ObjectiveTo develop an intervention program based on a shared mental model to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards. MethodsUsing the shared mental model as the theoretical framework, the intervention program was preliminarily drafted through literature review to establish a theoretical foundation and qualitative research to identify clinical needs. The Delphi method was then used to revise and refine the program. ResultsBased on literature review and qualitative research, intervention elements were extracted across four dimensions: equipment, tasks, team interaction and team members, forming the initial draft of the intervention program. Two rounds of consultations were conducted with 18 experts, achieving a 100% valid response rate in both rounds. The expert authority coefficients were 0.87 and 0.90, respectively. In the second round of consultation, the variation coefficients for the importance scores of each item ranged from 0 to 0.20 (overall Kendall's W = 0.272, P < 0.001), and the variation coefficients for feasibility scores ranged from 0 to 0.21 (overall Kendall's W = 0.275, P < 0.001). The final intervention program included five first-level indicators, eight second-level indicators, and 29 third-level indicators, aligning with the four dimensions of the shared mental model. ConclusionThe intervention program was developed to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards based on the shared mental model.

Objective To retrieve,analyze and synthesize evidence on post-transplant diabetes mellitus(PTDM)in lung transplant patients,providing reference for clinical healthcare professionals in preventing and managing PTDM in lung transplant patients.Methods Based on the"6S"evidence model,systematic searches were conducted across guideline websites,professional associations,and Chinese/English databases regarding post-transplant diabetes mellitus(PTDM)in lung transplant patients.The search period spanned from data-base inception to January 2025.Two researchers independently completed literature screening,quality assess-ment,and evidence extraction.Results A total of 14 articles were included,comprising 1 clinical decision,2 guidelines,5 expert consensuses,2 specifications,1 evidence summary,and 3 systematic reviews.Twenty-four pieces of best evidence were synthesized from seven aspects:risk factors,diagnosis,screening,prevention,treatment,glycemic control targets,and health education.Conclusion The best evidence for preventing and managing post-transplant diabetes mellitus in lung transplant patients provides an evidence-based foundation for clinical practice among healthcare professionals.Evidence should be selected and applied according to spe-cific clinical situations and patient needs.

Objective To investigate the diagnostic value of serum human β-defensin 2(HBD2)and soluble growth stimulating gene 2(sST2)levels in pediatric refractory Mycoplasma pneumonia.Methods A total of 145 children diagnosed with Mycoplasma pneumonia were recruited,and divided into refractory pneumonia group(n=53)and common pneumonia group(n=92)based on whether they had refractory or common pneumonia.General data were compared between the two groups.Ser-um HBD2 and sST2 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multi-variate logistic regression analysis was used to identify influencing factors for the occurrence of refracto-ry Mycoplasma pneumonia.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of serum HBD2 and sST2 levels in refractory Mycoplasma pneumonia.Results The proportion of lung consolidation and pleural effusion in refractory pneumonia group was significantly higher,and the fever time was significantly longer than that in common pneumonia group(P＜0.05).Serum HBD2 and sST2 levels in the refractory pneumonia group were signifi-cantly higher than those in the common pneumonia group(P＜0.05).Multivariate Logistic regres-sion analysis indicated that lung consolidation,pleural effusion,high serum HBD2 level and high serum sST2 level were risk factors for pediatric refractory Mycoplasma pneumonia(P＜0.05).The area under the curve and Youden's index for diagnosing pediatric refractory Mycoplasma pneumonia were 0.817 and 0.557 for serum HBD2 level,and 0.841 and 0.607 for serum sST2 level,respec-tively.Combined diagnosis using both markers resulted in an area under the curve of 0.916 and a Youden's index of 0.721.Conclusion The combined detection of serum HBD2 and sST2 levels holds significant diagnostic value for pediatric refractory Mycoplasma pneumonia.

