OBJECTIVE To investigate the effect and mechanism of Jingangteng capsules in the treatment of non-alcoholic fatty liver disease （NAFLD）. METHODS Thirty-two SD rats were randomly divided into normal group and modeling group. The modeling group was fed a high-fat diet to establish a NAFLD model. The successfully modeled rats were then randomly divided into model group， atorvastatin group[positive control， 2 mg/（kg·d）]， and Jingangteng capsules low- and high-dose groups [0.63 and 2.52 mg/（kg·d）]， with 6 rats in each group. The pathological changes of the liver were observed by hematoxylin-eosin staining and oil red O staining. Enzyme-linked immunosorbent assay was performed to determine the serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， alanine transaminase （ALT）， aspartate transaminase （AST）， tumour necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-18. 16S rDNA amplicon sequencing and metabolomics techniques were applied to explore the effects of Jingangteng capsules on gut microbiota and metabolisms in NAFLD rats. Based on the E-mail：591146765@qq.com metabolomics results， Western blot analysis was performed to detect proteins related to the nuclear factor kappa-B （NF-κB）/NOD-like receptor family protein 3 （NLRP3） signaling pathway in the livers of NAFLD rats. RESULTS The experimental results showed that Jingangteng capsules could significantly reduce the serum levels of TG， TC， LDL-C， AST， ALT， TNF-α， IL-1β， IL-6， IL-18， while increased the level of HDL-C， and alleviated the hepatic cellular steatosis and inflammatory infiltration in NAFLD rats. They could regulate the gut microbiota disorders in NAFLD rats， significantly increased the relative abundance of Romboutsia and Oscillospira， and significantly decreased the relative abundance of Blautia （P＜0.05）. They also regulated metabolic disorders primarily by affecting secondary bile acid biosynthesis， fatty acid degradation， O-antigen nucleotide sugar biosynthesis， etc. Results of Western blot assay showed that they significantly reduced the phosphorylation levels of NF-κB p65 and NF-κB inhibitor α， and the protein expression levels of NLRP3， caspase-1 and ASC （P＜0.05 or P＜0.01）. CONCLUSIONS Jingangteng capsules could improve inflammation， lipid accumulation and liver injury in NAFLD rats， regulate the disorders of gut microbiota and metabolisms， and inhibit NF-κB/NLRP3 signaling pathway. Their therapeutic effects against NAFLD are mediated through the inhibition of the NF-κB/NLRP3 signaling pathway.

Subarachnoid hemorrhage (SAH) is the third common type of stroke in the world,and its mortality and disability rates have declined over the past few decades due to the advances in neuroimaging technology and endovascular interventional therapy and promotion of healthy physical examination,but long-term neurological deficits and cognitive impairment of the patients have not significantly improved,which may be related to the white matter injury (WMI) after SAH.Little attention has been paid to WMI after SAH in the past,which may be an important reason for the poor prognosis of the patients with SAH.The neuroin-flammation response is an important pathophysiological process after SAH,and the neuroinflammation after SAH can aggravate WMI.This article reviews the relationship between neuroinflammation and WMI after SAH in order to deepen the understanding of its effects on cognitive function after SAH.

To have better clinical understanding of Schimke immuno-osseous dysplasia(SIOD) through analyzing the clinical features, treatment, and prognosis of four patients with SIOD.

Mutations in the SAMD9 and SAMD9L genes are associated with MIRAGE syndrome and ATXPC syndrome, respectively. This study reports the clinical characteristics and genetic analysis of one case with SAMD9 mutation (c.3809T > A, p.F1270Y) and two cases with SAMD9L mutations (c.2675T > G, p.M892R; c.1096T > G, p.F366V and c.4517T > C, p.L1506p), none of which have been previously reported. All patients presented with recurrent infections, growth retardation, and myelodys-plasia, with varying degrees of involvement of multiple systems, including respiratory, gastrointestinal, immune, endocrine, neurological, and reproductive systems. In terms of treatment, two patients underwent regular intravenous immunoglobulin and their clinical symptoms improved, while one patient had a favorable recovery following hematopoietic stem cell transplantation at the age of 1 year and 5 months of age. SAMD9/SAMD9L gene mutations, therefore, chould be considered in children with recurrent infections, myelodysplasia, pancytopenia, and growth retardation. Early genetic testing is crucial for timely diagnosis and treatment, which may improve patient outcomes.

With the continuous development of information technology,smart financial systems has gradually become an important tool for financial management in public hospitals.As an important component of the smart financial system,electronic accounting record management is of great practical significance in adapting to the trend of"green and carbon free"economic development,improving the efficiency of financial management in public hospitals,and promoting high-quality development of hospitals.Henan Provincial People's Hospital is taken as an example(hereinafter referred to as the sample hospital)to deeply interpret national policies,explore the difficulties in electronic accounting file management,and combine with the specific situation of the hospital.Guided by the overall strategic goals of the hospital,starting from the top-level design integration,it creates a set of replicable and promotable electronic accounting voucher electronic reimbursement,entry,and archiving progress,so as to provide theoretical and practical experience for the transformation and upgrading of electronic record management in public hospitals,and provide a new template for the development and reform of economic management in public hospitals in China.

