Background Hypertension is one of the chronic diseases with the highest prevalence in China, and a history of hypertension may potentially exacerbate hearing loss. Investigating the association between long-term blood pressure trends and hearing thresholds could contribute to hearing protection efforts for occupationally noise-exposed populations. Objective By investigating hearing thresholds and blood pressure levels among occupationally noise-exposed workers in an urban rail transit enterprise, and conducting a comprehensive analysis of the association between long-term blood pressure changes and hearing thresholds, to provide data references for health management strategies targeting occupationally noise-exposed workers. Methods Workers exposed to occupational noise at a rail transit enterprise were enrolled as study subjects and underwent pure-tone audiometry. Group-based trajectory modeling was employed to identify blood pressure trajectories. Categorical data were compared using chi-square tests, while normally distributed continuous variables were analyzed via t-tests and analysis of variance (ANOVA). Generalized linear mixed models (GLMMs) were subsequently applied toexamine associations between these trajectory groups and high-frequency hearing thresholds. Results Among 2 002 occupationally noise-exposed workers, the median (P₂₅, P₇₅) age was 32 (28, 35) years, with a median (P₂₅, P₇₅) working tenure of 7 (3, 10) years. In 2019, the positive hypertension rate was 9.04%, with a mean systolic blood pressure (SBP) of (122.97±11.60) mmHg and a mean diastolic blood pressure (DBP) of (76.37±9.02) mmHg. The hearing loss prevalence was 10.1%, showing bilateral high-frequency average hearing thresholds of (17.18±8.71) dB and speech-frequency average thresholds of (13.79±3.46) dB. Three distinct trajectory groups were identified for both SBP and DBP. Compared with other trajectory groups, the high-stable DBP group exhibited significantly higher hearing loss prevalence (χ²=6.34, P=0.042) and elevated high-frequency hearing thresholds (all Ps<0.05). Specifically, within the 30-39 age subgroup, the moderate-stable DBP group demonstrated 1.96 dB lower high-frequency thresholds than the high-stable group [β(95%CI): −1.96 (−3.61, −0.32), P=0.020]. Conclusion Among occupationally noise-exposed workers in a municipal rail transit enterprise, DBP trajectories demonstrated a positive association with high-frequency hearing thresholds. Notably, in young and middle-aged occupationally noise-exposed populations, DBP may exert a more critical influence than SBP on the progression of hearing loss.

Objective:To explore the adaptability of health resources allocation and the economic development level in Sichuan Province and its influencing factors,so as to provide reference and suggestions for optimizing health resources allocation.Methods:Based on the panel data of 21 cities(states)in Sichuan Province,it analyzes the adaptability of health resources allocation and economic development in Sichuan Province from 2017 to 2021 and its influencing factors through entropy method,coupling coordination model and grey relational model.Results:From 2017 to 2021,the allocation level of health resources in most areas of Sichuan Province showed a gradual upward trend,but the rising speed was obviously lower than the growth rate of economic development;In 2021,the adaptability between the allocation of health resources and the level of economic development in most parts of Sichuan Province is still in a low coordination stage.Conclusion:Different regions should adopt differentiated development strategies based on their actual geographical conditions,optimize the allocation of health resources according to local conditions,and promote the coordinated development of health resource allocation and economic level.

