Objective:To explore the clinical features, genetic traits and prognosis status of acute myeloid leukemia (AML) patients with TP53 mutation.Methods:A retrospective case series study was performed. Clinical data of 42 AML patients with TP53 mutation abundance of at least 10% who were admitted to the First Hospital of Jilin University from April 2018 to August 2023 were collected. Chromosomal karyotypes were detected using fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS) was performed on bone marrow samples from these patients. The Kaplan-Meier method was utilized to analyze the recurrence-free survival (RFS) of 22 patients who achieved complete remission (CR) after induction therapy, as well as the overall survival (OS) of 39 patients who underwent treatment. The Cox proportional hazards model was employed to analyze the factors influencing RFS and OS. Thirty-one patients who underwent induction therapy for ≥ 2 courses were divided into the non-refractory group (22 cases) and the refractory group (9 cases) based on whether CR was achieved after induction therapy, and the clinical and genetic characteristics and prognosis of the two groups were compared.Results:Among the 42 AML patients with TP53 mutation, there were 26 males and 16 females, with a median age [ M( Q1, Q3)] of 57.0 (44.0, 63.5) years. At the initial stage, the median white blood cell count in peripheral blood was 4.06×10 9/L (2.59×10 9/L, 27.36×10 9/L), the median proportion of bone marrow primitive cells was 45.25% (29.00%, 80.63%), the proportion of primitive and immature cells in bone marrow cell immune analysis was 28.70% (12.71%, 61.48%), and the median TP53 mutation abundance was 55.48% (38.72%, 73.31%). Among the 42 patients, 23 cases (54.76%) had complex chromosomal karyotypes, with the most frequent abnormal chromosomes being chromosome 5 (47.62%, 20 cases), chromosome 7 (45.24%, 19 cases) and chromosome 17 (26.19%, 10 cases). The mutant genes with high mutation frequency were DNMT3A (19.05%, 8 cases), N/KRAS (19.05%, 8 cases), ASXL1 (16.67%, 7 cases) and NPM1 (16.67%, 7 cases). Among the 39 patients with detailed TP53 mutation data, 36 had missense mutations and 3 had frameshift mutations. In the non-refractory and refractory groups, the N/KRAS mutation rates were 13.6% (3/22) and 55.6% (5/9), respectively ( P = 0.027). The median RFS time of 22 CR patients after induction therapy was 109 d (95% CI: 57-483 d). The results of multivariate Cox regression analysis showed that complex chromosomal karyotype was an independent risk factor for RFS ( HR = 11.819, 95% CI: 1.345-103.880, P = 0.028). The median RFS time of patients without and with complex chromosomal karyotypes was 842 d (95% CI: 0-1 716 d) and 148 d (95% CI: 88-208 d), respectively, and the difference in RFS between the two groups was statistically significant ( P = 0.001). The median OS time of 39 patients receiving treatment was 151 d (95% CI: 75-227 d). The results of multivariate Cox regression analysis showed that NPM1 gene mutation was an independent protective factor for OS ( HR = 0.289, 95% CI: 0.075-1.114, P = 0.071). The median OS time of patients with and without NPM1 gene mutation was 1 562 d (95% CI: 610- 1 710 d) and 136 d (95% CI: 99-173 d), respectively, and the difference in OS between the two groups was statistically significant ( P = 0.020). Conclusions:TP53-mutant AML patients often have poor chromosomal karyotypes and genetic abnormalities, while refractory AML patients often have N/KRAS mutation. The complex chromosomal karyotype is a risk factor for RFS, while NPM1 gene mutation is a protective factor for OS.

Objective:To investigate the effect of polystyrene microplastics(PS-MPs)combined with high-fat treatment on vascular endothelial cells.Methods:Human umbilical vein endothelial cells(HUVECs)were cultured in the DMEM medium containing 5%fe-tal bovine serum.HUVECs were treated with conventional culture,high-fat treatment,and PS-MPs combined with high-fat treatment.The experiment was conducted in the three groups of control group,high-fat treatment group and PS-MPs+high-fat treatment group.CCK-8 assay was used to measure cell viability,F-actin staining was used to observe cell morphological changes,and flow cytometry,scratch assay,and tube formation assay were used to measure the apoptosis,migration,and tube-forming ability of cells.Results:After HUVECs were exposed to the high-fat environment,there was a significant reduction in cell viability,shrinkage of cells,a signifi-cant increase in cell apoptosis,and significant reductions in cell migration and tube-forming ability.Compared with the high-fat treat-ment group,there were no significant changes in cell viability,cell morphology,cell apoptosis,and cell migration ability after PS-MPs combined with high-fat treatment,but the tube-forming ability of cells was further impaired.Conclusion:High-fat treatment will affect cell viability,change cell morphology,and damage vascular endothelial cell function,and PS-MPs combined with high-fat treat-ment can aggravate the damage of vascular endothelial cell function.

