Objective:To assess the relationship between basophil levels and mortality in patients with intra-abdominal infection.Methods:Information on patients with intraperitoneal infection admitted to the intensive care unit were extracted from the MIMIC database.A time-dependent Cox regression model was used to adjust for confounders associated with 28-day mortality.Propensity score matching(PSM)was used to balance the baseline differences be-tween groups with different basophil levels,and a restricted cube chart(RCS)was used to show the relationship between basophil count and 28-day mortality in patients with intra-abdominal infection.Results:A total of 4403 patients with intra-abdominal infection were enrolled in the MIMIC database.Patients with high basophil levels have lower mortality than those with low basophil levels.There was an L-shaped curve between basophil level and 28-day mortality,with a cut-off value of 0.47×109/L.Cox regression analysis showed that basophil levels were an independent protective factor for mortal-ity in patients with intra-abdominal infection after adjusting for potential confounders(HR=0.586,95%CI:0.443-0.769).Protective factors for death at basophil levels remained after PSM adjusted for potential confounders(HR=0.628,95%CI:0.470-0.832).Conclusion:Basophil level is an independent protective factor for mortality in patients with intra-abdominal infection,and basophil levels should be dynamically monitored to better evaluate the prognosis of patients.

Objective:To quantitatively evaluate the policy texts on mutual recognition of examination and inspection results at the national and local levels in China from 2006 to 2025 based on the PMC index model,and provide reference for policy formulation and improvement.Methods:The ROSTCM6 software was used to sort out and conduct text mining on 27 policy documents issued at the national and local levels,establishing the PMC index model for the mutual recognition of examination and inspection results in China.Quantitative analysis was conducted through a PMC evaluation system consisting of 9 first-level variables and 39 second-level variables.Results:The average PMC index was 6.06(excellent level).Among the 27 policies,4 were rated as perfect,18 as excellent,and 5 as acceptable.Conclusions:Current policies need to strengthen the formulation of scientific and feasible goals,improve legal guarantees and medical insurance coordination mechanisms,and build a complete data security maintenance system to provide policy support and guarantees for the continuous advancement of the mutual recognition of examination and inspection results.

Objective To analyze the serum of patients with pancreatic cancer by fourier transform infrared spectroscopy(FTIR),explore the characteristic spectral parameters related to pancreatic cancer,and evaluate its potential clinical diagnostic value.Methods Serum samples were collected from 100 patients diagnosed with pancreatic cancer and 92 healthy volunteers at Chongming Hospital Affiliated to Shanghai Health Medical College from August 2022 to July 2023.These samples underwent FTIR and principal component analysis(PCA)to assess spectral differences between the two cohorts.The diagnostic potential of the serum spectra in distinguishing pancreatic cancer patients from healthy individuals was further evaluated using machine learning techniques,specifically support vector machine(SVM),k-nearest neighbor(kNN),and linear discriminant analysis(LDA)as classification methods.The diagnostic efficacy across various thresholds was evaluated using the receiver operating characteristic(ROC)curve.Results The findings indicate that the peak positions within the 1 090～1 070cm-1(1 076.537±15.183cm-1 vs 1 081.061±4.043cm-1),1 420～1 380 cm-1(1 399.958±1.508cm-1 vs 1 400.500±1.782cm-1),2 990～2 950cm-1(2 940.167±15.287cm-1 vs 2 945.124±7.498cm-1)and 3 500～3 000 cm-1(3 293.155±3.096cm-1 vs 3 294.893±2.582cm-1)range in the serum of individuals with pancreatic cancer exhibited a significant blue-shift compared to the healthy group and was statistically significant(t=2.265～4.236,all P<0.05),suggesting alterations in the structures of proteins,lipids and nucleic acids.Furthermore,a statistically significant disparity in peak absorption was observed between the group of patients with pancreatic cancer and the healthy group within the spectral ranges of 1 700～1 600cm-1(0.918±0.012cm-1 vs 0.858±0.021cm-1)and 3 500～3 000 cm-1(0.766±0.096cm-1 vs 0.804±0.090cm-1)(t=-24.031,2.830,all P<0.05),indicating that the protein concentration changes.PCA results showed that the PC2 axis was clearly separated,which could distinguish serum samples from patients with pancreatic cancer.Utilizing a machine learning model to differentiate the serum spectra of patients with pancreatic cancer from those of healthy controls,the sensitivity,the spesitivity,the specificity and accuracy of linear discriminant analysis(LDA)classification method were 93.2%,97.3%and 95.8%,respectively.The area under curve(AUC)as determined by ROC analysis was 0.982.Conclusion Serum spectroscopy using FTIR combined with PCA and machine learning model can be a simple,minimally invasive and reliable diagnostic test for pancreatic cancer detection.

