Objective To understand the medical decision-making preferences of doctors in tertiary grade A hospitals,providing evidence to promote clinical guidelines and improve healthcare service value.Methods A discrete choice model was constructed using the Delphi method.A total of 106 valid samples were collected via a questionnaire survey.The mixed logit model was used to assess doctors' preferences in medical decision-making across scenarios of hypertension,abdominal infection,and IgA nephropathy,analyzing heterogeneity in decision-making preferences based on doctors' characteristics.Results Overall,treatment efficacy,patient preference,and the value of medical exploration significantly influenced doctors' decision-making preferences(P＜0.05).In hypertension and IgA nephropathy scenarios,adverse reactions had a significant impact on decision-making preferences(P＜0.001).The relative importance of decision-making attributes was treatment efficacy＞adverse reactions＞patient preference＞medical exploration value＞cost control.Doctors with higher education levels valued treatment efficacy more in abdominal infection and IgA nephropathy scenarios(P＜0.05)and adverse reactions more in hypertension scenarios(P＜0.05).Conclusion Treatment efficacy is the primary factor in medical decision-making.Cost control plays a limited role in current decision-making,and preferences vary by disease specificity across different clinical practice scenarios.

Objective:To analyze the research progress and hotspots of clinical pathway informatization at home and abroad, and provide references and guidance for the construction of clinical pathway informatization in China.Methods:The relevant literature on clinical pathway informatization research were retrieved from China National Knowledge Infrastructure and Web of Science databases, which were published from January 1, 2000 to July 20, 2023. Bibliometric and thematic analysis methods were used to analyze the commonalities and differences in annual publication volume, high-frequency author collaboration networks, high-frequency keywords, and research hotspots of domestic and foreign literature.Results:This study included a total of 257 domestic literature and 174 foreign literature. The number of domestic publications had gradually increased since 2005, with the highest number in 2012 and a significant downward trend after 2015; The overall number of foreign publications was on the rise. Domestic high-frequency authors mostly came from medical institutions, while foreign high-frequency authors were mainly concentrated in universities and research institutes, and both had formed author collaboration networks. However, the research continuity of foreign authors were better than that of domestic authors. There were commonalities in the electronicization and semantics of clinical pathways, process design and management, disease management, and clinical decision support in relevant research hotspots at home and abroad, but there were significant differences in system integration, process design, pathway analysis, and disease management. Foreign related researches had the advantages of leading technology.Conclusions:There were certain similarities and differences in the research topics of clinical pathway informatization at home and abroad, and relevant studies abroad had shown certain frontiers in the application of new technologies. In the future, China should learn from international advanced experience, utilize emerging technologies such as machine learning and big language models, strengthen patient-centered, promote the precise and intelligent development of clinical pathway management, and improve the quality of medical services.

Knee adduction moment(KAM)is a key biomechanical index in knee joint biomechanics research,which is closely related to the occurrence and development of knee osteoarthritis(KOA).Therefore,understanding the factors influencing KAM is important for the diagnosis and treatment of KOA diseases.This review summarizes the factors that may affect KAM based on relevant research.

Knee adduction moment(KAM)is a key biomechanical index in knee joint biomechanics research,which is closely related to the occurrence and development of knee osteoarthritis(KOA).Therefore,understanding the factors influencing KAM is important for the diagnosis and treatment of KOA diseases.This review summarizes the factors that may affect KAM based on relevant research.

Objective To understand the medical decision-making preferences of doctors in tertiary grade A hospitals,providing evidence to promote clinical guidelines and improve healthcare service value.Methods A discrete choice model was constructed using the Delphi method.A total of 106 valid samples were collected via a questionnaire survey.The mixed logit model was used to assess doctors' preferences in medical decision-making across scenarios of hypertension,abdominal infection,and IgA nephropathy,analyzing heterogeneity in decision-making preferences based on doctors' characteristics.Results Overall,treatment efficacy,patient preference,and the value of medical exploration significantly influenced doctors' decision-making preferences(P＜0.05).In hypertension and IgA nephropathy scenarios,adverse reactions had a significant impact on decision-making preferences(P＜0.001).The relative importance of decision-making attributes was treatment efficacy＞adverse reactions＞patient preference＞medical exploration value＞cost control.Doctors with higher education levels valued treatment efficacy more in abdominal infection and IgA nephropathy scenarios(P＜0.05)and adverse reactions more in hypertension scenarios(P＜0.05).Conclusion Treatment efficacy is the primary factor in medical decision-making.Cost control plays a limited role in current decision-making,and preferences vary by disease specificity across different clinical practice scenarios.

Objective:To analyze the research progress and hotspots of clinical pathway informatization at home and abroad, and provide references and guidance for the construction of clinical pathway informatization in China.Methods:The relevant literature on clinical pathway informatization research were retrieved from China National Knowledge Infrastructure and Web of Science databases, which were published from January 1, 2000 to July 20, 2023. Bibliometric and thematic analysis methods were used to analyze the commonalities and differences in annual publication volume, high-frequency author collaboration networks, high-frequency keywords, and research hotspots of domestic and foreign literature.Results:This study included a total of 257 domestic literature and 174 foreign literature. The number of domestic publications had gradually increased since 2005, with the highest number in 2012 and a significant downward trend after 2015; The overall number of foreign publications was on the rise. Domestic high-frequency authors mostly came from medical institutions, while foreign high-frequency authors were mainly concentrated in universities and research institutes, and both had formed author collaboration networks. However, the research continuity of foreign authors were better than that of domestic authors. There were commonalities in the electronicization and semantics of clinical pathways, process design and management, disease management, and clinical decision support in relevant research hotspots at home and abroad, but there were significant differences in system integration, process design, pathway analysis, and disease management. Foreign related researches had the advantages of leading technology.Conclusions:There were certain similarities and differences in the research topics of clinical pathway informatization at home and abroad, and relevant studies abroad had shown certain frontiers in the application of new technologies. In the future, China should learn from international advanced experience, utilize emerging technologies such as machine learning and big language models, strengthen patient-centered, promote the precise and intelligent development of clinical pathway management, and improve the quality of medical services.

