Acute kidney injury (AKI) has high morbidity and mortality, but effective clinical drugs and management are lacking. Previous studies have suggested that macrophages play a crucial role in the inflammatory response to AKI and may serve as potential therapeutic targets. Emerging evidence has highlighted the importance of forkhead box protein O1 (FoxO1) in mediating macrophage activation and polarization in various diseases, but the specific mechanisms by which FoxO1 regulates macrophages during AKI remain unclear. The present study aimed to investigate the role of FoxO1 in macrophages in the pathogenesis of AKI. We observed a significant upregulation of FoxO1 in kidney macrophages following ischemia-reperfusion (I/R) injury. Additionally, our findings demonstrated that the administration of FoxO1 inhibitor AS1842856-encapsulated liposome (AS-Lipo), mainly acting on macrophages, effectively mitigated renal injury induced by I/R injury in mice. By generating myeloid-specific FoxO1-knockout mice, we further observed that the deficiency of FoxO1 in myeloid cells protected against I/R injury-induced AKI. Furthermore, our study provided evidence of FoxO1's pivotal role in macrophage chemotaxis, inflammation, and migration. Moreover, the impact of FoxO1 on the regulation of macrophage migration was mediated through RhoA guanine nucleotide exchange factor 1 (ARHGEF1), indicating that ARHGEF1 may serve as a potential intermediary between FoxO1 and the activity of the RhoA pathway. Consequently, our findings propose that FoxO1 plays a crucial role as a mediator and biomarker in the context of AKI. Targeting macrophage FoxO1 pharmacologically could potentially offer a promising therapeutic approach for AKI.

Objective To study the levels of serum Periostin and interleukin(I1-)-18 in preterm infants with bronchopulmonary dysplasia(BPD),and to analyze their correlation with the severity of the disease and their predictive value for BPD.Methods A total of 62 preterm infants with BPD diagnosed and treated in the hospital from January 2019 to January 2022 were retrospectively selected as the BPD group,and 80 preterm in-fants without BPD during the same period were selected as the non-BPD group.According to the severity of BPD,the infants with BPD were divided into mild subgroup(22 cases),moderate subgroup(24 cases)and se-vere subgroup(16 cases).The serum levels of Periostin and IL-18 were detected by enzyme-linked immu-nosorbent assay.Pearson correlation analysis was used to analyze the correlation between the clinical parameters.Multivariate Logistic regression was used to analyze the influencing factors of BPD,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of each indicator for BPD.Results Compared with the non-BPD group,the BPD group had a significantly higher proportion of infants with pulmonary surfactant(PS)use,neonatal respiratory distress syndrome,apnea,patent ductus arteriosus,and serum levels of Periostin and IL-18,as well as a significantly longer duration of mechanical ventilation,noninvasive respiratory support,and length of hospital stay.The lung function parameters[tidal volume per kilogram(VT/kg),ratio of time to peak tidal expiratory flow to time(TPTEF/TE),ratio of volume to peak tidal expiratory flow to volume(VPEF/VE),expiratory flow at 50％tidal volume(50％TEF),expiratory flow at 75％tidal volume(75％TEF)]and 1,5 min Apgar score of BPD group were lower than that of non-BPD group,and the differences were statistically significant(P＜0.05).The serum levels of Periostin and IL-18 in mild subgroup,moderate subgroup and severe subgroup were increased in turn.The levels of serum Periostin and IL-18 were negatively correlated with pulmonary function indexes(VT/kg,50％TEF,75％TEF,TPTEF/TE,VPEF/VE,P＜0.05).Serum Periostin,IL-18 and neonatal respiratory distress syndrome were independent risk factors for BPD(P＜0.05),and PS was a protective factor(P＜0.05).Serum Periostin,IL-18 and neonatal respiratory distress syndrome were independent risk factors for the severity of BPD(P＜0.05).The area under the curve(95％CI)of serum Periostin and IL-18 alone and in combination for predicting BPD were 0.841(0.814-0.899),0.863(0.820-0.897),0.922(0.878-0.949),respectively.The sensitivity and specificity of combined prediction were 0.902 and 0.825,respectively.The area under the curve of the combination of the two indica-tors for predicting BPD was greater than that of each index alone,and the difference was statistically signifi-cant(Z=5.357,4.894,P＜0.001).Conclusion The levels of serum Periostin and IL-18 are increased in in-fants with BPD,which are related to the severity of BPD and lung function.The combination of serum Perios-tin and IL-18 has a high predictive value for BPD.

