With the advance of hospital digitization, the computer technology and the utilization of database are greatly enhanced, and thus the information security situation of hospital has been more and more serious. The computer entering hospital's network illegally and the unauthorized application program seriously threaten the security of hospital's database and network. This article discusses a security model of medical database of LAN in practice from the aspects of authorized document library, daemon program and monitoring, reporting and the orientation of the illegal computer. With source creativity, the model is significant to the security of medical network or other network. It is suggested that a real-time medical database monitoring system be set up to monitor network.

Objective To design a set of feasible program of data monitor based on the database's security of the "No.1 Military Medical Project" in many years of running successful operation to enhance safety audit of database.Methods The system was consisted with date's collection of active and passive for safety information,preservation of backup data,and analysis of credibility dictionaries and auditing.Results The complete processing program of network security monitor which could form alarm message and advance corresponding disposal plans was came into being and its better reliability.Conclusion By using the way,the question of the "No.1 Military Medical Project" in database monitoring is solved in network environment and ensured safe operation of database,the network security of the "No.1 Military Medical Project" system is promoted.

Objective To evaluate the clinical efficacy of vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection in the treatment of thoracolumbar vertebrae fractures.Methods Twenty-eight patients with thoracolumbar vertebrae fractures admitted in our department in recent 2 years were enrolled in this study,including 21 cases of type A,3 cases of type B,and 4 cases of type C.All patients were fixed with vertebral pedicle screw,and then verteplasty was performed using calcium sulfate cement injection.Results All patients were followed up for an average time of 16 months.Within the follow-up,there was no complication noted,such as loosening or breakage of internal fixation,chronical lumbar back pain,and loss of effected vertebral height.Artificial bones injected into vertebrae were absorbed in about 3 months.Conclusion Vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection is an effective and safe procedure for thoracolumbar vertebrae fractures,which renders it possible to bear weight early and to maintain corrected vertebral height postoperatively.

Objective: To investigate the prevalence and influencing factors of repeated HIV antibody tests among men who have sex with men (MSM) in Wuhan City, so as to provide insights into the development of interventions against AIDS among MSM. Methods: MSM with self-reported homosexual behaviors in a community studio in Wuhan City were recruited using a convenient sampling method from January to April 2019, and participants' demographic features, sexual behaviors, HIV antibody tests and recognition of HIV antibody tests were collected using questionnaires. Factors affecting repeated HIV antibody tests were identified using a multivariable logistic regression model. Results: Totally 300 valid questionnaires were recovered, with a mean age of (31.06±10.24) years. Among all the participants, 196 participants had the first homosexual behaviors over 18 years of age (65.33%), 107 participants were insertive partners (35.67%), and 125 participants received sex-transmitted diseases (STDs) tests in the past six months (41.67%). The mean score for recognizing the risk of HIV infection was 12.41±3.09, for HIV antibody test self-efficiency was 17.07±2.12, and for perceived social supports was 17.42±2.41. A total of 287 respondents received HIV antibody tests (95.67%), including 192 participants receiving repeated HIV antibody tests (64.00%). Multivariable logistic regression analysis showed that age of >18 years for the first homosexual sex behavior (OR=0.404, 95%CI: 0.223-0.734), receiving STDs tests in the past six months (OR=3.896, 95%CI: 2.145-7.076), sex role as receptive partners or both receptive and insertive partners (OR=0.502, 95%CI: 0.275-0.917), satisfying with HIV antibody test services (OR=2.955, 95%CI: 1.311-6.660), and high score for HIV antibody test self-efficiency (OR=1.149, 95%CI: 1.005-1.314) were factors affecting repeated HIV antibody tests among MSM. Conclusions The detection of repeated HIV antibody tests was 64.00% among MSM in Wuhan City in 2019, and age for the first homosexual behavior, STDs tests, sex role, evaluation of HIV antibody test services and self-efficiency of HIV antibody tests may be factors affecting repeated HIV antibody tests among MSM.

Objective: To optimize the extraction technology of Chinese medicinal materials in Yanyanling dispersible tablets.Methods: Orthogonal design was used to study the effects of three factors, including the ratio of liquid to materials, extraction time and extraction times on the extraction rate of Chinese medicinal materials and the comprehensive score of gallic acid content and total solid yield was used as the index.Results: The optimum extraction conditions were as follows: the ratio of materials to liquid was 1∶10 (g·ml-1), the extraction time was one hour, and the extraction times was three.Conclusion: Under the optimum conditions, the extraction rate of gallic acid in Chinese medicinal materials in Yanyanling dispersible tablets is 0.058%, and the total solid yield is 21.4%.The optimal process is stable and feasible, which can provide reference for the production of Yanyanling dispersible tablets.

