Testicular radiation injury is a structural and functional abnormality of the testes caused directly or indirectly by radiation, which disrupts spermatogenesis and compromises male fertility. The development of effective preventive and therapeutic interventions is essential because of the high prevalence of this condition in clinical settings and its profound effect on patients′ reproductive health and overall well-being. The concept of "the struggle between vital qi and pathogen" is first seen in the Treatise on Cold Pathogenic Diseases. It denotes the dynamic struggle between vital and pathogenic qi. The occurrence, development, and sequelae of all diseases reflect this ongoing conflict. In this context, this study defines the "vital qi" of the testis as its capacity to generate and preserve the essence of reproduction and to resist damage. The pathogenic qi associated with testicular radiation injury is categorized into two types: ionizing poison and retaining evil. The pathogenesis of testicular radiation damage is delineated into three stages by integrating the characteristics of vital and pathogenic qi: the injury, adhesion, and recovery phases. Based on the theoretical framework advanced by this study, the therapeutic approach for testicular radiation injury should adhere to the fundamental principle of strengthening vital qi and eliminating pathogenic factors. Although the primary focus of treatment should be on strengthening vital qi, it should also be complemented by strategies to eliminate pathogenic influences. This paper aims to provide a novel perspective and strategic approach to the traditional Chinese medicine diagnosis, prevention, and treatment of testicular radiation injury. By elucidating the process of testicular radiation injury and its corresponding treatment principles, it seeks to offer valuable insights for clinical practice.

OBJECTIVE To make up the research gap of the concept of collaboration between clinical pharmacists and physicians in China， and to provide a theoretical basis for further improving the collaboration. METHODS Literature analysis was used to sort out the existing concepts of collaboration. Combined with the current practice and development trend of the collaboration between clinical pharmacists and physicians in China， the basic elements of the concept were deconstructed and the connotation of each component of the concept was explained in detail. RESULTS & CONCLUSIONS Based on the above theoretical research and practical analysis， the concept of collaboration between clinical pharmacists and physicians in the context of China was defined， that is， clinical pharmacists and physicians adhere to the patient-centered and rational drug use as the core in clinical drug therapy， and make joint decisions on drug management and drug therapy on the basis of communication， respect， trust and sharing， so as to ensure the effectiveness， safety and economy of clinical pharmaceutical care， and improve the coordination and cooperation process of comprehensive disease treatment system.

OBJECTIVE To explore the influential factors for the collaboration between clinical pharmacists and physicians， and provide reference for improving the collaboration between clinical pharmacists and physicians in China. METHODS The published literature about influential factors for the collaboration between pharmacists and physicians from various countries was collected from Chinese and English databases； the division methods of influential factors for the collaboration were summarized； then the influential factors and possible mechanisms were summarized referring to the collaborative working relationship model， and the integrity and applicability of existing influential factors in Chinese health system were discussed. RESULTS & CONCLUSIONS Finally， a total of 27 pieces of literature were included and all in English. Different studies had different ways of classifying the influential factors. There were three main classifications： the perspective of the collaboration subject， the progress stage of collaboration/external and internal factors， existing collaboration conceptual model and measurement tool structure. By summarizing the existing literature， it can be obtained that there are influential factors and specific connotation for the collaboration between clinical pharmacists and physicians in China based on three dimensions of the characteristics of individual， context and exchange. In addition， the personnel situation and social publicity with Chinese characteristics can also be taken into consideration.

The local microenvironment is essential to stem cell-based therapy for ischemic stroke, and spatiotemporal changes of the microenvironment in the pathological process provide vital clues for understanding the therapeutic mechanisms. However, relevant studies on microenvironmental changes were mainly confined in the acute phase of stroke, and long-term changes remain unclear. This study aimed to investigate the microenvironmental changes in the subacute and chronic phases of ischemic stroke after stem cell transplantation. Herein, induced pluripotent stem cells (iPSCs) and neural stem cells (NSCs) were transplanted into the ischemic brain established by middle cerebral artery occlusion surgery. Positron emission tomography imaging and neurological tests were applied to evaluate the metabolic and neurofunctional alterations of rats transplanted with stem cells. Quantitative proteomics was employed to investigate the protein expression profiles in iPSCs-transplanted brain in the subacute and chronic phases of stroke. Compared with NSCs-transplanted rats, significantly increased glucose metabolism and neurofunctional scores were observed in iPSCs-transplanted rats. Subsequent proteomic data of iPSCs-transplanted rats identified a total of 39 differentially expressed proteins in the subacute and chronic phases, which are involved in various ischemic stroke-related biological processes, including neuronal survival, axonal remodeling, antioxidative stress, and mitochondrial function restoration. Taken together, our study indicated that iPSCs have a positive therapeutic effect in ischemic stroke and emphasized the wide-ranging microenvironmental changes in the subacute and chronic phases.
Animals ; Cell Differentiation ; Disease Models, Animal ; Ischemic Stroke ; Proteomics ; Rats ; Stem Cell Transplantation/methods* ; Stroke/therapy*

