Objective: To investigate the incidence, characteristics, and influencing factors of resolution discrepancies within the minipool (MP) testing model across Chinese blood station laboratories in 2024. Methods: A nationwide, multicenter, cross-sectional study was conducted, including 334 blood station laboratories that reported nucleic acid reactive data among enzyme immunoassay non-reactive samples. Of these, 296 laboratories adopted the pool resolution model, with a total of 12 536 273 samples tested. Systematic analysis was performed on resolution data, focusing on the MP-NAT reactivity rate, the pool resolution concordance rate, and the resolution discrepancy rate. Subgroup analyses were conducted based on reagent types, viral targets, and Ct values. Potential causes were further explored through laboratory surveys and re-examination of raw amplification curves. Results: In 2024, the national average MP-NAT reactivity rate was 0.15%. The overall pool resolution concordance rate was 57.86%, which showed a gradual decline as Ct values increased across all reagents. The national average resolution discrepancy rate was 0.081‱(102/12 536 273), with 17.91%(53/296) of laboratories reporting at least one discrepancy. Nine reagent types were associated with these events, exhibiting reagent-specific patterns. For Reagent A2, the predominant discrepancy was HBV reactive pools resolving as HIV (36.36%); for Reagent D1, HBV pools frequently resolved as HCV (38.89%); and for Reagent E, the most common pattern was HIV pools resolving as HBV (48.00%). These resolution discrepancies were strongly associated with high Ct values: the median pool Ct for HBV exceeded 38, while those for HCV and HIV both exceeded 40. Investigations across 16 laboratories revealed that most discrepant samples exhibited “tailing” amplification curves, with some cases linked to cross-contamination or reagent batch-specific issues. Conclusion: While the incidence of resolution discrepancies in the MP-NAT model remains low in China, variations exist across different reagents and laboratories. These discrepancies are closely associated with low viral load, reagent performance, and laboratory operational practices.

Objective:To explore the method for selecting characteristic prices of Chinese patent medicines based on informa-tion entropy theory.It involves analyzing the connotative differences among various price indicators and utilizing information entropy metrics to validate the scientific rigor of characteristic price selection so as to optimize the pricing model for Chinese patent medi-cines and improve the accuracy of price evaluation.Methods:A correlation analysis and information entropy calculation are con-ducted on the median price of the smallest preparation unit,average daily cost,and average course cost of TCM.It compares the information diversity and uncertainty of different pricing indicators.Results:The average daily cost exhibits the highest information diversity and uncertainty among all the pricing indicators examined.Conclusion:It is recommended that the average daily cost be used as the dependent variable for characteristic prices in TCM pricing research.This choice plays an important role in optimizing TCM pricing models and enhancing the accuracy of price evaluation.

Objective:To establish a scientific,systematic,and objective indicator system for the characteristic price variables of Traditional Chinese Patent Medicines(TCPM),providing a reference framework for the pricing mechanism of TCPM.Methods:The brainstorming method was initially used to screen related variable indicators.The Nominal Group Technique(NGT)and Delphi methods were applied to gather expert opinions,and SPSS 28.0 was employed for data statistical analysis.It led to the development of a TCPM characteristic price variable indicator system consisting of 6 dimensions,14 characteristic variables and 26 measurement indicators.Results:The authority coefficient of the experts exceeded 0.7,indicating the representativeness of the results.Expert opinions were generally concentrated.Based on the collected opinions and statistical analysis,the scope of selected TCPM characteristic price variables was preliminarily established.Conclusion:The TCPM characteristic price variable indicator system was initially developed.However,due to the complexity of the pricing mechanism and divergent expert opinions,further qualitative and quantitative research methods,along with a dynamic adjustment mechanism,are needed to verify and refine the system.

The National Essential Medicines System could protect public health and ensure access to essential medications.Although the current selection methods for China's National Essential Medicines Lists(NEMLs)are becoming more scientific and standardized,there are still problems such as much emphasis on expert experience and the lack of transparency of decision-making basis.To address these issues,it proposes an evidence-based decision-making pathway for NEMLs selection guided by clinical value.This approach ensures a strong integration of evidence and decision-making,offering valuable insights for improving the adjustment procedures and selection criteria of the NEMLs in China.

