AIM:This study aims to investigate the molecular mechanism by which tubeimoside I(TBMS1)inhibits Snail expression in pancreatic cancer cells(PANC-1).METHODS:Human pancreatic cancer PANC-1 cells were cultured in vitro.The inhibitory effect of TBMS1 on PANC-1 cells was assessed using the MTT assay,and the data were analyzed based on the IC50 value of TBMS1.The impact of TBMS1 on the clonal formation ability of PANC-1 cells was evaluated through colony formation assays.The Transwell assay was employed to assess the effect of TBMS1 on the migrato-ry capability of PANC-1 cells.Apoptosis and cell cycle alterations in PANC-1 cells were analyzed using acridine orange staining and flow cytometry.The expression of Snail protein in pancreatic cancer and its relationship with survival of the patients were analyzed using the GEPIA database and Kaplan-Meier Plotter data.Immunofluorescence staining was con-ducted to investigate the effect of TBMS1 on Snail expression,while Western blot was used to evaluate the expression of poly(ADP-ribose)polymerase(PARP),E-cadherin and Snail in the cells.The ubiquitination of Snail protein was mea-sured using immunoprecipitation techniques.RESULTS:As the concentration of TBMS1 increased,the survival rate and number of clones formed by PANC-1 cells progressively decreased,leading to apoptosis,cleavage of PARP,and cell cycle arrest in the G1 phase.There was also a reduction in the proportion of cells in the S phase and a decrease in cell migration ability.The expression of Snail protein,a critical factor in cell migration,was inhibited,while E-cadherin protein levels were increased.Treatment with the proteasome inhibitor MG132 was able to reverse the suppression of Snail protein ex-pression caused by TBMS1.Immunoprecipitation results indicated that TBMS1 enhances the ubiquitination and subse-quent degradation of Snail protein.CONCLUSION:TBMS1 effectively inhibits the malignant progression of pancreatic cancer cells by promoting the ubiquitination and degradation of Snail protein in PANC-1 cells.

Objective To explore the clinical value of modified HOOD technique in laparoscopic radical prostatectomy.Methods A retrospective analysis was conducted on the perioperative data of 71 patients who underwent laparoscopic radical prostatectomy performed by the same surgical team during Jul.20,2022 and Dec.20,2024.The patients were divided into the observation group(n=28,modified HOOD resection)and conventional group(n=43,conventional resection).Results The observation group had better urinary continence,with higher immediate continence rate(20％vs.9.3％),shorter drainage tube removal time[4(3-6)d vs.6(3-9)d]and shorter hospital stay[6.5(4-13)d vs.9(5-11)d]compared with the conventional group.There were no statistically significant differences in operation time,intraoperative blood loss,and postoperative pathological staging between the two groups(P＞0.05).Conclusion The modified HOOD technique is safe and feasible in laparoscopic radical prostatectomy,which can effectively improve postoperative urinary continence,promote recovery,and enhance patients'quality of life.

With the implementation of DRG payment method reform in China,how to apply the DRG payment method to Traditional Chinese Medicine (TCM) has become a key issue that needs to be solved urgently.Although at present,TCM medical institutions in China may not implement the DRG payment method for the time being,but combined with the policy orientation and the process of work at the present stage of China,the combination of the DRG method payment reform and TCM has become a general trend.In order to explore the feasibility of the combination of DRG method payment and TCM diseases,it firstly combs through the status quo and dilemma of the implementation of DRG payment method reform in TCM diseases,and then discusses the feasibility of the combination of DRG payment method and TCM diseases and joint promotion of the policy based on the idea of the same price for the same disease and combining with the concept of TCM culture,in order to provide theoretical support for the further exploration of the health insurance payment method in accordance with the characteristics of TCM at the next stage.The purpose is to provide theoretical support for the next stage of further exploration of health insurance payment methods in line with the characteristics of TCM.

With the implementation of DRG payment method reform in China,how to apply the DRG payment method to Traditional Chinese Medicine (TCM) has become a key issue that needs to be solved urgently.Although at present,TCM medical institutions in China may not implement the DRG payment method for the time being,but combined with the policy orientation and the process of work at the present stage of China,the combination of the DRG method payment reform and TCM has become a general trend.In order to explore the feasibility of the combination of DRG method payment and TCM diseases,it firstly combs through the status quo and dilemma of the implementation of DRG payment method reform in TCM diseases,and then discusses the feasibility of the combination of DRG payment method and TCM diseases and joint promotion of the policy based on the idea of the same price for the same disease and combining with the concept of TCM culture,in order to provide theoretical support for the further exploration of the health insurance payment method in accordance with the characteristics of TCM at the next stage.The purpose is to provide theoretical support for the next stage of further exploration of health insurance payment methods in line with the characteristics of TCM.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

The design of the salary structure in public hospitals is an important part of the salary system reform.The salary structure is in a dynamic evolutionary process as the reform deepens,and at this stage,it is gradually shifting towards a development direction that emphasizes incentive-based salary performance.Continuous optimization of the salary structure is key to exploring the accurate measurement of doctors' value and the sustainable development of the hospital's public welfare attributes.Through literature research and comparative analysis,it presented a tabular presentation of the four incentive compensation models formed so far in the dynamic optimization of China's public hospitals after the new healthcare reform,and to conduct a comparative analysis of their respective advantages and disadvantages,in order to provide reference and information for the continuous optimization of the pay structure of public hospitals.

