Objective:To analyze the medical operation efficiency of the Beijing-Tianjin-Hebei region, so as to provide references for optimizing medical resource allocation in the area.Methods:Based on the China Statistical Yearbook (2012 to 2023), data regarding healthcare operational inputs (3 indicators including number of healthcare institutions, number of healthcare personnel, and number of beds in healthcare institutions) and outputs (6 indicators including number of patients treated and discharged, etc.) in the Beijing-Tianjin-Hebei region were included, and the DEA-Malmquist index model was employed to analyze healthcare operational efficiency in the region. The grey prediction model was used to predict the number of healthcare institutions, healthcare personnel, and beds in healthcare institutions from 2023 to 2027. Results:From 2011 to 2022, the overall efficiency of medical operations in Beijing and Tianjin showed an increasing trend, with total factor productivity of 1.213 1 and 1.246 0, respectively. However, the overall efficiency of medical operations in Hebei was showing a downward trend, with a total factor production of 0.933 1 and a scale efficiency of 0.909 5. The number of healthcare institutions, healthcare personnel, and beds in healthcare institutions showed an upward trend in the Beijing-Tianjin-Hebei region from 2023 to 2027.Conclusions:The medical operational efficiency in Beijing and Tianjin was consistently improving. The utilization rate of medical resources in Hebei was relatively low, accompanied by a persistent decline in medical operational efficiency. The Beijing-Tianjin-Hebei region should further enhance the rational allocation of medical resources, so as to promote the coordinated development of the regional healthcare system.

Objective:To compare the short-term outcomes of arthroscopic suture bridge technique versus those of arthroscopic tie knot technique in the treatment of tibial avulsion fractures of the anterior cruciate ligament (ACL).Methods:A retrospective study was conducted to analyze the 53 patients with ACL tibial avulsion fracture who had been treated arthroscopically at Department of Sports Medicine, Wuhai People's Hospital between February 2018 and February 2024. There were 31 males and 22 females, with an age of (48.2±5.1) years. The left knee was affected in 27 cases and the right knee in 26 cases. According to the Meyers-Mckeever classification, 32 cases were of type Ⅱ and 21 cases of type Ⅲ. The patients were divided into 2 groups according to different fixation methods: 20 cases were fixed by the arthroscopic tie knot technique (the tie knot group) and 33 cases by the arthroscopic suture bridge technique (the suture bridge group). The operation time and fracture healing time were recorded and compared between the 2 groups. At preoperation, 3 and 6 months after operation, and the last follow-up, the knee pain was evaluated by visual analogue scale (VAS) pain score, the knee stability (side to side disparity) by a KT-1000 arthrometer, and the knee function by The International Knee Documentation Committee (IKDC) subjective score, Lysholm score, knee range of motion, and activities of daily living (ADL) scale. Comparisons were made between and within the 2 groups.Results:The differences in the general preoperative data were not statistically significant between the 2 groups, indicating comparability ( P>0.05). The tie knot group and the suture bridge group were followed up respectively for (13.9±2.1) and (14.5±2.1) months. The surgical time for the suture bridge group [(66.9±8.4) min] was significantly longer than that for the tie knot group [(51.2±6.3) min] ( P<0.05). At 3 months after operation, the VAS pain score [(1.2±0.2) points], side to side disparity [(2.5±0.6) mm], IKDC subjective score [(89.6±1.6) points], Lysholm score [(88.0±1.4) points], knee range of motion (132.1°±2.1°), and ADL score [(88.8±3.3) points] in the suture bridge group were significantly better than those in the tie knot group [(2.1±0.3) points, (3.0±0.9) mm, (87.0±1.4) points, (84.0±1.6) points, 102.1°±2.1°, and (80.3±3.4) points] ( P<0.05). However, there were no significant differences in VAS pain score, side to side disparity, IKDC subjective score, Lysholm score, knee range of motion or ADL score between the 2 groups at 6 months after operation or at the last follow-up ( P>0.05). Statistically significant differences were observed between all time points for VAS pain scores, side-to-side disparity, IKDC subjective scores, Lysholm scores, knee range of motion, and ADL scores in all patients ( P<0.05). No incision infection, nerve injury or other complications occurred in the 2 groups after operation. Conclusions:Both arthroscopic suture bridge technique and arthroscopic tie knot technique are safe and effective intervention options for avulsion fractures of the ACL tibial insertion. The suture bridge technique, with its stable biomechanical properties, can significantly accelerate the process of early postoperative knee function recovery to shorten the recovery period. However, it requires longer surgical time.

