Building a doctor-patient destiny community in the New Era is related to advancing the “healthy China” strategy， achieving a better life for people， and creating a harmonious society. Therefore， exploring the construction of a doctor-patient destiny community from three dimensions of realistic concern， value care， and practical relevance can not only clarify the question of why to build it from a theoretical perspective， but also answer the question of how to build it from a realistic perspective. In terms of realistic concern， building a doctor-patient destiny community is a response to the current dilemma of confrontation in the doctor-patient relationship， the increasing health demands of people for a better life， and the threat of global diseases. From the perspective of value care， it can not only assist in achieving a better life marked by dignity and happiness but also promote the creation of a harmonious socialist society and contribute to building a human health community. Regarding practical relevance， it is necessary to not only uphold the principle of intersubjectivity， but also inseparable from the cultivation of doctor-patient empathy ability， as well as the improvement of institutional mechanisms， social security systems， and legal institutions.

【Objective】 To compare the clinical efficacy of percutaneous transforaminal endoscopic decompression （PEID） and percutaneous interlaminar endoscopic decompression （PETD） in the treatment of L5-S1 lateral recess stenosis. 【Methods】 We selected the patients in our center diagnosed with L5-S1 lateral recess stenosis from March 2018 to October 2019 and divided them into Group A and Group B according to the principle of prospective， single-blind， and randomized control （A： PETD； B： PEID）. The operation was performed by the same senior surgeon with mature spinal endoscopy technology. We recorded the basic information， operation duration， usage count of C-arm， hospital stay， VAS score and ODI index of lower back and lower limbs before operation and 3 days， 1 month， 1 year and the last follow-up after the operation， and the operative excellent and good rates （the last follow-up）. The angle of bony lateral recess was measured during pre- and postoperative CT. 【Results】 A total of 95 patients （A： n=48； B： n=47） successfully completed the operation and were followed up for at least 1 year. The two groups did not significantly differ in age， gender， hospital stay， or complication by lumbar intervertebral disc herniation， but PEID group had significantly shorter operation duration and fewer usage counts of C-arm （P<0.001）. VAS score of lower back and lower limbs， and ODI index were significantly reduced at 3 days，1 month， 1 year and the last follow-up after the operation， with no significant difference between the two groups at the same time； no statistical difference was found between the two groups in operative excellent and good rates at the last follow-up （P>0.05）. The postoperative bony side recess angle was significantly improved （P<0.05）， while there was no significant difference in either pre- or postoperative bony side recess angle between the two groups （P>0.05）. 【Conclusion】 Both PEID and PETD are effective strategies in the treatment of L5-S1 lateral recess stenosis and can achieve good clinical outcomes.

【Objective】 To explore the effect of Lactobacillus rhamnosus on postpartum depression （PPD） and its potential mechanism. 【Methods】 The mouse model of PPD was established by using dexamethasone sodium phosphate during pregnancy. At the end of adaptive feeding， 50 pregnant female mice were randomly divided into low-dose group （group Ⅰ）， high-dose group （Group Ⅱ）， positive control group （Group Ⅲ）， model control group （Group IV）， and blank control group （Group Ⅴ）. The mice in Group Ⅰ and Group II were given Lactobacillus rhamnosus 1×10⁷ and1×10⁸CFU（kg·d）. The mice in Group Ⅲ were given 1.8 mg /（kg·d） paroxetine， and the mice in Groups IV and V were given the same amount of normal saline for 4 weeks. The 24-hour food consumption test， open field test and sugar water consumption test were used to detect the behavior of mice in each group. The concentrations of 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and dopamine （DA） were determined by RP-HPLC. The changes in Enterococcus faecalis， Bifidobacterium， Lactobacillus and Escherichia coli in the cecum of mice were detected by Real-time fluorescence quantitative PCR （RT-qPCR）. 【Results】 Before modeling， there were no significant differences in food intake， weight change rate， open field moving distance and speed， and percentage of sugar consumption among the groups （P>0.05）. After modeling， there was no significant difference in food intake or weight change rate among the five groups， but the open field moving distance， moving speed and percentage of sugar preference were significantly reduced （P<0.05）. After intervention with Lactobacillus rhamnosus， compared with Group Ⅳ， the depression-like behavior in Group Ⅰ and Group Ⅱ mice was improved； the weight change rate， open field moving distance and speed， percentage of sugar preference， and monoamine neurotransmitter concentration in Group I and Group Ⅱ were significantly increased compared with those in Group Ⅳ （P<0.05）， while Enterococcus faecalis， Escherichia coli and lactobacillus were significantly decreased （P<0.05）， and Bifidobacterium had an upward trend， but without significant difference. There was no significant change in food intake. 【Conclusion】 Lactobacillus rhamnosus can improve the depression-like behavior， affect monoamine neurotransmitters in mice， and regulate intestinal flora， which provides a new direction for studies on postpartum depression.

