Objective The aim of this study is to understand the quality of the medical records front page,analyze the reasons,and propose targeted measures to continuously improve the quality of medical records front page,providing accurate and reliable data assurance for the DIP model.Methods A stratified sampling method was used to select 15 020 discharged medical records from a tertiary hospital in Guangzhou from 2022 to 2023.Senior coders performed quality control on the selected medical records front page using a double-person double-quality control mode.Data collection was conducted using Microsoft Excel 2007,and statistical description was performed using SPSS 26.0.Results The defect rate of the medical records front page in the stud-ied tertiary hospital in Guangzhou was 19.91％.The defect rates for non-surgical departments and surgical departments were 17.26％and 23.40％,respectively.There were 4,121 cases(49.28％)with information system transmission errors.The main defects affecting DIP inclusion in the medical records front page were the primary surgical or operative procedure name(903 ca-ses,10.80％)and the primary diagnosis(828 cases,9.90％).Conclusion The defect rate of the medical records front page in the studied tertiary hospital in Guangzhou is at a medium-to-high level,with prominent issues of information system transmis-sion errors and defects affecting DIP inclusion.Measures such as strengthening information construction,enhancing training and communication,and organizing medical records front page knowledge competitions should be implemented to improve the quality of medical records front page.

Encephalomyocarditis virus(EMCV)is a zoonotic pathogen that causes encephalitis and myocarditis as its primary clinical manifestations.To explore effective preventive measures,this study utilized a Bac-to-Bac expression system to insert the EMCV P12A and 3C genes into the pFastBacDual shuttle vector,resulting in the generation of the recombinant baculovirus Ac-P12A-3C.This facilitated the large-scale expression and purification of EMCV virus-like particles(VLPs),which were correctly assembled into particles of approximately 30 nm in diameter,as ob-served by electron microscopy.Immunization and challenge experiments in mice demonstrated that these VLPs could effectively protect against EMCV infection,achieving a protection rate of 100％.Histopathological sections indicated that,compared to the PBS control group,the VLP immuniza-tion group exhibited significantly reduced tissue damage,along with a marked decrease in viral load within the tissues.In piglets,immunization with the VLPs elicited a robust humoral response,with neutralizing antibody titers reaching 1∶320 to 1∶640 after a second immunization,and no signifi-cant adverse reactions were observed throughout the immunization process.This study preliminarily explores the immunogenicity and safety of the VLP vaccine,laying the foundation for the development of a subunit vaccine based on EMCV VLPs and offering a new strategy for the prevention and control of encephalomyocarditis.

Objective: To investigate the potential protective effect of Shexiang Tongxin dropping pills (STDP) on ischemia-reperfusion injury and its underlying mechanisms in improving endothelial cell function in coronary microvascular disease (CMVD). Methods: A rat model of myocardial ischemia-reperfusion injury with CMVD was established using ligation and reperfusion of the left anterior descending artery. The effect of STDP (21.6 mg/kg) on cardiac function was evaluated using echocardiography, hematoxylin-eosin staining, and Evans blue staining. The effects of STDP on the microvascular endothelial barrier were assessed based on nitric oxide production, endothelial nitric oxide synthase expression, structural variety of tight junctions (TJs), and the expression of zonula occludens-1 (ZO-1), claudin-5, occludin, and vascular endothelial (VE)-cadherin proteins. The mechanisms of STDP (50 and 100 ng/mL) were evaluated by examining the expression of sphingosine 1-phosphate receptor 2 (S1PR2), Ras Homolog family member A (RhoA), and Rho-associated coiled-coil-containing protein kinase (ROCK) proteins and the distribution of ZO-1, VE-cadherin, and F-actin proteins in an oxygen and glucose deprivation/reoxygenation model. Results: The administration of STDP on CMVD rat model significantly improved cardiac and microvascular endothelial cell barrier functions (all P < .05). STDP enhanced the structural integrity of coronary microvascular positioning and distribution by clarifying and completing TJs and increasing the expression of ZO-1, occludin, claudin-5, and VE-cadherin in vivo (all P < .05). The S1PR2/RhoA/ROCK pathway was inhibited by STDP in vitro, leading to the regulation of endothelial cell TJs, adhesion junctions, and cytoskeletal morphology. Conclusion STDP showed protective effects on cardiac impairment and microvascular endothelial barrier injury in CMVD model rats induced by myocardial ischemia-reperfusion injury through the modulation of the S1PR2/RhoA/ROCK pathway.

