AIM:To study the protective effect of transient receptor potential vanilic acid subtype 1(TRPV1)agonist capsaicin(CAP)on traumatic blood loss shock rats,and to further explore its possible mechanism by network pharmacology.METHODS:Forty-five SD rats were divided into 5 groups by random number table method:normal group,shock group,lactated Ringer's solution(LR)group,CAP pretreatment(single administration before shock)group,CAP pre-final administration(twice administration before and after shock)group,with 9 rats in each group for survival observation.Then 32 SD rats were divided into 4 groups according to the results of survival experiment:normal group,shock group,LR group,CAP pre-final administration group,with 8 rats in each group for blood pressure,hemodynamics,arterial blood gas,vascular reactivi-ty and hepaticand renal blood flow.At the same time,the potential mechanism of CAP in the treat-ment of traumatic hemorrhagic shock was investi-gated by network pharmacology.Furthermore,ap-ply the dataset to validate and analyse the diagnos-tic value of the hub genes.RESULTS:Rats in shock group died within hours of the completion of the shock model,and the mean survival time was 1.25(0.42,6.21)h.LR resuscitation could improve the survival of rats to some extent.The survival rate and survival time of rats in the CAP pretreatment group were slightly increased as compared with the LR group,while twice administration of CAP be-fore and after shock(CAP pre-final administration)resulted in better outcomes than LR resuscitation alone.Further results indicated that CAP pre-final administration significantly reduced the blood lac-tic acid level,improved the vasoconstrictive and di-astolic reactivity,and increased the liver and kidney blood flow of shock rats as compared with LR group.The improvement of hemodynamics and blood gas indexes in CAP group was slightly higher than LR group,but there was no statistical signifi-cance.A total of 37 genes related to CAP anti-trau-matic hemorrhage shock were obtained by net-work pharmacology.KEGG enrichment analysis showed that the Ca ion signaling pathway and Ras signaling pathway were significantly enriched.Vali-dation of the dataset showed that the expression levels of CXCR4,NF-kB1,GFPA and NTF3 hub gene were significantly different in the normal and shock groups,and that CXCR4 has a high diagnostic value for traumatic haemorrhagic shock.CONCLUSIONS:CAP,the TRPV1 agonist,significantly improved vas-cular function,increased organ blood flow,and cor-rected the lactic acidosis in rats with traumatic hemorrhagic shock,thus markedly improved the survival outcomes.The mechanism may be related to Ca ion signal pathway and Ras signal pathway.CXCR4,NF-kB1,GFPA and NTF3 may be having an important role in it.

Objective To systematically evaluate the ICD coding data on the front page of inpatient medical records filed out by clinicians,and to analyze the quality of ICD codes reasonably,objectively and comprehensively by employing the 3×3 Da-ta Quality Assessment(3×3 DQA)model.Methods A total of 1 410 medical records from a tertiary women and children's hospital between June 2021 to July 2024 were randomly selected.Based on the 3×3 DQA model,the data quality of ICD codes for diagnosis and surgical procedures on the front pages filed out by clinicians was assessed.Results Among 1,410 medical re-cords reviewed,778 had defects,resulting in a total defect rate of 55.18％,including a completeness defect rate of 32.98％and an accuracy defect rate of 30.57％.Totally,a total of 9 302 ICD codes were reviewed,among which 1 254 had defects,with a total defect rate of 13.48％.The defect rates for the principal diagnosis,other diagnosis,principal operation,and other operation were 22.20％,17.72％,4.53％and 4.92％,respectively.For diagnostic ICD codes,the completeness defect rate was relative-ly high,while for surgical ICD codes,the accuracy defect rate was higher.In terms of specialties,there were statistically signifi-cant differences in the overall defect rates among gynecology,obstetrics,and pediatrics,with pediatrics and gynecology having defect rates higher than the overall average.Conclusion The quality of ICD code data on the front page of medical records filed out by clinicians is suboptimal,and there are differences in data quality across different specialties and ICD categories.There-fore,it is still necessary to conduct research on the supervision and improvement measures for ICD data quality in hospital medical record management.

