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.

The digitization of traditional Chinese medicine (TCM) has generated vast amounts of data. However, these data are characterized by significant heterogeneity and complex semantic structures, posing substantial challenges for systematic integration and intelligent analysis, and limiting its potential for modern clinical and computational research. To address the challenges posed by the high heterogeneity and complex structure in TCM data, we designed and developed the TCM Data Hub platform, which is powered by the YiYuan large language models (LLMs). This platform aims to enhance intelligent data processing capabilities and unlock the potential for clinical application of TCM data through systematic integration and efficient utilization, thereby bridging the gap between traditional knowledge and modern computational research. This study first analyzed the heterogeneity and complexity of TCM information with respect to data types, structures, and semantics. A standardized data framework was constructed to enhance data integration and interoperability. Based on the TCM Intelligent Computing Platform of the China Academy of Chinese Medical Sciences, we trained the YiYuan LLMs to acquire domain-specific semantic understanding of TCM, thereby improving the platform’s comprehension of specialized terminology and knowledge systems. Leveraging the natural language processing capabilities of the LLMs, we developed a human-in-the-loop data processing system to enable efficient extraction, cleansing, and structured organization of TCM data. In addition, utilizing Vue and Java technologies, we developed multiple LLM-powered intelligent agents and systems, including a human-in-the-loop data processing system, as well as automated prescription mining and network pharmacology analysis agents. Task-specific agents tailored to TCM data processing were developed to enhance the model’s effectiveness in clinical knowledge discovery. System functionality and platform infrastructure were implemented using Java and Vue technologies.The TCM Data Hub platform has completed system construction and core functionality implementation. It supported integrated management and efficient access to 8 key types of TCM data: prescriptions, materia medica, ingredients, targets, diseases (Western medicine), diseases (TCM), syndromes, and therapeutic methods. The human-in-the-loop data processing system achieved an accuracy of 95.34% in structuring TCM data and supported annotation for data requiring manual labeling. The intelligent agent-driven big-data analytics module enabled 1-click, end-to-end workflows for TCM prescription mining, herb-syndrome association analysis, network pharmacology, and molecular biology research, completing a full data mining task in approximately 30 minutes. Users can interact with and manipulate data through a visual front-end interface. The system demonstrated stable performance, strong scalability, and a user-friendly experience. Empowered by the YiYuan LLMs, the TCM Data Hub platform significantly improves the accessibility, usability, and intelligence of TCM data. It effectively bridges traditional TCM knowledge with modern intelligent technologies, providing robust data support and intelligent tools for TCM research and clinical applications.

Objective To evaluate the efficacy,safety and economy of sugemalimab in the first-line treatment of non-small cell lung cancer(NSCLC)by rapid health technology assessment.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data,VIP and official websites of health technology assessment(HTA)institutions were systematically searched to collect HTA reports,systematic reviews/Meta-analysis and pharmacoeconomic studies of sugemalimab in first-line treatment of NSCLC from inception to October 31,2024.Two reviewers independently screened the literature,extracted information and performed quality assessment of the included studies,and then performed descriptive analysis on the results.Results A total of 15 articles were selected,including 4 systematic reviews/Meta-analysis and 11 pharmacoeconomic studies.In terms of effectiveness,compared with chemotherapy alone,sugemalimab combined with chemotherapy significantly improved progression-free survival(PFS),overall survival(OS),and objective response rate(ORR)in patients with NSCLC.In terms of safety,compared with chemotherapy alone,sugemalimab combined chemotherapy had higher incidence of overall adverse events,but it had a better safety profile compared to other immune combination therapies.In terms of economy,most studies suggested that compared with chemotherapy alone,sugemalimab combined with chemotherapy was not cost-effective,which may be related to the high price of sugemalimab.However,a few studies indicated that sugemalimab combined with chemotherapy could be cost-effective in specific scenarios.Conclusion Sugemalimab has good efficacy in the first-line treatment of NSCLC,but its safety and economy need to be further studied.

