AIM: To investigate the changes of microRNA-34a(miR-34a)and microRNA-29b(miR-29b)levels in lens epithelial cells of age-related cataracts(ARC)patients and their clinical significance.METHODS: A total of 65 ARC patients(study group)and 53 cases of clear lens anterior capsulorhexis(control group)who visited our hospital from February 2023 to February 2024 were gathered. Pearson was applied to test the correlation between miR-34a and miR-29b. Multifactor Logistic regression was applied to determine the factors affecting the occurrence of ARC.RESULTS: Compared with the control group, the expression levels of miR-34a and miR-29b in lens epithelial cells of the research group showed a significant decrease trend(all P<0.05). There was a positive correlation between miR-34a and miR-29b in the lens epithelial cells of ARC patients(r=0.472, P<0.05). MiR-34a and miR-29b were influence factors for ARC(all P<0.05).CONCLUSION: The levels of miR-34a and miR-29b in lens epithelial cells of ARC patients are significantly reduced, which is associated with the occurrence of ARC.

Objective:To explore the application value of breast ultrasound structured report in the clinical teaching of standardized residency training of ultrasonography.Methods:Forty-eight residents from the Department of Ultrasonography in Renmin Hospital of Wuhan University were selected as the research objects, and were randomly divided into experimental group and control group in average. The experimental group used structured report template to write the breast ultrasound report, while the control group used free text. After 1 month of clinical teaching, the teachers who were not clear about the grouping assessed and analyzed the differences between the two groups of residents in grasping the characteristics of lesions and reporting content. At the same time, the students were asked to fill in a questionnaire for self-evaluation to analyze the learning situation of the two groups of students. SPSS 21.0 statistical analysis software was used for t-test and Chi-square test. Results:In terms of teacher evaluation, the scores of residents in the experimental group were higher than those in the control group in terms of completeness of report content, accuracy of description of peripheral conditions of lesions, standardization of professional terms and practicality of differential diagnosis (all P<0.001). There was no significant difference in the accuracy of lesion description between the two groups ( P=0.342). In terms of self-evaluation of residents in the standardized residency training, the evaluations of residents in the experimental group on the degree of mastery of knowledge points, clinical thinking cultivation and satisfaction of teaching mode were significantly higher than those of residents in the control group ( P=0.006, 0.012, <0.001, respectively). There were no significant differences between the two groups in learning interest and operation convenience ( P=0.186, 0.065, respectively). Conclusions:The structured report of breast ultrasound is helpful for the residents to master the characteristics of lesions and write a complete and professional report. It is also helpful for them to improve the standardization of operation and clinical thinking ability.

Background::Gastric cancer (GC), a malignant tumor with poor prognosis, is one of the leading causes of cancer-related deaths worldwide; consequently, identifying novel therapeutic targets is crucial for its corresponding treatment. NUF2, a component of the NDC80 kinetochore complex, promotes cancer progression in multiple malignancies. Therefore, this study aimed to explore the potential of NUF2 as a therapeutic target to inhibit GC progression. Methods::Clinical samples were obtained from patients who underwent radical resection of GC at Lanzhou University Second Hospital from 2016 to 2021. Cell count assays, colony formation assays, and cell-derived xenotransplantation (CDX) models were used to determine the effects of NUF2 on GC progression. Flow cytometry was used to detect the effect of NUF2 or quercetin on cell cycle progression and apoptosis. A live-cell time-lapse imaging assay was performed to determine the effect of NUF2 on the regulation of mitotic progression. Transcriptomics was used to investigate the NUF2-associated molecular mechanisms. Virtual docking and microscale thermophoresis were used to identify NUF2 inhibitors. Finally, CDX, organoid, and patient-derived xenograft (PDX) models were used to examine the efficacy of the NUF2 inhibitor in GC. Results::NUF2 expression was significantly increased in GC and was negatively correlated with prognosis. The deletion of NUF2 suppressed GC progression both in vivo and in vitro. NUF2 significantly regulated the mitogen-activated protein kinase (MAPK) pathway, promoted G2/M phase transition, and inhibited apoptosis in GC cells. Additionally, quercetin was identified as a selective NUF2 inhibitor with low toxicity that significantly suppressed tumor growth in GC cells, organoids, CDX, and PDX models. Conclusions::Collectively, NUF2-mediated G2/M phase transition and apoptosis inhibition promoted GC progression; additionally, NUF2 inhibitors exhibited potent anti-GC activity. This study provides a new strategy for targeting NUF2 to suppress GC progression in clinical settings.

