Objective:It aims to examine the effects of the employee medical insurance outpatient mutual assistance on medical insurance costs for patients with diabetes mellitus,offering insights for optimizing outpatient insurance policies and chronic disease management strategies.Methods:Outpatient cost settlement data of urban employees with diabetes mellitus in Lanzhou from 2022 to 2023 was collected.Univariate analysis and interrupted time-series models were used to compare relevant medical insurance cost indicators before and after the reform.Results:The inpatient data of 765 730 diabetes mellitus patients were included in the study,and male patients account for 62.67％.After the reform,average per-visit pooling fund expenditure,average per-visit individual payment expenditures,average per-visit personal account expenditure,average per-visit eligible expense amount,average per-visit total fund payment,and the average per-visit proportion of basic medical pooling payments were decreased(P＜0.05).Moreover,average per-visit pooling fund expenditure,average per-visit individual account expenditure,average per-visit cash payment,average per-visit eligible expense amount,average per-visit total fund payment,and the average per-visit proportion of basic medical pooling payments showed a notable declining trend post-reform(P＜0.05).In contrast,the per-visit fully out-of-pocket expenditure exhibited no significant change before and after the reform(P＞0.05).Conclusion:The reform of the employee medical insurance outpatient mutual assistance system has alleviated the economic burden of disease for diabetic patients and improved the efficiency of medical insurance fund utilization,but it reduced the proportion of basic medical pooling payments.It is recommended to continuously refine the outpatient medical insurance payment system,strengthen supervision of medical expenses and service quality,and balance patient benefits with fund pressure to enhance chronic disease outpatient benefits.

Objective:It aims to examine the effects of the employee medical insurance outpatient mutual assistance on medical insurance costs for patients with diabetes mellitus,offering insights for optimizing outpatient insurance policies and chronic disease management strategies.Methods:Outpatient cost settlement data of urban employees with diabetes mellitus in Lanzhou from 2022 to 2023 was collected.Univariate analysis and interrupted time-series models were used to compare relevant medical insurance cost indicators before and after the reform.Results:The inpatient data of 765 730 diabetes mellitus patients were included in the study,and male patients account for 62.67％.After the reform,average per-visit pooling fund expenditure,average per-visit individual payment expenditures,average per-visit personal account expenditure,average per-visit eligible expense amount,average per-visit total fund payment,and the average per-visit proportion of basic medical pooling payments were decreased(P＜0.05).Moreover,average per-visit pooling fund expenditure,average per-visit individual account expenditure,average per-visit cash payment,average per-visit eligible expense amount,average per-visit total fund payment,and the average per-visit proportion of basic medical pooling payments showed a notable declining trend post-reform(P＜0.05).In contrast,the per-visit fully out-of-pocket expenditure exhibited no significant change before and after the reform(P＞0.05).Conclusion:The reform of the employee medical insurance outpatient mutual assistance system has alleviated the economic burden of disease for diabetic patients and improved the efficiency of medical insurance fund utilization,but it reduced the proportion of basic medical pooling payments.It is recommended to continuously refine the outpatient medical insurance payment system,strengthen supervision of medical expenses and service quality,and balance patient benefits with fund pressure to enhance chronic disease outpatient benefits.

Objective·To investigate the performance and psychological mechanisms of inhibitory control in patients with alcohol use disorder(AUD)under different emotional contexts,and to examine the influence of emotion regulation difficulties on inhibitory control.Methods·A total of 28 male AUD inpatients(AUD group)and 28 age-and education-matched healthy controls(HC group)were recruited.The emotional Go/Nogo task(angry/neutral facial expressions)was used to evaluate the subjects'behavioral inhibition,and the hierarchical drift-diffusion model(HDDM)was used to quantify the cognitive parameters(drift rate,decision threshold,and non-decision time).The Difficulties in Emotion Regulation Scale(DERS)and Alcohol Use Disorder Identification Test(AUDIT)were used for clinical evaluation.The moderated mediation effects were tested by bootstrap method.Results·The AUD group scored higher than the HC group on the DERS total score and all sub-dimensions(goal-directed behavior,impulse control,strategy access,and emotional clarity),and the difference was statistically significant(all P<0.05).At the behavioral level,compared with the HC group,the AUD group had elevated commission error rates[F(1,54)=8.62,P=0.005]and omission error rates[F(1,54)=4.28,P=0.043],and the reaction time of angry face stimuli was generally prolonged[F(1,54)=12.26,P=0.001].Cognitive modeling showed that the drift rate of the AUD group was significantly lower than that of the HC group[F(1,54)=15.56,P<0.001],indicating impaired information processing efficiency.The moderated mediation model showed that,under the condition of angry face stimuli,the drift rate partially mediated the relationship between group and commission error rate,and the total indirect effect value was 9.564(95%CI 3.874?16.387).Further analysis showed that the conditional indirect effect increased to 10.133(95%CI 3.963?17.927)at high levels of emotion regulation difficulty(one standard deviation above the mean),and to 9.011(95%CI 3.778?14.921)at low levels(one standard deviation below the mean).Conclusion·The deficits in information processing efficiency of AUD patients partly explains the impairment of inhibitory control,and this effect is associated with individual emotion regulation capacity.It is suggested that abnormal processing of social threat information may be an important factor affecting the impairment of inhibitory control in AUD patients,especially in individuals with weak emotion regulation ability.

