The red doctor spirit is a spiritual quality gradually molded during the process of the Communist Party of China （CPC） leading China’s healthcare undertakings. It has witnessed the century-long history of China’s healthcare undertakings and is an important part of the CPC’s red culture. The formation of the red doctor spirit not only stems from the scientific guidance of Marxism but is also deeply rooted in the civilizational nourishment of the excellent traditional Chinese culture， which was ultimately formed in the revolutionary practice of the CPC. Currently， the red doctor spirit still has important contemporary value in building good medical ethics and professionalism， practicing socialist core values， and accelerating the construction of a healthy China. In the context of the new era， accelerating the modernization translation of the red doctor spirit requires exploring its material expression forms， hastening the organic integration of the red doctor spirit and digital technology， and promoting the integration of the red doctor spirit into the ideological and political education in colleges and universities， thereby realizing the inheritance and development of the red doctor spirit in the context of the new era.

Colleges and universities are not only an important base for cultivating young talents, but also the forefront of ideological education. Strengthening ideological education in colleges and universities is related to the long-term peace and stability of the party and the country. Traditional Chinese Medicine (TCM) is a great creation of the Chinese nation and a treasure of ancient Chinese science. In the face of COVID -19, the TCM delivered in a satisfactory answer, which once again blessed the life and health of the people. TCM culture condenses the experience and wisdom of the Chinese nation for nearly one thousand years, and has unique national characteristics and spiritual pursuit. It is a great creation of Chinese culture. In the context of the new era, integrating TCM culture into ideological education in colleges and universities and giving full play to the function of TCM culture as the "key" of Chinese civilization is not only the urgent call of moral education in colleges and universities, but also the realistic development requirement of contemporary China.

OBJECTIVE To provide a reference for accurately identifying and treating adverse reactions of osteonecrosis induced by bevacizumab. METHODS Clinical pharmacists participated in the treatment process of an adult patient with glioma who developed femoral head necrosis after the use of bevacizumab. By searching the FDA Adverse Event Reporting System （FAERS） and consulting relevant literature and drug instructions， the association between femoral head necrosis and bevacizumab was assessed. Medication recommendations were provided to the physician， and medication educations were provided to the patient. RESULTS The association between the patient’s femoral head necrosis and bevacizumab was assessed as “possibly related”. The physicians accepted the clinical pharmacists’ advice to discontinue bevacizumab and switched to anlotinib to continue antitumor treatment. The patient also followed the clinical pharmacists’ advice to avoid prolonged standing. Upon re-examination， the patient’s pain symptoms were under control， and the femoral head necrosis had not progressed. CONCLUSIONS Patients who receive long-term bevacizumab should attach great importance to bone pain and osteonecrosis， undergo regular imaging examinations， and detect and treat symptoms early to prevent the occurrence of severe osteonecrosis.

DEFENCATH?(taurolidine/heparin)is the first hemodialysis central venous catheter lock solution approved by the FDA.Taurolidine has broad-spectrum antibacterial activity against Gram-negative and Gram-positive bacterium and fungal species and anti-endotoxin and anti-exotoxin activities.Moreover,microbial resistance has not been observed,and the safety is good.Low-dose heparin is effective in anticoagulation and has a low risk of bleeding,and the two complement each other,clinical studies have reported that the catheter lock solution(CLS)effectively reduces the incidence of catheter-related blood stream infection(CRBSI),with good safety and significant clinical value.It will bring benefits to renal failure patients undergoing maintenance hemodialysis.

