Esophageal cancer is a prevalent malignant tumor of the digestive tract in China, and radical surgery remains the cornerstone of its comprehensive treatment. However, multifactorial challenges such as postoperative gastrointestinal tract reconstruction, traumatic stress, and tumor-related metabolic disturbances render esophageal cancer patients highly susceptible to malnutrition. Perioperative nutritional support therapy plays a crucial role in enhancing surgical safety, improving clinical outcomes, and elevating patients' quality of life by regulating metabolic homeostasis, preserving organ function, and optimizing the immune microenvironment. This article reviews the mechanisms underlying malnutrition in esophageal cancer, methods for nutritional status assessment, and precision intervention pathways based on multi-omics evaluations. The aim is to strengthen clinicians' awareness of standardized perioperative nutritional management for esophageal cancer patients and promote its clinical implementation, thereby facilitating postoperative recovery and improving long-term quality of life.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To understand the current situation of reprocessing reusable sterilized items in the central sterile supply departments(CSSD)of hospitals and provide a scientific basis for further standardized management.Methods Using the convenience sampling method,a self-designed questionnaire on the current situation of reprocessing of reusable disinfection items in CSSDs was used to conduct a survey in 31 provinces(autonomous regions and municipalities)from June 11th to 23rd,2024.The questionnaire covered 2 aspects,including the basic situation of the hospital and the reprocessing of disinfection items.Results A total of 1 835 questionnaires were distributed,and 1 603 valid questionnaires were retrieved.Regarding the use of reusable disinfection items,with the most frequently used items being humidification bottles,tourniquets,breathing bags and their accessories,and ventilator tubing systems etc.Among them,1 558 hospitals(97.19％)established standardized disposal procedures,and 996 hospitals(62.13％)assigned dedica-ted personnel to be responsible.In terms of the reprocessing procedures of reusable disinfection items,all 1 603 hospitals carried out drying process for the items;the main packaging method was plastic self-sealing bags(59.95％),and 541 hospitals(33.75％)sterilized the packaging materials.Additionally,935 hospitals(58.33％)used oil-free air compressors;among them,51 hospitals(58.62％)installed activated carbon filters at the end of the compressors.Conclusion The current situation of reprocessing reusable sterilized items in CSSDs of nationwide hospitals needs improvement.It is recommended to strengthen the training of professional disinfection knowledge,unify the sterilization standards for plastic self-sealing bags,develop a storage management system,and adopt a medical air compressor system without oil and water to reduce the risk of hospital infections.

Objective To investigate the application of offline solid-phase extraction-high performance liquid chromatography-tandem mass spectrometry for detecting four synthetic cannabinoids(5F-ADB,5F-MDMB-PICA,4F-MDMB-BUTINACA,and MDMB-4en-PINACA)and their marker metabolites in urban wastewater.Methods Samples were pre-treated using an Oasis PRiME HLB column(60 mg,3CC)and analyzed by ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry.The mobile phases consisted of 0.02%formic acid-2 mmol/L ammonium formate aqueous solution and acetonitrile solution,with a WATERS ACQUITY UPLCHSS T3 column.Analysis was conducted in positive ionization mode of the ESI ion source,combining multiple reaction monitoring(MRM),information-dependent acquisition(IDA),and enhanced product ion(EPI)scanning modes for qualitative and quantitative analysis of the eight target compounds.Results Good linearity was observed for 4F-MDMB-BUTINACA-M,5F-ADB,5F-ADB-M,and 5F-MDMB-PICA in the concentration range of 1～250 ng/L;for MDMB-4en-PINACA in the range of 5～250 ng/L;and for 4F-MDMB-BUTINACA,5F-MDMB-PICA-M,and 4F-MDMB-BUTINACA-M in the range of 1～500 ng/L.The recovery rates of samples spiked with different concentrations of the eight target compounds ranged from 87.68%to 104.68%,with matrix effects between 88.61%and 112.78%.Both intra-day and inter-day precision were less than 5%.Conclusion The established method demonstrates good accuracy and reproducibility,making it suitable for qualitative and quantitative detection of four synthetic cannabinoids and their metabolites in urban wastewater.