Objective To compare the clinical efficacy and safety of 1 470 nm laser en bloc resection of bladder tumor(1 470 nm-EBRBT)and transurethral resection of bladder tumor(TUR-BT).Methods Clinical data of 85 non-muscle-invasive bladder cancer(NMIBC)patients from June 2018 to June 2021 were analyzed retrospectively.The patients were divided into 1 470 nm-EBRBT group(n=40)and TUR-BT group(n=45)according to different surgical methods,the postoperative chemotherapy regimen of bladder perfusion was the same in both groups.The surgical safety,clinical efficacy,pathological results and recurrence free survival rate of two groups were recorded.Results There were no statistically significant differences in operation time,incidence of bladder perforation,and incidence of postoperative delayed hemorrhage between the two groups(P＞0.05).Compared with the TUR-BT group,the 1 470 nm-EBRBT group had less blood loss,shorter bladder irrigation time,catheter indwelling time and postoperative hospital time,and no obturator nerve reflex,the differences were statistically significant(P＜0.05).The proportion of detrusor in the first resected pathological specimens in 1 470 nm-EBRBT group was higher than that in TUR-BT group(P＜0.05).There were no statistically significant differences in tumor recurrence rate of one year,tumor cumulative recurrence rate of two years and recurrence free survival time between the two groups(P＞0.05).Conclusion Compared with traditional TUR-BT,1 470 nm-EBRBT is a safe and effective method,which has the advantages of complete pathological specimens,fewer complications,faster recovery and so on.Therefore,it is worthy of clinical application.

Skeletal muscle is the largest metabolic and endocrine organ in the body.As the basic unit of skeletal muscle,muscle fiber has high plasticity.Skeletal muscle fibers are mainly divided into oxidative and glycolytic muscle fibers,and muscle fibers type is an important factor affecting the contraction and energy metabolism of skeletal muscle.Understanding the molecular mechanism regulating skeletal muscle fiber type conversion is of great significance for regulating skeletal muscle-related diseases.Mitochondria is the energy factory of cell life activities,and the characteristics of mitochondria,namely the content,shape and distribution of mitochondria,are closely related to the function of mitochondria.The mitochon-drial characteristics of various types of muscle fiber are different,which is related to the difference of en-ergy metabolism of different muscle fiber types.Mitochondrial homeostasis is a dynamic equilibrium process,which is usually regulated by mitochondrial biogenesis,mitochondrial fusion and fission,mito-chondrial autophagy and other processes.These processes not only affect the morphology and quantity of mitochondria,but also affect the metabolic balance of glucose and fatty acids in the body.Many studies have also shown that mitochondria-mediated changes in the substrates of energy metabolism of skeletal muscle affect the type conversion process of skeletal muscle fiber.Exercise is a non-drug treatment that can generally promote the formation of oxidized muscle fibers by maintaining skeletal muscle mitochondri-al homeostasis.In this paper,the mitochondrial characteristics of different types of skeletal muscle fibers and the role of maintaining mitochondrial homeostasis in regulating muscle fiber type conversion were re-viewed.On this basis,the molecular mechanism of mitochondrial involvement in PGC1α,Ca2+and ROS signaling pathways mediated by fiber type conversion of skeletal muscle was summarized.Mitochondria are the energy factories of skeletal muscle,and targeted intervention through understanding their regulato-ry mechanism may be a new direction for the treatment of skeletal muscle-related diseases in the future.

