Objective To propose a whole-life cycle management model for valvular heart disease (VHD), systematically elucidate its underlying logic and implementation pathways, and concurrently review and analyze its preliminary application outcomes. Methods Since 2020, West China Hospital of Sichuan University has established a management system encompassing "assessment-decision-intervention-follow-up", including: (1) a risk-stratified, tiered management pathway; (2) six core functions ("promotion, screening, prevention, diagnosis, treatment, and rehabilitation") coordinated by disease-specific managers; (3) an intelligent decision support information platform; and (4) a collaborative network of multidisciplinary teams and regional academic alliances. To evaluate the effectiveness of this management model, we retrospectively included three cohorts: (1) the population screened by echocardiography from 2020 to 2024, analyzing the detection rate of aortic valve disease and risk stratification; (2) patients enrolled in the whole-life cycle management from April 2021 to December 2024, assessing follow-up outcomes, hospital satisfaction, and changes in quality of life; (3) patients who underwent transcatheter aortic valve replacement (TAVR) from January 2022 to January 2024, evaluating the one-year all-cause mortality rate, perioperative complications, and improvements in New York Heart Association (NYHA) classification. Results Between 2020 and 2024, a total of 583 874 individuals underwent echocardiographic screening. A total of 48 089 patients with aortic valve disease were identified, including 3 401 (7.1%) high-risk patients, 18 657 (38.8%) moderate-risk patients, and 26 031 (54.1%) low-risk patients. Among them, 2 417 patients were enrolled in whole-life cycle management. Patient satisfaction scores showed a yearly increase, rising from 73.89 points before 2020 to 93.74 points in 2024. The 1-year mortality rate in the TAVR cohort decreased to 5.3%, significantly lower than the 8.2% observed under early standard management between 2014 and 2019 (P<0.01). Conclusion Through process optimization and resource integration, the VHD whole-life cycle management model has demonstrated significant effectiveness in standardizing diagnostic and follow-up procedures, enhancing patient satisfaction and quality of life, and reducing mortality. These outcomes highlight its practical value for broader implementation in China.

Tricuspid valve, also known as "forgotten valve" because of the high natural and surgical mortality. Transcatheter tricuspid valve replacement is an innovative surgical method to treat tricuspid regurgitation, which improves the prognosis of patients and is gradually being popularized in clinics. However, postoperative pulmonary complications are still the main causes affecting the rapid recovery and death. More and more medical experts begin to use preoperative inspiratory muscle training to reduce postoperative pulmonary complications and improve the quality of life of patients after cardiac surgery. However, there was no report on the effect of preoperative inspiratory muscle training on pulmonary complications after transcatheter tricuspid valve replacement. Therefore, for the first time, we boldly speculate that inspiratory muscle training can reduce pulmonary complications after transcatheter tricuspid valve replacement, and put forward suggestions for its treatment mechanism and strategy. But this rehabilitation intervention lacks practical clinical research. Unknown challenges may also be encountered, which may be a new research direction.

Objective:To evaluate the efficacy by using domestic recombinant human thyroid-stimulating hormone (rhTSH) in patients with differentiated thyroid cancer (DTC) before or after 131I therapy. Methods:From May 2019 to November 2020, a total of 24 patients with DTC (5 males, 19 females, median age 41 years) in Peking Union Medical College Hospital and Affiliated Tumor Hospital of Zhengzhou University were enrolled into the open-label, dose escalation phase Ⅰ study. All patients were divided into 4 domestic rhTSH dose groups: 0.9 mg×1 d (group A), 0.9 mg×2 d (group B), 1.8 mg×1 d (group C), 1.8 mg×2 d (group D) in succession, with 6 patients in each group. Each patient underwent rhTSH phase and thyroid hormone withdrawal (THW) phase. The end point included safety, tolerability, the quality of life (hypothyroidism symptom and sign score (Billewicz score), profile of mood states (POMS)), effectiveness (thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels, diagnostic whole-body scan (Dx-WBS)) and pharmacokinetic characteristics (peak time, peak concentration) of rhTSH. Paired t test and Wilcoxon signed rank test were used for statistical analysis. Results:There were no dose-limiting toxicities, serious adverse events, or no grade ≥3 adverse events reported. The quality of life in rhTSH phase was significantly better than those in THW phase, including the lower Billewicz score (-53.00(-53.00, -53.00) vs -39.50(-47.00, -23.00); S=119.50, P<0.001) and the lower POMS score (91.92±12.06 vs 99.67±19.13; t=0.95, P=0.025). Serum TSH level was increased from 0.04(0.02, 0.11) mU/L (baseline) to 150.00(105.20, 173.31) mU/L 24 h after the last rhTSH administration, which was increased along with the elevation of rhTSH doses. In the THW phase, patients′ TSH levels were≥30 mU/L after 23 d (median) of THW, with the median of 73.51(57.22, 106.22) mU/L. Median Tg level of baseline was 0.10(0.10, 0.41) μg/L, which reached a peak of 0.85(0.12, 3.01) μg/L at 48 h after rhTSH administration. The peak Tg level in the THW phase was 0.88(0.15, 8.04) μg/L. The Dx-WBS consistency rate between rhTSH and THW phase was 95.8%(23/24). Conclusion:rhTSH is a safe and effective method to stimulate the serum Tg level and radioiodine uptake in patients undergoing post-operation or post- 131I assessment for DTC, as well as maintain a higher quality of life in comparison to THW phase.