Objective To detect the expression of death-associated protein kinase like 1(DAPL1)and mismatch repair gene(Mut L homologue 1,MLH1)methylation level in bronchoalveolar lavage fluid(BALF)of patients with lung cancer,and further investigate the diagnostic value of gene methylation in early lung cancer and its relationship with clinicopathological features.Methods A total of 142 patients with suspected early stage lung cancer admitted the Second People's Hospital of Mengcheng County from January 2022 to January 2024 were retrospectively selected and divided into lung cancer group(n=82)and lung benign lesion group(n=60)according to the final pathological results.Quantitative real time polymerase chain reaction(qRT-PCR)was used to detect the methylation levels of DAPL1 and MLH1 in BALF samples.The clinical diagnostic value of DAPL1 and MLH1 methylation in early stage lung cancer and its relationship with clinicopathological features of lung cancer patients were analyzed.Results The methylation levels of DAPL1 and MLH1 gene in BALF in lung cancer group were 53.66％(44/82)and 56.10％(46/82),respectively,which were significantly higher than those in benign disease group[11.67％(7/60)and 18.33％(11/60)],and the difference was statistically significant(x2=56.544,20.565,all P＜0.05).The sensitivity of DAPL1 andMLH1 gene methylation in the diagnosis of early lung cancer was 53.66％(44/82)and 56.10％(46/82),the specificity was 88.33％(53/60)and 81.67％(49/60),and the accuracy were 68.31％(97/142)and 66.90％(95/142),respectively.The sensitivity and accuracy of DAPL1 methylation combined with MLH1 methylation in the diagnosis of early lung cancer was 86.59％(71/82),and 85.92％(122/142),respectively,both of which were higher than that of a single index(Z=24.411,16.450,all P＜0.05).The methylation levels of DAPL1 and MLH1 genes in BALF of lung cancer patients were closely correlated with clinical stage,smoking history and lymph node metastasis(x2=5.493,13.083;8.167,6.946;9.303,4.523,all P＜0.05).Spearman correlation showed that DAPL1 and MLH1 gene methylation were positively correlated with clinical stage,smoking history and lymph node metastasis in patients with lung cancer(r=0.523,0.602;0.548,0.498;0.630,0.524,all P＜0.05).Conclusion The methylation of DAPL1 and MLH1 genes in BALF has high clinical diagnostic value for early lung cancer,and the methylation levels of both genes are related to the disease progression and smoking history of lung cancer patients.

Diabetic kidney disease （DKD） is a kidney disease caused by hyperglycemia，which is one of the most common microvascular complications of diabetes. Due to the high incidence of diabetes，the incidence of DKD has also increased year by year，and DKD has become a global public health problem. The pathogenesis of DKD is related to mechanisms such as oxidative stress，inflammation，renal fibrosis，and decreased mitophagy activity，which are developed under a variety of complex mechanisms. In traditional Chinese medicine，it is believed that the incidence of DKD is closely related to damp heat. Therefore，it is necessary to grasp the treatment method of clearing heat and removing dampness in clinical medication. Huangkui Capsules （HKC） have the effect of clearing damp heat，detoxifying， and detumescence. Because of its unique curative effect on DKD，HKC is often used in the treatment of DKD. HKC plays a role in the treatment of DKD with a variety of pharmacokinetic and pharmacodynamic processes. In many laboratory studies，it has been found that the specific mechanisms of HKC in the treatment of DKD include increasing mitophagy，reducing mitochondrial damage，reducing renal fibrosis，controlling inflammatory response，and inhibiting oxidative stress，which can achieve the purpose of reducing renal damage and promoting renal function. Some clinical studies have also verified that the application of HKC alone can exert renal protective function through anti-inflammatory，anti-oxidative stress，anti-renal fibrosis effects，as well as reduction of urinary protein. Since DKD is not a single injury of renal function，it is often accompanied by problems in blood pressure，blood lipids，blood circulation，body immunity， and other aspects. Therefore，the combination of HKC with other drugs can often achieve more comprehensive results，improve the advantages of various drugs，and improve the therapeutic effect. The combination of drugs such as antihypertensive，lipid-lowering， vascular circulation improvement，immunity inhibition，and anti-oxidative stress with HKC has achieved good results. In addition，HKC is often used in combination with other Chinese patent medicines in clinics. The application of HKC in the treatment of DKD has made some progress，but there are still many places worthy of further study，and the research on the mechanism of HKC is not comprehensive enough. The research on its long-term effect and safety in clinical application is relatively lacking，and the drug variety is relatively single when combined with certain drugs. These problems deserve further attention. Finally，it is necessary to pay attention to the promotion and application of HKC in clinical practice so that HKC can be better applied in clinical practice and better solve practical problems for patients.

