Objective To explore the risk factors of cognitive dysfunction in patients with sepsis and constructing a predictive model.Methods A total of 102 patients treated in the Department of this hospital from April 2021 to April 2024 were selected as the research subjects.According to the scores of the Mini-Men-tal State Examination(MMSE)three months after discharge,the patients were divided into the cognitive im-pairment group and the non-cognitive impairment group.Demographic data,critical illness-related scores and laboratory indicators of the patients were collected.Univariate analysis and multivariate logistic regression were used to analyze the risk factors for cognitive impairment in patients with sepsis.A nomogram model was constructed and its performance was verified through internal data.Results According to the MMSE scores,there were 60 patients were divided into the cognitive impairment group and 42 patients into the non-cognitive impairment group.The results of logistic regression analysis showed that age,educational level,the time of hospital stay,total hospitalization cost,chronic diseases,APACHEⅡ score,SOFA score,WBC,use of vasoac-tive drugs,indwelling urinary catheter,opening of artificial airway,medical devices,and clinical conditions were influencing factors for the occurrence of cognitive impairment(P＜0.05).The area under the receiver operating characteristic curve of the nomogram model for predicting the occurrence of cognitive dysfunction was 0.883.The predicted probability of the occurrence of cognitive impairment was highly similar to the actu-al situation,indicating that the predictive model had good discrimination and accuracy.Conclusion The nomo-gram risk model can predict the incidence of cognitive impairment in sepsis patients relatively well,which is beneficial to the early identification,early evaluation,early intervention and treatment of high-risk groups.

ObjectiveTo investigate the epidemiological characteristics of hand, foot, and mouth disease (HFMD) in Baoshan District of Shanghai from 2008 to 2023, and to provide scientific evidence for surveillance and standardized management of HFMD. MethodsCase data for HFMD reported in the China Disease Control and Prevention Information System from 2008 to 2023 were collected. Descriptive epidemiological methods were used to analyze the population characteristics, and the Joinpoint regression models were applied to assess the temporal trends of HFMD in Baoshan District. ResultsA total of 43 853 HFMD cases were reported from 2008 to 2023 in Baoshan District, with a male-to-female ratio of 1.50∶1. The majority of cases were children, among which scattered children and preschool children accounted for 54.67% and 36.58%, respectively, with 88.00% occurring in children under 5 years old. The average annual incidence rate was147.22/100 000 individuals. The pathogen detection rate in 2018 was 58.60% (109/186). Prior to 2020, CoxA16 was the predominant strain, while EV71 was not detected after 2019. ConclusionThe incidence of HFMD in Baoshan District of Shanghai was influenced by multiple factors including the inclusion in the notifiable infectious disease surveillance system, the introduction of EV71 vaccination, and the COVID-19 pandemic timeline. Populations characterized by highly mobility and frequent external contacts were at high risk for HFMD in Baoshan District. The predominant circulating strains had shifted sequentially from EV71 and CoxA16 to CoxA6.

OBJECTIVES: To investigate the role of long noncoding RNA (lncRNA) HClnc1 in regulating proliferation, invasion, and migration of hepatocellular carcinoma (HCC) cells and the regulatory mechanism. METHODS: HClnc1 expression levels in liver cancer tissues were analyzed using data from the TCGA database. BrdU incorporation, plate cloning, and transwell assays were employed to examine the effects of HClnc1 silencing/overexpression and/or ODC1 silencing on proliferation, invasion, and migration of liver cancer cells. The effects of HClnc1 silencing on ODC1 protein and mRNA expression in the liver cancer cells were analyzed using qRT-PCR and Western blotting. The activity of ODC1 promoter was analyzed using a dual luciferase reporter gene assay. Pull-down experiment, mass spectrometry analysis, and chromatin immunoprecipitation (ChIP) assay were used for identification of HClnc1-binding proteins and their interactions. Protein interactions with the ODC1 promoter region and their binding efficiencies were investigated using RNA interference and ChIP analysis. RESULTS: HClnc1 was significantly overexpressed in HCC tissues. In liver cancer cells, HClnc1 silencing significantly inhibited cell proliferation, invasion, and migration, while HClnc1 overexpression promoted these behaviors. ODC1 silencing also suppressed malignant behaviors of liver cancer cells, and counteracted the effects of HClnc1 overexpression. Interference of HClnc1 obviously inhibited ODC1 promoter activity. RBBP5 and KAT2B proteins were identified to bind simultaneously with HClnc1. HClnc1 overexpression upregulated ODC1 protein expression, while interference of RBBP5 or KAT2B downregulated ODC1 protein expression and blocked HClnc1-induced upregulation of ODC1 protein. Both RBBP5 and KAT2B could directly bind to ODC1 promoter region; knocking out KAT2B or RBBP5 reduced the binding efficiency, while knocking out HClnc1 reduced the binding of both RBBP5 and KAT2B to ODC1 promoter region. CONCLUSIONS By targeting the RBBP5/KAT2B epigenetic modification complex, HClnc1 increases ODC1 promoter activity to enhance ODC1 transcription and promote the proliferation and migration of liver cancer cells.
Humans ; Cell Proliferation ; RNA, Long Noncoding/genetics* ; Cell Movement ; Liver Neoplasms/metabolism* ; Cell Line, Tumor ; Carcinoma, Hepatocellular/genetics* ; Promoter Regions, Genetic ; Gene Expression Regulation, Neoplastic

