ObjectiveTo construct and validate a clinical prediction model for inflammatory remission outcomes in rheumatoid arthritis （RA） patients with liver and kidney deficiency syndrome treated with Bushen Zhiwang Decoction （补肾治尪汤， BZD） based on metabolomics. MethodsA prospective cohort study was conducted， enrol-ling 60 RA patients with liver and kidney deficiency syndrome. All patients were treated with BZD and conventional-dose oral conventional synthetic disease-modifying antirheumatic drugs （csDMARDs） for 12 months. Clinical data were collected， and the change in disease activity score in 28 joints （DAS28） after treatment compared with baseline （△DAS28） was used as the primary outcome and grouping criterion. Peripheral blood samples were collected before treatment to analyze plasma metabolites. Differential analysis and least absolute shrinkage and selection operator （LASSO） regression were used to preliminarily screen differential metabolites， followed by machine learning algorithms to further identify a core metabolite combination. Based on the expression levels of the core metabolite combination， a novel metabolite index， namely the metabolomics-based inflammatory remission score （Met-IRS）， was calculated using standar-dized metabolite values， and its clinical applicability was evaluated. A clinical prediction model was constructed by integrating clinical characteristics and Met-IRS， and the model performance was assessed. ResultsAmong the 60 patients， those with △DAS28 ≥ 0.27 were assigned to the high inflammatory remission group， while those with △DAS28 ＜ 0.27 were assigned to the low inflammatory remission group， with 30 cases in each group. Compared to the low inflammatory remission group， the high inflammatory remission group showed a higher frequency of methotrexate use and a lower positive rate of rheumatoid factor （RF） （P＜0.05）. Seven core metabolites were identified as the optimal combination， including mangiferic acid， fatty acid-hydroxy fatty acid ester 40∶6， fatty acid-hydroxy fatty acid ester 18∶0， fatty acid-hydroxy fatty acid ester 36∶1， glucosylceramide， lysophosphatidylcholine 22∶5， and pregnanetriol ketone. The calculated Met-IRS comprehensively reflected the characteristics of differential metabolites and demonstrated clinical applicability. Met-IRS was significantly higher in the high inflammatory remission group than in the low inflammatory remission group， and was positively correlated with high inflammatory remission outcomes （P＜0.05）. Based on the variables Met-IRS， methotrexate use， leflunomide use， and RF positivity， a clinical prediction model for inflammatory remission in RA treatment （Cj-RTRM） was constructed. Model performance evaluation demonstrated that the model had good clinical predictive ability， with an area under the receiver operating characteristic curve （AUC） of 0.880， sensitivity 0.967， specificity 0.700 and Youden's index 0.667. ConclusionThe clinical prediction model Cj-RTRM constructed based on the metabolomics-based inflammatory remission score Met-IRS can effectively predict clinical inflammatory remission outcomes in RA patients treated with BZD and accurately identify the advantageous population for this treatment. This model provides guiding evidence for dynamic inflammation monitoring， targeted management， and identification of populations with advantages in traditional Chinese medicine.

Objective To explore the application effect of outpatient 5G guided wristbands in reducing medical obstacles for the aged and improving service experience,and provide evidence for their promotion and application.Method A total of 216 aged patients who visited our hospital's outpatient department from January to December 2022 were selected as the research subjects.They were divided into a control group and an trial group based on the parity of the last digits of their medical card numbers,with 108 patients in each group.Patients in the trial group received 5G guided hand ring intervention on the basis of traditional guidance,while patients in the control group received traditional guidance methods.The arrival time and emergency response time of patients medical experience,and satisfaction with medical treatment were compared between the two groups of patients.Results The arrival time and emergency response time of patients in the trial group were shorter than those in the control group;The trial group had better scores in all six dimensions of medical experience than those of the control group;excepting the medical environment and health conditions,the clarity of the outpatient department distribution route map and the service of the triage staff,the ease of registration,waiting time for medical treatment,and overall satisfaction of patients in the trial group were better than those in the control group,and the difference between the two groups was statistically significant(all P<0.05).Conclusion The outpatient 5G guided wristband can improve the efficiency of handling sudden problems and the medical experience for elderly patients,thereby increasing patient satisfaction.

