Animal model research on spleen and stomach diseases in traditional Chinese medicine （TCM） is of great significance for elucidating the nature of diseases and syndromes and for revealing the mechanisms of action of Chinese herbal medicinals. At present， studies on classical TCM syndrome models of spleen and stomach diseases mainly focus on spleen deficiency syndrome， liver constraint syndrome， and damp-heat syndrome. Model construction is mostly based on the etiological and pathophysiological characteristics of syndrome， and model evaluation primarily involves macroscopic manifestations and physicochemical indicators. This paper summarizes the current research status of animal models integrating disease and syndrome for seven common spleen and stomach diseases， including chronic gastritis and gastric precancerous lesions， gastroesophageal reflux disease， functional dyspepsia， inflammatory bowel disease， irritable bowel syndrome， functional constipation， and functional diarrhea. The modeling methods and characteristics of disease-syndrome combined animal models for each disease are analyzed. It is proposed that future research on disease-syndrome integration in spleen and stomach diseases should move toward syste-matic， precise， and integrative development， and that interdisciplinary and cross-disciplinary research approaches should be adopted to enhance the predictive value and application efficiency of disease-syndrome combined animal models.

Objective:To construct a comprehensive performance evaluation index system based on diagnosis related groups(DRG) and analyze the overall performance of a hospital before and after the implementation of DRG payment using an improved radar chart method.Methods:A literature analysis method was employed to preliminarily determine the performance evaluation framework in combination with the actual situation of the hospital. Subsequently, the Delphi method was used to establish a comprehensive performance evaluation index system based on DRG. Data related to inpatients from 2019 to 2022 (with 2019 being the period before the implementation of DRG payment) were extracted from the hospital information system and medical insurance system of a tertiary general hospital in Liaoning Province. The improved radar chart method was then utilized to conduct a comprehensive performance evaluation of the hospital.Results:The comprehensive performance evaluation index system based on DRG included five first-level indicators (service capacity, service efficiency, medical quality, medical safety, and revenue and costs) and 19 second-level indicators. The weights of medical quality and medical safety were the highest, both at 0.212. The evaluation results using the improved radar chart method showed that the comprehensive performance values of the hospital from 2019 to 2022 were 0.427 0, 0.463 3, 0.505 2, and 0.545 0, respectively. Overall, the five first-level indicators showed an improving trend, but the development of service capacity, service efficiency, medical quality, and revenue and costs was more balanced compared with medical safety.Conclusions:With the implementation of DRG payment reform, the performance of the hospital has improved and was trending towards more balanced development. The evaluation index system constructed in this study is scientifically sound and feasible. Combined with the improved radar chart method, it can more intuitively reflect changes in hospital performance and can serve as a reference for performance evaluation in public hospitals.

[Objective] To compare the efficacy and safety of deglycerolized red blood cells (DRBC) and suspended red blood cells (SRBC) based on the propensity score matching (PSM) method, so as to provide evidence for the rational use of DRBC resources in clinical practice. [Methods] A total of 89 patients who received DRBC transfusion and 2 916 patients who received SRBC transfusion in our hospital from January 2023 to September 2024 were included. A 1∶1 nearest neighbor PSM was used to balance covariates such as gender, age, and body mass index (BMI). The changes of hemoglobin (Hb), red blood cell (RBC) count, hematocrit (HCT), and inflammatory markers such as white blood cell (WBC) count, neutrophil (NE) count, C-reactive protein (CRP), and Interleukin-6(IL-6) in the last 72 hours after transfusion were analyzed by SPSS 26.0 and R software to evaluate clinical efficacy and transfusion safety. [Results] The baseline of the two groups was balanced after PSM (P>0.05). There was no significant difference in the total effective rate between the DRBC group (80.9%) and the SRBC group (86.5%) (P>0.05). In the SRBC group, WBC (×10 /L) increased from 9.634±6.742 to 10.147±6.835, CRP (mg/dL) increased from 5.468±4.647 to 6.174±6.114, and IL-6(pg/mL) decreased from 213.733±587.191 to 157.255±552.626. In the DRBC group, WBC (×10 /L) decreased from 11.123±7.880 to 11.011±8.549, CRP (mg/dL) decreased from 5.729±4.761 to 5.326±4.466, and IL-6(pg/mL) decreased from 238.806±639.060 to 152.255±266.558. Compared with the before treatment, the differences between the SRBC group and DRBC group were not statistically significant (P>0.05). Among all patients included in the statistics, the overall incidence of transfusion adverse reactions was 0.205% (6/2 916) in the SRBC group, and no adverse reactions occurred in the DRBC group. The incidence in the SRBC group was higher than that in the DRBC group. [Conclusion] Based on PSM analysis, there was no significant difference in the efficacy and safety of DRBC transfusion compared with SRBC transfusion, which can provide evidence-based support for routine application.

