Dry eye disease(DED)is a common ocular surface disorder worldwide, primarily characterized by a loss of homeostasis of the tear film, and frequently associated with meibomian gland dysfunction(MGD), decreased tear film stability, ocular discomfort, and visual impairment. In recent years, factors such as the widespread use of digital devices,the aging population, and environmental changes have contributed to a significant increase in its global prevalence, making it a major public health concern. Red light therapy(RLT), also known as low-level laser therapy(LLLT)or photobiomodulation(PBM), is a non-invasive treatment that utilizes low-energy red or near-infrared light to irradiate tissues. It exerts photobiomodulatory effects to promote cellular repair and functional recovery. This therapy has demonstrated considerable potential in treating various ocular conditions. Its broader clinical application could improve therapeutic outcomes, alleviate patient discomfort and financial burden, and reduce the consumption of healthcare resources, thereby yielding significant socio-economic benefits. This paper systematically reviews the multifaceted mechanisms and application prospects of RLT in managing DED, including its anti-inflammatory effects, improvement of meibomian gland function, promotion of conjunctival goblet cell repair, and alleviation of visual fatigue, aiming to provide a theoretical foundation and practical reference for its clinical adoption.

ObjectiveTo systematically organize the relevant research on the treatment of uterine fibroids with Xiaojie'an capsules through clinical evidence evaluation and comprehensive value analysis in the "6+1" dimension，highlighting the efficacy and characteristics of Xiaojie'an capsules. MethodsBased on evidence-based medicine，epidemiology，pharmacoeconomics，health technology assessment （HTA）， and other methodologies，this study adopted qualitative and quantitative evaluation methods. Through a questionnaire survey，official website data information，published literature， and secondary evaluation of real world data，a total of "6+1" dimensions were used to build an evaluation system for the safety，effectiveness，economy，innovation，suitability，accessibility of Chinese patent medicines， and characteristics of traditional Chinese medicines. Results① Safety：From January 2009 to March 2023，the National Adverse Drug Reaction Monitoring Center reported 159 cases （248 cases） of general adverse reactions and four cases of serious adverse reactions to Xiaojie'an capsules，all of which were classified as general adverse reactions after expert judgment. Through literature search，a total of 6 865 patients were treated with Xiaojie'an capsules，of which 26 articles reported adverse reactions to Xiaojie'an capsules，resulting in a total of 244 adverse reactions. The clinical manifestations of adverse reactions to Xiaojie'an capsules include nausea，vomiting，stomach discomfort，diarrhea，rash，itching，dizziness，headache，insomnia，etc. The prognosis was good， and the drug surveillance system was sound. Based on the evaluation of known risks and sufficient evidence，in terms of known risk assessment， according to the monitoring results of the spontaneous reporting system （SRS）， there were four cases of serious adverse reactions to Xiaojie'an capsules. After expert discussion， the four cases of serious adverse reactions were finally judged as general adverse reactions， and the known risks were considered to be small in combination with the known risk evaluation criteria. According to the types of studies carried out on Xiaojie'an capsules （randomized controlled trial and its systematic review， SRS data analysis， real world human experience studies， and non-clinical safety studies） and the evaluation criteria of sufficient evidence， it was considered that Xiaojie'an capsules had sufficient evidence. The safety evidence of this variety was sufficient， and the result was confirmed. ② Effectiveness： Meta-analysis results showed that the combination of Xiaojie'an capsules and Mifepristone tablets had better clinical efficacy compared to Mifepristone tablets alone and had a better effect in reducing the maximum uterine fibroid volume. Due to limitations and imprecision caused by downgrading factors，the quality of evidence was evaluated as Grade C. Based on comprehensive effectiveness evidence and value evaluation，the effectiveness evidence of this variety was relatively sufficient， and the results were clear ③ Economy：The economic evaluation results showed that treating one more patient with uterine fibroid required an additional cost of 5 438.57 yuan by using the combination of Xiaojie'an capsules and Mifepristone tablets，which was lower than the patient's willingness to pay （36 883 yuan according to 2022 National Bureau of Statistics data）. This suggested that compared with using Mifepristone tablets alone，the combination of Xiaojie'an capsules and Mifepristone tablets had a certain economy. The sensitivity analysis results were relatively robust，indicating that this variety had good economy ④ Innovation：Currently，most traditional Chinese medicine treatments for uterine fibroids advocate the method of attacking evil，which can easily harm the body. However，Xiaojie'an capsules not only soften and disperse nodules but also balance supporting the body and supplementing deficiency. The comprehensive evaluation showed sufficient evidence of the innovation of this variety，and the results were confirmed. ⑤ Suitability： The service information of Chinese patent medicines derived from the drug was complete，and the questionnaire survey results showed that the drug was suitable for clinicians，nurses，pharmacists， and patients in multiple dimensions such as individual compliance，system， and management. The comprehensive evaluation of the suitability of the product had sufficient evidence and clear results. ⑥ Accessibility：The daily cost of Xiaojie'an capsules was 16.97 yuan，and the treatment cost was 407.16 yuan. It was affordable for urban residents and rural residents and was available for sale in 23 provinces， cities，municipalities，and autonomous regions across the country. The medicinal resources were abundant and sustainably supplied，and there was sufficient evidence of accessibility with clear results. ⑦ Characteristics of traditional Chinese medicine：Xiaojie'an capsules were derived from the classic Dai medicine formula of Dr. CHEN Benshan，a renowned Dai doctor，and they have been clinically used for over 20 years. Dai medicine originated from Xishuangbanna，Yunnan province，with the core theory of "four pagodas and five elements". The comprehensive evaluation showed that this variety exhibited significant characteristics of traditional Chinese medicine. ⑧ Comprehensive evaluation of clinical value：Based on the "6+1" dimensions mentioned above，combined with the multi-criteria decision analysis （MCDA） model and calculations using CSC v2.0 software，the results showed that there was sufficient evidence for the clinical value of Xiaojie'an capsules，and the results were clear. ConclusionThe comprehensive evaluation of Xiaojie'an capsules has sufficient evidence of safety and innovation，and the results are confirmed. The evidence of effectiveness，suitability，and accessibility is relatively sufficient，with clear results. The economy is good，and the characteristics of traditional Chinese medicine are prominent. The comprehensive evaluation of clinical value believes that there is sufficient evidence of the clinical value of Xiaojie'an capsules，and the results are clear. In the future，it is recommended to focus on clinical value， conduct high-quality and effective research that is in line with the characteristics of traditional Chinese medicine， and improve acute toxicity testing to provide a scientific and objective basis for clinical efficacy and safety research.

