Objective Objective To analyze the potential spatial factors affecting the genetic differentiation of Oncomelania hupensis robertsoni in Yunnan Province. Methods A total of 13 administrative villages were selected from schistosomiasis-endemic areas of Yunnan Province as O. hupensis snail sampling sites. At least 200 snails were collected in each site, and the spatial variable data of each site were recorded, including longitude, latitude and altitude. Thirty active and Schistosoma japonicum uninfected O. hupensis snails were selected from each sampling site by means of the crawling method and the cercarial shedding method. Genomic DNA was extracted from O. hupensis snails. Following PCR amplification, purification of PCR amplification products and sequencing, the gene sequences of O. hupensis snail samples were spliced and edited using the DNAstar software and the NCBI database to yield the complete mitochondrial sequences of O. hupensis snails at each sampling site, and the mitochondrial genetic distance matrix of O. hupensis robertsoni was calculated at each sampling site. The geographical coordinates of each sampling site were marked using the software ArcGIS 10.2, and the straight-line geographical distance between each sampling site was calculated. The altitude difference, longitude difference and latitude difference between each sampling site were calculated using the Excel software, and the correlation between the mitochondrial genetic distance matrix of O. hupensis robertsoni and each spatial variable matrix was examined by using the Mantel test at 13 sampling sites in Yunnan Province. Results Among the 13 O. hupensis snail sampling sites in Yunnan Province, the largest mitochondrial genetic distance of O. hupensis robertsoni snail populations was seen between Anding Village, Nanjian Yi Autonomous County and Caizhuang Village, Midu County (26.244 2), and the largest geographical distance was seen between Dongyuan Village, Gucheng District and Cangling Village, Chuxiong County (272.64 km). The highest altitude difference was seen between Anding Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1 086.10 m), and the largest longitude difference was found between Qiandian Village, Eryuan County and Cangling Village, Chuxiong County (1.86°), while the largest latitude difference was measured between Leqiu Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1.81°). In addition, the mitochondrial genetic distance of O. hupensis robertsoni snail populations was positively correlated with altitude at 13 snail sampling sites in Yunnan Province (r = 0.542 8, P < 0.001), and showed no significant correlations with geographical distance (r = 0.093 4, P > 0.05), longitude (r = −0.199 5, P > 0.05) or latitude (r = 0.205 7, P > 0.05). Conclusion Altitude may be a potential spatial factor affecting the genetic differentiation of O. hupensis robertsoni in Yunnan Province.

The report Cancer Statistics, 2026 systematically estimated new cancer cases and deaths in the United States for 2026 and provided an overview of long-term cancer trends in the country. This article focuses on the core data for children and adolescents (aged 0–19 years) from the report, interpreting the incidence, survival, and mortality rates, their temporal trends, and the long-term risks among survivors. By comparing these findings with the latest childhood and adolescent cancer burden data in China, we propose implications for cancer prevention and control in Chinese children and adolescents.

Objective:To investigate the clinical characteristics and prognostic significance of germline mutations in patients with myelodysplastic neoplasms (MDS) .Methods:Clinical data from 407 patients with MDS [male, 252; female, 155; median age, 64 (range, 19-85) years] diagnosed at the First Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The clinical features and prognostic effects of germline mutations were evaluated.Results:The prevalence of germline mutations in patients with MDS was 5.9% (24/407), peaking at 20.0% in the group aged 21-30 years. The spectrum of germline mutations comprised DDX41 (9 cases, 2.2%), TP53 (3 cases, 0.7%), and single cases of RUNX1, TET2, MPL, CBL, ATRX, CEBPA, ETV6, IDH1, KDM5C, SBDS, GNAS, and CTC1. Patients with germline mutations exhibited significantly lower peripheral WBC counts than those without (1.87×10 9/L vs 2.50×10 9/L, P=0.018), but showed comparable median overall survival (21.3 months vs 21.1 months, P=0.97). Patients with DDX41 germline mutations, compared with those with other germline mutations, had a significantly older median age (65 vs 54 years, P=0.010), lower WBC counts (1.51×10 9/L vs 2.31×10 9/L, P=0.040), increased mean corpuscular volume (111.80 fl vs 97.25 fl, P=0.003), and a higher prevalence of normal karyotypes (100.0% vs 53.3%, P=0.022). The most frequently co-occurring somatic mutations in DDX41 germline mutation carriers were ASXL1, TET2, and RUNX1. Conclusion:In this study, the detection rate of germline mutations in MDS patients was 5.9% (24/407), peaking at 20% in the group aged 21-30 years. DDX41 and TP53 were the most prevalent germline mutations. DDX41 mutation carriers displayed distinct clinical characteristics; however, germline mutations overall showed no significant prognostic effect.

