ObjectiveTo explore the mechanism by which Sini San （SNS） inhibits ferroptosis， alleviates inflammation and myocardial injury， and improves myocardial infarction （MI）. MethodsThe active ingredients of SNS were obtained by searching the Traditional Chinese Medicine System Pharmacology Platform （TCMSP） database， its target sites were predicted using the SwissTargetPrediction Database， and the core components were screened out using the CytoNCA plug-in. The targets of MI and ferroptosis were obtained by using GeneCards， Online Mendelian Inheritance in Man （OMIM） database， DrugBank， Therapeutic Target Database （TTD）， FerrDb database and literature review， respectively. The intersection of these targets of SNS-MI-ferroptosis was plotted as a Venn diagram. The protein-protein interaction （PPI） network was constructed using the STRING database， and the visualization graph was prepared using Cytoscape. The core targets were screened out using the CytoNCA plug-in， and the biological functions were clustered by the MCODE plug-in. Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were performed using the David database. Molecular docking was performed using AutoDock and visualized with PyMOL2.5.2. The Kunming mice were randomly divided into the control group， the model group， the SNS group， and the trimetazidine （TMZ） group. The mice were subcutaneously injected with isoprenaline （ISO， 5 mg·kg^-1·d^-1） to establish an MI model. The drug was continuously intervened for 7 days. The ST-segment changes were recorded by electrocardiogram （ECG）， and the tissue morphology changes were observed by hematoxylin-eosin （HE） staining. Cardiomyocyte ferroptosis was investigated by transmission electron microscopy. Serum creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， reduced glutathione （GSH）， and malondialdehyde （MDA） levels were detected by biochemical assay. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of interleukin （IL）-6 and 4-hydroxynonenal （4-HNE）. Immunohistochemical staining was employed to detect IL-6 and phosphorylated signal transducer and transcription activator 3 （p-STAT3） in cardiac tissues. Western blot was used to detect STAT3 and p-STAT3 in cardiac tissues. Real-time PCR was used to detect the levels of IL-6， IL-18， solute carrier family 7 member 11 （SLC7A11）， arachidonic acid 15-lipoxygenase （ALOX15）， and glutathione peroxidase 4 （GPx4） in cardiac tissues. ResultsA total of 121 active ingredients of SNS were obtained， and 58 potential targets of SNS in the treatment of MI by regulating ferroptosis were screened. The three protein modules with a score5 were mainly related to the inflammatory response. The GO function was mainly related to inflammation， and KEGG enrichment analysis showed that SNS mainly regulated ferroptosis- and inflammation- related signaling pathways. Molecular docking indicated that the core component had a higher binding force to the target site. Animal experiments confirmed that SNS reduced the level of p-STAT3 （P0.01）， down-regulated the expression of ALOX15 mRNA （P0.01）， up-regulated the level of serum GSH， and the expressions of SLC7A11 and GPx4 mRNA， reduced MDA and 4-HNE levels （P0.05， P0.01）. Additionally， SNS improved the mitochondrial injury induced by cardiomyocyte ferroptosis， reduced the area of MI， alleviated inflammation and myocardial injury， lowered the levels of serum CK， CK-MB， LDH， IL-6， and the mRNA expression levels of IL-16 and IL-18 （P0.05）， and improved ST segment elevation. ConclusionSNS can reduce ISO-induced STAT3 phosphorylation levels， inhibit ferroptosis in cardiomyocytes， alleviate inflammation and myocardial injury， thereby improving MI.

