OBJECTIVES: To assess the preliminary efficacy and safety of a dose-intensified C5VD regimen (cisplatin, 5-fluorouracil, vincristine, and doxorubicin) in children with locally advanced hepatoblastoma. METHODS: This prospective study enrolled 24 children with newly diagnosed, locally advanced hepatoblastoma who received the dose-intensified C5VD regimen at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, and Shanghai Children's Hospital between January 2020 and December 2023. Clinical characteristics, treatment outcomes, and chemotherapy-related toxicities were analyzed. RESULTS: Of the 24 patients, 13 were male and 11 were female, with a median age at diagnosis of 18.7 months (range: 3.5-79.4 months). All patients achieved complete macroscopic resection of hepatic lesions without liver transplantation. Serum alpha-fetoprotein levels decreased significantly after two chemotherapy cycles. During a median follow-up of 38.4 months (range: 15.8-50.7 months), all patients maintained continuous complete remission, with 3-year event-free survival and overall survival rates of 100%. Across 144 chemotherapy cycles, the incidence rates of grade 3-4 neutropenia, thrombocytopenia, and infections were 97%, 77%, and 71%, respectively; no treatment-related deaths occurred. Notably, 5 patients (21%) developed Brock grade ≥3 hearing loss, of whom 1 required a hearing aid. CONCLUSIONS The dose-intensified C5VD regimen demonstrates significant efficacy with an overall favorable safety profile in the treatment of newly diagnosed, locally advanced pediatric hepatoblastoma. Grade 3-4 myelosuppression and infection are the predominant toxicities. However, high‑dose cisplatin-induced ototoxicity remains a concern, highlighting the need for improved otoprotective strategies.
Humans ; Hepatoblastoma/pathology* ; Male ; Female ; Infant ; Liver Neoplasms/pathology* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Child, Preschool ; Prospective Studies ; Doxorubicin/adverse effects* ; Child ; Cisplatin/adverse effects* ; Vincristine/adverse effects* ; Fluorouracil/adverse effects*

OBJECTIVE To optimize drug treatment plans for patients in cardiovascular FM35 disease group using full-process pharmaceutical services， and achieve the goals of ensuring patient medication safety and controlling drug costs. METHODS Overall 213 patients in the cardiovascular FM35 disease group who were discharged from July to August 2023 were selected as control group； all medical orders were screened and complex network analysis and drug evaluation standards of our hospital were used to establish an optimized treatment drug library； 83 FM35 patients who newly admitted to the cardiovascular department in September 2023 were selected as intervention group； a model of policy promotion-treatment plan intervention was established and applied to provide full process pharmaceutical services to patients. The treatment cost， length of stay and outcome were analyzed and compared between 2 groups. RESULTS Through the full process pharmaceutical services provided by clinical pharmacists， compared with the control group， the total hospitalization cost， drug cost， drug proportion， and case proportion of medical insurance settlement amount in the intervention group significantly decreased （P＜0.05）. The median length of hospital stay in the intervention group was shortened by 1 d， and the discharge improvement outcome rates of both groups of patients were ≥99%. CONCLUSIONS Clinical pharmacists can effectively improve the efficiency of medical services and save the medical costs through full-process pharmaceutical services， meanwhile ensuring medical quality and safety. This can effectively assist in the smooth implementation of DRGs.

ObjectivesTo investigate the effect of acupuncture intervention at different time during the acute phase of ischemic stroke on limb motor dysfunction 6 months after onset. MethodsThe enrolled ischemic stroke patients from four tertiary hospitals all received western basic treatment for ≥14 days； additionally， they were given the cleaning-mind and opening-orifices acupuncture method， with acupuncture at bilateral Neiguan （PC 6）， Shuigou （GV 26）， and Sanyinjiao （SP 6） of the affected side， once a day for at least 2 times. Three cohorts were formed by the timing of acupuncture intervention of the onset of the disease within 10 days， namely， the acupuncture group of 1-3 days after onset of the disease （195 cases）， the acupuncture group of 4-7 days after onset of the disease （171 cases）， and the acupuncture group of 8-10 days after onset of the disease （96 cases）. Propensity score matching was performed using R4.3.3 software， and there were 89 patients in each of the three groups after matching. Modified Rankin Scale （mRS） score， Fugl-Meyer Scale （FMA） score， EuroQoL 5-Dimension 5-Level （EQ-5D-5L） score and the proportion of good functional outcome were observed in the 3 groups of patients before treatment and 6 months after onset. A logistic regression model was constructed to analyse the effect of the timing of acupuncture intervention on the effectiveness of acupuncture treatment for limb motor dysfunction in ischaemic stroke. ResultsCompared with the pre-treatment of this group， mRS and EQ-5D-5L scores decreased and FMA increased in all three groups 6 months after onset （P＜0.01）， and all the indexes of the onset 1-3 days acupuncture group and the onset 4-7 days acupuncture group were better than those of the onset 8-10 days acupuncture group （P＜0.05）. The proportions of good functional outcome in the onset 1-3 days acupuncture group， the onset 4-7 days acupuncture group， and the onset 8-10 days acupuncture group were 76.40%， 80.90%， and 57.30%， respectively， and the proportions of good functional outcome in the onset 1-3 days acupuncture group and the onset 4-7 days acupuncture group were significantly higher than those in the onset 8-10 days acupuncture group （P＜0.05）. Multifactorial logistic analysis showed that compared with the group with 8-10 days of onset， the group with 1-3 days of onset （OR=2.796， 95%CI： 1.340~5.836， P = 0.006）， and the group with 4-7 days of onset （OR=3.482， 95%CI： 1.647~7.362， P = 0.001） increased the likelihood that patients would be nondisabled 6 months after onset. ConclusionThe intervention of cleaning-mind and opening-orifices acupuncture within 1-7 days of onset for patients with acute ischemic stroke can reduce the rate of disability 6 months after onset， improve limb motor function， and enhance the quality of life.

