Knowledge graphs have been more popular in the medical industry in recent years due to the development of big data analysis technologies.Information reflecting a range of physiological markers of patients is gathered in laboratory medicine,which forms an essential basis for clinical decision-making.Knowledge graphs could uncover the hidden value in inspection and consequently furnish accurate inspection data.Knowledge graphs are currently used in laboratory medicine to forecast possible adverse drug responses,help with diagnosis,integrate historical trends of patient laboratory inspections,and identify correlations across detection projects.The interaction between inspection items,auxiliary diagnosis,and medication guidance are three angles from which the use of knowledge graphs in laboratory medicine is analyzed and evaluated.Further support the intelligent construction of clinical laboratory diagnosis,it is also suggested that the development of test medical knowledge graphs extend in the direction of semantic search,decision support,and intelligent question answer.

Objective To investigate the effects of Tongyangxiao(TYX)lotion on the healing of infected wounds and the expression of interleukin(IL)-1β and inhibitor of nuclear factor κBα(IκBα)/p65 in rats.Methods Fifty rats were randomly assigned to the model group,potassium permanganate(PP)group,and low-,medium-,and high-dose(TYX-L,TYX-M,TYX-H)groups,with 10 rats in each group.An open infection model of full-thickness skin defects was established,and the rats in each group were treated with the corresponding medicinal solution for dressing changes once a day for a total of 14 days.The wound healing of rats was observed,and immunofluorescence,immunohistochemistry,and Western blotting were used to detect the nuclear translocation rate of p65 and the expression levels of IL-1β,p-IκBα/IκBα,and p-p65/p65 proteins in the granulation tissue.Results Compared with the model group,the wound healing rates of both the TYX-M group and the TYX-H group increased on the 7th day of treatment(P<0.05).Compared with the model group and the PP group,the wound healing rates of the TYX-L group,the TYX-M group and the TYX-H group increased on the 14th day of treatment(P<0.05).On the 7th day of treatment,the expression of IL-1β in the TYX-M group was lower than that in the PP group and the Model group(P<0.05),and the p-IκBα/IκBα ratio in the TYX-H group was lower than that in the PP group and the model group(P<0.05).The nuclear translocation rates of p65 in the TYX-L group,TYX-M group and TYX-H group were lower than those in the PP group and model group(P<0.05).On the 14th day of treatment,the p-p65/p65 ratio in the TYX-H group and the TYX-M group was lower than that in the model group(P<0.05),and the IL-1β in the TYX-L group,the TYX-M group,and the TYX-H group and p-IκBα/IκBα ratio in the TYX-H group were lower than those in the PP group and the model group(P<0.05).Conclusion The mechanism of TYX lotion in promoting the healing of infected wounds was associated with the suppression of the activation of NF-κB signaling pathway and alleviation of inflammatory responses.

Glaesserella parasuis is the causative agent of Gl?sser's disease in pigs.However,the pathogenic mechanisms underlying its virulence is not yet fully understood.The RuvB protein,a member of the AAA+superfamily,is implicated in various cellular processes,yet its specific role in the virulence of Glaesserella parasuis has not been fully characterized.In this study,we con-structed a RuvB gene deletion mutant,designated ΔRuvB,using the serotype 13 Glaesserella pa-rasuis strain ZJ1208 and a suicide plasmid-mediated natural transformation approach.To elucidate the functional role of the RuvB gene,we comprehensively evaluated the biological characteristics of the ΔRuvB strain through a series of assays,including growth kinetics,colony morphology,bac-terial staining,transmission electron microscopy(TEM),osmotic stress tolerance,high-tempera-ture tolerance,heat shock resistance,UV resistance,capsular polysaccharide quantification,serum bactericidal assays,and murine virulence experiments.Our findings revealed that the growth rate of ΔRuvB showed no significant difference compared to the parental strain.TEM revealed a notable increase in bacterial cell length;however,the number of outer membrane vesicles(OMVs)on the surface of ΔRuvB did not significantly increase.Notably,the ΔRuvB strain displayed a significant reduction in capsular polysaccharide production and serum resistance,as well as diminished toler-ance to UV radiation and high temperatures.Significant alterations were observed in its resistance to osmotic stress or oxidative stress.In the mouse toxicity challenge experiment,in com-parison with the parental strain ZJ1208,the mortality rate dropped by 20 percentage points,suggesting that the virulence of ΔRuvB has been weakened to some extent.Collectively,these results underscore the critical role of the RuvB gene in enhancing the environmental adaptability of Glaesserella parasuis.

