OBJECTIVE To systematically identify the dilemmas in value assessment of antitumor combination therapies， and to provide evidence for health insurance coverage， drug pricing， and clinical decision-making. METHODS The concept of “surplus value space” was introduced to cons truct a value assessment framework， under which the dilemmas in three assessment scenarios were analyzed. Optimization recommendations were proposed by drawing on international research addressing similar challenges. RESULTS & CONCLUSIONS The core dilemma of value assessment for antitumor combination therapies lies in insufficient surplus value space. When the cost of the backbone therapy exceeds its corresponding health value， the add-on drug encounters a “free but uneconomical”problem. Existing international value assessment methods have limitations such as flawed evaluation frameworks， difficulty in operationalizing the quality-adjusted life year allocation framework， and frequent occurrence of the “free but uneconomical”problem， rendering them inadequate for the complex scenarios of antitumor combination therapies. To address these dilemmas， strategies such as adjusting payment thresholds， exploring discounted pricing， conducting multi-product linkage negotiations， and delaying insurance access are recommended to improve the rationality and feasibility of value assessment for antitumor combination therapies.

Objective:To establish an ion chromatography-integrated amperometric detection method for iodide in water.Methods:After the water sample was filtered through a filter membrane, the AS 11-HC anion chromatography column of ion chromatography method was used to separate iodide ions under the conditions of 70 mmol/L sodium hydroxide solution as the eluent, injection volume of 100 μl, column temperature of 30 ℃, and flow rate of 1.0 ml/min. The results were determined by silver working electrode integral amperometric detection method. Under the optimized experimental conditions, methodological evaluations such as method calibration curves, detection limits, quantification limits, precision, and accuracy were conducted.Results:Iodide followed a square correction curve within the concentration range of 0 - 100 μg/L, with a correlation coefficient ( r) > 0.999 9. The detection limit of the method was 0.30 μg/L, and the quantification limit was 1.00 μg/L. The determination results of the national standard substances GBW09113f and GBW09114f for iodine composition analysis in water were within the reference range [(8.4 ± 1.2), (55 ± 6) μg/L]. The recovery rates of low, medium, and high concentration spiked samples with low background values ranged from 91.7% to 97.2%, and the relative standard deviation ranged from 0.40% to 1.60%. Conclusion:This method has the characteristics of simple water sample pretreatment, high sensitivity, and good accuracy, which can meet the determination of trace iodides in bulk water samples for iodine deficiency disorders monitoring.

The aim of this study was to identify the Salmonella strains isolated from an outbreak of foodborne illness in a seafood buffet restaurant and analyze their pathogenic characteristics.Epidemiological data,fecal samples from patients and chefs,and food/environmental samples from the restaurant were analyzed.Research methods included bacterial culture,serotyping,quadruple fluo-rescence PCR identification,whole-genome sequencing and antibiotic susceptibility testing.The results showed that 4 S.Java strains(serotype 1,4,12∶b∶1,2;ST42)were isolated from two outbreak cases and two sporadic cases.All isolates exhibited similar genomic features,harboring 9 virulence islands and 98 virulence genes.Antimicrobial resistance profiling revealed streptomycin monoresis-tance,mediated by aac(6′)-Iy and aac(6′)-Iaa genes.In conclusion,this event was the first reported outbreak of foodborne illness caused by S.Java in China,indicating that S.Java may be prevalent in the surveyed district.The catering industry should optimize food handling and processing procedures and enhance the surveillance of high risk pathogens.Meanwhile,further studies should ad-dress differential diagnosis and pathogenic mechanism differences between S.Java and S.paratyphi B,which will facilitate evidence-based monitoring in China.

