Objective:To explore the effectiveness of the"full-chain"integrated medical and elderly care service model in addressing key issues in medical-nursing services such as weak medical support capacity and insufficient provision of community-and home-based medical-nursing services.Methods:The development pathway for the"full-chain"integrated medical-elderly care service standardization system,encompassing core components such as operational mechanisms,smart platforms,policy documents,and quality control systems was systematically outlined.Effectiveness based on dimensions including service coverage,quality improvement,talent development,and social benefits was evaluated.With standardization as the core driver,the'1234567'management model was innovatively implemented.Results:The model leveraged the downward allocation of high-quality resources from tertiary general hospitals to strengthen subdistrict community health service centers.By collaborating with subdistrict elderly-care service centers,it established"subdistrict medical-elderly care and wellness service centers".These centers enhanced the capabilities of"community-embedded elderly-care complexes",including community daytime care centers,established two-way referral channels between medical and elderly care services,aligned with healthcare demands to provide elderly individuals with reliable medical support.It reduced the burden on families and society,stimulated market vitality,boosted domestic demand,promoted the development of integrated medical-elderly care and wellness initiatives,thereby advancing the silver economy.With provincial government endorsement,the model had been applied to 203 communities across 37 counties by the end of 2024.Conclusion:The established"full-chain"integrated medical-elderly care service model facilitates regional high-quality development in integrated care by consolidating healthcare group resources and seamlessly connecting the service chain across hospitals,nursing homes,community institutions,and home-based settings,thereby creating a practical paradigm for comprehensive elderly care service delivery.

Neutralizing antibodies have been designed to specifically target and bind to the receptor binding domain (RBD) of spike (S) protein to block severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from attaching to angiotensin converting enzyme 2 (ACE2). This study reports a distinctive nanobody, designated as VHH21, that directly catalyzes the S-trimer into an irreversible transition state through postfusion conformational changes. Derived from camels immunized with multiple antigens, a set of nanobodies with high affinity for the S1 protein displays abilities to neutralize pseudovirion infections with a broad resistance to variants of concern of SARS-CoV-2, including SARS-CoV and BatRaTG13. Importantly, a super-resolution screening and analysis platform based on visual fluorescence probes was designed and applied to monitor single proteins and protein subunits. A spontaneously occurring dimeric form of VHH21 was obtained to rapidly destroy the S-trimer. Structural analysis via cryogenic electron microscopy revealed that VHH21 targets specific conserved epitopes on the S protein, distinct from the ACE2 binding site on the RBD, which destabilizes the fusion process. This research highlights the potential of VHH21 as an abzyme-like nanobody (nanoabzyme) possessing broad-spectrum binding capabilities and highly effective anti-viral properties and offers a promising strategy for combating coronavirus outbreaks.
Single-Domain Antibodies/immunology* ; Spike Glycoprotein, Coronavirus/metabolism* ; SARS-CoV-2/immunology* ; Animals ; Humans ; Antibodies, Neutralizing/immunology* ; Camelus ; COVID-19/immunology* ; Antibodies, Viral/immunology* ; Angiotensin-Converting Enzyme 2

Objective:To explore the effectiveness of the"full-chain"integrated medical and elderly care service model in addressing key issues in medical-nursing services such as weak medical support capacity and insufficient provision of community-and home-based medical-nursing services.Methods:The development pathway for the"full-chain"integrated medical-elderly care service standardization system,encompassing core components such as operational mechanisms,smart platforms,policy documents,and quality control systems was systematically outlined.Effectiveness based on dimensions including service coverage,quality improvement,talent development,and social benefits was evaluated.With standardization as the core driver,the'1234567'management model was innovatively implemented.Results:The model leveraged the downward allocation of high-quality resources from tertiary general hospitals to strengthen subdistrict community health service centers.By collaborating with subdistrict elderly-care service centers,it established"subdistrict medical-elderly care and wellness service centers".These centers enhanced the capabilities of"community-embedded elderly-care complexes",including community daytime care centers,established two-way referral channels between medical and elderly care services,aligned with healthcare demands to provide elderly individuals with reliable medical support.It reduced the burden on families and society,stimulated market vitality,boosted domestic demand,promoted the development of integrated medical-elderly care and wellness initiatives,thereby advancing the silver economy.With provincial government endorsement,the model had been applied to 203 communities across 37 counties by the end of 2024.Conclusion:The established"full-chain"integrated medical-elderly care service model facilitates regional high-quality development in integrated care by consolidating healthcare group resources and seamlessly connecting the service chain across hospitals,nursing homes,community institutions,and home-based settings,thereby creating a practical paradigm for comprehensive elderly care service delivery.

