Objective:To evaluate the safety of neoadjuvant therapy with pembrolizumab combined with 5-fluorouracil (5-FU) and cisplatin in patients with advanced temporal bone squamous cell carcinoma (TBSCC), and its impact on tumor response rate and disease-free survival (DFS).Methods:This prospective, single-arm, open-label clinical study enrolled patients with advanced (Stage Ⅲ/Ⅳ) TBSCC from Sun Yat-sen Memorial Hospital. Patients received 2-3 cycles of neoadjuvant therapy with pembrolizumab, 5-FU, and cisplatin, followed by definitive surgery. Postoperatively, patients received 6 cycles of pembrolizumab combined with radiotherapy. The primary endpoint was the 2-year disease-free survival (DFS) rate. Secondary endpoints included objective response rate (ORR) and safety indicators. Survival analysis was performed using the Kaplan-Meier method. Adverse events (AE) were assessed using the National Cancer Institute′s Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Statistical analyses were conducted using SPSS software, version 22.0.Results:From August 2021 to April 2024, 16 patients with advanced TBSCC were enrolled (13 males and 3 females), with a median age of 54 years and a median follow-up time of 2.32 years. Following neoadjuvant therapy, the objective response rate (ORR) was 64.3% (9/14), and the disease control rate (DCR) was 92.9% (13/14). The 2-year DFS rate was 86.6%. Common treatment-related adverse events (TRAE) included leukopenia (56.3%, 9/16), nausea and vomiting (50.0%, 8/16), diarrhea, oral mucositis, and elevated liver function tests (25.0%, 4/16). One patient (6.25%) experienced a grade 3 adverse event.Conclusion:Neoadjuvant pembrolizumab-chemotherapy significantly enhances objective response rate and disease-free survival in advanced TBSCC.

To promote the primary Traditional Chinese Medicine(TCM)service capacity,promote the high development of TCM in County Medical Communities,it takes Jinjiang as the subject to explore the construction path of TCM service system in County Medical Communities based on"healthcare,medical insurance and medicine"linkage reform.A tertiary TCM service network of"city-town-village"is constructed through implementing"three projects"and"six enhancements".The mode significantly improved the service accessibility of TCM,and formed the innovation mechanism,including differentiation appraisal system and"pharmacy sharing online",etc.It explores the practical challenges of human resources weakness and insufficient information exchange,promotes the improvement strategies of enhancing talent group construction and promoting information platform,so as to provide practical references for contructing the TCM service system of County Medical Communities in China.

Objective To mine the risk signals of adverse drug events(ADEs)related to lecanemab through the U.S.Food and Drug Adminstration Adverse Event Reporting System(FAERS)database,to provide a reference for the safe clinical use of lecanemab.Methods Data on adverse events related to lecanemab from the fourth quarter,2010 to the second quarter 2024 in the FAERS were collected.Potential ADE signals were mined using the reporting odds ratio(ROR)method,Medicines and Healthcare Products Regulatory Agency(MHRA)method,Bayesian confidence propagation neural network(BCPNN)method and multi-item gamma Poisson shrinker(MGPS)method.The top 30 ADEs in terms of report frequency and signal strength,as well as ADEs categorized by system organ class(SOC),were statistically analyzed.Results A total of 868 adverse event reports related to lecanemab were collected,involving 1,986 instances of ADEs with 38 related ADE identified,the proportion of serious ADEs was 23.39％,and 87.15％of ADEs occurred in the first 3 months after the initiation of the drug.The top 30 PT signals in reported cases were headache,chills,fatigue,effusion type amyloid-related imaging abnormalities(ARIA-E),hemorrhage-type amyloid-related imaging abnormalities(ARIA-H),and so on.The top 30 signals in terms of signal intensity mainly included ARIA-E,ARIA-H,brain fog,infusion-related reactions.ADEs related to nervous system diseases were the most common.Fifteen new suspected or serious ADEs not recorded in the instructions were discovered,such as brain fog,formication,status epilepticus.Conclusion Risk assessment of patients'medication should be conducted before clinical use of lecanemab,especially in the first 3 months of the medication period,focus should be placed on monitoring common ADEs,such as ARIA-E,ARIA-H,infusion-related reactions.Attention also needs to be paid to the newly discovered suspected ADEs,to ensure the patients'medication safety.

