Objective To analyze the evaluation and influencing factors of healthy enterprises in Hubei Province from 2020 to 2023. Methods A total of 351 enterprises participated in the healthy enterprise evaluation in Hubei province were selected as the study subjects using the judgmental sampling method. The differences in evaluation results including scales, industry sector, and ownership type of the enterprises were compared. Results The median and the 25th and 75th percentiles [M (P₂₅, P₇₅)] of the evaluation score among the 351 enterprises was 869 (838, 941) points. The evaluation pass rate was 82.3%. The M(P₂₅, P₇₅) of scores for the management system, health environment, health management and services, health culture, and health outcome review were 183 (174, 192), 190 (181, 198), 340 (321, 376), 133 (122, 142), and 26 (24, 28) points, with the score percentage of 91.5%, 86.4%, 85.0%, 88.7%, and 86.7%, respectively. The deduction rate exceeded 50.0% in six items, which predominantly concentrated within the primary indicator of the health management and services, among the tertiary indicators. The result of multiple linear regression analysis revealed that smaller enterprises had significantly lower evaluation scores (P<0.05), and domestically funded enterprises scored significantly lower than those with investment from Hong Kong, Macao and Taiwan, or foreign investments (all P<0.05). Conclusion Health management and services represent a weak area in healthy enterprise development in Hubei Province. It was suggested to improve policy incentives and support for medium-, small- and micro-sized enterprises, and domestically funded enterprises, to enhance healthy enterprise development levels.

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

Mitochondrial DNA (mtDNA) acts as a damage-associated molecular pattern to activate the stimulator of interferon genes (STING) signaling in macrophages, promoting tissue inflammation. However, its role in acute myocardial infarction (AMI) remains unclear. Macrophage-specific Sting1 knockout mice were used to validate STING's pathological role in AMI. Cardiac and liver mtDNA were used to activate macrophages in co-culture systems with cardiomyocytes to assess fibrosis and hypertrophy. Panaxatriol saponin (PTS) was tested for its ability to block mtDNA-driven macrophage activation and subsequent cardiomyocyte damage. STING-PTS binding ability was analyzed. AMI rats received PTS to evaluate its effects on myocardial inflammation and ventricular remodeling. In vivo, macrophage-specific Sting1 knockout reduced myocardial inflammation and injury after AMI. In vitro, mtDNA-activated macrophages induced cardiomyocyte fibrosis and hypertrophy through STING signaling. PTS suppressed mtDNA-driven macrophage activation by directly binding STING, thereby blocking inflammatory cascades. In AMI rats, PTS treatment attenuated acute inflammation and reversed ventricular remodeling. These findings establish the mtDNA-STING axis in macrophages as a critical driver of post-AMI inflammation and identify pharmacological STING inhibition with PTS as a promising therapeutic strategy. The study bridges genetic validation with translational applications, highlighting macrophage STING as a novel target for ischemic heart disease management.

Aim To investigate whether SIRT6 overexpression inhibits angiotensin Ⅱ(Ang Ⅱ)-induced cardio-myocyte apoptosis by activating adenosine 5'-monophosphate-activated protein kinase/nuclear factor erythroid 2-related factor 2/heme oxygenase-1(AMPK/Nrf2/HO-1)signaling pathway.Methods The experiment was divided into 4 groups:control group,AngⅡ group,Ang Ⅱ+SIRT6 group,Ang Ⅱ+empty vector(EV)group.The mRNA level of SIRT6 was detected by RT-PCR.The cell activity was measured by MTT assay.The cell apoptosis was analyzed by flow cy-tometry.SIRT6,cardiomyocyte apoptosis related proteins(Bax,cleaved Caspase-3,Bcl-2),DNA damage related pro-teins(γ-H2AX,p-ATM),AMPK/Nrf2/HO-1 signaling pathway related proteins(p-AMPK,Nrf2,HO-1)were measured by Western blot.The reactive oxygen species(ROS)content was determined by DCFH-DA staining.The changes of the above indexes among the groups were observed.Results Compared with control group,the mRNA and protein ex-pression levels of SIRT6 and cell activity were significantly decreased in Ang Ⅱ group.Apoptosis rate,the expressions of Bax,cleaved Caspase-3 were increased,and the expression of Bcl-2 was decreased.The expressions of γ-H2AX and p-ATM were increased,and the expressions of p-AMPK,Nrf2,HO-1 were decreased.The activity of ROS was increased(P＜0.01).Compared with Ang Ⅱ+EV group,the expression of SIRT6 and cell activity were significantly increased in Ang Ⅱ+SIRT6 group.Apoptosis rate,the expressions of Bax and cleaved Caspase-3 were decreased,and the expression of Bcl-2 was increased.The expressions of γ-H2AX and p-ATM were decreased,the expressions of p-AMPK,Nrf2,HO-1 were increased.The activity of ROS was decreased(P＜0.01).Conclusion SIRT6 overexpression inhibits Ang Ⅱ-induced cardiomyocyte apoptosis through activation of AMPK/Nrf2/HO-1 signaling pathway.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To analyze the operational efficiency of the oncology department in multi-campus hospital, providing reference for rational resource allocation and efficiency enhancement.Methods:A certaion tertiary grade A Hospital is a multi-campus public hospital with integrated management. This study focused on its oncology department, with 9 wards located in different campus as decision-making units. Data from 2020 to 2022 were extracted from the hospital′s medical records management system, disease diagnosis-related groups management system, and hospital information system. The super-efficiency DEA model and Malmquist index model were used to evaluate efficiency variations of the oncology department in different time slots and decision-making units. Identifying input redundancies and output deficiencies in wards not achieving constant returns to scale through projection value analysis. Selecting the total number of medical staff and the actual total number of bed-days occupied as input indicators, while bed utilization rate, discharge rate, and case mix index as output indicators.Results:From 2020 to 2022, the wards with a DEA super-efficiency value greater than 1 were 0, 2, and 4, respectively, showing a gradual increase in overall efficiency. In 2022, wards S3, S4, S7, and S9 achieved constant returns to scale with super-efficiency values of 1.001, 1.005, 1.113, and 1.112, respectively. The other five wards had zero input redundancy, but some suffered from insufficient outputs. For example, wards S5 and S8 should increase their bed utilization rates by 5% and 4%, respectively. Wards S1 and S8 needed to increase their annual discharge numbers by 24% and 1%, respectively, while wards S2 and S6 should increase their annual case mix index by 21% and 20%, respectively. From 2020 to 2021, the Malmquist index of the oncology department was 0.959, while from 2021 to 2022 it rose to 1.030, and the Malmquist index of each ward was greater than 1.Conclusions:By implementing integrated management across multiple campus, the operational efficiency of the oncology department has been comprehensively improved. The use of the super efficient DEA-Malmquist index model to evaluate the operational efficiency of departments has practical significance.

