Traditional experimental methods are insufficient in the study of layered double hydroxides (LDHs) supramolecular structure and hydration expansion performance, and information on interlayer anionic arrangement and structural water molecules cannot be obtained. Aspartic acid intercalated magnesium aluminum hydrotalcite was synthesized using coprecipitation and ion exchange. The structure of hydrotalcite precursor and its aspartic acid composite materials was characterized by X-ray powder diffraction, differential thermal analysis, and infrared spectroscopy, and Materials Studio software was used to simulate the molecular dynamics of microstructure and hydration properties of LDHs intercalated with the aspartic acid drug. The prepared composite material had a regular layered structure and a single crystal phase. After intercalation with aspartic acid, the interlayer spacing increased from 0.84 nm to 1.13−1.17 nm; after intercalation, the thermal decomposition temperature of aspartic acid increased from 249 °C to 334 °C, greatly improving its thermal stability. The interlayer spacing of the intercalated hydrotalcite obtained from the experiment was close to the molecular dynamics simulation results when Nw=3−4. As more water molecules were inserted between the layers, the greater the interlayer distance became. Hydration energy increased gradually and tended to a certain value. The total number of hydrogen bonds increased gradually, the hydrogen bonds between laminates and anions decreased gradually, but the hydrogen bonds between laminates and water molecules increased gradually. The simulation results are close to the experimental results, which can lay a foundation for the design and synthesis of LDHs-based drug composites.

Objective To investigate the activation of microglia and astrocytes, the secretion of pro-inflammatory factors, and the survival of neurons in the hippocampus of mice with acute seizures induced by pentylenetetrazol (PTZ) 24 hours after the onset of seizures. Methods Adult male C57BL/6 mice were randomly assigned to the control group and the PTZ-induced acute epileptic seizure group using random numbers, with 28 mice in each group. The activation status of microglia and astrocytes in the CA1 region of the hippocampus was evaluated by immunofluorescence 24 hours after the onset of seizures. RNA was extracted from the hippocampal tissue to detect the expression level of inflammatory factor mRNA, and HE staining was used to assess the survival of neurons in the hippocampus. Results Twenty-four hours after PTZ-induced acute seizures in mice, the numbers of activated Iba1⁺ microglia (55.72±4.29 vs 35.71±9.66, P＜0.001) and GFAP⁺ astrocytes (51.61±8.21 vs 37.64±5.27, P＜0.01) in the CA1 region were significantly increased compared with the control group; the proportion of M1 microglia was significantly increased (0.58±0.02 vs 0.35±0.08, P＜0.0001), while the proportion of M2 microglia was significantly decreased (0.25±0.08 vs 0.44±0.09，P＜0.01); the mRNA level of pro-inflammatory factor IL-1β in the hippocampus was significantly higher than that in the control group (2.49±1.61 vs 1.02±0.68, P＜0.05); the numbers of neurons in the CA1 (284.91±73.32 vs 498.88±176.79, P＜0.05) and CA3 (247.42±50.20 vs 457.78±150.08, P＜0.05) regions during the acute phase was significantly reduced compared with the control group. Conclusions Twenty-four hours after PTZ-induced acute epileptic seizures in mice, microglia and astrocytes in the CA1 region of the hippocampus are activated, with microglia mainly presenting the M1 phenotype to exert pro-inflammatory effects, secretions of pro-inflammatory factors increasing, and surviving hippocampal neurons decreasing.

