Objective To investigate the structural changes and influencing factors of the average inpatient cost per admis-sion in public hospitals in Guangdong Province.Methods Grey relational analysis and structural variation degree analysis were used to analyze the correlation and changes between the average inpatient cost per admission and various cost components in public hospitals of Guangdong Province from 2017 to 2023.Results The average inpatient cost per admission in public hospitals of Guangdong Province showed an overall upward trend from 2017 to 2023,with an average annual growth rate of 3.84％.Among the components,laboratory test fees and examination fees grew at average annual rates of 6.17％and 6.68％,respectively.The top four cost components with the highest grey relational degree with the average inpatient cost were laboratory test fees(0.867),exam-ination fees(0.835),nursing fees(0.784),and treatment fees(0.728).The top four components with the largest structural vari-ation values were surgery fees(2.57％),medical material fees(1.77％),laboratory test fees(1.56％),and examination fees(1.45％).Conclusion The growth of the average inpatient cost per admission has slowed,and the cost structure has been opti-mized to some extent.However,the relatively rapid increase in laboratory test and examination fees has a significant impact on the cost structure.It is necessary to deepen the coordinated governance of healthcare,medical insurance,and medicine,strengthen the leveraging role of medical insurance payment,improve the external governance system and scientific compensation mechanism,and combine these with refined hospital management to promote reasonable cost control and high-quality development in public hospitals.

Objective To investigate the structural changes and influencing factors of the average inpatient cost per admis-sion in public hospitals in Guangdong Province.Methods Grey relational analysis and structural variation degree analysis were used to analyze the correlation and changes between the average inpatient cost per admission and various cost components in public hospitals of Guangdong Province from 2017 to 2023.Results The average inpatient cost per admission in public hospitals of Guangdong Province showed an overall upward trend from 2017 to 2023,with an average annual growth rate of 3.84％.Among the components,laboratory test fees and examination fees grew at average annual rates of 6.17％and 6.68％,respectively.The top four cost components with the highest grey relational degree with the average inpatient cost were laboratory test fees(0.867),exam-ination fees(0.835),nursing fees(0.784),and treatment fees(0.728).The top four components with the largest structural vari-ation values were surgery fees(2.57％),medical material fees(1.77％),laboratory test fees(1.56％),and examination fees(1.45％).Conclusion The growth of the average inpatient cost per admission has slowed,and the cost structure has been opti-mized to some extent.However,the relatively rapid increase in laboratory test and examination fees has a significant impact on the cost structure.It is necessary to deepen the coordinated governance of healthcare,medical insurance,and medicine,strengthen the leveraging role of medical insurance payment,improve the external governance system and scientific compensation mechanism,and combine these with refined hospital management to promote reasonable cost control and high-quality development in public hospitals.

Objective:To observe the safety and short-term efficacy of using an autologous fascia lata sling (AFLS) for tension-free mid-urethral sling (MUS) in the treatment of stress urinary incontinence (SUI).Methods:Between February 2022 and December 2023, 11 patients with SUI underwent AFLS-MUS. Preoperative data were recorded, including basic patient information and completion of urinary distress inventory 6 (UDI-6). During surgery, AFLS was harvested through a small incision using a tendon extractor, and used as a sling for transobturator or retropubic MUS. Perioperative indicators were recorded, including surgical approach, operation time, intraoperative blood loss, postoperative hospital stay, duration of catheterization, perioperative complications (Clavien-Dindo classification), and surgical costs. Follow-ups included outpatient physical examination at 2 months postoperatively, and telephone follow-up at 6 months, 1 year, and annually thereafter. Follow-up content included the presence or absence of urinary leakage symptoms, UDI-6, satisfaction, patient global impression of improvement (PGI-I), and complications.Results:The age of the 11 patients was (54.8±10.9) years (range: 41-72 years), with body mass index of (23.9±1.8) kg/m2 (range: 21.4-27.3 kg/m2). All patients experienced urinary leakage after coughing, sneezing and physical activity, with positive SUI provocation tests. The preoperative UDI-6 was 50.0±21.6 (range: 16.7-79.2), the result of 1-hour pad test was (18.9±12.0) g (range: 2.5-71.2 g). Four cases underwent MUS only, with operation time of (98.0±13.3) minutes (range: 86-117 minutes), and intraoperative blood loss of (17.5±5.0) ml (range: 10-20 ml); 7 cases also underwent pelvic floor repair simultaneously. The postoperative hospital stay was (3.5±2.0) days (range: 2-9 days). The duration of catheterization was (4.5±3.8) days (range: 2-11 days), with postoperative urinary retention in three cases, one of which underwent sling release surgery due to severe postoperative voiding difficulty 1 week after MUS, with no other complications of Clavien-Dindo grade 2 or above. The cost of AFLS harvest plus MUS was (2 762±293) yuan. At the 2-month outpatient follow-up, all patients were free of urinary leakage symptoms, with UDI-6 of 2.3±1.9 (range: 0-8.3); satisfaction was "very satisfied" in 10 cases and "fairly satisfied" in 1 case, with PGI-I all being "much better", and pelvic examinations were normal. Telephone follow-up showed one case lost to follow-up, and the remaining 10 cases had follow-up time of (18.6±4.9) months (range: 7-26 months), all without urinary leakage, with UDI-6 of 2.7±2.6, satisfaction rated as "very satisfied", and PGI-I all "much better".Conclusion:This modified AFLS-MUS for the treatment of SUI shows good short-term efficacy and high safety in harvest site, with the need for more data accumulation and long-term follow-up.

