Objective To compare and analyze the changes in the use of lung cancer therapeutic drugs before and after the national initiation of health insurance negotiations, and to study the impact of a series of policies on the use of lung cancer drugs. Methods Descriptive statistical methods were used analyze the basic situation of lung cancer patients and the changes of corresponding therapeutic drugs in Peking University People's Hospital from 2014 to 2020, as well as to the hospital procurement data of lung cancer therapeutic drugs in the database of the Chinese Medicine Economic Information. Results From 2014 to 2020, the total cost per capita of lung cancer patients showed a trend of first increasing and then decreasing, increasing before the national drug negotiation and gradually decreasing after the negotiation. After 2017, the use of small ATC categories such as VEGF/VEGFR inhibitors and EGFR tyrosine kinase inhibitors increased significantly, along with a rise in the number of monoclonal antibody varieties. The DDDs of osimertinib, anlotinib, alectinib, crizotinib and other drugs in the medical insurance list increased significantly, and the average daily cost decreased significantly. Conclusion The number of hospitalization days for lung cancer patients had continued to shorten in recent years, and the structure of drug use had changed significantly. The adjustment of the medical insurance catalog had led to more innovative lung cancer drugs showing the trend of volume up and price down.

Objective To investigate the in vitro drug release behavior of hydroxyapatite-wedelolactone(Hap-Wed)and its effect on promoting osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs).Methods The in vitro release behavior of Hap-Wed fusion materials was detected by chromatographic technique.After the cells were passed continuously up to the third generation,they were divided into:① control group:complete medium;② Os group:osteogenic inducer(1mmol/L dexamethasone,10mmol/L vitamin C,1mol/L β-glycerol phosphate);③ Wed group:1μg/ml Web and osteogenic inducer were added to the complete medium;④ Hap-Web group:1 μg/ml Web,osteogenic inducer and Hap were added to the complete medium.Alkaline phosphates(ALP)activity assay,alizarin red S staining assay,real-time quantitative polymerase chain reaction(RT-qPCR)detection of osteocalcin,Osterix and Runx2 gene expression,analysis of Hap-Wed on BMSCs osteoblast differentiation.Results Hap-Wed fusion material released the drug slowly.Compared with control group,the number of ALP staining and the number of calcified nodules increased significantly in Hap-Wed experimental group.The Hap-Wed experimental group increased gene expression of osteocalcin,Osterix and Runx2.Conclusion Hap-Wed fusion material can slow and effective stimulation of osteoblast differentiation,which may provide a promising application prospect for the future development of the carrier material.

Objective To investigate the in vitro drug release behavior of hydroxyapatite-wedelolactone(Hap-Wed)and its effect on promoting osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs).Methods The in vitro release behavior of Hap-Wed fusion materials was detected by chromatographic technique.After the cells were passed continuously up to the third generation,they were divided into:① control group:complete medium;② Os group:osteogenic inducer(1mmol/L dexamethasone,10mmol/L vitamin C,1mol/L β-glycerol phosphate);③ Wed group:1μg/ml Web and osteogenic inducer were added to the complete medium;④ Hap-Web group:1 μg/ml Web,osteogenic inducer and Hap were added to the complete medium.Alkaline phosphates(ALP)activity assay,alizarin red S staining assay,real-time quantitative polymerase chain reaction(RT-qPCR)detection of osteocalcin,Osterix and Runx2 gene expression,analysis of Hap-Wed on BMSCs osteoblast differentiation.Results Hap-Wed fusion material released the drug slowly.Compared with control group,the number of ALP staining and the number of calcified nodules increased significantly in Hap-Wed experimental group.The Hap-Wed experimental group increased gene expression of osteocalcin,Osterix and Runx2.Conclusion Hap-Wed fusion material can slow and effective stimulation of osteoblast differentiation,which may provide a promising application prospect for the future development of the carrier material.

