ObjectiveTo explore the effect of the medical-community linkage model on activities of daily living, psychological status and motor function of stroke patients in the community. MethodsA total of 60 stroke patients admitted to two community health service centers and their affiliated stations in Fengtai District, Beijing, from January, 2024 to August, 2025 were enrolled and randomly divided into control group (n = 30) and intervention group (n = 30). The control group received routine medicine, dietary care and rehabilitation management, while the intervention group underwent rehabilitation with the medical-community linkage model, for twelve weeks. They were assessed with modified Barthel Index (MBI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Fugl-Meyer Assessment (FMA) before and after intervention. ResultsAfter intervention, the MBI, HAMA, HAMD and FMA scores of patients improved in both groups (|t| > 5.599, P < 0.001), and improved more in the intervention group than in the control group (P < 0.05), except MBI. The HAMA and HAMD scores of family members decreased in both groups (|t| > 10.333, P < 0.001), and decreased more in the intervention group than in the control group (t > 5.681, P < 0.001). ConclusionThe medical-community linkage model can further improve the motor function of stroke patients in community, as well as the psychological status of both patients and their family members.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To explore the feasibility and clinical value of sentinel lymph node (SLN) biopsy through cervix-uterine combined two-step injection with two tracers in patients with early stage endometrial cancer.Methods:From July 2019 to April 2021, a total of 73 patients, aged (54.2±3.3) year, who were preoperatively diagnosed as stage Ⅰ-Ⅱ endometrial cancer (including 56 low-risk patients and 17 medium-high risk patients) in Affiliated Hospital of Qingdao University were selected. According to the different sites of tracer injection, the patients were randomly divided into three groups: cervical injection group (25 cases): 1 ml of nano-carbon was used to inject at 3 and 9 o'clock in the cervix; uterine injection group (21 cases): the magnetic resonance imaging examination was performed to determine the location of the lesion, and 4 ml of methylene blue was injected into the uterine body at 2 sites where the lesion was located; combined injection group (27 cases): cervical injection of nano-carbon (1 ml) combined with uterine injection of methylene blue (4 ml). The SLN in all patients were identified under laparoscopy, removed, and followed by frozen pathological examination. Pathological ultra-staging was performed if the postoperative pathological outcome of SLN was negative. The total detection rate of SLN, bilateral pelvic SLN detection rate, sensitivity, negative predictive value, and location of SLN in each group were calculated and compared.Results:(1) In 73 patients with endometrial cancer, the overall detection rate of SLN was 88% (64/73), the detection rate of bilateral pelvic SLN was 67% (49/73), and the detection rate of para-aortic SLN was 49% (36/73). The overall detection rate of SLN (71%, 15/21) and bilateral pelvic SLN (43%, 9/21) in the intrauterine injection group were significantly lower than those in the cervical injection group [92% (23/25), 76% (19/25), respectively] and the combined injection group [96% (26/27), 78% (21/27), respectively; all P<0.05]; the detection rate of para-aortic SLN in the cervical injection group (28%, 7/25) was significantly lower than those in the intrauterine injection group and combined injection group [52% (11/21) and 67% (18/27), respectively; both P<0.05]. Among 73 cases with endometrial cancer, 9 had lymph node metastasis confirmed by postoperative pathological examination, 8 of them had lymph node metastasis detected by SLN and 1 had no lymph node metastasis detected by SLN, with a total sensitivity of 89% and a negative predictive value of 98%. The sensitivity and negative predictive value of cervical injection group and combined injection group were 100%, while the sensitivity and negative predictive value of intrauterine injection group were 67% and 95%. Among 56 low-risk patients, only one patient with lymph node metastasis was confirmed by postoperative pathology by SLN detection, and the metastasis rate was 2% (1/56), and the sensitivity and negative predictive value were 100%. Lymph node metastasis was confirmed in 8 of 17 patients (8/17) with a sensitivity of 88% and a negative predictive value of 90%. (2) A total of 459 SLN were detected in 73 endometrial cancer patients, with the highest proportion of external iliac (33.3%, 153/459).The obturator foramen was 25.3% (116/459), para-aortic 19.6% (90/459), iliac 12.0% (55/459), and presacral 9.8% (45/459). The proportion of para-aortic SLN in the cervical injection group was 12.4% (21/169), which were significantly lower than that in the intrauterine injection group and the combined injection group [27.4% (26/95) and 22.1% (43/195), respectively; both P<0.05]. (3) Pathological super-staging results: among 64 patients with negative SLN routine paraffin pathology, 4 cases of lymph node micro-metastases and 1 case of isolated tumor cell metastasis were detected, and the SLN micro-metastases rate was 8% (5/64), including 2 cases of low-risk patients and 3 cases of medium-high risk patients. Conclusions:SLN biopsy has high sensitivity and negative predictive value in patients with early endometrial cancer and could be used as an alternative to systematic lymph node dissection in low-risk patients. The SLN mapping through cervical-uterine combined injection could further improve the detection rate effectively and avoid the missed detection of positive para-aortic lymph node, especially for high-risk patients or patients with fundal tumor involvement.

