Objective In order to investigate the patients'medical experiences,willingness to use online diagnosis and treatment in the context of"Internet+medical health",and the factors influencing these choice of medical channels.Methods We conducted an online and offline sampling survey through a questionnaire.1 215 questionnaires were distributed,and 1 010 were valid.After looking at the basic details of the survey participants,we used a logistic regression model to find out what affects patients'willingness to see a doctor online.Results Whether patients have solved their own problem,and the degree of help on the Internet play a significant role in the willingness to recommend Internet diagnosis and treatment.In addition,with the de-crease of age,the improvement of education level,the increase of economic development level of the city where the respondents live,and the decrease of medical expenditure in the past year,residents'willingness to use Internet diagnosis and treatment will show a gradually increasing trend.Conclusion Internet diagnosis and treatment in the future still need to further meet the needs of multi-group medical services,improve and perfect service quality and medical insurance management,to achieve"full node"coverage,"full chain"supervision.

Objective To investigate the effects of imatinib mesylate and sunitinib malate on the migration and invasion of gastroin-testinal stromal tumor(GIST)cells.Methods After identifying primary-cultured GIST cells,their morphology was characterized using atomic force microscopy(AFM).Changes in the expression of genes related to the PI3K/AKT signaling pathway were analyzed using quan-titative real-time PCR following drug treatments.Changes in the binding of related molecules were detected using AFM,and alterations in cell migration,invasive ability,and apoptosis were determined using scratch assay,Transwell assay,and flow cytometry,respectively.Results AFM imaging showed that pseudopods were flatly spread around the GIST cells,indicating characteristics consistent with easy metastasis.Administration of either imatinib or sunitinib significantly reduced the expression of genes related to the PI3K/AKT signaling pathway,the density of epidermal growth factor receptor(EGFR)on the surface of GIST cells,and molecular binding force with EGF.These changes were more pronounced with the combination treatment.Correspondingly,the invasive and migratory abilities of GIST cells were significantly reduced when either drug was administered alone and the inhibitory effect was more significant when the drugs were combined.Conclusion Both imatinib and sunitinib can significantly inhibit the expression of genes related to the PI3K/AKT signaling pathway,reduce the density of EGFR on the surface of GIST cells,and attenuate their molecular binding to EGF,thereby reducing the migration and invasion of GIST cells.However,the combination of these two drugs has a more significant effect.

Objective To investigate the mechanism of kaempferol(KPF)in the treatment of macular edema sec-ondary to retinal vein occlusion(RVO-ME).Methods RVO model was established in SD rats using photocoagulation.Twenty SD rats were randomly divided into:Control group(normal rats,saline injection),Model group(RVO model rats,saline injection),Low KPF group[RVO model rats,KPF injection(8 mg·kg-1·d-1)],High KPF group[RVO model rats,KPF injection(16 mg·kg-1·d-1)],with 5 rats per group for 14 days.Fundus photography observed retinal vessels;HE staining evaluated retinal structural changes.HRMECs were randomly divided into:control group(no intervention),CoCl2 group(300 μmol·L-1 CoCl2),Low-dose KPF group(300 μmol·L-1 CoCl2+20 μmol·L-1 KPF),High-dose KPF group(300 μmol·L-1 CoCl2+30 μmol·L-1 KPF)and pathway inhibitor group(DAPT group)(300 μmol·L-1 CoCl2+20 μmol·L-1 DAPT),with 24-hour intervention.CCK-8 assay detected cell viability;Scratch test measured cell migration rate;ELISA quantified inflammatory factors[interleukin(IL)-6,tumor necrosis factor(TNF)-α];FITC-dextran assay evalu-ated endothelial monolayer permeability;Immunofluorescence detected zonula occludens(ZO)-1 expression;Western blot and RT-PCR measured protein and mRNA levels of ZO-1,Occludin,Notch1,and Hes1.Results Fundus photography showed interrupted venous blood flow and retinal edema in Model group,alleviated by KPF.HE staining revealed disorder-ed retinal arrangement and severe edema in the Model group,improved by KPF.Compared with CoCl2 group,Low-and High-dose KPF groups showed reduced cell migration rate,increased cell vitality(both P＜0.05),IL-6 and TNF-α levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),permeability coefficient decreased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 expression increased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 and Occludin protein/mRNA levels increased;Notch1 and Hes1 protein/mRNA levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05).Conclusion KPF treat RVO-ME by inhibiting the Notch1/Hes1 pathway,exerting anti-inflammatory effects and improving intercellular tight junctions.

