Objectives: . The prognostic value of the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in head and neck cancer (HNC) remains uncertain. This meta-analysis aimed to evaluate the predictive role of AAPR for survival outcomes in patients with HNC. Methods: . A comprehensive search of the Cochrane Library, PubMed, and Embase databases was conducted to identify relevant studies published up to July 30, 2024. We included studies on AAPR and survival outcomes in HNC patients. Results: . Eight studies comprising 1,737 HNC patients were analyzed using random-effects models. Lower AAPR values were significantly correlated with worse overall survival (hazard ratio [HR], 2.08), progression-free survival (HR, 2.00), and disease-free survival (HR, 2.18). Sensitivity analyses confirmed the robustness of these results, with no significant publication bias detected. Conclusion . Our findings suggest that pretreatment AAPR could serve as a valuable and cost-effective prognostic indicator in HNC, potentially aiding clinicians in risk stratification and treatment decision-making. However, additional validation studies are warranted to confirm its clinical applicability.

This study aimed to clarify the appropriate disease coding for coronary heart disease(CHD)and procedure coding for coronary stent implantation through an in-depth analysis of the I20-I25 classification for ischemic heart disease in the International Classification of Diseases,Tenth Revision(ICD-10),and the 36.06-36.07 procedure codes for coronary stents in the International Classification of Diseases,Ninth Revision,Clinical Modification(ICD-9-CM-3),2011 revision.Representative cases from a tertiary general hospital were analyzed to illustrate and validate accurate coding practices.Based on coding guidelines and case analyses,a set of correct codes for CHD and coronary stent procedures was compiled.This work provides guidelines for standardizing medical information documentation and provides a reference for medical insurance payment reform in CHD patients undergoing coronary stent implantation.

Objective This study aims to evaluate the effectiveness of intelligent bed management model in integrating bed resources in a large comprehensive hospital.Methods Inpatient data from a tertiary hospital between January 2021 and De-cember 2024 were collected.An intelligent hospital-wide bed management platform was constructed to implement bed resource sharing mechanisms and establish a standardized bed reservation grading system.The implementation effect of the system was e-valuated from the perspective of bed occupancy rate,average length of stay,and patient satisfaction.Results After implementa-tion,bed occupancy rates in key monitored departments moved into a reasonable range:Rehabilitation Medicine Department fell from 113.18％to 101.48％(t=4.26,P＜0.01),while Neurology Department increased from 88.18％to 96.20％(t=3.85,P＜0.01).Annual inpatient admissions increased from 83,931 to 103,852(x2=156.82,P＜0.001),and average length of stay shortened from 7.15 days to 6.21 days(t=4.73,P＜0.01).The admission waiting time was cut by 72.7 hours(-43.1％),and satisfaction with bed allocation rationality improved by 11.2 points(t=5.94,P＜0.001).Staff time spent on bed-assignment fell by 42 minutes per shift(t=8.92,P＜0.001),and cross-department transfers increased by 378 episodes per month(x2=145.26,P＜0.001).Conclusion The intelligent bed management model can effectively improve hospital bed utili-zation efficiency,enhance healthcare service quality,reduce staff workload,and merits wider application in similar hospitals.

Objective:To detect the serum levels of 25(OH)D,miR-125b-5p,hypoxia-inducible factor-1α(HIF-1α)and vascular endothelial growth factor A(VEGFA)in patients with multiple myeloma(MM),and explore the role of miR-125b-5p/HIF-1α pathway in the involvement of vitamin D deficiency in the pathogenesis of MM.Methods:Fifty three newly diagnosed/relapsed MM patients admitted to the department of hematology of our hospital from October 2021 to December 2023 were included.Meanwhile,25 healthy individuals matched in gender and age from our hospital's Health Management Center were selected as controls.The serum level of 25(OH)D was monitored by mass spectrometry,the serum level of miR-125b-5p was detected by real-time fluorescence quantitative PCR,and serum levels of HIF-1α and VEGFA were measured by enzyme-linked immunosorbent assay.The levels of 25(OH)D,miR-125b-5p,HIF-1α,and VEGFA were compared between the two groups.According to the level of 25(OH)D,the MM patients were divided into vitamin D deficiency group(＜20 ng/ml)and vitamin D non-deficiency group(≥ 20 ng/ml),and the levels of miR-125b-5p,HIF-1α,and VEGFA were compared between the two groups.The correlations between 25(OH)D,miR-125b-5p,HIF-1α and VEGFA were analyzed.The receiver operating characteristic(ROC)curve analysis was used to determine the diagnostic value of25(OH)D combined with miR-125b-5p for newly diagnosed MM.Results:The level of 25(OH)D in MM patients was significantly lower than that in control group(P＜0.01).There was no significant difference in 25(OH)D level between newly diagnosed and relapsed MM patients(P＞0.05).Compared with the control group,the level of miR-125b-5p was significantly reduced in MM patients(P＜0.01),while the levels of HIF-1α and VEGFA were significantly increased(both P＜0.001).In MM patients,the miR-125b-5p level in the vitamin D deficiency group was significantly decreased than that in the non-deficiency group(P＜0.01),while the levels of HIF-1 α and VEGFA were significantly increased(both P＜0.05).In MM patients,25(OH)D was positively correlated with miR-125b-5p,while negatively correlated with HIF-1α and VEGFA(both P＜0.05).Moreover,miR-125b-5p was negatively correlated with HIF-1α and VEGFA(both P＜0.05).The area under the curve(AUC)for diagnosing MM with 25(OH)D,miR-125b-5p,and their combination were 0.699,0.751,and 0.791,respectively.Conclusion:The incidence of vitamin D deficiency is high in MM patients.Vitamin D deficiency may promote angiogenesis and participate in the occurrence and development of MM by downregulating miR-125b-5p and upregulating HIF-1α and VEGFA expression.

