Background::Pulmonary arterial hypertension (PAH) is characterized by excessive proliferation of small pulmonary arterial vascular smooth muscle cells (PASMCs), endothelial dysfunction, and extracellular matrix remodeling. G protein-coupled receptor kinase 2 (GRK2) plays an important role in the maintenance of vascular tone and blood flow. However, the role of GRK2 in the pathogenesis of PAH is unknown.Methods::GRK2 levels were detected in lung tissues from healthy people and PAH patients. C57BL/6 mice, vascular smooth muscle cell-specific Grk2-knockout mice ( Grk2?SM22), and littermate controls ( Grk2flox/flox) were grouped into control and hypoxia mice ( n = 8). Pulmonary hypertension (PH) was induced by exposure to chronic hypoxia (10%) combined with injection of the SU5416 (cHx/SU). The expression levels of GRK2 and Yes-associated protein (YAP) in pulmonary arteries and PASMCs were detected by Western blotting and immunofluorescence staining. The mRNA expression levels of Grk2 and Yes-associated protein ( YAP) in PASMCs were quantified with real-time polymerase chain reaction (RT-PCR). Wound-healing assay, 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide (MTT) assay, and 5-Ethynyl-2′-deoxyuridine (EdU) staining were performed to evaluate the proliferation and migration of PASMCs. Meanwhile, the interaction among proteins was detected by immunoprecipitation assays. Results::The expression levels of GRK2 were upregulated in the pulmonary arteries of patients with PAH and the lungs of PH mice. Moreover, cHx/SU-induced PH was attenuated in Grk2?SM22 mice compared with littermate controls. The amelioration of PH in Grk2?SM22 mice was accompanied by reduced pulmonary vascular remodeling. In vitro study further confirmed that GRK2 knock-down significantly altered hypoxia-induced PASMCs proliferation and migration, whereas this effect was severely intensified by overexpression of GRK2. We also identified that GRK2 promoted YAP expression and nuclear translocation in PASMCs, resulting in excessive PASMCs proliferation and migration. Furthermore, GRK2 is stabilized by inhibiting phosphorylating GRK2 on Tyr86 and subsequently activating ubiquitylation under hypoxic conditions. Conclusion::Our findings suggest that GRK2 plays a critical role in the pathogenesis of PAH, via regulating YAP expression and nuclear translocation. Therefore, GRK2 serves as a novel therapeutic target for PAH treatment.

Objective This study aimed to analyze the use of various virtual surgical planning and 3D printing templates in mandibular angle ostectomy.Methods Twelve patients with mandibular angle prominence were selected from the Affiliated Stomatological Hospital of Guizhou Medical University between January 2022 and January 2023.Preoperative craniofacial CT scans were used to create three-dimensional models.Two types of virtual surgical planning and templates were designed:ascend-ing branch-fixed templates on the ramus(Group Ⅰ)and inferior border-fixed templates on the excised mandibular angle(GroupⅡ).Patients were divided into two groups based on the template used during surgery.The changes in the mandibular angle be-fore and two weeks after surgery were compared between the groups,and deviations between the surgical plans and postopera-tive results were measured.Results All patients healed successfully with satisfactory cosmetic outcomes.Lateral mandibular angles were observed in all patients of Group Ⅰ.In Group Ⅱ,one patient presented with a lateral angle,while the others showed medial angles.An increase in the mandibular angle(P＜0.01)was noted with no significant difference between the bilateral an-gles(P＞0.05).The deviation from the surgical planning was also not significantly different between the groups(P＞0.05).Conclusion Virtual surgical planning and 3D printed templates in mandibular angle ostectomy result in high accuracy and favor-able cosmetic outcomes.Ramus-fixed template is suitable for lateral mandibular angle type,while lower edge-fixed template is better for medial mandibular angle type.

Scrotal mass is a common problem in the outpatient department of urology, accounting for 1% of all emergency patients. The diagnosis of scrotal masses is challenging due to the overlapping symptoms and signs of various scotal masses. Failure to correctly identify and treat scrotal masses, such as testicular torsion, testicular cancer, varicocele, and hydrocele, may lead to infertility, testicular loss, or even death. Misdiagnosis or missed diagnosis of scrotal masses may result in infertility, testicular loss, or even death. Therefore, we must maintain a high degree of vigilance and accurately identify scrotal masses that may affect life and testicular function. A full understanding of the manifestations and differences of various scrotal masses can help clinicians make accurate diagnoses and provide optimal treatment plans. The most critical aspect is to exclude emergency situations that may endanger life or testicular function, such as testicular torsion, testicular cancer, and necrotizing fasciitis, which require immediate medical attention. Scrotal ultrasonography is the best method for distinguishing scrotal masses based on their origin. Magnetic resonance imaging is the best tool for diagnosing scrotal hematoma. However, good clinical judgment and decision-making are still the most important factors for successful treatment of scrotal masses. The purpose of this article is to describe correct evaluation methods for scrotal masses and identify potential conditions that may threaten testicular survival, enabling accurate pathological diagnosis, evaluation, and treatment plans for each scrotal mass.

Objective:To study the impact of the national volume-based procurement policy on inpatient medical costs.Methods:Firstly,a descriptive analysis on the completion of the procurement volume of drugs in the hospital was carried out,and furthermore,using the data on the medical costs of inpatients before and after the implementation of the policy,conducted statistics on changes in the structure of patients'medical expenses.Taking the time of the first day of using the volume-based procurement drugs as the breakpoint,a sharp regression discontinuity model was constructed to compare the changes in the different categories of costs.Re-sults:There is still room for improvement in the use of volume-based procurement drugs in the hospital.After the use of those drugs,in addition to the cost of comprehensive services and consumables rose by 1.01 and 3.07 percentage points respectively,the rest of the categories of costs were on a downward trend,the per capita total medical costs and drug costs of inpatients fell by 644.58 yuan and 300.19 yuan respectively.In addition,the average hospital stay of patients decreased significantly after the implementation of the poli-cy.Conclusion:The national volume-based procurement policy has achieved certain results,but there is a need to set more reason-able procurement volume targets and to adjust cost control measures in a comprehensive manner to further optimize the structure of medical costs.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.

Objective:Clarify the correlation between the Centralized Drug Volume-based Purchasing Policy,changes in physical&mental health status,and health inequalities among the older adults,as well as exploring whether this correlation differs between urban and rural areas so as to determine the role played by the total cost of healthcare.Methods:Based on CFPS 2018 and 2020,DID and PSM-DID were used to verify the impact of the Centralized Drug Volume-based Purchasing Policy on physical&mental health status and health inequalities of the elderly in urban and rural China.Three-step method and Sobel test were used to verify the mediating effect of total medical costs.Results:The pilot effect of the Centralized Drug Volume-based Purchasing Policy was first realized among the urban elderly population,promoting their physical and mental health through the intermediary mechanism of reducing the total medical costs,but for the time being did not show a significant correlation with health inequalities within this group.Among the rural elderly population,none of the three dependent variables was significant(P＞0.1).Conclusion:The underlying logic of the Centralized Drug Volume-based Purchasing Policy is right,but its future reform should focus on the rural elderly group,and consider the fairness of the effect within the group and between urban and rural areas,so as to improve the health level of the whole society in the longer term.