Application of extended reality technology for real-time navigation in clinical operation / 南方医科大学学报

OBJECTIVE@#To explore the application of extended reality (XR) technology in clinical surgeries for improving the success rate of surgeries.@*METHODS@#To assist the surgeons to better understand the location, size and geometric shape of the lesions and reduce potential radiation exposure in minimally invasive surgical navigation based on two-dimensional images, we constructed three-dimensional models based on CT data and used XR technology to achieve intraoperative navigation. An improved quaternion method was used to improve the accuracy of electromagnetic positioning, with which the system error of positioning accuracy was reduced to below 2 mm. A 5G network was used to optimize the server GPU programming algorithm, and real-time video stream coding strategy and network design were adopted to reduce data transmission jam and delay in the remote surgery network, which achieved an average delay of less than 60 ms. A Gaussian distribution deformation model was used to simulate collision detection and stress deformation of the tissues to achieve a tactile perception effect.@*RESULTS AND CONCLUSION@#The intraoperative navigation system based on XR technology allowed more accurate determination of the location of the lesions, effectively reduced the surgical risk, and avoided the risk of intraoperative radiation exposure. The low latency and high fidelity of 5G network achieved real-time interaction during the surgery to provide a technical basis for multi-terminal remote cooperative surgery. The combination of force feedback technology and XR technology enables the surgeons to conduct deep immersion preoperative planning and virtual surgery to improve the success rate of surgery and shorten the learning curve.

Research Progress on the Application of Intervention Mapping in Tertiary Prevention of Cancer / 中国医学科学院学报

Intervention mapping (IM) is a framework for formulating theory-and evidence-based health education projects with participatory approaches from ecological perspectives.The intervention program designed via IM plays a role in reducing the exposure of cancer risk factors,increasing cancer prevention behaviors,and promoting early cancer screening and rehabilitation of cancer patients.This study summarizes the characteristics,implementation steps,and application status of IM in tertiary prevention of cancer,aiming to provide reference for the application of IM in the health education projects for cancer in China.

Mobile-health information searching behaviors and its influencing factors for patients with cancer / 中华行为医学与脑科学杂志

Objective:To explore the behavior and influencing factors of mobile health (m-Health) information searching among patients with cancer, aiming to provide evidence for the provision of medical health information.Methods:A cross-sectional survey was conducted.A total of 535 patients with cancer were recruited from a cancer hospital in Zhejiang Province from September to December 2017.Measurement tools included the demographic information questionnaire, mobile health information search behavior questionnaire, mobile health information search environment questionnaire, cancer needs questionnaires-short form and ehealth literacy scale.SPSS 26.0 was used for descriptive statistical analysis, one-way analysis of variance, Pearson correlation analysis and multiple linear regression analysis.Results:The total score of mobile health information search behavior of cancer patients was (60.84±9.60), and 66.5% of participants reported that they "never" or "occasionally" searched health information via mobile.The total score of information needs was (80.99±27.86), electronic health literacy was (26.54±7.85), mobile health information search environment was (8.00±2.86). m-Health information search behavior was positively correlated with information needs ( r=0.251, P<0.01), ehealth literacy ( r=0.538, P<0.01), and m-Health information search environment ( r=0.267, P<0.01). The stepwise regression analysis revealed that the place of residence, working status, income level, ehealth literacy, mobile health information search environment and information needs were statistically significant associated with the m-Health information searching behavior among cancer patients, which accounted for 39.3% of the total variance ( F=12.151, P<0.01). Compared with patients living in the central cities, those living in the small and medium-sized cities( β=0.092, P=0.031) had higher score in m-Health information behavior.Compared with patients working on normal schedule, those took sick days ( β=0.156, P=0.017) and working fewer hours ( β=0.138, P=0.002) had higher score m-Health information behavior.Compared with patients with monthly income of 1 000-3 000 yuan ( β=-0.194, P=0.002), those with monthly income less than 1 000 yuan had higher score in m-Health information behavior.The ehealth literacy ( β=0.425, P=0.000), mobile health information search environment ( β=0.179, P=0.000) and information needs ( β=0.091, P=0.027) were positive influencing factors of m-Health information search behavior. Conclusion:Patients with cancer did not report high m-Health information search behavior.Place of residence, working status, income level, ehealth literacy, m-Health information search environment and information demand were the influencing factors of m-Health information search behavior among patients with cancer.

