Objective Against the backdrop of the country's initiative to channel high-quality medical resources to grassroots levels,the development model of public hospitals with multiple campuses has become a trend.This paper aims to pro-vide a reference for achieving the coordinated development of multiple campuses.Methods Taking the Traditional Chinese Med-icine Hospital Affiliated to Guangzhou Medical University as an example,this paper analyzed the patient satisfaction in public hospitals with multiple campuses,and studied the service differences and their causes from the perspective of patients' perception in different campuses.Results In 2024,the patient satisfaction scores of Tianhe,Zhuji,and Tongde branches were 89.15,89.91,and 88.71 respectively.For outpatient service satisfaction,the highest-scoring items were the consultation environment(91.19)at Tianhe branch,hospital services(91.99)at Zhuji branch,and the consultation process(89.35)at Tongde branch.Regarding inpatient service satisfaction,the highest scores in all three branches were for hospital management,while the lowest scores were for logistics services.Conclusion There are differences in patient satisfaction among different branches.There are significant differences in outpatient services among the branches.The satisfaction scores of non-medical services such as the envi-ronment and process in Tianhe branch are relatively high,while the scores of hospital services in Zhuji branch and Tongde branch are relatively high.However,the evaluations of inpatient services among the branches are relatively consistent.The satisfaction scores,from high to low,are in the order of hospital management＞diagnosis and treatment services＞consultation process＞inpatient environment＞logistics services.

The aim of this study is to establish an gene editing method of Mesomycoplasma hyo-pneumoniae(Mhp)based on the homologous recombination principle.The restriction enzyme di-gestion and ligation method combined with gene synthesis were used to construct a shuttle plasmid to achieve replication in both Mhp and Escherichia coli(E.coli).The pGEM?-T vector was used as the skeleton.The oriC sequence of Mhp which can achieve the replication of the plasmid in Mhp was inserted into the vector.Sequences of the Spiroplasma promoter and puromycin resistance gene were then inserted into the above constructed plasmid to screen recombinant clones.The up-stream and downstream homologous arms of p97 were constructed to initiate homologous recombination.The recA gene of E.coli is inserted to improve the efficiency of homologous recom-bination.The obtained shuttle plasmid was then delivered into Mhp by electro-transformation or chemical transformation.A shuttle plasmid,pGEM?-Mhp-oriC-p 97,which can replicate in both Mhp and E.coli was constructed.With the transformation of this plasmid,the carried puromycin gene and recA gene can be expressed,the p97 gene can be edited.Finally,the genetically unstable p97 gene mutant was initially obtained.In this study,a tool for Mhp gene editing based on the principle of homologous recombination was established,which laid a foundation for the develop-ment of tools for studying the pathogenesis of Mhp.

Objective:To explore the association between mouth breathing (MB) and functional speech sound disorders (FSSDs) in children, aiming to establish a novel theoretical basis for FSSD interventions.Methods:Eighty-nine children with an FSSD aged 4-12 years formed the FSSD group, while eighty-five age-matched healthy children served as controls. Their clinical data were processed using independent sample t-tests and chi-square tests to test for any significant differences between the two groups in terms of gender, age, mouth breathing status, post-frenotomy condition, Mandarin exposure before age 4, and delayed speech onset. Multivariate logistic regressions were evaluated to identify risk factors for FSSD in such children and to seek any association between mouth brea-thing and FSSD.Results:The regression analysis identified the following risk factors for childhood FSSD, ranked by odds ratio ( OR) magnitude: mouth breathing (adjusted OR=22.168, 95% CI=7.849-62.608, P≤0.01), delayed speech onset (adjusted OR=20.091, 95% CI=4.812-83.878, P≤0.01), age (a protective effect) (adjusted OR=0.979, 95% CI=0.962-0.997, P≤0.05). Univariate analysis of mouth breathing and associated factors revealed significant associations of FSSD with mouth breathing (χ 2=52.15, P≤0.01) and delayed speech onset (χ 2=25.873, P≤0.01). Conclusions:The significant risk factors for childhood functional speech sound disorders are mouth breathing (showing the highest adjusted OR), delayed speech onset and age. These findings suggest that early screening and therapeutic interventions for mouth breathing should be clinically prioritized to minimize FSSD risk.