With the continuous development of information technology,smart financial systems has gradually become an important tool for financial management in public hospitals.As an important component of the smart financial system,electronic accounting record management is of great practical significance in adapting to the trend of"green and carbon free"economic development,improving the efficiency of financial management in public hospitals,and promoting high-quality development of hospitals.Henan Provincial People's Hospital is taken as an example(hereinafter referred to as the sample hospital)to deeply interpret national policies,explore the difficulties in electronic accounting file management,and combine with the specific situation of the hospital.Guided by the overall strategic goals of the hospital,starting from the top-level design integration,it creates a set of replicable and promotable electronic accounting voucher electronic reimbursement,entry,and archiving progress,so as to provide theoretical and practical experience for the transformation and upgrading of electronic record management in public hospitals,and provide a new template for the development and reform of economic management in public hospitals in China.

With the continuous development of information technology,smart financial systems has gradually become an important tool for financial management in public hospitals.As an important component of the smart financial system,electronic accounting record management is of great practical significance in adapting to the trend of"green and carbon free"economic development,improving the efficiency of financial management in public hospitals,and promoting high-quality development of hospitals.Henan Provincial People's Hospital is taken as an example(hereinafter referred to as the sample hospital)to deeply interpret national policies,explore the difficulties in electronic accounting file management,and combine with the specific situation of the hospital.Guided by the overall strategic goals of the hospital,starting from the top-level design integration,it creates a set of replicable and promotable electronic accounting voucher electronic reimbursement,entry,and archiving progress,so as to provide theoretical and practical experience for the transformation and upgrading of electronic record management in public hospitals,and provide a new template for the development and reform of economic management in public hospitals in China.

Objective Analyze the risk factors associated with severe subarachnoid hemorrhage(SAH)and rebleeding in small intracranial aneurysms.Methods From July 2014 to January 2020,patients with SAH caused by small ruptured intracranial aneurysms admitted to the Neurosurgery Department of the First Affiliated Hospital,Chongqing Medical University were retrospectively and continuously included.Small intracranial aneurysms refer to intracranial aneurysms with a maximum diameter of less than 5 mm.Baseline data and clinical data of patients were collected,including age,gender,past history(hypertension,diabetes,coronary heart disease),smoking history,drinking history,admission Glasgow coma scale(GCS)score and Hunt-Hess grade.Patient imaging data were collected to clarify the characteristics of aneurysms,including the number of aneurysms(single or multiple),the shape of SAH responsible aneurysms(irregular aneurysms with subcapsular,polycystic,or lobulated aneurysms),and their location(anterior communicating artery,posterior communicating artery,middle cerebral artery,anterior cerebral artery,internal carotid artery,and posterior circulation).Based on the CT images of the head at admission,the distribution of SAH in patients was determined.The modified Fisher grading system was used to classify SAH into 1-4 levels,and the Hijdra score was used to assess the bleeding volume of SAH in patients.The treatment methods of patients(interventional embolization,clipping)were collected.All patients were grouped according to the modified Fisher classification,with grades 1-2 being the minor SAH group and grades 3-4 being the massive SAH group.Baseline data and clinical data and aneurysm characteristics were compared between minor SAH group and massive SAH group.Multiple Logistic regression analysis was conducted using the modified Fisher grades 3-4 as the dependent variable,and factors with P＜0.1 in baseline data that may affect SAH bleeding volume as independent variables,the risk factors associated with the massive SAH in small ruptured intracranial aneurysms were analyzed.New bleeding visible on preoperative CT of the patient,with or without neurological deterioration,is defined as rebleeding.All patients are divided into rebleeding group and non-rebleeding group based on the occurrence of rebleeding.Baseline data and aneurysm characteristics between patients with rebleeding and those without rebleeding were compared.Multivariate Logistic regression analysis was conducted with rebleeding as the dependent variable,and factors with P＜0.1 in baseline data and aneurysm characteristics were used as independent variables,the risk factors associated with rebleeding in small aneurysms were analyzed.Results A total of 363 SAH patients with small ruptured aneurysms were included in this study,including 103 males and 260 females;age range from 25 to 85 years old,with an average age of(55±11)years.According to the modified Fisher classification,there were 198 cases in the massive SAH group and 165 cases in the minor SAH group.Compared with patients in the minor SAH group,patients in the massive SAH group were older(P=0.011),with a higher proportion of males,concomitant hypertension,and smoking history(all P＜0.05).The proportion of admitted Hunt Hess grade Ⅳ to V was higher(26.3％vs.2.4％,P＜0.01),the GCS score was lower([13.1±1.8]points vs.[13.9±0.8]points,P＜0.01),and the Hijdra score was higher([19.7±5.4]points vs.[8.4±2.6]points,P＜0.01).There was no statistically significant difference in the number of aneurysms and the location and morphology of responsible aneurysms between the massive and minor SAH groups(all P＞0.05).According to whether patients experienced rebleeding before surgery,there were 30 cases in the rebleeding group and 333 cases in the non-rebleeding group.Compared with the non-rebleeding group,patients in the rebleeding group had a higher proportion of concomitant hypertension(83.3％vs.49.2％,P＜0.01)and a higher proportion of admitted Hunt Hess grades Ⅳ-V(43.3％vs.12.9％,P＜0.01),lower GCS scores(12[9,14]points vs.14[13,14]points,P＜0.01),and higher Hijdra scores(18[9,26]points vs.14[9,18]points,P=0.024).There was no statistically significant difference in the number of aneurysms,responsible aneurysm morphology,and location between the rebleeding group and the non-rebleeding group(all P＞0.05).There was no statistically significant difference between the coiling and clipping in the two group(both P＞0.05).Multiple Logistic regression analysis was conducted using modified Fisher grading 3-4 and rebleeding as dependent variables respectively.The results showed that age(OR,1.027,95％CI 1.006-1.049,P=0.012)and hypertension(OR,1.858,95％CI 1.196-2.886,P=0.006)were independent risk factors associated with massive SAH in small ruptured aneurysms.Hypertension(OR,3.775,95％CI 1.371-10.391,P=0.010)and lower GCS score(OR,0.677,95％CI 0.561-0.816,P＜0.01)were independent risk factors associated with rebleeding in small ruptured aneurysms.Conclusions Older age and concomitant hypertension are risk factors associated with massive SAH in patients with small ruptured aneurysms.Coexisting hypertension and lower GCS score are risk factors associated with rebleeding in patients with small ruptured aneurysms.

