New quality productive forces could be an inherent requirement and key driving force for the high-quality development of traditional Chinese medicine (TCM) hospitals. Based on the theory of new quality productive forces, the authors explored the mechanism of new quality productive forces enabling high-quality development of TCM hospitals, and proposed the path to improve the new quality productive forces enabling high-quality development of TCM hospitals, including improving the basis of digital construction of TCM hospitals, promoting the transformation of internal and external production relations, and promoting the upgrading of production factors of TCM hospitals through the construction of key specialties and special diseases of TCM.

New quality productive forces could be an inherent requirement and key driving force for the high-quality development of traditional Chinese medicine (TCM) hospitals. Based on the theory of new quality productive forces, the authors explored the mechanism of new quality productive forces enabling high-quality development of TCM hospitals, and proposed the path to improve the new quality productive forces enabling high-quality development of TCM hospitals, including improving the basis of digital construction of TCM hospitals, promoting the transformation of internal and external production relations, and promoting the upgrading of production factors of TCM hospitals through the construction of key specialties and special diseases of TCM.

Objective:To investigate the clinical characteristics and prognostic factors of malignant peritoneal mesothelioma (MPeM).Methods:A retrospective case series study was conducted. Clinical and follow-up data of 73 MPeM patients who received pemetrexed and cisplatin (AP regimen)-based treatment at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2004 to December 2022 were collected. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Kaplan-Meier method was used to perform the survival analysis; univariate and multivariate analyses were performed to identify the influencing factors of prognosis by log-rank test and Cox proportional hazards model.Results:In 73 MPeM patients, there were 33 males and 40 females, with a median age of 57 years old (range: 20-76 years old). Among them, 41 patients (56.2%) were aged ≥55 years old, 5 patients (6.8%) had a history of asbestos exposure, 45 patients (61.6%) presented with ascites, and 32 patients (43.8%) had distant metastasis, 70 patients (95.9%) were epithelioid subtype, 38 patients (52.1%) underwent surgery, and 3 patients (4.1%) received radiotherapy. The median OS time of all patients was 30 months (95% CI: 25-50 months), and the median PFS time was 8 months (95% CI: 6-14 months). Univariate analysis results showed that the differences in OS and PFS between patients with different ages (<55 years old vs. ≥55 years old: the median OS time not reached vs. 25 months, P < 0.001; the median PFS time 13 months vs. 7 months, P = 0.046) and Eastern Cooperative Oncology Group (ECOG) score (1 point vs. 2 points: the median OS time 37 months vs. 21 months, P < 0.001; the median PFS time 14 months vs. 4 months, P = 0.004) were statistically significant. There were statistically significant differences in OS among patients with different status of surgery (with vs. without: the median OS time 37 months vs. 24 months, P = 0.020), history of asbestos exposure (with vs. without: the median OS time 32 months vs. 18 months, P = 0.002) and distant metastasis (with vs. without: the median OS time 58 months vs. 20 months, P < 0.001). Multivariate analysis results showed that ECOG score of 2 points ( HR = 5.04, 95% CI: 1.29-19.73, P = 0.020) and distant metastasis ( HR = 4.26, 95% CI: 1.77-10.24, P = 0.001) were independent risk factors for OS of patients. Conclusions:Most MPeM patients are female, the epithelioid subtype is predominant, and the overall prognosis is poor. However, patients aged <55 years old, without history of asbestos exposure, with a good general condition, with surgery, or without distant metastasis have relatively good prognosis.

To analyze the interest distribution relationship and symbiotic mode in the construction of urban medi-cal groups,based on the symbiotic theory,a framework for analyzing the interest distribution relationship of urban medical groups is constructed.Based on actual cases,urban medical groups are summarized and divided into four types:one-way supply type,partial benefit symbiosis type,asymmetric reciprocity symbiosis type,and symmetric reciprocity symbiosis type.The focus of a one-way supply oriented urban medical group is on reshaping the profit distribution mechanism,a partial benefit symbiotic urban medical group is on establishing a profit compensation mechanism for benefit medical institutions,and an asymmetric and mutually beneficial symbiotic urban medical group is on building a long-term benefit balance mechanism.

