1.Research progress on the toxic effects and mechanisms of perfluorobutyric acid
Lin ZHONG ; Yiru QIN ; Zuofei XIE ; Banghua WU ; Lihua XIA
China Occupational Medicine 2025;52(6):709-712
Perfluorobutyric acid (PFBA) is a representative short-chain compound of per- and polyfluoroalkyl substances (PFAS), which is widely used in fluorochemical manufacturing, food packaging, and outdoor textile processing industries. PFBA primarily enters into the human body via oral intake, inhalation, and dermal exposure and can be efficiently metabolized. PFBA exhibits cytotoxicity by disrupting cell proliferation, inducing oxidative stress, and disturbing lipid metabolism, thereby impairing cellular homeostasis. In addition, PFBA can induce abnormal activation of peroxisome proliferator-activated receptor α-dependent and/or independent pathways, leading to lipid metabolism disorders and subsequent liver injury. Animal studies have demonstrated that PFBA exposure alters renal biochemical parameters and induces epidermal inflammation, abnormal keratinization, and even necrosis, suggesting potential nephrotoxicity and dermal toxicity. PFBA is capable of crossing the placental barrier, and PFBA levels in umbilical cord blood have been negatively correlated with insulin and insulin-like growth factor 1. Moreover, plasma PFBA levels in patients infected with coronavirus disease 2019 have been associated with infection severity, indicating potential reproductive, developmental, and immunotoxic effects. At present, systematic occupational and environmental exposure monitoring data for PFBA remain limited, the toxic mechanisms in certain target organs have not been fully elucidated, and the molecular regulatory networks underlying reproductive and immune toxicity remain unclear. Future research should focus on improving PFBA monitoring strategies, strengthening studies on PFBA occupational exposure detection methods, toxic effects and mechanisms, and refining occupational risk assessment systems, to provide a scientific basis for establishing occupational exposure limits, optimizing risk management strategies, and safeguarding public health.
2.Effect of the DrCloudme platform on follow-ups of patients with intracranial aneurysms
Dongni PAN ; Lihua PAN ; Ping WEI ; Xuemei QIN ; Shanshan HUANG ; Fangqian CHEN
Modern Hospital 2025;25(5):776-779
Objective To evaluate the efficacy of the DrCloudme platform in follow-ups of intracranial aneurysm(IA)patients.Methods A randomized controlled trial was conducted with 120 IA patients treated at Hechi People's Hospital from July 2021 to June 2024.Participants were equally allocated via random number table method into two groups:The control group(n=60)received conventional telephone follow-up post interventional embolization,while the intervention group(n=60)uti-lized the DrCloudme platform for digital follow-up management.Outcome measures included medical compliance,social functio-ning(assessed by Social Disability Screening Schedule,SDSS),quality of life(evaluated using Quality of Life Instrument for Head and Neck Cancer,QLICP-HN),follow-up completion rates,and patient satisfaction.Results The observation group dem-onstrated significantly higher medical compliance,follow-up completion rate,and follow-up patient satisfaction compared to the control group(P<0.05).Additionally,the observation group had lower SDSS scores and higher QLICP-HN scores,indicating better social function and quality of life(P<0.05).Conclusion The DrCloudme platform can not only improve the follow-up completion rate for healthcare providers,but also enhance medical compliance,social functioning,and quality of life among dis-charged IA patients.Moreover,it significantly boosts patient satisfaction with follow-ups.