Diabetic kidney disease （DKD） is a kidney disease caused by hyperglycemia，which is one of the most common microvascular complications of diabetes. Due to the high incidence of diabetes，the incidence of DKD has also increased year by year，and DKD has become a global public health problem. The pathogenesis of DKD is related to mechanisms such as oxidative stress，inflammation，renal fibrosis，and decreased mitophagy activity，which are developed under a variety of complex mechanisms. In traditional Chinese medicine，it is believed that the incidence of DKD is closely related to damp heat. Therefore，it is necessary to grasp the treatment method of clearing heat and removing dampness in clinical medication. Huangkui Capsules （HKC） have the effect of clearing damp heat，detoxifying， and detumescence. Because of its unique curative effect on DKD，HKC is often used in the treatment of DKD. HKC plays a role in the treatment of DKD with a variety of pharmacokinetic and pharmacodynamic processes. In many laboratory studies，it has been found that the specific mechanisms of HKC in the treatment of DKD include increasing mitophagy，reducing mitochondrial damage，reducing renal fibrosis，controlling inflammatory response，and inhibiting oxidative stress，which can achieve the purpose of reducing renal damage and promoting renal function. Some clinical studies have also verified that the application of HKC alone can exert renal protective function through anti-inflammatory，anti-oxidative stress，anti-renal fibrosis effects，as well as reduction of urinary protein. Since DKD is not a single injury of renal function，it is often accompanied by problems in blood pressure，blood lipids，blood circulation，body immunity， and other aspects. Therefore，the combination of HKC with other drugs can often achieve more comprehensive results，improve the advantages of various drugs，and improve the therapeutic effect. The combination of drugs such as antihypertensive，lipid-lowering， vascular circulation improvement，immunity inhibition，and anti-oxidative stress with HKC has achieved good results. In addition，HKC is often used in combination with other Chinese patent medicines in clinics. The application of HKC in the treatment of DKD has made some progress，but there are still many places worthy of further study，and the research on the mechanism of HKC is not comprehensive enough. The research on its long-term effect and safety in clinical application is relatively lacking，and the drug variety is relatively single when combined with certain drugs. These problems deserve further attention. Finally，it is necessary to pay attention to the promotion and application of HKC in clinical practice so that HKC can be better applied in clinical practice and better solve practical problems for patients.

OBJECTIVE To investigate the causal association between ticagrelor and risk of infection METHODS Two-sample Mendelian randomization was adopted. Genetic instrumental variables were selected based on the results of the largest genome-wide association analysis to in vivo exposure of ticagrelor and its major active metabolite AR-C124910XX. The causal associations of ticagrelor and its major active metabolite AR-C124910XX with drug indications （coronary artery disease， unstable angina pectoris， myocardial infarction， stroke and ischemic stroke）were analyzed by inverse variance weighted Mendelian randomization model as a positive control for genetic instrumental variables. The causal relationship between ticagrelor and bacterial infection， acute lower respiratory infection， bacterial pneumoniae， pneumoniae，acute upper respiratory infection and sepsis were furtheranalyzed by using this method， and the robustness of the results was assessed by using heterogeneity tests and horizontal 202002030415） pleiotropy tests. RESULTS The increase of area under the curve at steady state （AUCss） of the genetic surrogated ticagrelor significantly reduced the risk of coronary artery disease， myocardial infarction and unstable angina pectoris （P＜0.001）. AUCss genetic instrument variables of its main active metabolite AR-C124910XX failed to pass positive control. Further analysis showed that the increase of the genetic surrogated ticagrelor exposure suggestively reduced the risk of bacterial infection [OR（95%CI）＝0.80（0.65，0.99），P＝0.040] and sepsis [OR （95%CI）＝0.84（0.73， 0.98）， P＝0.023]. The results of the heterogeneity tests showed that there was no heterogeneity in the causal association of the genetic surrogated ticagrelor AUCss with bacterial infection and sepsis （P＞0.05）. The results of horizontal pleiotropy tests showed that the causal association of genetic surrogated ticagrelor AUCss with bacterial infection and sepsis had no effects on horizontal pleiotropy （P＞0.05）. CONCLUSIONS Ticagrelor has a potential role in reducing the risk of sepsis and bacterial infections.