Objective To observe the origin and course of the obturator artery(OA),so as to provide anatomical reference for reducing hemorrhage during pelvic surgery and pubic fracture fixation.Methods A total of 65 human hemi-pelvises specimens with intact structure were dissected to observe the origin,course and other variations of OA.Measure the length of the inner section of OA basin and the outer diameter at the origin,etc.Results OA originated from the internal iliac artery in 57 cases(87.7%),including 3 cases(4.6%)of the superior gluteal artery,5 cases(7.7%)of the inferior gluteal artery,3 cases(4.6%)of the external iliac artery and 5 cases(7.7%)of the inferior epigastric artery.OA participated in the formation of the arterial trunk in 3 cases(4.6%).The length of the pelvic segment of the OA in male and female was(50.87±15.41)mm and(51.71±14.19)mm,respectively,with no statistically significant difference between them(P>0.05).The outer diameters at the origin of the OA in male and female were(2.79±1.05)mm and(2.35±0.86)mm,and there was no statistically significant difference between them(P>0.05).Conclusion OA mainly originated from the anterior trunk of the internal iliac artery,with a few OA originated from the branches of the posterior trunk or the inferior epigastric artery,or participated in the formation of the arterial trunk.In pelvic surgery involving OA area,attention should be paid to the length of its pelvic segment and the outer diameter at the origin of OA,so as to better locate and protect blood vessels during surgery.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment.Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020.Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chi-nese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The in-cidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06％,95％CI;1.13％-9.14％,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05).The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05).Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strength-ened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collab-orative diagnosis and treatment to reduce the disease burden.

Objective:To investigate the impacts of 1,25-dihydroxyvitamin D 3 (VD) and Lactobacillus plantarum (LP) on intestinal flora in animals with metabolic dysfunction-associated fatty liver disease (MAFLD) and their possible mechanisms. Methods:A methionine- choline-deficient (MCD) diet-induced rat model of MAFLD was created. Forty 10-week-old male Sprague-Dawley rats were randomized into methionine-choline-sufficient (MCS) group, MCD group, VD group, LP group, and VD-LP group, with 8 rats in each group. The intervention groups (VD group, LP group, and VD-LP group) were gastrically fed with VD peanut oil solution (6 ng/100 g daily), Lactobacillus plantarum solution (2×10 9CFU/100 g daily), and a combination of these two solutions, respectively. MCS group, MCD group, and LP group were given the same volume of peanut oil on a daily basis. Fecal samples from rats were collected at week 4 and analyzed using 16S rRNA gene sequencing for fecal flora structure. Portal vein blood samples were collected to detect liver biochemistry and lipopolysaccharide (LPS) levels. Pathological changes in liver and terminal ileum tissues were observed using hematoxylin and eosin (H&E) staining. Results:Compared with the MCS group, the MCD group exhibited massive steatosis and lipid infiltration in liver tissues, markedly thinned ileum mucosa, severely damaged villi structure, excessive necrotic and shedding of epithelial cells, and infiltration of inflammatory cells. Compared with the histopathological changes in the MCD group, the steatosis and lipid infiltration of liver tissue, the damage to the ileal mucosa structure and epithelial cells, and the infiltration of inflammatory cells were alleviated in the VD group, LP group, and VD-LP group. Compared with MCS group, the MCD group had significantly higher serum alanine aminotransferase (ALT) (158.50±14.03 U/L vs. 20.38±7.39 U/L), aspartate aminotransferase (AST) (43.88±11.36 U/L vs. 25.75±5.90 U/L), total bile acid (TBA) (140.60±11.77 μmol/L vs. 19.96±4.31 μmol/L), and LPS (16.57±1.19 pg/ml vs. 7.43±0.95 pg/ml) (All P<0.001),which confirmed the successful establishment of rat models of MAFLD. Serum ALT, AST, TBA, and LPS levels in all the three intervention groups were significantly lower than those in MCD group, and the most significant reductions in ALT (51.38±9.05 U/L vs. 158.50±14.03 U/L), AST (55.88±12.19 U/L vs. 143.88±11.36 U/L), TBA (21.00±8.17 μmol/L vs. 140.60±11.77 μmol/L), and LPS (9.72±0.71 pg/ml vs. 16.57±1.19 pg/ml) were seen in the VD-LP group. The microbiota in the MCD group predominantly featured Muribaculaceae, while the MCS group and other intervention groups primarily harbored Lactobacillus. Firmicutes and Lactobacillus were significantly decreased in the MCD group ,while Bacteroidete, Proteobacteria, Verrucomicrobiota, Prevotellaceae UCG-003, Escherichia coli, Bacteroides, and Enterococcus increased significantly. The opposite was true for each intervention group. There were significant differences in Lactobacillus between MCD group and the other four groups. Conclusion:VD and LP can remarkably improve lipid deposition in MAFLD by regulating intestinal flora.

