Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1％to 100.0％,and the proportion of values processed within 30 min increased from 80.91％to 83.42％.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.

Objective To investigate the expression of T cell immunoglobulin mucin molecule(Tim-3)and Galectin-9 and their clinical significance in tumor T cell immunity in nasopharyngeal carcinoma.Methods The expression of Tim-3 in various tumor tissues in the TCGA database was searched,and Tim-3 and its ligand Galectin-9,which were closely related to the immune system of nasopha-ryngeal carcinoma patients were selected as the research genes;the data on the changes in peripheral blood T cell subsets detected by im-mune cell pathology chip technology before and after radiotherapy from 65 nasopharyngeal carcinoma patients with tumor tissues,65 naso-pharyngeal inflammatory specimens during the same period,and corresponding nasopharyngeal carcinoma patients admitted to Guangxi Zhuang Autonomous Region Ethnic Hospital from March 2018 to March 2022 were collected,and follow-up observation were conducted.Results Bioinformatics analysis of sequencing data from nasopharyngeal carcinoma in the TCGA database showed that Tim-3 was highly expressed in most tumor tissues and significantly upregulated in nasopharyngeal carcinoma tissues compared to normal adjacent tissues.The expression of Tim-3 and its ligand Galectin-9 was positively correlated in cancer tissues;Immunohistochemical results showed that the expression levels of Tim-3 and Galectin-9 in nasopharyngeal carcinoma tissue were significantly higher than that in nasopharyngeal inflammatory tissue(P＜0.05);the high expression of Tim-3 and Galectin-9 were closely related to lymph node involvement(P＜0.05)and later TNM stage(P＜0.05);the expression levels of Tim-3 and Galectin-9 were not related to factors such as age,gender,and EB virus infection(P＞0.05);the expression of Tim-3 and Galectin-9 was positively correlated in nasopharyngeal carcinoma(r=0.313,P=0.011);follow-up revealed that high expression of Tim-3 and Galectin-9 may be associated with poor prognosis in naso-pharyngeal carcinoma;the T lymphocyte subpopulation measurements of nasopharyngeal carcinoma patients 3days before and 7days after radiotherapy showed a significant decrease in CD4+and CD4+/CD8+ratios compared to before radiotherapy(P＜0.05),there was no significant difference in the changes of CD3+and CD8+(P＞0.05).The radiotherapy sensitivity of Tim-3 and Galectin-9 protein posi-tive groups was significantly higher than that of Tim-3 and Galectin-9 negative groups(P＜0.05).Conclusion The Tim-3/Galectin-9 signaling pathway plays an important role in the occurrence,development,and metastasis of nasopharyngeal carcinoma,and T cell immuni-ty plays an important role in the treatment of nasopharyngeal carcinoma.The joint detection of changes in Tim-3,Galectin-9 and T cell subsets in nasopharyngeal carcinoma tissue may provide new parameters for clinical evaluation of tumor monitoring and tumor immunotherapy.

Staphylococcus aureus has the ability to invade bovine mammary epithelial cells and cause persistent intracellular infections.For diagnosing mastitis in cows caused by the bacterial in-fections,it is necessary to determine whether there is a persistent intracellular infection by S.au-reus within mammary epithelial cells,and to establish scientific treatment strategies and imple-ment proactive management decisions.The content of this study is the establishment of a brand new diagnostic method aimed at confirming this type of bovine disease efficiently and cost-effec-tively.The diagnostic procedure is as follows:Add 100 μL S.aureus liquid culture with a concentra-tion of 8.5 ×1010 CFU/mL to the well-grown bovine mammary epithelial cell line and co-culture at 37 degrees Celsius for 2 h to establish an intracellular infection model;After the co-cultivation is completed,add 100 μL of lysostaphin to the dish to thoroughly eliminate extracellular S.aureus.It can be confirmed that the model has been successfully established that black spherical bacteria with a diameter of approximately 1μm are observed within the sample cells using a transmission e-lectron microscope.Intracellular infection is evidenced by the observation of DNA-staining positive material within the cytoplasm of DAPI-stained sample cells,as observed through a laser confocal microscope.The sample is subjected to gram staining after being treated with 200 μL of 0.5％Tri-tonX-100 for 15 min,and intracellular infection is observed within the cytoplasm of the sample cells with Gram-positive results under oil immersion microscopy.The results of the novel"Tri-tonX-100 & gram staining method"validate that the presence of Staphylococcus aureus individu-als within bovine mammary epithelial cells is consistent with images observed under transmission electron microscopy and laser confocal microscopy.The verification results indicate that the"Tri-tonX-100 & gram staining method"is suitable for the diagnosis of S.aureus persistent intracellu-lar infection in bovine mastitis.Later,somatic cells from milk were extracted by gradient centrifu-gation and purified to obtain bovine mammary epithelial cells for clinical testing of 70 S.aureus positive mastitis cattle,which showed a positive rate of 82.9％and a negative rate of 17.1％.