Purpose/Significance By summarizing the construction experience of the immunology database and analysis portal(ImmPort),the study aims to provide insights and references for the development of a large-scale immunology database in China.Method/Process It comprehensively analyzes the architecture of ImmPort and the functionalities of its various modules,and delineates the data flow for data collection,organization,sharing,and analysis within the database.Finally,it summarizes the practical achieve-ments of the ImmPort platform.Result/Conclusion In the process of constructing the immunology database,our country should prioritize the standardization of data organization and modeling.Standardized terminology should be actively adopted to provide semantic support,and data sharing should be carried out in the management of classification and grading,while developing a supporting tool system to en-sure the safe and effective sharing and utilization of immunology data.

Objective To investigate the expression of Thymosinβ10(TMSB10)in gastric cancer and its molecular mechanism in promoting the progression of gastric cancer.Methods We collected pathological sections of 70 patients with gastric cancer in our hospital,detected expression of TMSB10 in gastric adenocarcinoma by immunohistochemistry,and analyzed its prognostic effect.In order to study the mechanism of action,the effects of TMSB10 on the proliferation and glycolysis of gastric cancer cells and its related mechanism were observed by trans-fection technique,CCK8 test,EDU assay,Transwell assay,scratch test,glycolysis assay and Western blot.Results Immunohistochemistry showed that TMSB10 was highly expressed in gastric cancer,while the expression level of TMSB10 was correlated with tumor size(P=0.032),TNM stage(P=0.002)and distant metastasis.In the mechanism study,we found that overexpression of TMSB10 promoted the proliferation,invasion,migration and glycolytic phenotype of gastric cancer cells through in vitro CCK-8 test,EDU assay,Transwel assay and glycolysis assay,and vice versa.Western blot results showed that overexpression of TMSB10 may regulate the occurrence of gastric cancer through up-regulation of the AMPK/mTOR signaling pathway.Conclusions TMSB10 promotes the proliferation,invasion,migration and glycolysis gastric cancer through the AMPK/mTOR signaling pathway.

ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections. MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections. ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P₂₅， P₇₅： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections. ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.

Objective:To explore the effects of high-efficiency centering pregnancy care (CPC) combined with information-knowledge-attitude-practice (IKAP) health education on cesarean delivery on maternal request (CDMR) rate, maternal and neonatal health status so as to provide referential significance for reducing CDMR rate and improving postpartum maternal and neonatal health status and breastfeeding rate.Methods:In the prospective, single-center and controlled study, a total of 82 primiparas undergoing antenatal examination and delivery in South Binhu Hospital of Hefei First People′s Hospital were enrolled as the research objects between January 2020 and December 2021 by convenience sampling method, including 41 cases given routine health care in routine group between January and December 2020 and 41 cases given high-efficiency CPC combined with IKAP health education on basis of routine group in combination group between January and December 2021. The cognition of cesarean section, delivery modes, incidence of postpartum complications, neonatal complications and breastfeeding between the two groups were compared.Results:The age of the routine group was (26.71 ± 2.18) years old, and the age of the combination group was (27.16 ± 1.79) years old. The proportions of correct cognition, partially correct cognition and incorrect cognition to cesarean section in combination group were 73.17% (30/41), 21.95% (9/41), 4.88% (2/41), and 53.66% (22/41), 26.83% (11/41), 19.51% (8/41) in routine group, and the difference between the two groups was statistically significant ( Z = 4.22, P<0.05). The incidence of cesarean section and CDMR in combination group was 24.39% (10/41) and 1/10, lower than that in routine group [46.34% (19/41), 10/19], and the difference between the two groups was statistically significant ( χ2 = 4.32, P<0.05; Fisher′s exact test, P = 0.049 ). The total incidence rates of postpartum complications of primiparas and neonatal complications in the combination group were 4.88%(2/41) and 7.32%(3/41), lower than 12.20%(5/41) and 12.20%(5/41) in the routine group, and the differences between the two groups were not statistically significant (Fisher′s exact test, P = 0.432, 0.712). The scores of functional health literacy, communicative health literacy and critical health literacy in combination group were (85.73 ± 4.09), (51.93 ± 4.72) and (58.63 ± 4.32) points, higher than those in routine group [(80.17 ± 5.26), (46.37 ± 5.11) , (52.71 ± 5.07) points], and the difference between the two groups was statistically significant ( t = 5.34, 5.12, 5.69, all P<0.01). At 3 months after delivery, exclusive breastfeeding rate, milk powder feeding rate and mixed feeding rate in combination group were 58.54% (24/41), 7.32%(3/41), 34.15(14/41), higher than 26.83% (11/41), 29.27(12/41), 43.90%(18/41) in routine group, and the difference between the two groups was statistically significant ( χ2 = 10.73, P<0.05). Conclusions:High-efficiency CPC combined with IKAP health education can reduce incidence of CDMR, decrease maternal and neonatal complications, enhance maternal postpartum health literacy and improve breastfeeding rate in primiparas by improving correct cognition to cesarean section. It is worthy of clinical application.