Numerous studies have shown that depression is main-ly associated with the abnormal expression of connexin 43(Cx43)in astrocytes(Astro)and its mediated dysfunction of gap junction(GJ).However,the molecular mechanism of post-translational modifications targeting Cx43 to regulate neuroin-flammation-associated depression is still unclear.Post-transla-tional modifications of Cx43 mainly include phosphorylation of specific amino acid sites by PKC,PKA,PKG,MAPK and PTK,and protein degradation of Cx43 through the K48/K63 polyubiq-uitylation and deubiquitination pathways,which ultimately lead to protein degradation through K48/K63 polyubiquitination and deubiquitination.These modifications are ultimately involved in the regulation of neuroinflammatory responses through the associ-ation of GJ function.In this paper,we systematically review the role of Cx43 post-translational modifications in neuroinflamma-tion,with the aim of further exploring the potential application of targeting these modifications to modulate the inflammatory re-sponse mechanism in improving depressive symptoms.

Objective To optimize the design of the existing water conductivity control system for pharmaceutical water equipment of full membrane process so as to solve its problems in precision and long cycle time due to water source,ambient temperature and intermittent working mode.Methods The optimized water conductivity control system was composed of an alkali metering pump,a conductivity sensor and a programmable logic controller(PLC),which used a fuzzy proportional-integral-derivative(PID)controller to regulate the water conductivity of pharmaceutical water equipment of full membrane process,and the particle swarm optimization(PSO)algorithm to optimize the parameters of the fuzzy PID controller.A simulation model was established with MATLAB software to verify the performance of the optimized control system.Results Simulation results showed the optimized control system had reductions in overshoot(by 19％)and adjustment time(by 29％)when compared with the fuzzy PID control system,and enhanced control efficiency effectively.Conclusion The optimized control system optimized by the PSO algorithm improves the quality of produced water,and can meet the demands for rapid and safe production of pharmaceutical water by pharmaceutical water equipment of full membrane process in different conditions.[Chinese Medical Equipment Journal,2025,46(6):14-19]

BACKGROUND:Studies have shown that vascular factors have an important impact on the occurrence of diabetic foot.OBJECTIVE:To investigate the important role of angiopoietin-like protein 4 in the formation of diabetic foot.METHODS:(1)Bioinformatics analysis was performed on the gene expression profile data of diabetic foot patients to find the key genes.The skin samples of diabetic foot patients and healthy people were collected for hematoxylin-eosin staining,immunohistochemical staining,and qRT-PCR experiments to detect the expression of angiopoietin-like protein 4.(2)The immortalized human skin fibroblast cell line and primary human umbilical vein endothelial cells were cultured.The two kinds of cells were divided into control group and exogenous angiopoietin-like protein 4 supplemented group.The migration ability and proliferation ability of fibroblasts were detected by scratch assay and CCK-8 assay.The proliferation ability of endothelial cells was detected by Ki67 assay.RESULTS AND CONCLUSION:(1)Bioinformatics analysis results showed that the down-regulation of angiopoietin-like protein 4 gene might be the key gene leading to the formation of diabetic foot.(2)Hematoxylin-eosin staining exhibited that compared with normal skin,angiopoietin-like protein 4 was weakly expressed in diabetic foot skin,and the mRNA level was decreased(P＜0.01).(3)Scratch assay results demonstrated that compared with the control group,fibroblast migration ability was significantly enhanced in the angiopoietin-like protein 4 group.CCK-8 assay showed that the absorbance value of fibroblasts in the angiopoietin-like protein 4 group was higher than that of the control group at 24 and 48 hours(P＜0.01,P＜0.001).It is suggested that angiopoietin-like protein 4 can enhance the migration and proliferation of fibroblasts.(4)Ki67 assay results demonstrated that the number of Ki67 positive cells in the angiopoietin-like protein 4 group was significantly more than that in the control group.CCK-8 assay results showed that the absorbance value of endothelial cells in the angiopoietin-like protein 4 group was higher than that of the control group at 24 and 48 hours(P＜0.05,P＜0.001).(5)All findings suggest that angiopoietin-like protein 4 can enhance the proliferation of endothelial cells treated with high glucose.

