Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

In this study, we employed a combination of genome mining and heteronuclear single quantum coherence (HSQC)-based small molecule accurate recognition technology (SMART) technology to search for fernane-type triterpenoids. Initially, potential endophytic fungi were identified through genome mining. Subsequently, fine fractions containing various fernane-type triterpenoids were selected using HSQC data collection and SMART prediction. These triterpenoids were then obtained through targeted isolation and identification. Finally, their antifungal activity was evaluated. As a result, three fernane-type triterpenoids, including two novel compounds, along with two new sesquiterpenes and four known compounds were isolated from one potential strain, Diaporthe discoidispora. Their structures were elucidated through analysis of high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) and nuclear magnetic resonance (NMR) spectroscopic data. The absolute configurations were determined using single-crystal X-ray diffraction analysis and electron capture detector (ECD) analysis. Compound 3 exhibited moderate antifungal activity against Candida albicans CMCC 98001 and Aspergillus niger.
Triterpenes/isolation & purification* ; Antifungal Agents/isolation & purification* ; Molecular Structure ; Candida albicans/drug effects* ; Ascomycota/genetics* ; Magnetic Resonance Spectroscopy ; Aspergillus niger/drug effects* ; Genome, Fungal ; Microbial Sensitivity Tests

On August 2-4,2023,the"Third Summit Forum on'Building a Community of Shared Future for Doctors and Patients'"was jointly organized by institutions such as the Chinese Medical Ethics,the Hospital Humanities Management and Talent Training Special Committee of the China Population and Culture Promotion Association,Center for Ethical Studies of Renmin University of China,the Newspaper for China's Physicians,the China Health Law Society,the China Anti-Cancer Association,and the China Association For Ethical Studies in Harbin.The conference arranged a sub-forum for the"Seminar on the Construction of Chinese Medical Humanities",with domestic medical humanities scholars attending the conference.After heated discussions at the seminar,the Scholars'Consensus on the Construction and Development of Chinese Medical Humanities was formed.It was proposed that in the new era,it is urgent to build the medical humanities discipline,as well as lead the academic integration and development of medical humanities under the core socialist values.At the same time,for the construction of the medical humanities discipline,it is necessary to optimize the organizational mechanism,prosper and develop the overall framework of the medical humanities discipline,accelerate the construction of a professional teaching team for the medical humanities discipline,promote the establishment of a new carrier medical humanities education and teaching in cultivating morality and nurturing talents,as well as focus on solving problems related to the cultivation of medical humanities graduate students.

OBJECTIVE To develop a whole-process intelligent model of pharmaceutical care for peritoneal dialysis （PD） patients， and to provide a reference for clinical pharmacists to provide standardized PD pharmaceutical care. METHODS The pharmaceutical care mode of PD patients at home and abroad was investigated and analyzed. Based on the actual situation of the First Affiliated Hospital of Soochow University （hereinafter referred to as “our hospital”）， with “home→PD center outpatient→ inpatient department” as the main node， the recycling process of medication reconciliation was optimized. The whole-process intelligent pharmaceutical care model of PD was illustrated by improving the Chinese version of the drug-related problems （DRPs） classification tool， developing the corresponding pharmaceutical care process， and presenting specific cases. RESULTS Based on the medication therapy management （MTM） platform， our hospital had built a closed-loop PD whole-process intelligent pharmaceutical care model of “in-hospital pharmaceutical care （building document）-PD outpatient MTM-home pharmaceutical care （online App management）”. A “double cycle” workflow of “admission→discharge→outpatient” medication reconciliation cycle and “discovery-analysis-intervention-follow-up-record-evaluation” DRPs cycle was formed. CONCLUSIONS The establishment of the whole-process intelligent pharmaceutical care model for PD in our hospital provides experience for standardizing pharmaceutical care for PD patients， and can reduce DRPs.

