Objective To construct a dynamic prediction model for JC polyomavirus (JCV) reactivation after kidney transplantation. Methods A retrospective analysis was conducted on the clinical data of 128 recipients who met the inclusion criteria and received kidney transplantation in Nanfang Hospital, Southern Medical University, from June 2021 to December 2024. Dynamic Cox regression and dynamic restricted mean survival time (RMST) regression based on the landmark method were adopted to establish the dynamic prediction models, and Monte Carlo cross-validation was used to evaluate model performance. Results The dynamic models could predict the incidence and onset time of JCV reactivation within the subsequent 3 months according to covariates at each landmark time point from the 1st to the 6th month after transplantation. Remuzzi score, body mass index and warm ischemia time were independent risk factors for JCV reactivation, while a history of urinary BK polyomavirus reactivation served as a protective factor. The median values of the area under the curve, C-index and Brier score of the dynamic Cox model were 0.873, 0.851 and 0.065 respectively, and the C-index of the dynamic RMST model was 0.829, all of which were superior to those of the static model. Conclusions The landmark-based dynamic models exhibit excellent predictive performance, which may integrate baseline data and post-transplant follow-up information to realize dynamic assessment of the risk and time window of JCV reactivation, thereby providing evidence for optimizing post-operative monitoring and individualized intervention strategies.

Objective To explore the impact of organizational innovation climate in public hospitals on doctors'innovation performance,providing a reference for improving doctors'innovation performance.Methods A questionnaire survey was conducted with practicing(assistant)physicians in 22 hospitals in Beijing,and 1 859 questionnaires were effectively recovered.The scores of hospital organizational innovation climate,physicians'individual innovation performance,innovation behavior,and innovation self-efficacy were analyzed by Pearson correlation;the partial least squares structural equation modeling was further used to explore the role of the organizational innovation climate of hospitals on physicians'innovation performance.Results The path of hospital organizational innovation climate on physicians'innovation performance.The difference in path coefficients for the mediating effect of hospital organizational innovation climate significantly affecting physicians'innovation performance,and physicians'innovation self-efficacy between hospital innovation climate and physicians'innovation behavior and innovation performance was statistically significant(P＜0.001).Conclusion The innovation performance of practicing(assistant)physicians in Beijing municipal hospitals is influenced by the organizational innovation climate,physicians'innovation self-efficacy and innovation behaviors,and physicians'innovation self-efficacy and innovation behaviors play a chain-mediated role.It is suggested that public hospitals should strengthen doctors'self-efficacy and consider the fit between the construction of innovation atmosphere and actual needs to stimulate innovation behavior and ultimately improve inno-vation performance.

Objective To analyze the willingness and influencing factors of doctors in Beijing public hospitals to set up clinics in the community,and to provide scientific basis for promoting quality health technicians to go down to the grassroots and realize hierarchical diagnosis and treatment.Methods Doctors from 6 specialized hospita ls and 3 general hospitals in Beijing were selected as subjects for questionnaire survey.By stratified sampling,a questionnaire survey was conducted on 518 doctors from 9 public hospitals in Beijing through stratified sampling method.Descriptive analysis,rank sum test and ordered logistic regression were used to explore doctors'willingness to open clinics and its influencing factors.Results In all survey respondents,212(40.93%)physicians were very or somewhat willing to open a clinic in the community,physicians with higher benefit perception,and greater willingness to publicize relevant policies were more willing to set up clinics.Conclusion Opening of clinics by doctors in public hospitals is affected by perceived benefits and willingness to advocate policies.It is suggested to further improve relevant systems and policies,reduce the risk of doctors opening clinics,and promote doctors in public hospitals to open clinics in communities,so as to realize the sinking of high-quality health human resources to the grassroots.

