Objective:To assess the effects of recognition function of four-lead electrocardiogram(ECG)synchronization technique and multi-parameter fusion technique in reducing the number of false alarms and improving the quality of alarms in intensive care units(ICU).Methods:Four-lead ECG synchronization technique and multi-parameter fusion technique were used to strengthen the monitoring and assessment for the alarm of clinical monitors,and reduce the false alarm rate of monitors.The clinical alarm data of bed units corresponding to 48 monitors in clinical use of ICU,cardiovascular intensive care unit(CCU)and neurosurgery intensive care unit(NICU)of Hainan General Hospital from October 14 to December 27,2024 were selected.According to the opening and close of the four-lead ECG synchronization and multi-parameter fusion technique algorithm of the monitors,they were divided into group A(opened four-lead ECG synchronization and multi-parameter fusion),group B(opened four-lead ECG synchronization,but closed multi-parameter fusion),group C(closed four-lead ECG synchronization,but opened multi-parameter fusion)and group D(closed four-lead ECG synchronization and multi-parameter fusion),with 12 units in each group.The numbers of total alarms and false alarms generated by monitor of each bed unit among different optimization strategies were compared.Results:The numbers of average daily alarm of the monitors in groups A,B and C were respectively(134.2±32.4)cases,(392.5±68.2)cases and(583.4±126.5)cases,which were lower than those in group D(1 073.2±168.6),with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).The optimization rates of the alarm numbers in groups A,B and C were increased by 87.51%,63.47%and 45.67%,respectively.The rates of average false alarm of the monitors in groups A,B and C were respectively(1.04±0.15)%,(1.73±0.12)%and(2.07±0.08)%,which were lower than(3.76±0.2)%in group D,with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).Conclusion:Four-lead ECG synchronization technique and multi-parameter fusion technique can effectively optimize the number of alarms in ICU,and reduce the proportion of false alarms of monitors in department,and decrease fatigue of medical staffs for alarm.

AIM:This study aims to investigate the role of dynamin-related protein 1(Drp1)in the A1 type activation of astrocytes and elucidate the underlying mechanism of abnormal astrocyte activation.METHODS:Rat astro-cyte line CTX-TNA2 was divided into control group,astrocyte-conditioned medium(ACM)group,and 5,10 and 25 μmol/L mitochondrial division inhibitor-1(Mdivi-1;a selective inhibitor of Drp1)+ACM group.The cells in ACM group were exposed to ACM containing interleukin-1α(IL-1α),tumor necrosis factor-α(TNF-α)and complement 1q(C1q)for 24 h to induce type A1 activation,while those in Mdivi-1+ACM group were pre-treated with various concentrations of Mdi-vi-1 for 2 h before stimulation with ACM for 24 h.RT-qPCR was used to detect the expression levels of A1 type activation-related indicators IL-1β,TNF-α and IL-10 mRNA in each group.Immunofluorescence was utilized to assess the expres-sion levels of A1 type activation marker molecules C3,inducible nitric oxide synthase(iNOS)and S100 calcium binding protein A10(S100A10).The level of mitochondrial reactive oxygen species(ROS)was measured using MitoSOX Red staining and flow cytometry analysis.The mitochondrial morphology was observed using the MICA full-field imaging analy-sis platform.Lastly,the expression level of mitochondrial fission protein 1(FIS1)and the activation level of Drp1 in each group were evaluated through immunoblotting analysis.RESULTS:The RT-qPCR and immunofluorescence results indi-cated that the ACM group exhibited significantly elevated levels of IL-1β and TNF-α mRNA,and C3 protein expression compared with control group,along with increased iNOS protein expression and reduced IL-10 mRNA and S100A10 pro-tein expression(P＜0.05).Interventions with 10 and 25 μmol/L Mdivi-1 effectively inhibited the rise in IL-1β and TNF-α mRNA,and C3 and iNOS protein expression induced by ACM,while promoting S100A10 expression.MitoSOX Red staining revealed a significant increase in mitochondrial ROS levels in astrocytes stimulated by ACM,which was effectively re-versed by Mdivi-1 intervention.The MICA full-field imaging analysis platform demonstrated that ACM induced the forma-tion of round-shaped mitochondria in astrocytes,while 10 and 25 μmol/L Mdivi-1 interventions facilitated the restoration of their tubular shape.Additionally,Western blot results confirmed that Mdivi-1 intervention effectively reversed the acti-vation of Drp1 and FIS1.CONCLUSION:The Drp1-mediated mitochondrial fission represents one of the intrinsic molecu-lar mechanisms underlying A1 type activation of astrocytes,and Mdivi-1,as a selective inhibitor of Drp1,can effectively inhibit abnormal astrocyte activation.