Objective To comprehensively assess the binocular function of college students with different glasses-wearing habits and myopic anisometropia using an eye-tracking-based,naked-eye 3D visual inspection system.Methods Between December 2023 and March 2024,a total of 137 myopic(equivalent spherical diopter per eye ≤-0.50 D)students were recruited at Sichuan University.They were divided into 2 groups,including a group of 78 participants who wore glasses continuously,and another group of 59 participants who did not wear glasses continuously.According to the degree of myopic anisometropia(the difference between the equivalent spherical diopters,ΔSE),the 2 groups were further divided into subgroups A(0 D＜ΔSE ≤ 1.00 D)and B(ΔSE＞1.00 D).Binocular function was examined using a naked-eye 3D display device based on human eye tracking,and the correlation between different glasses-wearing habits and myopic anisometropia and binocular visual function was analyzed.Results There was no statistically significant difference in the degree of myopic anisometropia between the continuous glasses-wearing group([1.15±1.15]D)and the non-continuous glasses-wearing group([1.20±1.15]D)(P=0.798).In addition,there was no statistically significant difference in refraction between the continuous glasses-wearing group and the non-continuous glasses-wearing group(P=0.158).There were statistically significant differences in the perceptual eye position of the right eye between the continuous glasses-wearing subgroups A and B(P＜0.05).There were statistically significant differences in coarse stereopsis between the non-continuous glasses-wearing subgroups A and B(P＜0.05).There were statistically significant differences in foveal suppression,fine stereopsis,and perceptual eye position between the continuous glasses-wearing group and the non-continuous glasses-wearing group(P＜0.05).Conclusion Both glasses-wearing habits and myopic anisometropia have effects on the binocular visual function of college students.

Objective To evaluate the association of different obesity phenotypes and their components with the risk of cognitive impairment in older Chinese adults,and to assess the association between obesity and cognitive impairment in different cognition-related genetic backgrounds.Methods A cross-sectional study based on the West China Health and Aging Cohort was conducted.Logistic regression was applied to estimate the association of obesity phenotypes and components with cognitive impairment in older Chinese adults stratified by APOE gene and polygenic risk scores.Results A total of 7 316 participants were enrolled,of whom 1 820 had cognitive impairment.Weight gains were associated with a reduced risk of cognitive impairment(odds ratio[OR]=0.96,95%CI,0.95-0.97).Being overweight with a normal waist-to-hip ratio was a protective factor for cognition(OR=0.74,95%CI,0.61-0.90),whereas the coexistence of elevated waist-to-hip ratio and overweight did not increase the risk of cognitive impairment.Sarcopenia was associated with an elevated risk of cognitive impairment.This association was found in both overweight(OR=2.03,95%CI,1.71-2.41)and non-overweight older adults(OR=1.86,95%CI,1.58-2.20),and was significant across all polygenic risk score strata.Conclusion Increasing body mass may serve as a key protective factor against cognitive decline in older adults.Having sarcopenia and obesity is associated with an elevated risk of cognitive impairment,independent of genetic susceptibility.

Objective To develop measurement instruments of dynamic capabilities for public hospitals,providing a reference for the evaluation and enhancement of their dynamic capabilities.Methods The initial construction of the measurement instruments of dynamic capabilities for public hospitals was based on literature review and focused group discussions.Two rounds of expert consultation were conducted using the Delphi method,and the reliability and validity of the questionnaire was initially examined through pre-survey.Results The effective response rates for both rounds of consultation were above 85％,with high positive coefficient,the authority coefficients greater than 0.8,and variation coefficients less than 0.25,indicating a high level of consensus among experts.Furthermore,the reliability and validity are acceptable.After integrating expert feedback,the measurement instruments of dynamic capabilities for public hospitals were finalized,encompassing four dimensions:sensing,learning,integration capability,and innovation capabilities.Conclusion The measurement instruments of dynamic capabilities for public hospitals,developed based on the Delphi method,can be applied in the practice of evaluating and enhancing the dynamic capabilities of public hospitals.

