Objective To explore the characteristics,potential challenges,and optimization paths of high-quality development policies for public hospitals in China,and to provide reference for policy formulation and implementation.Methods The 31 policy documents on high-quality development of public hospitals issued at the central and provincial levels between 2021 and 2024 were coded using Nvivo 11 software,and a three-dimensional analytical framework was constructed on the basis of the policy tools,stakeholders,and system dimensions,combining both quantitative and qualitative methods for content analysis.Results It found that the distribution of policy content in the three dimensions was characterized by stage imbalance:policy tools were mainly environmental,followed by supply,and demand;stakeholder attention was focused on public hospitals and healthcare administrations,and patient attention was low;The system dimension focused mainly on the macro level,with less distribution at the meso and micro levels.Although the unbalanced distribution of policy instruments is relevant at certain stages,the long-term structural imbalance may lead to insufficient systemic policies and weakened stakeholder synergies,and there is an urgent need to optimize the structure of instruments.Conclusions It is recommended to increase the proportion of demand-based policy instruments in policy design and dynamically adjust the synergistic application of the three types of instruments;to strengthen the attention to vulnerable stakeholders,such as patients;and to optimize the design of policies at the meso-levels and micro-levels in order to enhance the systemicity and sustainability of policy implementation.

Objective To explore the effect of training weights on energy expenditure(EE)among young males during squatting.Methods Twenty young males with strength training experience≥1 year were recruited and performed 3 sets of squats,with 5 repetitions per set,at 40%1RM,60%1RM and 80%1RM,respectively,with an interval of at least 72 hours.Oxygen uptake(VO2),heart rate,blood lactate,and the mechanical work on the barbell during squat exercises were measured before,during,and after each sets.Moreover,one-way repeated-measures ANOVA was used to compare EE differenc-es between different training weights,and two-way ANOVA was employed to examine the weight×method effect on metabolic equivalent(MET)values.Meanwhile,Pearson's correlation analysis was conducted to examine the correlation between EE and barbell mechanical work.Results(1)Training weight has significant effects on the total energy expenditure and EE during excess post-exercise oxy-gen consumption(EPOC)stage(P<0.001),while a significant increase was observed in the glycolytic EE only at 80%1RM and the aerobic EE with no less than 60%1RM(P<0.01 and P<0.05).(2)The percentage of EPOC-stage and glycolytic EE in the total energy expenditure was significantly higher than the aerobic EE(P<0.01),while that of aerobic EE at 40%1RM and 60%1RM was significantly higher than at 80%1RM(P<0.01).(3)Total energy expenditure(r=0.65,P<0.001)and EPOC-stage EE(r=0.68,P<0.001)showed moderate correlation with the mechanical work done.(4)Aerobic EE was significantly lower than the mechanical work done during squatting(P<0.001).Moreover,the MET values of squats calculated using aerobic EE during exercise at 40%-80%1RM was 2.42±0.54,2.89±0.87 and 2.7±0.56,while the MET ones calculated using the total energy expenditure reached 14.99±2.94,20.52±4.51 and 28.57±6.88.Conclusions Only EPOC-stage and glycolytic EE elevate with the increase of weight.Moreover,EE and the MET value scalculated using VO2 dur-ing exercise may under estimate the actual intensity of squat.Meanwhile,the accuracy of EE estima-tion may be improved by introducing the mechanical work.

