Skeletal muscle atrophy refers to a pathological condition characterized by muscle fiber atrophy as well as decreased muscle mass and muscle strength induced by various predisposing factors. It falls under the category of “flaccidity syndrome” in traditional Chinese medicine， and its pathogenesis is mainly associated with disturbed protein homeostasis， mitochondrial dysfunction and oxidative stress injury. Active ingredients of traditional Chinese medicine exerts synergistic regulatory effects via multiple pathways， thus possessing unique advantages in the clinical prevention and treatment of skeletal muscle atrophy. This paper reviews the mechanisms by which active ingredients of traditional Chinese medicine alleviate skeletal muscle atrophy. Existing studies have demonstrated that such active ingredients can ameliorate skeletal muscle atrophy through multiple approaches： regulating protein metabolic balance （geniposide， matrine， schisandrin A， etc.） and oxidative stress （astragaloside Ⅳ， Gastrodia elata polysaccharide， Angelica sinensis polysaccharide， etc.）， improving mitochondrial function （parthenolide， berberine， curcumin， etc.）， facilitating myogenesis and myogenic differentiation （cucurbitacin Ⅱb， saikosaponin A， saikosaponin D， etc.）， suppressing inflammatory response （ursolic acid， triptolide， emodin， etc.）， ameliorating insulin resistance （akebiasaponin D， etc.）. In the future， active ingredients of traditional Chinese medicine are expected to achieve breakthroughs in clinical treatment for skeletal muscle atrophy， providing novel ideas and strategies for the prevention and treatment of degenerative disorders.

Objective:To assess the value of chromosomal microarray analysis (CMA) for the detection of low-level mosaicisms in amniotic fluid samples, and to retrospectively analyze the rare cases of mosaicisms.Methods:Chromosomal karyotype of the fetus was determined by G-banding analysis of cultured amniotic fluid cells. CMA was used to detect copy number variation of fetal chromosomes, and fluorescence in situ hybridization (FISH) was used to determine the proportion of fetal chromosomal mosaicisms in uncultured amniotic fluid cells. Results:Among 825 prenatal samples, 4 cases of true fetal mosaicisms were detected, which yielded an incidence of 0.48%. Two cases were sex chromosomal mosaicisms, and two were autosomal mosaicisms, which involved chromosomes 8 and 9, respectively. All cases were verified by G-banding analysis of cultured amniotic fluid cells, CMA, and/or FISH.Conclusion:CMA has a great value for detecting low-level mosaicisms in amniotic fluid samples, though the positive results need to be verified by other techniques and should be interpreted with caution. The review of rare cases can provide a basis for prenatal genetic counseling.

OBJECTIVE To prepare vancomycin hydrochloride(VH)-loaded polydopamine(PDA)nanoparticles(VH@PDA nanoparticles),and study their antimicrobial effect in combination with photothermal therapy.METHODS Using PDA as the carrier,VH was loaded to prepare VH@PDA nanoparticles(PDA nanoparticles were prepared using the same method).The nanoparticles were characterized with laser particle size analyzer,transmission electron microscope,and UV visible absorption spectrometer;the drug loading capacity and encapsulation efficiency of the nanoparticles were determined.The near-infrared laser irradiation was adopted to determine their photothermal ability.Taking Staphylococcus aureus as the research object,the bactericidal properties of the nanoparticles in combination with photothermal therapy in vitro were clarified through plate colony coating method,live/dead staining analysis,crystal violet staining.Using L929 cells as the research object,the effects of VH@PDA nanoparticles at different mass concentrations(0,3.125,6.25,12.5,25,50 and 100 μg/mL)on cell viability were investigated to assess their biocompatibility.RESULTS VH@PDA nanoparticles were successfully loaded with VH,exhibiting uniform particle size(approximately 300 nm),distinct pore size,and a spherical structure.The drug loading capacity was 11.34%,the encapsulation efficiency was 32.00%,the photothermal conversion efficiency reached 23.55%,and they demonstrated stable photothermal performance.The antibacterial effect results of the combined photothermal therapy demonstrated that without near-infrared laser irradiation,the antibacterial effects of VH,PDA nanoparticles,and VH@PDA nanoparticles were not significant.However,when subjected to near-infrared laser irradiation,VH@PDA nanoparticles exhibited a pronounced antibacterial effect.The results of the cell experiments revealed that after treatment with VH@PDA nanoparticles at various mass concentrations,the cell viability rates remained above 80%.CONCLUSIONS VH@PDA nanoparticles are successfully prepared,which exhibit stable photothermal properties,significant antibacterial effects when combined with photothermal therapy,and good biocompatibility.

