Internet healthcare represents a new form of online medical services for patients,evolved from traditional physical hospitals through the integration of digital technology.Currently,China's conventional medical services confronts numer-ous challenges,with an unmet demand for high-quality and convenient healthcare services.In this context,the progression of in-ternet hospitals aligns with the requirements of modern social development in China.Despite this,the construction of China's in-ternet hospital remains nascent.As a forerunner in digital transformation initiatives,Shanghai,recognized as the"international digital capital",offers a fertile ground for such explorations.This study presents S Hospital in Shanghai as a model case,summa-rizing the development process,highlights and challenges encountered in the construction of its internet hospitals.It distills opti-mization strategies from the vantage points of hospital management and governmental authorities,aiming to provide insights into advancement of Shanghai's healthcare sector.

Objective To analyze the status of coronary collateral circulation(CCC)in patients with acute myocardial infarction(AMI)and explore its relationship with thrombus burden.Meth-ods Convenient sampling was used to select 161 AMI patients diagnosed and treated in Tongling People's Hospital from May 2022 to March 2024.Their CCC status was assessed by Rentrop clas-sification,and according to the results,they were divided into well-(grade 2～3,84 cases)and poorly-developed CCC groups(grade 0～1,77 cases).The general clinical data,cardiac function in-dicators and thrombus burden were compared between the two groups.Multivariate logistic re-gression was employed to identify the independent influencing factors for CCC status in AMI pa-tients,and ROC curve was plotted to analyze the relationship between CCC status and thrombus burden.Results In the 161 AMI patients,the incidence of adverse CCC was 47.83％(77/161).The poorly-developed CCC group had significantly lower Gensini score,and higher white blood cell count than the well-developed CCC group(P＜0.01);There is a statistically significant differ-ence in proportion of infarct related blood vessels between two groups(P＜0.01).The rate of high thrombus burden in the poorly-developed CCC group was obviously higher than that in the well-developed group(79.22％vs 26.19％,P＜0.01).Multivariate logistic regression analysis showed that infarction-related vessels(left anterior descending coronary artery),white blood cell count and thrombus burden were independent risk factors for poor development of CCC,while Gensini score was independent protective factors(OR=2.051,95％CI:1.071-3.928;OR=1.647,95％CI:1.353-2.006;OR=6.418,95％CI:2.654-15.519;OR=0.973,95％CI:0.948-0.999).ROC curve analysis indicated that the AUC value of thrombus burden was 0.752(95％CI:0.678-0.817).Conclusion It is quite common of poorly developed CCC in AMI patients,which is associ-ated with the increase of thrombus burden.

Objective:To investigate the efficacy and safety of daratumumab in the treatment of systemic light chain amyloidosis.Methods:The clinical data of 24 patients with systemic light chain amyloidosis who received daratumumab-based regimens in Sichuan Provincial People's Hospital from January 2020 to November 2022 were retrospectively analyzed. The treatment process of patients was summarized and the therapeutic efficacy was evaluated. Kaplan-Meier method was used to make survival analysis and the adverse reactions were analyzed.Results:All 24 patients included 2 cases (8.33%) of Mayo 2004 stageⅠ, 2 cases (8.33%) of Mayo 2004 stage Ⅱ and 20 cases (83.33%) of Mayo 2004 stage Ⅲ. All patients were treated with daratumumab-based regimen, and 17 patients had evaluable efficacy. In the chemotherapy regimens, 15 patients received DVd (daratumumab + bortezomib + dexamethasone) regimen, 7 patients received DVCd (daratumumab + bortezomib + cyclophosphamide + dexamethasone) regimen, 1 patient received DRd (daratumumab + lenalidomide + dexamethasone) regimen, and 1 patient received DTd (daratumumab +thalidomide + dexamethasone) regimen. After 1 course of daratumumab-based regimens in 17 cases with evaluable efficacy, the strict complete remission (sCR) rate was 41.18% (7/17), the overall response rate (ORR) was 88.24% (15/17). Among 17 patients who received daratumumab-based chemotherapy regimen as the first-line treatment, sCR rate of 11 cases with evaluable efficacy was 36.36% (4/11) after 1 course of treatment ORR was 90.90% (10/11). Among 5 relapsed/refractory patients, sCR rate of 4 cases with evaluable efficacy was 50.00% (2/4) after 1 course of treatment; ORR was 75.00% (3/4). Among 24 patients, renal involvement was found in 17 patients at the initial diagnosis. After 1 course of daratumumab-based chemotherapy regimen, ORR of 7 cases with evaluable efficacy was 85.71% (6/7), among which 42.86% (3/7) patients with renal involvement had an assessed renal response of very good partial remission (VGPR) or above. At the initial diagnosis, 19 cases had cardiac involvement; ORR of 14 cases with evaluable efficacy was 85.71% (12/14), among which 42.86% (6/14) patients had cardiac response to VGPR or above. After daratumumab-based chemotherapy regimen, the main adverse reactions were infusion-related adverse reactions, myelosuppression and infection, all of which were tolerated by the patients. The median follow-up time of 24 patients was 7.0 months (0.5- 16.5 months), the median progression-free survival time was 7.0 months (0.5-16.5 months) and the median overall survival time was 7.0 months (0.5-35.0 months).Conclusions:Daratumumab-based chemotherapy regimen has good efficacy and safety in the treatment of systemic light chain amyloidosis.