Objective·To investigate the predictive value of the geriatric nutritional risk index(GNRI)for the occurrence of lung infection in hospitalized elderly patients with type 2 diabetes mellitus(T2DM).Methods·Elderly T2DM patients who were admitted to the Geriatric Department of Shanghai Tongren Hospital between June 2022 and June 2024 were retrospectively and consecutively enrolled.They were divided into infected and non-infected groups according to whether lung infection occurred during hospitalization.Baseline data(gender,age,height,weight,duration of diabetes,comorbidities,etc.)were collected and GNRI was calculated.A multivariate Logistic regression model was used to screen the independent risk factors for pulmonary infections,and the predictive value of GNRI for pulmonary infections in T2DM patients was analysed using receiver operating characteristic(ROC)curves.Results·A total of 264 elderly T2DM patients were enrolled,among whom 154 developed pulmonary infections.Significant differences were observed between the infected and non-infected groups in GNRI,albumin,leukocyte count,neutrophil ratio,lymphocyte ratio,glycated hemoglobin,fasting glucose,interleukin-6,C-reactive protein,and procalcitonin levels(P<0.05).Multivariate Logistic regression analysis showed that a lower GNRI was an independent risk factor for lung infection(OR=0.798,95%CI 0.712?0.894;P<0.001).Correlation analysis showed that GNRI was negatively correlated with C-reactive protein and calcitoninogen.ROC curve analysis showed that GNRI predicted pulmonary infection with an area under the curve of 0.828,a sensitivity of 77.9%,and a specificity of 76.6%.Conclusion·A lower GNRI is an independent risk factor for pulmonary infections in elderly T2DM patients,and also has a good predictive value for the occurrence of pulmonary infections.

Objective·To investigate the predictive value of the geriatric nutritional risk index(GNRI)for the occurrence of lung infection in hospitalized elderly patients with type 2 diabetes mellitus(T2DM).Methods·Elderly T2DM patients who were admitted to the Geriatric Department of Shanghai Tongren Hospital between June 2022 and June 2024 were retrospectively and consecutively enrolled.They were divided into infected and non-infected groups according to whether lung infection occurred during hospitalization.Baseline data(gender,age,height,weight,duration of diabetes,comorbidities,etc.)were collected and GNRI was calculated.A multivariate Logistic regression model was used to screen the independent risk factors for pulmonary infections,and the predictive value of GNRI for pulmonary infections in T2DM patients was analysed using receiver operating characteristic(ROC)curves.Results·A total of 264 elderly T2DM patients were enrolled,among whom 154 developed pulmonary infections.Significant differences were observed between the infected and non-infected groups in GNRI,albumin,leukocyte count,neutrophil ratio,lymphocyte ratio,glycated hemoglobin,fasting glucose,interleukin-6,C-reactive protein,and procalcitonin levels(P<0.05).Multivariate Logistic regression analysis showed that a lower GNRI was an independent risk factor for lung infection(OR=0.798,95%CI 0.712?0.894;P<0.001).Correlation analysis showed that GNRI was negatively correlated with C-reactive protein and calcitoninogen.ROC curve analysis showed that GNRI predicted pulmonary infection with an area under the curve of 0.828,a sensitivity of 77.9%,and a specificity of 76.6%.Conclusion·A lower GNRI is an independent risk factor for pulmonary infections in elderly T2DM patients,and also has a good predictive value for the occurrence of pulmonary infections.

Objective To analyze the willingness and influencing factors of doctors in Beijing public hospitals to set up clinics in the community,and to provide scientific basis for promoting quality health technicians to go down to the grassroots and realize hierarchical diagnosis and treatment.Methods Doctors from 6 specialized hospita ls and 3 general hospitals in Beijing were selected as subjects for questionnaire survey.By stratified sampling,a questionnaire survey was conducted on 518 doctors from 9 public hospitals in Beijing through stratified sampling method.Descriptive analysis,rank sum test and ordered logistic regression were used to explore doctors'willingness to open clinics and its influencing factors.Results In all survey respondents,212(40.93%)physicians were very or somewhat willing to open a clinic in the community,physicians with higher benefit perception,and greater willingness to publicize relevant policies were more willing to set up clinics.Conclusion Opening of clinics by doctors in public hospitals is affected by perceived benefits and willingness to advocate policies.It is suggested to further improve relevant systems and policies,reduce the risk of doctors opening clinics,and promote doctors in public hospitals to open clinics in communities,so as to realize the sinking of high-quality health human resources to the grassroots.