Objective:To explore the ideological and political education elements and methods in the introduction to nursing course, so as to enhance its ideological educational effectiveness. Methods:In February 2024, based on a "three-stage" teaching model (pre-class, in-class, and post-class), this study reformed the ideological and political education plan for the introduction to nursing course by integrating online and offline case studies and resources, expanding educational materials, and organizing teaching assessments and effectiveness surveys. A semester-long ideological and political education practice was implemented for 237 first-year nursing students from four classes in Medical College of Xinjiang University of Science and Technology. The effectiveness was evaluated by exam scores and a self-designed Introduction to Nursing Teaching Effectiveness Evaluation Scale under the ideological and political education framework. Results:Among the 237 students, there were 107 males and 130 females, aged (18.50 ± 1.12) years old, 63 achieved a passing grade, 149 achieved a good grade, and 18 achieved an excellent grade, with a pass rate of 97.05% (230/237). The scores of the six dimensions of interest stimulation in teaching methods, acceptance of teaching methods, knowledge review and application, knowledge comprehension and retention, self-challenge and improvement, and satisfaction with learning outcomes within 1 week after the end of the course scores were (3.92 ± 1.11), (4.21 ± 0.82), (4.05 ± 0.97), (4.05 ± 0.89), (4.11 ± 0.94), (4.03 ± 0.90) points, which were significantly higher than 1 week before the start of the course (3.43 ± 1.00), (3.54 ± 1.03), (3.48 ± 1.08), (3.47 ± 1.04), (3.52 ± 1.05), (3.47 ± 1.01) points. The differences were statistically significant ( t values were -19.38- -13.22, all P < 0.01). Conclusions:The "three-stage" teaching model in the introduction to nursing course effectively integrates professional education with ideological and political education, improves students′ academic performance, enhances learning effectiveness in nursing practice, and strengthens the overall impact of ideological and political education.

Objective::To analyze fetal renal abnormality genetic features and the prenatal characteristics of the 17q12 microdeletion syndrome.Methods::This prospective cohort study examined prenatal ultrasound findings of renal abnormalities in pregnant women who underwent single nucleotide polymorphism (SNP) array or copy number variation sequencing (CNV-seq) testing on amniotic fluid or fetal tissue at Tianjin Central Obstetrics and Gynecology Hospital between January 2016 and August 2022. The study cohort comprised women with advanced maternal age, fetal ultrasound anomalies, high-risk non-invasive prenatal testing results, or suspected 17q12 microdeletion syndrome. Comprehensive clinical data, including maternal age, detailed ultrasound findings, and pregnancy outcomes, were systematically collected. SNP-array analysis was conducted using an Affymetrix CytoScan 750 K Array Chip to identify CNVs and loss of heterozygosity, while CNV-seq was performed on the Illumina HiSeq 2000 platform. Detected variants were classified according to the American College of Medical Genetics and Genomics guidelines. Statistical analyses were performed using SPSS version 27.0.Results::Abnormal renal development was identified in 141 patients, among whom 26 exhibited hyperechogenic kidneys (HCK). Of these, 12 cases were associated with 17q12 microdeletion syndrome, while the remaining 14 were linked to other chromosomal abnormalities. When excluding patients with HCK, those diagnosed with polycystic kidney disease demonstrated a higher prevalence of chromosomal abnormalities compared to those with multicystic dysplastic kidney and renal dysplasia. Although isolated conditions such as horseshoe kidney, hydronephrosis, ectopic kidney, and unilateral kidney typically presented with normal chromosomal findings, the incidence of chromosomal abnormalities increased when these conditions coexisted with other anomalies. A detailed analysis of the correlation between 17q12 microdeletion syndrome and HCK revealed that 12 out of the 14 patients diagnosed with 17q12 microdeletion syndrome exhibited HCK. Genetic testing confirmed the syndrome in seven patients, with five cases attributed to novel mutations and two cases resulting from inherited mutations.Conclusion::Fetal HCK was closely associated with the 17q12 microdeletion syndrome, and polycystic kidney disease showed a higher rate of chromosomal abnormalities. Chromosome test results were mostly normal in patients with other renal abnormalities, such as kidney dysplasia, horseshoe kidneys, hydronephrosis, kidney deficiency, and ectopic kidneys. Prenatal diagnosis is recommended, especially in cases of non-isolated fetal renal abnormalities. This study provides strong evidence supporting a link between fetal renal abnormalities and genetic syndromes.