AIM:To investigate the effect and mechanism of panax notoginseng saponins(PNS)inhibiting the proliferation of pulmonary artery smooth muscle cells(PASMCs)in rats under the ef-fect of monocrotaline(MCT).METHODS:PASMCs cultured in vitro were randomly divided into the normal control(Control)group,the monocrotaline(MCT)group,the panax notoginseng saponins(PNS)group,the knockdown(M+Si ADAM10)group,the knockdown postconditioning(M+P+Si ADAM10)group,the overexpression(M+OE AD-AM10)group,and the overexpression postcondi-tioning(M+P+OE ADAM10)group.After the model was constructed,the cell viability of each group was measured using the CCK-8 assay,along with Western blot utilized to detect the expression of proliferating cell nuclear antigen(PCNA),disinteg-rin metalloproteinase 10(ADAM10),and notch ho-mology protein-3(Notch3)at the cellular neurogen-ic locus,respectively.RESULTS:Under the effect of MCT,the viability of PASMCs was significantly en-hanced(P<0.05 or P<0.01);0-400 mg/L PNS was not toxic to the viability of normal cells,and 100 mg/L PNS could significantly inhibit the MCT-in-duced viability(P<0.01).After the knockdown of ADAM10,the viability of PASMCs significantly de-clined(P<0.01),and the expression of PCNA protein was significantly decreased(P<0.05),evidently in the M+P+Si ADAM10 group.Meanwhile,the ex-pression of ADAM10 and Notch3 protein was signif-icantly decreased(P<0.05 or P<0.01),evidently in the M+P+Si ADAM10 group.After overexpression of ADAM10,the viability of PASMCs was significant-ly enhanced(P<0.01),the expression of PCNA pro-tein was significantly increased(P<0.01),the PCNA value was slightly higher(P>0.05),and the expres-sion of ADAM10 and Notch3 protein was signifi-cantly elevated(P<0.05)in the M+P+OE ADAM10 group.Additionally,PASMCs overexpressing AD-AM10 with concomitant PNS exhibited a significant decrease in the expression of PCNA protein com-pared with PASMCs knocking down ADAM10(P<0.01),and the expression of ADAM10 and Notch3 protein declined to varying degrees(P>0.05).CON-CLUSION:Panax notoginseng saponins can mitigate MCT-induced PASMCs proliferation in rats by inhib-iting the ADAM10/Notch3 signaling pathway.

Objective To investigate the expression of GJB4 gene in pancreatic cancer tissue and its correlation with clinicopathology.Methods The expression levels of GJB4 mRNA in pancreatic cancer and adjacent cancer tissues were analyzed using bioinformatics to analyze the Cancer Genome Atlas(TCGA)and Genotype-Tissue Expression(GTEx)RNA sequencing datasets.A total of 120 pancreatic cancer samples and 40 adjacent cancer samples from the Pathology Department of The Second Affiliated Hospital of Kunming Medical University from January 2019 to December 2023 were collected and sorted.Immunohistochemistry staining method was used to detect the expression difference of GJB4 protein between the two groups.RT-qPCR method was used to detect the expression levels of GJB4 in four pancreatic cancer cell lines.Univariate and multivariate Cox regression and Kaplan-Meier curves were used to analyze the clinical pathological data of GJB4 and pancreatic cancer patients.DAVID functional annotation bioinformatics and GSEA enrichment analysis were used to explore the relevant pathways of GJB4 in pancreatic cancer.Results The expression level of GJB4 mRNA in pancreatic cancer was higher than that in adjacent tissues,and the high expression of GJB4 was significantly associated with poor prognosis of patients(P<0.05).Immunohistochemical analysis showed that GJB4 protein was brown-yellow granular in pancreatic cancer tissues,mainly expressed in cytoplasm and cell membrane,and GJB4 protein expression was up-regulated in pancreatic cancer(P<0.05).The RT-qPCR test results showed that out of 4 pancreatic cancer cell lines,3 of them had upregulated expression(P<0.05).COX regression analysis showed that GJB4 gene was an independent risk factor in the prognosis of pancreatic cancer patients.The results of GO enrichment analysis showed that GJB4 was related to the transmembrane transport,ion channel,signal release and membrane potential regulation of pancreatic cancer.GSEA analysis showed that GJB4 was enriched in the Wnt/β-catenin signaling pathway.Conclusion In pancreatic cancer,the high expression level of GJB4 is closely related to the clinicopathological features of the patients,which may predict the poor prognosis of the patients.GJB4 may be involved in regulating the Wnt/β-catenin signaling pathway of pancreatic cancer,and is expected to be one of the potential biomarkers of pancreatic cancer prognosis.