Objective:To analyze the medical operation efficiency of the Beijing-Tianjin-Hebei region, so as to provide references for optimizing medical resource allocation in the area.Methods:Based on the China Statistical Yearbook (2012 to 2023), data regarding healthcare operational inputs (3 indicators including number of healthcare institutions, number of healthcare personnel, and number of beds in healthcare institutions) and outputs (6 indicators including number of patients treated and discharged, etc.) in the Beijing-Tianjin-Hebei region were included, and the DEA-Malmquist index model was employed to analyze healthcare operational efficiency in the region. The grey prediction model was used to predict the number of healthcare institutions, healthcare personnel, and beds in healthcare institutions from 2023 to 2027. Results:From 2011 to 2022, the overall efficiency of medical operations in Beijing and Tianjin showed an increasing trend, with total factor productivity of 1.213 1 and 1.246 0, respectively. However, the overall efficiency of medical operations in Hebei was showing a downward trend, with a total factor production of 0.933 1 and a scale efficiency of 0.909 5. The number of healthcare institutions, healthcare personnel, and beds in healthcare institutions showed an upward trend in the Beijing-Tianjin-Hebei region from 2023 to 2027.Conclusions:The medical operational efficiency in Beijing and Tianjin was consistently improving. The utilization rate of medical resources in Hebei was relatively low, accompanied by a persistent decline in medical operational efficiency. The Beijing-Tianjin-Hebei region should further enhance the rational allocation of medical resources, so as to promote the coordinated development of the regional healthcare system.

Objective:To compare the short-term outcomes of arthroscopic suture bridge technique versus those of arthroscopic tie knot technique in the treatment of tibial avulsion fractures of the anterior cruciate ligament (ACL).Methods:A retrospective study was conducted to analyze the 53 patients with ACL tibial avulsion fracture who had been treated arthroscopically at Department of Sports Medicine, Wuhai People's Hospital between February 2018 and February 2024. There were 31 males and 22 females, with an age of (48.2±5.1) years. The left knee was affected in 27 cases and the right knee in 26 cases. According to the Meyers-Mckeever classification, 32 cases were of type Ⅱ and 21 cases of type Ⅲ. The patients were divided into 2 groups according to different fixation methods: 20 cases were fixed by the arthroscopic tie knot technique (the tie knot group) and 33 cases by the arthroscopic suture bridge technique (the suture bridge group). The operation time and fracture healing time were recorded and compared between the 2 groups. At preoperation, 3 and 6 months after operation, and the last follow-up, the knee pain was evaluated by visual analogue scale (VAS) pain score, the knee stability (side to side disparity) by a KT-1000 arthrometer, and the knee function by The International Knee Documentation Committee (IKDC) subjective score, Lysholm score, knee range of motion, and activities of daily living (ADL) scale. Comparisons were made between and within the 2 groups.Results:The differences in the general preoperative data were not statistically significant between the 2 groups, indicating comparability ( P>0.05). The tie knot group and the suture bridge group were followed up respectively for (13.9±2.1) and (14.5±2.1) months. The surgical time for the suture bridge group [(66.9±8.4) min] was significantly longer than that for the tie knot group [(51.2±6.3) min] ( P<0.05). At 3 months after operation, the VAS pain score [(1.2±0.2) points], side to side disparity [(2.5±0.6) mm], IKDC subjective score [(89.6±1.6) points], Lysholm score [(88.0±1.4) points], knee range of motion (132.1°±2.1°), and ADL score [(88.8±3.3) points] in the suture bridge group were significantly better than those in the tie knot group [(2.1±0.3) points, (3.0±0.9) mm, (87.0±1.4) points, (84.0±1.6) points, 102.1°±2.1°, and (80.3±3.4) points] ( P<0.05). However, there were no significant differences in VAS pain score, side to side disparity, IKDC subjective score, Lysholm score, knee range of motion or ADL score between the 2 groups at 6 months after operation or at the last follow-up ( P>0.05). Statistically significant differences were observed between all time points for VAS pain scores, side-to-side disparity, IKDC subjective scores, Lysholm scores, knee range of motion, and ADL scores in all patients ( P<0.05). No incision infection, nerve injury or other complications occurred in the 2 groups after operation. Conclusions:Both arthroscopic suture bridge technique and arthroscopic tie knot technique are safe and effective intervention options for avulsion fractures of the ACL tibial insertion. The suture bridge technique, with its stable biomechanical properties, can significantly accelerate the process of early postoperative knee function recovery to shorten the recovery period. However, it requires longer surgical time.

