Objective To investigate the influence of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on the curative effect,macrophage migration inhibitory factor(MIF)level and hemorheology in patients with acute cerebral infarction(ACI).Methods A total of 116 patients with ACI were divided into the western medicine group(treated with tirofiban)and the combined group(treated with Salvia miltiorrhiza polyphenolate injection combined with tirofiban)by random number table method,with 58 cases in each group.Neurological deficit score(NIHSS)reduction was calculated,and the therapeutic effect was evaluated.Serum MIF,interleukin(IL)-6 and IL-1β levels were detected by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Changes of hemorheological indexes(whole blood viscosity,whole blood low tangential viscosity and fibrinogen)of ACI patients were detected by SA-6600 automatic hemorheometer before and after treatment.The occurrence of adverse reactions during treatment was recorded.The modified Rankin Scale(mRS)was used to evaluate the clinical outcome at 90 days of onset,and the Barthel index was used to evaluate the living ability of the patients before and after treatment.Results The total clinical effective rate of ACI patients was higher in the combined group than that in the western medicine group(89.66%vs.74.14%,P＜0.05).After treatment,the levels of MIF,whole blood viscosity,whole blood low shear viscosity,fibrinogen,IL-6 and IL-1β were lower in 2 groups than those before treatment,and those were lower in the combined group than those in the western medicine group(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).The Barthel index was higher after treatment in the two groups,and which was higher in the combined group than that of the western medicine group(P＜0.05).The good outcome rate was higher in the combination group than that of the western medicine group(51.72%vs.32.76%,P＜0.05).Conclusion Salvia miltiorrhiza polyphenolate injection combined with tirofiban has a obvious effect for ACI patients,which can reduce serum levels of MIF and inflammatory factors,improve hemorheology indicators and has a high safety.

Objective This study aimed to adapt the data-driven Palliative Care Outcomes Collaboration(PCOC)model to the local context and evaluate its feasibility and preliminary effectiveness in a palliative care unit in China,with the goal of informing its broader integration into national palliative care practice.Methods Based on international experience,a localized implementation protocol for the PCOC model was developed through expert con-sultations and a pilot study.The protocol incorporated key elements including organizational and managerial sup-port,team training and capacity building,information system integration,supervision and feedback mechanisms,pro-cess optimization,and data-driven decision-making.From June to December 2023,the protocol was piloted in the palliative care unit of a tertiary cancer hospital in Changsha,China.Implementation outcomes were assessed by comparing patients' urgent care response rates,symptom stability rates,and symptom improvement rates between the first 1～3 months and 4～6 months after implementation.Results During the study period,a total of 355 inpatients were enrolled,with the PCOC assessment achieving full coverage(100％)and a completion rate of 97.78％.There was no statistically significant difference in the urgent needs response rate between the first 1～3 months and the 4～6 months after the implementation of the PCOC model(P=0.533).However,compared to the first 1～3 months af-ter implementation,patients in the 4～6 months period showed significantly higher symptom stability rates for pain,psychological/spiritual issues,and family/caregiver problems,as well as a higher improvement rate for pain(P＜0.05).Conclusion The localized PCOC implementation protocol facilitates standardized assessment and symptom manage-ment,and its application can enhance the quality of palliative care.

Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective This study aimed to adapt the data-driven Palliative Care Outcomes Collaboration(PCOC)model to the local context and evaluate its feasibility and preliminary effectiveness in a palliative care unit in China,with the goal of informing its broader integration into national palliative care practice.Methods Based on international experience,a localized implementation protocol for the PCOC model was developed through expert con-sultations and a pilot study.The protocol incorporated key elements including organizational and managerial sup-port,team training and capacity building,information system integration,supervision and feedback mechanisms,pro-cess optimization,and data-driven decision-making.From June to December 2023,the protocol was piloted in the palliative care unit of a tertiary cancer hospital in Changsha,China.Implementation outcomes were assessed by comparing patients' urgent care response rates,symptom stability rates,and symptom improvement rates between the first 1～3 months and 4～6 months after implementation.Results During the study period,a total of 355 inpatients were enrolled,with the PCOC assessment achieving full coverage(100％)and a completion rate of 97.78％.There was no statistically significant difference in the urgent needs response rate between the first 1～3 months and the 4～6 months after the implementation of the PCOC model(P=0.533).However,compared to the first 1～3 months af-ter implementation,patients in the 4～6 months period showed significantly higher symptom stability rates for pain,psychological/spiritual issues,and family/caregiver problems,as well as a higher improvement rate for pain(P＜0.05).Conclusion The localized PCOC implementation protocol facilitates standardized assessment and symptom manage-ment,and its application can enhance the quality of palliative care.

Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective To investigate the influence of Salvia miltiorrhiza polyphenolate injection combined with tirofiban on the curative effect,macrophage migration inhibitory factor(MIF)level and hemorheology in patients with acute cerebral infarction(ACI).Methods A total of 116 patients with ACI were divided into the western medicine group(treated with tirofiban)and the combined group(treated with Salvia miltiorrhiza polyphenolate injection combined with tirofiban)by random number table method,with 58 cases in each group.Neurological deficit score(NIHSS)reduction was calculated,and the therapeutic effect was evaluated.Serum MIF,interleukin(IL)-6 and IL-1β levels were detected by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Changes of hemorheological indexes(whole blood viscosity,whole blood low tangential viscosity and fibrinogen)of ACI patients were detected by SA-6600 automatic hemorheometer before and after treatment.The occurrence of adverse reactions during treatment was recorded.The modified Rankin Scale(mRS)was used to evaluate the clinical outcome at 90 days of onset,and the Barthel index was used to evaluate the living ability of the patients before and after treatment.Results The total clinical effective rate of ACI patients was higher in the combined group than that in the western medicine group(89.66%vs.74.14%,P＜0.05).After treatment,the levels of MIF,whole blood viscosity,whole blood low shear viscosity,fibrinogen,IL-6 and IL-1β were lower in 2 groups than those before treatment,and those were lower in the combined group than those in the western medicine group(P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).The Barthel index was higher after treatment in the two groups,and which was higher in the combined group than that of the western medicine group(P＜0.05).The good outcome rate was higher in the combination group than that of the western medicine group(51.72%vs.32.76%,P＜0.05).Conclusion Salvia miltiorrhiza polyphenolate injection combined with tirofiban has a obvious effect for ACI patients,which can reduce serum levels of MIF and inflammatory factors,improve hemorheology indicators and has a high safety.

Objective To investigate the effects of Danshen polyphenolate combined with edara-vone on cognitive function,cerebral artery pulse index(PIMCA)and serum trypanoprotein-like pro-tein-1(VILIP-1)levels in patients with acute cerebral infarction(ACI).Methods A total of 88 pa-tients with ACI were selected as study objects.The patients were divided into single drug group(n=44)and combination group(n=44)according to random number table method.The single drug group was treated with edaravone,and the combination group was treated with edaravone combined with salvianolic acid for injection.The efficacy,cognitive function,PIMCA and serum VILIP-1 levels of the two groups were observed and compared.Results The overall effective rate of treatment in the combi-nation group was higher than that of the single drug group(81.82％versus 54.55％,P＜0.05).Af-ter treatment,the scores of Montreal Cognitive Assessment Scale(MoCA),Reactivity Exploration Scale(RSS)and Simple Mental State Assessment Scale(MMSE)in two groups were higher than be-fore treatment,and the combination group was higher than the single drug group(P＜0.05).After treatment,the levels of PIMCA and serum VILIP-1 in two groups were lower than before treatment,and the combination group was lower than the single drug group(P＜0.05).Conclusion Compared with edaravone alone,salvia miltiorrhiza polyphenolate injection combined with edaravone has a better therapeutic effect in ACI patients,which can effectively improve the patients'cognition,reduce PIMCA and serum VILIP-1 levels.