Objective To explore the impact of organizational innovation climate in public hospitals on doctors'innovation performance,providing a reference for improving doctors'innovation performance.Methods A questionnaire survey was conducted with practicing(assistant)physicians in 22 hospitals in Beijing,and 1 859 questionnaires were effectively recovered.The scores of hospital organizational innovation climate,physicians'individual innovation performance,innovation behavior,and innovation self-efficacy were analyzed by Pearson correlation;the partial least squares structural equation modeling was further used to explore the role of the organizational innovation climate of hospitals on physicians'innovation performance.Results The path of hospital organizational innovation climate on physicians'innovation performance.The difference in path coefficients for the mediating effect of hospital organizational innovation climate significantly affecting physicians'innovation performance,and physicians'innovation self-efficacy between hospital innovation climate and physicians'innovation behavior and innovation performance was statistically significant(P＜0.001).Conclusion The innovation performance of practicing(assistant)physicians in Beijing municipal hospitals is influenced by the organizational innovation climate,physicians'innovation self-efficacy and innovation behaviors,and physicians'innovation self-efficacy and innovation behaviors play a chain-mediated role.It is suggested that public hospitals should strengthen doctors'self-efficacy and consider the fit between the construction of innovation atmosphere and actual needs to stimulate innovation behavior and ultimately improve inno-vation performance.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective:To investigate the impacts of ionizing radiation on protein expression profiles in esophageal tissues of rats using quantitative proteomics, in order to reveal the molecular mechanisms underlying the onset and development of radiation-induced esophagitis (RIE).Methods:A total of twenty-four male SD rats were divided by simple randomization into three groups: the control, 25 Gy irradiation, and 35 Gy irradiation groups, and their esophageal tissues were collected at 7 d post-irradiation to extract total protein. Then, changes in the protein expression profiles of the esophageal tissues in irradiated rats were investigated using tandem mass tag (TMT)-labeled quantitative proteomics and bioinformatics analysis. Additionally, the expressions of two key proteins, Hp and Ndufs4, were validated using immunohistochemistry and Western blot.Results:A comparison with the control group revealed a total of 847 differentially expressed proteins (DEPs; 483 up-regulated and 364 down-regulated) following 25 Gy irradiation and 699 DEPs (443 up-regulated and 256 down-regulated) following 35 Gy irradiation. Different radiation doses led to common 326 up-regulated proteins, which were mainly involved in biological processes and signaling pathways related to immune and inflammatory responses, and 210 down-regulated proteins, which were primarily involved in biological processes and signaling pathways related to energy production and metabolism. Furthermore, a total of 155 proteins were screened using a constructed protein protein interaction(PPI) network. Of these proteins, the up-regulated ones were most associated with three functional pathways, namely innate immune responses, complement and coagulation cascades, and innate immune system, while the down-regulated ones were most associated with energy acquisition via oxidizing organic compounds, oxidative phosphorylation, and the tricarboxylic acid (TCA) cycle and respiratory electron transfer. These functions were enriched with nine complement-related up-regulated and five mitochondria-related down-regulated proteins, respectively. Ionizing radiation significantly up-regulated Hp ( t = 27.94, 10.96, P<0.001) and down-regulated Ndufs4 ( t = 59.27, 54.07, P<0.001), consistent with the protein sequencing result. Conclusions:Ionizing radiation can change the protein expression profiles in the esophageal tissues of rats, and these DEPs are involved in multiple radiobiology-related functional pathways such as immune processes, inflammatory responses, and abnormal energy metabolism. Screening and validation of key proteins are helpful for identifying potential biomarkers of radiation-induced esophagitis.

Objective:To analysis the incentive level of family doctors in primary medical and health institutions in Beijing, and to explore its influencing factors, so as to provide references for promoting family doctors′ contract service.Methods:From October to December 2021, 40 family doctors were randomly selected from 135 urban community health service centers in 8 districts of Beijing, and a survey was conducted on basic demographic information, institutional organizational capacity evaluation, and family doctor incentive level evaluation (including four dimensions of work value, organizational environment, personal development, and reward compensation), and the influencing factors of family doctor incentive level was analyzed. Chi-square test and Pearson correlation analysis were used for univariate analysis, and multiple linear regression analysis was used for multivariate analysis.Results:A total of 4 568 family doctors were included, and the score of family doctors′ incentive level was 3.75±0.81, among which the work value score was the highest(3.89±0.77), followed by the organizational environment score(3.69±0.92) and personal development score(3.75±0.90), and the lowest score was reward(3.75±0.90). Age, education, professional title, working years and average total working hours per week negatively affected the incentive level( P<0.05), while the average monthly income, the frequency of attending training and further study, and the organizational ability of the organization positively affected the incentive level( P<0.05). Conclusions:The overall incentive level of family doctors in primary medical and health institutions in Beijing needed improvement, and there were many factors that affect the incentive level of family doctors. It was recommended to appropriately increase the salary and benefits of family doctors, reasonably arrange the workload of family doctors, strengthen the training mechanism of family doctors, and strengthen the organizational capacity building of primary medical and health institutions.