Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Objective: To explore the association between dietary patterns and overweight and obesity among primary and middle school students, so as to provide the guidance of diet balance and obesity prevention for students. Methods: Students from 11 primary and middle schools in Tongzhou District, Beijing Municipality, were selected using the stratified cluster sampling method. Demographic information was collected through a general questionnaire, and dietary intake types and frequencies over the past week were assessed using a food frequency questionnaire. Dietary patterns were determined using factor analysis, and the dietary pattern factor scores were divided into Q1, Q2, Q3, and Q4 groups based on quartiles. Height and weight were collected through physical examinations, and Z-scores of body mass index adjusted for gender and age were calculated to assess overweight and obesity. The association between dietary patterns and overweight and obesity was analyzed using a multivariable logistic regression model. Results: A total of 1 485 students were surveyed, including 745 males (50.17%) and 740 females (49.83%). The mean age was (12.87±2.86) years. Three dietary patterns were identified: animal and plant protein dietary pattern, high-fat and high-sugar dietary pattern, and vegetable-fruit-dairy dietary pattern. The detection rates of overweight and obesity were 42.57%, 48.42%, and 34.75%, respectively, with statistically significant differences (P<0.05). Multivariable logistic regression analysis showed that compared with the vegetable-fruit-dairy dietary pattern, the animal and plant protein dietary pattern (OR=1.406, 95%CI: 1.084-1.823) and the high-fat and high-sugar dietary pattern (OR=2.137, 95%CI: 1.643-2.779) were associated with a higher risk of overweight and obesity among primary and middle school students. Compared with the Q1 group of dietary pattern factor scores, the Q3 group (OR=1.631, 95%CI: 1.206-2.208) and Q4 group (OR=1.965, 95%CI: 1.446-2.671) of the high-fat and high-sugar dietary pattern had an increased risk of overweight and obesity, while the Q4 group of the vegetable-fruit-dairy dietary pattern (OR=0.551, 95%CI: 0.406-0.747) had a reduced risk of overweight and obesity. There was no statistical association between factor scores of animal and plant protein dietary pattern and overweight and obesity (all P>0.05). Conclusions The animal and plant protein dietary pattern and the high-fat and high-sugar dietary pattern are associated with a higher risk of overweight and obesity among primary and middle school students. Within the same dietary pattern, the more inclined students are to the high-fat and high-sugar dietary pattern, the higher their risk of overweight and obesity, while the more inclined they are to the vegetable-fruit-dairy dietary pattern, the lower their risk of overweight and obesity.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

Background and Objectives: The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea. Methods: A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D. Results: From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis. Conclusions Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.

ObjectiveTo compare the development status of health facilities in different regions （non-agricultural and agricultural districts）and different types across four dimensions： organizational management， health environment， health activities， and health outcomes， to explore factors that may affect the current development status and summarize effective experiences， and to provide a foundation for the subsequent comprehensive， standardized， and effective promotion of health facility development and tiered and classified management. MethodsInvestigators conducted a health status survey based on the four dimensions for 50 health facilities in 16 districts of Shanghai， representing three types （including government agencies， enterprises， and communities）. Evaluation forms were filled out through on-site observation and document reviews， which were developed in accordance with the Shanghai Health Settings Evaluation Standards （for trial implementation in 2019）. ResultsThe average total score of health facilities in Shanghai was （88.42±11.93） points， with an overall excellence rate of 86.0%. The excellence rate of each dimension， from highest to lowest， were healthy environment （84.0%）， organizational management （82.0%）， health activities （78.0%）， and health outcomes （44.0%）. Health facilities in agricultural districts scored higher in both total score and average score on the organizational management dimension compared to non-agricultural districts. The excellence rate for the organizational management dimension was also higher in agricultural districts than in non-agricultural districts. There was no statistical significance in the total score， the score of each dimension， the overall excellence rate， and the excellence rate of each dimension among different types of health facilities （P>0.05）. ConclusionThe development of health facilities among government agencies， enterprises， and communities in Shanghai has begun to yield positive results. Health facilities in non-agricultural districts should actively draw on the experience of those in agricultural districts， particularly in organizational management， adjust development ideas and planning based on their own realities， so as to continuously improve the levels of development.

The development of health-promoting hospitals is an important part of the Healthy China Initiative， facilitating the transformation of medical institutions from a primary focus on medical and surgical treatments to a patient-centered approach prioritizing public health. To promote the scientific， standardized， and sustainable development of health-promoting hospitals， the Shanghai Municipal Center for Health Promotion， together with Shanghai General Hospital and other institutions， has jointly developed the Standards for the Development of Health⁃promoting Hospitals （Standards） in accordance with the principles of scientific rigor， feasibility， and advancing with the times. The Standards outlines the requirements for the development of health-promoting hospitals across four aspects： organizational and institutional guarantees， creation of a healthy environment， implementation of health education and promotion， and evaluation. It is applicable to all levels and types of public medical institutions in Shanghai， and can also be referred to and implemented by other medical institutions. The introduction of the Standards is of great significance for promoting the formation of a long-term mechanism in health-promoting hospitals. This paper introduces the basis， principles， main content， precautions， and implementation suggestions of the Standards. Taking into account relevant policies and standards， it interprets the technical aspects in the process of developing health-promoting hospitals， which is helpful for medical institutions and their management to better understand and apply the standards in their work.