Objective To investigate the effects of Danshen polyphenolate combined with edara-vone on cognitive function,cerebral artery pulse index(PIMCA)and serum trypanoprotein-like pro-tein-1(VILIP-1)levels in patients with acute cerebral infarction(ACI).Methods A total of 88 pa-tients with ACI were selected as study objects.The patients were divided into single drug group(n=44)and combination group(n=44)according to random number table method.The single drug group was treated with edaravone,and the combination group was treated with edaravone combined with salvianolic acid for injection.The efficacy,cognitive function,PIMCA and serum VILIP-1 levels of the two groups were observed and compared.Results The overall effective rate of treatment in the combi-nation group was higher than that of the single drug group(81.82％versus 54.55％,P＜0.05).Af-ter treatment,the scores of Montreal Cognitive Assessment Scale(MoCA),Reactivity Exploration Scale(RSS)and Simple Mental State Assessment Scale(MMSE)in two groups were higher than be-fore treatment,and the combination group was higher than the single drug group(P＜0.05).After treatment,the levels of PIMCA and serum VILIP-1 in two groups were lower than before treatment,and the combination group was lower than the single drug group(P＜0.05).Conclusion Compared with edaravone alone,salvia miltiorrhiza polyphenolate injection combined with edaravone has a better therapeutic effect in ACI patients,which can effectively improve the patients'cognition,reduce PIMCA and serum VILIP-1 levels.

Objective:To systematically evaluate the association between the hepatic lipase ( LIPC) gene rs10468017 polymorphism and susceptibility to age-related macular degeneration (AMD). Methods:A systematic search was performed in both English databases (PubMed, Embase, EBSCO, Web of Knowledge and Cochrane library) and Chinese databases (CNKI, WanFang, VIP and CBM) from database establishment to December 31, 2019.Literature about LIPC rs10468017 polymorphism and AMD was searched.Odds ratios ( OR) and 95% confidence intervals ( CI) of allele mode (T and C), heterozygous model (TC and CC) and homozygous model (TT and CC) as well as the correlation between types of AMD and races were calculated using Stata 12.0 software. Results:Twenty-one studies were included in the Meta-analysis.There were 25 649 AMD patients and 26 294 normal controls.There was a significant correlation between LIPC rs10468017 polymorphism and risk of AMD in different genetic models (T vs. C: OR=0.83, 95% CI: 0.80-0.87; TC vs. CC: OR=0.82, 95% CI: 0.75-0.90; TT vs. CC: OR=0.65, 95% CI: 0.56-0.76). The subgroup analysis showed that the LIPC rs10468017 polymorphism was significantly associated with the risk of early AMD ( OR=0.87, 95% CI: 0.78-0.96), advanced AMD ( OR=0.83, 95% CI: 0.77-0.88), geographic atrophy ( OR=0.79, 95% CI: 0.72-0.87) and choroidal neovascularization ( OR=0.83, 95% CI: 0.78-0.89). Stratified analysis by ethnicity showed that there was a significant association between T allele and the decreased risk of AMD in the Caucasian population (early AMD: OR=0.77, 95% CI: 0.67-0.89; advanced AMD: OR=0.80, 95% CI: 0.75-0.87), but not in the Asian population (early AMD: OR=0.98, 95% CI: 0.85-1.13; advanced AMD: OR=0.93, 95% CI: 0.81-1.06). Conclusions:There is a significant association between T allele of LIPC rs10468017 polymorphism and the reduced risk of AMD, which exists in different subtypes of AMD with certain racial differences.

Objective:To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients.Methods:The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed.Results:The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively ( P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively ( P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm 3, the median survival time of SIB and No-SIB group was 34.7 and 30.3 months ( P=0.155), respectively. In the patients whose GTV volume>50 cm 3, the median survival time of SIB and No-SIB group was 16.1 and 20.1 months ( P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group ( P<0.001). Conclusions:The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.