Objective:To construct a medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory,starting from the entire process of medical treatment.Method:A comprehensive study was conducted on the screening of medical quality evaluation indicators for hospitalized patients using literature analysis,key informant interviews,and expert inquiry methods.Results:The effective recovery rate of the two rounds of expert consultation was 100%,with high enthusiasm from the experts.The authority coefficient was above 0.7,and Kendall's W coordination coefficient was 0.267(P＜0.05).The evaluation indicators for medical quality of hospitalized patients,including 3 primary indicators,10 secondary indicators,and 51 tertiary indicators,were determined.Conclusions:The medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory has certain scientificity and reliability.However,the weight analysis of the index system has not been carried out and is still in the theoretical exploration stage.Further empirical research is needed for verification and improvement.

Objective:To construct a medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory,starting from the entire process of medical treatment.Method:A comprehensive study was conducted on the screening of medical quality evaluation indicators for hospitalized patients using literature analysis,key informant interviews,and expert inquiry methods.Results:The effective recovery rate of the two rounds of expert consultation was 100%,with high enthusiasm from the experts.The authority coefficient was above 0.7,and Kendall's W coordination coefficient was 0.267(P＜0.05).The evaluation indicators for medical quality of hospitalized patients,including 3 primary indicators,10 secondary indicators,and 51 tertiary indicators,were determined.Conclusions:The medical quality evaluation index system for inpatients in public hospitals based on the life cycle theory has certain scientificity and reliability.However,the weight analysis of the index system has not been carried out and is still in the theoretical exploration stage.Further empirical research is needed for verification and improvement.

Objective To investigate the effect of sulforaphane(SFN)on the expression of apoptosis-related proteins(caspase-3 and caspase-9),in brain tissue of rats with acute carbon monoxide poisoning(ACOP),and to explore the molecular mechanism underlying its intervention in ACOP-induced brain injury.Methods The healthy male Sprague-Dawley(SD)rats were randomly assigned to three groups:normal control(NC)group,ACOP group,and SFN group,with 36 rats in each group.An ACOP animal model was established by exposing the rats to carbon monoxide(CO)in a hyperbaric oxygen chamber,while the rats in the NC group were allowed to breathe fresh air.The SFN group received an intraperitoneal injection of SFN 20 mg/kg within 2 hours after poisoning,once daily,until euthanasia.The NC and ACOP groups were injected with an equivalent volume of saline.Rats from each group were sacrificed on days 1,3,and 7 of the intervention to collect brain tissue,hematoxylin-eosin(HE)staining was performed to assess pathological damage in the brain tissue;Nissl staining was used to examine neuronal pathological changes;Immunohistochemistry was employed to detect the positive expression of caspase-3 and caspase-9 in the cortical region of the brain.Western blotting and quantitative reverse transcription-polymerase chain reaction(qRT-PCR)were conducted to measure the protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue.Results After CO poisoning,brain tissue damage in the ACOP group progressively worsened,with a gradual decrease in the number of Nissl bodies and a gradual increase in the number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain.The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue also gradually increased.Compared with the NC group at the same time point,the differences were statistically significant[Nissl bodies:69.33±0.94 vs.91.33±1.25;caspase-3 positive expression(A value):0.149±0.003 vs.0.113±0.004;caspase-9 positive expression(A value):0.178±0.002 vs.0.111±0.010;caspase-3 protein(caspase-3/GAPDH):1.634±0.045 vs.0.844±0.021;caspase-9 protein(caspase-9/GAPDH):1.754±0.024 vs.0.811±0.053;caspase-3 mRNA(2-ΔΔCt):1.718±0.052 vs.1;caspase-9 mRNA(2-ΔΔCt):1.722±0.066 vs.1,all P<0.05).Compared with the ACOP group at the same time point,the brain tissue damage in the SFN group improved,with a significant increase in the number of Nissl bodies(84.67±1.53 vs.69.33±0.94,P<0.05).The number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain decreased significantly(A value:0.126±0.002 vs.0.149±0.003,0.127±0.002 vs.0.178±0.002,both P<0.05).The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue were significantly reduced[caspase-3 protein(caspase-3/GAPDH):0.999±0.037 vs.1.634±0.045;caspase-9 protein(caspase-9/GAPDH):0.993±0.040 vs.1.754±0.024;caspase-3 mRNA(2-ΔΔCt):1.120±0.059 vs.1.718±0.052;caspase-9 mRNA(2-ΔΔCt):0.520±0.045 vs.1.722±0.066,all P<0.05].Conclusion SFN partially attenuated ACOP-induced brain injury in rats,potentially by downregulating both protein and mRNA expression of caspase-3 and caspase-9,thereby reducing cellular apoptosis.