Research Progress of Adaptive Intervention / 中国医学科学院学报

Adaptive intervention(AI)is a methodology which dynamically evaluates adaptive variables at decision points and timely adjusts and develops tailored strategies to meet individual needs.The study reviewed the origin and development and elaborated the core elements(including intervention outcomes,intervention options,decision points,tailoring variables,and decision rules)and the classification of AI.Based on the literature,the key points of the design and implementation of AI were prospected,which can provide evidence for the research and development of health behavior intervention.

Antithrombotic therapy after iliac vein stenting / 浙江大学学报·医学版

Stenting for iliac vein stenosis or compression has become a common therapeutic approach in recent years. The antithrombotic therapy after the stent deployment, however, reaches no consensus. Medications strategies and patients' prognoses differ in non-thrombotic, acute thrombotic and chronic thrombotic these three circumstances. Non-thrombotic patients usually possess satisfactory stent patency whatever antithrombotic therapy is used. Anticoagulant is the basic medication for acute thrombotic patients, benefits from additional antiplatelet drug remains to be clarified. In terms of chronic thrombotic patients, their prognoses are unsatisfactory under all antithrombotic therapies. In this review, we outlined the recent progress of antithrombotic therapy after iliac vein stenting, aiming to provide feasible medication plans for each circumstance.

The inhibition mechanism of the uptake of lamivudine via human organic anion transporter 1 by Stellera chamaejasme L. extracts / 中国天然药物

Stellera chamaejasme L. is a traditional Chinese medicine with a long history to treat stubborn skin ulcer, and it also has antiviral and antitumor effects. Neochamaejasmine B (NCB), Neochamaejasmine A (NCA) and Chamaechromone (CMC) are the major components in dried roots of Stellera chamaejasme L.. Our studies suggested that NCB, NCA and CMC are inhibitors of Organic anion transporter 1 (OAT1). OAT1 is encoded by solute carrier family 22 member 6 gene (SLC22A6) in humans and plays a critical role in the organic anion drug uptake and excretion in the kidney. Lamivudine is the typical substrate of OAT1 and is frequently used in combination with other antiviral drugs in clinical antiviral treatments. The aim of this study is to investigate the interaction and its mechanism between these bi-flavone components in Stellera chamaejasme L. and lamivudine via OAT1 both in vitro and in vivo. In vitro, the uptake studies in Madin-Darby canine kidney (MDCK) cells overexpressing OAT1 suggested that NCB inhibited the uptake of 6-CFL and lamivudine.Similar results were obtained for NCA and CMC. NCB was a noncompetitive and competitive inhibitor interaction with OAT1. IC values of NCB, NCA and CMC for inhibiting OAT1-mediated lamivudine transport were 2.46, 8.35 and 0.61 μmol·L, respectively. In vivo, the pharmacokinetic results of lamivudine in rats showed that the mean area under the plasma concentration-time curve (AUC) and maximal plasma concentration (C) of lamivudine after co-administration is increased 2.94-fold and 1.87-fold, respectively, compared to lamivudine administration alone. The results of interactions between lamivudine and these bi-flavone components in Stellera chamaejasme L. extracts via OAT1 in vivo are consistent with studies in vitro. The inhibition of OAT1-mediated uptake of lamivudine by NCB, NCA and CMC is the possible mechanism for Stellera chamaejasme L. extracts improving the oral bioavailability of lamivudine in rats.

