Objective It analyzes the characteristics of the policy text of Sanming City on the basis of two dimen-sions,policy tools and policy objectives,to accumulate the experience of abolishing the increase in the price of tradi-tional Chinese medicine tablets in Sanming City,and puts forward some reflections.Methods Using literature re-search combined with content analysis,a two-dimensional analysis framework of policy tools and objectives was constructed to code 26 policy documents published publicly in Sanming City from January 2013-April 2023 regarding the policy of abolishing the markup on Chinese medicine tablets.Results A total of 87 articles were coded,with de-mand-type,supply-type and environment-type accounting for 16.09 per cent,34.49 per cent and 49.42 per cent respectively,with the overall distribution of policy tools favouring the use of supply-type and environment-type;and there was a certain tendency towards a certain policy objective,"ensuring the quality of Chinese medicine tablet","improving the price mechanism of Chinese medicine tablets","standardising the use of Chinese medicine tablets","strengthening the organisation and implementation,and implement the government's responsibility to invest"ac-counted for 11.49%per cent,39.08 per cent,18.39 per cent and 31.03 per cent respectively.Conclusion Innovative use of demand-based tools,such as market shaping,to promote the development of the beverage production chain in a high quality manner;taking into account the level of the regional economy,returning the price initiative to the market,optimising the market structure of the traditional Chinese medicine beverage industry,and cooperating with publicity measures to promote the implementation of the policy;and reforming the personnel and remuneration system of the pharmacy staff and regulating medical practices.

Background::Endovascular abdominal aortic aneurysm repair (EVAR) is the major treatment for abdominal aortic aneurysm (AAA); however, EVAR still carries a considerable risk of acute kidney injury (AKI). The present study aimed to investigate the risk factors for AKI after elective EVAR procedures.Methods::This was a retrospective observational study. Eligible patients who underwent EVAR from September 2011 to March 2019 in West China Hospital were included. The primary outcome was the occurrence of AKI within two days after EVAR, which was defined by the Kidney Disease Improving Global Outcomes Clinical Practice Guideline. Demographics, comorbidities, medications, laboratory tests, anatomical parameters of AAA, and relative operative details were collected as variables. Univariable and multivariable logistic regression analyses were applied to identify the risk factors among variables, and covariate interactions were further assessed.Results::A total of 679 eligible patients were included. The incidence of postoperative AKI was 8.2% (56/679) in the whole cohort, and it was associated with a lower 5-year survival rate (63.5% vs. 80.9%; χ2 = 4.10; P = 0.043). The multivariable logistic regression showed that chronic kidney disease (OR, 5.06; 95% CI: 1.43-17.95; P = 0.012), angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) (OR, 2.60; 95% CI: 1.17-5.76; P = 0.019), and short neck (OR, 2.85; 95% CI: 1.08-7.52; P = 0.035) were independent risk factors for postoperative AKI. In the covariate interaction analysis, the effect of ACEIs/ARBs use on postoperative AKI was similar across all subgroups ( P > 0.05), thereby suggesting a robust effect of ACEIs/ARBs use in all patients undergoing elective endovascular abdominal aortic aneurysm repair. Conclusions::Postoperative AKI was associated with lower survival rate, and the use of ACEIs/ARBs was the only adjustable independent risk factor. Clinicians should consider withdrawing ACEIs/ARBs in high-risk patients undergoing elective endovascular abdominal aortic aneurysm repair to prevent postoperative AKI.

