Objective To study the spatial distribution of the incidence of pulmonary tuberculosis in Hubei Province and its influencing factors, so as to improve the theoretical basis for scientific development of tuberculosis prevention and control measures in the future. Methods The data of reported incidence of tuberculosis and related influencing factors in various counties and districts of Hubei Province in 2020 were collected. Global Moran's I index, hotspot analysis and geographically weighted regression (GWR) model analysis were used to calculate the spatial autocorrelation of the incidence of tuberculosis, and to analyze the influencing factors affecting the incidence rate of tuberculosis. Results There were obvious regional differences in the space distribution of the incidence rate of tuberculosis. Hot spot analysis showed positive spatial correlation and obvious clustering. The GWR model (AICc=784.251) in this study had higher AICc value compared to the ordinary least squares regression (OLS) model (AICc=804.2585). The GWR model showed that the increase in the proportion of the population aged 65 and above and the proportion of the ethnic minority population had a significant promoting effect on the increase of the incidence rate of tuberculosis, and there was significant spatial heterogeneity. The effect of PM_2.5 concentration on the incidence rate of pulmonary tuberculosis varied in different regions, and the degree of effect was also different. Conclusion The proportion of people aged 65 and above and the proportion of ethnic minorities may significantly influence the incidence of pulmonary tuberculosis. The effect of PM_2.5 concentration varies in different regions, so targeted measures should be formulated according to the situation in different regions.

Objective To explore the value of a CT radiomics model in differentiating Xpert MTB/RIF-negative pulmonary tuber-culosis(PTB)from non-tuberculous mycobacteria pulmonary disease(NTM-PD).Methods A retrospective analysis was performed on 90 patients with Xpert MTB/RIF-negative PTB and 127 patients with NTM-PD.All patients were randomly divided into training set and testing set at the ratio of 7∶3.Radiomics features were extracted from chest CT images.Feature dimensionality reduction and selection were sequentially performed using the maximum relevance and minimum redundancy(mRMR)algorithm and the least absolute shrinkage and selection operator(LASSO)algorithm.Clinical,radiomics,and combined models were constructed by multi-variable logistic regression.The area under the curve(AUC)of receiver operating characteristic(ROC)curve was utilized to assess the model diagnostic performance.Calibration curves were used to evaluate model stability,and the decision curve analysis(DCA)was used to evaluate the clinical utility.Results The combined model had the highest diagnostic performance in both training and testing sets,with AUC of 0.90 and 0.86,respectively,which were higher than clinical and radiomics models.The calibration curve showed that the combined model had a good consistency between the predicted and the actual observations,and DCA revealed the highest clinical benefit.Conclusion The clinical-radiomics combined model has excellent predictive ability in differentiating Xpert MTB/RIF-negative PTB from NTM-PD,which can provide robust support for clinical diagnosis.

Objective:To investigate the relationship between serum histone deacetylase-3(HDAC3)and the severity of endometriosis(EMT).Methods:The clinical data of 109 EMT patients admitted to the Affiliated Hospi-tal of Inner Mongolia Medical University from June 1,2021 to November 30,2023 were extracted and analyzed.Pa-tients were divided into stage Ⅰ/Ⅱ group(56 cases)and stage Ⅲ/Ⅳ group(53 cases)according to the revised EMT staging criteria of the American Society for Reproductive Medicine(ASRM).Univariate analysis and binary Logistic regression were used to analyze the correlation factors between serum HDAC3 and the severity of EMT patients,and receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to evaluate the diagnostic value of stage Ⅲ/Ⅳ EMT.Results:The levels of serum HDAC3,human epididymal protein 4(HE4),serum carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),platelet to lymphocyte count ratio(PLR),and fibrinogen(Fib)in stage Ⅲ/Ⅳ patients were significantly higher than those in stage Ⅰ/Ⅱ patients,with statistical significant differences(P＜0.05).Binary Logistic regres-sion analysis showed that serum HDAC3,CA125,and VEGF were related factors affecting stage Ⅲ/Ⅳ EMT pa-tients(OR＞1,P＜0.05).The ROC curve showed that the AUC of serum HDAC3,CA125,and VEGF for phaseⅢ/Ⅳ EMT evaluation were 0.898,0.701,and 0.795,respectively,and the AUC for combined detection evaluation was 0.956.Conclusions:The serum HDAC3 level is related to the severity of EMT patients,and gradually increa-ses with the increase of EMT staging.HDAC3 combined with CA125 and VEGF has a high preoperative evaluation value for stage Ⅲ/Ⅳ EMT patients.