Objective:To explore the application value of integrated Chinese and western medicine in the treatment of sepsis-induced coagulopathy (SIC) induced by bacterial pneumonia sepsis.Methods:A total of 60 inpatients with bacterial pneumonia and sepsis admitted to the Dongzhimen Hospital of Beijing University of Chinese Medicine from October 2023 to June 2024 were collected in a cross-sectional study. Serum samples were collected, and immune indexes, coagulation function and some laboratory test results of the patients were detected or recorded. Sepsis Associated Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were evaluated.Results:Among the 60 patients, 71.7%( n=43) were associated with coagulation disorder, 65%( n=39) showed hemorrhagic SIC; A total of 37 patients (61.7%) were treated with integrated traditional Chinese and western medicine, and 23 patients (38.3%) were treated with Western medicine. The main types of syndrome differentiation were toxic-heat syndrome ( n=48, 80.0%) and blood-stasis syndrome ( n=11, 18.3%). Serum human monocyte chemoattractant protein-1 (MCP-1) and platelet count (PLT) in patients with blood stasis syndrome were significantly lower than those in toxic-heat syndrome (all P<0.05). In patients with bacterial pneumonia sepsis, the total score of syndrome of excess of fu-viscera (Fu-shi-zheng) was positively correlated with programmed death ligand-1 (PD-L1) ( r=0.293, P=0.023) and tumor necrosis factor-α (TNF-α) ( r=0.436, P=0.001). The total score of toxin-heat syndrome ( r=0.323, P=0.016) and excess of fu-viscera syndrome ( r=0.354, P=0.008) were positively correlated with prothrombin time (PT). PD-1 was positively correlated with SOFA score ( r=0.343, P=0.007) and APACHE Ⅱ score ( r=0.354, P=0.006). The PD-1 level and SOFA and APACHE Ⅱ scores of the patients treated with integrated Chinese and western medicine were significantly lower than those treated with Western medicine alone (all P<0.05). Conclusions:The combined intervention of traditional Chinese medicine and Western medicine based on " Fuzheng Touxie Jiedu (The method of strengthening the body and removing the toxin)" has strong clinical guiding significance, and can effectively improve the immune function and prognosis of bacterial pneumonia SIC.

Objective:To investigate the completion rate of tumor evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients in the national multicenter real-world database.Methods:The prospective real-world study was conducted. The clinicopathological data of 1 074 patients who underwent surgical treatment for mid and low rectal cancer in 47 national medical institutions, including Peking Union Medical College Hospital et al, from May 12,2023 to May 11,2024 were collected. Observation indicators: (1) clinical characteristics of patients with mid and low rectal cancer; (2) initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer; (3) initial imaging evaluation of patients with mid and low rectal cancer; (4) imaging evaluation after neoadjuvant therapy for patients with mid and low rectal cancer. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absoluter numbers and/or percentages. Results:(1) Clinical characteristics of patients with mid and low rectal cancer. Of the 1 074 patients, there were 713 males and 361 females, aged 63(56,70)years. The body mass index of 1 074 patients was 24(21,26)kg/m 2.For American Society of Anesthesiologists classification, there were 147 cases of stage Ⅰ, 641 cases of stage Ⅱ, 157 cases of stage Ⅲ, 2 cases of stage Ⅳ, and there were 127 cases missing data. (2) Initial colonoscopy and pathologic evaluation of tumors in patients with mid and low rectal cancer. Of the 1 074 patients, there were 787 cases (73.28%) undergoing complete colonoscopy, and there were only 197 cases (18.34%) undergoing immunohistochemical evaluation of all four mismatch repair proteins. (3) Initial imaging evaluation of patients with mid and low rectal cancer. Of the 1 074 patients, there were 842(78.40%) patients completing magnetic resonance imaging (MRI) or ultrasound evaluation, and there were 914(85.10%) patients completing chest, abdomen, and pelvis enhanced computed tomography (CT) evaluation. In the 149 patients completing rectal ultrasound evaluation, there were 122 cases (81.88%) comple-ting T staging evaluation, and there were 81 cases (54.36%) completing N staging evaluation. In the 808 patients completing rectal MRI evaluation, there were 708 cases (87.62%) completing T staging evaluation, and there were 590 cases (73.02%) completing N staging evaluation. (4) Imaging evalua-tion after neoadjuvant therapy for patients with mid and low rectal cancer. Of the 388 patients with neoadjuvant therapy, there were 332 patients (85.57%) completing MRI or ultrasound evaluation, and there were 327 patients (84.28%) completing chest, abdomen, and pelvis enhanced CT evalua-tion. In the 70 patients completing rectal ultrasound evaluation, there were 65 cases (92.86%) com-pleting T staging evaluation, and there were 49 cases (70.00%) completing N staging evaluation. In the 327 patients completing rectal MRI evaluation, there were 246 cases (75.23%) completing T staging, and there were 228 cases (69.72%) completing N staging evaluation. Conclusion:The com-pletion rate of tumor imaging evaluation at initial assessment and after neoadjuvant therapy for mid and low rectal cancer patients on a national scale is relatively good.

Objective To investigate the application of offline solid-phase extraction-high performance liquid chromatography-tandem mass spectrometry for detecting four synthetic cannabinoids(5F-ADB,5F-MDMB-PICA,4F-MDMB-BUTINACA,and MDMB-4en-PINACA)and their marker metabolites in urban wastewater.Methods Samples were pre-treated using an Oasis PRiME HLB column(60 mg,3CC)and analyzed by ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry.The mobile phases consisted of 0.02%formic acid-2 mmol/L ammonium formate aqueous solution and acetonitrile solution,with a WATERS ACQUITY UPLCHSS T3 column.Analysis was conducted in positive ionization mode of the ESI ion source,combining multiple reaction monitoring(MRM),information-dependent acquisition(IDA),and enhanced product ion(EPI)scanning modes for qualitative and quantitative analysis of the eight target compounds.Results Good linearity was observed for 4F-MDMB-BUTINACA-M,5F-ADB,5F-ADB-M,and 5F-MDMB-PICA in the concentration range of 1～250 ng/L;for MDMB-4en-PINACA in the range of 5～250 ng/L;and for 4F-MDMB-BUTINACA,5F-MDMB-PICA-M,and 4F-MDMB-BUTINACA-M in the range of 1～500 ng/L.The recovery rates of samples spiked with different concentrations of the eight target compounds ranged from 87.68%to 104.68%,with matrix effects between 88.61%and 112.78%.Both intra-day and inter-day precision were less than 5%.Conclusion The established method demonstrates good accuracy and reproducibility,making it suitable for qualitative and quantitative detection of four synthetic cannabinoids and their metabolites in urban wastewater.

