Objective To investigate the relationship between the levels of Versican(VCAN)and Cyclin D1(CCND1)in peripheral blood and the progression and prognosis of multiple myeloma(MM).Methods A total of 121 patients with MM(MM group)and 109 healthy volunteers(control group)were selected and admitted to the Department of Hematology of Suzhou Municipal Hospital from January 2018 to May 2022.According to the International Staging System(ISS),the patients with MM were divided into a stage I group(n=46),a stage II group(n=41),and a stage III group(n=34).Real time fluorescence quantitative PCR(RT-PCR)was used to detect the expression levels of VCAN mRNA and CCND1 mRNA in peripheral blood,the patients were followed up for 24 months after discharge to make statistics on the survival of MM patients.The VCAN mRNA and CCND1 mRNA expression in the peripheral blood of MM patients with different ISS was compared.Kaplan-Meier method was used to draw the survival curve of MM,and multi-factor COX proportional regression analysis was established to analyze the factors affecting the prognosis of MM patients.Results The expressions of VCAN mRNA(2.69±0.63)and CCND1 mRNA(3.29±0.63)in peripheral blood of MM group were higher than those of control group(1.32±0.46,1.53±0.37),and the differences were statistically significant(t=18.659,25.473,all P<0.05).The expressions of VCAN mRNA(3.05±0.31)and CCND1 mRNA(3.75±0.21)in peripheral blood of stage Ⅲ group were higher than those of stage Ⅱ(2.76±0.31,3.29±0.36)and stage Ⅰ groups(2.36±0.25,2.95±0.29),and the differences were statistically significant(t=7.626～16.831,all P<0.05).During the follow-up period,1 case was lost to follow-up,36 cases died and 84 cases survived.The overall survival rate of patients with high VCAN mRNA(58.06%)and CCND1 mRNA(57.14%)expression MM was lower than that of patients with low VCAN mRNA(82.76%)and CCND1 mRNA(84.21%),and the differences were statistically significant(χ2=8.727,10.820,all P<0.05).The age of the death group was higher than that of the survival group(t=3.020),ISS stage III,and bone marrow cells proportion≥60%,chromosome karyotype 1q21+proportion,peripheral blood VCAN mRNA and CCND1 mRNA i expression were all higher than those of the survival group(t/χ2=5.988～8.589),and the differences were statistically significant(all P<0.05),respectively.Multivariate COX risk ratio analysis,ISS stage III,high expression of VCAN mRNA and CCND1 mRNA were risk factors for death in MM patients during follow-up(Wald χ2=10.672,5.682,5.969,all P<0.05).Conclusion The expression of VCAN mRNA and CCND1 mRNA in peripheral blood of MM patients is significantly increased,which is related to high clinical stage and poor prognosis.

Objective To investigate the correlation of vascular senescence indicators,brachial-ankle pulse wave velocity(baPWV),cardio-ankle vascular index(CAVI),ankle-brachial index(ABI)with total burden of MRI in patients with cerebral small vessel disease(CSVD).Methods A total of 200 CSVD patients admitted to our hospital from November 2023 to October 2024 were retrospectively recruited,and based on their total MRI burden,they were divided into a low-burden group(score:0-1,103 cases)and a high-burden group(score:2-4,97 cases).A athero-sclerosis monitoring device(VS-1500A)was used to detect baPWV,CAVI,and ABI values.The relationships of the three indicators with total MRI burden score and their predictive values for the burden score were analyzed.Results The high-burden group had significantly higher BMI,el-evated homocysteine and uric acid levels,and increased baPWV and CAVI,but lower ABI than the low-burden group(P＜0.01).Multivariate logistic analysis showed that baPWV,CAVI and ABI were independent influencing factors for high MRI burden of CSVD patients.Spearman correlation analysis showed that baPWV and CAVI values were positively correlated(r=0.589,P=0.000;r=0.458,P=0.000),and ABI was negatively correlated with the total MRI burden score of CSVD patients(r=-0.352,P=0.000).ROC curve analysis showed that baPWV(AUC=0.816,P=0.000),CAVI(AUC=0.725,P=0.000)and ABI(AUC=0.676,P=0.000)were all predic-tors for high MRI burden score in CSVD patients.Conclusion baPWV and CAVI are positively,and ABI is negatively correlated with the total MRI burden score of CSVD patients.baPWV,CAVI and ABI show higher predictive value for the high burden score,with baPWV most significant.

