The Multi-disciplinary diagnosis and treatment(MDT)outpatient service is widely used in the diagnosis and treatment of patients with tumors,difficult critical and complex diseases and multiple diseases.The purpose of this paper is to study the one-stop treatment mode of MDT outpatient service in tertiary hospitals and the closed-loop management after diagnosis,which plays an important role in integrating medical resources,optimizing medical treatment process,improving patient medical experience,and ensuring medical quality and safety.In view of the weak links and difficulties in quality control in MDT outpa-tient management,such as insufficient attention from functional departments,low enthusiasm of clinicians,low initiative of pa-tients,imperfect information construction of MDT outpatient service,poor quality improvement effect,etc.,Effective manage-ment methods such as core members'guidance,supporting incentive and assessment mechanism,regular reporting of quality,im-proving information construction,extending service scope,and increasing publicity efforts have been adopted for continuous im-provement,and remarkable results have been achieved in increasing the number of cases and diseases,expanding brand influ-ence,and improving the quality of consultation.

Background::Adamantinomatous craniopharyngioma (ACP) is the commonest pediatric sellar tumor. No effective drug is available and interpatient heterogeneity is prominent. This study aimed to identify distinct molecular subgroups of ACP based on the multi-omics profiles, imaging findings, and histological features, in order to predict the response to anti-inflammatory treatment and immunotherapies.Methods::Totally 142 Chinese cases diagnosed with craniopharyngiomas were profiled, including 119 ACPs and 23 papillary craniopharyngiomas. Whole-exome sequencing (151 tumors, including recurrent ones), RNA sequencing (84 tumors), and DNA methylome profiling (95 tumors) were performed. Consensus clustering and non-negative matrix factorization were used for subgrouping, and Cox regression were utilized for prognostic evaluation, respectively.Results::Three distinct molecular subgroups were identified: WNT, ImA, and ImB. The WNT subgroup showed higher Wnt/β-catenin pathway activity, with a greater number of epithelial cells and more predominantly solid tumors. The ImA and ImB subgroups had activated inflammatory and interferon response pathways, with enhanced immune cell infiltration and more predominantly cystic tumors. Mitogen-activated protein kinases (MEK/MAPK) signaling was activated only in ImA samples, while IL-6 and epithelial-mesenchymal transition biomarkers were highly expressed in the ImB group, mostly consisting of children. The degree of astrogliosis was significantly elevated in the ImA group, with severe finger-like protrusions at the invasive front of the tumor. The molecular subgrouping was an independent prognostic factor, with the WNT group having longer event-free survival than ImB (Cox, P = 0.04). ImA/ImB cases were more likely to respond to immune checkpoint blockade (ICB) therapy than the WNT group ( P <0.01). In the preliminary screening of subtyping markers, CD38 was significantly downregulated in WNT compared with ImA and ImB ( P = 0.01). Conclusions::ACP comprises three molecular subtypes with distinct imaging and histological features. The prognosis of the WNT type is better than that of the ImB group, which is more likely to benefit from the ICB treatment.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Chinese traditional culture is the soil for the survival and development of traditional Chinese medi-cine,among them,the concept of A thing is valued if it is rare portal factions and master has influenced the development,communication and popularization of traditional Chinese medicine.But the spirit and thinking of harmony unity of heaven and man comparative state benevolence and self-cultivation and self-re-straint has played an active role in the development of traditional Chinese medicine.Thus this paper put forward the suggestions and opinions of strengthening the cultivation of humanistic spirit of higher traditional Chinese medi-cine talents:establishing a comprehensive evaluation standards of higher traditional Chinese medicine talents,es-tablishing scientific development concept to treat the inheritance and innovation of traditional Chinese medicine cul-ture,perfecting the curriculum provision of relevant professions,creating the conducive environment for the trans-mission of traditional Chinese medicine culture,hoping to provide a reference for the explanation of the relationship between traditional culture and traditional Chinese medicine.

Objective To investigate the situation of human papillomavirus (HPV) infection and the distribution of HPV genotypes among women attending hospital in Meizhou,Guangdong province.Methods Flow-through hybridization and gene chip technique was used to detect HPV in cervical exfoliated cell specimens collected from 24 450 women for HPV screening in Department of Gynecology,Meizhou People's Hospital,Meizhou Hospital Affiliated to Sun Yat-sen University,and then the situation of HPV infection and distribution of HPV genotypes were analyzed.Results Among 24 450 female exfoliated cell specimens,3 922 were found to be positive for HPV infection,with the total infection rate of 16.04％.Among 3 922 samples,the top three high-risk subtypes of HPV were HPV-16 (30.37％),HPV-52 (17.77％) and HPV-58 (15.53％),the majority of low-risk HPV was HPV-CP8304 (5.61％).The positivity of various HPV types peaked among 30-50 years old.The differences of the HPV positive rates in different age groups was statistical significance (P ＜ 0.001).Conclusions The majority of women attending hospital detected with HPV-16 in Meizhou and the positivity of various HPV types peaked among women aged 30-50 years.Genotyping of HPV was meaningful for preventing and treating cervical cancer.

OBJECTIVETo study the effect of allitridum on rapidly delayed rectifier potassium current (IKr) in HEK293 cell line.

