Cerebrovascular diseases, characterized by high incidence, disability, and mortality rates, have emerged as a leading global cause of death and long-term disability. Organoid technology, a three-dimensional in vitro culture system derived from stem cells or tissue cells, enables the simulation of organ development, physiological processes, and pathological mechanisms, demonstrating significant potential in cerebrovascular disease research and therapeutic development. This review summarizes recent advances in organoid applications for cerebrovascular diseases, with a focus on strategies for constructing vascularized cerebral organoids, including in vivo transplantation, in vitro culture systems, and bioengineering approaches. Studies reveal that these models not only recapitulate neurovascular unit interactions but also serve as powerful platforms for drug screening and mechanistic investigations, offering novel therapeutic strategies for cerebrovascular disorders. Current challenges include insufficient vascularization efficiency and limited integration capacity with host tissues. Future integration of gene editing, microfluidic chips, and high-throughput 3D bioprinting technologies is expected to enhance the functionality and clinical translatability of vascularized cerebral organoids, thereby advancing personalized medicine and precision healthcare.

As one of the flexible means of drug supervision， the “compassionate medicine use system” has become a new way to meet the drug accessibility of patients at present. The “compassionate medicine use system” in Britain， that is， Early Access to Medicine Scheme， intervenes in the drug development process of the applicant enterprises at an early stage through the cooperation of different government departments， which not only ensures patients obtain innovative drugs in time， but also accelerates the drug listing and payment and reimbursement process. At present， China has only made principled provisions on the “compassionate medicine use system”， but has not issued specific implementation rules. It is suggested that the access conditions of “compassionate medicine use”， the responsibilities and obligations of different subjects， the payment mechanism of expenses and how to promote the cooperation of relevant departments should be clearly defined as soon as possible in combination with the system experience of Britain， so as to form a standardized and operable “compassionate medicine use system” suitable for China’s national conditions.

Objective To investigate the identification of octreotide(OCT)modified chitosan(CS)miR-155 molecular beacon nanoparticles(CS-miR-155-MB-OCT)and imaging of lung cancer cells for the early screening of lung cancer.Methods A nude mouse model of lung transplantation tumor was established by injecting A549 lung cancer cells into tail veins to establish lung xenograft models.Cre adenovirus was injected through nasal cavity,and mice were killed at 4,6,8 and 12 weeks after adenovirus injection to establish lung cancer models of atypical hyperplasia,adenoma,carcinoma in situ and adenocarcinoma of lung in LSL K-ras G12D transgenic mice at different pathological stages.Lung tissue samples were taken and observed by HE staining.Immunohistochemistry were used to detect the expression of somatostatin receptor 2(SSTR2).Real-time fluorescence quantitative PCR was used to detect miR-155 expression levels in lung xenograft models and transgenic mice at different stages of lung cancer.Then CS-miR-155-MB and CS-miR-155-MB-OCT were injected via tail vein in lung xenograft models.CS-miR-155-MB-OCT was injected via tail vein in transgenic mice models.The fluorescence signals of lung in nude mice and transgenic mice at different disease stages were imaged by living imaging system.Frozen slices of lung tissue were made.The source of fluorescence signal was detected by laser confocal scanning microscope(CLSM).Results HE staining showed that lung transplantation tumor models and lung cancer models of atypical hyperplasia,adenoma,carcinoma in situ and lung adenocarcinoma at different pathological stages were successfully constructed.Immunohistochemical analysis showed somatostatin receptor 2(SSTR2)was expressed in transplanted lung tumor and tissue at different pathological stages.In transgenic mouse models,the expression of miR-155 was gradually increased as the disease progressed(P＜0.05).In lung xenograft models,the fluorescence signals were significantly higher in the CS-miR-155-MB-OCT group than those of the CS-miR-155-MB group(P＜0.05).In transgenic mouse models,the fluorescence signals gradually increased with the gradual progression of lesions(P＜0.05).After re-imaging the lung tissue,it was found that the fluorescence signal came from lung,and CLSM showed that the fluorescence signal came from cancer cells and some normal alveolar epithelial cells.Conclusion CS-miR-155-MB-OCT can dynamically reflect the occurrence and development of lung cancer according to changes of different fluorescence intensity,thus providing a new technology for the early diagnosis of lung cancer.