Aiming at the quality problem of preparing gut for patients in test and treatment with colonoscopy,this article involved in one kind of quality judgement system based on cloud processing,which composed of information collection module,cloud processing analysis module,and identification and judgment module for doctor.It could realize automatic interpretation and medication guidance for the quality of preparing gut.In the system,the obtained operation information of depending collection module,and the cloud processor with the ability of analyzing and processing data can judge the quality of preparing gut for patients,and effectively solve a series of problems such as inefficient judgment for preparing gut,and poor quality of preparation.It can help patients to adjust medication,and relieve the pressure of medical staffs in guideline and communication for preparing gut,and enhance the quality of preparing gut,and avoid the influence of insufficient preparation for gut on the test and treatment of colonoscopy,so as to provide more effective safety and guarantee for clinical practice.

OBJECTIVE To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection in the intensive care unit of a traditional Chinese medicine hospital,identify the source of infec-tion and transmission routes,and provide a basis for prevention and control of CRKP infection.METHODS Epide-miological investigations were conducted on five patients with CRKP infections or colonization who were identi-fied in Jul.2024 at Suiyang County Hospital of Traditional Chinese Medicine.Samples were collected from pa-tients,the ward environments,and hand surfaces to detect CRKP.Fourteen CRKP isolates were selected for car-bapenemase gene testing,and homology analysis was performed by enterobacterial repetitive intergenic consensus polymerase chain reaction(ERIC-PCR)and multilocus sequence typing(MLST).RESULTS The median age of the five cases was 73 years,and all had undergone multiple invasive procedures.Environmental monitoring showed a CRKP positive rate of 26.35％,with CRKP isolates detected on the hands of healthcare workers,surfaces in the wards and medical equipment surfaces.Genetic analysis showed that all 14 CRKP strains carried the KPC resist-ance gene;except for case 1,other strains carried the VIM gene.MLST identified CRKP of all strains as sequence type 48(ST48);while ERIC-PCR revealed two distinct genotypes:genotype A for case 1 and genotype B for the other cases and environmental isolates.After strengthening patient isolation and group treatment,strictly cleaning and disinfecting the ward environments and medical equipment,and strictly implementing hand hygiene,the infec-tion was effectively controlled.CONCLUSIONS Inadequate disinfection of the ward environments and medical e-quipment and poor compliance with hand hygiene are the main contributors to the suspected CRKP outbreak.Ho-mology analysis suggests the existence of two independent transmission chains.Timely identification and manage-ment of the infection sources,interruption of transmission routes,protection of susceptible individuals and imple-mentation of comprehensive infection control measures are essential for effective outbreak control.

Objective:To conduct evidence synthesis on disease communication between parents and their minor children from the perspective of parents with cancer, so as to provide information for clinical healthcare providers to deliver improved health education to patients and their children.Methods:Computer retrieval was implemented in PubMed, CINAHL, Embase, Web of Science, PsycINFO, Cochrane Library, ProQuest, China National Knowledge Infrastructure, and Wanfang Data. The search period was from January 1, 2000 to March 6, 2025. The literature was assessed according to the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The JBI aggregative integration method was employed for the Meta-synthesis.Results:A total of nine articles were included. Thirty-two results were extracted, divided into ten categories, and integrated into five results, namely willingness to communicate illness, factors influencing communicating willingness, disease communication strategies, supporting children's coping, and perceptions of illness information.Conclusions:Disease communication between cancer parents and their minor children is influenced by multiple factors and exhibits complex diversity. Healthcare providers should fully understand and accurately recognize the distinct approaches of parents with cancer, offering guidance, advice, and encouragement whenever possible, and should dynamically provide timely medical support and assistance tailored to the evolving needs of patients throughout different stages of their disease treatment.