Objective To evaluate the diagnostic value of shear wave dispersion(SWD)in preoperative assessment of liver fibrosis in patients with hepatocellular carcinoma(HCC).Methods A total of 62 patients with HCC who were admitted to the hospital between January 2022 and January 2024 were included in this study.All patients underwent shear wave elastography(SWE)examination prior to hepatectomy.The extent of liver fibrosis was assessed based on surgical and pathological findings.Patients were categorized into two groups:a low-grade fibrosis group(stages S0-S2)and a high-grade fibrosis group(stages S3-S4).Baseline characteristics and liver parenchymal SWE values were compared between the two groups.Multivariate logistic regression analysis was conducted to identify factors influencing the degree of liver fibrosis in HCC patients.The diagnostic performance of SWE in preoperative evaluation of liver fibrosis was assessed using receiver operating characteristic(ROC)curve analysis.Results Among the 62 patients with HCC,pathological results indicated that there were 11,13,20,and 18 cases in fibrosis stages S1,S2,S3,and S4,respectively.The SWD values of liver parenchyma significantly differed among patients with varying degrees of liver fibrosis.As the severity of liver fibrosis increased,the SWD of liver parenchyma also increased(P<0.05).Spearman correlation analysis revealed a positive correlation between the SWD value of liver parenchyma and the degree of liver fibrosis in preoperative HCC patients(r=0.608,P<0.05).Platelet count(PLT)was lower in the high-grade fibrosis group compared to the low-grade fibrosis group(P<0.05).Additionally,both the S index and SWD value of liver parenchyma were higher in the high-grade fibrosis group than in the low-grade fibrosis group(P<0.05).Multivariate logistic regression analysis demonstrated that the S index and SWD value were independent influencing factors for the degree of liver fibrosis in preoperative HCC patients(P<0.05).ROC curves showed that the area under the curve(AUC)of the SWD value was greater than that of the S index for assessing the degree of liver fibrosis in preoperative HCC patients(P<0.05).The cutoff value,sensitivity,and specificity of the SWD value for assessing the degree of liver fibrosis were 16.25 m/s·kHz-1,65.79%,and 95.83%,respectively.Conclusion The SWD value of liver parenchyma is closely associated with the extent of liver fibrosis in patients with HCC and provides a highly valuable assessment of the degree of liver fibrosis.

Objective To introduce an information system into the medical waste collection and transportation manage-ment process in medical and health institutions and assess its impact on collection and transportation.Methods The relevant in-dex data,such as the total amount of medical waste,per capita waste output,and handover weight error rate of a certain tertiary hospital in Guangzhou,were compared between pre-and post-introduction of the information system.Results After the intro-duction of the system,the total output of medical waste decreased by 2％year-on-year,the average daily output of medical waste per hospital bed decreased by 13％year-on-year,and the error rate between the in-hospital transfer volume and the waste disposal by medical waste companies decreased from 4.54％to 0.47％.Conclusion The medical waste treatment information system can improve the accuracy of collection and transportation data,and reduce medical wastes,thereby improving the management of medical waste treatment,and enhancing the collection and transportation efficiency of medical wastes.