Objective To investigate the inhibition of gigantol on corneal neovascularization(CNV)in rats after corneal alkali burn.Methods Animal models of corneal alkali burn were made with SD rats,which were divided into normal control group,model control group,low-concentration gigantol group,high-concentration gigantol group and aflibercept group,with 10 rats in each group.The rats in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were treated with 2.5 mg/0.05 mL gigantol,5 mg/0.05 mL gigantol,and 2 mg/0.05 mL aflibercept by subconjunctival injection after modeling.The CNV,corneal opacity score,and thickness of the cornea were observed and compared on the 3rd,7th,and 14th days after alkali burn.The ratio of CNV area to corneal area was calculated.On the 14th day,all rats were sacrificed.Hematoxylin and eosin staining and immunohistochemistry were used to detect the expression of CD34 and VEGF.The protein expression of VEGF,IL-1β,and TNF-α was detected by ELISA.Results On the 7th and 14th days after alkali burn,the percentages of CNV to total corneal area in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were significantly smaller than those in model control group(all P＜0.05).On the 14th day,the corneal opacity score was lower in high-concentration gigantol group than model control group(P＜0.05).The corneal thickness in model control group and low-concentration gigantol group were significantly greater than that in normal control group(all P＜0.001).However,the corneal thickness in high-concentration gigantol group and aflibercept group were not significantly different from that in normal control group(all P＞0.05).In addition,the protein expression of VEGF,IL-1β,and TNF-α in corneal tissues in low-concentration gigantol group,high-concentration gigantol group and aflibercept group were significantly lower than that in model control group(all P＜0.01).Conclusions Gigantol administration by subconjunctival injection can inhibit the formation of CNV in rats after alkali burn and promote absorption of the corneal edema.

Taking the reform of payment methods based on diagnosis related groups as an opportunity, implementing performance management based on disease groups is an important lever to promote the improvement of hospital diagnosis and treatment level and high-quality development. In 2023, a tertiary comprehensive hospital introduced benchmarking management into performance management, using the average days of stay, drug costs, and consumables costs of the disease group as cost benchmark indicators. The cost benchmark values for each disease group was determined based on the big data of the disease group of the tertiary comprehensive hospital in the region and the clinical pathway management goals of the hospital. Through multidimensional and multi-level comparative analysis of the hospital′s historical values and regional big data distribution values of the benchmark indicators for each disease group, the cost benchmark values for each disease group was determined. The hospital has established a performance reward and punishment mechanism based on the benchmark value of disease group costs, and at the same time, established a performance management communication mechanism to promote relevant departments and medical groups to improve their management against the benchmark. In addition, with changes in the external environment and internal practices, the cost benchmark value of the disease group was dynamically optimized, forming a closed-loop management system that included establishing benchmarks, comparing benchmarks, achieving benchmarks, and optimizing benchmarks. Since the implementation of performance management based on disease group cost benchmarking in March 2023, the hospital′s case mix index has increased from 1.52 in March to 1.54 in September; The average days of stay decreased from 6.22 days to 5.90 days; The monthly payment weight has increased from 18 103 to 18 558; The average hospitalization cost has decreased from 16 724 yuan/person to 15 278 yuan/person, mainly due to the decrease in drug and consumables costs. The proportion of drug costs has decreased from 27.45% to 26.32%, the proportion of consumables costs has decreased from 28.75% to 26.85%, and the proportion of medical service revenue has increased from 24.64% to 26.08%; The proportion of low magnification cases decreased from 9.09% to 8.24%; The medical insurance payment rate has increased from 99.3% to 107.0%; The job satisfaction of physicians has increased from 70.00% in 2022 to 76.77% in 2023, which can provide reference for performance management practices in other hospitals.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Osteoporosis （OP） is a systemic metabolic bone disease characterized by bone microstructure degeneration and bone mass loss， which has a high prevalence and disability rate. Effective prevention and treatment of OP is a major difficulty in the medical community. The nature of OP is that multiple pathological factors lead to the imbalance of human bone homeostasis maintained by osteoblasts and osteoclasts. Ferroptosis is a non-apoptotic cell death pathway， and its fundamental cause is cell damage caused by iron accumulation and lipid peroxidation. Studies have shown that ferroptosis is involved in and affects the occurrence and development of OP， which leads to OP by mediating the imbalance of bone homeostasis. Ferroptosis is an adjustable form of programmed cell death. The intervention of ferroptosis can regulate the damage degree and death process of osteoblasts and osteoclasts， which is beneficial to maintain bone homeostasis， slow down the development process of OP， improve the clinical symptoms of patients， reduce the risk of disability， and improve their quality of life. However， there are few studies on ferroptosis in OP. Traditional Chinese medicine （TCM） is a medical treasure with unique characteristics and great application value in China. It has been widely used in China and has a long history. It has the multi-target and multi-pathway advantages in the treatment of OP， with high safety， few toxic and side effects， and low treatment cost， and has a significant effect in clinical application. The intervention of TCM in ferroptosis to regulate bone homeostasis may be a new direction for the prevention and treatment of OP in the future. This article summarized the regulatory mechanisms related to ferroptosis， discussed the role of ferroptosis in bone homeostasis， and reviewed the current status and progress of active ingredients in TCM compounds and monomers in the regulation of OP through ferroptosis， so as to provide a theoretical basis for the participation of TCM in the prevention and treatment of OP in the future.

