Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

Objective:To compare the efficacy and safety of standard treatment with or without adjuvant chemotherapy in patients with highly malignant non-metastatic prostate cancer.Methods:In this prospective non-randomized controlled study, consecutive non-metastatic prostate cancer patients with pathologically proven Gleason score of 9-10 or Gleason score of 5 admitted to Peking University First Hospital were enrolled. Four to six cycles of chemotherapy using docetaxel ± carboplatin regimen were added or not after standard radical therapy. The primary end point was 5-year event-free survival (EFS), and the secondary end points were distant metastasis-free survival (MFS), overall survival (OS), and treatment-related adverse events. The survival curve was drawn by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test.Results:A total of 176 patients were consecutively enrolled from November 2019 to January 2022 of which 138 patients received only standard radical therapy (control group), and 38 patients received adjuvant chemotherapy after standard radical therapy (chemotherapy group). The median follow-up time was 13.4 (2.0-34.0) months. All patients survived. The 30-month EFS rates in the chemotherapy and control groups were 100% and 85.6%, respectively ( P=0.064). There were no events in the chemotherapy group, while there were 12 cases of events in the control group, including 6 cases of biochemical recurrence and 6 cases of imaging progression. The 30-month MFS rates in two groups were 100% and 91.9%, respectively ( P=0.205). After the 1 vs. 2 propensity score matching, the EFS and MFS rates in two groups were 100% vs. 85.7% ( P=0.056), and 100% vs. 92.2% ( P=0.209), respectively. The incidence rates of grade 2 and above urinary toxicity in the chemotherapy and control groups were 2.6% and 7.2% ( P=0.354), respectively. The incidence rates of grade 2 and above rectal toxicity were 5.3% and 5.1% ( P=0.711), respectively. Grade 3 and above chemotherapy-related toxicity in the chemotherapy group were leukopenia (31.6%), thrombocytopenia (2.6%) and alopecia (13.2%). Conclusion:The addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall EFS of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long-term follow-up results.

The pathogenesis of gouty arthritis contains internal cause and external cause. The deficiency of Zang Fu organs is the internal cause and the invasion of external pathogens is the external cause, which is related to the liver, spleen and kidney. In clinical treatment, we should grasp the pathological factors such as dampness, heat and blood stasis, and treat this diseaseaccording to different stages and types, anddeal with both symptoms and the root cause. Clinically, orally taken Traditional Chinese Medicine (TCM), acupuncture, collateral pricking and bleeding, and external application of TCM are the common methods to treat this disease and combining various methods together has better curative effect, which could significantly relieve the pain and alleviate inflammation with safetiness. However, the operation methods and standards of the existing studies are not unified, which needs long-term follow-up, large samples and high-quality studies.

China and Asean countries all have a history of usingtraditional medicine. With the establishment and development of asean economic zone, traditional medicine has been included in the key areas of economic and social cooperation between China and Asean Countries. We designed and constructed the China-Asean traditional medicine database for understanding and taking advantages of traditional medicine in Asean countries. Based on the principle of software engineering design, referred to the construction ideas, functional modules and construction methods of traditional Chinese medicine database, this paper designed and constructed China-Asean traditional Chinese medicine database, which has provided the basic information system for the exchange, cooperation and development. The database of and asean traditional medicine based on Internet is established, which provides basic data information service for the mutual exchange, cooperation and development of traditional medicine research. The "China-Asean traditional medicine database" has been token as the basic data platform for information centralization and sharing, and it lays a foundation for the construction of higher level knowledge base and intelligent application system to accumulate data in the field of traditional medicine.