Respiratory syncytial virus(RSV)infection is a major respiratory disease threatening the health of infants and immuno-compromised populations worldwide,with no specific therapeutic drugs available.Traditional Chinese medicine(TCM)has shown unique advantages of multi-target and multi-pathway in the prevention and treatment of RSV infection,and its mechanism is closely re-lated to the regulation of cellular signaling pathways.This article systematically reviews the research progress of TCM including mono-mer components and compound prescriptions in intervening RSV infection through nuclear factor-κB(NF-κB),Janus kinase/signal transducer and activator of transcription(JAK/STAT),phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),mitogen-activated protein kinase(MAPK),nuclear factor E2-related factor 2/heme oxygenase-1(Nrf2/HO-1)and other signaling pathways.Current re-search still has problems such as insufficient analysis of pathway synergy mechanisms,unclear material basis of compounds,and single technical means.Future studies should focus on cross-talk of multiple pathways,identification of active component groups of TCM,and research on"syndrome-type-pathway"association,combined with cutting-edge technologies such as network pharmacology and or-ganoid models,so as to provide a scientific basis for the mechanism and clinical transformation of TCM against RSV infection.

Objective:To analyze the risk factors for growth disturbance (GD) in children with distal femoral epiphyseal fracture (DFEF) after surgical treatment.Methods:A retrospective study was conducted to analyze the clinical data of the 72 children who had undergone surgery for DFEF at Department of Pediatric Orthopaedics, The Second General Hospital of Fuzhou between February 2013 and February 2024. There were 52 boys and 20 girls with an age of 11.0 (5.0, 13.0) years. The data collected included age at injury, gender, side affected, cause for injury, time from injury to surgery, the maximum fracture displacement, Salter-Harris fracture classification, and presence of high-energy trauma. The risk factors for GD after DFEF surgical treatment were determined through univariate analysis and logistic regression analysis.Results:Distal femur GD occurred in 40.2% (29/72) of the children treated surgically for DFEF. The univariate analysis showed that, compared with the children without GD, those with GD had a significantly significantly longer time from injury to surgery ( P=0.005), a significantly greater fracture displacement ( P=0.002), and more severe Salter-Harris fracture classification ( P=0.045). The logistic analysis showed that all the 3 factors were independent risk factors for GD ( P<0.05). Conclusion:After DFEF surgery, the GD risk is significantly increased by the 3 factors:longer time from injury to surgery, greater fracture displacement, and more severe fracture classification.

Bombesin receptor subtype-3 (BRS3) is an orphan G protein-coupled receptor (GPCR) that plays critical roles in energy homeostasis, glucose metabolism, and insulin secretion. Recent structural studies have elucidated BRS3 signaling mechanisms using synthetic ligands, including BA1 and MK-5046. However, the molecular basis of BRS3 activation by bioactive natural compounds and their derivatives, particularly those derived from traditional Chinese medicine, remains unclear. Here, we present high-resolution cryogenic electron microscopy (cryo-EM) structures of the human BRS3-G_q complex in both unliganded and active states bound by two herb-derived compounds (DSO-5a and oridonin), at resolutions of 2.9, 2.8, and 2.9 Å, respectively. These structures display distinct ligand recognition patterns between DSO-5a and oridonin. Although both compounds bind to the orthosteric pocket, they differentially engage the interaction network of BRS3, as demonstrated by mutagenesis studies assessing calcium mobilization and inositol phosphate 1 (IP1) accumulation. These findings enhance our understanding of BRS3 activation and provide valuable insights into the development of small-molecule BRS3 modulators with therapeutic potential.

