Pancreatic cancer is a highly malignant solid tumor of the digestive system with extremely poor treatment prognosis. Although its incidence rate is low， its mortality rate is extremely high. In recent years， the number of diagnosed cases worldwide has continued to rise， making pancreatic cancer the sixth leading cause of cancer-related deaths globally. Currently， clinical treatment primarily relies on operation and chemotherapy to suppress tumors. However， these approaches face challenges such as suboptimal efficacy， high postoperative recurrence rates， and severe adverse reactions. Therefore， identifying safe and effective treatment modalities remains a pressing challenge for the medical community. In recent years， research on traditional Chinese medicine （TCM） interventions for pancreatic cancer has increased significantly. Multiple studies have shown that single-herb TCM， TCM formulas， and their derived single compounds can regulate the levels of tumor cell signaling pathways through multiple action targets. They inhibit the development and progression of pancreatic cancer by inhibiting cancer cell proliferation， promoting cell apoptosis， inhibiting tumor angiogenesis， reducing cancer cell invasion and migration capabilities， regulating the cell cycle， and modulating the tumor microenvironment. Additionally， TCM has the advantages of significantly enhancing the anticancer efficacy of chemotherapy drugs and causing fewer adverse reactions. However， the specific action mechanisms by which TCM intervenes in pancreatic cancer remain unclear. Further extensive research is still needed to validate the role of regulating classical signaling pathways such as phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Wnt/β-catenin， nuclear transcription factor-κB （NF-κB）， notch， and hedgehog in the treatment of pancreatic cancer. Therefore， this paper reviewed Chinese and international studies on TCM intervention in pancreatic cancer through relevant signaling pathways in recent years， summarized the potential action mechanisms of TCM in the treatment of pancreatic cancer， and provided references for related research in the future.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Objective:To investigate the impact of the development of the digital economy on the unfair of healthcare resource allocation in China.Methods:The sample data from 23 provinces across the country from 2015 to 2021 were tested using econometric regression.Results:It is found that the development of the digital economy will exacerbate the unfairness of the allocation of medical and health resources in China.Further analysis results show that there are regional differences in the impact of digital economy on the distribution of medical resources,which is mainly manifested in the central and western regions,but weaker in the eastern region,and this impact will weaken with the improvement of the development level of digital economy.At the same time,it also explores the possible influencing mechanisms.It is found that due to the demand-oriented allocation of medical and health resources,the development of digital economy will lead to more unfair allocation of medical resources by affecting economic level,education level and income gap.Conclusion:In the face of the challenges brought by the digital economy to the allocation of medical and health resources,effective measures need to be taken to solve them,thus laying a solid foundation for achieving the goals of comprehensive health coverage and common prosperity.

Telepsychiatry,as an innovative healthcare model that utilizes remote communication technology for the diagnosis,treatment,counseling,and management of mental illnesses,not only has seen rapid development during the coronavirus disease 2019 pandemic,but also has played a crucial role in alleviating the global shortage of mental health resources.In recent years,with the rapid advancement of digital technology,emerging technologies such as artificial intelligence,virtual reality,and wearable digital health devices have demonstrated broad application prospects in the field of telepsychiatry.This article systematically reviews the relevant literatures on telepsychiatry,delving into its concepts,major tools,and clinical applications,providing insights for researchers and decision-makers in the field,and ultimately promoting the widespread adoption of telepsychiatry.

Objective:To investigate the impact of the development of the digital economy on the unfair of healthcare resource allocation in China.Methods:The sample data from 23 provinces across the country from 2015 to 2021 were tested using econometric regression.Results:It is found that the development of the digital economy will exacerbate the unfairness of the allocation of medical and health resources in China.Further analysis results show that there are regional differences in the impact of digital economy on the distribution of medical resources,which is mainly manifested in the central and western regions,but weaker in the eastern region,and this impact will weaken with the improvement of the development level of digital economy.At the same time,it also explores the possible influencing mechanisms.It is found that due to the demand-oriented allocation of medical and health resources,the development of digital economy will lead to more unfair allocation of medical resources by affecting economic level,education level and income gap.Conclusion:In the face of the challenges brought by the digital economy to the allocation of medical and health resources,effective measures need to be taken to solve them,thus laying a solid foundation for achieving the goals of comprehensive health coverage and common prosperity.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Objective To observe the value of integrated 18F-FET PET/MR combined with arterial spin labeling(ASL)for predicting isocitrate dehydrogenase(IDH)genotype and Ki-67 index of glioma.Methods Eighty patients with glioma were retrospectively enrolled.The patients were divided into mutant group(n=31)and wild group(n=49)according to IDH genotype,or into high index group(＞10％,n=57)and low index group(≤10％,n=23)according to Ki-67 index.Integrated 18F-FET PET/MR was performed to obtain PET,structural MR and ASL images,simultaneously.The maximum and mean target-to-background ratio(TBRmax,TBRmean),the maximum and mean normalized cerebral blood flow(nCBFmax,nCBFmean)were calculated based on tumor's volume of interest(VOI)and were compared between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy of PET/MR parameters,ASL parameters,optimal PET/MR+optimal ASL parameters(dual-mode parameters),as well as clinical+dual-mode parameters(combined parameters)for predicting IDH genotype and Ki-67 index of glioma.Results Patients'age,proportion of high WHO grade,TBRmax,TBRmean,nCBFmax and nCBFmean in mutant group were all lower than those in wild group(all P＜0.01).Patients'age,proportion of high WHO grade,TBRmax,TBRmean and nCBFmax in high index group were all higher than those in low index group(all P＜0.01).AUC of TBRmax,TBRmean,nCBFmax,nCBFmean,dual-mode parameters(TBRmax+nCBFmax)and combined parameters(age+TBRmax+nCBFmax)for predicting IDH genotype of glioma was 0.758,0.702,0.773,0.708,0.816 and 0.866,respectively.AUC of TBRmax,TBRmean,nCBFmax,dual-mode parameters(TBRmax+nCBFmax),combined parameters(age+TBRmax+nCBFmax)for predicting Ki-67 index of glioma was 0.823,0.719,0.701,0.823 and 0.854,respectively.Conclusion Integrated 18F-FET PET/MR combined with ASL could predict IDH genotype and Ki-67 index of gliomas effectively.

Purpose/Significance The current situation of internet diagnosis and treatment in medical institutions in Beijing is ana-lyzed and studied to provide references for further promoting internet diagnosis and treatment and improving supervision of internet diagno-sis and treatment in medical institutions.Method/Process By using the methods of literature analysis,questionnaire survey and on-site interview,the current situation of internet diagnosis and treatment in medical institutions that have been qualified for internet diagnosis and treatment in Beijing is investigated.Result/Conclusion The internet diagnosis and treatment has been attached great importance by medical institutions in Beijing and has developed rapidly.However,it is also necessary to further optimize the internal and external envi-ronment for the development of internet diagnosis and treatment,strengthen supervision,and improve the public's acceptance.

Plasma exchange therapy is applied for treatment of severe immune diseases of multiple organ systems and severe liver diseases by removing pathogenic factors and regulating immune function. Regional citrate anticoagulation has no effect on systemic coagulation function and does not increase bleeding risk, and it is one of the optional anticoagulation methods for plasma exchange therapy. This article reviews recent literature on simple plasma exchange therapy with regional citrate anticoagulation to provide a reference for clinical application of this therapy.