Acute lung injury (ALI) is a significant complication of sepsis, characterized by high morbidity, mortality, and poor prognosis. Neutrophils, as critical intrinsic immune cells in the lung, play a fundamental role in the development and progression of ALI. During ALI, neutrophils generate neutrophil extracellular traps (NETs), and excessive NETs can intensify inflammatory injury. Research indicates that Taohe Chengqi decoction (THCQD) can ameliorate sepsis-induced lung inflammation and modulate immune function. This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients, seeking to provide novel perspectives and interventions for clinical treatment. The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture (CLP)-induced ALI mouse model. Furthermore, THCQD diminished neutrophil and macrophage infiltration, inflammatory responses, and the production of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α). Notably, subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro. Moreover, THCQD significantly decreased the expression of peptidyl arginine deiminase 4 (PAD4) protein, and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4. PAD4 overexpression partially reversed THCQD's inhibitory effects on PAD4. These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
Extracellular Traps/immunology* ; Acute Lung Injury/immunology* ; Animals ; Sepsis/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Neutrophils/immunology* ; Male ; Protein-Arginine Deiminase Type 4/genetics* ; Mice, Inbred C57BL ; Humans ; Disease Models, Animal ; Cytokines/metabolism*

Senile osteoporosis is a growing public health challenge with significant impacts on the daily life of the elderly population as a result of its hidden nature,high prevalence,and high risk of disability.Suitable animal models that simulate senile osteoporosis are crucial for understanding its pathological mechanism and to facilitate the development of anti-osteoporosis drugs and identify new therapeutic targets.This review considers the most commonly used method for creating animal models of senile osteoporosis,analyzes their advantages and limitations,and discusses research progress in animal models in terms of evaluation indicators,to provide references for research using animal models of senile osteoporosis.

Objective To analyze the expression levels of RNA demethylase alkB homolog 5(ALKBH5)and p21 activated kinase 5(PAK5)in high-risk human papillomavirus(HR-HPV)positive cervical cancer tissue,and explore their clinical significance.Methods A total of 96 patients with HR-HPV positive cervical cancer were selected as the research object.The expressions of ALKBH5 and PAK5 mRNA and protein in cancer tissue and adjacent tissue were analyzed by real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay.The expression levels of ALKBH5 and PAK5 proteins in patients with HR-HPV positive cervical cancer with different clinicopathological characteristics were compared.Multivariate Cox regression analysis was used to analyze influencing factors of death in patients with HR-HPV positive cervical cancer.Kaplan-Meier curve was used to analyze the effects of ALKBH5 and PAK5 protein expression on the 5-year survival rate of patients.Results The results of real-time fluorescent quantitative PCR,immunohistochemistry and Western blot assay showed that expression levels of ALKBH5 and PAK5 mRNA and protein in HR-HPV positive cervical cancer tissue were higher than those in adjacent tissue(P<0.05).The positive rates of ALKBH5 and PAK5 in cancer tissue of HR-HPV positive cervical cancer patients with FIGO stage ⅡA and lymph node metastasis were increased(P<0.05).ALKBH5 positive(HR=1.467,95％CI:1.104-1.949),PAK5 positive(HR=1.435,95％CI:1.093-1.884),FIGO stage ⅡA(HR=1.435,95％CI=1.065-1.933)and lymph node metastasis(HR=1.652,95％CI:1.053-2.593)were risk factors affecting the prognosis of HR-HPV positive cervical cancer patients(P<0.05).The 5-year cumulative survival rate was lower in the ALKBH5 positive group[72.58％(45/62)vs.91.18％(31/34)]than that of the ALKBH5 negative group(log rank χ2=4.481,P=0.034).The 5-year overall survival rate of the PAK5 positive group[71.67％(43/60)vs.91.67％(33/36)]was lower than that of the PAK5 negative group(log rank χ2=4.153,P=0.043).Conclusion The expression levels of ALKBH5 and PAK5 are significantly up-regulated in HR-HPV positive cervical cancer,both of which are related to the poor clinicopathological features of patients,and are helpful to evaluate the prognosis.

Objective To explore the service quality of video consultation from the patient's perspective and its in-fluencing factors,and to provide theoretical basis and practical reference for public hospitals to promote the develop-ment of video consultation.Methods Based on the video consultation service quality questionnaire designed by the SUTAQ scale,a questionnaire survey was conducted with 345 patients who participated in the video consultation field trial,and the influencing factors were analyzed by using multiple linear regression.Results The total score of pa-tients' video consultation service quality was 14.80±3.43,and the dimensional scores,from lowest to highest,con-tinue using,and immediacy of consultation.The results of multiple linear regression showed that the differences in the effects of marital status,education,willingness to pay and waiting time on the quality of video consultation ser-vice were statistically significant(P＜0.05).Conclusion Patients' evaluation of the service quality of video consulta-tion is good overall,and there are differences in the scores of each dimension,in which the immediacy of diagnosis and treatment is the most prominent value of video consultation,and the patient's perceived risk is a non-negligible problem.It is recommended to strengthen risk regulation and privacy protection,focus on group heterogeneity and synergize with family doctors,and optimize service pricing and waiting process to enhance patients' trust and ex-perience and promote the healthy and sustainable development of video consultation.