Effects of dexmedetomidine on early postoperative cognitive function in elderly patients undergoing liver resection / 实用医学杂志

Objective To investigate the effect of dexmedetomidine on early postoperative cognitive func-tion in elderly patients undergoing liver resection. Method Fifty-four ASAⅡ~Ⅲelderly patients scheduled for liver resection were divided into 3 groups(18 in each group):the control group(group C),group D1 and group D2. The levels of serum 8-iso-PGF2α,IL-6,TNF-α and S100β protein were measured,and Da-jvO2,CjvO2and CERO2were calculated at the time before operation and at the end of operation,respectively.Incidence of postoper-ative cognitive dysfunction(POCD)were recorded within seven days after operation. Results Compared with the time before operation,levels of serum 8-iso-PGF2α,IL-6,TNF-α,S100β protein and Da-jvO2,CERO2of patients in 3 groups significantly increased at the end of operation(P < 0.05,respectively). The levels of serum 8-iso-PGF2α,IL-6,TNF-α,S100β protein and Da-jvO2,CERO2of patients decreased in group D1 and D2 than those in group C at the end of operation(P<0.05).Incidence of POCD in group D1 and D2 was lower than that of group C (P<0.05).Conclusion Dexmedetomidine can decrease the incidence of POCD for the elderly patients undergo-ing liver resection,the potential mechanism is that dexmedetomidine can reduce oxidative stress response,inhibit inflammatory response in patients and improve the cerebral oxygen metabolism during the operation.

Research progress in toxic effects of antitumor drugs based on drug transporter / 药学学报

Differences of the individual toxic effects of antitumor drugs have been a concern in clinical treatment of cancers. The drug toxicity was not only related to the age, sex, and drug interactions, but also to the expression of protein involved in the metabolism, targets and transporters of drugs. Drug transporter mediates the absorption, distribution and elimination of some drugs, which exhibits a great significance in pharmacology and clinical practice. The purpose of this review is to provide information regarding trans-porter-medicated toxic effects of antitumor drugs in order to reduce or avoid the transporter-medicated toxic effects, and to promote reasonable drug use and individualized application of antitumor drugs in clinics.

Guideline Formulation of the Off-label Use of Drugs Based on Evidences / 中国药房

OBJECTIVE:To explore an effective method to formulate management-related strategies for off-lable use of drugs by the evidence-based medicine. METHODS:The process of guideline formulation included seven procedures,i.g. establishment ofguideliesformulation workgroup;investigation and selection of the status quo on off-label drug use;identification of the clinical problems;retrieval and evaluation and comprehensing of evidence;applification of GRADE in evidence quality grading;formation of the recommendations consensus;peer review and result publication. And eventually guidelines were formed based on the steps. This study took off-label use of rheumatoid immunoprotective subjects as a case to explore. RESULTS & CONCLUSIONS:Based on the evidence evaluation system and above 7 steps,the methods and process of guideline formulation on off-label use of rheuma-toid immunoprotective subjects that integrated administration,law,clinical medicine,pharmacy subjects were made .The process of guideline formulation fully reflects multidisciplinary characteristics of the workgroup,the advanced nature of the process,the comprehensiveness of evidence ,the rigor of evidence quality grading,and the normalization of consensus. It provides reference in methodology for establishing a comprehensive evidence-based evaluation and management system of off-label use of drugs for all clinical specialist disease. Therefore,this scientific research results may promote the standardization and legalization of the off-label use of drugs management in China.

Effect of Cholecalciterol Cholesterol Emulsion on Liver of Zymosan-induced Multiple Organ Failure in Mice / 中国医科大学学报