BACKGROUND:The structure,physical and chemical properties(such as rheological properties)and biological activity of hyaluronic acid with different molecular weights are quite different.When the degradation degree of non-cross-linked hyaluronic acid is too large and the high-molecular-weight hyaluronic acid is degraded to low-molecular-weight hyaluronic acid,the properties and biological functions of the product will also change,which will affect the use of the product. OBJECTIVE:To review the mechanism of molecular weight degradation of non-cross-linked hyaluronic acid and the impacts of molecular weight degradation on the structure,rheological properties,biological activity and applications of non-cross-linked hyaluronic acid. METHODS:The first author searched the articles related to the molecular weight of hyaluronic acid collected in PubMed,CNKI database and other databases.The high-quality articles with high correlation were screened according to the inclusion and exclusion criteria.The search time was from January 2017 to December 2022.The Chinese and English search terms were"hyaluronic acid,non-cross-linked hyaluronic acid,molecular weight,degradation,structure,rheological properties,biologic activity".Finally,47 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)The molecular weight of non-cross-linked hyaluronic acid is mainly degraded by specific enzymatic hydrolysis and non-specific free radical degradation.(2)The molecular weight degradation of non-cross-linked hyaluronic acid will change its structure and rheological properties,resulting in the untie of polymer network structure,the decrease of rheological properties such as viscosity and viscoelasticity,and the decrease of mechanical properties,which will eventually affect the practical application effect of the product.(3)The biological activity of non-cross-linked hyaluronic acid is molecular weight dependent,and the biological activity of different molecular weight hyaluronic acid is different.Even the same receptor combined with high-molecular-weight hyaluronic acid and low-molecular-weight hyaluronic acid will express completely opposite biological effects.(4)The degradation of molecular weights of non-cross-linked hyaluronic acid will reduce the safety and efficacy of the products,affect their service life and application performance,and ultimately influence the clinical application results.(5)Non-cross-linked hyaluronic acid has great potential as a biodegradable biomaterial in wound healing,tissue engineering,aesthetic medicine and other fields,and further research and understanding of the correlation between molecular weight degradation of non-cross-linked hyaluronic acid and bioactivity is a prerequisite for better development of wound dressings,drug delivery systems and tissue-engineered scaffolds.(6)However,there are currently few studies on the molecular weight degradation of non-cross-linked hyaluronic acid,and it is unclear how to effectively avoid the potential risks associated with the molecular weight degradation of non-cross-linked hyaluronic acid in clinical applications.(7)Therefore,a series of potential risks associated with the molecular weight degradation of non-cross-linked hyaluronic acid during its application,including the effects on its structure,properties and biological activity,and the resulting changes on the body,is one of the future directions that need to be closely investigated.

The medical assistance system plays a backup role in China's multi-level medical security system,and has achieved important phased results in improving the accessibility and affordability of medical services for disadvantaged groups.However,there is still insufficient protection for medical assistance in China,and the phenomenon of"poverty caused by illness and returning to poverty due to illness"still exists.Therefore,it summarizes and analyzes the current development status of China's medical assistance system by reviewing national policy documents and analyzing local situations,summarizes and analyzes the existing problems,and proposes countermeasures and suggestions.

The reform of medical insurance payment is a critical part of deepening the medical reform.It plays an important role in guiding the behavior of healthcare providers.The latest progress in the reform of health insurance payment in the US.is the imple-mentation of value-based payment models.The literature research method is applied to review the development of value-based pay-ment practices in the US.It finds the main value-based payment models in the United States are targeted hospitals and physicians as the incentive object,with the characteristics of the combination of reward and punishment,the combination of horizontal and ver-tical evaluation,the continuous improvement of evaluation system,and the full use of information means.On this basis,combined with the national conditions of China,it puts forward four suggestions on establishing effective incentive mechanism,formulating scientific evaluation system,insisting on continuous improvement mechanism and strengthening medical information construction for future reform of medical insurance.

