The Third Plenary Session of the 20th Central Committee of the Communist Party of China puts forward the"health priority development strategy",marking that giving priority to health development has become an overall task of further deepening reform in the New Era.The health oriented development strategy is determined by the nature and purpose of the Communist Party of China,and has its historical inevitability and practical necessity."Giving priority to health development"is a collection of series concepts and development models that place the maintenance and promotion of health as the priority in the economic and social development goals,fields and matters of development,based on the basic status and leading role of health.The"health priority development strategy"is the institutionalization,systematization and integration of the concepts and models of giving priority to health development.It is a comprehensive strategy to realize the coordinated and mutually promoting development of health with economy and society.Prioritizing health development is a relative priority to the whole system,it is a development concept and value-oriented approach with free and comprehensive human development at core,it is a health-oriented model and path to achieve high-quality development,and it is a systematic project involving changes in values,lifestyles and modes of production,consumption,governance and institutional systems.The system of prioritizing health development is an organically linked institutional complex formed around the maintenance and promotion of people's health and various norms of conduct,and its practical requirements include the"priority"of concept,planning,policy,investment,team,organization and assessment.

Thyrotoxic periodic paralysis(TPP) is a rare but potentially life-threatening complication of thyrotoxicosis. TPP secondary to thyrotoxicosis factitia(TF) is exceptionally uncommon. Here, we report the case of a 31-year-old female who developed TF and subsequent TPP after taking laxatives containing unknown ingredients. The patient presented with acute onset of quadriplegia. Laboratory investigations revealed severe hypokalemia(serum potassium 1.47mmol/L), thyrotoxicosis[thyroid stimulating hormone(TSH)<0.005 mIU/L, free thyroxine(FT 4) 30.84 pmol/L, free triiodothyronine(FT 3) 7.71 pmol/L], and a decreased thyroglobulin level(3.08 ng/mL). The patient′s symptoms resolved rapidly following potassium supplementation, and thyroid function gradually normalized after discontinuation of the suspected medication. This case highlights the importance of considering TF in the differential diagnosis of TPP, particularly in patients with a history of unknown medication use. It also underscores the diagnostic value of thyroglobulin measurement in identifying TF and outlines clinical strategies for the management of TF-induced TPP.

The Third Plenary Session of the 20th Central Committee of the Communist Party of China puts forward the"health priority development strategy",marking that giving priority to health development has become an overall task of further deepening reform in the New Era.The health oriented development strategy is determined by the nature and purpose of the Communist Party of China,and has its historical inevitability and practical necessity."Giving priority to health development"is a collection of series concepts and development models that place the maintenance and promotion of health as the priority in the economic and social development goals,fields and matters of development,based on the basic status and leading role of health.The"health priority development strategy"is the institutionalization,systematization and integration of the concepts and models of giving priority to health development.It is a comprehensive strategy to realize the coordinated and mutually promoting development of health with economy and society.Prioritizing health development is a relative priority to the whole system,it is a development concept and value-oriented approach with free and comprehensive human development at core,it is a health-oriented model and path to achieve high-quality development,and it is a systematic project involving changes in values,lifestyles and modes of production,consumption,governance and institutional systems.The system of prioritizing health development is an organically linked institutional complex formed around the maintenance and promotion of people's health and various norms of conduct,and its practical requirements include the"priority"of concept,planning,policy,investment,team,organization and assessment.

Thyrotoxic periodic paralysis(TPP) is a rare but potentially life-threatening complication of thyrotoxicosis. TPP secondary to thyrotoxicosis factitia(TF) is exceptionally uncommon. Here, we report the case of a 31-year-old female who developed TF and subsequent TPP after taking laxatives containing unknown ingredients. The patient presented with acute onset of quadriplegia. Laboratory investigations revealed severe hypokalemia(serum potassium 1.47mmol/L), thyrotoxicosis[thyroid stimulating hormone(TSH)<0.005 mIU/L, free thyroxine(FT 4) 30.84 pmol/L, free triiodothyronine(FT 3) 7.71 pmol/L], and a decreased thyroglobulin level(3.08 ng/mL). The patient′s symptoms resolved rapidly following potassium supplementation, and thyroid function gradually normalized after discontinuation of the suspected medication. This case highlights the importance of considering TF in the differential diagnosis of TPP, particularly in patients with a history of unknown medication use. It also underscores the diagnostic value of thyroglobulin measurement in identifying TF and outlines clinical strategies for the management of TF-induced TPP.