Objective:To quantitatively evaluate the policy texts on mutual recognition of examination and inspection results at the national and local levels in China from 2006 to 2025 based on the PMC index model,and provide reference for policy formulation and improvement.Methods:The ROSTCM6 software was used to sort out and conduct text mining on 27 policy documents issued at the national and local levels,establishing the PMC index model for the mutual recognition of examination and inspection results in China.Quantitative analysis was conducted through a PMC evaluation system consisting of 9 first-level variables and 39 second-level variables.Results:The average PMC index was 6.06(excellent level).Among the 27 policies,4 were rated as perfect,18 as excellent,and 5 as acceptable.Conclusions:Current policies need to strengthen the formulation of scientific and feasible goals,improve legal guarantees and medical insurance coordination mechanisms,and build a complete data security maintenance system to provide policy support and guarantees for the continuous advancement of the mutual recognition of examination and inspection results.

ObjectiveTo investigate the effects of modified Ditan tang on genes related to the transcription-translation feedback loop （TTFL） of biorhythm in the rat model of non-alcoholic fatty liver disease （NAFLD） and its mechanism for prevention and treatment of NAFLD. MethodsSixty-five healthy SPF male SD rats were randomly assigned into blank （n=20）， model （n=15）， and low-， medium-， and high-dose （2.68， 5.36， and 10.72 g·kg^-1·d^-1， respectively） modified Ditan tang （n=10） groups. Other groups except the blank group were fed a high-fat diet for 12 weeks. The modified Ditan tang groups were treated with the decoction at corresponding doses by gavage， and the blank and model groups were treated with an equal volume of normal saline from the 9th week for 4 weeks. The levels of triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） in the serum were measured by an automatic biochemical analyzer. TG and non-esterified fatty acid （NEFA） assay kits were used to measure the levels of TG and NEFA in the liver. The pathological changes in the hypothalamus and liver were observed by hematoxylin-eosin staining， and the lipid deposition in the liver was observed by oil red O staining. The levels of brain-muscle ARNT-like protein 1 （BMAL1/ARNTL） in the hypothalamus and liver were determined by immunohistochemical staining. The mRNA and protein levels of BMAL1， circadian locomotor output cycles kaput （CLOCK）， period circadian clock 2 （PER2）， and cryptochrome1 （Cry1） in the hypothalamus and liver were determined by Real-time PCR and Western blot， respectively. ResultsCompared with the blank group， the model group showed elevated levels of TG， TC， LDL-C， AST， and ALT （P<0.01） and a lowered level of HDL-C （P<0.05） in the serum， elevated levels of TG and NEFA in the liver （P<0.01）， pyknosis and deep staining of hypothalamic neuron cells， and a large number of vacuoles in the brain area. In addition， the model group showed lipid deposition in the liver， up-regulated mRNA and protein levels of CLOCK and BMAL1 （P<0.01）， and down-regulated mRNA and protein levels of Cry1 and PER2 （P<0.01） in the hypothalamus and liver. Compared with the model group， all the three modified Ditan tang groups showed lowered levels of TG， TC， LDL-C， ALT， and AST （P<0.05， P<0.01） and an elevated level of HDL-C （P<0.05） in the serum， and lowered levels of TG and NEFA （P<0.05， P<0.01） in the liver. Furthermore， the three groups showed alleviated pyknosis and deep staining of hypothalamic neuron cells， reduced lipid deposition in the liver， down-regulated mRNA and protein levels of CLOCK and BMAL1 （P<0.05， P<0.01）， and up-regulated mRNA and protein levels of Cry1 and PER2 （P<0.05， P<0.01） in the hypothalamus and liver. ConclusionModified Ditan tang can reduce lipid deposition in the liver and regulate the expression of CLOCK， BMAL1， Cry1， and PER2 in the TTFL of NAFLD rats.