Objective To study the effect of cholecalciterol cholesterol emulsion(CCE)in the zymosan(Z)-induced acute hepatic injury. Meth-ods A total of 36 C57 BL/6 mice were randomly divided into 4 groups,namely negative control(CON)group,CCE group,Z group and CCE+Z group,respectively. There were 9 mice in each group. Mice from CON group and Z group were fed with pure water. Mice from CCE group and CCE+Z group were fed with cholecalciterol cholesterol emulsion 20μL dissolved in 200 mL pure water which was kept in darkness. After 14 days, Z group and CCE+Z group were injected with zymosan at a dose of 500 mg/kg. After 18 hours,all the mice in each group were sacrificed. The liver tissues were harvested for histopathological examination. The serum ALT levels were determined. The molecular expression of IL-6 and IL-18 in liv-er tissue of mice were evaluated by Western blotting and real-time quantitative PCR method. Results The results of histopathological examination showed that liver tissue damage in CCE+Z group was lighter than that of Z group ,and heavier than that of the CON group. Compared to the CON group,Z group had the highest serum ALT level,followed by CCE+Z group,while in Z group was significantly lower than that in CON group(all P<0.05). The expression of IL-6 and IL-18 protein and mRNA showed level of Z group was apparently higher than those of CON group and CCE+Z group(all P<0.05). Conclusion Cholecalciterol cholesterol emulsion can play certain protective effect on zymosan-induced liver injury in mice.

Chemotherapy-related risk management toward safe administration of medications: apply failure mode and effects analysis to reduce the incidence of chemotherapy errors

Chemotherapy is considered a high-risk procedure where system failures are more likely to occur. Failure mode and effects analysis [FMEA] is a systematic, multidisciplinary team-based approach to error prevention. We described our experience of using FMEA as a prospective risk-management technique throughout the chemotherapy process. The occurrence, detectability and severity were assessed. Fifteen potential risk factors associated with 10 failure modes were identified. Improvement measures were proposed according to risk priority number. A computerized physician order entry [CPOE] and complete prescription audit system [CPAS] were introduced to reduce potential risks during chemotherapy. Introduction of this system was associated with a decrease from 2.60% to 0.60%. As a result, FMEA is a useful tool to evaluate potential risk in healthcare processes

Effect of montelukast sodium intervention on airway remodeling and percentage of Th17 cells/CD4+CD25+ regulatory T cells in asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the dynamic changes in the percentage of Th17 cells/CD4CD25regulatory T cells after intervention with montelukast sodium, a leukotriene receptor antagonist, in asthmatic mice and the association between them.</p><p><b>METHODS</b>Balb/c mice were randomly divided into blank group, asthma group, and montelukast sodium group. The asthmatic mouse model of airway remodeling was established by sensitization with intraperitoneal injection of chicken ovalbumin (OVA) and aluminum hydroxide suspension and aerosol inhalation of OVA. The mice in the blank group were given normal saline, and those in the montelukast sodium group were given montelukast sodium by gavage before aerosol inhalation. Eight mice were randomly sacrificed within 24 hours after 2, 4, and 8 weeks of aerosol inhalation. The pathological sections of lung tissue were used to observe the degree of airway remodeling. Flow cytometry was used to measure the percentages of Th17 cells and CD4CD25regulatory T cells in CD4T cells.</p><p><b>RESULTS</b>The asthma group and the montelukast sodium group had significantly higher bronchial wall thickness and smooth muscle thickness at all time points compared with the blank group (P<0.05). At 8 weeks of intervention, the montelukast sodium group had significantly greater improvements in the above changes compared with the asthma group (P<0.05). Compared with the blank group, the asthma group and the montelukast sodium group had significant increases in Th17 cells (positively correlated with airway remodeling) and significant reductions in CD4CD25regulatory T cells (negatively correlated to airway remodeling) at all time points (P<0.05). At 8 weeks of intervention, the montelukast sodium group had a significant reduction in the number of Th17 cells and a significant increase in the number of CD4CD25regulatory T cells compared with the asthma group (P<0.05).</p><p><b>CONCLUSIONS</b>Montelukast sodium intervention can alleviate airway remodeling and achieve better improvements over the time of intervention. The possible mechanism may be related to the improvement of immunologic derangement of CD4CD25regulatory T cells and inhibition of airway inflammation.</p>

Clustering Analysis on Subject Terms of SCI Papers Related to Medical Treatment Cloud / 医学信息学杂志

The paper retrieves SCI papers related to medical treatment cloud and analyzes the current research direction of this topic.It makes the bibliometric analysis of SCI papers on this topic in Web of Science TM core integrated database,counts up the occurrence frequency of high-frequency subject terms in the same document and generates the co-occurrence matrix.By clustering analysis of various document contents in the matrix with SPSS,it obtains the research direction of this topic.