3.Metabolic profiling analysis of acute renal toxicity in mice exposed to perfluorobutanoic acid
Lin ZHONG ; Yiru QIN ; Zhiming HU ; Zuofei XIE ; Jingjing QIU ; Banghua WU ; LiHua XIA
China Occupational Medicine 2025;52(4):368-375
Objective To explore the nephrotoxic effects of exposure to perfluorobutanoic acid (PFBA) and its mechanism in mice, with a particular focus on analyzing the changes in kidney metabolism and their potential implications. Methods The specific pathogen free C57BL/6 mice were randomly divided into control group, low-dose group, and high-dose group, with 10 mice in each group. Mice in the three groups received intragastric administration of PFBA solution at doses of 0, 35 and 350 mg/kg body weight, once per day for seven consecutive days. The histopathological changes of kidneys of mice in these three groups were evaluated. Metabolomic profiling of mouse kidneys was performed using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Differentially accumulated metabolites (DAMs) were identified based on the Human Metabolome Database, and related metabolic pathways were analyzed through MetaboAnalyst 6.0 and Kyoto Encyclopedia of Genes and Genomes (KEGG). Results Histopathological analysis of kidneys showed that the renal pelvis mucosa of mice in the low-dose group presented focal mild inflammatory changes without marked structural damage, whereas mice in the high-dose group showed severe inflammation and partial destruction of renal structure. The kidney coefficient of mice in both low-dose group and the high-dose group decreased (both P<0.05), and the Paller scores of renal tissues increased (both P<0.05) compared with that in the control group. The Paller score of mouse renal tissue in the high-dose group was higher than that in the low-dose group (P<0.05). Metabolomic profiling identified 46 DAMs (26 upregulated, 20 downregulated) in the low-dose group and 104 DAMs (54 upregulated, 50 downregulated) in the high-dose group, with 26 shared DAMs between the two dose groups. KEGG pathway analysis revealed that DAMs were mainly involved in metabolic pathways such as glycerophospholipid metabolism, glycerolipid metabolism, sphingolipid and steroid hormone synthesis. Conclusion Acute exposure to PFBA can cause kidney injury in mice. Lipid metabolism pathways such as glycerophospholipid and sphingolipid metabolism is involved in the development of acute renal toxicity of PFBA.
4.Potential profile analysis and influencing factors of exercise fear in adult kidney transplant recipients
Hongyan TONG ; Lihua WANG ; Qin YANG ; Xiaosong XU
Journal of Army Medical University 2025;47(17):2124-2133
Objective To understand the latent profiles of kinesiophobia in kidney transplant recipients and explore the influencing factors of different profiles.Methods A cross-sectional study was conducted on 230 kidney transplant recipients subjected with convenient sampling from Department of Nephrology,the First Affiliated Hospital of Army Medical University from November 2024 to February 2025.General Information Questionnaire,Tampa Scale of Kinesiophobia-11(TSK-11),Exercise Compliance Questionnaire,Fatigue Scale-14(FS-14),Patient Health Questionnaire-9(PHQ-9)and Chinese Version of the Self-Efficacy to Manage Chronic Disease Scale(C-SEMCD)were used for investigation and latent profile analysis.Univariate analysis and logistic regression analysis were applied to explore the influencing factors of different profiles.Results Kinesiophobia in the participants was classified into 3 latent profiles:fearless movement type-low kinesiophobia group(54 cases,23.48%),cautious movement type-moderate kinesiophobia group(98 cases,42.61%),and resistant movement type-high kinesiophobia group(78 cases,33.91%).Statistical differences were observed among the 3 groups in terms of age,education level,post-operative duration,depression score,fatigue score,and self-efficacy score of chronic disease management(P<0.05).Logistic regression analysis showed that age(OR=8.82,95%CI:1.27~61.10),education level[junior high school or below(OR=0.14,95%CI:0.04~0.50);technical secondary school or senior high school(OR=0.08,95%CI:0.02~0.27)],post-operative duration[<1 year(OR=11.39,95%CI:2.53~51.30);1-5 years(OR=11.05,95%CI:2.48~49.22)],fatigue(OR=1.32,95%CI:1.10~1.59),and depression(OR=1.53,95%CI:1.19~1.98)were influencing factors for resistant movement type-high kinesiophobia in the kidney transplant recipients.Education level(technical secondary school or senior high school:OR=0.32,95%CI:0.12-0.86)and self-efficacy of chronic disease management(OR=0.95,95%CI:0.90-1.00)were influencing factors for cautious movement type-moderate kinesiophobia in the recipients.Conclusion Kinesiophobia in kidney transplant recipients can be classified into 3 latent profiles.Recipients'age,education level,post-operative duration,fatigue,and depression are influencing factors for the resistant movement type-high kinesiophobia,and education level and chronic disease management self-efficacy are important influencing factors for the cautious movement type-moderate kinesiophobia.