Objective To explore effective management methods for improving the efficiency of medical record quality control and enhancing medical record quality.Methods Based on a medical record quality control system,a full-cycle medical record quality management model was constructed,encompassing"pre-task reminders,real-time quality control during treatment,in-hospital process control,submission verification upon discharge,post-discharge terminal quality control,and re-verification af-ter archiving."Results Medical records achieved 100％quality control,and their quality significantly improved.The defect rate of medical record front pages and the delayed writing rate of surgical records in the hospital's discharged medical records continued to decline in the year before system implementation,the first year after implementation,and the second year after im-plementation.The 3-day retrieval rate of medical records increased significantly in the first year after implementation,with statis-tically significant differences in all three indicators(front page defect rate:x2=114.966,P＜0.001;delayed writing rate of sur-gical records:x2=8 056.614,P＜0.001;3-day retrieval rate:x2=798.201,P＜0.001).Conclusion The full-cycle medi-cal record management model based on a quality control system can effectively improve medical record quality and enhance man-agement efficiency.Future efforts should focus on integrating continuously optimized AI technology to strengthen system perform-ance.

Objective To analyze the quality of medical record home pages for discharged patients in a tertiary hospital in Guangzhou in 2023 based on the dual dimensions of Diagnosis-Related Groups(DRG)and Disease Intervention Program(DIP),and to provide a basis for improving the refinement of medical record home page quality management.Methods Dis-charge medical records from a tertiary general hospital in 2023 were selected.All medical records were grouped using DRG,while medical records under Guangzhou medical insurance and cross-province medical insurance implemented under DIP were simulated for DIP grouping.The writing defects in the discharge medical records were analyzed,as well as the DRG grouping,RW,and DIP standard scores of medical records with home page filling defects.Results Among 172 230 discharge medical records,171 786 were grouped into DRG,91 768 were grouped into DIP,and 91 604 were grouped into both DRG and DIP.A significant positive correlation was found between RW and DIP standard scores(r2=0.681,P＜0.001).Among the 91 604 medical records grouped into both DRG and DIP,1 942(2.12％)had writing defects,including 837(0.91％)with home page defects.DRG groups with more home page defect records included NC15,HK2,EJ13,EB15,HJ13,and RE19.Conclusion Quality defects in medical record home pages impact the accuracy of DRG and DIP grouping.Systematic measures such as strengthening medical record writing training and establishing scientific reward and punishment mechanisms should be implemented to provide data sup-port for the further advancement of DRG/DIP payment reform.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective To explore effective management methods for improving the efficiency of medical record quality control and enhancing medical record quality.Methods Based on a medical record quality control system,a full-cycle medical record quality management model was constructed,encompassing"pre-task reminders,real-time quality control during treatment,in-hospital process control,submission verification upon discharge,post-discharge terminal quality control,and re-verification af-ter archiving."Results Medical records achieved 100％quality control,and their quality significantly improved.The defect rate of medical record front pages and the delayed writing rate of surgical records in the hospital's discharged medical records continued to decline in the year before system implementation,the first year after implementation,and the second year after im-plementation.The 3-day retrieval rate of medical records increased significantly in the first year after implementation,with statis-tically significant differences in all three indicators(front page defect rate:x2=114.966,P＜0.001;delayed writing rate of sur-gical records:x2=8 056.614,P＜0.001;3-day retrieval rate:x2=798.201,P＜0.001).Conclusion The full-cycle medi-cal record management model based on a quality control system can effectively improve medical record quality and enhance man-agement efficiency.Future efforts should focus on integrating continuously optimized AI technology to strengthen system perform-ance.