Objective:To explore the efficacy of the features of ultrasound imaging omics at the area peripheral thyroid nodule in predicting cervical lymph node metastasis(LNM)of papillary thyroid carcinoma(PTC),and construct a prediction model based on the features of imaging omics and to verify its performance.Methods:A total of 237 PTC patients who admitted to Shaanxi Provincial Hospital of Chinese Medicine from March 2021 to June 2024 and were confirmed by pathology were retrospectively collected.They were divided into the training set(166 cases)and the validation set(71 cases)as a ratio of 7 to 3.According to the postoperatively pathological results,237 patients were divided into the metastasis group(108 cases)and the non-metastasis group(129 cases).The clinical data and conventional ultrasound characteristic information of all patients were collected,and a feature model of imaging omics was constructed through quantitative extracting and screening the features of ultrasound imaging omics within nodules and peripheral nodules,and utilizing machine learning classifier.Then,the feature score(Rad-Score)of image omics was obtained.The Rad-Score values within and peripheral nodules,and the Rad-Score values peripheral nodules of metastasis group and non-metastasis group were compared.In training set,the independent risk factors of affecting neck LNM were analyzed,and a clinical-ultrasonic model was constructed,which was combined with Rad-Score to construct a joint model based on the features of imaging omics peripheral nodules.The receiver operating characteristic(ROC)curve was used to analyze and compare its predictive efficacy.The nomogram of the joint model was constructed,and then,the calibration and fitting degrees of the nomogram were assessed by calibration curve and Hosmer-Lemeshow test.Result:In training set,6 features of imaging omics within nodules and 11 features of imaging omics peripheral nodules were respectively extracted and screened out through the least absolute shrinkage and selection operator(LASSO)algorithm.In the training set and validation set,the Rad-Scores peripheral the nodules in the metastasis group were respectively(7.43±0.45)points and(7.19±0.51)points,which were significantly higher than(3.25±0.28)points and(3.51±0.32)points peripheral the nodules in the non-metastasis group,and the differences were statistically significant(t=72.708,61.222,P<0.05).The results of factor analysis showed that age,capsule invasion,microcalcification,ultrasound-indicated lymph node positivity and Rad-Score around nodules were independent risk factors of affecting cervical LNM of PTC patients(OR=0.592,2.983,3.593,4.424,2.575,P<0.05).The ROC curve showed that the area under curve(AUC)values of the ROC curve of joint model in training set and validation set were respectively 0.861 and 0.872 in predicting LNM,respectively,which were superior to 0.759 and 0.783 of the clinical-ultrasound model.Conclusion:In both the training set and the validation set,the nomogram of joint model has favorable calibration and fitting in predicting cervical LNM of PTC patients.The construction of clinical model based on the features of ultrasound imaging omics peripheral nodules has a favorable efficacy in predicting the status of cervical lymph node of PTC patients before surgery,which is expected to be an effective tool of individual prediction for LNM.

Objective:To explore the adaptability of health resources allocation and the economic development level in Sichuan Province and its influencing factors,so as to provide reference and suggestions for optimizing health resources allocation.Methods:Based on the panel data of 21 cities(states)in Sichuan Province,it analyzes the adaptability of health resources allocation and economic development in Sichuan Province from 2017 to 2021 and its influencing factors through entropy method,coupling coordination model and grey relational model.Results:From 2017 to 2021,the allocation level of health resources in most areas of Sichuan Province showed a gradual upward trend,but the rising speed was obviously lower than the growth rate of economic development;In 2021,the adaptability between the allocation of health resources and the level of economic development in most parts of Sichuan Province is still in a low coordination stage.Conclusion:Different regions should adopt differentiated development strategies based on their actual geographical conditions,optimize the allocation of health resources according to local conditions,and promote the coordinated development of health resource allocation and economic level.

