Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

To establish a highly specific,sensitive,and efficient method for detecting antibodies a-gainst the Erns protein of classical swine fever virus(CSFV),and to distinguish CSFV vaccine strains from wild strains infections in combination with the E2 subunit vaccine.The purified Erns protein of the CSFV expressed by baculovirus was conjugated to carboxylated magnetic beads as a solid-phase carrier and horseradish peroxidase(HRP),separately.A double-antigen sandwich chemiluminescent enzyme immunoassay(CLEIA)was developed by optimizing various reaction parameters using a fully automated chemiluminescence analyzer.This method was then applied to quantitatively detect Erns protein antibodies in sera from pigs infected with prevalent strains and those immunized with the CSFV E2 subunit vaccine and challenged with field strains.The results showed that the optimal conditions for coupling protein-to-magnetic bead were as follows:coupling buffer pH of 8.0,a protein coupling amount of 2.5 mg/g,blocking solution of 10％BSA,serum sample volume of 20 μL.The optimal dilution of enzyme-labeled antigen was at 1:500 with a one-step reaction time of 15 minutes.The cutoff value of the established CLEIA method for detecting CSFV Erns protein antibodies was 5.83 U/mL and a diagnostic sensitivity of 1:128.No cross-reac-tivity was observed with positive sera against African swine fever virus,pseudorabies virus,porcine circovirus type 2,porcine epidemic diarrhea virus,porcine reproductive and respiratory syndrome virus,or porcine gastroenteritis virus.Additionally,the method yielded negative results with sera from pigs immunized with the E2 subunit vaccine.In repeatability tests,the intra-assay coefficient of variation(CV)ranged from 0.77％to 11.56％,and the inter-assay CV ranged from 10.30％to 14.55％,both below 15％.The positive and negative concordance rates with a commercial CSFV Erns protein antibody detection kit were 95.24％and 92.71％,separately,with an overall concord-ance rate of 93.23％.The double-antigen sandwich chemiluminescence method established in this study exhibits high sensitivity,excellent repeatability,and suitability for automated detection,making it applicable for serological differentiation between CSFV E2 subunit vaccination and infec-tion with prevalent strains.

To establish a highly specific,sensitive,and efficient method for detecting antibodies a-gainst the Erns protein of classical swine fever virus(CSFV),and to distinguish CSFV vaccine strains from wild strains infections in combination with the E2 subunit vaccine.The purified Erns protein of the CSFV expressed by baculovirus was conjugated to carboxylated magnetic beads as a solid-phase carrier and horseradish peroxidase(HRP),separately.A double-antigen sandwich chemiluminescent enzyme immunoassay(CLEIA)was developed by optimizing various reaction parameters using a fully automated chemiluminescence analyzer.This method was then applied to quantitatively detect Erns protein antibodies in sera from pigs infected with prevalent strains and those immunized with the CSFV E2 subunit vaccine and challenged with field strains.The results showed that the optimal conditions for coupling protein-to-magnetic bead were as follows:coupling buffer pH of 8.0,a protein coupling amount of 2.5 mg/g,blocking solution of 10％BSA,serum sample volume of 20 μL.The optimal dilution of enzyme-labeled antigen was at 1:500 with a one-step reaction time of 15 minutes.The cutoff value of the established CLEIA method for detecting CSFV Erns protein antibodies was 5.83 U/mL and a diagnostic sensitivity of 1:128.No cross-reac-tivity was observed with positive sera against African swine fever virus,pseudorabies virus,porcine circovirus type 2,porcine epidemic diarrhea virus,porcine reproductive and respiratory syndrome virus,or porcine gastroenteritis virus.Additionally,the method yielded negative results with sera from pigs immunized with the E2 subunit vaccine.In repeatability tests,the intra-assay coefficient of variation(CV)ranged from 0.77％to 11.56％,and the inter-assay CV ranged from 10.30％to 14.55％,both below 15％.The positive and negative concordance rates with a commercial CSFV Erns protein antibody detection kit were 95.24％and 92.71％,separately,with an overall concord-ance rate of 93.23％.The double-antigen sandwich chemiluminescence method established in this study exhibits high sensitivity,excellent repeatability,and suitability for automated detection,making it applicable for serological differentiation between CSFV E2 subunit vaccination and infec-tion with prevalent strains.