ObjectiveTo investigate the ameliorative effect of Xingpi capsules on functional dyspepsia（FD） and the potential mechanism. MethodsSixty SPF-grade male SD neonatal rats（7 days old） were randomly divided into the normal group（n=12） and the modeling group（n=48）， and the FD model was prepared by iodoacetamide gavage in the modeling group. After the model was successfully prepared， the rats in the modeling group were randomly divided into the model group， the low-dose and high-dose groups of Xingpi capsules（0.135， 0.54 g·kg^-1） and the domperidone group（3 mg·kg^-1）， with 12 rats in each group. Rats in the normal and model groups were gavaged with distilled water， and rats in the rest of the groups were gavaged with the corresponding medicinal solution， once a day for 7 d. The general survival condition of the rats was observed， and the water intake and food intake of the rats were measured， the gastric emptying rate and the small intestinal propulsion rate were measured at the end of the treatment， the pathological damage of the rat duodenum was examined by hematoxylin-eosin（HE） staining， and the expressions of colonic tight junction protein（Occludin） and zonula occludens protein-1（ZO-1） were detected by immunofluorescence. The differentially expressed genes in the duodenal tissues of the model group and the normal group， and the high-dose group of Xingpi capsules and the model group were detected by transcriptome sequencing after the final administration， and Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses were carried out. The transcriptomic results were validated by Western blot， immunofluorescence， and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the active ingredients of Xingpi capsules were screened for molecular docking with the key targets. ResultsCompared with the normal group， the general survival condition of rats in the model group was poorer， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly reduced（P<0.05）， inflammatory infiltration was seen in duodenal pathology， and the fluorescence intensities of Occludin and ZO-1 in the colon were significantly reduced（P<0.01）. Compared with the model group， the general survival condition of rats in the high-dose group of Xingpi capsules improved significantly， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly increased（P<0.05）， the duodenal pathology showed a decrease in inflammatory infiltration， and the fluorescence intensities of colonic Occludin and ZO-1 were significantly increased（P<0.01）. Transcriptomic results showed that Xingpi capsules might exert therapeutic effects by regulating the phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt） through the key genes such as Slc5a1， Abhd6. The validation results showed that compared with the normal group， the phosphorylation levels of PI3K and Akt proteins， the protein expression level of interleukin（IL）-1β， and the fluorescence intensities of IL-6 and IL-1β were significantly increased in the model group（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3， Slc5a9 and other key genes were significantly increased（P<0.01）. Compared with the model group， the phosphorylation levels of PI3K and Akt， the protein expression level of IL-1β and the fluorescence intensities of IL-6 and IL-1β in the high-dose group of Xingpi capsules were significantly reduced（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3 and Slc5a9 were significantly reduced（P<0.05）. Weighted gene co-expression network analysis and molecular docking results showed that E-nerolidol and Z-nerolidol in Xingpi capsules were well bound to ABDH6 protein， and linarionoside A， valerosidatum and senkirkine were well bound to Slc5a1 protein. ConclusionXingpi capsules can effectively improve the general survival and gastrointestinal motility of FD rats， its specific mechanism may be related to the inhibition of PI3K/Akt signaling pathway to alleviate the low-grade inflammation of duodenum， and E-nerolidol， Z-nerolidol， linarionoside A， valerosidatum and senkirkine may be its key active ingredients.