ObjectiveTo explore the mechanism by which Sini San （SNS） inhibits ferroptosis， alleviates inflammation and myocardial injury， and improves myocardial infarction （MI）. MethodsThe active ingredients of SNS were obtained by searching the Traditional Chinese Medicine System Pharmacology Platform （TCMSP） database， its target sites were predicted using the SwissTargetPrediction Database， and the core components were screened out using the CytoNCA plug-in. The targets of MI and ferroptosis were obtained by using GeneCards， Online Mendelian Inheritance in Man （OMIM） database， DrugBank， Therapeutic Target Database （TTD）， FerrDb database and literature review， respectively. The intersection of these targets of SNS-MI-ferroptosis was plotted as a Venn diagram. The protein-protein interaction （PPI） network was constructed using the STRING database， and the visualization graph was prepared using Cytoscape. The core targets were screened out using the CytoNCA plug-in， and the biological functions were clustered by the MCODE plug-in. Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were performed using the David database. Molecular docking was performed using AutoDock and visualized with PyMOL2.5.2. The Kunming mice were randomly divided into the control group， the model group， the SNS group， and the trimetazidine （TMZ） group. The mice were subcutaneously injected with isoprenaline （ISO， 5 mg·kg^-1·d^-1） to establish an MI model. The drug was continuously intervened for 7 days. The ST-segment changes were recorded by electrocardiogram （ECG）， and the tissue morphology changes were observed by hematoxylin-eosin （HE） staining. Cardiomyocyte ferroptosis was investigated by transmission electron microscopy. Serum creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， reduced glutathione （GSH）， and malondialdehyde （MDA） levels were detected by biochemical assay. Enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of interleukin （IL）-6 and 4-hydroxynonenal （4-HNE）. Immunohistochemical staining was employed to detect IL-6 and phosphorylated signal transducer and transcription activator 3 （p-STAT3） in cardiac tissues. Western blot was used to detect STAT3 and p-STAT3 in cardiac tissues. Real-time PCR was used to detect the levels of IL-6， IL-18， solute carrier family 7 member 11 （SLC7A11）， arachidonic acid 15-lipoxygenase （ALOX15）， and glutathione peroxidase 4 （GPx4） in cardiac tissues. ResultsA total of 121 active ingredients of SNS were obtained， and 58 potential targets of SNS in the treatment of MI by regulating ferroptosis were screened. The three protein modules with a score5 were mainly related to the inflammatory response. The GO function was mainly related to inflammation， and KEGG enrichment analysis showed that SNS mainly regulated ferroptosis- and inflammation- related signaling pathways. Molecular docking indicated that the core component had a higher binding force to the target site. Animal experiments confirmed that SNS reduced the level of p-STAT3 （P0.01）， down-regulated the expression of ALOX15 mRNA （P0.01）， up-regulated the level of serum GSH， and the expressions of SLC7A11 and GPx4 mRNA， reduced MDA and 4-HNE levels （P0.05， P0.01）. Additionally， SNS improved the mitochondrial injury induced by cardiomyocyte ferroptosis， reduced the area of MI， alleviated inflammation and myocardial injury， lowered the levels of serum CK， CK-MB， LDH， IL-6， and the mRNA expression levels of IL-16 and IL-18 （P0.05）， and improved ST segment elevation. ConclusionSNS can reduce ISO-induced STAT3 phosphorylation levels， inhibit ferroptosis in cardiomyocytes， alleviate inflammation and myocardial injury， thereby improving MI.

Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

Objective With the increasing demand from the country for optimizing the allocation of medical resources and improving service balance,this study aims to promote the improvement of regional medical service levels through the explora-tion and practice of the management model of provincial medical quality control centers.Methods The First Affiliated Hospital of Sun Yat-sen University,as the affiliated unit of one of the 14 provincial quality control centers,organizes the quality control center to play a professional role and improve its management efficiency through stable construction,solid framework,reorgani-zation,and multiple support.Results With the leadership and support of the health administrative department in Guangdong Province,the hospital has organized the provincial quality control center to carry out its work in an orderly manner,promoting the continuous improvement of the comprehensive strength of regional medical services and key indicators of various professional qual-ity control centers.Conclusion The management model of the quality control center in this study has shown initial effectiveness.

