Objective To investigate the population density and seasonal fluctuations of Aedes albopictus in Guangzhou City, Guangdong Province, from 2021 to 2023, so as to provide insights into A. albopictus control and management of dengue fever. Methods The surveillance of A. albopictus density was performed in all surveillance sites assigned across all streets (townships) in Guangzhou City during the period from January to December from 2021 to 2023. The surveillance frequency was twice every half month from May to September, and once every month for the rest of a year. In each surveillance period, A. albopictus mosquito larvae were captured from indoor and outdoor small water containers in residential areas, parks, medical facilities, schools, other government sectors and social organizations, construction sites, special industries and others for mosquito species identification. Adult mosquitoes were captured using electric mosquito suction apparatus for species identification and gender classification. Adult mosquitoes and mosquito eggs were collected with mosquito and egg traps at the breeding and dwelling places of Aedes mosquitoes for identification. The mosquito oviposition index (MOI), Breteau index (BI), adult mosquito density index (ADI) and standard space index (SSI) were calculated. The A. albopictus density was classified into grades 0, 1, 2 and 3 in each surveillance site, with Grade 0 density defined eligible, and the eligible rate of A. albopictus density was calculated at all surveillance sites each year from 2021 to 2023. In addition, the changing trends in MOI, SSI, BI and ADI of A. albopictus were analyzed in Guangzhou City from 2021 to 2023. Results The eligible rates of A. albopictus density were 61.69%, 68.75% and 55.15% in surveillance sites of Guangzhou City from 2021 to 2023 (χ² = 297.712, P < 0.001), and appeared a tendency towards a reduction followed by a rise each year, which gradually reduced since January, maintained at a low level during the period between May and October, and gradually increased from November to December. The MOI, SSI, BI and ADI of A. albopictus all appeared a tendency towards a rise followed by a reduction in Guangzhou City during the period between January and December from 2021 to 2023. The BI of A. albopictus peaked in the first half of June in 2021 (4.03), the first half of July in 2022 (3.89) and the last half of August in 2023 (5.02), and the SSI of A. albopictus peaked in the last half of June in 2021 (0.93), the last half of May in 2022 (0.59), and the last half of June (0.94) and the first half of September in 2023 (1.12). In addition, the MOI of A. albopictus peaked in the first half of May in 2021 (8.64), the first half of June in 2022 (8.96), and the last half of May (10.21) and the last half of June in 2023 (10.89), and the ADI of A. albopictus peaked in the first half of June in 2021 (3.41), the last half of June in 2022 (4.06), and the first half of July in 2023 (3.61). Conclusions The density of A. albopictus is high in Guangzhou City during the period from May to October, and the risk of local outbreak caused by imported dengue fever is high. Persistent intensified surveillance of the density and seasonal fluctuation of A. albopictus is recommended and timely mosquito prevention and control is required according to the fluctuation in the A. albopictus density.

