With the advancement of China's healthcare reform,enhancing the capacity of primary healthcare services has become a pivotal task.Colorectal cancer,one of the most prevalent malignancies in China,highlights the critical importance of early screening and diagnosis to improve patient survival rates.This study,guided by the principles of Party building and Xi Jinping Thought on Socialism with Chinese Characteristics,examines the implementation and outcomes of a rural outreach program focused on colorectal cancer screening and diagnostic technologies.By promoting the dissemination of colorectal cancer screening initiatives,the paper aims to provide empirical evidence to support the deepening of primary-care services,foster high-quality ad-vancement of grassroots health services,and align with the national Healthy China Initiative,thereby more effectively safeguarding population health.

With the advancement of China's healthcare reform,enhancing the capacity of primary healthcare services has become a pivotal task.Colorectal cancer,one of the most prevalent malignancies in China,highlights the critical importance of early screening and diagnosis to improve patient survival rates.This study,guided by the principles of Party building and Xi Jinping Thought on Socialism with Chinese Characteristics,examines the implementation and outcomes of a rural outreach program focused on colorectal cancer screening and diagnostic technologies.By promoting the dissemination of colorectal cancer screening initiatives,the paper aims to provide empirical evidence to support the deepening of primary-care services,foster high-quality ad-vancement of grassroots health services,and align with the national Healthy China Initiative,thereby more effectively safeguarding population health.

Hepatic fibrosis is a chronic pathological condition characterized by hepatic stellate cell activation and excessive deposition of extracellular matrix， which would progress to liver cirrhosis and even hepatocellular carcinoma. Therefore， reversal of hepatic fibrosis is of great importance for improving quality of life and prolonging survival time. Currently， various therapeutic drugs for hepatic fibrosis have entered the stage of clinical trial. This article reviews the research advances in therapeutic drugs for hepatic fibrosis in the recent years， in order to provide insights into the treatment of hepatic fibrosis and future research directions for drugs.

The proposal of new quality productive forces provide the key driving force and strategy for the high-quality de-velopment of public hospitals and the acceleration of health modernization.In the era of promoting high-quality development with new quality productive forces,large public hospitals,as the main force to promote the development of China's health cause,ex-plore the path of international innovation and development has become its important mission.This paper summarizes experience of The First Affiliated Hospital,Sun Yat-sen University on how to promote discipline construction,scientific innovation,talent train-ing,brand construction,etc.,through international exchange and cooperation.The authors put forward suggestions for public hospitals on cultivating new quality productive forces,aiming to provide reference for empowering high-quality development through international exchange and cooperation while facing new challenges.

Objective:To explore the expression levels of adrenomedullin (ADM) in follicular fluid of patients with polycystic ovary syndrome (PCOS) and its correlation with ovarian function and inflammation.Methods:To conduct a cohort study, the data on infertile couples who received an antagonistic regimen of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) to promote ovulation from March to December 2023 at the Reproductive Medicine Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) were collected. PCOS patients were selected as the PCOS group, and patients who underwent IVF/ICSI assisted pregnancy solely due to tubal and/or male factors during the same period were selected as control group. The general clinical data of two groups of patients were analyzed, and the expression of ADM, interleukin 1β (IL-1β), IL-18, transforming growth factor β (TGF-β) in the follicular fluid were compared between the two groups of patients. And taking the concentration of ADM in follicular fluid as the main research indicator, correlation and multiple linear regression analysis were conducted with other indicators. Simultaneously the ADM mRNA expression, cell cycle and cell apoptosis of granulosa cells were compared between the two groups. Results:This study included 20 cases in the PCOS group and 20 cases in control group. Compared with control group, the expression of ADM in follicular fluid and granulosa cells of patients with PCOS were significantly lower (both P<0.001), while its testosterone, the ratio of luteinizing hormone and follicle-stimulating hormone, antral follicle count (AFC), number of retrieved eggs, ovarian sensitivity index, as well as IL-1β, IL-18 and TGF-β in follicular fluid were higher and negatively correlated with ADM ( r=-0.37, P=0.019; r=-0.32, P=0.047; r=-0.50, P<0.001; r=-0.38, P=0.017; r=-0.38, P=0.016; r=-0.44, P=0.005; r=-0.37, P=0.018; r=-0.54, P<0.001). Multiple linear regression showed that AFC, gonadotropin initiation dose, IL-1β and TGF-β were the independent related factors that affect local ADM levels ( r=-0.37, P=0.008; r=-0.27, P=0.035; r=-0.28, P=0.028; r=-0.45, P<0.001). There was no statistically significant difference in the cell cycle of granulocytes between the two groups ( P>0.05), but the apoptosis rate (AR) of granulocytes was higher in the PCOS group than in control group (median AR in the PCOS group was 46.07%, median AR in control group was 28.57%, n=10, P=0.036). Conclusion:The decreased expression of ADM in follicles of PCOS patients is related to ovarian endocrine disorders, multiple vesicles, high ovarian responsiveness and local inflammatory status.