Staphylococcus aureus has the ability to invade bovine mammary epithelial cells and cause persistent intracellular infections.For diagnosing mastitis in cows caused by the bacterial in-fections,it is necessary to determine whether there is a persistent intracellular infection by S.au-reus within mammary epithelial cells,and to establish scientific treatment strategies and imple-ment proactive management decisions.The content of this study is the establishment of a brand new diagnostic method aimed at confirming this type of bovine disease efficiently and cost-effec-tively.The diagnostic procedure is as follows:Add 100 μL S.aureus liquid culture with a concentra-tion of 8.5 ×1010 CFU/mL to the well-grown bovine mammary epithelial cell line and co-culture at 37 degrees Celsius for 2 h to establish an intracellular infection model;After the co-cultivation is completed,add 100 μL of lysostaphin to the dish to thoroughly eliminate extracellular S.aureus.It can be confirmed that the model has been successfully established that black spherical bacteria with a diameter of approximately 1μm are observed within the sample cells using a transmission e-lectron microscope.Intracellular infection is evidenced by the observation of DNA-staining positive material within the cytoplasm of DAPI-stained sample cells,as observed through a laser confocal microscope.The sample is subjected to gram staining after being treated with 200 μL of 0.5％Tri-tonX-100 for 15 min,and intracellular infection is observed within the cytoplasm of the sample cells with Gram-positive results under oil immersion microscopy.The results of the novel"Tri-tonX-100 & gram staining method"validate that the presence of Staphylococcus aureus individu-als within bovine mammary epithelial cells is consistent with images observed under transmission electron microscopy and laser confocal microscopy.The verification results indicate that the"Tri-tonX-100 & gram staining method"is suitable for the diagnosis of S.aureus persistent intracellu-lar infection in bovine mastitis.Later,somatic cells from milk were extracted by gradient centrifu-gation and purified to obtain bovine mammary epithelial cells for clinical testing of 70 S.aureus positive mastitis cattle,which showed a positive rate of 82.9％and a negative rate of 17.1％.

Objective The digital transformation of healthcare has made data-driven approaches critical for improving the quality and efficiency of medical services.This study aims to improve the quality of critical value management by a data-driv-en intervention.Methods This study built an advanced digital platform to precisely record the time-stamp of each step,from de-tection to solution.This platform also delivered real-time notifications of patient critical value information to doctors' mobile de-vices,thereby optimizing the critical value management.Data were collected via this platform.A cohort study was designed:March 2024 data(pre-go-live)served as the control group and May 2024 data(post-go-live)as the intervention group.Comple-tion rate,processing time,and the proportion of in-patient critical values which were entered into the electronic progress were compared.Results The critical-value completion rate rose from 97.1％to 100.0％,and the proportion of values processed within 30 min increased from 80.91％to 83.42％.Among alerts that required ≥30 min,median(IQR)processing time fell from 100.27(230.09)min in March 2024 to 91.07(169.73)min in May 2024.Median processing time shortened for both e-mergency and out-patient alerts,with the out-patient reduction being statistically significant(median-45 min,P=0.042).Conclusion The data-driven platform not only improved the critical-value management,but also enhanced the transparency and traceability,providing clinical decision support and enhancing patient safety.

