OBJECTIVE To evaluate the cost-effectiveness of cefiderocol versus best available therapy （BAT） or standard-of- care （SOC） for the treatment of confirmed or suspected carbapenem-resistant Gram-negative bacterial （CRGNB） serious infections from the perspective of the Chinese healthcare system， and to explore its reasonable pricing. METHODS A decision tree model was constructed based on data from two phase Ⅲ clinical trials （CREDIBLE-CR and GAME CHANGER） to simulate the cost- effectiveness of cefiderocol in two scenarios： salvage therapy for confirmed CRGNB infection （scenario 1） and empirical therapy for suspected CRGNB infection （scenario 2）. The primary outcome measure was the incremental cost-effectiveness ratio （ICER）. The willingness-to-pay （WTP） was set at 1 to 3 times China’s per capita GDP in 2024. To verify the robustness of the results， one- way and probabilistic sensitivity analyses were conducted， and based on these， a reasonable price range for cefiderocol in the Chinese market was explored. RESULTS The results for scenario 1 showed that the clinical cure rate in the cefiderocol group was higher than that in the BAT group （47.50% vs. 34.21%）， but its ICER was 415 065.03 yuan per cured case， exceeding three times China’s GDP per capita. Scenario 2 revealed that the ICER for cefiderocol relative to SOC was as high as 1 362 446.16 yuan per cured case， far exceeding the WTP. Sensitivity analysis indicated that the treatment duration and price of cefiderocol were key factors affecting its cost-effectiveness. In the two scenarios described above， the unit price of cefiderocol must fall below 683.47 and 242.00 yuan/g， respectively， to be considered cost-effective. CONCLUSIONS Based on the current market price， cefiderocol lacks sufficient cost-effectiveness for treating confirmed or suspected CRGNB serious infections within China’s healthcare system. To improve its accessibility， price negotiations or a tiered medical insurance payment strategy are required.

Objectives: Hypoparathyroidism (HP) is a rare endocrine disorder caused by parathyroid hormone (PTH) defi ciency. The PTH is a candidate gene for familial isolated hypoparathyroidism (FIH). This study aimed to investigate the pathogenicity of two novel rare variants (RVs) ofPTH through in vitro functional study. Methods: Targeted next-generation sequencing was used to identify candidate gene mutations. Clinical data were retrospectively collected. Wild-type (WT) PTH was used as a template for site-directed mutagenesis to create mutant eukaryotic expression plasmids, which were transfected into cells. Treated with or without 4-phenylbu tyric acid (4-PBA), the levels of intact PTH (iPTH) and PTH (1-84) were measured by chemiluminescence, and protein expression was assessed using Western blotting. Results: Two patients carrying PTH mutations (c.154G > A: p.Val52Ile, c.270G > T: p.Leu90Phe) were identified.Patient 1, a 45-year-old male, presented with carpal and pedal numbness, muscle cramps, and low serum calcium (1.29 mmol/L). Patient 2, a 12-year-old female, had muscle twitches, convulsions, low calcium (1.50 mmol/L), and iPTH of 4 pg/mL. The iPTH or PTH (1-84) levels in the medium transfected with mutant Val52Ile and Leu90Phe PTH decreased by 31%–38%, and 51%–96% compared to WT (allP < 0.05), which were not rescued by 4-PBA. No significant changes in intracellular PTH expression were observed. Conclusions In this study, two novel RVs of PTH(Val52Ile and Leu90Phe) were identified that may impair hormone synthesis and secretion. Our study has broadened the mutation spectrum of the PTH and shed light on potential mechanisms underlying FIH.

