Objective:To build an internet hospital cost-benefit evaluation index system based on a large public tertiary hospital, for references for improving the operation and management of internet hospitals.Methods:From May to October 2024, this study identified the elements of cost-benefit through on-site investigation, literature analysis and expert discussion, and built an initial evaluation index system of cost-benefit of internet hospitals; Delphi method and Pareto chart method were used to determine indicators and their weights; This evaluation index system was used to quantitatively evaluate an internet hospital since its operation for two years (from May 2022 to April 2024).Results:Five profit entities and 26 cost-benefit components had been identified; The expert authority coefficient of the two rounds of Delphi method was 0.73, and the Kendall coefficient was 0.80 ( P<0.001). The costs and benefits of an internet hospital since its operation for two years were 14.06 million yuan and 134.95 million yuan, respectively, with a benefit cost ratio of 9.60. Conclusions:The cost-benefit evaluation index system of internet hospitals built in this study was suitable for these relying on physical hospitals. This system was scientific and practical, and could provide references for cost-benefit evaluation of other Internet hospitals.

Objective:To build an internet hospital cost-benefit evaluation index system based on a large public tertiary hospital, for references for improving the operation and management of internet hospitals.Methods:From May to October 2024, this study identified the elements of cost-benefit through on-site investigation, literature analysis and expert discussion, and built an initial evaluation index system of cost-benefit of internet hospitals; Delphi method and Pareto chart method were used to determine indicators and their weights; This evaluation index system was used to quantitatively evaluate an internet hospital since its operation for two years (from May 2022 to April 2024).Results:Five profit entities and 26 cost-benefit components had been identified; The expert authority coefficient of the two rounds of Delphi method was 0.73, and the Kendall coefficient was 0.80 ( P<0.001). The costs and benefits of an internet hospital since its operation for two years were 14.06 million yuan and 134.95 million yuan, respectively, with a benefit cost ratio of 9.60. Conclusions:The cost-benefit evaluation index system of internet hospitals built in this study was suitable for these relying on physical hospitals. This system was scientific and practical, and could provide references for cost-benefit evaluation of other Internet hospitals.

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS.

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS.

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS.

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS.

Objective:To explore the safety and feasibility of adrenal tumor resection under day surgery mode for the treatment of unilateral primary aldosteronism (UPA).Methods:The clinical data of 83 patients who underwent adrenalectomy for the treatment of UPA from January 2020 to January 2023 were retrospectively analyzed. There were 42 males (50.6%)and 41 females (49.4%), age (49.0±12.3)years old. Body mass index (25.4±3.6)kg/m 2. There were 17 patients with diabetes, 58 patients with preoperative hypertension, and the duration of hypertension was 8.2(1, 15)years. Systolic blood pressure was 151.8(137.0, 160.0)mmHg (1 mmHg=0.133 kPa), and diastolic blood pressure was 97.4(87.0, 107.0)mmHg. 20 cases had severe preoperative hypokalemia, with preoperative blood potassium levels of (2.9±0.6)mmol/L. The ratio of preoperative plasma aldosterone to renin activity was 54.1(13.0, 77.2). Tumors were located on the left side in 47 cases (56.6%)and on the right side in 36 cases (43.4%). The maximum diameter of the tumor is 1.5(1.0, 1.7)cm. Patients diagnosed with unilateral primary aldosteronism were included, and patients diagnosed with adrenal pheochromocytoma, adrenal malignancy, or severe cardiovascular disease that cannot tolerate surgery were excluded. The patient was admitted to the hospital on the same day, underwent surgery on the same day, and was evaluated after extubation within one day after surgery. The patient had no fever or lower back pain after surgery, was able to freely get out of bed, and had no obvious abnormalities in blood routine, electrolyte and other test indicators. The patient was discharged from the hospital and received continuous care outside the hospital. The patient was guided to undergo regular outpatient follow-up. Evaluate the efficacy using the Primary Aldosterone Hyperaldosteronism Surgical Outcome (PASO)criteria. Results:The patients had a mean length of hospital stay of 43.0(40.3, 44.6)hours, an operation time of 89.6(70.0, 103.0)minutes, and an operation cost of 23 820.2 (21 150.8, 24 948. 3)yuan. The postoperative free position time was 29.5(20.8, 39.7)hours, the postoperative time for fluid placement of the diet was 25.2(20.1, 27.8) hours, and 42.2(37.9, 41.9)hours of postoperative drain removal. The overall postoperative clinical remission rate was 85.5%. There were four postoperative complications, accounting for 4.8% of cases. These included two cases of interosseous vein thrombosis, one case of delayed healing, and one case of peritoneal rupture. No case of readmission was reported within 30 days.Conclusions:UPA adrenal tumour resection in ambulatory mode is safe and effective when strict inclusion and exclusion criteria are followed, adequate preoperative preparation is carried out, and expert physician assessment is provided.

