ObjectiveTo investigate the effects of 7-dehydrocholesterol reductase （DHCR7） in promoting proliferation， migration， and invasion of lung adenocarcinoma cells and the underlying signaling mechanisms. MethodsThe expression level of DHCR7 in lung adenocarcinoma and its prognosis were analyzed by using public databases. DHCR7 protein expression levels in the lung adenocarcinoma cell lines H1299 and A549 were assessed by Western blot， using the normal lung epithelial cell line BEAS-2B as a control. Small interfering RNA （siRNA） was used to knock down DHCR7 expression in H1299 and A549 cells. Assays including colony formation， CCK-8， wound healing， and Transwell experiments were conducted to assess the proliferation， migration， and invasion of the knockdown cells. Next， Western blot was employed to assess the phosphorylation levels of key signaling molecules in the phosphoinositide 3-kinase/protein kinase B （PI3K/AKT）， janus kinase/signal transducer and activator of transcription 3 （JAK/STAT3），mitogen-activated protein kinase/extracellular signal-regulated kinase pathway （MAPK/ERK） （p-AKT， p-STAT3， p-ERK）. ResultsBioinformatics results indicated that both DHCR7 mRNA and protein were highly expressed in lung adenocarcinoma compared with normal tissues adjacent to cancer. Furthermore， higher DHCR7 mRNA level was associated with poor prognosis （P<0.001）. The expression levels of DHCR7 were significantly higher in both H1299 and A549 cells than that in BEAS-2B cells （P<0.05， P<0.01）. Compared with si-control， the proliferation， migration， and invasion abilities of si-DHCR7 H1299 and A549 cells significantly decreased. Among the phosphorylated signaling molecules detected， p-ERK was significantly downregulated （P<0.000 1， P<0.01） whereas p-AKT and p-STAT3 levels were not significantly changed. ConclusionDHCR7 has prominent effects in promoting the proliferation， migration， and invasion of lung adenocarcinoma cells， and the underlying mechanisms are related to the MAPK/ERK signaling pathway.

Objective To analyze the imaging features of cerebral small vessel disease in patients with type 2 diabetes mellitus by multimodal MRI.Methods The clinical data of 160 patients with cerebral small vessel disease admitted to our hospital from January to December 2020 were retrospectively analyzed.According to whether they were complicated with type 2 diabetes mellitus,they were divided into the diabetic group and the non-diabetic group,with 80 cases in each group.Both groups underwent multimodal MRI scans.And the severity of lacunar infarction,the severity of subcortical and periventricular white matter lesions,white matter integral and cerebral microbleeds of patients in the two groups were compared.Results The severity of lacunar infarction(χ2=34.076,P=0.001),subcortical white matter lesions(χ2=25.000,P=0.001),periventricular white matter lesions(χ2=22.895,P=0.001)and white matter integral(t=12.370,P=0.001)of patients in the diabetic group were significantly higher than those in the non-diabetic group.No cerebral microbleeds were detected in either group of patients.Conclusion Patients with cerebral small vessel disease and type 2 diabetes mellitus show characteristic multimodal MRI changes.The increase in the number of lacunar infarction lesions and the aggravation of white matter lesions can be used as the characteristic imaging basis for the diagnosis of type 2 diabetes mellitus related cerebral small vessel disease.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.

Objective To address the current issues of strong subjectivity in drug classification,vague classification standards,and complex influencing factors,this study aims to explore a scientific method for drug classification to reduce inventory costs and improve inventory effectiveness.Methods A total of 700 drugs were randomly selected from the historical data of a tertiary hospital in Beijing from 2021 to 2022 as the research subjects.The classification was conducted using the Principal Component Analysis(PCA)algorithm and the K-means clustering algorithm(K-means).Results The optimal number of classifications was determined to be 4,with a silhouette coefficient of 0.347 0.The 700 drugs were divided into four categories,with 363 in the first category,186 in the second,94 in the third,and 57 in the fourth.The drug classification method studied in this paper was simulated and applied to the drug inventory management of a certain tertiary hospital in the second quarter of 2023.The simulation results indicated that the classification method studied in this paper could reduce inventory costs and improve inventory effectiveness.Conclusion The drug classification method based on PCA algorithm and K-means clustering algorithm can provide a reliable basis for the management of drug inventory classification.

Objective To address the current issues of strong subjectivity in drug classification,vague classification standards,and complex influencing factors,this study aims to explore a scientific method for drug classification to reduce inventory costs and improve inventory effectiveness.Methods A total of 700 drugs were randomly selected from the historical data of a tertiary hospital in Beijing from 2021 to 2022 as the research subjects.The classification was conducted using the Principal Component Analysis(PCA)algorithm and the K-means clustering algorithm(K-means).Results The optimal number of classifications was determined to be 4,with a silhouette coefficient of 0.347 0.The 700 drugs were divided into four categories,with 363 in the first category,186 in the second,94 in the third,and 57 in the fourth.The drug classification method studied in this paper was simulated and applied to the drug inventory management of a certain tertiary hospital in the second quarter of 2023.The simulation results indicated that the classification method studied in this paper could reduce inventory costs and improve inventory effectiveness.Conclusion The drug classification method based on PCA algorithm and K-means clustering algorithm can provide a reliable basis for the management of drug inventory classification.