In this work,four salicylhydrazone compounds(L1?L4)were designed and synthesized by using vanillin derivatives as raw material.The structures were confirmed by nuclear magnetic resonance(NMR)and high-resolution mass spectrometry(HRMS).The optical experiments showed that probe L1 and probe L3 could be used as aluminium ion(Al3+)fluorescence probes.The fluorescence color of probe L1 solution changed from colorless to blue after adding Al3+,and the limit of detection was 25.1 nmol/L.Compared with probe L1,the fluorescence color of probe L3 solution changed from colorless to green after complexing with Al3+,and the limit of detection was 17.3 nmol/L.Probe L1 and probe L3 showed the advantages of fast response speed,high selectivity and good anti-interference.The mechanism of Al3+recognition was further demonstrated by HRMS and 1H NMR.Cell imaging experiments showed that probe L1 and L3 had low cytotoxicity and had great application potential in detection of Al3+in vivo.

Objective:To investigate the influence of the complexity metrics of the multi-leaf collimator (MLC) on the γ-pass rate of volumetric modulated arc therapy (VMAT) plans for nasopharyngeal carcinoma (NPC).Methods:A total of 60 VMAT plans for NPC were selected to measure the γ-pass rate. The MLC data across all control points (CPs) in each VMAT plan were analyzed to calculate the mean field area (MFA), average leaf gap (ALG), small aperture score (SAS), and their corresponding weighted metrics including MFAW, ALGW, and SASW, considering dose weight (W). Pearson′s bivariate correlation analysis was conducted to examine the correlations between MLC complexity metrics and the γ-pass rate. Moreover, the receiver operating characteristic (ROC) analysis was employed to assess the predictive efficacy of MLC complexity metrics on dose verification result.Results:Under the 3%/3 mm, 3%/2 mm, and 2%/2 mm criteria, the MFA in the 60 VMAT plans exhibited a positive correlation with the γ-pass rate ( r=0.82, 0.79, 0.72, P<0.05), and the MFAW was also positively correlated with the γ-pass rate ( r=0.83, 0.81, 0.75, P<0.05). The ALG manifested a positive correlation with the γ-pass rate ( r=0.82, 0.79, 0.74, P<0.05), as did the ALGW ( r=0.83, 0.81, 0.77, P<0.05). The SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), and SAS(3-4 cm) displayed negative correlations with the γ-pass rate ( r= -0.86, -0.82, -0.71, -0.84, -0.82, -0.72, -0.79, -0.79, -0.73, -0.30, -0.35, -0.42, P<0.05), whereas the SAS(4-5 cm), SAS(5-6 cm), and SAS(6-40 cm) showed positive correlations with the γ-pass rate ( r=0.49, 0.45, 0.33, 0.73, 0.71, 0.59, 0.79, 0.79, 0.76, P<0.05). The outcomes of SASW reveal slightly stronger correlations than those of SAS. In terms of correlations among complexity metrics, a positive correlation was observed between MFA and ALG ( r=0.98, P<0.05). ALG was negatively correlated with SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), and SAS(3-4 cm) ( r= -0.95, -0.94, -0.89, -0.39, P<0.05), and positively correlated with SAS(4-5 cm), SAS(5-6 cm), and SAS(6-40 cm) ( r=0.51, 0.77, 0.92, P<0.05). The weighted result mirrored these correlations. The ROC-derived analytical result indicate that MFA, MFAW, ALG, ALGW, SAS(0-1 cm), SAS(1-2 cm), SAS(2-3 cm), SAS(6-40 cm), SASW(0-1 cm), SASW(1-2 cm), SASW(2-3 cm), and SASW(6-40 cm) demonstrated exceptional predictive efficacy for dose verification result [Area under the curve (AUC) > 0.9, P<0.05]. Conclusions:The γ-pass rate of VMAT plans for NPC is strongly correlated with MLC complexity metrics, which demonstrate excellent predictive efficacy for dose verification result. The increased uncertainty in dose calculations and measurements caused by narrow fields generated by the MLC is a significant factor contributing to the reduced γ-pass rate of VMAT plans. This finding is associated with discrepancies in the precision of treatment planning system (TPS) modeling and the accuracy of dose verification tools, providing a reference for similar challenges.