Objective In order to investigate the patients'medical experiences,willingness to use online diagnosis and treatment in the context of"Internet+medical health",and the factors influencing these choice of medical channels.Methods We conducted an online and offline sampling survey through a questionnaire.1 215 questionnaires were distributed,and 1 010 were valid.After looking at the basic details of the survey participants,we used a logistic regression model to find out what affects patients'willingness to see a doctor online.Results Whether patients have solved their own problem,and the degree of help on the Internet play a significant role in the willingness to recommend Internet diagnosis and treatment.In addition,with the de-crease of age,the improvement of education level,the increase of economic development level of the city where the respondents live,and the decrease of medical expenditure in the past year,residents'willingness to use Internet diagnosis and treatment will show a gradually increasing trend.Conclusion Internet diagnosis and treatment in the future still need to further meet the needs of multi-group medical services,improve and perfect service quality and medical insurance management,to achieve"full node"coverage,"full chain"supervision.

Objective To investigate the mechanism of kaempferol(KPF)in the treatment of macular edema sec-ondary to retinal vein occlusion(RVO-ME).Methods RVO model was established in SD rats using photocoagulation.Twenty SD rats were randomly divided into:Control group(normal rats,saline injection),Model group(RVO model rats,saline injection),Low KPF group[RVO model rats,KPF injection(8 mg·kg-1·d-1)],High KPF group[RVO model rats,KPF injection(16 mg·kg-1·d-1)],with 5 rats per group for 14 days.Fundus photography observed retinal vessels;HE staining evaluated retinal structural changes.HRMECs were randomly divided into:control group(no intervention),CoCl2 group(300 μmol·L-1 CoCl2),Low-dose KPF group(300 μmol·L-1 CoCl2+20 μmol·L-1 KPF),High-dose KPF group(300 μmol·L-1 CoCl2+30 μmol·L-1 KPF)and pathway inhibitor group(DAPT group)(300 μmol·L-1 CoCl2+20 μmol·L-1 DAPT),with 24-hour intervention.CCK-8 assay detected cell viability;Scratch test measured cell migration rate;ELISA quantified inflammatory factors[interleukin(IL)-6,tumor necrosis factor(TNF)-α];FITC-dextran assay evalu-ated endothelial monolayer permeability;Immunofluorescence detected zonula occludens(ZO)-1 expression;Western blot and RT-PCR measured protein and mRNA levels of ZO-1,Occludin,Notch1,and Hes1.Results Fundus photography showed interrupted venous blood flow and retinal edema in Model group,alleviated by KPF.HE staining revealed disorder-ed retinal arrangement and severe edema in the Model group,improved by KPF.Compared with CoCl2 group,Low-and High-dose KPF groups showed reduced cell migration rate,increased cell vitality(both P＜0.05),IL-6 and TNF-α levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),permeability coefficient decreased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 expression increased in Low-and High-dose KPF groups and DAPT group(all P＜0.05),ZO-1 and Occludin protein/mRNA levels increased;Notch1 and Hes1 protein/mRNA levels de-creased in Low-and High-dose KPF groups and DAPT group(all P＜0.05).Conclusion KPF treat RVO-ME by inhibiting the Notch1/Hes1 pathway,exerting anti-inflammatory effects and improving intercellular tight junctions.

Objective To investigate the effects of imatinib mesylate and sunitinib malate on the migration and invasion of gastroin-testinal stromal tumor(GIST)cells.Methods After identifying primary-cultured GIST cells,their morphology was characterized using atomic force microscopy(AFM).Changes in the expression of genes related to the PI3K/AKT signaling pathway were analyzed using quan-titative real-time PCR following drug treatments.Changes in the binding of related molecules were detected using AFM,and alterations in cell migration,invasive ability,and apoptosis were determined using scratch assay,Transwell assay,and flow cytometry,respectively.Results AFM imaging showed that pseudopods were flatly spread around the GIST cells,indicating characteristics consistent with easy metastasis.Administration of either imatinib or sunitinib significantly reduced the expression of genes related to the PI3K/AKT signaling pathway,the density of epidermal growth factor receptor(EGFR)on the surface of GIST cells,and molecular binding force with EGF.These changes were more pronounced with the combination treatment.Correspondingly,the invasive and migratory abilities of GIST cells were significantly reduced when either drug was administered alone and the inhibitory effect was more significant when the drugs were combined.Conclusion Both imatinib and sunitinib can significantly inhibit the expression of genes related to the PI3K/AKT signaling pathway,reduce the density of EGFR on the surface of GIST cells,and attenuate their molecular binding to EGF,thereby reducing the migration and invasion of GIST cells.However,the combination of these two drugs has a more significant effect.