Objective To systematically evaluate the ICD coding data on the front page of inpatient medical records filed out by clinicians,and to analyze the quality of ICD codes reasonably,objectively and comprehensively by employing the 3×3 Da-ta Quality Assessment(3×3 DQA)model.Methods A total of 1 410 medical records from a tertiary women and children's hospital between June 2021 to July 2024 were randomly selected.Based on the 3×3 DQA model,the data quality of ICD codes for diagnosis and surgical procedures on the front pages filed out by clinicians was assessed.Results Among 1,410 medical re-cords reviewed,778 had defects,resulting in a total defect rate of 55.18％,including a completeness defect rate of 32.98％and an accuracy defect rate of 30.57％.Totally,a total of 9 302 ICD codes were reviewed,among which 1 254 had defects,with a total defect rate of 13.48％.The defect rates for the principal diagnosis,other diagnosis,principal operation,and other operation were 22.20％,17.72％,4.53％and 4.92％,respectively.For diagnostic ICD codes,the completeness defect rate was relative-ly high,while for surgical ICD codes,the accuracy defect rate was higher.In terms of specialties,there were statistically signifi-cant differences in the overall defect rates among gynecology,obstetrics,and pediatrics,with pediatrics and gynecology having defect rates higher than the overall average.Conclusion The quality of ICD code data on the front page of medical records filed out by clinicians is suboptimal,and there are differences in data quality across different specialties and ICD categories.There-fore,it is still necessary to conduct research on the supervision and improvement measures for ICD data quality in hospital medical record management.

AIM:To study the protective effect of transient receptor potential vanilic acid subtype 1(TRPV1)agonist capsaicin(CAP)on traumatic blood loss shock rats,and to further explore its possible mechanism by network pharmacology.METHODS:Forty-five SD rats were divided into 5 groups by random number table method:normal group,shock group,lactated Ringer's solution(LR)group,CAP pretreatment(single administration before shock)group,CAP pre-final administration(twice administration before and after shock)group,with 9 rats in each group for survival observation.Then 32 SD rats were divided into 4 groups according to the results of survival experiment:normal group,shock group,LR group,CAP pre-final administration group,with 8 rats in each group for blood pressure,hemodynamics,arterial blood gas,vascular reactivi-ty and hepaticand renal blood flow.At the same time,the potential mechanism of CAP in the treat-ment of traumatic hemorrhagic shock was investi-gated by network pharmacology.Furthermore,ap-ply the dataset to validate and analyse the diagnos-tic value of the hub genes.RESULTS:Rats in shock group died within hours of the completion of the shock model,and the mean survival time was 1.25(0.42,6.21)h.LR resuscitation could improve the survival of rats to some extent.The survival rate and survival time of rats in the CAP pretreatment group were slightly increased as compared with the LR group,while twice administration of CAP be-fore and after shock(CAP pre-final administration)resulted in better outcomes than LR resuscitation alone.Further results indicated that CAP pre-final administration significantly reduced the blood lac-tic acid level,improved the vasoconstrictive and di-astolic reactivity,and increased the liver and kidney blood flow of shock rats as compared with LR group.The improvement of hemodynamics and blood gas indexes in CAP group was slightly higher than LR group,but there was no statistical signifi-cance.A total of 37 genes related to CAP anti-trau-matic hemorrhage shock were obtained by net-work pharmacology.KEGG enrichment analysis showed that the Ca ion signaling pathway and Ras signaling pathway were significantly enriched.Vali-dation of the dataset showed that the expression levels of CXCR4,NF-kB1,GFPA and NTF3 hub gene were significantly different in the normal and shock groups,and that CXCR4 has a high diagnostic value for traumatic haemorrhagic shock.CONCLUSIONS:CAP,the TRPV1 agonist,significantly improved vas-cular function,increased organ blood flow,and cor-rected the lactic acidosis in rats with traumatic hemorrhagic shock,thus markedly improved the survival outcomes.The mechanism may be related to Ca ion signal pathway and Ras signal pathway.CXCR4,NF-kB1,GFPA and NTF3 may be having an important role in it.