Objective:To estimate the economic burden of 14 chronic diseases among middle-aged and elderly people in China.Methods:This cross-sectional study was based on longitudinal data from five waves (2011 to 2020) of the China Health and Retirement Longitudinal Study (CHARLS). Participants aged 45 and over who had been diagnosed with exactly one target chronic disease were included in the study. The 14 chronic diseases included: hypertension, dyslipidemia, diabetes or elevated blood glucose, malignant tumors, chronic pulmonary diseases, liver diseases, heart diseases, stroke, kidney diseases, digestive system diseases, emotional and mental diseases, memory-related diseases, arthritis or rheumatic diseases, and asthma. The economic burden of disease was measured in terms of both direct and indirect economic burden, with the results adjusted using a healthcare-specific Consumer Price Index (CPI). The direct economic burden included direct medical and non-medical burden. The human capital method was employed to calculate the indirect economic burden. A generalized linear mixed model (GLMM) was conducted to compare the differences in the economic burden between urban and rural areas, with provinces and prefecture-level cities set as random effects and residence (urban or rural areas) as fixed effects to control for the effects of geographic hierarchical structure. Gender, age and educational attainment were also included as covariates to control for confounding factors. The model′s robustness was assessed by comparing the significance of urban-rural differences before and after adding the covariates.Results:The median annual economic burden of the 14 chronic diseases among the middle-aged and elderly population in China ranged from 7 565 to 17 174 CNY, of which the direct economic burden ranged from 6 909 to 16 565 CNY, and the indirect burden ranged from 284 to 1 276 CNY. The direct economic burden was primarily driven by direct medical burden (83.67% to 95.01% of direct economic burden). Out-of-pocket expenses for outpatient medical burden ranged from 50% to 100%, while those for inpatient ranged from 36.30% to 61.29%. GLMM analysis revealed no statistically significant difference in the overall economic burden between urban and rural areas across diseases. However, the burden of inpatient medical burden for arthritis or rheumatism was higher in urban areas than in rural areas (5 338 vs. 3 898 CNY; LR=6.04, P=0.014). Similarly, the burden of self-treatment for hypertension was also higher in urban areas than in rural areas (324 vs. 238 CNY; LR=8.30, P=0.004). The outpatient non-medical burden for diabetes or elevated blood glucose (59 vs. 149 CNY; LR=5.99, P=0.014), stroke (0 vs. 307 CNY; LR=4.55, P=0.033), and digestive system diseases (45 vs. 107 CNY; LR=9.58, P=0.002) was lower in urban areas than rural. Conclusions:Chronic diseases cause heavy economic burden on middle-aged and elderly people in both urban and rural areas of China, with direct economic burden accounting for the majority of expenditure. The outpatient medical burden accounts for a higher proportion of out-of-pocket expenses than the inpatient.

