United Nations(UN)agencies are key actors in global procurement of health products,with the United Nations Children's Fund(UNICEF)currently accounting for the largest share of UN procurement expenditures.This study developed a conceptual framework to analyze the processes of UN's global procurement for health products.Based on this framework,the study analyzed the mechanisms and key characteristics of UN procurement practices,identified potential challenges faced by Chinese products and suppliers seeking to engage with the UN's global procurement.The findings indicate a steady increase in the volume of Chinese products procured and their alignment with the UN's sustainable procurement policies.However,Chinese suppliers still face notable barriers,including gaps in technical standards,bidding and contracting capacities,and price competitiveness.In addition,the strategic compliance capabilities of Chinese suppliers and products,such as the ability to offer strategically valuable products and build long-term partnership,remains limited.Based on this,the study recommends that China enhance its participation and influence in the UN health procurements by stabilizing the production capacity,promoting knowledge-sharing among suppliers to enhance their engagement capabilities,and improving the long-term strategic competitiveness of Chinese enterprises in the global market.

Objective:To investigate the efficacy of bone melon extract injection combined with calcitriol in patients after surgery for osteoporotic vertebral compression fractures.Methods:The clinical data of 108 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty at The First People's Hospital of Xianyang from January 2021 to January 2024 were retrospectively analyzed. The patients were divided into a control group ( n = 54, treatment with calcitriol) and a treatment group ( n = 54, treatment with bone melon extract injection and calcitriol). Both groups were treated for 3 months. Serum bone metabolism indexes, inflammatory factors, bone density, vertebral anterior edge height and Cobb angle were compared between the two groups before and after treatment. Additionally, adverse reactions, such as gastrointestinal symptoms, hypercalcemia, and allergic reactions were recorded. Results:After treatment, the levels of β-collagen degradation products in the treatment group were significantly lower than those in the control group [(0.75 ± 0.08) μg/L vs. (0.94 ± 0.10) μg/L; t = 10.90, P<0.001]. The serum levels of type I collagen amino-terminal peptide in the treatment group were significantly higher than those in the control group [(34.31 ± 3.56) μg/L vs. (29.64 ± 3.05) μg/L; t = -7.64, P<0.001]. The serum levels of interleukin-1 and interleukin-6 in the treatment group were (70.51 ± 7.13) ng/L and (60.74 ± 6.12) μg/L, respectively, which were significantly lower than those in the control group [(89.64 ± 8.66) ng/L, (71.65 ± 7.32) μg/L; t = 12.53, 8.40, both P<0.001]. The bone mineral densities of the femoral neck and L 1-L 4 in the treatment group were (0.77 ± 0.08) g/cm2 and (0.71 ± 0.07) g/cm2, respectively, both of which were significantly higher than those in the control group [(0.68 ± 0.07) g/cm2, (0.63 ± 0.06) g/cm2; t = -6.22, -6.38, both P<0.001]. Additionally, the anterior vertebral height in the treatment group was significantly greater than that in the control group [(29.03 ± 2.97) mm vs. (25.05 ± 2.61) mm; t = -7.40, P<0.001]. The Cobb angle in the treatment group was significantly lower than that in the control group [(21.39 ± 2.18)° vs. (27.63 ± 2.82)°; t = 12.87, P<0.001]. There was no statistically significant difference in the overall incidence of adverse reactions, such as gastrointestinal symptoms and hypercalcemia, between the two groups ( P>0.05). Conclusions:The treatment regimen using bone melon extract injection combined with calcitriol after surgery for osteoporotic vertebral compression fractures has shown considerable effects. It can reduce postoperative inflammatory responses, improve bone metabolism indicators, restore bone density and vertebral curvature in patients, and demonstrates high safety.