Objective To investigate correlations of peripheral blood inflammatory and immune-related indices with clinicopathological features and prognosis in breast cancer patients.Methods A total of 144 breast cancer patients admitted to the Breast Surgery Department of Maternity and Child Healthcare Hospital of Tongzhou District of Beijing were included in cancer group,44 patients with a-typical breast hyperplasia were included in precancerous lesion group,and 131 patients with breast hyperplasia were included in breast hyperplasia group.The neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and lymphocyte-to-monocyte ratio(LMR)were compared among the three groups.A three-year follow-up was conducted for prognosis assessment.Based on different NLR,PLR,and LMR levels,the cancer group was divided into low NLR group(＜2.12,67 pa-tients),high NLR group(≥2.12,77 patients),low PLR group(＜133.21,65 patients),high PLR group(≥ 133.21,79 patients),low LMR group(＜5.05,80 patients),and high LMR group(≥5.05,64 patients).The correlations of NLR,PLR,and LMR with clinicopathological features and prognosis in breast cancer patients were analyzed.Results NLR in the cancer group was higher than that in the precancerous lesion group and breast hyperplasia group,the PLR was higher than that in the breast hyperplasia group,and the LMR was lower than that in the breast hyperplasia group(P＜0.05).NLR and PLR in the precancerous lesion group were higher and LMR was lower than those in the breast hyperplasia group(P＜0.05).PLR between patients with different menopa-usal statuses and Ki-67 levels showed statistically significant differences(P＜0.05).LMR between patients with different menopausal status also showed a statistically significant difference(P＜0.05).After a three-year follow-up,5 patients in the cancer group had a poor prognosis and 139 had a good prognosis.Poor prognosis rates between the low NLR and high NLR groups,low PLR and high PLR groups,and low LMR and high LMR groups showed statistically significant differences(P＜0.05).Logistic regression analysis results indicated that increased NLR and PLR were risk factors for poor prognosis in cancer patients,while increased LMR was a protective factor.Conclu-sion Peripheral blood inflammatory and immune-related indicators in breast cancer patients exhibit abnormal changes.Increased NLR and PLR are risk factors for poor prognosis,while increased LMR is a protective factor.

Objective:To construct a comprehensive performance evaluation index system based on diagnosis related groups(DRG) and analyze the overall performance of a hospital before and after the implementation of DRG payment using an improved radar chart method.Methods:A literature analysis method was employed to preliminarily determine the performance evaluation framework in combination with the actual situation of the hospital. Subsequently, the Delphi method was used to establish a comprehensive performance evaluation index system based on DRG. Data related to inpatients from 2019 to 2022 (with 2019 being the period before the implementation of DRG payment) were extracted from the hospital information system and medical insurance system of a tertiary general hospital in Liaoning Province. The improved radar chart method was then utilized to conduct a comprehensive performance evaluation of the hospital.Results:The comprehensive performance evaluation index system based on DRG included five first-level indicators (service capacity, service efficiency, medical quality, medical safety, and revenue and costs) and 19 second-level indicators. The weights of medical quality and medical safety were the highest, both at 0.212. The evaluation results using the improved radar chart method showed that the comprehensive performance values of the hospital from 2019 to 2022 were 0.427 0, 0.463 3, 0.505 2, and 0.545 0, respectively. Overall, the five first-level indicators showed an improving trend, but the development of service capacity, service efficiency, medical quality, and revenue and costs was more balanced compared with medical safety.Conclusions:With the implementation of DRG payment reform, the performance of the hospital has improved and was trending towards more balanced development. The evaluation index system constructed in this study is scientifically sound and feasible. Combined with the improved radar chart method, it can more intuitively reflect changes in hospital performance and can serve as a reference for performance evaluation in public hospitals.