BACKGROUND: The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts. METHODS: Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts. RESULTS: In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use. CONCLUSIONS Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.
Humans ; Arthritis, Psoriatic/drug therapy* ; East Asian People ; Enthesopathy/complications* ; Registries ; Severity of Illness Index ; Spondylarthritis/epidemiology*

Objective:To predicate whether China can achieve the United Nations Sustainable Development Goals (SDGs) 3.4.1 to reduce the age-standardized mortality rate of four major non-communicable diseases (NCDs) in residents aged 30-70 years by 2030 based on the trend of the mortality from 1990 to 2019.Methods:We collected the mortality data on cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes by age, gender and year in China from the Global Disease Burden Study 2019 (GBD2019). The age-period-cohort (APC) Bayesian model was applied for modeling the age-standardized mortality rate of four major NCDs in China during 2020-2030 according to the trend of the mortality during 1990-2019, and comparing the predicted value in 2030 with the observed value in 2015 to evaluate the possibility of achieving SDGs 3.4.1.Results:The age-standardized mortality rate of the four major NCDs in China showed a downward trend during 1990-2019. It is predicted that the number of death of the four NCDs in Chinese residents aged 30-70 years would increase from 2.96 million in 2020 to 3.19 million in 2030, while the age-standardized mortality rate would decrease from 308.49/100 000 in 2020 to 277.80/100 000 in 2030. The age-standardized mortality rate in 2030 would only decrease by 15.94% (18.73% for males and 14.31% for females) compared with 330.46/100 000 in 2015, with a 25.09% decrease for cardiovascular diseases, 4.76% for cancers, 37.21% for chronic respiratory diseases, and unchanged for diabetes.Conclusion:Although the age-standardized mortality rate of four major NCDs declined from 1990 to 2019 in China, it is difficult to achieve the SDGs of a 1/3 mortality rate reduction by 2030 according to the current declining trend, suggesting more active and effective efforts for NCD prevention and control are needed.

Objective:To analyze the spatial distribution characteristics of dogs infected with Leishmania in Wenxian and Diebu counties of Gansu Province, and provide a scientific basis for implementation of precise prevention and control measures. Methods:In 2019, blood samples were collected from all dogs in visceral leishmaniasis endemic areas Xinglong Village, Wenxian County and Luoda Village, Diebu County, Gansu Province, by cluster sampling method. The primer RV1-RV2 which was commonly used to diagnose visceral leishmaniasis, was used for PCR amplification of dog blood samples. SaTScan V9.5 software was used to analyze the spatial clustering of dogs infected with Leishmania. Results:A total of 537 dogs were investigated, and the number of positive infection was 221, with a positive rate of 41.2%. Among them, the positive rates of dogs infected with Leishmania in Wenxian and Diebu counties were 64.6% (95/147) and 32.3% (126/390), respectively. The results of SaTScan analysis showed that the spatial clustering of dogs infected with Leishmania in Wenxian and Diebu counties were not statistically significant ( P > 0.05). Conclusions:There are no spatial clustering of dogs infected with Leishmania in Wenxian and Diebu counties, but the positive rate of dogs infected with Leishmania is higher, and there is a higher risk of epidemic. It is recommended to strengthen health education in local area, strictly drive out lacewings, detect and kill diseased dogs, and reduce the risk of visceral leishmaniasis transmission.