Objective To investigate the effects of Tongyangxiao(TYX)lotion on the healing of infected wounds and the expression of interleukin(IL)-1β and inhibitor of nuclear factor κBα(IκBα)/p65 in rats.Methods Fifty rats were randomly assigned to the model group,potassium permanganate(PP)group,and low-,medium-,and high-dose(TYX-L,TYX-M,TYX-H)groups,with 10 rats in each group.An open infection model of full-thickness skin defects was established,and the rats in each group were treated with the corresponding medicinal solution for dressing changes once a day for a total of 14 days.The wound healing of rats was observed,and immunofluorescence,immunohistochemistry,and Western blotting were used to detect the nuclear translocation rate of p65 and the expression levels of IL-1β,p-IκBα/IκBα,and p-p65/p65 proteins in the granulation tissue.Results Compared with the model group,the wound healing rates of both the TYX-M group and the TYX-H group increased on the 7th day of treatment(P<0.05).Compared with the model group and the PP group,the wound healing rates of the TYX-L group,the TYX-M group and the TYX-H group increased on the 14th day of treatment(P<0.05).On the 7th day of treatment,the expression of IL-1β in the TYX-M group was lower than that in the PP group and the Model group(P<0.05),and the p-IκBα/IκBα ratio in the TYX-H group was lower than that in the PP group and the model group(P<0.05).The nuclear translocation rates of p65 in the TYX-L group,TYX-M group and TYX-H group were lower than those in the PP group and model group(P<0.05).On the 14th day of treatment,the p-p65/p65 ratio in the TYX-H group and the TYX-M group was lower than that in the model group(P<0.05),and the IL-1β in the TYX-L group,the TYX-M group,and the TYX-H group and p-IκBα/IκBα ratio in the TYX-H group were lower than those in the PP group and the model group(P<0.05).Conclusion The mechanism of TYX lotion in promoting the healing of infected wounds was associated with the suppression of the activation of NF-κB signaling pathway and alleviation of inflammatory responses.

Glaesserella parasuis is the causative agent of Gl?sser's disease in pigs.However,the pathogenic mechanisms underlying its virulence is not yet fully understood.The RuvB protein,a member of the AAA+superfamily,is implicated in various cellular processes,yet its specific role in the virulence of Glaesserella parasuis has not been fully characterized.In this study,we con-structed a RuvB gene deletion mutant,designated ΔRuvB,using the serotype 13 Glaesserella pa-rasuis strain ZJ1208 and a suicide plasmid-mediated natural transformation approach.To elucidate the functional role of the RuvB gene,we comprehensively evaluated the biological characteristics of the ΔRuvB strain through a series of assays,including growth kinetics,colony morphology,bac-terial staining,transmission electron microscopy(TEM),osmotic stress tolerance,high-tempera-ture tolerance,heat shock resistance,UV resistance,capsular polysaccharide quantification,serum bactericidal assays,and murine virulence experiments.Our findings revealed that the growth rate of ΔRuvB showed no significant difference compared to the parental strain.TEM revealed a notable increase in bacterial cell length;however,the number of outer membrane vesicles(OMVs)on the surface of ΔRuvB did not significantly increase.Notably,the ΔRuvB strain displayed a significant reduction in capsular polysaccharide production and serum resistance,as well as diminished toler-ance to UV radiation and high temperatures.Significant alterations were observed in its resistance to osmotic stress or oxidative stress.In the mouse toxicity challenge experiment,in com-parison with the parental strain ZJ1208,the mortality rate dropped by 20 percentage points,suggesting that the virulence of ΔRuvB has been weakened to some extent.Collectively,these results underscore the critical role of the RuvB gene in enhancing the environmental adaptability of Glaesserella parasuis.

Knowledge graphs have been more popular in the medical industry in recent years due to the development of big data analysis technologies.Information reflecting a range of physiological markers of patients is gathered in laboratory medicine,which forms an essential basis for clinical decision-making.Knowledge graphs could uncover the hidden value in inspection and consequently furnish accurate inspection data.Knowledge graphs are currently used in laboratory medicine to forecast possible adverse drug responses,help with diagnosis,integrate historical trends of patient laboratory inspections,and identify correlations across detection projects.The interaction between inspection items,auxiliary diagnosis,and medication guidance are three angles from which the use of knowledge graphs in laboratory medicine is analyzed and evaluated.Further support the intelligent construction of clinical laboratory diagnosis,it is also suggested that the development of test medical knowledge graphs extend in the direction of semantic search,decision support,and intelligent question answer.