Objective To investigate the therapeutic effect and underlying mechanism of action of a CXCR3 inhibitor in rheumatoid arthritis(RA)in mice model.Methods Thirty BALB/C mice were randomly divided into control,model,and treatment groups.RA model was established in both the model and treatment groups using a collagen induction method.Upon successful modeling,mice in the treat-ment group received a daily oral administration of 1 mg/kg SCH 546738(CXCR3 inhibitor)for 4 weeks,whereas those in the control and model groups received equivalent volumes of saline.During treatment,the weekly arthritis index scores of mice were recorded.The expres-sion of TNF-α,IFN-γ,and IL-1β in joint tissues was determined based on Western blotting and qRT-PCR analyses.In addition,we used flow cytometry to assess peripheral blood Th1/Th2 cell ratios,and serum levels of IFN-γ and IL-4 were measured using ELISA.Peripheral blood CD4+T cells were isolated and co-incubated with SCH 546738,and subsequently assessed as CD4+T and CD4+T+SCH 546738 groups.In addition,Th1/Th2 cell ratios were assessed using flow cytometry.Results Compared with the control group,mice in the model group were characterized by elevated weekly arthritic index scores,increases in the joint tissues expression of TNF-α,IFN-γ,and IL-1β,heightened peripheral blood Th1/Th2 cell ratios,and raised serum IFN-γ levels(P＜0.05).In contrast to the model group,the treatment group mice had lower weekly arthritis index scores,reductions in the joint tissue expression of TNF-α,IFN-γ,and IL-1β,diminished peripheral blood Th1/Th2 cell ratios,and lowered serum IFN-γ levels(P＜0.05).Moreover,compared with the CD4+T group,the CD4+T+SCH 546738 group was characterized reduced Th1/Th2 cell ratios(P＜0.001).Conclusion The CXCR3 inhibitor SCH 546738 can alle-viate the progression of RA in mice by reducing Th1/Th2 cell ratios,thereby ameliorating the immune response.

The mixed samples of sperm and epithelial cells have long posed a technical challenge in forensic identification due to complex examination process,limited separation efficacy,and intricate result interpretation.To address this issue,it is beneficial to optimize the characterization of sperm cell-specific aptamer parameters using techniques such as molecular docking,high-throughput sequencing,and other molecular biology and chemical cross-fusion approaches.This will aid in enriching and separating single-source STR typing of sperm cells.This review examines,the development status,advantages and existing problems of aptamer technology,while exploring its potential application in forensic identification of spermatogenic mixed spot.The goal is to provide a new research idea for the detection and identification of mixed DNA samples,and also provide a basis for the evidentialization of the interpretation of mixed sample results,so as to promote the maximization of litigation benefits of scientific detection and identification results.

Objective:To measure the length and width of maxillary nodules in patients with different bony malocclusions in Uyghurs and to investigate the limits of distal displacement of maxillary molars in patients with different bony malocclusions in Uyghurs.Methods:60 adult Uyghur patients with bony Class Ⅰ(n=21),Class Ⅱ(n=21),and Class Ⅲ(n=18)malocclusion with 120 lateral maxillary tubercle CBCT images were analyzed,and the length(L:left,R:right)and width(W)of the maxillary tubercle area at different locations were measured on the designated sagittal and axial sections.The length and width of maxillary tuberosities in patients with different bony malocclusion were analyzed using SPSS 26.0 software,and the data were compared among the 3 groups.Results:The length and width of maxillary nodules in Uyghur patients with skeletal type Ⅲ were significantly smaller than those in the other 2 groups at measurement levels of 3.0,6.0 and 9.0 mm from the cemento-enamel junction of the maxillary second molar towards the root apex(L3,L6,L9),W6 and W9(P＜0.05).No significant difference was seen between the length and width of the maxillary tuberosity in osseous category Ⅰ and osseous category Ⅱ subjects.The widest maxillary nodule was loca-ted at the W3 level(12.52±2.07)mm and the narrowest at the W9 level(6.73±3.35)mm.The longest maxillary nodule was loca-ted at the L9 level(8.64±2.70)mm and the shortest at the L3 level(7.62±2.15)mm.Conclusion:The length and width of the maxillary tubercle in Uyghur patients with bony Class Ⅲ malocclusion are smaller than those of bony Class Ⅰ and bony Class Ⅱ.When pushing the distal displacement of maxillary molars,attention should be focused on the anatomical morphology of the maxillary tubercle to determine the limits of distal displacement of the maxillary dentition.

Objective:To analyze the coupling coordination relationship and spatial correlation among the service demand,resource allocation and utilization efficiency of Traditional Chinese Medicine(TCM),aiming to provide theoretical support and optimization strategies for achieving the coordinated operation of the TCM systems in various provinces and promoting the coordinated development of TCM in different provinces.Methods:The data were collected from the China Health and Family Planning Statistical Yearbook(2013-2017)and the China Health Statistics Yearbook(2018-2023),the entropy method was employed to determine the weight of each evaluation index within the subsystems.A coupling coordination degree model and spatial econometric model were applied to assess the coupling coordination values and spatial correlations of the TCM system across various provinces in China.Results:In 2022,the national average coupling coordination degree was 0.603,with values of 0.648,0.577,and 0.563 for the eastern,central,and western regions,respectively.The western region had the highest number of provinces classified as"disordered type".A spatial clustering effect of the coupling coordination degree across 30 provinces.Conclusions:While the allocation of TCM resources has shown steady improvement,the demand for TCM services and utilization efficiency have exhibited a declining trend.The coupling coordination degree follows a decreasing gradient from east to west and exhibits significant spatial effects,a regional collaborative development mechanism for TCM should be established.