Objective To explore the application effect of outpatient 5G guided wristbands in reducing medical obstacles for the aged and improving service experience,and provide evidence for their promotion and application.Method A total of 216 aged patients who visited our hospital's outpatient department from January to December 2022 were selected as the research subjects.They were divided into a control group and an trial group based on the parity of the last digits of their medical card numbers,with 108 patients in each group.Patients in the trial group received 5G guided hand ring intervention on the basis of traditional guidance,while patients in the control group received traditional guidance methods.The arrival time and emergency response time of patients medical experience,and satisfaction with medical treatment were compared between the two groups of patients.Results The arrival time and emergency response time of patients in the trial group were shorter than those in the control group;The trial group had better scores in all six dimensions of medical experience than those of the control group;excepting the medical environment and health conditions,the clarity of the outpatient department distribution route map and the service of the triage staff,the ease of registration,waiting time for medical treatment,and overall satisfaction of patients in the trial group were better than those in the control group,and the difference between the two groups was statistically significant(all P<0.05).Conclusion The outpatient 5G guided wristband can improve the efficiency of handling sudden problems and the medical experience for elderly patients,thereby increasing patient satisfaction.

Objective To develop measurement instruments of dynamic capabilities for public hospitals,providing a reference for the evaluation and enhancement of their dynamic capabilities.Methods The initial construction of the measurement instruments of dynamic capabilities for public hospitals was based on literature review and focused group discussions.Two rounds of expert consultation were conducted using the Delphi method,and the reliability and validity of the questionnaire was initially examined through pre-survey.Results The effective response rates for both rounds of consultation were above 85％,with high positive coefficient,the authority coefficients greater than 0.8,and variation coefficients less than 0.25,indicating a high level of consensus among experts.Furthermore,the reliability and validity are acceptable.After integrating expert feedback,the measurement instruments of dynamic capabilities for public hospitals were finalized,encompassing four dimensions:sensing,learning,integration capability,and innovation capabilities.Conclusion The measurement instruments of dynamic capabilities for public hospitals,developed based on the Delphi method,can be applied in the practice of evaluating and enhancing the dynamic capabilities of public hospitals.

Objective:To assess the prevalence and type of tissue prolapse (TP) occurring after endovascular treatment (ET), investigate the association between TP types and plaque morphological characteristics before ET, and observe in-stent neointimal hyperplasia (NIH) using optical coherence tomography (OCT).Methods:Patients who underwent carotid artery stenting and received pre- and post-ET OCT assessment at Jinling Hospital between July 2018 and December 2019 were collected. Baseline plaque characteristics and TP features were evaluated using OCT. The TPs were classified into two categories: smooth TP (STP) and irregular and/or high attenuated TP (I/HTP). The association between I/HTP and plaque characteristics was analyzed, while NIH feature was also summarized.Results:A total of 29 patients were included in the study, of whom 23 patients (79.3%) presented with TP. Among these 23 patients, 9 were classified as I/HTP and 14 were classified as STP. Compared with STP, I/HTP was more commonly observed in lipid-rich plaques (7/9 vs 2/14, P=0.007), and lesions with cap rupture (7/9 vs 4/14, P=0.036). Additionally, the longitudinal length of TP appeared to be longer in cases with I/HTP compared to those with STP [3.0 (1.5, 4.6) mm vs 1.1 (0.7, 3.2) mm, Z=1.294, P=0.201]. Six patients underwent OCT follow-up for a mean duration of 6.7 months, of whom 3 patients with I/HTP showed severe heterogeneous NIH (50.1%-61.8%), while 1 patient with STP and 2 patients without TP only demonstrated mild NIH. Conclusions:The study observed that I/HTP was commonly found in plaques with larger lipid core and/or cap rupture, and suggested a potential relationship between I/HTP and NIH. These preliminary findings obtained from a limited sample should be verified by prospective large-scale studies.