The aim of this study was to identify the Salmonella strains isolated from an outbreak of foodborne illness in a seafood buffet restaurant and analyze their pathogenic characteristics.Epidemiological data,fecal samples from patients and chefs,and food/environmental samples from the restaurant were analyzed.Research methods included bacterial culture,serotyping,quadruple fluo-rescence PCR identification,whole-genome sequencing and antibiotic susceptibility testing.The results showed that 4 S.Java strains(serotype 1,4,12∶b∶1,2;ST42)were isolated from two outbreak cases and two sporadic cases.All isolates exhibited similar genomic features,harboring 9 virulence islands and 98 virulence genes.Antimicrobial resistance profiling revealed streptomycin monoresis-tance,mediated by aac(6′)-Iy and aac(6′)-Iaa genes.In conclusion,this event was the first reported outbreak of foodborne illness caused by S.Java in China,indicating that S.Java may be prevalent in the surveyed district.The catering industry should optimize food handling and processing procedures and enhance the surveillance of high risk pathogens.Meanwhile,further studies should ad-dress differential diagnosis and pathogenic mechanism differences between S.Java and S.paratyphi B,which will facilitate evidence-based monitoring in China.

Objective:To establish an ion chromatography-integrated amperometric detection method for iodide in water.Methods:After the water sample was filtered through a filter membrane, the AS 11-HC anion chromatography column of ion chromatography method was used to separate iodide ions under the conditions of 70 mmol/L sodium hydroxide solution as the eluent, injection volume of 100 μl, column temperature of 30 ℃, and flow rate of 1.0 ml/min. The results were determined by silver working electrode integral amperometric detection method. Under the optimized experimental conditions, methodological evaluations such as method calibration curves, detection limits, quantification limits, precision, and accuracy were conducted.Results:Iodide followed a square correction curve within the concentration range of 0 - 100 μg/L, with a correlation coefficient ( r) > 0.999 9. The detection limit of the method was 0.30 μg/L, and the quantification limit was 1.00 μg/L. The determination results of the national standard substances GBW09113f and GBW09114f for iodine composition analysis in water were within the reference range [(8.4 ± 1.2), (55 ± 6) μg/L]. The recovery rates of low, medium, and high concentration spiked samples with low background values ranged from 91.7% to 97.2%, and the relative standard deviation ranged from 0.40% to 1.60%. Conclusion:This method has the characteristics of simple water sample pretreatment, high sensitivity, and good accuracy, which can meet the determination of trace iodides in bulk water samples for iodine deficiency disorders monitoring.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.

Objective To explore the relevant relationship and specificity between the implicit and explicit loyalty of military cadets in order to provide a theoretical basis and objective indicators for a more comprehensive and objective assessment for individual loyalty.Methods E-Prime 2.0,a classic implicit association paradigm was employed to construct an implicit association loyalty test for 64 military cadets.Simultaneously,an explicit loyalty measurement was conducted using the Chinese Military Personnel Loyalty Scale.Results ① Significant implicit effect was observed in the loyalty assessment of military cadets,indicating a general tendency to perceive higher levels of personal loyalty and lower levels of loyalty to external entities.② Explicit loyalty assessment revealed that the participants had the highest loyalty score towards the Party,the Nation,and the People(4.79±0.34),followed by the loyalty score to their profession(4.38±0.53),and the relatively lower loyalty score towards the unit and leaders(4.03±0.83).Among the 3 dimensions of loyalty,the normative loyalty score ranked highest,while continuance loyalty score took lower.③ There were no correlations among the scores of loyalty to the Party,the Nation,and the People(r=-0.030,P=0.823),to the profession(r=-0.047,P=0.728),to the unit(r=0.050,P=0.710),or to the leaders(r=0.043,P=0.749).Conclusion The implicit effect in the loyalty assessment is significant in military cadets,and there is no significant correlation between explicit and implicit loyalty measurements.Thus,we cannot rely solely on explicit measurements to assess their loyalty attitudes.