Objective To investigate the expression of T cell immunoglobulin mucin molecule(Tim-3)and Galectin-9 and their clinical significance in tumor T cell immunity in nasopharyngeal carcinoma.Methods The expression of Tim-3 in various tumor tissues in the TCGA database was searched,and Tim-3 and its ligand Galectin-9,which were closely related to the immune system of nasopha-ryngeal carcinoma patients were selected as the research genes;the data on the changes in peripheral blood T cell subsets detected by im-mune cell pathology chip technology before and after radiotherapy from 65 nasopharyngeal carcinoma patients with tumor tissues,65 naso-pharyngeal inflammatory specimens during the same period,and corresponding nasopharyngeal carcinoma patients admitted to Guangxi Zhuang Autonomous Region Ethnic Hospital from March 2018 to March 2022 were collected,and follow-up observation were conducted.Results Bioinformatics analysis of sequencing data from nasopharyngeal carcinoma in the TCGA database showed that Tim-3 was highly expressed in most tumor tissues and significantly upregulated in nasopharyngeal carcinoma tissues compared to normal adjacent tissues.The expression of Tim-3 and its ligand Galectin-9 was positively correlated in cancer tissues;Immunohistochemical results showed that the expression levels of Tim-3 and Galectin-9 in nasopharyngeal carcinoma tissue were significantly higher than that in nasopharyngeal inflammatory tissue(P＜0.05);the high expression of Tim-3 and Galectin-9 were closely related to lymph node involvement(P＜0.05)and later TNM stage(P＜0.05);the expression levels of Tim-3 and Galectin-9 were not related to factors such as age,gender,and EB virus infection(P＞0.05);the expression of Tim-3 and Galectin-9 was positively correlated in nasopharyngeal carcinoma(r=0.313,P=0.011);follow-up revealed that high expression of Tim-3 and Galectin-9 may be associated with poor prognosis in naso-pharyngeal carcinoma;the T lymphocyte subpopulation measurements of nasopharyngeal carcinoma patients 3days before and 7days after radiotherapy showed a significant decrease in CD4+and CD4+/CD8+ratios compared to before radiotherapy(P＜0.05),there was no significant difference in the changes of CD3+and CD8+(P＞0.05).The radiotherapy sensitivity of Tim-3 and Galectin-9 protein posi-tive groups was significantly higher than that of Tim-3 and Galectin-9 negative groups(P＜0.05).Conclusion The Tim-3/Galectin-9 signaling pathway plays an important role in the occurrence,development,and metastasis of nasopharyngeal carcinoma,and T cell immuni-ty plays an important role in the treatment of nasopharyngeal carcinoma.The joint detection of changes in Tim-3,Galectin-9 and T cell subsets in nasopharyngeal carcinoma tissue may provide new parameters for clinical evaluation of tumor monitoring and tumor immunotherapy.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Pemphigus vulgaris is a severe and refractory autoimmune skin disease with a prolonged and recurrent course, requiring long-term management by specialized clinicians. Due to the rarity of the disease, clinicians often have a relatively insufficient understanding of its treatment regimens, resulting in some misunderstandings. This article focuses on the challenges in the treatment of pemphigus vulgaris in recent years, as well as the corresponding strategies, in order to enhance clinical physicians′ understanding of pemphigus vulgaris and improve patient prognosis.

Objective:To report the clinical manifestations, structural and functional imaging features of 3 patients with progressive supranuclear palsy with predominant cerebellar ataxia (PSP-C) assisted by florzolotau ( 18F) positron emission tomography (tau PET) imaging, and conduct a literature review, aiming to provide a basis for the diagnosis and treatment of this rare type of PSP. Methods:The clinical data, brain magnetic resonance imaging, 18F-fluorodeoxyglucose PET ( 18F-FDG PET) and tau PET head imaging features of 3 patients with PSP-C who were admitted to the Department of Neurology, Peking Union Medical College Hospital from January 2019 to December 2021 were summarized, and a systematic review of related case reports or series studies from China and abroad was conducted. Results:The age of onset of the 3 patients was 55-61 years, and the disease duration was 2-5 years at the time of diagnosis. All patients had an onset of instable walking and had repeated falls, and the duration between fall and disease onset was 0.5-3.0 years, with an average of 1.5 years. At the time of diagnosis, all patients showed gait ataxia with or without limb ataxia. The results of the brain magnetic resonance imaging showed that all patients had midbrain atrophy and midbrain-to-pons ratio<0.52. The tau PET results of all patients showed significant tau protein deposition in the midbrain and mild to moderate tau protein deposition in the cerebellum, and case 2 had concomitant mild tau protein deposition in the prefrontal lobe and decreased 18F-FDG PET metabolism in this region, supporting the diagnosis of PSP. Literature review showed that 24 patients with PSP complicated with cerebellar ataxia were reported, and 23 patients provided detailed clinical data. All patients had gait ataxia on physical examination and the clinical manifestations were consistent with those of this group. Conclusions:PSP-C is characterized by early gait ataxia and falls as the core manifestations. Structural imaging shows mesencephalic atrophy, and tau PET shows mesencephalic and cerebellar uptake. In the case of atypical PSP, head magnetic resonance imaging combined with tau PET imaging is helpful to further determine the diagnosis of PSP.