This study aims to understand the biological characteristics of Streptococcus dysgalacti-ae of yak origin.Bacterial isolation and identification,drug susceptibility test,virulence gene test and pathogenicity test were carried out on milk samples of yaks from Naqu City to evaluate the bi-ological characteristics of the isolated strains.Meanwhile,molecular biological information such as virulence factors and drug resistance genes were analyzed by whole genome sequencing,and viru-lence genes were verified by PCR.The results showed that a strain of Streptococcus dysgalactiae was isolated from the milk of yak,and its colony morphology was pinpoint size,smooth edge and milky white.This strain is sensitive to many antibiotics(penicillin G,cephalosporin,ciprofloxacin,tetracycline,erythromycin,etc.).Virulence gene test results showed that the strain carries six key virulence genes(cyl,eno,scpB,bca,bac and napr),which may be closely related to its pathoge-nicity.In the pathogenicity test,the mice were listless and less active after infection,but no death occurred during the observation period.The pathological changes of spleen,kidney,liver and lung tissue were found,suggesting that the strain had certain pathogenic potential but not high lethali-ty.Whole genome sequencing data showed that the gene length of this strain was 4 079 280 bp,the GC content was 39.41％,3 964 coding genes were predicted,604 of which were annotated as viru-lence factors,and another 28 gene mutations may enhance its pathogenic ability.Through annota-tion of CARD database,two Pat A resistance genes and two lmrp resistance genes were found,re-vealing their potential resistance mechanism.Through whole genome sequencing technology and bioinformatics analysis method,this study revealed the genomic characteristics,drug resistance and pathogenicity mechanism of Streptococcus dysgalactiae of yak origin.The findings provide impor-tant scientific evidence for further exploration of the pathogenicity,drug resistance mechanisms,and molecular evolution of yak-derived Streptococcus agalactiae.

Operation management is an important tool to promote the high-quality development of public hospitals in China.Since the founding of New China,based on China's economic and social development and medical and health system reform,the evolution of operation management of public hospitals in China can be divided into four stages,the system building stage(1949-1978),the liberalization and revitalization stage(1979-1996),the operation mechanism reform stage(1997-2020),and the new stage of high-quality development(2021 present).The development trend of public hospital operation management in future should deepen the public welfare-oriented public hospital operation management,explore the value-oriented medical operation management model based on high-quality development and the refined operation and management model of public hospitals,so as to promote the high-quality development of public hospitals in China.

Objective To investigate the value of prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome(OTCS).Methods A total of 67 children with suspected tethered cord syndrome(TCS)and confirmed OTCS by surgery were prospectively enrolled as OTCS group,while 73 healthy subjects were recruited as control group.Supine-and prone-position lumbar MR examinations were performed in both groups.The position of filum terminale on prone axial T2WI and the presence or absence of"sunset sign"(i.e.filum terminale located within the dorsal 1/2 of spinal canal on prone axial T2WI)were observed,spinal cord conus mobility was calculated.The efficacy of"sunset sign"for diagnosing OTCS in children was calculated through comparison between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of spinal cord conus mobility.Results On prone-position axial T2WI,"sunset sign"was found in 58 cases(58/67,86.57％)but not in 9 cases(9/67,13.43％)in OTCS group,which was not even observed in control group.The sensitivity of"sunset sign"for diagnosing pediatric OTCS was 86.57％(58/67),with specificity of 100％(73/73),positive predictive value of 100％(58/58)and negative predictive value of 89.02％(73/82).The spinal cord conus mobility was(19.30±5.89)％in OTCS group and(31.71±6.58)％in control group,being statistically different between groups(t=-11.722,P＜0.001).The sensitivity,specificity and AUC of spinal cord conus mobility for diagnosing pediatric OTCS was 80.60％,90.41％and 0.920,respectively.Conclusion Prone-position MRI of lumbar spine could be used in diagnosing pediatric OTCS.

Objective To investigate the role and mechanism of inflammatory marker C5a in regulating the polarization of M2 macro-phages as well as its clinical application value in the prognosis evaluation of lung cancer.Methods The phorbol 12-myristate 13-ace-tate(PMA)-pulsed human monocytic leukemia cell line THP-1 was stimulated with C5a for 0,6,12,24,and 48 h or 0,1,2,3,6,and 12 h,and then the expression levels of M2 markers CD163 and CD206 mRNA were determined by real-time fluorescence quantita-tive PCR(qRT-PCR).The expression level of general control non-repressed protein 5(GCN5)with histone acetyltransferase(HAT)activity was detected by Western blot.Co-immunoprecipitation(co-IP)was used to determine the acetylation of GATA binding protein 3(GATA3),a key transcription factor for macrophages,and its binding ability to GCN5 and E1A binding protein p300(Ep300/p300).After the macrophages pre-treated with GCN5 inhibitor butyrolactone 3(MB-3)were stimulated with C5a,the expression levels of CD163 and CD206,acetylation of GATA3,and its binding ability to GCN5 were determined by Western blot and co-IP.The clinical significance of the expression of C5a receptor 1(C5aR1)and GCN5 in lung cancer tissues in the prognosis of lung cancer patients was analyzed using the KM plotter database.Results C5a could significantly increase the expression levels of CD163 and CD206 mRNA,expression of GCN5,acetylation of GATA3,and its binding ability to GCN5 in PMA-induced adherent macrophages,but did not affect the binding of GATA3 to p300.Inhibiting the activity of GCN5 not only significantly reduced the acetylation of GATA3 and its binding ability to GCN5,but also down-regulated the expressions of CD163 and CD206.The overall survival rate of lung cancer patients with high expression of C5aR1 or GCN5 was significantly reduced.Conclusion C5a promotes the polarization of M2 macrophages by indu-cing GCN5 to acetylate GATA3.The expressions of C5aR1 and GCN5 in lung cancer tissues may have certain clinical application value for the prognosis of the patients.

