Objective To compare and analyze the changes in the use of lung cancer therapeutic drugs before and after the national initiation of health insurance negotiations, and to study the impact of a series of policies on the use of lung cancer drugs. Methods Descriptive statistical methods were used analyze the basic situation of lung cancer patients and the changes of corresponding therapeutic drugs in Peking University People's Hospital from 2014 to 2020, as well as to the hospital procurement data of lung cancer therapeutic drugs in the database of the Chinese Medicine Economic Information. Results From 2014 to 2020, the total cost per capita of lung cancer patients showed a trend of first increasing and then decreasing, increasing before the national drug negotiation and gradually decreasing after the negotiation. After 2017, the use of small ATC categories such as VEGF/VEGFR inhibitors and EGFR tyrosine kinase inhibitors increased significantly, along with a rise in the number of monoclonal antibody varieties. The DDDs of osimertinib, anlotinib, alectinib, crizotinib and other drugs in the medical insurance list increased significantly, and the average daily cost decreased significantly. Conclusion The number of hospitalization days for lung cancer patients had continued to shorten in recent years, and the structure of drug use had changed significantly. The adjustment of the medical insurance catalog had led to more innovative lung cancer drugs showing the trend of volume up and price down.

Objective To analyze chemical constituents of compound Maxing Shigan decoction by ultra-high perfor-mance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). Methods The separation was performed on a UPLC BEH C₁₈ column (2.1 mm×100 mm, 2.5 µm)，with a gradient elution applying 0.1% aqueous formic acid solution and 0.1% formic acid acetonitrile as a mobile phase. The column temperature was 40 °C. The flow rate was 0.4 ml/min and the analysis time was 15 min. Mass spectrometry (MS) data were collected in both positive and negative ESI ion modes. Results Through UPLC-QTOF/MS analysis and reference validation, a total of 59 chemical components in Maxing Shigan decoction were identified. Conclusion An ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS) method was established to identify the chemical components of Maxing Shigan decoction. This method is simple, efficient, sensitive and accurate, and provides a basis for the elucidation of the pharmacodynamic material basis and mechanism of Maxing Shigan decoction. It can provide data reference for the optimization of the compatibility of traditional Chinese medicine in the treatment of COVID-19.

Objective To preliminarily design a wide-energy-spectrum CR-39 solid-state nuclear track individual neutron dosimeter with different energy sections. Methods The thickness of the converter was optimized using the Monte Carlo SRIM program to broaden the energy range of the dosimeter. The self-made wide-energy-spectrum CR-39 individual neutron dosimeter was calibrated using ²⁴¹Am-Be, ²⁵²Cf, and thermal neutron sources to evaluate its dosimetric performance, including linearity, energy response, and neutron energy resolution. Results The linear correlation coefficient of the measurement system exceeded 0.98. The relative deviations of the energy response were 35.0% for blank section and 42.0% for polyethylene section, falling within the range of −50% to + 100% and meeting the monitoring requirements. The detection sensitivity for thermal neutron dose was 67 137.2 tr·cm⁻²·mSv⁻¹, and the detection sensitivity for thermal neutron fluence was 0.98 × 10⁻³ tr·n⁻¹, demonstrating good thermal neutron detection capability. Conclusion The self-made wide-energy-spectrum CR-39 individual neutron dosimeter fundamentally meets the requirements for individual neutron dose monitoring and is suitable for individual neutron dose monitoring in the energy range of thermal neutrons (up to approximately 15 MeV).

As one of the major public health challenges globally, tuberculosis requires epidemiological research for its control and prevention. With the advent of the big data era, machine learning has advantages over traditional methods in handling complex, high-dimensional datasets and providing accurate predictive results. This paper introduces the application of machine learning in the discovery and diagnosis of tuberculosis cases, risk factor analysis, predictive modeling, and evaluation of intervention strategies, providing new means for more in-depth exploration of the value in tuberculosis epidemiological research.