Mitochondria are organelles in eukaryotic cells that play a crucial role in cellular energy me-tabolism,oxidative stress,heat production,and signal transduction.Mitochondrial transplantation(MT)is currently one of the most advanced techniques for treating mitochondrial dysfunction and anti-aging re-search.This study aimed to explore the feasibility and effectiveness of xenogeneic MT by transplanting mitochondria from yak(Bos grunniens),domestic cattle(Bos taurus),and horse(Equus caballus)into mice(Mus musculus).The results demonstrated that mitochondria from yak,domestic cattle,and horse could be successfully transplanted into mice and maintained in various tissues and organs of the mice for at least 14 days,as confirmed by confocal imaging,digital PCR,and DNA sequencing.MT mice exhibi-ted positive biological effects,including increased ATP content and mitochondrial DNA copy number(P＜0.05),with the maximum effect observed on day 7,which was sustained until day 14.Reactive oxygen species(ROS)levels in MT mice significantly increased at 2 hours post-injection(P＜0.05),then grad-ually decreased towards baseline levels by day 7 and day 14(P＞0.05).These findings support the effec-tiveness of xenogeneic MT and suggest that the effects can be maintained for up to 14 days.This study provides scientific evidence for future clinical applications.

Objective:To analyze the preferences of medical staff in TCM hospitals in Beijing regarding the achievements transformation of hospital traditional Chinese medicine preparations,and to provide a reference for formulating incentive policies.Methods:233 medical staff from five TCM hospitals in Beijing were taken as the research objects,and surveyed with a questionnaire designed based on the discrete choice experiment(DCE).Mixed logit models and latent class models were then used to analyze their transformation preferences.Results:The mixed Logit model revealed that seven key attributes significantly influenced medical staff's preferences for the achievements transformation of traditional Chinese medicine preparations(P<0.05).Latent class analysis identified three distinct preference groups among respondents:an organization-dependent group(27.0%),a pro-transformation group(61.4%),and a conservative group(11.6%).Conclusions:Medical Staff preferred transformation conditions that increased monthly income;utilized"human use+re-experimentation";involved the hospital's achievements transformation department as the entity;were funded by the hospital;offered a 70%profit share;enabled promotion three years earlier,and assigned patents to the hospital.The study recommends implementing diverse incentive measures and developing differentiated strategies tailored to the distinct Medical Staff categories to facilitate the transformation of hospital traditional Chinese medicine preparations into new drugs.

OBJECTIVE To explore comprehensive management and potential issues associated with long-term prescriptions medications of psychiatry， in order to provide a reference for the comprehensive management of long-term prescriptions of psychiatry in psychiatric hospitals and other medical institutions’ pharmacies. METHODS Starting from the applicable principles for long-term prescriptions of psychiatry， this study introduced the standardized assessment and precautions before issuing long-term prescriptions， the formulation and adjustment of the drug list， as well as the rational management of the long-term prescriptions. It also analyzed potential issues that may arise in the comprehensive management of long-term prescription medications and proposed corresponding countermeasures and suggestions. RESULTS & CONCLUSIONS Prior to initiating long-term prescriptions， a standardized assessment should be conducted on patients from the aspects of their psychiatric condition and long-term potential risk factors， pharmacological treatment plans and other non-pharmacological therapies， physical illnesses. Additionally， healthcare providers should fulfill their obligation to inform patients or their family members. The comprehensive management of long-term prescription medications should be jointly established and improved by multiple departments， and the formulation of drug catalogs should avoid including drugs with potential social harm or medication risks while complying with policy requirements. Furthermore， measures such as adding special identifiers to long-term prescriptions， providing patients with reminders about （No.YGLX202537） prescription expiration， or offering online consultations can also effectively enhance the rationality of medication use under long-term prescriptions. Currently， the implementation of long-term prescriptions in psychiatry remains challenged by inconsistencies in prescription duration， incomplete coverage of diagnostic categories， poor patient adherence， and the risk of deviation in clinical assessments. In this regard， measures such as collaborating with multiple departments to strengthen long-term prescription information management， providing matching pharmaceutical services， ensuring the quality and rationality of long-term prescription implementation， and using modern methods to screen high-risk patients can be taken to improve patient medication compliance and safety.