Objective:To investigate the Leishmania infection status in dogs in canine-derived visceral leishmaniasis endemic areas in Wenxian County and Diebu County of Gansu Province, to provide basis for formulating effective prevention and treatment measures for visceral leishmaniasis. Methods:In 2019, household survey method was used to collect dog basic information (such as gender and age) in villages with higher incidence of previous cases in Wenxian County and Diebu County of Gansu Province; and venous blood of dog was collected, PCR method was used to detect microloop DNA of Leishmania. Results:A total of 537 dogs were investigated, the positive rate of Leishmania detected by PCR was 41.15% (221/537); the positive rates of PCR detection were 64.63% (95/147) and 32.31% (126/390) in Wenxian County and Diebu County, respectively, and the positive rate in Wenxian County was higher than that in Diebu County (χ 2=46.044, P < 0.05). In 35 dogs with clinical symptoms of visceral leishmaniasis, the positive rate of PCR detection was 74.29% (26/35); the positive rates of PCR detection in symptomatically infected dogs were 84.62% (22/26) and 4/9 in Wenxian County and Diebu County, respectively, the positive rate in Wenxian County was higher than that in Diebu County ( P < 0.05). The positive rate of PCR detection was 38.84% (195/502) in 502 asymptomatic dogs; the positive rates of PCR detection were 60.33% (73/121) and 32.02% (122/381) in Wenxian County and Diebu County, respectively, the positive rate in Wenxian County was higher than that in Diebu County (χ 2=39.982, P < 0.05). Conclusions:The infection rates of Leishmania in dogs are high in Wenxian County and Diebu County of Gansu Province, the positive rate of PCR detection in asymptomatic dogs infected with Leishmania is high. This indicates that local residents and dogs are at high risk of infection with Leishmania. It is recommended that relevant departments should enhance residents' awareness of active protection and strengthen efforts to control the Leishmania infection of dogs.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

Objective:To investigate the feasibility and safety of laparoscopic radical resection of hilar cholangiocarcinoma at multiple centers in China.Methods:Between December 2015 and August 2019, the clinical data of 143 patients who underwent LRHC in Affiliated Hospital of North Sichuan Medical College, Second Hospital of Hebei Medical University, Affiliated Hospital of Xuzhou Medical University, Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hunan Provincial People′s Hospital, the First Hospital Affiliated to Army Medical University, Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University, West China Hospital of Sichuan University, Nanfang Hospital of Southern Medical University and the First Affiliated Hospital of Chongqing Medical University were collected prospectively. There were 92 males and 51 females with age of (64±11) years (range: 53 to 72 years). Bismuth type: type I, 38 cases (26.6%), type Ⅱ, 19 cases (13.3%), type Ⅲa, 15 cases (10.5%), type Ⅲb, 28 cases (19.6%) and type Ⅳ, 43 cases (30.0%). The patients within the first 10 operation cases in each operation time (the first 10 patients in each operation team) were divided into group A (77 cases), and the patients after 10 cases in each operation time were classified as group B (66 cases); the cases with more than 10 cases in the center were further divided into group A 1 (116 cases), and the center with less than 10 cases was set as group A 2 (27 cases). T test or Wilcoxon test was used to compare the measurement data between groups, and the chi square test or Fisher exact probability method was used to compare the counting data between groups. Kaplan Meier curve was used for survival analysis. Results:All patients successfully completed laparoscopic procedure. The mean operation time was (421.3±153.4) minutes (range: 159 to 770 minutes), and the intraoperative blood loss was 100 to 1 500 ml (median was 300 ml) .Recent post-operative complications contained bile leakage, abdominal bleeding, abdominal infection, gastrointestinal bleeding, and delay gastric emptying, pulmonary infection, liver failure, et al.The post-operative hospital stay was (15.9±9.2) days. The operation time in group B was relatively reduced ( (429.5±190.7)minutes vs. (492.3±173.1)minutes, t=2.063, P=0.041) and the blood loss (465 ml vs. 200 ml) was also reduced ( Z=2.021, P=0.043) than that in group B. The incidence of postoperative biliary fistula and lung infection in patients in group A was significantly higher than that in group B (χ 2=4.341, 0.007; P=0.037, 0.047) .Compared with group A 2, the operation time in group A 1 was relatively reduced( (416.3±176.5)minutes vs. (498.1±190.4)minutes, t=2.136, P=0.034) , the incidence of bile leakage and abdominal cavity infection in group A 1 was lower than that in group A 2 (χ 2=7.537, 3.162; P=0.006, 0.046) . Kaplan Meier survival curve showed that the difference of short-term survival time between group A and group B was statistically significant ( P<0.05) . Conclusions:The completion of laparoscopic hilar cholangiocarcinoma radical surgery is based on improved surgical skills, and proficiency in standardized operation procedures.It is feasible for laparoscopic radical resection of hilar cholangiocarcinoma to well experienced surgeon with cases be strictly screened, but it is not recommended for widespread promotion at this exploratory stage.