OBJECTIVE To investigate the impact of dapagliflozin on contrast-induced acute kidney injury(CIAKI)and prognosis in patients with diabetes mellitus type 2(T2DM)and acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).METHODS Retrospective selection of data on T2DM patients with ACS who underwent PCI treatment in the Cardiology Department of Tianjin Chest Hospital from January 1st 2021 to December 31st 2022.The patients were divided into dapagliflozin group(96 cases)and control group(148 cases)based on whether they received dapagliflozin or not.Renal function indicators were measured for all enrolled patients before PCI and at 48 h and 1 week after PCI,including blood urea nitrogen(BUN),serum creatinine(Scr),estimated glomerular filtration rate(eGFR),cystatin-C(Cys-C),kidney injury molecule-1(KIM-1)and β2-microglobulin(β2-MG).All patients were followed up for at least 1 year.The incidence of CIAKI and major adverse cardiac event(MACE)during follow-up were recorded for both groups.Logistic regression was used to analyze the impact of dapagliflozin on the occurrence of CIAKI,while the Log-rank test was applied to compare the incidence of MACE between the two groups.Cox regression was employed to analyze the impact of dapagliflozin on prognosis.RESULTS At 48 h and 1 week after PCI,serum levels of Cys-C,KIM-1 and β2-MG were significantly lower in the dapagliflozin group compared to the control group(P＜0.05).The incidence of CIAKI was lower in the dapagliflozin group compared to the control group(6.25%vs.14.86%,P=0.042).Logistic regression analysis revealed that dapagliflozin was an independent protective factor against CIAKI(OR=0.280,95%CI 0.101-0.780,P=0.015).During the follow-up period,the incidence of MACE was lower in the dapagliflozin group compared to the control group(7.29%vs.17.57%,P=0.049).Cox regression analysis indicated that dapagliflozin reduced the occurrence of MACE after PCI(HR=0.374,95%CI 0.161-0.866,P=0.022).CONCLUSIONS With adequate hydration,the use of dapagliflozin does not increase the risk of CIAKI following PCI in T2DM patients with ACS.

It analyzes the significance and value of prioritizing health development,explains the basic connotation and core meaning of prioritizing health development,and puts forward the framework of the system of prioritizing health development.It proposes that health priority development is a collection of a series of ideas,systems and development models that arrange health as a priority in a country's economic and social development.The system of health priority development refers to a unified whole composed of all kinds of systems or behavior rules that are conducive to promoting and protecting residents'health.Healthy civilization,healthy promotion society and health impact assessment system are building blocks of system construction.