Hypoxemia is a common pathological state characterized by low oxygen saturation in the blood. This condition compromises mucosal barrier integrity particularly in the gut and oral cavity. However, the mechanisms underlying this association remain unclear. This study used periodontitis as a model to investigate the role of platelet activation in oral mucosal immunopathology under hypoxic conditions. Hypoxia upregulated methyltransferase-like protein 4 (METTL4) expression in platelets, resulting in N⁶-methyladenine modification of mitochondrial DNA (mtDNA). This modification impaired mitochondrial transcriptional factor A-dependent cytosolic mtDNA degradation, leading to cytosolic mtDNA accumulation. Excess cytosolic mt-DNA aberrantly activated the cGAS-STING pathway in platelets. This resulted in excessive platelet activation and neutrophil extracellular trap formation that ultimately exacerbated periodontitis. Targeting platelet METTL4 and its downstream pathways offers a potential strategy for managing oral mucosa immunopathology. Further research is needed to examine its broader implications for mucosal inflammation under hypoxic conditions.
DNA, Mitochondrial/metabolism* ; Mouth Mucosa/pathology* ; Hypoxia/immunology* ; Methyltransferases/metabolism* ; Blood Platelets/metabolism* ; Animals ; Periodontitis/immunology* ; Humans ; Platelet Activation ; Mice

To analyze the factors affecting the cost of hospitalization for patients and provide insights using the intrauterine lesion surgery group (DRG code NE19) as an example.

BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to find a light-weight,convenient prediction method through machine learning. METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation. RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the five most important features were acuity,arrival transportation,age,shock index,and respiratory rate. CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.

The rational use of medical insurance fund(MIF) plays an important role in promoting the high-quality development of public hospitals, and the supervision of MIF is in a trend of under the rule of law, normalization, professionalization and standardization, and unannounced inspection will become the norm. The authors systematically analyzed three main trends of MIF unannounced inspections, namely, gradually increasing intensity, constantly innovating methods, and increasingly serious consequences. The problems exposed in unannounced inspections were sorted out from five dimensions: form of results, severity, scope of attribution, subjective intention, and regulatory screening ideas. The enlightenment of MIF unannounced inspections to hospital management was explored from four aspects: compliance awareness, organizational system, fine management, and daily supervision. It was proposed that public hospitals should transform their roles and positions, improve the working mechanism of departmental collaboration, and achieve fine management in policy understanding, system formulation, process design, information support, data governance, regulatory implementation, personnel training, and performance matching. At the same time, internal simulated unannounced inspections in hospitals should be regarded as a routine work.