AIM: To investigate the relationship between vascular smooth muscle cell (VSMC) injury, organelle stress response and autophagic cell death (autophagy) and ferroptosis induced by the chemical hypoxia inducer cobalt chloride (CoCl2) through the bioinformatics analysis and in vitro cell experimentation. METHODS: The dataset GSE119226 of VSMC treated with cobalt chloride was acquired from the gene expression database (GEO). The R language was used to investigate the relationship between CoCl2 treatment and organelle stress response (Golgi stress, endoplasmic reticulum stress) and two forms of cell death (ferroptosis and autophagic cell death). With primary cultured rat VSMC (rVSMC) and CoCl2-induced anoxia model, the changes in cell viability were detected by CCK-8 method, and reactive oxygen species (ROS) levels were measured using DCFH-DA method. The expression levels of HIF-1α (a key molecule in hypoxia), Golgi stress markers GM130 and p115, endoplasmic reticulum stress markers GRP78 and CHOP, autophagy markers LC3-II / LC3-I and Beclin1, and ferroptosis markers GPx4 and xCT were detected by Western blot. The effect of inducing or inhibiting organelle stress and cell death on the CoCl2-induced cell damage was also observed. RESULTS: Differentially expressed genes analysis of GSE119226 dataset showed that CoCl2 treatment of VSMCs had significant effects on organelle function and stress response, autophagy and ferroptosis-related genes, in which endoplasmic reticulum stress, protein processing in endoplasmic reticulum, regulation of Golgi to plasma membrane protein transport, autophagy / autophagic cell death, and ferroptosis pathways were remarkably enriched. The results of in vitro experiment showed that compared with normal rVSMC, cell viability was significantly decreased after CoCl2 treatment, as well as HIF-1α protein expression and ROS levels in rVSMCs were increased. In rVSMC treated with Co-Cl2, the expression levels of Golgi structural proteins GM130 and p115 (reflecting the occurrence of Golgi stress) were decreased, while the markers GRP78 and CHOP (reflecting the occurrence of endoplasmic reticulum stress) were increased. At the same time, CoCl2 treatment also reduced the expression of autophagy markers LC3-II/LC3-I and Beclin1 (indicating the decrease levels of autophagy), while the expression of ferroptosis markers GPx4 and xCT were decreased (indicating the occurrence of ferroptosis). Compared with CoCl2 treatment group, induced Golgi stress, endoplasmic reticulum stress, or ferroptosis could further reduce cell viability, while inhibition of these processes could improve cell viability. On the other hand, increasing the level of autophagy can improve the cell viability. CONCLUSION: Hypoxia induced by cobalt chloride can lead to VSMC injury. Golgi stress, endoplasmic reticulum stress, ferroptosis, and the reduction of autophagy level play an important role in it. Inhibition of organelle stress response and ferroptosis, or increase of autophagy level can improve VSMC injury caused by cobalt chloride.

Objective:To establish the ultra high performance liquid chromatography (UPLC) fingerprints of Mume flos at different flowering stages; To provide reference for the quality research of Mume flos.Methods:The fingerprints of Mume flos were established by UPLC method, and the common peaks were identified by high performance liquid chromatography high resolution mass spectrometry (LC-MS). Chemometrics analysis was carried out with the fingerprints' common peak area of plum blossom at different flowering stages as a variable. Semiquantitative analysis of changes in flavonoids and phenolic acids in Mume flos at different flowering stages was conduct using peak area calculation method.Results:Totally 31 common peaks were identified in the fingerprints of plum blossom medicinal materials at different flowering stages and 9 components were identified. Clustering analysis (HCA) and principal component analysis (PCA) both classified plum blossom medicinal herbs at different flowering stages into three categories. Among them, there were significant differences between the groups at the bud stage, blooming period, and final flowering period, while the differences between the groups at blooming period and final flowering period were relatively small. The orthogonal partial least squares discriminant analysis (OPLS-DA) screened 16 different components with VIP>1.0. The contents of phenolic acids in different flowering stages were as follows: bud stage>blooming period>final flowering period, while the contents of flavonoids were as follows: blooming period>final flowering period>bud stage.Conclusions:This method is simple and reliable, and can provide reference for the quality evaluation of plum blossom medicinal materials at different flowering stages.

Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.

OBJECTIVE: To retrospectively analyze the results of second-trimester serological prenatal screening and explore the factors which may influence the false-positive rate (FPR). METHODS: From January 2013 to December 2022, false-positive samples with follow-up outcomes from 632,825 second-trimester serological prenatal screening samples tested at Sichuan Provincial Maternity and Child Health Care Hospital were selected as the study group, while true-negative samples were 1 : 1 matched as the control group by propensity-score matching (PSM). Univariate and binary logistic regression models were used to analyze the influencing factors. This study was approved by the Medical Ethic Committee of Sichuan Provincial Maternity and Child Health Care Hospital (Ethic No. 20240607-270). RESULTS: The study and control groups were each matched with 305,998 cases. Univariate analysis showed that sampling season, the difference between ultrasound and gestational weeks calculated by last menstrual period (LMP), monthly median multiple of the median (mMoM) of alpha-fetoprotein (AFP), and monthly mMoM of free β -human chorionic gonadotropin (free β -hCG) were significantly different between the two groups (P < 0.05). Binary logistic regression analysis showed that Winter (OR = 0.938; 95%CI: 0.893 ~ 0.985), monthly AFP mMoM ≥ 1.11 (OR = 0.846; 95%CI: 0.761 ~ 0.941), monthly free β -hCG mMoM ≥ 0.89 (OR = 0.827; 95%CI: 0.737 ~ 0.929) are protective factors for FPR increase, whilst Spring (OR = 1.124; 95%CI: 1.072 ~ 1.179), Summer (OR = 1.121; 95%CI: 1.062 ~ 1.183), the difference between ultrasound and gestational weeks calculated by LMP of 8 ~ 14 days (OR = 1.319; 95%CI: 1.241 ~ 1.402), < 14 days (OR = 1.689; 95%CI: 1.542 ~ 1.850), monthly AFP mMoM of 0.90 ~ 0.94 (OR = 1.088; 95%CI: 1.046 ~ 1.131), and monthly free β -hCG mMoM of 1.05 ~ 1.10 (OR = 1.046; 95%CI: 1.000 ~ 1.094), ≥ 1.11 (OR = 1.062; 95%CI: 1.002 ~ 1.126) are risk factors for FPR increase. CONCLUSION Sampling season, difference between ultrasound and gestational weeks by LMP, monthly AFP mMoM, and monthly free β -hCG mMoM are risk factors for FPR during serological prenatal screening. Screening laboratories should look for the cause of abnormal FPR through such factors and adjust them accordingly.
Humans ; Female ; Pregnancy ; Propensity Score ; Pregnancy Trimester, Second/blood* ; Retrospective Studies ; China ; False Positive Reactions ; Adult ; Prenatal Diagnosis/methods* ; alpha-Fetoproteins/analysis* ; Logistic Models ; Chorionic Gonadotropin, beta Subunit, Human/blood*

