Objective: To analyze the mediating effect of activities of daily living (ADL) among patients with chronic obstructive pulmonary disease (COPD) on caregiver ability and caregiver burden, so as to provide a basis for improving the quality of care. Methods: From February 2024 to March 2025, COPD patients and their caregivers from the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in Haikou were selected using convenience sampling method. Data on the basic characteristics of both caregivers and patients were collected through questionnaire surveys. The Chinese version of the Family Caregiver Capacity Scale, the Chinese version of the Caregiver Burden Inventory, and the Barthel Index were used to assess caregiver ability, caregiver burden, and patients' ADL, respectively. The mediating effect of ADL among COPD patients on caregiver ability and caregiver burden was analyzed using the Process macro 4.0, with the significance tested via the Bootstrap method. Results: A total of 348 caregivers were surveyed, among whom 274 (78.74%) were females and 74 (21.26%) were males. The majority of caregivers were aged 40 years and above, with 291 individuals (83.62%). The relationship between caregivers and patients was primarily that of being their children, with 185 individuals (53.16%). Correspondingly, 348 COPD patients were surveyed, and the predominant type of medical insurance was the New Rural Cooperative Medical Scheme, with 172 cases (49.43%). The median scores of caregiver ability, caregiver burden, and patients' ADL were 19.00 (interquartile range, 5.00), 47.00 (interquartile range, 8.00) and 45.00 (interquartile range, 15.00) points, respectively. Mediating analysis showed that caregiver ability directly affected caregiver burden, with an effect value of 0.693 (95%CI: 0.553-0.832). It also indirectly affected caregiver burden through the patients' ADL, with an effect value of 0.104 (95%CI: 0.029-0.179). This mediating effect accounted for 13.05% of the total effect. Conclusion The ADL of COPD patients played a mediating role between caregiver ability and caregiver burden, with caregiver ability exerting a significant positive indirect effect on caregiver burden through patients' ADL.

By establishing a complete data organizational structure,technical architecture,quality control framework,and concept framework,hospitals can effectively regulate data management,data security,and quality monitoring,achieving full-cycle monitoring of data management.Breaking down the resource barriers of data systems,improving the efficiency of data usage and circulation,and promoting the increase in data value.It drives the hospital's scientific research innovation,medical insurance cost control,data value monetization,and the improvement of high-quality capabilities.Through the establishment of a sustainable digital culture and operational philosophy,it integrates data with hospital assets,continuously enhancing the value realization of hospital data in operations,management,diagnosis and treatment,and scientific research.

In the current era filled with change and challenges,public hospitals,as a crucial part of the national healthcare system,urgently need to enhance their agility to swiftly respond to the ever-changing environment.Current it outlines the origins and connotations of organizational agility,argues for the necessity of organizational agility in public hospitals,and proposes the core competencies required to maintain organizational agility in public hospitals,namely:patient-centeredness,environmental sensitivity,proactive planning,organizational integration capability,flexibility,rapid response,iterative regulation,and continuous learning.Furthermore,it attempts to establish a cultivation pathway for organizational agility in public hospitals,encompassing multiple dimensions such as organizational culture,agile leadership,communication systems,organizational structure,the embedding of new productivity,management systems,partner management,training systems,performance evaluation,and compliance management.