Objective:To explore associated factors of post-discharge depressive symptom severity in patients with bipolar disorder.Methods:A longitudinal follow-up was conducted to investigate the demographic,behavioral,and clinical characteristics,and social function among discharged patients with bipolar disorder who met the DSM-5 diagnostic criteria.Clinical characteristics were assessed with the Hamilton Depression Scale(HAMD)and Brief Psychiatric Rating Scale(BPRS).Single factor and multivariate regression were carried out to explore the associat-ed factors of depressive symptom severity in patients with bipolar disorder.Results:A total of 298 discharged pa-tients with bipolar disorder were face-to-face interviewed to complete the follow-up survey.At follow-up time,psy-chotic symptoms(standardized(β)=0.18),housework((β)=0.23),social interaction((β)=0.17)and BPRS total score((β)=0.46)were positively associated with HAMD total score.Productive labor and work((β)=-0.27)and person-al life management((β)=-0.15)were negatively associated with HAMD total scores.Conclusion:Post-discharge depressive symptom severity in bipolar disorder patients is influenced by multiple factors.Effective management of psychotic symptoms,combined with enhanced community-based social rehabilitation and functional recovery,may help reduce the persistence or worsening of depressive symptoms and improve prognosis.

This study aims to understand the biological characteristics of Streptococcus dysgalacti-ae of yak origin.Bacterial isolation and identification,drug susceptibility test,virulence gene test and pathogenicity test were carried out on milk samples of yaks from Naqu City to evaluate the bi-ological characteristics of the isolated strains.Meanwhile,molecular biological information such as virulence factors and drug resistance genes were analyzed by whole genome sequencing,and viru-lence genes were verified by PCR.The results showed that a strain of Streptococcus dysgalactiae was isolated from the milk of yak,and its colony morphology was pinpoint size,smooth edge and milky white.This strain is sensitive to many antibiotics(penicillin G,cephalosporin,ciprofloxacin,tetracycline,erythromycin,etc.).Virulence gene test results showed that the strain carries six key virulence genes(cyl,eno,scpB,bca,bac and napr),which may be closely related to its pathoge-nicity.In the pathogenicity test,the mice were listless and less active after infection,but no death occurred during the observation period.The pathological changes of spleen,kidney,liver and lung tissue were found,suggesting that the strain had certain pathogenic potential but not high lethali-ty.Whole genome sequencing data showed that the gene length of this strain was 4 079 280 bp,the GC content was 39.41％,3 964 coding genes were predicted,604 of which were annotated as viru-lence factors,and another 28 gene mutations may enhance its pathogenic ability.Through annota-tion of CARD database,two Pat A resistance genes and two lmrp resistance genes were found,re-vealing their potential resistance mechanism.Through whole genome sequencing technology and bioinformatics analysis method,this study revealed the genomic characteristics,drug resistance and pathogenicity mechanism of Streptococcus dysgalactiae of yak origin.The findings provide impor-tant scientific evidence for further exploration of the pathogenicity,drug resistance mechanisms,and molecular evolution of yak-derived Streptococcus agalactiae.