Objective:To evaluate the association between polycystic ovary syndrome (PCOS)-related symptom combinations and ovarian stimulation high response in infertile patients with PCOS symptoms and controlled ovarian stimulation treatment by recombinant Human Follitropin Alfa (r-hFSHα) solution for injection, and to evaluate the efficacy and safety outcomes of using the r-hFSHα prefilled injection pen in high-risk patients with ovarian hyperstimulation syndrome (OHSS).Methods:This prospective, observational, phase Ⅳ study enrolled 1055 patients with at least one symptom/sign of PCOS using the r-hFSHα prefilled pen for over 4 months follow-up observation from December 2015 to September 2017 in the Second Hospital of Hebei Medical University, Center for Reproductive Medicine, Shandong University, Tangdu Hospital of the Air Force Military Medical University, Dalian Maternity and Child Health Care Hospital, Nanjing Maternity and Child Health Care Hospital, Jiangxi Maternity and Child Health Care Hospital, the First Affiliated Hospital of Xinjiang Medical University, the First Affiliated Hospital of Anhui Medical University, the Affiliated Hospital of Inner Mongolia Medical University. The primary endpoints assessed included the development of polycystic ovaries, elevated serum testosterone levels, menstrual cycle disturbances, development of hirsutism, and completion of egg retrieval. The efficacy endpoints of the study included the number of ocoytes retrieved, the number of M Ⅱ oocyte, the biochemical pregnancy rate, the clinical pregnancy rate, and the implantation rate. Results:In the full analysis set ( n=997), polycystic ovary rate was 54.5% (543/997), serum testosterone level was (0.4±0.2) μg/L, menstrual cycle disorder rate was 45.0% (449/997), hirsutism rate was 10.5% (105/997). The average number of oocytes retrieved after ovarian stimulation was 14.4. The clinical pregnancy rate per transfer cycle was 53.6% (251/468), the live birth rate was 45.3% (212/468), the biochemical pregnancy rate was 60.9% (285/468), the implantation rate was 39.1% (349/893), and the fresh embryo transfer cancellation rate was 24.0% (239/997). OHSS incidence was diagnosed in 1.8% (19/1054) of patients (safety set, n=1054), including 8 (0.8%) mild cases, 10 (0.9%) moderate cases and 1 (0.1%) severe case. According to the results of exploratory analysis, a decrease in body mass index (BMI) was associated with an increased risk of high response. For every 1 kg/m 2 decrease in BMI, the risk of high response (number of retrieved oocytes >15) increased by approximately 9%, the risk of high response (number of retrieved oocytes >20) increased by approximately 9%. For every 1 increase in antral follicle count (AFC), the risk of high response(number of retrieved oocytes >15) increased by approximately 6% and the risk of high response (number of retrieved oocytes >20) by approximately 4%. Conclusion:Patients with at least one symptom/sign of ovarian hyperstimulation achieved good clinical outcomes with the use of the r-hFSHα prefilled pen, and high response was associated with lower BMI and AFC.

Objective:To evaluate the association between polycystic ovary syndrome (PCOS)-related symptom combinations and ovarian stimulation high response in infertile patients with PCOS symptoms and controlled ovarian stimulation treatment by recombinant Human Follitropin Alfa (r-hFSHα) solution for injection, and to evaluate the efficacy and safety outcomes of using the r-hFSHα prefilled injection pen in high-risk patients with ovarian hyperstimulation syndrome (OHSS).Methods:This prospective, observational, phase Ⅳ study enrolled 1055 patients with at least one symptom/sign of PCOS using the r-hFSHα prefilled pen for over 4 months follow-up observation from December 2015 to September 2017 in the Second Hospital of Hebei Medical University, Center for Reproductive Medicine, Shandong University, Tangdu Hospital of the Air Force Military Medical University, Dalian Maternity and Child Health Care Hospital, Nanjing Maternity and Child Health Care Hospital, Jiangxi Maternity and Child Health Care Hospital, the First Affiliated Hospital of Xinjiang Medical University, the First Affiliated Hospital of Anhui Medical University, the Affiliated Hospital of Inner Mongolia Medical University. The primary endpoints assessed included the development of polycystic ovaries, elevated serum testosterone levels, menstrual cycle disturbances, development of hirsutism, and completion of egg retrieval. The efficacy endpoints of the study included the number of ocoytes retrieved, the number of M Ⅱ oocyte, the biochemical pregnancy rate, the clinical pregnancy rate, and the implantation rate. Results:In the full analysis set ( n=997), polycystic ovary rate was 54.5% (543/997), serum testosterone level was (0.4±0.2) μg/L, menstrual cycle disorder rate was 45.0% (449/997), hirsutism rate was 10.5% (105/997). The average number of oocytes retrieved after ovarian stimulation was 14.4. The clinical pregnancy rate per transfer cycle was 53.6% (251/468), the live birth rate was 45.3% (212/468), the biochemical pregnancy rate was 60.9% (285/468), the implantation rate was 39.1% (349/893), and the fresh embryo transfer cancellation rate was 24.0% (239/997). OHSS incidence was diagnosed in 1.8% (19/1054) of patients (safety set, n=1054), including 8 (0.8%) mild cases, 10 (0.9%) moderate cases and 1 (0.1%) severe case. According to the results of exploratory analysis, a decrease in body mass index (BMI) was associated with an increased risk of high response. For every 1 kg/m 2 decrease in BMI, the risk of high response (number of retrieved oocytes >15) increased by approximately 9%, the risk of high response (number of retrieved oocytes >20) increased by approximately 9%. For every 1 increase in antral follicle count (AFC), the risk of high response(number of retrieved oocytes >15) increased by approximately 6% and the risk of high response (number of retrieved oocytes >20) by approximately 4%. Conclusion:Patients with at least one symptom/sign of ovarian hyperstimulation achieved good clinical outcomes with the use of the r-hFSHα prefilled pen, and high response was associated with lower BMI and AFC.