OBJECTIVE:To conduct a Meta-analysis of evaluating the effects of whole-body vibration training on bone mineral density in postmenopausal women.METHODS:We searched CNKI,WanFang,PubMed,and Web of Science for studies on whole body vibration training to improve bone mineral density in postmenopausal women from database inception to April 3,2024,with the search terms whole-body vibration training,postmenopausal women,osteoporosis,and bone mineral density.Included indicators were lumbar spine(L1-L4,L2-L4),femoral neck,greater trochanter,Ward's triangle,and whole-body bone density.Revman 5.3 and R 4.3.3 were used for data analysis.RESULTS:(1)A total of 28 randomized controlled studies were included.(2)Vibration intensity:Vibration frequency＞20 Hz and amplitude＞2 mm could significantly increase the bone mineral density of the femoral neck,greater trochanter,Ward region,L1-L4 and L2-L4 lumbar vertebrae(P＜0.01,I2＞50％).(3)Training period and frequency:2-3 times per week,48-96 times per week,the bone mineral density at each site increased significantly(P＜0.05,I2＜50％).(4)Movement patterns:Dynamic training significantly increased bone mineral density in the femoral neck(P=0.03,/2=0％),greater trochanter(P＜0.001,I2=0％)and Ward region(P＜0.001,I2=0％);static squat significantly increased bone mineral density in L1-L4 lumbar spines(P＜0.001,I2=0％);and static multiple squatting was effective in improving bone mineral density in L2-L4 lumbar spines(P＜0.01,/2=0％)and the femoral neck(P=0.04,I2=34％).CONCLUSION:Whole-body vibration training has potential in improving bone mineral density in postmenopausal women.Recommended vibration frequencies and amplitudes are not less than 20 Hz and 2 mm,respectively,with no less than 48 training sessions.Static training is recommended for improving lumbar bone mineral density,while dynamic training is recommended for improving hip bone mineral density.

AIM:This study aimed to confirm the glycolytic inhibitory activity of 3-bromopyruvic acid(3BP)and to assess whether this inhibition could ameliorate hypoxia-induced pulmonary hypertension in rats.METHODS:PAH model rats were generated from normal SD rats via exposure to normal pressure and hypoxia.Intervention groups I and II(6 rats per group)were then intraperitoneally injected with 3BP(15 mg/kg),and the normal and hypoxia groups(6 rats per group)were given the same amount of normal saline for a total of 21 d.The average pulmonary artery pressure of the rats in each group was measured via right heart catheterisation,and hilar tissue measurements.The right ventricle(RV),left ventricle,and interventricular septum(LV+S)were weighed,and the ratio of RV/(LV+S)was calculated as an index of right ventricular hypertrophy.Right lower lung tissues were fixed in 4%paraformaldehyde-PBS buffer,sec-tioned in conventional paraffin(5 μm thick),stained with HE and Masson,photographed under a microscope.Then the thickness ratio of the tunica media and the area ratio of collagen fibres were calculated.The expression of pyruvate kinase isozyme type M2(PKM2),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),and pyruvate de-hydrogenase(PDH)proteins in the hilar tissues of each group were detected by western blot,whereas interleukin-1β(IL-1β)and IL-18 contents were detected using ELISA,and lactic acid content was detected using a lactic acid kit.RE-SULTS:The results showed that 3-brpa effectively inhibited glycolysis and significantly improved hypoxia-induced pulmo-nary hypertension in rats.Compared with the hypoxia group,in intervention group II,PKM2 expression was decreased(P<0.05),PDH expression increased significantly(P<0.01),and NLRP3 expression was decreased(P<0.05).The IL-18 and IL-1β contents decreased(P<0.05 or P<0.01,respectively).Pulmonary hemodynamic indexes showed that the pro-portion of the right ventricle and the mean pressure of the pulmonary artery decreased(P<0.05 or P<0.01,respectively).The HE and Masson staining results showed that the thickness ratio of the tunica media and the area ratio of collagen fibres decreased significantly(P<0.01).Lactic acid content was significantly decreased(P<0.01).CONCLUSION:This study showed that 3BP can inhibit glycolysis and alleviate hypoxia-induced pulmonary hypertension in rats.

