Objective:To analyze the association between healthcare workers mental health,institu-tional supplies and facilities,inter-organizational coordination during infectious disease outbreaks,and the healthcare institution resilience.Methods:An online questionnaire survey was conducted among the healthcare workforce from 146 institutions in Beijing from January 13,2023 to February 9,2023,and a total of 1 434 eligible respondents were included.The sample comprised 408 responses from tertiary hos-pitals,117 from secondary hospitals,and 909 from primary care institutions.The resilience indicator for healthcare institutions was defined as the degree to which medical services met patient demands,with in-fluencing factors including physical factors,such as material shortages and facility space adaptation or ex-pansion,organizational factors such as information sharing and patient referral,and psychological factors were evaluated using job satisfaction(extrinsic satisfaction,intrinsic satisfaction),burnout(emotional exhaustion,depersonalization,reduced personal accomplishment),and depression status.Ordered mul-ticlassification Logistic regression was used to examine the impact of various factors on the degree to which healthcare services met patient needs;additionally,demographic factors that might influence institutional resilience were controlled.Results:During the emergency response phase,93％of hospitals maintained the capacity to meet patient needs,though tertiary hospitals demonstrated significantly higher rates of service inadequacy(21.05％).Material shortages were reported across all institutions,with tertiary hos-pitals experiencing more frequent multi-item shortages.Inter-institutional collaboration patterns revealed substantial variation:87.50％of primary care facilities,42.86％of secondary hospitals,and 31.58％of tertiary hospitals.Healthcare workers across all levels reported mild depressive symptoms and moderate-to-severe burnout levels.Regression analysis showed high satisfaction(overall satisfaction β=0.04,ex-trinsic satisfaction β=0.06,and intrinsic satisfaction β=0.08),low degree of job burnout(emotional exhaustion β=-0.04,depersonalization β=-0.07 and reduced personal accomplishment β=0.01),low degree of depression(β=-0.06)were significantly associated with higher healthcare institution re-silience.In addition,material shortages were significantly associated with lower resilience,and renova-tion and expansion of treatment spaces,and information sharing,were all associated with higher resilience.Demographic factors(age,gender,marital status,educational background,etc.)had no sig-nificant impact on resilience.Conclusion:Mental health status significantly influences healthcare institu-tion resilience.As human resources constitute the core asset of healthcare institutions,strategic optimiza-tion of workforce allocation and psychological support interventions can effectively strengthen resilience.Moreover,healthcare institution resilience is positively impacted by orderly material supply chains,timely resource distribution,and adaptive reconfiguration of clinical spaces.Finally,facilitating information sharing also enhances institutional resilience.

Objective To establish a rat model of venous thrombosis in a plateau hypobaric hypoxic environment and to investigate the effect of this environment on venous thrombosis.Methods A total of 144 healthy male SD rats were assigned randomly to four groups(n=36 rats per group):a plains sham operation(A)group,plains operation(B)group,plateau altitude 6000 m+sham operation(C)group,and plateau altitude 6000 m+surgery(D)group.Rats in A and B groups were maintained in a plains normoxic environment,while rats in C and D groups C and D were subjected to a plateau environment.Rats in the surgical groups underwent quantitative constriction to incompletely obstruct the inferior vena cava blood flow.Each group was further divided into subgroups based on time:1,3,5,7,14,and 21 d(n=6 rats per group).Regular vascular ultrasound monitoring was conducted,and blood samples were taken for whole blood viscosity testing and the assessment of inflammatory indicators,including endothelin-1(ET-1),interleukin-6(IL-6)and tissue factor(TF).Coagulation function was evaluated through the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer.After the observation period,the experimental animals were sacrificed and the limbs were removed.Thrombus samples were stained with hematoxylin/eosin(HE),and the thrombus wet mass was measured.Results The thrombosis incidence was significantly higher in the plateau D group than in B group,accompanied by a marked increase in blood viscosity and hematocrit(P＜0.01).Additionally,levels of ET-1,IL-6,and TF were significantly elevated(P＜0.05),indicating a coagulation disorder.Conclusions A plateau hypoxic environment model can be successfully simulated by quantitative coarctation of the inferior vena cava,combined with a specialized environmental chamber.The findings of this study suggest that a plateau hypoxic environment promotes venous thrombosis.

