Objective To investigate the effects and underlying mechanisms of a spray prepared from exosomes derived from M2 macrophages induced by interleukin-4 （IL-4） and tantalum particles （Ta） on the healing of pressure ulcers. Methods Bone marrow-derived macrophages were polarized into M2 macrophages using IL-4 or Ta, and exosomes （Exo-IL-4/Exo-Ta） were extracted. The regulatory effects of Exo-IL-4/Exo-Ta on M1 macrophage phenotypes and fibroblast matrix secretion were evaluated in vitro. Proteomic analysis was conducted to explore the biological processes and regulatory networks associated with Exo-Ta. A rat pressure ulcer model was used to assess the effects of Exo-IL-4/Exo-Ta spray on wound healing rate, inflammatory cell infiltration, and collagen deposition. Results In vitro, Exo-IL-4/Exo-Ta induced the polarization of M1 macrophages to M2 macrophages, reduced the secretion of pro-inflammatory factors, and promoted the expression of anti-inflammatory substances. Additionally, Exo-IL-4/Exo-Ta enhanced the production of collagen and fibronectin in fibroblasts. Proteomic analysis revealed that Exo-Ta primarily participated in biological processes such as energy metabolism and macromolecule biosynthesis. In vivo, Exo-IL-4/Exo-Ta spray accelerated wound healing, reduced inflammatory infiltration, and improved tissue remodeling in the rat pressure ulcer model. Conclusion Exosome sprays derived from M2 macrophages could accelerate pressure ulcer healing by modulating inflammation and promoting tissue regeneration, which demonstrated excellent clinical application potential.

Objective The sample hospital is currently in the exploration stage of creating patient satisfaction service un-der the one-hospital and multi-district management mode.In order to improve the overall feeling of patients in the process of hos-pital treatment,the application effect of the existing all-round full-cycle patient service intelligent management platform in the hos-pital is quantitatively evaluated,so as to better improve the service mode.Methods A survey was conducted to collect satisfac-tion data from two groups:the experimental group,which utilized the comprehensive and full-cycle patient service intelligent man-agement platform for diagnosis and treatment services,and the control group,which followed the conventional patient admission and discharge process.The work efficiency number was obtained and calculated through the background of the system,including the average time to handle hospitalization procedures,the average waiting time for examination,the average time to handle dis-charge procedures,the time spent on each follow-up visit and the response rate of follow-up patients.The data were analyzed sta-tistically.Results The work efficiency of the experimental group was significantly better than that of the control group,and the satisfaction of hospitalized patients and staff was higher than that of the control group.Conclusion The application of the com-prehensive and full-cycle patient service intelligent management platform can improve the satisfaction of patients and staff,opti-mize the efficiency of treatment,and better serve the management mode of one hospital and multiple districts.

Objective The sample hospital is currently in the exploration stage of creating patient satisfaction service un-der the one-hospital and multi-district management mode.In order to improve the overall feeling of patients in the process of hos-pital treatment,the application effect of the existing all-round full-cycle patient service intelligent management platform in the hos-pital is quantitatively evaluated,so as to better improve the service mode.Methods A survey was conducted to collect satisfac-tion data from two groups:the experimental group,which utilized the comprehensive and full-cycle patient service intelligent man-agement platform for diagnosis and treatment services,and the control group,which followed the conventional patient admission and discharge process.The work efficiency number was obtained and calculated through the background of the system,including the average time to handle hospitalization procedures,the average waiting time for examination,the average time to handle dis-charge procedures,the time spent on each follow-up visit and the response rate of follow-up patients.The data were analyzed sta-tistically.Results The work efficiency of the experimental group was significantly better than that of the control group,and the satisfaction of hospitalized patients and staff was higher than that of the control group.Conclusion The application of the com-prehensive and full-cycle patient service intelligent management platform can improve the satisfaction of patients and staff,opti-mize the efficiency of treatment,and better serve the management mode of one hospital and multiple districts.

OBJECTIVE To explore the anti-tumor effect of Yiqi Yangyin Jiedu Recipe on Lewis lung cancer mice and its influ-ence on immunomodulation.METHODS Lewis lung cancer mouse model was constructed by subcutaneous injection of Lewis lung cancer cells under the armpit and divided into model group,low dose group,medium dose group and high dose group.The tumor vol-ume,tumor inhibition rate and survival rate were calculated.The apoptosis and DNA damage of tumor cells were detected by HE stai-ning,TUNEL assay and comet assay respectively.The expression levels of IFN-γ,IL-2 and TNF-α were detected by ELISA.CD8+,CD8+/CD4+,PD1+,IFN-γ+,CD28+cells were detected by immunofluorescence and flow cytometry.The protein levels of PD1,CD69 and CD28 were detected by Western blot.RESULTS Yiqi Yangyin Jiedu Recipe has anti-tumor effects,prolonging survival,promo-ting apoptosis of tumor cells and aggravating DNA damage of tumor cells.Drug treatment promoted the expression of IFN-γ,IL-2 and TNF-α,increased the proportion of CD8+T,CD8+/CD4+T,IFN-γ+and CD28+cells,and inhibited the proportion of PD1+cells and protein expression,and the protein levels of CD69 and CD28 were significantly increased.CONCLUSION Yiqi Yangyin Jiedu Reci-pe can inhibit the development of tumor,and its regulation of immune function is the potential mechanism of its anti-tumor effect.