Objective:To investigate the therapeutic efficacy and safety of conditioning regimen with oral melphalan in tandem autologous hematopoieticstem cell transplantation (ASCT) for patients with malignant plasma cell diseases.Methods:A retrospective case series study was conducted. The clinical data of 13 patients with malignant plasma cell diseases who underwent tandem ASCT between October 2019 and March 2024 in the First Affiliated Hospital of Xi'an Jiaotong University were collected. Compared with the use of intravenous melphalan as conditioning regimen for the first ASCT, hematopoietic reconstruction after transplantation, the therapeutic effects, adverse reactions after drug usage and survival of conditioning regimen with oral melphalan after tandem ASCT were analyzed.Results:Among the 13 patients, there were 10 males and 3 females, with a median age [ M ( Q1, Q3)] of 53 (48, 61) years; 11 cases were multiple myeloma and 2 cases were plasma cell leukemia. Before the first ASCT, tandem ASCT was performed 2-6 months later. The median reconstruction time of neutrophils after the first and second ASCT were both 9 (9, 10) d, and the median reconstruction time of platelets after the first and second ASCT were both 10 (9, 11) d, and there were no statistically significant differences in reconstruction rate of granulocytes on day 9 [69.2% (9/13) vs. 61.5% (8/13)] and platelets on day 10 [46.2% (6/13) vs. 53.8% (7/13)] between the first and second transplantation (all P > 0.05). There were 4 cases of strict complete remission (sCR), 3 cases of complete remission (CR), 4 cases of very good partial remission (VGPR), and 2 cases of partial remission (PR) before the first ASCT. After the first ASCT 1 month later, 1 case achieved VGPR, 1 case achieved PR, 11 cases achieved sCR; all 13 patients achieved sCR at 6 months after second ASCT. Compared with conditioning regimen of intravenous melphalan for the first ASCT, the non-hematological adverse reactions such as nausea (7 cases vs. 9 cases), vomiting (4 cases vs. 13 cases), diarrhea (4 cases vs. 13 cases) and oral mucositis (2 cases vs. 9 cases) in the conditioning regimen of oral melphalan after the second ASCT was reduced, and the differences were statistically significant (all P < 0.01). After the 2 transplantation conditioning regimen with melphalan, Ⅳ degree myelosuppression occurred in 13 cases. After the second ASCT, the median follow-up time was 14 (10, 22) months, 7 patients received maintenance therapy containing lenalidomide, 3 patients received maintenance therapy containing bortezomib, 2 patients received pomalidomide maintenance therapy, and 1 patient received maintenance therapy containing CD38 monoclonal antibody. At the last follow-up, all patients survived, among which 6 multiple myeloma patients relapsed; and the median recurrence time was 13 (10, 22) months after the second ASCT. The estimated 5-year progression-free survival rate was 28.6%. Conclusions:Conditioning regimen with oral melphalan for the second ASCT is safe and well tolerated, and it may further improve the efficacy of the first transplantation.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To screen the influencing factors of hepatitis C cirrhosis patients progressing to hepatocellular carcinoma(HCC)using commonly used laboratory testing indicators,establish a prediction model using these indicators and validate them.Methods A total of 231 patients with hepatitis C cirrhosis and 179 patients with hepatitis C HCC hospitalized at the First Affiliated Hospital of Xi'an Jiaotong University between June 2020 and May 2023 were enrolled as the training set,and 105 patients with hepatitis C cirrhosis and 86 patients with hepatitis C HCC hospitalized between June 2023 and February 2024 were enrolled as the validation set.The routine laboratory test indexes of the study subjects in the two groups within the training set were compared,and logistic regression analysis was applied to screen the independent predictors of hepatocellular carcinoma occurrence.Receiver operating characteristic(ROC)curve was used to construct the curve model and validate the model.Results The age,male ratio,ALT,AST,AFP,WBC,NEU,MO,PLT,MPV,PDW,Fbg,NLR and PLR levels of the HCC group were higher than those of the cirrhosis group in the training set(H=-9.07～-2.19),while the levels of INR and LMR were lower than those of the cirrhosis group(H=-4.49,-2.65),and the differences were significant(all P＜0.05).The differences in TP,eGFR,LY and AST/ALT values between the two groups of patients were not significant(H=-1.46～-0.15,all P＞0.05).Multifactorial Logistic regression analysis showed that age(OR=1.048,95％CI:1.023～1.074),Male(OR=1.467,95％CI:1.413～1.765),AST(OR=1.010,95％CI:1.002～1.019),NEU(OR=1.186,95％CI:1.018～1.382)and Fbg(OR=2.245,95％CI:1.639～3.076)were independent risk factors for hepatocellular carcinoma patients(all P＜0.05),and these five independent risk factors were used to construct the HCC column-line graph prediction model,with the AUC for the training set and the validation set AUC(95％Cl)were 0.813(0.771～0.854)and 0.712(0.639～0.784),respectively,and the Hosmer-Lemeshow test showed a good fit of the model with P=0.650 for the training set and P=0.310 for the validation set.Conclusion The prediction model of HCC based on age,gender,AST,NEU and Fbg can have good predictive efficacy and clinical application value.