High-quality development of public hospitals requires cultural construction as an endogenous driving force,ai-ming to build a cultural system that integrates systematic,innovative,and humanistic characteristics.Leveraging its century-old historical legacy,Qilu Hospital of Shandong University has established a cultural construction pathway characterized by"strategic planning,heritage preservation,brand building,exemplary leadership,and communication innovation"through five major sys-tems:improving top-level design,inheriting historical heritage,building distinctive brands,cultivating exemplary models,and expanding communication channels.This approach provides cultural and spiritual impetus for the hospital's high-quality develop-ment.Empirical evidence demonstrates that cultural construction in public hospitals must emphasize systematic top-level design,distinctive cultural identity,synergy between tradition and innovation,and long-term sustainability,ultimately transforming cul-tural"soft power"into"hard support"for development.This practice offers a replicable"Qilu Model"for nationwide public hos-pital cultural development,while injecting new connotations into the implementation of the Healthy China strategy.

To establish an immunochromatographic method for rapid detection of caprine enterovir-us(CEV),the monoclonal antibody against CEV VP1 protein was used as gold-labeled monoclonal antibodies,and the purified rabbit-derived polyclonal antibody of CEV-VP1 and sheep anti-mouse IgG were used as the detection line and quality control line,respectively.The colloidal gold immu-nochromatographic test strips for CEV were prepared according to the principle of double antibody sandwich,evaluated,and applied for clinical specimen detection.The results showed that the meth-od specifically recognized CEV without cross-reaction with bovine enterovirus and bovine viral di-arrhea virus.The minimum detection limit of the method was 102.49 TCID50/mL and had good re-producibility.The prepared test strips had a shelf life of three months kept at 4 ℃.Detection of clin-ical samples using the immunochromatographic test strips showed 100％coincidence rate with RT-PCR method.In conclusion,the colloidal gold immunochromatographic test strips for detection of the emerging CEV with good specificity,sensitivity and repeatability,which provides a new techni-cal means easily used for the rapid detection/diagnosis and epidemiological investigation on CEV infection.

AIM:This study aims to investigate the sensitizing effects of lycorine(Lyc)in combination with cisplatin(Cis)on human osteosarcoma cells and to explore the underlying mechanisms of action.METHODS:Human osteosarcoma cell lines MG63,HOS,and cisplatin-resistant HOS/DDP cells were utilized to evaluate the effects of Lyc and cisplatin,both alone and in combination,on cell viability using the CCK8 assay.The clonogenic assay was performed to assess cell proliferation capacity,while the scratch assay evaluated the drugs' effects on cell migration.Reactive oxygen species(ROS)levels were measured using a ROS assay kit,and changes in intracellular glutathione(GSH)levels were assessed with a GSH/oxidized glutathione(GSSG)assay kit.The mitochondrial membrane potential was analyzed via JC-1 staining to determine the drugs' effects on mitochondrial function.Intracellular iron(Ⅱ)content changes were detected us-ing FerrOrange,a fluorescence probe,and cellular malondialdehyde(MDA)levels were measured using an MDA assay kit.RT-qPCR was employed to evaluate the expression levels of key genes related to ferroptosis,and Western blot analysis was conducted to detect changes in the protein expression levels of Yes-associated protein 1(YAP1),acyl-CoA synthetase long-chain family member 4(ACSL4),glutathione peroxidase 4(GPX4),heme oxygenase-1(HO-1),and transferrin re-ceptor(TFRC).RESULTS:Both Lyc and cisplatin effectively inhibited the proliferation of human osteosarcoma cells.Notably,the combination of Lyc and cisplatin led to a more substantial reduction in cell viability,proliferation,and migra-tion abilities in MG63,HOS,and HOS/DDP cells compared to cisplatin alone.Additionally,this combination significant-ly increased ROS levels while decreasing GSH content,indicating mitochondrial damage and elevated iron(Ⅱ)and MDA levels.RT-qPCR results revealed that the combination treatment more significantly downregulated ferroptosis-promoting genes and upregulated ferroptosis-inhibiting genes compared to cisplatin treatment alone(P<0.05).Western blot results showed a slight decrease in GPX4 protein expression following Lyc and cisplatin treatment,while expression levels of YAP1,TFRC,ACSL4,and HO-1 were significantly increased(P<0.05).CONCLUSION:Lyc enhances the sensitivi-ty of MG63,HOS,and HOS/DDP cells to cisplatin by promoting ferroptosis through the YAP1/TFRC signaling pathway.