Objective:To establish and validate the prediction model for bone marrow metastasis (BMM) in malignant tumors by screening out laboratory multiparameters.Methods:This case-control study collected 444 cases of malignant tumor patients who were hospitalized in the First Hospital of Jilin University from March 2018 to March 2024, including 243 cases for model establishment set and 201 cases for model validation set. The model establishment set was divided into BMM positive group (81 cases) and BMM negative group (162 cases), and the model validation set was divided into positive group (67 cases) and a negative group (134 cases). We collected patients′ clinical information such as gender, age, clinical diagnosis, and results of 47 laboratory tests including routine blood analysis, coagulation, liver function, tumor markers, potassium, sodium, chloride, and calcium ion tests, bone marrow morphology, and bone marrow biopsy. BMM was taken as the outcome event, differencial variables were analyzed using inter group comparisons, the correlation among parameters was analyzed using Pearson correlation analysis, the risk factors for BMM were analyzed using multivariate conditional logistic regression analysis, to establish logistic model, followed by efficiency evaluation on BMM predictive model using receiver operating characteristic (ROC) curves.Results:In the model establishment set, Pearson correlation analysis of 28 parameters that differed between the BMM positive and negative groups revealed that the correlation coefficients of 17 parameters, including mean platelet volume (MPV), hematocrit (HCT), hemoglobin (HGB), and prothrombin time (PT), were no more than 0.6 ( P<0.05). Further multivariate conditional logistic regression analysis demonstrated that MPV, HGB, HCT, PT, red cell distribution width (RDW), platelet count (PLT), alkaline phosphatase (ALP), chloride (Cl -), and mean erythrocyte hemoglobin concentration (MCHC) were the risk factors of BMM occurence in malignancy [MPV ( OR=9.929, 95% CI 2.688-71.335), HCT ( OR=8.232, 95% CI 6.223-9.841), HGB ( OR=4.300, 95% CI 1.947-16.577), PT ( OR=3.738, 95% CI 1.359-11.666), RDW ( OR=1.995, 95% CI 1.275-3.807), ALP ( OR=1.025, 95% CI 1.012-1.045), PLT ( OR=1.014, 95% CI 1.002-1.031), MCHC ( OR=0.724, 95% CI 0.523-0.880) and Cl -( OR=0.703, 95% CI 0.472-0.967)]. In the model establishment set, combiation of risk factors provided an AUC of 0.943 (95% CI 0.898-0.987, P<0.001), a sensitivity of 86.3%, and a specificity of 89.2% for BMM prediction. In the model validation set, the AUC was 0.924 (95% CI 0.854-0.960, P<0.001), with a sensitivity and specificity of 86.7% and 83.8%, respectively. Conclusion:This study built and validated a multiple-parameter model for BMM, which may facilitate the timely detection of BMM and provide reference for decision making of bone marrow aspiration.

【Objective】 To explore the efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) and transurethral bipolar plasmakinetic resection of prostate (TUPKP) for patients with small volume (≤30 mL) benign prostatic hyperplasia (BPH) and the effects on urinary control and sexual function. 【Methods】 Clinical data of BPH patients who underwent surgical treatment during Jun.2021 and Jan.2022 were reviewed. A total of 95 patients with prostate volume ≤30 mL and regular sexual life were selected as subjects, including 45 patients who received TUCBDP as the TUCBDP group and 50 patients who received TUPKP as the TUPKP group. The patients were followed up for 12 months, and the perioperative data and follow-up results were analyzed. 【Results】 The TUCBDP group had shorter operation time, less intraoperative blood loss, less postoperative hemoglobin loss and sodium concentration loss, shorter bladder irrigation time, lower pain score, shorter urinary tube indwelling time and shorter hospital stay than the TUPKP group (P<0.05). Twelve months after surgery, the International Prostate Symptom score (IPSS), quality of life score (QoL), residual urine volume (PVR) and maximum urine flow rate (Qmax) were significantly improved in both groups (P<0.05). The International Index of Erectile Function-5 (IIEF-5), Erection Hardness Grading Score (EHS), Sexual Function Score in Patients with Premature Ejaculation-5 (CIPE-5) score had no significant differences compared with those before surgery (P>0.05). The TUPKP group had worse ejaculation function score and ejaculation disturbance score after surgery (P<0.05), while the TUCBDP group had no significant change (P>0.05), and the two indexes were superior in the TUCBDP group than in the TUPKP group. The TUCBDP group had significantly lower complication rate than the TUPKP group (P<0.05). 【Conclusion】 TUCBDP is safe and effective in the treatment of small volume (≤30 mL) BPH, less trauma, less biochemical interference, less pain, fewer complications, and shorter course of disease. It has little effect on the ejaculation function and erectile function, and is more suitable for patients requiring retention of sexual function. It has a good application prospect in the treatment of small volume BPH.