Objective Under the guidance of Zhuang medicine theory,this study aims to investigate the medicinal and compatibility rules of authentic medicinal pearls.Method This article focuses on the fourth national survey of traditional Chinese medicine resources—general survey of marine traditional Chinese medicine resources in Guangxi,led by Professor Lin Jiang's team from Guangxi University of Traditional Chinese Medicine and Guangxi Famous Traditional Chinese Medicine.The survey collected original prescriptions containing pearls,as well as data recorded in Zhuang medicine monographs containing pearls.The study integrated the efficacy,indications,pharmacology,and clinical research of pearl Zhuang medicine.Under the guidance of Zhuang medicine prescription compatibility theory,Zhuang medicine disease classification,and Zhuang medicine classification theory,this study explores the compatibility rules based on the data and functions of Zhuang medicine pearl formula.Result Zhuang medicine pearls taste sweet and salty,with a cold nature;It has the effects of activating the Qiao wu(brain),regulating Long lu(blood circulatory system)and Huo lu(nervous system),clearing heat and toxins,calming the mind,calming palpitations,relieving cough,promoting muscle growth,nourishing yin fluids,and Clearing eye mistiness;Indications:Nian nao nuo(Insomnia),Hen feng(Infantile Convulsions),Long lei(Epilepsy),Fright Palpitations,A rou tian(Diabetes),Huo yan ma(Sore throat),Bei ding(Deep-Rooted Boil),Bei nong(Sores and Ulcers),Redness and visual obstruction due to corneal opacity,Re Nong(Otitis media),Kou chuang(Oral ulcers),Da ning(Swelling and pain of eye).Based on the analysis of data on the formula of Zhuang medicine pearls,it was found that the topical use of Zhuang medicine pearls is concentrated in diseases of the ENT(Ear,Nose,and Throat),Ophthalmology,and diseases of the skin and subcutaneous tissue.When combined with drugs such as regulating Long lu,clearing heat toxin,and eliminating dampness-toxin,it is used to treat diseases such as Redness and visual obstruction due to corneal opacity,Oral ulcers,and Skin ulcers;For internal use,it is often combined with medicines that regulating Long lu,replenishing qi and blood,eliminating dampness-toxin,and nourishing the heart-mind,used in hypertension and palpitations.When paired with the medicines of clearing heat toxin,replenishing qi and blood,regulating Qiaowu,it is used to treat insomnia and epilepsy.Based on the analysis of pearl function,it is used in combination with airway and detoxifying drugs to treat airway diseases;Combination therapy with regulating Long lu and Qiao wu(brain)medicine for the treatment of Long lu disease;Combination treatment of gynecological diseases with regulating Long lu and Huo lu medicine and Bu xu medicine;Combination therapy with heat-clearing,detoxifying,and swelling-reducing medicines or astringents,for the treatment of persistent non-healing sores and ulcers;Used in combination with antipyretic drugs and yin tonifying drugs to treat ophthalmic diseases.Conclusion Zhuang medicine pearl has a wide range of therapeutic effects,and its efficacy can be enhanced by compatibility with different Zhuang medicines.Future research can combine modern compatibility methods of traditional Chinese medicine to optimize the compatibility scheme of pearls,study the specialized disease and prescription of Zhuang medicine pearls,combine Zhuang medicine with Western medicine to form prescriptions,and combine the pharmacological effects of pearls to form prescriptions.In depth exploration of the pharmacological substance basis and mechanism of action of pearl prescriptions can be conducted to develop new Zhuang medicine preparations for pearls.

