Objective To construct a One Health-based performance evaluation indicator system for integrated interventions for schistosomiasis in the elimination phase, clarify the dimensions and connotations of intervention performance evaluation, and provide methodological reference for subsequent real-world performance evaluation in schistosomiasis control. Methods On the basis of literature analysis, a preliminary indicator system was developed through group discussion and expert consultation. Nineteen experts in schistosomiasis control were invited to participate in two rounds of Delphi consultation. Expert response rate, degree of consensus, coordination of opinions, and authority were assessed. The indicators were optimized and refined according to the scoring results and expert feedback, and the analytic hierarchy process was used to determine the normalized weights of indicators at each level. Results Through literature analysis, group discussion, and expert consultation, a preliminary performance evaluation indicator system for integrated interventions for schistosomiasis was developed, consisting of 4 first-level indicators, 8 second-level indicators, and 20 third-level indicators. The response rates of the two rounds of expert consultation were both 100.00%. In the first round, the ranges of the experts’ judgment coefficient, familiarity coefficient, and authority coefficient were 0.88 ~ 1.00, 0.74 ~ 0.99, and 0.82 ~ 0.99, respectively; in the second round, the corresponding ranges were 0.88 ~ 0.98, 0.73 ~ 0.98, and 0.81 ~ 0.98, respectively. In the first round, Kendall’s coefficients of concordance for the rationality, importance, and operability of the indicators were 0.201, 0.252, and 0.221, respectively; in the second round, the corresponding values were 0.267, 0.319, and 0.296, respectively. The Kendall’s coefficients of concordance in both rounds were statistically significant (χ² = 112.063, 140.415, 123.386, 121.939, 145.393, and 135.072, all P < 0.05). After optimization and revision, the final indicator system consisted of 4 first-level indicators, 7 second-level indicators, and 14 third-level indicators. Among the first-level indicators, the normalized weights of “health performance”, “economic performance”, “ecological performance”, and “social performance” were 40.44%, 13.88%, 11.67%, and 34.01%, respectively. Among the second-level indicators, the normalized weights of “disease burden level” and “promotion of health equity” were both 100.00%; those of “resource consumption” and “production capacity” were both 50.00%; and those of “water and soil regulation”, “atmospheric environmental regulation”, and “species conservation” were all 33.33%. Conclusions A One Health-based performance evaluation indicator system was constructed for integrated interventions for schistosomiasis in the elimination phase. The system incorporates performance evaluation indicators across multiple dimensions, including health, economic, ecological, and social domains, and provides a tool for evaluating the performance of cross-sector collaborative governance in integrated schistosomiasis interventions.

Acute ischemic stroke (AIS) is a cerebrovascular disease characterized by high morbidity, disability, and mortality, posing a significant threat to human health. Endovascular treatment has now been established as a key method for AIS management, in which stent retrievers that can mechanically remove blood clots play a key role in this technique. In recent years, stent retrievers have evolved in complexity and functionality to improve the ability of clot removing and surgical safety. However, the present instruments still have limitations on treatment efficiency, vascular adaptability, and operational precision, posing an urgent need for innovation in the design of stent retrievers. This paper systematically reviewed the structural features and working principles of AIS stent retrievers from the perspective of efficacy evaluation metrics, historical development, recent advancements in stent retrieval technology, and future prospects.
Humans ; Ischemic Stroke/surgery* ; Stents ; Endovascular Procedures/methods* ; Thrombectomy/methods* ; Device Removal/methods*