Objective:To understand the awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention and related factors in primary and secondary school teachers.Methods:Cross-sectional study design and stratified random sampling method were used to select 5 teachers from each of 51 primary schools and 40 middle schools in a district of Beijing from April 17 to 21, 2024. A questionnaire survey was conducted in the selected teachers with an estimated sample size of 1 040. The survey collected the information about their demographic characteristics, awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention. Multivariate logistic regression model was used to analyze the factors related to influenza vaccination status and intention.Results:In the 975 primary and secondary school teachers, the awareness of susceptibility and severity of influenza and the benefits of influenza vaccination were high. In terms of safety of influenza vaccine, 48.00% (468/975) of the teachers believed that adverse reaction would occur after the vaccination. Influenza like illness occurred in 41.13% (401/975) of the teachers during 2023-2024, and in these teachers, 40.15% (161/401) asked for leave from work due to illness, 40.90% (164/401) sought medical care and 32.93% (54/164) were influenza virus positive. In the 975 teachers, 13.95% (136/975) were vaccinated against influenza during 2023-2024 and 34.46% (336/975) were willing to be vaccinated against influenza during 2024-2025. Multivariate logistic regression analysis showed that being teacher in charge of a class (a OR=1.58, 95% CI: 1.06-2.35), believing that influenza vaccination could effectively prevent influenza (a OR=1.99, 95% CI: 1.05-3.80), believing that teachers' vaccination could improve students' willingness to be vaccinated (a OR=1.98, 95% CI: 1.12-3.50) were the positive factors for teachers' vaccination, and worrying about adverse reactions after the vaccination (a OR=0.52, 95% CI: 0.34-0.80) was the negative factor. Doctors' recommendation (a OR=2.62, 95% CI: 1.41-4.86) and free influenza vaccination (a OR=10.26, 95% CI: 5.17-20.39) were positively correlated with teachers' intention to influenza vaccination. Conclusions:Primary and secondary school teachers in a district of Beijing had high awareness of influenza and influenza vaccine, but their awareness of influenza vaccine safety should be improved. The incidence of influenza-related infection was high in the primary and secondary school teachers. The influenza vaccination rate was low and the willingness to receive influenza vaccination in following year was not strong. For the better prevention and control of influenza in schools, it is necessary to strengthen the health education in primary and secondary school teachers to improve their awareness of influenza vaccine safety and vaccination rate.

Objective:To understand the awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention and related factors in primary and secondary school teachers.Methods:Cross-sectional study design and stratified random sampling method were used to select 5 teachers from each of 51 primary schools and 40 middle schools in a district of Beijing from April 17 to 21, 2024. A questionnaire survey was conducted in the selected teachers with an estimated sample size of 1 040. The survey collected the information about their demographic characteristics, awareness of influenza and influenza vaccine, influenza incidence, influenza vaccination status and intention. Multivariate logistic regression model was used to analyze the factors related to influenza vaccination status and intention.Results:In the 975 primary and secondary school teachers, the awareness of susceptibility and severity of influenza and the benefits of influenza vaccination were high. In terms of safety of influenza vaccine, 48.00% (468/975) of the teachers believed that adverse reaction would occur after the vaccination. Influenza like illness occurred in 41.13% (401/975) of the teachers during 2023-2024, and in these teachers, 40.15% (161/401) asked for leave from work due to illness, 40.90% (164/401) sought medical care and 32.93% (54/164) were influenza virus positive. In the 975 teachers, 13.95% (136/975) were vaccinated against influenza during 2023-2024 and 34.46% (336/975) were willing to be vaccinated against influenza during 2024-2025. Multivariate logistic regression analysis showed that being teacher in charge of a class (a OR=1.58, 95% CI: 1.06-2.35), believing that influenza vaccination could effectively prevent influenza (a OR=1.99, 95% CI: 1.05-3.80), believing that teachers' vaccination could improve students' willingness to be vaccinated (a OR=1.98, 95% CI: 1.12-3.50) were the positive factors for teachers' vaccination, and worrying about adverse reactions after the vaccination (a OR=0.52, 95% CI: 0.34-0.80) was the negative factor. Doctors' recommendation (a OR=2.62, 95% CI: 1.41-4.86) and free influenza vaccination (a OR=10.26, 95% CI: 5.17-20.39) were positively correlated with teachers' intention to influenza vaccination. Conclusions:Primary and secondary school teachers in a district of Beijing had high awareness of influenza and influenza vaccine, but their awareness of influenza vaccine safety should be improved. The incidence of influenza-related infection was high in the primary and secondary school teachers. The influenza vaccination rate was low and the willingness to receive influenza vaccination in following year was not strong. For the better prevention and control of influenza in schools, it is necessary to strengthen the health education in primary and secondary school teachers to improve their awareness of influenza vaccine safety and vaccination rate.

