Under the background of the Healthy China Strategy, public hospitals urgently need to break through the limitations of the traditional medical mode, build a precise and continuous medical service system to meet the growing personalized health needs of the people. In 2022, a tertiary public hospital launched a multidisciplinary whole course management service practice. By integrating multidisciplinary medical and health resources, clarifying service targets and contents, forming a whole course management service team, constructing a supporting information platform, linking full process services, creating standardized service processes, and providing patients with comprehensive, full process, professional, and accurate full cycle intervention management and care. The hospital covered diseases in stages, ensuring continuous medical for patients after leaving the hospital, improving their medical experience, and supporting the high-quality development of the hospital. As of June 2024, the hospital′s multidisciplinary whole course management services had covered 25 departments and 41 disease, and 43 management teams have been established. A total of 7 453 patients signed up for the whole course service. This practice achieved good results, could provide references for the implementation of whole course management services led by public hospitals.

Breast cancer has emerged as the leading cause of cancer incidence and mortality among women globally,with approximately 70%of cases being estrogen receptor(ER)and/or progesterone receptor(PR)positive.The primary treatment for hormone receptor(HR)positive breast cancer is endocrine therapy;however,endocrine therapy resistance remains a critical area of ongoing research.Cyclin D1 is recognized as a biomarker for tumor phenotype and disease progression,and it has been established to correlate with the onset,progres-sion,and prognosis of breast cancer.Recently,studies have also reported the significant role of Cyclin D1 in endocrine resistance in breast cancer.This article provides an overview of the research progress on Cyclin D1 in breast cancer,with a particular emphasis on its relation-ship with endocrine therapy resistance,aiming to offer novel insights for the endocrine treatment of breast cancer.

Objective:To explore the effects of Levothyroxine Sodium (L-T4) treatment on coagulation function and adverse pregnancy outcomes in patients with hypothyroidism during pregnancy in early and mid-to-late pregnancy.Methods:A total of 120 patients with hypothyroidism during pregnancy who were treated by L-T4 in Linyi Central Hospital from Mar. 2021 to Mar. 2024 were included, and their clinical data were retrospectively analyzed. According to the gestational age of the patients at the time of treatment, 64 cases with a gestational age of <12 weeks were included in the early pregnancy group, and 56 cases with a gestational age of ≥12 weeks were included in the mid-to-late pregnancy group. The serum thyroid hormone indexes, coagulation function indexes, adverse pregnancy outcomes, and neuropsychological development of the offspring were compared between the two groups. Statistical analyses were conducted using independent/paired t-tests and chi-square tests.Results:After treatment, there were no significant differences in the thyroid hormone indexes and coagulation function indexes between the early pregnancy group and the middle and late pregnancy group ( P>0.05). The incidence of fetal growth restriction and gestational hypertension in the early pregnancy group was 10.94% (7/64) and 17.19% (11/64), and that in the middle and late pregnancy group was 26.79% (15/56) and 33.93% (19/56), respectively. The incidence in the early pregnancy group was significantly lower than that in the middle and late pregnancy group ( χ2=5.010, 4.464, P<0.05). The developmental quotient (DQ) of the offspring in the early pregnancy group at 6 months of age in various areas of neuropsychological development (social behavior, language, adaptability, fine motor skills and gross motor skills) was significantly higher than that in the middle and late pregnancy group. The DQ of the first trimester group was (97.82±7.25) points, (94.59±6.85) points, (95.87±8.02) points, (96.08±7.25) points, and (98.34±8.07) points. The DQ of the second trimester group was (92.54±7.06) points, (90.45±6.14) points, (91.01±7.51) points, (91.24±7.08) points, and (92.74±7.38) points. The DQ of the first trimester group was significantly higher than that of the second trimester group ( t=4.029, 3.466, 3.411, 3.688, 3.946, P<0.05) . Conclusion:L-T4 treatment in early or mid- to late-pregnancy patients with gestational hypothyroidism can effectively improve their thyroid hormone levels and coagulation function, but treatment in early pregnancy is beneficial to reduce the incidence of adverse pregnancy outcomes such as fetal growth restriction and alleviate the impact of the disease on the neuropsychological development of offspring.

