ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Neonatal diabetes mellitus （NDM） is a rare monogenic disorder primarily caused by insufficient insulin secretion resulting from mutations in the KCNJ11 and ABCC8 genes. Sulfonylureas， represented by glibenclamide， have become the standard therapy for this type of NDM by precisely closing the mutated ATP-sensitive potassium channels in pancreatic β cells， thereby restoring insulin secretion. Clinical studies confirm that sulfonylureas enable over 90% of patients to successfully transition from insulin to oral treatment， achieving long-term stable glycemic control and improving neurological outcomes to a certain extent. In terms of safety， severe hypoglycemia induced by sulfonylureas is relatively rare and gastrointestinal reactions are mild； moreover， sulfonylureas show good long-term tolerability， and have no adverse effects on child growth and development. In the future， by further refining the full-chain management pathway of “rapid genetic diagnosis-early intervention-specialized dosage forms-long-term follow-up”， the clinical application of sulfonylureas is expected to provide NDM patients with an optimized treatment regimen and maximize their health benefits.

AIM To prepare anisamide-modified ursolic acid self-assembled nanoparticles,and to evaluate their anti-drug resistance effect of enzalutamide on prostate cancer.METHODS Nanoparticle precipitation method was adopted in the preparation of anisamide-modified and non-anisamide-modified self-assembled nanoparticles,respectively,after which the particle size,Zeta potential and encapsulation efficiency were determined,and the morphology was observed under transmission electron microscope.The intake of cancer-associated fibroblasts(CAFs)was investigated,after which the model for enzalutamide resistance in prostate cancer was established,CCK8 assay was applied to analyzing the sensitization effect of self-assembled nanoparticles on enzalutamide,and Western blot was used for the detection of NRG1,HER3,AKT expressions.RESULTS The anisamide-modified self-assembled nanoparticles demonstrated the average particle size,Zeta potential and encapsulation efficiency of(195.13±8.06)nm,(-29.07±0.55)mV and(94.58±0.84)％,respectively.CAFs displayed higher intake in the anisamide-modified self-assembled nanoparticles than that in the non-modified preparation and free Cy5(P＜0.05).Meanwhile,anisamide-modified self-assembled nanoparticles were able to inhibit enzalutamide resistance caused by CAFs,reduce NRG1 expression on CAFs,and anisamide-modified self-assembled nanoparticles-treated conditioned medium of CAFs could reduce HER3 and AKT expression on LNCaP cells(P＜0.05,P＜0.01).CONCLUSION Anisamide-modified ursolic acid self-assembled nanoparticles can enhance the targeting of CAFs,alleviate the drug resistance effect of enzalutamide on prostate cancer caused by CAFs,and reduce NRG1 expression in CAFs.

AIM To prepare anisamide-modified ursolic acid self-assembled nanoparticles,and to evaluate their anti-drug resistance effect of enzalutamide on prostate cancer.METHODS Nanoparticle precipitation method was adopted in the preparation of anisamide-modified and non-anisamide-modified self-assembled nanoparticles,respectively,after which the particle size,Zeta potential and encapsulation efficiency were determined,and the morphology was observed under transmission electron microscope.The intake of cancer-associated fibroblasts(CAFs)was investigated,after which the model for enzalutamide resistance in prostate cancer was established,CCK8 assay was applied to analyzing the sensitization effect of self-assembled nanoparticles on enzalutamide,and Western blot was used for the detection of NRG1,HER3,AKT expressions.RESULTS The anisamide-modified self-assembled nanoparticles demonstrated the average particle size,Zeta potential and encapsulation efficiency of(195.13±8.06)nm,(-29.07±0.55)mV and(94.58±0.84)％,respectively.CAFs displayed higher intake in the anisamide-modified self-assembled nanoparticles than that in the non-modified preparation and free Cy5(P＜0.05).Meanwhile,anisamide-modified self-assembled nanoparticles were able to inhibit enzalutamide resistance caused by CAFs,reduce NRG1 expression on CAFs,and anisamide-modified self-assembled nanoparticles-treated conditioned medium of CAFs could reduce HER3 and AKT expression on LNCaP cells(P＜0.05,P＜0.01).CONCLUSION Anisamide-modified ursolic acid self-assembled nanoparticles can enhance the targeting of CAFs,alleviate the drug resistance effect of enzalutamide on prostate cancer caused by CAFs,and reduce NRG1 expression in CAFs.