Objective:To systematically evaluate the efficacy and safety of intravenous thrombolysis with tenecteplase (TNK) in acute ischemic stroke (AIS) across different time windows.Methods:Randomized controlled trials investigating TNK in AIS were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases, with data collected up to May 2025. Experimental group received intravenous thrombolysis with 0.25 mg/kg TNK, either alone or in combination with mechanical thrombectomy (MT). Control group received alteplase, placebo, standard medication (containing butylphthalide), MT, or above-mentioned drugs combined with MT. These patients were within 4.5 hours of onset (within-time window) or within 4.5-24 hours of onset (extended-time window). Efficacy indexes included functional outcome excellent rate (modified Rankin scale [mRS] score of 0-1 at 3 months after treatment), early neurological improvement rate (National Institutes of Health Stroke Scale [NIHSS] score improvement≥4 or NIHSS score ranged 0-1 within 72 of treatment), and recanalization rate 24 h after treatment. Safety indexes comprised symptomatic intracranial hemorrhage (sICH) rate within 48 h of treatment, and mortality rate and rate of serious adverse events (SAEs) within 90 d of treatment. Quality of the trials was assessed according to Cochrane handbook for systematic reviews of interventions (version 5.1). Meta-analysis was conducted using Stata software, with pooling data as risk difference ( RD). Results:Sixteen articles (11 were within-time window ones, and 5 were extended-time window ones), involving 9,430 AIS patients, were included. Quality grade of these articles is B-level. (1) In articles of within-time window: the experimental group had a significantly higher functional outcome excellent rate compared with the control group ( RD=0.031, 95% CI: 0.009-0.052, P=0.005); no significant difference was observed in early neurological improvement rate ( RD=0.016, 95% CI: -0.012-0.043, P=0.260), recanalization rate ( RD=0.040, 95% CI: 0.000-0.081, P=0.053), sICH rate ( RD=0.005, 95% CI: -0.002-0.012, P=0.198), mortality rate ( RD=0.000, 95% CI: -0.012-0.013, P=0.950), or SAE rate ( RD=0.003, 95% CI: -0.028-0.033, P=0.870) between the two groups. (2) In articles of extended-time window: the experimental group exhibited significantly higher functional outcome excellent rate ( RD=0.064, 95% CI: 0.016-0.113, P=0.009), early neurological improvement rate ( RD=0.101, 95% CI: 0.023-0.180, P=0.012), and recanalization rate ( RD=0.131, 95% CI: 0.059-0.203, P<0.001) compared with the control group; no significant difference was found in sICH rate ( RD=0.014, 95% CI: -0.003-0.032, P=0.097), mortality rate ( RD=0.006, 95% CI: -0.030-0.041, P=0.752), or SAE rate ( RD=0.030, 95% CI: -0.037-0.097, P=0.385) between the two groups. Conclusion:Intravenous thrombolysis with TNK is safe and effective in AIS patients at both within-time window and extended-time window.

Objective:To understand the usage situation of e-cigarettes among residents aged 18-65 in Beijing, explore the relationship between e-cigarette use and cigarette smoking as well as smoking cessation behaviors, and provide scientific support for the developing and improving policies and measures related to e-cigarettes.Methods:Using 19 684 residents data from the Beijing Non-communication Chronic Disease and Risk Factors Surveillance in 2022, complex sampling weighted methods were used to estimate proportions, and complex sampling logistic regression analysis was applied to explore the relationship between e-cigarette use, cigarette smoking, and smoking cessation.Results:Among all study participants, the proportion of those who had ever used e-cigarettes was 3.36%, with the current e-cigarette use at 1.26%. The proportion of current e-cigarette users (1.87%) and the former e-cigarette users (3.47%) were higher ( χ2=64.70, P<0.001) among males compared to females (0.60% and 0.64% respectively). The top three reasons for using e-cigarettes were wanting to quit smoking, perceiving e-cigarettes as less harmful, and enjoying the flavors of e-cigarettes. 83.54% of e-cigarette users started with cigarettes. The results of the complex sampling multivariable logistic regression analysis showed that current smoking ( OR=61.35, 95% CI: 36.98-101.76) and former smoking ( OR=31.20, 95% CI: 15.52-62.71) were positively associated with e-cigarette, while current e-cigarette use ( OR=0.13, 95% CI: 0.04-0.39) was negatively associated with quitting cigarette smoking. Conclusions:The proportion of e-cigarette use in Beijing was relatively low. E-cigarette use was associated with cigarette use and was not conducive to smoking cessation. Therefore, stronger regulatory measures and health education campaigns regarding the risks of e-cigarettes should be implemented.