Objective: To investigate the effects of platelet-rich plasma (PRP) combined with polylactic acid/polycaprolactone (PLA/PCL) on healing of mininature pig deep soft tissue defect caused by fragment injury. Methods: Two male Bama miniature pigs with 11 to 12 months (the same below) were selected by lottery to prepare PRP. The other twenty-seven male Bama miniature pigs were used to reproduce deep soft tissue defect caused by high-explosive ammunition fragment injury on bilateral posterior femoral region. According to the random number table, 27 pigs were divided into control group, material group, and PRP+material group, with 9 pigs in each group. After debridement, wounds of pigs in material group and PRP+material group were filled with PLA/PCL and PLA/PCL+2 mL activated PRP, respectively. Pigs in each group received suture of full-thickness skin to close the wounds. The operative duration was recorded. The length and volume of wounds of pigs in the above groups were measured immediately after surgery. In 1, 2, and 4 weeks after surgery, 3 pigs in each group were sacrificed to collect femoral wounds tissue on two sides, and PLA/PCL were collected from wounds of pigs in material group and PRP+material group for general observation of wounds tissue and degradation of the material. In 2 and 4 weeks after surgery, wounds tissue was obtained to observe the histological changes by hematoxylin-eosin staining, and expressions of transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF), and angiogenesis were determined by immunohistochemical method. In 1, 2, and 4 weeks after surgery, wounds tissue was collected to determine mRNA expressions of TGF-β and VEGF by real-time quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, one-way analysis of variance, and least significant difference-t test. Results: (1) There were no significantly statistical differences in length and volume of the wounds of pigs among the three groups (F=0.336, 0.282, P>0.05). The operative duration in control group [(30.9±2.1)min] was significantly shorter than that of material group [(39.7±2.2)min] and PRP+material group[(40.0±2.6)min], t=-11.45, -11.88, P<0.01. (2) There were respectively 10, 7, and 5 wounds tissue with infection in pigs of control group, material group, and PRP+material group. In 1, 2, 4 weeks after surgery, all of the wounds tissue of pigs was infected in control group, while none of wounds tissue of pigs was infected in material group and PRP+material group. In pigs of material group and PRP+material group, materials and tissue were easily separated in 1 week after surgery; some materials were integrated with tissue and showed a tendency of degradation in 2 weeks after surgery; materials were completely embedded with tissue in 4 weeks after surgery. (3) In pigs of control group, erythrocytes and inflammatory cells infiltration in wounds tissue were observed in 2 weeks after surgery, and necrotic tissue and inflammatory cells infiltration in wounds tissue were still observed in 4 weeks after surgery. In pigs of material group and PRP+material group, a large number of erythrocytes and inflammatory cells infiltration were observed in 2 weeks after surgery. Compared with that of material group, wounds tissue of pigs in PRP+material group had no inflammatory cells infiltration in 4 weeks after surgery. (4) Protein expressions of TGF-β in fibroblasts and multinuclear macrophagocytes, VEGF in fibroblasts and vascular endothelial cells, and blood vessel formation in wounds tissue of pigs in PRP+material group were significantly more than those of pigs in control group and material group in 2 and 4 weeks after surgery. (5) The mRNA expression of TGF-β in wounds tissue of pigs in material group was significantly higher than that in control group in 4 weeks after surgery (t=-3.93, P<0.01). Compared with those of pigs in control group and material group, the mRNA expression of TGF-β in wounds tissue of pigs in PRP+material group was significantly increased at each time point (t=9.23, 13.81, 11.73, -7.51, -12.04, -7.80, P<0.01). The mRNA expression of VEGF in wounds tissue of pigs increased significantly in material group compared with that of pigs in control group in 4 weeks after surgery (t=-3.94, P<0.01). Compared with those of pigs in control group and material group, the mRNA expression of VEGF in wounds tissue increased significantly in wound tissue of pigs in PRP+material group at each time point (t=12.33, 3.95, 7.97, -11.36, -2.97, -4.04, P<0.01). Conclusions PRP combined with PLA/PCL can accelerate wound healing of deep soft tissue defect of mininature pigs caused by fragment injury by providing physical scaffold for newborn tissue growth, promoting mRNA and protein expressions of TGF-β and VEGF.