Objective:To investigate the differences in dosimetric parameters for target volumes and organs at risk (OARs), radiation doses to reconstructed tissues, and beam-on time in radiotherapy among helical tomotherapy (HT), volumetric modulated arc therapy (VMAT), and fixed-field intensity-modulated radiotherapy (F_IMRT) following immediate breast reconstruction for breast cancer, thereby providing a reference for the selection of clinical radiotherapy techniques.Methods:This study retrospectively investigated 15 breast cancer patients who underwent radiotherapy following modified radical mastectomy and immediate breast reconstruction at the Liuzhou Worker′s Hospital from August 2018 to July 2023. During target volume delineation, precautions were taken to avoid the reconstructed tissues, which were delineated separately. Customized HT, VMAT, and F_IMRT treatment plans were designed for each patient. The plans were categorized into the HT, VMAT, and F_IMRT groups based on different radiotherapy techniques employed. They were comparatively analyzed through one-way analysis of variance (ANOVA), with multiple comparisons further conducted in the case of significant differences.Results:Statistical analyses reveal significant differences in various parameters of target volumes among the three groups of plans ( F = 38.73, 14.95, 37.01, 48.05, 35.55, 22.56, 34.30, P < 0.05). Pairwise comparisons indicate that the maximum dose ( D2%), minimum dose ( D98%), mean dose ( Dmean), and the proportion of high-dose volumes within the target volume ( V107%and V110%) in both the HT and VMAT groups were significantly better than those in the F_IMRT group. The HT group demonstrated the optimal conformity index (CI), while the VMAT group displayed the superior homogeneity index (HI) compared to the other two groups. In terms of OAR, the V20 of the ipsilateral lung was the lowest in the HT group ( F = 14.31, P < 0.05) and the highest in the F_IMRT group ( F = 14.31, P < 0.05). However, the V5 and Dmean for both the ipsilateral and contralateral lungs in the HT group significantly surpassed those of the other groups ( F = 39.16, 31.91, P < 0.05). The mean dose Dmean ( F = 5.57, P < 0.05) of the contralateral breast was significantly reduced in the VMAT group compared to the other two groups. No statistically significant differences were observed for other OARs, including the heart, spinal cord PRV, thyroid, and humeral head ( P > 0.05). The radiation doses to reconstructed tissues ( Dmax, V53.5, Dmean) ascended in the order of HT, VMAT, and F_IMRT groups ( F = 17.69, 17.53, 15.11, P < 0.05). The HT and F_IMRT groups showed similar beam-on times ( P > 0.05), both exceeding that of the VMAT group by several folds ( F = 28.72, P < 0.05). Conclusions:The comparative analysis indicates that the three radiotherapy techniques exhibit distinct advantages and limitations, with F_IMRT demonstrating the least comprehensive advantage. HT can enhance the conformity of target volumes while reducing the overall radiation doses to reconstructed tissues and the crucial indicator V20 in the ipsilateral lung. VMAT demonstrates the highest treatment efficiency, yielding improved dose uniformity in the target volume and reduced radiation doses to the contralateral breast. It is advisable to prioritize HT or VMAT based on actual clinical conditions.

