OBJECTIVE To construct ensemble learning models for predicting high-use days of budesonide based on meteorological factors， thereby providing reference for hospital pharmacy management. METHODS Meteorological data for 2024 and outpatient budesonide usage data from the jurisdiction of Sanming Hospital of Integrated Traditional Chinese and Western Medicine were collected. High-use days were defined as the 75th percentile of outpatient budesonide usage， and a corresponding dataset was established. The prediction task was formulated as a classification problem， and three ensemble learning models were developed： Random Forest， Extreme Gradient Boosting （XGBoost）， and Histogram-based Gradient Boosting Classifier. Model performance was evaluated using accuracy， precision， recall， F1-score， and log-loss. Model interpretability was analyzed using Shapley Additive Explanations （SHAP）. RESULTS The Histogram-based Gradient Boosting Classifier achieved the best performance （accuracy＝0.75， F1-score＝0.48）， followed by XGBoost （accuracy＝0.74， F1-score＝0.43） and Random Forest （accuracy＝0.72， F1-score＝0.22）. SHAP results suggested that the prediction results of the last two models have the highest correction. CONCLUSIONS Ensemble learning models can effectively predict high-use days of budesonide， with the Histogram- based Gradient Boosting Classifier demonstrating the best predictive performance. Low temperature， high humidity， and low atmospheric pressure show significant positive impacts on the prediction of daily budesonide usage.

Objective:To investigate the current state of death cognition among healthcare providers in hematology department and their attitudes toward hospice care for patients with hematologic malignancies.Methods:A cross-sectional investigation study was conducted. A total of 198 medical staff in hematology department of 4 teaching hospitals, including the First School of Clinical Medicine of Guangdong Medical University, Fujian Medical University Union Hospital, the Affiliated Hospital of Putian University and the First Affiliated Hospital of Gannan Medical University from March 2024 to June 2024 were selected as the investigation subjects. The general situation and background of medical staff in hematology department were investigated by using the "General Sociological Questionnaire". "Death Attitude Description Scale (Chinese version)" was used to investigate the status of death cognition among medical staff in hematology department. "Frommelt Attitudes Toward Care of the Dying Scale Form B (Chinese version)" was used to investigate the hospice care attitude of medical staff in hematology department. The survey results of doctors and nurses were compared.Results:There were 105 doctors and 93 nurses in hematology department included in this study. A total of 198 qualified "General Sociology Questionnaires" were collected. After excluding 6 unqualified questionnaires, 192 copies of "Death Attitude Description Scale (Chinese version)" and "Frommelt Attitudes Toward Care of the Dying Scale Form B (Chinese version)" were collected. There were statistically significant differences in gender, educational background, political status and experience of taking care of terminally ill patients between doctors and nurses (all P < 0.05). The scores of approaching acceptance, neutral acceptance, death escape, death fear and flight acceptance were (4.35±0.37), (4.03±0.51), (2.98±0.62), (2.54±0.29) and (2.19±0.42) points, respectively in the doctor group; the corresponding scores were (3.12±0.41), (3.89±0.46), (2.66±0.63), (2.81±0.57) and (2.37±0.65) points, respectively in the nurse group, and the differences between the 2 groups were statistically significant (all P < 0.05). The total score of hospice care attitude of doctors in hematology department was (108±15) points, and that of nurses was (116±13) points, and the difference was statistically significant ( t = -3.61, P < 0.001). The hospice care attitude of doctors and nurses towards patients with hematologic malignancies is generally between positive and neutral. The nurse group showed more recognition of the positive role of the patient's family members in the process of hospice care, and the doctor group showed more recognition of the promoting role of medical staff in hospice care. There were statistically significant differences in hospice care attitude scores of medical staff in hematology department to patients with different occupational background, gender, age, place of residence, family discussion about death, whether the only child, whether they had the experience of taking care of terminally ill patients, and whether they suffered from serious illness and religious belief (all P < 0.05). Conclusions:The death cognition of medical staff in hematology department is neutral, and they show a certain sense of hospice care.