Objective:To compare the effects of volume-controlled ventilation (VCV),pressure-controlled ventilation (PCV) and pressure controlled ventilation-volume guarantee (PCV-VG) on respiratory mechanics and respiratory function index in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods:Seventy-five patients who underwent EBUS-TBNA under general anesthesia during February to December in 2019 in Lishui City People's Hospital,China were included in this study.They were randomly assigned to undergo VCV (Group V),PCV (Group P) or PCV-VG (Group G),with 25 patients in each group during EBUS-TBNA.After exclusion because of different reasons,25,24 and 24 patients from the Groups V,P and G respectively were included in the final analysis.Peak airway pressure (P peak),pulmonary dynamic compliance (C dyn),the partial pressure of carbon dioxide in arterial blood (PaCO 2),and oxygenation index (OI) at baseline (T 0),at the time of EBUS-TBNA for 30 (T 1) and 60 min (T 2) and immediately after EBUS-TBNA (T 3). Results:At T 2 and T 3,P peak in the Group P was (22.5 ±5.2) cmH 2O and (16.2 ± 2.8) cmH 2O respectively,which was significantly lower than that in the Group V [(25.8 ± 3.5) cmH 2O,(18.2 ± 3.2) cmH 2O, q = 3.672,3.454, P = 0.031,0.045).At T 1,T 2 and T 3,C dyn in the Group P was (26.4 ± 5.0) mL/cmH 2O,(24.1 ± 4.5) mL/cmH 2O and (32.5 ± 4.2) mL/cmH 2O,respectively,which was significantly higher than that in the Group V [(23.0 ± 2.7) mL/cmH 2O,(19.9 ± 2.1) mL/cmH 2O,(28.5 ± 3.7) mL/cmH 2O, q = 3.732,4.795,4.118, P = 0.027,0.004,0.013).At T 2 and T 3,P peak in the Group G was (21.7 ± 4.3) cmH 2O,(15.6 ± 2.6) cmH 2O,respectively,which was significantly lower than that in the Group V [(25.8 ± 3.5) cmH 2O,(18.2 ± 3.2) cmH 2O, q = 4.493,4.332, P = 0.006,0.009]. At T 1,T 2,and T 3,C ydn in the Group G was (26.6 ± 5.6) mL/cmH 2O,(24.3 ± 5.6) mL/cmH 2O,(33.2 ± 6.3) mL/cmH 2O,which was higher than that in the Group V [(23.0 ± 2.7) mL/cmH 2O,(19.9 ± 2.1) mL/cmH 2O,(28.5 ± 3.7) mL/cmH 2O, q = 3.852,4.936,4.791, P = 0.022,0.002,0.003]. At T 2 and T 3,PaCO 2 in the Group G was (41.1 ± 3.8) mmHg,(38.4 ± 3.4) mmHg,respectively,which was significantly lower than that in the group V [(45.7 ± 3.4) mmHg,(41.0 ± 3.0) mmHg, q = 5.969,3.682, P = 0.000,0.030].At T 2,OI in the group G was significantly higher than that in the group V [(358.0 ± 32.8) mmHg vs.(326.6 ± 29.7) mmHg, q = 4.782, P = 0.030].There were no significant differences in indexes between groups P and G (all P>0.05). Conclusion:During EBUS-TBNA for>60 min,PCV combined with VG can not only reduce airway pressure and improve lung compliance,but also prevent respiratory acidosis and improve oxygenation.

Objective:To determine the risk profile of venous thromboembolism (VTE) and evaluate VTE prophylaxis implementation of the hospitalized cancer patients in the DissolVE 2 study.Methods:The data of hospitalized cancer patients in the DissolVE 2 study were analyzed. The risk distribution of VTE, preventive measures and in-hospital VTE events of hospitalized patients with tumors were described by percentage and 95% confident interval (CI).Results:A total of 1 535 cancer patients were included. According to the Padua score, 826 (53.8%) patients were at low risk of VTE, while 709 (46.2%) patients were at high VTE risk. VTE events occurred in 4 low-risk patients (0.5%; 95% CI: 0.1%, 1.2%) and 5 high-risk patients (0.7%; 95% CI: 0.2%, 1.6%). The overall incidence was 0.6% (9/1 535, 95% CI: 0.3%, 1.1%). Among patients with high VTE risk, 666 (93.9%) did not receive any VTE prophylaxis, and only 11 (1.6%) patients received appropriate VTE prophylaxis. Among patients who received VTE prevention, no VTE event was observed. Conclusions:Nearly half of the hospitalized cancer patients are at high risk of VTE, but most of them don′t receive VTE prophylaxis. The results reflect the insufficient management of VTE risk for hospitalized cancer patients in China, and improvement of awareness and practice of VTE prophylaxis is urgently needed.

