OBJECTIVE To upgrade the drug traceability code management system for a pediatric hospital under the “payment by code” background， aiming to comprehensively enhance traceability integrity， efficiency， and compliance. METHODS Taking Xiamen Children’s Hospital as the implementation setting， a before-and-after control design was adopted to construct an intelligent drug traceability code management system through systematic upgrades involving the technology platform， core mechanisms， and coordination with medical insurance. Key interventions included： upgrading a traceability code management platform and designing a dynamic code pool； innovating differentiated traceability mechanisms for routine， split-dose， and special drugs； establishing a tiered early-warning and emergency response system； and constructing a data coordination and quality control system. The drug traceability code upload rate served as the primary outcome. Process indicators such as the root causes distribution of failed uploads and the duration of medication returns， and a comprehensive outcome （the number of insurance-flagged abnormal prescriptions） were also analyzed. The data between the baseline period （April 2025） and the observation period （June-August 2025） were compared and evaluated. RESULTS After the upgrade， the overall upload rate of drug traceability codes increased from 9.21% （baseline） to 99.86% （August 2025）. The upload rate of traceability codes in previously unmanaged areas， such as the inpatient pharmacy and pharmacy intravenous admixture services， soared from 0 to nearly 100%. The proportion of non-uploads due to system issues fell from 66.44% （June 2025） to 2.62% （August Additionally， the number of insurance-flagged） abnormal prescriptions dropped sharply from 2 275.00 in the first “payment by code” policy month （July 2025） to 212.00 by the end of the observation period （August 2025）， a 90.70% decrease. CONCLUSIONS The developed management system effectively addresses complex scenario challenges such as high-frequency drug splitting. It significantly enhances traceability code upload performance and ensures a high degree of compliance with medical insurance data requirements. These outcomes contribute to proactive risk mitigation against insurance claim denials and demonstrate a concurrent optimization of pharmacy operations.

Background Diarrhea disease is a common intestinal infectious disease, and its incidence is affected by meteorological conditions. A better understanding of its epidemiological patterns and influencing factors, together with the construction of reliable prediction models, is of great significance for precise public health prevention and control. Objective To clarify the epidemic characteristics of adult diarrhea disease in Shanghai, analyze the associations of meteorological factors and a web search index with adult diarrhea disease, and develop and compare forecasting models to support precise regional prevention and control. Methods Weekly surveillance data of adult diarrhea disease cases from the Shanghai Comprehensive Surveillance Information System for Diarrhea Diseases, together with concurrent meteorological observation data and web search index (Baidu index) data from 2014 to 2019, were collected. A distributed lag non-linear model (DLNM) was adopted to analyze the associations of multiple meteorological factors and the web search index with the number of diarrhea disease cases. By integrating meteorological factors and web search index data, three types of forecasting models were developed, including autoregressive integrated moving average (ARIMA), Random Forest, and extreme gradient boosting (Xgboost), and their predictive performances were evaluated. Results Adult diarrhea disease in Shanghai exhibited seasonal variation, with an major incidence peak in summer and winter peaks in some years. The number of cases declined annually after 2015. Mean temperature was significantly associated with the risk of diarrhea disease, and both low and high temperature exposures were associated with increased risks. The highest risk was observed at 32.8°C (RR=2.04, 95%CI: 1.62, 2.55), while the strongest effect of low temperature was observed at 0.9 °C (RR=1.53, 95%CI: 1.25, 1.88). When relative humidity exceeded 69%, the risk of diarrhea disease increased with relative humidity, reaching a peak at 81% (RR=1.20, 95%CI: 1.07, 1.35). When weekly cumulative precipitation exceeded 16 mm, the risk also increased with increasing precipitation, reaching a maximum at 105 mm (RR=1.23, 95%CI: 1.07, 1.42). The web search index was positively associated with the risk of diarrhea disease. Model prediction indicated that both the Random Forest model and the Xgboost model adequately captured the overall trend in diarrhea disease cases, with R² values generally exceeding 0.7. Notably, the Xgboost model demonstrated greater accuracy in capturing peak intensities. Conclusion Meteorological factors are associated with adult diarrhea disease in Shanghai. The web search index may serve as an auxiliary indicator for diarrhea forecasting. Machine learning models, with advantages in integrating multisource data, may provide effective predictive tools for the prevention and control of diarrhea disease.

