In order to achieve the quality homogenization of medical services among regions,Chi-na actively explores and promotes the construction of regional national medical centers.This paper illustrates the substantive cooperation during the integration period of the establishment of the re-gional center between output hospital(Sun Yat-Sen University Cancer Center)and the input hospi-tal(Gansu Cancer Hospital).During the integration period a collaborative management model with vertical and horizontal linkages was formed,and the cross-regional long-distance cooperation bar-riers were effectively overcome.Based on the patients-oriented medical service,the two hospitals have achieved remarkable results in the construction and development of clinical service,teach-ing,research and management of Gansu Hospital,which would provide a practical reference for the construction and management of regional national medical center.

AIM:To investigate the regulatory effects of proanthocyanidins on autophagy and apoptosis in the retinas of guinea pigs with form-deprivation myopia via the AMPK/Wnt/β-catenin pathway.METHODS:Fifty guinea pigs were randomly divided into a normal control group, a myopia model group, and low-dose, medium-dose, and high-dose proanthocyanidins groups(25, 50 and 100 mg/kg). Refractive power and axial length of right eye were measured using a retinoscope and A-scan ultrasound. Retinal pathological changes were observed via HE staining. Immunohistochemistry assessed p-AMPK and p-mTOR expression in the retina. Immunofluorescence detected p62 and LC3 expression. TUNEL staining evaluated retinal cell apoptosis. Western blot examined expression of proteins related to the AMPK/Wnt/β-catenin pathway and autophagy(p62, Beclin1, LC3-II/LC3-I), and apoptosis-related proteins(Bax, Bcl-2, Cleaved-Caspase3, Caspase3)in the retina.RESULTS:Compared with the control group, the myopia model group showed significantly reduced refractive power and significantly increased axial length(both P<0.05); retinal cell arrangement became sparse and retinal thickness thinned. The p-AMPK levels in the retina were significantly reduced, while p-mTOR levels were significantly increased(both P<0.05), indicating suppression of the AMPK-Wnt/β-catenin pathway. The p62 levels were significantly elevated and LC3 levels were significantly reduced(both P<0.05), suggesting inhibition of autophagy. Bax and Cleaved-Caspase3 were significantly increased, while Bcl-2 was significantly decreased, indicating significantly increased apoptosis(both P<0.05). Compared with the myopia model group, all proanthocyanidins dose groups significantly inhibited refractive error reduction and axial length growth(both P<0.05), restored retinal cell alignment and thickness, activated the AMPK/Wnt/β-catenin pathway, significantly increased p-AMPK expression, and suppressed p-mTOR expression(all P<0.05); significantly suppressed p62 expression, increased Beclin1 and LC3-II/LC3-I expression(both P<0.05), and activated retinal autophagy; significantly suppressed Bax and Cleaved-Caspase3 expression, increased Bcl-2 expression(both P<0.05), and inhibited retinal cell apoptosis.CONCLUSION:Proanthocyanidins enhance retinal autophagy by activating the AMPK/Wnt/β-catenin pathway, thereby inhibiting retinal apoptosis and preventing or alleviating the onset of myopia.

In order to achieve the quality homogenization of medical services among regions,Chi-na actively explores and promotes the construction of regional national medical centers.This paper illustrates the substantive cooperation during the integration period of the establishment of the re-gional center between output hospital(Sun Yat-Sen University Cancer Center)and the input hospi-tal(Gansu Cancer Hospital).During the integration period a collaborative management model with vertical and horizontal linkages was formed,and the cross-regional long-distance cooperation bar-riers were effectively overcome.Based on the patients-oriented medical service,the two hospitals have achieved remarkable results in the construction and development of clinical service,teach-ing,research and management of Gansu Hospital,which would provide a practical reference for the construction and management of regional national medical center.

