To analyze inpatient mortality cases in a tertiary general hospital in Beijing based on diagnosis-related groups (DRG), with the aim of providing references for healthcare quality management.

Objective To explore the anti-intestinal fibrosis mechanism of Dahuang Zhechong pill.Methods Based on the network pharmacology method,the traditional Chinese medicine systems pharmacology database and analysis platform,SwissTargetPrediction database and metabolomics technology was used.OmicsNet 2.0 platform combined with the findings of network pharmacology and metabolomics,and molecular simulation docking and molecular biology methods were used to study the mechanism of anti-intestinal fibrosis of Dahuang Zhechong pill.Results Dahuang Zhechong pill contains 142 potential active ingredients and 855 anti-intestinal fibrosis targets.The 10 core ingredients(quercetin,acacetin,oroxylin a,kaempferol,moslosooflavone,panicolin,etc.)may play a role in regulating lipid metabolism and atherosclerosis,EGFR tyrosine kinase inhibitor resistance,HIF-1 signaling pathway,TNF signaling pathway and IL-17 signaling pathway.Metabolomics results showed that 59 endogenous substances(oxaloacetic acid,ethylthioisonicamide,6-benzylaminopurine,tyrosine and cortisol,etc.)may be the key metabolites of this drug against intestinal fibrosis.Central carbon metabolism,TCA cycle and amino acid metabolism were the key mechanisms,EGFR,AKT1,MAPK1,PTPN11,CASP3,PPARG,MET and PDGFRB may be the core targets.Dahuang Zhechong pill could significantly improve the levels of colorectal edema,inflammatory factors,inflammatory cell infiltration,collagen fiber deposition and α-SMA expression in mice with intestinal fibrosis,reduce the expression levels of pro-inflammatory factors IL-17 and IL-23 in serum,and increase the level of anti-inflammatory factor IL-10.Molecular dynamics simulations demonstrated stable conformational binding between core active ingredients and key targets.Conclusion Dahuang Zhechong pill may regulate EGFR/AKT1/MAPK mediated metabolism-inflammation interaction network through flavonoid components,and can improve intestinal fibrosis in multiple dimensions through molecular validation.

The health of women and children serves as the cornerstone of comprehensive public health and represents a crucial barometer for measuring social progress and civilization. It directly impacts family well-being and social harmony. As a national-level guidance center for complex disease diagnosis and treatment, Beijing's critical maternal care center, and the designated consultation hospital for pregnancy complicated by rheumatic immune and endocrine disorders, Peking Union Medical College Hospital bears significant responsibilities in managing complex medical cases and implementing counterpart assistance programs. Confronted with diverse and complicated maternal sources, particularly emergency cases lacking standardized prenatal care, the hospital has established a multi-tiered, whole-process, and comprehensive maternal-infant safety management system. Through implementing high-risk maternal management protocols, optimizing critical care procedures, promoting informatization development, and enhancing multidisciplinary collaboration, Peking Union Medical College Hospital has substantially improved the efficiency of critical maternal care and maternal-infant safety assurance. This paper systematically summarizes the institutional development experience in maternal management and explores potential optimization approaches, aiming to provide valuable references for enhancing maternal-infant safety management systems in domestic healthcare institutions.

