Objective:To investigate the subacute toxicity and target organs of triethylenediammonium perchlorate ammonium complex salt (DAP-4) .Methods:In August 2024, 40 SPF-grade SD rats were selected, with 10 rats in each group, half male and half female. There were 45, 140, and 420 mg/kg DAP-4 groups and a control group. Rats in each dose DAP-4 group were orally administered the corresponding amount of DAP-4 solution, while the control group was given the same dose of 1% sodium carboxymethyl cellulose. SD rats were given intragastric administration once a day for 28 consecutive days. The behaviors, histopathological changes, and blood physiological and biochemical indicators of rats were detected at the corresponding time points respectively. One-way analysis of variance was used for the comparison of quantitative data between groups.Results:Compared with the control group, the body weight, food intake and food utilization rate of female and male rats in the 420 mg/kg DAP-4 group were significantly decreased ( P<0.05), while no abnormalities were observed in the other dose groups. Compared with the control group, the white blood cell count of female rats in the 420 mg/kg DAP-4 group decreased, while the hemoglobin and hematocrit decreased and the total serum protein increased of male rats ( P<0.05). Compared with the control group, fibrinogen was increased in both female and male rats in the 420 mg/kg DAP-4 group, and the thrombin time of female rats was shortened ( P<0.05). In each dose group, the livers of female and male rats showed varying degrees of vacuolar degeneration, and the renal tubules of female rats were swollen. Conclusion:420 mg/kg DAP-4 can cause damage to the liver and kidney of rats, and the maximal no effect level of DAP-4 for rats is 140 mg/kg.

Objective To develop and validate a"quick self-assessment questionnaire for cochlear implant out-come(QSACI)".Methods A research team,composed of audiologists,otolaryngologists,data analysis experts,and cochlear implant(CI)recipients,was formed to establish objectives,research subject criteria,and framework of the QSACI.An item pool was creaed through literature review and brainstorming.Question items were evaluated and screened,and the framework and answer options of the questionnaire were established.The comprehensibility,etc.,was analyzed and refined through pilot test,interviews,and expert consultation,leading to the development of the final version.A total of 39 post-lingually deafened adults with known stable outcomes completed the question-naire.The split-half and test-retest reliabilty of the questionnaire was analyzed,and the validity was quantitatively analyzed by comparing scores with the categories of auditory performance(CAP)scores.Results The initial item pool of the questionnaire had 18 items,and the final questionnaire consisted of 12 questions in four dimensions:com-munication status,audiological status,medical factors,and other factors.The average score of 39 recipients was 88.81±6.17 and CAP was 6.19±0.94.The questionnaire showed good reliability and validity,with a Cronbach's alpha coefficient of 0.71 and a test-retest reliability of 0.824(P＜0.05).The criterion-related validity,assessed by the correlation between the self-assessment questionnaire scores and CAP scores,showed a significant moderate pos-itive correlation(r=0.512,P＜0.05).The correlation coefficient between self-assessment and professional assess-ment was 0.720(P＜0.05),indicating a significant correlation.The area under the receiver operating characterstic(ROC)curve was 0.82(P＜0.05),the cutoff values corresponding to the maximal Youden index were 82.5 and 88.6,therefore score of 85 was taken as the median threshold score of judgement.Conclusion The QSACI reflects the post-imlplant outcomes,and it can serve as a tool for people with postlingually deafness and their families to un-derstand the eligbility of CI and the expected outcomes,helping to establish realistic expectations before CI surgery.

Objective:To investigate the subacute toxicity and target organs of triethylenediammonium perchlorate ammonium complex salt (DAP-4) .Methods:In August 2024, 40 SPF-grade SD rats were selected, with 10 rats in each group, half male and half female. There were 45, 140, and 420 mg/kg DAP-4 groups and a control group. Rats in each dose DAP-4 group were orally administered the corresponding amount of DAP-4 solution, while the control group was given the same dose of 1% sodium carboxymethyl cellulose. SD rats were given intragastric administration once a day for 28 consecutive days. The behaviors, histopathological changes, and blood physiological and biochemical indicators of rats were detected at the corresponding time points respectively. One-way analysis of variance was used for the comparison of quantitative data between groups.Results:Compared with the control group, the body weight, food intake and food utilization rate of female and male rats in the 420 mg/kg DAP-4 group were significantly decreased ( P<0.05), while no abnormalities were observed in the other dose groups. Compared with the control group, the white blood cell count of female rats in the 420 mg/kg DAP-4 group decreased, while the hemoglobin and hematocrit decreased and the total serum protein increased of male rats ( P<0.05). Compared with the control group, fibrinogen was increased in both female and male rats in the 420 mg/kg DAP-4 group, and the thrombin time of female rats was shortened ( P<0.05). In each dose group, the livers of female and male rats showed varying degrees of vacuolar degeneration, and the renal tubules of female rats were swollen. Conclusion:420 mg/kg DAP-4 can cause damage to the liver and kidney of rats, and the maximal no effect level of DAP-4 for rats is 140 mg/kg.

