Objective:To investigate the effects and mechanism of Jianpi Yangzheng Xiaozheng Prescription in lung pre-metastatic niche formation of gastric cancer by regulating the content of programmed death receptor ligand 1 (PD-L1) in gastric cancer exosomes.Methods:Totally 30 615 mice were divided into normal group, model group, Jianpi Yangzheng Xiaozheng Prescription low- and high-dosage groups, and exosome inhibitor group according to random number table method, with 6 mice in each group. The mouse model of lung pre-metastatic niche formation of gastric cancer was established by tail vein injection of MFC cells. After 12 days of administration, the lung metastasis under the intervention of Jianpi Yangzheng Xiaozheng Prescription was evaluated by observing the infiltration of tumor into lung tissue, weighing lung weight and hematoxylin-eosin (HE) staining of lung tissue. Mouse serum exosomes were extracted by ExoQuick kit and identified by transmission electron microscopy and nanoparticle tracking analysis (NTA). The content of PD-L1 in serum exosomes and the expression levels of serum transforming growth factor-β (TGF-β), interleukin-10 (IL-10) and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent assay (ELISA). Immunofluorescence was used to detect the phenotype of myeloid-derived suppressor cells (MDSC) and tumor-associated macrophages (TAM) and the expression of PD-L1 in MDSC and TAM.Results:Compared with the model group, after the intervention of Jianpi Yangzheng Xiaozheng Prescription, the lung metastases of mice were reduced ( P<0.05), and the weight of metastatic tumors decreased ( P<0.05). PD-L1 in serum exosomes and the proportion of MDSC and M2 TAM in lung tissue microenvironment decreased, as well as the expression of PD-L1 on MDSC and TAM decreased ( P<0.05). The serum levels of IL-10 and IL-6 significantly decreased ( P<0.05). Conclusion:Jianpi Yangzheng Xiaozheng Prescription can reduce the proportion of MDSC and M2 TAM and the expression level of PD-L1 in the microenvironment of lung tissue before metastasis by inhibiting the transmission of gastric cancer exosome PD-L1 to MDSC and TAM, and reduce the contents of inflammatory factorsIL-10 and IL-6, so as to play a role in improving the microenvironment before lung metastasis of gastric cancer.

Objective To explore the network structural characteristics,core factors,and gender differences in the comprehensive assessment of mental health in military personnel.Methods A total of 4 105 officers and soldiers were subjected and surveyed using the Comprehensive Mental Health Assessment Questionnaire for Soldiers.Through network analysis,a network model for comprehensive mental health assessment of military personnel was constructed with the R qgraph Package.The core factors of their mental health were explored using the qgraph package,and the reliability of the network structure was evaluated using the bootnet package.Then a comparative analysis was conducted on the network characteristics of comprehensive mental health assessments between male and female participants using permutation tests with the NetworkComparisonTest package in R.Results In the network of the comprehensive assessment of military personnel mental health,the strongest association was observed between institutional trust and interpersonal trust,followed by interpersonal trust and sense of meaning in life,adaptability and positive coping,as well as depression and negative emotions,with a regularized partial correlation coefficient of 0.49,0.45,0.44,and 0.42,respectively.The core factors were interpersonal trust,work engagement,and institutional trust,with an expected influence of 1.095,1.060,and 1.039,respectively.The 95%confidence intervals(CIs)obtained from the edge weight accuracy assessment were relatively narrow,and the correlation stability coefficient of the network was 0.75,indicating a stable and reliable network structure.Furthermore,there were significant differences in the network structure of comprehensive mental health assessments between male and female participants(M=0.335,P<0.001),especially in the core factor,interpersonal trust,with particularly significant gender difference(P<0.01).Conclusion Interpersonal trust,work engagement,and institutional trust are the core factors in the comprehensive assessment of military personnel's mental health.There are gender differences in the network structure of the comprehensive assessment of mental health for military personnel.

The financial and accounting supervision of public hospitals is a complex systematic project,which lacks comprehensive and systematic guidance at present,and needs to improve the relevant theoretical system through practice.The financial and accounting supervision system of public hospitals isanalyzed based on CAS theory framework.The operating mechanism model of public hospital financial and accounting supervision system is constructed based on Complex Adaptive System(CAS)theory.The financial and accounting supervision of public hospitals conforms to the characteristics of aggregation,nonlinearity,factor flow and diversity of the CAS theory.The CAS model of public hospital financial and accounting supervision can promote the construction of public hospital financial and accounting supervision system under complex governance environment.It has feasibility and popularization.

