OBJECTIVE To systematically evaluate pharmacoeconomic studies on treatment strategies for transfusion- dependent β thalassemia （TDT） both in China and internationally， to inform clinical decision-making and health resource allocation， and provide methodological references for future domestic research in China. METHODS Databases including PubMed， Embase， Web of Science， the Cochrane Library， CNKI， Wanfang Data， and VIP were searched for pharmacoeconomic studies related to TDT treatments from inception to December 2024. Two researchers independently screened the literature， extracted data， and assessed risk of bias using the Consolidated Health Economic Evaluation Reporting Standards 2022 （CHEERS 2022） checklist. A qualitative systematic review was conducted focusing on model structure， costs， health outcomes， uncertainty analysis， and economic evaluation results. RESULTS A total of 1 685 articles were initially identified， and 13 pharmacoeconomic studies were ultimately included. The overall quality of the included studies was relatively high， covering interventions including blood transfusion and iron chelation therapy （BT-ICT）， hematopoietic stem cell transplantation （HSCT）， and gene therapy. All studies employed cost-utility analysis from societal， healthcare system， and payer perspectives. Markov models were most frequently used in model design. Most studies adopted a lifetime horizon with a cycle length of one year and a discount rate of 1.5% to 5%. Costs mainly focused on direct medical costs， sourced from national insurance databases and published literature. Utility values were primarily derived from literature or measured using techniques such as time trade-off. Most studies conducted both deterministic and probabilistic sensitivity analyses， identifying the costs of iron chelators and utility values as key influential parameters. Some studies also performed scenario analyses. CONCLUSIONS HSCT was likely more cost-effective than BT-ICT for pediatric/ adolescent patients. BT-ICT demonstrated superior cost-utility for adult patients， with the deferiprone regimen potentially being the most cost-effective option. Current domestic and international pharmacoeconomic evaluations for TDT remain limited. Future research should adopt a societal perspective， use a lifetime horizon， and strictly follow the CHEERS 2022 checklist when conducting pharmacoeconomic evaluations of treatments for TDT.

The aim of this study was to identify the Salmonella strains isolated from an outbreak of foodborne illness in a seafood buffet restaurant and analyze their pathogenic characteristics.Epidemiological data,fecal samples from patients and chefs,and food/environmental samples from the restaurant were analyzed.Research methods included bacterial culture,serotyping,quadruple fluo-rescence PCR identification,whole-genome sequencing and antibiotic susceptibility testing.The results showed that 4 S.Java strains(serotype 1,4,12∶b∶1,2;ST42)were isolated from two outbreak cases and two sporadic cases.All isolates exhibited similar genomic features,harboring 9 virulence islands and 98 virulence genes.Antimicrobial resistance profiling revealed streptomycin monoresis-tance,mediated by aac(6′)-Iy and aac(6′)-Iaa genes.In conclusion,this event was the first reported outbreak of foodborne illness caused by S.Java in China,indicating that S.Java may be prevalent in the surveyed district.The catering industry should optimize food handling and processing procedures and enhance the surveillance of high risk pathogens.Meanwhile,further studies should ad-dress differential diagnosis and pathogenic mechanism differences between S.Java and S.paratyphi B,which will facilitate evidence-based monitoring in China.

Objective:To understand the feelings and experiences of patients with dizziness caused by cerebrovascular diseases, and to provide a reference basis for the development of nursing intervention measures.Methods:Semi-structured interviews were carried out from November 2024 to February 2025 by phenomenology method. The patients with dizziness caused by cerebrovascular diseases who were hospitalized in the First Affiliated Hospital of Zhengzhou University were selected by purposive sampling method. The interview data were analyzed by the Colaizzi 7-step analysis method to summarize and extract the themes.Results:Finally, 16 patients with dizziness caused by cerebrovascular diseases were interviewed, including 6 males and 10 females, aged 43 to 73 years. The feeling and experience of patients with dizziness caused by cerebrovascular diseases could be summarized into three themes: persistent physical symptoms (physiological function imbalance, the superposition of multiple symptoms); patients had cognitive biases (symptom risk cognitive bias, symptom knowledge cognitive bias, drug effect cognitive bias); patients' self-perceived burden was obvious(physical burden, emotional burden, and economic burden).Conclusions:The patients with dizziness caused by cerebrovascular diseases show multi-dimensional characteristics, and there are many burdens and needs in physiological, psychological and social aspects. We should pay attention to the symptom experience and psychological feelings of such patients, and give targeted health education and multi-dimensional social support.