OBJECTIVE To analyze the dose-adjusted concentrations of Posaconazole oral suspension in patients undergoing hematopoietic stem cell transplantation （HSCT） and their influential factors. METHODS Data were collected from hospitalized HSCT patients admitted to the First Affiliated Hospital of Shandong First Medical University （Shandong Provincial Qianfoshan Hospital） from January 2021 to April whtwhm@yeah.net 2023 who took Posaconazole oral suspension for the prevention of invasive fungal disease （IFD） and received blood concentration of posaconazole. The rate of concentration attainment and clinical failure rate of posaconazole for the prevention of IFD were evaluated， and one-way and multiple linear regression analyses were performed for the influential factors of dose-adjusted concentrations （C0/D） of posaconazole. RESULTS A total of 44 patients were enrolled； the mean C0 of posaconazole in patients was （0.99±0.94） µg/mL， and 20 patients had a C0≥0.7 μg/mL， with a concentration attainment rate of 45.45% for the prevention of IFD； 13 cases were clinical failures， with a clinical failure rate of 29.55%. Of 24 patients who did not achieve C0/D of posaconazole for IFD prophylaxis， one patient was a clinical failure despite timely dose adjustment of posaconazole in seven patients； seven of the thirteen patients who did not undergo dose adjustment were clinical failures； and the remaining four patients were switched to other antifungal agents. The results of univariate analysis showed that gender， body mass index （BMI）， renal function， combined use of sodium phenytoin， omeprazole and metoclopramide had a significant effect on the C0/D of posaconazole （P＜0.05）； the results of multivariate linear regression analysis showed that gender， BMI and combined use of sodium phenytoin were the independent factors affecting the C0/D of posaconazole （P＜0.05）. CONCLUSIONS Significant individual differences are reflected in the blood concentration of Posaconazole oral suspension； gender， BMI and combined use of sodium phenytoin are independent factors affecting the C0/D of posaconazole.

Objective:To investigate the clinical effect of CAG stimulating regimen for refractory adult early T cell precursor acute lymphoblastic leukemia (ETP-ALL) complicated with fusarium infection and the clinical features as well as antifungal strategy of cutaneous fusarium infection.Methods:The diagnosis and treatment of 1 adult patient diagnosed as ETP-ALL complicated with cutaneous fusarium infection in the First Hospital of Jilin University in September 2020 were retrospectively analyzed, and related literatures were reviewed.Results:VICP chemotherapy regimen showed no effectiveness in this patient who was presented with persistent agranulocytosis complicated with cutaneous fusariosis infection. After amphotericin B therapy for infection, he achieved the stable disease and successfully underwent CAG stimulating regimen salvage treatment. The minimal residual disease turned into negative after consolidation chemotherapy based on the myeloid regimen. Finally this patient survived from haploid allogeneic hematopoietic stem cell transplantation after consolidation chemotherapy and fusarium was under the control by using posaconazole as secondary prevention therapy.Conclusions:CAG stimulating regimen can be recommended as reinduction therapy for relapsed/refractory ETP-ALL. Sequential therapy of amphotericin B followed by posaconazole can be a useful antifungal strategy for fusarium infection.