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.

Objective:To build an experimental curriculum system of Oral Preventive Medicine with the goal of improving the job competence of oral medical students.Methods:By establishing knowledge modules, adjusting the experimental content, integrating teaching methods, and improving the comprehensive assessment system of teaching, the teaching reform is carried out in the experimental teaching of Oral Preventive Medicine for undergraduates from 2016 to 2017 in the Department of Stomatology at Zhuhai Campus of Zunyi Medical University.Results:The experimental curriculum system and teaching evaluation system of Oral Preventive Medicine with the goal of improving the job competence of medical students have been established. Cultivate students' independent learning ability and innovative and practical spirit, guide undergraduates to participate in social services, enhance the sense of social responsibility, and integrate theoretical education, ability training and quality education.Conclusions:Explore the new model of experimental oral medicine teaching, initially build the experimental curriculum system of Oral Preventive Medicine with the goal of job competence, promote the transformation of undergraduate teaching concept, deepen the connotation of teaching, and improve the depth and breadth of the teaching of Oral Preventive Medicine.

Objective:To clarify the morphological relationship between the upper airway and TMJ in patients with normal-angle skeletal Ⅱ and skeletal Ⅰ malocclusion.Methods:30 skeletal class Ⅰ and 22 skeletal class Ⅱ patients with normal-angle were included.CBCT examination was performed,and Mimics 21.0 software was used to conduct 3D reconstruction and measurements of the samples.Data was analyzed by using independent t-test and the Pearson correlation test.Results:12 measurements,including the sagittal diameter of nasopharyngeal segment,the sagittal,coronal diameter,minimum cross-sectional area,the volume of palato-pharyngeal segment and glossopharyngeum segment,the total volume of upper airway,posterior oblique slope of the articular eminence and the length of the condylar showed significant differences between skeletal Ⅱ and skeletal Ⅰ subjects with normal-angle(P＜0.05).The posterior oblique slope of the articular eminence showed a positive correlation with the sagittal diameter of the palatopharyngeal segment,volume and minimum cross-sectional area of glossopharyngeum lingual segment(P＜0.05).The liner ratio showed a negative correction with the coronal diameter of palatopharyngeal and glossapharyngeal segment as well as minimum cross-section area of glos-sapharyngeal segment(P＜0.05).Conclusion:The structure of upper airway is correlated with that of TMJ.Differences in the upper airway are statistically significant between skeletal Ⅱ and skeletal Ⅰ malocclusion with normal-angle(P＜0.05).

Objective To explore the role of clinical pharmacists in the treatment of advanced breast cancer patients with severe myelosuppression.Methods This case report describes the diagnostic and therapeutic process of an advanced breast cancer patient who developed severe myelosuppression after applying ADC-based drug therapy.The clinical pharmacist proposed a prophylactic antimicrobial drug selection plan and medication monitoring recommendations for the patient's granulocytopenic fever after assessing the risk of infection and liver and renal function.For oncology drug-associated thrombocytopenia,when the doctor proposed to use the recombinant human thrombopoietin combined with TPO agonists in the case of the ineffectiveness of conventional treatment,the clinical pharmacist searched for the pharmacological basis of the combination regimen,the clinical studies of the efficacy and the adverse reactions to assist the physician's decision-making and provided targeted medication monitoring of the patient.Results The clinician and clinical pharmacist developed and implemented a rational treatment plan,and the patient was discharged with improvement.Conclusions Clinical pharmacists can assist physicians in optimizing individualized treatment plans through pharmacological monitoring of advanced breast cancer patients with severe myelosuppression.This collaborative treatment model can provide patients with more individualized treatment;it can also provide clinical reference to the treatments of patients with severe myelosuppression.