【Objective】 To provide data reference for the implementation of the homogenization of pre-donation blood testing by investigating the relevant situation of pre-donation blood testing in various blood services in Chongqing and analyzing their differences. 【Methods】 A questionnaire covering the basic information of pre-donation blood testing items, quality control and the management of deferral donors was developed, and issued to 19 blood services in Chongqing through E-mails by Chongqing Society of Blood Transfusion. The data collected were sorted, revised and analyzed. 【Results】 A total of 19 questionnaires from 19 blood services(including 1 blood center, 1 sub-center, 6 central blood stations and 11 central blood banks) were collected. All of the pre-donation blood test items of 19 blood services met the Blood Donor Health Test Requirements. Hemoglobin, blood group, ALT and HBsAg testing were carried out by 19 blood services, anti-TP testing by 15, and lipid blood testing by 11, using different detection methods and reagents. Significant differences were found in the frequency and rules of internal quality control for quantitative testing items. In addition, the deferral time and re-recruitment strategy of deferral blood donors were also significantly different. 【Conclusion】 There were differences in the management of pre-donation blood testing and blood donor management after blood donation among blood services in Chongqing. Further standardization was needed to realize regional homogenization and guarantee blood safety and the safety of blood donors.

Objective:To evaluate the safety and effectiveness of a new Chinese-made surgical biopatch for atrial septum under the establishment of atrial septal defect animal model in miniature pigs.Methods:From June 2018 to April 2019, 26 pigs were divided into experimental group (15 pigs) and the control group (11 pigs). Animal models of atrial septal defect were established by traditional surgical methods. The to-be-evaluated and listed surgical biological patches (with a diameter of 10 mm) were implanted in the experimental group and the control group to repair the atrial septal defect. Cardiac ultrasound and blood examination of all animals were performed before and at 7, 30, 90, 180 days after operation, the results were analyzed with repetitive measurement and analysis of variance. At 90 days and 180 days after the operation, tissue samples were taken from animals after euthanasia. Pathological examination of heart and major organs were conducted. The independent sample t test and rank sum test were used to compare the data between the two groups, and the nonparametric was used to compare the patch calcification score between the two groups. Results:In total of 26 animals, 14 animals in the experimental group(6 at 90 days, 8 at 180 days) and 9 animals in the control group(4 at 90 days, 5 at 180 days) reached the end of the experiment. The other 3 animals (1 in the experimental group and 2 in the control group) died of arrhythmia, whole heart failure and right heart failure, the results of pathological examination showed that the causes of death were unrelated to the experimental materials. Cardiac ultrasound showed no patch leakage in all animals. There was no statistically significant difference in cardiac ultrasound and blood examination between the two groups at different time points after operation (all P>0.05). The pathological results showed that all the implants were intact and had good biocompatibility. There was no significant difference in the mean endothelialization rate between the experimental group and the control group at 90 and 180 days after operation ((80.8±29.1)% vs. (82.5±23.6)%, t=0.095, P=0.927; (78.8±36.4)% vs. (82.0±19.2)%, t=0.182, P=0.859) on 90 and 180 days, there was no significant difference in the patch calcification score between the two groups (1.00(1.25) vs. 2.00(0.75), Z=6.500, P=0.214; 0(0.75) vs. 1.00(2.00), Z=12.000, P=0.139). Conclusion:The new Chinese-made surgical biopatch for atrial septum has comparable safety and efficacy to that of the marketable patch in miniature pig atrial septal defect animal model.