Objective:To explore the mediating roles of rumination and avoidance coping between information anxiety and suicidal ideation.Methods:In March 2022, a total of 896 college students were surveyed by the information anxiety scale(IAS), ruminative responses scale(RRS), coping style questionnaire(CSQ)and self-rating idea of suicidal ideation scale(SIOSS). The ANOVA analysis, Pearson correlation analysis and mediating effect analysis were performed by the SPSS 22.0 software.Results:The detection rate of suicidal ideation among college students was 9.15%(82/896). The information anxiety score was(73.84±17.29), the rumination score was(47.73±12.16), the avoidance coping score was(3.76±2.52), and the suicidal ideation score was(5.41±4.09). Information anxiety was significantly positively correlated with rumination, avoidance coping and suicidal ideation( r=0.49, 0.36, 0.37, all P<0.05). Rumination was significantly positively correlated with avoidance coping and suicidal ideation( r=0.42, 0.59, both P<0.05). There was a significantly positive correlation between avoidance coping and suicidal ideation( r=0.45, P<0.05). Information anxiety affected suicidal ideation of college students through four paths.The direct effect value of information anxiety on suicidal ideation was 0.06, accounting for 16.67% of the total effect. The effect values of the separate mediating effect of rumination and avoid coping were 0.22 and 0.04, and accounting for 61.11% and 11.11% of the total effect respectively. The chain mediating effect value of rumination and avoid coping was 0.04, accounting for 11.11% of the total effect. Conclusion:Information anxiety can directly affect suicidal ideation of college students and indirectly affect suicidal ideation through rumination and avoidance coping.

Lysobacter harbors a plethora of cryptic biosynthetic gene clusters (BGCs), albeit only a limited number have been analyzed to date. In this study, we described the activation of a cryptic polyketide synthase (PKS)/nonribosomal peptide synthetase (NRPS) gene cluster (lsh) in Lysobacter sp. DSM 3655 through promoter engineering and heterologous expression in Streptomyces sp. S001. As a result of this methodology, we were able to isolate two novel linear lipopeptides, lysohexaenetides A (1) and B (2), from the recombinant strain S001-lsh. Furthermore, we proposed the biosynthetic pathway for lysohexaenetides and identified LshA as another example of entirely iterative bacterial PKSs. This study highlights the potential of heterologous expression systems in uncovering cryptic biosynthetic pathways in Lysobacter genomes, particularly in the absence of genetic manipulation tools.
Lysobacter/metabolism* ; Streptomyces/metabolism* ; Lipopeptides/metabolism* ; Polyketide Synthases/genetics* ; Multigene Family

Various c-mesenchymal-to-epithelial transition (c-MET) inhibitors are effective in the treatment of non-small cell lung cancer; however, the inevitable drug resistance remains a challenge, limiting their clinical efficacy. Therefore, novel strategies targeting c-MET are urgently required. Herein, through rational structure optimization, we obtained novel exceptionally potent and orally active c-MET proteolysis targeting chimeras (PROTACs) namely D10 and D15 based on thalidomide and tepotinib. D10 and D15 inhibited cell growth with low nanomolar IC₅₀ values and achieved picomolar DC₅₀ values and >99% of maximum degradation (D_max) in EBC-1 and Hs746T cells. Mechanistically, D10 and D15 dramatically induced cell apoptosis, G1 cell cycle arrest and inhibited cell migration and invasion. Notably, intraperitoneal administration of D10 and D15 significantly inhibited tumor growth in the EBC-1 xenograft model and oral administration of D15 induced approximately complete tumor suppression in the Hs746T xenograft model with well-tolerated dose-schedules. Furthermore, D10 and D15 exerted significant anti-tumor effect in cells with c-MET^Y1230H and c-MET^D1228N mutations, which are resistant to tepotinib in clinic. These findings demonstrated that D10 and D15 could serve as candidates for the treatment of tumors with MET alterations.