Objective:To evaluate the role of hippocampal activating transcription factor 5 (ATF5) in cognitive impairment induced by neuropathic pain and the relationship with mitochondrial unfolded protein response(mtUPR) in mice.Methods:This study was conducted in 2 parts. Experiment Ⅰ Twenty-four SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 2 groups ( n=12 each) using a random number table method: sham operation group (S1 group) and neuropathic pain group (NP group). Neuropathic pain was induced by chronic constriction injury to the sciatic nerve. The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before developing the model and at 7, 14, 21 and 28 days after developing the model. Mouse cognitive function was assessed using the novel object recognition test from 30-31 days after developing the model. After the end of the novel object recognition test, mice were sacrificed and the hippocampal CA1 region was harvested for determination of the expression of ATF5 (by Western blot) and the expression of ATF5 in neurons, microglia and astrocytes (by immunofluorescence double staining). Experiment Ⅱ Thirty-six SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 3 groups ( n=12 each) using a random number table method: sham operation group (S2 group), neuropathic pain + ATF5 up-regulation group (NA group), and neuropathic pain + empty virus group (NE group). On day 14 after developing the model, a virus that specifically up-regulated ATF5 expression in neurons and empty virus were injected into the hippocampal CA1 region. The MWT and TWL were measured at days 28 and 35 after developing the model. The novel object recognition test was performed on day 36 after developing the model to evaluate the cognitive function. After the end of the behavioral test, mice were sacrificed and the hippocampal CA1 region was harvested for detection of the expression of ATF5 and mtUPR marker proteins (Lon protease [LONP1] and heat shock protein 60 [HSP60]) by Western blot. Results:Experiment Ⅰ Compared with S1 group, no statistically significant change was found in the MWT and TWL before developing the model ( P>0.05), the MWT and TWL were significantly decreased on days 7, 14, 21 and 28 after developing the model, the discrimination index (DI) was decreased at day 31 after developing the model, the expression of ATF5 was down-regulated, the expression of ATF5 in neurons was down-regulated ( P<0.05), and no statistically significant change was found in the expression of ATF5 in mircrolia and astrocytes in NP group ( P>0.05). Experiment Ⅱ Compared with S2 group, the MWT and TWL were significantly decreased on days 28 and 35 after developing the model in NE group and NA group, DI was decreased, and the expression of ATF5, LONP1 and HSP60 was down-regulated in NE group ( P<0.05), and no significant change was found in NA group ( P>0.05). Compared with NE group, no significant change was found in the MWT and TWL in NA group ( P>0.05), DI was significantly increased, and the expression of ATF5, LONP1 and HSP60 was up-regulated in NA group ( P<0.05). Conclusions:Down-regulated ATF5 in the hippocampus is involved in the process of cognitive impairment caused by neuropathic pain, and the mechanism may be related to the inhibition of mtUPR.

Objective:To explore the association between mouth breathing (MB) and functional speech sound disorders (FSSDs) in children, aiming to establish a novel theoretical basis for FSSD interventions.Methods:Eighty-nine children with an FSSD aged 4-12 years formed the FSSD group, while eighty-five age-matched healthy children served as controls. Their clinical data were processed using independent sample t-tests and chi-square tests to test for any significant differences between the two groups in terms of gender, age, mouth breathing status, post-frenotomy condition, Mandarin exposure before age 4, and delayed speech onset. Multivariate logistic regressions were evaluated to identify risk factors for FSSD in such children and to seek any association between mouth brea-thing and FSSD.Results:The regression analysis identified the following risk factors for childhood FSSD, ranked by odds ratio ( OR) magnitude: mouth breathing (adjusted OR=22.168, 95% CI=7.849-62.608, P≤0.01), delayed speech onset (adjusted OR=20.091, 95% CI=4.812-83.878, P≤0.01), age (a protective effect) (adjusted OR=0.979, 95% CI=0.962-0.997, P≤0.05). Univariate analysis of mouth breathing and associated factors revealed significant associations of FSSD with mouth breathing (χ 2=52.15, P≤0.01) and delayed speech onset (χ 2=25.873, P≤0.01). Conclusions:The significant risk factors for childhood functional speech sound disorders are mouth breathing (showing the highest adjusted OR), delayed speech onset and age. These findings suggest that early screening and therapeutic interventions for mouth breathing should be clinically prioritized to minimize FSSD risk.