The aim of this study was to qualitatively and quantitatively detect coronavirus(CoV)in the feces of bats from Qinghua Cave,Yunnan Province,China.CoV was qualitatively tested with reverse transcription polymerase chain reaction(RT-PCR),and homology and genetic evolution were analyzed with bioinformatics software.The established reverse transcription real-time fluores-cence quantitative PCR(qRT-PCR)method was applied to CoV quantification in bat feces.The positivity rate of CoV in 306 fecal samples collected from the fulvous fruit bat(Rousettus leschenaultia)was 7.8%(24/306)according to RT-PCR.All 24 strains of CoV belonged to β-CoV,and showed a similarity of 86.8%-100.0%at the nucleotide level and 95.2%-100.0%at the amino acid level,with respect to other β-CoV sequences in the NCBI database.The positivity rate of CoV was 18.6%(57/306)according to qRT-PCR,a value higher than that according to RT-PCR(χ2=25.3,P<0.05).The mean β-CoV load was 1.3×103 copies/μL.In conclusion,the bats in Qinghua Cave,Yunnan Province,carried CoV belonging to β-CoV.The established qRT-PCR method achieved good sensitiv-ity,accuracy,reproducibility,and a higher detection rate than that of RT-PCR,and can be used for rapid detection of β-CoV in bats.

Objective To establish a rat model of venous thrombosis in a plateau hypobaric hypoxic environment and to investigate the effect of this environment on venous thrombosis.Methods A total of 144 healthy male SD rats were assigned randomly to four groups(n=36 rats per group):a plains sham operation(A)group,plains operation(B)group,plateau altitude 6000 m+sham operation(C)group,and plateau altitude 6000 m+surgery(D)group.Rats in A and B groups were maintained in a plains normoxic environment,while rats in C and D groups C and D were subjected to a plateau environment.Rats in the surgical groups underwent quantitative constriction to incompletely obstruct the inferior vena cava blood flow.Each group was further divided into subgroups based on time:1,3,5,7,14,and 21 d(n=6 rats per group).Regular vascular ultrasound monitoring was conducted,and blood samples were taken for whole blood viscosity testing and the assessment of inflammatory indicators,including endothelin-1(ET-1),interleukin-6(IL-6)and tissue factor(TF).Coagulation function was evaluated through the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer.After the observation period,the experimental animals were sacrificed and the limbs were removed.Thrombus samples were stained with hematoxylin/eosin(HE),and the thrombus wet mass was measured.Results The thrombosis incidence was significantly higher in the plateau D group than in B group,accompanied by a marked increase in blood viscosity and hematocrit(P＜0.01).Additionally,levels of ET-1,IL-6,and TF were significantly elevated(P＜0.05),indicating a coagulation disorder.Conclusions A plateau hypoxic environment model can be successfully simulated by quantitative coarctation of the inferior vena cava,combined with a specialized environmental chamber.The findings of this study suggest that a plateau hypoxic environment promotes venous thrombosis.