Objective Based on clinical consultation practices,it systematically evaluates the outcomes of remote video consultation services,identifies key factors influencing these outcomes,and provides empirical evidence for optimizing telemedicine services.Methods It recruited 201 patients nationwide requiring video consultations,objectively recorded diagnostic outcomes,and analyzed influencing factors using hierarchical regression.Results Among the 201 participants,62(30.84％)achieved effective diagnosis and treatment,while 139(69.16％)did not meet expected outcomes.Hierarchical regression results revealed that disease category,physician title,availability of auxiliary diagnostic information,and presence of assisting personnel significantly impacted consultation outcomes(P＜0.05).Higher physician titles,richer auxiliary diagnostic information provided by patients,and involvement of assisting personnel correlated with better alignment of outcomes with expectations.Conclusion Significant variations in video consultation outcomes were observed,primarily influenced by assisting personnel,physician qualifications,auxiliary diagnostic information and disease category.It is suggested to introduce a large artificial intelligence model for pre-triage,set up standardized video consulting rooms in primary medical and health institutions and configure collaborative personnel,and build a regional patient information sharing platform,so as to improve patient satisfaction during treatment and promote the further development and optimization of video consultation.

Objective To explore the economic impact and ecological value of video consultations on hospitals and patients,providing a reference for the development of video consultation services.Methods A total of 345 patients and 31 physicians who participated in video consultation practices in 2024 were surveyed using questionnaires and in-terviews.The economic impacts,social benefits,and potential risks and challenges of video consultations for hospi-tals and patients were analyzed.Independent sample t-tests were conducted to compare the differences in video consultation evaluations between patients and physicians.Results During the experimental period,video consulta-tions resulted in a minimum revenue loss of 18 375 yuan for various hospital departments.However,each patient saved no less than 1 000 yuan in transportation,accommodation,and wage loss expenses.Patients' overall satis-faction and timeliness ratings were significantly higher than those of physicians(P＜0.05),while patients' willing-ness to continue using video consultations was significantly lower than that of physicians(P＜0.05).There was no statistically significant difference between patients and physicians in terms of perceived effectiveness(P＞0.05).Conclusion Video consultations effectively reduce patients' economic burden and improve the accessibility of health-care services.The revenue loss for hospitals stems primarily from low service efficiency and the shift of income from pharmaceuticals and diagnostic services.Disease types play a critical role in influencing consultation efficiency and economic outcomes.It is recommended to introduce intelligent triage systems,establish an integrated online and of-fline service model,enhance patient operational experience,and improve regulatory mechanisms to promote the high-quality development of video consultations.

The construction of telemedicine in county public medical institutions is an inevitable choice for the supply of high-quality medical services in remote areas as well as for the coverage of village-level health services,and it is also a new mode of service provision for public hospitals to link with grassroots level within the county medi-cal community.At present,China's county telemedicine has derived three different modes in the development of various regions,and some problems have been exposed in the implementation.By combing the literature and poli-cies and conducting field research in representative telemedicine construction areas,it analyses the existing prob-lems and the logic of their emergence,and put forward corresponding recommendations.

Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective To systematically review the manage effects of prescription refill in hypertension management in our country,and to provide suggestions for chronic disease policies.Methods Web of Science,PubMed,Embase,Cochrane Library,SinoMed,CNKI,WanFang Data,VIP databases were electronically searched to collect randomized controlled trails(RCTs)of prescription refill services for hypertension management from inception to March 31,2024.Two reviewers independently screened the literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was conducted by using RevMan 5.3 software.Results A total of 14 RCTs involving 1,386 patients were included.Meta-analysis results showed that systolic blood pressure[MD=-9.19,95％CI(-12.20,-6.17),P<0.001],diastolic blood pressure[MD=-4.98,95％CI(-6.71,-3.26),P<0.001]in experimental group was significantly lower than the control group.Patient compliance score[SMD=2.05,95％CI(0.44,3.66),P=0.01],compliance rate[RR=1.15,95％CI(1.08,1.23),P<0.001],patient satisfaction[RR=1.28,95％CI(1.16,1.42),P<0.001]in experimental group were significantly higher than the control group.Conclusion the prescription refill for chronic diseases is rapidly developing in our country,and has achieved remarkable results in the management of hypertension patients.In the future,it is necessary to further promote the safe,effective and standardized implementation of prescription refill services,and carry out high-quality service models with multi-disciplinary participation.

Objective To explore the service quality of video consultation from the patient's perspective and its in-fluencing factors,and to provide theoretical basis and practical reference for public hospitals to promote the develop-ment of video consultation.Methods Based on the video consultation service quality questionnaire designed by the SUTAQ scale,a questionnaire survey was conducted with 345 patients who participated in the video consultation field trial,and the influencing factors were analyzed by using multiple linear regression.Results The total score of pa-tients' video consultation service quality was 14.80±3.43,and the dimensional scores,from lowest to highest,con-tinue using,and immediacy of consultation.The results of multiple linear regression showed that the differences in the effects of marital status,education,willingness to pay and waiting time on the quality of video consultation ser-vice were statistically significant(P＜0.05).Conclusion Patients' evaluation of the service quality of video consulta-tion is good overall,and there are differences in the scores of each dimension,in which the immediacy of diagnosis and treatment is the most prominent value of video consultation,and the patient's perceived risk is a non-negligible problem.It is recommended to strengthen risk regulation and privacy protection,focus on group heterogeneity and synergize with family doctors,and optimize service pricing and waiting process to enhance patients' trust and ex-perience and promote the healthy and sustainable development of video consultation.