ObjectiveTo reveal the influence of Jianchangbang characteristic processing method on the change process of volatile components and the processing mechanism of reducing toxicity and increasing efficiency of Magnoliae Officinalis Cortex（MOC） by studying the changes in the composition and content of volatile components during the processing of ginger processed Xingpo pieces. MethodSamples of raw products， ginger juice moisturized products and stir-fried and heap moisturized products of MOC were taken according to the set time points， and headspace gas chromatography-mass spectrometry（HS-GC-MS） was used to determine the contents of volatile components in the samples， and the relative content of each component was obtained by peak area normalization. Principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were performed on the sample data using SIMCA 14.1 software， and the differential components during the processing were screened with variable importance in the projection（VIP） value>1 as the indicator. ResultA total of 68 volatile components were identified in the samples， among which some of the chemical components with similar structures showed similar trends of changes， and there was also the phenomenon of interconversion between compounds. Compared with the raw products， the contents of 42 components in ginger juice moisturized products increased， while the contents of 25 components decreased， 19 components were unique， and 4 components were unique to the raw products. Compared with ginger juice moisturized products， MOC in the early stage of piling had three unique components， and the contents of 11 components such as cyclosativene and （+）-α-pinene increased， and the contents of 5 components such as tricyclic terpene and α-curcumene decreased， and ginger juice moisturized products had four unique components. Compared with the early stage of piling， in the later stage， the contents of 8 components such as （+）-α-pinene and camphene significantly increased， while the contents of 6 components such as linalool and α-selinene significantly decreased. During the processing of MOC， there were significant changes in the chemical composition of the samples before and after 20 days. The differences between ginger juice moistening and the early stage of piling， the early stage and the later stage of piling could be clearly distinguished. ConclusionDuring the preparation process of ginger processed Xingpo pieces， the addition of ginger juice can reduce the contents of stimulating components， and the contents of active components continue to increase in several stages， such as the addition of ginger juice， frying and heap moisturizing， the quality of the decoction pieces may change significantly at about 20 d of processing. This study can provide a research basis for exploring the processing mechanism of ginger processed Xingpo pieces.

OBJECTIVE To evaluate the economics of trastuzumab deruxtecan versus the physician-selected chemotherapy （TPC） regimen in the second-line treatment of advanced breast cancer with epidermal growth factor receptor 2 （HER-2） low expression from the perspective of the Chinese healthcare system. METHODS Based on the data of DESTINY-Breast04 clinical trial， the dynamic Markov model was constructed. The time frame of the model simulation was 10 years， and the cycle was 3 weeks. Taking cost， quality-adjusted life year （QALY） and incremental cost-effectiveness ratio （ICER） as the model output indicators， the discount rate of 5% was applied， and 3 times China’s per capita gross domestic product （GDP） in 2023 was taken as the willingness-to-pay （WTP） threshold value. Cost-utility analysis was used to evaluate the economics of the two treatment regiments in the hormone receptor-positive cohort and all patient cohorts， and uncertainty analysis was used to verify the robustness of the basic analysis result. RESULTS The results of the basic analysis showed that compared with the TPC regimen， the ICER value of trastuzumab deruxtecan regimen edu.cn were 1 045 655.76 and 906 404.99 yuan/QALY in the hormone receptor-positive cohort and all patients， respectively， both exceeding the WTP threshold （268 074 yuan/QALY）. The results of single factor sensitivity analysis showed that progression-free survival utility value， the price of trastuzumab deruxtecan and progression disease utility had a significant influence on the model results. The results of probability sensitivity analysis showed that when the WTP threshold was 3 times China’s per capita GDP in 2023， the probability of economic viability of trastuzumab deruxtecan was 0. The results of scenario analysis showed that when the patient assistance program for trastuzumab deruxtecan was considered， the probability of trastuzumab deruxtecan regimen being economical was 0. However， when the price of trastuzumab deruxtecan was reduced by 70%， the probability of its being cost-effective was significantly increased to 82.80%. CONCLUSIONS At a WTP threshold of 3 times China’s per capita GDP in 2023， the trastuzumab deruxtecan regimen is not cost-effective compared to TPC regimen for the second-line treatment of advanced breast cancer with HER-2 low expression. Reducing the price of trastuzumab deruxtecan by region can improve its cost-effectiveness.