In observational research,a primary objective is to accurately and reliably assess the causal impact of exposure on outcomes.Identifying and properly adjusting for confounding factors is a key prerequisite and central challenge to achieving this goal.Ineffective management of confounders,whether by neglecting significant ones,(leading to residual confounding),or by over-adjusting for irrelevant factors,(introducing collider bias),can distort effect estimates and lead to erroneous scientific conclusions and clinical decisions.Therefore,it is essential to develop and implement systematic,transparent,and reproducible methods for identifying and selecting confounding factors to enhance the validity and reliability of causal inferences in observational studies.This paper provides a systematic review of directed acyclic graphs(DAGs),a robust visual causal modeling tool,and offers a detailed examination of three prominent criteria for selecting confounding factors based on DAGs:the Pre-exposure criterion,the Common cause criterion,and the Modified disjunctive cause criterion.The aim is to equip researchers with a structured and theoretically grounded framework for identifying and selecting confounding factors,thereby improving the process of estimating causal effects in observational studies.

Objective The purpose of this study is to explore the implementation strategies of the"two-in-one"medical and care integration model in People's Hospital of Nanhai Economic Development Zone,focusing on resource integration,talent shortage,service quality,funding support,and information construction.Methods Through field research,data analysis,and literature review,the study investigates the"two-in-one"model of the hospital managing a government-run nursing home,and an-alyzes its specific practices and effects in resource integration,talent development,and information construction.Results Through vertical management,resource integration,and information construction,the hospital significantly improved the service quality of the nursing home.Conclusion The model of the hospital managing a nursing home has achieved a transformation from passive response to external pressure to active stimulation of internal growth,providing a reference for the promotion of medical and care integration services at the village level and offering a new solution to solve the development dilemma of hospitals.

In observational research,a primary objective is to accurately and reliably assess the causal impact of exposure on outcomes.Identifying and properly adjusting for confounding factors is a key prerequisite and central challenge to achieving this goal.Ineffective management of confounders,whether by neglecting significant ones,(leading to residual confounding),or by over-adjusting for irrelevant factors,(introducing collider bias),can distort effect estimates and lead to erroneous scientific conclusions and clinical decisions.Therefore,it is essential to develop and implement systematic,transparent,and reproducible methods for identifying and selecting confounding factors to enhance the validity and reliability of causal inferences in observational studies.This paper provides a systematic review of directed acyclic graphs(DAGs),a robust visual causal modeling tool,and offers a detailed examination of three prominent criteria for selecting confounding factors based on DAGs:the Pre-exposure criterion,the Common cause criterion,and the Modified disjunctive cause criterion.The aim is to equip researchers with a structured and theoretically grounded framework for identifying and selecting confounding factors,thereby improving the process of estimating causal effects in observational studies.

Objective:To investigate the iodine nutrition status of children aged 8 - 10 and pregnant women in Xining City, Qinghai Province.Methods:From 2019 to 2021, a stratified cluster sampling method was used to divide 7 counties (districts) under the jurisdiction of Xining City, Qinghai Province into 5 sampling areas according to east, west, south, north, and center each year. One township (town, street) was selected from each area. Forty non boarding students aged 8 to 10 from each primary school (half male and half female, age balanced) and 20 pregnant women from each township (town, street) location were selected to collect edible salt samples at home and a random urine sample to measure salt iodine and urinary iodine level. B-ultrasound was used to measure thyroid volume in children and the goiter rate was calculated.Results:A total of 6 534 samples of household edible salt were collected from children and pregnant women, with an average salt iodine concentration of 25.58 mg/kg. The coverage rate of iodized salt was 97.50% (6 371/6 534), and the qualified iodized salt consumption rate was 89.46% (5 845/6 534). A total of 4 362 urine samples were collected from children, with a median urinary iodine level of 183.10 μg/L. The difference between different years was statistically significant ( H = 20.27, P < 0.001). A total of 2 169 urine samples were collected from pregnant women, with a median urinary iodine level of 168.90 μg/L. The difference between different years was statistically significant ( H = 107.09, P < 0.001). A total of 3 336 cases of thyroid gland examination were conducted in children, including 33 cases of thyroid enlargement, with a goiter rate of 0.99%. There was a statistically significant difference between different years (χ 2 = 15.00, P < 0.001). Conclusion:From 2019 to 2021, children aged 8 to 10 and pregnant women in Xining City are at an appropriate level of iodine, and the achievements in prevention and treatment of iodine deficiency disorders still need to be continuously consolidated.

