Objective To investigate the influence of intravenous esketamine infusion on anesthetic effect and awakening quality in elderly patients undergoing laparoscopic surgery for prostate cancer.Methods One hundred and twenty patients with laparoscopic radical prostatectomy were selected and divided into the esketamine group(group E)and control group(group C)by the random number table method,60 ca-ses in each group.The group E used esketamine for anesthesia induction and maintenance,while the group C received the same amount of physiological saline at the same time during operation process as control.The es-ketamine pumping infusion or normal saline in the two groups was stopped at 30 min before operation end.In addition,the types and doses of other drugs used during the induction and maintenance phase of anesthesia were identical between the two groups.The use total amounts of anesthetic drugs during perioperative period were recorded.The heart rate(HR)and mean arterial pressure(MAP)were recorded before operation(T1),instantly before tracheal intubation(T2),at 1 min after tracheal intubation(T3),1 h during surgery(T4),end of skin suture(T5),and 5 min after extubation(T6)in the two groups respectively;the anesthetic recovery time after extubation was recorded.The Riker sedation and restlessness score was used to conduct the agita-tion evaluation,the incidence rates of agitation and bucking and the resuscitation room stay time were recor-ded.The pain VAS score was used to conduct the pain evaluation in the patients.The incidence rates of ad-verse events such as respiratory depression,shiverring,nausea,vomiting,drowsiness after extubation were re-corded.Results The perioperative doses of resutanil and propofol in the group E were significantly lower than those in the group C,and the difference was statistically significant(P＜0.05).HR and MAP at T2 in the group E were higher than those in the group C,while HR and MAP at T3 in the group E were lower than those in the group C.The recovery time after extubation in the group E was longer than that in the group C,the agitation incidence rate,acute bucking incidence rate and VAS score were lower,the stay time in the recov-ery room was shorter.The incidence rate of drowsiness in the group E was significantly higher than that in the group C(P＜0.05).The incidence rates of other adverse events had no statistical differnece(P＞0.05).Con-clusion Esketamine is safe and effective in the elderly patients with laparoscopic prostate cancer surgery,which is conducive to stabilize the hemodynamic parameters and reduce the incidence rate of agitation and buc-king.

Objective:To study the effects of TCM ointment rubbing technique on pain, swelling, and knee joint function in patients with knee osteoarthritis (KOA) after total knee arthroplasty (TKA).Methods:A randomized controlled trial was conducted. In this study, 80 patients with KOA who underwent TKA treatment in the Department of Sports Medicine I, Wangjing Hospital, China Academy of Traditional Chinese Medicine from October 2022 to March 2024 were taken as the study subjects. They were divided into two groups with random number table method, with 40 cases in each group. Both groups were treated with conventional Western medicine + rehabilitation training after surgery, and the observation group was combined with TCM paste mo technique on this basis. VAS score was used to assess the degree of pain at different time points, and skin fold was used to measure the circumference of the upper knee circumference and the circumference of the lower knee circumference, and knee Injury and osteoarthritis outcome score (KOOS) was used to assess the degree of knee joint function recovery.Results:After treatment, the observation group after surgerythe at 7 d (2.57 ± 0.84 vs. 4.00 ± 0.85, t=7.54) and 14 d (0.80 ± 0.93 vs. 2.70 ± 1.04, t=8.56) VAS scores were lower than those in the control group ( P<0.001). After treatment, the observation group after surgerythe at 7 d the superior circumference [(48.32 ± 4.57) cm vs. (50.53 ± 3.97) cm, t=2.32], and inferior circumference [(36.71 ± 2.95) cm vs. (39.21 ± 6.86) cm, t=2.12], at 14 d the superior circumference [(45.68 ± 4.69) cm vs. (47.96 ± 3.89) cm, t=2.37], and inferior circumference [(34.96 ± 2.96) cm vs. (36.70 ± 4.35) cm, t=2.10] were lower than those in the control group ( P<0.05). The observation group after surgerythe at 14 d the the knee joint mobility [(115.32 ± 2.12) ° vs. (113.34 ± 2.16) °, t=4.14] and KOOS scores (85.52 ± 0.82 vs. 80.32 ± 1.13, t=23.56) were higher than those in the control group ( P<0.01). Conclusion:TCM ointment rubbing technique has significant advantages in improving pain, swelling and knee joint mobility after artificial knee arthroplasty, which can effectively restore knee joint function.

Objective To summarize the exploration and current situation of pharmaceutical service fees in China,to analyze it in conjunction with practices in foreign countries,and to provide references for further improvement of pharmaceutical service fees in China.Methods The official websites of the National Health Commissi,National Healthcare Security Administration,and their provincial braches were retrieved to summarize the changes in policies in China and the latest pharmaceutical service fees policies in each province.At the same time,databases such as CNKI,VIP,and Pubmed were searched to summarize research on pharmaceutical service fees.Results There were some studies in China on the calculation of pharmaceutical service costs and fee standards,but they mostly focused on pharmacy dispensing services,with less discussion on the technical and labor value of specific pharmaceutical services,while international research in this area was relatively abundant.Currently,eight provinces and one municipality directly under the central government have issued medical service price items related to pharmaceutical service,with differences in fee items,fee standards,medical insurance payment ratios,and monitoring and evaluation indicators.Conclusions The inclusion of pharmaceutical services in the national medical pricing system recognizes the transformation of pharmaceutical services and the value of pharmacists.However,it is still in the early stages,and there is room for improvement and enhancement.