The SVA and different serotypes of VSV(VSNJV and VSIV)are susceptible to infect pigs and cause blister injuries to the lips and hoof of pigs.The clinical symptoms of diseases caused by these viruses are very similar,which is easy to cause misdiagnosis.Therefore,a multiplex nano-PCR method was developed for the simultaneous defection of VSV,VSNJV and VSIV.In this stud-y,three pairs of specific primers were designed according to the SVA-P gene,VSNJV-N gene and VSIV-N gene.The optimal annealing temperature and optimal primer concentration were tested,and the reaction system and conditions were optimized.We have developed a novel,rapid and sensitive multiple nano-PCR detection method for simultaneous detection of SVA,VSNJV and VSIV,which was developed by using nano-metal materials.The specific test results showed that the method could specifically amplify the target genes of SVA,VSNJV and VSIV,with no cross-reactivity to PRV,ASFV,PCV2 and PHEV.The sensitivity test results showed that the minimum nucleic acid detection of the method was 10 copies/μL,which sensitivity was great.In addition,the optimal primers showed good reactivity and stability to different batches of enzymes and plasmids.There were 7 among 50 of diseased pig samples were SVA positive by multiple nano-PCR detec-tion method,and 5 out of 50 of diseased pig samples were SVA positive by ordinary single PCR method.Moreover,no VSNJV and VSIV were detected by the two methods.In conclusion,this es-tablished multiple nano-PCR detection method has higher specificity and sensitivity in the detec-tion of SVA,VSNJV and VSIV.And this study could provide technical support for the rapid differ-ential diagnosis,prevention and control of swine viral vesicular diseases in clinical settings.

Objective:To prepare domestic 64Cu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE), and to verify its distribution and preliminary diagnostic value in neuroendocrine tumors (NETs). Methods:DOTATATE was labeled with the domestic 64Cu to obtain 64Cu-DOTATATE. The lipophilicity, in vitro stability, and pharmacokinetics were studied. Biodistribution experiments and microPET imaging were performed on NCI-H727 (somatostatin receptor (SSTR)2 positive expression) tumor-bearing nude mice. The preliminary clinical applications were conducted on 10 NETs patients (5 males, 5 females; age (58.5±13.0) years) from Chinese PLA General Hospital between May 2023 and April 2024. Data were analyzed by using independent-sample t test. Results:64Cu-DOTATATE was successfully prepared with the radiochemical purity greater than 98%, log P of -2.609±0.051 and good stability. Pharmacokinetic experiments in BALB/c mice suggested rapid blood clearance of the drug (elimination half-time of 22.78min). Biodistribution results in tumor-bearing mice showed that 64Cu-DOTATATE was mainly metabolized through the liver and kidneys, with significant tumor uptake at 1h ((2.519±0.273) percentage activity of injection dose per gram of tissue (%ID/g)) and sustained high uptake at 24h ((4.331±0.549)%ID/g). MicroPET imaging of tumor-bearing mice showed a slight increase in uptake and good retention at 24h, with a significant statistical difference compared to the blocked group ((2.197±0.250) vs (0.985±0.064) % ID/g; t=6.40, P=0.008). The tumor/liver ratios were 0.075±0.007, 0.083±0.011, 0.118±0.005, 0.263±0.031 at 1, 2, 6 and 24h, respectively. Preliminary clinical application indicated that 64Cu-DOTATATE exhibited good targeting in patients, and the liver radioactivity distribution was moderate (SUV max=10.62±3.46), providing good image quality. Conclusion:Domestic 64Cu-DOTATATE PET/CT imaging is a promising imaging evaluation method in NETs with the value for further clinical research.

The SVA and different serotypes of VSV(VSNJV and VSIV)are susceptible to infect pigs and cause blister injuries to the lips and hoof of pigs.The clinical symptoms of diseases caused by these viruses are very similar,which is easy to cause misdiagnosis.Therefore,a multiplex nano-PCR method was developed for the simultaneous defection of VSV,VSNJV and VSIV.In this stud-y,three pairs of specific primers were designed according to the SVA-P gene,VSNJV-N gene and VSIV-N gene.The optimal annealing temperature and optimal primer concentration were tested,and the reaction system and conditions were optimized.We have developed a novel,rapid and sensitive multiple nano-PCR detection method for simultaneous detection of SVA,VSNJV and VSIV,which was developed by using nano-metal materials.The specific test results showed that the method could specifically amplify the target genes of SVA,VSNJV and VSIV,with no cross-reactivity to PRV,ASFV,PCV2 and PHEV.The sensitivity test results showed that the minimum nucleic acid detection of the method was 10 copies/μL,which sensitivity was great.In addition,the optimal primers showed good reactivity and stability to different batches of enzymes and plasmids.There were 7 among 50 of diseased pig samples were SVA positive by multiple nano-PCR detec-tion method,and 5 out of 50 of diseased pig samples were SVA positive by ordinary single PCR method.Moreover,no VSNJV and VSIV were detected by the two methods.In conclusion,this es-tablished multiple nano-PCR detection method has higher specificity and sensitivity in the detec-tion of SVA,VSNJV and VSIV.And this study could provide technical support for the rapid differ-ential diagnosis,prevention and control of swine viral vesicular diseases in clinical settings.

