Brucellosis is a zoonotic infectious disease caused by Brucella infection. So far, animal to animal Brucellosis has not been eradicated, and there is a lack of safe and effective human vaccine. Therefore, "early, combined, sufficient, and full course" drug treatment remains an important strategy in the management of human Brucellosis. The goal of treating brucellosis is to alleviate and shorten the symptom period, reduce complications, relapses, and chronicity. At present, although antibiotic treatment is effective for most patients, there are still some patients who experience treatment failure or later recurrence, so the treatment strategy for brucellosis urgently needs to be optimized. This article elaborates on the treatment principles, clinical treatment status, and future development trends of brucellosis, in order to provide references for optimizing drug treatment methods for brucellosis.

Objective To analyze the quantity,quality,and research layout of medical scientific papers(in Chinese)published by various regions,hospitals,and institutions in Inner Mongolia Autonomous Region from 2018 to 2022,in order to understand the overall scientific and technological level of our region,providing an overview of support for medical scientific research in the entire region and provi-ding references for the rational layout of medical scientific and technological development.Methods From July to August 2023,Chinese National Knowledge Infrastructure(CNKI)was used as the data source to systematically retrieve Chinese medical literature related to Inner Mongolia Autonomous Region from 2018 to 2022.Bibliometric methods were applied to analyze the quantity and quality of literature,as well as regional and institutional distribution.Results From 2018 to 2022,there were 5 273 articles published in core journals in Inner Mongo-lia,accounting for 30.96%of the total.Among them,1095 articles(20.77%)were indexed in CSCD,1 567 articles(29.72%)in Peking University Core Journals,and5164 articles(97.93%)in Science and Technology Core Journals.The journal with the highest publication volume among the top10 core journals was"Journal of Inner Mongolia Medical University,"accounting for20.77%.The top three regions in terms of total output of core journal articles were Hohhot,Baotou,and Chifeng,while Xing'an League and Alxa League had very few pub-lications.Among different levels of hospitals,tertiary hospitals had much higher publication volumes than primary and secondary hospitals.Among different types of institutions,medical institutions had higher publication volumes than higher education institutions.The top three in-stitutions in terms of publication volumes in core journals were Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia Med-ical University,and Inner Mongolia People's Hospital.Conclusion The number of core journals in Inner Mongolia needs to be increased,and the quantity of research output varies among regions.It is necessary to strengthen scientific research management systems,improve the level of research achievements,and promote scientific and technological innovation in Inner Mongolia.

In recent years, the artificial intelligence machine learning and deep learning technology have made leap progress. Using clinical decision support system for auxiliary diagnosis and treatment is the inevitable developing trend of wisdom medical. Clinicians tend to ignore the interpretability of models while pursuing its high accuracy, which leads to the lack of trust of users and hamper the application of clinical decision support system. From the perspective of explainable artificial intelligence, the authors make some preliminary exploration on the construction of clinical decision support system in the field of liver disease. While pursuing high accuracy of the model, the data governance techniques, intrinsic interpretability models, post-hoc visualization of complex models, design of human-computer interactions, providing knowledge map based on clinical guidelines and data sources are used to endow the system with interpretability.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Objective: To investigate the effect of co-culture of adipose-derived stem cells(ADSC) and endothelial progenitor cells(EPC) on the activity of EPC and its related mechanism． Methods: Rat ADSC and EPC were isolated，cultured，expanded and identified in vitro ．The experiment was divided into three groups : EPC group，EPC + ADSC co-culture group，and EPC + ADSC + PI3K-inhibitor group．After 48 hours of co-culture，the cells of the three groups were treated with Transwell．The effects of ADSC and EPC co-culture and PI3K / AKT pathway on EPC activity were evaluated by CCK-8 assay，scratch assay and angiogenesis assay，respectively．Western blot was used to detect vascular endothelial growth factor A (VEGFA) and endothelial nitric oxide synthase (eNOS) ，vascular endothelial-cadherin ( VE-cadherin) ，CD133 ，phospho-phosphatidylinositol 3-kinase ( phospho-phosphatidylinositol 3-kinase(p-PI3K) and phospho-protein Kinase B (p-AKT) expression levels in EPC to detect the effects of ADSC and EPC co-culture and PI3K / AKT pathway on the differentiation ability of EPC into mature endothelial cells. Results: CCK-8 results showed that the absorbance at 450 nm of EPC in EPC + ADSC co-culture group was higher than that in EPC group and EPC + ADSC + PI3K-inhibitor group at different time points，and the difference was statistically significant (P＜0. 01) ．The scratch test showed that the relative scratch distance of EPC + ADSC co-culture group was smaller than that of EPC group and EPC + ADSC + PI3K-inhibitor group after 24 hours ，and the difference was statistically significant (P＜0. 01) ．Tube formation assay showed that the average number of tubelike structures formed in EPC + ADSC co-culture group was higher than that in EPC group and EPC + ADSC + PI3K-inhibitor group，and the difference was statistically significant (P＜0. 01) ．Western blot showed that the expression levels of VEGFA，eNOS，VE-cadherin，p-PI3K and p-AKT of EPC in EPC + ADSC co-culture group were higher than those in EPC group and EPC + ADSC + PI3K-inhibitor group．The expression level of CD133 in EPC group was lower than that in EPC + ADSC + PI3K-inhibitor group，and the difference was statistically significant (P ＜0. 01) ． Conclusion Co-culture of ADSC and EPC can improve the proliferation，migration，differentiation and vasogenic activity of EPC through the regulation of PI3K / AKT pathway.

