OBJECTIVE To provide direction and reference for the adjustment of the discount rate （DR） in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research， health technology assessment agencies in various countries/regions， as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR， adjustment trends， and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis， the effects of different DR on the incremental cost-effectiveness ratio （ICER） were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines， the base-case DR ranged from 1.5% to 5%， with 5% being the most common value； the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes， while in the Netherlands， Belgium， Poland and Czech Republic， DR for costs was higher than for health outcomes. In recent years， Korea， France and Ireland had lowered their DR in response to economic changes， whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%， and localized empirical research can be conducted using internationally common estimation methods.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild rodents in schistosomiasis-endemic areas of China, so as to provide insights into formulation of technical guidelines for monitoring of and the precise control strategy for S. japonicum infections in wild rodents during the elimination phase. Methods Two administrative villages where schistosomiasis was historically highly prevalent were selected each from Dongzhi County, Anhui Province, and Duchang County, Jiangxi Province as study villages. Wild rodents were captured from study villages with baited traps or cages at night in June and September, 2021. The number of rodents captured was recorded, and the rodent species was characterized based on morphologi-cal characteristics. Liver tissues were sampled from captured rodents for macroscopical observation of the presence of egg granu- lomas, and S. japonicum infection was detected simultaneously using liver tissue homogenate microscopy, examinations of mesenteric tissues for parasites, and modified Kato-Katz thick smear technique (Kato-Katz technique). A positive S. japonicum infection was defined as detection of S. japonicum eggs or adult worms by any of these methods. The rate of wild rodent capture and prevalence of S. japonicum infections in wild rodents were compared in different study villages and at different time periods, and the detection of S. japonicum infections in wild rodents was compared by different assays. Results The overall rate of wild ro- dent capture was 8.28% (237/2 861) in Dongzhi County, and the wild rodent capture rates were 9.24% (133/1 439) and 7.31% (104/1 422) in two study villages (χ² = 3.503, P = 0.061), and were 8.59% (121/1 409) and 7.99% (116/1 452) in June and September, 2021, respectively (χ² = 0.337, P = 0.561). The overall rate of wild rodent capture was 3.72% (77/2 072) in Duchang County, and the wild rodent capture rates were 6.91% (67/970) and 0.91% (10/1 102) in two study villages (χ² = 51.901, P < 0.001), and were 4.13% (39/945) and 3.37% (38/1 127) in June and September, 2021, respectively (χ² = 0.815, P = 0.365). Rattus norvegicus was the predominant rodent species captured in both counties, accounting for 70.04% (166/237) of all captured wild rodents in Dongzhi County and 88.31% (68/77) in Duchang County. No S. japonicum infection was detected in wild rodents captured in Duchang County. Nevertheless, the overall prevalence of S. japonicum infections was 51.05% (121/237) in wild rodents captured in Dongzhi County, with prevalence rates of 50.38% (67/133) and 51.92% (54/104) in two study villages (χ² = 0.098, P = 0.755), and 54.31% (63/116) and 47.93% (58/121) in September and June, 2021, respectively (χ² = 0.964, P = 0.326). Of 237 wild rodents captured in Dongzhi County, there were 140 (59.07%) rodents with visible hepatic egg granulomas, 117 (49.47%) tested positive for S. japonicum eggs by liver tissue homogenate microscopy, 34 (14.35%) tested positive for S. japonicum eggs with Kato-Katz technique; however, no adult S. japonicum worms were detected in mesenteric tissues. In addition, hepatic egg granulomas were found in all wild rodents tested positive for S. japonicum eggs with liver tissue homogenate microscopy. Conclusions The rate of wild rodent capture and prevalence of S. japonicum infection in wild rodents vary greatly in schistosomiasis-endemic areas of China, and the prevalence of S. japonicum infection is slightly higher in wild rodents captured in autumn than in summer. Liver tissue is recommended as the preferred sample for surveillance of S. japonicum infection in wild rodents, and a combination of macroscopical observation of hepatic egg granulomas and liver tissue homogenate microscopy may be a standard method for surveillance of S. japonicum infection in wild rodents.

