OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors （DTIs） in patients during the perioperative period. METHODS Led by Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC）， a multidisciplinary working group was established. Through literature review and the Delphi method， clinical questions related to the rational perioperative use of parenteral DTIs were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” framework； systematic searches were conducted in CNKI， Medline， Embase and other databases. Relevant evidence from randomized controlled trials and cohort studies was included and synthesized. Evidence quality was assessed using the Grades of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven recommendations （each with an expert consensus rate exceeding 90%） on the use of parenteral DTIs in perioperative patients were developed. These recommendations specify drug selection， dosing ranges， key monitoring points， and safety management strategies for parenteral DTIs in various scenarios， including the perioperative period of ventricular assist device implantation， the perioperative period of cardiac surgery， perioperative patients with lower-extremity atherosclerotic disease， the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome， the perioperative period of carotid artery stenting in patients with carotid stenosis， the perioperative period of patients with right heart thrombosis， and patients who develop related thrombosis and dysfunction after a central venous catheter insertion. In addition， warning and management pathways for perioperative bleeding and thrombotic events were proposed. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.

OBJECTIVE To form an expert consensus addressing clinical issues regarding the use of parenteral direct thrombin inhibitors （DTIs） in special populations. METHODS Led by the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital（the Affiliated Hospital of UESTC）， a multidisciplinary working group was formed comprising experts from multiple fields， including clinical pharmacy， cardiac surgery， obstetrics， pediatrics and evidence-based medicine. Through literature review and the Delphi method， clinical questions regarding the efficacy and safety of parenteral DTIs used in special populations were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” （PICO） framework；systematic searches were conducted in CJFD， PubMed， Embase and other databases. Relevant evidence from randomized controlled trials，cohort studies and systematic reviews were included and synthesized. Evidence quality was assessed using the Grading of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through three rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven clinical questions were ultimately selected （with a consensus rate exceeding 90%）， resulting in the formulation of seven recommendations on the use of parenteral DTIs in special populations， including children， pregnant women， patients with hepatic or renal impairment， patients with mesenteric venous thrombosis， and individuals with thrombophilia. These recommendations clarify the preferred agents， dosing ranges， monitoring parameters， and safety management strategies for parenteral DTIs in these special populations. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in special populations.

Uncariae Ramulus Cum Uncis has the effects of wind-extinguishing and convulsion resolving,clearing heat and liver smoothing It can be used to treat cancer,cardio-cerebrovascular diseases,neurodegenerative diseases,depression and other diseases.Studies have shown that Uncariae Ramulus Cum Uncis has significant anti-tumor activity and has inhibitory effects on many kinds of cancers,and monoterpene indole alkaloids are the main source of pharmacological effects of Uncariae Ramulus Cum Uncis.This paper reviewed the research related to the anti-tumor effect of monoterpene indole alkaloids from Uncariae Ramulus Cum Uncis in the last decade,and the anti-tumor mechanism was summarized to offer theoretical basis for the further study of monoterpene indole alkaloids in Uncariae Ramulus Cum Uncis.

Objective To explore the application of Mini-CEX oriented by nurses'core competencies in the clinical teaching of intern nursing students.Methods A total of 50 students,interning in the First Affiliated Hospital of Kunming Medical University from January 1,2023 to April 30,2024,were randomly divided into experimental group and control group,with 25 students in each group.The control group was taught by traditional clinical teaching methods,and the experimental group by Mini-CEX.The data indicators of the two groups of intern nursing students were analyzed and compared at entry into and exit from the department,respectively.Results The scores of the two groups were higher than those at entry into the department(P<0.05),and the intern nursing students in the experimental group had excellent scores in nursing consultation,nursing examination,nursing diagnosis,nursing measures,humanistic care,organizational effectiveness,health consultation,and overall evaluation,and the scores were higher than those of the control group(P<0.05).The improvement in all the scores was also better than that of the control group(P<0.05).Conclusion Mini-CEX,which is oriented to the nurse'core competencies of nurses,can improve the clinical nursing abilities of intern nursing students and enhance the cultivation effect of clinical practice skills.

Janus kinase inhibitors (JAKi) are a kind of small molecule targeted drugs used to treat a variety of immune-mediated inflammatory diseases by inhibiting the excessive response of a variety of cytokines. Currently, JAKi has shown good clinical efficacy, but it also has risk of major adverse cardiovascular events (MACE). The specific mechanism of JAKi-caused MACE is still unclear. This paper reviews the pharmacological molecular mechanisms and classification of JAKi and the research progress of MACE related to the JAKi (tolvaptan, baricitinib, ruxolitinib, upadacitinib, and abrocitinib) that have been approved for marketing in China. The risk factors that lead to MACE, including age, combined cardiovascular disease and inflammatory diseases, types of JAKi, dosage forms, and treatment duration are analyzed, so as to provide reference for the clinical rational use of JAKi and better prevention of MACE related to JAKi.