OBJECTIVE: To design and synthesize folate-modified pH-responsive chitosan-based nanomicelles and investigate the anti-tumor activity of the drug-loaded micelles. METHODS: CHI-DMA was obtained by reductive amination reaction of aldehyde-based chitosan and hydrophilic amine compounds, and CHI-DMA-LA was obtained by condensation reaction with lauric acid; FA-CHI-DMA-LA was obtained after modification with folic acid (FA). The drug-loaded nanomicelles FA-CHI-DMA-LA/DOX were assembled by solvent change method. The physicochemical properties of polymers were characterized by hydrogen nuclear magnetic resonance and transmission electron microscope. The particle size and surface potential were determined by dynamic light scattering method. Folic acid access rate, doxorubicin (DOX) loading rate and entrapped efficiency were measured by UV-vis spectrophotometer. The drug release properties of DOX-loaded micelles were monitored by fluorescence spectrophotometer at different pHs (7.4, 6.5, 5.0). The cytotoxicity against human oral cancer KB cells was detected by MTT assay. Fluorescence microscope and flow cytometry were applied to investigate the phagocytosis of DOX-loaded micelles on KB cells. RESULTS: FA-CHI-DMA-LA was synthesized. The particle sizes of FA-CHI-DMA-LA-1 and FA-CHI-DMA-LA-2 micelles which used for the subsequent experiments were (73±14) nm and (106±15) nm, zeta potential were (15.59±1.98) mV and (21.20±2.35) mV, respectively. The drug loading rates of drug-loaded micelles FA-CHI-DMA-LA-1/DOX and FA-CHI-DMA-LA-2/DOX are (4.08±1.12)%and (4.12±0.44)%, respectively. drug release is pH-responsive, with cumulative release of DOX up to 37%and 36%at pH 5.0, which is about 1.5 times higher than that of pH 7.4. For FA-CHI-DMA-LA micelles with 1.25 to 125 μg/mL concentration, the survival rate of KB cells is more than 70%after incubation for 24 hours. The cell uptake of FA-CHI-DMA-LA/DOX micelles was enhanced compared to CHI-DMA-LA/DOX, and the cell uptake was higher in incubation without FA medium than that with FA. Compared with free DOX or CHI-DMA-LA/DOX, FA-CHI-DMA-LA/DOX nanomicelles showed higher cyctoxicity to KB cells, especially the FA-CHI-DMA-LA-2/DOX nanomicelles, the cell survival rate was about 17% after incubation for 24 hours. CONCLUSIONS FA-modified chitosan-based nanomicelle with good biocompatibility was successfully prepared, which exhibits tumor microenvironmental pH responsive drug release and tumor targeting.
Antineoplastic Agents ; Chitosan ; Doxorubicin ; Drug Carriers ; Folic Acid ; Humans ; Micelles ; Nanostructures ; Polymers

Objective To determine the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for gastrointestinal lesions with inconclusive endoscopic biopsies. Methods A retrospective analysis was performed in 65 patients who were found to have gastrointestinal lesions with inconclusive endoscopic biopsies and underwent EUS-FNA in Drum Tower Hospital. Diagnostic value of EUS-FNA was determined by comparing with surgical histopathology and follow-up results. Results This study included 41 males ( 63％) and 24 females ( 37％) with median age of 60 years. The most common lesion was diffuse infiltrative lesions ( 37, 56. 9％) , followed by submucosal protrusion types ( 17, 26. 2％) . Fifty-four cases ( 83. 1％) were malignant lesions, and 11 cases ( 16. 9％) were benign. The overall sensitivity, specificity, and accuracy of EUS-FNA for gastrointestinal lesions with inconclusive biopsies were 76. 8％ ( 95％CI: 65. 7％-87. 8％) , 100. 0％ ( 95％CI: 66. 4％-100. 0％) , and 80. 0％( 95％CI: 70. 3％-89. 7％) , respectively. Sub-group analysis showed the sensitivity, specificity, and accuracy of EUS-FNA for diffuse infiltrative lesions were 70. 6％ ( 95％CI: 55. 3％-85. 9％, 100. 0％( 95％CI:29. 2％-100. 0％) , and 73. 0％ ( 95％CI: 58. 7％-87. 3％) , respectively. For submucosal protrusions, the sensitivity, specificity, and accuracy of EUS-FNA were 68. 8％ ( 95％CI: 46. 0％ -91. 5％) , 100. 0％ ( 95％CI: 2. 5％-100. 0％) , and 70. 6％ ( 95％CI: 44. 0％-89. 7％) , respectively. Conclusion EUS-FNA has moderate diagnostic value for endoscopic biopsy-inconclusive gastrointestinal lesions. It can be an alternative option when standard methods, such as endoscopic mucosal forceps biopsy, fail to provide a definitive diagnosis.

Objective To explore the application disturbance coefficient (DC) value of noninvasive brain edema monitoring in patients after traumatic brain injury.Methods A total of 54 cerebral injury patients were performed by non-invasive brain edema monitoring from June to November 2016.The essential information,DC,intracranial pressure (ICP),and 6-month-later glasgow outcome score (GOS) were collected.Results DC was negatively correlated with ICP (r=-0.779 5,P＜0.01),and it was positively correlated with glasgow coma scale (GCS) and GOS (r=0.667 5,P＜0.01;r=0.630 6,P＜0.01).The mean of DC with good prognosis patients was 106.99±4.09,and that of the poor prognosis patients was85.26±4.45,the difference was statistically significant (P＜0.05).Conclusion DC has a good clinical application value.