There is a large gap between production and demand of plant oil in China, which leads to the heavy reliance on imports. Diacylglycerol acyltransferase (DGAT) and phospholipid: diacylglycerol acyltransferase (PDAT) are two key enzymes responsible for the synthesis of triacylglycerol, thereby affecting the yield and quality of plant oil. This paper comprehensively reviews the research progress in DGAT and PDAT in terms of their biological functions in plant oil synthesis, the molecular mechanisms of regulating plant lipid metabolism, growth, and development under stress, and their roles in driving oil synthesis under the background of synthetic biology. Furthermore, future research and application of DGAT and PDAT are prospected. This review aims to provide a basis for deeply understanding the molecular mechanism of plant oil synthesis and improving the quality and productivity of oil crops by the utilization of DGAT and PDAT genes.
Diacylglycerol O-Acyltransferase/physiology* ; Plant Oils/metabolism* ; Acyltransferases/metabolism* ; Lipid Metabolism/genetics* ; Gene Expression Regulation, Plant ; Triglycerides/biosynthesis*

Abnormal glucose metabolism is one of the common complications of acromegaly.Patients with acromegaly have a signifi-cantly higher prevalence rate of abnormal glucose metabolism compared with the normal population,and the patients with acromegaly and diabetes mellitus(DM)have significantly higher prevalence rates of tumor and cardiovascular diseases.Growth hormone and insulin-like growth factor-1 have different effects on glucose metabolism in patients with acromegaly,and surgeries or drugs(such as somatostatin receptor ligands)for the treatment of acromegaly may disturb or affect glucose metabolism in the body,which requires fur-ther clarification.This article reviews the research advances in the diagnosis and treatment of abnormal glucose metabolism in patients with acromegaly,in order to identify optimal treatment strategies and achieve better management of acromegaly and related metabolic complications.

Objective:To investigate the influence of prealbumin on cerebral infarction severity, hemorrhage transformation and 1-year prognosis.Methods:A retrospective study was conducted to select 752 patients with cerebral infarction who were treated in Beijing Tiantan Hospital,Capital Medical University from December 2018 to December 2019 as the study objects. Personal information and laboratory indicators of the patients were collected including prealbumin, hemoglobin, white blood cell count, etc.Patients were divided into group B1 (<238 mg/L) and group B2 (≥238 mg/L) based on median prealbumin. By inquiry patient's case, NIHSS score (<16 was classified as mild, ≥16 as moderate and severe)and cerebral infarction volume (<20 cm 3 as small infarct, >20 cm 3 as large infarct) were recorded to evaluate the severity of the disease, and whether hemorrhage transformation occurred during hospitalization was recorded. Patients were followed up 1 year after discharge, and prognostic information of patients was recorded, including neurological function recovery (mRS score <3 was classified as good recovery, ≥3 as poor recovery),all-cause case fatality rate, and recurrence of cardio-cerebrovascular events. Normally distributed measurement data were expressed as xˉ±s, non-normally distributed measurement data were expressed as median and quartiles[ M( Q1, Q3)], categorical variable were expressed as ratio and percent(%). Comparison between groups of measurement data were performed by independent sample t test and Mann-Whitney U test. Chi-square test were used on comparison between groups of categorical variable. Single-factor comparison, Spearman correlation analysis and multiple Logistic regression were used to analyze the correlation between prealbumin and other laboratory indicators, cerebral infarction severity, hemorrhage transformation and 1-year prognosis, respectively. Results:The NIHSS score and infarct volume of patients in group B1 were 5(2,10) and 3.18(0.72,18.00) cm 3, and those in group B2 were 3(2,7) and 2.0(0.5,10.0) cm 3, respectively, which were higher in group B1 than in group B2, the differences were statistically significant ( Z=3.85, P<0.001, Z=2.81, P=0.005). The proportion of mRS Score ≥3 in group B1 was 28.8%(107/371), and the all-cause case fatality rate was 7.5%(28/371), both higher than 20.5%(78/381) and 3.1%(12/381) in group B2, with statistical significance ( χ2=7.10, P=0.008, χ2=7.22, P=0.007). Hemorrhage transformation and recurrence of cardio-cerebrovascular events were 13.5%(50/371) and 11.6%(43/371) in group B1 and 9.2% (35/381) and 8.7%(33/381) in group B2, respectively, with no significant difference between the two groups ( χ2=3.45, P=0.063, χ2=1.78, P=0.183). Multivariate logistic regression analysis showed that, after adjusted for potential confounding factors, prealbumin was protective factor of NIHSS ( OR and 95% CI: 0.990(0.984-0.997), P=0.035), poor neurological recovery(mRS≥3) ( OR and 95% CI:0.992(0.988-0.997), P<0.001) and all-cause case fatality rate ( OR and 95% CI:0.991(0.983-0.999), while prealbumin had no significant influence on cardiocerebrovascular recurrence events ( OR and 95% CI: 0.999(0.993-1.005), P=0.729). Conclusion:Prealbumin is significantly associated with the severity of cerebral infarction and poor prognosis 1 year after discharge, and low prealbumin was an independent risk factor for NIHSS score(≥16), poor neurological recovery (mRS≥3) and all-cause case fatality rate.

