Objective:To analyze the coupling coordination relationship and spatial correlation among the service demand,resource allocation and utilization efficiency of Traditional Chinese Medicine(TCM),aiming to provide theoretical support and optimization strategies for achieving the coordinated operation of the TCM systems in various provinces and promoting the coordinated development of TCM in different provinces.Methods:The data were collected from the China Health and Family Planning Statistical Yearbook(2013-2017)and the China Health Statistics Yearbook(2018-2023),the entropy method was employed to determine the weight of each evaluation index within the subsystems.A coupling coordination degree model and spatial econometric model were applied to assess the coupling coordination values and spatial correlations of the TCM system across various provinces in China.Results:In 2022,the national average coupling coordination degree was 0.603,with values of 0.648,0.577,and 0.563 for the eastern,central,and western regions,respectively.The western region had the highest number of provinces classified as"disordered type".A spatial clustering effect of the coupling coordination degree across 30 provinces.Conclusions:While the allocation of TCM resources has shown steady improvement,the demand for TCM services and utilization efficiency have exhibited a declining trend.The coupling coordination degree follows a decreasing gradient from east to west and exhibits significant spatial effects,a regional collaborative development mechanism for TCM should be established.

Objective:To investigate the effect of baicalin on Th17/Treg cell balance in autoimmune myocarditis(AM)rats and its possible mechanism.Methods:AM rats were grouped into control group,model group,low-dose baicalin group[20 mg/(kg·d)],high-dose baicalin group[100 mg/(kg·d)],and high mobility group B1(HMGB1)inhibitor group;the cardiac ultrasound diagnostic instrument was applied to detect the cardiac function of rats in each group,the cardiac mass index,hematoxylin eosin(HE)staining was applied to detect myocardial pathology,ELISA was applied to detect serum levels of cytokines such as IFN-γ,IL-4,IL-17 and TGF-β,Western blot was applied to detect the expression levels of myocardial HMGB1 and receptor for advanced glycation end product(RAGE)proteins,flow cytometry was applied to detect the proportions of Th17 and Treg cells in the spleen.Results:Com-pared with the control group,the rats in the model group showed myocarditis symptoms and diffuse inflammatory cell infiltration under the endocardium,the left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVEDs),IFN-γ,IL-4,IL-17,TGF-β,the proportion of Th17 cells and the expression levels of HMGB1 and RAGE proteins increased,the left ventricular short axis shortening fraction(FS%),ejection fraction(LVEF%),cardiac mass index,and the proportion of Treg cell decreased(P<0.05);compared with the model group,the myocardial interstitial edema and inflammatory cell infiltration were reduced in the ba-icalin low and high dose groups and HMGB1 inhibitor groups,and the proportion of LVEDd,LVEDs,serum IFN-γ and IL-17,spleen Th17 cells and the expression levels of myocardial HMGB1 and RAGE protein were decreased.FS%,LVEF%,heart mass index,IL-4,TGF-β,Treg cell proportion increased;compared with the low-dose baicalin group,the symptoms of myocarditis in the high-dose baicalin group and the HMGB1 inhibitor group were obviously improved,the LVEDd,LVEDs,IFN-γ,IL-17,the proportion of Th17 cells,and the expression levels of HMGB1 and RAGE proteins decreased,the FS%,LVEF%,cardiac mass index,IL-4,TGF-β,and the proportion of Treg cells increased(P<0.05);there was no statistically obvious difference in each index between the high-dose baicalin group and the HMGB1 inhibitor group(P>0.05).Conclusion:The protective effect of baicalin on AM rats is related to the inhibition of HMGB1/RAGE axis activation.

Ferroptosis is a programmed cell death depends on iron and lipid peroxidation,which has been recognized as the key pathogenic factor for the occurrence of various diseases in recent years,especially playing a significant role in neurodegenerative diseases.Ferroptosis triggers lipid peroxidation and oxidative stress in neuronal cells,leading to neuronal damage and death,thereby accelerating disease progression.Hydrogen sulfide,as an endogenous gaseous signaling molecule,exhibits multiple protective effects,including anti-inflammatory,antioxidant,and anti-ferroptosis properties.Hydrogen sulfide can effectively inhibit the occurrence of ferroptosis through various mechanisms,such as regulating iron metabolism,inhibiting lipid peroxidation,and enhancing the activity of antioxidant enzymes,thereby slowing down the progression of neurodegenerative diseases.This article reviews the related research progress on hydrogen sulfide and ferroptosis and ferroptosis-mediated neurodegenerative diseases,and analyzes the underlying mechanisms,aims to provide new insights and theoretical foundations for the treatment of neurodegenerative diseases.