Objective To explore the efficacy of an 11-item modified frailty index(mFI-11)combined with surgical Apgar score(SAS)for predicting postoperative complications in elderly patients with colorectal cancer undergoing laparoscopic radical resection.Methods We enrolled a total of 481 elderly patients(aged≥65 years)undergoing laparoscopic radical resection of colorectal cancer.We performed a frailty assessment preoperatively using mFI-11 and calculated the SAS based on the lowest mean arterial pressure and heart rate as well as blood loss during surgery.Finally,we compared the clinical data,mFI-11,and SAS of patients with and without post-operative complications,and then analyzed their relationship with the postoperative complications and predictive values.Results The mFI-11,SAS,and operation time independently correlated with postoperative complication occurrence(P<0.05).The AUC of post-operative complications obtained using the mFI-11,SAS,and operation time were 0.805,0.800,and 0.610,respectively.The AUC of the postoperative complications derived from mFI-11 combined with SAS was 0.902.Conclusion In elderly patients undergoing laparo-scopic radical resection of colorectal cancer,the mFI-11,SAS,and operation time significantly correlated with postoperative complication occurrence.The combination of mFI-11 and SAS displayed a higher predictive power for postoperative complications compared to the use of a single indicator,which it could provide a reliable basis for early clinical identification of complications and reduce their occurrence.

Objective:To compare the social support levels as understood by family doctor team members in township hospitals/community health centers, and village clinics/community clinics, and their influencing factors, in order to provide reference for improving the work status of family doctor team members and enhancing the quality of family doctors′ contracted services.Methods:A multi-stage random cluster sampling method was used to sample medical workers from contracted family doctor teams in township hospitals/community health centers and their subordinate village clinics/community clinics in 6 counties (cities, districts) of Tai′an city, Shandong province. In August 2020, a questionnaire survey was conducted on the perceived level of social support among family doctor team members using the perceived social support scale. Descriptive analysis was conducted on the data, and independent sample t-tests and one-way ANOVA were used to conduct univariate analysis on the influencing factors of perceived social support scores of family doctor team members at different levels, while multiple linear regression analysis was used to conduct multivariate analysis. Results:A total of 765 valid questionnaires were collected, with 203 and 562 from township hospitals/community health centers and village clinics/community clinics, respectively. The total perceived social support scores of family doctor team members in township hospitals/community health centers and village clinics/community clinics were (65.56±10.29) and (67.31±10.14), respectively, featuring statistically significant differences ( t=-2.11, P<0.05). In-mirage marital status ( β=0.18, P=0.008), good/very good self-rated health status ( β= 0.25, P=0.048), participation of work-related training within one year ( β=0.17, P=0.010), relatively satisfied/very satisfied for job promotion ( β= 0.17, P=0.046), as well as above/far above average self-rated economic status as ( β=-0.15, P=0.027), were the influencing factor on the perceived social support scores of family doctor team members in township hospitals/community health centers. In-marriage marital status ( β= 0.12, P=0.002), good/very good self-rated health status ( β=0.14, P=0.026), junior or intermediate level or above professional title ( β=-0.11, P=0.003; β=-0.10, P=0.006), participation of work-related training within one year ( β= 0.14, P<0.001), and relatively satisfied/very satisfied for job promotion ( β= 0.16, P<0.001) were the influencing factors on the perceived social support scores of family doctor team members in village clinics/community clinics. Conclusions:Members of the family doctor teams in primary medical institutions in Tai′an city had a higher level of understanding of social support. There were differences in the social support levels of family doctor team members between the two levels of primary medical and health care institutions, and the influencing factors were not completely consistent. Targeted measures should be taken based on specific circumstances to enable them to better receive and perceive support from family and friends, and to improve the quality of family doctors′ contracted services.

In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.