Objective:This study aims to explore the predictive value of the ratio of caliceal pelvic height to infundibular length（CPH/IL）for the stone-free rate（SFR）in the treatment of lower calyx stones using flexible ureteroscopic lithotripsy（FURL）combined with a distally bendable negative pressure suction sheath.Methods:A retrospective analysis was conducted on the clinical data and anatomical parameters of 312 patients with lower calyx stones or combined lower calyx stones admitted to the Third Xiangya Hospital of Central South University from September 2022 to December 2023，all of whom were treated with FURL combined with a distally bendable negative pressure suction sheath. Stone clearance was defined as no residual stones or residual stones with a diameter of ≤3 mm without any symptoms. Patients were divided into the clearance group（265 cases，84.90%）and the non-clearance group（47 cases，15.10%）. There were no significant differences in gender（male/female：173/92 cases vs. 29/18 cases），age［（44.69 ± 13.14）years vs.（42.60 ± 10.93）years］，degree of hydronephrosis（no hydronephrosis/mild hydronephrosis/moderate to severe hydronephrosis：122/85/58 cases vs. 21/12/14 cases），side of lower calyx stones（left/right：157/108 cases vs. 31/16 cases），maximum diameter of stones（MDS）［（19.23 ± 6.41）mm vs.（17.77 ± 6.18）mm］，and CT value of stones［（993.46 ± 249.12）Hu vs.（1013.43 ± 300.90）Hu］between the two groups（ P > 0.05），indicating comparability between groups. There was no significant difference in the distance from the midpoint of the lower lip of the renal pelvis to the ureter at the lowest plane of the lower calyx（K-A line）between the clearance and non-clearance groups［（26.16 ± 5.18）mm vs.（25.70 ± 8.66）mm， P > 0.05］. However，significant differences were observed in the infundibulopelvic angle（IPA）［（53.97 ± 15.72）° vs.（37.43 ± 15.39）°］，infundibular length（IL）［（27.26 ± 5.11）mm vs.（33.04 ± 7.38）mm］，infundibular width（IW）［（8.27 ± 2.82）mm vs.（7.09 ± 3.20）mm］，caliceal pelvic height（CPH）［（19.96 ± 4.63）mm vs.（30.32 ± 7.56）mm］，ureter-lower calyx distance（ULD）［（23.00 ± 5.59）mm vs.（18.78 ± 6.31）mm］，CPH/IL ratio［（0.73 ± 0.11）vs.（0.92 ± 0.09）］，and curvature of the lower calyx of the renal pelvis［（0.06 ± 0.01）mm -1 vs.（0.08 ± 0.03）mm -1］between the two groups（ P <0.05）. Univariate and logistic multivariate regression analyses were used to identify the independent risk factors affecting the postoperative SFR of FURL-treated lower calyx stones and to assess the value of CPH/IL for SFR in the treatment of lower calyx stones using FURL combined with a distally bendable negative pressure suction sheath. A logistic multivariate regression model and a corresponding nomogram were constructed，and the predictive ability of the model for SFR was evaluated using the receiver operating characteristic（ROC）curve. The calibration curve and the Hosmer -Lemeshow test were used to assess the consistency and accuracy of the model. The clinical utility of the model was evaluated using decision curve analysis（DCA）. Results:Univariate analysis revealed that seven anatomical parameters differed significantly between the clearance and non-clearance groups（all P < 0.05）：infundibulopelvic angle（IPA， OR = 0.27，95% CI 0.17-0.42， P < 0.01），infundibular length（IL， OR = 2.52，95% CI 1.83-3.47， P < 0.01），infundibular width（IW， OR = 0.64，95% CI 0.45-0.90， P = 0.011），caliceal pelvic height（CPH， OR = 5.78，95% CI 3.67-9.10， P < 0.01），ureter-lower calyx distance（ULD， OR = 0.43，95% CI 0.30-0.63， P < 0.01），CPH/IL ratio（ OR = 13.62，95% CI 6.86-27.03， P < 0.01），and curvature of the lower calyx of the renal pelvis（ O = 3.15，95% CI 2.08-4.78， P < 0.01）. Multivariate logistic regression further identified CPH/IL（ OR = 9.87，95% CI 4.92-19.79， P < 0.01），IPA（ OR = 0.41，95% CI 0.23-0.71， P = 0.001），and ULD（ OR = 0.50，95% CI 0.29-0.87， P = 0.014）as independent risk factors influencing the stone-free rate after flexible ureteroscopic lithotripsy combined with a distally bendable negative-pressure suction sheath. The area under the ROC curve（AUC）of the univariate regression model showed that for IPA，the AUC was 0.788（95% CI 0.711-0.864）；for IL，it was 0.731（95% CI 0.643-0.819）；for ULD，it was 0.677（95% CI 0.586-0.767）；for CPH，it was 0.867（95% CI 0.804-0.929）；for IW，it was 0.628（95% CI 0.535-0.721）；for CPH/IL，it was 0.906（95% CI 0.850-0.961）with an optimal cutoff value of 0.882，corresponding to a sensitivity of 83.02% and a specificity of 92.08%；and for curvature of the lower calyx of the renal pelvis，it was 0.744（95% CI 0.662-0.827）. The AUC of the multivariate regression model was 0.929（95% CI 0.884-0.974）with an optimal cutoff value of 0.364，corresponding to a sensitivity of 82.98% and a specificity of 95.09%. Calibration curves demonstrated close agreement between the predicted and actual stone-free rates after FURL（C-index = 0.921）. The Hosmer-Lemeshow goodness-of-fit test indicated no significant discrepancy between predicted and observed probabilities（ P = 0.135，>0.05）. Decision-curve analysis further revealed that basing clinical decisions on the model ，s predicted probability yields a higher net clinical benefit than either withholding FURL for all patients or treating all patients regardless of risk，and it also outperforms strategies guided by any single independent predictor alone. Conclusions:IPA，IL，IW，CPH，ULD，CPH/IL ratio，and curvature of the lower calyx of the renal pelvis can all predict the postoperative SFR of FURL combined with a distally bendable negative pressure suction sheath for the treatment of lower calyx stones to varying degrees. Among them，CPH/IL has the highest predictive value. When CPH/IL >0.88，it may be difficult to use FURL to treat lower calyx stones.