Objective:It aims to explore the advantages,disadvantages,opportunities and challenges of Chinese medicine practitioners participating in the"three-division co-management"service model in diabetes management,analyze its performance in policy support,resource matching and patient satisfaction,and put forward optimization strategies to enhance the role of Chinese medicine practitioners in chronic disease management.Methods:Through literature analysis,questionnaire survey and semi-structured interview,the data of six pilot units of"three divisions co-management"in Jinjiang were collected,and the internal and external environment of Chinese medicine practitioners participating in the"three divisions co-management"model was systematically evaluated by the Strengths,Weaknesses,Opportunities,Threats(SWOT)and the Politics,Economic,Society,Technology(PEST).Results:Chinese medicine practitioners' participation in the"three-division co-management"model has obvious advantages in policy support,resource matching and patient satisfaction,but it also faces key obstacles such as lack of incentive mechanism,shortage of Chinese medicine practitioners' resources and limitation of medical insurance reimbursement.The survey shows that 99.7％of the respondents are willing to choose this mode again,and 96.43％of the respondents said that the medical experience has improved significantly.However,43.92％of the subjects think that the professional knowledge and skills of doctors need to be improved,and 32.2％of the subjects think that the effect of Chinese medicine treatment on reducing the dependence and side effects of western medicine is limited.Conclusion:It is feasible and practical for Chinese medicine practitioners to participate in the"three divisions co-management"model,but it is necessary to further improve its service effect and sustainability by improving the performance appraisal mechanism,expanding the scope of medical insurance reimbursement,and strengthening the training for Chinese medicine practitioners' resources.

To promote the primary Traditional Chinese Medicine(TCM)service capacity,promote the high development of TCM in County Medical Communities,it takes Jinjiang as the subject to explore the construction path of TCM service system in County Medical Communities based on"healthcare,medical insurance and medicine"linkage reform.A tertiary TCM service network of"city-town-village"is constructed through implementing"three projects"and"six enhancements".The mode significantly improved the service accessibility of TCM,and formed the innovation mechanism,including differentiation appraisal system and"pharmacy sharing online",etc.It explores the practical challenges of human resources weakness and insufficient information exchange,promotes the improvement strategies of enhancing talent group construction and promoting information platform,so as to provide practical references for contructing the TCM service system of County Medical Communities in China.

Objective:It aims to explore the advantages,disadvantages,opportunities and challenges of Chinese medicine practitioners participating in the"three-division co-management"service model in diabetes management,analyze its performance in policy support,resource matching and patient satisfaction,and put forward optimization strategies to enhance the role of Chinese medicine practitioners in chronic disease management.Methods:Through literature analysis,questionnaire survey and semi-structured interview,the data of six pilot units of"three divisions co-management"in Jinjiang were collected,and the internal and external environment of Chinese medicine practitioners participating in the"three divisions co-management"model was systematically evaluated by the Strengths,Weaknesses,Opportunities,Threats(SWOT)and the Politics,Economic,Society,Technology(PEST).Results:Chinese medicine practitioners' participation in the"three-division co-management"model has obvious advantages in policy support,resource matching and patient satisfaction,but it also faces key obstacles such as lack of incentive mechanism,shortage of Chinese medicine practitioners' resources and limitation of medical insurance reimbursement.The survey shows that 99.7％of the respondents are willing to choose this mode again,and 96.43％of the respondents said that the medical experience has improved significantly.However,43.92％of the subjects think that the professional knowledge and skills of doctors need to be improved,and 32.2％of the subjects think that the effect of Chinese medicine treatment on reducing the dependence and side effects of western medicine is limited.Conclusion:It is feasible and practical for Chinese medicine practitioners to participate in the"three divisions co-management"model,but it is necessary to further improve its service effect and sustainability by improving the performance appraisal mechanism,expanding the scope of medical insurance reimbursement,and strengthening the training for Chinese medicine practitioners' resources.

Objective To mine the risk signals of adverse drug events(ADEs)related to lecanemab through the U.S.Food and Drug Adminstration Adverse Event Reporting System(FAERS)database,to provide a reference for the safe clinical use of lecanemab.Methods Data on adverse events related to lecanemab from the fourth quarter,2010 to the second quarter 2024 in the FAERS were collected.Potential ADE signals were mined using the reporting odds ratio(ROR)method,Medicines and Healthcare Products Regulatory Agency(MHRA)method,Bayesian confidence propagation neural network(BCPNN)method and multi-item gamma Poisson shrinker(MGPS)method.The top 30 ADEs in terms of report frequency and signal strength,as well as ADEs categorized by system organ class(SOC),were statistically analyzed.Results A total of 868 adverse event reports related to lecanemab were collected,involving 1,986 instances of ADEs with 38 related ADE identified,the proportion of serious ADEs was 23.39％,and 87.15％of ADEs occurred in the first 3 months after the initiation of the drug.The top 30 PT signals in reported cases were headache,chills,fatigue,effusion type amyloid-related imaging abnormalities(ARIA-E),hemorrhage-type amyloid-related imaging abnormalities(ARIA-H),and so on.The top 30 signals in terms of signal intensity mainly included ARIA-E,ARIA-H,brain fog,infusion-related reactions.ADEs related to nervous system diseases were the most common.Fifteen new suspected or serious ADEs not recorded in the instructions were discovered,such as brain fog,formication,status epilepticus.Conclusion Risk assessment of patients'medication should be conducted before clinical use of lecanemab,especially in the first 3 months of the medication period,focus should be placed on monitoring common ADEs,such as ARIA-E,ARIA-H,infusion-related reactions.Attention also needs to be paid to the newly discovered suspected ADEs,to ensure the patients'medication safety.