Objective To investigate the therapeutic effects of combined magnetic and electrical stimulation with an"intelligent exercise prescription"and novel matrix radiofrequency therapy in patients with pelvic organ prolapse(POP).Methods A total of 158 patients with POP who received treatment at the Gynecological Pelvic Floor Rehabilitation Center of the Eighth Affiliated Hospital of Southern Medical University between October 2022 and July 2025 were retrospectively enrolled and divided into an observation group(n=64)and a control group(n=94)based on their treatment plans.The control group underwent magnetic and electrical stimulation combined with an"intelligent exercise prescription"regimen.Specifically,patients received 10 sessions of electrical stimulation,5 sessions of magnetic stimulation,and performed 15～20 minutes of daily home exercise training guided by the"intelligent exercise prescription."The observation group received,in addition to the aforementioned treatments,four sessions of novel matrix radiofrequency therapy.Changes in the muscle strength grades of type Ⅰ and type Ⅱ pelvic floor muscles,Glazer surface electromyography(EMG)values,and POP-Q staging were compared between the two groups before and after treatment.Results After treatment,both groups demonstrated significant improvements in type Ⅰ and type Ⅱ muscle fiber strength compared to baseline(all P<0.05),with the observation group showing greater improvement in type Ⅰ muscle fiber strength than the control group(P<0.05).The muscle potential values of the observation group during rapid contraction,tense contraction,and endurance contraction stages were markedly increased compared to pre-treatment levels.Moreover,the muscle potential values during the pre-resting stage were significantly reduced after treatment(P<0.05).In the observation group,POP-Q grades of the anterior vaginal wall,uterus,and posterior vaginal wall were all significantly lower post-treatment than pre-treatment(all P<0.05).However,no statistically significant differences were observed between the observation group and the control group in these parameters(P>0.05).Both groups exhibited relatively high compliance rates(both≥75.0%),with no significant difference between them(P>0.05).The treatment cost for the observation group was significantly higher than that for the control group(P<0.05).Conclusions The combination of magneto-electrical stimulation,an"intelligent exercise prescription,"and novel matrix radiofrequency therapy can significantly improve pelvic floor muscle strength and muscle potential values in the short term,compared to pre-treatment levels.This integrated approach also effectively alleviates the prolapse of the anterior vaginal wall,uterus,and posterior vaginal wall.Furthermore,the combination of magnetic and electrical stimulation,"intelligent exercise prescription,"and matrix radiofrequency therapy demonstrates superior efficacy in enhancing type Ⅰ pelvic floor muscle fiber strength when compared to the combination of magnetic and electrical stimulation with"intelligent exercise prescription"alone.However,this treatment protocol entails a relatively high economic burden,and its clinical application should be carefully evaluated in consideration of patients'functional needs and financial conditions.

Objective To investigate the impact of Mycoplasma infection(MP)on the reproductive tract microbiota of patients with endometritis.Methods A retrospective analysis was conducted on the clinical data of patients with endometritis who was visited in the First People's Hospital of Shuangliu District from April 2023 to April 2024.Based on inclusion and exclusion criteria,a total of 60 subjects were ultimately included in each of the MP-positive and MP-negative groups.Univariate analysis was used to compare the differences in inflammation,immunity,endometrial morphology,and disease severity between the two groups.The Illumina Nova sequencing platform was used to sequence and analyze the reproductive tract secretions of 120 subjects.The detected microbial flora was subdivided into different taxonomic levels including kingdom,phylum,class,order,family,genus and species.Mothur software was employed to calculate the Shannon diversity index and Simpson diversity index to evaluate species richness.The Wilcoxon rank-sum test was used to compare the abundance of colonies between the two groups.Using R software(v4.0.1),evaluated the differences in gene ontology(GO)annotations and metabolic pathways of Kyoto encyclopedia of genes and genomes(KEGG)pathways between different groups.Results Compared with the MP-negative group,the MP-positive group exhibited statistically significant differences in levels of inflammatory and immune indicators,as well as in the proportions of congestion and edema,atypical blood vessels,varying thicknesses,and severe disease severity(t/χ2=3.043～26.830,all P<0.05).The reproductive tract flora of the two groups was divided into four phyla:Proteobacteria,Actinobacteria,Firmicutes and Bacteroidetes.The abundance of Proteobacteria(47.95%vs 33.32%),Bacteroidetes(9.48%vs 3.41%)and Actinobacteria(4.11%vs 2.04%)increased,while the abundance of Firmicutes(38.46%vs 61.23%)decreased in the MP-positive group compared to the MP-negative group,and the differences were statistically significant(χ2=10.126～12.745,all P<0.05).A comparison of the α-diversity analysis results of the reproductive tract microbiota between the two patient groups revealed that the Shannon index and Simpson index in the MP-positive group were 4.81±0.14 and 1.68±0.07,respectively,while those in the MP-negative group were 4.07±0.18 and 1.42±0.04,respectively.The Shannon index and Simpson index in the MP-positive group were both significantly higher than those in the MP-negative group,and the differences were statistically significant(t=9.342,9.583,all P<0.001).Compared with the MP-negative group,the abundance of Streptococcus[proportion difference(PD):5.26,95%CI:2.63～6.27],Escherichia(PD:2.71,95%CI:1.34～4.58),Staphylococcus(PD:4.00,95%CI:2.06～6.14),Enterococcus(PD:4.10,95%CI:1.02～4.58),Mycoplasma(PD:6.05,95%CI:3.08～8.79),Pseudomonas(PD:2.97,95%CI:1.28～4.06)and Gardnerella(PD:6.07,95%CI:2.59～8.75)increased in the MP-positive group,while the abundance of Lactobacillus(PD:-19.22,95%CI:-21.97～-10.39)and Bifidobacterium(PD:-16.91,95%CI:-24.06～-10.57,)decreased,and the differences were statistically significant(t=3.857～11.306,all P<0.05).Analysis of metabolic pathways in the two patient groups revealed that,within the MP-positive chronic endometritis(CE)cohort,functional gene categories with significantly increased relative enrichment included ATP-binding function,DNA repair processes,inosine monophosphate biosynthetic processes,fatty acid biosynthetic processes,arginine biosynthetic processes,and peptidase activity.Analysis of signaling pathways in both patient groups found that ABC transporter complexes,aminoacyl-tRNA biosynthesis,unsaturated fatty acid biosynthesis,phenylalanine metabolism,tyrosine metabolism,tryptophan metabolism,and insulin signaling pathways were notably active in MP-positive CE patients.Conclusion Compared to MP-negative CE patients,MP-positive patients exhibited more pronounced inflammatory and immune responses,as well as a higher proportion of endometrial morphological abnormalities and severe disease severity.The reproductive tract microbiota diversity increased in MP-positive CE patients,with Streptococcus becoming the dominant genus and a decreasing trend in the relative abundance of Lactobacillus.