Objective The sample hospital is currently in the exploration stage of creating patient satisfaction service un-der the one-hospital and multi-district management mode.In order to improve the overall feeling of patients in the process of hos-pital treatment,the application effect of the existing all-round full-cycle patient service intelligent management platform in the hos-pital is quantitatively evaluated,so as to better improve the service mode.Methods A survey was conducted to collect satisfac-tion data from two groups:the experimental group,which utilized the comprehensive and full-cycle patient service intelligent man-agement platform for diagnosis and treatment services,and the control group,which followed the conventional patient admission and discharge process.The work efficiency number was obtained and calculated through the background of the system,including the average time to handle hospitalization procedures,the average waiting time for examination,the average time to handle dis-charge procedures,the time spent on each follow-up visit and the response rate of follow-up patients.The data were analyzed sta-tistically.Results The work efficiency of the experimental group was significantly better than that of the control group,and the satisfaction of hospitalized patients and staff was higher than that of the control group.Conclusion The application of the com-prehensive and full-cycle patient service intelligent management platform can improve the satisfaction of patients and staff,opti-mize the efficiency of treatment,and better serve the management mode of one hospital and multiple districts.

Objective To observe the value of T2 mapping for quantitatively evaluating the changes of junctional zone and outer myometrium caused by endometrial fibrosis.Methods A total of 73 infertility patients with endometrial fibrosis confirmed by hysteroscopy(disease group)and 33 healthy women of childbearing age(control group)were prospectively enrolled,and MR examinations were performed at the late proliferative phase of endometrium.The thickness and T2 value of junctional zone,T2 value of outer myometrium on anterior,posterior and fundus wall of midsagittal corpus uteri were measured,and the mean value of the above measurements on the three walls were calculated.Receiver operating characteristic curves were constructed,the areas under the curves(AUC)were calculated to explore the efficacy of those with significant difference among the mean thickness and the mean T2 value of junctional zone,the mean T2 value of outer myometrium and their combination for evaluating endometrial fibrosis.Results The thickness and T2 value of anterior wall,posterior wall,fundus wall and the mean junctional zone in disease group were all significantly higher than those in control group(all P＜0.001).No significant difference of T2 value of anterior wall,posterior wall,fundus wall nor the mean outer myometrium was found between groups(all P＞0.05).The mean thickness and the mean T2 value of junctional zone and their combination could be used to effectively evaluate endometrial fibrosis,with AUC of 0.839,0.822 and 0.922,respectively,and their combination had the best performance(both P＜0.01).Conclusion T2 mapping could be used to quantitatively evaluate the injury of junctional zone caused by endometrial fibrosis.

Objective:It aims to analyze regional disparity and evolution trend of health financing level and structure,providing a reference for subsequent adjustment and improvement of regional health financing policy.Methods:Based on the estimates of Total Health Expenditure(THE)by financing source,it examined the levels,structures,and trends of regional health financing.Results:In 2023,THE across regions continued to increase,but there are still significant disparities among regions,with the eastern region significantly higher than the central and western regions.Additionally,the structure of THE varied greatly by region,and the share of Out-of-Pocket payment(OOP)still accounted for a relatively high proportion in some regions.Conclusion:There are significant disparities in health investment across different regions in China,which may exacerbate health inequities.The differences in financing structures among regions are pronounced,and some areas face challenges in achieving the targets set out in the 14th Five-Year Plan regarding the proportion of OOP in THE.There is a need to optimize the health financing system,emphasizing inclusive development to ensure that health financing is adequate,effective,equitable,and sustainable.