Objective To generate and identify the Itgbl1(integrin beta-like)promoter-driven Cre knock-in mouse line.Methods Itgbll-Cre knock-in mice were generated using clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)gene editing.The Itgbl1-Cre mice were crossed with the Cre reporter ROSALSL-tdTomato)mice to detect the expression profile of Cre activity.The tdTomato expression pattern across tissues and cell-specific markers were used to identify the cell types of Itgbl1-expressing cells and their progeny.Results and Conclusion tdTomato was specifically expressed in mucous acinar cells of the sublingual gland,pancreatic islet cells,and gastric endocrine cells.In addition,tdTomato expression was also found in some of the neurons of the retina and brain,as well as in a few cells in the serosal layer of the intestine,articular cartilage,periosteum,and bone marrow.The first Itgbl1-Cre recombinase transgenic mouse line was established,which can specifically label the mucous acinar cells of the sublingual gland.

Objective To analyze the risk factors affecting the prognosis of patients with advanced gastric cancer,so as to provide evidence for identifying high-risk populations and guiding clinical treatment.Methods The clinical data of 282 patients with advanced gastric cancer who admitted to Zhoushan Hospital of Traditional Chinese Medicine from January 2017 to December 2021 were retrospectively analyzed.The survival outcome of patients was obtained by telephone follow-up and regular review.Kaplan-Meier method was used to analyze the overall survival(OS).Univariate and multivariate COX regression models were used to analyze the effects of clinical features on OS in patients with advanced gastric cancer.Results The median OS of 282 patients with advanced gastric cancer was 10.0 months.Univariate analysis showed that first-line chemotherapy,traditional Chinese medicine treatment,body mass index(BMI),Karnofsky performance status(KPS)score,hemoglobin(Hb)and albumin(Alb)were significantly correlated with the survival of patients with advanced gastric cancer(P<0.05).Multivariate COX regression models analysis showed that first-line chemotherapy,BMI,KPS score and Alb were independent risk factors affecting the survival of patients with advanced gastric cancer(P<0.05).Conclusion BMI,Alb,KPS score and first-line chemotherapy are independent risk factors for predicting the prognosis of patients with advanced gastric cancer,indicating nutrition management may be an important way to improve the outcome of patients with advanced gastric cancer.

