Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

Rare diseases are a collective term for diseases with extremely low prevalence and incidence rates.Up to now,China has released two lists identifying a total of 207 rare diseases.Given that most rare diseases do not have drugs with corresponding indications,physicians frequently resort to using off-label drugs when treating patients with rare diseases.However,there is currently no systematic guideline or expert consensus for the use of off-label medications in China.To comprehensively collect existing evidence of off-label drug use for rare diseases,fully analyze and evaluate the rationality of off-label drug use for rare diseases,and standardize the management of off-label drug use for rare diseases,the Rare Disease Branch of Beijing Medical Association,Chinese Pharmaceutical Association,Beijing Pharmaceutical Association,and the School of Public Health,Peking University have jointly initiated the drafting of the Expert Consensus on Off-label Use of Drugs for Rare Diseases.This consensus refer to the WHO Handbook for Guideline Development,the Guidelines for Developing/Revising Clinical Diagnostic and Treatment Guidelines in China(2022 Edition),the AGREE Ⅱ and the STAR tools.This protocol outlines the background and purpose of consensus,as well as the comprehensive framework for consensus development,encompassing panel formation,clinical issue identification,evidence retrieval,data extraction,and evidence-based recommendation formulation.

Rare diseases are a collective term for diseases with extremely low prevalence and incidence rates.Up to now,China has released two lists identifying a total of 207 rare diseases.Given that most rare diseases do not have drugs with corresponding indications,physicians frequently resort to using off-label drugs when treating patients with rare diseases.However,there is currently no systematic guideline or expert consensus for the use of off-label medications in China.To comprehensively collect existing evidence of off-label drug use for rare diseases,fully analyze and evaluate the rationality of off-label drug use for rare diseases,and standardize the management of off-label drug use for rare diseases,the Rare Disease Branch of Beijing Medical Association,Chinese Pharmaceutical Association,Beijing Pharmaceutical Association,and the School of Public Health,Peking University have jointly initiated the drafting of the Expert Consensus on Off-label Use of Drugs for Rare Diseases.This consensus refer to the WHO Handbook for Guideline Development,the Guidelines for Developing/Revising Clinical Diagnostic and Treatment Guidelines in China(2022 Edition),the AGREE Ⅱ and the STAR tools.This protocol outlines the background and purpose of consensus,as well as the comprehensive framework for consensus development,encompassing panel formation,clinical issue identification,evidence retrieval,data extraction,and evidence-based recommendation formulation.

Objective The aim is to understand the common scenarios of non-medical use of prescription opioids(NMUPO)and analyze the potential facilitating and hindering factors in the regulatory process of NMUPO from the perspective of healthcare professionals.Methods Healthcare professionals in local hospitals were surveyed through a two-stage purposive sampling from June to August 2022 in Ningbo,China.The survey was conducted using a semi-structured questionnaire on topics,and thematic analysis were used to identify and summarise key themes and patterns.Results A total of 75 participants were included,the average age was(43.9±7.2)years,and 54(72.0%)were male.The most common NMUPO scenarios involved middle-aged males pretending acute severe pain to obtain injectable opioids.The facilitating and hindering factors related to the regulation of NMUPO can be categorized into three types:institutional governance,technical support,and individual behaviors.At the institutional level,facilitating factors included strict national prescribing policies and local"narcotic drug card"systems,while barriers comprised incomplete lists of controlled substances.At the technological support level,facilitating factors included the establishment of regional health information platforms,while barriers included the lack of standardized prescription guidelines and diagnostic decision-support tools.At the individual level,facilitating factors included the public's cautious attitude toward drug misuse,while barriers included strained doctor-patient relationships.Conclusion China still faces significant challenges in addressing NMUPO and urgently needs to improve the existing regulatory system.It is recommended that reforms be carried out in areas such as pharmaceutical control mechanisms,drug treatment and rehabilitation services,preventive health education activities,and the optimized use of health information systems.

The relationship between glycolysis and viral infectious diseases is close,and the inter-action between viral and host glycolysis is a common mechanism found in a wide range of viruses.Therefore,the regulation of glycolysis may be an important antiviral strategy.The coronavirus diseases 2019 pandemic has brought about a tremendous disaster to humanity,compelling us to seek effective solutions from various perspectives.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection can induce an increase in host glycolysis,the level of which plays an important role in virus replication and infection,associated with the progression of the disease and a variety of clinical symp-toms and complications.The study on the interaction between host glycolysis and SARS-CoV-2 infec-tion can shed light on the pathogenic mechanism of SARS-CoV-2 and promote the research on related drugs.This article reviews the interactions between SARS-CoV-2 infection and host glycolysis in the hopes of providing a new perspective to understand the relationships between viral infections and disease in terms of metabolic regulation and formulate countermeasures.