Objective Under the guidance of Zhuang medicine theory,this study aims to investigate the medicinal and compatibility rules of authentic medicinal pearls.Method This article focuses on the fourth national survey of traditional Chinese medicine resources—general survey of marine traditional Chinese medicine resources in Guangxi,led by Professor Lin Jiang's team from Guangxi University of Traditional Chinese Medicine and Guangxi Famous Traditional Chinese Medicine.The survey collected original prescriptions containing pearls,as well as data recorded in Zhuang medicine monographs containing pearls.The study integrated the efficacy,indications,pharmacology,and clinical research of pearl Zhuang medicine.Under the guidance of Zhuang medicine prescription compatibility theory,Zhuang medicine disease classification,and Zhuang medicine classification theory,this study explores the compatibility rules based on the data and functions of Zhuang medicine pearl formula.Result Zhuang medicine pearls taste sweet and salty,with a cold nature;It has the effects of activating the Qiao wu(brain),regulating Long lu(blood circulatory system)and Huo lu(nervous system),clearing heat and toxins,calming the mind,calming palpitations,relieving cough,promoting muscle growth,nourishing yin fluids,and Clearing eye mistiness;Indications:Nian nao nuo(Insomnia),Hen feng(Infantile Convulsions),Long lei(Epilepsy),Fright Palpitations,A rou tian(Diabetes),Huo yan ma(Sore throat),Bei ding(Deep-Rooted Boil),Bei nong(Sores and Ulcers),Redness and visual obstruction due to corneal opacity,Re Nong(Otitis media),Kou chuang(Oral ulcers),Da ning(Swelling and pain of eye).Based on the analysis of data on the formula of Zhuang medicine pearls,it was found that the topical use of Zhuang medicine pearls is concentrated in diseases of the ENT(Ear,Nose,and Throat),Ophthalmology,and diseases of the skin and subcutaneous tissue.When combined with drugs such as regulating Long lu,clearing heat toxin,and eliminating dampness-toxin,it is used to treat diseases such as Redness and visual obstruction due to corneal opacity,Oral ulcers,and Skin ulcers;For internal use,it is often combined with medicines that regulating Long lu,replenishing qi and blood,eliminating dampness-toxin,and nourishing the heart-mind,used in hypertension and palpitations.When paired with the medicines of clearing heat toxin,replenishing qi and blood,regulating Qiaowu,it is used to treat insomnia and epilepsy.Based on the analysis of pearl function,it is used in combination with airway and detoxifying drugs to treat airway diseases;Combination therapy with regulating Long lu and Qiao wu(brain)medicine for the treatment of Long lu disease;Combination treatment of gynecological diseases with regulating Long lu and Huo lu medicine and Bu xu medicine;Combination therapy with heat-clearing,detoxifying,and swelling-reducing medicines or astringents,for the treatment of persistent non-healing sores and ulcers;Used in combination with antipyretic drugs and yin tonifying drugs to treat ophthalmic diseases.Conclusion Zhuang medicine pearl has a wide range of therapeutic effects,and its efficacy can be enhanced by compatibility with different Zhuang medicines.Future research can combine modern compatibility methods of traditional Chinese medicine to optimize the compatibility scheme of pearls,study the specialized disease and prescription of Zhuang medicine pearls,combine Zhuang medicine with Western medicine to form prescriptions,and combine the pharmacological effects of pearls to form prescriptions.In depth exploration of the pharmacological substance basis and mechanism of action of pearl prescriptions can be conducted to develop new Zhuang medicine preparations for pearls.

The aim of this study was to qualitatively and quantitatively detect coronavirus(CoV)in the feces of bats from Qinghua Cave,Yunnan Province,China.CoV was qualitatively tested with reverse transcription polymerase chain reaction(RT-PCR),and homology and genetic evolution were analyzed with bioinformatics software.The established reverse transcription real-time fluores-cence quantitative PCR(qRT-PCR)method was applied to CoV quantification in bat feces.The positivity rate of CoV in 306 fecal samples collected from the fulvous fruit bat(Rousettus leschenaultia)was 7.8%(24/306)according to RT-PCR.All 24 strains of CoV belonged to β-CoV,and showed a similarity of 86.8%-100.0%at the nucleotide level and 95.2%-100.0%at the amino acid level,with respect to other β-CoV sequences in the NCBI database.The positivity rate of CoV was 18.6%(57/306)according to qRT-PCR,a value higher than that according to RT-PCR(χ2=25.3,P<0.05).The mean β-CoV load was 1.3×103 copies/μL.In conclusion,the bats in Qinghua Cave,Yunnan Province,carried CoV belonging to β-CoV.The established qRT-PCR method achieved good sensitiv-ity,accuracy,reproducibility,and a higher detection rate than that of RT-PCR,and can be used for rapid detection of β-CoV in bats.