ObjectiveTo investigate the ameliorative effect of Xingpi capsules on functional dyspepsia（FD） and the potential mechanism. MethodsSixty SPF-grade male SD neonatal rats（7 days old） were randomly divided into the normal group（n=12） and the modeling group（n=48）， and the FD model was prepared by iodoacetamide gavage in the modeling group. After the model was successfully prepared， the rats in the modeling group were randomly divided into the model group， the low-dose and high-dose groups of Xingpi capsules（0.135， 0.54 g·kg^-1） and the domperidone group（3 mg·kg^-1）， with 12 rats in each group. Rats in the normal and model groups were gavaged with distilled water， and rats in the rest of the groups were gavaged with the corresponding medicinal solution， once a day for 7 d. The general survival condition of the rats was observed， and the water intake and food intake of the rats were measured， the gastric emptying rate and the small intestinal propulsion rate were measured at the end of the treatment， the pathological damage of the rat duodenum was examined by hematoxylin-eosin（HE） staining， and the expressions of colonic tight junction protein（Occludin） and zonula occludens protein-1（ZO-1） were detected by immunofluorescence. The differentially expressed genes in the duodenal tissues of the model group and the normal group， and the high-dose group of Xingpi capsules and the model group were detected by transcriptome sequencing after the final administration， and Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses were carried out. The transcriptomic results were validated by Western blot， immunofluorescence， and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the active ingredients of Xingpi capsules were screened for molecular docking with the key targets. ResultsCompared with the normal group， the general survival condition of rats in the model group was poorer， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly reduced（P<0.05）， inflammatory infiltration was seen in duodenal pathology， and the fluorescence intensities of Occludin and ZO-1 in the colon were significantly reduced（P<0.01）. Compared with the model group， the general survival condition of rats in the high-dose group of Xingpi capsules improved significantly， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly increased（P<0.05）， the duodenal pathology showed a decrease in inflammatory infiltration， and the fluorescence intensities of colonic Occludin and ZO-1 were significantly increased（P<0.01）. Transcriptomic results showed that Xingpi capsules might exert therapeutic effects by regulating the phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt） through the key genes such as Slc5a1， Abhd6. The validation results showed that compared with the normal group， the phosphorylation levels of PI3K and Akt proteins， the protein expression level of interleukin（IL）-1β， and the fluorescence intensities of IL-6 and IL-1β were significantly increased in the model group（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3， Slc5a9 and other key genes were significantly increased（P<0.01）. Compared with the model group， the phosphorylation levels of PI3K and Akt， the protein expression level of IL-1β and the fluorescence intensities of IL-6 and IL-1β in the high-dose group of Xingpi capsules were significantly reduced（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3 and Slc5a9 were significantly reduced（P<0.05）. Weighted gene co-expression network analysis and molecular docking results showed that E-nerolidol and Z-nerolidol in Xingpi capsules were well bound to ABDH6 protein， and linarionoside A， valerosidatum and senkirkine were well bound to Slc5a1 protein. ConclusionXingpi capsules can effectively improve the general survival and gastrointestinal motility of FD rats， its specific mechanism may be related to the inhibition of PI3K/Akt signaling pathway to alleviate the low-grade inflammation of duodenum， and E-nerolidol， Z-nerolidol， linarionoside A， valerosidatum and senkirkine may be its key active ingredients.

Objective To analyze the disease burden,changing trends,and differences of atrial fibrillation(AF)/atrial flutter(AFL)globally and in China and Japan from 1990 to 2021,and to predict their future trends,aiming to provide references for health decision-making.Methods Based on the Global Burden of Disease Study Database 2021(GBD 2021),we extracted age-standardized prevalence rate(ASPR)and age-standardized disability-adjusted life year rate(ASDALYR)data for AF/AFL by sex globally,in China,and Japan.The estimated annual percentage change(EAPC)was used to assess the trends.Joinpoint regression analysis and the Bayesian age-period-cohort(BAPC)model were employed for trend analysis and prediction.Results From 1990 to 2021,the ASPR and ASDALYR for AF/AFL in males were increased significantly globally,with EAPC of 0.05(95%CI:0.01～0.08)and 0.09(95%CI:0.08～0.11),respectively.Changes were significantly declined in females,with EAPC of-0.11(95%CI:-0.14～-0.07)and-0.10(95%CI:-0.12～-0.07).In China,the ASPR for AF/AFL were increased in both males and females,with those of males more notably(EAPC=0.77,95%CI:0.65～0.88).However,the ASDALYR for AF/AFL showed gender divergence,with an increase in males(EAPC=0.40,95%CI:0.30～0.49)while a decrease in females(EAPC=-0.55,95%CI:-0.67～-0.44).In Japan,both the ASPR and ASDALYR for males and females showed continuous declines,and the reduction was more pronounced among females(ASPR EAPC=-1.77,95%CI:-2.32～-1.22;ASDALYR EAPC=-1.73,95%CI:-2.11～-1.35).Joinpoint regression analysis showed that from 1990 to 2021,for the ASDALYR of AF/AFL,the average annual percentage change(AAPC)was 0.28%(P<0.001)for Chinese males and-0.37%(P<0.001)for Chinese females,while the AAPC was-0.70%(P<0.001)and-1.43%(P<0.001)for Japanese males and females.BAPC model revealed that by 2036,the ASDALYR for Chinese males is predicted to increase from 91.45 per 100 000 in 2022 to 101.11 per 100 000,and for females is from 88.85 per 100 000 to 100.98 per 100 000.For Japanese males,the ASDALYR is projected to increase slightly from 88.79 to 89.86 per 100 000,while for females,it is projected decrease slightly from 41.13 to 39.67 per 100 000,indicating only minor fluctuations in the ASDALYR for both Japanese males and females.Conclusion The disease burden of AF/AFL continues to increase globally and in China.So,Japan's lifestyle and health policies are worth considering,and more scientific and effective public health policies and clinical intervention strategies should be formulated and implemented.Countermeasure The relevant government agencies should promote the transformation of the food industry through the policy-market mechanism,carry out activities related to national health management,and continuously optimize the AF/AFL management model of medical and health institutions to effectively cope with this disease burden change.