Thimerosal has been widely used as a preservative in drug and vaccine products for decades.Due to the strong propensity to modify thiols in proteins,conformational changes could occur due to covalent bond formation between ethylmercury(a degradant of thimerosal)and thiols.Such a conformational change could lead to partial or even complete loss of desirable protein function.This study aims to investigate the effects of thimerosal on the capsid stability and antigenicity of recombinant human papillomavirus(HPV)18 virus-like particles(VLPs).Dramatic destabilization of the recombinant viral capsid upon thimerosal treatment was observed.Such a negative effect on the thermal stability of VLPs preserved with thimerosal was shown to be dependent on the thimerosal concentration.Two highly neutralizing antibodies,13H12 and 3C3,were found to be the most sensitive to thimerosal treatment.The kinetics of antigenicity loss,when monitored with 13H12 or 3C3 as probes,yielded two distinctly different sets of kinetic parameters,while the data from both monoclonal antibodies(mAbs)followed a biphasic expo-nential decay model.The potential effect of thimerosal on protein function,particularly for thiol-containing proteinaceous active components,needs to be comprehensively characterized during formulation development when a preservative is necessary.

OBJECTIVE：To construct the evaluation system for TCM pharmaceutical care quality in public hospitals of Jilin province，and to provide reference for improving the quality of TCM pharmaceutical care in public hospitals. METHODS ：On Nov. 2020，20 relevant personnel and 10 experts in the field of TCM in Jilin province were selected by theoretical sampling method and objective sampling method ，respectively；grounded theory and Delphi method were adopted to sort out and score the evaluation system of TCM pharmaceutical care quality in public hospitals. Analytic hierarchy process （AHP）was used to determine the weight of each index. RESULTS ：In the two rounds of evaluation ，experts’enthusiasm，authority and opinion coordination were relatively high. Finally ，the evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin Province was constructed ， consisting of 5 criterion layer indexes and 27 field layer indexes. The weights of the five criterion layer indexes from high to low are 0.290 for TCM pharmaceutical care management ，0.283 for TCM pharmaceutical care equipment ，0.163 for TCM prescription rationality，0.150 for TCM quality management ，0.144 for TCM pharmaceutical care ability. CONCLUSIONS ：The evaluation system of TCM pharmaceutical care quality in public hospitals of Jilin province established in this study is scientific and applicable ， and provides a basis for improving the quality of TCM pharmaceutical care in public hospitals. Public hospitals can set up priority improvement dimensions according to the results of the quality evaluation system ，and focus the limited human and material resources on priority improvement indexes.

Objective:To investigate the effects of ovarian cancer ascites-derived exosomes on the stem cell properties and invasion ability of ovarian cancer stem-like cell (OCS-LC).Methods:(1) A2780 cells were induced into OCS-LC in serum-free medium, and authenticating their stem-like properties by sphere-forming test, differentiation test and CD 133 marker detection. (2) Exosomes from ascites and A2780 cell were extracted by ultracentrifugation, then authenticating them. The morphology of exosomes was observed by the transmission electron microscope, exosome particle size was measured by nanoparticle tracking analysis (NTA). The expressions of heat shock protein 70 (HSP-70), CD 63 and CD 9 were detected by western blot. (3) The exosomes from ovarian cancer ascites and tumor cell supernate were co-cultured with OCS-LC. The groups were divided into control group, ascites-derived exosomes (ADE) group (ADE+OCS-LC group), and cells-derived exosomes (CDE) group (CDE+OCS-LC group). The sphere-forming ability was evaluated by sphere-forming cycle, maximum sphere diameter and sphere-forming rate of each group; the expression of CD 133 was detected by immunofluorescence staining under microscope; quantitative real-time (qRT)-PCR was used to detected the expression levels of octamer-4 (Oct-4), Nanog mRNA of the signature genes in the stem cells of each group; the metastasis ability of each group was measured by transwell assay. Results:(1) Identification of OCS-LC: sphere-forming experiment showed that the suspension of OCSC single cells was grown in serum-free medium in secondary sphere-forming. Differentiation function experiment showed that OCS-LC were differentiated into adherent A2780 cells by changing the growth mode in serum containing medium. Flow cytometry showed that the proportion of CD 133 positive ( CD133+) cells in OCS-LC group was (18.9±0.9)%, significantly higher than that of control group (0.6±0.5)% ( t=38.570, P<0.01). (2) Under transmission electron microscope, clear lipid bilayer structure was observed in ADE and CDE, and one side presented a concave hemispheric or cup like structure. NTA showed that the diameter