AIM:This study aimed to confirm the glycolytic inhibitory activity of 3-bromopyruvic acid(3BP)and to assess whether this inhibition could ameliorate hypoxia-induced pulmonary hypertension in rats.METHODS:PAH model rats were generated from normal SD rats via exposure to normal pressure and hypoxia.Intervention groups I and II(6 rats per group)were then intraperitoneally injected with 3BP(15 mg/kg),and the normal and hypoxia groups(6 rats per group)were given the same amount of normal saline for a total of 21 d.The average pulmonary artery pressure of the rats in each group was measured via right heart catheterisation,and hilar tissue measurements.The right ventricle(RV),left ventricle,and interventricular septum(LV+S)were weighed,and the ratio of RV/(LV+S)was calculated as an index of right ventricular hypertrophy.Right lower lung tissues were fixed in 4%paraformaldehyde-PBS buffer,sec-tioned in conventional paraffin(5 μm thick),stained with HE and Masson,photographed under a microscope.Then the thickness ratio of the tunica media and the area ratio of collagen fibres were calculated.The expression of pyruvate kinase isozyme type M2(PKM2),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),and pyruvate de-hydrogenase(PDH)proteins in the hilar tissues of each group were detected by western blot,whereas interleukin-1β(IL-1β)and IL-18 contents were detected using ELISA,and lactic acid content was detected using a lactic acid kit.RE-SULTS:The results showed that 3-brpa effectively inhibited glycolysis and significantly improved hypoxia-induced pulmo-nary hypertension in rats.Compared with the hypoxia group,in intervention group II,PKM2 expression was decreased(P<0.05),PDH expression increased significantly(P<0.01),and NLRP3 expression was decreased(P<0.05).The IL-18 and IL-1β contents decreased(P<0.05 or P<0.01,respectively).Pulmonary hemodynamic indexes showed that the pro-portion of the right ventricle and the mean pressure of the pulmonary artery decreased(P<0.05 or P<0.01,respectively).The HE and Masson staining results showed that the thickness ratio of the tunica media and the area ratio of collagen fibres decreased significantly(P<0.01).Lactic acid content was significantly decreased(P<0.01).CONCLUSION:This study showed that 3BP can inhibit glycolysis and alleviate hypoxia-induced pulmonary hypertension in rats.

Objective To explore the effect of training weights on energy expenditure(EE)among young males during squatting.Methods Twenty young males with strength training experience≥1 year were recruited and performed 3 sets of squats,with 5 repetitions per set,at 40%1RM,60%1RM and 80%1RM,respectively,with an interval of at least 72 hours.Oxygen uptake(VO2),heart rate,blood lactate,and the mechanical work on the barbell during squat exercises were measured before,during,and after each sets.Moreover,one-way repeated-measures ANOVA was used to compare EE differenc-es between different training weights,and two-way ANOVA was employed to examine the weight×method effect on metabolic equivalent(MET)values.Meanwhile,Pearson's correlation analysis was conducted to examine the correlation between EE and barbell mechanical work.Results(1)Training weight has significant effects on the total energy expenditure and EE during excess post-exercise oxy-gen consumption(EPOC)stage(P<0.001),while a significant increase was observed in the glycolytic EE only at 80%1RM and the aerobic EE with no less than 60%1RM(P<0.01 and P<0.05).(2)The percentage of EPOC-stage and glycolytic EE in the total energy expenditure was significantly higher than the aerobic EE(P<0.01),while that of aerobic EE at 40%1RM and 60%1RM was significantly higher than at 80%1RM(P<0.01).(3)Total energy expenditure(r=0.65,P<0.001)and EPOC-stage EE(r=0.68,P<0.001)showed moderate correlation with the mechanical work done.(4)Aerobic EE was significantly lower than the mechanical work done during squatting(P<0.001).Moreover,the MET values of squats calculated using aerobic EE during exercise at 40%-80%1RM was 2.42±0.54,2.89±0.87 and 2.7±0.56,while the MET ones calculated using the total energy expenditure reached 14.99±2.94,20.52±4.51 and 28.57±6.88.Conclusions Only EPOC-stage and glycolytic EE elevate with the increase of weight.Moreover,EE and the MET value scalculated using VO2 dur-ing exercise may under estimate the actual intensity of squat.Meanwhile,the accuracy of EE estima-tion may be improved by introducing the mechanical work.