Objective: To study the mechanism of Heshi-Gejiugao on the nerve endocrine immune network in the treatment of perimenopausal syndrome. Methods: A total of 100 patients with perimenopausal syndrome were randomly divided into treatment group and control group, 50 cases in each group. The control group was only given general treatment, while the treatment group was treated with Heshi-Gejiugao on the basis of general treatment for 30 days. The clinical efficacy, Kupperman score, nerve, endocrine and immune related indexes of the two groups before and after treatment were observed. Results: The total effective rate was 96.0% (48/50) in the treatment group and 50.0% (25/50) in the control group. There was significant difference between the two groups (χ²=37.639, P<0.01). The Kupperman score (17.52 ± 2.73 vs. 24.22 ± 6.87, t=6.409) in the treatment group was significantly lower than that in the control group (P<0.01). After treatment, NE (1 878.08 ± 931.57 ng/m vs. 1 278.43 ± 866.32 ng/ml, t=3.331), DA (1 568.56 ± 597.15 ng/ml vs. 1 183.62 ± 798.72 ng/ml, t=2.729) in the treatment group were significantly higher than those in the control group (P<0.05); E₂ (42.12 ± 9.77 pg/ml vs. 35.91 ± 12.55 pg/ml, t=2.761), FSH (62.70 ± 15.96 mIU/ml vs. 72.67 ± 30.18 mIU/ml, t=2.065), LH (33.88 ± 12.18 mIU/ml vs. 42.93 ± 9.83 mIU/ml, t=4.089) were significantly lower than those of the control group (P<0.05). CD3⁺ (1 087.34/μl ± 432.19/μl vs. 918.27/μl ± 199.72/μl, t=2.511), CD4⁺ (738.16/μl ± 326.75/μl vs. 588.43/μl ± 212.55/μl, t=2.716) and CD4/CD8 (1.87 ± 0.56 vs. 1.16 ± 0.55), t=6.483) were significantly higher than those of the control group (P<0.05); CD8⁺ (788.32/μl ± 214.56/μl vs. 976.37/μl ± 318.62/μl, t=3.462) was significantly lower than that of the control group (P<0.05). Conclusions Heshi-Gejiugao can reduce the symptoms and improve the quality of life by regulating the multi target and multi direction of the neuroendocrine immune network of perimenopausal patients.

Objective: To investigate the histological features and prognostic factors of angioimmunoblastic T-cell lymphoma (AITL). Methods: The pathological data of 62 patients with AITL with complete follow-up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed. Results: The cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki-67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki-67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival. Conclusions AITL could be divided into two different prognostic groups, low-grade and high-grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low-grade malignant group progresses slowly, and high-grade malignant group is highly invasive.

Objective To investigate the histological features and prognostic factors of angioimmunoblastic T?cell lymphoma (AITL). Methods The pathological data of 62 patients with AITL with complete follow?up information were retrospectively collected and analyzed from Changhai Hospital during September 2012 and September 2017. Histological and immunohistochemical (IHC) examination, in situ hybridization (ISH), and single nucleotide polymorphisms (SNP) gene mutation analysis were done. Subgroup evaluation with histology, IHC, ISH, SNP gene mutation, and association with clinical progression were performed. Results The cohort included 62 cases of AITL, including 46 males and 16 females patients, with a median age of 64 years. Follicular dendritic cells (FDC) area showed significantly expansion (≥30%) in 40 cases; increased plasma cells (≥10%) was seen in 37 cases; B cells were distributed around blood vessels in 37 cases; and increased p53 mutation positive cells (≥40%) were seen in 39 cases; high Ki?67 index (≥40%) was seen in 39 cases; RHOA mutation was seen in 19 cases; TET2 mutation was seen in 9 cases. Overall survival analysis showed these factors were significantly correlated with tumor prognosis (P<0.05). Multivariate analysis showed that CD38 positive cells<10%, Ki?67≥40%, RHOA and TET2 mutations were risk factors associated with overall survival. Conclusions AITL could be divided into two different prognostic groups, low?grade and high?grade, with statistically significance outcome, based on the FDC area expansion, degree of plasma cell proliferation, B cells distribution pattern combined with gene mutations and clinical progression. Low?grade malignant group progresses slowly, and high?grade malignant group is highly invasive.

[Abstract] Objective: To search valuable candidate molecular markers for LSCC by screening and identifying differentially expressed long non-coding RNAs (lncRNAs) in metastatic laryngeal squamous cell carcinoma (LSCC) with high throughput gene microarray technique. Methods: Four pairs of LSCC tissues and corresponding para-cancer tissues that pathologically confirmed with lymph node metastasis were collected from Bio-sample lab of Otorhinolaryngology Department, the Second Hospital of Hebei Medical University. After total RNA extraction, the SBC-lncRNA (human 4x180k) chip assay was then applied to detect the differentially expressed lncRNAs and mRNAs, and Fold-change and Student's t-test methods were used to identify differentially expressed genes; the Fold Change (linear)≤0.5 or≥2.0, P<0.05 was used to identify the differentially expressed genes. The reliability of the chip results was confirmed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Results: The gene expression profiles of metastatic LSCC tissues and corresponding para-cancer tissues were significantly different. There were 3 073 differentially expressed lncRNAs, including 1 967 up-regulated and 1 106 down-regulated lncRNAs in cancer tissues. There were 2 809 differentially expressed mRNAs, including 1 791 up-regulated and 1 018 down-regulated mRNAs in cancer tissues. The differentially expressed lncRNAs were mainly involved in cell proliferation and apoptosis, immune response biological process, and were associated with cytokine and cytokine receptor interaction, chemokine signaling pathway, cell cycle regulation, P53 signaling pathway, etc. In addition, 10 significantly differentially expressed lncRNAs were chosen and validated by qRT-PCR in 25 cases of LSCC tissues, and the results were in agree with microarray detection. Conclusions: There were obvious differences in lncRNAs expression between metastasis LSCC and corresponding para-cancer tissues; in-depth analysis of these differences may has important significance on clarifying the mechanisms of invasion and metastasis of LSCC, which can provide the theoretical basis for biomarker screening and effective targeted therapy for LSCC.·