Objective:To investigate the relationship between plasma levels of complements before treatment and the clinicopathological feathers and prognoses of diffuse large B-cell lymphoma (DLBCL) patients treated with Rituximab (R)-CHOP or R-CHOP-like therapy.Methods:The clinicopathological data of 105 DLBCL patients treated in cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2016 were collected. The plasma samples from 105 DLBCL patients treated with R-CHOP or R-CHOP-like therapy and 80 healthy controls were used to detect 34 complement levels before treatment by utilizing antibody microarray. The relationship between plasma levels of complements and the clinicopathological feathers and prognosis of DLBCL patients were analyzed.Results:The signal values of C1QA and CR1L in patients with international prognostic index (IPI) scores of 3-5 were 1 261.43±138.9 and 2 214.69±98.58, respectively, higher than 950.79±80.19 and 984.67±121.79 in patients with IPI scores of 0~2 (both P<0.05). The levels of C1QA and CR1L in the non-complete response (CR) group were 1 165.43±98.56 and 2 263.13±145.63, respectively, higher than 914.70±100.77 and 1 821.34±84.68 in the CR group (both P<0.05). Cox regression analysis showed that elevated C1QA signal value was associated with poor progression-free survival (PFS) and poor overall survival (OS) (PFS: HR=2.063, 95% CI: 1.220-3.489, P=0.007; OS: HR=2.23, 95% CI: 1.036~4.798, P=0.040). After IPI correction by Cox multivariate model, the elevated C1QA signal value was still correlated with poor PFS ( HR=1.765, 95% CI 1.034~3.013, P=0.037). Conclusions:The baseline plasma levels of C1QA and CR1L are correlated with IPI scores and therapeutic effects of DLBCL patients treated with R-CHOP. The baseline plasma level of C1QA has a certain predictive value for the prognostic evaluation of DLBCL.

Objective:To determine the risk profile of venous thromboembolism (VTE) and evaluate VTE prophylaxis implementation of the hospitalized cancer patients in the DissolVE 2 study.Methods:The data of hospitalized cancer patients in the DissolVE 2 study were analyzed. The risk distribution of VTE, preventive measures and in-hospital VTE events of hospitalized patients with tumors were described by percentage and 95% confident interval (CI).Results:A total of 1 535 cancer patients were included. According to the Padua score, 826 (53.8%) patients were at low risk of VTE, while 709 (46.2%) patients were at high VTE risk. VTE events occurred in 4 low-risk patients (0.5%; 95% CI: 0.1%, 1.2%) and 5 high-risk patients (0.7%; 95% CI: 0.2%, 1.6%). The overall incidence was 0.6% (9/1 535, 95% CI: 0.3%, 1.1%). Among patients with high VTE risk, 666 (93.9%) did not receive any VTE prophylaxis, and only 11 (1.6%) patients received appropriate VTE prophylaxis. Among patients who received VTE prevention, no VTE event was observed. Conclusions:Nearly half of the hospitalized cancer patients are at high risk of VTE, but most of them don′t receive VTE prophylaxis. The results reflect the insufficient management of VTE risk for hospitalized cancer patients in China, and improvement of awareness and practice of VTE prophylaxis is urgently needed.

Objective:To investigate the relationship between plasma levels of complements before treatment and the clinicopathological feathers and prognoses of diffuse large B-cell lymphoma (DLBCL) patients treated with Rituximab (R)-CHOP or R-CHOP-like therapy.Methods:The clinicopathological data of 105 DLBCL patients treated in cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2016 were collected. The plasma samples from 105 DLBCL patients treated with R-CHOP or R-CHOP-like therapy and 80 healthy controls were used to detect 34 complement levels before treatment by utilizing antibody microarray. The relationship between plasma levels of complements and the clinicopathological feathers and prognosis of DLBCL patients were analyzed.Results:The signal values of C1QA and CR1L in patients with international prognostic index (IPI) scores of 3-5 were 1 261.43±138.9 and 2 214.69±98.58, respectively, higher than 950.79±80.19 and 984.67±121.79 in patients with IPI scores of 0~2 (both P<0.05). The levels of C1QA and CR1L in the non-complete response (CR) group were 1 165.43±98.56 and 2 263.13±145.63, respectively, higher than 914.70±100.77 and 1 821.34±84.68 in the CR group (both P<0.05). Cox regression analysis showed that elevated C1QA signal value was associated with poor progression-free survival (PFS) and poor overall survival (OS) (PFS: HR=2.063, 95% CI: 1.220-3.489, P=0.007; OS: HR=2.23, 95% CI: 1.036~4.798, P=0.040). After IPI correction by Cox multivariate model, the elevated C1QA signal value was still correlated with poor PFS ( HR=1.765, 95% CI 1.034~3.013, P=0.037). Conclusions:The baseline plasma levels of C1QA and CR1L are correlated with IPI scores and therapeutic effects of DLBCL patients treated with R-CHOP. The baseline plasma level of C1QA has a certain predictive value for the prognostic evaluation of DLBCL.