Objective To explore the relevant protective/risk factors during the development of coronary heart disease blood stasis evidence in the process of pre-existing evidence based on the macro-,meso-,and micro-health state characterization parameter system of Chinese medicine state science.Methods 253 cases of coronary heart disease to be investigated were collected from the outpatient and inpatient departments of the Department of Cardiology in the hospitals affiliated to Hunan University of Traditional Chinese Medicine,and questionnaires were formulated according to the three dimensions of macro,meso,and micro,and the collected parameters were categorized with Python software,and the patients were diagnosed as pre-coronary heart disease blood stasis evidence(150 cases)and coronary heart disease blood stasis evidence(100 cases),and statistical analyses were performed with frequency analysis,χ2 test,and Logistic regression and other methods for statistical analysis.Results ①The results of univariate analysis showed that:age,BMI,history of smoking,history of alcohol consumption,history of hypertension,history of diabetes mellitus,average monthly high temperature,air quality,season,type of occupation,social environment,coronary artery angiographic stenosis,diastolic blood pressure,systolic blood pressure,creatinine,uric acid and total cholesterol differed between patients diagnosed as pre-Coronary artery disease blood stasis evidence and those diagnosed as Coronary artery disease blood stasis evidence,and all the differences were statistically significant(P<0.05).② Binary logistic regression analysis showed that age,BMI,history of alcohol consumption,type of occupation,coronary angiographic stenosis,diastolic blood pressure,creatinine,and dark red tongue were independent risk factors.A prediction model was established:P=1/[1+exp(16.522-1.427×age-0.975×BMI-3.55×drinking history+1.982×monthly average high temperature+0.709×season-1.827×occupational type-1.1×coronary angiographic stenosis-0.072×diastolic blood pressure-0.076×creatinine+2.398×dizziness-4.108×dark red tongue+4.169×pulse asthenia)],the model prediction rate was 90.5%.Conclusion The logistic regression model of coronary heart disease with blood stasis evidence is good with clinical diagnosis,which lays the foundation for the exploration of the state between the already diseased and undiseased of coronary heart disease,and provides important basic data for the theory of subhealth.

Objective:To investigate the whole genome of SARS-CoV-2 causing COVID-19 in Rongcheng city of Shandong Province in May 2022 and to further analyze the nucleotide and amino acid variations for source tracing.Methods:High-throughput sequencing was used to sequence the SARS-CoV-2 genome in 15 nasopharyngeal swab samples from COVID-19 cluster infections and three environmental samples related to an aquatic product import company. Whole-genome sequence splicing, variant site analysis and sequence typing were performed on the raw sequencing data using virus sequence and variant analysis software. A phylogenetic tree was constructed by evolutionary analysis software. Epidemiological investigation was used to trace the potential source of infection.Results:Thirteen whole genome sequences of SARS-CoV-2 with the length ranging from 29 653 bp to 29 780 bp were successfully obtained from the nasopharyngeal swab samples. The average sequencing depth was 1 756-6 565 X and the genome coverage was 99.20%-99.63%. The results of Pangolin typing showed that the 13 genomes belonged to the VOC/Gamma (P.1.15) evolutionary branch. Compared with the Wuhan reference strain (NC_045512.2), the 13 genome sequences had 40-41 nucleotide mutation sites. There were 23-24 amino acid variation sites in seven protein domains (ORF1a, ORF1b, S, ORF3a, ORF8, ORF9b and N proteins). Evolutionary analysis showed that the viral sequence was grouped to the same subclade as the reference strain from Argentina (EPI_ISL_4082233).Conclusions:In this study, the whole genome sequences of 13 Gamma variant strains were obtained from COVID-19 cluster infections associated with imported cold-chain aquatic products in Rongcheng city, and the imported seafood from South America in 2021 was found to be the source of the virus in a timely manner. This study provided reference for the SARS-CoV-2 variant analysis and case tracing and also suggested that the survival and transmission ability of SARS-CoV-2 on the surface of cold-chain products should not be underestimated and needed further investigation.