Objective To observe the effects of four different modeling method on the hypothalamus-pituitary-adrenal(HPA)axis,blood rheology,platelet aggregation rate,and myocardial ischemia in rats,and to provide new ideas for the establishment of a rat model of"double heart"disease in line with clinical diagnosis and treatment characteristics.Methods Sixty-nine male Sprague-Dawley rats were divided randomly into a Control group(unstimulated),chronic unpredictable mild stimulation(CUMS)group,isoproterenol(ISO)group(intraperitoneal injection of ISO),high-fat diet(HFD)group(fed high-fat chow),and composite model(CUMS+ISO+HFD)group(n=12 rats in the Control and HFD groups;n=15 rats in the other three groups,respectively).Modeling procedures were carried out for a total of 8 weeks,with ISO injection started from week 6 of the experiment for a total of 3 weeks.At the end of modeling,rats in each group were subjected to absent-field and sugar-water preference behavioral tests.Electrocardiography(ECG)was performed to observe changes in ECG lead Ⅱ in each group.Serum levels of adrenocorticotropic hormone(ACTH),cortisol(Cor),corticosterone(CORT),endothelin-1(ET-1),and soluble intercellular adhesion molecule-1(sICAM-1)were detected by enzyme-linked immunosorbent assay.Myocardial histopathological changes were detected by hematoxylin/eosin(HE)staining.Serum total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)were measured using an enzyme labeling instrument.Whole-blood high-cut viscosity(200 V/S),whole-blood low-cut viscosity(10 I/S),plasma viscosity,and fibrinogen were assessed using an automatic blood rheology analyzer.The maximum platelet aggregation rate(MAR)and average platelet aggregation rate(AAR)induced by arachidonic acid and adenosine diphosphate were detected using a whole-blood platelet aggregometer.Results Compared with the Control group,all four model groups had significantly lower absenteeism distance and number of entries into the central region in the absent-field test,and a lower sugar-water preference ratio(P＜0.01).ECG revealed ST-segment elevation in the ISO and CUMS+ISO+HFD groups,tachycardia in the CUMS group,and mild ST-segment elevation in the HFD.Serum ACTH,Cor,CORT,ET-1,and sICAM-1 were all significantly elevated in the four model groups(P＜0.01).HE staining showed that myocardial tissue was severely damaged in rats in the ISO and CUMS+ISO+HFD groups,with pathological changes such as localized fibrosis and inflammatory infiltration of the myocardium,while mild cardiomyocyte disarrangement and fracture was seen in the CUMS and HFD groups.Rats in the HFD group had increased serum TC and LDL(P＜0.01)and decreased HDL contents(P＜0.01).Compared with the Control group,whole-blood high-cut viscosity(200 V/S),whole-blood low-cut viscosity(10 I/S),plasma viscosity,and fibrinogen were all increased in the CUMS,HFD,and CUMS+ISO+HFD groups(P＜0.01,P＜0.05),while whole blood high-cut viscosity(200 V/S),whole blood low-cut viscosity(10 I/S),plasma viscosity,and fibrinogen levels were decreased in rats in the ISO group(P＜0.01,P＜0.05).MAR and AAR were significantly higher in rats in the CUMS,HFD,and CUMS+ISO+HFD groups(P＜0.01),while the platelet aggregation rate was decreased in the ISO group compared with the Control group(P＜0.01,P＜0.05).Conclusions These result showed that the rat CUMS+ISO+HFD model better reflected the complexity of clinical double heart disease than the other three models.

