Objective To explore the long-term and short-term therapeutic effects and mechanisms of electroacupuncture at Baihui(GV20)point and Dazhui(GV14)point in rats with ischemic stroke.Methods Thirty rats were randomly divided into a sham-operated group,a model group,and an electroacupuncture group,with 10 rats in each group.The model group and the electroacupuncture group were subjected to middle cerebral artery occlusion(MCAO)using the modified Longa method.The electroacupuncture group received electroacupuncture at Baihui point and Dazhui point once daily for one week.Long-term neurological recovery was assessed using the adhesive removal test and the forelimb placement test at 14,21 and 28 days after MCAO.On the second day after MCAO,cerebral cortical histopathological changes were observed using transmission electron microscopy,the expression of Iba-1 in cortical tissue was detected by immunofluorescence,and the expression levels of hypoxia-inducible factor 1α(HIF-1α),vascular endothelial growth factor(VEGF),interleukin 1β(IL-1β),and tumor necrosis factor α(TNF-α)in cortical tissue were measured by Western Blot.Results(1)Compared with the sham-operated group at the same time points,the model group showed prolonged adhesive removal time and increased forelimb stepping times at 14,21 and 28 days after MCAO(P＜0.05).Compared with the model group at the same time points,the electroacupuncture group exhibited significantly shortened adhesive removal time and reduced forelimb stepping times at 14,21 and 28 days after MCAO(P＜0.05).Within 28 days after MCAO,the adhesive removal time was gradually decreased,and forelimb stepping times were gradually reduced.(2)On the second day after MCAO:compared with the sham-operated group,the model group showed degeneration and necrosis of microglia in cortical ischemic penumbra,mitochondrial damage,increased expression of Iba-1 in cortical tissue,and elevated levels of HIF-1α,VEGF,IL-1β and TNF-α,with statistically significant differences(P＜0.05).Compared with the model group,the electroacupuncture group exhibited the improvement of microglia injury in cortical ischemic penumbra,reduced expression of Iba-1 in cortical tissue and decreased levels of HIF-1α,VEGF,IL-1β and TNF-α,with statistically significant differences(P＜0.05).Conclusion Electroacupuncture at Baihui point and Dazhui point can improve symptoms in rats with ischemic stroke in the long term and ameliorate degeneration and necrosis of cortical microglia in the ischemic penumbra in the short term.The mechanism may be related to the downregulation of HIF-1α,VEGF,IL-1β and TNF-α expressions in cerebral cortical tissue and the inhibition of microglial transformation to the M1 phenotype.

Objective:To evaluate the effects of nasal endoscopy in curettage of large mandibular cyst.Methods:20 cases of large mandibular cyst admitted to Xianyang Hosptial of Yan'an University from January 2022 to December 2023 were included.The curet-tage of mandibular cyst was performed under general anesthesia through intraoral incision by nasal endoscopy-assisted illumination and enlargement of the lesion area during the operation.The application effects were evaluated from the aspects of surgical incision length,nerve injury and cyst recurrence.Results:During operation,the surgical filed of view was clear and the operation was suc-ceeded in all cases.There was no complication in and after the nasal endoscopy-assisted curettage,no cyst recurrence was observed during 1-year follow-up.Conclusion:Nasal endoscopy-assisted curettage of large mandibular cyst is effective and safe.