Interventions for endometriosis(EMs)include surgical excision of lesions and hormonal therapy,which usually have limited efficacy and adverse drug reactions.Traditional Chinese medicine(TCM)has the multi-component and multi-target characteristics,which can help patients achieve good clinical benefits by intervening in different parts of the disease.In this paper,we briefly discuss the modern pharmacology of Sanlang and Curcuma longa,and deeply summarize the possible mechanisms of action of TCM monomer and classical compound extracts and their active ingredients through signal pathways in inflammation,immune system,angiogenesis,hormone regulation,etc.,so as to provide theoretical bases for the clinical use of TCM monomers,drug-to-drug groups and compounds in the treatment of EMs.

Objective To provide a longitudinal evaluation tool based on the frequency of aggressive be-havior for the aggression assessment of schizophrenia patients.Methods The Life History of Aggression was translated and revised to form the Life History of Aggression-Chinese Version(LHA-CV)based on 369 patients diagnosed with schizophrenia in the Chengdu community and compulsory medical insti-tution.The reliability of LHA-CV was analyzed by means of split-half reliability,test-retest reliability and inter-evaluator consistency.The validity was analyzed by item analysis,construct validity and crite-rion validity.Results Item analysis found that LHA-CV had good homogeneity and discriminant validity.Exploratory factor analysis found that the Kaiser-Meyer-Olkin(KMO)test value was 0.80,and the Bartlett's sphericity test χ2=1203.46(P<0.05),and it revealed four factors including non-physical ag-gression,physical aggression,self-directed aggression and antisocial behavior/consequences.The factor loadings for all 11 items were greater than 0.40.Confirmatory factor analysis was performed on the factor model,Chi-square degree of freedom(χ2/df)was 3.61,root mean square error of approxima-tion(RMSEA)was 0.07,goodness-of-fit index(GFI)was 0.92,comparative fit index(CFI)was 0.90,incremental fit index(IFI)was 0.90,and the discriminant validity of each factor was good.The criterion validity test showed the total score of LHA-CV was positively correlated with the aggressive behavior level of MacArthur Community Violence Instrument,the total score of Buss-Perry Aggression Scale,and the score of Antisocial Personality Disorder Subscale of Personality Diagnostic Question-naire-4th Edition Plus(PDQ-4+_ASPD,P<0.05).The Cronbach's α coefficient of non-physical aggres-sion,physical aggression,self-directed aggression,antisocial behavior/consequences and LHA-CV total score were 0.82,0.73,0.74,0.56 and 0.79,respectively.The test-retest reliability,Spearman-Brown split-half reliability and intra-class correlation coefficient of LHA-CV total score were 0.82(P<0.05),0.66 and 0.99,respectively.Conclusion LHA-CV has good reliability and validity,and can be used as an evaluation tool for longitudinally assessing aggressive behavior in schizophrenia patients.

Human brain banks use a standardized protocol to collect,process and store post-mortem human brains and related tissues,along with relevant clinical information,and to provide the tissue samples and data as a resource to foster neuroscience research according to a standardized operating protocols(SOP).Human brain bank serves as the foundation for neuroscience research and the diagnosis of neurological disorders,highlighting the crucial rule of ensuring the consistency of standardized quality for brain tissue samples.The first version of SOP in 2017 was published by the China Human Brain Bank Consortium.As members increases from different regions in China,a revised SOP was drafted by experts from the China Human Brain Bank Consortium to meet the growing demands for neuroscience research.The revised SOP places a strong emphasis on ethical standards,incorporates neuropathological evaluation of brain regions,and provides clarity on spinal cord sampling and pathological assessment.Notable enhancements in this updated version of the SOP include reinforced ethical guidelines,inclusion of matching controls in recruitment,and expansion of brain regions to be sampled for neuropathological evaluation.