The exoskeleton robot for lower limb medical rehabilitation in foreign countries and China was introduced in terms of the research status,structure and working principle,and analysis was carried out over its key technologies.It's pointed out the exoskeleton robot for lower limb medical rehabilitation would be enhanced in energy endurance,safety and comfort,individualized and intelligent control,modularity and lightweight design.[Chinese Medical Equipment Journal,2025,46(1):88-100]

Objective:To explore the predictive value of Nomogram prediction model for poor prognosis of severe pneumonia(SP)based on micrornas(miR)-221-3p,miR-155-5p and confusion,uremia,respiratory,BP,age 65years(CURB-65)score.Methods:439 SP patients who were admitted to Yichun People's Hospital from January 2021 to June 2024 were prospectively selected,they were randomly divided into modeling group(n=307)and validation group(n=132)according to the ratio of 7:3.The serum levels of miR-221-3p and miR-155-5p were detected before treatment,and the CURB-65 score was used for evaluation.The prognosis of SP patients within 28 days of hospitalization was observed,and the SP patients were divided into death group and survival group according to the prognosis within 28 days.Lasso regression was used to analyze the influencing factors of poor prognosis of SP patients,and multivariate Logistic regression was used to analyze the risk factors for poor prognosis of SP patients.A Nomogram prediction model for poor prognosis of SP patients was constructed,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the Nomogram model for poor prognosis of SP patients.Results:The mortality rates in the modeling group and the validation group were 29.32％(90/307)and 28.79％(38/132)respectively,and there was no significant difference in mortality rates and clinical data between the two groups(P＞0.05).The age,proportion of underlying lung disease,pneumonia severity index(PSI)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,CURB-65 score,serum miR-221-3p,miR-155-5p,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)indexes in modeling and validation of the death group were higher than those of survival group(P＜0.05).Logistic multivariate regression analysis showed that advanced age,high APACHE Ⅱ score,high expression of miR-221-3p,high expression of miR-155-5p and high CURB-65 score were risk factors for poor prognosis of SP(P＜0.05).The area under the curve(AUC)of the constructed Nomogram prediction model for the poor prognosis of SP was 0.824,which had good prediction efficiency.Conclusion:High expression of miR-221-3p,high expression of miR-155-5p,high CURB-65 score,older age and high APACHE Ⅱ score are risk factors for poor prognosis of SP patients,and the Nomogram prediction model based on the above factors has a high predictive value for the poor prognosis of SP.

Objective:To explore the ideological and political education elements and methods in the introduction to nursing course, so as to enhance its ideological educational effectiveness. Methods:In February 2024, based on a "three-stage" teaching model (pre-class, in-class, and post-class), this study reformed the ideological and political education plan for the introduction to nursing course by integrating online and offline case studies and resources, expanding educational materials, and organizing teaching assessments and effectiveness surveys. A semester-long ideological and political education practice was implemented for 237 first-year nursing students from four classes in Medical College of Xinjiang University of Science and Technology. The effectiveness was evaluated by exam scores and a self-designed Introduction to Nursing Teaching Effectiveness Evaluation Scale under the ideological and political education framework. Results:Among the 237 students, there were 107 males and 130 females, aged (18.50 ± 1.12) years old, 63 achieved a passing grade, 149 achieved a good grade, and 18 achieved an excellent grade, with a pass rate of 97.05% (230/237). The scores of the six dimensions of interest stimulation in teaching methods, acceptance of teaching methods, knowledge review and application, knowledge comprehension and retention, self-challenge and improvement, and satisfaction with learning outcomes within 1 week after the end of the course scores were (3.92 ± 1.11), (4.21 ± 0.82), (4.05 ± 0.97), (4.05 ± 0.89), (4.11 ± 0.94), (4.03 ± 0.90) points, which were significantly higher than 1 week before the start of the course (3.43 ± 1.00), (3.54 ± 1.03), (3.48 ± 1.08), (3.47 ± 1.04), (3.52 ± 1.05), (3.47 ± 1.01) points. The differences were statistically significant ( t values were -19.38- -13.22, all P < 0.01). Conclusions:The "three-stage" teaching model in the introduction to nursing course effectively integrates professional education with ideological and political education, improves students′ academic performance, enhances learning effectiveness in nursing practice, and strengthens the overall impact of ideological and political education.