Objective:To prepare domestic 64Cu-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE), and to verify its distribution and preliminary diagnostic value in neuroendocrine tumors (NETs). Methods:DOTATATE was labeled with the domestic 64Cu to obtain 64Cu-DOTATATE. The lipophilicity, in vitro stability, and pharmacokinetics were studied. Biodistribution experiments and microPET imaging were performed on NCI-H727 (somatostatin receptor (SSTR)2 positive expression) tumor-bearing nude mice. The preliminary clinical applications were conducted on 10 NETs patients (5 males, 5 females; age (58.5±13.0) years) from Chinese PLA General Hospital between May 2023 and April 2024. Data were analyzed by using independent-sample t test. Results:64Cu-DOTATATE was successfully prepared with the radiochemical purity greater than 98%, log P of -2.609±0.051 and good stability. Pharmacokinetic experiments in BALB/c mice suggested rapid blood clearance of the drug (elimination half-time of 22.78min). Biodistribution results in tumor-bearing mice showed that 64Cu-DOTATATE was mainly metabolized through the liver and kidneys, with significant tumor uptake at 1h ((2.519±0.273) percentage activity of injection dose per gram of tissue (%ID/g)) and sustained high uptake at 24h ((4.331±0.549)%ID/g). MicroPET imaging of tumor-bearing mice showed a slight increase in uptake and good retention at 24h, with a significant statistical difference compared to the blocked group ((2.197±0.250) vs (0.985±0.064) % ID/g; t=6.40, P=0.008). The tumor/liver ratios were 0.075±0.007, 0.083±0.011, 0.118±0.005, 0.263±0.031 at 1, 2, 6 and 24h, respectively. Preliminary clinical application indicated that 64Cu-DOTATATE exhibited good targeting in patients, and the liver radioactivity distribution was moderate (SUV max=10.62±3.46), providing good image quality. Conclusion:Domestic 64Cu-DOTATATE PET/CT imaging is a promising imaging evaluation method in NETs with the value for further clinical research.

OBJECTIVE To investigate the current situation of the review and comment on inpatient medical orders in Beijing municipal hospitals， and to put forward countermeasures and suggestions for further improving related work. METHODS A questionnaire survey was conducted to investigate the current situation of the review and comment on inpatient medical orders in 22 Beijing municipal hospitals. The statistical analysis was conducted for the survey results. RESULTS A total of 22 questionnaires were distributed， with recovery effective rate of 100%. The 22 hospitals carried out inpatient medical order comment， but their proportion varied among hospitals （0.88%-98.54%）； medical order comment mainly focused on antibiotics， proton pump inhibitors， anesthetic drugs/class Ⅰ psychotropic drugs， auxiliary drugs and other categories； 205 pharmacists participated in the comment of inpatient medical orders， most of whom hold intermediate or higher professional titles （89.27%）； 21 hospitals conducted inpatient medical order comment and feedback the results to relevant departments/responsible persons， but the intervention situation was not the same. Eighteen hospitals had carried out the review of inpatient medical orders； reviewed drug category was roughly the same as the category involved in the medical order comment； review content involved the suitability of administration routes， dosage， etc. The review was conducted mainly through the cooperation of audit software and pharmacists. CONCLUSIONS The comment and review of inpatient medical orders in Beijing municipal hospitals carried out in an orderly manner， and preliminary results have been achieved； at the same time， it is necessary to further increase the ability of participating pharmacists， improve audit standards， optimize pre-audit （No.ZYLX201805） software， and promote rational drug use among hospitalized patients through doctor-pharmacist collaboration.

Objective:To compare the clinical efficacy between fusion with anterior plate and cross screw (APCS) via the anterolateral approach and that with posterior plate (PP) via the posterior approach in ankle arthrodesis.Methods:A retrospective study was conducted to analyze the 64 patients (64 feet) with end-stage ankle arthritis who had been admitted to Department of Foot and Ankle Surgery, Honghui Hospital of Xi'an Jiaotong University from January 2017 to March 2021. They were 24 males and 40 females with an age of (57.7±5.5) years; by the Kellgren-Lawrence staging, 25 cases were in grade Ⅲ and 39 ones in grade Ⅳ. According to the different surgical approaches and internal fixation methods, the patients were divided into a APCS group of 31 cases subjected to the fusion with APCS via the anterolateral approach and a PP group of 33 cases subjected to the fusion with PP via the posterior approach. The clinical efficacy was compared between the 2 groups and between preoperatoion and postoperation in terms of talus center migration (TCM), sagittal talar migration (STM), foot and ankle ability measure (FAAM), and visual analog scale (VAS).Results:There was no statistically significant difference in the preoperative baseline data between the 2 groups of patients, indicating comparability ( P>0.05). In the PP group, the postoperative STM [(4.45±2.21)] mm was significantly smaller than the postoperative one [(7.22±4.22)] mm ( P<0.001). There were no statistically significant differences in the postoperative comparisons of TCM and STM between the 2 groups, in the comparison between postoperative TCM and preoperative TCM in the PP group, or in the comparisons between postoperative and preoperative TCM and STM in the APCS group ( P>0.05). All patients were followed up for (28.1±6.8) months. At the last follow-up, there was no statistically significant difference between the 2 groups in the FAAM life score, FAAM exercise score, or VAS pain score ( P>0.05). The FAAM life score, FAAM motor score, and VAS pain score at the last follow-up were significantly improved in all the patients compared with the preoperative values ( P<0.05). Fusion failure was found in only 1 patient in the APCS group. Conclusion:Both PP and APCS fusion techniques can lead to similarly fine clinical outcomes in ankle arthrodesis, but PP may lead to a significant correction of sagittal talar migration.

