Objective To assess the efficacy of an innovative operational management model in enhancing the refined operational management of a public hospital.Methods An innovative operational management model,"One Body,Two Wings and Three Drives",was developed,which involved establishing a systematic operational management system,strengthening per-formance and cost control,and reinforcing the supporting roles of discipline construction,scientific and technological innovation,and smart hospital initiatives.This comprehensive approach aimed to systematically promote hospital operational management re-forms and improve overall efficiency and quality.Results After using this model,the hospital presented continuous improve-ments in operational efficiency and medical quality,with key performance indicators trending positively.Over the past three years,the average annual growth rate of outpatient and emergency service visits reached 6.6％,inpatient service visits increased by 5.7％,and the Case Mix Index(CMI)rose by 0.22 over two consecutive years.Conclusion This model is highly systemat-ic,practical,and policy-compatible,providing a replicable path for the high-quality development of public hospitals.

Objective::There is limited evidence regarding the choice of P2Y 12 receptor inhibitors as a component of dual antiplatelet therapy in patients with left main (LM) disease undergoing percutaneous coronary intervention (PCI). This study aimed to evaluate long-term clinical outcomes of ticagrelor- vs. clopidogrel-based dual antiplatelet therapy strategy in acute coronary syndrome (ACS) patients undergoing LM PCI. Methods::This is a post-hoc analysis from a prospective, single-center, real-world PCI registry. A total of 1,163 patients discharged post-ACS who underwent LM PCI and received ticagrelor or clopidogrel between March 2016 and March 2019 were included in the study. The primary endpoint was ischemic events at 12 months, including cardiac death, myocardial infarction, or stroke. Secondary outcomes included all-cause death and Bleeding Academic Research Consortium types 2, 3, and 5, and types 3 and 5 bleeding. Propensity score matching was used to adjust for bias due to confounders between the 2 groups.Results::The ticagrelor and clopidogrel groups comprised 529 (45.49%) and 634 (54.51%) patients, respectively. During the follow-up period, the rate of ischemic events was significantly lower with ticagrelor than with clopidogrel before (1.32% (7/529) vs. 3.63% (23/634), P = 0.013,6) and after propensity score matching (1.41% (6/425) vs. 4.00% (17/425), P = 0.020,1). The rates of all-cause death, Bleeding Academic Research Consortium-defined type 2, 3, and 5 bleeding, and type 3 and 5 bleeding were similar between the ticagrelor group and clopidogrel group before or after propensity score matching adjustment (all P > 0.05). Conclusion::Among patients with ACS undergoing LM PCI, ticagrelor use was associated with ischemic events benefit without excessive risk of bleeding at 12 months compared with clopidogrel.

Objective:This study aims to investigate the effects on the behavior of mice by optogenetic activation the neural projections from the central amygdala(CeA)to the dorsal raphe nucleus(DRN).Methods:AAV-hSyn-eYFP virus was injected into CeA of C57BL/6J mice,and the projections from CeA to DRN were observed by immunofluores-cent staining.The AAV-hSyn-ChR2-mCherry virus was injected into CeA,and AAV-DIO-eYFP was injected into DRN in Ser-Cre mouse to specifically label the serotonergic neurons.Patch-clamp recording combined with optogenetic tech-nology were employed to record the light-evoked inward currents of DRN serotonergic neurons.AAV-hSyn-ChR2-mCher-ry virus was injected into CeA and optical fiber was implanted into DRN,and the effects of optogenetic activation of the CeA-DRN neural circuit on the locomotor ability of mice was studied by open field test.Results:Four weeks after injec-tion of AAV-hSyn-eYFP virus into CeA of C57BL/6J mice,axon terminals from CeA eYFP-cells were observed in the DRN.Activation of the neural projections from the CeA to the DRN induced inhibitory inward currents in DRN seroton-ergic neurons.Activation of the projections from CeA to DRN circuit decreased the total distance and the time of the center of the open field in mice,and increased the immobility time of mice.Conclusion:The CeA neurons directly pro-ject to the DRN.Activation of CeA-DRN circuit exerts an inhibitory regulatory effect on DRN serotonergic neurons and reduces the locomotor ability of mice.