Objective To investigate the relationship between the levels of Versican(VCAN)and Cyclin D1(CCND1)in peripheral blood and the progression and prognosis of multiple myeloma(MM).Methods A total of 121 patients with MM(MM group)and 109 healthy volunteers(control group)were selected and admitted to the Department of Hematology of Suzhou Municipal Hospital from January 2018 to May 2022.According to the International Staging System(ISS),the patients with MM were divided into a stage I group(n=46),a stage II group(n=41),and a stage III group(n=34).Real time fluorescence quantitative PCR(RT-PCR)was used to detect the expression levels of VCAN mRNA and CCND1 mRNA in peripheral blood,the patients were followed up for 24 months after discharge to make statistics on the survival of MM patients.The VCAN mRNA and CCND1 mRNA expression in the peripheral blood of MM patients with different ISS was compared.Kaplan-Meier method was used to draw the survival curve of MM,and multi-factor COX proportional regression analysis was established to analyze the factors affecting the prognosis of MM patients.Results The expressions of VCAN mRNA(2.69±0.63)and CCND1 mRNA(3.29±0.63)in peripheral blood of MM group were higher than those of control group(1.32±0.46,1.53±0.37),and the differences were statistically significant(t=18.659,25.473,all P<0.05).The expressions of VCAN mRNA(3.05±0.31)and CCND1 mRNA(3.75±0.21)in peripheral blood of stage Ⅲ group were higher than those of stage Ⅱ(2.76±0.31,3.29±0.36)and stage Ⅰ groups(2.36±0.25,2.95±0.29),and the differences were statistically significant(t=7.626～16.831,all P<0.05).During the follow-up period,1 case was lost to follow-up,36 cases died and 84 cases survived.The overall survival rate of patients with high VCAN mRNA(58.06%)and CCND1 mRNA(57.14%)expression MM was lower than that of patients with low VCAN mRNA(82.76%)and CCND1 mRNA(84.21%),and the differences were statistically significant(χ2=8.727,10.820,all P<0.05).The age of the death group was higher than that of the survival group(t=3.020),ISS stage III,and bone marrow cells proportion≥60%,chromosome karyotype 1q21+proportion,peripheral blood VCAN mRNA and CCND1 mRNA i expression were all higher than those of the survival group(t/χ2=5.988～8.589),and the differences were statistically significant(all P<0.05),respectively.Multivariate COX risk ratio analysis,ISS stage III,high expression of VCAN mRNA and CCND1 mRNA were risk factors for death in MM patients during follow-up(Wald χ2=10.672,5.682,5.969,all P<0.05).Conclusion The expression of VCAN mRNA and CCND1 mRNA in peripheral blood of MM patients is significantly increased,which is related to high clinical stage and poor prognosis.

Objective To investigate the correlation of vascular senescence indicators,brachial-ankle pulse wave velocity(baPWV),cardio-ankle vascular index(CAVI),ankle-brachial index(ABI)with total burden of MRI in patients with cerebral small vessel disease(CSVD).Methods A total of 200 CSVD patients admitted to our hospital from November 2023 to October 2024 were retrospectively recruited,and based on their total MRI burden,they were divided into a low-burden group(score:0-1,103 cases)and a high-burden group(score:2-4,97 cases).A athero-sclerosis monitoring device(VS-1500A)was used to detect baPWV,CAVI,and ABI values.The relationships of the three indicators with total MRI burden score and their predictive values for the burden score were analyzed.Results The high-burden group had significantly higher BMI,el-evated homocysteine and uric acid levels,and increased baPWV and CAVI,but lower ABI than the low-burden group(P＜0.01).Multivariate logistic analysis showed that baPWV,CAVI and ABI were independent influencing factors for high MRI burden of CSVD patients.Spearman correlation analysis showed that baPWV and CAVI values were positively correlated(r=0.589,P=0.000;r=0.458,P=0.000),and ABI was negatively correlated with the total MRI burden score of CSVD patients(r=-0.352,P=0.000).ROC curve analysis showed that baPWV(AUC=0.816,P=0.000),CAVI(AUC=0.725,P=0.000)and ABI(AUC=0.676,P=0.000)were all predic-tors for high MRI burden score in CSVD patients.Conclusion baPWV and CAVI are positively,and ABI is negatively correlated with the total MRI burden score of CSVD patients.baPWV,CAVI and ABI show higher predictive value for the high burden score,with baPWV most significant.