Objective To study the predictive value of umbilical artery blood gas analysis combined with early postnatal myocardial enzyme spectrum for neonatal respiratory distress syndrome(RDS)and its severity in premature infants.Methods From January 2018 to December 2024,85 newborns with the gestation age of 30-36+6 weeks who were diagnosed as RDS after birth form Hangzhou Women's Hospital were selected as study group.85 newborns without diagnosed as RDS during the same period were included as control group in a 1:1 ratio.All of them born by cesarean section.The umbilical arterial blood gas analysis was performed and blood samples were collected for blood biochemical tests.The umbilical artery blood pH,base excess,lactate,and myocardial enzyme spectrum such as aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase isoenzymes(CK-MB)were compared between two groups.Binary Logistic regression was used to analyze the correlation between umbilical artery blood gas analysis and venous blood myocardial enzyme spectrum and RDS.Receiver operating characteristic curve of umbilical artery blood pH value and creatine kinase isoenzyme alone and their combined detection for predicting RDS was detected,and area under the curve(AUC),sensitivity and specificity of the single detection and combined detection were compared.The study group was further divided into subgroup A(mild)and subgroup B(severe)and the differences of the above indicators between two subgroups were compared.Results Compared with control group,tstudy group had lower pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were higher than those in control group with statistically significant differences(P＜0.05).pH and CK-MB were correlated with RDS(P＜0.05).The AUC of umbilical artery blood pH in predicting RDS was 0.728,the sensitivity was 0.588 and the specificity was 0.812.Combined with CK-MB,the AUC of predicting RDS was 0.813,the sensitivity was 0.729,and the specificity was 0.824.In the study group,subgroup A had higher pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were lower than those in subgroup B with statistically significant differences(P＜0.05).CK-MB was correlated with disease severity in newborns with RDS(P＜0.01).Conclusion Compared with simple application of pH,the combined use of CK-MB can more accurately predict RDS in premature infants,and also has a certain significance for the severity of RDS in premature infants.

Objective To explore the impact of peak and duration of intrapartum fever on umbilical arterial blood gas analysis.Methods From January 2022 to December 2024,a total of 82 full-term singleton pregnant women after vaginal delivery in Hangzhou Women's Hospital with a system fever ≥38.0℃ were included as fever group.164 pregnant women with a body temperature＜38.0℃ during the same period were included as control group in a 1∶2 ratio.The umbilical arterial blood gas analysis was performed in all of them.General data,situation during childbirth and umbilical arterial blood gas analysis were compared between fever group and control group.The fever group was further divided into 3 subgroups,including 52 cases in subgroup A with temperature 38.0℃ to＜38.5℃,21 cases in subgroup B with temperature from 38.5℃ to＜39.0℃,9 cases in subgroup C with temperature ≥39.0℃.General data,situation during childbirth and umbilical arterial blood gas analysis of 3 subgroups were compared.Results There were no statistical significance in general data and situation during childbirth between fever group and control group(P＞0.05).Compared with control group,lower pH and base excess levels in umbilical artery blood as well as higher lactate levels in fever group with statistically significant differences(P＜0.05).There were no statistical significance in general data and situation during childbirth among subgroups(P＞0.05).pH,base excess and lactate levels in umbilical artery blood had no statistically significant differences among subgroups(P＞0.05).Logistic regression analysis showed that the fever duration was associated with umbilical artery acidosis(P=0.048,OR=1.005,95％CI:1.000-1.009).Conclusion Intrapartum fever leads to a decrease in pH and base excess in umbilical artery blood,as well as an increase in lactate levels.The peak of intrapartum fever leads no statistically significant differences in umbilical arterial blood gas analysis.For women with fever ≥38.0℃,controlling fever time may be helpful to reduce the incidence of acidosis and neonatal morbidity.

