Objective To investigate the current distribution of radiotherapy resources in Gansu Province, evaluate the equity of resource allocation, and provide a scientific basis for optimizing regional resource allocation. Methods A questionnaire survey was carried out to assess radiotherapy resources in medical institutions across Gansu Province, China. The equity of radiotherapy resource distribution and associated disparities were assessed using the Gini coefficient, Lorenz curve, and Theil index. Results A total of 23 medical institutions in Gansu Province provided radiotherapy services, comprising 39 radiotherapy devices and 438 professionals, of whom medical physicists accounted for 16.9%. The radiotherapy frequency was 0.47 cases per thousand population. The Gini coefficients for radiotherapy resource distribution ranged from 0.38 to 0.56 by population and from 0.52 to 0.70 by geography. The Theil index for radiotherapy resources ranged from 1.36 to 3.67. Conclusion Radiotherapy resources in Gansu Province were insufficient, and the capacity of radiotherapy service was suboptimal. The equity of radiotherapy resource allocation by geography was worse than that by population. Therefore, it is imperative to address the shortage of radiotherapy resources, strengthen the professional workforce, enhance the capacity radiotherapy service and resource utilization, optimize resource allocation, and promote regional equity in radiotherapy provision in Gansu Province.

Background and aims:Noninvasive assessments play a crucial role in ruling out high-risk esophageal varices(HREV)in cirrhotic patients.However,the value of sound touch elastography(STE)in predicting HREV has not been comprehensively investigated.Therefore,this study aimed to establish prediction models based on liver and spleen stiffness measurements obtained by STE and provide assessment strategies and cutoff values tailored for different clinical situations.Methods:This prospective study included cirrhotic patients who underwent esophagogastroduodeno-scopy(EGD).Liver and spleen stiffness measurements by STE were performed within six months of EGD examination.Various prediction models and their corresponding cutoff values were established for different clinical situations,incorporating spleen diameter and laboratory parameters.Results:A total of 154 cirrhotic patients were included in the study and stratified into training(n=119)and validation(n=35)sets.Multivariable analysis revealed platelet,spleen diameter and spleen stiffness measurement as independent predictors of HREV.The model incorporating spleen stiffness measurement,platelet,and spleen diameter demonstrated superior performance in predicting HREV,yielding an area under the receiver operating characteristic curve(AUC)of 0.878 and 0.853 in the training set and validation set,respectively.Application of this model for screening cirrhotic patients could avoid EGDs in 39.7％(27/68)and 35.3％(6/17)of patients in the training and validation sets,respectively.Conclusions:Liver and spleen stiffness measurements obtained through STE are valuable for predicting HREV in cirrhotic patients.The developed prediction models and their corresponding cutoff values provide tailored solutions for various clinical situations,thereby effectively reducing the need for un-necessary endoscopies.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with diverse phenotypes and endotypes. The emphysema phenotype, characterized by destruction of the terminal bronchioles and alveolar walls, is associated with more severe lung function impairment, heightened airway inflammation, and greater systemic dysfunction compared to other subtypes. Early diagnosis via biomarkers, signaling pathway analysis, and imaging, combined with targeted therapies, may improve patient outcomes. However, further research is needed to fully elucidate this phenotype. This review summarizes recent advances in the pathology, biomarkers, signaling pathways, and clinical management of the emphysema phenotype of COPD, aiming to enhance its recognition and inform future research.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with diverse phenotypes and endotypes. The emphysema phenotype, characterized by destruction of the terminal bronchioles and alveolar walls, is associated with more severe lung function impairment, heightened airway inflammation, and greater systemic dysfunction compared to other subtypes. Early diagnosis via biomarkers, signaling pathway analysis, and imaging, combined with targeted therapies, may improve patient outcomes. However, further research is needed to fully elucidate this phenotype. This review summarizes recent advances in the pathology, biomarkers, signaling pathways, and clinical management of the emphysema phenotype of COPD, aiming to enhance its recognition and inform future research.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To investigate the iodine nutrition status of pregnant women in Jiangmen City.Methods:From 2018 to 2023, a multi-stage stratified random sampling method was adopted to analyze the iodine nutrition status of pregnant women in 7 counties (cities and districts) of Jiangmen City. Each county (city and district) was divide into 5 sampling areas based on east, west, south, north, and center directions. One town (street) was selected from each area, and 20 pregnant women were selected in each town (street). A total of 700 pregnant women were selected each year and their urinary iodine and salt iodine levels were tested; and their iodine supplementation status in 2023 was investigated.Results:A total of 4 200 urine samples from pregnant women were tested, with a median urinary iodine level of 158.50 μg/L. Over the course of 6 years, the median urinary iodine levels of pregnant women were 138.55, 161.30, 153.20, 166.80, 166.60, and 159.00 μg/L, respectively. A total of 4 200 salt samples were tested, with a median salt iodine of 24.50 mg/kg. The median range of salt iodine for pregnant women over 6 years was 23.70 - 24.90 mg/kg, and the coverage rate of iodized salt ranged from 98.43% (689/700) to 99.71% (689/700). The qualified iodized salt consumption rate ranged from 96.57% (676/700) to 99.14% (694/700). The median urinary iodine levels (158.70, 138.00, 89.95 μg/L) of pregnant women who consumed qualified iodized salt, unqualified iodized salt, and no iodized salt were compared, and the difference was statistically significant ( H = 8.18, P = 0.017). The iodine supplementation rate of pregnant woman was 99.57% (697/700) in 2023. Conclusions:The overall iodine nutrition of pregnant women in Jiangmen City is insufficient ( < 150 μg/L ) in 2018 and maintained at an appropriate level (150 - 249 μg/L) from 2019 to 2023. However, the iodine nutrition of pregnant women fluctuates within the lower limit of the standard, posing a risk of iodine deficiency.