Numerous studies have shown that depression is main-ly associated with the abnormal expression of connexin 43(Cx43)in astrocytes(Astro)and its mediated dysfunction of gap junction(GJ).However,the molecular mechanism of post-translational modifications targeting Cx43 to regulate neuroin-flammation-associated depression is still unclear.Post-transla-tional modifications of Cx43 mainly include phosphorylation of specific amino acid sites by PKC,PKA,PKG,MAPK and PTK,and protein degradation of Cx43 through the K48/K63 polyubiq-uitylation and deubiquitination pathways,which ultimately lead to protein degradation through K48/K63 polyubiquitination and deubiquitination.These modifications are ultimately involved in the regulation of neuroinflammatory responses through the associ-ation of GJ function.In this paper,we systematically review the role of Cx43 post-translational modifications in neuroinflamma-tion,with the aim of further exploring the potential application of targeting these modifications to modulate the inflammatory re-sponse mechanism in improving depressive symptoms.

Objective:To analyze the synergistic relationship between financing and payment systems in China's urban employee basic medical insurance under the background of aging,providing decision-making basis for promoting coordinated development of these two systems.Methods:Based on statistical yearbook data from medical security systems,the Delphi method was employed to identify collaborative analysis indicators for urban employee medical insurance financing and payment under the aging population context.A collaborative theory-based model was constructed to measure the coordination degree of China's urban employee medical insurance financing and payment composite system,while simultaneously assessing the orderliness of the financing and payment system and the coordination degree of the composite system.Results:The order degree of the financing system ranged from 0.324 in 2019 to 0.517 in 2023;the order degree of the payment system ranged from 0.454 in 2019 to 0.517 in 2023;the synergy degree of both systems reached-0.084 in 2023.Conclusions:Influenced by aging,the development speed and scale of China's urban employee basic medical insurance financing system and payment system are asynchronous,with the payment system being more affected than the financing system,resulting in a non-coordinated and disordered development state of the composite financing-payment system.

AIM:To investigate the effects of emo-din on autophagy and apoptosis in rats with severe pneumonia(KP)caused by K.pneumoniae and its possible mechanism.METHODS:The KP rat model was established by infecting K pneumonia was treat-ed with Emodin.The rats were grouped into Sham surgery group,KP group,low concentration Emodin group,medium concentration Emodin group,high concentration Emodin group,and Emodin+sirtinol(SIRT1 activity inhibitor)group;Arterial partial pres-sure of carbon dioxide(PaCO2),arterial partial pres-sure of oxygen(PaO2)and arterial oxygen saturation(SaO2)were measured by blood gas analyzer;the white blood cells and neutrophils in bronchoalveo-lar lavage fluid(BALF)were measured by Wright-Gi-emsa staining;HE staining was applied to detect pathological changes in lung tissue in each group;ELISA was applied to detect the expression of IL-6,TNF-α,and IL-1β in lung tissues of each group;elec-tron microscopy scanning was applied to observe the autophagy of cells in lung tissues of each group;the expression of LC3B in lung tissues was observed by immunofluorescence staining;TUNEL method was applied to detect changes in cell apoptosis in lung tissue of rats in each group;Western blot was applied to detect the expression of silent informa-tion regulatory factor(SIRT1),adenosine monophos-phate activated protein kinase(AMPK),LC3-Ⅱ,LC3-Ⅰ,c-caspase-3,and caspase-3 proteins in lung tissue.RESULTS:K.pneumoniae caused severe lung tissue damage in rats with pneumonia,increased inflam-matory infiltration and cytokine release in the lungs,arterial blood PaO2 and SaO2 levels de-creased,PaCO2 levels increased,white blood cells and neutrophils count increased in BALF,increased cell apoptosis rate and c-caspase-3/caspase-3 level,and the cell autophagy and the levels of autophagy related proteins LC3-Ⅱ/LC3-Ⅰ were decreased(all P＜0.05),after Emodin treatment,SIRT1/AMPK signal-ing pathway was activated,PaO2 and SaO2 levels in arterial blood were increased,PaCO2 levels was de-creased,inflammatory reaction was inhibited,cell apoptosis in lung tissue was inhibited(all P＜0.05),and cell autophagy level was restored,sirtinol,a SIRT1 inhibitor,partially reversed the therapeutic ef-fect of Emodin on KP rats after inhibiting SIRT1/AMPK signaling pathway(P＜0.05).CONCLUSION:Emodin may enhance autophagy of lung tissue cells and inhibit apoptosis of rat lung tissue cells by acti-vating SIRT1/AMPK pathway,which may provide po-tential therapeutic options for KP.