Objective To investigate the effect of sulforaphane(SFN)on the expression of apoptosis-related proteins(caspase-3 and caspase-9),in brain tissue of rats with acute carbon monoxide poisoning(ACOP),and to explore the molecular mechanism underlying its intervention in ACOP-induced brain injury.Methods The healthy male Sprague-Dawley(SD)rats were randomly assigned to three groups:normal control(NC)group,ACOP group,and SFN group,with 36 rats in each group.An ACOP animal model was established by exposing the rats to carbon monoxide(CO)in a hyperbaric oxygen chamber,while the rats in the NC group were allowed to breathe fresh air.The SFN group received an intraperitoneal injection of SFN 20 mg/kg within 2 hours after poisoning,once daily,until euthanasia.The NC and ACOP groups were injected with an equivalent volume of saline.Rats from each group were sacrificed on days 1,3,and 7 of the intervention to collect brain tissue,hematoxylin-eosin(HE)staining was performed to assess pathological damage in the brain tissue;Nissl staining was used to examine neuronal pathological changes;Immunohistochemistry was employed to detect the positive expression of caspase-3 and caspase-9 in the cortical region of the brain.Western blotting and quantitative reverse transcription-polymerase chain reaction(qRT-PCR)were conducted to measure the protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue.Results After CO poisoning,brain tissue damage in the ACOP group progressively worsened,with a gradual decrease in the number of Nissl bodies and a gradual increase in the number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain.The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue also gradually increased.Compared with the NC group at the same time point,the differences were statistically significant[Nissl bodies:69.33±0.94 vs.91.33±1.25;caspase-3 positive expression(A value):0.149±0.003 vs.0.113±0.004;caspase-9 positive expression(A value):0.178±0.002 vs.0.111±0.010;caspase-3 protein(caspase-3/GAPDH):1.634±0.045 vs.0.844±0.021;caspase-9 protein(caspase-9/GAPDH):1.754±0.024 vs.0.811±0.053;caspase-3 mRNA(2-ΔΔCt):1.718±0.052 vs.1;caspase-9 mRNA(2-ΔΔCt):1.722±0.066 vs.1,all P<0.05).Compared with the ACOP group at the same time point,the brain tissue damage in the SFN group improved,with a significant increase in the number of Nissl bodies(84.67±1.53 vs.69.33±0.94,P<0.05).The number of positive cells for caspase-3 and caspase-9 in the cortical region of the brain decreased significantly(A value:0.126±0.002 vs.0.149±0.003,0.127±0.002 vs.0.178±0.002,both P<0.05).The protein and mRNA expression of caspase-3 and caspase-9 in the brain tissue were significantly reduced[caspase-3 protein(caspase-3/GAPDH):0.999±0.037 vs.1.634±0.045;caspase-9 protein(caspase-9/GAPDH):0.993±0.040 vs.1.754±0.024;caspase-3 mRNA(2-ΔΔCt):1.120±0.059 vs.1.718±0.052;caspase-9 mRNA(2-ΔΔCt):0.520±0.045 vs.1.722±0.066,all P<0.05].Conclusion SFN partially attenuated ACOP-induced brain injury in rats,potentially by downregulating both protein and mRNA expression of caspase-3 and caspase-9,thereby reducing cellular apoptosis.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective:To investigate the early outcome of endoscopy-assisted percutaneous non-fusion fixation of unilateral C 1 lateral mass screw and C 2 pedicle screw in treatment of type II odontoid fracture in elderly patients. Methods:A retrospective case series study was conducted to analyze clinical data of 12 elderly patients with type II odontoid fracture admitted to Second Affiliated Hospital of Chongqing Medical University from July 2016 to September 2018. There were 5 males and 7 females, aged 66-89 years [(75.2±6.7)years]. American Society of Anesthesiologists (ASA) scores for all patients were greater than 2 points. Ten patients were classified to Grade E and the other two were classified to Grade D by American Spinal Injury Association (ASIA) scale scores. All patients underwent endoscopy-assisted percutaneous non-fusion fixation of unilateral C 1 lateral mass screw and C 2 pedicle screw. The operation time, intraoperative blood loss, hospital stays, intraoperative and postoperative complications were collected. The Neck Disability Index (NDI) scores and ASIA scale scores were compared preoperatively and 6 weeks postoperatively. The visual analogue scales (VAS) were recorded preoperatively, 6 weeks, 3, 6, 9 and 12 months postoperatively. Fracture healing was followed up postoperatively. Results:Operation time was 98-169 minutes [(123.2±17.7)minutes]. Intraoperative blood loss was 20-40 ml [(30.0±7.1)ml]. Hospital stays were 6-9 days [(7.3±0.7)days]. No neurovascular injury was observed intraoperatively and postoperatively. The NDI were 8%-30%[(19.3±6.3)%] 6 weeks postoperatively, significantly lower than 19%-45%[(33.1±9.9)%] preoperatively( P<0.05). All patients' ASIA scale scores reached grade E postoperatively. The VAS constantly decreased from 6-9 points [(7.8±0.9)points] preoperatively to 1-3 points [(1.8±0.6)points] 12 months postoperatively ( P<0.05). All the patients achieved bone healing after 4-11 months [(7.3±2.1)months]. Conclusion:For type II odontoid fracture in elderly patients, endoscopy-assisted percutaneous unilateral atlantoaxial screw non-fusion fixation can relieve pain and achieve rapid recovery of neck function and bone healing.

With the rapid development of new technologies and global trade and increasing collaboration among countries worldwide,public health has become a global issue.Global health,as a new discipline,has been drawing more attention from both academia and governments.The Belt and Road (B&R) Initiative,proposed by China in 2013,aims to promote trade and resource exchange,including education,research,and health issues,with over 60 countries in Asia,Africa,and Europe.The B&R Initiative provides good opportunities for involved countries to address health problems jointly as well.In response to the B&R Initiative and to promote international collaboration on global health issues,"The 2017 Belt and Road Initiative Global Health International Congress & 2017 Chinese Preventive Medicine Association-Chinese Society on Global Health Annual Meeting" was held on September 24-27,2017 in Xi'an,China.Thus far,this is the largest high-quality international conference held in China that focused on the B&R Initiative global health issues.This article summarizes the background,key sessions and topics covered during the congress,important events and highlights different perspectives of the B&R Initiative and global health by invited experts from China and abroad.The conference included 17 sessions (3 keynote speech forums and 10 scientific sessions,3 young scholar forums,and a research poster session) and about 100 speakers,around 40 of which were leading experts outside of China.All the major sessions were held in English.More than 40 leaders and experts of health sectors from 13 countries presented their work in the congress.Approximately 400 delegates from 29 countries attended the congress.Delegates had extensive discussions about global health related issues,future cooperation and development in global health.The congress fostered international exchange and collaboration.

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted treatment has been a standard therapy for advanced non-small cell lung cancer (NSCLC), but it is not tolerated well by all patients. In China, some studies have reported that traditional Chinese medicinal herbs (TCMHs) may increase efficacy and reduce toxicity when combined with EGFR-TKI, but outside of China few studies of this kind have been attempted.