Objective:To evaluate the clinical efficacy of allogeneic hematopoietic stem cell transplantation（allo-HSCT）in children with severe aplastic anemia（SAA）.Methods:Twenty-seven cases with SAA who had been treated with allo-HSCT from January 2020 to December 2022 were retrospectively analyzed and reviewed.Results:（1）A total of 27 SAA patients were enrolled，including 18 males and 9 females，with a median age of 8 (2-15) years.There were 20 cases of SAA-Ⅰ type,7 cases of SAA-Ⅱ type.Based upon donor sources，three cases of matched sibling donors hematopoietic stem cell transplantation,and 24 cases of haploidentical hematopoietic stem cell transplantation were adopted.（2）Hematopoietic reconstruction was achieved in all 27 cases.The median implantation time of neutrophils and platelets was 10（9-20）days and 12（7-26）days respectively.The cumulative incidence of acute graft-versus-host disease（GVHD）was 66.67%（18/27）.The incidence of grade Ⅰ-Ⅱ was 55.56%（15/27）and that of grade Ⅲ-Ⅳ was 11.11%（3/27）.The incidence of chronic GVHD was 7.41%（2/27）.Transplant-associated thrombotic microangiopathy (TA-TMA) occurred in 7.41%（2/27）patients,cytomegalovirus viremia in 62.96%（17/27）patients,epstein-barr virus infection in 33.33%（9/27）patients,and 14.81%（4/27）patients progressed to post-transplant lymphoproliferative disorder (PTLD).（3）The median follow-up time was 12 (2-28) months.The overall survival rate was 96.29%.Twenty-six patients survived,and one patient died due to multiple complications of severe acute GVHD,TA-TMA,cytomegalovirus infection,PTLD and secondary epilepsy.Conclusion:Allo-HSCT is an effective therapy for SAA in children.The effective rate of this research is 96.29%.Acute GVHD is still the key to therapy.The incidence rate of acute GVHD is 66.67% in this study.The blood incompatibility of donor and recipient may affect the incidence of GVHD.The intensity of GVHD prevention should be reduced after HLA-matched sibling donor-hematopoietic stem cell transplantation so as to avoid the complications of virus recurrence and PTLD.

Traditional health economic evaluation mainly focuses on efficiency and lacks quantitative consideration of equity.To further quantify different equity factors based on traditional economic evaluation,equity-informative economic evaluations have been gradually developed.This paper reviews and summarizes 5 methods to incorporate equity into economic evaluations,among which the 3 widely used including equity-based weighting(EBW),distributional cost-effectiveness analysis(DCEA),and extended cost-effectiveness analysis(ECEA)are introduced in detail regarding basic concept,data requirements,advantages and disadvantages.The equity-informative economic evaluations will provide an effective tool for decision-makers to trade off between the efficiency maximization and distributional equity in the allocation of health resources formally and transparently,and will have a good prospect in China.However,the lack of relevant basic data is one of the main challenges limiting the practical application of such methods.It is also a research barrier that future researchers in related fields need to break through.