Objective:To explore the efficacy of the features of ultrasound imaging omics at the area peripheral thyroid nodule in predicting cervical lymph node metastasis(LNM)of papillary thyroid carcinoma(PTC),and construct a prediction model based on the features of imaging omics and to verify its performance.Methods:A total of 237 PTC patients who admitted to Shaanxi Provincial Hospital of Chinese Medicine from March 2021 to June 2024 and were confirmed by pathology were retrospectively collected.They were divided into the training set(166 cases)and the validation set(71 cases)as a ratio of 7 to 3.According to the postoperatively pathological results,237 patients were divided into the metastasis group(108 cases)and the non-metastasis group(129 cases).The clinical data and conventional ultrasound characteristic information of all patients were collected,and a feature model of imaging omics was constructed through quantitative extracting and screening the features of ultrasound imaging omics within nodules and peripheral nodules,and utilizing machine learning classifier.Then,the feature score(Rad-Score)of image omics was obtained.The Rad-Score values within and peripheral nodules,and the Rad-Score values peripheral nodules of metastasis group and non-metastasis group were compared.In training set,the independent risk factors of affecting neck LNM were analyzed,and a clinical-ultrasonic model was constructed,which was combined with Rad-Score to construct a joint model based on the features of imaging omics peripheral nodules.The receiver operating characteristic(ROC)curve was used to analyze and compare its predictive efficacy.The nomogram of the joint model was constructed,and then,the calibration and fitting degrees of the nomogram were assessed by calibration curve and Hosmer-Lemeshow test.Result:In training set,6 features of imaging omics within nodules and 11 features of imaging omics peripheral nodules were respectively extracted and screened out through the least absolute shrinkage and selection operator(LASSO)algorithm.In the training set and validation set,the Rad-Scores peripheral the nodules in the metastasis group were respectively(7.43±0.45)points and(7.19±0.51)points,which were significantly higher than(3.25±0.28)points and(3.51±0.32)points peripheral the nodules in the non-metastasis group,and the differences were statistically significant(t=72.708,61.222,P<0.05).The results of factor analysis showed that age,capsule invasion,microcalcification,ultrasound-indicated lymph node positivity and Rad-Score around nodules were independent risk factors of affecting cervical LNM of PTC patients(OR=0.592,2.983,3.593,4.424,2.575,P<0.05).The ROC curve showed that the area under curve(AUC)values of the ROC curve of joint model in training set and validation set were respectively 0.861 and 0.872 in predicting LNM,respectively,which were superior to 0.759 and 0.783 of the clinical-ultrasound model.Conclusion:In both the training set and the validation set,the nomogram of joint model has favorable calibration and fitting in predicting cervical LNM of PTC patients.The construction of clinical model based on the features of ultrasound imaging omics peripheral nodules has a favorable efficacy in predicting the status of cervical lymph node of PTC patients before surgery,which is expected to be an effective tool of individual prediction for LNM.

OBJECTIVE To establish the fingerprint of Pinghuo tea standard decoction and a method for determination of multi-component to clarify the transfer relationship of quantities and quality from pieces and standard decoction.METHODS Fifteen batches of Pinghuo tea standard decoction were prepared and the extract rate was determined;the fingerprint of the preparation was established by using high-performance liquid chromatography(HPLC);the similarity evaluation and the determination of common peaks were performed,and chemometric analysis was performed;the same method was used to determine the content of indicator components and the transfer rate was calculated.The chromatographic column was Venusil C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid solution (gradient elution);the column temperature was 30 ℃,and the detection wavelengths were 238 nm (0-37 min,85-102 min) and 330 nm (37-85 min) at a flow rate of 1.0 mL/min with an injection volume of 10 μL.RESULTS The similarity of HPLC fingerprints for 15 batches of Pinghuo tea standard decoction was not lower than 0.968.A total of 24 common peaks were calibrated and 9 peaks were recognized,which were as follows neochlorogenic acid (peak 3),chlorogenic acid (peak 6),geniposide (peak 9),glycyrrhizin (peak 10),galuteolin (peak 11),isochlorogenic acid A (peak 14),luteolin (peak 21),kaempferol (peak 23) and glycyrrhizic acid (peak 24).Cluster analysis,principal component analysis and orthogonal partial least squares discriminant analysis showed consistent results,all of which could classify the 15 batches of samples into three categories.The linear range of indicator components in 15 batches of Pinghuo tea standard decoction,such as geniposide,luteolin,isochlorogenic acid A,glycyrrhizin,and glycyrrhizic acid,were 0.020580-0.411600,0.001617-0.080850,0.006076-0.607600,0.005125-0.071740,and 0.017288-0.432200 mg/mL,respectively;RSDs of precision,repeatability,stability and recovery rate tests were all not higher than 4％ (n=6).The mass fractions ranged 3.2279-10.0022,0.2974-0.5546,3.3501-6.1596,0.7206-1.0733,2.0031-3.0301 mg/g;transfer rates from the pieces and standard decoction were 19.7628％-35.8405％,12.1233％-21.2540％,46.0972％-82.8694％,58.7088％-91.6296％,39.1143％-63.7106％.The transfer rates of the extract from 15 batches of Pinghuo tea standard decoction ranged from 61.15％-84.68％.CONCLUSIONS Established HPLC fingerprint and content determination methods in this study are simple and accurate,which can provide reference for the quantitative value transfer study,quality control,clinical application and the development of subsequent formulations of Pinghuo tea standard decoction.