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Objective:To investigate the effect of ligand of numb-protein X1(LNX1)on the proliferation,invasion and migration of renal clear cell carcinoma cells and its underlying molecular mechanism. Methods:Gene Expression Profiling Interactive Analysis(GEPIA)database was used to analyze the mRNA expression level of LNX1 in renal clear cell carcinoma tissues and its relationship with the prognosis of patients with renal clear cell carcinoma.LNX1 gene specific shRNA(shLNX1)was delivered into renal clear cell carcinoma cell lines 786-O and ACHN by lentiviral infection,and flag-LNX1 plasmid was delivered into 786-O and ACHN cells by transient transfection.CCK-8 assay and colony formation assay were used to assess the effects of LNX1 silencing or overexpression on the proliferation of 786-O and ACHN cells.Transwell assay was used to evaluate the effects of LNX1 silencing or overexpression on the invasion and migration of 786-O and ACHN cells.Bioinformatics analysis was used to screen the downstream target genes of LNX1.Western blotting was used to examine the effects of LNX1 silencing or overexpression on the expression level of T-lymphoma invasion and metastasis-inducing protein 1(TIAM1)as well as the expression levels of total and phosphorylated ERK(phospho-ERK,p-ERK)in the ERK signaling pathway downstream of TIAM1 in 786-O and ACHN cells.786-O and ACHN cells overexpressing LNX1 were treated with proteasome inhibitor MG132,and the protein expression level of TIAM1 was analyzed by Western blotting.Finally,myc-TIAM1 recombinant plasmid was transfected into LNX1-overexpressing cells.Then,the expression levels of proteins in the ERK signaling pathway and the abilities of proliferation,invasion and migration of 786-O and ACHN cells were examined by Western blotting,colony formation assay and Transwell assay,respectively. Results:The mRNA expression level of LNX1 in renal clear cell carcinoma tissue was decreased(P＜0.05)and was positively correlated with the survival time of patients with renal clear cell carcinoma(P＜0.001).LNX1-silencing 786-O and ACHN cells and LNX1-overexpressing 786-O and ACHN cells were constructed successfully.After LNX1 silencing,the proliferation,invasion and migration of 786-O and ACHN cells were significantly enhanced(all P＜0.05).After LNX1 overexpression,the abilities of proliferation,invasion and migration of 786-O and ACHN cells were significantly decreased(all P＜0.05).Bioinformatics analysis identified TIAM1 as a potential target of LNX1.After silencing LNX1,the protein expression levels of TIAM1 and p-ERK were significantly increased(all P＜0.05),while the expression level of ERK remained unchanged.After LNX1 overexpression,the protein expression levels of TIAM1 and p-ERKwere significantly decreased(all P＜0.01),while the expression level of ERK was unchanged.Treatment with proteasome inhibitor MG132 increased the protein expression level of TIAM1 in LNX1-overexpressing 786-O and ACHN cells(P＜0.01 and P＜0.001).After LNX1-overexpressing cells were transfected with myc-TIAM1 plasmid,the protein expression level of p-ERK was increased,the abilities of cell proliferation,invasion and migration were enhanced(all P＜0.05),and the expression level of ERK protein remained unchanged. Conclusion:LNX1 inhibits the proliferation,invasion and migration of renal clear cell carcinoma cells by degrading TIAM1 which further regulates the phosphorylation of ERK.

Depressive disorder ranks as a major bur-den of disease worldwide,yet the current antidepressant medications are limited by frequent non-responsiveness and significant side effects.The lateral septum(LS)is thought to control of depression,however,the cellular and circuit substrates are largely unknown.Here,we identified a subpopulation of LS GABAergic adenosine A2A receptors(A2AR)-positive neurons mediating depres-sive symptoms via direct projects to the lateral habenula(LHb)and the dorsomedial hypothalamus(DMH).Activa-tion of A2AR in the LS augmented the spiking frequency of A2AR-positive neurons leading to a decreased activation of surrounding neurons and the bi-directional manipula-tion of LS-A2AR activity demonstrated that LS-A2ARs are necessary and sufficient to trigger depressive pheno-types.Thus,the optogenetic modulation(stimulation or inhibition)of LS-A2AR-positive neuronal activity or LS-A2AR-positive neurons projection terminals to the LHb or DMH,phenocopied depressive behaviors.Moreover,A2AR are upregulated in the LS in two male mouse mod-els of repeated stress-induced depression.This identifica-tion that aberrantly increased A2AR signaling in the LS is a critical upstream regulator of repeated stress-induced depressive-like behaviors provides a neurophysiological and circuit-based justification of the antidepressant poten-tial of A2AR antagonists,prompting their clinical transla-tion.