OBJECTIVE To evaluate the relationship and impact of long-term budesonide treatment results and medication compliance of children with asthma in Shaoxing through multidisciplinary precision medication nursing led by clinical pharmacists. METHODS Randomized controlled trial design was adopted. Children with asthma admitted to Shaoxing Maternity and Child Health Care Hospital from January 1, 2022 to December 1, 2022 were taken as the research objects. According to the inclusion and exclusion criteria, 106 patients were selected to be included in the group, and randomly divided into intervention group(multidisciplinary precision care group led by pharmacists) and control group(conventional care group). Compared the differences of lung function, Morisky Children’s Medication Compliance Scale, IgE, eosinophil count, drug information satisfaction scale and medication belief scale between the two groups. RESULTS The lung function level, Morisky score, lgE, eosinophil count and medication compliance of the intervention group were significantly better than those of the control group, and the differences had statistical significance. CONCLUSION A multidisciplinary nursing team led by clinical pharmacists has significantly improved the clinical outcomes and medication compliance of children with asthma.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Cell Cycle Checkpoints/genetics* ; Checkpoint Kinase 1/metabolism* ; Heterozygote ; Humans ; Mitosis/genetics* ; Mutation ; Zygote/metabolism*

Objective:To investigate the capability of 18F-FDG PET/CT imaging in monitoring combined immunotherapy response and detecting immune related adverse events (irAEs) in patients with advanced hepatobiliary carcinoma. Methods:From August 2018 to July 2019, 21 patients (14 males, 7 females, age (58.5±10.0) years) with advanced hepatobiliary carcinoma routinely underwent 66 18F-FDG PET/CT examinations in Peking Union Medical College Hospital. SUV max, the occurrence time and symptoms of irAEs were obtained and analyzed. Therapy response (complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), progressive metabolic disease (PMD)) was evaluated according to PET response criteria in solid tumors (PERCIST). Results:(1) Clinical results. Twenty-two irAEs occurred in 16 patients, while were not found in 5 patients. Six organs were involved, including thyroiditis(8), colitis(5), pneumonitis(4), rash(2), hepatitis(2), myositis and fasciitis(1). The appearance time of each irAEs were (103.0±58.0), (141.6±103.5), 34.0(6.0, 308.8), 9 and 117, 62 and 67, and 87 d after therapy, respectively. PET/CT detected all pneumonitis and myositis and fasciitis, but no rash and hepatitis were found. For colitis and thyroiditis, PET/CT detected 4 and 6 times respectively. (2) PET/CT signs of irAEs. Except thyroiditis, all irAEs lesions exhibited exudative changes in CT and high-avidity in PET. SUV max of the lesions were 9.0(7.9, 17.6) (colitis), 7.1±3.2 (thyroiditis), 5.3 and 8.6 (pneumonitis), 4.1 (myositis and fasciitis), respectively. (3) Therapy assessment. Among 21 patients, there were 7 for PMR, 9 for SMD, 5 for PMD, which were 7, 8, 1 in patients with irAEs and 0, 1, 4 in patients without irAEs. Conclusions:Patients with advanced hepatobiliary carcinoma can benefit from combined immunotherapy. 18F-FDG PET/CT can be used to evaluate the efficacy of immunotherapy by detecting the changes of tumor lesions and the occurrence of irAEs simultaneously. However, it is necessary to use CT to distinguish tumor progression from irAEs.

ObjectiveTo determine the quality of life among HIV-infected individuals and risk factors in Jing’an District of Shanghai. MethodsThis is a cross-sectional study. Cluster sampling strategy was used to select HIV-infected individuals who were registered with the national HIV/AIDS case reporting system in eight community health service centers in Jing’an District of Shanghai. The short form 36 （SF-36） scale， self-rating anxiety scale （SAS）， social support scale （SSS） and specifically designed questionnaires were used to collect information. Logistic regression was used to determine the factors associated with quality of life. ResultsIn total， 365 HIV-infected individuals were included in the study. The total average score of quality of life was 79.5±10.4. The scores in general health， vitality and emotional well-being were lower than the norm， whereas the scores in other dimensions were higher than the norm. Multivariable logistic regression indicated that age of 45‒ years （vs age of 18‒ years： OR=0.23， 95%CI： 0.08‒0.68） was significantly associated with the quality of life. Furthermore， smoking （OR=2.18， 95%CI： 1.22‒3.90）， lower CD4⁺T cell counts （<350 cell·μL^-1， OR=2.89， 95%CI： 1.54‒5.40）， comorbidity （≥2 kinds， OR=3.40， 95%CI： 1.15‒10.04） and anxiety （OR=1.09， 95%CI： 1.05‒1.14） were risk factors associated with declining quality of life. ConclusionIt warrants more attention to those HIV-infected individuals with poor psychological status， smoking， low CD4⁺T cell counts and comorbidities. Targeted health care and social support could effectively improve the quality of life among HIV-infected individuals.