This study explores the SWOT analysis and countermeasure research for operational management of public hos-pitals under the"three-medical"(healthcare insurance,medical services,and pharmaceuticals)coordination background.It an-alyzes the internal strengths,weaknesses,external opportunities,and threats faced by public hospitals in the coordination of healthcare insurance,medical services,and pharmaceuticals.Public hospitals should focus on three key aspects—decision-mak-ing management,business processes,and foundational support—to enhance operational management capabilities.Through meas-ures such as optimizing resource allocation,strengthening information system construction,and cultivating professional talents,hospitals can achieve coupling coordination between data asset management and operational management,thereby promoting high-quality development.

AIM:This study aims to investigate the role of dynamin-related protein 1(Drp1)in the A1 type activation of astrocytes and elucidate the underlying mechanism of abnormal astrocyte activation.METHODS:Rat astro-cyte line CTX-TNA2 was divided into control group,astrocyte-conditioned medium(ACM)group,and 5,10 and 25 μmol/L mitochondrial division inhibitor-1(Mdivi-1;a selective inhibitor of Drp1)+ACM group.The cells in ACM group were exposed to ACM containing interleukin-1α(IL-1α),tumor necrosis factor-α(TNF-α)and complement 1q(C1q)for 24 h to induce type A1 activation,while those in Mdivi-1+ACM group were pre-treated with various concentrations of Mdi-vi-1 for 2 h before stimulation with ACM for 24 h.RT-qPCR was used to detect the expression levels of A1 type activation-related indicators IL-1β,TNF-α and IL-10 mRNA in each group.Immunofluorescence was utilized to assess the expres-sion levels of A1 type activation marker molecules C3,inducible nitric oxide synthase(iNOS)and S100 calcium binding protein A10(S100A10).The level of mitochondrial reactive oxygen species(ROS)was measured using MitoSOX Red staining and flow cytometry analysis.The mitochondrial morphology was observed using the MICA full-field imaging analy-sis platform.Lastly,the expression level of mitochondrial fission protein 1(FIS1)and the activation level of Drp1 in each group were evaluated through immunoblotting analysis.RESULTS:The RT-qPCR and immunofluorescence results indi-cated that the ACM group exhibited significantly elevated levels of IL-1β and TNF-α mRNA,and C3 protein expression compared with control group,along with increased iNOS protein expression and reduced IL-10 mRNA and S100A10 pro-tein expression(P＜0.05).Interventions with 10 and 25 μmol/L Mdivi-1 effectively inhibited the rise in IL-1β and TNF-α mRNA,and C3 and iNOS protein expression induced by ACM,while promoting S100A10 expression.MitoSOX Red staining revealed a significant increase in mitochondrial ROS levels in astrocytes stimulated by ACM,which was effectively re-versed by Mdivi-1 intervention.The MICA full-field imaging analysis platform demonstrated that ACM induced the forma-tion of round-shaped mitochondria in astrocytes,while 10 and 25 μmol/L Mdivi-1 interventions facilitated the restoration of their tubular shape.Additionally,Western blot results confirmed that Mdivi-1 intervention effectively reversed the acti-vation of Drp1 and FIS1.CONCLUSION:The Drp1-mediated mitochondrial fission represents one of the intrinsic molecu-lar mechanisms underlying A1 type activation of astrocytes,and Mdivi-1,as a selective inhibitor of Drp1,can effectively inhibit abnormal astrocyte activation.