Objective To analyze the procurement data of lipid-lowering drugs in hospitals at different levels in Jiangsu Province from October 2019 to September 2023,to evaluate the impact of the volume-based procurement(VBP)policy,and to provide references for clinical rational drug use and healthcare policy optimization.Methods Based on procurement data from the Jiangsu Provincial Health Information Center,statistical analyses of procurement expenditures,defined daily doses(DDDs),and defined daily cost(DDC)were conducted.Mixed-effects models were applied to assess changes in procurement expenditures,DDDs,and DDC before and after VBP implementation.Results From 2019 to 2023,statins dominated the market in Jiangsu Province,with rosuvastatin recording the highest DDDs(748 million).Statins,traditional Chinese medicines,and cholesterol absorption inhibitors ranked highest in procurement expenditures.Tertiary hospitals accounted for the largest share of usage(47.6%)and expenditures(55.8%),while secondary hospitals had the lowest DDC(1.22 yuan)and tertiary hospitals the highest(1.89 yuan).Post-VBP,procurement expenditures and DDC decreased by 53.9%and 35.4%,respectively.Primary hospitals showed the largest expenditure reduction(61.6%),and secondary hospitals exhibited the greatest DDC decline(53.9%).DDDs increased significantly in primary care settings(e.g.,pitavastatin surged by 239.79%in secondary hospitals),while tertiary hospitals saw reduced usage of some drugs(e.g.,amlodipine/atorvastatin decreased by 7.34%).Mixed-effects models confirmed that VBP significantly reduced expenditures(OR=-1.07,P<0.01)and DDC(OR=-2.70,P<0.01)while indirectly lowering prices of non-VBP drugs.After covariate adjustment,expenditure reductions for rosuvastatin and atorvastatin narrowed,ezetimibe expenditures increased(OR=0.13,P<0.01),and pitavastatin usage declined(OR=-0.10,P<0.01).Changes in amlodipine/atorvastatin and ezetimibe lacked statistical significance due to short VBP implementation periods.Tertiary hospitals demonstrated the strictest policy adherence,with the largest expenditure and DDC reductions(P<0.01).Subgroup analysis revealed that the policy did not significantly affect clinical demand(DDDs)in hospitals at different levels,though it was considered to have triggered adjustments in medication structure.Conclusion Jiangsu's lipid-lowering drug structure aligns with guidelines(statin-based,moderate-intensity preference).VBP effectively reduced costs,with tertiary hospitals prioritizing originator-to-generic substitution and primary hospitals reflecting cost-control and demand variations.Confounding factors influenced policy evaluation.The study recommends continuous monitoring and policy optimization to enhance procurement efficiency,ensure rational clinical use,and sustain cost savings,providing insights for further healthcare reform.