Objective : To assess and to compare the diagnostic performance of cervical ultrasound and 18F fluorodeoxyglucose(18F-FDG PET/CT) in identifying cervical lymph node metastases in patients with differentiated thyroid cancer(DTC) following total thyroidectomy, focusing on both early and delayed imaging phases. Methods : A retrospective review was performed on 83 DTC patients with DTC who had undergone total thyroidectomy. A total of 143 cervical lymph nodes, comprising both metastatic and non-metastatic nodes, were evaluated using 18F-FDG PET/CT and ultrasound. Sensitivity, specificity, and overall diagnostic accuracy were calculated for each imaging modality. Differences in lymph node detection rates across cervical regions using ultrasound were analyzed, along with nodal size parameters(long and short axis diameters), to investigate potential limitations of ultrasound in this context. Additionally, PET/CT parameters including axial ratio, early and delayed maximum standardized uptake values(SUVmax), and changes in SUVmax between imaging timepoints(ΔSUVmax) were compared between metastatic and non-metastatic lymph nodes to evaluate the diagnostic value and underlying mechanisms of PET/CT in this clinical setting. Results : 18 F-FDG PET/CT demonstrated a sensitivity of 91 . 58% (98/107) , a specificity of 72. 22% (26/36) , and an overall diagnostic accuracy of 86. 71% (124/143) in identifying cervical lymph node metastases post-total thyroidectomy in DTC patients . In comparison , ultrasound showed a lower sensitivity of 50. 47% (54/107) , but a higher specificity of 97. 22% (35/36) , with an overall accuracy of 62. 24% (89/ 143) . Notably , ultrasound exhibited a significantly higher false-negative rate in the first cervical lymph node group compared to the second group [56. 6% (30/53 ) vs 43 . 4% (23/53 ) ; χ2 = 20. 396 , P < 0. 001] . In delayed PET/CT imaging , metastatic lymph nodes showed a significantly increased SUV max compared to early-phase imaging (Z = - 8. 147 , P < 0. 001) . Using an SUV max threshold of 2. 5 , delayed imaging identified a greater number of positive lymph nodes than early imaging ( χ2 = 18. 127 , P < 0. 001) . Furthermore , metastatic lymph nodes exhibi- ted a significantly lower axial ratio than non-metastatic nodes (Z = - 4. 529 , P < 0. 001) . Both early and delayed SUV max values were significantly higher in malignant nodes compared to benign ones (Z = - 3 . 689 , P < 0. 001 and Z = - 4. 550 , P < 0. 001 , respectively) . Additionally , ΔSUV max was markedly elevated in metastatic lymph nodes (Z = - 4. 189 , P < 0. 001) . Conclusion Dual-phase 18 F-FDG PET/CT proves to be superior to ultrasound in di- agnosing cervical lymph node metastasis in patients with differentiated thyroid cancer (DTC) following total thyroid- ectomy . Delayed-phase imaging offers higher tumor-to-background ratio , which enhances the visibility of metastatic lymph nodes . In addition , dual-phase 18 F-FDG PET/CT plays greater advantages in the differential diagnosis be- tween metastatic lymph nodes and non-metastatic lymph nodes .

[Objective]To investigate the research landscape,predominant themes and emerging trends in scientific research competency cultivation for traditional Chinese medicine(TCM)professional degree postgraduates in China over the past decade,in order to provide a reference for in-depth research on the cultivation of scitifin research capabilities of postgraduates in the professional degree in TCM.[Methods]A systematic literature review was conducted by using the China National Knowledge Infrastructure(CNKI)from January 1,2015 to December 31,2024,focusing on publications related to research capacity development for TCM professional degree programs.CiteSpace 6.4.R1 software was employed to perform bibliometric analyses of authorship patterns,institutional collaborations and keyword co-occurrence networks.[Results]A total of 103 eligible studies were included.The overall publication volume showed a significant increasing trend,with a rapid growth phase from 2020 to 2024,peaking at 18 articles in 2022,reflecting rising attention to this field.Author collaboration network analysis indicated that JIANG Youming and MO Jie topped the list with 3 publications each,while most other authors conducted research independently with limited cooperation.The institutional collaboration network had a density of 0.0096,indicating low inter-institutional cooperation,with Hu'nan University of Chinese Medicine leading in publications(5 articles).Keyword co-occurrence analysis revealed core research hotspots such as"training model""teaching reform""double-track integration".Keyword burst analysis showed prominent terms like"curriculum system""medical-education collaboration""clinical thinking""new medical discipline"from 2015 to 2024,with"new medical discipline"emerging as a recent hotspot reflecting interdisciplinary integration trends.[Conclusion]The number of articles on the scientific research ability cultivation for postgraduates of TCM professional degrees in China has generally increased,and the research scope has continuously expanded.However,there are differences in research levels among different regions.It is necessary to strengthen the cooperation between multi-disciplines and multi-regions,conduct broader and deeper research,and formulate scientific research ability training programs suitable for postgraduates of TCM professional degrees in China to further improve their scientific research ability.