OBJECTIVE: To explore early effectiveness of unilateral biportal endoscopy (UBE) technique in the treatment of migrated lumbar intervertebral disc herniation. METHODS: A retrospective analysis was conducted on 87 patients with migrated lumbar intervertebral disc herniation, who were treated with UBE technique between May 2021 and December 2022 and met the selection criteria. There were 55 males and 32 females, with an average age of 48.8 years (range, 29-74 years). The disease duration ranged from 2 to 23 months, with an average of 9.1 months. The surgical segments included 17 cases of L _{3, 4}, 32 cases of L _{4, 5}, and 38 cases of L ₅, S ₁. According to Lee's classification criteria, there were 12 cases of type 1, 17 cases of type 2, 37 cases of type 3, and 21 cases of type 4. The operation time, length of hospital stay, and complications were recorded. The visual analogue scale (VAS) score was used to assess the degree of low back and leg pain before operaion and at 3 days, 3 months, 6 months, and 12 months after operation. The Oswestry disability index (ODI) was used to evaluate the lumbar spine function. At last follow-up, the modified MacNab criteria was used to evaluate the effectiveness. According to the preoperative migrated intervertebral disc classification, the patients were allocated into groups Ⅰ to Ⅳ. The differences in VAS score and ODI were compared. RESULTS: All 87 patients successfully completed the operations. There was no nerve root injury, dural sac injury, or dural tear during operation. The operation time was (58.6±14.6) minutes and the length of hospital stay was (4.0±0.8) days. All incisions healed by first intention after operation. No symptomatic epidural hematoma occurred. All patients were followed up for 12 months. There were significant differences in VAS scores and ODI at each time point after operation when compared with those before operation ( P<0.05). There were significant differences in VAS score at 3 days after operation when compared with that at 3, 6, and 12 months after operation ( P<0.05). For ODI, except that there was no significant difference between 6 and 12 months after operation ( P>0.05), there were significant differences between other time points after operation ( P<0.05). At last follow-up, the effectiveness was rated as excellent in 66 cases, good in 13 cases, and fair in 8 cases according to the modified MacNab criteria, and the excellent and good rate was 90.8%. There was no intervertebral disc herniation recurred during follow-up period. There was no significant difference in VAS score and ODI among groups Ⅰ -Ⅳ before operation and at each time point after operation ( P>0.05). CONCLUSION The UBE technique is safe and effective in the treatment of migrated lumbar intervertebral disc herniation, with a low complication rate and satisfactory early effectiveness.
Humans ; Intervertebral Disc Displacement/surgery* ; Male ; Female ; Middle Aged ; Retrospective Studies ; Lumbar Vertebrae/surgery* ; Adult ; Endoscopy/methods* ; Treatment Outcome ; Aged ; Pain Measurement ; Magnetic Resonance Imaging ; Operative Time

Objective     To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods     Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results     Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion     This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.

Hepatocellular carcinoma (HCC) is a common malignant tumor with poor prognosis and high mortality. In this study, we demonstrated a novel vaccine targeting HCC and tumor neovascular endothelial cells by fusing recombinant MHCC97H cells expressing porcine α-1,3-galactose epitopes (αGal) and endorphin extracellular domains (END) with dendritic cells (DCs) from healthy volunteers. END⁺/Gal⁺-MHCC97H/DC fusion cells induced cytotoxic T lymphocytes (CTLs) and secretion of interferon-gamma (IFN-γ). CTLs targeted cells expressing αGal and END and tumor angiogenesis. The fused cell vaccine can effectively inhibit tumor growth and prolong the survival time of human hepatoma mice, indicating the high clinical potential of this new cell based vaccine.