OBJECTIVE To study the effects of Ro 64-6198,a selective nociceptin/orphanin FQ receptor(NOPR)agonist,on heroin self-administration and drug-seeking behavior in rats.METHODS Rats were trained to self-administer heroin intravenously at a dose of 0.05 mg·kg-1 under a fixed ratio 1(FR1)reinforcement schedule.Heroin motivation was assessed using a progressive ratio(PR)schedule.Firstly,a stable heroin self-administered rat model was established before the effects of Ro 64-6198 on heroin rewarding under the FR1 schedule were observed.After three days of self-administration recovery training,the effects of Ro 64-6198 on heroin reward motivation were observed under the PR3-4 schedule.Following extinction,the reinstatement of heroin seeking induced by either conditioned cues or heroin priming was evaluated in rats withdrawn from self-administration.The expressions of cAMP response element-binding protein(CREB)and brain-derived neurotrophic factor(BDNF)in the ventral tegmental area(VTA)were analyzed using Western blotting,while the expression of the NOPR in neurons in the VTA was examined through immunofluorescence staining.RESULTS Pretreatment with 3 mg·kg-1 Ro 64-6198 significantly reduced active responses and heroin infusions during FR1 testing,as well as decreased breakpoints,indicating reduced motivation under the PR schedule.At a dose of 1 mg·kg-1,Ro 64-6198 markedly attenuated the reinstatement of heroin-seeking behavior induced by conditioned cues or heroin priming.Furthermore,the administration of SB-612111,an NOPR antagonist,blocked the inhibitory effects of Ro 64-6198 on cue-induced heroin-seeking,although SB-612111 alone had no effect on heroin-seeking behavior.Ro 64-6198 treatment also suppressed the reduction of both phos-phorylated CREB(p-CREB)and BDNF levels in the VTA and the decreased expression of NOPR and p-CREB in dopaminergic neurons of the VTA.CONCLUSION These results demonstrate that Ro 64-6198 can mitigate heroin-seeking behavior through NOPR activation and CREB/BDNF pathway in the VTA.This study is expected to offer evidence for its potential as a clinical treatment for heroin addiction and relapse.

Objective:To explore the chain mediating effect of empowerment and activation between chronic disease resources and self-management in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods:A convenience sampling method was used to select 306 elderly COPD patients who were treated at the Affiliated Hospital of Shaoxing University from December 2022 to May 2024. General information questionnaires, COPD Self-Management Scale (COPD-SMS), Chronic Illness Resources Survey-Chinese version (CIRS-C), COPD Empowerment Evaluation Scale, and the Patient Activation Measure (PAM 13) were used for the survey. AMOS 22.0 software was employed to construct a structural equation model to analyze the pathways influencing self-management in COPD patients.Results:A total of 306 questionnaires were distributed, with 291 valid ones returned, resulting in an effective response rate of 95.10%. Empowerment and activation played a mediating role between chronic disease resources and self-management in elderly COPD patients. A total of three pathways were identified: chronic disease resources→activation→self-management (effect size=0.099, accounting for 18.07% of the total effect), chronic disease resources→empowerment→self-management (effect size=0.084, accounting for 15.33% of the total effect), and chronic disease resources→empowerment →activation→self-management (effect size=0.039, accounting for 7.11% of the total effect). Chronic disease resources also had a direct effect on self-management (effect size=0.326, accounting for 59.49% of the total effect) .Conclusions:The self-management level of elderly COPD patients urgently needs improvement. Nursing staff should focus on optimizing the allocation of chronic disease resources for elderly COPD patients, empowering them to stimulate activation and promote the improvement of their self-management abilities.