of exosomes mainly ranged from 30 to 100 nm, with an average diameter of 67.2 nm. Western blot analysis showed that the specific protein molecules HSP-70, CD 63 and CD 9 were positive. (3) Three groups′ OCS-LC could continue to grow into spheres, and the group of ADE+OCS-LC showed two growth modes, most of the cells continued to grow into spheres, while a small part of cells grew in adherent differentiation. The sphere-forming rate of OCS-LC in the control group, ADE+OCS-LC group, and CDE+OCS-LC group were (1.05±0.20)%, (4.15±0.10)%, and (10.45±0.25)%, the sphere-forming cycle of OCS-LC in the three groups were (15.3±1.5), (10.3±0.6), and (6.7±0.6) days, and the maximum diameters of OCS-LC were (100.3±3.2), (145.2±5.1) and (170.0±2.1) μm, respectively. And the differences were statistically significant (all P<0.05). After co-culture of exosomes with OCS-LC, the sphere-forming ability of cells in the group of CDE+OCS-LC was prior to ADE+OCS-LC group (all P<0.05). Immunofluorescence staining showed that the number of CD 133 green fluorescent chromophore cells in OCS-LC groups [(46.2±2.1)%, (58.4±2.2)%] was significantly higher than that in the control group [(26.6±1.5)%] after the addition of exosomes in co-culture, the positive rate of CD 133 was higher than that in the control group( F=187.588, P<0.05). The qRT-PCR results showed that the expression levels of Oct-4 mRNA in ADE+OCS-LC and CDE+OCS-LC groups were 3.46±0.24, 4.03±0.31, compared with that in control group (1.04±0.12), the differences were statistically significant ( F=134.932, P<0.05). The mRNA expression levels of Nanog were 1.57±0.32, 2.66±0.15, which were significantly higher than that in the control group (1.00±0.07), and the differences were statistically significant ( F=49.329, P<0.05). And the expression of both in CDE+OCS-LC group increased more significantly than ADE+OCS-LC group (all P<0.05). The number of invasive cells in the three groups of OCS-LC were: control group 30±5, ADE+OCS-LC group 102±4, CDE+OCS-LC group 210±7, and there were statistically significant differences among three groups ( F=820.800, P<0.05). Compared with the control group, the number of invaded cells in the co-culture group were significantly increased ( P<0.05), and the CDE+OCS-LC group had the higher cell invasion ability then the ADE+OCS-LC group ( t=23.202, P<0.05). Conclusions:Exosomes derived from ovarian cancer ascites could enhance and maintain the stemness of OSC-LC, and promote the invasion of tumor cells. Moreover, CDE is superior to ADE.

Objective: To evaluate the effects of repeated ultraviolet A (UVA) radiation on DNA damage, repair and replication processes in human skin fibroblasts, and to explore their mechanisms. Methods: Fibroblasts were isolated from the circumcised foreskins of 3 children in the Department of Urological Surgery, Third Affiliated Hospital, Sun Yat-sen University, and subjected to a primary culture. Cultured human skin fibroblasts of 3rd-10th passages were divided into 2 groups: UVA group treated with repeated UVA radiation to establish a chronic photodamaged cell model, and control group receiving no treatment. Cell counting kit 8 (CCK-8) assay, β-galactosidase staining and flow cytometry were performed to assess cellular proliferative activity, and determine the proportion of photoaged cells and apoptosis rate respectively. Reverse transcription reaction was performed to establish a differentially expressed cDNA library, which was then subjected to high-throughput sequencing. The cDNA sequencing results were compared between the control group and UVA group, and the differentially expressed genes were analyzed in Kyoto Encyclopedia of Genes and Genomes (KEGG) database. The data were compared between the two groups by using two independent sample t test. Results: Compared with the control group, the UVA group showed significantly decreased cellular proliferative activity (72.0% ± 5.2% vs. 96.0% ± 3.7%, t = 6.51, P < 0.05) , but significantly increased proportion of photoaged cells (79.7% ± 5.2% vs. 6.4% ± 0.8%, t=24.12, P < 0.05) and apoptosis rate (29.0% ± 3.3% vs. 6.0% ± 5.9%, t= 5.89, P < 0.05) . Among the key enzymes involved in DNA mismatch repair, replication and base excision repair processes, the expression of DNA ligase 1 (Lig1) , ribonuclease (RNase) H2A and helicase Dna2 in the UVA group was 0.47 ± 0.13, 0.44 ± 0.07 and 0.49 ± 0.11 times (all P < 0.01) that in the control group respectively. After the UVA-induced chronic photodamage in the human skin fibroblasts, After the UVA-induced chronic photodamage in the human skin fibroblasts, Lig expression decrease could block DNA single-base excision repair, Lig and Lig1 expression decrease could block DNA multiple-base excision repair, Lig1 expression decrease could block DNA mismatch repair, and RNaseH2A, Dna2 and Lig1 expression decrease could block DNA replication. Conclusion Repeated UVA radiation can change the expression of key enzymes involved in DNA base excision repair, DNA mismatch repair and DNA replication processes in skin fibroblasts, and then affect DNA repair and DNA replication processes in skin fibroblasts.