Objective:To evaluate the clinical effect of transforaminal endoscopic spine system (TESSYS) technique in treating single-level lumbar spinal stenosis (LSS) based on computed tomography (CT) imaging and traumatic stress indicators. Methods:A total of 112 patients with single-level LSS admitted to The Third Hospital of Qinhuangdao from June 2019 to June 2021 were selected,and they were divided into observation group and control group by random number table method,with 56 cases in each group. The observation group was treated with TESSYS technique,and the control group was treated with "broad easy immediate surgery (BEIS)" technique of intervertebral foramen scope. The indicators of CT imaging of spinal canal area and protrusion ratio,as well as traumatic stress indicators included lactate dehydrogenase (LDH),myoglobin (MYO) and cortisol (COR),of two groups were compared before and 1 week after surgery. Oswestry Disability Index (ODI),Visual Analogue Scale (VAS) score and Japanese Orthopaedic Association (JOA) Scores were compared between the two groups. Excellent rates of treatment and postoperative complications of two groups were compared at the 6 th month after surgery. Results:The average hospital stay and operation time of observation group were respectively (4.29±1.08)d and (93.53±22.01)min,which were significantly shorter than (6.61±1.72)d and (112.29±26.68)min of control group,and the intraoperative blood loss of observation group was (30.15±8.26) ml,which was shorter than that (41.35±11.58) ml of control group,and the differences of them between two groups (t=8.548,4.059,5.892,P<0.05),respectively. At the 1st week after surgery,the ODI and VAS scores of observation group were lower than those of control group,and the JOA score was higher than that of control group,and the differences of them between two groups were significant (t=9.443,t=8.969,6.084,P<0.05),respectively. At the 3rd month after surgery,the ODI and VAS scores of observation group were respectively lower than those of control group,and JOA score of observation group was higher than that of control group,and the differences of them were significant (t=9.706,3.753,5.894,P<0.05),respectively. The rate of excellent and good treatment of observation group was 94.64％,which was higher than that (80.36％) of control group,and the differences of them between the two groups were statistically significant (t=5.225,P<0.05). At the 1st week after surgery,the vertebral canal area of observation group was larger than that of control group,and the ratio of protrusion invasion was less than that of control group,and the differences of them between the two groups were statistically significant (t=3.404,5.578,P<0.05),respectively. At the 1st d after surgery,the serum LDH,MYO and COR levels of observation group were lower than those of control group,and the differences of them between two groups were statistically significant (t=7.570,9.687,5.242,P<0.05),respectively. At the 3rd d after surgery,the serum LDH,MYO and COR levels of observation group were respectively than those of control group,and the differences of them between two groups were significant (t=6.856,9.729,2.744,P<0.05). There was no significant difference in complication rate between the two groups (P>0.05). Conclusion:Compared with BEIS technique,TESSYS technique has the advantages of less trauma,faster postoperative recovery and higher excellent and good rate in treating single-segment LSS,which can alleviate stress reaction of early postoperative trauma. Its comprehensively clinical efficacy is ideal.

Objective To develop a refined management model for operating rooms and assess its clinical impact on op-erational efficiency and cost control.Methods The study included 10,728 elective surgeries from January to June 2024 as the study group and 9 414 elective surgeries from January to June 2023 as the control group.The differences in operational metrics before and after implementing the refined management model were compared.The model was developed through comprehensive management by hospital leadership and multi-department collaboration,focusing on management structure,systems,processes,information technology,and resource allocation.Results In terms of efficiency,the on-time start rate of the first surgeries in the study group was significantly higher than in the control group(P＜0.05).The turnover time between surgeries was shorter in the study group(P＜0.01),and the rate of unexpected surgery cancellations was lower(P＜0.01).The average cost per surgery for consumables,excluding the impact of centralized procurement of consumables,was approximately 971 yuan,representing an 11% reduction compared to the previous year,despite a 14% increase in surgical volume.The average daily operating cost per operating room was about 12 303 yuan,a 7% reduction.Economic benefits increased by 8.43 million yuan,a 38% year-on-year increase.Conclusion Implementing a refined management model in operating rooms can significantly enhance efficiency,re-duce costs,and achieve dual improvements in social and economic benefits.