Objective:To evaluate the safety and effectiveness of a new Chinese-made surgical biopatch for atrial septum under the establishment of atrial septal defect animal model in miniature pigs.Methods:From June 2018 to April 2019, 26 pigs were divided into experimental group (15 pigs) and the control group (11 pigs). Animal models of atrial septal defect were established by traditional surgical methods. The to-be-evaluated and listed surgical biological patches (with a diameter of 10 mm) were implanted in the experimental group and the control group to repair the atrial septal defect. Cardiac ultrasound and blood examination of all animals were performed before and at 7, 30, 90, 180 days after operation, the results were analyzed with repetitive measurement and analysis of variance. At 90 days and 180 days after the operation, tissue samples were taken from animals after euthanasia. Pathological examination of heart and major organs were conducted. The independent sample t test and rank sum test were used to compare the data between the two groups, and the nonparametric was used to compare the patch calcification score between the two groups. Results:In total of 26 animals, 14 animals in the experimental group(6 at 90 days, 8 at 180 days) and 9 animals in the control group(4 at 90 days, 5 at 180 days) reached the end of the experiment. The other 3 animals (1 in the experimental group and 2 in the control group) died of arrhythmia, whole heart failure and right heart failure, the results of pathological examination showed that the causes of death were unrelated to the experimental materials. Cardiac ultrasound showed no patch leakage in all animals. There was no statistically significant difference in cardiac ultrasound and blood examination between the two groups at different time points after operation (all P>0.05). The pathological results showed that all the implants were intact and had good biocompatibility. There was no significant difference in the mean endothelialization rate between the experimental group and the control group at 90 and 180 days after operation ((80.8±29.1)% vs. (82.5±23.6)%, t=0.095, P=0.927; (78.8±36.4)% vs. (82.0±19.2)%, t=0.182, P=0.859) on 90 and 180 days, there was no significant difference in the patch calcification score between the two groups (1.00(1.25) vs. 2.00(0.75), Z=6.500, P=0.214; 0(0.75) vs. 1.00(2.00), Z=12.000, P=0.139). Conclusion:The new Chinese-made surgical biopatch for atrial septum has comparable safety and efficacy to that of the marketable patch in miniature pig atrial septal defect animal model.

Odontogenic keratocysts (OKCs) are common cystic lesions of odontogenic epithelial origin that can occur sporadically or in association with naevoid basal cell carcinoma syndrome (NBCCS). OKCs are locally aggressive, cause marked destruction of the jaw bones and have a propensity to recur. PTCH1 mutations (at ∼80%) are frequently detected in the epithelia of both NBCCS-related and sporadic OKCs, suggesting that PTCH1 inactivation might constitutively activate sonic hedgehog (SHH) signalling and play a major role in disease pathogenesis. Thus, small molecule inhibitors of SHH signalling might represent a new treatment strategy for OKCs. However, studies on the molecular mechanisms associated with OKCs have been hampered by limited epithelial cell yields during OKC explant culture. Here, we constructed an isogenic PTCH1 cellular model of PTCH1 inactivation by introducing a heterozygous mutation, namely, c.403C>T (p.R135X), which has been identified in OKC patients, into a human embryonic stem cell line using the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Cas9) system. This was followed by the induction of epithelial differentiation. Using this in vitro isogenic cellular model, we verified that the PTCH1 heterozygous mutation causes ligand-independent activation of SHH signalling due to PTCH1 haploinsufficiency. This activation was found to be downregulated in a dose-dependent manner by the SHH pathway inhibitor GDC-0449. In addition, through inhibition of activated SHH signalling, the enhanced proliferation observed in these induced cells was suppressed, suggesting that GDC-0449 might represent an effective inhibitor of the SHH pathway for use during OKC treatment.
Anilides ; pharmacology ; Basal Cell Nevus Syndrome ; Hedgehog Proteins ; genetics ; pharmacology ; Humans ; Molecular Targeted Therapy ; Odontogenic Cysts ; genetics ; physiopathology ; therapy ; Odontogenic Tumors ; genetics ; physiopathology ; therapy ; Pyridines ; pharmacology