Objective:To present an evaluation indicator system for access to cancer screening services.Methods:The evaluation indicator pool was constructed through a scoping review. The theoretical framework was constructed based on the multi-source indicators, and the qualitative expert consultation method was employed to form the initial version of the three-level evaluation indicator system. Delphi expert consultation method was conducted in two rounds to evaluate the relevance, importance, and availability of the proposed evaluation indicator system. The expert positive coefficient, authority coefficient, coordination degree of expert opinions, and concentration of expert opinions were subjected to analysis. Subsequently, the three-level evaluation indicator system for access to cancer screening services was adjusted and determined based on the boundary value method and the open opinions of experts. Finally, the combination weight method was employed to determine the weight.Results:The initial version of the indicator system comprised 3 primary (first-level) indicators, 11 secondary (second-level) indicators, and 46 tertiary (third-level) indicators. Delphi expert consultation was conducted for the initial version, and 17 experts ultimately completed it, exhibiting a positive coefficient of 100% and an authority coefficient of 0.87. In comparison to the initial round of consultation, Kendall's W coefficient ranges (0.15-0.43, all P<0.05) of relevance, importance, and availability scores for each tertiary indicator in the second round exhibited an improvement. The analysis of the importance dimension indicates that expert opinions are also more concentrated, as evidenced by an increase of 8.5% and 7.0% in the proportion of the tertiary indicators with an arithmetic mean above 8 and a full mark ratio above 0.5, respectively. The final evaluation indicator system comprises three primary indicators, with the weights of structure evaluation, process evaluation, and outcome evaluation being 0.338, 0.378, and 0.285, respectively. It also comprises 11 secondary indicators and 45 tertiary indicators. Conclusions:The evaluation indicator system developed in this article can be an effective evaluation tool for quantitative comparison of access to cancer screening services across different populations, cancer types, and before and after intervention. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Objective:To evaluate the clinical efficacy of percutaneous balloon pulmonary valvuloplasty (PBPV) via antegrade venous-arterial loop in neonates with critical pulmonary stenosis with intact ventricular septum (CPS-IVS).Methods:A retrospective case review was conducted. Fifteen neonates with CPS-IVS who underwent PBPV via antegrade venous-arterial loop at the Women and Children′s Hospital, Qingdao University between September 2020 and September 2023 were included. Pre-and post-operative right ventricular functional parameters, surgical complications, and follow-up outcomes were analyzed. Paired-sample t-test was used to compare changes in right ventricular systolic pressure (RVSP), percutaneous oxygen saturation (SpO 2), and echocardiographic findings pre-and post-operatively, as well as during the follow-up period. Results:Among the 15 neonates (9 males and 6 females) with CPS-IVS, the surgical age was (3.6±0.5) d. All neonates underwent successful PBPV via antegrade venous-arterial loop under general anesthesia. The immediate post-operative trans-pulmonary valve pressure gradient was (35±6) mmHg (1 mmHg=0.133 kPa), with a significant reduction in RVSP from (96±16) mmHg to (59±14) mmHg ( t=6.70, P<0.001). SpO 2 (with an inspired oxygen concentration of 0.48) increased from 0.86±0.07 pre-operatively to 0.97±0.03 post-operatively ( t=4.81, P<0.001). One month postoperatively, SpO 2 (without oxygen supplementation) normalized in all patients, with a statistically significant difference compared to pre-operative values ( t=0.16, P<0.001). Immediately postoperative, mild to moderate diastolic pulmonary valve regurgitation was observed in 8 patients, with no cases of severe regurgitation. Additionally, the severity of tricuspid valve regurgitation decreased from severe to mild-to-moderate in 6 patients. Three months postoperatively, one patient underwent a second PBPV due to an increased trans-pulmonary valve pressure gradient of 74 mmHg, which decreased to 27 mmHg immediately after the procedure, with subsequent good recovery. Over a one-year follow-up period, all 15 patients demonstrated improvements in right ventricular indices. The Z-score of the tricuspid valve annulus significantly improved from -1.9±0.8 pre-operatively to -0.4±0.1 post-operatively ( t=6.88, P<0.001). At the last follow-up, mild to moderate pulmonary valve regurgitation was observed in 3 patients, and mild tricuspid regurgitation in 2 patients, with no cases of moderate or severe regurgitation. Conclusion:Intervention via antegrade venous-arterial loop for the treatment of CPS-IVS in neonates is safe and effective.

Objective To retrospectively analyze the related influencing factors of the infection oc-currence after using tofacitinib in the patients with rheumatoid arthritis.Methods The case data of 211 pa-tients with rheumatoid arthritis treated by tofacitinib in the rheumatology and immunology department of Chongqing Municipal Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were col-lected.The patients were grouped according to whether infection occurred or not.After single factor test on gender,age,Chinese medicine syndromes,time of taking Chinese medicine,lung system diseases and lympho-cyte count,then the factors with statistically significant differences were included in the Logistic regression a-nalysis.Results Spleen deficiency and dampness syndrome,taking traditional Chinese medicine time 1-4 weeks,and>4-<8 weeks were the protective factors for the infection occurrence after using tofacitinib in rheumatoid arthritis(OR=0.427,95%CI:0.184-0.988,P<0.05;OR=0.233,95%CI:0.093-0.580,P<0.05;OR=0.328,95%CI:0.135-0.799,P<0.05),complicating pulmonary interstitial lesions and bronchi-ectasis were the risk factors for infection occurrence after using tofactitinib(OR=3.000,95%CI:1.306-6.894,P<0.05;OR=16.615,95%CI:1.782-154.945,P<0.05).Conclusion The risk of infection occur-rence after using tofacitinib in the patients with rheumatoid arthritis is closely correlated with Chinese medi-cine syndromes,time of taking Chinese medicine and lung system diseases.