Objective:To evaluate the safety and effectiveness of fuzuloparib for the treatment of ovarian epithelial cancer patients in the real world setting.Methods:A retrospective analysis was conducted on the baseline data of 4 620 ovarian cancer patients who had received fuzuloparib monotherapy or combination therapy. Another 224 ovarian cancer patients who were willing to receive fuzuloparib monotherapy or combination therapy were prospectively enrolled, and their baseline characteristics, drug effectiveness, and safety data were analyzed.Results:(1) Among the 4 620 patients in the retrospective cohort, the median age of patients was 60 years; tumor types: 89.8% (4 149/4 620) had ovarian cancer. Among patients with clearly documented information, the vast majority had a histological type of serous carcinoma (82.9%, 3 770/4 546) and International Federation of Gynecology and Obstetrics (FIGO) staging of Ⅲ-Ⅳ (90.9%, 1 537/1 691). (2) Among the 224 patients in the prospective cohort, the median age of patients was 57 years; tumor types: 83.9% (188/224) had ovarian cancer. Among patients with clearly documented records, the predominant pathologic type was serous carcinoma (91.9%, 193/210), and FIGO stage was Ⅲ-Ⅳ in 79.9% (139/174). (3) Among the 224 prospective patients: 84 patients received first-line fluzoparib maintenance therapy, 92 patients received fluzoparib maintenance therapy after platinum-sensitive recurrence, 23 patients received direct fluzoparib treatment after platinum-sensitive recurrence, 19 patients received direct fluzoparib treatment after platinum-resistant recurrence. The median follow-up durations were 8.5, 8.7, 7.9, and 6.7 months, respectively. The median durations of fluzoparib treatment were 6.7, 4.8, 3.1, and 1.9 months, respectively. The median progression-free survival (PFS) times were not reached during follow-up, 12.6 months, not reached during follow-up, and 4.8 months, respectively. The 1-year PFS rates were 84.1%, 55.0%, 69.8%, and 45.5%, respectively. The remaining 6 patients received other fluzoparib regimens. (4) Among the 224 patients in the prospective dataset, 205 had safety data recorded. Of these, 127 patients (62.0%, 127/205) experienced treatment-related adverse events, with common events including anemia (24.4%, 50/205), thrombocytopenia (21.0%, 43/205), and leukopenia (19.5%, 40/205). Among the 205 patients, 43 (21.0%, 43/205) experienced grade 3 or higher treatment-related adverse events, with common events including anemia (8.3%, 17/205) and thrombocytopenia (8.3%, 17/205).Conclusions:The effectiveness of fuzuloparib in clinical application is generally consistent with other drugs in the same class, with good safety. This study provids new clinical evidence for the treatment of ovarian cancer with fuzuloparib.

OBJECTIVE To analyze the impact of hospital-acquired infections on medical resource consumption un-der the diagnosis-related group(DRG)payment method.METHOD Medical record information and settlement lists of all discharged patients from Zhejiang Provincial People's Hospital from 2022 to 2023 were selected.Based on the Zhejiang Provincial Medical Insurance Bureau's diagnosis-related groups(ZJ-DRG)Edition 1.0,indicators such as time consumption index,cost consumption index,length of stay,total hospitalization costs and detailed cost breakdowns were used to analyze cases in the hospital-acquired infection group and the non-hospital-ac-quired infection group.RESULTS Among the 268 278 cases included in the study,2 186 were infected,with an in-fection rate of 0.81％.The infection rates for medical DRG disease group,surgical DRG disease group,and proce-dural DRG disease group were 0.86％(917/105 916),0.82％(1 069/131 112),and 0.64％(200/31 250),re-spectively.The time consumption index and cost consumption index were higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P＜0.05).In the RW21 group,the length of stay,total hospitalization costs and detailed cost breakdowns were all higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P＜0.05).Similarly,in the BB21 and GK11 groups,the hospital-ac-quired infection group had high length of stay,total hospitalization costs,medicine fees,treatment fees,material fees,laboratory fees,examination fees and other fees compared to the non-hospital-acquired infection group(P＜0.05).Bone(joint)infections,respiratory infections,and infectious fever had a significant impact on the time consumption index,while respiratory infections,bone(joint)infections and urinary tract infections had a relative-ly great impact on the cost consumption index.CONCLUSIONS Hospital-acquired infections result in additional consumption of medical resources.By analyzing the consumption of medical resources related to DRG disease groups,key monitoring disease groups for nosocomial infection control can be identified,which can aid relevant departments and clinical departments in taking early intervention measures,strengthen key prevention efforts,re-duce the incidence of nosocomial infections,and shorten the length of stay.