Gastric cancer is a high-incidence malignancy that poses a serious threat to public health in China, ranking among the top three cancers in both incidence and mortality. The majority of patients are diagnosed at an advanced stage, resulting in limited treatment options and poor prognosis. To address key challenges in gastric cancer diagnosis and treatment, a research team led by Professor Jiafu Ji at Peking University Cancer Hospital has focused on the project "Development and Dissemination of Precision Medicine Approaches in Gastric Cancer Management". Through a series of high-quality multicenter clinical studies, the team established a set of new international standards in perioperative treatment, individua-lized drug selection, intelligent noninvasive diagnostics, and novel immunotherapy strategies. These advances have significantly improved treatment efficacy and reduced surgical trauma, achieving key technological breakthroughs in diagnosis, therapy, and mechanistic understanding, and systematically enhancing outcomes for gastric cancer patients. The project ' s findings had a broad international impact, including hosting China ' s first International Gastric Cancer Congress. Through nationwide dissemination, they have promoted the development of precision diagnosis and treatment of gastric cancer as a discipline, and led the formulation of the National Health Commission's guidelines for gastric cancer diagnosis and treatment. In recognition of its achievements, the project was awarded the First Prize of the 2024 Chinese Medical Science and Technology Award.
Stomach Neoplasms/genetics* ; Humans ; Precision Medicine/methods* ; China ; Immunotherapy/methods*

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Objective To investigate the release kinetics of Zn2+ from nZCP-loaded polylactic acid/hydroxyapatite(PLA/HA)composite scaffold(PHZ)and determine the optimal nZCP content in the scaffold.Methods The particle size of nZCP was measured by DLS measurement,and PXRD,FTIR,and SEM were used to characterize the scaffolds and nZCP distribution;EDS was used to analyze element composition of the scaffold.Compression strength of the scaffold was determined,and ion release profile was investigated using ICP-MS.The biocompatibility of the materials was evaluated by CCK-8 assay and dead/alive staining of rat bone marrow stem cells(BMSCs)incubated with their aqueous extracts.ALP staining,alizarin red staining,RT-qPCR,and Western blotting were used to assess the osteogenic potential of the treated cells.In a rat model of bilateral ovariectomy(OVX)with femoral condylar bone defect,PHZ-1,PHZ-2,PHZ-3 or PLA/HA scaffold was implanted into the bone defect,and bone repair was observed using a microCT scanner and histological staining at 6 and 12 weeks.Results DLS,PXRD,SEM,FTIR,and EDS confirmed successful synthesis of 10-nm ZCP and efficient nZCP loading in the scaffold.PHZ-2 and PHZ-3 had significantly greater compression strength than PLA/HA.ICP-MS showed that Zn2+ release from PHZ-1,PHZ-2 and PHZ-3 were all optimal for promoting osteogenesis.In rat BMSCs,all the 4 scaffolds showed good biocompatibility,and their extracts enhanced ALP activity and extracellular matrix mineralization and promoted expressions of ALP,RUNX2,and OCN in the cells.In the rat models,nZCP in the implants improved bone graft integration at 6 weeks,and PHZ-2 and PHZ-3 more effectively induced new bone formation at 12 weeks(P<0.05).Conclusion PHZ scaffold is capable of stable Zn2+ release to promote osteoporotic bone defect healing,and PHZ-2 and PHZ-3 scaffolds with nZCP mass fraction of 4.5%-7.5%have better osteogenic activity.

Since the 18th CPC National Congress,General Secretary Xi Jinping has attached great significance to health assistance for foreign countries,and has made a series of important instructions.China's health assistance for foreign countries has entered a new era of development and cooperation,and has made an important contribution to the promotion of building a global community of health for all.The First Affiliated Hospital,Sun Yat-sen University has actively responded to the national strategy and send medical experts to over 11 countries along the"Belt and Road"region,such as Ghana,Equatorial Guinea,Fi-ji,Serbia,Dominica,and so on.The First Affiliated Hospital,Sun Yat-sen University has won awards at home and abroad for its efforts,including the National Advanced Group for health assistance for foreign countries,the National Advanced Individual for health assistance for foreign countries,and the Serbian Government's Gold Medal of Merit.Taking medical experts in Serbia and Dominica as examples,the author focuses on building a global reputation,and summarizes a series of initiatives from The First Affiliated Hospital,Sun Yat-sen University,including the creation of a multi-level and whole-process management system,the cohesion of back-up strength for health assistance for foreign countries.