Objective:To evaluate the potential of 177Lu-prostate specific membrane antigen (PSMA)-3Q in the treatment of metastatic castration-resistant prostate cancer (mCRPC) and compare it with 177Lu-PSMA-I&T. Methods:177Lu-PSMA-3Q was prepared and the quality control and stability testing were performed. Pharmacokinetic evaluation and biodistribution of 177Lu-PSMA-3Q and 177Lu-PSMA-I&T were conducted in normal BALB/c mice and 22Rv1 tumor-bearing mice. SPECT imaging was performed on 2 patients (60 and 76 years old) with mCRPC from Chinese PLA General Hospital at 24, 72, and 120 h after injection of 177Lu-PSMA-3Q or 177Lu-PSMA-I&T ((7.40±0.74) GBq). Data were analyzed by using independent-sample t test. Results:177Lu-PSMA-3Q was prepared with the total activity of 74 GBq, the yield rate of 95% (uncorrected), and the radiochemical purity was still above 95% after 168 h at room temperature. The distribution half-lives of 177Lu-PSMA-3Q and 177Lu-PSMA-I&T were (0.75±0.22) and (0.86±0.19) min, and the clearance half-lives were (24.74±3.77) and (29.53±3.42) min. Biodistribution of normal mice showed that the uptake values in the liver, lungs, and kidneys 5 d after injection of 177Lu-PSMA-3Q were lower than those of 177Lu-PSMA-I&T ( t values: 4.24-8.36, all P<0.05). The tumor uptake of 177Lu-PSMA-3Q after 24 h injection was the highest and was higher than that of 177Lu-PSMA-I&T ((0.856±0.183) vs (0.579±0.126) percentage activity of injection dose per gram of tissue (%ID/g); t=2.78, P=0.024) in 22Rv1 tumor-bearing mice. The rapid clearance pattern resulted in a higher tumor/muscle (T/M) ratio for 177Lu-PSMA-3Q (99.604±11.106), which was significantly higher than that for 177Lu-PSMA-I&T (45.078±10.444; t=7.80, P<0.001). According to SPECT imaging of patients with mCRPC, the residual lesion counts of 177Lu-PSMA-3Q and 177Lu-PSMA-I&T at 120 h accounted for 0.32±0.05 and 0.58±0.04 of those at 24 h, with significant difference ( t=7.62, P=0.002). Conclusion:177Lu-PSMA-3Q is easy to label, and has high yield and radiochemical purity, good stability, excellent biological performance, good targeting ability in patients, longer retention time, and fast background clearance rate, which is an ideal prostate cancer treatment drug targeting PSMA.

A purified polysaccharide with a galactose backbone(SPR-1,Mw 3,622 Da)was isolated from processed Polygonati Rhizoma with black beans(PRWB)and characterized its chemical properties.The backbone of SPR-1 consisted of[(4)-β-D-Galp-(1]9→ 4,6)-β-D-Galp-(1 → 4)-α-D-GalpA-(1 → 4)-α-D-GalpA-(1 →4)-α-D-Glcp-(1 → 4,6)-α-D-Glcp-(1 → 4)-α/β-D-Glcp,with a branch chain of R1:β-D-Galp-(1 → 3)-β-D-Galp-(1 → connected to the →4,6)-β-D-Galp-(1 → via O-6,and a branch chain of R2:α-D-Glcp-(1 →6)-α-D-Glcp-(1 → connected to the →4,6)-α-D-Glcp-(1 → via O-6.Immunomodulatory assays showed that the SPR-1 significantly activated macrophages,and increased secretion of NO and cytokines(i.e.,IL-1β and TNF-α),as well as promoted the phagocytic activities of cells.Furthermore,isothermal titration calorimetry(ITC)analysis and molecular docking results indicated high-affinity binding between SPR-1 and MD2 with the equilibrium dissociation constant(KD)of 18.8 μM.It was suggested that SPR-1 activated the immune response through Toll-like receptor 4(TLR4)signaling and downstream responses.Our research demon-strated that the SPR-1 has a promising candidate from PRWB for the TLR4 agonist to induce immune response,and also provided an easily accessible way that can be used for PR deep processing.