OBJECTIVE To study the efficacy and mechanism of Shugan Jianpi Jiedu decoction in the treatment of the precancerous lesions of breast cancer through animal experiment. METHODS SD rats were taken and divided into 6 groups(10 rats in each group), namely blank group, breast precancerous lesion model group, tamoxifen group, Shugan Jianpi Jiedu decoction groups with low dose, middle dose, and high dose. DMBA modeling method was used to carry out modeling for breast precancerous lesion. HE staining was used to observe the pathological changes of breast tissue. CD4+, CD8+ were detected by flow cytometry. ELISA was used to detect IL-2, IL-4, IL-6, IL-10, IL-12, E2, P. The protein expression of ER, PI3K, p-Akt and mTOR was detected by Western blotting. RESULTS HE staining showed changes in rat mammary tissue, indicating successful modeling. Compared with the blank group, the content of CD4+ decreased and the content of CD8+ increased in the model group(P<0.01); compared with model group, the content of CD4+ increased and the content of CD8+ decreased in low, middle, high dose groups of Shugan Jianpi Jiedu decoction and tamoxifen group(P<0.01). The levels of IL-2, IL-4 and IL-10 in the model group were significantly lower than those in the blank group(P<0.01), while IL-12 and IL-6 were significantly increased(P<0.01). Compared with the model group, the concentrations of IL-2, IL-4 and IL-10 in the low, middle and high dose groups of Shugan Jianpi Jiedu decoction and the tamoxifen group were significantly increased(P<0.01), while IL-12 and IL-6 decreased significantly(P<0.05 or P<0.01). Compared with the blank group, the contents of E2 and P in the model group increased significantly(P<0.05 or P<0.01), the contents of E2 and P in the low, middle and high dose groups of Shugan Jianpi Jiedu decoction and the tamoxifen group were significantly lower than those in the model group(P<0.01). The Western blotting results showed that compared with the blank group, the expression of ER, PI3K, p-Akt and mTOR in the model group was significantly increased(P<0.01). Compared with the model group, the expression of ER, PI3K, p-Akt and mTOR in the low, medium and high dose groups of Shugan Jianpi Jiedu decoction and the tamoxifen group were significantly decreased(P<0.01). CONCLUSION Shugan Jianpi Jiedu decoction may inhibit the expression of ER, thus inhibiting the expression of PI3K/Akt/mTOR signaling pathway. Meanwhile, it can affect the immune response and reverse the precancerous lesions of breast cancer.

New quality productive forces with innovation and efficient utilization of resources as its core,is a new engine driving the innovative development of the national healthcare system.Healthcare big data has become the core motivity of the new quality productive forces,with the rapid development of industrial technologies including data governance and cloud storage,digital intelligence technology,and artificial intelligence,etc.From the perspective of new quality productive forces,it expounds on how to drive the innovative development of health economics and pharmacoeconomics research based on big data,including aspects of developing the innovative instruments for health outcome measurement,building the innovative frameworks of value assessment for innovative medications,and enhancing the precise evidence of healthcare policy evaluation.It describes how to use Healthcare big data as a driver to promote the innovative development of scientific research in related fields,and give full play to the role of economics evidence generation and decision-making support,so as to promote health care decision-making and optimal allocation of resources towards a new stage of improving quality and efficiency.

New quality productive forces with innovation and efficient utilization of resources as its core,is a new engine driving the innovative development of the national healthcare system.Healthcare big data has become the core motivity of the new quality productive forces,with the rapid development of industrial technologies including data governance and cloud storage,digital intelligence technology,and artificial intelligence,etc.From the perspective of new quality productive forces,it expounds on how to drive the innovative development of health economics and pharmacoeconomics research based on big data,including aspects of developing the innovative instruments for health outcome measurement,building the innovative frameworks of value assessment for innovative medications,and enhancing the precise evidence of healthcare policy evaluation.It describes how to use Healthcare big data as a driver to promote the innovative development of scientific research in related fields,and give full play to the role of economics evidence generation and decision-making support,so as to promote health care decision-making and optimal allocation of resources towards a new stage of improving quality and efficiency.

New quality productive forces with innovation and efficient utilization of resources as its core,is a new engine driving the innovative development of the national healthcare system.Healthcare big data has become the core motivity of the new quality productive forces,with the rapid development of industrial technologies including data governance and cloud storage,digital intelligence technology,and artificial intelligence,etc.From the perspective of new quality productive forces,it expounds on how to drive the innovative development of health economics and pharmacoeconomics research based on big data,including aspects of developing the innovative instruments for health outcome measurement,building the innovative frameworks of value assessment for innovative medications,and enhancing the precise evidence of healthcare policy evaluation.It describes how to use Healthcare big data as a driver to promote the innovative development of scientific research in related fields,and give full play to the role of economics evidence generation and decision-making support,so as to promote health care decision-making and optimal allocation of resources towards a new stage of improving quality and efficiency.