Objective It aims to investigate the current status of patient trust in physicians among inpatients at tertiary public hospitals in China and to analyze the factors influencing this trust.The goal is to provide insights for enhancing patient trust and improving doctor-patient relationships.Methods Relying on the third"third party evaluation of national action to improve medical services"project,it surveyed inpatients from 136 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.A total of 21 092 inpatient questionnaires were returned.Data obtained were statistically analyzed using R software version 4.3.2.Results The trust level in attending physicians among inpatients at tertiary public hospitals in China was found to be 98.37％.Influential factors on this trust level included patient occupation,annual family income,type and region of the hospital and so on.Conclusion Overall,the level of trust in physicians among inpatients at tertiary public hospitals in China is high,though regional differences exist.It should pay attention to non-medical factors such as inpatient ward environment and hospital service quality.Improving these aspects can enhance the overall patient experience,further improve doctor-patient relationships.

Objective It aims to investigate the status quo of nurses'emotional exhaustion in tertiary public hospitals in China and analyze its influencing factors,so as to provide suggestions for formulating targeted policy measures to reduce nurses'emotional exhaustion.Methods Relying on the fifth"The Third-Party Evaluation of the China Healthcare Improvement Initiatives"project,it surveyed nurses from 143 tertiary public hospitals across 31 provinces(including autonomous regions and municipalities)and the Xinjiang Production and Construction Corps.Univariate analyses were performed using the Pearson chi-square test.Multifactorial analyses were performed using ordered multicategorical logistic regression analysis.Results The score of nurses'emotional exhaustion in tertiary public hospitals in China was 8.00(2.00～16.00),of which mild exhaustion accounted for 79.00％,moderate exhaustion accounted for 10.00％,and severe exhaustion accounted for 11.00％.Gender,age,number of children,region,type of hospital,department,employment form,assume scientific research task,excessive workload,salary and hospitals carry out psychological guidance were the influencing factors of nurses'emotional exhaustion.Conclusion Nurses in tertiary public hospitals in China are at a mild level of emotional exhaustion,but in some groups the degree is more serious.Policy makers and hospital managers should focus on special groups,implement the reform of salary system,reduce nurses'workload,reasonably arrange working hours,improve the working environment of hospitals,and strengthen nurses'psychological guidance.

With the development of the economy and technological progress,more and more animal-derived mesh products are being utilized in the medical field for tissue and organ repair and replacement.Owing to the complexity of their structure and production process,these animal-derived meshes still face several challenges in practical applications,such as insufficient mechanical strength,rapid degradation rates,and the detection of harmful leachable substances.Among these challenges,the production process is a key factor affecting product quality.This paper reviews the key aspects of the production process and quality control for animal-derived meshes in China,offering new insights for the quality control and regulatory oversight of such products.

Objective To construct logistic regression,random forest and SVM models to predict the influencing factors of overweight and obesity in medical students,and the prediction performance of the three models was compared,so as to obtain the optimal model for the risk assessment of overweight and obesity.Methods Participants included 1 866 medical students from a city in Hebei Province from May to December 2020.The relevant data of overweight and obesity screening were collected through self-test questionnaire;three models of logistic regression,random forest and SVM are constructed by python.Results The test set showed that the accuracy of logistic regression,random forest and SVM models were 96.26%,98.66%and 98.13%respectively;the specificity were 99.77%,100%and 99.00%,respectively;and the AUC were 0.88,0.99 and 0.88 respectively.Random forest is the optimal prediction model;according to the random forest model results,subjective well-being,negative events and students'economic status are more than 10%of weight in the model.Conclusion Subjective well-being,negative events and students'economic status are the main factors affecting the incidence of overweight and obesity in medical students;the prediction performance of random forest model was better than logistic regression model and SVM model.