Objective:To observe and analyze the risk factors of positive conjunctival capsule microbial culture in patients with intravitreal injection treatment (IVT) before treatment.Methods:A prospective study. A total of 1 092 patients who received IVT at the Vitreous Injection Center of Tianjin Medical University Eye Hospital from February 2021 to February 2024 were included in the study. Among them, 539 were males and 553 were females. The age was (62.29±13.61) years. Hypertension and diabetes were 661 and 576 cases, respectively. There were 742 cases of urban residence and 350 cases of rural residence. Three and one days before IVT, 364 patients received antibiotics and 364 patients did not receive antibiotics. Patients' gender, age, history of hypertension and diabetes, pre-IVT antibiotic eye drops use history, and differences in residence (town/country) were collected in detail. Samples were collected after the conjunctival sac was rinsed, and microbial culture was performed. The differences in conjunctival microbial culture positivity rates was compared between those who did not use antibiotic eye drops before IVT, those who used them 1 day before IVT, and those who used them 3 days before IVT. The positive rate of conjunctival sac microbial culture were compared among individuals of different ages, genders, with/without hypertension, with/without diabetes, with different IVT times, and from different living areas (urban/rural). The clinical baseline of positive conjunctival capsule bacterial culture was compared and observed. χ2 test was used to compare the positive rate of conjunctival capsule microbial culture among different clinical baselines. Logistic binary regression analysis was used to analyze the influencing factors. Results:Among the 1 092 patients, 54 cases (4.95%, 54/1 092) were positive for microbial culture of conjunctival sac. There was no significant difference ( P>0.05) in the positive rate of conjunctival sac microbial culture among patients of different ages ( χ2=5.599), gender ( χ2=0.549), residence ( χ2=0.153), with or without hypertension and diabetes ( χ2=3.545, 0.044), and with or without diabetic macular edema ( χ2=0.180). There was no significant difference ( P>0.05) in the positive rate of conjunctival sac microbial culture between patients with different numbers of IVT ( χ2=0.961) or between those who received antibiotic eye drops before IVT and those who did not ( χ2=5.600). Logistic binary regression analysis showed that none of the above factors were risk factors for positive conjunctival capsule microbial culture ( P>0.05). No infective endophthalmitis occurred in all patients during the observation period. Conclusion:The use of antibiotics before IVT is not the decisive factor for positive microbial culture in conjunctival sac.