【Objective】 To investigate the effect of decompression technique with bone-chisel under percutaneous spinal endoscopy through transforaminal approach in elderly patients with unilateral lateral recess stenosis （ULLRS）. 【Methods】 We enrolled 46 old patients with ULLRS who underwent percutaneous spinal endoscopy through transforaminal approach assisted with bone-chisel technique from March 2017 to July 2019. The visual analogue scale （VAS） score of low back pain and leg pain， the Oswestry dysfunction index （ODI）， and the modified MacNab score before and after operation were obtained. We also recorded preoperative and postoperative sagittal diameter measured by computer tomography （CT） to evaluate decompression of the lateral recess. All the patients were followed up for at least 1 year for complications. 【Results】 All the 46 patients were followed up for 17 to 42 months. Dural tear occurred in one case， transient nerve root irritation in two cases， and there were no other complications. The low back pain VAS score， lower limb pain VAS score， and ODI index of all the patients were significantly improved in the last follow-up （P<0.05）. The results of the modified MacNab efficacy evaluation at the last follow-up revealed that the excellent and good rate was 91.3% （excellent in 38， good in 4， and fair in 4）. The sagittal diameter （mm） of the bony lateral recess 1 year after surgery increased by an average of 55.8%， which was significantly better than that before surgery （t=6.354， 4.22±1.25 vs. 2.71±0.57， P<0.001）. 【Conclusion】 Percutaneous spinal endoscopy through transforaminal foramen approach combined with bone-chisel technique is effective in treating ULLRS in elderly patients.

OBJECTIVE To explore the predictive factors of cefoperazone/sulbactam-induced thrombocytopenia in adult inpatients， and to establish and validate the nomogram prediction model. METHODS Data of adult inpatients treated with cefoperazone/sulbactam in Xi’an Central Hospital from Jun. 30th， 2021 to Jun. 30th， 2023 were retrospectively collected. The training set and internal validation set were randomly constructed in a 7∶3 ratio. Singler factor and multifactor Logistic regression analysis were used to screen the independent predictors of cefoperazone/sulbactam-induced thrombocytopenia. The nomogram was drawn by using “RMS” of R 4.0.3 software， and the predictive performance of the model was evaluated by the receiver operating characteristic curve and C-index curve. Hosmer-Lemeshow goodness-of-fit test was used to evaluate the calibration degree of the model. Using the same standard， the clinical data of hospitalized patients receiving cefoperazone/sulbactam in Xi’an First Hospital in the same period were collected for external validation of the nomogram prediction model. RESULTS A total of 1 045 patients in Xi’an Central Hospital were included in this study， among which 67 patients suffered from cefoperazone/sulbactam-induced thrombocytopenia， with an incidence of 6.41%. After the false positive patients were excluded， 473 patients were included finally， including 331 in the training set and 142 in theinternal validation set. Multifactor Logistic regression analysis showed that age [OR＝1.043， 95%CI （1.017， 1.070）]， estimated glomerular filtration rate （eGFR） [OR＝0.988，95%CI（0.977， 0.998）]， baseline platelet （PLT） [OR＝0.989， 95%CI（0.982， 0.996）]， nutritional risk [OR＝3.863， 95%CI（1.884， 7.921）] and cumulative defined daily doses （DDDs） [OR＝1.082， 95%CI（1.020， 1.147）] were independent predictors for cefoperazone/sulbactam-induced thrombocytopenia （P＜0.05）. The C-index values of the training set and the internal validation set were 0.824 [95%CI （0.759， 0.890）] and 0.828 [95%CI （0.749， 0.933）]， respectively. The results of the Hosmer-Lemeshow test showed that χ 2 values were 0.441 （P＝0.802） and 1.804 （P＝0.406）. In the external validation set， the C-index value was 0.808 [95%CI （0.672， 0.945）]， the χ 2 value of the Hosmer-Lemeshow test was 0.899 （P＝0.638）. CONCLUSIONS The independent predictors of cefoperazone/sulbactam-induced thrombocytopenia include age， baseline PLT， eGFR， nutritional risk and cumulative DDDs. The model has good predictive efficacy and extrapolation ability， which can help clinic identify the potential risk of cefoperazone/sulbactam-induced thrombocytopenia quickly and accurately.