OBJECTIVE: To investigate the molecular mechanism and explore blood transfusion strategies for a proband exhibiting the JK (a-b-) phenotype and anti-JK³ high frequency antigen antibody and her eight family members. METHODS: The Kidd blood phenotype and irregular antibodies in a family were identified by serologic tests. Exon 4-11 and intron region of SLC14A1 gene were sequenced by Sanger method. RESULTS: The combination of the gene JK*B (c.499A>G,c.512G>A,c.588A>G) and gene JK*B (c.342-1G>A,588A>G) in this family were considered to result in the JK (a-b-) phenotype in two members. The members carrying gene JK*A(c.130G>A,588A>G) all present serological JK^a+W. Members carrying gene JK*B (c.499A>G,c.588A>G) all present serological JK^b+W, which has not been previously reported to cause antigenic weakening. The proband with JK (a-b-) phenotype produced anti-JK³ antibodies, the hospital formulated a number of blood preparation strategies for the patient and she was discharged after recovery. CONCLUSION In this study, the molecular mechanism of JK (a-b-) in this family was identified, the transfusion strategy of rare blood group was established in our institution preliminary, and the necessity of establishing a rare blood group bank was revealed in this region. It is suggested that JK*B (c.499A>G,c.588A>G) may be a new genetic pattern leading to the weakening of Kidd antigenicity, which lays a foundation for the study of population genetics.
Humans ; Blood Transfusion ; Female ; Kidd Blood-Group System/genetics* ; Phenotype ; Pedigree

Objective To explore the clinical effects and influencing factors of recombinant human growth hormone(rhGH)treatment in pediatric patients with growth hormone deficiency.Methods The study subjects were pediatric patients with growth hormone deficiency,all of whom received a combination therapy of stanozolol tablets 2 mg(qd)and 0.1 U·kg-1·d-1 of recombinant human growth hormone injection for a continuous period of one year.After one year,the patients were divided into active group and invalid group based on clinical outcomes.Comparisons were made between the two groups in terms of height,annual growth velocity(GV)and height standard deviation score(HtSDS)before and after treatment,and safety evaluations were conducted.Multivariate Logistic regression analysis was used to identify factors that influenced the treatment outcomes in pediatric patients with growth hormone deficiency.Results After one year of treatment,a total of 93 cases pediatric patients were included in the analysis,with 62 cases in the active group and 31 cases in the invalid group.The heights of the patients before and after treatment were(119.40±2.48)and(129.08±2.37)cm,respectively;the GV were(3.08±0.39)and(7.34±1.02)cm·year-1,respectively;the HtSDS were-2.45±0.49 and-1.68±0.35,respectively,with statistically significant differences observed for all comparisons(all P＜0.05).In the active and invalid groups,the proportions of patients with GV＜3.0 cm·year-1 before treatment were 32.26％and 58.06％,respectively;the proportions of patients with peak growth hormone(GH)levels＜5.0 ng·mL-1 before treatment were 30.65％and 54.84％,respectively;the average maternal heights were(158.83±5.76)and(155.48±6.58)cm,respectively,with statistically significant differences observed for all comparisons(all P＜0.05).The results of the Logistic regression model showed that GV＜3.0 cm·year-1 before treatment,peak GH levels＜5.0 ng·mL-1 before treatment,and a shorter maternal height were independent risk factors for poor treatment outcomes with rhGH in pediatric patients with growth hormone deficiency(all P＜0.05).No severe adverse reactions occurred during the treatment of any patient;seven patients experienced pain at the injection site,one patient had a slight increase in blood glucose,and five patients had mild decreased appetite.The total incidence of adverse drug reactions were 13.98％(13 cases/93 cases).Conclusion Treatment with rhGH for pediatric patients with growth hormone deficiency can significantly improve height development and has good safety,but it is influenced by factors such as growth velocity,peak GH levels,and maternal height.