OBJECTIVE To investigate a suspected outbreak of carbapenem-resistant Klebsiella pneumoniae(CRKP)infection in the intensive care unit of a traditional Chinese medicine hospital,identify the source of infec-tion and transmission routes,and provide a basis for prevention and control of CRKP infection.METHODS Epide-miological investigations were conducted on five patients with CRKP infections or colonization who were identi-fied in Jul.2024 at Suiyang County Hospital of Traditional Chinese Medicine.Samples were collected from pa-tients,the ward environments,and hand surfaces to detect CRKP.Fourteen CRKP isolates were selected for car-bapenemase gene testing,and homology analysis was performed by enterobacterial repetitive intergenic consensus polymerase chain reaction(ERIC-PCR)and multilocus sequence typing(MLST).RESULTS The median age of the five cases was 73 years,and all had undergone multiple invasive procedures.Environmental monitoring showed a CRKP positive rate of 26.35％,with CRKP isolates detected on the hands of healthcare workers,surfaces in the wards and medical equipment surfaces.Genetic analysis showed that all 14 CRKP strains carried the KPC resist-ance gene;except for case 1,other strains carried the VIM gene.MLST identified CRKP of all strains as sequence type 48(ST48);while ERIC-PCR revealed two distinct genotypes:genotype A for case 1 and genotype B for the other cases and environmental isolates.After strengthening patient isolation and group treatment,strictly cleaning and disinfecting the ward environments and medical equipment,and strictly implementing hand hygiene,the infec-tion was effectively controlled.CONCLUSIONS Inadequate disinfection of the ward environments and medical e-quipment and poor compliance with hand hygiene are the main contributors to the suspected CRKP outbreak.Ho-mology analysis suggests the existence of two independent transmission chains.Timely identification and manage-ment of the infection sources,interruption of transmission routes,protection of susceptible individuals and imple-mentation of comprehensive infection control measures are essential for effective outbreak control.

Objective To establish an ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry(UPLC-QTOF-MS)method for identifying the active ingredients of Zhizi Houpu decoction,and to predict its material basis and mechanism of anti-insomnia effects using network pharmacology.Methods The chemical components of Zhizi Houpu decoction were identified according to UHPLC-QTOF-MS ion fragmentation rule combined with compound library and literature review.Components with oral bioavailability(OB)≥30％and drug-like properties(DL)≥0.18 were selected to construct the Zhizi Houpu decoction-active ingredients-target network.The STRING database and the Database for Annotation,Visualization,and Integrated Discovery(DAVID)were used to screen key target proteins.Subsequently,enrichment analysis was performed for biological processes,molecular functions,cellular components,and signaling pathways.Results A total of 107 chemical components were identified,including 35 compounds related to insomnia and 11 anti-insomnia targets such as AKT serine/threonine kinase 1,tumor protein 53,and prostaglandin-endoperoxide synthase 2.Gene Ontology functional enrichment analysis indicated that Zhizi Houpo decoction may exert its effects through cellular components such as the presynaptic membrane,dendrite,and plasma membrane,by participating in biological processes like chemical synaptic transmission,G protein signaling pathway,and neuron apoptosis,and by regulating molecular functions such as G protein-coupled serotonin receptor activity.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed that its anti-insomnia effects were mainly concentrated in pathways such as neuroactive ligand-receptor interaction,calcium signaling pathway,serotonergic synapse,and cyclic adenosine monophosphate signaling pathway.Conclusion The anti-insomnia effect of Zhizi Houpo decoction is the result of a synergistic action involving multiple components,multiple targets,and multiple pathways.Its material basis and mechanism of action are primarily related to regulating biological processes such as neurotransmitter metabolism,synaptic function,neuronal apoptosis,and inflammatory response.