Objective To establish an initial diagnostic method for β-thalassemia (BT) using a double antibody sandwich ELISA approach. Methods The hybridoma producing monoclonal antibodies against anti-HbF were screened using a trailing count method. The mAbs were evaluated through ELISA,modified immunocytochem-istry,and Western blot analysis. A double antibody-sandwich ELISA assay was established by labeling the pairs of mAbs with ALP using the glutaral method,and this detection system was used to analyze 40 serum samples. Results The results demonstrate the successful generation of nine hybridoma cell lines capable of secreting highly active anti-HbF monoclonal antibodies (mAbs). Specifically,four mAbs (3F7,4G1,6C1,and 9H7) exhibited exclusive reactivity towards HbF without any cross-reactivity with hemoglobin variants (HbA and HbA2). These four HbF-specific mAbs displayed exceptional specificity and sensitivity,with a maximum titer of 1:256000 and the highest affinity constant (Ka) recorded at 2.36×108 L/mol. Among these mAbs,optimal antibody pairing was achieved using capture antibody 3F7 in conjunction with ALP-4G1 for the development of a sandwich ELISA detec-tion method. By employing this approach,fetal and healthy human blood samples were successfully quantified for HbF levels with an impressive detection sensitivity reaching up to 80％. Conclusion This sandwich ELISA dem-onstrated precise quantification of HbF levels,making it suiTab.for both research and diagnostic purposes in the field of β-thalassemia.

Objective To compare the efficacy,acceptability and safety of a low-volume magnisium sodicum potassium sulfate oral sulfate solution(OSS)with polyethylene glycol(PEG)electrolytes powder in bowel preparation for colonoscopy.Methods A prospective,single-blinded and single-center cohort study was conducted.The ambulatory and hospitalized 1 037 patients who underwent colonoscopy from April 2023 to January 2024 were enrolled.Participants were divided into OSS group(639 cases)and PEG group(398 cases),according to the bowel cleansing drugs taken orally.After propensity score matching(PSM),each group included 385 cases.The success rate of bowel preparation,scores of Boston bowel preparation scale(BBPS),medication taste,patients'satisfaction and the occurrence of adverse events were compared.Results The success rate of bowel preparation in the OSS group was 96.4％(371/385),higher than the 91.7％(353/385)in the PEG group,and the difference was statistically significant(P＜0.05).The total and segmented BBPS scores of the OSS group were higher than those of the PEG group,the differences were statistically significant(P＜0.05).The medication taste and patients satisfaction of the OSS group were significantly better than those of the PEG group,the differences were statistically significant(P＜0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P=0.800).Conclusion Compared to PEG,OSS has a better intestinal cleaning effect,medication taste,and patients satisfaction.In addition,OSS has security that is not inferior to PEG.

AIM:This study aims to investigate the effect of Agaricus blazei extract FA-2-b-β on ferroptosis of Burkitt lymphoma cells and its mechanism.METHODS:Burkitt lymphoma cell lines Raji and CA46 were treated with FA-2-b-β alone and in combination with ferrostatin-1,a ferroptosis inhibitor,or Stattic,a signal transducer and activator of transcription 3(STAT3)inhibitor.Cell viability was assessed using the CCK-8 method,and the half-maximal inhibitory concentration(IC50)of FA-2-b-β was calculated.Flow cytometry was used to detect apoptosis,cell cycle,mitochondrial membrane potential,and reactive oxygen species(ROS).Additionally,malondialdehyde(MDA)and glutathione(GSH)levels were measured using kits.The mRNA and protein expression levels of ferroptosis-related molecules were determined by RT-qPCR and Western blot.RESULTS:The extract FA-2-b-β at different concentrations significantly inhibited the proliferation of Raji and CA46 cells(P＜0.05),promoted their death,regulated cell arrest in G0/G1 phase,and decreased the mitochondrial membrane potential.(2)ROS and MDA levels were significantly increased with different concentrations of the extract FA-2-b-β(P＜0.05),while the GSH content was significantly decreased(P＜0.05).(3)The protein and mRNA levels of signal transducer and activator of transcription 3(STAT3),p-STAT3,and glutathione peroxidase 4(GPX4)were down-regulated at different concentrations of the extract FA-2-b-β.In addition,prostaglandin-endoperoxide synthase 2(PTSG2)and transferrin receptor protein 1(TfR1)protein and mRNA were up-regulated(P＜0.05),while the protein and mRNA levels of solute carrier family 7 member 11(SLC7A11)were not significantly changed.CONCLU-SION:The extract FA-2-b-β can induce ferroptosis in burkitt lymphoma,and the mechanism may be related to the inhibi-tion of STAT3/GPX4 signaling pathway.