AIM To investigate the effects of Rutong Ruanjian Tablets on angiogenesis in cancer tissues of rats with preneoplastic breast cancer(PBC).METHODS 60 female SD rats were randomly divided into a blank group of 10 rats and a model group of 50 rats for the establishment of the PBC models of Liver-Qi Stagnation and Blood Stasis Pattern with 9 weeks of oral administration of 7,12-dimethylbenz[a]anthracene(DMBA)and cervical ligation.After successful modeling,the rats were randomly divided into the model group,the tamoxifen group(3.2 mg/kg),the Rutong Ruanjian Tablets group(128 mg/kg),the 3,5-difluorobenzoyl group(DAPT,5 mg/kg),and the Rutong Ruanjian Tablets(128 mg/kg via gavage)+DAPT(5 mg/kg intraperitoneal injection)group,for 1 month corresponding drug administration,with 10 rats in each group.Then the rats had their cancer progression and syndrome scores observed;their angiogenesis evaluated by assessment of microvascular density(MVD);their vascular endothelial growth factor(VEGF)expression assessed by immunohistochemistry;and their mRNA and protein expressions of proteins related to the DLL4/Notch1/Hes1 pathway measured using RT-qPCR,immunohistochemistry and Western blot.RESULTS During carcinogenesis of rats induced by DMBA,there was gradual disappearance of E-cadherin expression and consistency of HE staining result with the PBC progression confirming the success of the modeling.Compared with the blank group,the model group showed increased MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).Compared with the model group,the Rutong Ruanjian Tablets group exhibited reduced MVD values,mRNA expression of Notch1 and Hes1,and protein expressions of VEGF,DLL4,Notch1 and Hes1(P＜0.05,P＜0.01).The Rutong Ruanjian Tablets+DAPT group showed reduced mRNA expression of Notch1 and Hes1,and protein expressions of DLL4,Notch1 and Hes1 compared to the Rutong Ruanjian Tablets group(P＜0.05,P＜0.01).CONCLUSION Rutong Ruanjian Tablets can inhibit angiogenesis and attenuate cancer progression in PBC rats of Liver-Qi Stagnation and Blood Stasis Pattern,and the mechanism may lie in the downregulation of DLL4/Notch1/Hes1 signaling pathway related proteins.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To establish an ion-pair chromatographic method combined with an electrospray detector(CAD)for the simultaneous determination of glycyrrhizin,glycine and D,L-methionine in compound glycyrrhizin tablets.Methods:An Agilent Poroshell 120 SB-C18 column(2.1 mm ×250 mm,4 μm)was adopted.0.3％non-afluorovaleric acid(A)-acetonitrile(B)was used as the mobile phase with a gradient elution(0-8 min,100％A,8-15 min,82％A,and 15-30 min,40％A).The flow rate was 0.2 mL·min-1.The column temperature was set at 30 ℃.The detector of CAD was applied with collection frequency of 10 Hz,nebulization temperature of 35 ℃,filter:5.Results:The peaks of glycyrrhizin,glycine,and D,L-methionine were well separated by this method,and the recoveries of spiked samples were 100.4％,100.4％,and 100.1％.The results of the three bat-ches of samples were in the range of 95.0％-105.0％.Conclusion:The method is show well convenience,sensi-tivity and accurate for the quality control of compound glycyrrhizin tablets.

Objective:Exploring the role and mechanism of CHMP4C in regulating necroptosis during gastric can-cer development and progression.Method:The expression of CHMP4C in pan-cancer was analyzed by bioinformatics methods,and the expression of CHMP4C was detected in human normal gastric epithelial cells and GC cell lines by RT-qPCR and Western blot.Overexpression or knockdown of CHMP4C was performed in GC cell lines,and the effects of CHMP4C on the growth and proliferation of GC cells were detected using CCK-8 and clone formation assays.The CCK-8 experiment and Hoechst/PI double staining experiment were used to detect the changes in GC cell mortality and PI positive cell ratio after treatment with the necroptsis inducer TSZ or inhibitor necrostatin-1(Nec-1).Western blot assay was used to detect the protein and phosphorylation levels of RIPK1,RIPK3,and MLKL in GC cells.Result:CHMP4C was upregulated in GC tissues and cells.The CCK-8 and clone formation experiments showed that overex-pression of CHMP4C significantly improved the proliferation ability and colony formation efficiency of GC cells,while knockdown of CHMP4C significantly weakened GC cells.Moreover,the results of CCK-8 and Hoechst 33342/PI double staining experiments showed that upregulated CHMP4C could inhibit TSZ induced GC cell death;Nec-1 can reverse the decrease in GC cell viability caused by CHMP4C knockdown.Western blot experiment showed that the levels of p-RIPK1,p-RIPK3,and p-MLKL were significantly decreased in overexpressing cells,while they were increased in knockdown cells.After treatment with Nec-1,the expression levels of these three proteins decreased in knockdown cells.Conclusion:CHMP4C may promote GC progression by negatively regulating necroptosis through inhibiting the phosphorylation of the RIPK1/RIPK3/MLKL signaling pathway,suggesting that it is expected to be a potential target for GC therapy.

Global procurement of health products is an important way for multilateral organizations in the health field to perform their functions.As one of the most important multilateral organizations in the global health field today,the Global Fund to Fight AIDS,Tuberculosis and Malaria occupies a huge share of the global procurement market for health products.This article introduces in detail the procurement methods of the Global Fund and the quality standards of its procured products;also it describes and analyzes the total amount of funds procured by the Global Fund,the types of procured health products,the main supply countries and their changing trends over time.Corresponding policy suggestions therefore are proposed for China to better participate in the governance of global health and for Chinese related companies to enter the international procurement market.