Objective:To explore the developmental trajectory and influencing factors of self-management behavior among stroke patients.Methods:A total of 478 ischemic stroke patients admitted to the department of neurology of a grade-Ⅲ hospital in Henan Province from July 2023 to June 2024 were selected as the investigation objects. Baseline data of patients were collected using the general situation questionnaire, stroke knowledge questionnaire, stroke health belief scale, stroke self-management behavior scale and self-rating depression scale. The self-management behavior level of patients was assessed at discharge, 1 month, 3 months and 6 months after discharge. Mplus 7.0 software was used to conduct trajectory analysis of stroke patients' self-management behaviors, and multiple Logistic regression analysis was used to analyze the influencing factors associated with the development trajectory types of different stroke self-management behaviors.Results:The self-management behavior scores of stroke patients at discharge, 1 month, 3 months and 6 months after discharge were 206.59(167.59, 230.57), 169.59(129.73, 196.73), 149.82(120.89, 171.48), and 147.14(123.02, 181.64), respectively. Four trajectory categories were described. Category 1 was low-level pattern of initial decrease followed by stabilization, accounting for 16.95%(81/478)( P<0.001, intercept=2.701). Category 2 was low-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept =2.696). Category 3 was medium-level pattern of initial decrease followed by stabilization, accounting for 57.11%(273/478)( P<0.001, intercept =3.829). Category 4 was high-level pattern of initial decrease followed by increase, accounting for 12.97%(62/478)( P<0.001, intercept=4.366). The self-management behavior of stroke patients with low level of stroke knowledge, low level of health belief, aged 60 to 70 years old, residence in rural areas and middle school and below education level were more likely to belong to the low level group(all P<0.05). Patients with low depression in the low level group were more likely to be classified as low-level pattern of initial decrease followed by increase( P<0.05). Conclusion:The trajectory category of self-management behavior could be predicted by stroke knowledge level, health belief level, age, place of residence, educational background and depression. Their self-management behavior level may be improved through targeted interventions according to the characteristics of different trajectory categories.

The aim of this study was to identify the Salmonella strains isolated from an outbreak of foodborne illness in a seafood buffet restaurant and analyze their pathogenic characteristics.Epidemiological data,fecal samples from patients and chefs,and food/environmental samples from the restaurant were analyzed.Research methods included bacterial culture,serotyping,quadruple fluo-rescence PCR identification,whole-genome sequencing and antibiotic susceptibility testing.The results showed that 4 S.Java strains(serotype 1,4,12∶b∶1,2;ST42)were isolated from two outbreak cases and two sporadic cases.All isolates exhibited similar genomic features,harboring 9 virulence islands and 98 virulence genes.Antimicrobial resistance profiling revealed streptomycin monoresis-tance,mediated by aac(6′)-Iy and aac(6′)-Iaa genes.In conclusion,this event was the first reported outbreak of foodborne illness caused by S.Java in China,indicating that S.Java may be prevalent in the surveyed district.The catering industry should optimize food handling and processing procedures and enhance the surveillance of high risk pathogens.Meanwhile,further studies should ad-dress differential diagnosis and pathogenic mechanism differences between S.Java and S.paratyphi B,which will facilitate evidence-based monitoring in China.