METHODSHEK293 cells were transiently transfected with HERG channel cDNA plasmid pcDNA3.1 via Lipofectamine. Allitridum was added to the extracellular solution by partial perfusion after giga seal at the final concentration of 30 µmol/L. Whole-cell patch clamp technique was used to record the HERG currents and gating kinetics before and after allitridum exposure at room temperature.

RESULTSThe amplitude and density of IHERG were both suppressed by allitridum in a voltage-dependent manner. In the presence of allitridum, the peak current of IHERG was reduced from 73.5∓4.3 pA/pF to 42.1∓3.6 pA/pF at the test potential of +50 mV (P<0.01). Allitridum also concentration-dependently decreased the density of the IHERG. The IC50 of allitridum was 34.74 µmol/L with a Hill coefficient of 1.01. Allitridum at 30 µmol/L caused a significant positive shift of the steady-state activation curve of IHERG and a markedly negative shift of the steady-state inactivation of IHERG, and significantly shortened the slow time constants of IHERG deactivation.

CONCLUSIONAllitridum can potently block IHERG in HEK293 cells, which might be the electrophysiological basis for its anti-arrhythmic action.

Allyl Compounds ; pharmacology ; Anti-Arrhythmia Agents ; Delayed Rectifier Potassium Channels ; drug effects ; Ether-A-Go-Go Potassium Channels ; HEK293 Cells ; drug effects ; Humans ; Patch-Clamp Techniques ; Potassium Channel Blockers ; pharmacology ; Sulfides ; pharmacology ; Transfection

Objective To construct stable chromokinesin KIF4A knockdown gastric cancer cell lines (SGC-7901) and study the mitotic spindle midzone formation in these cells.Methods Short hairpin RNA (shRNA) expression plasmids of pGPU-GFP-shKIF4A,pGPU-GFP-shNC specific targetting KIF4A and non-sense DNA sequences were constructed respectively and then transfected into SGC-7901 cells.The cells were cultured in selection medium containing G418 to form single clones.Stable KIF4A shRNA expressing SGC-7901 cells were picked up under an fluoroscent microscope and identified by Western Blot.The spindle midzone in these cells was analyzed after immunofluorescence staining.Results Three cell lines stably expressing KIF4A shRNA and one with shNC were successfully constructed.Compare to the control cell line,KIF4A knockdown cell lines represented remarkable elongation of spindle midzone and the less the KIF4A,the longer spindle midzone.Conclusions Stable KIF4A knockdown SGC-7901 cell lines were successfully constructed that can serve for further study of KIF4A ' s function and its role in proliferation and development of gastric cancer.

OBJECTIVETo study the chemical constituents of the dried rhizome of Ardisia gigantifolia.

METHODThe 60% ethanol extract was extracted with EtOAc, and then separated and purified by column chromatography using silica gel and preparative HPLC. Their structures were identified on the basis of spectral analysis and physico-chemical properties.

RESULTNine compounds were isolated and identified as 11-O-galloylbergenin (1), 11-O-syringylbergenin (2), 11-O-protocatechuoylbergenin (3), 4-O-galloylbergenin (4), 11 -O-vanilloylbergenin (5), (-) -epicatechin-3-gallate (6), stigmasterol-3-O-beta-D-glucopyranoside (7), (-) -4'-hydroxy-3-methoxyphenyl-beta-D-[6-O-(4"-hydroxy-3", 5"-dimethoxybenzoyl)] -glucopyranoside (8), and beta-sitosterol (9).

CONCLUSIONCompounds 3, 4 and 7 were isolsted from the genus Ardisia for the first time, while compounds 1, 2, 5 and 6 were isolated from this plant for the first time.

Ardisia ; chemistry ; Rhizome ; chemistry

Objective To evaluate the efficacy of dural tenting suture and epidural drainage in craniotomy. Methods In 145 cases of intracranial lesions, dural tenting suture and epidural drainage were performed to prevent epidural hematoma. Results Postoperative computed tomography (CT) showed no epidural hematoma required surgery in both groups. Conclusion Both dural tenting suture and epidural drainage are effective in preventing epidural hematoma. Hemostasis is the key step. Dural tenting suture without epidural drainage relieves psychological stress. It decreases the risk of intracranial infection and avoids some unusual complications.

OBJECTIVE: To determine the efficacy of subarachnoid space protection in intracranial operation. METHODS: Data collected from 156 consecutive cranial operations, in which subarachnoid space protective technology was prophylacticly used, were analyzed. RESULTS: Fourteen patients had a postoperative fever for more than 1 week and 16 patients who required lumbar puncture to release blood contaminated cerebro-spinal fluid (CSF) or exclude meningitis. All except 3 patients were discharged as expected. No patients had symptomatic vasospasm and hydrocephalus. CONCLUSION The subarachnoid space protective technology has good effect on preventing postoperative fever and improving the outcome of patients.
Adolescent ; Adult ; Aged ; Brain Neoplasms ; surgery ; Child ; Child, Preschool ; Craniotomy ; methods ; Female ; Humans ; Infant ; Male ; Microsurgery ; methods ; Middle Aged ; Postoperative Complications ; prevention & control ; Subarachnoid Space ; physiopathology ; Vasospasm, Intracranial ; prevention & control ; Young Adult