Objective To investigate the value of serum tumor markers in the diagnosis of lung cancer.Methods A total of 138 patients with newly diagnosed lung cancer patient(lung cancer group)and 52 patients with benign lung diseases(control group)in Anhui NO.2 Provincial People's Hospital from June 2020 to March 2024 were selected as the research objects.The clinical data and serum tumor markers[neuron-specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),Pro-gastrin-relea-sing peptide(ProGRP)and squamous cell carcinoma antigen(SCC)]of all groups were compared.Results There were significant differences in age and smoking history between the two groups(P＜0.05).The serum levels of NSE,CYFRA21-1,CEA,ProGRP and SCC in lung cancer group were significantly higher than those in control group,and the differences were statistically significant(P＜0.05).The results of binary Logistic regression analysis showed that smoking history,age,CYFRA21-1 and CEA levels were all influen-cing factors for the occurrence of lung cancer(P＜0.05).Receiver operating characteristic(ROC)curve analy-sis results showed that the area under the curve(AUC)of smoking history,age,CEA and CYFRA21-1 in the combined diagnosis of lung cancer was 0.906(95％CI:0.865-0.947),which was higher than the AUC for the individual diagnosis of each index.The levels of serum CYFR21-1 and CEA in the stage Ⅰ—Ⅱ group were significantly lower than those in the stage Ⅲ-Ⅳ group,and the difference was statistically significant(P＜0.05).The results of binary Logistic regression analysis showed that CYFRA21-1 and CEA levels were influ-ential factors in the occurrence of lung cancer stage Ⅲ-Ⅳ(P＜0.05).ROC curve analysis showed that the AUC of CEA and CYFRA21-1 for the diagnosis of lung cancer stage Ⅲ-Ⅳ were 0.750(95％CI:0.667-0.832)and 0.771(95％CI:0.691-0.852),respectively.The AUC of combined diagnosis was 0.834(95％CI:0.765-0.902),the sensitivity was 58.9％,and the specificity was 95.3％.Conclusion Smoking history,age,CEA,and CYFRA21-1 may be potential biomarkers for the diagnosis and prognosis of lung cancer,espe-cially CEA and CYFRA21-1,which are also of great significance for the staging of lung cancer from stage Ⅲ to stage Ⅳ.