Objective To observe the clinical efficacy and safety of vericiguat tablets combined with sacubitril valsartan sodium(Sac/Val)tablets in the treatment of patients with heart failure with reduced ejection fraction(HFrEF).Methods The HFrEF patients were divided into control group and treatment group according to the cohort method.The control group was treated with Sac/Val tablets 200 mg per time,bid,orally.On the basis of control group,the treatment group was treated with vericiguat tablets 2.5 mg per time,qd,taken with meal.Two groups were treated for 3 months.The clinical efficacy,left ventricular ejection fraction(LVEF),left ventricular end-diastolic dimension(LVEDD)and end-systolic diameter(LVESD),levels of high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),nitric oxide(NO),N-terminal pro-brain natriuretic peptide(NT-proBNP),blood urea nitrogen(BUN)and serum creatinine(SCr),and safety were compared between the two groups.During follow-up,the heart failure rehospitalization rates and major adverse cardiovascular events were compared between the two groups.Results Treatment group was enrolled 53 patients,control group was enrolled 53 patients.After treatment,the total effective rates of treatment and control groups were 94.34％(50 cases/53 cases)and 81.13％(43 cases/53 cases)with statistical significant difference(P＜0.05).After treatment,the LVEF of treatment and control groups were(48.02±5.20)％and(43.02±4.33)％,the LVEDDs were(52.85±6.30)and(55.63±6.88)mm,the LVESDs were(41.64±6.40)and(44.22±5.85)mm,the levels of hs-CRP were(10.22±2.63)and(14.60±2.98)mg L-1,the levels of IL-6 were(14.48±2.40)and(17.36±2.52)pg·mL-1,the levels of NO were(102.60±20.16)and(92.16±16.33)μmol·L-1,the levels of NT-proBNP were(898.74±102.20)and(1315.60±182.64)ng·L-1,the levels of BUN were(12.02±2.28)and(13.45±2.33)mmol·L-1,the levels of SCr were(82.22±5.89)and(85.64±6.03)μmol·L-1,the heart failure rehospitalization rates were 5.66％and 13.21％,respectively;the differences were statistical significant between two groups(all P＜0.05).The adverse drug reactions of treatment group were hyperkalemia,hypotension,renal dysfunction,dizziness and headache,while those in control group were renal dysfunction,hyperkalemia,and hypotension.The major adverse cardiovascular events of treatment group were angina pectoris and acute myocardial infarction,while those in control group were angina pectoris,acute myocardial infarction and atrial fibrillation.The incidences of total adverse drug reactions in treatment and control groups were 13.21％and 7.55％,the incidences of major adverse cardiovascular events were 5.66％and 13.21％,respectively,without statistically significant differences(all P＞0.05).Conclusion Vericiguat tablets combined with Sac/Val tablets have a definitive clinical efficacy in the treatment of HFrEF patients,which can improve cardiac and endothelial function,reduce inflammatory response and readmission times,without increasing the incidences of adverse drug reactions.

OBJECTIVE To understand the disinfectant-resistant genes in the gram-negative bacteria isolated from the dirt retention on air recure filters of air conditioners and observe the drug resistance.METHODS The dirt re-tention samples were collected from the air return filters of air conditioners of some wards in 3 hospitals of Wuhan(Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan Central Hospital,and Hubei Provincial Maternal and Child Health Hospital)from 2018 to 2024.The gram-negative bac-teria were screened out,the disinfectant-resistant genes in the strains were detected by polymerase chain reaction(PCR),and the results of drug susceptibility test were analyzed.RESULTS Of 354 dirt retention samples that were collected from the air return filers of air conditioners,77 were detected with 138 strains of gram-negative bacteria,87 of which were Acinetobacter baumannii,50 were Enterobacteriaceae,and 1 was Pseudomonas aerug-inosa.The detection rates of qacEΔ1,qacEΔ1-sul1,aceI and qacA/B were 73.19％,82.61％,69.57％and 2.90％,respectively.None of the strains were detected with qacC,qacH or qacJ.The result of drug susceptibility test showed that 76.81％of the gram-negative bacteria were resistant to at least 1 type of antibiotic;93 strains of multidrug-resistant gram-negative bacteria were isolated,most of which were isolated from intensive care unit(ICU).The detection rates of qacEΔ1 and qacEΔ1-sul1 were higher in the drug-resistant strains than those in the non-drug-resistant strains;there were significant differences in the drug resistance rates to carbapenems,quin-olones and β-lactams between the qacEΔ1-sul 1-positive strains and the qacEΔ1-sul1-negative strains(P＜0.05).CONCLUSIONS There are drug-resistant gram-negative bacteria contaminations in some wards of the 3 hospitals in Wuhan.The carrying rates of disinfectant-resistant genes of the strains are high,and the strains show varying degree of resistance to the commonly used antibiotics;the strains carrying the qacEΔ1-sul1 have certain statistical association with the drug resistance.It is suggested that the hospital should take targeted disinfec-tion measures for the environment and reasonably use antibiotics.