Objectives:To explore the effects of infarct volume, infarct type, inflammation, and coagulation indicators on hemorrhagic transformation in patients with acute cerebral infarction.Methods:711 patients with cerebral infarction admitted to Beijing Tiantan Hospital were retrospectively included as the study objects from December 2018 to December 2019 [535 males and 176 females, age 22-95 years, mean age (59.6±12.1) years]. Clinical data, laboratory indicators such as inflammation and coagulation function of patients were collected, and information such as location, volume and type of infarction were recorded. The patients were divided into hemorrhage transformation group and non-hemorrhage transformation group according to whether hemorrhage transformation occurred during hospitalization. Normally distributed measurement data were expressed as xˉ± s, non-normally distributed measurement data were expressed as median and quartiles [ M( Q1, Q3)], categorical variable were expressed as ratio and percent (%). Comparison between groups of measurement data were performed by independent sample t test and Mann-Whitney U test. χ2 test were used on comparison between groups of categorical variable. Univariate comparison and multivariate Logistic regression were used to analyze the correlation between hemorrhage transformation and infarct volume, infarction type and laboratory indicators, respectively, to explore the risk factors of hemorrhage transformation. ROC curve analysis was used to evaluate the diagnostic value of indicators. Results:The rates of coronary heart disease and atrial fibrillation history in the hemorrhage transformation group were 23.5% (20/85) and 22.4% (19/85), respectively, which were significantly higher than those in the non-hemorrhage transformation group (13.9% (87/626) and 5.8% (36/626), respectively), and the difference between the two groups was statistically significant ( χ2=5.43, χ2=28.90, P=0.020, P<0.001, respectively). The NIHSS score [10(4,17) points] and infarct volume [46.50 (14.21,118.42) mL] in the hemorrhage transformation group were significantly higher than those in the non-hemorrhage transformation group [4(2,7) points, 2.00(0.51,8.94) mL]. The difference between the two groups was statistically significant ( Z values were 6.69 and 10.69, respectively, P<0.001). The results of multivariate Logistic regression analysis showed that atrial fibrillation (OR=2.604, 95% CI: 1.186-5.716, P=0.107), infarct volume (OR=1.009, 95% CI: 1.004-1.015, P=0.001), infarct type of Chinese ischemic stroke subclassfication (OR=1.371, 95% CI: 1.085-1.731, P=0.008) and neutrophil/lymphocyte ratio (OR=1.047, 95% CI: 1.006-1.090, P=0.023) were independent risk factors for hemorrhage transformation. ROC curve analysis showed that the area under curve (AUC) of infarct volume and neutrophil/lymphocyte ratio were 0.861 (0.821-0.901) and 0.684 (0.626-0.741), respectively, which were effective in predicting hemorrhage transformation after cerebral infarction. The prediction of infarct volume was more efficient. Conclusion:History of atrial fibrillation, classification of cardioembolic stroke, infarct volume, and neutrophil/lymphocyte ratio are all risk factors for hemorrhagic transformation after acute cerebral infarction.

Objective To investigate the short-term efficacy of arthroscopic total internal suture combined with platelet-rich plasma(PRP)in the treatment of lateral meniscal popliteal hiatus area injuries.Methods Forty-eight patients diagnosed with lateral meniscal popliteal hiatus area injuries in our hospital from January 2020 to December 2022 were selected and divided into Fast-Fix total internal suture group(FF group,n=23)and Fast-Fix total internal suture combined with PRP group(PRP group,n=25)according to treatment methods.The positive rate of McMurray test at 6 and 12 months after surgery,the preoperative and postoperative visual analogue scale(VAS)of pain,the International Knee Documentation Committee(IKDC)scores,the Lysholm Knee Function Scores,and the Knee Society Scores(KSS)were compared between the two groups.Results No adverse events such as vascular and nerve injury,fever and infection occurred in both groups.There was no significant difference between the two groups in the positive rates of McMurray test at 6 and 12 months(χ2=0.880,P=0.348;Fisher's exact test,P=0.479).In the PRP group,25 cases were followed up for11-14 months,with an average of(12.2±0.8)months;in the FF group,23 cases were followed up for11-14 months,with an average of(12.8±0.8)months.The VAS scores at 6 months and 12 months after surgery were significantly lower than those before surgery in both groups(all P=0.000).The VAS scores of the PRP group at 6 and 12 months after surgery were significantly lower than those of the FF group(P<0.05).Both groups showed significant improvements in IKDC,Lysholm,and KSS scores at 6 and 12 months after surgery compared to preoperative levels(all P=0.000).The IKDC,Lysholm,and KSS scores of the PRP group at 6 and 12 months after surgery were significantly higher than those of the FF group(P<0.05).Conclusion Compared to Fast-Fix total internal suture alone,PRP joint cavity adjuvant therapy based on Fast-Fix total internal suture surgery could reduce the postoperative pain of patients,and promote the functional recovery of the knee joint,which is more recommended in clinical practice.

