Under the background of the in-depth implementation of the Healthy China initiative,the high-quality devel-opment of public hospitals has become a key link in deepening the reform of the medical and health system.This research,focu-sing on public hospitals in Tianjin,systematically investigates innovative approaches to operational management through literature review and field research methods.Typical case analysis illustrates the status of construction of operational management depart-ments of Tianjin's public hospitals.Meanwhile the study explores the issues such as underdeveloped management infrastructure,inadequate intelligentization,and challenges in inter-departmental coordination.Consequently,it proposes countermeasures and suggestions such as establishing a data-driven real-time monitoring systems and improving cross-departmental governance frame-works.This research offers theoretical insights for optimizing the operational and management system of public hospitals,provides replicable practical experience for healthcare reforms in similar cities,and contributes to achieving the synergistic alignment of so-cial benefits and operational quality of public hospitals.

Under the background of the in-depth implementation of the Healthy China initiative,the high-quality devel-opment of public hospitals has become a key link in deepening the reform of the medical and health system.This research,focu-sing on public hospitals in Tianjin,systematically investigates innovative approaches to operational management through literature review and field research methods.Typical case analysis illustrates the status of construction of operational management depart-ments of Tianjin's public hospitals.Meanwhile the study explores the issues such as underdeveloped management infrastructure,inadequate intelligentization,and challenges in inter-departmental coordination.Consequently,it proposes countermeasures and suggestions such as establishing a data-driven real-time monitoring systems and improving cross-departmental governance frame-works.This research offers theoretical insights for optimizing the operational and management system of public hospitals,provides replicable practical experience for healthcare reforms in similar cities,and contributes to achieving the synergistic alignment of so-cial benefits and operational quality of public hospitals.

Objective To explore the application value of simultaneous multi-slice(SMS)technique in diffusion tensor imaging(DTI)for evaluating brain glioma.Methods Thirty-four brain glioma patients were prospectively enrolled,and brain conventional DTI and SMS-DTI were acquired.The subjective scores of image quality,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were compared between SMS-DTI and conventional DTI,so were the numbers of whole brain fiber bundles,tumor relative fractional anisotropy(rFA)and relative mean diffusivity(rMD)obtained based on SMS-DTI and conventional DTI.Results Among 34 patients,there were 23 cases of high-grade glioma and 11 cases of low-grade glioma.No significant difference of subjective scores of image quality,tumor edge clarity nor magnetic susceptibility artifacts was found between SMS-DTI and conventional DTI(all P＞0.05).SNR and CNR on SMS-DTI were both lower than those on conventional DTI(both P＜0.05).No significant difference of the numbers of whole brain fiber bundles,rFA nor rMD of gliomas with different pathological grades was detected based on SMS-DTI compared with those on conventional DTI(all P＞0.05).Conclusion SMS applicated in DTI for evaluating brain gliomas was able to shorten acquisition time under the condition of ensuring image quality and quantitative analysis accuracy.

Objective To investigate the expression of inositol polyphosphate 4-phosphatase type Ⅱ B(INPP4B)in colorectal cancer(CRC)and the relevant clinical significance,to determine the relationship between INPP4B and matrix metallopeptidase 7(MMP7)in CRC cells,and to make preliminary exploration of the effects of INPP4B on the proliferation and migration of CRC cells and mechanisms involved.Methods The TIMER2.0 and GEPIA2 databases were used to analyze the differences in INPP4B expression between cancer and para-cancerous tissues and the effects of such differences on the prognosis of CRC.The expression of INPP4B in 102 surgically resected CRC tumors was determined by immunohistochemistry(IHC),and the correlation between INPP4B and clinical pathological indicators was analyzed.In CRC cells with overexpressed/knocked-down INPP4B,the expression of INPP4B and MMP7 were examined by real time fluorogenic quantitative PCR,the protein expression of INPP4B was assessed by Western blot,cell proliferation was determined using the CellTiter 96? AQueous One assay,and cell migration and invasion were assessed using wound healing assay and real-time label-free dynamic cell analysis(RTCA).The LinkedOmics database was used to analyze signaling pathways related to INPP4B function,and the role of potential key molecules was validated at the cellular level.Results Analysis with the TIMER2.0 database and GEPIA2 database showed elevated INPP4B expression(colon adenocarcinoma[COAD]:2.30,rectal adenocarcinoma[READ]:2.33)in CRC compared to normal tissue(COAD:1.91,READ:1.89).IHC testing confirmed that INPP4B was upregulated in clinical CRC tissues and paracancerous tissues(P＜0.001).Cox regression model analysis showed that INPP4B(hazards ratio[HR]=1.457,95％confidence interval[CI]:1.003-2.115)affected the prognosis of CRC,and the Kaplan-Meier curve showed that patients with high INPP4B expression had shorter overall survival(P＜0.05).x2 test was performed to analyze the relationship between INPP4B expression and clinicopathological indexes,and it was found that high expression of INPP4B was correlated with lymph node metastasis(x2=3.997,P=0.046)and neural invasion(x2=8.511,P=0.004).In in vitro experiments,CRC cells overexpressing INPP4B showed a significantly increased cell proliferation and migration compared to the cells in the control group(P＜0.05).Analysis using the LinkedOmics database showed that INPP4B was correlated with extracellular matrix remodeling and cell migration.Pearson's correlation analysis showed that MMP7 was positively correlated with INPP4B(r=0.3782,P＜0.001).INPP4B overexpression or knockdown in vitro also led to the upregulation or the downregulation of MMP7 expression in CRC cells.Conclusion INPP4B is highly expressed in CRC tissues and significantly correlated with lymph node metastasis,neural invasion,and patient prognosis.MMP7 may mediate the role of INPP4B in promoting CRC cell migration and invasion.