Objective To analyze the medication rules of traditional Chinese medicine in treating breast cancer based on real-world data mining.Methods Inpatients with breast cancer who received traditional Chinese medicine treatment at the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2017 to December 2021 were selected.Python 3.10 software was used to mine traditional Chinese medicine prescription data;SPSS 23.0 software was applied for descriptive analysis,and systematic cluster analysis was performed on high-frequency drugs.Results A total of 3026 consultation records of inpatients with breast cancer were collected.The main traditional Chinese medicine syndrome diagnosis of"predominantly liver depression and Qi stagnation"accounted for 60.94％of the total consultations.A total of 240 kinds of traditional Chinese medicine were used,with a cumulative frequency of 35 462 times.Among them,29 kinds of traditional Chinese medicine such as Danggui,Fuling,Baizhu,Chaihu had a cumulative usage frequency exceeding 300 times.Regarding the four natures of drugs,cold-natured(43.55％),warm-natured(30.05％),and neutral-natured(23.34％)drugs were predominant;In terms of five flavors,sweet(46.12％),bitter(30.91％),and pungent(20.02％)were the main ones.The most frequently used drugs were tonifying herbs(32.77％),followed by heat-clearing herbs(15.96％)and phlegm-resolving herbs(14.71％).Systematic cluster analysis yielded 7 groups of drug combinations.Conclusion In real-world clinical practice,traditional Chinese medicine for breast cancer mainly uses tonifying herbs,reflecting the traditional Chinese medicine principle of"strengthening healthy Qi and cultivating the root"in treating tumors.The four natures and five flavors of drugs follow syndrome differentiation and the combination of cold and heat.The clustered drug combinations have extensive therapeutic effects,covering various syndromes of breast cancer at different stages,which can provide a reference for clinical medication.

AIM To establish LC-MS and GC-MS method and analyze the chemical constituents of Dendrobium huoshanense C.Z.Tang & S.J.Cheng flowers.METHODS LC-MS was performed on a Zorbax Eclipse C18 column(2.1 mm×100 mm,1.8 μm),with the mobile phase comprising of water(containing 0.1％formic acid)-acetonitrile flowing at 0.3 mL/min,and electrospray ionization was operated in both positive and negative ion modes.The GC-MS employed headspace solid-phase microextraction for sample preparation,and the analysis was performed on an HP-5MS column(30 m×0.25 mm,0.25 μm),with the following temperature program:initial temperature 50 ℃(held for 2 min),increased at 5 ℃/min to 180 ℃(held for 5 min),then raised at 10 ℃/min to 250 ℃(held for 5 min),and electron impact ion source was employed.RESULTS A total of 62 compounds were identified by LC-MS,including 35 flavonoids,4 coumarins,6 alkaloids,6 terpenoids,3 amino acids,2 polyphenols,2 ketones and 4 others.A total of 101 volatile components were identified by GC-MS,including ketones,aldehydes,alcohols,esters,ethers,and acid.CONCLUSION This method can comprehensively analyze the chemical constituents of D.huoshanense flowers,and provide a scientific basis for elucidating its pharmacodynamic material basis.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

Objective To study the predictive value of umbilical artery blood gas analysis combined with early postnatal myocardial enzyme spectrum for neonatal respiratory distress syndrome(RDS)and its severity in premature infants.Methods From January 2018 to December 2024,85 newborns with the gestation age of 30-36+6 weeks who were diagnosed as RDS after birth form Hangzhou Women's Hospital were selected as study group.85 newborns without diagnosed as RDS during the same period were included as control group in a 1:1 ratio.All of them born by cesarean section.The umbilical arterial blood gas analysis was performed and blood samples were collected for blood biochemical tests.The umbilical artery blood pH,base excess,lactate,and myocardial enzyme spectrum such as aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase isoenzymes(CK-MB)were compared between two groups.Binary Logistic regression was used to analyze the correlation between umbilical artery blood gas analysis and venous blood myocardial enzyme spectrum and RDS.Receiver operating characteristic curve of umbilical artery blood pH value and creatine kinase isoenzyme alone and their combined detection for predicting RDS was detected,and area under the curve(AUC),sensitivity and specificity of the single detection and combined detection were compared.The study group was further divided into subgroup A(mild)and subgroup B(severe)and the differences of the above indicators between two subgroups were compared.Results Compared with control group,tstudy group had lower pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were higher than those in control group with statistically significant differences(P＜0.05).pH and CK-MB were correlated with RDS(P＜0.05).The AUC of umbilical artery blood pH in predicting RDS was 0.728,the sensitivity was 0.588 and the specificity was 0.812.Combined with CK-MB,the AUC of predicting RDS was 0.813,the sensitivity was 0.729,and the specificity was 0.824.In the study group,subgroup A had higher pH and base excess levels in umbilical artery blood as well as AST,LDH and CK-MB were lower than those in subgroup B with statistically significant differences(P＜0.05).CK-MB was correlated with disease severity in newborns with RDS(P＜0.01).Conclusion Compared with simple application of pH,the combined use of CK-MB can more accurately predict RDS in premature infants,and also has a certain significance for the severity of RDS in premature infants.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.