Objective To develop a risk management system for complications associated with peripheral venous indwelling needles and to evaluate its application effect in order to reduce the risk of related complications.Methods We designed a comprehensive risk management system for peripheral intravenous indwelling needle complications,integrating specialized evidence-based guidelines with clinical practice insights,including 5 modules:intelligent assessment and decision support,intelligent inspection reminders,educational modules,collaborative case management procedures,and a knowledge base.Patients admitted to the neurology and internal classification metabolism departments of a tertiary hospital in Jilin Province were conveniently selected as the research subjects.Patients were assigned to a control group(from May to July 2022,before the implementation of the system)and an experimental group(from September to December 2022,after the implementation of the system).The incidence of complications,duration of indwelling needle,compliance rate of core indicators for nursing quality and number of nursing consultations were compared between the groups.Additionally,a self-administered questionnaire was used to assess clinical nurses'evaluations of the system.Results A total of 189 patients were included in the experimental group and 177 patients in the control group.The incidence of complications associated with peripheral intravenous indwelling needles was lower than that in the control group.The duration of indwelling peripheral intravenous needles was longer than that in the control group.The quality compliance rate of peripheral venous indwelling needle care in the experimental group was higher than that in the control group,and the number of consultation cases in the experimental group was higher than that in the control group.Comparisons between the 2 groups showed statistically significant differences for all indicators(P＜0.05).The nurses'recognition rates for the system's user-friendliness,professional guidance,and patient benefit were 77.78％,81.74％,and 82.13％,respectively.Conclusion The application of a peripheral vein indwelling needle complication risk management system can reduce the incidence of complications,prolong the duration of indwelling,and improve nursing quality.Nurses have a high recognition of this system.

Objective:To investigate the effects of different doses of rosuvastatin on lipid metabolism and left ventricular function in patients with type 2 diabetes mellitus (T2DM) accompanied by coronary heart disease (CHD).Methods:A prospective study was conducted involving 63 patients with T2DM accompanied by CHD who were treated at Jinan 2 nd People's Hospital and The Fifth People's Hospital of Jinan from January 2022 to June 2023. In a randomized case-control study, patients were assigned to either a control group ( n = 31, receiving 10 mg/d of rosuvastatin) or an observation group ( n = 32, receiving 20 mg/d of rosuvastatin) using a random number table method. After 8 weeks of treatment, the therapeutic effects were evaluated, and blood lipid levels and left ventricular function were recorded before and after treatment. Plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), homocysteine (Hcy), C-reactive protein (CRP), and the distance covered in a 6-minute walk test were compared between the two groups. Patients were followed for 1 year to monitor adverse reactions and the occurrence of adverse cardiovascular events. Results:The effective treatment rate in the observation group was significantly higher than that in the control group [90.63% (29/32) vs. 70.97% (22/31), χ2 = 3.95, P < 0.05). Prior to treatment, there were no statistically significant differences between the two groups regarding blood lipid levels, cardiac ultrasound indicators, serum levels of NT-proBNP, Hcy, and CRP, the distance covered in the 6-minute walk test, and the incidences of adverse reactions and adverse cardiovascular events (all P > 0.05). After treatment, both groups showed a reduction in total cholesterol and low-density lipoprotein cholesterol (both P < 0.05), with the observation group demonstrating significantly lower levels ( t = 10.54, 14.01, both P < 0.001). Additionally, both groups showed an increase in high-density lipoprotein cholesterol ( P < 0.05), but the observation group achieved significantly higher levels ( t = -14.07, P < 0.001). Both groups also exhibited an increase in left ventricular ejection fraction ( P < 0.05), with a greater improvement in the observation group ( t = -2.34, P < 0.05). The left ventricular end-diastolic diameter decreased in both groups ( P < 0.05), but the observation group had a smaller diameter ( t = 2.78, P < 0.05). Levels of NT-proBNP, Hcy, and CRP decreased in both groups (all P < 0.05), with the observation group showing significantly lower levels ( t = 6.55, 3.94, 6.38, all P < 0.001). Finally, the distance covered in the 6-minute walk test increased in both groups ( P < 0.05), with the observation group covering a greater distance ( t = -4.32, P < 0.001). Conclusions:High-dose rosuvastatin can effectively improve lipid metabolism and left ventricular function in patients with T2DM complicated by CHD. It significantly reduces levels of NT-proBNP, Hcy, and CRP, enhances exercise capacity, and demonstrates high safety, indicating a high potential for clinical application.

