ObjectiveTo elucidate the critical role of rehabilitation medical records (including electronic records) in rehabilitation medicine's clinical practice and management, comprehensively analyzed the structure, core content and data standards of rehabilitation medical records, to develop a standardized medical record data architecture and core dataset suitable for rehabilitation medicine and to explore the application of rehabilitation data in performance evaluation and payment. MethodsBased on the regulatory documents Basic Specifications for Medical Record Writing and Basic Specifications for Electronic Medical Records (Trial) issued by National Health Commission of China, and referencing the World Health Organization (WHO) Family of International Classifications (WHO-FICs) classifications, International Classification of Diseases (ICD-10/ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), this study constructed the data architecture, core content and data standards for rehabilitation medical records. Furthermore, it explored the application of rehabilitation record summary sheets (home page) data in rehabilitation medical statistics and payment methods, including Diagnosis-related Groups (DRG), Diagnosis-Intervention Packet (DIP) and Case Mix Index. ResultsThis study proposed a systematic standard framework for rehabilitation medical records, covering key components such as patient demographics, rehabilitation diagnosis, functional assessment, rehabilitation treatment prescriptions, progress evaluations and discharge summaries. The research analyzed the systematic application methods and data standards of ICD-10/ICD-11, ICF and ICHI Beta-3 in the fields of medical record terminology, coding and assessment. Constructing a standardized data structure and data standards for rehabilitation medical records can significantly improve the quality of data reporting based on the medical record summary sheet, thereby enhancing the quality control of rehabilitation services, effectively supporting the optimization of rehabilitation medical insurance payment mechanisms, and contributing to the establishment of rehabilitation medical performance evaluation and payment based on DRG and DIP. ConclusionStructured rehabilitation records and data standardization are crucial tools for quality control in rehabilitation. Systematically applying the three reference classifications of the WHO-FICs, and aligning with national medical record and electronic health record specifications, facilitate the development of a standardized rehabilitation record architecture and core dataset. Standardizing rehabilitation care pathways based on the ICF methodology, and developing ICF- and ICD-11-based rehabilitation assessment tools, auxiliary diagnostic and therapeutic systems, and supporting terminology and coding systems, can effectively enhance the quality of rehabilitation records and enable interoperability and sharing of rehabilitation data with other medical data, ultimately improving the quality and safety of rehabilitation services.

Objective:To explore the efficacy and safety of the ballistic-ultrasound-negative pressure three-in-one energy platform (Trilogy) for micro-channel percutaneous nephrolithotomy (mini-PCNL).Methods:A retrospective analysis was conducted on the clinical data of 140 patients with upper urinary tract stones treated at Tianjin Medical University Second Hospital from February to October 2024. All patients underwent mini-PCNL and were divided into the holmium laser group and the Trilogy group based on the stone fragmentation equipment used during the procedure. There were 69 patients in the holmium laser group and 71 in the Trilogy group. The two groups had similar mean ages (55.1±10.2 years vs. 53.4±10.8 years), male patient proportions (50 cases, 72.5% vs. 50 cases, 70.4%), body mass indices (25.2±3.6 kg/m 2 vs. 25.3±4.0 kg/m 2), incidence rates of hypertension (29 cases, 42.0% vs. 31 cases, 43.7%), diabetes (15 cases, 21.7% vs. 12 cases, 16.9%), mean cumulative stone lengths (39.2±12.6 mm vs. 35.9±14.8 mm), total stone volumes preoperatively (6 184.3±3 653.5 mm 3 vs. 5 644.9±4 173.8 mm 3), mean CT values for stones (1 138.2±264.3 HU vs. 1 151.3±208.0 HU), stone locations (ureter 14 cases, 20.3% vs. 22 cases, 31.0%; kidney 48 cases, 69.6% vs. 39 cases, 54.9%; both ureter and kidney 7 cases, 10.1% vs. 10 cases, 14.1%), preoperative mean urinary white blood cell counts [9.6(3.6, 31.2) cells/HPF vs. 11.9(3.8, 34.5) cells/HPF], proportions of patients with preoperative urinary white blood cells (+ + + ; 23 cases, 33.3% vs. 25 cases, 35.2%), nitrite positivity rates (4 cases, 5.8% vs. 3 cases, 4.2%), and urine culture positivity rates (12 cases, 17.4% vs. 18 cases, 25.4%) showed no statistically significant differences. The proportion of patients with moderate or higher hydronephrosis in the holmium laser group was lower than that in the Trilogy group (32 cases, 46.4% vs. 47 cases, 66.2%, P=0.018). The holmium laser group utilized holmium laser lithotripsy, where stone fragments were either flushed out with a vortex or retrieved with a stone basket. The Trilogy group employed a three-in-one energy platform to break the stones. This device incorporated pneumatic ballistic, ultrasound, and negative pressure suction capabilities within the same metallic probe, allowing the stone to be fragmented into small pieces while simultaneously performing ultrasonic negative pressure stone clearance. The parameters for the three-in-one energy platform were adjusted based on intraoperative conditions, typically setting negative pressure at 30%-50%, ultrasound power at 80%-100%, ballistic power at 80%, and frequency at 8 Hz. During the stone fragmentation process, the ballistic device fragmented the stones while ultrasound further reduced larger fragments and removed them. Some fragments that were difficult to break could also be flushed out or retrieved with a stone basket. The efficiency of stone clearance (volume of stones cleared per unit time) was compared between the two groups, as well as the stone-free rates on postoperative day 1 and day 30. Stone clearance time was defined as the duration from the start of fragmentation to the placement of the nephrostomy tube. Changes in postoperative white blood cells, hemoglobin, and albumin levels compared to preoperative levels, as well as the incidence of Clavien-Dindo complications, were compared between the two groups. Equipment failure incidents were recorded (fiber fracture in the holmium laser group indicating it could not be used; probe fracture in the Trilogy group). Patients were sub-grouped based on stone CT values into CT ≥ 1 000 HU and CT < 1 000 HU categories to compare stone clearance efficiency between the two devices within each sub-group. In the CT≥1 000 HU sub-group, there were 51 cases in the holmium laser group and 54 in the Trilogy group, there were no significant differences in preoperative total stone volume (6 785.0±3 902.3 mm 3 vs. 5 678.1±4 297.7 mm 3). In the CT < 1 000 HU sub-group, there were 18 cases in the holmium laser group and 17 in the Trilogy group. There were no significant differences between the groups in preoperative total stone volume (4 482.2±2 110.6 mm 3 vs. 5 530.9±3 845.3 mm 3). Results:The overall stone clearance efficiency in the Trilogy group was higher than that in the holmium laser group (87.9±35.7 mm 3/min vs. 77.1±24.3 mm 3/min, P=0.038). There were no significant differences in residual stone volume before discharge [5.5(0, 84.0) mm 3 vs. 5.3(0, 175.0) mm 3], stone clearance time (79.4±43.2 min vs. 66.6±49.7 min), or the proportion of patients using stone baskets during the procedure (33 cases, 47.8% vs. 36 cases, 50.7%). Postoperative changes in white blood cells, hemoglobin, and albumin compared to preoperative levels were not significantly different [(4.1±2.9)×10 9/L vs. (3.3±2.2)×10 9/L; (-2.9±10.5) g/L vs. (-1.6±9.3) g/L; (-2.5±3.6) g/L vs. (-1.8±5.0) g/L] Furthermore, there were no statistically significant differences in equipment failure rates (1 case, 1.4% vs. 4 cases, 5.6%), stone-free rates (postoperative day 1: 43 cases, 62.3% vs. 47 cases, 66.2%; postoperative day 30: 50 cases, 72.5% vs. 53 cases, 74.6%), or Clavien-Dindo complication rates (grade Ⅰ: 11 cases, 15.9% vs. 8 cases, 11.3%; grade Ⅱ: 2 cases, 2.8% vs. 0 cases; grade Ⅲ: 1 case, 1.4% vs. 0 cases). In the CT ≥ 1 000 HU sub-group, the clearance time for the holmium laser was longer than that for Trilogy (93.3±41.0 min vs. 74.6±51.9 min, P=0.044), there were no significant differences in residual stone volume before discharge [6.3(1.6, 173.8) mm 3 vs. 4.5(0, 69.0) mm 3] between the two groups. In the CT < 1 000 HU sub-group, the overall stone clearance efficiency of the Trilogy group exceeded that of the holmium laser group (134.2±38.0 mm 3/min vs. 105.5 ± 7.1 mm 3/min, P=0.004), there were no significant differences between the groups in residual stone volume before discharge [0(0, 51.1) mm 3 vs. 16.3(0, 957.2) mm 3], or stone clearance time (40.2±18.1 min vs. 39.1±27.5 min). Conclusions:In mini-PCNL surgery, the stone fragmentation efficiency of the three-in-one lithotripsy energy platform is superior to that of the holmium laser, while the overall complication rate is comparable to that of the holmium laser.

The prevention and treatment of esophageal cancer constitute an important component of China's cancer control efforts.As the earliest established cancer prevention and control field site in China,the Linzhou Esophageal Cancer Prevention and Treatment Site has developed a sys-tematic prevention and control strategy encompassing tumor registration,etiological research,early diagnosis and treatment,and other key areas,providing valuable experience for refining China's cancer prevention system.Based on over six decades of practical experience at the Linzhou site,this paper reviews its historical development,the construction of its prevention-control system,and emerging challenges in the new era,while exploring its reference significance for China's na-tionwide cancer prevention and control initiatives.

Background and purpose:Patients with prostate cancer(PCa)have consistently shown suboptimal responses to immunotherapy,which may be closely related to the immunosuppressive state of the PCa tumor microenvironment.MYC,a key transcription factor in cancer cells,is involved in cell proliferation,differentiation,apoptosis and immune surveillance by regulating the expression of intracellular genes.This study aimed to elucidate the mechanisms through which MYC fosters an immunosuppressive state within the PCa tumor microenvironment and to delineate its functional impact on PCa cells.Methods:We performed clustering and annotation of single-cell RNA sequencing(scRNA-seq)data from PCa,and conducted subcluster analyses for tumor cells,T cells,and macrophages respectively.The expression changes of MYC and CD47 across tumor subtype were analyzed,and the expression variations of signal regulatory protein alpha(SIRPα)among macrophage subtype were assessed.Furthermore,we divided the PCa transcriptomic dataset samples into high-and low-MYC expression groups based on MYC expression levels,and performed differential expression analysis and enrichment analysis for each group.The functional role of MYC in PCa cells was validated using chromatin immunoprecipitation-quantitative polymerase chain reaction(ChIP-qPCR)and experimental analyses.Furthermore,animal experiments(reviewed and approved by the ethics committee of the First Affiliated Hospital of Henan University of Science and Technology,approval number:D-2025-B015)were conducted to further validate the relationship between MYC and CD47.Finally,we analyzed and validated the whey acidic protein four-disulfide core domain 2(WFDC2)+tumor subtype using transcriptomic data from PCa.Results:Through the analysis of scRNA-seq data from PCa,a total of 32,977 cells were identified,and 7 distinct cell types were annotated.The tumor cells were further divided into 10 tumor cell subtypes,among which the WFDC2+tumor cell subtype exhibited more intensive cellular communication with CD8+T cells and macrophages within the PCa tumor microenvironment.MYC and CD47 exhibited high expression levels during the middle-to-late stages of differentiation in PCa cells,whereas SIRPα maintained high expression throughout the macrophage differentiation trajectory.Enrichment analysis revealed that the WFDC2+tumor cell subtype was primarily enriched in signaling pathways such as transforming growth factor-β(TGF-β)and Wnt/β-catenin.ChIP-qPCR confirmed the regulatory relationship between MYC and CD47 expression.Additionally,it was found that MYC knockdown significantly inhibited the proliferation and invasion abilities of PCa cells,while overexpression of CD47 could reverse this effect.Animal experiment results confirmed an positive correlation between MYC and CD47 protein expression.Furthermore,Tumor Immune Dysfunction and Exclusion(TIDE)and Estimate analyses indicated that patients in the low-expression group of the WFDC2+tumor cell subtype exhibited a potentially better response to immunotherapy compared to those in the high-expression group.Conclusion:The findings of this study elucidate the role of MYC in the PCa tumor immune microenvironment.Specifically,MYC promotes the proliferation and migration of PCa cells by regulating the expression of CD47.These insights provide novel perspectives for the treatment of PCa patients.

OBJECTIVE To design and synthesize rifamycin S derivatives and load them into milk exosomes to evaluate their in vitro antimicrobial activity.METHODS Rifamycin S derivatives were synthe-sized and characterized by mass spectrometry and NMR.Using the dilution assay method,the inhibitory activity of each rifamycin S derivatives molecule against Staphylococcus aureus and Pseudomonas aerugi-nosa was determined,and the IC50 was calculated.Derivatives molecules with excellent antimicrobial activity were selected and loaded into milk exosomes using the ultrasonication method,resulting in the preparation of milk exosome-loaded rifamycin S derivatives.The antimicrobial activity against Staphylo-coccus aureus was determined using the dilution assay method.The inhibitory effect of the exosome-loaded rifamycin S derivatives on Staphylococcus aureus residing within macrophages was detected using the plate colony counting method.RESULTS Three rifamycin S derivatives were successfully designed and synthesized,which demonstrated superior antimicrobial activity against Staphylococcus aureus(the parent compound's antimicrobial activity is merely from 1/20 to 1/80 of that of the three rifamycin S derivatives)and Pseudomonas aeruginosa(the parent compound's antimicrobial activity is only 1/14 and 1/9 of that of compound 1 and compound 3)compared to the parent compound.The loading of milk exosomes with the rifamycin S derivatives compound 3 was successfully achieved,with a loading efficiency of 10.9％.The antimicrobial activity of the compound after exosome loading was significantly enhanced against Staphylococcus aureus in vitro and against Staphylococcus aureus residing within macrophages(P＜0.01).CONCLUSION The designed and synthesized derivatives of rifamycin S possess stronger anti-microbial activity,and their antibacterial efficacy against both extracellular and intracellular bacteria can be further enhanced after loading into exosomes.

Objective:To establish HPLC fingerprint of Shaoyao Gancao Keli to provide quality control.Methods:Waters Xselect CSH C18 column was used.The mobile phase was acetonitrile-0.05％phosphoric acid solution with gradient elution.The detection wavelength was 232 nm.The column temperature was 35 ℃.The flow rate was 0.8 mL·min-1.The injection volume was 10 μL.10 samples were tested by the method.The similarity of 10 samples were evaluated,and the common peaks were identified.Results:HPLC fingerprint of 17 common peaks was estab-lished.10 common peaks were identified which were gallic acid,albiflorin,paeoniflorin,liquiritin apioside,liquiritin,β-1,2,3,4,6-pentagalloylglucose,isoliquiritin apioside,isoliquiritin,liquiritigenin,glycyrrhizic acid.The similarity of 10 samples was higher than 0.95.Conclusion:The method has good separation,accuracy,re-peatability and stability,and could be used as a standard for quality control of Shaoyao Gancao Keli.

The prevention and treatment of esophageal cancer constitute an important component of China's cancer control efforts.As the earliest established cancer prevention and control field site in China,the Linzhou Esophageal Cancer Prevention and Treatment Site has developed a sys-tematic prevention and control strategy encompassing tumor registration,etiological research,early diagnosis and treatment,and other key areas,providing valuable experience for refining China's cancer prevention system.Based on over six decades of practical experience at the Linzhou site,this paper reviews its historical development,the construction of its prevention-control system,and emerging challenges in the new era,while exploring its reference significance for China's na-tionwide cancer prevention and control initiatives.

OBJECTIVE To design and synthesize rifamycin S derivatives and load them into milk exosomes to evaluate their in vitro antimicrobial activity.METHODS Rifamycin S derivatives were synthe-sized and characterized by mass spectrometry and NMR.Using the dilution assay method,the inhibitory activity of each rifamycin S derivatives molecule against Staphylococcus aureus and Pseudomonas aerugi-nosa was determined,and the IC50 was calculated.Derivatives molecules with excellent antimicrobial activity were selected and loaded into milk exosomes using the ultrasonication method,resulting in the preparation of milk exosome-loaded rifamycin S derivatives.The antimicrobial activity against Staphylo-coccus aureus was determined using the dilution assay method.The inhibitory effect of the exosome-loaded rifamycin S derivatives on Staphylococcus aureus residing within macrophages was detected using the plate colony counting method.RESULTS Three rifamycin S derivatives were successfully designed and synthesized,which demonstrated superior antimicrobial activity against Staphylococcus aureus(the parent compound's antimicrobial activity is merely from 1/20 to 1/80 of that of the three rifamycin S derivatives)and Pseudomonas aeruginosa(the parent compound's antimicrobial activity is only 1/14 and 1/9 of that of compound 1 and compound 3)compared to the parent compound.The loading of milk exosomes with the rifamycin S derivatives compound 3 was successfully achieved,with a loading efficiency of 10.9％.The antimicrobial activity of the compound after exosome loading was significantly enhanced against Staphylococcus aureus in vitro and against Staphylococcus aureus residing within macrophages(P＜0.01).CONCLUSION The designed and synthesized derivatives of rifamycin S possess stronger anti-microbial activity,and their antibacterial efficacy against both extracellular and intracellular bacteria can be further enhanced after loading into exosomes.

Background and purpose:Patients with prostate cancer(PCa)have consistently shown suboptimal responses to immunotherapy,which may be closely related to the immunosuppressive state of the PCa tumor microenvironment.MYC,a key transcription factor in cancer cells,is involved in cell proliferation,differentiation,apoptosis and immune surveillance by regulating the expression of intracellular genes.This study aimed to elucidate the mechanisms through which MYC fosters an immunosuppressive state within the PCa tumor microenvironment and to delineate its functional impact on PCa cells.Methods:We performed clustering and annotation of single-cell RNA sequencing(scRNA-seq)data from PCa,and conducted subcluster analyses for tumor cells,T cells,and macrophages respectively.The expression changes of MYC and CD47 across tumor subtype were analyzed,and the expression variations of signal regulatory protein alpha(SIRPα)among macrophage subtype were assessed.Furthermore,we divided the PCa transcriptomic dataset samples into high-and low-MYC expression groups based on MYC expression levels,and performed differential expression analysis and enrichment analysis for each group.The functional role of MYC in PCa cells was validated using chromatin immunoprecipitation-quantitative polymerase chain reaction(ChIP-qPCR)and experimental analyses.Furthermore,animal experiments(reviewed and approved by the ethics committee of the First Affiliated Hospital of Henan University of Science and Technology,approval number:D-2025-B015)were conducted to further validate the relationship between MYC and CD47.Finally,we analyzed and validated the whey acidic protein four-disulfide core domain 2(WFDC2)+tumor subtype using transcriptomic data from PCa.Results:Through the analysis of scRNA-seq data from PCa,a total of 32,977 cells were identified,and 7 distinct cell types were annotated.The tumor cells were further divided into 10 tumor cell subtypes,among which the WFDC2+tumor cell subtype exhibited more intensive cellular communication with CD8+T cells and macrophages within the PCa tumor microenvironment.MYC and CD47 exhibited high expression levels during the middle-to-late stages of differentiation in PCa cells,whereas SIRPα maintained high expression throughout the macrophage differentiation trajectory.Enrichment analysis revealed that the WFDC2+tumor cell subtype was primarily enriched in signaling pathways such as transforming growth factor-β(TGF-β)and Wnt/β-catenin.ChIP-qPCR confirmed the regulatory relationship between MYC and CD47 expression.Additionally,it was found that MYC knockdown significantly inhibited the proliferation and invasion abilities of PCa cells,while overexpression of CD47 could reverse this effect.Animal experiment results confirmed an positive correlation between MYC and CD47 protein expression.Furthermore,Tumor Immune Dysfunction and Exclusion(TIDE)and Estimate analyses indicated that patients in the low-expression group of the WFDC2+tumor cell subtype exhibited a potentially better response to immunotherapy compared to those in the high-expression group.Conclusion:The findings of this study elucidate the role of MYC in the PCa tumor immune microenvironment.Specifically,MYC promotes the proliferation and migration of PCa cells by regulating the expression of CD47.These insights provide novel perspectives for the treatment of PCa patients.

Objective:To establish HPLC fingerprint of Shaoyao Gancao Keli to provide quality control.Methods:Waters Xselect CSH C18 column was used.The mobile phase was acetonitrile-0.05％phosphoric acid solution with gradient elution.The detection wavelength was 232 nm.The column temperature was 35 ℃.The flow rate was 0.8 mL·min-1.The injection volume was 10 μL.10 samples were tested by the method.The similarity of 10 samples were evaluated,and the common peaks were identified.Results:HPLC fingerprint of 17 common peaks was estab-lished.10 common peaks were identified which were gallic acid,albiflorin,paeoniflorin,liquiritin apioside,liquiritin,β-1,2,3,4,6-pentagalloylglucose,isoliquiritin apioside,isoliquiritin,liquiritigenin,glycyrrhizic acid.The similarity of 10 samples was higher than 0.95.Conclusion:The method has good separation,accuracy,re-peatability and stability,and could be used as a standard for quality control of Shaoyao Gancao Keli.