Objective To analyze the basic characteristics of patients with acute myocardial infarction in a tertiary hospi-tal from 2014 to 2023,and provide references for the prevention,treatment,management,and quality control of this disease.Methods Based on the data from the medical records of patients with acute myocardial infarction admitted to a tertiary hospital from January 1,2014,to December 31,2023,the basic characteristics of hospitalized patients and trends in hospitalization costs were analyzed to summarize the development patterns.Results Over the past decade,the number of hospitalized patients with a-cute myocardial infarction has been increasing,while the average length of hospital stay,average cost per hospitalization,and mortality rate have been decreasing.Among the 19 937 patients,there were 16 037 male patients(80.44％)and 3 900 female patients(19.56％),with a male-to-female ratio of 4.11∶1.The median age for male patients was 60 years,while for female patients it was 68 years,indicating that males tend to develop the disease approximately 10 years earlier than females.Among pa-tients aged 60 and above,the mortality rate is positively correlated with age,while among patients below 60,the mortality rate is negatively correlated with age.The decision to undergo surgery has a significant impact on hospitalization costs.From the per-spective of cost structure,the proportion of consumables has decreased from 69.81％to 54.60％in the past decade but remains relatively high.Conclusion With the advancement of hospital management and medical insurance policies,the diagnosis,treat-ment,and quality of care for acute myocardial infarction have significantly improved.However,consumables management remains a key focus.Men and individuals aged 50 and above should be given special attention.During the diagnosis and treatment process,greater attention should also be given to younger or older patients and female patients to reduce the mortality rate.

Objective:To explore the multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanism of perceived overqualification on the information literacy of Operating Room nurses engaged in organ transplantation.Methods:On November 2023, 308 Operating Room nurses engaged in organ transplantation from 12 hospitals in China were selected for the survey using convenience sampling method. General information questionnaire, Information Literacy Self-Rating Scale for Clinical Nurses, the 9-item Scale of Perceived Over Qualification, Intrinsic Motivation Scale, and Proactive Behavior Scale were used to investigate and to construct the chain mediating model.Results:A total of 308 questionnaires were collected and 294 questionnaires were valid, with a valid recovery rate of 95.45%. The total scores of information literacy, perceived overqualification, intrinsic motivation and proactive behavior of 294 Operating Room nurses engaged in organ transplantation were (133.95±19.07), (23.71±7.82), (76.47±13.38) and (38.01±6.31) respectively. The indirect effect of perceived overqualification of Operating Room nurses engaged in organ transplantation on information literacy existed, with a total indirect effect value of -0.348. The specific indirect effect of intrinsic motivation was 40.80% of the total indirect effect, the specific indirect effect of proactive behavior was 31.03% of the total indirect effect, and the chain mediating effect of intrinsic motivation and proactive behavior was 28.16% of the total indirect effect.Conclusions:Multiple mediating roles of intrinsic motivation and proactive behavior in the influence mechanisms of perceived overqualification on the information literacy of Operating Room nurses involved in organ transplantation are established. Managers can improve the information literacy of Operating Room nurses engaged in organ transplantation by reducing their perceived overqualification and stimulating intrinsic motivation and proactive behavior.