Objective:To compare clinical effectiveness of the ulnar flap of dorsal cutaneous branch of proper palmar digital artery (PPDA) of little finger and the perforator flap of the 4th dorsal metacarpal artery (DMA) for reconstruction of small and medium-sized defects of ulnar palm.Methods:A retrospective case-control study method was employed in this study. From March 2017 to February 2024, a total of 42 patients of small and medium-sized defects of ulnar palm were treated in the Department of Hand Surgery, the Second Hospital of Tangshan. Twenty-four defects were reconstructed by the ulnar flaps of dorsal cutaneous branch of PPDA (PPDA group) of little finger and the rest of 18 defects were reconstructed by the perforator flap of the 4th DMA (DMA group). Sizes of the defects and flaps in PPDA group were 1.5 cm×1.2 cm-5.2 cm×2.3 cm and 1.6 cm×1.3 cm-6.0 cm×2.5 cm, respectively. Dimensions of the defects and flaps in DMA group ranged from 1.7 cm×1.2 cm-5.0 cm×2.4 cm and 2.0 cm×1.5 cm-6.2 cm×2.7 cm, respectively. Donor sites in both groups were all directly closed. Survival of the flaps and wound healing of donor sites were observed between the 2 groups after surgery. And the surgical time, intraoperative blood loss and duration of follow-up of the 2 groups were recorded. Postoperative follow-up included outpatient clinic visits, telephone interviews and WeChat video-clips. Static two-point discrimination (TPD) of the flaps were measured, and appearance of flaps and donor sites were evaluated based on the Michigan Hand Function Questionnaire (MHQ) evaluation criteria and Vancouver Scar Scale (VSS), respectively. The measurement and count data acquired from both groups were compared by independent sample t-test and χ2 tests or Fisher's exact test, respectively. P<0.05 was considered statistically significant. Results:All 24 flaps in PPDA group and 14 flaps in DMA group survived primarily, except 4 flaps in DMA group that had blisters and healed by dressing changes. Primary survival rate of the flaps in PPDA group (100%) was higher than that of DMA group (78%), and the difference was statistically significant ( P<0.05). Donor site incisions in both groups all healed primarily. The surgery time, intraoperative blood loss and duration of follow-up in PPDA and DMA groups were 64.50 min±7.70 min, 87.08 ml±25.11 ml, 15.46 months±3.83 months, and 62.44 min±8.28 min, 91.67 ml±27.28 ml, 16.39 months±3.24 months, respectively, and of which there was no statistically significant difference between the 2 groups ( P>0.05). At the final follow-up, static TPD and MHQ scores for flap appearance in PPDA group were 13.71 mm±2.91 mm and 4.63±0.50, which were better than 15.78 mm±2.78 mm and 4.28±0.46 in DMA group with a statistically significant difference ( P<0.05). VSS scores of donor site appearance in PPDA and DMA groups were (3.38±0.97 and 3.89±1.02, respectively. Although there was no statistically significant difference between the 2 groups ( P>0.05), the donor sites in PPDA group were more concealed and easier accepted by patients. Conclusion:The ulnar flap of dorsal cutaneous branch of PPDA of little finger and the perforator flap of the 4th DMA are both suitable for reconstruction of small and medium-sized defects of ulnar palm. Compared with the perforator flap of the 4th DMA, the ulnar flap of dorsal cutaneous branch of PPDA of little finger has advantages in higher primary survival rate, better flap sensation and appearance with more concealed donor site.

Objective:To analyze the non-medical technology security liability dispute litigation cases in hospitals and propose corresponding countermeasures, for references for optimizing hospital safety management.Methods:Through the China Judgments Online, non-medical technical security liability dispute litigation cases in hospitals (279 cases) nationwide from 2021 to 2023 were collected. Swiss cheese model and content analysis were employed to examine the basic case details, reasons for judgment, types of hospital liability, characteristics of suicide cases, and plaintiffs′ claims regarding.Results:The 279 cases involved 231 hospitals (excluding anonymous and duplicate hospitals) and 279 patients. Among them, there were 144 tertiary hospitals, accounting for 62.34%; The inpatient department was a high-risk area for accidents (103 times, 36.92%); The frequency of falls was the highest (182 times, 65.23%); 210 cases were ruled against the hospital, accounting for 75.27%. From the perspective of court judgment reasons, the precursor of unsafe behavior (122 cases, 58.10%) was the most common primary reason, the proportion of cases which hospital bore the main responsibility was relatively high (46 cases, 71.88%); 50 cases (23.81%) were due to safety hazards in hospital facilities caused by secondary reasons. Among the 41 cases of patient suicide, 36 cases were fatal, 18 cases occurred in general hospitals, and 24 cases were without medical fault.Conclusions:The inpatient department of the hospital was a high-risk area for accidents, and the medical side had a relatively high failure rate; The warning signs of unsafe behavior were easily overlooked, and there were more cases of suicide among patients in general hospitals. It is recommended that hospitals should enhance their safety management systems, establish collaborative tiered nursing teams involving medical and nursing staff, promote the application of artificial intelligence in refined logistical management, and implement a documentation and oversight mechanism for critical procedures.