Objective:To evaluate the clinical effect of transforaminal endoscopic spine system (TESSYS) technique in treating single-level lumbar spinal stenosis (LSS) based on computed tomography (CT) imaging and traumatic stress indicators. Methods:A total of 112 patients with single-level LSS admitted to The Third Hospital of Qinhuangdao from June 2019 to June 2021 were selected,and they were divided into observation group and control group by random number table method,with 56 cases in each group. The observation group was treated with TESSYS technique,and the control group was treated with "broad easy immediate surgery (BEIS)" technique of intervertebral foramen scope. The indicators of CT imaging of spinal canal area and protrusion ratio,as well as traumatic stress indicators included lactate dehydrogenase (LDH),myoglobin (MYO) and cortisol (COR),of two groups were compared before and 1 week after surgery. Oswestry Disability Index (ODI),Visual Analogue Scale (VAS) score and Japanese Orthopaedic Association (JOA) Scores were compared between the two groups. Excellent rates of treatment and postoperative complications of two groups were compared at the 6 th month after surgery. Results:The average hospital stay and operation time of observation group were respectively (4.29±1.08)d and (93.53±22.01)min,which were significantly shorter than (6.61±1.72)d and (112.29±26.68)min of control group,and the intraoperative blood loss of observation group was (30.15±8.26) ml,which was shorter than that (41.35±11.58) ml of control group,and the differences of them between two groups (t=8.548,4.059,5.892,P<0.05),respectively. At the 1st week after surgery,the ODI and VAS scores of observation group were lower than those of control group,and the JOA score was higher than that of control group,and the differences of them between two groups were significant (t=9.443,t=8.969,6.084,P<0.05),respectively. At the 3rd month after surgery,the ODI and VAS scores of observation group were respectively lower than those of control group,and JOA score of observation group was higher than that of control group,and the differences of them were significant (t=9.706,3.753,5.894,P<0.05),respectively. The rate of excellent and good treatment of observation group was 94.64％,which was higher than that (80.36％) of control group,and the differences of them between the two groups were statistically significant (t=5.225,P<0.05). At the 1st week after surgery,the vertebral canal area of observation group was larger than that of control group,and the ratio of protrusion invasion was less than that of control group,and the differences of them between the two groups were statistically significant (t=3.404,5.578,P<0.05),respectively. At the 1st d after surgery,the serum LDH,MYO and COR levels of observation group were lower than those of control group,and the differences of them between two groups were statistically significant (t=7.570,9.687,5.242,P<0.05),respectively. At the 3rd d after surgery,the serum LDH,MYO and COR levels of observation group were respectively than those of control group,and the differences of them between two groups were significant (t=6.856,9.729,2.744,P<0.05). There was no significant difference in complication rate between the two groups (P>0.05). Conclusion:Compared with BEIS technique,TESSYS technique has the advantages of less trauma,faster postoperative recovery and higher excellent and good rate in treating single-segment LSS,which can alleviate stress reaction of early postoperative trauma. Its comprehensively clinical efficacy is ideal.

N1-methyladenosine(m1A)RNA methylation is critical for regulating mRNA translation;however,its role in the development,progression,and immunotherapy response of head and neck squamous cell carcinoma(HNSCC)remains largely unknown.Using Tgfbr1 and Pten conditional knockout(2cKO)mice,we found the neoplastic transformation of oral mucosa was accompanied by increased m1A modification levels.Analysis of m1A-associated genes identified TRMT61A as a key m1A writer linked to cancer progression and poor prognosis.Mechanistically,TRMT61A-mediated tRNA-m1A modification promotes MYC protein synthesis,upregulating programmed death-ligand 1(PD-L1)expression.Moreover,m1A modification levels were also elevated in tumors treated with oncolytic herpes simplex virus(oHSV),contributing to reactive PD-L1 upregulation.Therapeutic m1A inhibition sustained oHSV-induced antitumor immunity and reduced tumor growth,representing a promising strategy to alleviate resistance.These findings indicate that m1A inhibition can prevent immune escape after oHSV therapy by reducing PD-L1 expression,providing a mutually reinforcing combination immunotherapy approach.

The objectification of facial diagnosis has been developed through recent years and has become a multidisciplinary research topic.However,many studies are still limited to the adjustment of algorithms and the design of data collection environment and equipments,few studies focus on facial diagnosis zoning.The purpose of this paper is to discuss the problems in the current research literature on machine learning-based intelligent TCM facial diagnosis zoning to build a foundation for subsequent related research.The study uses bibliometric methods and text analysis to clarify and analyze the current intelligent TCM facial diagnosis zoning methods,which mainly include facial feature point-based,facial feature block-based and complete face-based method;then by analyzing the influencing factors of facial diagnosis zoning research and summarizing the common machine learning algorithms,the advantages and disadvantages of different machine learning algorithms and the corresponding common facial diagnosis zoning methods are obtained;Finally,we discuss three aspects of the current phase of facial diagnosis zoning research:dataset construction,advantages of deep learning,and embodiment of facial diagnosis theory.

Pulse recognition is an important part of the objectification and intelligence of TCM.This non-invasive and fast diagnostic method has great clinical value,however,data imbalance and cumbersome feature extraction are still challenging problems.The feature vectors were extracted from the one-dimensional pulse signal obtained after the Butterworth bandpass filter using the tsfresh library.And 9 columns of medical auxiliary features selected by exploratory data analysis were added.The feature filtering is performed jointly to derive 21 columns of feature vectors,which are used as input to the weighted soft voting fusion model.The data imbalance problem is solved by Borderline SMOTE algorithm.Construct a weighted soft-voting fusion model based on four types of machine learning:XGBoost,RF,LGBM,and GBDT.Eventually,the models will output specific pulse categories and demonstrate the performance by evaluating the metrics accuracy,precision,recall and F1 score.The experimental results show that the screened 21 feature vectors for a total of six types of pulse signal test sets achieve an accuracy of 90.04%in the five-fold cross-validation and take only 65.9466 seconds.It can provide a more accurate and intelligent auxiliary reference for pulse signal recognition,with lower operational complexity and higher accuracy compared to commonly used pulse recognition methods.The shorter training time also makes it more clinically useful in the recognition of multiple pulse signals.