Role of Clinical Pharmacists in Therapy for Patient with Interstitial Lung Disease Induced by Erlotinib / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists in therapy for patient with interstitial lung disease (ILD) induced by erlotinib. METHODS:Clinical pharmacists participated in the therapy for ILD in a patient receiving erlotinib target treat-ment after thoracic vertebra and lumbar radiation,analyzed the cause of ILD and suggested to stop taking imipenem and cilastatin sodium,fluconazol and erlotinib according to lab indexes and patient’s symptom;took prednisone 30 mg,po,qd,for anti-inflam-mation instead of methylprednisolone;adjusted the dose of prednisone to 40 mg/d,and additionally took Carbocisteine oral solution 10 ml,tid,for improving respiratory symptom;panipenem betamipron 1 g,ivgtt,bid,instead of piperacillin sodium and sulbactam sodium. RESULTS:Physicians adopted the suggestions of clinical pharmacists,and the symptom of anhelation and double pneumo-nia recovered;discharged medication plan was erlotinib 150 mg,po,qd. CONCLUSIONS:The patient with radiation history easily suffers from ILD when using erlotinib,and should use erlotinib carefully in the clinic. Clinical pharmacists participated in drug ther-apy and promote safe and rational use of drugs in the clinic.

Clinical Significance Interpretation of Positive Sputum Samples from One Patient with Acinetobacter Bau-manni Infection after Colon Cancer Surgery / 中国药师

Objective:To discuss the results interpretation and clinical significance of Acinetobacter Baumanni ( AB) positive spu-tum samples .Methods:The anti-infection treatment of one patient with lung infection after colon cancer surgery in ICU was analyzed , and the results interpretation and clinical significance of AB positive sputum samples were discussed .Results:Although the culture re-sults of sputum samples were positive , the quality of sputum samples was low and the credibility was poor .The possibility of multiple drug resistance AB ( XDR-AB) screened by antibiotics selective stress was small .Meanwhile, the clinical infection symptoms were mild, and the treatment with imipenem was effective .Although the patient had high risk factors for the colonization of Baumanni infec-tion, XDR-AB was not a pathogen .Conclusion:When respiratory samples are AB positive , the quality of samples should be evaluated by smear results firstly , especially the existence of white blood cell phagocytosis or accompanying should be paid attention to , and then the possibility of AB screened by antibiotics selective stress and high risk factors for colonization should be analyzed .Finally, combined with the clinical symptoms of patients and the treatment efficacy before drug sensitivity tests , whether XDR-AB is pathogenic bacteria should be judged , and then the corresponding anti-infection treatment plan should be determined .

Advances in nucleotide reductase inhibitors for antiviral therapy / 中华临床感染病杂志

Ribonucleotide reductase ( RR ) is a rate-limiting enzyme, and it is responsible for reducing ribonucleotides to their corresponding deoxyribonucleotides , which are the building blocks required for DNA replication and repair .Recent studies have revealed that RR activity is associated with DNA replication in virus , and RR inhibitors have been used for clinical antiviral treatment .This paper reviews research progress on RR and its inhibitors , including the classification , structure and function of RR; the classification, mechanism and clinical application of RR inhibitors in antiviral therapy and the future prospects of RR inhibitors .