The financial and accounting supervision of public hospitals is a complex systematic project,which lacks comprehensive and systematic guidance at present,and needs to improve the relevant theoretical system through practice.The financial and accounting supervision system of public hospitals isanalyzed based on CAS theory framework.The operating mechanism model of public hospital financial and accounting supervision system is constructed based on Complex Adaptive System(CAS)theory.The financial and accounting supervision of public hospitals conforms to the characteristics of aggregation,nonlinearity,factor flow and diversity of the CAS theory.The CAS model of public hospital financial and accounting supervision can promote the construction of public hospital financial and accounting supervision system under complex governance environment.It has feasibility and popularization.

Objective:To adapt to the deepening reform of the medical and health system,and to meet the new needs of hospital financial management driven by the rapid development of intelligent information technology and digital economy.Methods:Literature research method,questionnaire survey method,expert consultation method and statistical analysis method were adopted.Results:A framework of 16 elements of digital ability of hospital financial personnel was constructed,which covered the dimensions of data skills,professional knowledge,thinking ability and personal traits.Conclusion:The construction of the framework of digital ability of hospital financial staff provides references for the digital ability of hospital financial staff,and provides new ideas for the recruit-ment and construction of hospital financial staff.

Ceramide (Cer) is a second messenger produced by the degradation of plasma membrane phospholipids in cells. It is an essential lipid mediator for normal cellular function, composed of sphingosine and different chains of fatty acids. Its receptors are widely present in red blood cells, endothelial cells, glial cells, immune cells, and nerve cells, and participate in various pathophysiological processes such as oxidative stress, inflammatory response, signal pathway transduction, and immune regulation. Many studies have confirmed that the increase of Cer level is related to cardiovascular disease, type 2 diabetes and lipid metabolism. Ceramide score can be used as a tool to evaluate the severity and prognosis of cardiovascular events. However, there is limited research on the impact of Cer on acute ischemic stroke (AIS). This article aims to elucidate the role of Cer and its impact on the occurrence, development, and prognosis of AIS.

Objective:To adapt to the deepening reform of the medical and health system,and to meet the new needs of hospital financial management driven by the rapid development of intelligent information technology and digital economy.Methods:Literature research method,questionnaire survey method,expert consultation method and statistical analysis method were adopted.Results:A framework of 16 elements of digital ability of hospital financial personnel was constructed,which covered the dimensions of data skills,professional knowledge,thinking ability and personal traits.Conclusion:The construction of the framework of digital ability of hospital financial staff provides references for the digital ability of hospital financial staff,and provides new ideas for the recruit-ment and construction of hospital financial staff.

Objective:To adapt to the deepening reform of the medical and health system,and to meet the new needs of hospital financial management driven by the rapid development of intelligent information technology and digital economy.Methods:Literature research method,questionnaire survey method,expert consultation method and statistical analysis method were adopted.Results:A framework of 16 elements of digital ability of hospital financial personnel was constructed,which covered the dimensions of data skills,professional knowledge,thinking ability and personal traits.Conclusion:The construction of the framework of digital ability of hospital financial staff provides references for the digital ability of hospital financial staff,and provides new ideas for the recruit-ment and construction of hospital financial staff.

Objective:To adapt to the deepening reform of the medical and health system,and to meet the new needs of hospital financial management driven by the rapid development of intelligent information technology and digital economy.Methods:Literature research method,questionnaire survey method,expert consultation method and statistical analysis method were adopted.Results:A framework of 16 elements of digital ability of hospital financial personnel was constructed,which covered the dimensions of data skills,professional knowledge,thinking ability and personal traits.Conclusion:The construction of the framework of digital ability of hospital financial staff provides references for the digital ability of hospital financial staff,and provides new ideas for the recruit-ment and construction of hospital financial staff.

Objective:To adapt to the deepening reform of the medical and health system,and to meet the new needs of hospital financial management driven by the rapid development of intelligent information technology and digital economy.Methods:Literature research method,questionnaire survey method,expert consultation method and statistical analysis method were adopted.Results:A framework of 16 elements of digital ability of hospital financial personnel was constructed,which covered the dimensions of data skills,professional knowledge,thinking ability and personal traits.Conclusion:The construction of the framework of digital ability of hospital financial staff provides references for the digital ability of hospital financial staff,and provides new ideas for the recruit-ment and construction of hospital financial staff.