Objective:To observe and analyze the clinical characteristics of children with autosomal dominant hereditary microcephaly with or without chorioretinopathy, lymphedema, or intellectual disability syndrome (MCLMR).Methods:A retrospective clinical study. In September 2023, the first patient and three family members (parents, brother) of MCLMR who were diagnosed through ophthalmic examination and genetic testing at Department of Ophthalmology of Henan Children's Hospital were included in the study. Clinical data were collected, inquired about medical history and family history in detail, and performed best corrected visual acuity (BCVA), optical coherence tomography (OCT), fluorescein angiography (FFA), flash visual evoked potential (F-VEP), full field electroretinogram (ERG), cranial magnetic resonance imaging (MRI), and systemic examination. 3 ml of peripheral venous blood were collected from the proband, her parents and younger brother, and extracted whole genome DNA. Second generation sequencing technology was used for gene sequencing. For suspected pathogenic sites, Sanger sequencing was used for validation, and bioinformatics analysis was performed to determine the pathogenicity of the genetic variant sites. The relevant literature of PubMed of the National Library of Medicine and Wan Fang Med Online by computer were searched. The genetic characteristics and conducted literature review were summarized.Results:The proband (Ⅱ-1) was an 8-year-old and 5-month-old female. Her head was relatively small, the lower jaw was small, the ears protrude, the nose was wide, the eyelid was tilted upwards, philtrum was long. Mild intellectual disability, no history of lymphedema. The BCVA values for the right and left eyes were 0.08 and 0.1, respectively. Bilateral nystagmus. Atrophic lesioned in the macular area and below choroid retina of both eyes. FFA examination showed mottled fluorescent staining in the macular area and the below retina, with no obvious fluorescein leakage in the late stage. OCT examination revealed shallow macular fovea morphology, absence of ellipsoidal bands, unclear layers, thinning of the entire retina, and significant atrophy of the choroid and retina beneath the macula. F-VEP examination, no waveform was detected in both eyes. Full field ERG examination showed severe reduction in amplitude of a wave and b wave in both eyes. Head magnetic resonance imaging showed widening of the subarachnoid space in the left temporal region, with no significant abnormal signals observed in the brain parenchyma. Her father (Ⅰ-1) had mild nystagmus and strabismus. The phenotypes of the eyes of the mother (Ⅰ-2) and brother (Ⅱ-2) were not significantly abnormal. The genetic testing results showed that the proband (Ⅱ-1) had a heterozygous missense mutation c.895A>G (p.Ile299Val) in exon 8 of the KIF11 gene, which was a known mutation. Her parents (Ⅰ-1, Ⅰ-2) and younger brother (Ⅱ-2) were both wild-type. The bioinformatics analysis results indicated that this mutation is a potentially pathogenic variant. A total of 109 cases were retrieved from 20 relevant literatures. Among them, 55 were male, 54 were females. There were 61 cases with family history and 48 cases without family history, respectively. Among the 109 cases, 98 cases (89.9%, 98/109) had microcephaly, 2 cases had premature closure of cranial sutures, and 11 patients underwent cranial MRI, which showed 11 cases of small head with simplified development of the cerebral gyrus. 50 cases (45.9%, 50/109) of lymphedema. 83 cases (76.1%, 83/109) of intellectual developmental disorders. 92 cases (84.4%, 92/109) had ocular abnormalities, 69 cases (63.3%, 69/109) had chorioretinopathy, 20 cases (18.3%, 20/109) had retinal folds, 10 cases (9.2%, 10/109) had nystagmus, and 17 cases (15.6%, 17/109) had retinal detachment. Conclusions:The main clinical manifestations of MCLMR are microcephaly, chorioretinopathy, with or without lymphedema, and intellectual disability. The main manifestations of eye diseases are low vision, nystagmus, and chorioretinopathy. The heterozygous missense mutation c.895A>G (p.Ile299Val) in exon 8 of KIF11 gene is the pathogenic variant of this family.

