OBJECTIVE To establish a “BRAND” pharmaceutical care model for advanced non-small cell lung cancer （NSCLC） patients with positive driver genes， providing theoretical and practical references for the clinical implementation of precise and individualized oncology pharmaceutical care. METHODS One hundred patients admitted to the department of pulmonary and critical care medicine in our hospital from January 2023 to May 2024 were collected meeting the inclusion and exclusion criteria. Patients were randomly divided into control group and intervention group， with 50 patients in each group. The control group received routine pharmaceutical care， while the intervention group received pharmaceutical care under the “BRAND” model （collecting patients’ basic information， reviewing disease treatment-related information， conducting precise medication assessments， formulating individualized pharmaceutical care plans for the next steps， and implementing medication guidance and follow-up management）. The study was conducted in a 3-week cycle for a total of 4 cycles. The medication compliance， quality of life， laboratory test indicators， incidence of drug-related adverse events and satisfaction of patients in both groups were compared before and after the intervention to evaluate the effects. RESULTS After 12 weeks of intervention， compared with the control group， the medication compliance， cognitive function， social function and satisfaction of patients in the intervention group were improved significantly （ P ＜0.05）； the severity of fatigue and constipation and the incidence of drug-related adverse events were significantly reduced （ P ＜0.05）， and there was no statistically significant difference in laboratory test indicators （ P ＞0.05）. CONCLUSIONS The “BRAND” pharmaceutical care model can effectively improve the medication compliance of patients with advanced NSCLC with positive driver genes and improve their quality of life. This study can provide a feasible path for clinical pharmacists to carry out standardized and high-quality pharmaceutical care.

Objective To elucidate the changes in the gut microbiota and molecular mechanism of huaier in enhancing the efficacy of oxaliplatin (OXA) chemotherapy in gastric cancer (GC). Methods The effects of huaier on the gut microbiota structure and intestinal barrier function in MKN45-bearing mice were analyzed by using 16S rRNA sequencing, RT-qPCR, and IHC. UPLC-MS and network pharmacology, as well as in vivo experimental approaches, were employed to investigate the key bioactive constituents of huaier systematically and elucidate the underlying mechanisms by which huaier exerts therapeutic effects against GC. The expression of the PI3K/AKT/SREBP pathway was detected in cancer cells and tissues via Western blot analysis. The safety profile of huaier combined with OXA was verified through serum biochemistry and HE-stained tissue section analyses. Results Huaier inhibited the PI3K/AKT/SREBP pathway by increasing the abundance of Akkermansia muciniphila, reduced lipid droplet deposition, and ultimately enhanced the sensitivity to OXA in the treatment of GC. Conclusion This study demonstrates the value of huaier in gastric cancer treatment by enhancing chemosensitivity and provides novel insights into its systemic therapeutic effects through molecular mechanisms and gut microbiota modulation.

ObjectiveTo evaluate the public health governance capacity in Jiangsu Province and provide an optimized pathway for the construction of a “strong, rich, beautiful, and high-quality” new Jiangsu. MethodsA total of 806 policy documents, 658 public information reports, and 148 research literatures related to public health governance capacity in Jiangsu Province from January 1995 to December 2023 were collected. The status of current public health goverance was assessed based on the evaluation criteria suitable for public health systems, and the strengths and the weaknesses of the system were identified. ResultsThe public health governance capability of Jiangsu Province was scored at 738.3 points, ranking 3rd nationally. Maternal health care and emergency response capacities achieved leading positions nationwide, both ranking 2nd. Jiangsu had exhibited a standardized guidance in the strategic level, a well-established management mechanism, an extensive coverage in information collection, and a scientifically established health targets setting. However, bottlenecks remained, including an unclear division of responsibilities across organizational departments, an insufficient public-health workforce, the absence of a stable growth mechanism for government funding investment, and difficulties in promptly identifying public needs. ConclusionJiangsu’s public-health system demonstrates leading nationally, yet several components remain underdeveloped. Future efforts should consolidate advantages while addressing weaknesses, further diversify content and forms, establish a stable funding increase mechanism, and clarify departmental functions, thereby providing solid health support for realizing the developmental goals of a “strong, rich, beautiful and high-quality” new Jiangsu.

ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

The superiority of magnetic resonance(MR)images in soft tissue imaging makes them indispensable for medical diagnosis and radiotherapy,but factors such as acquisition cost and contraindications limit their widespread application.In contrast,computed tomography(CT)scanning has the advantages of fast imaging speed and low cost.Herein,this review summarizes the research progress of generative deep learning models in the field of medical CT to MR image synthesis,and especially analyzes the technical characteristics,performance advantages,and challenges of various MR image synthesis methods from clinical scenarios such as spinal lesions,acute ischemic stroke,and tumor segmentation.Furthermore,the application value and future research prospects of medical image synthesis are discussed.

Adverse pregnancy outcome (APO) refers to any pregnancy outcome other than a normal live birth, mainly including preeclampsia, fetal growth restriction, recurrent pregnancy loss, etc., which seriously threaten the health of both the mother and the fetus. Most APOs originate from abnormal uterine endometrial microenvironment before pregnancy. Once a woman confirms pregnancy, intervening in the uterine endometrium at this stage is often too late. The uterine endometrium, as a key site for embryo implantation and development, its abnormal microenvironment can lead to APO. Therefore, in-depth exploration of the relationship between the pre-pregnancy uterine endometrial microenvironment and APO is helpful for clarifying the mechanism of APO occurrence and providing key ideas and methods for early prevention and treatment. This article reviews the latest research on the mechanism of action between uterine endometrial microenvironment and APO, systematically summarizing the research progress and main conclusions in this field from several aspects such as immune imbalance, inflammatory response, abnormal energy metabolism, and senescence of uterine endometrial stromal cells.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Osteoporosis caused by type 2 diabetes mellitus(T2DM)increases the risk of fracture and post-fracture mortality.However,the pathogenesis of the disease remains unclear,resulting in a lack of effective strategies for its prevention and treatment.In this review,firstly,the effects of advanced glycation end products(AGEs)produced by non-enzymatic glycation on bone matrix composition,bone structure,and mechanical properties of T2DM are summarized.Then,the biological mechanism of AGEs and receptor for AGEs(RAGE)affecting bone degeneration in T2DM is clarified.Finally,antidiabetic and other drugs that are beneficial to bone anabolism are discussed.These drugs positively affect bone quality through inhibiting AGE/RAGE signaling pathway.Accordingly,it is expected to provide potential intervention targets and ideas for the prevention and treatment of T2DM-related osteoporosis.

Leakage rate is a critical metric for evaluating protective efficacy of masks.This paper reviews the cur-rent status of experimental methods and numerical simulation studies for assessing the leakage rates of masks,and reveals that leakage rates are related to multiple factors.The inward and outward leakage rates of masks are further compared and analyzed,and the importance of developing a standardized test method for outward leakage rate is em-phasized.Finally,future development direction of mask leakage rate assessment is proposed,aiming to realize the scientific and comprehensive assessment on mask leakage rate and provide guidance for formulating public health policies.

Osteoporosis caused by type 2 diabetes mellitus(T2DM)increases the risk of fracture and post-fracture mortality.However,the pathogenesis of the disease remains unclear,resulting in a lack of effective strategies for its prevention and treatment.In this review,firstly,the effects of advanced glycation end products(AGEs)produced by non-enzymatic glycation on bone matrix composition,bone structure,and mechanical properties of T2DM are summarized.Then,the biological mechanism of AGEs and receptor for AGEs(RAGE)affecting bone degeneration in T2DM is clarified.Finally,antidiabetic and other drugs that are beneficial to bone anabolism are discussed.These drugs positively affect bone quality through inhibiting AGE/RAGE signaling pathway.Accordingly,it is expected to provide potential intervention targets and ideas for the prevention and treatment of T2DM-related osteoporosis.