This study explores the SWOT analysis and countermeasure research for operational management of public hos-pitals under the"three-medical"(healthcare insurance,medical services,and pharmaceuticals)coordination background.It an-alyzes the internal strengths,weaknesses,external opportunities,and threats faced by public hospitals in the coordination of healthcare insurance,medical services,and pharmaceuticals.Public hospitals should focus on three key aspects—decision-mak-ing management,business processes,and foundational support—to enhance operational management capabilities.Through meas-ures such as optimizing resource allocation,strengthening information system construction,and cultivating professional talents,hospitals can achieve coupling coordination between data asset management and operational management,thereby promoting high-quality development.

Objective:To assess the effects of recognition function of four-lead electrocardiogram(ECG)synchronization technique and multi-parameter fusion technique in reducing the number of false alarms and improving the quality of alarms in intensive care units(ICU).Methods:Four-lead ECG synchronization technique and multi-parameter fusion technique were used to strengthen the monitoring and assessment for the alarm of clinical monitors,and reduce the false alarm rate of monitors.The clinical alarm data of bed units corresponding to 48 monitors in clinical use of ICU,cardiovascular intensive care unit(CCU)and neurosurgery intensive care unit(NICU)of Hainan General Hospital from October 14 to December 27,2024 were selected.According to the opening and close of the four-lead ECG synchronization and multi-parameter fusion technique algorithm of the monitors,they were divided into group A(opened four-lead ECG synchronization and multi-parameter fusion),group B(opened four-lead ECG synchronization,but closed multi-parameter fusion),group C(closed four-lead ECG synchronization,but opened multi-parameter fusion)and group D(closed four-lead ECG synchronization and multi-parameter fusion),with 12 units in each group.The numbers of total alarms and false alarms generated by monitor of each bed unit among different optimization strategies were compared.Results:The numbers of average daily alarm of the monitors in groups A,B and C were respectively(134.2±32.4)cases,(392.5±68.2)cases and(583.4±126.5)cases,which were lower than those in group D(1 073.2±168.6),with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).The optimization rates of the alarm numbers in groups A,B and C were increased by 87.51%,63.47%and 45.67%,respectively.The rates of average false alarm of the monitors in groups A,B and C were respectively(1.04±0.15)%,(1.73±0.12)%and(2.07±0.08)%,which were lower than(3.76±0.2)%in group D,with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).Conclusion:Four-lead ECG synchronization technique and multi-parameter fusion technique can effectively optimize the number of alarms in ICU,and reduce the proportion of false alarms of monitors in department,and decrease fatigue of medical staffs for alarm.

Objective To investigate the effect of leflunomide(LEF)on the expression of associated autophagy genes in synoviocytes of rheumatoid arthritis(RA)by regulating HIF-1α signal pathway.Methods Three genera-tions of RA synovial cells were divided into blank control group,LEF group and Tripterygium wilfordii polyglyco-sides group.The blank control group was added with the same volume of DMEM culture medium.The drug group was treated with LEF(concentration 0.2 mg/ml)and Tripterygium wilfordii polyglycosides(concentration 0.03 mg/ml),the proliferation and apoptosis of synovial cells were detected by flow cytometry,the expression of IL-1 β,TNF-α,ANGPTL-4 and VEGF was detected by ELISA,the expression of HIF-1α mRNA was detected by qRT-PCR,and the expression of HIF-1 α,Beclin-1 and BNIP3 protein was detected by Western blot.Results Com-pared with Tripterygium wilfordii polyglycosides group,the expression of IL-1 α,TNF-α,ANGPTL-4 and VEGF in synovial supernatant of LEF group decreased;compared with the blank control group,the expression of HIF-1αmRNA in synovial cells of LEF group and Tripterygium wilfordii polyglycosides group decreased,and the effect of LEF group was the most obvious;compared with the blank control group,the protein expressions of HIF-1α,Bec-lin-1 and BNIP3 in synovial cells of LEF group and Tripterygium wilfordii polyglycosides group decreased,and the effect of LEF group was the most obvious.Conclusion LEF can inhibit the expression of inflammatory factors in RA synovial cells,inhibit HIF-1α signaling pathway,inhibit the expression of autophagy-related genes Beclin-1 and BNIP3,and improve the pathological state of synovitis.