Objective To analyze the procurement data of lipid-lowering drugs in hospitals at different levels in Jiangsu Province from October 2019 to September 2023,to evaluate the impact of the volume-based procurement(VBP)policy,and to provide references for clinical rational drug use and healthcare policy optimization.Methods Based on procurement data from the Jiangsu Provincial Health Information Center,statistical analyses of procurement expenditures,defined daily doses(DDDs),and defined daily cost(DDC)were conducted.Mixed-effects models were applied to assess changes in procurement expenditures,DDDs,and DDC before and after VBP implementation.Results From 2019 to 2023,statins dominated the market in Jiangsu Province,with rosuvastatin recording the highest DDDs(748 million).Statins,traditional Chinese medicines,and cholesterol absorption inhibitors ranked highest in procurement expenditures.Tertiary hospitals accounted for the largest share of usage(47.6%)and expenditures(55.8%),while secondary hospitals had the lowest DDC(1.22 yuan)and tertiary hospitals the highest(1.89 yuan).Post-VBP,procurement expenditures and DDC decreased by 53.9%and 35.4%,respectively.Primary hospitals showed the largest expenditure reduction(61.6%),and secondary hospitals exhibited the greatest DDC decline(53.9%).DDDs increased significantly in primary care settings(e.g.,pitavastatin surged by 239.79%in secondary hospitals),while tertiary hospitals saw reduced usage of some drugs(e.g.,amlodipine/atorvastatin decreased by 7.34%).Mixed-effects models confirmed that VBP significantly reduced expenditures(OR=-1.07,P<0.01)and DDC(OR=-2.70,P<0.01)while indirectly lowering prices of non-VBP drugs.After covariate adjustment,expenditure reductions for rosuvastatin and atorvastatin narrowed,ezetimibe expenditures increased(OR=0.13,P<0.01),and pitavastatin usage declined(OR=-0.10,P<0.01).Changes in amlodipine/atorvastatin and ezetimibe lacked statistical significance due to short VBP implementation periods.Tertiary hospitals demonstrated the strictest policy adherence,with the largest expenditure and DDC reductions(P<0.01).Subgroup analysis revealed that the policy did not significantly affect clinical demand(DDDs)in hospitals at different levels,though it was considered to have triggered adjustments in medication structure.Conclusion Jiangsu's lipid-lowering drug structure aligns with guidelines(statin-based,moderate-intensity preference).VBP effectively reduced costs,with tertiary hospitals prioritizing originator-to-generic substitution and primary hospitals reflecting cost-control and demand variations.Confounding factors influenced policy evaluation.The study recommends continuous monitoring and policy optimization to enhance procurement efficiency,ensure rational clinical use,and sustain cost savings,providing insights for further healthcare reform.

Steroid-induced osteonecrosis of the femoral head （SONFH） is a severe musculoskeletal disorder often induced by the prolonged or excessive use of glucocorticoids. Characterized by ischemia of bone cells， necrosis， and trabecular fractures， SONFH is accompanied by pain， femoral head collapse， and joint dysfunction， which can lead to disability in severe cases. The pathogenesis of SONFH involves hormone-induced osteoblast apoptosis， bone microvascular endothelial cell （BMEC） apoptosis， oxidative stress， and inflammatory responses. The phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway plays a pivotal role in the development of the disease. Modulating the PI3K/Akt signaling pathway can promote Akt phosphorylation， thereby stimulating the osteogenic differentiation of bone marrow mesenchymal stem cells and osteoblasts， promoting angiogenesis in BMECs， and inhibiting osteoclastogenesis. The research on the treatment of SONFH with traditional Chinese medicine （TCM） has gained increasing attention. Recent studies have shown that TCM monomers and compounds have potential therapeutic effect on SONFH by intervening in the PI3K/Akt signaling pathway. These studies not only provide a scientific basis for the application of TCM in the treatment of SONFH but also offer new ideas for the development of new therapeutic strategies. This review summarized the progress in Chinese and international research on the PI3K/Akt signaling pathway in SONFH over the past five years. It involved the composition and transmission mechanisms of the signaling pathway， as well as its regulatory effects on osteoblasts， mesenchymal stem cells， osteoclasts， BMECs， and other cells. Additionally， the review explored the TCM understanding of SONFH and the application of TCM monomers and compounds in the intervention of the PI3K/Akt pathway. By systematically analyzing and organizing these research findings， this article aimed to provide references and point out directions for the clinical prevention and treatment of SONFH and promote further development of TCM in this field. With in-depth research on the PI3K/Akt pathway and the modern application of TCM， it is expected to bring safer and more effective treatment options for patients with SONFH.

The reliability and practicality of research findings in health economics are gradually becoming core issues of close concern for clinical and public health experts. As healthcare resources remain under increasing pressure, conducting efficient cost-effectiveness analyses and achieving rational resource allocation are becoming ever more critical. In recent years, medical laboratory health economics has transitioned from purely academic discussions to integration into clinical practice, becoming a key tool for improving the efficiency and quality of healthcare services. It has demonstrated remarkable results in optimizing patient management and medical decision-making processes. So we invited experts from the fields of medical laboratory science and health economics to share valuable experiences and unique insights on topics such as cost assessment methods, pricing strategies, quality regulation, and the role of medical laboratory health economics in enhancing clinical practice and patient benefits. These experts generally agree that, while research in medical laboratory health economics has shown significant advantages and effectively addressed urgent clinical needs in resource allocation and cost control, it still faces multiple challenges, including limitations in research methodology application, high operational costs, and insufficient standardization of management systems.