Objective To investigate the prevalence of substantia nigra(SN)hyperechogenicity in patients with Parkinson's disease(PD)using transcranial ultrasound(TCS),identify the associated influencing factors,and construct a predictive model.Methods A retrospective analysis was conducted on 101 PD patients admitted to Chengde City Central Hospital between August 2022 and July 2024.All patients underwent TCS examination to detect SN hyperechogenicity.Based on TCS findings,patients were categorized into case group(SN hyperechogenicity,stagesⅢ-V)and control group(normal SN echogenicity,stagesⅠ-Ⅱ).The prevalence of TCS-detected SN hyperechogenicity in PD patients was evaluated,and the clinical and laboratory data between two groups were compared.The risk factors for SN hyperechogenicity in PD patients were identified using multivariate Logistic regression,and a regression equation model of Logit(P)was established based on the results of multivariate analysis.The established model was validated by the Hosmer-Lemeshow goodness-of-fit test and the likelihood ratioχ2 test.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive accuracy of the model for SN hyperechogenicity in PD patients,and the area under the curve(AUC)was calculated.Results Among 101 PD patients,34(33.66%)exhibited SN hyperechogenicity.Compared with control group,case group had higher percentages of olfactory dysfunction,sleep disorders and H-Y stage≥Ⅲ(P<0.05),and lower levels of serum copper and ceruloplasmin(P<0.05).Multivariate Logistic regression analysis identified olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin as independent risk factors for SN hyperechoicity in PD patients(OR=2.168,2.008,2.063,2.300,1.921,respectively;P<0.05).The predictive model was formalized as Logit(P)=-9.233+olfactory dysfunction×0.774+sleep disorders×0.697+H-Y stage≥Ⅲ×0.724+decreased serum copper×0.833+reduced ceruloplasmin×0.653.ROC analysis showed that when Logit(P)>13.00,the AUC value was 0.876(95%CI:0.795-0.933),with a sensitivity of 73.53%and a specificity of 82.09%.Conclusion The phenomenon of TCS-detected SN hyperechogenicity is severe in PD patients,and its occurrence was associated with olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin,and the predictive model incorporating these factors demonstrated excellent predictive value.

Objective:To investigate the molecular mechanism of Xiaoshuantongmai Decoction(XSTMD)targeting JAK2/STAT3 signaling pathway to regulate the function of dendritic cells(DCs)in treatment of deep vein thrombosis(DVT).Methods:After treatment of DVT with XSTMD,expressions of fibrinogen beta chain(FGB)and D-dimer(D2D)protein in plasma of patients with DVT were detected by ELISA,proportion of plasmacytoid dendritic cell(pDC)and conventional dendritic cell(cDC),and expression of HLA-DR protein in peripheral blood mononuclear cells(PBMCs)of patients with DVT were detected by flow cytometry,expressions of CD80 and CD86 mRNA were detected by qRT-PCR,Western blot was used to detect protein levels of JAK2,STAT3 and phosphory-lation(p-JAK2 and p-STAT3)in PBMC of DVT patients and mice.LPS-induced mouse DC2.4 cells were treated with XSTMD drug-containing serum.Western blot was used to determine the protein levels of JAK2,STAT3,p-JAK2 and p-STAT3.ELISA was used to detect protein levels of IL-6,TNF-α,IL-10 and TGF-β1 in cell culture supernatant.Results:After treatment with XSTMD,weight and length of thrombus were significantly reduced in mice with DVT(P<0.001).Compared with before treatment,expressions of FGB and D2D were significantly decreased in plasma of DVT patients(P<0.001),proportion of pDC was significantly increased,while pro-portion of cDC was significantly decreased in PBMC of DVT patients(P<0.01),expression of HLA-DR protein and mRNA levels of CD80 and CD86 were significantly decreased in PBMC of DVT patients(P<0.05,P<0.01,P<0.001)after treatment with XSTMD.Levels of p-JAK2 and p-STAT3 protein were significantly increased in PBMC from DVT patients and mice treated with XSTMD(P<0.05).After treatment with serum containing XSTMD,protein levels of p-JAK2 and p-STAT3 induced by LPS were significantly increased in murine DC2.4 cells(P<0.05).Protein expressions of IL-6 and TNF-α were significantly decreased,while protein expressions of IL-10 and TGF-β1 were significantly increased in cell supernatant(P<0.01,P<0.001).Conclusion:XSTMD effectively treats DVT by pre-cisely regulating the JAK2/STAT3 signaling pathway to promote the differentiation of DCs into pDC and alleviate inflammatory injury.