Objective·To investigate the performance and psychological mechanisms of inhibitory control in patients with alcohol use disorder(AUD)under different emotional contexts,and to examine the influence of emotion regulation difficulties on inhibitory control.Methods·A total of 28 male AUD inpatients(AUD group)and 28 age-and education-matched healthy controls(HC group)were recruited.The emotional Go/Nogo task(angry/neutral facial expressions)was used to evaluate the subjects'behavioral inhibition,and the hierarchical drift-diffusion model(HDDM)was used to quantify the cognitive parameters(drift rate,decision threshold,and non-decision time).The Difficulties in Emotion Regulation Scale(DERS)and Alcohol Use Disorder Identification Test(AUDIT)were used for clinical evaluation.The moderated mediation effects were tested by bootstrap method.Results·The AUD group scored higher than the HC group on the DERS total score and all sub-dimensions(goal-directed behavior,impulse control,strategy access,and emotional clarity),and the difference was statistically significant(all P<0.05).At the behavioral level,compared with the HC group,the AUD group had elevated commission error rates[F(1,54)=8.62,P=0.005]and omission error rates[F(1,54)=4.28,P=0.043],and the reaction time of angry face stimuli was generally prolonged[F(1,54)=12.26,P=0.001].Cognitive modeling showed that the drift rate of the AUD group was significantly lower than that of the HC group[F(1,54)=15.56,P<0.001],indicating impaired information processing efficiency.The moderated mediation model showed that,under the condition of angry face stimuli,the drift rate partially mediated the relationship between group and commission error rate,and the total indirect effect value was 9.564(95%CI 3.874?16.387).Further analysis showed that the conditional indirect effect increased to 10.133(95%CI 3.963?17.927)at high levels of emotion regulation difficulty(one standard deviation above the mean),and to 9.011(95%CI 3.778?14.921)at low levels(one standard deviation below the mean).Conclusion·The deficits in information processing efficiency of AUD patients partly explains the impairment of inhibitory control,and this effect is associated with individual emotion regulation capacity.It is suggested that abnormal processing of social threat information may be an important factor affecting the impairment of inhibitory control in AUD patients,especially in individuals with weak emotion regulation ability.

OBJECTIVES: To investigate the effect of avitinib for suppressing NLRP3 inflammasome activation and alleviating septic shock and explore the underlying mechanism. METHODS: Mouse bone marrow-derived macrophages (BMDM), human monocytic leukemia cell line THP-1, and peripheral blood mononuclear cells (PBMC) isolated from healthy volunteers were pre-treated with avitinib, followed by activation of the canonical NLRP3 inflammasome using agonists including nigericin, monosodium urate (MSU) crystals, or adenosine triphosphate (ATP). Non-canonical NLRP3 inflammasome activation was induced via intracellular transfection of lipopolysaccharide (LPS). Western blotting was used to detect the secretory protein markers of NLRP3 inflammasome activation and assess pyroptosis, and the levels of inflammatory cytokines in cell culture supernatant were determined with ELISA. In a mouse model of LPS-induced septic shock, the effect of avitinib treatment on the levels of inflammatory cytokines in serum and peritoneal lavage fluid were examined with ELISA, and survival curves of the mice were plotted using the Kaplan-Meier method. RESULTS: Avitinib significantly inhibited NLRP3 inflammasome activation in multiple cell types, and dose-dependently reduced IL-1β secretion and caspase-1 cleavage while suppressing GSDMD-mediated pyroptosis without obviously affecting IL-6 or TNF-α levels. In the mouse models of LPS-induced septic shock, avitinib significantly lowered IL-1β levels in serum and peritoneal fluid and extended survival time of the mice. CONCLUSIONS Avitinib suppresses NLRP3 inflammasome activation and alleviates septic shock in mice.
Animals ; Shock, Septic/metabolism* ; Mice ; NLR Family, Pyrin Domain-Containing 3 Protein ; Inflammasomes/drug effects* ; Humans ; Macrophages/metabolism* ; Interleukin-1beta/metabolism* ; Lipopolysaccharides