Objective:To evaluate the diagnostic efficacy of the multiparametric MRI (mpMRI) deep learning artificial intelligence (AI) analysis system combined with 68Ga-prostate specific membrane antigen (PSMA) PET for prostate cancer. Methods:Data of 103 patients (age: 45-85 years) who underwent 68Ga-PSMA PET/MR at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from May 2018 to October 2023 for suspected or confirmed prostate cancer were retrospectively collected. ROI was delineated to measure SUV max of primary tumor or prostate, and a deep learning AI system was applied to analyze MR images of the prostate. The diagnostic efficacies of T 2 weighted imaging (WI), diffusion WI (DWI), mpMRI, PET SUV max, and PET/MR for prostate cancer were assessed, with using the pathological results as the gold standard. Results:Among 103 patients, 82 cases (79.61%) were with prostate cancer. PET unimodality demonstrated the best specificity (100%, 21/21), positive predictive value (100%, 58/58), and AUC (0.860, 95% CI: 0.777-0.920). The mpMRI AI analysis provided rapid diagnostic results and the sensitivity and accuracy were improved by combining with PET (sensitivities of PET, mpMRI and the combination of the two were 70.73%(58/82), 86.59%(71/82), and 92.68%(76/82), respectively; the accuracies were 76.70%(79/103), 81.55%(84/103) and 86.41%(89/103), respectively). Among 44 patients with negative PET, 30 patients received an accurate diagnosis when the results of mpMRI AI analysis were added. Conclusions:68Ga-PSMA PET demonstrates good specificity for prostate cancer and mpMRI AI analysis is time-saving. The combined application improves the diagnostic sensitivity and accuracy, which provides a valuable tool for 68Ga-PSMA PET/MR image analysis.

Kidneys filter bloodand regulate fluid and electrolyte balances.However,the kidney is susceptible to toxicity of various compounds,Resulting in renal damage.Hence,prevention and treatment of renal injury is a hot research topic.Zebrafish is an ideal animal model,because it is closely related to humans in terms of morphology,physiology,and kidney functions and its response to compounds.In this article,we review the method and evaluation indexes of zebrafish kidney injury modeling.

Objective:To explore the value of intermittent photic stimulation (IPS) in children′s video electroencephalography (EEG).Methods:The data of 8 994 children aged 1 to 18 years, who received IPS in the video EEG examination at the Liangjiang Campus of the Children′s Hospital of Chongqing Medical University from March 2021 to March 2022, were analyzed retrospectively.Patients were divided into non-epilepsy group and confirmed or suspected epilepsy group.Their IPS responses, clinical and EEG characteristics were collected.Categorical variables were expressed using frequencies and percentages.The relationship between IPS response and age was determined by Chi- square test or Fisher′ s exact probability method. Results:The median age of 8 994 children was 6.3 years.There were 2 310 (25.7%) children in the non-epileptic group, including 1 364 (59.0%) males and 946 (41.0%) females.There were 6 684 (74.3%) children in the confirmed or suspected epileptic group, including 3 842 (57.5%) males and 2 842 (42.5%) females.In the non-epileptic group, 141 cases (6.1%) had IPS photo-driving responses, and 1 case had photo paroxysmal response (PPR). In the confirmed or suspected epilepsy group, IPS photo-driving responses (2.4%) occurred in 160 cases, PPR (1.2%) in 82 cases, photo convulsion responses(0.3%) in 18 cases, and asymmetric photo-driving responses (0.2%) in 14 cases.The IPS photosensitivity responses varied among children of different ages, sexes, epileptic discharge types and seizure types in the confirmed or suspected epilepsy group.The children aged 6 to 18 years showed significantly stronger photosensitivity responses than those aged 1 to <6 years ( P<0.001). The photosensitivity activity in females was 1.9 times higher than that in males.The photosensitivity activity in patients with generalized discharges was 1.7 times more intense than that in patients with focal discharges.The photosensitivity reaction in patients with photo convulsive generalized seizures was 2.5 times stronger than that in patients with focal seizures. Conclusions:Routine standardized IPS is important for the detection of photosensitivity in children diagnosed or suspected with epilepsy.It can effectively guide the medical practice.