Objective:To explore the risk factors of renal function progression in patients with acute renal injury (AKI) after moderate hypothermic circulatory arrest surgery in acute aortic dissection (AD).Methods:Retrospective analysis was made base on the data of 290 patients with acute AD who underwent surgical treatment from January 2014 to August 2022 in the Affiliated Hospital of Jining Medical University. According to the Kidney Disease: Improving Global Outcomes (KDIGO) AKI diagnostic criteria in 2015, patients with AKI after surgery were selected as the study objects. Patients with progressive deterioration of renal function or required continuous renal replacement therapy after AD operation were defined as the progression group of AKI, the other patients with gradual improvement of renal function after AD operation were defined as the improvement group of AKI. The clinical data of the two groups were compared, and the risk factors for the progression of AKI after AD were analyzed by multivariate logistic regression.Results:A total of 290 AD surgeries were completed, of which 143 cases developed AKI after surgery, including 81 cases in AKI progression group and 62 cases in AKI improvement group. In the progression group of AKI, before surgery the proportion of patients with coronary heart disease: 24.7% (20/81) vs.11.3% (7/62), serum creatinine (Scr) >133 μmol/L: 24.7% (20/81) vs. 3.2% (2/62), pericardial tamponade: 22.2% (18/81) vs. 8.1% (5/62), lower limb ischemia: 25.9% (21/81) vs. 3.2% (2/62) were significantly increased. Postoperative acute physiology and chronic health evaluation Ⅱ (APACHE) score: 14.00 (9.00, 19.75) scores vs. 10.00 (7.00, 12.00) scores, ICU hospitalization days: 8 (5, 13) d vs. 5 (3, 7) d, postoperative mortality: 24.7%(20/81) vs. 1.6%(1/62), the proportion of KDIGO phase 3 ratio: 46.9%(38/81) vs. 3.2%(2/62), postoperative infection: 61.7%(50/81) vs. 38.7% (24/62), low cardiac output syndrome: 29.6% (24/81) vs. 6.5% (4/62), cerebral infarction complications: 38.2%(31/81) vs. 16.1%(10/62), and mortality after surgery were also higher. Compared with improvement group of AKI, all differences were statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that preoperative lower limb ischemia ( OR = 9.430, 95% CI 1.975 to 45.032, P = 0.005), postoperative low cardiac output syndrome ( OR = 5.288, 95% CI 1.543 to 18.126, P = 0.008), and postoperative infection ( OR = 2.273, 95% CI 1.022 to 5.057, P = 0.044) were independent risk factors for the progression of AKI after AD surgery. Conclusions:The independent risk factors of renal function progression in patients with AKI after hypothermic circulatory arrest surgery in acute AD include preoperative lower limb ischemia, postoperative low cardiac output syndrome, and postoperative infection.

Background Previous studies have confirmed that nicotine exposure is an independent risk factor for miscarriage, but it is not clear whether nicotine causes unexplained recurrent spontaneous abortion (URSA) through oxidative stress. Objective To explore potential mediating effect of oxidative stress on the relationship between nicotine exposure and URSA. Methods Using a 1∶1 matched case-control study, 88 patients with URSA visiting Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from April to October in 2018 were selected as the case group, and 88 pregnant women without adverse pregnancy outcomes and seeking induced abortion in the outpatient clinic of the same hospital were selected as the control group. The levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and 8-iso-prostaglandin F2α (8-iso-PGF2α) in urine were determined by enzyme-linked immunosorbent assay, and the level of urinary nicotine was determined by gas chromatography-mass spectrometry. Conditional logistic regression was used to analyze the associations of nicotine, 8-OHdG, and 8-iso-PGF2α with the risk of URSA. Multiple linear regression was used to analyze the association of nicotine with 8-OHdG and 8-iso-PGF2α. The potential mediating effect of oxidative stress on URSA after nicotine exposure was explored by dichotomous mediating model. Results The median concentrations (creatinine corrected) of nicotine, 8-OHdG, and 8-iso-PGF2α in urine of the case group were 7.78, 4.84, and 44.10 μg·g⁻¹, respectively, while those of the control group were 6.48, 3.34, and 29.39 μg·g⁻¹, respectively. The concentrations of nicotine, 8-OHdG, and 8-iso-PGF2α in urine of the case group were all higher than those of the control group (P < 0.05). The results of conditional logistic regression model showed that after adjusting selected confounding factors, compared with the Q₁ groups of nicotine and 8-iso-PGF2α, the OR (95%CI) values of URSA in the Q₄ groups were 4.20 (1.33-13.29) and 6.25 (1.66-23.59), respectively. Compared with the Q₁ group of 8-OHdG, the OR (95%CI) values of URSA in the Q₁, Q₂, and Q₃ groups were 5.47 (1.43-20.93), 4.24 (1.28-14.07), and 6.36 (1.82-22.28), respectively. The results of multiple linear regression showed that after adjusting confounding factors, there was a positive correlation between urinary nicotine and 8-OHdG in both the case group and the control group, and the b (95%CI) values were 0.76 (0.67-0.86) and 0.81 (0.67-0.95) respectively; there was a positive correlation between urinary nicotine and 8-iso-PGF2α in both the case group and the control group, and the b (95%CI) values were 0.65 (0.55-0.75) and 0.76 (0.64-0.87), respectively. The results of dichotomous mediating analysis showed that the mediating effect of 8-iso-PGF2α and its 95%CI on the relationship between nicotine exposure and URSA was 1.518 (0.749-2.311). Conclusion Internal nicotine exposure is a risk factor for URSA and is positively correlated with oxidative stress, and it may lead to URSA through lipid peroxidation damage.