OBJECTIVE To analyze a strain of multidrug-resistant Pseudomonas fulva by whole genome sequencing,investigate the genomic characteristics and analyze the significance in phyletic evolution.METHODS A strain of P.fulva,NY4814,was isolated from the Chinese PLA General Hospital in 2014.The genome sequence data of the strain were obtained after the purification,preservation and whole genome sequencing.The specie of the strain was identified by comparing with average nucleotide identity(ANI);the minimum inhibitory concentra-tions(MIC)of the strains were determined by VITEK2 system.All of the data regarding to the genomic se-quences of P.fulva were downloaded from RefSeq database of National Center of Biotechnology Information(NCBI)to construct the phylogenetic tree.RESULTS The P.fulva NY4814 was resistant to carbapenems and quinolones.The chromosome carried a newly discovered Tn7675 unit transposon,which mediated resistance to aminoglycosides and chloramphenicol.Simultaneously,the plasmid pNY4814-IMP drove the wide dissemination of the blaIMP resistance gene across Pseudomonas species via a highly conserved conjugative and transfer mechanism,and the Tn6485i unit transposon carried by the chromosome mediated the resistance to β-lactams.CONCLUSIONS As one of the potential carriers for the transmission of carbapenems resistance genes and other types of drug re-sistance genes,the P.fulva leads to the infection as a seldom opportunistic pathogen.The genetic structure of NY4814 and its association with genetic evolution of the species are observed in the study,which intensify the un-derstanding of the species and provide theoretical bases for prevention and monitoring of bacterial infections.

Objective:To study echinococcosis in the population and canine Echinococcus infection in Yushu City, Qinghai Province, and to explore the current epidemic situation and main transmission species of Echinococcus. Methods:In June 2023, a multi-stage sampling method was used to select 2 villages each in Shanglaxiu Township and Longbao Town, Yushu City, Qinghai Province. Each village included at least 100 permanent residents who had lived locally for at least 1 year and were 2 years old or older as the survey subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum antibodies against Echinococcus larvae in the population, and B-mode ultrasound was used for abdominal organ scanning. Meanwhile, on the main roads of Shanglaxiu Township and Longbao Town, canine feces were collected in designated areas at intervals. ELISA was used to detect the antigen of canine fecal Echinococcus, and PCR was used to detect the types of parasites ( Echinococcus multilocularis, Echinococcus granulosus and Echinococcus shiquicus). Results:A total of 511 residents were investigated in Yushu City, and the positive rate of serum Echinococcus larvae antibodies in the population was 26.22% (134/511), and the detection rate of echinococcosis B-mode ultrasound was 1.37% (7/511). Among them, the detection rates of B-mode ultrasound for cystic echinococcosis (CE) and alveolar echinococcosis (AE) were 1.17% (6/511) and 0.20% (1/511), respectively. The positive rate of Echinococcus antigen in 543 canine feces detected by ELISA was 12.89% (70/543). PCR was used to test 497 canine feces, and the detection rate of Echinococcus was 3.02% (15/497). Among them, the detection rate of Echinococcus multilocularis was higher than that of Echinococcus granulosus [2.82% (14/497) vs 0.20% (1/497)], and the difference was statistically significant (χ 2 = 11.44, P < 0.001). No Echinococcus shiquicus was detected. Conclusions:The positive rates of Echinococcus larvae antibodies in the population and canine Echinococcus antigen in Yushu City, Qinghai Province are both relatively high. There is a mixed epidemic of CE and AE, with Echinococcus multilocularis being the main species.

Objective To analyze the application effect of narrow band imaging(NBI)combined with magnifying endoscopy(ME)in early gastric cancer(EGC)screening.Methods A total of 199 patients who found focal lesions by ordinary white light endoscopy(WLE)were selected from April 2022 to October 2023.NBI combined with ME examination was performed,and histopathological examination of the specimen obtained from the lesion area was conducted.The pathological diagnosis results were recorded,and the endoscopic image qualities of WLE and NBI combined with ME examination were observed.The consistency between WLE,NBI combined with ME and patho-logical diagnosis was analyzed.The diagnostic value of WLE and NBI combined with ME for EGC was evaluated.Results The image qualities of microvascular and glandular duct by NBI combined with ME were better than those by WLE(P<0.05).The consistency between WLE diagnosis and pathological diagnosis was comparatively strong(Kappa=0.687).The consistency between NBI combined with ME and pathological diagnosis was very strong(Kappa=0.947).The consistency between NBI combined with ME and pathological diagnosis was better than that of WLE.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and area under the curve(AUC)of NBI combined with ME in diagnosing EGC were higher than those of WLE,with statistically significant differences(P<0.05).The AUC of NBI combined with ME for diagnosing EGC was higher than that of WLE,with statistically significant difference(Z=3.493,P=0.000).Conclusion NBI combined with ME can increase the diagnostic efficiency of EGC,along with good image quality.