Objective To explore the effect of evening primrose oil(EPO)on aortic endothelial damage in rats with polycystic ovary syndrome(PCOS),using network pharmacology and in vivo experiments.Methods The potential targets of EPO for improving aortic endothelial injury in PCOS rats were predicted by network pharmacology,and the selected core targets and renin-angiotensin signaling(RAS)pathway were verified by experiments.Fifty-eight female SD rats were divided randomly into a blank group(n=10)and a modeling group(n=48).Rats in the blank group were fed a normal diet and rats in the modeling group received a high-fat diet for 8 weeks.The PCOS model was prepared at week 6 by administration of letrozole(1 mg/(kg·d))for 21 days.Blood was taken from the tail vein after modeling and serum was collected to detect hormone levels.The model rats were then divided randomly into four groups and treated with the corresponding drugs for 6 weeks.Blood,blood vessels,and ovaries were then collected.Tissue morphology was examined by hematoxylin and eosin staining and serum levels of luteinizing hormone(LH),testosterone(T),follicle-stimulating hormone(FSH),endothelin(ET-1),and tumor necrosis factor(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA).Serum levels of nitric oxide(NO)were determined by spectrophotometry.Protein expression levels of core targets and RAS pathway-related factors were assessed by western blotting and immunohistochemistry.Results Twenty-five intersection targets of EPO and PCOS were identified by network pharmacological analysis.Kyoto encyclopedia of genes and genomes analysis showed that EPO improved vascular injury in PCOS rats via multiple pathways,including RAS.Serum levels of ET-1,FSH,LH,and T measured by ELISA were significantly decreased after EPO treatment,compared with the model group(P＜0.01).EPO significantly decreased the expression levels of Ang Ⅰ,VEGF-B,AT2R,ET-1,and TNF-α proteins in the aorta(P＜0.01)and significantly increased expression levels of Ang Ⅱ,CD31,and endothelial NO synthase proteins(P＜0.01).Conclusions EPO may ameliorate vascular endothelial injury in PCOS model rats by inhibiting the RAS signaling pathway and by overactivation of the ACE/Ang Ⅱ/AT1 axis.

Atherosclerosis(AS)is the important pathological foundation of cardiovascular and cerebrovascular diseases.There is a high degree of consistency between AS and yin-nature carbuncles in terms of etiology,disease-location,severity of illness,pathogenesis,therapies and progression of disease.Based on the theory of yin-nature carbuncles and after the analysis of the characteristics of zang-fu organs mainly involved in AS and the intricate pathogenesis of AS,this paper put forward the use of warming-eliminating,warming-expulsing and warming-tonifying therapies together for treating AS,and established Chiqilin Powder,the experienced prescription including triplet medicinals,i.e.,Notoginseng Radix et Rhizoma,Draconis Sanguis,and Fermentum Rubrum.In the prescription,Notoginseng Radix et Rhizoma mainly has the warming-tonifying and warming-expulsing actions,and also exerts the warming-eliminating actions;Draconis Sanguis exerts eliminating,expulsing and tonifying actions simultaneously;Fermentum Rubrum mainly has the warming-tonifying and warming-eliminating actions,and also exerts the warming-expulsing actions.In clinical practice,the application of Chiqilin Powder in the treatment of AS patients with yang deficiency and phlegm blended with blood stasis syndrome has achieved remarkable therapeutic effects,which will provide reference for the clinical use of Chinese herbal medicine in the treatment of AS.

By analyzing the problems existing in the existing medical service model,this paper explores the core health needs of people in the era of intelligent medical care,and puts forward people-oriented,"4S-PAMA"(Self-Perception,Self-Assessment,Self-Management,Self-Adaption)health service model with individual active health promotion as the core.At the same time to build a multi-level,many modules,interactive health management of traditional Chinese medicine harbor as the breakthrough point,science and technology innovation as the means,through to transform traditional medical center or create new health management,in order to further carry out"perception model of the health management"model applied to provide theoretical basis.

Objective To explore the effect of evening primrose oil(EPO)on aortic endothelial damage in rats with polycystic ovary syndrome(PCOS),using network pharmacology and in vivo experiments.Methods The potential targets of EPO for improving aortic endothelial injury in PCOS rats were predicted by network pharmacology,and the selected core targets and renin-angiotensin signaling(RAS)pathway were verified by experiments.Fifty-eight female SD rats were divided randomly into a blank group(n=10)and a modeling group(n=48).Rats in the blank group were fed a normal diet and rats in the modeling group received a high-fat diet for 8 weeks.The PCOS model was prepared at week 6 by administration of letrozole(1 mg/(kg·d))for 21 days.Blood was taken from the tail vein after modeling and serum was collected to detect hormone levels.The model rats were then divided randomly into four groups and treated with the corresponding drugs for 6 weeks.Blood,blood vessels,and ovaries were then collected.Tissue morphology was examined by hematoxylin and eosin staining and serum levels of luteinizing hormone(LH),testosterone(T),follicle-stimulating hormone(FSH),endothelin(ET-1),and tumor necrosis factor(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA).Serum levels of nitric oxide(NO)were determined by spectrophotometry.Protein expression levels of core targets and RAS pathway-related factors were assessed by western blotting and immunohistochemistry.Results Twenty-five intersection targets of EPO and PCOS were identified by network pharmacological analysis.Kyoto encyclopedia of genes and genomes analysis showed that EPO improved vascular injury in PCOS rats via multiple pathways,including RAS.Serum levels of ET-1,FSH,LH,and T measured by ELISA were significantly decreased after EPO treatment,compared with the model group(P＜0.01).EPO significantly decreased the expression levels of Ang Ⅰ,VEGF-B,AT2R,ET-1,and TNF-α proteins in the aorta(P＜0.01)and significantly increased expression levels of Ang Ⅱ,CD31,and endothelial NO synthase proteins(P＜0.01).Conclusions EPO may ameliorate vascular endothelial injury in PCOS model rats by inhibiting the RAS signaling pathway and by overactivation of the ACE/Ang Ⅱ/AT1 axis.