Objective:To investigate the efficacy of the ABC-X model-based nursing in patients with vitiligo undergoing autologous cell-spray grafting of non-cultured epidermal cells (Recell technique) .Methods:A total of 84 vitiligo patients treated with ReCell technique admitted to the Department of Dermatology of the First Affiliated Hospital of Zhengzhou University from February 2022 to February 2024 were selected for the study using the convenience sampling method. The patients were divided into observation group (42 cases) and control group (42 cases) according to randomized numerical table method. Control group received conventional nursing, and observation group was treated with ABC-X model-based nursing on the basis of control group. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Trait Coping Style Questionnaire (TCSQ), and Dermatology Life Quality Index (DLQI) scores were compared between the two groups before and after the intervention.Results:After the intervention, the SAS and SDS scores of observation group were lower than those of control group, and the differences were statistically significant (all P<0.05). After the intervention, the positive coping score in TCSQ of observation group was higher than that of control group, and the negative coping score was lower than that of control group, and the differences were all statistically significant (all P<0.05). After the intervention, the total DLQI score of observation group was lower than that of control group, and the difference was statistically significant ( P<0.05) . Conclusions:The nursing based on ABC-X model in vitiligo patients treated with ReCell technique can improve patients' psychological conditions, promote positive coping, and enhance the quality of life, which is worthy of popularization and application.

Objective:To study the morphological characteristics and ethnic differences of the chin soft and hard tissue of Han and Uyghur adult females of class Ⅱ 1.Methods:90 Uyghur and Han female subjects of class Ⅱ 1 aged 18-35 years old were enrolled and respectively divided into 3 groups according to the vertical skeletal types:high,average and low angle groups(n=30).The various indexes of the chin soft and hard tissue of the subjects were measured by X-ray lateral cephalic radiographs.The data were statisti-caly analyzed.Results:(1)The Po-Pos of the Han subjects with high angle was higher than that of those with low and average an-gle;the minimum chin thickness,the ratio of the chin thickness to the chin height,the ratio of the minimum chin thickness to the chin thickness and the angle of chin in the high angle group were smaller than those in the average angle group and the low angle group(P＜0.05).The chin height,the chin depression and the cervical-mandibular angle of the Uyghur subjects with high angle were higher than those of the Uyghur subjects with low angle and average angle;the minimum chin thickness,the ratio of the chin thickness to the chin height and the ratio of the minimum chin thickness to the chin thickness in the high angle group were smaller than those in the average and the low angle groups(P＜0.05).(2)In the low angle group,there were significant differences in the angle of chin,cervical-mandibular angle,soft tissue chin angle and Me-Mes between the 2 ethnic groups(P＜0.05).In the average angle group,there were significant differences in the height of chin,LI-LL and Me-Mes between the 2 ethnic groups(P＜0.05).In the high angle group,there were significant differences in the ratio of anterior to posterior chin thickness,in the angle of chin,LL-Pos and Po-Pos between the 2 ethnic groups(P＜0.05).(3)The positive correlation between FH/MP and Po-Pos,cervical-mandib-ular angle,chin depression,chin lip angle,chin height,ratio of anterior and posterior chin thickness and LL-Pos were found in Han and Uyghur subjects(P＜0.05).Mentolabial sulcus,the chin thickness,the ratio of the chin thickness to the chin height,the angle of chin and the ratio of the minimum chin thickness to the chin thickness were negatively correlated with FH/MP in both ethnic groups(P＜0.05).Conclusion:Han and Uy-ghur adult females of class Ⅱ 1 have different chin soft and hard tissue morphology in different vertical skeletal types with certain differences between the ethnic groups in the same vertical skeletal types,and there is a correlation between the chin soft and hard tis-sue morphology of different vertical skeletal types and the vertical skeletal types in Han and Uyghur adult females of class Ⅱ 1.