Objective To develop and validate a"quick self-assessment questionnaire for cochlear implant out-come(QSACI)".Methods A research team,composed of audiologists,otolaryngologists,data analysis experts,and cochlear implant(CI)recipients,was formed to establish objectives,research subject criteria,and framework of the QSACI.An item pool was creaed through literature review and brainstorming.Question items were evaluated and screened,and the framework and answer options of the questionnaire were established.The comprehensibility,etc.,was analyzed and refined through pilot test,interviews,and expert consultation,leading to the development of the final version.A total of 39 post-lingually deafened adults with known stable outcomes completed the question-naire.The split-half and test-retest reliabilty of the questionnaire was analyzed,and the validity was quantitatively analyzed by comparing scores with the categories of auditory performance(CAP)scores.Results The initial item pool of the questionnaire had 18 items,and the final questionnaire consisted of 12 questions in four dimensions:com-munication status,audiological status,medical factors,and other factors.The average score of 39 recipients was 88.81±6.17 and CAP was 6.19±0.94.The questionnaire showed good reliability and validity,with a Cronbach's alpha coefficient of 0.71 and a test-retest reliability of 0.824(P＜0.05).The criterion-related validity,assessed by the correlation between the self-assessment questionnaire scores and CAP scores,showed a significant moderate pos-itive correlation(r=0.512,P＜0.05).The correlation coefficient between self-assessment and professional assess-ment was 0.720(P＜0.05),indicating a significant correlation.The area under the receiver operating characterstic(ROC)curve was 0.82(P＜0.05),the cutoff values corresponding to the maximal Youden index were 82.5 and 88.6,therefore score of 85 was taken as the median threshold score of judgement.Conclusion The QSACI reflects the post-imlplant outcomes,and it can serve as a tool for people with postlingually deafness and their families to un-derstand the eligbility of CI and the expected outcomes,helping to establish realistic expectations before CI surgery.

Objective To compare the value of multimodal ultrasound and ultrasound-guided fine-needle aspiration biopsy(US-FNAB)for distinguishing benign and malignant thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS)grade 4.Methods Data of 247 thyroid nodules in 201 patients were retrospectively analyzed,including 193 malignant and 54 benign noes.Taken postoperative pathology as the gold standards,the value of multimodal ultrasound,i.e.the combination of conventional ultrasound,shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)and US-FNAB for distinguishing benign and malignant thyroid nodules were compared.Results The sensitivity,specificity,accuracy,misdiagnosis rate and rate of missed diagnosis of conventional ultrasound for diagnosing malignant thyroid nodules was 86.53％,59.26％,80.57％,40.74％and 13.47％,respectively,of SWE was 78.76％,74.07％,77.73％,25.93％and 21.24％,respectively,of CEUS was 90.16％,77.78％,87.45％,22.22％and 9.84％,respectively,while of multimodal ultrasound was 97.93％,88.89％,95.95％,11.11％and 2.07％,respectively,and of US-FNAB was 89.64％,96.30％,91.09％,3.70％and 10.36％,respectively.The sensitivity,specificity and accuracy of multimodal ultrasound for distinguishing benign and malignant thyroid nodules were higher,while the misdiagnosis rate and missed diagnosis rate were lower than those of conventional ultrasound,SWE and CEUS alone.The sensitivity,accuracy and misdiagnosis rate of multimodal ultrasound were higher,while its specificity and missed diagnosis rate were both lower than those of US-FNAB(all P＜0.05).Conclusion For distinguishing benign and malignant thyroid nodules of C-TIRADS grade 4,multimodal ultrasound had higher sensitivity and accuracy but higher misdiagnosis rate,while US-FNAB had higher specificity but also higher missed diagnosis rate.

Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

Background::Triple-negative breast cancer (TNBC) is a type of highly invasive breast cancer with a poor prognosis. According to new research, long noncoding RNAs (lncRNAs) play a significant role in the progression of cancer. Although the role of lncRNAs in breast cancer has been well reported, few studies have focused on TNBC. This study aimed to explore the biological function and clinical significance of forkhead box C1 promoter upstream transcript (FOXCUT) in triple-negative breast cancer.Methods::Based on a bioinformatic analysis of the cancer genome atlas (TCGA) database, we detected that the lncRNA FOXCUT was overexpressed in TNBC tissues, which was further validated in an external cohort of tissues from the General Surgery Department of the First Affiliated Hospital of Nanjing Medical University. The functions of FOXCUT in proliferation, migration, and invasion were detected in vitro or in vivo. Luciferase assays and RNA immunoprecipitation (RIP) were performed to reveal that FOXCUT acted as a competitive endogenous RNA (ceRNA) for the microRNA miR-24-3p and consequently inhibited the degradation of p38. Results::lncRNA FOXCUT was markedly highly expressed in breast cancer, which was associated with poor prognosis in some cases. Knockdown of FOXCUT significantly inhibited cancer growth and metastasis in vitro or in vivo. Mechanistically, FOXCUT competitively bounded to miR-24-3p to prevent the degradation of p38, which might act as an oncogene in breast cancer. Conclusion::Collectively, this research revealed a novel FOXCUT/miR-24-3p/p38 axis that affected breast cancer progression and suggested that the lncRNA FOXCUT could be a diagnostic marker and therapeutic target for breast cancer.

Cross-provincial medical treatment can meet the high-quality health needs of residents and make up for the shortage of high-quality medical resources in underdeveloped areas. However, in economically developed areas with abundant medical resources, the phenomenon of residents seeking medical treatment across provinces was prominent. The author took J City as an example to present the distribution of cross-provincial medical visits, costs, and disease types in J City from 2017 to 2021 through on-site visits and surveys. Combined with in-depth interviews, the causes of residents in J city seeking cross-provincial medical treatment were explored, including the effective promotion of health integration in the Yangtze River Delta, the need to improve local medical technology, incomplete medical insurance policies, and relatively low reimbursement rates for major illness insurance. And strategic suggestions were proposed, including building local medical brand, improving the medical technology level of public hospitals, and reforming and improving medical insurance reimbursement policies.

【Objective】 To investigate the resource allocation status of blood testing laboratories in 14 blood stations in Gansu Province, explore the impact of differences in basic conditions on the comprehensive testing ability of laboratories, so as to promote the homogenization and standardization of blood screening capacity in blood stations in Gansu and improve blood safety and effectivenes. 【Methods】 An evaluation index system of laboratory resource allocation was constructed and a question-naire was designed. The data of human resources, infrastructure and key equipment of 14 blood stations were collected. The entropy weight -TOPSIS method was used to evaluate and rank the resource allocation of 14 blood stations. 【Results】 In the comprehensive evaluation of blood testing laboratory resource allocation in 14 blood stations in Gansu, the top three were laboratories A, B and I, and the last three were laboratories G, M and J. On the whole, the main issue was unreasonable structure of human resources: most laboratories had unreasonable age structure; except for Laboratory A, there was no personnel with bachelor's degree or above in laboratories; most laboratories had not established a team with intermediate professional titles. In terms of infrastructure, the size of seven laboratories could not meet the needs of modern laboratory testing, and all eight blood stations had no spare nucleic acid laboratories nor a mutual spare laboratory with other blood stations As for the key equipment, 5 laboratories had no automatic blood grouping diagnostic instrument, 5 laboratories only had one set of enzyme immunoassay detection system, 3 laboratories had no spare equipment for the key equipment, which means if the equipment failure could not be repaired in time, the release of results would be affected. 【Conclusion】 There were significant differences in human resources, infrastructure and key equipment of blood testing laboratories in 14 blood stations in Gansu, which had a great impact on laboratory testing capacity and subsequent development. It is suggested that governments at all levels and health administrative departments optimize the input of laboratory resource allocation according to the blood collection volume of blood stations to gradually narrow the differences in resource distribution between different regions, improve the degree of laboratory automation and optimize the personnel structure, so as to build high-quality and efficient blood testing laboratories and ensure the safety of clinical blood use.

With the rapid changes in people's lifestyles, natural and social environments in recent years, the prevalence of chronic and non-communicable diseases in China and its related risk factors have also had tremendous changes. The epidemiological characteristics of chronic and non-communicable diseases and their risk factors vary throughout the country, and the impact of unique climate, diet and lifestyle in southern China on the incidence and prevalence of chronic and non-communicable chronic diseases remains to be elucidated. Therefore, large-scale cohort study is urgently needed to provide evidence for the etiological research and management of chronic and non-communicable chronic diseases in different areas, and for the national management strategy for major chronic and non-communicable diseases. The prospective cohort study of chronic and non-communicable diseases in general population in southern China was established in December 2017. The study recruited permanent residents aged 35-74 years from both urban and rural areas in Guangdong, Hainan, Fujian Provinces and Guangxi Zhuang Autonomous Region. A big data platform of precision medicine which integrates health information with biological samples for long-term follow up has been established. A baseline database of 116 520 people aged (54.9±12.5) years, including 71 077 women (61.0%), has been established. Collecting questionnaire survey data, physical examination data, and biological samples. This paper briefly introduces the concept, design and progress of the prospective cohort study of chronic and non-communicable diseases in general population in southern China.