OBJECTIVE To compare the emergency specialist clinical pharmacist training programs between China and the United States， providing valuable insight for the development of specialized clinical pharmacist training in emergency departments within China. METHODS By reviewing the official website of the American Society of Health-System Pharmacists （ASHP）， the websites of some training institutions offering PGY2 emergency medicine （EM） residency programs in the United States， the official website of China’s National Health Commission， and the website of the Pharmaceutical Affairs Committee of the Chinese Hospital Association， relevant materials and data on the training of emergency medicine clinical pharmacists were collected. Microsoft Excel and NVivo software were utilized to analyze the implementation status of these training programs. Literature searches were conducted via Chinese （CNKI） and English （PubMed） databases， followed by screening， categorization， and thematic analysis aligned with research objectives. RESULTS As of now， there are 115 accredited PGY2 EM residency programs in the United States， which provide 120 specialized pharmacist training positions. These programs are distributed across 35 states and are hosted by a variety of institutions， including hospitals， medical centers， and universities. The predominant training model follows a hospital+acute care framework. Eligibility requirements for PGY2 EM residency programs include possession of a doctor of pharmacy （Pharm.D.） degree， pharmacist licensure， and completion of a PGY1 residency. The training standards are structured into three tiers： competency areas， competency goals， and learning objectives. The curriculum typically includes core rotations， elective rotations， and longitudinal training components. Assessment is conducted through a combination of formative and summative evaluations， with results categorized into four proficiency levels. In China， there is only one training base currently for emergency clinical pharmacist specialty training with an annual enrollment of three trainees. Applicant eligibility primarily involves requirements regarding academic degree， professional background， years of experience， and professional title. The training content covers four domains： general competency， clinical theoretical knowledge and skills， pharmacological knowledge and application， and clinical medication practice skills. The training process centers on rotations within emergency departments. Assessment methods include theoretical examinations， daily performance evaluations， and final completion assessments. CONCLUSIONS PGY2 EM residency programs in the United States emphasize inclusivity and professionalism in their implementation. Program admission involves a rigorous selection process， and they offer attractive incentive structures for trainees. The training content focuses on competency-based approaches and pragmatic applicability， while assessment methods are closely aligned with defined competence objectives. In contrast， specialist clinical pharmacist training in emergency medicine in China is currently in the exploratory and nascent stages. Admission criteria tend to be less stringent， and incentives for trainees are often insufficient. The training content appears relatively stereotyped and superficial， with assessment methods still primarily reliant on quantifiable metrics. In expanding and popularizing China’s emergency specialist clinical pharmacist training programs， it is essential to draw on advanced experiences from developed countries like the United States， particularly in areas such as training base distribution， application requirements， training content， and assessment methods. Aligned with the realities of emergency clinical practice in China， efforts should focus on enhancing program accessibility and training efficacy.

OBJECTIVE T o carry out the health economics evaluation and cost-benefit analysis of the type b Hae-mophilus influenzae(Hib)vaccination for the children who were hospitalized due to Hib infection so as to provide evidence for public health policies.METHODS The children who were diagnosed with Hib-related respiratory tract infections or meningitis and were hospitalized in respiratory medicine department,infection management depart-ment,emergency rooms and neurology department of Jiangxi Provincial Children's Hospital from Jan.1,2021 to Dec.31,2023 were recruited as the research subjects.Based on a 1∶1 matching condition,the matching variables included four items such as the same age for the admission to the hospital,same gender,same department and same grade of disease severity.The children for whom the primary immunization of Hib vaccination(including Hib monovalent vaccine and Hib-containing combination vaccine)were completed and the integrity of vaccination infor-mation could be checked out were assigned as the intervention group,while the children for whom the primary im-munization of Hib vaccination was not completed were chosen as the control group.The clinical data,vaccination data and the data such as length of hospital stay and hospitalization cost were collected from the children.The cost-benefit of the Hib vaccination among the children with Hib infection was observed.RESULTS A total of 622 hospi-talized children who were detected with Hib-positive respiratory tract infections or meningitis were enrolled in the study,and 73 children(20 children from infection management department,27 children from respiratory medi-cine department,26 children from emergency rooms)were finally included in the intervention group after matc-hing and multiple rounds of screening,73 children were chosen as the control group based on a 1∶1 matching con-dition.The male children accounted for 57.53％(42 cases)in both groups,and the female children accounted for 42.47％(31 cases)in both groups.With the respect to the length of hospital stay,it was 7.00(5.00,8.00)days in the intervention group,7.00(6.00,8.00)days in the control group(Z=-0.341,P=0.733).In terms of the hospitalization cost,it was 7 756.17(6 617.92,10 617.69)yuan in the intervention group,9 040.65(8 033.76,10 935.84)yuan in the control group(Z=-2.795,P=0.005).The cost of Hib vaccination was 343.03 yuan per capita in the intervention group,and the benefit-cost ratio(BCR)was 1∶3.74(343.03 yuan/1 284.48 yuan).CONCLUSIONS The Hib vaccination can save the hospitalization cost and has high cost effectiveness.It is sugges-ted that the Hib vaccination should be promoted and the coverage rate of Hib vaccination should be raised among the age-eligible children.