In order to understand the representative situation of medical services supply for China's public hospital in the mobile side,the research takes China hospital technology (comprehensive) influence ranked top 100 hospitals as the research object.From service supply channels,service content,providing mode,supply cooperation,comparative analysis of public hospitals from the traditional medical treatment to the mobile health reform is done.The 100 hospitals attaches great importance to the channel construction of mobile terminals,and App and WeChat have been mostly layout;On the basis of the medical process,a variety of service content is derived and innovated;Service providers change gradually to the context of navigation and mobile O2O medicine;The cooperation between hospitals and the technology companies is becoming more and more frequent.At the same time,these changes will also in turn promote the hospital process optimization,interconnection and multi game deepening governance.

Objective To investigate the role of apoptosis and the regulating role of receptor interacting protein 1(RIP1) in acute pancreatitis .Methods Thirty C57 mice were divided into three groups :control group ,acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group .The AEP group was continuously injected by cerulein 50 μg/kg for 13 times ,the ANP group was continuously injected by cerulein 50μg/kg for 13 times and lipopolysaccharide 15 mg/kg once;the con‐trol group was injected by the same volume of normal saline for 7 times .The acinar cell apoptosis was observed by the terminal de‐oxynucleotidyl transferase‐mediated deoxyuridine triphosphate nick‐end labeling (TUNEL) assay .The RIP1 mRNA expression was measured by real time fluorescence PCR .The expression of RIP1 protein was detected by Western blotting .Results The mouse models of AEP and ANP were established successfully .Compared with the control group ,acinar cell apoptosis existed in both AEP and ANP model groups ,moreover compared with the AEP group ,apoptosis in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Compared with the control group ,the expression of RIP1 mRNA and protein in the AEP group was increased ,while which in the ANP group were decreased ,the differences were statistically significant(P<0 .05) .Conclusion RIP1 participate in the pathogenesis of acute pancreatitis ,which may associate with acinar cell apoptosis .

OBJECTIVETo evaluate the safety and efficacy of gemcitabine combined with S-1 in the treatment of advanced pancreatic cancer.

METHODSA retrospective analysis of the clinical data of 49 patients with advanced pancreatic cancer, who did not receive radiotherapy and chemotherapy, were divided into two groups: the study group (25 cases), and control group (24 cases). Patients in the study group received gemcitabine 1 000 mg/m² via intravenous drip at the first and 8th days, and received S-1 80 mg/m², morning and evening (twice a day) for the first 14 days, and 21 days as a treatment cycle of chemotherapy.The control group was given GEMOX regimen: Gemcitabine 1 000 mg/m² via intravenous drip at the first and 8 days, and oxaliplatin 130 mg/m² via intravenous drip at the first day, and 21 d for a treatment cycle of chemotherapy. The efficacy and adverse reactions in patients of the study and control groups were observed and compared.

RESULTSThe efficiency of the study group was 32.0% and disease control rate was 72.0%. The efficiency of the control group was 25.0% and disease control rate was 58.3%. The differences between the two groups were statistically not significant (P > 0.05 for all). The clinical benefit rate in the study group and control group were 80.0% and 50.0%, respectively, showing a significant difference (P < 0.05). The median survival time was 9.7 months in patients of the study group and 9.0 months in the control group, with a significant difference (P < 0.05). The drug toxicity was well tolerated in both groups, and no chemotherapy-related death occurred. The major adverse reactions were myelosuppression and digestive tract reactions, and the adverse reactions in the study group were lower than those in the control group.

CONCLUSIONSGemcitabine combined with S-1 is effective and safe in the treatment of advanced pancreatic cancer, with less side effects, and can be tolerated by the patients.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Deoxycytidine ; administration & dosage ; adverse effects ; analogs & derivatives ; Drug Administration Schedule ; Drug Combinations ; Humans ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Oxonic Acid ; administration & dosage ; adverse effects ; Pancreatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Tegafur ; administration & dosage ; adverse effects