Objective To evaluate the diagnostic value of shear wave dispersion(SWD)in preoperative assessment of liver fibrosis in patients with hepatocellular carcinoma(HCC).Methods A total of 62 patients with HCC who were admitted to the hospital between January 2022 and January 2024 were included in this study.All patients underwent shear wave elastography(SWE)examination prior to hepatectomy.The extent of liver fibrosis was assessed based on surgical and pathological findings.Patients were categorized into two groups:a low-grade fibrosis group(stages S0-S2)and a high-grade fibrosis group(stages S3-S4).Baseline characteristics and liver parenchymal SWE values were compared between the two groups.Multivariate logistic regression analysis was conducted to identify factors influencing the degree of liver fibrosis in HCC patients.The diagnostic performance of SWE in preoperative evaluation of liver fibrosis was assessed using receiver operating characteristic(ROC)curve analysis.Results Among the 62 patients with HCC,pathological results indicated that there were 11,13,20,and 18 cases in fibrosis stages S1,S2,S3,and S4,respectively.The SWD values of liver parenchyma significantly differed among patients with varying degrees of liver fibrosis.As the severity of liver fibrosis increased,the SWD of liver parenchyma also increased(P<0.05).Spearman correlation analysis revealed a positive correlation between the SWD value of liver parenchyma and the degree of liver fibrosis in preoperative HCC patients(r=0.608,P<0.05).Platelet count(PLT)was lower in the high-grade fibrosis group compared to the low-grade fibrosis group(P<0.05).Additionally,both the S index and SWD value of liver parenchyma were higher in the high-grade fibrosis group than in the low-grade fibrosis group(P<0.05).Multivariate logistic regression analysis demonstrated that the S index and SWD value were independent influencing factors for the degree of liver fibrosis in preoperative HCC patients(P<0.05).ROC curves showed that the area under the curve(AUC)of the SWD value was greater than that of the S index for assessing the degree of liver fibrosis in preoperative HCC patients(P<0.05).The cutoff value,sensitivity,and specificity of the SWD value for assessing the degree of liver fibrosis were 16.25 m/s·kHz-1,65.79%,and 95.83%,respectively.Conclusion The SWD value of liver parenchyma is closely associated with the extent of liver fibrosis in patients with HCC and provides a highly valuable assessment of the degree of liver fibrosis.

Objective:To explore the association of 21-gene recurrence score (RS) and clinicopathologic characteristics of hormone receptor (HR) positive T1-3N1M0 breast cancer and its value in prognosis evaluation.Methods:The clinicopathological data of 287 patients with T1-3N1M0 breast cancer were collected, the 21-gene assay was completed, and follow-up was conducted. According to the 21-gene RS, the patients were divided into the RS<26 and RS≥26 groups. The relationship between the 21-gene RS and clinicopathological characteristics, treatment, recurrence, and metastasis was analyzed. Univariate and multivariate statistical analyses were used to analyze the risk factors for disease free survival (DFS).Results:The median RS of the 287 patients was 16. There were 240 cases with RS <26 and 47 cases with RS≥26. Tumor size, grade, estrogen receptor (ER), progesterone receptor (PR), and Ki-67 index were significantly different between the two cohorts ( P<0.05 for all). After a median follow-up of 74 months, the recurrence rate in the RS<26 group (8.3%) was significantly lower than that in the RS≥26 group (23.4%), the locoregional recurrence (LRR) rates in the RS<26 and RS≥26 groups were 2.1% and 0%,and the distant metastasis (DM) rates were 6.3% and 23.4%, respectively. The 5-year relapse free survival (RFS) rates of patients with RS<26 and RS≥26 were 93.8% (95% CI: 90.7%-96.9%) and 87.2% (95% CI: 78.2%-97.3%), and the 5-year DFS rates were 92.1% (95% CI: 88.7%-95.6%) and 85.1% (95% CI: 75.5%-95.9%), respectively, with significant differences between the two cohorts ( P=0.007 and P=0.006, respectively). Univariate analysis showed age, tumor size, grade, PR status, Ki-67 index and RS were prognostic factors for DFS ( P<0.05 for all). Multivariate analysis showed that age and tumor size were independent significant predictors for DFS ( P<0.05). Conclusions:The 21-gene RS of T1-3N1M0 breast cancer is related to tumor size, grade, ER, PR, and Ki-67 index. RS is an important factor affecting DM and DFS.