AIM:To investigate the effect and mechanism of panax notoginseng saponins(PNS)inhibiting the proliferation of pulmonary artery smooth muscle cells(PASMCs)in rats under the ef-fect of monocrotaline(MCT).METHODS:PASMCs cultured in vitro were randomly divided into the normal control(Control)group,the monocrotaline(MCT)group,the panax notoginseng saponins(PNS)group,the knockdown(M+Si ADAM10)group,the knockdown postconditioning(M+P+Si ADAM10)group,the overexpression(M+OE AD-AM10)group,and the overexpression postcondi-tioning(M+P+OE ADAM10)group.After the model was constructed,the cell viability of each group was measured using the CCK-8 assay,along with Western blot utilized to detect the expression of proliferating cell nuclear antigen(PCNA),disinteg-rin metalloproteinase 10(ADAM10),and notch ho-mology protein-3(Notch3)at the cellular neurogen-ic locus,respectively.RESULTS:Under the effect of MCT,the viability of PASMCs was significantly en-hanced(P<0.05 or P<0.01);0-400 mg/L PNS was not toxic to the viability of normal cells,and 100 mg/L PNS could significantly inhibit the MCT-in-duced viability(P<0.01).After the knockdown of ADAM10,the viability of PASMCs significantly de-clined(P<0.01),and the expression of PCNA protein was significantly decreased(P<0.05),evidently in the M+P+Si ADAM10 group.Meanwhile,the ex-pression of ADAM10 and Notch3 protein was signif-icantly decreased(P<0.05 or P<0.01),evidently in the M+P+Si ADAM10 group.After overexpression of ADAM10,the viability of PASMCs was significant-ly enhanced(P<0.01),the expression of PCNA pro-tein was significantly increased(P<0.01),the PCNA value was slightly higher(P>0.05),and the expres-sion of ADAM10 and Notch3 protein was signifi-cantly elevated(P<0.05)in the M+P+OE ADAM10 group.Additionally,PASMCs overexpressing AD-AM10 with concomitant PNS exhibited a significant decrease in the expression of PCNA protein com-pared with PASMCs knocking down ADAM10(P<0.01),and the expression of ADAM10 and Notch3 protein declined to varying degrees(P>0.05).CON-CLUSION:Panax notoginseng saponins can mitigate MCT-induced PASMCs proliferation in rats by inhib-iting the ADAM10/Notch3 signaling pathway.

Objective To explore the characteristics,potential challenges,and optimization paths of high-quality development policies for public hospitals in China,and to provide reference for policy formulation and implementation.Methods The 31 policy documents on high-quality development of public hospitals issued at the central and provincial levels between 2021 and 2024 were coded using Nvivo 11 software,and a three-dimensional analytical framework was constructed on the basis of the policy tools,stakeholders,and system dimensions,combining both quantitative and qualitative methods for content analysis.Results It found that the distribution of policy content in the three dimensions was characterized by stage imbalance:policy tools were mainly environmental,followed by supply,and demand;stakeholder attention was focused on public hospitals and healthcare administrations,and patient attention was low;The system dimension focused mainly on the macro level,with less distribution at the meso and micro levels.Although the unbalanced distribution of policy instruments is relevant at certain stages,the long-term structural imbalance may lead to insufficient systemic policies and weakened stakeholder synergies,and there is an urgent need to optimize the structure of instruments.Conclusions It is recommended to increase the proportion of demand-based policy instruments in policy design and dynamically adjust the synergistic application of the three types of instruments;to strengthen the attention to vulnerable stakeholders,such as patients;and to optimize the design of policies at the meso-levels and micro-levels in order to enhance the systemicity and sustainability of policy implementation.