Objective:To assess the correlation and consistency between the cancer risk-oriented endoscopic Kimura-Takemoto classification and the operative link for gastritis assessment (OLGA) in risk stratification of gastric cancer in patients with chronic gastritis after Helicobacter pylori ( H. pylori) eradication. Methods:From January 1, 2018 to October 31, 2021, 97 patients with chronic gastritis who successfully underwent H. pylori eradication at Beijing Friendship Hospital affiliated to Capital Medical University were selected. During the follow-up period, all patients underwent standardized magnifying endoscopy to assess gastric mucosal atrophy with the Kimura-Takemoto classification, which was classified as no or mild atrophy, moderate atrophy, and severe atrophy. Additionally, according to the new Sydney staging system, endoscopic biopsies were conducted at 5 sites of the patients to classify into OLGA stages 0, Ⅰ, Ⅱ, Ⅲ, or Ⅳ. Spearman rank correlation analysis and Kappa consistency test were performed to evaluate the correlation and consistency between the 2 evaluation systems, respectively. Area under the curve (AUC) of the receiver operating characteristic curve was used to calculate the predictive ability of the grading of gastric mucosal atrophy under endoscopy in high-risk histological staging. Furthermore, multivariate logistic regression analysis was used to assess factors influencing the consistency of the 2 evaluation systems. Chi-square test or Fisher′s exact test were used for statistical analysis. Results:Longitudinal follow-up was completed in 97 cases, with a follow-up time of (37.38±13.18) months after H. pylori eradication. The proportion of OLGA stage Ⅲ to Ⅳ in patients with no or mild atrophy (21.7%, 10/46) was lower than that in patients with moderate and severe atrophy (63.0%, 29/46 and 5/5, respectively), and the differences were statistically significant( χ2=16.07 and 13.30, both P<0.001). However, there was no significant difference in distribution of OLGA staging between patients with moderate atrophy and patients with severe atrophy (all P>0.05). The consistency rate of high-risk assessment for gastric cancer between the 2 evaluation systems was 73.2% (71/97). The correlation between the Kimura-Takemoto classification and OLGA staging was moderate ( r=0.47, 95% confidence interval(95% CI) 0.30 to 0.61, P<0.001). The result of consistency test indicated that the consistency of the 2 evaluation systems was moderate, and the Kappa value was 0.46 (95% CI 0.29 to 0.64, P<0.001). For patients with chronic gastritis after H. pylori eradication, the sensitivity of Kimura-Takemoto classification of moderate to severe atrophy under endoscopy in identifying high-risk of OLGA stages was 77.21% (95% CI 62.16% to 88.53%), the specificity was 69.81% (95% CI 55.66% to 81.66%), and the AUC was 0.735 (95% CI 0.636 to 0.820, P<0.01). As the time after H. pylori eradication increased (post- H. pylori eradication less than 18, 18 to 36, and more than 36 months), the consistency of atrophy assessment between the Kimura-Takemoto classification and OLGA staging reduced (7/8, 84.4% (27/32), 64.9% (37/57), respectively), and the difference was statistically significant ( χ2=4.36, P=0.037). The result of multivariate logistic regression analysis revealed that the time after H. pylori eradication more than 36 months ( OR=3.443, 95% CI 1.117 to 10.614, P=0.031) and gastric ulcer ( OR=3.928, 95% CI 1.177 to 13.110, P=0.026) were independent factors influencing the consistency between the Kimura-Takemoto classification and OLGA staging. Conclusions:The endoscopic and histological changes of chronic gastritis after eradication of H. pylori are consistent. Within short period after H. pylori eradication (no more than 36 months), the sensitivity of high-risk classification under endoscopy is high and the specificity is moderate, which can predict high-risk histological staging to a certain degree.

Objective:To explore the effects of “Internet plus” management based on attention-interest-search-action-share (AISAS) mode on health-promoting lifestyles in young and middle-aged patients with hypertension.Methods:A prospective randomized controlled trial was used by this study, 212 young and middle-aged patients with hypertension from Cardiovascular Medicine Department of the First Affiliated Hospital of Nanchang University were divided into"Internet plus"management group and routine management group according to the random number table method between January 2021 and January 2023, 106 cases in each group. The regular management group were given regular management intervention, and the “Internet plus” management group were used the “Internet plus” management model intervention based on the AISAS model, each lasting 12 months. All patients were intervened for 12 months. At 1d before discharge, 6 months and 12 months after discharge, health-promoting lifestyles were evaluated by Chinese version of Health Promotion Lifestyle Scale (HPLP-IIC), quality of life were evaluated by the 36-item shot-form health status survey (SF-36), and treatment compliance were evaluated by therapeutic adherence scare for hypertensive patients (TASHP).Results:With discharge time, scores of HPLP-IIC, SF-36 and TASHP were significantly increased in both groups (all P<0.05). At 6 and 12 months after discharge, the scores of HPLP-IIC [(117.58±16.43) and (134.37±20.25) points], SF-36 [(79.58±5.43) and (84.37±3.25) points] and TASHP [(101.84±6.32) and (115.37±4.25) points] in “Internet plus” management group were significantly higher than those in routine management group [HPLP-IIC: (96.25±13.74) and (108.05±14.73) points, SF-36: (61.25±5.09) and (78.05±4.37) points, TASHP: (81.05±5.37) and (94.68±3.37) points] (all P<0.001), while systolic blood pressure (SBP) [(128.52±4.02) and (126.81±2.34) mmHg (1 mmHg=0.133 kPa)] and diastolic blood pressure (DBP) [(81.84±6.32) and (79.37±4.25) mmHg] were significantly lower than those in routine management group [SBP: (133.09±5.16) and (133.35±2.57) mmHg, DBP: (85.68±7.15) and (86.05±5.37) mmHg](all P<0.001). And, decrease of SBP [6 months: (-4.43±1.19) and (-6.14±2.01) mmHg] and DBP [6 months: (-3.75±1.71) and (-6.22±2.38) mmHg] in “Internet plus” management group were significantly higher than those in routine management group [SBP: (-1.28±0.75) and (-1.02±0.26) mmHg; DBP: (-1.05±0.62) and (-0.68±0.29) mmHg](all P<0.001). Conclusion:The “Internet plus” management based on AISAS mode can control blood pressure by improving the lifestyle, compliance and quality of life of young and middle-aged hypertensive patients.