Objective:To unveil the dynamic molecular characteristics of colorectal cancer (CRC) progression, identify key molecules and signaling pathways driving disease development, and provide a theoretical basis for precision diagnosis and treatment.Methods:Differentially expressed genes (DEGs) were identified using DESeq2 based on the TCGA-CRC dataset (556 colorectal cancer samples) and three independent validation cohorts from the GEO database (GSE39582, GSE68468, GSE41258). Mfuzz time-series analysiswas applied to identify gene clusters with continuously upregulated expression during tumor progression. Functional enrichment analysis was performed using clusterProfiler, and protein-protein interaction (PPI) networks were constructed via the STRING online platform to pinpoint hub genes. Single-cell sequencing data (GSE132465/GSE144735) were integrated to resolve the cellular origins and intercellular communication of key genes. The prognostic value of genes was assessed using a univariate Cox proportional hazards model (likelihood ratio test), and single-cell sequencing data were analyzed using the Seurat pipeline with Wilcoxon rank-sum test to identify DEGs.Results:Time-series analysis identified Gene Cluster 4 (containing 186 genes) with a sustained upregulation trend across CRC stages from Ⅰ to Ⅳ. Functional enrichment revealed these genes were significantly involved in extracellular matrix (ECM) remodeling and pathways such as PI3K-Akt and MAPK signaling. PPI network analysis screened 10 hub genes ( COL10A1, THBS2, SPP1, etc.), whose high expression correlated significantly with poor patient prognosis. Single-cell sequencing demonstrated that these hub genes were predominantly expressed in fibroblast subpopulations, while SPP1 was enriched in macrophages. Cell-cell communication analysis confirmed that THBS2-CD47 and SPP1-CD44 were the primary pathways mediating fibroblast-immune/endothelial cell interactions. Conclusion:ECM-related genes are closely associated with the progression of CRC, in which the key molecules THBS2 and SPP1 may drive stromal-immune cell communication in the tumor microenvironment by mediating the THBS2-CD47 and SPP1-CD44 interaction pathways, thereby promoting the progression of CRC.

【Objective】 To explore the correlation between CSAG1 expression and the prognosis and tumor-infiltrating lymphocytes in renal clear cell carcinoma (RCCC), and to predict the survival and tumor progression. 【Methods】 The gene expression profiles and clinical information of CSAG1 were downloaded from the Cancer Genome Atlas (TCGA). Based on the differential mRNA expression, GO annotation and KEGG pathway analysis were performed. The relationship between CSAG1 and tumor immune infiltration was assessed with Tumor Immunoassay Resource (Timer 2.0) database. The mRNA expression of CSAG1 in human RCCC specimens was validated with qRT-PCR. 【Results】 CSAG1 expression was significantly higher in RCCC tissues than in normal tissues (P<0.05). The qRT-PCR results revealed that the mRNA level of CSAG1 was consistent with that predicted by bioinformatic analysis. The KEGG analysis and GO annotation indicated high GSAG1 expression in RCCC was related to transmembrane transport, tricarboxylic acid cycle and lysosome. CSAG1 expression was positively related to the infiltration of pDC, aDC, CD8⁺ T cells, cytotoxic cells, TFH, TH1 cells, Tem, NK CD56^dm cells, Treg and T cells, but negatively correlated with macrophage infiltration. 【Conclusion】 CSAG1 may be associated with poor prognosis of RCCC and become a potential immunotherapy target.