Objective:To explore the effects of Levothyroxine Sodium (L-T4) treatment on coagulation function and adverse pregnancy outcomes in patients with hypothyroidism during pregnancy in early and mid-to-late pregnancy.Methods:A total of 120 patients with hypothyroidism during pregnancy who were treated by L-T4 in Linyi Central Hospital from Mar. 2021 to Mar. 2024 were included, and their clinical data were retrospectively analyzed. According to the gestational age of the patients at the time of treatment, 64 cases with a gestational age of <12 weeks were included in the early pregnancy group, and 56 cases with a gestational age of ≥12 weeks were included in the mid-to-late pregnancy group. The serum thyroid hormone indexes, coagulation function indexes, adverse pregnancy outcomes, and neuropsychological development of the offspring were compared between the two groups. Statistical analyses were conducted using independent/paired t-tests and chi-square tests.Results:After treatment, there were no significant differences in the thyroid hormone indexes and coagulation function indexes between the early pregnancy group and the middle and late pregnancy group ( P>0.05). The incidence of fetal growth restriction and gestational hypertension in the early pregnancy group was 10.94% (7/64) and 17.19% (11/64), and that in the middle and late pregnancy group was 26.79% (15/56) and 33.93% (19/56), respectively. The incidence in the early pregnancy group was significantly lower than that in the middle and late pregnancy group ( χ2=5.010, 4.464, P<0.05). The developmental quotient (DQ) of the offspring in the early pregnancy group at 6 months of age in various areas of neuropsychological development (social behavior, language, adaptability, fine motor skills and gross motor skills) was significantly higher than that in the middle and late pregnancy group. The DQ of the first trimester group was (97.82±7.25) points, (94.59±6.85) points, (95.87±8.02) points, (96.08±7.25) points, and (98.34±8.07) points. The DQ of the second trimester group was (92.54±7.06) points, (90.45±6.14) points, (91.01±7.51) points, (91.24±7.08) points, and (92.74±7.38) points. The DQ of the first trimester group was significantly higher than that of the second trimester group ( t=4.029, 3.466, 3.411, 3.688, 3.946, P<0.05) . Conclusion:L-T4 treatment in early or mid- to late-pregnancy patients with gestational hypothyroidism can effectively improve their thyroid hormone levels and coagulation function, but treatment in early pregnancy is beneficial to reduce the incidence of adverse pregnancy outcomes such as fetal growth restriction and alleviate the impact of the disease on the neuropsychological development of offspring.

Breast cancer has emerged as the leading cause of cancer incidence and mortality among women globally,with approximately 70%of cases being estrogen receptor(ER)and/or progesterone receptor(PR)positive.The primary treatment for hormone receptor(HR)positive breast cancer is endocrine therapy;however,endocrine therapy resistance remains a critical area of ongoing research.Cyclin D1 is recognized as a biomarker for tumor phenotype and disease progression,and it has been established to correlate with the onset,progres-sion,and prognosis of breast cancer.Recently,studies have also reported the significant role of Cyclin D1 in endocrine resistance in breast cancer.This article provides an overview of the research progress on Cyclin D1 in breast cancer,with a particular emphasis on its relation-ship with endocrine therapy resistance,aiming to offer novel insights for the endocrine treatment of breast cancer.

Under the background of the Healthy China Strategy, public hospitals urgently need to break through the limitations of the traditional medical mode, build a precise and continuous medical service system to meet the growing personalized health needs of the people. In 2022, a tertiary public hospital launched a multidisciplinary whole course management service practice. By integrating multidisciplinary medical and health resources, clarifying service targets and contents, forming a whole course management service team, constructing a supporting information platform, linking full process services, creating standardized service processes, and providing patients with comprehensive, full process, professional, and accurate full cycle intervention management and care. The hospital covered diseases in stages, ensuring continuous medical for patients after leaving the hospital, improving their medical experience, and supporting the high-quality development of the hospital. As of June 2024, the hospital′s multidisciplinary whole course management services had covered 25 departments and 41 disease, and 43 management teams have been established. A total of 7 453 patients signed up for the whole course service. This practice achieved good results, could provide references for the implementation of whole course management services led by public hospitals.

Objective To investigate the expression,synergistic relationship and clinical significance of alcohol de-hydrogenase(ADH1A)and vascular endothelial growth factor-A(VEGFA)in hepatocellular carcinoma(HCC).Methods The expression and correlation of ADH1A and VEGFA in HCC and adjacent normal tissues were ana-lyzed by GEPIA.TCGA and GSEA were used to analyze the pathway of ADH1A in HCC.The clinical and patho-logical data of 84 patients with HCC were collected,and 54 patients with paracancer normal tissue samples were se-lected as controls to analyze the correlation between ADH1A and VEGFA and clinicopathological parameters of HCC.Immunohistochemistry was used to detect the protein expression of ADH1A and VEGFA in cases and con-trols,and the correlation between the expression of ADH1A and VEGFA and the clinical progression and prognosis of patients with HCC was analyzed based on clinical pathological parameters and Kaplan-Meier.Results Bioinfor-matics analysis found that ADH1A was low-expressed in HCC and VEGFA was highly expressed in HCC,and there was a negative correlation between the two(P<0.001);immunohistochemical detection results showed that the expression of ADH1A in HCC tissue was lower than that in normal tissue adjacent to cancer(P<0.01)while the expression rate of VEGFA in HCC tissue was significantly higher than that of normal tissue adjacent to cancer(P<0.01);The recurrence rate of vascular thrombus and HCC patients in HCC group with high expression of ADH1A was lower(P<0.05).The proportion of tumor diameter>5 cm,high TNM stage,microsatellite and G2-G3 dif-ferentiation in HCC tissues in VEGFA high expression group was higher(P<0.05).Kaplan-Meier survival analy-sis showed that patients with high ADH1A expression and low VEGFA expression had a higher five-year survival rate.Conclusion Low expression of ADH1A and high expression of VEGFA in tumor tissues of patients with HCC indicate tumor progression and can be used as one of the prognostic evaluation indicators for patients with HCC.