Objective To compare ovulation recovery rate and metabolic indicators between ethinyl-estradiol/drospirenone(EE/DRSP)combined with orlistat and EE/DRSP alone in overweight/obese patients with polycystic ovary syndrome(PCOS).Methods This study was a randomized controlled clinical trial conducted based on the 2004 Rotterdam criteria.From October 2020 to December 2023,180 overweight/obese PCOS patients aged 20-40 were recruited from the Department of Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients were randomly divided into two groups in a 1∶2 ratio.Among them,60 patients received treatment with EE/DRSP(EE20 μg,DRSP 3 mg),while 120 patients received a combination treatment of EE/DRSP and orlistat(360 mg/d).The height,weight,waist circumference,hip circumference,and blood pressure of the patients were measured before treatment and after 12 weeks of treatment.Laboratory tests included measurements of follicle-stimulating hormone(FSH),luteinizing hormone(LH),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),free androgen index(FAI),alanine transaminase(ALT),aspartate transaminase(AST),gamma-glutamyl transferase(GGT),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],sex hormone-binding globulin(SHBG),total testosterone(T),and free testosterone(FT).After 12 weeks of treatment,the medication was discontinued,and natural ovulation was observed.Results After 12 weeks of treatment,the ovulation rate of the EE/DRSP combined with orlistat group reached 70.8%,while the natural ovulation rate of the EE/DRSP group alone was only 35%,indicating that the ovulation rate was significantly increased after EE/DRSP combined with orlistat treatment.After 12 weeks of treatment,both groups showed a significant decrease in total testosterone,free testosterone,and low-density lipoprotein levels(all P<0.05),and the decrease in BMI,waist circumference,fasting insulin,and HOMA-IR in the EE/DRSP combined with orlistat group was greater than that in the EE/DRSP group alone(P<0.05).After treatment,both groups showed a significant increase in high-density lipoprotein and triglyceride levels(all P<0.05),with no significant changes in total cholesterol and fasting blood glucose(all P>0.05).Conclusion After 12 weeks of treatment,EE/DRSP combined with orlistat can significantly improve the ovulation rate of PCOS patients.It is superior to EE/DRSP alone in reducing androgen levels,body weight,insulin resistance,and low-density lipoprotein levels.