Objective:To explore the expression levels of adrenomedullin (ADM) in follicular fluid of patients with polycystic ovary syndrome (PCOS) and its correlation with ovarian function and inflammation.Methods:To conduct a cohort study, the data on infertile couples who received an antagonistic regimen of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) to promote ovulation from March to December 2023 at the Reproductive Medicine Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) were collected. PCOS patients were selected as the PCOS group, and patients who underwent IVF/ICSI assisted pregnancy solely due to tubal and/or male factors during the same period were selected as control group. The general clinical data of two groups of patients were analyzed, and the expression of ADM, interleukin 1β (IL-1β), IL-18, transforming growth factor β (TGF-β) in the follicular fluid were compared between the two groups of patients. And taking the concentration of ADM in follicular fluid as the main research indicator, correlation and multiple linear regression analysis were conducted with other indicators. Simultaneously the ADM mRNA expression, cell cycle and cell apoptosis of granulosa cells were compared between the two groups. Results:This study included 20 cases in the PCOS group and 20 cases in control group. Compared with control group, the expression of ADM in follicular fluid and granulosa cells of patients with PCOS were significantly lower (both P<0.001), while its testosterone, the ratio of luteinizing hormone and follicle-stimulating hormone, antral follicle count (AFC), number of retrieved eggs, ovarian sensitivity index, as well as IL-1β, IL-18 and TGF-β in follicular fluid were higher and negatively correlated with ADM ( r=-0.37, P=0.019; r=-0.32, P=0.047; r=-0.50, P<0.001; r=-0.38, P=0.017; r=-0.38, P=0.016; r=-0.44, P=0.005; r=-0.37, P=0.018; r=-0.54, P<0.001). Multiple linear regression showed that AFC, gonadotropin initiation dose, IL-1β and TGF-β were the independent related factors that affect local ADM levels ( r=-0.37, P=0.008; r=-0.27, P=0.035; r=-0.28, P=0.028; r=-0.45, P<0.001). There was no statistically significant difference in the cell cycle of granulocytes between the two groups ( P>0.05), but the apoptosis rate (AR) of granulocytes was higher in the PCOS group than in control group (median AR in the PCOS group was 46.07%, median AR in control group was 28.57%, n=10, P=0.036). Conclusion:The decreased expression of ADM in follicles of PCOS patients is related to ovarian endocrine disorders, multiple vesicles, high ovarian responsiveness and local inflammatory status.

Objective The tissue motion mitral annular displacement(TMAD)technique was used to evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism,and its correlation with myocardial damage was analyzed.Methods Sixty-nine cases of hyperthyroidism diagnosed in Affiliated Hospital of Youjiang Medical University for Nationalities from July 2021 to November 2022 were selected as the study objects.According to whether the patients were combined with hyperthyroidism heart disease,they were divided into simple hyperthyroidism group(n=43)and thyrotoxic heart group(n=26).35 healthy people who underwent physical examination in our hospital during the same period were selected as normal control group.Three-dimensional echocardiography was used to obtain the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF)and TMAD parameters.The differences of above parameters among all groups were compared,and the correlations of TMAD parameters with creatine kinase isoenzymes(CK-MB)and high-sensitivity cardiac troponin T(hs-cTnT)were analyzed.Results The LVEDV,LVESV,LVEF,TMAD parameters,CK-MB and hs-cTnT of three groups were statistically significant(P<0.001),and LVEDV,LVESV,CK-MB and hs-cTnT of normal control groupsimple hyperthyroidism group>thyrotoxic heart group.All parameters of TMAD were positively correlated with LVEF(P<0.001),and some parameters of TMAD were negatively correlated with CK-MB(P<0.05).Conclusion TMAD technology can early evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism,and is related to CK-MB and hs-cTnT.