Objective:To investigate the clinical characteristics and prognostic factors of malignant peritoneal mesothelioma (MPeM).Methods:A retrospective case series study was conducted. Clinical and follow-up data of 73 MPeM patients who received pemetrexed and cisplatin (AP regimen)-based treatment at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2004 to December 2022 were collected. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Kaplan-Meier method was used to perform the survival analysis; univariate and multivariate analyses were performed to identify the influencing factors of prognosis by log-rank test and Cox proportional hazards model.Results:In 73 MPeM patients, there were 33 males and 40 females, with a median age of 57 years old (range: 20-76 years old). Among them, 41 patients (56.2%) were aged ≥55 years old, 5 patients (6.8%) had a history of asbestos exposure, 45 patients (61.6%) presented with ascites, and 32 patients (43.8%) had distant metastasis, 70 patients (95.9%) were epithelioid subtype, 38 patients (52.1%) underwent surgery, and 3 patients (4.1%) received radiotherapy. The median OS time of all patients was 30 months (95% CI: 25-50 months), and the median PFS time was 8 months (95% CI: 6-14 months). Univariate analysis results showed that the differences in OS and PFS between patients with different ages (<55 years old vs. ≥55 years old: the median OS time not reached vs. 25 months, P < 0.001; the median PFS time 13 months vs. 7 months, P = 0.046) and Eastern Cooperative Oncology Group (ECOG) score (1 point vs. 2 points: the median OS time 37 months vs. 21 months, P < 0.001; the median PFS time 14 months vs. 4 months, P = 0.004) were statistically significant. There were statistically significant differences in OS among patients with different status of surgery (with vs. without: the median OS time 37 months vs. 24 months, P = 0.020), history of asbestos exposure (with vs. without: the median OS time 32 months vs. 18 months, P = 0.002) and distant metastasis (with vs. without: the median OS time 58 months vs. 20 months, P < 0.001). Multivariate analysis results showed that ECOG score of 2 points ( HR = 5.04, 95% CI: 1.29-19.73, P = 0.020) and distant metastasis ( HR = 4.26, 95% CI: 1.77-10.24, P = 0.001) were independent risk factors for OS of patients. Conclusions:Most MPeM patients are female, the epithelioid subtype is predominant, and the overall prognosis is poor. However, patients aged <55 years old, without history of asbestos exposure, with a good general condition, with surgery, or without distant metastasis have relatively good prognosis.

Objective:To investigate differences in clinical characteristics between bullous pemphigoid (BP) patients with stroke and those without, and their relationship with the prognosis of stroke.Methods:A retrospective analysis was performed on medical records of 330 BP inpatients in the First Affiliated Hospital of Zhengzhou University from September 2012 to April 2020. These patients were divided into BP + stroke (ST) group and BP - ST group according to whether they were accompanied by stroke, and clinical manifestations and relevant laboratory examination results were compared between the two groups. According to the stroke outcome score assessed by modified Rankin Scale (mRS), patients in the BP + ST group were further divided into good-prognosis ST group (mRS ≤ 2 points) and poor-prognosis ST group (mRS > 2 points), and subgroup analysis was conducted. Correlations between measurement data (such as age, disease course and laboratory examination results) and mRS scores were analyzed.Results:In the BP - ST group (256 cases), 151 were males and 105 were females, and their age ranged from 19 to 92 (66.8 ± 13.6) years; in the BP + ST group (74 cases), 45 were males and 29 were females, and their age ranged from 48 to 92 (74.6 ± 9.6) years; Compared with the BP - ST group, the BP + ST group showed older age ( t = -5.57, P < 0.001), shorter disease course of BP ( Z = -3.07, P = 0.002), and higher anti-BP180 IgG antibody levels (215.0 [157.2, 283.1] U/ml vs. 155.0 [63.9, 279.8] U/ml; Z = -2.12, P = 0.034). The distribution of skin lesions significantly differed between the two groups ( χ2 = 10.51, P = 0.015), and the BP + ST group showed a significantly lower proportion of patients with generalized lesions ( P<0.05), but a higher proportion of patients with lesions on the limbs ( P<0.05). Subgroup analysis showed significant differences in the patients′ age, BP course, lesion distribution and anti-BP180 IgG antibody levels among the good-prognosis ST group, poor-prognosis ST group and BP - ST group ( F = 10.83, P<0.001; Z = 17.24, P<0.001; χ2 = 15.57, P = 0.026; Z = 6.29, P = 0.043, respectively). There was no significant difference in the age between the good-prognosis ST group and poor-prognosis ST group (adjusted P = 1.000), but the patients were significantly older in the two above groups than in the BP - ST group (adjusted P = 0.001, 0.007, respectively) ; the poor-prognosis ST group showed significantly shorter BP courses (adjusted P = 0.016, < 0.001, respectively) and a higher proportion of patients with lesions on the limbs (both P < 0.05) compared with the good-prognosis ST group and BP - ST group, and significantly higher serum anti-BP180 IgG antibody levels compared with the BP - ST group (226.2 [163.6, 285.8] U/ml vs. 155.0 [63.9, 279.8] U/ml; adjusted P = 0.037). There were no significant differences in the gender distribution, lesional morphology, percentages and counts of peripheral blood eosinophils, serum total IgE levels, and anti-BP230 IgG antibody levels between the BP + ST group and BP - ST group (all P > 0.05), or among the good-prognosis ST group, poor-prognosis ST group and BP - ST group (all P > 0.05). Correlation analysis in the BP + ST group showed a significantly negative correlation between the BP course and mRS scores ( r = -0.33, P = 0.004), and a significantly positive correlation between the anti-BP180 IgG antibody levels and mRS scores ( r = 0.34, P = 0.032) . Conclusion:There were differences in the patients′ age, BP course, lesion distribution, and anti-BP180 IgG antibody levels between the BP patients with stroke and those without, and the differences were more obvious between the poor-prognosis ST group and BP - ST group.