Osteoporosis is a systemic disease characterized by imbalanced bone metabolism and destruction of bone microstructure, with reduced bone density, decreased bone quality, and significantly increased risk of fracture as its hallmarks. At present, osteoporosis is primarily diagnosed through bone density measurement. However, this method has low sensitivity and is challenging for the early diagnosis of osteoporosis. We analyzed osteoporosis-related metabolomics studies based on blood, urine, and fecal samples, as well as the application of multi-omics approaches in elucidating its pathogenesis. Evidence suggests that metabolomics can detect metabolic alterations prior to measurable changes in bone mineral density, offering promising avenues for early osteoporosis detection. Blood-based metabolomics studies indicate that amino acid metabolism dysregulation is a key feature of osteoporosis. Specifically, glycine, glutamine, lysine, and hydroxyproline exhibit negative correlations with bone mineral density, whereas tryptophan, branched-chain amino acids, and arginine show positive associations. Lipid metabolism disturbances are characterized by increased levels of phosphatidylcholine, phosphatidylethanolamine, and triglycerides, alongside decreased levels of sphingomyelin and carnitine. Fecal metabolomics studies highlight the significance of the "gut-bone axis" in osteoporosis, where gut microbiota dysbiosis influences bone metabolism through modulation of arginine and proline metabolism and aminoacyl-tRNA biosynthesis pathways. Multi-omics approaches integrate metabolomics, genomics, proteomics, and other omics data to provide a more comprehensive understanding of osteoporosis' molecular mechanisms, enabling the identification of key biomarkers and therapeutic targets. Metabolomics holds considerable potential for early diagnosis, while multi-omics integration offers novel insights into the complex pathophysiological mechanisms underlying osteoporosis. As detection technologies and analytical methods continue to advance, omics-based strategies are expected to play a pivotal role in the development of precision medicine for osteoporosis.

Objective To analyze bedside radiation dose rates for interventional surgery operators in Guangdong Province, examine dose distribution patterns, and identify potential weaknesses in radiation protection, and to provide guidance for optimizing radiation monitoring and protection measures. Methods A total of 209 digital subtraction angiography devices measured in Guangdong Province between 2017 and 2024 were used as the research objects. The first and second operator positions were set at 30 cm and 90 cm horizontally from the X-ray tube focal point, respectively. Monitoring points were set up at 155, 125, 105, 80, and 20 cm above the ground. Results The median bedside radiation dose rate for interventional surgery operators in Guangdong Province was 83.0 (3.9, 1044.0) μSv/h, indicating instances of exceeding standard limits. The overall dose rates under the old and new standards were 29.8 (3.9-346.5) μSv/h and 114.0 (4.0-1044.0) μSv/h respectively. Results for both standards showed a higher dose rate at the second than the first operator position. The dose rates at the heights of 105 cm (abdomen), 125 cm (chest), and 155 cm (head) were higher in the second operator position than in the first operator position. Additionally, 71.5% and 56.8% of the highest dose rate points under the new and old standards, respectively, were concentrated at 105 cm (abdomen), 125 cm (chest) and 155 cm (head) in the second operator position. Conclusion The principle of protection optimization should be followed, auxiliary protective facilities should be placed correctly, and attention should be paid to the protection of the second surgery operator position, especially above the abdomen. The dose rate results under the new standard were lower than those under the old standard, suggesting that the measurement method may overestimate radiation exposure at the secondary operator position.