Objective To investigate the effect of resveratrol on endoplasmic reticulum stress and apoptosis in thyroid follicular cells induced by high iodine. Methods The thyroid follicular cell line Nthy-ori 3-1 was cultured in vitro and divided into four groups based on different culture methods: normal culture group (Normal group), high iodine group (HI group), resveratrol group (RES group), and high iodine combined with resveratrol group (HI+RES group). Cell proliferation activity was detected by CCK-8 assay, cell apoptosis was detected by TUNEL assay, and the BIP, CHOP, IRE1 mRNA expressions were detected by real-time quantitative polymerase chain reaction (PCR). Western blot was used to detect the protein expressions of BIP, CHOP, and IRE1. Results Compared with the Normal group, the proliferation activity of cells in the HI group decreased after 72 hours of culture, the proportion of apoptotic cells increased, the proportion of TUNEL staining positive cells increased, and the relative expressions of BIP, CHOP, IRE1 mRNA, as well as BIP and CHOP proteins were significantly elevated (P < 0.001 or P < 0.05). Compared with the HI group, the proliferation activity of cells in the HI+RES group increased after 72 hours of culture, the proportion of apoptotic cells decreased, the proportion of TUNEL staining positive cells decreased, and the relative expressions of BIP, CHOP mRNA, as well as BIP and CHOP proteins, were significantly reduced(P < 0.001 or P < 0.01). Conclusion Resveratrol exerts a protective effect on thyroid follicular cells induced by high iodine, significantly inhibiting endoplasmic reticulum stress and apoptosis caused by excessive iodine intake.

Objective To identify core genes of Alzheimer's disease (AD) through bioinformatic analysis and explore potential pathogenic signaling pathways. Methods Gene expression profiling data related to AD were downloaded from the Gene Expression Omnibus (GEO) database, with datasets GSE227221 and GSE162873 selected for analysis. GEO2R online analysis software was applied to screen differentially expressed genes (DEGs) between AD tissue samples and normal brain tissue samples. The Disease Ontology (DO) enrichment analysis of DEGs was performed using the DOSE package in R software, while Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted through the online data analysis tool DAVID. Protein-protein interactions (PPI) among genes were analyzed using the STRING database, and a PPI network was constructed with Cytoscape software. Hub genes within the PPI network were identified and screened using the MCODE plugin. Based on MCODE scores, further analysis was conducted to select core genes. Results A total of 1, 373 DEGs with consistent expression trends involved in the onset and progression of AD were identified from the two datasets, with the core genes of GIMAP genes (including GIMAP1, GIMAP4, GIMAP5, GIMAP6, GIMAP7, and GIMAP1-GIMAP5). DO enrichment analysis revealed the strongest associations between DEGs and three diseases: systemic lupus erythematosus, lupus erythematosus, and atherosclerosis. GO functional enrichment analysis indicated that DEGs were primarily enriched in three signaling pathways: the classical Wnt signaling pathway, phospholipase C-activated G protein-coupled receptor pathway, and plasma membrane lateral domain pathway. KEGG pathway enrichment analysis showed that DEGs were primarily enriched in pathways such as cytokine-cytokine receptor interaction, neuroactive ligand-receptor interaction, and cancer-related transcriptional dysregulation. Conclusion The core pathogenic gene of AD may be the GIMAP gene, and the associated pathways are complex, potentially implicating immune dysfunction.

Objective The efficacy and safety of pitolisant in the treatment of adult narcolepsy have been confirmed in clinical trials abroad， but there is a lack of data on the application of pitolisant in Chinese patients. The aim of this study is to investigate the efficacy and safety of pitolisant in the treatment of adult narcolepsy in China.Methods A total of 30 subjects were enrolled in this study and were given individualized titration once a day for 8 weeks. Epworth Somnolence Scale （EES） and daily cataplexy rate （DCR） were used as the primary outcome measures，and Clinical Global Impression-Severity scale（CGI-S） and Clinical Global Impression of Change Scale （CGI-C） were used as the secondary outcome measures；safety indicators included adverse event （AE） records and laboratory examination.Results The results showed that there were significant improvements in ESS score and number of cataplexy attacks after medication. At the end of treatment，ESS score was reduced by（7.63±4.79）（P<0.001）. For all subjects， the average daily number of cataplexy attacks was 0.83 at baseline，which was reduced significantly to （0.39±0.82）after 3 weeks of pitolisant treatment and（0.38±0.79）after 5 weeks of pitolisant treatment（P<0.05）. After the treatment ended， the median CGI-S score of excessive daytime sleepiness （EDS） improved from "severe" at baseline to "mild"（P<0.001）， and the CGI-S score of cataplexy improved from "mild" at baseline to "basically normal"（P<0.001）. Most AEs were mild and did not receive any drug treatment， and there were no significant changes in other laboratory markers used to monitor the general condition of the subjects before and after treatment. Conclusion Pitolisant has good efficacy and safety in the treatment of EDS and cataplexy in Chinese adults with narcolepsy.
Narcolepsy ; Histamine ; Cataplexy