Current status and future prospects of the development of clinical pharmacy in China: a SWOT analysis

In many industrialized countries, clinical pharmacy has developed into a separate discipline and become a vital part of inpatient care in hospitals. However, as compared to many established branches of medicine, clinical pharmacy is still in its infancy, with much room for growth, improvement, and recognition by both the medical community and patients. In this study, a widely-recognized development strategy analysis tool, Strength, Weakness, Opportunity and Threat [SWOT], was used to systematically address several key issues to the development of clinical pharmacy in China. This analysis aims to provide feasible recommendations for the development of clinical pharmacy in China by identifying current problems and growth opportunities. Full development of clinical pharmacy as a mature clinical discipline will help promote the rational use of drugs by both clinicians and patients and lead to enhanced drug efficacy and safety

Dynamic changes in percentages of CD4⁺ CD25⁺ regulatory T cells and Th17 cells in process of airway remodeling in mouse model of asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the dynamic changes in Th17 cells and CD4⁺ CD25⁺ regulatory T cells (Treg) in the spleen and to analyze their relationship with airway remodeling.</p><p><b>METHODS</b>A total of 48 female specific pathogen-free Balb/c mice were randomly divided into control and asthmatic groups. To establish the asthmatic airway remodeling model, the mice were sensitized to ovalbumin (OVA) through intraperitoneal injection of OVA and aluminum hydroxide suspension and challenged by inhalation of aerosol OVA. The matched control group was treated with normal saline instead. In 24 hours after 2-week, 4-week, and 8-week aerosol inhalation, 8 mice were randomly selected from each group and sacrificed. Then histopathological examination of the left lung was performed to measure the degree of airway remodeling. The percentages of Th17 and CD4⁺ CD25⁺ Treg cells in total CD4(+) cells from the spleen were determined by flow cytometry.</p><p><b>RESULTS</b>In the asthmatic group, the ratios of total bronchial wall area to bronchial basement membrane perimeter (WAt/Pbm) and bronchial smooth muscle area to bronchial basement membrane perimeter (WAm/Pbm) significantly increased as the challenge proceeds (P<0.01). The percentage of Th17 cells derived from the cell suspension of the spleen gradually increased and it was positively correlated with the degree of asthmatic airway remodeling (P<0.01). The percentage of CD4⁺ CD25⁺ Treg cells from the suspension gradually decreased and it was negatively correlated with the degree of asthmatic airway remodeling (P<0.01).</p><p><b>CONCLUSIONS</b>In mice with asthma, as the challenge proceeds, the airway remodeling becomes more severe, the percentage of Th17 cells increases, and the percentage of CD4⁺ CD25⁺ Treg cells decreases. The immunological imbalance is possibly one of the important factors inducing airway remodeling.</p>

Cluster Analysis of Research Hotspots of Remote Medical Education in the Last Ten Years / 医学信息学杂志

The paper uses bibliometrics method to analyze literatures in Web of ScienceTM relevant to remote medical education pub-lished from 2005 to 2015 and carries out cluster analysis, works out the main research directions in recent 10 years including evaluation of remote medical education in light of META Analysis;utilization of remoted medicine technology in continuing medical education;dis-cussion on the route, approach and experience of developing remote medical education; the method to enhance the medical care level, improve health of the patients and further raise their life quality.

Redox-Responsive Vesicles Prepared from Supramolecular 2-Hydroxypropyl-β-Cyclodextrin and Ferrocene Derivative for Drug Delivery / 分析化学

A novel hydrophobic ferrocene polymer ( P-Fc) was synthesized successfully. Taken the advantage of 2-hydroxypropyl-β-cyclodextrin ( HP-β-CD ) with hydrophilic outside and hydrophobic inside, P-Fc was successfully enveloped in the cavity of HP-β-CD to form macromolecular vesicle by a self-assembly process. The structure and morphology of the macromolecular vesicle was characterized by FTIR, 1HNMR, SEM and CV. Rhodamine 6G (R6G) and doxorubicin hydrochloride (DOX) was used as target drugs and loaded in the vesicles successfully. After added the oxidant, ferrocene was oxidized to dicyclopentadienyl iron, which destroyed the vesicles successfully. The rapid directional release of the drugs was realized. The maximum loading values of R6G and DOX were 6. 89 and 39. 06 μg/mg, respectively. The release rates were 73. 7%and 88. 2%, respectively. It would increase the utilization level of the drugs and enhance their efficiency.