OBJECTIVE To understand the disinfectant-resistant genes in the gram-negative bacteria isolated from the dirt retention on air recure filters of air conditioners and observe the drug resistance.METHODS The dirt re-tention samples were collected from the air return filters of air conditioners of some wards in 3 hospitals of Wuhan(Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan Central Hospital,and Hubei Provincial Maternal and Child Health Hospital)from 2018 to 2024.The gram-negative bac-teria were screened out,the disinfectant-resistant genes in the strains were detected by polymerase chain reaction(PCR),and the results of drug susceptibility test were analyzed.RESULTS Of 354 dirt retention samples that were collected from the air return filers of air conditioners,77 were detected with 138 strains of gram-negative bacteria,87 of which were Acinetobacter baumannii,50 were Enterobacteriaceae,and 1 was Pseudomonas aerug-inosa.The detection rates of qacEΔ1,qacEΔ1-sul1,aceI and qacA/B were 73.19％,82.61％,69.57％and 2.90％,respectively.None of the strains were detected with qacC,qacH or qacJ.The result of drug susceptibility test showed that 76.81％of the gram-negative bacteria were resistant to at least 1 type of antibiotic;93 strains of multidrug-resistant gram-negative bacteria were isolated,most of which were isolated from intensive care unit(ICU).The detection rates of qacEΔ1 and qacEΔ1-sul1 were higher in the drug-resistant strains than those in the non-drug-resistant strains;there were significant differences in the drug resistance rates to carbapenems,quin-olones and β-lactams between the qacEΔ1-sul 1-positive strains and the qacEΔ1-sul1-negative strains(P＜0.05).CONCLUSIONS There are drug-resistant gram-negative bacteria contaminations in some wards of the 3 hospitals in Wuhan.The carrying rates of disinfectant-resistant genes of the strains are high,and the strains show varying degree of resistance to the commonly used antibiotics;the strains carrying the qacEΔ1-sul1 have certain statistical association with the drug resistance.It is suggested that the hospital should take targeted disinfec-tion measures for the environment and reasonably use antibiotics.

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

Objective:To analyze the epidemiological characteristics of herpes zoster (HZ) in Zhoushan and Shaoxing cities of Zhejiang Province from 2022 to 2024.Methods:The HZ data were obtained from the Zhejiang Regional Health Information Platform. Specifically, information was sourced from 42 public hospitals and 149 primary healthcare institutions in Zhoushan and Shaoxing, covering both outpatient and inpatient records (e.g., name, sex, date of birth, ID number, visit date, diagnosis code, admission/discharge dates, and medical expenses). Additionally, vaccination records were matched by ID number from the Zhejiang Immunization Planning Smart Service Information System, including vaccination date, dose, and manufacturer. Permanent resident population data for both cities were collected and stratified by age, sex, and district/county. Based on these data, the epidemiological characteristics of HZ, such as incidence rate, hospitalization rate, and recurrence rate, as well as the occurrence of complications and vaccination, were analyzed.Results:From 2022 to 2024, a total of 45 280 initial HZ cases were identified. The mean age of patients was 57.82 years, with 52.69% being female patients and 95.01% being outpatient cases. Notably, the overall incidence rate of HZ was 3.18‰, showing a significant upward trend ( P<0.001). HZ occurred throughout the year without marked seasonality. The incidence rate increased with age ( P<0.001). The incidence rate was higher in females than males (3.46‰ vs. 2.91‰, P<0.001) and also higher in Shaoxing than Zhoushan (3.38‰ vs. 1.87‰, P<0.001). Regarding complications, these occurred in 44.51% (20 157/45 280) of patients, with the most common complication being postherpetic neuralgia. The incidence rate of HZ with complications was lower than that without complications (1.41‰ vs. 1.76‰, P<0.001), but both hospitalization (0.14‰ vs. 0.03‰, P<0.001) and recurrence rates (27.43‰ vs. 6.69‰, P<0.001) were higher for cases with complications. Additionally, among individuals aged ≥40 years, the overall HZ vaccination rate was 1.42‰. Conclusion:Herpes zoster imposes a substantial disease burden in Zhejiang Province, while the vaccination rate remains low.