Skeletal muscle is the largest metabolic and endocrine organ in the body.As the basic unit of skeletal muscle,muscle fiber has high plasticity.Skeletal muscle fibers are mainly divided into oxidative and glycolytic muscle fibers,and muscle fibers type is an important factor affecting the contraction and energy metabolism of skeletal muscle.Understanding the molecular mechanism regulating skeletal muscle fiber type conversion is of great significance for regulating skeletal muscle-related diseases.Mitochondria is the energy factory of cell life activities,and the characteristics of mitochondria,namely the content,shape and distribution of mitochondria,are closely related to the function of mitochondria.The mitochon-drial characteristics of various types of muscle fiber are different,which is related to the difference of en-ergy metabolism of different muscle fiber types.Mitochondrial homeostasis is a dynamic equilibrium process,which is usually regulated by mitochondrial biogenesis,mitochondrial fusion and fission,mito-chondrial autophagy and other processes.These processes not only affect the morphology and quantity of mitochondria,but also affect the metabolic balance of glucose and fatty acids in the body.Many studies have also shown that mitochondria-mediated changes in the substrates of energy metabolism of skeletal muscle affect the type conversion process of skeletal muscle fiber.Exercise is a non-drug treatment that can generally promote the formation of oxidized muscle fibers by maintaining skeletal muscle mitochondri-al homeostasis.In this paper,the mitochondrial characteristics of different types of skeletal muscle fibers and the role of maintaining mitochondrial homeostasis in regulating muscle fiber type conversion were re-viewed.On this basis,the molecular mechanism of mitochondrial involvement in PGC1α,Ca2+and ROS signaling pathways mediated by fiber type conversion of skeletal muscle was summarized.Mitochondria are the energy factories of skeletal muscle,and targeted intervention through understanding their regulato-ry mechanism may be a new direction for the treatment of skeletal muscle-related diseases in the future.

In recent years,micro photoionization detectors(μPID),with their rapid response speed and excellent sensitivity,have attracted widespread attention in both scientific research and industry.This study developed a portable gas chromatograph based on μPID technology(GC-μPID),and examined its key performance characteristics such as reproducibility,sensitivity,and online analytical capability.The results showed that the method's relative standard deviation(RSD)was controlled within 2.7%,demonstrating good reproducibility;for the standard curves of 27 kinds of volatile organic compounds(VOCs),the linearity was excellent(R2≥0.99),with detection limits of≤10 μg/m3 and benzene series compounds reaching detection limits as low as 0.5 μg/m3.In field applications at an industrial park,this method successfully identified and quantified 17 kinds of VOCs,accurately capturing their diurnal concentration variations.The results above validated that the method developed here had the capability of onsite real-time monitoring and provided an effective tool for in situ monitoring atmospheric pollutants.

Objective:To explore the diagnosis and treatment strategy of emphysematous pyelonephritis (EPN).Methods:The clinical data of 11 cases patients with EPN admitted to 3 hospitals from March 2016 to June 2022 were retrospectively analyzed, among them, 4 cases from Qianhai Shekou Free Trade Zone Hospital, 5 cases from the Second Hospital Affiliated to Kunming Medical University, 2 cases from the Second Affiliated Hospital of Hubei University of Scinece and Technology. Among the 11 patients, 2 were males and 9 were females, aged 50-82 years; the lesions were located on the left side in 6 cases, right side in 4 cases and bilateral in 1 case; all patients had type 2 diabetes and poor glycemic control. The clinical manifestations at admission including back pain in 8 cases, fever in 11 cases, nausea and vomiting in 5 cases, disturbance of consciousness in 3 cases, septic shock in 3 cases, accompanied with ureteral or kidney stones in 5 cases. The pathogenic bacteria were Escherichia coli in 8 cases, Klebsiella pneumoniae in 2 cases and Proteus mirabilis in 1 case. All patients received minimally invasive surgery, anti-infection, subcutaneous injection of insulin, fluid rehydration and nutritional support after admission. 2 cases had a combination of an initial ureteral stenting and second stage percutaneous drainage, 3 patients underwent ureteral stent implantation, 6 patients underwent percutaneous drainage. According to the CT classification of EPN, there were 1 case of type Ⅰ, 3 cases of type Ⅱ, 2 cases of type ⅢA, 4 cases of type ⅢB, and 1 case of type Ⅳ. Results:All 11 cases were cured, 4 cases were admitted to intensive care unit for 2-7 days, 1 case underwent nephrectomy during hospitalization, and 1 case underwent nephrectomy due to renal atrophy during follow-up. After 12 to 18 months of follow-up with urinary CT or B-ultrasound, there were no recurrence cases.Conclusions:EPN is a rare and serious renal parenchymal necrotic infection. Early urinary CT examination is necessary for the diagnosis, and positive minimally invasive surgery combined with comprehensive medical treatment is the preferred treatment strategy. If those above treatment does not work, nephrectomy should be performed.