Objective:To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation for the treatment of combined immunodeficiency (CID) and explore prognostic risk factors.Methods:In this retrospective cohort study, clinical characteristics, laboratory tests and prognosis of 73 CID children who underwent allogeneic hematopoietic stem cell transplantation from February 2014 to April 2022 in the Children′s Hospital of Fudan University were analyzed. Based on the subtypes of diseases, all patients were divided into severe combined immunodeficiency disease (SCID) group and other CID group. Based on the types of donors, all patients were divided into matched sibling donor group, matched unrelated donor group, unrelated cord blood group, and haploidentical donor group. Kaplan-Meier method and Log-Rank test were used to analyze the survival data. Cox regression was used to analyze prognostic factors.Results:Among the 73 patients, there were 61 (84%) males and 12 (16%) females. Fifty-five (75%) patients were SCID, and 18 (25%) patients were other CID. Donor source included 2 (3%) matched sibling donors (MSD), 3 (4%) matched unrelated donors (MUD), 64 (88%) unrelated cord blood (UCB), and 4 (5%) haploidentical donors. The age at transplant was 10.7 (5.9, 27.5) months, and the follow-up time was 36.2 (2.5, 62.9) months. The 3-year overall survival rate of 73 patients with CID was (67±6) %. No significant difference was found in the 3-year overall survival rates between patients with SCID (55 cases) and other CID (18 cases) ((64±7) % vs. (78±10) %, χ2=1.31, P=0.252). And no significant difference was found in the 3-year overall survival rates among patients who received MSD or MUD (5 cases), UCB (64 cases), and haploidentical donor (4 cases) transplant (100% vs. (66±6)% vs. (50±25) %, χ2=2.30, P=0.317). Cox regression analysis showed that the medical history of sepsis ( HR=2.55, 95% CI 1.05-6.20, P=0.039) and hypoalbuminemia at transplant ( HR=2.96, 95% CI 1.14-7.68, P=0.026) were independent risk factors for the prognosis of allogeneic hematopoietic stem cell transplantation in pediatric patients with CID. Conclusions:Allogeneic hematopoietic stem cell transplantation is an effective treatment for CID. The medical history of sepsis and hypoalbuminemia at transplant were risk factors for prognosis. Enhancing infection prevention and nutritional intervention before transplant can improve patient prognosis.

With the continuous development of information technology,smart financial systems has gradually become an important tool for financial management in public hospitals.As an important component of the smart financial system,electronic accounting record management is of great practical significance in adapting to the trend of"green and carbon free"economic development,improving the efficiency of financial management in public hospitals,and promoting high-quality development of hospitals.Henan Provincial People's Hospital is taken as an example(hereinafter referred to as the sample hospital)to deeply interpret national policies,explore the difficulties in electronic accounting file management,and combine with the specific situation of the hospital.Guided by the overall strategic goals of the hospital,starting from the top-level design integration,it creates a set of replicable and promotable electronic accounting voucher electronic reimbursement,entry,and archiving progress,so as to provide theoretical and practical experience for the transformation and upgrading of electronic record management in public hospitals,and provide a new template for the development and reform of economic management in public hospitals in China.