Objective:To investigate the effects and underlying molecular mechanisms of Utidelone (UTD1) in small cell lung cancer (SCLC).Methods:The study utilized small cell lung cancer H446 and H1048 cell lines along with animal models. Cell proliferation, cell cycle progression, apoptosis, autophagy, and related activities following UTD1 treatment were assessed using Cell Counting Kit-8 (CCK-8), flow cytometry, immunofluorescence staining, reactive oxygen species (ROS) generation assay, and Western blot analysis. The involvement of the ROS/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway was also examined. Data analysis was performed using GraphPad Prism version 8 software.Results:UTD1 inhibited the viability of H446 and H1048 cells in a dose- and time-dependent manner. The half inhibitory concentrations (IC 50) of UTD1 for H446 and H1048 cells were 0.675 and 0.439 μg/ml, respectively. The proportion of cells in the G 2/M phase for H446 and H1048 cells in the UTD1 group at 6 h, 12 h, and 24 h was [(53.86±4.54)%, (68.59±5.49)%, (60.89±3.26)%] and [(46.83±2.20)%, (60.67±3.44)%, (57.88±5.11)%], which were significantly higher than that in the control group, except for the proportion of H1048 cells at 6 h [(38.99±2.60)% vs. (40.73±2.50)%, P＜0.05]. The apoptosis rates were [(23.57±0.12)%, (35.79±1.59)%, and (46.15±4.57)%] for H446 cells and [(23.05±2.70)%, (37.73±2.97)%, and (43.39±3.31)% for H1048 cells], all of which were significantly higher than those in the control group [(6.44±0.96)%, (6.31±0.75)%, respectively; all P＜0.05]. The number of LC3 fluorescent spots was [(56±11), (69±8), and (66±8)] for H446 cells and [(39±7), (56±12), and (50±11)] for H1048 cells, both significantly higher than those in the control group [(13±6) and (12±5), respectively; both P＜0.05]. The relative fluorescence intensity of ROS was 2.54±0.48, 2.85±0.68, and 5.03±0.72 for H446 cells and 2.26±0.51, 4.17±0.35, and 4.66±0.51 for H1048 cells, which were also significantly higher than those in the control group ( P＜0.05). The expression levels of cyclin B1, cyclin A2, and P21 of H446 cells in the three time points were [(0.63±0.07, 0.33±0.05, 0.23±0.04), (0.68±0.08, 0.46±0.03, 0.27±0.06), and (0.64±0.03, 0.32±0.05, 0.22±0.03), respectively], all significantly lower compared to the control group ( P＜0.05). The apoptosis rates of H446 and H1048 cells in the UTD1+Z-VAD-FMK group were (19.97±3.19)% and (17.68±3.14)%, both lower than those in the UTD1 group [(40.73±3.35)% and (39.82±2.45)%, respectively; all P＜0.05]. The absorbance values of H446 and H1048 cells in the UTD1+3-MA group were significantly higher than those in the UTD1 group at 6h, 12h, and 24h (all P＜0.05). The levels of p-AMPKα/AMPKα, LC3-II expression, and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+NAC group were [(1.33±0.09, 1.33±0.11), (1.49±0.16, 1.55±0.05), (17.24±2.15)%, and (19.40±4.28)%], all of which were lower than those observed in the UTD1 group [(1.98±0.17, 2.23±0.23), (2.81±0.19, 2.49±0.38), (38.07±3.53)%, and (41.20±1.87)%, all P＜0.05]. The number of LC3 fluorescence points and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+si-AMPKα group [(24±5, 23±3), (18.35±1.15)%, and (19.15±3.46)%] were all lower than those in the UTD1+si-NC group [(46±6, 36±6), (39.34±1.77)%, and (39.50±2.15)%, all P＜0.05]. The tumor inhibition rates in small cell lung cancer tumor-bearing nude mice for the 2.5 mg/kg UTD1 group and the 5 mg/kg UTD1 group were 46.43% and 58.33%, respectively. Furthermore, the proportions of apoptosis-positive cells and p-AMPKα-positive cells in the UTD1 group were significantly higher compared to the control group, while the levels of Ki-67 positivity were significantly reduced. Conclusion:UTD1 inhibits SCLC cell proliferation, induces G 2/M phase arrest, and promotes cell apoptosis and autophagy through the activation of the ROS/AMPK signaling pathway.