Objective:To investigate the efficacy and value of preemptive analgesia in older adult patients undergoing laparoscopic hepatectomy.Methods:A total of 150 older adult patients with liver cancer, who underwent laparoscopic hepatectomy at The 2 nd Affiliated Hospital of Wenzhou Medical University between July 2019 and April 2020, were randomly assigned to two groups: a control group ( n = 75) and an observation group ( n = 75) using the random number table method. The control group received postoperative analgesia with parecoxib sodium, while the observation group received preemptive analgesia with parecoxib sodium. A comparative analysis was conducted between the control and observation groups in terms of the Numerical Rating Scale (NRS) scores at 8, 12, and 24 hours postoperatively, postoperative recovery, length of hospital stay, and overall cost. Results:There were no statistically significant differences in operation time, dosage of Sufentanil 24 hours postoperatively, or the total and effective usage counts of patient-controlled intravenous analgesia with Sufentanil between the control and observation groups (both P > 0.05). However, the NRS scores of the observation group were significantly lower than those of the control group at 8, 12, and 24 hours postoperatively. Specifically, the NRS scores of the observation group were (4.38 ± 1.24) points, (3.41 ± 0.19) points, and (2.90 ± 0.17) points, respectively, while those of the control group were (5.24 ± 1.01) points, (4.65 ± 1.24) points, and (3.32 ± 1.00) points, respectively ( t = 4.66, 8.56, 3.59, all P < 0.001). Patients in the observation group exhibited significantly more frequent off-bed activities [(2.62 ± 1.24) times], a notably longer cumulative duration of off-bed activities [(1.36 ± 0.20) hours], and a significantly shorter duration of first anal exhaust [(13.50 ± 1.27) hours] compared with those in the control group [(1.06 ± 0.12) times, (0.36 ± 0.09) hours, (20.10 ± 2.16) hours, t = -10.84, -39.49, 22.81, all P < 0.001]. Furthermore, the observation group demonstrated a shorter postoperative hospital stay [(8.90 ± 1.34) days], lower hospitalization costs [(55.8 ± 2.1) thousand yuan], and higher patient satisfaction scores [(88.98 ± 5.64) points] compared with the control group [(11.15 ± 1.29) days, (59.4 ± 6.2) thousand yuan, (72.16 ± 3.26) points, t = 10.48, 4.76, -22.36, all P < 0.001]. Conclusion:The implementation of preemptive analgesia intervention among older adult patients undergoing laparoscopic hepatectomy effectively enhances analgesic outcomes, accelerates postoperative recovery, reduces hospitalization duration, and markedly decreases hospitalization costs.

Objective:Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer.This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging(GRASP DCE-MRI)to predict the presence of peritoneal free cancer cells in gastric cancer patients.Methods:All enrolled patients were consecutively divided into analysis and validation groups.Preoperative magnetic resonance imaging(MRI)scans and perfusion were performed in patients with gastric cancer undergoing surgery,and peritoneal lavage specimens were collected for examination.Based on the peritoneal lavage cytology(PLC)results,patients were divided into negative and positive lavage fluid groups.The data collected included clinical and MR information.A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid,and the validity of the model was verified based on data from the verification group.Results:There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test.MR tumor stage,tumor thickness,and perfusion parameter Tofts-Ketty model volume transfer constant(Ktrans)were independent predictors of positive peritoneal lavage fluid.The nomogram model featured a concordance index(C-index)of 0.785 and 0.742 for the modeling and validation groups,respectively.Conclusions:GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients.The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

Objective To explore the nutritional status and immune function of hospitalized patients with decompensated cirrhosis.Methods A total of 132 patients with decompensated cirrhosis who were hospi-talized in this hospital from January 2020 to June 2022 were selected.According to Nutritional Risk Screening 2002 (NRS2002) score,the patients were divided into the high-nutritional-risk group,the low-nutritional-risk group,and the non-nutritional-risk group.Comparative analysis was conducted on nutritional status indica-tors,cellular immune indicators,Child-Pugh classification of liver function,and complications among the three groups.Results BMI,TSF,AMC,Hb,ALB,PA,RBP and TG in the high-nutritional-risk group and low-nu-tritional-risk group were lower than those in the non-nutritional-risk group.BMI,TSF,and AMC in the low-nutritional-risk group were lower than those in the non-nutritional-risk group.ALB and TG in the high-nutri-tional-risk group were lower than those in the low-nutritional-risk group,with statistically significant differ-ences (P<0.05).The immune indexes IgG and IgA in the high-nutritional-risk group and the low-nutritional-risk group were higher than those in the non-nutritional-risk group,with statistically significant differences (P<0.05).The percentage of CD4+T cells and the ratio of CD4+T cells to CD8+T cells (CD4+T/CD8+T) in the high-nutritional-risk group and the low-nutritional-risk group were lower than those in the non-nutrition-al-risk group,with statistically significant differences (P<0.05).The NRS2002 score was negatively correla-ted with BMI,TSF,AMC,Hb,ALB,PA,RBP,TC,TG,CD4+T,CD4+T/CD8+T (P<0.05).It was positive-ly correlated with IgG,IgA,IgM (P<0.001).Multivariate stepwise regression analysis showed that there was a linear regression relationship between Hb,TSF,AMC,ALB,RBP,and NRS2002 score.Conclusion The nu-tritional status and immune function of patients with high nutritional risk decompensated cirrhosis are poor.It is necessary to carry out nutritional intervention in patients with high nutritional risk decompensated cirrhosis in time.