Objective:To observe and analyze the risk factors of positive conjunctival capsule microbial culture in patients with intravitreal injection treatment (IVT) before treatment.Methods:A prospective study. A total of 1 092 patients who received IVT at the Vitreous Injection Center of Tianjin Medical University Eye Hospital from February 2021 to February 2024 were included in the study. Among them, 539 were males and 553 were females. The age was (62.29±13.61) years. Hypertension and diabetes were 661 and 576 cases, respectively. There were 742 cases of urban residence and 350 cases of rural residence. Three and one days before IVT, 364 patients received antibiotics and 364 patients did not receive antibiotics. Patients' gender, age, history of hypertension and diabetes, pre-IVT antibiotic eye drops use history, and differences in residence (town/country) were collected in detail. Samples were collected after the conjunctival sac was rinsed, and microbial culture was performed. The differences in conjunctival microbial culture positivity rates was compared between those who did not use antibiotic eye drops before IVT, those who used them 1 day before IVT, and those who used them 3 days before IVT. The positive rate of conjunctival sac microbial culture were compared among individuals of different ages, genders, with/without hypertension, with/without diabetes, with different IVT times, and from different living areas (urban/rural). The clinical baseline of positive conjunctival capsule bacterial culture was compared and observed. χ2 test was used to compare the positive rate of conjunctival capsule microbial culture among different clinical baselines. Logistic binary regression analysis was used to analyze the influencing factors. Results:Among the 1 092 patients, 54 cases (4.95%, 54/1 092) were positive for microbial culture of conjunctival sac. There was no significant difference ( P>0.05) in the positive rate of conjunctival sac microbial culture among patients of different ages ( χ2=5.599), gender ( χ2=0.549), residence ( χ2=0.153), with or without hypertension and diabetes ( χ2=3.545, 0.044), and with or without diabetic macular edema ( χ2=0.180). There was no significant difference ( P>0.05) in the positive rate of conjunctival sac microbial culture between patients with different numbers of IVT ( χ2=0.961) or between those who received antibiotic eye drops before IVT and those who did not ( χ2=5.600). Logistic binary regression analysis showed that none of the above factors were risk factors for positive conjunctival capsule microbial culture ( P>0.05). No infective endophthalmitis occurred in all patients during the observation period. Conclusion:The use of antibiotics before IVT is not the decisive factor for positive microbial culture in conjunctival sac.

Objective : To examine the association between dietary patterns during pregnancy and gestational diabetes mellitus (GDM), so as to provide the evidence for guiding the establishment of healthy and balanced dietary patterns and reducing the prevalence of GDM. Methods: Pregnant women who underwent oral glucose tolerance tests in Hangzhou Obstetrics and Gynecological Hospital from 2020 to 2021 were enrolled, and their demographic information were collected using questionnaires. Pregnant women's diets during the past three months were collected using Food Frequency Questionnaires (FFQs), and dietary patterns were extracted using principal component analysis. In addition, the association between dietary patterns and risk of GDM was examined using a multivariable logistic regression model. Results: A total of 1 689 pregnant women were included, with a median age of 28.53 (interquartile range, 2.47) years and a median gestational age of 26.00 (interquartile range, 2.00) weeks. Five dietary patterns were identified according to pregnant women's types of diets, including meat-based diets, dessert-fruit-refined grain diets, plant-based diets, eggs-milk-nut diets and whole-grain diets, with a cumulative contribution rate of 58.76%. The prevalence of GDM was 24.57% (415 cases) among the study subjects. Multivariable logistic regression analysis showed that pregnant women with scores in the highest quartile (Q4) of the meat-based diets had an increased risk of GDM (OR=1.372, 95%CI: 1.043-2.055) relative to those with scores in the lowest quartile (Q1), and pregnant women with Q4 scores of the dessert-fruit-refined grain diets had an increased risk of GDM (OR=1.743, 95%CI: 1.397-2.432) relative to those with Q1 scores, while pregnant women with Q4 scores of the plant-based diets had a reduced risk of GDM (OR=0.382, 95%CI: 0.346-0.613) relative to those with Q1 scores. Conclusion A plant-based dietary pattern may reduce the risk of GDM, while meat-based and dessert-fruit-refined grain dietary patterns may increase the risk of GDM.

Ribosome-inactivating proteins (RIPs) belong to a family of enzymes that attack eukaryotic ribosomes and potently inhibit cellular protein synthesis. RIPs possess several biomedical properties, including anti-viral and anti-tumor activities. Multiple RIPs are known to inhibit tumor cell proliferation through inducing apoptosis in a variety of cancers, such as breast cancer, leukemia/lymphoma, and hepatoma. This review focuses on the anti-tumor activities of RIPs and their apoptotic effects through three closely related pathways: mitochondrial, death receptor, and endoplasmic reticulum pathways.
Animals ; Antineoplastic Agents ; Apoptosis ; Endoplasmic Reticulum ; Humans ; Mitochondria ; Plant Proteins ; Receptors, Death Domain ; Ribosome Inactivating Proteins ; Ribosomes