Aim To investigate the protective effect of Shengmai Yin on myocardial ischemia/reperfusion in-jury(MI/RI)in vitro and in vivo and to unravel the underlying mechanism.Methods SD rats were divid-ed into the sham group,model group,and Shengmai Yin group(SM).Rat MI/RI model was established.Cardiac function,infarct area,pathological changes,cardiomyocyte apoptosis,macrophage infiltration,and serum cTnT and CK-MB levels were measured.The mRNA and protein expressions of Calpain-1 and Cal-pain-2 were assessed.The hypoxia/reoxygenation(H/R)model was constructed in H9c2 cells.The active ingredients of Shengmai Yin were screened using net-work pharmacology and verified by CCK-8.In the car-diomyocytes H/R model,Fluo-4 AM staining was used to detect the changes of Ca2+levels.Results Com-pared with model group,LVEF and LVFS of Shengmai Yin-treated rats increased,myocardial infarction area was reduced,while myocardial tissue injury was allevi-ated.Myocardial apoptosis rate and the number of macrophages were reduced.Similarly,cTnT and CK-MB levels decreased.In addition,the expression lev-els of Calpain-1 and Calpain-2 mRNA and protein de-creased in the SM treatment group.Under the H/R model,all the active ingredients of Shengmai decoction had protective effects on cardiomyocytes,and the treat-ment could reduce the level of Ca2+in cardiomyocytes.Conclusions Shengmai Yin has protective effects on MI/RI in rats.This effect may be related to the de-crease in Ca2+levels,as well as Calpain-1 and Calap-in-2 mRNA and protein expression.

Objective To investigate the current situation of the ventilator use and management in secondary and tertiary medical institutions in Sichuan Province to provide references for management and training of ventilator users.Methods A questionnaire survey involving in 235 nurses from 13 secondary and tertiary medical institutions in Sichuan Province was conducted in terms of general information of the respondents,pipeline connection and parameter setup of ventilators,cleaning,sterilization and maintenance of ventilators,identification and treatment of ventilator alarms and hospital-acquired infection prevention and control.Results The results showed 20.4％of the respondents were nurses from critical care departments,and 79.6％of the respondents underwent the training for using the ventilator in their department;91.9％of the respondents could conduct ventilator self-testing by connecting the simulated lungs after the ventilator was switched on;66.4％of the respondents indicated that the initial parameters of the ventilator were set by the doctor;60.9％of the respondents proved that the performance monitoring and routine maintenance of the ventilator were carried out by the nurse;63.4％of the respondents showed disposable lines were commonly used in the departments.There were 89.8％of the respondents said the daily sterilization and management of the ventilator were performed by the nurse;46.0％of the respondents expressed the external surface of the ventilator was disinfected mainly with gamma disinfectant wipes;44.7％of the respondents indicated the external surface of the ventilator was sterilized every day;48.5％of the respondents said the internal airway of the ventilator was disinfected;57.0％of the respondents proved the disinfection was conducted after the expiratory flow sensors were used by any patient.There were 74.5％of the respondents that had paid attention to the ventilator waveform,and by the ventilator waveform only 21.3％were correct in determining whether there was secretion or fluid in the circuit and 22.1％in clarifying whether there was air leakage in the circuit.There were 59.1％of the respondents indicated that the closed suction tube was replaced once every 24 h;71.1％of the respondents could perform airbag pressure monitoring by the special pressure gauge.Conclusion Most of the nurses from secondary and tertiary medical institutions in Sichuan Province can use ventilators correctly,who have problems in disinfection specifications,infection prevention and control or recognition of ventilation waveform.It's suggested the training be strengthened to enhance the clinical nursing staffs in ventilator management.[Chinese Medical Equipment Journal,2025,46(3):75-80]

Objective:Exploring the role and mechanism of CHMP4C in regulating necroptosis during gastric can-cer development and progression.Method:The expression of CHMP4C in pan-cancer was analyzed by bioinformatics methods,and the expression of CHMP4C was detected in human normal gastric epithelial cells and GC cell lines by RT-qPCR and Western blot.Overexpression or knockdown of CHMP4C was performed in GC cell lines,and the effects of CHMP4C on the growth and proliferation of GC cells were detected using CCK-8 and clone formation assays.The CCK-8 experiment and Hoechst/PI double staining experiment were used to detect the changes in GC cell mortality and PI positive cell ratio after treatment with the necroptsis inducer TSZ or inhibitor necrostatin-1(Nec-1).Western blot assay was used to detect the protein and phosphorylation levels of RIPK1,RIPK3,and MLKL in GC cells.Result:CHMP4C was upregulated in GC tissues and cells.The CCK-8 and clone formation experiments showed that overex-pression of CHMP4C significantly improved the proliferation ability and colony formation efficiency of GC cells,while knockdown of CHMP4C significantly weakened GC cells.Moreover,the results of CCK-8 and Hoechst 33342/PI double staining experiments showed that upregulated CHMP4C could inhibit TSZ induced GC cell death;Nec-1 can reverse the decrease in GC cell viability caused by CHMP4C knockdown.Western blot experiment showed that the levels of p-RIPK1,p-RIPK3,and p-MLKL were significantly decreased in overexpressing cells,while they were increased in knockdown cells.After treatment with Nec-1,the expression levels of these three proteins decreased in knockdown cells.Conclusion:CHMP4C may promote GC progression by negatively regulating necroptosis through inhibiting the phosphorylation of the RIPK1/RIPK3/MLKL signaling pathway,suggesting that it is expected to be a potential target for GC therapy.