Objective:To analyze long-term prognosis and influencing factors of recurrence in vocal fold leukoplakia treated by endoscopic cordectomy with CO 2 laser. Methods:A retrospective review was conducted on 599 patients with vocal fold leukoplakia [566 males and 33 females, aged 17-84 years (median age 55 years)], undergoing endoscopic cordectomy by CO 2 laser under general anesthesia at the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital, Capital Medical University, from January 2000 to December 2023. The study analyzed the clinical features, pathological grade, surgical methods, postoperative voice function, recurrence, malignant changes and analyzed the long-term efficacy and and its influencing factors. The patients were followed up for a duration of 6-249 months postoperatively, with a median follow-up time of 48 months. SPSS 20.0 software was used for statistical analysis. Results:Among the 599 patients, the histopathological grades included simple squamous cell hyperplasia in ( n=264, 44.08%), mild dysplasia ( n=96, 16.03%), moderate dysplasia ( n=74, 12.35%), severe dysplasia( n=43, 7.81%), carcinoma in situ( n=35, 5.84%), and carcinoma in situ with microinvasion( n=87, 14.52%). The 3-year and 5-year overall recurrence rates were 12.91% and 16.00%, respectively. In patients with precancerous lesion, 3.91% of recurrences presented with an upgraded pathologic grade and 2.34% evolved into carcinoma. The risk of recurrence was higher in lesions involving the anterior commissure, larger lesions, significant reduction/absence of mucosal waves, neovascularization/suspected neovascularization, and pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinvasion( F=44.76,21.54,11.55,8.78,23.20,respectively, P<0.05). Additionally, patients with recurrent disease exhibited higher reflux symptom index scores compared to those without recurrence. Exophytic lesion characteristics and the inability to cease smoking postoperatively were identified as independent risk factors for recurrence with an upgraded pathological grade, with odds ratios of 8.675 and 11.380 times greater than those with non-exophytic lesions and successful smoking cessation, respectively. At the 6-months postoperative assessment, patients who underwent subepithelial cordectomy (typeⅠ) demonstrated a statistically significant increase in fundamental frequency ( t=-3.38, P<0.05), and while other voice acoustic parameters were not significantly different.Conversely, those who underwent transmuscular cordectomy (TypeⅢ) exhibited significant alterations in multiple voice acoustic parameters when compared to preoperative values ( P<0.05). Furthermore, postoperative vocal fold adhesions developed in 84 patients with 13 of these individuals requiring surgical intervention for adhesion release. Conclusions:Lesions involving the anterior commissure, larger lesions, pathology of dysplasia/carcinoma in situ/carcinoma in situ with microinfiltration, significant reduction/absence of vocal fold mucosal waves, and neovascularization visible under NBI are indicative of an increased risk of recurrence, whereas exophytic lesions and the inability to cease smoking postoperatively significantly increase the risk of recurrence with elevated pathologic grade. Recovery of postoperative voice quality is procedure-dependent, underscoring the importance of surgical approach selection in the management of vocal fold leukoplakia.

OBJECTIVE To establish the UHPLC fingerprint of Miao Medicine Ficus tikoua Bur., study its spectrum-effect relationship with antioxidant activity, and screen the antioxidant active components. METHODS UHPLC was used to establish the fingerprint of Ficus tikoua Bur.. Evaluation System for Similarity of Chromatographic Fingerprint of Chinese Herbal Medicine (Version 2012) was used to evaluate the similarity and identify the common peaks. SPSS 16.0 and SIMCA 14.1 software were used for hierarchical cluster analysis(HCA) and principal component analysis(PCA). The 1,1-diphenyl-2-picrylhydrazyl(DPPH) free radical scavenging method, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt(ABTS) free radical scavenging method and total antioxidant capacity method were used to evaluate the antioxidant activity of 16 batches of ethanol extracts from Ficus tikoua Bur. Three methods including grey relational analysis(GRA), bivariate correlation analysis and partial least squares regression(PLSR) were used to study the spectrum-effect relationship. RESULTS The UHPLC fingerprints of 16 batches of Ficus tikoua Bur. were established and 13 common peaks were identified. The similarities were 0.613−0.996. At the same time, it was identified that peak 9 was rutin, peak 10 was isoquercetin, and peak 12 was narcissin. The results of HCA showed that the samples were clustered into two categories, which was consistent with the PCA results. Sixteen batches of Ficus tikoua Bur. had different degrees of antioxidant activity. The results of GRA showed that the correlation between 13 common peaks and antioxidant activity was >0.8, and all of them had high correlation. The results of bivariate correlation analysis and PLSR analysis showed that the correlation coefficient and regression coefficient of peak 5, peak 9(rutin), peak 10(isoquercetin), peak 11 and peak 12(narcissin) were positively correlated with antioxidant activity, and the contribution rate was larger(variable importance in projection>1), which were the main active components of antioxidant activity. CONCLUSION All the 16 batches of Ficus tikoua Bur. have good antioxidant activity, and its antioxidant effect is the result of the synergistic action of the internal antioxidant component group. The components corresponding to the common peaks 5, 9, 10, 11, 12 are closely related to their antioxidant activity, revealing the pharmacodynamic material basis of the antioxidant activity of Ficus tikoua Bur.