Objective:To investigate the factors influencing the prognosis of critically ill patients and the predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index.Methods:A retrospective analysis was conducted on the clinical data of 122 critically ill patients admitted to Guoyao Dongfeng General Hospital affiliated with Hubei University of Medicine from June 2022 to December 2023. Patients were divided into a death group and a survival group based on their 28-day prognosis. Clinical data were compared between the two groups to analyze the factors influencing prognosis and assess the predictive value of various indicators. Normally distributed measurement data were expressed as Mean±SD, and intergroup comparisons were performed by independent samples t-test; non-normally distributed measurement data were expressed as M( Q1,Q3), and intergroup comparisons were performed by the Mann-Whitney U test. Counting data were expressed as case (%), and intergroup comparisons were performed by the χ2 test. Multivariate logistic regression was used to analyze factors influencing patient prognosis, and receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator. Results:The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate, CRP, and B-type natriuretic peptide levels in the death group were higher than those in the survival group [22 (17, 30) points vs. 17 (14, 22) points, (4.8±1.4) mmol/L vs. (3.3±1.0) mmol/L, 134 (83, 2 381) mg/L vs. 13 (10, 27) mg/L, 259 (111, 592) ng/L vs. 108 (40, 247) ng/L; Z=3.04, P=0.002; t=5.79, P<0.001; Z=8.57, P<0.001; Z=3.28, P=0.001, respectively]. Albumin, neutrophil count, lymphocyte count (LYC), and the CALLY index were lower in the death group than in the survival group [(31±5) g/L vs. (37±6) g/L, (58±9)×10 9/L vs. (63±10)×10 9/L, 0.6 (0.4, 0.8)×10 9/L vs. 1.3 (0.8, 1.7)×10 9/L, 0.03 (0.02, 0.11) vs. 0.26 (0.13, 0.49); t=6.05, P<0.001; t=3.04, P=0.003; Z=5.82, P<0.001; Z=6.52, P<0.001, respectively]. Multivariate logistic regression analysis indicated that the APACHE Ⅱ score and CRP were risk factors for poor prognosis in critically ill patients ( OR=1.349, 95% CI: 1.004-1.821, P=0.048; OR=1.006, 95% CI: 1.003-1.010, P=0.001, respectively), while LYC and the CALLY index were protective factors ( OR=0.297, 95% CI: 0.111-0.795, P=0.016; OR=0.989, 95% CI: 0.955-0.999, P=0.001, respectively). The area under the ROC curve for the CALLY index predicting 28-day mortality in critically ill patients was 0.872 (95% CI: 0.800-0.926), which was higher than that of the APACHE Ⅱ score, LYC, and CRP [0.673 (95% CI: 0.582-0.756), 0.664 (95% CI: 0.573-0.748), 0.576 (95% CI: 0.482-0.665), respectively]. The cut-off values were 0.06, 20 points, 0.8×10 9/L, and 50 mg/L, respectively. When the CALLY index was 0.06, the specificity was 97.65%, the sensitivity was 72.97%, and the Youden index was 0.706. Conclusions:The APACHE Ⅱ score, CRP, LYC, and CALLY index are all factors influencing the prognosis of critically ill patients. The CALLY index has certain predictive value, but its false negative rate is relatively high. Further combination with other indicators is needed to improve its predictive value.

Cilia,as cellular sensory organelles,actively partici-pate in and regulate cellular processes such as autophagy and metabolic breakdown during their generation and transportation.Autophagy,on the other hand,is a cell self-protection mecha-nism that maintains cellular homeostasis by clearing aggregates and damaged organelles.Combining recent research findings,this review comprehensively elucidates the bidirectional crosstalk between primary cilia and autophagy.Specifically,it highlights the crucial role of cilia-dependent signaling pathways in activa-ting cellular autophagy and how autophagy regulates cilia genera-tion and length by degrading specific ciliary proteins.Moreover,the dysregulation of primary cilia and autophagy is closely asso-ciated with the clinical manifestations and pathogenesis of vari-ous ciliopathy-related diseases such as polycystic kidney disease and tuberous sclerosis.In terms of pharmacotherapy,this review provides a comprehensive and in-depth overview of small mole-cule inhibitors targeting ciliogenesis,including cytoskeletal drugs and Hedgehog signaling pathway inhibitors.Despite the current limitations in clinical use,these drugs lay the groundw-ork for developing highly specific targeted small molecule inhibi-tors of ciliogenesis and for the treatment of ciliopathies and canc-ers.By systematically discussing ciliogenesis,autophagy,disea-ses and drugs,this review offers new insights for further elucida-ting the crosstalk between ciliogenesis and autophagy,exploring their pathological mechanisms in disease development,and de-veloping therapeutic strategies in the future.