Objective:To investigate the effects of bunched cognitive behavior intervention on disease fear and psychological security in patients with glioma.Methods:A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enrollment, all subjects were divided into research group( n=44)and control group( n=48). The patients in control group received routine medical and nursing intervention, and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention, including 4 intervention cycles.At enrollment, 2 weeks after intervention, and 4 weeks after intervention, all subjects were evaluated by the fear of progression questionnaire-short form (FoP-Q-SF), safety questionnaire (SQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF, SQ, SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups. Results:(1)The total FoP-Q-SF score, physiological health dimension scores, and social family dimension scores of the two groups showed significant interaction effects before and after intervention ( F=254.839, 52.738, 12.237, all P<0.05). Further simple effect analysis showed that after 2 and 4 weeks of intervention, the FoP-Q-SF scores of the research group (2 weeks after intervention: 33.80±4.94, 36.48±4.04; 4 weeks after intervention: 31.25±4.55, 35.94±4.47) and social family dimensions (2 weeks after intervention: 15.32±2.56 points, 17.06±2.14; 4 weeks after intervention: 14.05±2.59, 16.96±1.99) were lower than those of the control group (all P<0.05). The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention (4 weeks after intervention: 17.30±2.92, 19.06±2.38) ( P<0.05). After 4 weeks of intervention, the FoP-Q-SF score, physiological health dimension score, and social family dimension score of the research group were all lower than those at 2 weeks after intervention and before intervention (all P<0.05). (2)The total SQ score, interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention( F=193.129, 54.706, 44.015, all P<0.05). Further simple effect testing showed that after 2 and 4 weeks of intervention, the total SQ score and interpersonal security score of the research group were higher than those of the control group (all P<0.05). The determined control score of the research group was higher than that of the control group after 4 weeks of intervention ( P<0.05). After 2 and 4 weeks of intervention, the total SQ score, interpersonal security score, and determination control score of the research group were higher than before intervention (all P<0.05), and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention (both P<0.05). (3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention( F=237.867, 282.882, both P<0.05). Further simple effect analysis showed that after 2 and 4 weeks intervention, the SAS and SDS scores of the research group were lower than those of the control group (all P<0.05). The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention (all P<0.05). The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention (both P<0.05). Conclusion:Bundled cognitive behavioral intervention can improve disease fear and negative emotions in patients with glioma, and enhance psychological security.

Objective:To explore the effectiveness of bundled cognitive-behavior intervention in postoperative patients with glioma.Methods:From January 2022 to June 2023, convenience sampling was used to select 95 patients with glioma who underwent surgical treatment at the Neurosurgery Department of Affiliated Hospital of Jining Medical University as subjects. The patients were divided into an observation group and a control group based on the order of enrollment. The control group received routine medical nursing intervention, while the observation group received bundled cognitive-behavior intervention on the basis of control group. The scores of the Chinese-Strategies Used by People to Promote Health (C-SUPPH), Short Form Health Survey (SF-36), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were compared between two groups of patients at different time points before and after intervention.Results:Repeated measures analysis of variance showed that there were intergroup, time, and interaction effects between the C-SUPPH, SF-36, SAS, and SDS scores of the two groups, and the differences were statistically significant (all P<0.05). At 1, 3, and 6 months after discharge, the C-SUPPH and SF-36 scores in observation group were lower than those in control group, and the differences were statistically significant (all P<0.05). At 3 and 6 months after discharge, the SAS and SDS scores of the observation group were lower than those of the control group, and the differences were statistically significant (all P<0.05) . Conclusions:Bundled cognitive-behavior intervention can increase the self-management efficacy of postoperative glioma patients, improve their quality of life, and alleviate their anxiety and depression.

Glycogen storage disease (GSD) is a rare autosomal recessive inherited disease in clinic. The paper reported a case of GSD Ⅰ a diagnosed by genetic testing, who had been experiencing numerous joint pains for 4 years, and had increased serum creatinine and severe high lactic acid metabolic acidosis. The serum creatinine declined and acidosis recovered after active fluid therapy and acidosis correction. The paper summarized the characteristics of this GSD patient with renal insufficiency and the relevant literature contents, to improve the understanding of clinicians on the disease and treatment effect.