Objective:To evaluate the safety of neoadjuvant therapy with pembrolizumab combined with 5-fluorouracil (5-FU) and cisplatin in patients with advanced temporal bone squamous cell carcinoma (TBSCC), and its impact on tumor response rate and disease-free survival (DFS).Methods:This prospective, single-arm, open-label clinical study enrolled patients with advanced (Stage Ⅲ/Ⅳ) TBSCC from Sun Yat-sen Memorial Hospital. Patients received 2-3 cycles of neoadjuvant therapy with pembrolizumab, 5-FU, and cisplatin, followed by definitive surgery. Postoperatively, patients received 6 cycles of pembrolizumab combined with radiotherapy. The primary endpoint was the 2-year disease-free survival (DFS) rate. Secondary endpoints included objective response rate (ORR) and safety indicators. Survival analysis was performed using the Kaplan-Meier method. Adverse events (AE) were assessed using the National Cancer Institute′s Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. Statistical analyses were conducted using SPSS software, version 22.0.Results:From August 2021 to April 2024, 16 patients with advanced TBSCC were enrolled (13 males and 3 females), with a median age of 54 years and a median follow-up time of 2.32 years. Following neoadjuvant therapy, the objective response rate (ORR) was 64.3% (9/14), and the disease control rate (DCR) was 92.9% (13/14). The 2-year DFS rate was 86.6%. Common treatment-related adverse events (TRAE) included leukopenia (56.3%, 9/16), nausea and vomiting (50.0%, 8/16), diarrhea, oral mucositis, and elevated liver function tests (25.0%, 4/16). One patient (6.25%) experienced a grade 3 adverse event.Conclusion:Neoadjuvant pembrolizumab-chemotherapy significantly enhances objective response rate and disease-free survival in advanced TBSCC.

Objective:To build a nursing care plan decision-making support system based on the hospital's nursing information system and evaluate its effects in newly hired nurses.Methods:This study adopted a non-synchronous pre-post control design. Totally 181 newly hired nurses recruited by Beijing Tiantan Hospital, Capital Medical University, were selected by convenience sampling. The control group consisted of 85 new nurses hired in August 2021, while the intervention group consisted of 96 new nurses hired in August 2022. The control group received traditional training methods, while the intervention group received training through the nursing care plan decision-making support system in addition to the traditional methods. The nursing decision-making ability and the quality of specialty nursing care were compared between the two groups.Results:Finally, 81 nurses were included in the control group, and 93 nurses were included in the intervention group. The nursing decision-making ability score in the intervention group was (80.15±4.59), which was significantly higher than the (78.62±5.13) in the control group ( t=-2.080, P=0.039). The intervention group also had a significantly higher qualified rate of specialty nursing care compared to the control group (χ 2=6.626, P=0.036) . Conclusions:The application of the nursing care plan decision-making support system in the standardized training of newly hired nurses can improve their nursing decision-making abilities and the quality of specialty nursing care.

Objective To investigate the protective effect of total flavonoids of Salvia divinorum extract against acetaminophen(APAP)-induced acute liver injury(ALI)and its molecular mechanism.Methods The main chemical constituents of total flavonoids of Salvia divinorum were obtained through literature search,and their pharmacological mechanisms were predicted using bioinformatics analysis.In a mouse model of APAP-induced ALI,the protective effects of 100,200 and 400 mg/kg total flavonoids of Salvia miltiorrhiza and 150 mg/kg bifidus were evaluated by observing changes in blood biochemistry and liver histopathology and detecting expressions of the key proteins in the Nrf2/HO-1 signaling pathway.Results Network pharmacology analysis suggested that the main active components in total flavonoids of Salvia divinorum for regulating APAP-induced liver injury included quercetin,lignocerol,caruric acid,and kaempferol,for which GO function enrichment analysis yielded 632 GO entries,including 472 involving biological processes,42 involving cellular composition,and 118 involving molecular function.KEGG enrichment analysis showed that the total flavonoids of Salvia divinorum regulated APAP-induced liver injury mainly through ferroptosis-related signaling pathway.In mice with APAP-induced ALI,treatment with the total flavonoids significantly lowered ALT and AST levels,improved liver histopathology and inflammatory cell infiltration,reduced iron deposition in liver tissues,improved lipid peroxidation-related indexes,promoted the expressions of Nrf2,HO-1,SLC7A11,and GPX-4 proteins,and inhibited the expression of keap1 protein.Conclusion The total flavonoids of Salvia divinorum alleviate APAP-induced ALI in mice possibly by suppressing hepatocyte ferroptosis via activating the Nrf2/SLC7A11/GPX-4 signaling pathway.