Objective:To analyze the prevalence of malnutrition among human immunodeficiency virus-exposed uninfected (HEU) children and to identify the associated factors in Hunan Province.Methods:All children born to human immunodeficiency virus (HIV)-infected mothers retrieved from Information System of Prevention of Mother-to-Child Transmission of human immunodeficiency virus Management (IPMTCT) in Hunan Province between July 2013 and June 2019 were included. Information including maternal demographic characteristic, maternal comorbidities/complications, anti-retroviral therapy during pregnancy, anti-retroviral prophylaxis for children, birth weight, and disease during follow-up was collected. The length and weight of children at one, three, six, nine, 12 and 18 months of follow-up time points were detected, and the prevalences of stunting, underweight, wasting and malnutrition among HEU children were evaluated. The generalized estimating equation was used to fit the logistic regression model to analyze the associated factors for malnutrition.Results:A total of 656 HEU children were finally included. The prevalences of stunting, underweight, wasting, and malnutrition among HEU children were highest at one month of age, which were 11.9%(78/656), 9.1%(60/656), 7.0%(45/656) and 21.0%(138/656), respectively. Maternal comorbidities/complications (adjusted odds ratio (a OR)=2.30, 95% confidence interval ( CI) 1.48 to 3.58), mono/dual anti-retroviral therapy during pregnancy (a OR=2.38, 95% CI 1.54 to 3.68), birth weight <2 500 g (a OR=2.66, 95% CI 1.69 to 4.21) and disease during follow-up (a OR=1.73, 95% CI 1.10 to 2.70) were the risk factors for malnutrition among HEU children (all P<0.050). Both taking zidovudine (a OR=0.60, 95% CI 0.38 to 0.94) and nevirapine (a OR=0.31, 95% CI 0.18 to 0.52) for anti-retroviral prophylaxis were the protective factors for malnutrition among HEU children (both P<0.050). Conclusions:The prevalence of malnutrition among HEU children is high. The prevalence of malnutrition is affected by maternal comorbidities/complications, anti-retroviral therapy during pregnancy, and birth weight, diseases during follow-up and anti-retroviral prophylaxis for children.