Objective:To investigate the diagnostic value of multi-slice computed tomography (MSCT) combined with serum interleukin-34 (IL-34) and monocyte chemoattractant protein-1 (MCP-1) detection for active pulmonary tuberculosis.Methods:The clinical data of 80 patients with pulmonary tuberculosis admitted to Yulin Third Hospital from March 2021 to March 2024 who underwent MSCT examination and IL-34 and MCP-1 detection, were retrospectively analyzed. The patients were divided into an active pulmonary tuberculosis group ( n = 44) and an inactive pulmonary tuberculosis group ( n = 36) based on the results of the etiological examination. The differences in MSCT signs, IL-34 and MCP-1 levels were compared between the two groups. The accuracy, sensitivity, specificity, and consistency of MSCT combined with serum IL-34 and MCP-1 detection in the diagnosis of active pulmonary tuberculosis were evaluated taking the etiological examination as the gold standard. Receiver operating characteristic curves were used to analyze the diagnostic efficacy of MSCT combined with serum IL-34 and MCP-1 detection for active pulmonary tuberculosis. Results:In the active pulmonary tuberculosis group, the prevalences of the tree bud sign [63.16% (27/44)], ground-glass opacities [52.27% (23/44)], lung consolidation [45.45% (20/44)], and cavities [68.18% (30/44)] were significantly higher than those in the inactive pulmonary tuberculosis group [36.11% (13/36), 25.00% (9/36), 13.89% (5/36), 44.44% (16/36); χ2 = 5.05, 6.14, 9.18, 4.57, all P < 0.05]. The levels of IL-34 [(2 074.48 ± 338.81) ng/L] and MCP-1 [(315.89 ± 91.89) ng/L] in the active pulmonary tuberculosis group were significantly higher than those in the inactive pulmonary tuberculosis group [(1 655.56 ± 232.37) ng/L, (260.73 ± 123.73) ng/L, t = 6.54, 2.22, both P < 0.05]. Using the etiological results as the gold standard, the accuracy of MSCT in diagnosing active pulmonary tuberculosis was 87.50%, with a sensitivity of 86.36% and specificity of 88.89%. The Kappa value was 0.749, indicating good consistency. Receiver operating characteristic curve analysis showed that the area under the curve for MSCT, IL-34, and MCP-1, both alone and in combination, in diagnosing active pulmonary tuberculosis was 0.876, 0.835, 0.631, and 0.950, respectively. When using cutoff values, the sensitivity for MSCT, IL-34, and MCP-1, both alone and in combination, was 0.889, 0.750, 0.932, 0.609, and 0.944, respectively, while the specificity was 0.864, 0.861, 0.689, and 0.886, respectively. Conclusions:The results of MSCT are consistent with those of pathogen examination. MCP-1 has diagnostic value for active pulmonary tuberculosis. MSCT, IL-34, and the combination of MSCT, IL-34, and MCP-1 demonstrate a high diagnostic value for active pulmonary tuberculosis. The combination of MSCT, IL-34, and MCP-1 offers a new non-invasive diagnostic method for clinical practice, which holds great scientific importance and clinical application value.

Objective:This study aims to investigate the effects on the behavior of mice by optogenetic activation the neural projections from the central amygdala(CeA)to the dorsal raphe nucleus(DRN).Methods:AAV-hSyn-eYFP virus was injected into CeA of C57BL/6J mice,and the projections from CeA to DRN were observed by immunofluores-cent staining.The AAV-hSyn-ChR2-mCherry virus was injected into CeA,and AAV-DIO-eYFP was injected into DRN in Ser-Cre mouse to specifically label the serotonergic neurons.Patch-clamp recording combined with optogenetic tech-nology were employed to record the light-evoked inward currents of DRN serotonergic neurons.AAV-hSyn-ChR2-mCher-ry virus was injected into CeA and optical fiber was implanted into DRN,and the effects of optogenetic activation of the CeA-DRN neural circuit on the locomotor ability of mice was studied by open field test.Results:Four weeks after injec-tion of AAV-hSyn-eYFP virus into CeA of C57BL/6J mice,axon terminals from CeA eYFP-cells were observed in the DRN.Activation of the neural projections from the CeA to the DRN induced inhibitory inward currents in DRN seroton-ergic neurons.Activation of the projections from CeA to DRN circuit decreased the total distance and the time of the center of the open field in mice,and increased the immobility time of mice.Conclusion:The CeA neurons directly pro-ject to the DRN.Activation of CeA-DRN circuit exerts an inhibitory regulatory effect on DRN serotonergic neurons and reduces the locomotor ability of mice.

BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.

BACKGROUND:The imbalance between bone resorption and bone formation in microgravity environments leads to significant bone loss in astronauts.Current research indicates that bone loss under microgravity conditions is the result of the combined effects of various cells,tissues,and systems. OBJECTIVE:To review different biological effects of microgravity on various cells,tissues,or systems,and summarize the mechanisms by which microgravity leads to the development of osteoporosis. METHODS:Databases such as PubMed,Web of Science,and the Cochrane Database were searched for relevant literature from 2000 to 2023.The inclusion criteria were all articles related to tissue engineering studies and basic research on osteoporosis caused by microgravity.Ultimately,85 articles were included for review. RESULTS AND CONCLUSION:(1)In microgravity environment,bone marrow mesenchymal stem cells tend to differentiate more into adipocytes rather than osteoblasts,and hematopoietic stem cells in this environment are more inclined to differentiate into osteoclasts,reducing differentiation into the erythroid lineage.At the same time,microgravity inhibits the proliferation and differentiation of osteoblasts,promotes apoptosis of osteoblasts,alters cell morphology,and reduces the mineralization capacity of osteoblasts.Microgravity significantly increases the number and activity of osteoclasts.Microgravity also hinders the differentiation of osteoblasts into osteocytes and promotes the apoptosis of osteocytes.(2)In a microgravity environment,the body experiences changes such as skeletal muscle atrophy,microvascular remodeling,bone microcirculation disorders,and endocrine disruption.These changes lead to mechanical unloading in the bone microenvironment,insufficient blood perfusion,and calcium cycle disorders,which significantly impact the development of osteoporosis.(3)At present,the mechanism by which microgravity causes osteoporosis is relatively complex.A deeper study of these physiological mechanisms is crucial to ensuring the health of astronauts during long-term space missions,and provides a theoretical basis for the prevention and treatment of osteoporosis.

[This corrects the article DOI: 10.1016/j.jpha.2023.08.006.].

To clarify the species, pathogenicity, and distribution of the pathogens causing the root rot of Atractylodes lancea in Hubei province, the tissue separation method was used to isolate the pathogens from root rot samples in the main planting areas of A. lancea in Hubei. Based on the preliminary identification of the Fusarium genus by the internal transcribed spacer(ITS) sequence, three housekeeping genes, EF1/EF2, Btu-F-FO1/Btu-F-RO1, and FF1/FR1, were amplified and sequenced. Subsequently, a phylogenetic tree was constructed based on these TEF gene sequences to classify the pathogens. The pathogenicity of these strains was determined using the root irrigation method. A total of 194 pathogen strains were isolated using the tissue separation method. Molecular identification using the three housekeeping genes identified the pathogens as F. solani, F. oxysporum, F. commune, F. equiseti, F. tricinctum, F. redolens, F. fujikuroi, F. avenaceum, F. acuminatum, and F. incarnatum. Among them, F. solani and F. oxysporum were the dominant strains, widely distributed in multiple regions, with F. solani accounting for approximately 54% of the total isolated strains and F. oxysporum accounting for approximately 34%. Other strains accounted for a relatively small proportion, totaling approximately 12%. The results of pathogenicity determination showed that there were certain differences in pathogenicity among strains. The analysis of the pathogenicity differentiation of the widely distributed F. solani and F. oxysporum strains revealed that these dominant strains in Hubei were mainly highly pathogenic. This study determined the species, pathogenicity, and distribution of the pathogens causing the root rot of A. lancea in Hubei province. The results provide a scientific basis for further understanding the root rot of A. lancea and its epidemic occurrence and scientifically preventing and controlling this disease.
Plant Diseases/microbiology* ; Atractylodes/microbiology* ; Phylogeny ; Plant Roots/microbiology* ; Fusarium/classification* ; China ; Virulence ; Fungal Proteins/genetics*