Objective:To analyze the preliminary explorations and practical effects of strengthening the process management of nursing special projects in a tertiary general hospital, so as to explore the refined management strategy of hospital projects and provide reference for improving the management level of the research project.Methods:This article takes a series of refined measures taken by the hospital in the process management of nursing special projects from August 2016 to August 2021 as the research example, including setting up subject directions around key disciplines, setting application conditions at different levels, standardizing selection procedures, strengthening mid-term assessments, strictly controlling final acceptance, establishing integrity files, and promoting the transformation of scientific achievements, etc. and these measures are deeply analyzed and discussed.Results:Through a series of measures, the hospital nursing team has significantly improved in terms of research paper publication, patent authorization, approval of projects above the bureau level, and nursing specialties ranking of Chinese hospital Science and Technology Evaluation Metrics (STEM) in the past six years.Conclusions:By strengthening the process management of nursing special research project, the construction level of nursing disciplines has been significantly improved, and the development of nursing disciplines has been greatly promoted.

Objective: To compare the calibration result of standard X-ray RQR radiation field between SSDL (NIRP) and CEA LIST LNHB(France), and to explore the feasibility of calibrating H_p(3) in standard X-ray RQR radiation field of SSDL(NIRP). Methods: Using a column model with a diameter and high of 20 cm, TLD was calibrated in SSDL (NIRP) and CEA LIST LNHB (France) to measure the personal dose equivalent eye lens dose H_p(3), X-ray RQR radiation field included RQR4(60 kV), RQR7(90 kV), RQR9(120 kV), with energy response, angle response and linear response. Results: In terms of energy response, the calibration results of TLD in both SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. The difference between exposure value and response value was less than 10%. In terms of angle response, the calibration result of TLD in CEA LIST LNHB (France) was better in SSDL(NIRP). The difference between exposure value and response value in CEA LIST LNHB (France) was less than 6%, while the difference between exposure value and response value in SSDL(NIRP) was more than 10% at angle of 20°. In terms of linear response, both calibration result of SSDL (NIRP) and CEA LIST LNHB (France) were in good agreement. Conclusions The standard X-ray RQR field in SSDL (NIRP) can be used for the calibration of H_p(3).

Objective: To study the association of single nucleotide polymorphism (SNP)276 in adiponectin gene with essential hypertension in population with impaired glucose regulation in Han people of Shanxi region. Methods: The study population consisted of 216 Chinese Hans residents with impaired glucose regulation (IGR) in Shanxi province. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied to test the adiponectin SNP276G/T polymorphism. Results: The distributions of genotypes and alleles of SNP276 both displayed significant difference between the IGR complicating norm tension group and the hypertension group (P=0.025, P=0.007). Compared with the TT genotype, the SNP276 non-TT (GT+ GG) genotype was associated with increased risk of complicating with hypertension (OR=3.346, 95% CI: 1.115-8.986, P=0.037), while after age- , sex- and BMI-adjusted, there was no significant difference between the 2 groups (P=0.349). Conclusions SNP276 in adipose most abundant gene transcript 1 (APM1) was associated with the susceptibility to be complicating essential hypertension in population with impaired glucose regulation in Han people of Shanxi region.