【Objective】 To explore the incidence rate and characteristics of hepatitis-C virus (HCV) infection in heroin addicts with pulmonary tuberculosis (TB) in Xi’an so as to provide a basis for pulmonary TB and HCV prevention and control measures. 【Methods】 We carried out behavior investigation and serological detection of 219 heroin addicts with pulmonary TB infection in Xi’an Eighth Hospital. We analyzed HCV infection risk factors by Chi-square test and multi-factor Logistic regression method. 【Results】 The prevalence of HCV infection in heroin addicts with pulmonary TB was 71.2% and 92.9% in injected drug users (IDUs). The HCV infection rate was higher than the infection rate of HBV (10.9%) and HIV (5.9%) in heroin addicts with pulmonary TB. The major infection risk factors were intravenous injection (OR=18.632, 95% CI: 8.146-41.284) and longer duration of drug use (OR=1.428, 95% CI: 1.086-1.876). 【Conclusion】 The study found high HCV infection rate in heroin addicts with pulmonary TB and that the independent risk factors are the drug injection and duration of drug use. In order to prevent further spread of HCV in heroin addicts with pulmonary TB, we should establish and perfect the management system of HCV infection.

【Objective】 To investigate and compare the effects and mechanisms of risperidone and haloperidol on early socially isolated mice. 【Methods】 C57BL/6 mice aged 3 weeks were raised in single cages after weaning for social isolation （SI）， and the control （GH） group was raised normally. Eight weeks later （mouse adult）， the mice received intraperitoneal injection of equal volumes of normal saline （NS）， risperidone （RIS） and haloperidol （HA）. Then they were divided into four groups： GH+NS， SI+NS， SI+RIS， and SI+HA. The dose of risperidone and haloperidol was 0.1 mg/kg and 0.2 mg/kg， respectively. After administration for 14 days， through the open field experiment， elevated plus maze experiment， forced swimming experiment， nesting experiment， social interaction experiment， novel object discrimination experiment， and prepulse suppression experiment， the mice’s schizophrenia-like behavior was evaluated in terms of autonomous activities， emotions， cognition， and social behavior. We also detected dopamine type 2 receptor （D2R） and the N-methyl-D-aspartate receptor subunit NR1 in the prefrontal cortex （PFC） and nucleus accumbens （NAc）. 【Results】 Compared with those in GH group， the anxiety-like behavior and depression-like behavior of SI mice were significantly increased （P<0.05）， while the nesting ability was significantly decreased （P<0.05） and social interaction and avoidance behavior were significantly reduced （P<0.05）； the cognitive function of PPI was impaired （P<0.05）. Compared with haloperidol， risperidone improved not only depression-like behavior and PPI impairment， but also anxiety-like behavior， nesting ability， social interaction， and avoidance behavior. In SI+RIS and SI+HAL groups， the content of D2R in NAC decreased significantly， and the difference of NR1 in PFC disappeared compared with the control group. 【Conclusion】 Early SI is a good model for simulating schizophrenia. Risperidone has a better intervention effect than haloperidol； risperidone and haloperidol may exert their effects through D2R and NR1.