Objective? To investigate the feasibility and safety of vacuum modelling pad for patients with lateral position in thoracic surgery to improve the convenience and comfortable experience for medical staff and patients. Methods? From May 2017 to March 2018, 100 patients who underwent thoracic surgery under general anesthesia with lateral position in the operating room of Sun Yat-sen University Cancer Center were randomly selected and divided into observation group(n=50) and control group (n=50) according to random number table. The polyurethane vacuum modelling pad was used for to secure the patients' position in the observation group, while the sand bag baffle was used to secure the patient's position in the control group. Position placement time and skin pressure blisters were recorded in both groups. Questionnaires were sent out after operation to collect the satisfaction of medical staff with this position. The patients' comfort was followed up within 24 hours after operation. Results? The position placement time in the observation group was (183.56±10.36) s, shorter than the control group with (290.80±14.71)s and the difference was statistically significant(P＜ 0.01); there were 11 cases of skin reddening under pressure and 2 cases of blister in the observation group, which is statistically different from the control group with 24 cases of skin reddening under pressure and 9 cases of blister(P＜ 0.05). Patients' comfort score was(6.72±0.39) in the observation group, higher than the control group with (6.02±0.44) and the difference was statistically significant(P＜ 0.01). In terms of the 4 items of "the convenient operation", "comfortable standing position", "patient safety" and"overall evaluation", the observation group scored higher than the control group with statistical differences (P＜0.01); in terms of the "surgical field exposure" and "fasten effects", there was no statistical difference (P＞0.05). Conclusions? The use of modelling pad for patient lateral position in thoracic surgery can not only prevent organ and skin damage and ensure patient safety, but also simplify the operation procedure, improve the comfort of standing position and the working efficiency and satisfaction of the medical staff.

BACKGROUND: Cassia seed acts on decreasing blood pressure and blood lipid, protecting liver and inhibiting bacteria. It is worth to carry on a further discussion on its effect of weight loss.OBJECTIVE: To observe the influence of cassia seed decoction drunk naturally on body mass of nutritional obese rats in physiological state.DESIGN: Completely randomized grouping was designed, in which, control experiment, analysis of variance and q test were applied in comparison among groups.SETTING: Cardiovascular Institute, Second Affiliated Hospital, Henan University of Science and Technology.MATERIALS: The experiment was performed in Cardiovascular Instutute,Second Affiliated Hospital, Henan University of Science and Technology from March 2004 to September 2004, in which, 27 male SD rats were employed and randomized into 3 groups, named normal control group, model group and cassia seed group, 9 rats in each one.METHODS: [1] In normal control, the rats were bred with basic forage(the contents of protein, fat, carbohydrate were 18.2%, 4.5% and 55.2%successively, with 14.54 kJ caloric each gram) and drank water naturally.In model group, the rats were bred with high nutritive forage (the contents of protein, fat, carbohydrate were 23.7%, 21.6% and 39.0% successively,with 19.56 kJ caloric each gram) and drank water naturally. In cassia seed group, the rats were bred with high nutritive forage and drank cassia seed decoction of various concentration naturally. The concentration of cassia seed decoction started at 10 g/L (equally contained 10 mg raw cassia seed each milliliter) and was increased by 100% concentration each day (10 g/L)till to 60 g/L on the 6th day. Since the 7th day, the concentration of 60 g/L was maintained till to the 7th weekend. [2] It was to record appetite and drinking quantity at definite time every day and calculate absorbed caloric(intake mass × caloric contained each gram). It was to measure body mass at definite time each week. On the 7th weekend, the body length of rat was measured and Lee's index was calculated [ 3√body mass (g)×103/body length (cm)]MAIN OUTCOME MEASURES: Influences of cassia seed on body mass, Lee's index, appetite, caloric and drinking quantity in nutritional obese rats.RESULTS: Twenty-seven rats all entered result analysis. [1] Body mass:that in model group from the 3rd to 7th week in experiment group was higher remarkably than normal control group (P ＜ 0.05-0.01). That in cassia seed group from the 2nd to 7th week was lower remarkably than that in the model group (P ＜ 0.05-0.01). [2] Lee's index: that in model group and cassia seed group on the 7th week of experiment was higher remarkably than that in the normal control group [(358.60±8.55), (341.84±7.29), (322.00±6.89) g/cm, P ＜ 0.05-0.01] and that in cassia seed group was lower remarkably than that in the model group (P ＜ 0.05). [3] Appetite: that in model group and cassia seed group was lower remarkably than that in the normal control group (P ＜ 0.05-0.01) and that in cassia seed group was near to the control group (P ＞ 0.05). [4] Absorbed caloric: that in model group and cassia seed group was higher remarkably than that in the normal control group (P ＜ 0.05-0.01) and that in cassia seed group was near to the control group (P ＞ 0.05). [5] Drinking quantity: that in cassia seed group was basically near to that in the model group and the control group (P ＞ 0.05) and that in model group was near to the control group. It was indicated that cassia seed decoction at mass concentration of 60 g/L did not affect appetite.CONCLUSION: Cassia seed decoction at mass concentration of 60 g/L inhibits remarkably the increased body mass of nutritional obese rats and is free from influence on appetite.