Objective:To retrospectively analyze the results of second-trimester serological prenatal screening and explore the factors which may influence the false-positive rate (FPR).Methods:From January 2013 to December 2022, false-positive samples with follow-up outcomes from 632, 825 second-trimester serological prenatal screening samples tested at Sichuan Provincial Maternity and Child Health Care Hospital were selected as the study group, while true-negative samples were 1 : 1 matched as the control group by propensity-score matching (PSM). Univariate and Multivariate Logistic Regression Models were used to analyze the influencing factors. The study has approved by the Medical Ethics Committee of the Sichuan Provincial Maternity and Child Health Care Hospital (Ethic No.20240607-270).Results:The study and control groups were each matched with 305, 998 cases. Univariate analysis showed that sampling season, the difference between ultrasound and gestational weeks calculated by last menstrual period (LMP), monthly median multiple of the median (mMoM) of alpha-fetoprotein (AFP), and monthly mMoM of free β-human chorionic gonadotropin (free β-hCG) were significantly different between the two groups ( P<0.05). Multivariate Logistic Regression analysis showed that winter ( OR=0.938; 95% CI: 0.893~0.985), monthly AFP mMoM ≥ 1.11 ( OR=0.846; 95% CI: 0.761~0.941), monthly free β-hCG mMoM ≤ 0.89 ( OR=0.827; 95% CI: 0.737~0.929) are protective factors for FPR increase, whilst spring ( OR=1.124; 95% CI: 1.072~1.179), summer ( OR=1.121; 95% CI: 1.062~1.183), the difference between ultrasound and gestational weeks calculated by LMP of 8~14 days ( OR=1.319; 95% CI: 1.241~1.402), > 14 days ( OR=1.689; 95% CI: 1.542~1.850), monthly AFP mMoM of 0.90~0.94 ( OR=1.088; 95% CI: 1.046~1.131), and monthly free β-hCG mMoM of 1.05~1.10 ( OR=1.046; 95% CI: 1.000~1.094), ≥ 1.11 ( OR=1.062; 95% CI: 1.002~1.126) are risk factors for FPR increase. Conclusion:Sampling season, difference between ultrasound and gestational weeks by LMP, monthly AFP mMoM, and monthly free β-hCG mMoM are risk factors for FPR during serological prenatal screening. Screening laboratories should look for the cause of abnormal FPR through such factors and adjust them accordingly.

Objective:To retrospectively analyze the results of second-trimester serological prenatal screening and explore the factors which may influence the false-positive rate (FPR).Methods:From January 2013 to December 2022, false-positive samples with follow-up outcomes from 632, 825 second-trimester serological prenatal screening samples tested at Sichuan Provincial Maternity and Child Health Care Hospital were selected as the study group, while true-negative samples were 1 : 1 matched as the control group by propensity-score matching (PSM). Univariate and Multivariate Logistic Regression Models were used to analyze the influencing factors. The study has approved by the Medical Ethics Committee of the Sichuan Provincial Maternity and Child Health Care Hospital (Ethic No.20240607-270).Results:The study and control groups were each matched with 305, 998 cases. Univariate analysis showed that sampling season, the difference between ultrasound and gestational weeks calculated by last menstrual period (LMP), monthly median multiple of the median (mMoM) of alpha-fetoprotein (AFP), and monthly mMoM of free β-human chorionic gonadotropin (free β-hCG) were significantly different between the two groups ( P<0.05). Multivariate Logistic Regression analysis showed that winter ( OR=0.938; 95% CI: 0.893~0.985), monthly AFP mMoM ≥ 1.11 ( OR=0.846; 95% CI: 0.761~0.941), monthly free β-hCG mMoM ≤ 0.89 ( OR=0.827; 95% CI: 0.737~0.929) are protective factors for FPR increase, whilst spring ( OR=1.124; 95% CI: 1.072~1.179), summer ( OR=1.121; 95% CI: 1.062~1.183), the difference between ultrasound and gestational weeks calculated by LMP of 8~14 days ( OR=1.319; 95% CI: 1.241~1.402), > 14 days ( OR=1.689; 95% CI: 1.542~1.850), monthly AFP mMoM of 0.90~0.94 ( OR=1.088; 95% CI: 1.046~1.131), and monthly free β-hCG mMoM of 1.05~1.10 ( OR=1.046; 95% CI: 1.000~1.094), ≥ 1.11 ( OR=1.062; 95% CI: 1.002~1.126) are risk factors for FPR increase. Conclusion:Sampling season, difference between ultrasound and gestational weeks by LMP, monthly AFP mMoM, and monthly free β-hCG mMoM are risk factors for FPR during serological prenatal screening. Screening laboratories should look for the cause of abnormal FPR through such factors and adjust them accordingly.