Objective:To study the risk factors of thyroid nodules in patients with type 2 diabetes.Methods:Data of patients with type 2 diabetes with normal thyroid function admitted to the Department of Endocrinology of Heze Municipal Hospital from January to June 2024 were collected. Binary logistic regression was used to analyze the influencing factors of thyroid nodules in patients with type 2 diabetes, and the receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of each influencing factor.Results:Among 162 patients with type 2 diabetes, 96 had thyroid nodules, accounting for 59.3%. The incidence of thyroid nodules in women was significantly higher than that in men (χ 2 = 4.56, P = 0.034). Multivariate logistic regression analysis showed that age (≥50 years old), overweight and obesity [body mass index (BMI)≥24.0 kg/m 2], high glycated hemoglobin (≥10%), and high total cholesterol ( > 6.5 mmol/L) were independent risk factors for thyroid nodules in patients with type 2 diabetes ( OR = 1.83, 1.67, 1.08, 3.65, P < 0.05), and men was an independent protective factor ( OR = 0.63, P = 0.039). The ROC curve results showed that total cholesterol and total cholesterol combined with glycated hemoglobin could distinguish patients with thyroid nodules from those without thyroid nodules, with AUC = 0.64 and 0.68, respectively, and the differences were statistically significant ( P < 0.05). Conclusions:The incidence of thyroid nodules in patients with type 2 diabetes is relatively high. Age, overweight and obesity, high glycated hemoglobin, and high total cholesterol are independent risk factors for thyroid nodules in patients with type 2 diabetes, and total cholesterol has the ability to distinguish patients with thyroid nodules.

Objective:To study the impact of fluoride exposure through drinking water on the risk of hypertension among residents in Jishan County, Shanxi Province.Methods:From March to April 2023, a cluster sampling method was used to select permanent residents aged ≥18 years and residing for ≥10 years in 12 villages in drinking water-borne endemic fluorosis areas of Jishan County, Shanxi Province as the survey subjects. A questionnaire survey, physical examination, and morning urinary fluoride level testing were conducted. The least absolute shrinkage and selection operator (Lasso) regression were used to analyze the key influencing factors of hypertension. Restricted cubic spline was used to evaluate the linear relationship between urinary fluoride and hypertension. Logistic regression was used to analyze the impact of urinary fluoride on hypertension.Results:Finally, 2 453 survey subjects were included, aged (62 ± 10) years, including 1 565 patients (63.80%) with hypertension. There were significant differences in the distribution of age, gender, education level, annual household income, body mass index (BMI), and the level and distribution of urinary fluoride between hypertension group and normal blood pressure group ( P < 0.05). The Lasso regression results showed that age, education level, BMI, and urinary fluoride were the key influencing factors of hypertension, with coefficients of 1.04, - 0.12, 0.24 and 0.01, respectively. The results of the restricted cubic spline showed that there was a linear relationship between urinary fluoride and hypertension after adjusting for age, education level, and BMI ( Poverall = 0.018, Pnonlinear = 0.482). The logistic regression results showed that after adjusting for age, education level, and BMI, urinary fluoride > 4.68 mg/L was a risk factor for hypertension ( OR = 1.42, 95% CI: 1.10 - 1.84, P = 0.007). Conclusion:High urinary fluoride is a risk factor for hypertension in drinking water-borne endemic fluorosis areas of Jishan County, Shanxi Province.

Metering unit is important component of medical service items and also serve as significant bases for scientifically estimating the costs of medical services.National Technical Specification of Medical Service Items(2023 Edition)has set up elements such as"metering unit"and"adjustment coefficient for resource consumption in special circumstances",which clearly stipulate the metering units of each medical service item and the multiples for discretionary increases or decreases in the overall resource consumption when special circumstances occur.These two elements are important references for the cost accounting in medical institutions.The project team has elaborated on the definitions,establishment principles and special circumstances of these two types of elements,namely"metering units"and"adjustment coefficient for resource consumption in special circumstances",providing references for the application of relevant governments and healthcare institutions.

The relative value of human resource consumption is a relative value scale of the workload and difficulty of medical personnel needed to provide medical service items.Based on"basic human resource consumption and time consumption","technical difficulty"and"risk level"of the medical service items,it is comprehensively calculated by"relative value indicator standardization","relative value indicator weight setting","relative value indicator calculation model construction",and"relative value indicator expert verification".By formulating the relative value of human resource consumption,it could be used in rationalizing the relative value scale of medical service items,promoting cost accounting in hospitals,and establishing a scientific and reasonable performance evaluation system as technical tools.

In September 2023,the issues of National Technical Specification of Medical Service Items(Version 2023)and Financial Classification of Medical Service Items provide national-level standards and guidance for regulating healthcare facilities'charging practices and economic operation management.It highlights the overarching design principles,structural frameworks,and practical implementation approaches of National Technical Specification of Medical Service Items(Version 2023),in order to provide comprehensive support and directional guidance for fee regulation,cost accounting,performance evaluation,and other critical areas.