AIM: To investigate how angles kappa and alpha affect postoperative visual quality in patients with multifocal intraocular lens(mIOLs)implantation.METHODS: Retrospective cases series. A total of 46 patients(46 eyes)who underwent phacoemulsification were subsumed. The correlation between Preoperative angles kappa and alpha, wave-front aberrations and objective visual quality of cornea, internal, and total eye after surgery were analyzed using iTrace.RESULTS: The magnitude of angle kappa was negatively correlated with internal and total modulation transfer function(MTF)at 3 mm; the magnitude of angle kappa was positively correlated with astigmatism, trefoil, higher-order aberrations(HOAs)of both internal and total eye at 3 mm. The magnitude of angle alpha was negatively correlated with total MTF and total Strehl ratio at 3 mm. The magnitude of angle alpha was positively correlated with corneal coma at 5 mm, internal astigmatism at both 3 mm and 5 mm, and total spherical aberration(SA)at 3 mm. Multivariate linear regression analysis showed that, among candidate independent variables(kappa, alpha, astigmatism, SA, coma, trefoil, and HOAs), astigmatism is the only independent factor for altering corneal MTF at 3 mm and 5 mm; astigmatism and HOAs emerged as independent factors for altering internal MTF at 3 mm and 5 mm, and total MTF at 3 mm; astigmatism, SA and HOAs emerged as independent factors for altering total MTF at 5 mm.CONCLUSION: With greater preoperative angle kappa or angle alpha, patients who accept mIOL implantation tend to have larger internal astigmatism and HOAs, which resulting in poor visual quality, especially those with small pupil size.

Objective　To analyze and study the status quo and deficiencies in the construction of talent teams at all levels of CDCs in Hainan Province and put forward countermeasures to provide a reference basis for the high-quality development of talent team construction in all levels of CDCs in Hainan Province. Methods Using field surveys and data retrieval, spatial analysis was employed to compare the overall differences in human resource status of the provincial-level CDC and CDCs in five regional areas (East, West, South, North, and Central Hainan). The coordination between human resource allocation and development strategies was analyzed. A descriptive analysis mainly utilized CDC survey questionnaires and other research forms to explore the health human resources of the province's CDCs. Results The professional and technical personnel in the provincial CDCs comprise 1 431 individuals, accounting for 82.3% (1 431/1 739) of the total number of actual employees, which falls short of the Central Institutional Reform Commission's (CIRC) mandate that technical professionals comprise at least 85% of the total workforce (CIRC Document [2014] No. 2). Among Hainan's CDC personnel, 115 individuals are recognized as high-level talents within the Hainan Free Trade Port framework. These include one Class C talent, 22 Class D talents, and 93 Class E talents. Class A, B, and C-level talents are deficient. The majority of staff at both the provincial and regional CDCs hold bachelor's degrees. There is a significant proportion of staff with associate degrees or lower qualifications, coupled with a severe shortage of highly educated personnel. Postgraduates with master’s degrees or above account for 27.8% (65/233) in the provincial CDC, indicating low educational credentials among personnel in Hainan's CDCs. The central region, characterized by slower economic and social development, faces greater challenges in attracting and retaining high-level talent. There is a scarcity of public health professionals with interdisciplinary expertise. Some public health staff lack clinical knowledge, experience, and skills in disease treatment. Furthermore, there is a need to strengthen on-site emergency response capabilities for public health emergencies. The structural ratio of senior, intermediate, and junior professional and technical positions in the provincial CDC is 40%∶45%∶15%. The position settings are limited to ranking levels without distinction by professional category, leading to a bottleneck-type competition like crossing the "one log bridge" for technical position promotions. Conclusion　Hainan Province faces significant challenges in developing its public health workforce, both in technical expertise and management capacity. Especially under the context of the closure operation of the Hainan Free Trade Port, it is necessary to continuously strengthen top-level talent design to cultivate a favorable policy, system, and cultural environment, thereby promoting the sustained and healthy development of the province's public health career.