Objective:To investigate improvement of dexamethasone(DM)treatment after intrauterine adhesion decomposition on uterine fibrosis and inflammatory factors.Methods:A total of 60 patients with moderate to severe intrauterine adhesions admitted to The Reproductive Medicine Center of Jilin Provincial People's Hospital from March 2021 to March 2023 were selected,and divided into experimental group and control group according to random number table method,with 30 cases in each group.Control group under-went simple hysteroscopic adhesion decomposition,and experimental group underwent intrauterine infusion treatment with DM injec-tion after intrauterine adhesion decomposition.Improvement of clinical symptoms in the two groups was observed.RT-qPCR was used to detect changes in mRNA levels of intimal receptivity-related factors ER,EGFR,LIF,ITGB3,HOXA10,HOXA11,fibrosis-related factors TGF-β1,E-cadherin,N-cadherin,Smad,and inflammatory related factors IL-8,IL-2 and CD138 in two groups.Western blot was used to detect changes in expression levels of inflammatory related proteins IL-8,IL-2 and CD138.Results:Compared with before treatment,endometrial thickness,mRNA levels of ER,EGFR,LIF,ITGB3,HOXA10,HOXA11 and E-cadherin were significantly increased,while mRNA levels of TGF-β1,N-cadherin,Smad,IL-8,IL-2 and CD138,protein levels of IL-8,IL-2 and CD138,and endometrial blood flow parameters PI,RI and adhesion were significantly decreased.Eendometrial thickness,mRNA levels of ER,EGFR,LIF,ITGB3,HOXA10,HOXA11 and E-cadherin in experimental group were significantly higher than those in control group,while mRNA levels of IL-8,IL-2,TGF-β1,N-cadherin,Smad,CD138,IL-8,IL-2 and CD138,and endometrial blood flow parameters PI,RI and adhesion were lower than those in control group(P<0.05).Conclusion:Treatment of DM after intrauterine adhe-sion decomposition can improve intrauterine adhesion,blood flow parameters and endometrial receptivity,and prevent the recurrence of intrauterine adhesion,which mechanism may be related to up-regulation of E-cadherin expression and down-regulation of IL-8,IL-2,CD138,TGF-β1,N-cadherin and Smad expressions.

As one of the major public health challenges globally, tuberculosis requires epidemiological research for its control and prevention. With the advent of the big data era, machine learning has advantages over traditional methods in handling complex, high-dimensional datasets and providing accurate predictive results. This paper introduces the application of machine learning in the discovery and diagnosis of tuberculosis cases, risk factor analysis, predictive modeling, and evaluation of intervention strategies, providing new means for more in-depth exploration of the value in tuberculosis epidemiological research.

Objective:To investigate improvement of dexamethasone(DM)treatment after intrauterine adhesion decomposition on uterine fibrosis and inflammatory factors.Methods:A total of 60 patients with moderate to severe intrauterine adhesions admitted to The Reproductive Medicine Center of Jilin Provincial People's Hospital from March 2021 to March 2023 were selected,and divided into experimental group and control group according to random number table method,with 30 cases in each group.Control group under-went simple hysteroscopic adhesion decomposition,and experimental group underwent intrauterine infusion treatment with DM injec-tion after intrauterine adhesion decomposition.Improvement of clinical symptoms in the two groups was observed.RT-qPCR was used to detect changes in mRNA levels of intimal receptivity-related factors ER,EGFR,LIF,ITGB3,HOXA10,HOXA11,fibrosis-related factors TGF-β1,E-cadherin,N-cadherin,Smad,and inflammatory related factors IL-8,IL-2 and CD138 in two groups.Western blot was used to detect changes in expression levels of inflammatory related proteins IL-8,IL-2 and CD138.Results:Compared with before treatment,endometrial thickness,mRNA levels of ER,EGFR,LIF,ITGB3,HOXA10,HOXA11 and E-cadherin were significantly increased,while mRNA levels of TGF-β1,N-cadherin,Smad,IL-8,IL-2 and CD138,protein levels of IL-8,IL-2 and CD138,and endometrial blood flow parameters PI,RI and adhesion were significantly decreased.Eendometrial thickness,mRNA levels of ER,EGFR,LIF,ITGB3,HOXA10,HOXA11 and E-cadherin in experimental group were significantly higher than those in control group,while mRNA levels of IL-8,IL-2,TGF-β1,N-cadherin,Smad,CD138,IL-8,IL-2 and CD138,and endometrial blood flow parameters PI,RI and adhesion were lower than those in control group(P<0.05).Conclusion:Treatment of DM after intrauterine adhe-sion decomposition can improve intrauterine adhesion,blood flow parameters and endometrial receptivity,and prevent the recurrence of intrauterine adhesion,which mechanism may be related to up-regulation of E-cadherin expression and down-regulation of IL-8,IL-2,CD138,TGF-β1,N-cadherin and Smad expressions.