Objective To explore the anti-intestinal fibrosis mechanism of Dahuang Zhechong pill.Methods Based on the network pharmacology method,the traditional Chinese medicine systems pharmacology database and analysis platform,SwissTargetPrediction database and metabolomics technology was used.OmicsNet 2.0 platform combined with the findings of network pharmacology and metabolomics,and molecular simulation docking and molecular biology methods were used to study the mechanism of anti-intestinal fibrosis of Dahuang Zhechong pill.Results Dahuang Zhechong pill contains 142 potential active ingredients and 855 anti-intestinal fibrosis targets.The 10 core ingredients(quercetin,acacetin,oroxylin a,kaempferol,moslosooflavone,panicolin,etc.)may play a role in regulating lipid metabolism and atherosclerosis,EGFR tyrosine kinase inhibitor resistance,HIF-1 signaling pathway,TNF signaling pathway and IL-17 signaling pathway.Metabolomics results showed that 59 endogenous substances(oxaloacetic acid,ethylthioisonicamide,6-benzylaminopurine,tyrosine and cortisol,etc.)may be the key metabolites of this drug against intestinal fibrosis.Central carbon metabolism,TCA cycle and amino acid metabolism were the key mechanisms,EGFR,AKT1,MAPK1,PTPN11,CASP3,PPARG,MET and PDGFRB may be the core targets.Dahuang Zhechong pill could significantly improve the levels of colorectal edema,inflammatory factors,inflammatory cell infiltration,collagen fiber deposition and α-SMA expression in mice with intestinal fibrosis,reduce the expression levels of pro-inflammatory factors IL-17 and IL-23 in serum,and increase the level of anti-inflammatory factor IL-10.Molecular dynamics simulations demonstrated stable conformational binding between core active ingredients and key targets.Conclusion Dahuang Zhechong pill may regulate EGFR/AKT1/MAPK mediated metabolism-inflammation interaction network through flavonoid components,and can improve intestinal fibrosis in multiple dimensions through molecular validation.

Objective:To investigate the relationship between gestational weight gain (GWG) in twin pregnancies and adverse perinatal outcomes.Methods:This retrospective study included twin pregnant women with live births at≥25 weeks of gestation and their offspring, who delivered at Peking University People's Hospital from January 2012 to October 2022. Total GWG was standardized according to gestational age and categorized into three groups based on the 2009 Institute of Medicine (IOM) guidelines: insufficient GWG (GWG below IOM recommendations), appropriate GWG (GWG within IOM recommendations), and excessive GWG (GWG above IOM recommendations). Comparisons between data of the three groups used analysis of variance, Kruskal-Wallis test or Bonferroni correction or Chi-square partitions. Multivariable logistic regression models and generalized estimating equations with logistic regression models were used to analyze the independent effects of GWG on maternal and neonatal outcomes. Results:A total of 794 twin pregnant women and their 1 588 live-born neonates were included in the study. There were 360 women (45.3%) with appropriate GWG, 356 (44.8%) with insufficient GWG, and 78 (9.8%) with excessive GWG. Both insufficient and excessive GWG were associated with an increased risk of preterm birth [adjusted ORs of 1.39 (95% CI: 1.04-1.88) and 1.70 (95% CI: 1.05-2.78), respectively]. Insufficient GWG was associated with an increased risk of gestational diabetes mellitus (adjusted OR=1.42, 95% CI: 1.00-2.01) and low birth weight infants (adjusted OR=2.04, 95% CI: 1.57-2.66). Insufficient GWG was also associated with a reduced risk of eclampsia or preeclampsia (adjusted OR=0.50, 95% CI: 0.33-0.75), cesarean section (adjusted OR=0.48, 95% CI: 0.30-0.77), discordant twin growth (adjusted OR=0.56, 95% CI: 0.37-0.85), and large for gestational age infants (adjusted OR=0.46, 95% CI: 0.35-0.61). Excessive GWG was associated with an increased risk of eclampsia or preeclampsia (adjusted OR=2.85, 95% CI: 1.65-4.91), and large for gestational age infants (adjusted OR=2.49, 95% CI: 1.60-3.86), while with a decreased risk of low birth weight infants (adjusted OR=0.42, 95% CI: 0.27-0.65). Conclusions:More than half of the twin pregnancies have GWG outside the recommended range of the IOM guidelines. Both insufficient and excessive GWG are associated with adverse perinatal outcomes, particularly an increased risk of preterm birth.

Purpose/Significance To expound the development status,difficulties and challenges of smart hospital in China,so as to pro-vide references for the subsequent related research.Method/Process By using the methods of bibliometrics and literature review,the definition of smart hospital is summarized and feasible suggestions on the construction of smart hospital are put forward.Result/Conclusion Smart hospital in China has initially established a"trinity"structural framework of smart healthcare,smart service and smart management,playing a positive role in improving patient satisfaction and promoting high-quality development of hospitals.It is necessary for the government,hospitals,social capital and other multi-party cooperation to jointly promote the construction of smart hospital in China and better protect people's health.