Objective:To investigate the relationship between the expression of CD103 +CD8 +T cells in locally advanced oral squamous cell carcinoma (LA-OSCC), and the response to neoadjuvant chemoimmunotherapy (NACI). Methods:Thirty LA-OSCC patients from the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, who underwent NACI from June 2020 to December 2022 were analyzed, including 16 responders and 14 non-responders. Using multiple immunofluorescence technique to stain sections of patients to verify the correlation between the expression of CD103 +CD8 +T cells and the efficacy of NACI. CD103 +CD8 +T cell density was counted using Inform and HALO software. The Spearman correlation coefficient in rank correlation is used to describe the correlation between CD103 +CD8 +T cell and neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII) It′s effectiveness as a predictive marker to NACI was analyzed by receiver operator characteristic (ROC) curve analysis and decision curve analysis (DCA). Two-tailed t-test or Mann-Whitney U-test was used to compare data between two groups, and one-way ANOVA was used to compare data between multiple groups. SPSS 22.0 and GraphPad prism 9.0 software were used for statistical analysis and plotting of relevant statistical graphs such as histograms. P<0.05 was considered a statistically significant difference. Results:The density of CD103 +CD8 +T cells has expanded in advanced OSCC patients who are responsive to NACI. The CD103 +CD8 +T cell densities in the responsive and nonresponsive groups were 118.30(41.92, 197.80) pcs/mm 2 and 21.63(4.91, 71.92) pcs/mm 2 respectively, with statistically significant differences( U=52.00, P=0.012). CD103 +CD8 +T cell abundance was negatively correlated with NLR, dNLR, PLR, and SII ( P<0.05). ROC curve analysis showed that the AUC for predicting efficacy of NLR, dNLR, PLR, and SII were 0.781 ( P=0.009, 95% CI: 0.5715-0.9910), 0.671 ( P=0.105, 95% CI: 0.467-0.881), 0.679 ( P=0.020 95% CI: 0.549-0.951), 0.750 ( P=0.096, 95% CI: 0.461-0.896), respectively. The AUC for CD103 +CD8 +T cells alone was 0.861 ( P=0.013, 95% CI: 0.585-0.950), and the AUC of combining CD103 +CD8 +T cells with NLR was 0.896 ( P=0.025, 95% CI: 0.454-0.938). Conclusions:The density of CD103 +CD8 +T cells is expanded in advanced OSCC patients who are responsive to NACI. CD103 +CD8 +T cells positively predict favorable responses as a strong indicator to NACI in advanced OSCC patients. Co-interpretation of CD103 +CD8 +T cells and NLR value enhances the predictive accuracy of NACI in advanced OSCC patients.

Objective:To evaluate the efficacy of remimazolam-propofol-sufentanil for anesthesia in patients undergoing painless gastroscopy.Methods:Eighty American Society of Anesthesiologists physical statusⅠor Ⅱ patients, aged 20-59 yr, weighing 44-69 kg, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=40 each) using a random number table method: remimazolam-propofol-sufentanil group (group RPS) and propofol-sufentanil group (group PS). The patients in group RPS received successive intravenous injection of sufentanil 0.1 μg/kg, remimazolam 0.15 mg/kg and propofol (at a rate of 4 mg/s). The patients in group PS received intravenous injection of sufentanil 0.1 μg/kg and propofol (at a rate of 4 mg/s). When Observer′ s Assessment of Alertness/Sedation Scale score was 0, gastroscopy was performed.The consumption of propofol, time of anesthesia, time for gastroscopy, emergence time and discharge time were recorded.The number of intraoperative assisted respiration cases, body movement and occurrence of adverse reactions at the time of discharge were observed. Results:Compared with group PS, the consumption of propofol was significantly decreased, and the time of anesthesia, emergence time and discharge time were shortened in group RPS ( P<0.05). There was no significant difference in the time for gastroscopy, the number of intraoperative assisted respiration cases, body movement and the occurrence of adverse reactions at discharge time between the 2 groups ( P>0.05). Conclusion:Remimazolam-propofol-sufentanil produces better efficacy for anesthesia than propofol-sufentanil in patients undergoing painless gastroscopy.

Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.