Objective:To investigate the interventional effects of the Fuzheng Huayu (FZHY) formula and its partial mechanistic role on cholestatic liver fibrosis in mice.Methods:Mdr2 gene knockout (Mdr2－/ －) mice were randomly divided into a model group, FZHY group, and Obeticholic acid group. Wild-type C57BL/6J mice of the same age served as the control group. Mdr2－/ －mice were given the corresponding drugs starting from the first day of 9 weeks of age by oral gavage in each group. The control and model groups were administered 0.3% sodium carboxymethylcellulose by oral gavage and were sacrificed at 12 weeks of age for specimen collection. High-speed biochemistry analyzer was used to detect serum alkaline phosphatase and alanine aminotransferase activity in mice. Hematoxylin-eosin staining and Sirius red staining were used to observe pathological changes in liver tissues. Hydroxyproline content was measured to assess collagen in liver tissues. Immunohistochemical staining, Western blotting, and real-time fluorescence quantitative PCR were used to detect the expression of fibrosis markers Col-I and alpha-smooth muscle actin in liver tissues. The expressional condition of cholangiocyte response markers Epcam, CK7, CK19, as well as Pcna, Mki67, and Ccnd1, inflammatory related factors Ccl2, Ccl5, Tnf-α, Il10, and Cxcl4, phosphorylated peroxisome proliferator-activated receptor alpha (PPARα) and nuclear factor kappa-B (NF-κB) were determined. Comparative analysis among multiple groups was performed using one-way ANOVA. The LSD method was used for comparisons between groups. Two-tailed statistical tests were used.Results:Compared with wild-type mice, Mdr2 －/ － mice had a significant increase in serum alanine aminotransferase and alkaline phosphatase activity ( P<0.001). The percentage of Sirius red-positive staining areas and hydroxyproline content in liver tissues was significantly increased ( P<0.01). The expression of Col-I, α-smooth muscle actin, Epcam, CK7, CK19, Pcna, Mki67, and Ccnd1, and the expression of Ccl2, Ccl5, Tnf-α, Il10, and Cxcl4 were significantly increased ( P<0.01); however, both FZHY and Obeticholic acid significantly reversed the increases in these indicators ( P<0.05; P<0.01). Further results showed that compared to wild-type mice, the expression of PPARα was significantly reduced in liver tissues of Mdr2 －/ － mice, while NF-κB was significantly enhanced ( P<0.01). In contrast, compared to Mdr2-/- mice, the expression of PPARα in the liver tissues of FZHY group mice was significantly increased ( P<0.05), while NF-κB was significantly inhibited ( P<0.05). Conclusion:FZHY can significantly improve liver fibrosis, cholangiocyte response, and inflammation in Mdr2 －/ － mice with spontaneously occurring cholestatic liver fibrosis, and its mechanistic role is related to the regulation of the PPARα/NF-κB pathway.

Objective To quantitatively evaluate the synergy level of Traditional Chinese Medicine(TCM)"three-medical"and advance TCM revitalization and healthcare reform.Methods Sort out the quantitative evalution indictors of the"three-medical"in TCM based on policy texts.Policy-derived evaluation indicators were refined through the Delphi method.The composite system synergy degree model was applied to calculate subsystem order degrees and overall synergy degrees across seven national TCM reform demonstration zones.Results From 2021 to 2023:the mean value of the orderliness of the TCM medical system in the 7 demonstration areas increased from 0.31 to 0.72,the orderliness of the TCM health insurance increased from 0.23 to 0.74,and the orderliness of the Herbal System increased from 0.34 to 0.70.From 2022 to 2023,the average value of synergy between medical and health insurance systems in the field of Chinese medicine in 7 demonstration areas grew from 0.17 to 0.29.The synergy between medical and pharmaceutical systems in the field of Chinese medicine grows from 0.19 to 0.31.The synergy between pharmaceutical and health insurance system in the field of Chinese medicine increased from 0.17 to 0.27.The overall synergy of the"three-medical"system of TCM increased from 0.19 to 0.36.Conclusion The degree of orderliness of the"three-medical"systems of TCM is gradually rising,showing a relatively good development trend in orderliness.The degree of synergy among the"three-medical"total systems of TCM is on the rise,but is still at the level of moderate synergy or below.