OBJECTIVE To explore the anti-tumor effect of Yiqi Yangyin Jiedu Recipe on Lewis lung cancer mice and its influ-ence on immunomodulation.METHODS Lewis lung cancer mouse model was constructed by subcutaneous injection of Lewis lung cancer cells under the armpit and divided into model group,low dose group,medium dose group and high dose group.The tumor vol-ume,tumor inhibition rate and survival rate were calculated.The apoptosis and DNA damage of tumor cells were detected by HE stai-ning,TUNEL assay and comet assay respectively.The expression levels of IFN-γ,IL-2 and TNF-α were detected by ELISA.CD8+,CD8+/CD4+,PD1+,IFN-γ+,CD28+cells were detected by immunofluorescence and flow cytometry.The protein levels of PD1,CD69 and CD28 were detected by Western blot.RESULTS Yiqi Yangyin Jiedu Recipe has anti-tumor effects,prolonging survival,promo-ting apoptosis of tumor cells and aggravating DNA damage of tumor cells.Drug treatment promoted the expression of IFN-γ,IL-2 and TNF-α,increased the proportion of CD8+T,CD8+/CD4+T,IFN-γ+and CD28+cells,and inhibited the proportion of PD1+cells and protein expression,and the protein levels of CD69 and CD28 were significantly increased.CONCLUSION Yiqi Yangyin Jiedu Reci-pe can inhibit the development of tumor,and its regulation of immune function is the potential mechanism of its anti-tumor effect.

Background::Sentinel lymph node (SLN) biopsy is gradually accepted as the standard of care in breast cancer patients with down-staged axillary disease after neoadjuvant chemotherapy (NAC). However, it is still difficult to precisely define pre-NAC clinical node-positive (cN1) and post-NAC clinical node-negative (ycN0). This prospective single-center trial was designed to evaluate the feasibility and accuracy of standard targeted axillary dissection (TAD) after NAC in highly selective pre-NAC cN1 patients (not considering ultrasound-based axillary ycN staging).Methods::This prospective trial included patients with initial pre-NAC cT1–3N1M0 invasive breast cancer but with a rigorous definition of cN1 from the Affiliated Cancer Hospital of Zhengzhou University. When NAC was effective (including complete and partial responses) and preoperative axillary palpation was negative, preoperative ultrasound-based axillary staging was not considered, and all patients underwent TAD followed by axillary lymph node (LN) dissection. The detection rate (DR) and false-negative rate (FNR) of TAD were calculated.Results::A total of 82 patients were included, and 77 of them were eligible for data analysis. The DR for TAD was 94.8% (73/77). There were 26 patients with one abnormal LN at the time of diagnosis based on ultrasound, 45 patients with two, and 2 patients with three. One patient had one TAD LN, four patients had two TAD LNs, and 68 patients had three or more TAD LNs. Preoperative axillary palpation yielded negative results for all 73 patients who successfully underwent TAD. Preoperative ultrasound-based ycN0 and ycN+ conditions were detected for 52 and 21 cases, respectively. The FNR was 7.4% (2/27) for standard TAD (≥3 SLNs), which was lower than that of all successful TAD (≥1 SLN; 10.0%, 3/30).Conclusions::In rigorously defined pre-NAC cN1 breast cancer patients, standard TAD is feasible for those with negative axillary palpation after NAC, and FNR is also less than 10%.Registration::chictr.org.cn, ChiCTR2100049093

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.

Objective To construct a usability scale for smart hospital platforms based on Quality of Experience(QoE)theory,and provide scientific measurement tool for the construction,operation,and improvement of smart hospitals.Method Literature review,focus meeting method,and pre survey were used to screen and revise the scale items,forming a formal scale.Using convenience sampling method,1 000 users from 8 smart hospital platforms in Shandong Province were selected as the research subjects to evaluate the reliability and validity of the scale.Result The availability scale of the smart hospital platform includes 6 dimensions and 24 items.Exploratory factor extraction identified 6 common factors,with a cumulative variance contribution rate of 64.045%.The overall Cronbach's with a coefficient of 0.941 for 6 dimensions.The coefficient is between 0.782 and 0.963,and the retest reliability is 0.967.The Average Standardized Content Validity Index is 0.972,and the Item-level Content Validity Index is between 0.86 and 1.00.The correlation coefficient between the six dimensions of the scale and the System Usability Scale is 0.606-0.653,and the overall correlation coefficient is 0.647.Conclusion The usability scale of the smart hospital platform developed based on QoE theory has good reliability and validity,and can be used to measure the user experience of the smart hospital platform.