Based on the theoretical framework of incentive compatibility,it analyzes the experience of the annual salary system of deans in the reform of public hospitals,summarizes the systemic efficacy and limitations of the annual salary system of deans,and extracts the empirical insights for the reform of physicians' remuneration.The annual salary system of deans cuts off the link between salary and economic gain,strengthens the assessment of public welfare,and initially realizes the incentive compatibility,but there are also assessment defects and incentive imbalance risks.The annual salary system for doctors needs to build a hierarchical and dynamic assessment system,and rely on medical insurance payment and financial protection to break the system's island effect.In the future,the appraisal framework should be dynamically optimized with regional differences,so as to promote the higher-order compatibility of individual rationality and public welfare attributes.

The reform of salary system in public hospitals is a key link in deepening the reform of medical and health system,which is of great significance to improving the quality of medical services.With the help of Smith policy implementation process model,it constructs the theoretical framework of policy analysis,and analyzes the implementation dilemma of the salary system reform in public hospitals from four dimensions of idealized policy,implementing agency,target group and policy environment.There are the core problems of contradiction between policy and demand,administrative dominance and specialty deficiency,incentive imbalance and external environment restriction.Put forward the development path of public welfare oriented adjustment mechanism,establishing a collaborative supervision system,building a compound incentive model,and building a salary community.

Objective To explore and analyze the incentive changes before and after the implementation of the annual salary system in public hospitals to provide guidance for the implementation.Methods Using the principal-agent theory,construct the structure and model of government,hospitals and doctors,and analyze the salary incentive before and after the implementation of the annual salary system.Results Former doctors"seek profit"and hospital"income orientation"conflict with the government public welfare goals;after implementation,doctors transfer"public welfare"and hospital and government goals seek"public welfare coordination",but there are also new problems such as insufficient incentives.Conclusion If public hospitals successfully implement the annual salary system,they should adopt fine parameter design,supporting system and dynamic equilibrium mechanism.

Objective To observe the value of deep learning image reconstruction(DLIR)algorithm in brain CT perfusion(CTP)using a protocol of 70 kVp and 40 ml contrast agent dose.Methods Totally 105 patients with suspected acute ischemic stroke(AIS)were prospectively enrolled and randomly divided into 3 groups,who underwent standard dose CTP scanning with 80 kVp and 150 mA combined with reconstruction as adaptive statistic iterative reconstruction V(ASIR-V)at 50％level(CN group,n=35),low dose(LD)scanning with 70 kVp and 100 mA combined with DLIR reconstruction at the highest level(DLIR-H)(LD group,n=35),or ultra-low dose(ULD)scanning with 70 kVp and 70 mA combined with DLIR-H reconstruction(ULD group,n=35).Radiation doses were compared among 3 groups.CT values and standard deviations(SDCT)of ROI of gray matter and white matter in the frontal,parietal and temporal lobes were measured.Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)between gray and white matter were calculated and compared among groups.Then pseudo-color images of cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to maximum of the tissue residual function(Tmax)were generated.The imaging quality of CTP pseudo-color images was evaluated,and the compatibility of the subjective scores within every kind of CTP pseudo-color images were assessed using Kappa test.Quantitative perfusion parameters were measured and compared among groups.Results Compared with CN group,both LD and ULD groups demonstrated significantly reduced volume CT dose index(CTDIvol),dose-length product(DLP)and effective dose(ED)(all adjusted P＜0.05).In ULD group,SDCT of white matter in frontal,parietal and temporal lobes were higher than those in CN group,and SDCT of white matter in parietal lobe was also higher than that in LD group(all adjusted P＜0.05).No significant difference of SDCT of gray matter was observed among groups(all P＞0.05).SNR of white matter in parietal and temporal lobes in both LD and ULD groups were lower than those in CN group(all P＜0.05),while no significant difference of SNR of white matter in frontal lobe,nor of gray matter in frontal,parietal and temporal lobes was found among groups(all P＞0.05).CNR of gray and white matter in the frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).High consistency of inter-observer subjective scores of CBV maps,CBF maps and Tmax maps(Kappa of 0.623,0.644 and 0.638,respectively)were noticed,which of MTT maps had moderate consistency(Kappa=0.560).No significant difference of intra-obsever subjective scores of CTP pseudo-color images was found among groups(all P＞0.05).CBV,CBF,MTT and Tmax values of gray and white matter in frontal,parietal and temporal lobes were not significantly different among groups(all P＞0.05).Conclusion DLIR algorithm applicated in low radiation dose and reduced contrast agent dosage might ensure imaging quality.