OBJECTIVE To analyze the impact of hospital-acquired infections on medical resource consumption un-der the diagnosis-related group(DRG)payment method.METHOD Medical record information and settlement lists of all discharged patients from Zhejiang Provincial People's Hospital from 2022 to 2023 were selected.Based on the Zhejiang Provincial Medical Insurance Bureau's diagnosis-related groups(ZJ-DRG)Edition 1.0,indicators such as time consumption index,cost consumption index,length of stay,total hospitalization costs and detailed cost breakdowns were used to analyze cases in the hospital-acquired infection group and the non-hospital-ac-quired infection group.RESULTS Among the 268 278 cases included in the study,2 186 were infected,with an in-fection rate of 0.81％.The infection rates for medical DRG disease group,surgical DRG disease group,and proce-dural DRG disease group were 0.86％(917/105 916),0.82％(1 069/131 112),and 0.64％(200/31 250),re-spectively.The time consumption index and cost consumption index were higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P＜0.05).In the RW21 group,the length of stay,total hospitalization costs and detailed cost breakdowns were all higher in the hospital-acquired infection group than in the non-hospital-acquired infection group(P＜0.05).Similarly,in the BB21 and GK11 groups,the hospital-ac-quired infection group had high length of stay,total hospitalization costs,medicine fees,treatment fees,material fees,laboratory fees,examination fees and other fees compared to the non-hospital-acquired infection group(P＜0.05).Bone(joint)infections,respiratory infections,and infectious fever had a significant impact on the time consumption index,while respiratory infections,bone(joint)infections and urinary tract infections had a relative-ly great impact on the cost consumption index.CONCLUSIONS Hospital-acquired infections result in additional consumption of medical resources.By analyzing the consumption of medical resources related to DRG disease groups,key monitoring disease groups for nosocomial infection control can be identified,which can aid relevant departments and clinical departments in taking early intervention measures,strengthen key prevention efforts,re-duce the incidence of nosocomial infections,and shorten the length of stay.

Objective With the increasing demand from the country for optimizing the allocation of medical resources and improving service balance,this study aims to promote the improvement of regional medical service levels through the explora-tion and practice of the management model of provincial medical quality control centers.Methods The First Affiliated Hospital of Sun Yat-sen University,as the affiliated unit of one of the 14 provincial quality control centers,organizes the quality control center to play a professional role and improve its management efficiency through stable construction,solid framework,reorgani-zation,and multiple support.Results With the leadership and support of the health administrative department in Guangdong Province,the hospital has organized the provincial quality control center to carry out its work in an orderly manner,promoting the continuous improvement of the comprehensive strength of regional medical services and key indicators of various professional qual-ity control centers.Conclusion The management model of the quality control center in this study has shown initial effectiveness.

Objective:To conduct a series case study on hospitalized anthrax cases in five hospitals in North China, to share clinical experiences in the diagnosis and treatment of cutaneous and pulmonary anthrax.Methods:A retrospective, multicenter cohort study was conducted on the anthrax patients admitted to five hospitals in North China from August 2018 to March 2022. Forty patients were divided into severe and mild groups. The clinical features, treatment and prognosis of the patients were collected and analysed. Statistical evaluations included independent sample t test, Mann-Whitney U test, and chi-square test. Results:Among the 40 patients with anthrax, 10(25.0%) were severely ill and 30(75.0%) were mildly ill. According to the sites of infection, 40 patients were classified as 39 cutaneous anthrax cases (one case had secondary pulmonary anthrax) and one pulmonary anthrax case. The rates of chills and fever, lymphadenopathy, liver dysfunction and hypoalbuminemia in the severe group were all higher than those in the mild group, with statistically significant differences ( χ2=5.71, 6.54, 4.68 and 9.22, respectively, all P<0.05). The peripheral white blood cell count, neutrophil count, neutrophil/lymphocyte ratio and C-reactive protein were (11.8±4.9)×10 9/L, (9.5±5.1)×10 9/L, 8.6±7.3, 27.9(8.6, 167.7) mg/L, respectively, which were all higher than those in mild disease group ((7.5±2.4)×10 9/L, (5.0±2.1)×10 9/L, 3.2±2.3, 3.5(1.2, 14.7) mg/L), with statistically significant differences ( t=2.66, t=2.71, t=2.32 and Z=-3.01, respectively, all P<0.05). The albumin level in the severe group was (35.5±8.1) g/L, which was lower than that of the mild group ((43.7±3.2) g/L), and the difference was statistically significant ( t=-3.13, P=0.011). The severe cases were more likely to have skin lesions greater than four centimetre in diameter, multiple, vesicular, or edematous, with a significant difference ( χ2=6.01, P=0.014). Among 39 patients with cutaneous anthrax, 28(71.8%) in the mild group were treated with penicillin alone, and nine (23.1%) in the severe group were treated with penicillin, ofloxacin, piperacillin/tazobactam combined with one of linezolid, doxycycline, or clindamycin for anti-infection treatment. The two patients with pulmonary anthrax were treated with closed thoracic drainage for pleural effusion and pneumothorax, and were treated with two bactericidal and one protein synthesis inhibitor antibiotics. All 40 anthrax patients were cured and discharged from hospital. Conclusions:Patients with mild cutaneous anthrax can generally be treated with single penicillin, and patients with severe cutaneous anthrax and pulmonary anthrax should be treated with combined antibiotics.