Purpose: This study explored the association of the elasticity modulus and shear wave velocity (SWV) of the tibialis anterior muscle, as measured by two-dimensional shear wave elastography (2D-SWE), with the intracompartmental pressure (ICP) determined using the Whitesides method in a New Zealand rabbit model of acute compartment syndrome (ACS). Additionally, it evaluated the viability of 2D-SWE as a noninvasive, quantitative tool for the early detection of ACS. Methods: An ACS model was established through direct external compression by applying pressure bandaging to the lower legs of 15 New Zealand rabbits using neonatal blood pressure cuffs. Another five animals represented a non-modeled control group. To measure the elasticity modulus and SWV of the tibialis anterior muscles, 2D-SWE was employed. Blood oxygen saturation, serum creatine kinase (CK), and myoglobin levels were monitored. Subsequently, the anterior tibial compartment was dissected, and the tibialis anterior was removed for hematoxylin and eosin staining to assess muscle injury. Results: The elasticity modulus and SWV of the tibialis anterior muscle increased with compression duration, as did serum CK and myoglobin levels. ICP was strongly positively correlated with these parameters, particularly mean velocity (r=0.942, P<0.001) and CK (r=0.942, P<0.001). Blood oxygen saturation was negatively correlated with ICP (r=-0.887, P<0.001). Histological analysis indicated progressive muscle cell swelling over time, with damage transitioning from reversible to irreversible and culminating in necrosis. Conclusion In a rabbit ACS model, ICP was strongly positively correlated with muscle elasticity modulus/SWV. Consequently, 2D-SWE may represent a novel tool for assessing early-phase ACS.

Objective To screen and verify the genes that play key role in the occurrence and development of esophageal cancer by u-sing bioinformatics and real-time fluorescence quantitative PCR(qRT-PCR)methods to find new markers for diagnosis of esophageal cancer(ESCA).Methods Using the TCGA database and Wayne plot analysis,the cross genes between the differentially expressed genes of ESCA and the genes which have the most significant impacts on disease-free survival(DFS)rate in esophageal cancer patients were preliminarily identified.Following conducting protein-protein interaction(PPI)network analysis on the overlapping genes,GO and KEGG functional analysis was performed to screen the potential key genes as the diagnostic markers of esophageal cancer.qRT-PCR was used to quantitatively analyze the expression of mRNA of the key gene in peripheral blood.Statistical analysis was con-ducted based on the clinico-pathological characteristics of the patients to determine its potential value as a new diagnostic marker for e-sophageal cancer.Results After overlapping of differentially expressed genes of ESCA and disease-free survival genes in the TCGA database,39 upregulated genes and 20 downregulated genes were found to be differentially expressed,all of which affected disease-free survival rate.After conducting PPI network analysis,15 upregulated genes with core interactions were identified,and the downregulat-ed genes did not form any interaction network.Further enrichment analysis of these 15 core interacting genes through GO and KEGG,revealed that fibronectin 1(FN1)may be a potential biomarker for ESCA diagnosis.The qRT-PCR results showed that compared with the healthy control group,the mRNA expression level of FN1 in the peripheral blood of esophageal cancer patients was significantly ele-vated.After analyzing the clinical characteristics of patients,it was found that the patients with poor differentiation and high clinico-pathological staging had significantly increased peripheral blood FN1 mRNA levels.The model with FN1 mRNA expression levels can distinguish esophageal cancer patients from healthy individuals.Conclusion FN1 mRNA may be a potential non-invasive diagnostic biomarker for esophageal cancer.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by persistent airflow limitation, with vascular endothelial dysfunction being one of its key pathogenic mechanisms. Endothelial progenitor cells (EPCs), a class of progenitor cells capable of vascular repair and regeneration, play a crucial role in the pathogenesis of COPD. In COPD patients, the number and function of circulating EPCs are significantly reduced, which is closely associated with disease severity, lung function decline, acute exacerbations, nutritional status, and comorbidities. Environmental factors such as smoking, nicotine, electronic cigarettes, and particulate matter 2.5 (PM2.5) can markedly impair both the function and quantity of EPCs. The underlying mechanisms may involve the regulation of vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR), C-X-C motif chemokine ligand 12/C-X-C motif chemokine receptor 4 (CXCL12/CXCR4) signaling pathways, and various cytokine regulations. Moreover, animal studies have shown that intratracheal transplantation of EPCs can significantly improve lung function and pathological changes in emphysema models, suggesting that targeting EPCs may be a promising therapeutic strategy for COPD. Elucidating the molecular mechanisms of EPC mobilization, homing, and dysfunction, and evaluating the efficacy and safety of their clinical application, may offer new insights into the treatment of COPD and other chronic lung diseases.
Humans ; Pulmonary Disease, Chronic Obstructive/pathology* ; Endothelial Progenitor Cells/cytology* ; Animals ; Signal Transduction ; Vascular Endothelial Growth Factor A/metabolism*