To prepare a nano-carrier based on combining bacterial outer membrane vesicles (OMV) with three block polymer pluronic F127 (PEO-PPO-PEO) (OMV-F127) and to investigate its immunological activity.Attenuated salmonella (sal) was cultivated. OMV were separated by centrifugal ultrafiltration or ultrasonication, and OMV-F127 was prepared by mechanical extrudation method. The protein contents and compositions were tested with BCA and SDS-PAGE; the morphology of OMV, F127 and OMV-F127 were observed with FM and TEM; the particle sizes and their zeta potential were determined with DLS. Mouse macrophage RAW246.7 cells were treated with OMV-F127 (50 μg/mL, 100 μg/mL) in vitro, and the concentrations of IL-12, TNF-α and IFN-γ in culture supernatant were measured with ELISA kits.The contents of protein in separated OMV by centrifugal ultrafiltration and ultrasonication were 2.8 mg/mL and 2.7 mg/mL, respectively. SDS-PAGE showed the marker protein OmpF/C in OMV. Under the FM and TEM, ball-like structure of F127 and OMV-F127 was observed. Size analysis revealed that the diameters of OMV, F127 and OMV-F127 were 72±2 nm, 90±3 nm and 92±2 nm, respectively. ELISA tests revealed that OMV-F127 significantly stimulated the secretion of IL-12, TNF-α and IFN-γ in RAW246.7 cells.A nano-carrier based on bacterial outer membrane vesicles has been prepared, which can stimulate the secretion of cytokines and may have immunomodulatory effects.

OBJECTIVE: To investigate the body sweat,urine excretion and water intake of iron and steel production workers working under high temperature.METHODS: Two hundred and twenty-six workers working under high-temperature were selected as high-temperature group and 39 non-high-temperature workers as control group from an iron and steel production enterprise of Tangshan City by cluster sampling method.The workers working under high-temperature were divided into 4 subgroups(moderate physical labor 30-34 ℃ subgroup Ⅰ,heavy physical labor 30-34 ℃ subgroup Ⅱ,35-39 ℃subgroup and 40-43 ℃ subgroup) according to the labor intensity and the exposure temperature.The wet bulb globe temperature(WBGT) index in workplace was determined.The water intake survey was carried out.Water loss was estimated by body mass difference.The unit of body mass difference before and after work was conversed from kg into mL with formula“1 kg = 1 000 mL”.RESULTS: The water intake was 1 200-4 102(2 456 ± 612) mL in workers working under high-temperature,the drinking amount accounting for 74.5%-80.0% in the total water intake which were 2 004-5 749(3 810 ±672) mL.The difference of body mass before and after work was 1 513-4 932(3 078 ± 662) mL in the hightemperature operation group.The sweat excretion accounted for 86.5% of the total water excretion.In moderate physical labor 30-34 ℃ subgroup I,the total water intake,the body mass difference before and after work,the sweat and the total fluid excretion were higher and the urine excretion was lower than those of control group(P<0.05).The total water intake,the body mass difference before and after work,the sweat and the total fluid excretion in body of heavy physical labor 30-34 ℃ subgroup Ⅱ were higher than those of moderate physical labor 30-34 ℃ subgroup Ⅰ(P<0.05).With the increase of WBGT index,the total water intake,the body mass difference before and after work,the sweat and the total fluid excretion in body of 3 heavy physical labor subgroups increased and their urine excretion decreased which showed a dose-effect relationship(P<0.05).The D-value between the water intake and the sweat excretion of high-temperature operation group workers were-769--322 mL,those between the total water intake and losses were-598--96 mL.CONCLUSION: The fluid intake and excretion in workers working under high-temperature in iron and steel plant are in a negative balance.The water intake is lower than the recommended drinking amount under high-temperature environment.Sweating is the main way of water loss under high-temperature working condition.

Objective:To prepare a nano-carrier based on combining bacterial outer membrane vesicles (OMV) with three block polymer pluronic F127 (PEO100-PPOss-PEO100) (OMV-F127) and to investigate its immunological activity.Methods:Attenuated salmonella (sal) was cultivated.OMV were separated by centrifugal ultrafiltration or ultrasonication,and OMV-F127 was prepared by mechanical extrudation method.The protein contents and compositions were tested with BCA and SDS-PAGE;the morphology of OMV,F127 and OMV-F127 were observed with FM and TEM;the particle sizes and their zeta potential were determined with DLS.Mouse macrophage RAW246.7 cells were treated with OMV-F127 (50 μg/mL,100 μg/mL) In vitro,and the concentrations of IL-12,TNF-α and IFN-γin culture supernatant were measured with ELISA kits.Results:The contents of protein in separated OMV by centrifugal ultrafiltration and ultrasonication were 2.8 mg/mL and 2.7 mg/mL,respectively.SDS-PAGE showed the marker protein OmpF/C in OMV.Under the FM and TEM,ball-like structure of F127 and OMV-F127 was observed.Size analysis revealed that the diameters of OMV,F127 and OMV-F127 were (72 ±2)nm,(90 ± 3)nm and (92 ± 2)nm,respectively.ELISA tests revealed that OMV-F127 significantly stimulated the secretion of IL-12,TNF-α and IFN-γ in RAW246.7 cells.Conclusion:A nano-carrier based on bacterial OMV has been prepared,which can stimulate the secretion of cytokines and may have immunomodulatory effects.