As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

OBJECTIVE: To determine risk factors for cutout failure in geriatric intertrochanteric fracture patients after cephalomedullary nail fixation. METHODS: A retrospective review of 518 elderly patients who underwent cephalomedullary nail fixation for intertrochanteric fractures between January 2008 and August 2018 was conducted, including 167 males and 351 females, age from 65 to 97 years old. All patients were followed up for at least one year after surgery and divided into a healed group and a cutout group based on whether the hip screw cutout occurred. Among all patients, 10 cases experienced hip screw cutout. The general information, surgical data, and radiological data of the two groups were compared, and risk factors influencing hip screw cutout were analyzed. Propensity score matching was then performed on the cutout group based on gender, age, body mass index(BMI), and American Society of Anesthesiologists(ASA), and 40 patients from the healed group were matched at a ratio of 1∶4. Key risk factors affecting hip screw cutout were further analyzed. Multivariable logistic regression analysis was conducted to evaluate associations between variables and cutout failure. RESULTS: There were no statistically significant differences between the healed group and the cutout group in terms of age, gender, BMI, ASA, and AO classification. However, statistically significant differences were observed between the two groups in terms of reduction quality(P=0.003) and tip-apex distance(TAD), P<0.001. Multivariate analysis identified poor reduction quality OR=23.138, 95%CI(2.163, 247.551), P=0.009 and TAD≥25 mm OR=30.538, 95%CI(2.935, 317.770), P=0.004 as independent risk factors for cutout failure. CONCLUSION The present study identified poor reduction quality and TAD≥25 mm as factors for cutout failure in geriatric intertrochanteric fractures treated with cephalomedullary nails. Further studies are needed to calculate the optimal TAD for cephalomedullary nails.
Humans ; Male ; Female ; Hip Fractures/surgery* ; Aged, 80 and over ; Aged ; Risk Factors ; Retrospective Studies ; Fracture Fixation, Intramedullary/adverse effects* ; Bone Nails ; Bone Screws

Glioblastoma (GBM) is a highly aggressive primary brain tumor characterized by poor prognosis. Conventional chemo-radiotherapy demonstrates limited therapeutic efficacy and is often accompanied by significant side effects, largely due to factors such as drug resistance, radiation resistance, the presence of the blood-brain barrier (BBB), and the activation of DNA damage repair mechanisms. There is a pressing need to enhance treatment efficacy, with BRD4 identified as a promising target for increasing GBM sensitivity to therapy. Lacking small molecule inhibitors, BRD4 can be degraded using PROteolysis Targeting Chimera (PROTAC), thereby inhibiting DNA damage repair. To deliver PROTAC, SIAIS171142 (SIS) effectively, we designed a responsive nanocapsule, MPL_(SS)P@SIS, featuring GBM-targeting and GSH-responsive drug release. Modified with 1-methyl-l-tryptophan (MLT), nanocapsules facilitate targeted delivery of SIS, downregulating BRD4 and sensitizing GBM cells to radiotherapy and chemotherapy. After intravenous administration, MPL_(SS)P@SIS selectively accumulates in tumor tissue, enhancing the effects of radiotherapy and temozolomide (TMZ) by increasing DNA damage and oxidative stress. GSH activates the nanocapsules, triggering BRD4 degradation and hindering DNA repair. In mouse models, the nanosensitizer, combined with TMZ and X-ray irradiation, efficiently inhibited the growth of GBM. These findings demonstrate a novel PROTAC-based sensitization strategy targeting BRD4, offering a promising approach for effective GBM therapy.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.

Objective:To guide cost control and the development of orthopedic specialty services in actual payment by thoroughly analyzing the functioning of DRG simulation in the pediatric orthopedic department of the Capital Institute of Pediatrics.Methods:A total of 736 patients from the orthopedic ward of the Capital Institute of Pediatrics were included as study subjects.The four-quadrant grouping method was employed to examine the profitability status of each diagnosis group in detail.A logistic regression model explored the key factors influencing profitability.Results:Congenital illnesses and traumas account for most pediatric orthopedic cases.Benefit groups(2 groups,4.8％),disadvantageous groups(15 groups,35.7％),key groups(8 groups,19.0％),and potential groups(17 groups,40.5％)are found using the Boston Matrix analysis.The profit group depends on the benefit groups(IF19,IH15)for 67.7％of its total revenue.No matter how profitable they are,medical consumables comprise a sizable portion(43％-45％).According to regression analysis,hospital profitability is highly impacted by age,consumable ratio,examination cost ratio,surgery cost ratio,and other cost ratios(P＜0.05).The consumable ratio is the most significant negative predictor(β=-2.238).Conclusion:Hospitals need to optimize their cost structure and increase the probability of profitability through refined management of consumables,the four-quadrant analysis method,strengthened cost accounting,and differentiated resource allocation.