Objective:To evaluate the efficacy and safety of limited pars plana vitrectomy(LPPV), pressure-controlled phacoemulsification(PCP), intraocular lens implantation(IOL), and posterior capsulotomy (PC) in treatment of nanophthalmic glaucoma eyes which intraocular pressure(IOP) were still out of control after peripheral iridectomy.Methods:All 24 patients(29 eyes) with nanophthalmic glaucoma whose IOP failed to be reduced after peripheral iridectomy and needed LPPV plus PCP plus IOL plus PC were recruited from July 2017 to April 2021. The age of these patients was(44.6±11.0) years old. Preoperative and postoperative IOP, best corrected visual acuity(BCVA), anterior chamber depth(ACD) and number of glaucoma medications were recorded by chart review and compared by using paired t-test or Wilcoxon signed rank-sum test. P<0.05 was considered as statistical significant. IOP could be controlled in normal range(≥5 mmHg and≤21 mmHg), without both of disease progression and serious complications were regarded as the success criteria of the operation. Surgical success rate was evaluated. Surgery-associated complications were recorded. Results:The average follow-up time was(11.52±12.44) months. After the microsurgery, IOP decreased from(33.12±9.25) mmHg to(14.23±3.44) mmHg( P<0.01); The ACD increased from(1.23±0.46) mm to(2.86±0.62) mm, and the median number of glaucoma medications dropped from 3(3,4) to 3(0,3) at final follow-up visit( P<0.05). There were no significant differences in BCVA( P=0.196) and the degrees of angle closure(AC) ( P=0.478) before and after operation. The total surgical success rate was 86.2%(25/29) at the final follow-up visit. Two eyes suffered from local choroidal detachment which recovered within 2 weeks with medical treatment. Conclusion:LPPV plus PCP plus IOL plus PC is a safe and effective novel surgical procedure in the treatment of nanophthalmic glaucoma patients with uncontrolled IOP after peripheral iridectomy. It could significantly decrease IOP, increase the depth of ACD, reduce the number of glaucoma medications and maintain BCVA. It can be considered as a first choice for the surgical management for patients with a such condition.

Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.

Objective: To investigate the effect of lncRNA SBF2-AS1 on epithelial-mesenchymal transition (EMT) of cervical cancer HeLa cell via regulating miR-140-5p/VEGFA (vascular endothelial growth factor A) axis. Methods: After cell culture and transfection, the cells were divided into 5 groups: NC group, miR-140-5p mimic group, miR-140-5p mimic+pcDNA-VEGFA group, si-lncRNA SBF2-AS1+pcDNA-VEGFA group and si-lncRNA SBF2-AS1+miR-140-5p mimic group. The expression level of lncRNA SBF2-AS1 in cervical cancer tissues and cell lines was detected by qPCR. The targeted relationship between lncRNA SBF2-AS1, miR-140-5p and VEGFA was confirmed by Dual luciferase reporter gene assay. The expression levels of VEGFA and EMT-related proteins N-cadherin, Vimentin and E-cadherin in HeLa cells were detected by WB. The invasion and migration of HeLa cells were detected by Transwell. Results: lncRNA SBF2-AS1 was highly expressed in cervical cancer tissues and cell lines (P<0.05 or P<0.01). Dual luciferase reporter gene assay confirmed that lncRNASBF2-AS1 targetedly combined with miR-140-5p and VEGFAwas a target gene of miR-140-5p (P< 0.05). Knockdown of lncRNA SBF2-AS1 inhibited invasion and migration as well as EMT of HeLa cells. Further experiment confirmed that lncRNA SBF2-AS1 up-regulated the expression level of VEGFA via miR-140-5p, thereby promoting invasion, migration and EMT of HeLa cells. Conclusion: lncRNASBF2-AS1 promotes EMT of HeLa cells via miR-140-5p/VEGFAaxis.