Objective To explore the predictive efficacy of several multimodal MRI-based machine learning models for the promoter methylation states of O6-methylguanine-DNA methyltransferase(MGMT)of glioblastoma muliforme(GBM)patients in terms of the GBM heterogeneity and the complexity of the tumor microenvironment.Methods Firstly,the multimodal MRI images of 317 GBM patients from The University of Pennsylvania Glioblastoma(UPENN-GBM)dataset were pre-processed,with four sequences involved in including T1-weighted imaging(T1WI)sequence,T1-weighted contrast-enhanced imaging(T1CE)sequence,T2-weighted imaging(T2WI)sequence and fluid-attenuated inversion recovery(FLAIR)sequence,and the radiomics features were extracted for two regions of interest(ROIs)such as the tumor core region and the tumor edema region.Secondly,the data of the 317 GBM patients were randomly divided into a training set(254 cases)and a test set(63 cases),which underwent normalization with Z-scores and feature selection and dimensionality reduction with Lasso regression.Finally,three models were established respectively with particle swarm optimization-support vector machine(PSO-SVM),C-support vector classification(C-SVC)and adaptive boosting(adaptive boosting(Adaboost)algorithms,and the predictive efficacy of the three models for glioblastoma multiforme MGMT promoter methylation states were evaluated in terms of accuracy and AUC.Results The Adaboost model based on T2WI sequence and radiomics features of the tumor core region had the highest predictive efficacy with accuracy and AUC values of 67％and 0.74,respectively,higher than those of other combinations of sequences,models and regions of interest.Conclusion The multimodal MRI-based machine learning models can be used for the prediction of glioblastoma multiforme MGMT promoter methylation states,which provides powerful support for personalized treatment and prognostic assessment of GBM.[Chinese Medical Equipment Journal,2025,46(6):7-13]

Alzheimer's disease(AD)is a common neurodegenerative disease in the elderly.Increasing evidence shows that peripheral immune cells are involved in the occurrence and development of AD.Both gut microbiota dysbiosis and abnormalities of peripheral immune cells occur in the early stage of AD.The gut microbiota can influence the central nervous system through mechanisms such as the gut-brain axis and the regulatory effects on peripheral immune cells.AD treatment methods targeting the gut microbiota and immune cells have been receiving increasing attention.This review summarizes the regulatory effects and mechanisms of the gut microbiota on peripheral immune cells,as well as the research progress on the gut microbiota's roles in the occurrence and development of AD,aiming to provide new ideas for relevant research on the prevention,diagnosis,and treatment of AD.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Objective To analyze the epidemiological characteristics and risk factors of an outbreak of influenza A H1N1 in a specialized psychiatric hospital in Shantou City,Guangdong Province,provide scientific basis for the pre-vention and control of respiratory infectious diseases in psychiatric health institutions.Methods Data of infection cases in this hospital in May 1-27,2024 were collected with on-site epidemiological investigation method,and were analyzed with descriptive epidemiological methods.The specimens of the cases were performed nucleic acid testing by reverse transcription polymerase chain reaction(RT-PCR)method.Results A total of 43 influenza-like cases in this outbreak have been reported,with an incidence of 16.67％,including 42 hospitalized patients and 1 healthcare worker.Among the 42 hospitalized patients,there were 41 males,with an incidence of 35.04％and 1 female with an incidence of 2.22％,there was a statistically significant difference in incidence between hospitalized patients of different genders(x2=18.23,P＜0.001).The epidemic curve shows that after the first case appeared on May 8,2024,the number of cases increased significantly from May 13,and reached its peak on May 17(n=17).31 pa-tients' throat swab specimens were collected,out of which 29(93.55％)were positive for influenza A H1N1 virus nucleic acid and 2(6.45％)were negative.Conclusion This epidemic is an outbreak of influenza A H1N1 in a psy-chiatric health institution,the epidemic curve shows a point source human-to-human transmission mode.Failure to effectively identify and isolate cases in the early stage can lead to the spread of the epidemic across floors and wards.It is necessary to regularly organize hospitalized patients and healthcare workers to receive influenza vaccines,strict-ly implement the health monitoring system,strengthen the control of external personnel,and enhance the early de-tection and emergency response capabilities for infectious disease outbreaks.