By sorting out and analyzing the contents about pulse diagnosis in Tanksuqnameh, it was found that in terms of pulse theory, the book contains academic viewpoints of different periods and doctors about three portions and nine readings pulse method and nutritive qi operation law in Huang Di Nei Jing, the Cunkou pulse-taking method and the Cunguanchi theory in Nan Jing, the Renying and Qikou pulse-taking method and the three-region pulse-taking method in Mai Jing, and the seven superficies-indicating, eight interior-indicating and nine channels pulse of Mai Jue, etc.; in terms of pulse theory interpretation, multiple annotations from famous doctors are cited, and TCM basic theories and knowledge of astronomy and mathematics are applied, combined with the background of ancient Iranian medicine and local medical experience for explanation; in terms of pulse diagnosis techniques, pulse diagnosis techniques such as "three fingers determining three guan", "adjusting finger density", "floating and sinking pulse", "foot back pulse breaking life and death" were recorded in books of Nan Jing, Mai Jue, Lei Zheng Huo Ren Shu, etc.; in terms of influencing pulse factors, the male and female pulse, physical pulse, and four time pulse were recorded. Tanksuqnameh is a universal work of Persian Traditional Chinese Medicine, compiled by the author Rashid-ul-Din based on his research on Chinese culture and medical knowledge, combined with the unique customs, language and culture, and way of thinking in the Middle East region, to reorganize various pulse theories from before the Han Dynasty to the Tang and Song Dynasties in China. The publication of this book indicates that TCM pulse diagnosis had been promoted to the Middle East in the 14th century and provided valuable experience for local medical development. The author's sense of identification and research spirit towards different cultures provide a historical example for achieving cross-cultural communication between TCM and medicine in different regions. The preserved literature from the Tang and Song Dynasties in the book can provide clues for a deeper understanding of ancient pulse theory in TCM, but some details do not explain thoroughly or does not match the current clinical practice. Therefore, attention should be paid to distinguishing in research and application.

Objectives:To explore the influencing factors of daily living abilities in patients with traumatic spinal cord injury.Methods:A cross-sectional study was conducted on 148 patients with traumatic spinal cord injury admitted to our hospital from January 2019 to January 2023.Factors that may affect the daily living abilities of patients were collected,including gender,age,marital status,course of injury,cause of in-jury,level of injury,American Spinal Injury Association(ASIA)impairment scale(AIS),surgical situation and urination pattern.The spinal cord independence measure Ⅲ(SCIM-Ⅲ)was used to evaluate the daily living abilities in patients with traumatic spinal cord injury.The relationship between the influencing factors and daily living abilities was analyzed by single factor analysis,and multiple linear regression was applied to ana-lyze the impact of the influencing factors on daily living abilities.Results:Univariate analysis showed that the level of injury,AIS and,the urination pattern had significant effects on daily living abilities(P＜0.05),while gender,age,marital status,course of injury,cause of injury,surgical situation had no significant effects on daily living abilities.With regard to the level of injury,patients with sacral spinal cord injury had the best daily living abilities,and patients with cervical spinal cord injury were the worst in daily living abilities.Regarding AIS,patients of level A were the worst in daily living abilities,and patients of level E were the best.In terms of urination pattern,patients who could spontaneous voiding were the best in daily living abil-ities,while those with indwelling catheter/bag had the worst daily living abilities.There were statistically significant differences in self-care,respiratory and sphincter management,movement and total scores between patients with different injury levels,urination patterns and AIS(P＜0.01).Multiple linear regression showed that injury level,urination pattern and AIS were the main factors affecting the daily living abilities.Conclusions:The level of injury,AIS,and the urination pattern are the main factors affecting the daily living abilities of patients with traumatic spinal cord injury,and patients with injury of cervical cord,AIS level A,and indwelling catheter/bag have poor daily living abilities.