Objective:To systematically evaluate the current financing status of Beijing's urban and rural residents'basic medical insurance,analyze equity disparities among different groups under the existing flat-rate financing policy.By simulating the equity changes of various financing schemes with different contribution rates,this study aims to provide foundations for advancing medical insurance financing system reform.Methods:Based on the per capita disposable income and number of insured residents in Beijing's 16 districts from 2018 to 2023,we separately calculated the Gini coefficient,concentration index,and Kakwani index,along with their changes before and after financing adjustments,to assess the funding burden among different insured groups.Using the geometric mean method,we projected per capita disposable income and insured populations for each district in Beijing from 2024 to 2035,simulating various financing schemes under different premium rate systems.Results:From 2018 to 2023,the Gini coefficient of net income after financing consistently exceeded that of original income before financing.The concentration index remained positive and showed an upward trend,while the Kakwani index was negative for all periods.The Gini coefficient after financing slightly decreased for the elderly and working populations with fiscal subsidy support,whereas it remained higher than that for students and children.Under the simulated differentiated rate system,the post-funding Gini coefficient for 2024-2035 was lower than the original value,and the Kakwani index was positive.Conclusions:The current fixed-amount financing mechanism for urban and rural residents'basic medical insurance exhibits regressive characteristics and insufficient fairness,with disparities in equity among different insured groups.It is necessary to establish differentiated financing standards based on differential rates,particularly implementing a financing mechanism with dynamic adjustments according to regional and group income levels,to enhance the fairness of financing for urban and rural residents'basic medical insurance.

Objective To estimate the prevalence of calcified nodule(CN)among patients with coronary artery disease(CAD)and identify the possible risk factors associated with an increased CN risk.Methods Databases include PubMed,Web of Science and Embase was conducted to identify studies reporting the prevalence and/or risk factors of CN.For this databases,the search was from inception to January 1,2024.Data analyses was performed using R statistical Software 4.2.2.Results A total of 46 studies involving 17 926 patients were included.Among them,13 studies with 4 187 patients reported both the prevalence and associated risk factors.The overall prevalence of CN was found to be 5.72％(95％CI 4.47％-7.31％),while in studies reporting both the prevalence and risk factors,the CN prevalence was slightly higher at 8.72％(95％CI 6.43％-11.71％).Hypertension(OR 1.75,95％CI 1.29-2.37),diabetes(OR 1.84,95％CI 1.46-2.33),chronic kidney disease(OR 2.50,95％CI 1.67-3.74),and hemodialysis(OR 7.77,95％CI 4.77-12.67)were associated with an elevated CN risk(all P＜0.001).Conversely,obesity(OR 0.39,95％CI 0.18-0.83)and history of smoking(OR 0.61,95％CI 0.47-0.80)were linked to a decreased CN risk(both P＜0.05).Conclusions The overall prevalence of CN is relatively low among patients with CAD.However,the prevalence of CN is influenced by a variety of clinical factors.Further research is warranted to elucidate the underlying mechanisms.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

BACKGROUND:Studies have shown that vascular factors have an important impact on the occurrence of diabetic foot.OBJECTIVE:To investigate the important role of angiopoietin-like protein 4 in the formation of diabetic foot.METHODS:(1)Bioinformatics analysis was performed on the gene expression profile data of diabetic foot patients to find the key genes.The skin samples of diabetic foot patients and healthy people were collected for hematoxylin-eosin staining,immunohistochemical staining,and qRT-PCR experiments to detect the expression of angiopoietin-like protein 4.(2)The immortalized human skin fibroblast cell line and primary human umbilical vein endothelial cells were cultured.The two kinds of cells were divided into control group and exogenous angiopoietin-like protein 4 supplemented group.The migration ability and proliferation ability of fibroblasts were detected by scratch assay and CCK-8 assay.The proliferation ability of endothelial cells was detected by Ki67 assay.RESULTS AND CONCLUSION:(1)Bioinformatics analysis results showed that the down-regulation of angiopoietin-like protein 4 gene might be the key gene leading to the formation of diabetic foot.(2)Hematoxylin-eosin staining exhibited that compared with normal skin,angiopoietin-like protein 4 was weakly expressed in diabetic foot skin,and the mRNA level was decreased(P＜0.01).(3)Scratch assay results demonstrated that compared with the control group,fibroblast migration ability was significantly enhanced in the angiopoietin-like protein 4 group.CCK-8 assay showed that the absorbance value of fibroblasts in the angiopoietin-like protein 4 group was higher than that of the control group at 24 and 48 hours(P＜0.01,P＜0.001).It is suggested that angiopoietin-like protein 4 can enhance the migration and proliferation of fibroblasts.(4)Ki67 assay results demonstrated that the number of Ki67 positive cells in the angiopoietin-like protein 4 group was significantly more than that in the control group.CCK-8 assay results showed that the absorbance value of endothelial cells in the angiopoietin-like protein 4 group was higher than that of the control group at 24 and 48 hours(P＜0.05,P＜0.001).(5)All findings suggest that angiopoietin-like protein 4 can enhance the proliferation of endothelial cells treated with high glucose.