Objective:To conduct periodic revalidation of the 15 items and 43 terms autoverification rules of blood analysis after 1 year of application, analyze the application suitability and make the rules improved.Methods:Track the results of 528 010 blood analysis samples of our hospital from August 1, 2019 to January 31, 2020, and analyze the pass rate and interception rate of autoverification; 600 specimens in total were selected randomly for microscope examination, including 300 specimens which touched autoverification rules (1 012 items of autoverification rules) and were intercepted by autoverification and 300 specimens which untouched autoverification rules and were released by autoverification. The abnormal characteristics and unacceptable Delta check of the specimens also need to be concerned at the same time.The false negative rate and false positive rate, true negative rate, true positive rate and pass correct rate of autoverification were verified and compared with the rate of the second phase verification when the autoverification rule was established. The false negative rate, false positive rate, true negative rate and true positive rate of the Delta check rule which 54 716 specimens touched were calculated and compared with the second phase verification rate when the autoverification rule was established.The results of microscopic examination were used as the gold standard for the calculation of the rates, and P<0.05 was considered as a significant difference. The false positive and true positive of 1 012 autoverification rules were analyzed item by item.The false positive and true positive of 108 specimens which touched blast cell autoverification rule were analyzed terms by terms. The mean TAT and median TAT of 528 010 specimens and 193 750 outpatient specimens were calculated respectively, and the report percentages of 528 010 samples that TAT<30, 30-60　and>60 min were calculated respectively. Analyze and evaluate the application suitability of autoverification rules to juge whether they meet the needs of doctors and laboratory. The design process and the rules and application process of autoverification were optimized and improved.Results:The autoverification pass rate was 63.06% (332 971/528 010), the interception rate was 36.94% (195 039/528 010). The false negative rate was 1.00% (1/600), the false positive rate was 12.67% (76/600), the true negative rate was 49% (294/600), the true positive rate was 37.33% (224/600), and the correct rate was 98% (294/300). The pass rate, true negative rate, true positive rate and correct rate of the periodic reverification group were higher than the second phase verification group, the false negative rate and false positive rate were lower than that the second phase verification group. The false negative rate and true positive rate of the Delta check of periodic verification group were lower than that the second phase verification group, the false positive rate and true negative rate were higher than the second phase verification group, there were significant differences in the comparition results. The mean TAT of 528 010 specimens was25 min, and the median TAT was 22 min. The mean TAT of 193 750 outpatient specimens was 23 min, and the median TAT was 20 min. The report percentages of 528 010 samples that TAT<30 min, 30 min-60 min and>60 min were 83.30% (439 819/528 010), 8.00% (42 250/528 010) and 8.70% (45 941/528 010), respectively.Conclusion:The results of periodic revalidation of autoverification after 1 years application show that the 15 items and 43 terms autoverification rules of blood analysis could meet requirements about the accuracy and efficiency of the laboratory, and have a good suitability for application.

Objective: To carry out the 4^th round of third-party evaluation on the implementation and effect of the 1^st year of the 2^nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. Methods: The 4^th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. Results: The 4^th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.

Objective To realize the distribution and characteristics of Mycobacterium leprae (M.leprae) species and its single nucleotide polymorphisms (SNPs) spreading currently in China.Methods A total of 171 cutaneous lesion specimen of leprosy patients from 22 provinces were collected.The 16S rRNA conservative region of Mycobacterium leprae was amplified by nest PCR and the positive products were sequenced directly and aligned by BLAST.The SNPs of M.leprae were genotyped by restricted fragment length polymorphism for the PCR products.Results The 171 specimen were all Mycobacterium leprae since the amplified fragments of DNA samples were 99％ similar to the Br4923 of M.leprae from Brazil.No new species (M.lepromatosis) was found.Among the 85 samples genotyped for SNPs,SNP3,SNP1 and SNP2 accounted for 78.8％ (67/85),20％ (17/85) and 1.2％ (1/85) respectively.There was no sample with SNP4 genotype to be detected.Among the 171 sequencing specimen,130 showed mutation C-T at 251 bp of 16S rRNA.There was no difference for mutant rate of 16S rRNA gene and SNP genotype among the samples with different clinical pathological types.Certain associations between 16S rRNA C251T mutation and SNP genotype were found.Most of the samples with C251T mutations of 16S rRNA sequence were SNP3,only a few were SNP1 but not SNP2.There was significant difference of SNP genotype distribution among the patients from different regions.The distribution rate of SNP3 genotype in the samples from inland region (97.1％,34/35)was significantly higher than that from coastal region (66％,33/50) (x2 =11.96,P ＜ 0.01) . There was significant difference of the gene mutation rate of 16S rRNA sequence among the patients from different regions.The mutation rate of 16S rRNA in the samples from inland region (94.8％,92/97) was significantly higher than that from coastal region (51.4％,38/74) (x2 =43.56,P ＜0.01).Conclusion C251T mutation in 16S rRNA gene sequence of M.leprae may associate with SNP type suggesting that the characteristics of geographical distribution presented in different genotypes of M.leprae.No new species of M.leprae was found in this study.