Objective:To investigate the efficacy of endoscopic sclerotherapy for internal hemorrhoids and its effects on patients' bowel function.Methods:A total of 111 patients who received endoscopic sclerotherapy at Xi'an No. 3 Hospital from September 2019 to August 2020 were retrospectively included in this study. Clinical efficacy, postoperative complications, perianal discomfort, and abnormal defecation were compared among patients with grade Ⅰ, Ⅱ, and Ⅲ internal hemorrhoids at 1, 4, 8, 12 weeks, and 6 months after surgery.Results:After 6 months of follow-up, the overall response rate was 77.48% (86/111), and the cure rate was 77.17% (79/111). The response rate and cure rate for rectal bleeding were 83.75% (67/80) and 80.00% (64/80), respectively. The response rate and cure rate for prolapse were 82.46% (47/57) and 75.44% (43/57), respectively. There were no statistically significant differences in the response rates and cure rates for rectal bleeding and prolapse symptoms among patients with grade Ⅰ, Ⅱ, and Ⅲ internal hemorrhoids at each follow-up time point (all P>0.05). Among the 111 patients, 27.93% (31/111) experienced perianal discomfort, and 40.54% (45/111) reported abnormal defecation. The incidences of perianal discomfort and abnormal defecation were not statistically significant among patients with grade Ⅰ, Ⅱ, and Ⅲ internal hemorrhoids (both P>0.05). In patients with gradeⅠ and Ⅱ internal hemorrhoids, perianal discomfort symptoms began to improve 4 weeks after surgery, while symptoms of abnormal defecation started to improve 1 week after surgery. Conclusions:Endoscopic sclerotherapy has a good clinical efficacy for rectal bleeding and prolapse symptoms in patients with grade Ⅰ, Ⅱ, and Ⅲ internal hemorrhoids. Additionally, it improves perianal discomfort and abnormal defecation by identifying the anal canal transition zone in patients with internal hemorrhoids.

Objective To compare the efficacy,acceptability and safety of a low-volume magnisium sodicum potassium sulfate oral sulfate solution(OSS)with polyethylene glycol(PEG)electrolytes powder in bowel preparation for colonoscopy.Methods A prospective,single-blinded and single-center cohort study was conducted.The ambulatory and hospitalized 1 037 patients who underwent colonoscopy from April 2023 to January 2024 were enrolled.Participants were divided into OSS group(639 cases)and PEG group(398 cases),according to the bowel cleansing drugs taken orally.After propensity score matching(PSM),each group included 385 cases.The success rate of bowel preparation,scores of Boston bowel preparation scale(BBPS),medication taste,patients'satisfaction and the occurrence of adverse events were compared.Results The success rate of bowel preparation in the OSS group was 96.4％(371/385),higher than the 91.7％(353/385)in the PEG group,and the difference was statistically significant(P＜0.05).The total and segmented BBPS scores of the OSS group were higher than those of the PEG group,the differences were statistically significant(P＜0.05).The medication taste and patients satisfaction of the OSS group were significantly better than those of the PEG group,the differences were statistically significant(P＜0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P=0.800).Conclusion Compared to PEG,OSS has a better intestinal cleaning effect,medication taste,and patients satisfaction.In addition,OSS has security that is not inferior to PEG.