Objectives:To compare the efficacy of unilateral biportal endoscopy(UBE)versus percutaneous endoscopy(PE)for treating cervical spondylotic radiculopathy(CSR)using meta-analysis.Methods:A compre-hensive search was conducted in PubMed,Embase,Cochrane Library,Web of Science,China National Knowl-edge Infrastructure(CNKI),Wanfang Database,and China Biomedical Literature Database for studies published since their inceptions up to June 2025 that reported clinical outcomes and complications of UBE and PE in the treatment of CSR.The Cochrane Risk of Bias tool was used to assess randomized controlled trials,while the Newcastle-Ottawa scale(NOS)was applied to evaluate retrospective studies.Outcome indicators were ex-tracted including visual analogue scale(VAS)scores for neck and upper limb pain,neck disability index(NDI),operative time,intraoperative blood loss,length of hospital stay,incision size,preoperative and postoperative serum creatine kinase(CK)and C-reactive protein(CRP)levels,and postoperative complications.Meta-analysis was performed using Review Manager 5.4 software.Results:A total of 10 literatures were included,all of which were retrospective studies,and six studies were 8 points of NOS scores,three studies were 7 points,and one study was 6 point,indicating moderate to high quality.The total sample comprised 782 patients(UBE:n=388;PE:n=394).Meta-analysis revealed no significant difference in operative time between groups[MD=-6.67,95％CI(-17.47,4.13),P=0.23].Intraoperative blood loss was significantly lower in the PE group[MD=10.86,95％CI(0.64,21.07),P=0.04].No significant difference was observed in postoperative length of hospital stay[MD=0.49,95％CI(-0.00,0.99),P=0.05].Incision size was significantly smaller in the PE group[MD=7.13,95％CI(1.76,12.50),P=0.009].There were no significant intergroup differences in postoperative CK[MD=1.25,95％CI(-5.08,7.75),P=0.70]or CRP levels[MD=-0.03,95％CI(-0.08,0.02),P=0.23].There was no significant difference in neck pain VAS scores at various timepoints between the two groups[MD=-0.07,95％CI(-0.17,0.04),P=0.20].However,the UBE group was significantly lower in upper limb pain VAS scores at 3 months postoperatively[MD=-0.14,95％CI(-0.26,-0.01),P=0.03].No significant differences were found in NDI scores across follow-up periods[MD=-0.24,95％CI(-0.50,0.02),P=0.07]or in complication rates[OR=1.02,95％CI(0.51,2.03),P=0.95].Conclusions:Both UBE and PE operations are effective and safe in the treatment of CSR.The PE technique is associated with less intraoperative blood loss and smaller incisions,while UBE provides superior improvement in upper limb pain at the 3-month follow-up.

AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels: group A: HbA1c <7%(n=18)and group B: 7%≤HbA1c<8.5%(n=27); a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C). All underwent phacoemulsification with intraocular lens implantation. Anterior segment parameters, including corneal, lens and anterior chamber measurements, were recorded. Correlations between phacoemulsification parameters and anterior segment parameters were analyzed, and differences among groups were compared.RESULTS: In groups A and B, effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315, P=0.035). Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm; r=0.402, P=0.006)and negatively correlated with the flat axis meridian curvature(K1), steep axis meridian curvature(K2), mean curvature(Km)of the anterior corneal surface, and lens density at 6 mm zones(PDZ3; all P<0.05). Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean), lens density at 2 mm zones(PDZ1), lens density at 4 mm zones(PDZ2), and PDZ3(all P<0.05), and negatively with pupil diameter(r=-0.385, P=0.009). In the group C, EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade, PDZ1, PDZ2, and PDZ3(all P<0.05). A positive correlation was observed between AVE and PNS classification(r=0.246, P=0.018). Conversely, AVE exhibited a negative correlation with CECD(r=-0.245, P=0.018). EPT in groups A and B was higher than that in the group C(P<0.05). Both EPT and APT in the group B were higher than those in the group A(P<0.05). In diabetic cataract patients, CECD, corneal density(CD), and posterior corneal surface height positively correlated with diabetes duration(P<0.05). Posterior corneal surface K1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05). Total corneal astigmatism negatively correlated with HbA1c, 2-hour post-breakfast blood glucose(2hPBG), and fasting insulin(FINS; P<0.05). CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION: Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels. EPT in diabetic cataract patients was higher than that in age-related cataract patients, while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.