Objective:To automatically segment diabetic retinal exudation features from deep learning color fundus images.Methods:An applied study. The method of this study is based on the U-shaped network model of the Indian Diabetic Retinopathy Image Dataset (IDRID) dataset, introduces deep residual convolution into the encoding and decoding stages, which can effectively extract seepage depth features, solve overfitting and feature interference problems, and improve the model's feature expression ability and lightweight performance. In addition, by introducing an improved context extraction module, the model can capture a wider range of feature information, enhance the perception ability of retinal lesions, and perform excellently in capturing small details and blurred edges. Finally, the introduction of convolutional triple attention mechanism allows the model to automatically learn feature weights, focus on important features, and extract useful information from multiple scales. Accuracy, recall, Dice coefficient, accuracy and sensitivity were used to evaluate the ability of the model to detect and segment the automatic retinal exudation features of diabetic patients in color fundus images.Results:After applying this method, the accuracy, recall, dice coefficient, accuracy and sensitivity of the improved model on the IDRID dataset reached 81.56%, 99.54%, 69.32%, 65.36% and 78.33%, respectively. Compared with the original model, the accuracy and Dice index of the improved model are increased by 2.35%, 3.35% respectively.Conclusion:The segmentation method based on U-shaped network can automatically detect and segment the retinal exudation features of fundus images of diabetic patients, which is of great significance for assisting doctors to diagnose diseases more accurately.

Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.

OBJECTIVE: To detect potential variant in an ethical Han Chinese pedigree affected with breast cancer. METHODS: The proband and her relatives were subjected to next-generation sequencing using a target capture sequencing kit containing 121 cancer-related genes. Candidate variants were selected by analysis of their type, frequency in population, and segregation with the phenotype. Candidate variant was verified by Sanger sequencing and TA cloning. RESULTS: A c.2013_2014ins GT variant was detected in the BRCA1 gene among all breast cancer patients from this pedigree but not among healthy females. The variant was not recorded in the 1000 Genome Project database or the Exome Aggregation Consortium (ExAC) database. The frameshifting insertion was predicted to form an premature stop codon in gene transcript and can give rise to a truncated protein. CONCLUSION The BRCA1 c.2013_2014ins GT variant probably underlies the pathogenesis of breast cancer in this Chinese pedigree.
Asian Continental Ancestry Group ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exome ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pedigree ; Phenotype

To explore the correlation of quality of life with self-care efficacy and social support in patients with nasopharyngeal carcinoma after radiotherapy.
 Methods: A total of 179 patients with nasopharyngeal carcinoma at 3 months after radiotherapy were surveyed using self-designed general information questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30 V3.0), Chinese-version of Strategies Used by People to Promote Health (C-SUPPH), and Perceived Social Support Scale (PSSS).
 Results: The score of cognitive function was the highest, while the score of social function was the lowest. The score of related symptoms was 22.21±10.24, the overall score for quality of life was 52.46±17.96, the score of self-care efficacy was 62.14±14.50, and the score of social support was 56.03±7.63. Self-care efficacy of patients with nasopharyngeal cancer after radiotherapy was positively correlated with 5 functional areas of quality of life and overall quality of life, and negatively correlated with relevant symptoms (P<0.01). Social support was positively correlated with physical function, social function and overall quality of life (P<0.01), and negatively correlated with relevant symptoms (P<0.05). Multiple regression analysis showed that self-care efficacy could predict 5 functional areas of life quality, relevant symptoms, overall quality of life and social support predicted social function in quality of life.
 Conclusion: Self-care efficacy and social support for patients with nasopharyngeal cancer after radiotherapy can affect their quality of life. Nursing staff should pay attention to improving the self-care efficacy of patients, guide them to actively seek or obtain social support, and in turn to improve their quality of life.
Humans ; Nasopharyngeal Carcinoma ; radiotherapy ; Nasopharyngeal Neoplasms ; radiotherapy ; Quality of Life ; Self Care ; Social Support

AIM:To explore the promoting action of chloroquine on the anti-proliferation effect of dexametha-sone on acute lymphoblastic leukemia cells .METHODS:CCK-8 assay was used to assess the viability of the dexametha-sone-resistant human acute lymphoblastic leukemia CEM-C1 cell line treated with the combination of chloroquine and dexa-methasone .Western blotting , quantitative real-time PCR and LysoTracker Red staining were utilized to examine the mecha-nism.RESULTS:Combination of chloroquine and dexamethasone significantly inhibited the proliferation of CEM -C1 cells compared with control group (P<0.01).The combination of chloroquine and dexamethasone increased the abundance of glucocorticoid receptor and inhibited lysosomal function , while lysosomal inhibitor bafilomycin A 1 also increased glucocorti-coid signaling .CONCLUSION:Dexamethasone combined with chloroquine triggers an anti-proliferation effect on CEM-C1 cells via a lysosome-mediated pathway .