Objective:To investigate epithelial cell heterogeneity in ovarian cancer(OC)and its impact on the tumor microenvironment(TME)by constructing OC epithelial subtypes using publicly available single-cell RNA sequencing(scRNA-seq)data and bioinformatics approaches.Methods:Eight cell types and gene expression matrices were identified from the GSE118828 OC scRNA-seq dataset,and a deconvolution approach was used to estimate cellular composition in bulk RNA sequencing(bulk RNA-seq)data.OC samples were stratified into high-epithelial(C1)and low-epithelial(C2)subtypes based on epithelial cell abundance.Differences in overall survival(OS)and immune microenvironment features between patients with C1 and C2 subtypes were analyzed.Differentially expressed genes(DEGs)between C1 and C2 subtypes,as well as between early-stage(stageⅠ～Ⅱ)and late-stage(stageⅢ-Ⅳ)OC groups were identified to screen epithelial-related genes associated with OC progression,and their influence on the TME was analyzed.Protein expression of the epithelial-related genes in OC progression was validated using data from the Human Protein Atlas(HPA)database.Results:Patients with the C1 subtype exhibited significantly better OS compared to those with C2 subtype(P<0.05).The C1 and C2 subtypes demonstrated distinct immune microenvironment infiltration profiles.Infiltration levels of T helper(Th)cells,M1 macrophages,and activated dendritic cells(DCs)were significantly higher in the C1 subtype(all P<0.05).In late-stage OC patients with C1 subtype,the expression of HAS1,DAPL1,and ADH1B was significantly upregulated(all P<0.05).Furthermore,DAPL1 expression was positively correlated with the degree of macrophage and regulatory T cells(Treg)infiltration in OC(P<0.05).HPA database analysis confirmed that DAPL1 protein expression was significantly upregulated in OC tissues.Conclusion:The high-epithelial subtype of ovarian cancer may exert anti-tumor effects through extensive infiltration of T helper(Th)cells,M1 macrophages,and activated dendritic cells within the tumor microenvironment.Conversely,upregulation of the epithelial-related gene DAPL1 may induce the infiltration of macrophages and Treg,thereby promoting OC progression.

Uncariae Ramulus Cum Uncis has the effects of wind-extinguishing and convulsion resolving,clearing heat and liver smoothing It can be used to treat cancer,cardio-cerebrovascular diseases,neurodegenerative diseases,depression and other diseases.Studies have shown that Uncariae Ramulus Cum Uncis has significant anti-tumor activity and has inhibitory effects on many kinds of cancers,and monoterpene indole alkaloids are the main source of pharmacological effects of Uncariae Ramulus Cum Uncis.This paper reviewed the research related to the anti-tumor effect of monoterpene indole alkaloids from Uncariae Ramulus Cum Uncis in the last decade,and the anti-tumor mechanism was summarized to offer theoretical basis for the further study of monoterpene indole alkaloids in Uncariae Ramulus Cum Uncis.

Janus kinase inhibitors (JAKi) are a kind of small molecule targeted drugs used to treat a variety of immune-mediated inflammatory diseases by inhibiting the excessive response of a variety of cytokines. Currently, JAKi has shown good clinical efficacy, but it also has risk of major adverse cardiovascular events (MACE). The specific mechanism of JAKi-caused MACE is still unclear. This paper reviews the pharmacological molecular mechanisms and classification of JAKi and the research progress of MACE related to the JAKi (tolvaptan, baricitinib, ruxolitinib, upadacitinib, and abrocitinib) that have been approved for marketing in China. The risk factors that lead to MACE, including age, combined cardiovascular disease and inflammatory diseases, types of JAKi, dosage forms, and treatment duration are analyzed, so as to provide reference for the clinical rational use of JAKi and better prevention of MACE related to JAKi.

Purpose/Significance To design a comprehensive data platform to meet the needs of collecting and sharing survey data on meteorological sensitive diseases,so as to enhance monitoring capabilities for meteorological sensitive diseases in China.Method/Process Through various methods such as data extraction,data exchange,data import and customized collection,disease data,meteoro-logical data,environmental data and diagnosis and treatment data are processed and integrated into the platform for unified management.Result/Conclusion This platform realizes the functions of data collection,aggregation,visualization display and data sharing,which can provide support for scientific researchers in various bases across the country to better manage and utilize meteorological sensitive disease survey data.

Hirsutine,an indole alkaloid extracted from the traditional Chinese herb Uncaria,has exhibits diverse pharmaco-logical activities,including antihypotensive,antiinfective,and cardioprotection.In cervical cancer,breast cancer,colon cancer,and oth-er malignant tumors,hirsutine has effects on anti-tumor by regulating cell apoptosis,immune regulation and other pathways,laying the foundation for the application of hirsutine in the field of cancer therapy.This article reviews relevant literature both domestically and internationally to elucidate the research progress of hirsutine in anti-tumor therapy,providing new ideas and strategies for cancer treat-ment.