Objective To evaluate the safety and efficacy of gemcitabine combined with S?1 in the treatment of advanced pancreatic cancer. Methods A retrospective analysis of the clinical data of 49 patients with advanced pancreatic cancer, who did not receive radiotherapy and chemotherapy, were divided into two groups:the study group (25 cases), and control group (24 cases). Patients in the study group received gemcitabine 1 000 mg/m2 via intravenous drip at the first and 8th days, and received S?1 80 mg/m2, morning and evening (twice a day) for the first 14 days, and 21 days as a treatment cycle of chemotherapy.The control group was given GEMOX regimen:Gemcitabine 1 000 mg/m2 via intravenous drip at the first and 8 days, and oxaliplatin 130 mg/m2 via intravenous drip at the first day, and 21 d for a treatment cycle of chemotherapy. The efficacy and adverse reactions in patients of the study and control groups were observed and compared. Results The efficiency of the study group was 32. 0% and disease control rate was 72.0%. The efficiency of the control group was 25.0% and disease control rate was 58.3%. The differences between the two groups were statistically not significant ( P>0. 05 for all ) . The clinical benefit rate in the study group and control group were 80.0% and 50.0%, respectively, showing a significant difference ( P<0.05) . The median survival time was 9.7 months in patients of the study group and 9.0 months in the control group, with a significant difference (P<0.05). The drug toxicity was well tolerated in both groups, and no chemotherapy?related death occurred. The major adverse reactions were myelosuppression and digestive tract reactions, and the adverse reactions in the study group were lower than those in the control group. Conclusions Gemcitabine combined with S?1 is effective and safe in the treatment of advanced pancreatic cancer, with less side effects, and can be tolerated by the patients.

Objective To evaluate the safety and efficacy of gemcitabine combined with S?1 in the treatment of advanced pancreatic cancer. Methods A retrospective analysis of the clinical data of 49 patients with advanced pancreatic cancer, who did not receive radiotherapy and chemotherapy, were divided into two groups:the study group (25 cases), and control group (24 cases). Patients in the study group received gemcitabine 1 000 mg/m2 via intravenous drip at the first and 8th days, and received S?1 80 mg/m2, morning and evening (twice a day) for the first 14 days, and 21 days as a treatment cycle of chemotherapy.The control group was given GEMOX regimen:Gemcitabine 1 000 mg/m2 via intravenous drip at the first and 8 days, and oxaliplatin 130 mg/m2 via intravenous drip at the first day, and 21 d for a treatment cycle of chemotherapy. The efficacy and adverse reactions in patients of the study and control groups were observed and compared. Results The efficiency of the study group was 32. 0% and disease control rate was 72.0%. The efficiency of the control group was 25.0% and disease control rate was 58.3%. The differences between the two groups were statistically not significant ( P>0. 05 for all ) . The clinical benefit rate in the study group and control group were 80.0% and 50.0%, respectively, showing a significant difference ( P<0.05) . The median survival time was 9.7 months in patients of the study group and 9.0 months in the control group, with a significant difference (P<0.05). The drug toxicity was well tolerated in both groups, and no chemotherapy?related death occurred. The major adverse reactions were myelosuppression and digestive tract reactions, and the adverse reactions in the study group were lower than those in the control group. Conclusions Gemcitabine combined with S?1 is effective and safe in the treatment of advanced pancreatic cancer, with less side effects, and can be tolerated by the patients.

OBJECTIVETo evaluate the efficacy and safety profile of XELOX (capecitabine/oxaliplatin) in patients with locally advanced gastric cancer who underwent curative D2 resection in China.

METHODSThis is a subgroup analysis of Chinese patients in the capecitabine and oxaliplatin adjuvant study in stomach cancer (CLASSIC study), which was a randomised, open-label, multicentre, parallel-group, phase III( study in the Asia-Pacific region. A total of 100 gastric cancer patients who received curative D2 gastrectomy were enrolled in this study and were randomly assigned to either XELOX group (oral capecitabine combined with intravenous oxaliplatin chemotherapy) or the control group (surgery alone). This study aims to compare the 3-year disease-free between the two groups.

RESULTSSubgroup analysis showed that 3-year DFS rate were 78% and 56% in XELOX and control group, respectively. The risk of relapse in XELOX group was reduced by 59% (HR=0.41, 95%CI:0.20-0.85, P=0.013), compared with the control group. The 3-year overall survival rate were 78% and 66% in XELOX and control group, with no statistically significant difference (HR=0.55, 95%CI:0.26-1.16, P=0.110).

CONCLUSIONAdjuvant XELOX chemotherapy following D2 gastrectomy may improve the survival in patients with advanced gastric cancer in China.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Capecitabine ; Chemotherapy, Adjuvant ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease-Free Survival ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Gastrectomy ; Humans ; Neoplasm Recurrence, Local ; Organoplatinum Compounds ; administration & dosage ; Stomach Neoplasms ; drug therapy ; surgery ; Survival Rate

Based on international framework of rehabilitation, this paper summarized the theories and practice of rehabilitation in Shenzhen. An inclusive rehabilitation model had been established in Shenzhen in light of international concepts of rehabilitation, in which the functions of medical rehabilitation, education, employment, assistive technology, care, right protection, accessible environment and culture had been integrated. The comprehensive services had been provided through this model and the target of inclusive development had been realized.