Inflammatory markers in peripheral blood,such as neutrophil-lymphocyte ratio and platelet-lymphocyte ratio,can reflect the reactive hyperplasia of inflammatory cells in tumors.The metabolic parameters of 18F-FDG PET/CT are also correlated with the reactive hyperplasia of inflammatory cells in tumors.However,only a few reports exist on the relationship between tumor metabolic parameters and peripheral blood inflammatory markers.Therefore,this review starts from three aspects:tumor peripheral blood inflammatory markers,inflammatory cell reactive hyperplasia in tumors,and 18F-FDG PET/CT metabolic parameters.The correlation between 18F-FDG PET/CT metabolic parameters and peripheral blood inflammatory markers is reviewed.

Community-acquired respiratory infection is the commonest cause of sepsis presenting to emergency departments. Yet current experimental animal models simulate peritoneal sepsis with intraperitoneal (I.P.) injection of lipopolysaccharide (LPS) as the predominant route. We aimed to compare the progression of organ injury between I.P. LPS and intranasal (I.N.) LPS in order to establish a better endotoxemia murine model of respiratory sepsis. Eight weeks old male BALB/c mice received LPS-Escherichia coli doses at 0.15, 1, 10, 20, 40 and 100 mg per kg body weight (e.g. LPS-10 is a dose of 10 mg/kg body weight). Disease severity was monitored by a modified Mouse Clinical Assessment Score for Sepsis (M-CASS; range 0–21). A M-CASS score ≥ 10 or a weight reduction of ≥ 20%, was used as a criterion for euthanasia. The primary outcome was the survival rate (either no death or no need for euthanasia). The progression of disease was specified as M-CASS, body weight, blood glucose, histopathological changes to lung, liver, spleen, kidney, brain and heart tissues. Survival rate in I.P. LPS-20 mice was 0% (2/3 died; 1/3 euthanized with M-CASS > 10) at 24 h. Survival rate in all doses of I.N. LPS was 100% (20/20; 3–4 per group) at 96 h. 24 h mean M-CASS post-I.P. LPS-10 was 6.4/21 significantly higher than I.N. LPS-10 of 1.7/21 (Unpaired t test, P < 0.05). Organ injury was present at 96 h in the I.P. LPS-10 group: lung (3/3; 100%), spleen (3/3; 100%) and liver (1/3; 33%). At 24 h in the I.P. LPS-20 group, kidney injury was observed in the euthanized mouse. At 96 h in the post-I.N. LPS-20 group, only lung injury was observed in 2/3 (67%) mice (Kruskal-Wallis test with Dunn’s, P < 0.01). At 24 h in the post-I.N. LPS-100 group all (4/4) mice had evidence of lung injury. Variable doses of I.N. LPS in mice produced lung injury but did not produce sepsis. Higher doses of I.P. LPS induced multi-organ injury but not respiratory sepsis. Lethal models of respiratory virus, e.g., influenza A, might provide alternative avenues that can be explored in future research.

Breast cancer is one of the most common malignant tumors and the primary cause of cancer-related deaths in women globally.Approximately 70%of all breast cancers are hormone receptor-positive,and endocrine therapy is the main treatment for this cancer type.Endocrine therapy resistance often leads to treatment failure and the death of patients,which is a clinical problem that needs urgent solu-tion.Research in the past few decades has shown that epithelial-mesenchymal transition(EMT)is a key event in cancer metastasis and asso-ciated with tumor treatment resistance.Increasing evidence suggests that EMT plays a key role in endocrine therapy resistance in breast cancer.This article reviews latest research on the relationship between EMT and endocrine resistance in breast cancer and discusses the specific molecular mechanisms involved,to provide new ideas and potential therapeutic targets for reversing endocrine therapy resistance in breast cancer.