Objective To observe the value of shear wave elastography(SWE)for evaluating therapeutic effect of ultrasound-guided drug injection for muscle injury.Methods Eighty patients with unilateral muscle injury were retrospectively included,including 40 cases underwent ultrasound-guided drug injection(group A)and 40 cases underwent electromagnetic wave physiotherapy plus external application of Yunnan Baiyao Gao(group B).Pain intensity was assessed using visual analogue scale(VAS)before treatment and 3 weeks after the final treatment,while the Young modulus(E)value of the injured muscle was measured before treatment and 1,2 and 3 weeks after final treatment,and the improvements of VAS scores and E values were compared between groups.Results The total effective rate in group A(35/40,87.50%)was higher than that in group B(21/40,52.50%;P＜0.05).Before treatment,no significant difference of VAS score was found between group A(8.07±0.83)and group B(7.88±0.85)(P＞0.05).After treatment,VAS scores decreased in both groups(both P＜0.05),which in group A(2.30±1.07)was more obviously than that in group B(4.80±0.82)(P＜0.05).After treatment,E values of injury muscles increased significantly in both groups(P＜0.05),while group A had a greater increase in overall magnitude and overall rate than group B(P＜0.05).Conclusion Ultrasound-guided drug injection therapy had significant therapeutic effect for muscle injuries,which could be dynamically monitored with SWE.

Objective To explore the relationship between the head injury criterion(HIC)values in anterior-posterior(AP)collisions and lateral-medial(LM)collisions.Methods A total of 102 male SD rats were randomly divided into a control group of 0 m(6 rats),4 AP groups(12 rats/group)and 4 LM groups(12 rats/group).After adaptive training,the classical Marmarou model was used to execute the brain AP and LM collisions under a series of different height impacts,and the HIC values were calculated.The experimental group data of the walk-pole test and grip strength test were collected at 24 hours before and after injury,and the data of the proportion of hemorrhage in the corpus callosum and pyramidal tracts were collected at 24 hours after injury.Results As the collision heights increased in both AP and LM groups,there were positive correlations with changes in WP test time and peak GS,and corresponding increases in the proportion of hemorrhage in the cc and py.According to the mathematical relationships between the comprehensive injury degrees and HIC values,it was found that at the same injury degree,LM-HIC value was less than AP-HIC value.A mathematical relationship between AP-HIC and LM-HIC was fitted based on the comprehensive injury degrees.At the same HIC,LM group experienced more severe injuries,and AP group was more tolerant to head collision.Conclusion The injury severity in LM group is greater than that of AP group at the same HIC.Preliminary results show there is a linear mathematical relationship between AP-HIC and LM-HIC.These results can be expected to expand the application scope of HIC and achieve an accurate assessment of the LM collision severity.

Taking Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine as an example,this paper sum-marizes the important role and practical experience of new cultural development in promoting the hospital's high-quality growth.It explores pathways for new cultural development to facilitate the high-quality advancement of integrated traditional Chinese and Western medicine hospitals,aiming to provide valuable practical guidance and theoretical support for such hospitals in the context of the new era.

Comorbidities will be a challenge faced by both Chinese and Western medicine in the future.The coexistence of multiple diseases logically begins with a holistic view of life that integrates form,qi,and spirit,and a holistic view of disease that integrates dis-ease and syndrome.From a Chinese medicine perspective,the core pathogenesis of comorbidities involves the interaction between ab-normal qi transformation and physical damage.The key to treatment lies in restoring the disordered state of qi.The basis for formula se-lection is the formula-syndrome.The therapeutic goal of the formula-syndrome is not a specific disease,but rather a holistic differenti-ation and treatment of the entire body.The"formula-disease-person"diagnosis and treatment model for treating comorbidities is a model for innovative theoretical guidance in clinical practice.It offers three approaches to diagnosing and treating comorbidities:formu-la-disease correspondence,formula-person correspondence,and formula-disease and formula-person correspondence,which provides a more original perspective and broader thinking for the study of comorbidity.