Purpose/Significance To analyze relevant patented technologies,and to provide experience for medical and commercial health insurance institutions to break through the data interaction blocking point and construct a multi-level medical security system.Method/Process The patentometrics method is used to analyze the data interaction patent technology between medical and health insurance institutions from four aspects:time trend,regional distribution,category distribution and text clustering.Result/Conclusion China should pay attention to the role of data interaction in deepening cooperation between medical and insurance institutions,improve the declaration,authorization,application and protection of high-quality patents,pay attention to cross-border integration and technology-driven,and innovate patent layout to meet technological development and social needs.

Objective:To establish the objective of zero inventory management of in vitro diagnostic reagents,to evaluate the quality of supply chain,and to improve the existing problems in the supply of reagents.Methods:The problems existing in the management of in vitro diagnostic reagents were analyzed from the aspects of inventory,supply efficiency and product quality,and the management system of hospital operation,management quality and patient benefit optimization was established,and the zero-inventory management path and quality evaluation model were constructed.85 models of 21 types of in vitro diagnostic reagents purchased by Jiangsu Subei People's Hospital from January 2020 to March 2023 were selected.According to different supply chain quality management methods,on-demand inventory management mode(referred to as mode 1)and zero inventory management mode(referred to as mode 2)were adopted respectively.The demand procurement,inventory management and clinical use effects of the two management modes were compared.Results:The reagent procurement demand compliance rate,supply capacity high-quality quality rate and clinical use matching rate of mode 2 were(93.35±3.62)%,(94.87±2.63)% and(96.08±2.31)%,respectively,which were higher than those of mode 1,the difference was statistically significant(Z=2.489,2.836,2.838,P<0.05).The number of cases of long-term overstocking of products,substandard environment and untimely information in mode 2 were(2.92±2.54)cases,(2.83±1.59)cases and(5.58±3.12)cases,respectively,which were lower than those in mode 1,the difference was statistically significant(Z=2.959,3.037,3.703,P<0.05).The satisfaction of clinical departments,medical technology departments and procurement center with the supply,distribution and information communication of in vitro diagnostic reagents in mode 2 were 97.8% and 93.3%,97.0% and 87.9%,100% and 84.6%,respectively,which were higher than those in mode 1,the difference was statistically significant(x2clinical departments=5.428,6.133,x2medical technology departments=3.958,3.937,x2procurement center=5.159,4.996,P<0.05).Conclusion:The zero inventory management model can improve the standardization of in vitro diagnostic reagent demand procurement,reduce the incidence of backlog failure in inventory management,and improve the quality of clinical supply services.

Objective:To construct the evaluation index system of lumbar puncture teaching for medical students, aiming to create a scientific assessment and evaluation method covering theoretical knowledge, skill practice, and professional accomplishment, so as to comprehensively evaluate the teaching effect of lumbar puncture for medical students, and improve the practical ability of clinical skills of medical students more effectively.Methods:The evaluation index scheme of lumbar puncture teaching for medical students was initially formulated through literature review and group discussion, and 20 experts related to clinical front-line work and medicine were invited to revise the scheme by applying Delphi expert consultation and applying analytic hierarchy process to quantify the entries and establish the final index weights at all levels.Results:The valid recovery rate of both rounds of expert consultation questionnaires in this study was 100%. The second round of expert consultation was conducted without changing experts, with an authority factor of 0.88. Kendall's coefficient of harmony was 0.136 and 0.184, respectively. After two rounds of expert consultation, the evaluation index system of lumbar puncture teaching for medical students, including 3 primary indicators (theoretical knowledge, comprehensive clinical ability and professionalism), 7 secondary indicators and 22 tertiary indicators, was initially constructed.Conclusion:The evaluation index system of lumbar puncture teaching for medical students constructed in this study is scientific and credible, which can provide quantitative basis for the training and assessment of medical students, and is of great theoretical and practical significance.

As the progress of population aging in China, the proportion of elderly population is increasing. Both chronic diseases and infectious diseases can threaten the health of the elderly. There are many kinds of infectious diseases, including vaccine preventable infectious diseases affecting the health of adults, such as influenza, pneumococcal diseases and herpes zoster. In addition, the newly emerged COVID-19 has caused a pandemic in the world, resulting the highest proportion of deaths occurred in the elderly and posing a serious threat to the health of the elderly. This paper mainly summarizes the prevention and control of vaccine preventable diseases and COVID-19 to which the elderly are susceptible, analyzes the infectious disease problems affecting the health of elderly population, and recommends countermeasures for the prevention and control of these diseases in elderly population.