Background and Aims:Primary hepatic diffuse large B-cell lymphoma(DLBCL)is rare and carries a poor prognosis,with no large-scale evidence supporting the value of chemotherapy.This study used real-world,large-sample data from the SEER database to evaluate the prognostic impact of chemotherapy in patients with primary hepatic DLBCL.Methods:Clinical data of patients pathologically diagnosed with primary hepatic DLBCL between 2000 and 2019 were extracted from the SEER database and grouped according to whether they received chemotherapy.Kaplan-Meier survival analysis,Cox proportional hazards models,and random survival forest models were employed to identify factors influencing overall survival(OS)and cancer-specific survival(CSS),and subgroup analyses were performed.Results:A total of 594 patients were included,with a median age of 66 years;435(73.2%)received chemotherapy.After a median follow-up of 17.5 months,the median OS was 81(7-173)months in the chemotherapy group versus 11(2-171)months in the non-chemotherapy group.The OS and CSS rates in the chemotherapy group were significantly higher than those in the non-chemotherapy group(67.99%vs.47.77%;71.03%vs.52.87%,both P<0.05).Multivariate analysis showed that chemotherapy was an independent protective factor for OS(HR=0.39,95%CI=0.31-0.48)and CSS(HR=0.37,95%CI=0.29-0.48).In the random survival forest model,chemotherapy ranked highest in variable importance.Subgroup analyses produced consistent results.Conclusion:Chemotherapy is an independent prognostic factor for patients with primary hepatic DLBCL and can significantly improve survival.The R-CHOP regimen may be the preferred therapeutic option.

Congenital infiltrating lipomatosis of the face (CIL-F) represents a rare lipomatous lesion, as evidenced by a case admitted to the Department of Plastic and Reconstructive Surgery at the Second Affiliated Hospital of Kunming Medical University in August 2023. The patient, a 7-year-old male, presented with diffuse enlargement of the right middle and lower face and a forehead mass since birth. Imaging assessments including CT scan with three dimensional reconstruction and MRI revealed infiltrative fatty growth in the right middle and lower face, abnormal subcutaneous fat hyperplasia in the forehead, and asymmetric abnormal hyperplasia of the right mandible. Following surgical resection, genetic testing of the excised tissue identified a mutation of the PIK3CA gene. Remarkably, the patient demonstrated satisfactory recovery six months post-surgery. Given its rarity in clinic, this case offers valuable clinical insights for managing similar disease.

Aim To investigate the effects of sodium lactate(NALA)on right heart failure induced by monocrotaline(MCT)-induced pulmonary arterial hy-pertension in rats and to reveal the underlying mecha-nisms.Methods Forty male Sprague-Dawley(SD)rats were randomly allocated into four groups,with ten rats in each group,namely,MCT group,NALA group,and NALA+MCT group;the MCT and NALA+MCT groups were administered a single intraperito-neal injection of MCT at 60 mg·kg-1 to induce pul-monary hypertension,and one week later,the NALA and NALA+MCT groups received intraperitoneal in-jections of NALA at 0.1 g·kg-1(once a day,for 5 weeks),while the CON and MCT groups received e-qual volumes of physiological saline(once a day,for 5 weeks);right heart function was assessed using echo-cardiography,right ventricular and pulmonary artery remodeling were evaluated via histopathological sec-tions,and the expression levels of ANP,BNP,and in-flammatory factors were measured by ELISA,along with assessments of oxidative stress levels,Western blot detection of the expression levels of proteins in the TLR4/NF-κB signaling pathway.Results Compared to the CON group,the MCT group exhibited increased RVSP and RVHI,decreased right heart function,in-creased collagen fiber deposition,and elevated oxida-tive stress and inflammatory factor expression,and the expression levels of proteins in the TLR4/NF-κB signa-ling pathway increased(P＜0.05);compared to the MCT group,the NALA+MCT group showed reduced RVSP and RVHI,improved right heart function,atten-uated pulmonary vascular remodeling,decreased ex-pression of ANP,BNP,inflammatory factors,and H2O2,along with increased antioxidant enzyme expres-sion,and the expression levels of proteins in the TLR4/NF-κB signaling pathway decreased(P＜0.05).Conclusion NALA can inhibit right ventric-ular remodeling in rats with pulmonary hypertension,and the underlying mechanism may involve the allevia-tion of inflammatory responses and oxidative stress through the inhibition of the TLR4/NF-κB signaling pathway.