Objective:To develop an EGFR-targeting nanobody engineered exosome drug delivery system and evaluate its antitumor efficacy for colorectal cancer.Methods:The HEK293T cell line stably expressing the pan-cancer inhibitor miR-204-5p, previously established by our group, was selected as a tool cell line to prepare miR-204-5p-enriched exosomes. Using metabolic glycoengineering combined with bioorthogonal reaction strategy, these exosomes were modified with the EGFR-specific nanobody 7D12. Western blot, electron microscopy, and dynamic light scattering were used to characterize the engineered exosomes. The tumor target potential of engineered exosomes was evaluated using immunofluorescence and RT-qPCR. The in vitro anti-tumor activities of engineered exosomes were evaluated using cell growth curves, colony formation, Transwell, and apoptosis analyses. The in vivo anti-tumor activity and safety of engineered exosomes were evaluated using a nude mouse xenograft tumor model. Results:The particle size of 7D12-hExo was (116.8±36.8) nm, with a potential of around -10 mV, and there was no significant change compared with the unmodified hExo. Immunofluorescence assay showed that the fluorescence intensity of the hExo group, 7D12-hExo group, and 7D12+7D12-hExo group were 48.4±3.9, 141.0±6.6, and 38.7±3.2 in EGFR + HCT116 cells, respectively. Compared with the hExo group, the fluorescence intensity of HCT116 cells in the 7D12-hExo group was significantly enhanced ( P＜0.05). Compared with the 7D12-hExo group, the fluorescence intensity in HCT116 cells in the 7D12+7D12-hExo group was significantly decreased ( P＜0.05). However, there was no significant difference in the uptake of hExo and 7D12-hExo in EGFR - SW620 colorectal cancer cells. The number of cell clones, invasion, and migration of HCT116 cells in the hExo (204) group was 215.0±14.0, 862.3±61.4, and 1 197.0 ± 36.7, respectively, with an apoptosis rate of (14.1±1.4)%. The number of cell clones, invasion, and migration of HCT116 cells in the 7D12-hExo (204) group was (65.0±15.1), (232.0±27.9), (725.7±32.7), respectively, with an apoptosis rate of (29.3±1.0)%. The 7D12-hExo (204) significantly inhibited the proliferation, invasion, and migration ability of HCT116 cells ( P＜0.05), resulting in promoting the apoptosis of HCT116 cells ( P＜0.05). Nude mouse experiments showed that 7D12-hExo (204) significantly inhibited the growth of tumors transplanted with HCT116 cells, with the inhibition rate being 82.8%. However, there was no significant change in mouse weight, and H&E staining of major organs such as heart, liver, spleen, lung, and kidney did not show any abnormalities. Conclusion:Naturally miR-204-5p-loaded exosomes were successfully modified with nanobody 7D12, which can efficiently deliver miR-204-5p into EGFR + tumor cells, thereby exerting good anti-tumor therapeutic effects.

Objective:To evaluate the effects of nasal endoscopy in curettage of large mandibular cyst.Methods:20 cases of large mandibular cyst admitted to Xianyang Hosptial of Yan'an University from January 2022 to December 2023 were included.The curet-tage of mandibular cyst was performed under general anesthesia through intraoral incision by nasal endoscopy-assisted illumination and enlargement of the lesion area during the operation.The application effects were evaluated from the aspects of surgical incision length,nerve injury and cyst recurrence.Results:During operation,the surgical filed of view was clear and the operation was suc-ceeded in all cases.There was no complication in and after the nasal endoscopy-assisted curettage,no cyst recurrence was observed during 1-year follow-up.Conclusion:Nasal endoscopy-assisted curettage of large mandibular cyst is effective and safe.

Objective:To develop an EGFR-targeting nanobody engineered exosome drug delivery system and evaluate its antitumor efficacy for colorectal cancer.Methods:The HEK293T cell line stably expressing the pan-cancer inhibitor miR-204-5p, previously established by our group, was selected as a tool cell line to prepare miR-204-5p-enriched exosomes. Using metabolic glycoengineering combined with bioorthogonal reaction strategy, these exosomes were modified with the EGFR-specific nanobody 7D12. Western blot, electron microscopy, and dynamic light scattering were used to characterize the engineered exosomes. The tumor target potential of engineered exosomes was evaluated using immunofluorescence and RT-qPCR. The in vitro anti-tumor activities of engineered exosomes were evaluated using cell growth curves, colony formation, Transwell, and apoptosis analyses. The in vivo anti-tumor activity and safety of engineered exosomes were evaluated using a nude mouse xenograft tumor model. Results:The particle size of 7D12-hExo was (116.8±36.8) nm, with a potential of around -10 mV, and there was no significant change compared with the unmodified hExo. Immunofluorescence assay showed that the fluorescence intensity of the hExo group, 7D12-hExo group, and 7D12+7D12-hExo group were 48.4±3.9, 141.0±6.6, and 38.7±3.2 in EGFR + HCT116 cells, respectively. Compared with the hExo group, the fluorescence intensity of HCT116 cells in the 7D12-hExo group was significantly enhanced ( P＜0.05). Compared with the 7D12-hExo group, the fluorescence intensity in HCT116 cells in the 7D12+7D12-hExo group was significantly decreased ( P＜0.05). However, there was no significant difference in the uptake of hExo and 7D12-hExo in EGFR - SW620 colorectal cancer cells. The number of cell clones, invasion, and migration of HCT116 cells in the hExo (204) group was 215.0±14.0, 862.3±61.4, and 1 197.0 ± 36.7, respectively, with an apoptosis rate of (14.1±1.4)%. The number of cell clones, invasion, and migration of HCT116 cells in the 7D12-hExo (204) group was (65.0±15.1), (232.0±27.9), (725.7±32.7), respectively, with an apoptosis rate of (29.3±1.0)%. The 7D12-hExo (204) significantly inhibited the proliferation, invasion, and migration ability of HCT116 cells ( P＜0.05), resulting in promoting the apoptosis of HCT116 cells ( P＜0.05). Nude mouse experiments showed that 7D12-hExo (204) significantly inhibited the growth of tumors transplanted with HCT116 cells, with the inhibition rate being 82.8%. However, there was no significant change in mouse weight, and H&E staining of major organs such as heart, liver, spleen, lung, and kidney did not show any abnormalities. Conclusion:Naturally miR-204-5p-loaded exosomes were successfully modified with nanobody 7D12, which can efficiently deliver miR-204-5p into EGFR + tumor cells, thereby exerting good anti-tumor therapeutic effects.