ObjectiveTo observe the clinical effectiveness and potential mechanism of combined tongue three-needle acupuncture and acupoint application on Lianquan （CV 23） for patients with dysphagia after ischemic stroke. MethodsA prospective study was conducted on 160 patients with post-stroke dysphagia， who were randomly divided into a treatment group and a control group， with 80 cases in each group. The control group received conventional rehabilitation training， while the treatment group received tongue three-needle acupuncture combined with acupoint application on Lianquan （CV 23） on the basis of conventional rehabilitation training， for 4 weeks in both groups. We compared the clinical effectivenss of both groups after treatment， and assessed the swallowing function including videofluoroscopic swallowing study （VFSS）， standardized swallowing assessment （SSA） and functional oral intake scale （FIOS）， swallowing contrast test including hyoid maximum displacement （HmaxD）， pharyngeal transit time （PTT）， and upper esophageal sphincter （UES） opening， surface electromyography （sEMG） test including maximum amplitude and swallowing duration as well as swallowing quality of life questionnaire （SWAL-QOL） score of the patients in both groups before treatment， after 2 weeks and 4 weeks of treatment， respectively. ResultsThe total effective rate in treatment group was 82.50% （66/80）， significantly higher than 66.25% （53/80） in control group （P＜0.05）. The VFSS， and FOIS scores， UES opening rate and HmaxD， sEMG maximal amplitude values， and SWAL-QOL scores were increased in both groups after 2 weeks and 4 weeks of treatment compared with the values before treatment （P＜0.05）， while SSA scores， PTT， and swallowing duration were decreased compared within group before treatment （P＜0.05）. VFSS and FOIS scores， UES opening rate and HmaxD， sEMG maximal amplitude values， and SWAL-QOL scores after 2 and 4 weeks of treatment in the treatment group were higher （P＜0.05）， while SSA scores， PTT， and swallowing duration were lower （P＜0.05） than those in the control group at the same time. ConclusionCombined tongue three-needle acupuncture and acupoint application on Lianquan （CV 23） for patients with dysphagia after ischemic stroke can significantly improve swallowing activities， and its mechanism of action may be related to the improvement of the contraction ability and coordination of swallowing-related muscle groups.

Objective:To search, evaluate, and summarize the best evidence for postpartum contraceptive health guidance, providing evidence-based support for clinical healthcare providers in implementing standardized contraceptive counseling and management.Methods:A systematic search was conducted across guideline repositories, professional association websites, and databases for literature related to postpartum contraception guidance, including guidelines, best practices, expert consensus, and systematic reviews, with a search timeframe from database inception to December 2023. Four researchers independently evaluated the quality of the included studies, extracted relevant data, and synthesized evidence from eligible literature.Results:According to the inclusion and exclusion criteria, 18 documents were included, comprising 5 guidelines, 2 clinical decision-making documents, 1 best practice document, 4 expert consensus statements, and 6 meta-analyses or systematic reviews. Totally 46 pieces of best evidence were summarized from 9 aspects, including health educators, health education recipients, assessment, planning, mode and content of health education, available contraceptive methods, evaluation index of health education, and considerations.Conclusion:This study systematically synthesizes the best available evidence on postpartum contraceptive health guidance. It emphasizes strengthening the competencies of clinical practitioners, supported by structured assessments and standardized guidance, to improve the feasibility and accessibility of contraceptive services. It further highlights the importance of ensuring the long-term sustainability of contraceptive plans and integrating digital tools to enhance the precision and coverage of guidance, ultimately reducing unintended and short-interval pregnancies and safeguarding women's reproductive health.