Objective To analyze the quality of medical record home pages for discharged patients in a tertiary hospital in Guangzhou in 2023 based on the dual dimensions of Diagnosis-Related Groups(DRG)and Disease Intervention Program(DIP),and to provide a basis for improving the refinement of medical record home page quality management.Methods Dis-charge medical records from a tertiary general hospital in 2023 were selected.All medical records were grouped using DRG,while medical records under Guangzhou medical insurance and cross-province medical insurance implemented under DIP were simulated for DIP grouping.The writing defects in the discharge medical records were analyzed,as well as the DRG grouping,RW,and DIP standard scores of medical records with home page filling defects.Results Among 172 230 discharge medical records,171 786 were grouped into DRG,91 768 were grouped into DIP,and 91 604 were grouped into both DRG and DIP.A significant positive correlation was found between RW and DIP standard scores(r2=0.681,P＜0.001).Among the 91 604 medical records grouped into both DRG and DIP,1 942(2.12％)had writing defects,including 837(0.91％)with home page defects.DRG groups with more home page defect records included NC15,HK2,EJ13,EB15,HJ13,and RE19.Conclusion Quality defects in medical record home pages impact the accuracy of DRG and DIP grouping.Systematic measures such as strengthening medical record writing training and establishing scientific reward and punishment mechanisms should be implemented to provide data sup-port for the further advancement of DRG/DIP payment reform.

AIM:To construct and breed infertility model mice with ATP/GTP binding carboxypeptidase 1(Agtpbp1)gene knockout homozygote(Agtpbp1-/-)by CRISPR/Cas9 technology,so as to provide an animal model for the subsequent exploration of the pathogenesis of Agtpbp1 gene in male sterility.METHODS:The CRISPR/Cas9 technology was used to obtain Agtpbp1 gene knockout heterozygote(Agtpbp1+/-)mice according to the data of the main protein functional region of Agtpbp1 gene and combined with Cas9 nuclease.The obtained Agtpbp1+/-mice were mated,and their offspring were genotyped by PCR and agarose gel electrophoresis.The expression of Agtpbp1 at different levels was detected by RT-PCR,Western blot and immunohistochemical staining to support the identification results.The HE staining was used to observe the mouse cerebellum and eyeball structure to analyze the effect of Agtpbp1 gene knockout on Purkinje cells and photoreceptor cells.The symptoms of ataxia in mice were observed in combination with behavioral tests.The growth of mice was observed,and the changes of testicular tissue volume and weight of male mice were analyzed.The HE staining was used to observe the changes of testicular structure,and PAS staining was used to observe the changes of testicular germ cell cycle.Finally,sperm analyzer was used to analyze the sperm motility,so as to analyze the growth and develop-ment of the mice.RESULTS:The male and female Agtpbp1+/-mice could continue to mate,and three genotypes,Agtpbp1 wild-type(Agtpbp1+/+),Agtpbp1+/-and Agtpbp1-/-,were obtained.The genotypes of the offspring mice were successfully identified by PCR.The results of RT-PCR,Western blot and immunohistochemical staining verified the successful con-struction of Agtpbp1-/-mouse model at different levels(P<0.05).The results of HE staining showed that Purkinje cells were lost in the cerebellum of Agtpbp1-/-mice and the number of photoreceptor cells in the eyeball was reduced.Behavioral tests confirmed that Agtpbp1-/-mice had ataxia symptoms such as motor dysfunction and uncoordinated movements.Com-pared with control group,the testicular volume and weight of Agtpbp1-/-mice were significantly reduced.The results of HE staining showed a very small amount of sperm in the testis of Agtpbp1-/-mice.Combined with the sperm analyzer,it was ob-served that the sperm motility,vitality and movement rate of Agtpbp1-/-mice were significantly lower than those of the con-trol mice.Testicular sections with PAS staining showed cell cycle arrest of the sperm from Agtpbp1-/-mice.CONCLU-SION:In this study,Agtpbp1 knockout mice were successfully bred.The deletion of Agtpbp1 caused the arrest of sper-matogenic cell differentiation and the decrease in sperm motility in adult male mice,resulting in infertility.At the same time,it provides a new experimental tool for further exploring the molecular mechanism of Agtpbp1-induced male sterility.

Isavuconazole represents a novel gen-eration of triazole antifungal agents for the treat-ment of invasive trichothecenes in adults.The phar-macokinetic profile of isavuconazole differs in spe-cial populations,including children,patients with ex-tracorporeal membrane oxygenation,those with he-patic or renal injury,patients undergoing blood puri-fication,and critically ill individuals and solid organ transplant recipients.These differences impact the safety and efficacy of patient treatment.This article presents the latest progress in the pharmacokinetic study of isavuconazole in these special populations.