Objective:To assess the impact of health insurance packaged payment in medical communities on the economicburden of patients,income and satisfaction of medical staff in counties.Methods:Using sample data from 2018-2022 from the national monitoring counties of medical communities,taking 2020 as the year of implementation of packaged payment,a double difference model was constructed with county population density and county per capita GDP as the control variables to assess the impact of packaged payment on the economic burden of patients,medical staff income and satisfaction in the county.Results:The packaged payment policy reduced the economic burden of patients to a certain extent and had a statistically significant positive effect on medical staff income in 2021,but it did not significantly increase the satisfaction of both supply and demand.Conclusion:The implementation of health insurance packaged payment of the MEC will not increase the economic burden of patients.It has a good pro-poor effect,and the income of medical staff has been improved to some extent,but there is still room for optimisation and improvement of the policy.

Objective:To assess the impact of health insurance packaged payment in medical communities on the economicburden of patients,income and satisfaction of medical staff in counties.Methods:Using sample data from 2018-2022 from the national monitoring counties of medical communities,taking 2020 as the year of implementation of packaged payment,a double difference model was constructed with county population density and county per capita GDP as the control variables to assess the impact of packaged payment on the economic burden of patients,medical staff income and satisfaction in the county.Results:The packaged payment policy reduced the economic burden of patients to a certain extent and had a statistically significant positive effect on medical staff income in 2021,but it did not significantly increase the satisfaction of both supply and demand.Conclusion:The implementation of health insurance packaged payment of the MEC will not increase the economic burden of patients.It has a good pro-poor effect,and the income of medical staff has been improved to some extent,but there is still room for optimisation and improvement of the policy.

Objective:To assess the impact of health insurance packaged payment in medical communities on the economicburden of patients,income and satisfaction of medical staff in counties.Methods:Using sample data from 2018-2022 from the national monitoring counties of medical communities,taking 2020 as the year of implementation of packaged payment,a double difference model was constructed with county population density and county per capita GDP as the control variables to assess the impact of packaged payment on the economic burden of patients,medical staff income and satisfaction in the county.Results:The packaged payment policy reduced the economic burden of patients to a certain extent and had a statistically significant positive effect on medical staff income in 2021,but it did not significantly increase the satisfaction of both supply and demand.Conclusion:The implementation of health insurance packaged payment of the MEC will not increase the economic burden of patients.It has a good pro-poor effect,and the income of medical staff has been improved to some extent,but there is still room for optimisation and improvement of the policy.

Objective:To assess the impact of health insurance packaged payment in medical communities on the economicburden of patients,income and satisfaction of medical staff in counties.Methods:Using sample data from 2018-2022 from the national monitoring counties of medical communities,taking 2020 as the year of implementation of packaged payment,a double difference model was constructed with county population density and county per capita GDP as the control variables to assess the impact of packaged payment on the economic burden of patients,medical staff income and satisfaction in the county.Results:The packaged payment policy reduced the economic burden of patients to a certain extent and had a statistically significant positive effect on medical staff income in 2021,but it did not significantly increase the satisfaction of both supply and demand.Conclusion:The implementation of health insurance packaged payment of the MEC will not increase the economic burden of patients.It has a good pro-poor effect,and the income of medical staff has been improved to some extent,but there is still room for optimisation and improvement of the policy.

Objective:To assess the impact of health insurance packaged payment in medical communities on the economicburden of patients,income and satisfaction of medical staff in counties.Methods:Using sample data from 2018-2022 from the national monitoring counties of medical communities,taking 2020 as the year of implementation of packaged payment,a double difference model was constructed with county population density and county per capita GDP as the control variables to assess the impact of packaged payment on the economic burden of patients,medical staff income and satisfaction in the county.Results:The packaged payment policy reduced the economic burden of patients to a certain extent and had a statistically significant positive effect on medical staff income in 2021,but it did not significantly increase the satisfaction of both supply and demand.Conclusion:The implementation of health insurance packaged payment of the MEC will not increase the economic burden of patients.It has a good pro-poor effect,and the income of medical staff has been improved to some extent,but there is still room for optimisation and improvement of the policy.