Objective:To analyze the influencing factors related to the prognosis of delayed replantation of avulsed permanent teeth.Methods:A retrospective study was conducted on the clinical data of 35 patients with 38 affected teeth underwent delayed replantation of permanent teeth.According to the prognosis after 12 to 108 months of follow-up,the replantation results of the cases were divided into-success,survival and failure groups.Survival curves were plotted using Kaplan-Meier method,Log-Rank test was used for univariate analysis,and Cox proportional risk regression models were used for multivariate analysis to assess the effects of gender,age,degree of tooth development,mode of tooth preservation and mode of endodontic treatment on the survival rate of replanted teeth.Results:Of the 38 replanted teeth,3 were successful,28 remained and 10 failed.The 9-year cumulative survival rate of the replanted teeth was 34.7％.The results showed that there were no statistically significant differences in the survival rate of the replanted teeth in the groups with different sex,age,degree of tooth development and the mode of preservation of avulsed teeth(P＞0.05).There were statistically significant differences in the cumulative survival rate of the replanted teeth among the groups with different endodontic treatment(P＜0.01),which showed that the cumulative survival rate in the root canal filling group＞continuous root canal sealing group＞pulp preserva-tion treatment group.Conclusion:For the delayed replantation of avulsed premanent teeth,survival prognosis of the teeth treated with pulp preservation is poor,early pulp extraction and root canal filling are recommended.

Objective:To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants.Methods:This study was based on data from a subcohort of a study called ge-netic susceptibility to cow's milk allergy in Chinese children,including infants born in Peking University People's Hospital between March 1,2020,and December 31,2020.The infants were divided into a cow's milk protein allergy(CMPA)group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year.We retrospectively collected the clinical data of infants and their mothers before and during pregnancy,and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants.Results:A total of 278 infants were enrolled in this study,including 52 infants with CMPA and 226 infants without CMPA.Among them,there were 143 boys and 135 girls.The proportion of male infants in the CMPA group(69.2％)was higher than that in the control group(47.3％),and the difference was statistically significant(P=0.004).There were no significant differences in the distribution of birth weight,gestational age at birth,low-birth-weight in-fants,premature,umbilical cord entangle neck,and neonatal asphyxia between the CMPA group and the control group(P＞0.05).The proportion of mothers complicated with autoimmune diseases,anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group,and there were statistical differences between the two groups(P＜0.05).There was no significant difference in the distribution of other pregnancy complications between the two groups(P＞0.05),such as eclamp-sia/preeclampsia,chronic hypertension/gestational hypertension,diabetes/gestational diabetes,thyroid diseases,and so on.There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group(P＞0.05).Multivariate Lo-gistic regression analysis showed that male infant,mothers complicated with autoimmune diseases or ane-mia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.Conclusion:Male infant,mothers complicated with autoimmune diseases or anemia,antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.

As a practical carrier for promoting the tiered diagnosis and treatment model, the medical consor-tium is of great significance for balancing medical resources and boosting medical service efficiency. The construction of medical consortiums not only improves the accessibility of high-quality medical resources for patients, but also enhances the diagnostic and treatment level of member units. Meanwhile, it provides space for the leading hospital to adjust the structure of diseases and improve the level of discipline construction. As the core of medical insurance payment reform, DRG, through indicators such as the case mix index(CMI) and the number of diagnosis related group (DRG), provides objective and quantified data support for case management and disease structure optimization, thus effectively guiding the rational allocation of medical resources and the adjustmentof diseases and surgical types within the medical consortium. Comprehensive use of DRG evaluation indicators can construct a multidimensional medical consortium construction evaluation system, provides a clear direction for medical consortium cooperation, thereby promoting the overall healthy and sustainable development of medical consortiums and achieving a win-win situation for all parties involved. This paper, based on the "1+5+1" medical consortium cooperation model centered around Peking Union Medical College Hospital, utilizes DRG indicators to analyze the benefits for patients, member hospitals, and the leading hospital during the medical consortium construction process, with the hope of providing reference for the construction of a medical consortium evaluation system.

To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources.