Objective To develop a value evaluation index system for health management and logistics positions in pub-lic hospitals,providing a research tool for future performance evaluations and salary reform.Methods Literature review,focus group interviews,and the point-factor method were employed to establish an initial index pool.A public hospital in Guangzhou was selected as a case study.Delphi expert consultation was then utilized to refine and finalize the indicators for the evaluation system.Results For the two rounds of Delphi expert consultation,the response rates were 87.5％and 100.0％,with the expert authority coefficient of 0.812.The Kendall's W coordination coefficients were 0.796 and 0.624 for the first round,and 0.747 and 0.918 for the second,(all＜0.001).The coefficients of variation ranged from 0.157 to 0.265 for the first round and from 0.108 to 0.230 for the second round.Experts provided four suggestions,leading to the removal of one secondary indicator and modifications to the definitions of three others.Finally,the evaluation system consists of 4 primary indicators and 12 secondary indicators.Conclusion This system can provide a research tool and reference for the follow-up performance evaluation,improve the salary reform of public hospitals,and promote the high-quality development of public hospitals.

AIM:This study aims to investigate the regulatory effect of the endocannabinoid 2-arachidonoyl glycerol(2-AG)on voltage-gated calcium channels(VGCCs)in caudate nucleus(CN)neurons subjected to kainic acid(KA)-induced damage,and to elucidate the underlying mechanisms involved.METHODS:Primary cultured CN neu-rons from neonatal Sprague-Dawley(SD)rats were treated with KA to establish an excitotoxic cellular model.The whole-cell patch-clamp technique was utilized to assess the effects of 2-AG on KA-induced excitotoxicity,along with the changes in the electrical properties of VGCCs.This included evaluations of current density,current-voltage relationships,and the kinetics of channel activation and inactivation.RESULTS:Treatment with KA significantly increased the current density and altered the electrical properties of VGCCs,as indicated by a reduction in the half-inactivation voltage and a shift of the inactivation curve towards depolarized potentials.Notably,KA did not affect the activation characteristics of VGCCs.Ad-ministration of exogenous 2-AG or the application of the monoacylglycerol lipase inhibitor URB602,which inhibits 2-AG degradation and elevates intracellular levels of 2-AG,effectively inhibited the KA-induced increase in VGCC current den-sity and the depolarization shift of the inactivation curve,highlighting the involvement of cannabinoid receptor 1(CB1R).CONCLUSION:The endocannabinoid 2-AG can modulate the function of VGCCs in CN neurons via the CB1R pathway,offering protective effects against excitotoxic damage induced by KA.

AIM:This study aims to investigate the regulatory effect of the endocannabinoid 2-arachidonoyl glycerol(2-AG)on voltage-gated calcium channels(VGCCs)in caudate nucleus(CN)neurons subjected to kainic acid(KA)-induced damage,and to elucidate the underlying mechanisms involved.METHODS:Primary cultured CN neu-rons from neonatal Sprague-Dawley(SD)rats were treated with KA to establish an excitotoxic cellular model.The whole-cell patch-clamp technique was utilized to assess the effects of 2-AG on KA-induced excitotoxicity,along with the changes in the electrical properties of VGCCs.This included evaluations of current density,current-voltage relationships,and the kinetics of channel activation and inactivation.RESULTS:Treatment with KA significantly increased the current density and altered the electrical properties of VGCCs,as indicated by a reduction in the half-inactivation voltage and a shift of the inactivation curve towards depolarized potentials.Notably,KA did not affect the activation characteristics of VGCCs.Ad-ministration of exogenous 2-AG or the application of the monoacylglycerol lipase inhibitor URB602,which inhibits 2-AG degradation and elevates intracellular levels of 2-AG,effectively inhibited the KA-induced increase in VGCC current den-sity and the depolarization shift of the inactivation curve,highlighting the involvement of cannabinoid receptor 1(CB1R).CONCLUSION:The endocannabinoid 2-AG can modulate the function of VGCCs in CN neurons via the CB1R pathway,offering protective effects against excitotoxic damage induced by KA.

Objective To develop a value evaluation index system for health management and logistics positions in pub-lic hospitals,providing a research tool for future performance evaluations and salary reform.Methods Literature review,focus group interviews,and the point-factor method were employed to establish an initial index pool.A public hospital in Guangzhou was selected as a case study.Delphi expert consultation was then utilized to refine and finalize the indicators for the evaluation system.Results For the two rounds of Delphi expert consultation,the response rates were 87.5％and 100.0％,with the expert authority coefficient of 0.812.The Kendall's W coordination coefficients were 0.796 and 0.624 for the first round,and 0.747 and 0.918 for the second,(all＜0.001).The coefficients of variation ranged from 0.157 to 0.265 for the first round and from 0.108 to 0.230 for the second round.Experts provided four suggestions,leading to the removal of one secondary indicator and modifications to the definitions of three others.Finally,the evaluation system consists of 4 primary indicators and 12 secondary indicators.Conclusion This system can provide a research tool and reference for the follow-up performance evaluation,improve the salary reform of public hospitals,and promote the high-quality development of public hospitals.

Ovulatory dysfunction (OD) is one of the main causes of infertility in women of childbearing age, which not only affects their reproductive ability, but also physical and mental health. Traditional treatment strategies have limited efficacies, and the emergence of biomedicines provides a promising alternative solution via the strategies of combining engineered design with modern advanced technology. This review explores the pathophysiological characteristics and related induction mechanisms of OD, and evaluates the current cutting-edge advances in its treatments. It emphasizes the potentials of biomedicines strategies such as hydrogels, nanoparticles and extracellular vesicles in improving therapeutic precision and efficacy. By mimicking natural physiological processes, and achieving controlled drug release, these advanced drug carriers are expected to address the challenges in ovarian microenvironment reprogramming, tissue repair, and metabolic and immune regulation. Despite the promising progress, there are still challenges in terms of biomedical complexity, differences between animal models and human physiology, and the demand for intelligent drug carriers in the therapy of OD. Future researches are mainly dedicated to developing precise personalized biomedicines in OD therapy through interdisciplinary collaboration, promoting the development of reproductive regenerative medicine.

Objective To evaluate the frailty status and risk factors among hospitalized elderly patients after percutaneous coronary intervention(PCI),and to provide a reference for improving and delaying their frailty.Methods From March to August 2024,using convenience sampling,patients aged over 75 years who underwent PCI in a tertiary cardiovascular disease specialist hospital in Beijing were selected as the survey participants.Patient-related informations were collected through a self-designed general information questionnaire.The Fried Phenotype Frailty Scale,the Katz Activities of Daily Living,Lawton Instrumental Activities of Daily Living(IADL)scale,the Charlson Comorbidity Index,the Morse Fall Scale,the Mini Nutritional Assessment-Short Form(MNA-SF),and the 15-item Geriatric Depression Scale(GDS-15)were evaluated postoperatively until discharge.Univariate and multivariate logistic analyses were conducted to identify factors associated with frailty among patients after PCI.Results A total of 278 patients were included.The incidence of frailty after PCI was 52.16％.Based on Fried Phenotype scores,patients were divided into a non-frail group and a frail group.Univariate analysis showed statistically significant differences between the 2 groups in terms of age,gender,hemoglobin,NT-ProBNP,LVEF,IADL scores,living alone status,nutrition status,falls risk,and depression level(P＜0.05).Multivariate logistic regression analysis revealed that age,Lawton IADL scores,falls risk,nutrition status,depression level were factors influencing frailty,with odds ratios of 1.167,0.575,1.597,0.399,and 3.610,respectively(P＜0.05).Conclusion The incidence of frailty is high among patients aged over 75 years after PCI,and there are multiple risk factors affecting their frailty status.Clinical healthcare providers should prioritize long-term management of these patients and implement comprehensive interventions with the consideration of their physiological,psychological,and social conditions.

Objective To evaluate the frailty status and risk factors among hospitalized elderly patients after percutaneous coronary intervention(PCI),and to provide a reference for improving and delaying their frailty.Methods From March to August 2024,using convenience sampling,patients aged over 75 years who underwent PCI in a tertiary cardiovascular disease specialist hospital in Beijing were selected as the survey participants.Patient-related informations were collected through a self-designed general information questionnaire.The Fried Phenotype Frailty Scale,the Katz Activities of Daily Living,Lawton Instrumental Activities of Daily Living(IADL)scale,the Charlson Comorbidity Index,the Morse Fall Scale,the Mini Nutritional Assessment-Short Form(MNA-SF),and the 15-item Geriatric Depression Scale(GDS-15)were evaluated postoperatively until discharge.Univariate and multivariate logistic analyses were conducted to identify factors associated with frailty among patients after PCI.Results A total of 278 patients were included.The incidence of frailty after PCI was 52.16％.Based on Fried Phenotype scores,patients were divided into a non-frail group and a frail group.Univariate analysis showed statistically significant differences between the 2 groups in terms of age,gender,hemoglobin,NT-ProBNP,LVEF,IADL scores,living alone status,nutrition status,falls risk,and depression level(P＜0.05).Multivariate logistic regression analysis revealed that age,Lawton IADL scores,falls risk,nutrition status,depression level were factors influencing frailty,with odds ratios of 1.167,0.575,1.597,0.399,and 3.610,respectively(P＜0.05).Conclusion The incidence of frailty is high among patients aged over 75 years after PCI,and there are multiple risk factors affecting their frailty status.Clinical healthcare providers should prioritize long-term management of these patients and implement comprehensive interventions with the consideration of their physiological,psychological,and social conditions.

Obesity contributes to reduced fertility, infertility and adverse maternal and infant outcomes through multiple mechanisms. Individuals with obesity encounter numerous impediments during fertility treatments and subsequent pregnancy, leading to intensified physical, psychological, and socio-economic burdens. Given the recent progress in research and the expansion of treatment modalities, there is an imperative need to refine the diagnostic and therapeutic frameworks for obese patients with infertility through a multidisciplinary approach. The Reproductive Medicine Specialized Committee of the Chinese Medical Doctor Association (CMDA) has established a multidisciplinary team of experts to develop an evidence-based guideline. This guideline's development will adhere to both national and international standards for guideline development and reporting. This proposal mainly describes the significance and purpose of guideline development, the method of evidence retrieval and quality assessment, the process of guideline development, and the plan for publication, implementation and dissemination of the guideline.

Objective:To explore the efficacy and safety of sirolimus in the treatment of diazoxide unresponsive congenital hyperinsulinism(CHI) and summarize the single-center experience.Methods:A retrospective analysis was conducted on the clinical data of 5 cases of CHI treated with sirolimus after ineffective treatment with diazoxide, admitted to the Children′s Hospital Affiliated to Zhengzhou University from January 2017 to December 2022. The efficacy and safety of sirolimus in the treatment of CHI were evaluated.Results:The study included 5 patients, 3 males and 2 females. The age of onset ranged from 1 to 90 days. Initial symptoms included poor mental state(2/5) and convulsions(3/5). Blood glucose levels were 1.1 to 2.3 mmol/L, and insulin levels ranged from 13.52 to 70.53 μIU/mL. Two cases were classified as diffuse type, and the histological type of 3 cases was unknown. Genetic testing confirmed the diagnosis, with whole-exome sequencing revealing an unreported novel mutation in 1 case(ABCC8 exon 25_28del). Of the five patients, three patients were treated with sirolimus after diazoxide and octreotide failed, one patient was treated after unresponsive diazoxide, and the other one was treated after diazoxide, octreotide, and even near-total pancreatectomy failed. The onset age of sirolimus therapy ranged from 1 to 20 months. The maximum dosage of sirolimus was 1.2-3.2 mg·m -2·d -1, and the duration of medication ranged from 2 to 12 months. One patient was fully responsive to sirolimus, and the other four patients were partially responsive. All patients achieved euglycemia with sirolimus alone or in combination with standard CHI treatment. During follow-up, non-infectious diarrhea, elevated carcinoembryonic antigen, elevated triglycerides, and elevated liver enzymes were observed. Conclusion:This study indicates that sirolimus has a certain degree of efficacy in CHI patients for whom diazoxide treatment is ineffective. However, the long-term efficacy and safety warrant further multicenter trials.

Objective To explore an overcorrection quantization method and related influencing factors through analyzing relationships between the achieved and preset intrusion values of mandibular anterior teeth with clear aligners.Methods Twenty pa-tients receiving Invisalign were recruited.The relative intrusion values in the ClinCheck software were recorded as the preset intrusion.The achieved intrusion values were measured through the digital model superimposition.Statistical analysis was conducted to assess the differences and linear relationships between the preset and achieved intrusion values,and investigate the effect of related factors such as intrusion amounts on the intrusion efficiency.Results For the mandibular anterior teeth,the mean intrusion efficiency was 62.2%,with the highest in the central incisors and the lowest in the canines.The intrusion amounts,incisors labial inclinations,and canine at-tachment types affected the intrusion efficiency.The differences between the preset and achieved values were significant,and the linear relationship existed.The formula of the intrusion overcorrection for the mandibular anterior teeth is"Z=(W-0.110)/0.533-W".Z re-presents the overcorrection and W represents the ideal intrusion.Conclusion The preset intrusion values in the treatment protocol could not be fully achieved.Moreover,correction should be designed in cases of mandibular canine intrusion,large amountsof intru-sion,orlingually inclined incisors.Compared to the optimized attachments,the vertical rectangular attachments on the mandibular ca-nines could improve the efficiency.