Objective:The effect of Xuan Bi Decoction on inhibition of cyclooxygenase-2(COX-2)pathway on inflammation in rats with acute gouty arthritis(GA).Methods:Sixty SD rats randomly allocated into control group,model group,celecoxib group(20 mg/kg),Xuan Bi Decoction low-dose group(5 g/kg),Xuan Bi Decoction medium-dose group(10 g/kg),Xuan Bi Decoction high-dose group(20 g/kg),with 10 rats in each group.The classic method of Coderre was used to establish a rat gout model and observe the general condition of each group of rats;analysis of rat gait scores and joint swelling of rats;the histopathological growth of rat ankle Sy-novial membrane were observed by HE staining;the levels of inflammatory factors IL-1β,TNF-α,PGE2 and LTB4 in rats joint fluid were detected by ELISA;Western blot detection of PGE2 receptor 2(EP2)and LTB receptor 1(BLT1)expressions in rats ankle syno-vial tissue;qRT-PCR to detect the effect of mRNA expression of COX-2 and 5-lipoxygenase(5-LOX).Results:Rats in the model group had swollen joints,lameness,lusterless fur and mental lethargy;the rats in the celecoxib group and Xuan Bi Decoction low,medium and high dose groups showed effective improvement in related symptoms;compared with control group,the gait score,degree of joint swelling,degree of histopathology,IL-1β,TNF-α,PGE2,LTB4,COX-2,5-LOX,EP2 and BLT1 levels of the rats in the model group were significantly higher(P<0.05);compared with the COX-2 inhibitor celecoxib,Xuan Bi Decoction(20 g/kg)showed better anti-arthritic properties in rats treated with MSU crystals,accompanied by reduced expression of IL-1β,TNF-α,PGE2,LTB4,COX-2,5-LOX,EP2 and BLT1.Conclusion:Dual inhibition of COX-2 and 5-LOX by Xuan Bi Decoction in GA rats to improve MSU crystal-induced inflammation and may serve as a novel therapeutic strategy.

[Abstract] [Objective] To compare and analyze the efficacy of platelet transfusion in patients with different doses, and to analyze the risk factors for platelet transfusion refractoriness. [Methods] A total of 5 827 patients who received platelet transfusion in the PLA General Hospital from May 2023 to May 2024 were selected as the research subjects, among which 4 780 patients were transfused with 1 therapeutic dose of platelets, and 1 047 patients were transfused with 0.5 therapeutic dose of platelets, and the efficacy of platelet transfusion was compared between the two groups. The effects of gender, disease type, white blood cell count before transfusion, fever, number of platelet transfusions, and platelet antibodies on platelet transfusion refractoriness were analyzed using univariate analysis, and the independent risk factors affecting platelet transfusion refractoriness were further analyzed by multivariate logistic regression. [Results] Among 4 780 patients, 3553 (74.3%) were effective and 1 227 (25.7%) were ineffective. Among 1 047 patients, 0.5 platelet infusion was effective in 755 cases (72.1%) and ineffective in 292 cases (27.9%). There was no significant difference in the effective rate of platelet transfusion between the two groups (P>0.05). Univariate analysis showed that the therapeutic effect of platelet transfusion was related to age, the number of platelet transfusion, disease type, platelet antibodies and white blood cell count before transfusion (P<0.05), while age, gender, fever and blood type were not related to the therapeutic effect of platelet transfusion (P>0.05). The results of multi-factor analysis showed that age, white blood cell count >50×10⁹/L, platelet transfusion times, disease type and platelet antibody were independent risk factors for ineffective transfusion (P<0.05). [Conclusion] There is no significant difference in the efficacy of platelet infusion with 0.5 therapeutic dose or 1 therapeutic dose. In addition, age, white blood cell count >50×10⁹/L, the number of platelet transfusion, disease type and platelet antibodies were the factors affecting the ineffective platelet transfusion in group 2.