Odontogenic keratocysts (OKCs) are common cystic lesions of odontogenic epithelial origin that can occur sporadically or in association with naevoid basal cell carcinoma syndrome (NBCCS).OKCs are locally aggressive,cause marked destruction of the jaw bones and have a propensity to recur.PTCH1 mutations (at ～80％) are frequently detected in the epithelia of both NBCCS-related and sporadic OKCs,suggesting that PTCH1 inactivation might constitutively activate sonic hedgehog (SHH) signalling and play a major role in disease pathogenesis.Thus,small molecule inhibitors of SHH signalling might represent a new treatment strategy for OKCs.However,studies on the molecular mechanisms associated with OKCs have been hampered by limited epithelial cell yields during OKC explant culture.Here,we constructed an isogenic PTCH1R135X/+ cellular model of PTCH1 inactivation by introducing a heterozygous mutation,namely,c.403C＞T (p.R135X),which has been identified in OKC patients,into a human embryonic stem cell line using the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated 9 (Casg) system.This was followed by the induction of epithelial differentiation.Using this in vitro isogenic cellular model,we verified that the PTCH1R135X/+ heterozygous mutation causes ligand-independent activation of SHH signalling due to PTCH1 haploinsufficiency.This activation was found to be downregulated in a dose-dependent manner by the SHH pathway inhibitor GDC-0449.In addition,through inhibition of activated SHH signalling,the enhanced proliferation observed in these induced cells was suppressed,suggesting that GDC-0449 might represent an effective inhibitor of the SHH pathway for use during OKC treatment.

Objective To evaluate the CT and MRI imaging features of primary ventricular lymphoma ,so as to provide a reference for the diagnosis and differential diagnosis of the disease .Methods The clinical data and imaging findings of primary ventricular lymphoma in one case was retrospectively analyzed with literature review and compared with primary lymphoma in parenchymal brain .Results Slightly high density tumor presented with regular shape in the trigone of lateral ventricles on CT findings , and slightly low signal intensity on T 1 and slightly high signal intensity on T 2 appeared on MRI findings with small cystic necrosis in tumour .An enhancement scan showed obviously enriched, and there was perilesional edema.After 14 day’s dehydration treatment, rechecked indicated that the lesions were significantly en-larged, the shape were irregula , the area of cystic necrosis was enlarged , heterogeneous enhanced scanning were enhanced , perilesional ede-ma became more heavier , and the imaging feature of “closed fist” appeared .It was proved to be diffuse large B cell lymphoma with surgical pathologic examination , and there was no lymphoma in other regions of the body with whole body PET-CT examination , which was clinically diagnosed as primary ventricular lymphoma .Conclusion Primary ventricular lymphoma is rarely reported ,and it has similar imaging mani-festations with primary lymphoma in parenchymal brain .The combination of multiple imaging modalities will be helpful to diagnosis and dif -ferential diagnosis for the suspected patients .

Objective To evaluate the clinical value of color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) in diagnosis of Budd-Chiari syndrome(BCS).Methods The CDUS and CTA data about 33 BCS patients diagnosed by digital subtraction angiography(DSA) and treated by interventional therapy were retrospectively analyzed.All of 33 patients with BCS were examined with CDUS,26 cases of then received CTA.The diagnostic value of BCS between two methods were compared.Results The diagnostic accordance rate of CDUS and CTA for BCS were 90.9％ and 96.2％ respectively,which had no significant statistical difference(P ＞ 0.05).The two methods could not only comprehensively systematically reflect the morphologic changes of liver and spleen,the stenosis and blood flow state of the lesion regions,but also clearly display the intrahepatic/extrahepatic collateral vessels trend in the abdomen.One week after interventional therapy,the CUDS results showed blood vessels pristine and stable hemodynamics.Conclusion CDUS is the preferred imaging in the diagnosis and postoperative re-examination of BCS.While,CTA can provide many important parameters for preoperative assessment and operation way.