BACKGROUND:In previous studies,the equivalent structure of three-dimensional cell reconstruction of tissue engineering oral mucosa is similar to normal oral mucosa,including epithelial-like structure,lamina propria-like structure,and vascular lumen-like structure,and has initially achieved the establishment of vascular equivalent,but its vascularization characteristics are not very clear.OBJECTIVE:Vascular-like structures of vascularized oral mucosa equivalent were obtained by targeting vascular endothelial cells specific marker expression profiles correlated with laser capture microdissection system,and their vascularization ability was evaluated to reveal their vascularization characteristics.METHODS:Human gingival epithelial cells were cultured from human gingival epithelium and human gingival fibroblasts,human gingival mesenchymal stem cells were cultured from human gingival lamina propria.Human gingival mesenchymal stem cells were induced to differentiate into vascular endothelial-like cells after monoclonal expansion culture.Human gingival epithelial cells,human gingival fibroblasts,and vascular endothelial-like cells were loaded with acellular vascular matrix-0.25%human-like collagen type Ⅰ scaffold to construct the vascularized oral mucosa equivalent.The layered structure of oral mucosa equivalent(experimental group)and the acellular vascular matrix-0.25%human-like collagen type Ⅰ scaffold(control group)were implanted subcutaneously into the back of nude mice,respectively.14 days later,the incision surface of the two groups was coated with biogel.The biogel surface of the experimental group was inoculated with human gingival epithelial cells,while the control group was not inoculated with cells.The samples were collected after 14 days of feeding.The layered structure of oral mucosa equivalent was observed by morphology.The neovascular-like structures in oral mucosa equivalents were labeled by immunohistochemistry and immunofluorescence with a more comprehensive expression profile of vascular endothelial cells,and the vascularization characteristics were analyzed.A laser capture microdissection system was used to capture the neovascularization structures in the oral mucosa equivalents specifically labeled by immunohistochemistry and analyze their vascularization characteristics.RESULTS AND CONCLUSION:(1)The morphology showed that the cell level of oral mucosa equivalent was clear,and the structure was similar to that of normal oral mucosa,that is,there were epithelioid structures,lamina-like structures,and vascular cavelike structures,and there were scattered erythrocytes in the vascular cavelike structures.(2)The results of EdU Apollo tracer seed cells in the oral mucosa equivalent group showed that human gingival epithelial cells labeled with EdU Apollo 488 showed green fluorescence expression.DAPI labeled human gingival fibroblasts showed blue fluorescence expression and formed lamina-like structures in vivo.EdU Apollo 567 labeled vascular endothelial-like cells showed red fluorescence expression and formed a vascular-like structure in vivo.(3)Vascular endothelial cell specific marker expression profile immunofluorescence labeling of vascular structure showed that compared with normal oral mucosa,the expressions of CD31,CD51,CD54,CD105,Tie-2,VWF,vascular endothelial growth factor receptor 1,and vascular endothelial growth factor receptor 2 in oral mucosa equivalents were increased(P<0.000 1).There were no significant changes in CD34 expression(P>0.05).(4)Compared with the specifically labeled oral mucosal vascular structures,the expression levels of CD51,CD54,CD105,Tie-2,VWF,vascular endothelial growth factor receptor 1,and vascular endothelial growth factor receptor 2 of the oral mucosa equivalents targeted by the laser capture microdissection system were increased(P<0.000 1).There were no significant changes in expression of CD31 and CD34(P>0.05).(5)The results showed that the oral mucosa equivalent reconstructed by three-dimensional cell stratification could achieve good vascularization,and its vascularization characteristics were consistent with the immunological function and characteristics of neovascularization.Vascularization helps three-dimensional cell layer reconstruction of oral mucosa equivalent regeneration.

Objective To investigate the correlation between voice fatigue index(VFI)and the subjective and objective assessment results of voice impairment.Methods Fifty-one patients with voice disorders and 48 normal subjects were selected for VFI assessment and comparison of the differences in scores between the two groups.Sub-jective voice handicap index(VHI)and objective acoustic assessment were performed on the patients with voice dis-orders to analyze the correlation between VFI scores and the results of subjective and objective assessment of voice disorders.Results There was significant difference of the VFI scores between the voice disorder patients and the control group,with the total VFI score,part Ⅰ and part Ⅱ scores higher than those of control group,and the partⅢ score lower than those of the control group(P＜0.05),and there was a strong correlation between the total and part VFI scores and the total and part VHI scores(P＜0.05 or P＜0.01).The VFI part Ⅰ and part Ⅱ scores were regatively correlated with the I-low(P＜0.05),but there was not a significant correlation with the other acoustics parameters and the dysphonia severity index(DSI)(P＞0.05).Conclusion Voice fatigue symptoms were more prominent in the voice-impaired population,and the VFI score was significantly correlated with the subjective voice disorder severity,but the correlation with the objective acoustic parameters was not significant.