Objective The application of nano-carbon tracer technique in radical antegrade modular pancreatosplenectomy (RAMPS) to treat malignant tumors of pancreatic body and tail.To investigate whether radical anterograde modulization of pancreatic body and tail combined with nano-carbon tracer technique is more beneficial to the prognosis of patients.Methods From January 2014 to September 2018,a retrospective analysis was performed in 48 patients in Linyi Central Hospital,all patients underwent RAMPS,all of whom were pathologically proved to be pancreatic carcinoma of the body and tail.Based on whether the nano-carbon lymph node tracer was performed during the operation,the patients were divided into two groups:nano-carbon group (nano-carbon lymph node tracing) and conventional operation group (no nano-carbon lymph node tracer).The differences between the two groups were analyzed,including operative time,intraoperative blood loss,postoperative complications (pancreatic fistula),postoperative hospitalization time,postoperative pathological lymph node status (number of dissection,number of positive lymph nodes,the positive rate of lymph node black staining in nano-carbon group) and survival time after operation.The measurement data were expressed as mean ± standard deviation (Mean ± SD),t-test were used for comparison among groups;Chi-square test was used for comparison of counting data,and Kaplan-Meier test was used for comparison of survival rate.Results There was no significant difference in the time of operation [(4.45 ± 0.59) h vs (4.41 ±0.65) h],the amount of blood lost during operation [(447.39 ± 109.51) ml vs (434.8 ± 76.38) ml] and the time of hospitalization after operation [(16.52 ± 4.12) d vs (16.56 ±2.92) d] between the two groups (P＞0.05).There were 1 case of pancreatic fistula in the nano-carbon group and 2 cases of pancreatic fistula in the convertional operation group,but the difference was not statistically significant (P =0.55).The number of lymph nodes dissected and positive lymph nodes in nano-carbon group were significantly higher than those in conventional operation group [(18.26 ± 2.49) vs (12.16 ± 2.19);(5.52 ± 1.50) vs (3.32 ± 0.85).The difference was statistically significant (P ＜ 0.05).The positive rate of lymph nodes in black stained lymph nodes (38.10％,96/252) was significantly higher than that in non-stained lymph nodes (18.45％,31/168),and the difference was statistically significant (P ＜ 0.05).The average survival time in the nano-carbon group [(25.48 ± 11.74) months] was significantly longer than that in the conventional operation group [(15.80 ± 11.64) months],and the difference was statistically significant (P ＜ 0.05).Conclusions It is safe,effective and feasible to treat malignant tumors of pancreatic body and tail by RAMPS combined with nano-carbon tracer technique.The positive rate of lymph node dissection and the detection rate of total lymph nodes are increased,and the prognosis of patients is improved,to improve the survival time of patients after operation is improved.