Objective:To investigate the accuracy of resting energy expenditure(REE)prediction formulas and to develop a new REE prediction formula suitable for hospitalized older adults.Methods:Older adults hospitalized in the Department of Geriatrics from October 1, 2022, to November 31, 2022, were included in the study.The predicted values of REE(pREE)were estimated using 13 commonly employed formulas that incorporate parameters related to resting energy expenditure, such as gender, age, body mass index(BMI), and body weight.Indirect calorimetry measurements(mREE)served as the gold standard for comparison.Group differences between pREE and mREE, the coefficient of concordance( ICC), and accuracy(defined as±10% of the mREE values)were utilized to evaluate the performance of the formulas.The ten-fold cross-validation method was employed to identify valid variables and to construct a new prediction formula.The performance of this new formula was compared to mREE, the Harris-Benedict formula, the European Society of Clinical Nutrition and Metabolism(ESPEN)formula, and the Chinese Society of Clinical Nutrition and Metabolism(CSPEN)formula. Results:A total of 223 hospitalized participants aged 60 to 98 years(mean age 79.5±8.2 years)were included in the study.Among these participants, 49.3%(110 cases)were male, and the prevalence of frailty was approximately 84.3%(188 cases).The median difference between pREE and mREE ranged from 9.1 to 232.1 kcal/d.The predictions from the Harris-Benedict, ESPEN, and CSPEN equations differed significantly from mREE(all P<0.05), with respective accuracies of 30.9%, 31.4%, and 24.7%.A new equation was developed: pREE=794.847+ 8.661×body weight -7.976 × age+ 14.757 ×grip strength+ 5.037 × heart rate, with an ICC of 0.6(95% CI: 0.5-0.7), and the accuracy reached 56.3%. Conclusions:Existing equations demonstrate low accuracy in predicting REE among hospitalized older adults.The newly developed equation shows improved performance compared to previous models and can serve as a reference method for predicting REE in this demographic.

Objective This study aimed to investigate the therapeutic efficacy of Sanjie Quban recipe in a keloid nude mice model and its impact on transforming growth factor-β 1(TGF-β1).Methods Keloid tissue after surgical resection was subcutaneously transplanted into the backs of healthy SPF BALB/C female nude mice,aged 6～8 weeks,and a keloid nude mice model was thus established.The mice were randomly divided into three groups,the Sanjie Quban recipe group,the Asiaticoside tablet group and the control gnup,with five in each group.They were respectively treated with Sanjie Quban recipe,Asiaticoside tablets,or sterile pure water.After 28 days of continuous gavage,the keloid tissue was exfoliated and weighed,and HE staining,Masson staining,and immunohistochemical staining for TGF-β1 were conducted.Differences in keloid weight between the three groups before and after treatment were compared,as were the differences in collagen fiber,fibroblast numbers,and TGF-β1 expression between the three groups after treatment.Results The difference in keloid weight before and after treatment in the Asiaticoside tablet group was greater than that of the control group,and the weight difference before and after treatment keloid treatment was the largest in the Sanjie Quban recipe group(P＜0.01).Compared with the control group,collagen fibers in the Sanjie Quban recipe group were looser and less numerous,and fibroblasts were decreased in number.The expression of TGF-β1 in the Sanjie Quban recipe group was decreased compared with that of the control group(P＜0.01).Conclusions Sanjie Quban recipe has certain therapeutic effects on keloids.The mechanism may involve reducing the expression of TGF-βl in keloid tissue and thereby reducing the proliferation of fibroblasts and the synthesis of extracellular matrix.This study provides experimental and theoretical bases for the clinical treatment of keloids with Chinese medicine.

Objective:To investigate the iodine nutrition status of pregnant women in Jiangmen City.Methods:From 2018 to 2023, a multi-stage stratified random sampling method was adopted to analyze the iodine nutrition status of pregnant women in 7 counties (cities and districts) of Jiangmen City. Each county (city and district) was divide into 5 sampling areas based on east, west, south, north, and center directions. One town (street) was selected from each area, and 20 pregnant women were selected in each town (street). A total of 700 pregnant women were selected each year and their urinary iodine and salt iodine levels were tested; and their iodine supplementation status in 2023 was investigated.Results:A total of 4 200 urine samples from pregnant women were tested, with a median urinary iodine level of 158.50 μg/L. Over the course of 6 years, the median urinary iodine levels of pregnant women were 138.55, 161.30, 153.20, 166.80, 166.60, and 159.00 μg/L, respectively. A total of 4 200 salt samples were tested, with a median salt iodine of 24.50 mg/kg. The median range of salt iodine for pregnant women over 6 years was 23.70 - 24.90 mg/kg, and the coverage rate of iodized salt ranged from 98.43% (689/700) to 99.71% (689/700). The qualified iodized salt consumption rate ranged from 96.57% (676/700) to 99.14% (694/700). The median urinary iodine levels (158.70, 138.00, 89.95 μg/L) of pregnant women who consumed qualified iodized salt, unqualified iodized salt, and no iodized salt were compared, and the difference was statistically significant ( H = 8.18, P = 0.017). The iodine supplementation rate of pregnant woman was 99.57% (697/700) in 2023. Conclusions:The overall iodine nutrition of pregnant women in Jiangmen City is insufficient ( < 150 μg/L ) in 2018 and maintained at an appropriate level (150 - 249 μg/L) from 2019 to 2023. However, the iodine nutrition of pregnant women fluctuates within the lower limit of the standard, posing a risk of iodine deficiency.