Taking Kunming Medical University as an example, we explore the mechanism for the separation and coordination of supervision, management, and evaluation, establish and implement a course quality rating system, and strengthen the course quality evaluation. The course quality rating system mainly consists of merit evaluation for courses of grades A and B and admittance evaluation for courses of grades C and D. Through the course quality rating, courses are diagnosed and compared, with the aim to improve course connotation construction (labeling, setting an example, promoting excellent courses, and removing inferior courses), achieve "good pay for good courses", encourage the faculty to strengthen curriculum quality, and measure ourselves with our own ruler. We discussed the problems about the difference in evaluation indicators, the professionality of evaluators, and the incentive effect of evaluation results, and also proposed strategies for improving course quality rating in medical colleges from the perspectives of deepening the content of evaluation indices, ensuring the effectiveness after evaluation, and ascertaining the main body of course construction in daily work.

Aim To study the effects of Taohong Siwu Tang(TSD)on serum lipid metabolites in rats with abnormal uterine bleeding(AUB),and to analyze the mechanism of action of TSD in improving lipid metabo-lism disorders in AUB.Methods The rat model of AUB was replicated by the method of incomplete abor-tion with drugs,and the lipid metabolites of serum were detected by applying UPLC-Q-Exactive Orbitrap/MS technology,and combined with the principal com-ponent analysis and orthogonal partial least squares-discriminant analysis to screen for differential lipids,the changes of lipids in serum before and after the in-tervention of TSD were clarified.Results A total of 11 differential lipids were screened,mainly phosphati-dyl inositol,phosphatidic acid,phosphatidyl ethanola-mine,phosphatidyl serine,sterol lipids,ceramide,acrylolipids and fatty acids.The screened differential lipids all tended to regress to normal after the adminis-tration of TSD intervention.Conclusion Improvement of AUB by TSD may be related to lipid metabolism such as phosphatidic acid,phosphatidyl inositol,phos-phatidyl ethanolamine,phosphatidyl serine,and ce-ramide.

An automatic ash-removal heat-sensitive moxibustion device was developed, which could keep relatively constant temperature of heat-sensitive moxibustion, and realize the automatic ignition and automatic ash removal of moxa sticks during heat-sensitive moxibustion. The automatic ash-removal heat-sensitive moxibustion device comprises a bracket and a moxibustion box fixed on the top of the bracket; the bracket is composed of a base and a movable telescopic arm. This device can solve the problems of temperature instability, moxa ash blocking heat transfer and moxa ash falling during heat-sensitive moxibustion, avoiding the scalding caused by moxa ash falling, and reduce the workload of medical staff.
Humans ; Hot Temperature ; Moxibustion ; Temperature

OBJECTIVE: To investigate whether Omicron BA.1 breakthrough infection after receiving the SARS-CoV-2 vaccine could create a strong immunity barrier. METHODS: Blood samples were collected at two different time points from 124 Omicron BA.1 breakthrough infected patients and 124 controls matched for age, gender, and vaccination profile. Live virus-neutralizing antibodies against five SARS-CoV-2 variants, including WT, Gamma, Beta, Delta, and Omicron BA.1, and T-lymphocyte lymphocyte counts in both groups were measured and statistically analyzed. RESULTS: The neutralizing antibody titers against five different variants of SARS-CoV-2 were significantly increased in the vaccinated population infected with the Omicron BA.1 variant at 3 months after infection, but mainly increased the antibody level against the WT strain, and the antibody against the Omicron strain was the lowest. The neutralizing antibody level decreased rapidly 6 months after infection. The T-lymphocyte cell counts of patients with mild and moderate disease recovered at 3 months and completely returned to the normal state at 6 months. CONCLUSION Omicron BA.1 breakthrough infection mainly evoked humoral immune memory in the original strain after vaccination and hardly produced neutralizing antibodies specific to Omicron BA.1. Neutralizing antibodies against the different strains declined rapidly and showed features similar to those of influenza. Thus, T-lymphocytes may play an important role in recovery.
Humans ; Antibodies, Neutralizing ; Prospective Studies ; SARS-CoV-2 ; Breakthrough Infections ; COVID-19 Vaccines ; COVID-19 ; T-Lymphocytes ; China/epidemiology* ; Antibodies, Viral