Since the outbreak of COVID-19, the epidemic has been spreading rapidly. As an important base to combat the epidemic, the hospital infection prevention and control work is facing great challenges. In particular, as one of the first COVID-19 designated hospitals in a province and a large general hospital at the same time, how to prevent and control nosocomial infection among patients and medical staff during the epidemic period of COVID-19 is of paramount importance. Our strategies start with the three key elements of infectious disease management, namely, "controlling the source of infection, cutting off the route of transmission, and protecting the susceptible population." The in-patients in pre-examination and triage, fever clinic, isolation ward and common ward were inspected from fever screening, pre-examination and triage, personal protection, in-patient management, emergency treatment, accompanying care management, and environmental disinfection. A series of interventions were carried out to effectively cut off the transmission of COVID-19 in hospitals. After effective screening and rational pre-examination and triage for outpatients, emergency patients and inpatients, medical personnel received a series of training, scientific protection, and accompanying personnel were effectively managed and controlled, there was not a single case of nosocomial infection during the epidemic of COVID-19. This series of intervention strategies provides some reference for other medical institutions to carry out effective prevention and control of the epidemic.

OBJECTIVE：To investigate drug use in an obstetrics and gynecology hospital and confirm the types of drugs that need to be monitored so as to provide reference for rational drug use in clinic. METHODS： Activity based classification （ABC） analysis， Vital-Essential-Nonessential Medicine （VEN） analysis and ABC-VEN matrix analysis were used to statistically analyze the types of drugs in the inpatients and outpatients of this hosptial during Jan. 2016-Dec. 2017， and consumption sum in the hospital so as to determine the types of monitoring focus drugs. RESULTS： The drugs were divided into class A， B， and C by using ABC analysis， and the constitute ratio of them were 6.08％， 7.71％ and 86.21％； the constitute ratio of consumption sum were 70.97％， 19.07％ and 9.96％， respectively. The drugs were divided into class V， E and N， and the constitute ratio of them were 36.51％， 43.61％ and 19.88％； constituent ratios of their consumption sum were 31.89％， 33.89％ and 34.22％， respectively. The drugs were divided into group Ⅰ （class AV， AE， AN， BV， CV）， group Ⅱ （class BE， CE， BN） and group Ⅲ （class CN） by using ABC-VEN matrix analysis； the constitute ratios of accumulative number of drug type were 40.56％， 44.43％ and 15.01％，while those of accumulative consumption sum were 77.29％， 20.52％ and 2.19％， respectively. Among class N， the constituent ratio of consumption sum of class AN as Chinese patent medicine， blood substitutes and perfusion solutions were higher， being 12.48％ and 7.92％； that of class BN as Chinese patent medicine was higher， being 3.21％； those of class CN as Chinese patent medicine， sex hormones and modulators of the genital system were higher， being 1.14％， 0.50％. CONCLUSIONS： In the Obstetrics and Gynecology Hospital， consumption sum of class A is the main part of the total consumption sum of drugs， and they should be seleted according to therapeutic efficacy. Active regulatory policies should be adopted for class V and E so that more drug types that possess cost- effectiveness advantages； for class N， management control and reasonable utilization should be monitored closely to reduce irrational drug use. Some Chinese patent medicines， blood substitutes and perfusion solutions among class AN should be monitored and controlled emphatically.

OBJECTIVE To explore the grouping efficacy of diagnosis related group （DRG） and the influential factors of hospitalization cost in diabetes cases， and to provide theoretical support for improving DRG payment system， reducing medical cost and enhancing the efficiency of medical insurance funds. METHODS The information of 4 368 diabetic patients who were hospitalized in a 3A hospital in Xi’an from January 1， 2021 to June 30， 2023 was retrospectively analyzed， and DRG grouping of them was summarized； the hospitalization costs of patients in different DRG groups were analyzed by using one way ANOVA and Bonferroni multiple comparison. Coefficient of variation （CV） was used for evaluation within the group， and the influential factors of hospitalization costs were analyzed by one-way linear regression analysis and multi-factor linear regression analysis. RESULTS & CONCLUSIONS The CV values of the four DRG groups were all lower than 0.8， indicating good grouping results and good consistency within the group； the difference of hospitalization cost among the four groups was statistically significant （P＜0.05）， and the hospitalization cost of China Healthcare Security-DRG version 1.1 FW11 group was significantly higher than those of other three groups （P＜0.05）. Length of stay， drug cost， the number of other diagnoses， test cost and payment method have significant positive effects on the hospitalization cost of diabetic patients. Whether there is pharmacist intervention has a significant negative influence on the hospitalization cost of patients. Under the DRG payment method， medical institutions can consider multidisciplinary linkage and incorporate a variety of management and service tools， including pharmacist’s intervention， to develop refined management measures， to reduce the economic burden of patients’ families and society.