Objectives:Accounting Total Health Expenditure(THE)in 2023,analyzing the changes of health financing in China since 2015,summarizing the main problems and challenges faced by health financing in China at present,and putting forward policy suggestions to improve health financing.Methods:Health expenditure accounting methods by financing source and by health provider were applied,and the change of total health expenditure in China is analyzed through the index analysis of time series.Results:THE in 2023 in China was 9 057.58 billion yuan,an increase of 6.77%over the previous year,accounting for 7.00%of GDP,and per capi-ta health expenditure was 6 425.32 yuan.The proportion of government health expenditure in THE decreased to 26.66%,the propor-tion of social health expenditure increased to 46.01%,and the proportion of household Out-of-Pocket(OOP)rebounded to 27.33%.Conclusions:The total scale of health expenditure in China continues to grow,but the growth rate slows down,and the stability and sustainability of health financing need to be strengthened.It is necessary to speed up the construction of a government investment mechanism based on health priority development,improve the social health insurance system,guide the rational resource allocation,and reduce the burden of medical treatment for residents.

Objective:To preliminarily investigate the safety and efficacy of programmed death-1(PD-1)inhibitor combined with cord blood-derived natural killer cells(NK cells)in the treatment of advanced malignant solid tumors in an exploratory clinical trial.Methods:Three patients with advanced solid tumors treated at the Second Affiliated Hospital of Xi'an Medical University from December 2019 to December 2021 were enrolled.According to tumor type and CSCO guidelines,patients received multiple treatment cycles(21 days per cycle)consisting of standard chemotherapy,targeted therapy,or bevacizumab combined with PD-1 inhibitor.Umbilical cord blood-derived NK cells(8×107 cells per infusion)were infused at appropriate intervals during the treatment course.Target lesion size,tumor markers,levels of 12 peripheral blood cytokines,and lymphocyte subsets were assessed in each treatment cycle.Adverse events were also monitored throughout the treatment.Results:Following the treatment with PD-1 inhibitor combined with cord blood NK cells,2 patients achieved stable disease(SD,per RECIST 1.1 criteria),with durations of 118 days and 92 days,respectively.After NK cell infusion,patient#1 exhibited a marked decrease in the tumor marker CA199 to normal range and sustained for three follow-up periods;patient#2 showed significant reductions in tumor markers CA199,CA242,and CA724.Conclusion:The combination of NK cells with chemotherapy and PD-1 inhibitor demonstrates potential therapeutic efficacy for solid tumors.No severe immune-related adverse reactions were observed in the three patients enrolled in this study.

AIM:To investigate the involvement of HIF-1α/VEGF regulation in its anti-angiogenesis effects using adjuvant-induced arthritis(AIA)rats.METHODS:AIA rats were orally treated by QLY ex-tract for 24 days.After sacrifice,the joints were subjected to histological examination,while the blood was used in ELISA or biochemical tests.In ad-dition,HUVEC cells were treated by QLY in vitro.MTT,wound-healing and tube-formation experi-ments were then performed.Expression of some relevant proteins in cells were investigated.RE-SULTS:Compared to the healthy controls,obvious synovial invasion and angiogenesis occurred in AIA rats.Blood levels of HIF-1α,VEGF,PDGF,and TGF-β1 were increased,while the ratio of MDA/SOD was decreased a lot.After QLY treatment,all these ab-normalities were attenuated.In vitro experiments,QLY showed notable potentials in inhibiting prolifer-ation,migration and tube-constructing abilities of HUVEC cells.Furthermore,it suppressed the ex-pression of p-MEK/MEK and p-ERK/ERK.CONCLU-SION:QLY can reduce the pathological functions of vascular endothelial cells by inhibiting HIF-1α/VEGF,and it consequently eased AIA-related abnor-mal angiogenesis in AIA rats'joints.

AIM:To investigate the involvement of HIF-1α/VEGF regulation in its anti-angiogenesis effects using adjuvant-induced arthritis(AIA)rats.METHODS:AIA rats were orally treated by QLY ex-tract for 24 days.After sacrifice,the joints were subjected to histological examination,while the blood was used in ELISA or biochemical tests.In ad-dition,HUVEC cells were treated by QLY in vitro.MTT,wound-healing and tube-formation experi-ments were then performed.Expression of some relevant proteins in cells were investigated.RE-SULTS:Compared to the healthy controls,obvious synovial invasion and angiogenesis occurred in AIA rats.Blood levels of HIF-1α,VEGF,PDGF,and TGF-β1 were increased,while the ratio of MDA/SOD was decreased a lot.After QLY treatment,all these ab-normalities were attenuated.In vitro experiments,QLY showed notable potentials in inhibiting prolifer-ation,migration and tube-constructing abilities of HUVEC cells.Furthermore,it suppressed the ex-pression of p-MEK/MEK and p-ERK/ERK.CONCLU-SION:QLY can reduce the pathological functions of vascular endothelial cells by inhibiting HIF-1α/VEGF,and it consequently eased AIA-related abnor-mal angiogenesis in AIA rats'joints.