Objective:To clarify the morphological relationship between the upper airway and TMJ in patients with normal-angle skeletal Ⅱ and skeletal Ⅰ malocclusion.Methods:30 skeletal class Ⅰ and 22 skeletal class Ⅱ patients with normal-angle were included.CBCT examination was performed,and Mimics 21.0 software was used to conduct 3D reconstruction and measurements of the samples.Data was analyzed by using independent t-test and the Pearson correlation test.Results:12 measurements,including the sagittal diameter of nasopharyngeal segment,the sagittal,coronal diameter,minimum cross-sectional area,the volume of palato-pharyngeal segment and glossopharyngeum segment,the total volume of upper airway,posterior oblique slope of the articular eminence and the length of the condylar showed significant differences between skeletal Ⅱ and skeletal Ⅰ subjects with normal-angle(P＜0.05).The posterior oblique slope of the articular eminence showed a positive correlation with the sagittal diameter of the palatopharyngeal segment,volume and minimum cross-sectional area of glossopharyngeum lingual segment(P＜0.05).The liner ratio showed a negative correction with the coronal diameter of palatopharyngeal and glossapharyngeal segment as well as minimum cross-section area of glos-sapharyngeal segment(P＜0.05).Conclusion:The structure of upper airway is correlated with that of TMJ.Differences in the upper airway are statistically significant between skeletal Ⅱ and skeletal Ⅰ malocclusion with normal-angle(P＜0.05).

Objective To explore the role of clinical pharmacists in the treatment of advanced breast cancer patients with severe myelosuppression.Methods This case report describes the diagnostic and therapeutic process of an advanced breast cancer patient who developed severe myelosuppression after applying ADC-based drug therapy.The clinical pharmacist proposed a prophylactic antimicrobial drug selection plan and medication monitoring recommendations for the patient's granulocytopenic fever after assessing the risk of infection and liver and renal function.For oncology drug-associated thrombocytopenia,when the doctor proposed to use the recombinant human thrombopoietin combined with TPO agonists in the case of the ineffectiveness of conventional treatment,the clinical pharmacist searched for the pharmacological basis of the combination regimen,the clinical studies of the efficacy and the adverse reactions to assist the physician's decision-making and provided targeted medication monitoring of the patient.Results The clinician and clinical pharmacist developed and implemented a rational treatment plan,and the patient was discharged with improvement.Conclusions Clinical pharmacists can assist physicians in optimizing individualized treatment plans through pharmacological monitoring of advanced breast cancer patients with severe myelosuppression.This collaborative treatment model can provide patients with more individualized treatment;it can also provide clinical reference to the treatments of patients with severe myelosuppression.

Objective:To build an experimental curriculum system of Oral Preventive Medicine with the goal of improving the job competence of oral medical students.Methods:By establishing knowledge modules, adjusting the experimental content, integrating teaching methods, and improving the comprehensive assessment system of teaching, the teaching reform is carried out in the experimental teaching of Oral Preventive Medicine for undergraduates from 2016 to 2017 in the Department of Stomatology at Zhuhai Campus of Zunyi Medical University.Results:The experimental curriculum system and teaching evaluation system of Oral Preventive Medicine with the goal of improving the job competence of medical students have been established. Cultivate students' independent learning ability and innovative and practical spirit, guide undergraduates to participate in social services, enhance the sense of social responsibility, and integrate theoretical education, ability training and quality education.Conclusions:Explore the new model of experimental oral medicine teaching, initially build the experimental curriculum system of Oral Preventive Medicine with the goal of job competence, promote the transformation of undergraduate teaching concept, deepen the connotation of teaching, and improve the depth and breadth of the teaching of Oral Preventive Medicine.