Objective:To explore the occurrence of medication errors (MEs) involving cytotoxic drugs in pharmacy intravenous admixture service (PIVAS).Methods:All the prescriptions containing cytotoxic drugs from January 2016 to December 2019 in PIVAS in Peking University Cancer Hospital were collected using the hospital information system. ME records found by pharmacists during the prescription review were screened out (defined as prescription error) and "the medication error record book" was searched to screen out MEs in PIVAS (defined as admixture errors) in the same period. Descriptive analysis was conducted on the grade, classification, links in which the MEs occurred, people who triggered, ME content, and the involved cytotoxic drugs of these MEs. In addition, the MEs that were not found in PIVAS but passed to the next link were defined as out-door errors.Results:A total of 347 367 prescriptions involving cytotoxic drugs were received in PIVAS in our hospital during the study period, in which 1 080 MEs were found, and the incidence of ME was 0.31%. The 1 080 MEs were all grade B errors that did not cause patient harm, of which 841 (77.87%) were prescription errors and 239 (22.13%) were admixture errors. Five MEs were not intercepted and led to out-door errors and the incidence of out-door errors was 0.01‰(5/347 367). The top 5 ME contents were wrong solvent (63.15%, 682/1 080), incomplete prescription (11.67%, 126/1 080), wrong number (8.80%, 95/1 080), wrong dose (6.11%, 66/1 080), and wrong method in intravenous administration (4.35%, 47/1 080). A total of 32 cytotoxic drugs were involved in 1 080 MEs and the top 5 were paclitaxels (23.24%, 251/1 080), fluorouracil (12.59%, 136/1 080), doxorubicin (6.39%, 69/1 080), cisplatin (5.46%, 59/1 080), and etoposide (5.37%, 58/1 080).Conclusions:The incidence of ME was 0.31% in PIVAS in our hospital, all of which were grade B errors. The errors mainly were prescription errors, the main contents were wrong solvent, and the main drugs involved were paclitaxels, fluorouracil, doxorubicin, cisplatin, and etoposide.

Objective:To explore the occurrence of medication errors (MEs) involving cytotoxic drugs in pharmacy intravenous admixture service (PIVAS).Methods:All the prescriptions containing cytotoxic drugs from January 2016 to December 2019 in PIVAS in Peking University Cancer Hospital were collected using the hospital information system. ME records found by pharmacists during the prescription review were screened out (defined as prescription error) and "the medication error record book" was searched to screen out MEs in PIVAS (defined as admixture errors) in the same period. Descriptive analysis was conducted on the grade, classification, links in which the MEs occurred, people who triggered, ME content, and the involved cytotoxic drugs of these MEs. In addition, the MEs that were not found in PIVAS but passed to the next link were defined as out-door errors.Results:A total of 347 367 prescriptions involving cytotoxic drugs were received in PIVAS in our hospital during the study period, in which 1 080 MEs were found, and the incidence of ME was 0.31%. The 1 080 MEs were all grade B errors that did not cause patient harm, of which 841 (77.87%) were prescription errors and 239 (22.13%) were admixture errors. Five MEs were not intercepted and led to out-door errors and the incidence of out-door errors was 0.01‰(5/347 367). The top 5 ME contents were wrong solvent (63.15%, 682/1 080), incomplete prescription (11.67%, 126/1 080), wrong number (8.80%, 95/1 080), wrong dose (6.11%, 66/1 080), and wrong method in intravenous administration (4.35%, 47/1 080). A total of 32 cytotoxic drugs were involved in 1 080 MEs and the top 5 were paclitaxels (23.24%, 251/1 080), fluorouracil (12.59%, 136/1 080), doxorubicin (6.39%, 69/1 080), cisplatin (5.46%, 59/1 080), and etoposide (5.37%, 58/1 080).Conclusions:The incidence of ME was 0.31% in PIVAS in our hospital, all of which were grade B errors. The errors mainly were prescription errors, the main contents were wrong solvent, and the main drugs involved were paclitaxels, fluorouracil, doxorubicin, cisplatin, and etoposide.