Objective:To explore the association between grip strength and cognitive function in elderly people aged 65 years and over.Methods:Information on grip strength, cognitive function, and lifestyle in the elderly population aged 65 years and over in Wuhan was collected by unified professionally trained investigators.A total of 533 study subjects aged(70.7±5.1)years were grouped by quartile into four grip strength groups of Q1(<18.6 kg), Q2(18.6~24.1 kg), Q3(24.2~31.1 kg), Q4(>31.1 kg).Multiple linear regression and Logistic regression analyses were used to analyze the relationship of grip strength with cognitive function scores and cognitive impairment.Results:The mean grip strength of the 533 subjects was(24.94±9.15)kg.After adjusting for sociodemographic characteristics, lifestyle factors, history of diseases, as compared with grip strength Q1 group, the linear regression coefficients(Beta value)of cognitive scores and 95% confidence intervals(95% CI)showed statistically significantly positive correlation[0.45(-0.36, 1.26)、0.40(-0.52, 1.32)and 1.19(0.07, 2.31), all P<0.05]only between cognitive scores and grip strength Q2、Q3 and Q4 value; and the odds ratio and 95% CI of incidence of cognitive impairment were 0.97(0.43, 2.21)for grip strength Q2, 0.79(0.30, 2.06)for grip strength Q3, and 0.22(0.05, 0.92)for grip strength Q4.Considering grip strength as the continuous variable, the risk of cognitive impairment was decreased by 6% and the cognitive score was increased by 0.07 with per 1kg increase of grip strength. Conclusions:The results of this study suggest that there is a positive correlation between grip strength and cognitive function in the elderly population, and a lower grip strength is related to increased risk of cognitive impairment.More attention should be paid to the grip strength of the elderly in the community.

The occurrence and development of hepatocellular carcinoma （HCC） induced by chronic infection of hepatitis B virus （HBV） is a typical process of Cancer Evolution-development. Viral replication， viral mutation， and viral integration are three major mechanisms by which HBV promotes evolution of HCC. The replication of HBV induces and maintains chronic inflammatory microenvironment， that induces the generation of somatic mutation and viral mutation and provides selective pressure. HBV mutation helps cells to get stem-ness characteristics by activating key signaling pathways. HBV integration activates oncogenes， participates in the mechanism underlying the male predilection of HCC， and promotes the maintenance of chronic infection. Biomarkers related with HBV are effective predictive and prognostic markers of HCC. Anti-viral treatment significantly reduces the risk of HCC occurrence. High risk HBV mutations can be applied for predicting the effect of anti-viral treatment on improving HCC survival. Continuing to exploring mechanisms of HBV induced hepatocarcinogenesis can improve the specific prophylaxis of HCC by providing more effective biomarkers and therapeutic targets.

To investigate the safety and effectiveness of endovascular treatment for non-acute symptomatic intracranial occlusive disease of internal carotid artery. Methods The general data，surgical data and follow-up data of the patients with non-acute intracranial occlusion of internal carotid artery admitted to the Affiliated Hospital of Qingdaso Univerity from July 2016 to February 2021 were retrospectively analyzed，including the success rate of recanalization，the incidence of perioperative complications，imaging follow-up data and clinical follow-up data. Thrombolysis test for cerebral infarction （TICI） was used to evaluate the success of recanalization，the National Institutes of Health Stroke Scale （NIHSS） score was used to evaluate the degree of neurological impairment before and after treatment，and the degree of postoperative neurological recovery was evaluated by the modified Rankin Scale （MRS）. Results 28 of the 30 cases of intracranial internal carotid artery were successfully opened （technical success rate was 93.3%）. The difference of mTICI grading before operation was statistically significant compared with that after operation （P<0.05）.Surgical complications occurred in 6 cases （20.0%），including dissection in 2 cases，hyperperfusion syndrome in 1 case，and subarachnoid hemorrhage in 3 cases. Follow-up imaging of the 18 patients showed that 3 patients had restenosis of the offending vessels. One of them had TIA in the offending vessels and presented with paroxysmic contralateral limb weakness，and the other one had asymptomatic stenosis. In the 30 cases of clinical follow-up，there was a statistically significant difference in the MRS score between the 28 cases with successful operation and that before operation （P<0.05），and there was no significant change in the MRS score during clinical follow up between the 2 cases with intraoperative complications and unsuccessful operation. Conclusion endovascular therapy is safe and effective in highly selected cases of non-acute symptomatic intracranial internal carotid occlusion. The long-term NIHSS score and MRS score can be used to follow up the neurological deficit and recovery，and then to evaluate the long-term efficacy of endovascular therapy.