Objective:To evaluate direct and indirect costs for schizophrenia,major depressive disorder(MDD)and bipolar disorder,and to compare their differences of cost composition,and to explore the drivers of the total costs.Methods:A total of 3 175 inpatients with schizophrenia,MDD,and bipolar disorder were recruited.In-patient's self-report total direct of medical costs outpatient and inpatient,out-of-pocket costs,and direct non-medical costs were regarded as direct costs.Productivity loss and other loss caused by damaging properties were defined as indirect costs.The perspectives of this study included individual and societal levels.Multivariate regression analysis was applied for detecting the factors influencing disease costs.Results:The total cost of schizophrenia was higher than those of MDD and bipolar disorder at individual and societal levels.The indirect costs of three mental disorders were higher than the direct costs,and the indirect cost ratio of bipolar disorder was higher than those of schizophre-nia and MDD.Age,gender,working condition and marital status(P＜0.05)were the important drivers of total costs.Conclusion:The economic burden of the three mental disorders is relatively heavy.Schizophrenia has heaviest disease burden,and the productivity loss due to mental disorders is the driving force of the soaring disease cost

Objective:To describe demographic,clinical and physiological characteristics,treatment between first-episode major depressive disorder(MDD)and relapse MDD,and to explore characteristics of relapse MDD.Methods:Totally 858 patients who met the diagnostic criteria for depression of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),were included by using the Mini International Neuropsychiatric Interview(MINI),Clinician-Rated Dimensions of Psychosis Symptom Severity,and Hamilton Depression Scale etc.Among them,529(58.6％)were first-episode depression and 329(36.0％)were relapsed.The differences of demographic characteristics,clinical and physiological characteristics,treatment were compared byx2test and Kruskal-Wallis rank sum test.Multivariate logistic regression was used to explore the characteristics of MDD recur-rence.Results:Compared to first-episode MDD,relapse MDD had more comorbidity(OR=2.11,95％CI:1.00-4.44),more days out of role(OR=1.26,95％CI:1.01-1.56),more history of using psychiatric drug more than one month(OR=1.41,95％CI:1.02-1.97)and electroconvulsive therapy(OR=3.23,95％CI:1.42-7.36),and higher waist-hip ratio(OR=33.88,95％CI:2.88-399.32).Conclusion:Relapse MDD has positive as-sociation with comorbidity of mental disorders,out of role,and higher waist-hip ratio.

Objective This study aims at establishing a teaching catalog and content for breast rare dis-eases and developing the syllabus for the breast rare disease using integrated multimodality of case-/problem-/resource-based learning(CBL+PBL+RBL).Methods By conducting bibliometrics co-occurrence analysis,we collected 6291 articles on breast rare disease published from January,1975 to June,2024.Additionally,we re-trieved the Textbook on Rare Diseases,the Catalog of Chinese Rare Disease,and Second Batch of Rare Dis-ease Catalog and then decided the teaching content.Results From 16,387 keywords,1000(6.1％)keywords were identified through co-occurrence analysis,including 50(0.3％)candidate diseases.These were classified into three categories:rare primary breast diseases,rare genetic mutation-related diseases associated with breast cancer,and rare systemic multi-system diseases involving the breast.From the candidate list,20(0.1％)rare primary breast diseases were further selected for their notable clinical teaching significance,and significant multi-systemic diseases affecting the breast,whether related to gene mutations or not.Teaching plans were draf-ted using a diversified parallel teaching approaches,taking into account the characteristics of different diseases and the focus of different teaching methods.Conclusions This study initiated the development of the teaching content for breast rare diseases and developed the teaching syllabus using the CBL+PBL+RBL integrated multi teaching model and targeting each rare breast disease for the critical point for teaching.