Objective To evaluate the cardiac safety of trastuzumab﹣containing regimens in patients with HER2﹣positive tumors. Methods The clinical data of adult patients with HER2﹣positive breast cancer,gastric cancer or gastroesophageal junction adenocarcinoma,with normal electrocardiogram and echocardiography before treatments,and treated with trastuzumab﹣containing regimens in Zhongshan Hospital Affiliated to Fudan University from January 2016 to February 2018 were collected through the hospital information system and cardiac adverse events after trastuzumab﹣containing regimens were retrospectively analyzed. ,The patients were divided into 4 groups according to the application history of antineoplastic drugs:group A ( neither anthracyclines nor fluoropyrimidines application history ), group B ( only anthracyclines application history),group C( only fluoropyrimidines application history),and group D (both anthracyclines and fluoropyrimidines application history). The occurrences of cardiac adverse events in the 4 groups were compared. Results A total of 90 patients were enrolled,including 34 males and 56 females,aged(60 ± 12)years. Of them,43 patients(47. 8% )were with breast cancer,46(51. 1% ) were with gastric cancer,and 1(1. 1% )was with gastroesophageal junction adenocarcinoma. Group A,B, C,and D comprised 11,20,52,and 7 patients,respectively. Of the 90 patients,65 patients developed 96 cases of adverse cardiac events. The incidence of adverse cardiac events was 72. 2% . The severity of cardiac adverse events was grade 1 in 91 cases and grade 2 in 5 cases. The adverse events with higher incidence were arrhythmia( 36. 7% ,33/90 ),abnormal cardiac structure ( 22. 2% ,20/90 ), valvular reflux (22. 2% ,20/90),and increased pulmonary arterial systolic pressure( 10. 0% ,9/90 ). There was no significant difference in the incidence of cardiac adverse events after trastuzumab treatment in patients with different antineoplastic drug application history among the 4 groups(all P﹥0. 05). Except for 2 patients with grade 2 sinus tachycardia whose heart rate returned to normal after treatment with beta﹣blocker,the other 63 patients did not need medical intervention. Conclusion The incidence of cardiac adverse events of trastuzumab treatment in patients with HER2﹣positive tumors was higher,but the severity of most of them were grade 1,which rarely cause serious cardiac functional or structural damage.

Objective To evaluate the cardiac safety of trastuzumab﹣containing regimens in patients with HER2﹣positive tumors. Methods The clinical data of adult patients with HER2﹣positive breast cancer,gastric cancer or gastroesophageal junction adenocarcinoma,with normal electrocardiogram and echocardiography before treatments,and treated with trastuzumab﹣containing regimens in Zhongshan Hospital Affiliated to Fudan University from January 2016 to February 2018 were collected through the hospital information system and cardiac adverse events after trastuzumab﹣containing regimens were retrospectively analyzed. ,The patients were divided into 4 groups according to the application history of antineoplastic drugs:group A ( neither anthracyclines nor fluoropyrimidines application history ), group B ( only anthracyclines application history),group C( only fluoropyrimidines application history),and group D (both anthracyclines and fluoropyrimidines application history). The occurrences of cardiac adverse events in the 4 groups were compared. Results A total of 90 patients were enrolled,including 34 males and 56 females,aged(60 ± 12)years. Of them,43 patients(47. 8% )were with breast cancer,46(51. 1% ) were with gastric cancer,and 1(1. 1% )was with gastroesophageal junction adenocarcinoma. Group A,B, C,and D comprised 11,20,52,and 7 patients,respectively. Of the 90 patients,65 patients developed 96 cases of adverse cardiac events. The incidence of adverse cardiac events was 72. 2% . The severity of cardiac adverse events was grade 1 in 91 cases and grade 2 in 5 cases. The adverse events with higher incidence were arrhythmia( 36. 7% ,33/90 ),abnormal cardiac structure ( 22. 2% ,20/90 ), valvular reflux (22. 2% ,20/90),and increased pulmonary arterial systolic pressure( 10. 0% ,9/90 ). There was no significant difference in the incidence of cardiac adverse events after trastuzumab treatment in patients with different antineoplastic drug application history among the 4 groups(all P﹥0. 05). Except for 2 patients with grade 2 sinus tachycardia whose heart rate returned to normal after treatment with beta﹣blocker,the other 63 patients did not need medical intervention. Conclusion The incidence of cardiac adverse events of trastuzumab treatment in patients with HER2﹣positive tumors was higher,but the severity of most of them were grade 1,which rarely cause serious cardiac functional or structural damage.