A young female patient with acne and elevated testosterone level underwent plasma steroid hormones testing and found a significant increase in aldosterone. We excluded testing interference and verified the absence of hypertension, hypokalemia, and adrenal occupancy, as well as primary and secondary hyperaldosteronism. During follow-up, a temporal correlation was found between aldosterone levels and the use of drospirenone and ethinylestradiol tablets. It was observed that the combination of drospirenone and ethinylestradiol could lead to the increase of aldosterone level and the concentration ratio of aldosterone to direct renin through different mechanisms. Drospirenone exerts an antagonistic effect on mineralocorticoid receptor to prevent the development of hypertension or hypokalemia. In clinical practice, it is necessary to pay attention to the effect of this drug on screening markers for primary aldosteronism. In the laboratory examination, when female patients with no symptoms of hypertension and hypokalemia but with elevated aldosterone levels are encountered, it can be verified whether they have a history of use of compound estrogen-progestin such as drospirenone and ethinylestradiol tablets, and appropriate tips are provided in the report.

bstract: Objective To elucidate the distribution characteristics of mosquito species and the population genetic diversity of important mosquito species in the Wuyi Mountain Nature Reserve, with the aim of providing a scientific basis for the prevention and control of mosquito-borne diseases in the region. Methods Within Wuyi Mountain Nature Reserve 2022- 2023, 16 sampling sites were selected, where larvae were collected using the pipette method and adult mosquitoes were collected using the mosquito trap lamp method. Mosquito species identification was accomplished by integrating morphological characteristics and molecular identification techniques based on CO Ⅰ and CO Ⅱ gene sequences. Software tools such as ClustalX, DnaSP v5.0, and Network v4.6.1.0 were utilized to analyze the genetic differentiation (Fst), gene flow (Nm) among populations of Aedes japonicus, Aedes albopictus and Armigeres subalbatus. Results The mosquito specimens collected from the Wuyi Mountain Nature Reserve were identified as 30 species belonging to 8 genera within the Culicidae family. Among them, there were 10 species of Aedes, 13 species of Culex, 1 species each of Armigeres, Orthopodomyia, Uranotaenia, Tripyeroides, and Anopheles, and 2 species of Toxorhynchites. Analysis of the genetic structure of important mosquito populations showed that the haplotype diversity index (Hd) of Ae. japonicus was 0.994 7, with a generally moderate degree of differentiation between populations and a higher degree of genetic differentiation between populations 6 and 12; Aedeslbopictus had a haplotype diversity index of 0.634 0, with significant genetic differentiation between populations 1 and 2 compared to other groups; Armigeres subalbatus had a haplotype diversity index of 0.703 3, with substantial genetic differentiation and limited gene flow between population 2 and populations 3, 4, 6, and 7. Conclusions The mosquito species are rich in Wuyi Mountain Nature Reserve. A comprehensive survey of the composition and distribution of mosquito populations was carried out, and the characteristics of the population genetic structure of the important species of Ae. japonicus, Ae. Albopictus, and Ar. subalbatus populations were analyzed, providing valuable scientific data reference for local mosquito-borne ecological research and disease prevention and control.

Both Wnt/β-catenin signaling pathway and NF-κB signaling pathway are highly conservative pathways that regulate a variety of biological processes, and their cross-regulation have attracted attention in many biological and medical research fields. In this review, we summarize the cross-regulation between Wnt/β-catenin signaling pathway and NF-κB signaling pathway and discuss their involvement in the multi-directional differentiation of mesenchymal stem cells.

The ideological and political construction of medical courses reveals the educational essence of "truth, goodness, and beauty" in medicine. Scientificity and humanity are the embodiment of "seeking truth" and "advocating goodness" in medicine, and the unity of their content and form reaches the highest level of "advocating beauty". Studying the ideological and political construction of medical courses plays an important role in implementing the fundamental task of fostering virtue through education, and carrying out the Healthy China initiative. In terms of teaching objectives, the goals of ideological and political education in medical courses should not only include the goals of basic literacy goals, such as political literacy, cultural literacy, legal literacy, and moral cultivation, but also include professional literacy goals, such as medical humanistic cultivation. Thus, a "five in one" model of ideological and political education in medical courses will be established. In the practical path, it is suggested to explore from five aspects that changing the educational concept and strengthening the educational awareness, establishing teaching objectives and clarifying education direction, digging deeply into the ideological and political elements and clearing teaching content, innovating teaching methods and improving teaching effectiveness, and constructing evaluation indicators and evaluating teaching effectiveness scientifically.