Objective:To observe the safety and short-term efficacy of using an autologous fascia lata sling (AFLS) for tension-free mid-urethral sling (MUS) in the treatment of stress urinary incontinence (SUI).Methods:Between February 2022 and December 2023, 11 patients with SUI underwent AFLS-MUS. Preoperative data were recorded, including basic patient information and completion of urinary distress inventory 6 (UDI-6). During surgery, AFLS was harvested through a small incision using a tendon extractor, and used as a sling for transobturator or retropubic MUS. Perioperative indicators were recorded, including surgical approach, operation time, intraoperative blood loss, postoperative hospital stay, duration of catheterization, perioperative complications (Clavien-Dindo classification), and surgical costs. Follow-ups included outpatient physical examination at 2 months postoperatively, and telephone follow-up at 6 months, 1 year, and annually thereafter. Follow-up content included the presence or absence of urinary leakage symptoms, UDI-6, satisfaction, patient global impression of improvement (PGI-I), and complications.Results:The age of the 11 patients was (54.8±10.9) years (range: 41-72 years), with body mass index of (23.9±1.8) kg/m2 (range: 21.4-27.3 kg/m2). All patients experienced urinary leakage after coughing, sneezing and physical activity, with positive SUI provocation tests. The preoperative UDI-6 was 50.0±21.6 (range: 16.7-79.2), the result of 1-hour pad test was (18.9±12.0) g (range: 2.5-71.2 g). Four cases underwent MUS only, with operation time of (98.0±13.3) minutes (range: 86-117 minutes), and intraoperative blood loss of (17.5±5.0) ml (range: 10-20 ml); 7 cases also underwent pelvic floor repair simultaneously. The postoperative hospital stay was (3.5±2.0) days (range: 2-9 days). The duration of catheterization was (4.5±3.8) days (range: 2-11 days), with postoperative urinary retention in three cases, one of which underwent sling release surgery due to severe postoperative voiding difficulty 1 week after MUS, with no other complications of Clavien-Dindo grade 2 or above. The cost of AFLS harvest plus MUS was (2 762±293) yuan. At the 2-month outpatient follow-up, all patients were free of urinary leakage symptoms, with UDI-6 of 2.3±1.9 (range: 0-8.3); satisfaction was "very satisfied" in 10 cases and "fairly satisfied" in 1 case, with PGI-I all being "much better", and pelvic examinations were normal. Telephone follow-up showed one case lost to follow-up, and the remaining 10 cases had follow-up time of (18.6±4.9) months (range: 7-26 months), all without urinary leakage, with UDI-6 of 2.7±2.6, satisfaction rated as "very satisfied", and PGI-I all "much better".Conclusion:This modified AFLS-MUS for the treatment of SUI shows good short-term efficacy and high safety in harvest site, with the need for more data accumulation and long-term follow-up.

Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.

Respiratory syncytial virus(RSV)infection is a major respiratory disease threatening the health of infants and immuno-compromised populations worldwide,with no specific therapeutic drugs available.Traditional Chinese medicine(TCM)has shown unique advantages of multi-target and multi-pathway in the prevention and treatment of RSV infection,and its mechanism is closely re-lated to the regulation of cellular signaling pathways.This article systematically reviews the research progress of TCM including mono-mer components and compound prescriptions in intervening RSV infection through nuclear factor-κB(NF-κB),Janus kinase/signal transducer and activator of transcription(JAK/STAT),phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),mitogen-activated protein kinase(MAPK),nuclear factor E2-related factor 2/heme oxygenase-1(Nrf2/HO-1)and other signaling pathways.Current re-search still has problems such as insufficient analysis of pathway synergy mechanisms,unclear material basis of compounds,and single technical means.Future studies should focus on cross-talk of multiple pathways,identification of active component groups of TCM,and research on"syndrome-type-pathway"association,combined with cutting-edge technologies such as network pharmacology and or-ganoid models,so as to provide a scientific basis for the mechanism and clinical transformation of TCM against RSV infection.

Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.