Objective To integrate and optimize the hospital adverse event reporting system,and to enhance the repor-ting rate of medical safety adverse events by using PDCA cycle management method.Achieve closed-loop management of adverse events,improve the efficiency of adverse event management in the hospital,assist in hospital grading review and-quality develop-ment,and reduce the mortality rate of low-risk groups in the hospital.Methods Based on the SPO theory,the quality control circle,PDCA management,flow chart and description method were used,and combined with the previous adverse event manage-ment experience,the adverse event reporting and tracking process was simplified,and adverse event management information platform was optimized and restructured.The period from January to December 2023(control group)and the period from January to 2024(observation group)were compared and analyzed for the number of adverse event reports per 100 discharges and the mor-tality rate of the low-risk group before and after the implementation of PDCA cycle management.Results The application of PDCA cycle management effectively improved the reporting rate of medical safety adverse events and reduced the mortality rate of the hospital's low-risk group.Conclusion The integrated and designed adverse event management system has good applicability and can be promoted for use in hospital management.

Aim To explore the possible regulatory effect of leptin on acyl-CoA synthetase long chain fami-ly member ACSL5 and their effect on migration and in-vasion of breast cancer cell,and to explore the underly-ing mechanism.Methods The expression of leptin receptor was detected by immunofluorescence assay.The migration and invasion ability of MCF-7 cells were detected by wound healing assay and Transwell assay respectively.The downstream target gene of leptin was analyzed by PCR microarray data.The expression of ACSL5 in breast cancer and its correlation with the staging and prognosis of breast cancer patients were as-sessed uing bioinformatics methods.The expression of ACSL5 in MCF-7 cells treated with different concentra-tions of leptin was detected using real time fluorescence quantitative polymerase chain reaction(RT-qPCR).Overexpressing ACSL5 was constructed by lentiviral transfection;the expressions of EMT related proteins,AMPK-α and p-AMPK-α were detected by Western blot.Results Leptin promoted breast cancer cell mi-gration and invasion and EMT.ACSL5 was significant-ly low expressed in breast cancer and related to progno-sis.Leptin downregulated the expression of ACSL5 through OBR.Leptin activated AMPK pathway to downregulate ACSL5 and promote migration,invasion and EMT of breast cancer cells.Conclusions Leptin may promote the migration,invasion and EMT of breast cancer by downregulating ACSL5 through activating AMPK pathway.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.

Objective:To retrospectively analyse the clinical data of patients after NUSS procedure for pectus excavatum, and summary of surgical techniques for NUSS bar removal.Methods:Retrospectively collected the clinical data of 276 patients undergoing NUSS bar removal from January 2024 to September 2024 in Beijing Children's Hospital affiliated to Capital Medical University. The age of the patients ranged from 6 to 20 years old, 211 males and 65 females. The average time the bar was in place in the body was 36 months.Results:All 276 patients successfully completed the NUSS bar removal. The average operative time was 22.6 min, with an average blood loss of 3.3 ml. 90 patients with bone scabs, 104 patients with wire breakage were successfully removed. 2 cases of postoperative wound infection, no other intraoperative and postoperative complications. The average hospitalization time after surgery was 1.2 days. Follow up for 3 months after surgery, and no abnormalities were found on the chest X-ray.Conclusion:Mastering the surgical techniques for pectus excavatum bar removal enhances the safety and efficiency of the procedure. It effectively reduces the incidence of intraoperative and postoperative complications, shortens operative time, and alleviates postoperative pain in patients.

Objective:To investigate the effect of baicalin on Th17/Treg cell balance in autoimmune myocarditis(AM)rats and its possible mechanism.Methods:AM rats were grouped into control group,model group,low-dose baicalin group[20 mg/(kg·d)],high-dose baicalin group[100 mg/(kg·d)],and high mobility group B1(HMGB1)inhibitor group;the cardiac ultrasound diagnostic instrument was applied to detect the cardiac function of rats in each group,the cardiac mass index,hematoxylin eosin(HE)staining was applied to detect myocardial pathology,ELISA was applied to detect serum levels of cytokines such as IFN-γ,IL-4,IL-17 and TGF-β,Western blot was applied to detect the expression levels of myocardial HMGB1 and receptor for advanced glycation end product(RAGE)proteins,flow cytometry was applied to detect the proportions of Th17 and Treg cells in the spleen.Results:Com-pared with the control group,the rats in the model group showed myocarditis symptoms and diffuse inflammatory cell infiltration under the endocardium,the left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVEDs),IFN-γ,IL-4,IL-17,TGF-β,the proportion of Th17 cells and the expression levels of HMGB1 and RAGE proteins increased,the left ventricular short axis shortening fraction(FS%),ejection fraction(LVEF%),cardiac mass index,and the proportion of Treg cell decreased(P<0.05);compared with the model group,the myocardial interstitial edema and inflammatory cell infiltration were reduced in the ba-icalin low and high dose groups and HMGB1 inhibitor groups,and the proportion of LVEDd,LVEDs,serum IFN-γ and IL-17,spleen Th17 cells and the expression levels of myocardial HMGB1 and RAGE protein were decreased.FS%,LVEF%,heart mass index,IL-4,TGF-β,Treg cell proportion increased;compared with the low-dose baicalin group,the symptoms of myocarditis in the high-dose baicalin group and the HMGB1 inhibitor group were obviously improved,the LVEDd,LVEDs,IFN-γ,IL-17,the proportion of Th17 cells,and the expression levels of HMGB1 and RAGE proteins decreased,the FS%,LVEF%,cardiac mass index,IL-4,TGF-β,and the proportion of Treg cells increased(P<0.05);there was no statistically obvious difference in each index between the high-dose baicalin group and the HMGB1 inhibitor group(P>0.05).Conclusion:The protective effect of baicalin on AM rats is related to the inhibition of HMGB1/RAGE axis activation.