Objective:To clarify the effect of the reform of Sichuan medical association on the coordinated development of medical re-sources supply and regional economy,and provide a basis for continuing to promote the coordinated development.Methods:Based on the panel data of 18 prefecture-level cities and 3 autonomous prefectures in Sichuan Province from 2009 to 2021,the medical resources invest-ment and economic development level of each city(state)in Sichuan Province were calculated by entropy weight method.Through the cou-pled coordination model,the degree of coordinated development was measured.The discontinuous time series model is used to measure the impact of the implementation of the medical association policy on the degree of coordinated development.Results:From 2009 to 2021,the supply of medical resources in Sichuan Province showed an overall upward trend,but the characteristics of the first concentration were ob-vious.In 2021,the coupling degree between medical resources investment and economic development in Sichuan Province is high(0.808),but the coupling coordination degree was still in a barely coordinated stage(0.540).The implementation of the reform of medical associa-tion effectively promoted the coordinated development of medical resource supply and regional economy.Conclusion:Local governments need to further strengthen the building of medical associations.By making long-term medical resources planning and exploring the role of digital technology in the medical field,it will further promote the expansion and balanced distribution of high-quality medical resources.

Personalized medicine emphasizes individualized and dynamic treatment decisions. There is an urgent need for a new efficacy evaluation system that can adapt to this approach. By reviewing past clinical research practices， this article pointed out the innovative needs of traditional Chinese medicine （TCM） efficacy evaluation from the perspective of personalized medicine in terms of ethical review， trial design， data management， and statistical analysis. Focusing on these needs， the article has proposed a strategic framework using syndrome differentiation and treatment in TCM as an example. The framework includes a method based on subgroup dynamic-static parallel group design and analysis， a safeguard mechanism of continuous review， dynamic informed consent， and multicenter ethical review， a technological support platform for personalized clinical efficacy evaluation and evidence support， and a statistical strategy integrating Bayesian and traditional analysis methods， aiming to promote the development of personalized TCM diagnosis and treatment.

Objective:To clarify the effect of the reform of Sichuan medical association on the coordinated development of medical re-sources supply and regional economy,and provide a basis for continuing to promote the coordinated development.Methods:Based on the panel data of 18 prefecture-level cities and 3 autonomous prefectures in Sichuan Province from 2009 to 2021,the medical resources invest-ment and economic development level of each city(state)in Sichuan Province were calculated by entropy weight method.Through the cou-pled coordination model,the degree of coordinated development was measured.The discontinuous time series model is used to measure the impact of the implementation of the medical association policy on the degree of coordinated development.Results:From 2009 to 2021,the supply of medical resources in Sichuan Province showed an overall upward trend,but the characteristics of the first concentration were ob-vious.In 2021,the coupling degree between medical resources investment and economic development in Sichuan Province is high(0.808),but the coupling coordination degree was still in a barely coordinated stage(0.540).The implementation of the reform of medical associa-tion effectively promoted the coordinated development of medical resource supply and regional economy.Conclusion:Local governments need to further strengthen the building of medical associations.By making long-term medical resources planning and exploring the role of digital technology in the medical field,it will further promote the expansion and balanced distribution of high-quality medical resources.

Objective:To clarify the effect of the reform of Sichuan medical association on the coordinated development of medical re-sources supply and regional economy,and provide a basis for continuing to promote the coordinated development.Methods:Based on the panel data of 18 prefecture-level cities and 3 autonomous prefectures in Sichuan Province from 2009 to 2021,the medical resources invest-ment and economic development level of each city(state)in Sichuan Province were calculated by entropy weight method.Through the cou-pled coordination model,the degree of coordinated development was measured.The discontinuous time series model is used to measure the impact of the implementation of the medical association policy on the degree of coordinated development.Results:From 2009 to 2021,the supply of medical resources in Sichuan Province showed an overall upward trend,but the characteristics of the first concentration were ob-vious.In 2021,the coupling degree between medical resources investment and economic development in Sichuan Province is high(0.808),but the coupling coordination degree was still in a barely coordinated stage(0.540).The implementation of the reform of medical associa-tion effectively promoted the coordinated development of medical resource supply and regional economy.Conclusion:Local governments need to further strengthen the building of medical associations.By making long-term medical resources planning and exploring the role of digital technology in the medical field,it will further promote the expansion and balanced distribution of high-quality medical resources.