Objective To explore dendritic cells (DCs)-mediated antigen presentation for radiation-injured cells by using the in vitro cell co-culture technology to simulate the in vivo microenvironment of the lung tissue. Methods ⁶⁰Co γ-irradiated mouse lung epithelial cells (MLE-12) were cultured with bone marrow-derived DCs and/or splenic T lymphocytes for 48 hours. Flow cytometry was used to measure the expression levels of costimulatory molecules (CD80/86) and antigenic peptide recognition complexes (the major histocompatibility complex [MHC] class Ⅰ/Ⅱ) on DCs and T cell activation markers (CD69/28/152) as well as the numbers of CD4⁺ and CD8⁺ T cells. Results ⁶⁰Co γ irradiation significantly increased the apoptosis rate of MLE-12 cells in a dose-dependent manner, and significantly stimulated the expression of CD80/86 and MHC Ⅱ on DCs, without direct activation of T cells. After γ (6 Gy)-irradiated MLE-12 cells were co-cultured with DCs and T lymphocytes for 48 h, there were significant increases in the expression of CD69 and CD28 on T cells, the numbers of CD4⁺ and CD8⁺ T cells, and the expression of CD86 and MHC I on DCs, as compared with the control groups. Conclusion Radiation-injured cells can stimulate antigen presentation by DCs and activate T cells.

Objective To investigate the role of complement in radiation-induced lung injury in mice after chest irradiation with ⁶⁰Co γ-rays at a single dose of 20 Gy. Methods C57BL/6 mice underwent chest irradiation with ⁶⁰Co γ-rays at a single dose of 20 Gy, followed by observation for the inflammatory reaction of the lung tissue in the early stage (within 15 d) and pulmonary fibrosis in the later stage (30 and 180 d). Enzyme-linked immunosorbent assay was used to measure the levels of C2, C3a, C4, and C5b-9 in the lung tissues at 1, 3, 7, 15, 30, and 180 d after irradiation. The expression of complement mRNA in BEAS-2B cells after irradiation was determined using RT-PCR. Results Radiation-induced lung injury in micepresented as inflammatory response in the early stage and fibrosis in the late stage. Complement C2, C4, and C5b-9 complexes were increased in the early period (3 or 7 d) after irradiation (P < 0.05), which might be associated with the inflammatory response induced by irradiation. During 3 to 180 d, complement C3a was significantly higher in the irradiated mice than in the control mice, suggesting a close relationship between C3a and radiation-induced lung injury. The irradiated cells showed increased mRNA expression of C2 and C3, with no changes in the mRNA levels of C4 and C5. Conclusion Different complement proteins have varying responses to radiation-induced lung injury, among which C3a is closely related to radiation-induced lung injury, suggesting that regulating C3a and its receptors may be a new way to prevent and treat radiation-induced lung injury.

OBJECTIVE：To study general chara cteristics and medication of medical damage liability disputes cases caused by medication error ， and to provide references for related departments and medical staff for preventing and reducing medication-induced medical disputes. METHODS ：A total of 240 cases of medical damage liability disputes cases caused by medication error were collected from Peking University ’s Fabao Law Database during Jan. 2001 to Feb. 2020，and analyzed in terms of general situation ，damage outcome ，level of the hospital involved ，liability judgment and compensation ，types of medication error and drug types. RESULTS ：medication-related medical damage liability disputes accounted for 25.3％ of overall medical damage disputes ；the most damage result of patients was death （68.3％）；medical negligence forensic appraisal was conducted as the main appraisal pattern with a proportion of 57.9％；the average case compensation was 203，000 yuan；the hospitals involved were mainly tertiary hospitals （48.8％）；the main type of medication error involved was prescription error ； chemical medicine was mainly involved ，of which the top three categories were systemic antibacterial ，systemic corticosteroids and antipsychotics. CONCLUSIONS ：ADR caused by medication errors are the common causes of medical disputes. Medical institutions should focus on improving the relevant systems and processes ，strengthen the construction of pharmaceutical information and automation system ，and reduce the probability of medication errors ；at the same time ，great importance should be paid to the cultivation of pharmaceutical talents in hospital ，give full play to the role of pharmacists ，and strengthen the monitoring and intervention of medication errors. Finally ，the relevant national judicial departments should constantly improve the settlement mechanism of medical damage liability disputes to provide reasonable protection for both doctors and patients.