Objective To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE)intervention timing and liver injury periodization in patients with exertional heat stroke(EHS).Methods Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected,then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT,AST,TBIL and DBIL.According to propensity score matching analysis,11 patients in the survival group and 12 patients in the death group were included in the statistical analysis,and 20 of them were treated with TPE.The changes in indicators and clinical outcomes before and after TPE were observed,in order to evaluate the impact of intervention timing on prognosis.Results Among the 23 patients,14 had no liver injury or could progress to the repair phase,resulting in 3 deaths(with the mortality rate of 21.43%),while 9 patients failed to pro-gress to the repair phase,resulting in 9 deaths(with the mortality rate of 100%),with significant differences(P＜0.05).The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13),while that of interven-tion after reaching or exceeding the third stage was 85.71%(6/7),and the difference was statistically significant(P＜0.05).Conclusion TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes,thereby improving prognosis and reducing mortality.

ObjectiveTo investigate the current situation of health communication carried out by medical institutions in Shanghai through new media platforms such as WeChat， Weibo， Toutiao， Douyin， Kuaishou， Bilibili and WeChat Videos， and to propose targeted measures. MethodsBased on the systematic collection of new media accounts of medical institutions in Shanghai， and through the combination of keyword screening and manual audit， health communication data of medical institutions on new media platforms were determined. ResultsData from 1 117 new media accounts of 162 medical institutions in Shanghai were collected， including 610 WeChat official accounts， 105 WeChat video accounts， 89 Weibo accounts， 18 Bilibili accounts， 198 Douyin accounts， 37 Toutiao accounts， and 60 Kuaishou accounts， totaling 111 853 posts. After keyword sorting and manual screening， a total of 66 761 health science posts were collected， with WeChat Official Accounts， Douyin， and Weibo having the top three highest number of posts. Video-based new media such as Douyin， WeChat Videos， Kuaishou， and Bilibili had a better communication impact than text and image-based new media like WeChat Official Accounts， Weibo， and Toutiao. Among them， Douyin and Toutiao were the best platforms for video and text-image-based new media， respectively. ConclusionMedical institutions in Shanghai recognize the importance of new media in health communication and have made full use of various media platforms to carry out health communication，having a certain impact on health education. In the future， medical institutions should choose appropriate platforms based on target audiences and content characteristics， fully leverage the advantages of various platforms， explore innovative communication strategies， promote the dissemination of health knowledge， and enhance the health literacy of the public.

Objective To investigate the inhibitory effect of epigallocatechin gallate(EGCG)on oxidative damage to the retina in a rat model of dry age-related macular degeneration(AMD)induced by sodium iodate.Methods A total of 36 male specific pathogen-free Sprague-Dawley rats were randomly divided into the blank control group,sodium iodate group and sodium iodate+EGCG group,with 12 rats in each group.Rats in the sodium iodate group and the sodium io-date+EGCG group were given 50 mg-kg·1 sodium iodate by tail vein injection by weight to build dry AMD models,while rats in the blank control group were administered with an equal volume of normal saline.Following the modeling proce-dure,rats in the sodium iodate+EGCG group received an intravitreal injection of 4 μL EGCG(0.5 g·L-1)into their right eyes,while the right eyes of rats in both the blank control and sodium iodate groups were treated with the same volume of normal saline.After 21 days,the rats were sacrificed,and ocular samples were collected for detection.Histopathological changes of the retinal tissues in each group were examined using hematoxylin and eosin(HE)staining.Additionally,the levels of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)in the retinal tis-sues were quantified.Western blot analysis was conducted to assess the protein expression levels of nuclear factor ery-throid-2-related factor 2(Nrf2),NADPH quinone oxidoreductase 1(NQO1),and heme oxygenase-1(HO-1)in the retinas.Furthermore,real-time quantitative polymerase chain reaction was performed to evaluate the relative messenger ribonucleic acid(mRNA)expression levels of Nrf2,NQO1 and HO-1 in the retinas of the rats.Results HE staining revealed that,in comparison to the blank control group,the entire retinal layer in the sodium iodate group exhibited injury,characterized by noticeable injury of the retinal pigment epithelial cells and disordered outer nuclear layer with wavy transformation.The so-dium iodate+EGCG group demonstrated ameliorated retinal injury across all layers compared to the sodium iodate group.Compared to the blank control group,the levels of SOD and GSH-Px were significantly reduced(both P＜0.01),while the level of MDA was significantly elevated(P＜0.01)in the sodium iodate group.Compared with the sodium iodate group,the sodium iodate+EGCG group showed a significant increase in the levels of SOD and GSH-Px(both P＜0.01),along-side a substantial decrease in the content of MDA(P＜0.01).Western blot analyses demonstrated that compared with the blank control group,the protein expression levels of Nrf2,NQO1 and HO-1 were significantly elevated in the sodium iodate group(all P＜0.01);compared with the sodium iodate group,the sodium iodate+EGCG group exhibited relatively higher protein expression levels of Nrf2,NQO1 and HO-1(all P＜0.05).The results from real-time quantitative polymerase chain reaction indicated that the relative mRNA expression levels of Nrf2,NQO1 and HO-1 in the retinas of rats in the sodium io-date group were significantly greater than those in the blank control group(all P＜0.05);compared with the sodium iodate group,the sodium iodate+EGCG group showed a significant increase in the relative mRNA expression levels of Nrf2,NQO1 and HO-1(all P＜0.05).Conclusion EGCG can improve the capacity to scavenge oxygen free radicals by promo-ting the upregulation of Nrf2 expression.This activation subsequently enhances the expression of downstream products such as NQO1 and HO-1,leading to increased levels of SOD and GSH-Px while simultaneously reducing the MDA level.Consequently,this process inhibits oxidative damage to the retina in rats with dry AMD induced by sodium iodate.