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

Objective:To identify risk factors affecting survival outcomes in elderly patients (≥75 years) with early gastric cancer (EGC) and establish a predictive scoring system to aid in treatment decision-making.Methods:A retrospective analysis was conducted on EGC patients who underwent gastroscopy, endoscopic submucosal dissection (ESD), surgical resection, or conservative treatment at the Endoscopy Center of the First Affiliated Hospital of Dalian Medical University between January 2016 and January 2023. Clinical data were analyzed to identify prognostic risk factors and develop a predictive scoring system. The low-risk group and high-risk group were divided according to the scores, and the overall survival of patients who received different treatments were compared between two groups.Results:A total of 180 patients were included, of whom 50 underwent ESD, 97 surgery, and 33 conservative treatment. Cox proportional risk model multivariate analysis identified three independent risk factors for survival: Charlson comorbidity index (CCI) >2 ( P=0.014, HR=2.411, 95% CI: 1.196-4.864), prognostic nutritional index (PNI) ≤43.275 ( P=0.011, HR=2.294, 95% CI: 1.205-4.365), and presence of multiple primary cancers ( P=0.004, HR=2.797, 95% CI: 1.401-5.585). A weighted scoring system assigned 1 point each for CCI>2, PNI≤43.275, and multiple primary cancers. Receiver operating characteristic curve analysis determined an optimal cutoff score of 1.5 ( P<0.001, area under curve=0.726). Patients were stratified into low-risk (score≤1) and high-risk (score≥2) groups. In the low-risk group, both ESD and surgical resection demonstrated superior overall survival compared with conservative treatment (95.1%, 87.5%, and 61.5%, respectively, P=0.003), with no significant difference between ESD and surgery ( P=0.466). In the high-risk group, no statistically significant overall survival difference was observed among ESD, surgery, and conservative treatment (55.6%, 64.7%, and 30.0%, respectively, P=0.152). Conclusion:CCI, PNI, and multiple primary cancers are critical prognostic factors for elderly EGC patients. The proposed scoring system (total 3 points) guides treatment decisions: ESD or surgery is recommended for low-risk patients (score≤1), while conservative management may benefit high-risk patients (score≥2).

Objective:To observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods:A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023, including 10 males and 7 females, with the age ranged from 28 to 68 (42.4±11.4) years old. All patients underwent immediate transplantation of the greater auricular nerve during the operation. The facial nerve function was evaluated according to the House-Brackmann (HB) facial paralysis grading standard at the last follow-up. Grade Ⅰ-Ⅲ was considered effective, and grade Ⅳ-Ⅵ was considered ineffective. The quality of life was evaluated using the physical function score (FDIP) and social function score (FDIS).Results:The follow-up time was 6-30 (18.3 ±6.6) months. The facial nerve function was classified as grade Ⅰ in four cases, grade Ⅱ in six cases, grade Ⅲ in four cases, and grade Ⅳ in three cases. This resulted in an effective rate of 14/17. The FDIP score at the final follow-up was (84.7 ±9.1) points, which was higher than the (54.1 ±20.6) points recorded at the immediate moment of repair ( P<0.001). In contrast, the FDIS score was (11.8 ±8.9) points, which was lower than the (57.5 ±11.7) points recorded at the immediate moment of repair ( P<0.001). Conclusion:The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective:To investigate the metabolic pathways and potential molecular targets associated with dapagliflozin in the treatment of type 2 diabetes mellitus.Methods:Plasma samples from patients with type 2 diabetes mellitus were collected before and after 12 months of dapagliflozin treatment and analyzed using UPLC-VION IMS Q-Tof-based metabolomics and timsTOF Pro2 diaPASEF-based proteomics. Multivariate statistical analyses were performed to identify significant differences pre- and post-treatment. Correlation analysis was then conducted to assess relationships between differentially expressed metabolites and proteins closely associated with type 2 diabetes mellitus. Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were used to construct metabolic pathway maps and predict therapeutic targets.Results:After 12 months of dapagliflozin treatment, 162 differential metabolites were identified, with 59 upregulated and 103 downregulated. A total of 440 differentially expressed proteins were detected, of which 272 were upregulated and 168 were downregulated. The main classes of differential metabolites included sphingolipids, glycerophospholipids, and glycosphingolipids. Key differentially expressed proteins included importin subunit alpha-11, synemin, Janus kinase 1, and far upstream element-binding protein 2. Correlation analysis revealed 98 shared enriched pathways between differential metabolites and proteins, involving neurotrophin signaling, chemokine signaling, and B cell receptor signaling pathways. Metabolic pathway analysis suggested that dapagliflozin might regulate insulin secretion by modulating glucose-dependent insulinotropic polypeptide, calmodulin-dependent protein kinase, and diacylglycerol levels.Conclusion:Dapagliflozin may exert therapeutic effects in type 2 diabetes mellitus through multiple mechanisms, including the modulation of metabolic and proteomic profiles, participation in key cellular signaling pathways, and regulation of insulin secretion.