety and cancer pain behavior in patients undergoing radiotherapy for advanced colorectal cancer, and to explore the mediating role of social support between anxiety and cancer pain behavior.Methods:A sample of 100 patients with advanced colorectal cancer admitted to the Oncology Radiotherapy Department of the Affiliated Hospital of Jiangnan University was recruited from March 2021 to March 2023. The hospital anxiety and depression scale (HADS), perceived social support scale (PSSS) and visual analogue scale (VAS) were utilized to assess patients' anxiety levels, individually perceived levels of social support and cancer pain intensity.The SPSS 25.0 software and AMOS 26.0 software were used for data analysis.Pearson correlation analysis was conducted to examine the relationships between these variables, and the Bootstrap method was employed to investigate the mediating role of social support in the relationship between anxiety and cancer pain behavior.Results:The patients' HADS anxiety score was (10.63±2.56), VAS pain score was (5.31±1.92), and PSSS social support score was (56.19±6.28). Pearson correlation analysis showed that anxiety was positively correlated with cancer pain behavior ( r=0.785, P<0.001), and social support was significantly correlated with both anxiety ( r=0.671) and cancer pain behavior ( r=0.672) (both P<0.001). Structural equation modeling indicated that social support partially mediated the relationship between anxiety and cancer pain behavior, with an indirect effect value of 0.177 (95% CI=0.033-0.287), accounting for 22.55%(0.177/0.785) of the total effect and the direct effect value was 0.608 (95% CI=0.287-0.642), accounting for 77.45%(0.608/0.785) of the total effect. Conclusion:Social support plays a mediating role in the effect of anxiety on cancer pain behavior in patients with advanced colorectal cancer undergoing radiotherapy. Enhancing social support can effectively alleviate anxiety in patients with advanced colorectal cancer undergoing radiotherapy, thereby alleviating cancer pain behavior, providing a theoretical basis for clinical comprehensive interventions.

Objective:To construct a quality assessment indicator system for undergraduate clinical medicine courses, and to provide scientific guidance for the assessment and improvement of the courses.Methods:The CIPP model was used as the research framework to determine the indicator system through two rounds of expert consultations based on the Delphi method, and the weights of the indicators were assigned using the analytic hierarchy process.Results:The quality assessment system for undergraduate clinical medicine courses comprised 4 primary indicators, 12 secondary indicators, and 43 tertiary indicators. Regarding the primary indicators, high weights were assigned to process assessment (0.398 8) and outcome assessment (0.336 1). Regarding the secondary indicators, the top three weights were assigned to capacity enhancement (0.193 0), teaching staffing (0.122 8), and course content (0.121 5).Conclusions:The assessment system constructed based on the CIPP model covers all aspects of background, input, process, and result. It takes into account the characteristics of clinical medicine courses that emphasize both theory and practice, making the indicators scientific and systematic.

Bladder-preserving treatment has become a research focus due to its potential to balance therapeutic efficacy and quality of life.In recent years,the rapid development of immunotherapy has brought new opportunities for bladder-sparing strategies.In high-risk non-muscle invasive bladder cancer(HR-NMIBC),emerging regimens such as bacillus calmette-guérin-based immunoenhancement,immuno-chemotherapy combinations,targeted therapy,and gene therapy have demonstrated encouraging efficacy and safety in trials like GU-123 and TRUCE-02,with complete remission rate ranging from 42％-100％.In muscle-invasive bladder cancer(MIBC),immunotherapy is being integrated with trimodal therapy,radiotherapy,chemotherapy,and antibody-drug conjugates,as evidenced by studies such as ReBirth and BTCRC-GU15-023,which reported significant improvements in bladder-intact event-free survival,progression-free survival,and complete remission rate.This review summarizes the latest advances in immunotherapy-based bladder-preserving strategies for both HR-NMIBC and MIBC,aiming to provide insights for future individualized treatment approaches.

Antimicrobial resistance poses a serious threat to human health and is the main cause for the increase in infection-related mortality.Rational and timely use of antimicrobial agents is crucial for improving the prognosis of infected patients,however,overdose and inappropriate use of antimicrobial agents can accelerate the acquisition of drug resistance of pathogenic microorganisms,promote the emergence of new resistance mechanisms,and ultimately lead to the emergence of"superbugs".Therefore,early identification of antimicrobial resistance is of significant im-portance for the rapid diagnosis and precise treatment of infectious diseases.With the development of molecular dia-gnostic techniques,third-generation sequencing(TGS)technique offers innovative solutions for detecting microbial resistance due to its advantages in long read length,easy operation,and rapid detection,significantly promoting ear-ly diagnosis and real-time monitoring of antimicrobial resistance.This review systematically summarizes the research progress of TGS in microbial resistance detection,analyzes its advantages and limitations in rapid detection of resis-tance in viruses,bacteria,and fungi,thus provides new perspectives for the early diagnosis and treatment of patho-genic microbial infections.

Objective To determine the related substances in ornidazole active pharmaceutical ingredient(API)and injections using high performance liquid chromatography(HPLC)and to study the impurity profile of ornidazole using liquid chromatography-tandem mass spectrometry(LC-MS/MS)combined with forced degradation tests,aiming to clarify the sources of impurities and their correlation with the prescription and production process and providing technical support for the unified evaluation and quality control of this product.Methods A Phenomenex Luna C18column(4.6 mm×250 mm,5 μm)was used for the separation of ornidazole and its impurities,with 0.000 5%formic acid as mobile phase A and methanol as mobile phase B under gradient elution.The impurity content of 4 batches of APIs,3 batches of reference preparations,and 11 batches of domestic generic preparations were determined.The structure of unknown impurities was predicted using Jet Stream Ion Focusing Electrospray Ionization-Time of Flight Mass Spectrometry(AJS-TOF-MS/MS),and the sources of impurities were identified combined with forced degradation experiments,the prescription and the production process of various manufacturers.Results Ornidazole and its known impurities were well separated under the chromatographic conditions.The structures of five unknown impurities were inferred,and the sources of the impurities were identified.Conclusion This study provides a reference for impurity analysis,quality control,and overall evaluation of ornidazole API and injection.