Objective:To analyze the evaluation value of contrast-enhanced ultrasound (CEUS) combined with automatic volumetric ultrasound in the efficacy of neoadjuvant chemotherapy (NAC) for breast cancer.Methods:A retrospective study was conducted on 98 female patients with breast cancer admitted to Shaanxi Provincial Cancer Hospital from January to December 2022. All patients received 4 cycles of NAC, and underwent conventional ultrasound, automatic volumetric ultrasound, CEUS, and histopathological examination before and after treatment. Based on the post-treatment histopathological efficacy, patients were divided into the effective group ( n=67) and the ineffective group ( n=31). The CEUS and automatic volumetric ultrasound parameters before and after treatment, as well as the evaluation efficacy of these two types of parameters for NAC efficacy in breast cancer, were compared. The value of CEUS combined with automatic volumetric ultrasound in evaluating NAC efficacy for breast cancer was analyzed. Results:After NAC treatment, the CEUS parameters [time to peak (TTP) and arrival time (AT) of contrast agent] were longer than those before treatment, while the peak intensity (PI) was lower than that before treatment (all P<0.05); the automatic volumetric ultrasound parameters (tumor volume, area, thickness, length, and width) after NAC treatment were all smaller than those before treatment (all P<0.05). After treatment, the PI, volume, area, thickness, length, and width in the effective group were significantly smaller than those in the ineffective group, while the TTP and AT were significantly longer than those in the ineffective group (all P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of CEUS parameters and automatic volumetric ultrasound parameters for predicting effective NAC efficacy in breast cancer was 0.837(0.749-0.904) and 0.864(0.780-0.925), respectively, with no statistically significant difference between the two ( P=0.674). The AUC of the combined parameters for predicting effective NAC efficacy was 0.942(0.875-0.979), which was significantly higher than that of CEUS parameters or automatic volumetric ultrasound parameters alone ( Z=2.947, 2.135, P=0.003, 0.033). Conclusions:The combination of CEUS and automatic volumetric ultrasound parameters has high value in the efficacy evaluation of NAC for breast cancer and can be used as a clinical reference.

Objective:To investigate and validate the performance of a dosiomics model that utilized 3D dose distribution to forecast radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 3578 patients diagnosed with NPC admitted to Jiangsu Cancer Hospital from January 2011 to December 2021 were retrospectively analyzed. According to the inclusion and exclusion criteria, 97 NPC patients who developed RTLI were assigned into the case group. A 1:1 propensity score matching (PSM) method was used to match 97 NPC patients without RTLI as the control group. Patients were assigned into the training cohort ( n=135) and the validation cohort ( n=59) at a 7:3 ratio by simple random method. Dosiomics features were extracted from the patients' three-dimensional dose distribution maps. Spearman rho and the least absolute shrinkage and selection operator regression were used to select dosiomics features. Clinical features were collected and screened by univariate and multivariate analyses. Eight machine learning classifiers were then trained to build dosiomics models and clinical models, respectively. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to compare the predictive performance of the dosiomics and clinical models. Multivariate analysis was conducted using logistic regression to assess the influencing factors, while comparisons of the ROC curves between two different models were performed using the DeLong test. Results:A total of 1130 dosiomics features were extracted from the three-dimensional dose distribution maps, and 14 features were retained for model building after feature selection. The model based on the support vector machine (SVM) classifier achieved the highest AUC value of 0.977 (95% CI: 0.949-1.000) in the validation cohort, with an AUC of 1.000 (95% CI: 1.000-1.000) in the training cohort. By conducting univariate and multivariate analyses of the patients' clinical features, 2 clinical features were retained to build the clinical model. The model based on the SVM classifier achieved the optimal AUC value of 0.667 (95% CI: 0.523-0.810) in the validation cohort, with an AUC of 0.804 (95% CI: 0.730-0.878) in the training cohort. DeLong test showed that the difference between the dosiomics and clinical models was statistically significant ( P<0.05). Conclusion:The dosiomics model based on 3D dose distribution yields high predictive performance for RTLI in NPC patients after IMRT, which surpasses the clinical feature model, providing a new approach for early clinical prediction of RTLI.

The European Association for Cardio-Thoracic Surgery (EACTS) has recently updated and published the "2024 EACTS guidelines on perioperative medication in adult cardiac surgery". Based on the latest evidence, the guidelines have been updated in multiple aspects including underlying disease management, antithrombotic medication, arrhythmia treatment and other supportive care, etc. This paper aims to summarize and interpret the guidelines, in order to promote clinicians’ understanding and optimize perioperative medical treatment in adult cardiac surgery.