Ferroptosis is a programmed cell death depends on iron and lipid peroxidation,which has been recognized as the key pathogenic factor for the occurrence of various diseases in recent years,especially playing a significant role in neurodegenerative diseases.Ferroptosis triggers lipid peroxidation and oxidative stress in neuronal cells,leading to neuronal damage and death,thereby accelerating disease progression.Hydrogen sulfide,as an endogenous gaseous signaling molecule,exhibits multiple protective effects,including anti-inflammatory,antioxidant,and anti-ferroptosis properties.Hydrogen sulfide can effectively inhibit the occurrence of ferroptosis through various mechanisms,such as regulating iron metabolism,inhibiting lipid peroxidation,and enhancing the activity of antioxidant enzymes,thereby slowing down the progression of neurodegenerative diseases.This article reviews the related research progress on hydrogen sulfide and ferroptosis and ferroptosis-mediated neurodegenerative diseases,and analyzes the underlying mechanisms,aims to provide new insights and theoretical foundations for the treatment of neurodegenerative diseases.

Aim To investigate the protective effect of Siwu decoction(SWD)on immune injury induced by 60Coγ-rays in mice and the related mechanism.Meth-ods C57BL/6J mice were randomly divided into six groups:Control group(Control),Model group(Mod-el),Siwu decoction low-dose group(SWD-L),Siwu decoction medium-dose group(SWD-M),Siwu decoc-tion high-dose group(SWD-H)and resveratrol positive group(Resveratrol,Res).The drug was continued to be administered 11 days before and after irradiation,with a single whole-body irradiation of 4 Gy,and all in-dexes were detected three days after irradiation.The changes of peripheral blood and organ indexes were de-tected.Serum levels of cytokine interferon gamma(IFN-γ),interleukin-1 β(IL-1 β),IL-2,IL-4,IL-6,IL-10,IL-17,transforming growth factor-β(TGF-β),tumor necrosis factor(TNF)-α,and immunoglobulin A(IgA),IgG,IgM,and complement protein 3(C3),C4 content were detected by enzyme-linked immunosorbent assay(ELISA).B lymphocytes,T lymphocytes,NK cells in spleen and T lymphocytes in thymus were de-tected by flow cytometry.The pathological changes of spleen and thymus were analyzed by hematoxylin-eosin(HE)staining.The expression of Sirt 1 protein in spleen after radiation was detected by immunofluores-cence staining.The protein contents of Sirt1,PI3K,Akt,p-Akt and mTOR in spleen were detected by Western blot assay.Results SWD could significantly increase LYMPH％and reduce pathological injury of spleen and thymus.Flow cytometry showed that SWD could significantly increase the percentage of CD19+B lymphocytes in spleen,decrease the percentage of NK lymphocytes and the ratio of CD4+/CD8+in spleen and thymus.ELISA results showed that SWD signifi-cantly inhibited the expression of IL-1 β,IL-2,IL-6,IL-17,IFN-γ,TGF-β,TNF-α,and increased the content of anti-inflammatory factors IL-4 and IL-10.At the same time,SWD significantly inhibited the increase of IgA,IgG,IgM,C3 and C4 induced by radiation.The results of immunofluorescence staining and Western blot showed that SWD could decrease the expression of PI3K,Akt,p-Akt and mTOR protein,and enhance the expression of Sirt1 protein.Conclusions SWD has obvious preventive effect on immune damage induced by 60Co gamma radiation in mice.The mechanism may be related to Sirt1-PI3K-Akt-mTOR.