Objective To investigate the impact of Mycoplasma infection(MP)on the reproductive tract microbiota of patients with endometritis.Methods A retrospective analysis was conducted on the clinical data of patients with endometritis who was visited in the First People's Hospital of Shuangliu District from April 2023 to April 2024.Based on inclusion and exclusion criteria,a total of 60 subjects were ultimately included in each of the MP-positive and MP-negative groups.Univariate analysis was used to compare the differences in inflammation,immunity,endometrial morphology,and disease severity between the two groups.The Illumina Nova sequencing platform was used to sequence and analyze the reproductive tract secretions of 120 subjects.The detected microbial flora was subdivided into different taxonomic levels including kingdom,phylum,class,order,family,genus and species.Mothur software was employed to calculate the Shannon diversity index and Simpson diversity index to evaluate species richness.The Wilcoxon rank-sum test was used to compare the abundance of colonies between the two groups.Using R software(v4.0.1),evaluated the differences in gene ontology(GO)annotations and metabolic pathways of Kyoto encyclopedia of genes and genomes(KEGG)pathways between different groups.Results Compared with the MP-negative group,the MP-positive group exhibited statistically significant differences in levels of inflammatory and immune indicators,as well as in the proportions of congestion and edema,atypical blood vessels,varying thicknesses,and severe disease severity(t/χ2=3.043～26.830,all P<0.05).The reproductive tract flora of the two groups was divided into four phyla:Proteobacteria,Actinobacteria,Firmicutes and Bacteroidetes.The abundance of Proteobacteria(47.95%vs 33.32%),Bacteroidetes(9.48%vs 3.41%)and Actinobacteria(4.11%vs 2.04%)increased,while the abundance of Firmicutes(38.46%vs 61.23%)decreased in the MP-positive group compared to the MP-negative group,and the differences were statistically significant(χ2=10.126～12.745,all P<0.05).A comparison of the α-diversity analysis results of the reproductive tract microbiota between the two patient groups revealed that the Shannon index and Simpson index in the MP-positive group were 4.81±0.14 and 1.68±0.07,respectively,while those in the MP-negative group were 4.07±0.18 and 1.42±0.04,respectively.The Shannon index and Simpson index in the MP-positive group were both significantly higher than those in the MP-negative group,and the differences were statistically significant(t=9.342,9.583,all P<0.001).Compared with the MP-negative group,the abundance of Streptococcus[proportion difference(PD):5.26,95%CI:2.63～6.27],Escherichia(PD:2.71,95%CI:1.34～4.58),Staphylococcus(PD:4.00,95%CI:2.06～6.14),Enterococcus(PD:4.10,95%CI:1.02～4.58),Mycoplasma(PD:6.05,95%CI:3.08～8.79),Pseudomonas(PD:2.97,95%CI:1.28～4.06)and Gardnerella(PD:6.07,95%CI:2.59～8.75)increased in the MP-positive group,while the abundance of Lactobacillus(PD:-19.22,95%CI:-21.97～-10.39)and Bifidobacterium(PD:-16.91,95%CI:-24.06～-10.57,)decreased,and the differences were statistically significant(t=3.857～11.306,all P<0.05).Analysis of metabolic pathways in the two patient groups revealed that,within the MP-positive chronic endometritis(CE)cohort,functional gene categories with significantly increased relative enrichment included ATP-binding function,DNA repair processes,inosine monophosphate biosynthetic processes,fatty acid biosynthetic processes,arginine biosynthetic processes,and peptidase activity.Analysis of signaling pathways in both patient groups found that ABC transporter complexes,aminoacyl-tRNA biosynthesis,unsaturated fatty acid biosynthesis,phenylalanine metabolism,tyrosine metabolism,tryptophan metabolism,and insulin signaling pathways were notably active in MP-positive CE patients.Conclusion Compared to MP-negative CE patients,MP-positive patients exhibited more pronounced inflammatory and immune responses,as well as a higher proportion of endometrial morphological abnormalities and severe disease severity.The reproductive tract microbiota diversity increased in MP-positive CE patients,with Streptococcus becoming the dominant genus and a decreasing trend in the relative abundance of Lactobacillus.