5.Severe COVID-19 and inactivated vaccine in diabetic patients with SARS-CoV-2 infection.
Yaling YANG ; Feng WEI ; Duoduo QU ; Xinyue XU ; Chenwei WU ; Lihua ZHOU ; Jia LIU ; Qin ZHU ; Chunhong WANG ; Weili YAN ; Xiaolong ZHAO
Chinese Medical Journal 2025;138(10):1257-1259
6.Chinese and international organoid research trends:a comparative bibliometric analysis based on CiteSpace
Zhihua CAO ; Tengjia HUANG ; Yixin LIU ; Xi CAO ; Ziying LI ; Sheng LI ; Lihua QIN
Journal of Clinical Medicine in Practice 2025;29(16):14-19,27
Objective To integrate multi-source heterogeneous literature data from China Na-tional Knowledge Infrastructure(CNKI),Wanfang,VIP,and Web of Science(WoS)databases u-sing bibliometric methods,and to comparatively analyze the differences in knowledge structure charac-teristics and evolutionary pathways of organoid research between China and foreign countries.Meth-ods CiteSpace software was employed to conduct a visual atlas analysis of the publication volume,countries,institutions,authors,and keywords of 1,118 Chinese literatures and 10,871 English lit-eratures.Results China ranked the second globally in terms of publication volume(accounting for 22.09%),but exhibited low centrality in international collaboration networks.The density of the do-mestic institutional collaboration network was 0.003,indicating a relatively loose structure,with Fudan University leading domestic output with 15 Chinese papers.Keyword emergence analysis revealed that"organ-on-a-chip"and"biomechanics"have emerged as new hotspots since 2024.Conclusion It is recommended to establish an interdisciplinary collaborative innovation alliance to focus on break-throughs in the translational directions of organ-on-a-chip and biomechanics,thereby addressing the imbalance between"scale and quality"in China's organoid research.
7.Principles and Methods of Using Metering Unit in National Technical Specification of Medical Service Items(Version 2023)
Jingjing LANG ; Jinming KONG ; Lihua YU ; Huanhuan CHANG ; Xingyu YANG ; Hailong ZHOU ; Qin JIANG
Chinese Health Economics 2025;44(7):10-12,15
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.
8.Setting up and Use of Relative Value Scale of Human Resource Consumption in the National Technical Specification of Medical Service Items(Version 2023)
Hailong ZHOU ; Qin JIANG ; Huanhuan CHANG ; Lihua YU
Chinese Health Economics 2025;44(7):13-15
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.
9.Overall Design and Implementation of National Technical Specification of Medical Service Items(Version 2023)
Lihua YU ; Qin JIANG ; Zhenzhong ZHANG
Chinese Health Economics 2025;44(7):1-3,9
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.
10.The Rationale and Implementation of the Financial Classification of Medical Service Items
Xingyu YANG ; Lihua YU ; Huanhuan CHANG ; Jingjing LANG ; Qin JIANG
Chinese Health Economics 2025;44(7):16-18
As an important indicator to assess the revenue structure of hospitals,healthcare service revenue can truly reflect the labor value of medical personnel.A unified financial classification is the premise of accurate calculation of revenue structure.Meeting the needs of financial management of medical institutions through mapping with current healthcare service items in various regions,Financial Classification of Medical Service Items has unified the financial classification from the aspects of bill classification,accounting subject and expense classification in medical record.

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