Objective:To analyze the risk factors for symptomatic cerebral infarction (SCI) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:A total of 337 patients with spontaneous ICH admitted to the stroke center of Zhengzhou People’s Hospital were consecutively collected from May 2019 to March 2023. Patients were divided into the SCI group and without SCI group according to whether the presence of new neurological deficits consistent with diffusion-weighted imaging hyperintense lesions distant from the hematoma. Magnetic resonance was used to quantify cerebral small vessel disease imaging markers and the degree of cerebral artery stenosis (CAS). SPSS 25.0 software was used for data analysis. Univariate and multivariable Logistic regression models were adopted to assess risk factors associated with concomitant SCI. Subgroup analysis stratified by mean arterial pressure (MAP) tertiles was performed.Results:Compared with patients without SCI, patients with SCI have more histories of ischemic stroke, higher rates of complication of pneumonia and deep venous thrombosis, higher baseline systolic blood pressure, greater MAP change, higher periventricular white matter hyperintensities score and deep white matter hyperintensities (DWMHs) score, and more severe CAS (all P<0.05). Multivariable regression analysis showed that, the degree of CAS ( B=1.095, OR=2.989, 95% CI=1.645-5.432, P<0.001) and DWMHs score ( B=0.789, OR=2.201, 95% CI=1.163-4.166, P=0.015) were risk factors for ICH patients with SCI. Compared with patients with mild CAS, the proportion of SCI significantly increased in patients with moderate and severe CAS in the maximum MAP change group (both P<0.05). Compared with patients with mild DWMHs, the proportion of SCI in patients with severe DWMHs in the maximum MAP change group significantly increased ( P=0.002). Conclusion:Severe CAS and DWMHs are independent risk factors for SCI after ICH, especially with greater fluctuations in MAP change.

AIM To investigate the ameliorative effects of Compound Fufangteng Mixture(CFM)on cyclophosphamide(CTX)-induced immunosuppression in mice.METHODS Forty-eight male C57BL/6J mice were randomly divided into the blank control group,the model group,the levamisole hydrochloride group(40 mg/kg)and the low-dose,medium-dose and high-dose CFM groups(3.75,7.5,10 g/kg),with 8 mice in each group,and given respective intervention orally once daily for 14 days.On the 5th to 7th day of administration,with the blank control group given normal saline intraperitoneally,the other groups underwent intraperitoneal CTX injections(80 mg/kg).24 hours after the last administration,organ indices of thymus and spleen were calculated;splenic histopathological alterations were assessed by HE staining;serum levels of IL-2,IL-6 and IgG were quantified using ELISA;splenic CD4+,CD8+T lymphocytes,alongside CD86+and CD206+macrophages populations were analyzed by flow cytometry;and splenic expression of CD4,CD8 and F4/80 was evaluated by immunohistochemical staining.RESULTS In CTX-treated mice,CFM administration mitigated body weight loss;enhanced thymus weight and thymic index;ameliorated splenic immune cell populations,elevated serum levels of cytokines IL-2,IL-6 and IgG in serum;and upregulated splenic levels of CD45+CD3+T lymphocytes and F4/80+CD11b+macrophages,alongside increasing the expression of CD4,CD8 and F4/80 surface markers.CONCLUSION CFM alleviates CTX-induced immunosuppression state in mice by modulating immune cells,restoring immune function and enhancing anti-inflammatory and tissue repair capabilities.

Objective:To investigate the preferences and influencing factors of Traditional Chinese Medicine(TCM)health management services among community healthcare workers,providing a reference for promoting and spreading TCM health management services in communities.Methods:Based on a discrete choice experiment,a questionnaire survey was conducted among 596 community healthcare workers across 9 administrative districts in Beijing.A mixed logit model was used to analyze their preferences.Results:Changes in post-tax monthly income,expected efficacy,single-service duration,technical difficulty,patient compliance,and insurance coverage significantly influenced community doctors'service preferences.Changes in post-tax monthly income had the highest relative importance(35.11%),followed by insurance coverage(34.87%).Preferences varied among healthcare workers with different professional titles,backgrounds,weekly working hours,and whether the service was included in performance evaluations.Conclusion:Both economic and non-economic factors influence community healthcare workers'service preferences to varying degrees.Optimizing the combination of TCM health management service attributes can enhance community healthcare workers'willingness to provide such services.It is recommended to use a combination of economic and non-economic incentive measures and develop differentiated strategies for healthcare workers with different characteristics to meet their service preferences and promote the development of TCM health management services in communities.

Objective:To explore the coordinated development status of the medical service supply-economy-society trinity systems in Zhejiang Common Prosperity Demonstration Zone,and to offer references for formulating policies conducive to the efficient and coordinated development of these three systems.Methods:Based on the panel data from 2013 to 2022,this research was conducted on the 11 prefectural-level cities in Zhejiang Province.Firstly,an evaluation index system for the three systems was established,and the entropy method was employed to determine the weights of each index and calculate the comprehensive evaluation index.Secondly,a triangular model was introduced to delineate the relative relationships among the three systems,and the coupling coordination degree model was utilized to disclose the coordination degree of the three systems.Finally,the spatial autocorrelation analysis method was applied to investigate the spatial autocorrelation of the coupling coordination degree of the three systems.Results:(1)On the whole,the development status of the three systems has improved over time,yet the comprehensive development level remains to be improved.(2)Overall,each prefectural-level city has transited from a medical service supply-society-dominated development to a balanced and coordinated development of the medical service supply-economy-society trinity systems.The coupling coordination degree of the three systems has risen from 0.468(on the verge of imbalance)in 2013 to 0.609(primary coordination)in 2022,presenting an upward trend in general.However,the coordination level remains to be improved and there exist imbalances among regions.(3)The coupling coordination degree of the three systems in Zhejiang Province exhibits a significant positive spatial correlation,and the spatial distribution characteristics are relatively stable. Conclusion:The coupling coordination degree of the medical service supply-economy-society trinity systems in Zhejiang Province awaits further enhancement. At the level of Zhejiang Province,favorable policy support should be provided,the layout of medical resources should be rationally planned,and high-quality economic and social development should be promoted. Each prefectural-level city should formulate strategies for medical service supply,economic,and social development in accordance with its own development level and local conditions,strengthen inter-city linkage and cooperation,and thereby elevate the coordinated development level of the three systems.

Objective To use AI-assisted motor dysfunction assessment for quantitative evaluation of motor function in Parkinson's disease(PD)and multiple system atrophy-Parkinsonian type(MSA-P)in order to achieve accurate differential diagnosis.Methods A total of 105 participants aged ≥60 years were consecutively enrolled from the First and Third Medical Centers of Chinese PLA General Hospital between January and September 2024.Based on diagnostic criteria,they were divided into a PD group(48 cases),a MSA-P group(31 cases),and a control group(26 cases).The general information was collected,and the motor function was evaluated with Move-ment Dysfunction Assessment Software in order to assess the diagnostic value of the AI-assisted assessment in differentiating between PD and MSA-P.Results Significantly differences were observed among the three groups in terms of facial expression indicators,bilateral finger tapping frequency,bilateral hand movement frequency,right hand movement amplitude change rate,bilat-eral palm flipping frequency,bilateral toe tapping frequency,freezing load of bilateral toe tapping,bilateral leg flexibility frequency,right leg flexibility amplitude change rate,freezing load of bilat-eral leg flexibility,upright extension angular velocity,turnaround time,forward step frequency,backward step frequency,forward average stride length,backward average stride length,forward average walking speed,backward average walking speed,forward average step width,backward average step width,bilateral postural tremor frequency,bilateral postural tremor maximum am-plitude,bilateral action tremor frequency,bilateral action tremor maximum amplitude,and com-parison of bilateral resting tremor frequency(P＜0.05,P＜0.01).The MSA-P group exhibited significantly lower blink frequency,maximum amplitude and frequency of facial tremors,upright extension angular velocity,and step frequency,while higher ratio of mouth opening duration and longer turnaround time when compared with the PD group(P＜0.05,P＜0.01).The AUC value of the combined nine motor function indicators and the five facial expression indicators in differ-entiating PD from MSA-P was 0.943(95％CI:0.895-0.991,P=0.000)and 0.925(95％CI:0.870-0.981,P=0.000),respectively,both better than that of individual indicators.Conclusion Combi-nation assessment of facial expression,posture,gait with AI assistance can contribute to the dif-ferential diagnosis of PD and MSA-P.

AIM To sequence the chloroplast genome of Artemisia vestita Wall.ex Bess.METHODS Based on ethnobotanical surveys,sample collection and original plant identification were carried out.The chloroplast genome was sequenced using the Illumina platform,followed by assembly and annotation.A comprehensive comparative analysis was conducted with six Artemisia species.The maximum likelihood(ML)phylogenetic tree was constructed based on the chloroplast genome sequences of A.vestita and 32 other Asteraceae species,with Leptocodon hirsutus D.Y.Hong of Campanulaceae as outgroup.RESULTS The chloroplast genome of A.vestita was 151 204 bp in length,including a small single-copy region of 18 331 bp,a large single-copy region of 82 949 bp,and inverted repeat regions of 24 962 bp,with a total GC content of 37.45％.134 genes were annotated,including 89 protein-coding genes,8 ribosomal RNA genes,and 37 transfer RNA genes.A total of 67 SSRs and 44 LSRs were detected in the chloroplast genome.Comparative analysis with closely related species of Artemisia revealed 3 highly variable genes(clpP,rpl36,ycf1)and 6 highly variable intergenic regions(trnK-UUU-matK,rps18-rpl20,rpl36-infA,rpl14-rpl16,rpl16-rpl3 and trnL-UAG-ccsA),which could serve as candidate DNA barcodes for Artemisia identification.Phylogenetic analysis showed that Artemisia formed a highly supportive monophyletic group,with A.vestita and A.gmelinii Web.ex Stechm.being closely related.CONCLUSION This study may provide fundamental data for phylogenetic analysis of Artemisia,taxonomic identification and DNA barcoding construction of Tibetan herb.

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.