Objective:To design an assisted management system for medical consumables that integrated management logic of diagnosis related groups(DRG)for disease,so as to standardize the use for medical consumables and to strengthen regulatory efficiency.Methods:The system was designed by a microservices architecture,and the data fusion of business data,data of diagnosis and treatment,and DRG data was realized through constructed data lake.A knowledge graph of associated rule for medical consumables was established,and the intelligent analysis function included prediction for demand,usage optimization,and anomaly detection was provided to assist management decision-making on the basis of inference for historical data and knowledge,and multi-dimensional data queries.A rule engine was deployed at key clinical nodes for real-time compliance review and intelligent alerts.A DRG-based business management process was constructed to cover full lifecycle of consumables,including admission,procurement,warehousing,storage,requisition,usage billing,and traceability,so as to realize real-time monitoring and early warning for consumable costs at the DRG level.Six clinical doctors with 2-3 years of experience in using medical consumable were selected as test users from Tangdu Hospital of the Air Force Medical University,and they were randomly assigned into a system group and a control group,with 3 subjects in each group.The system group utilized the auxiliary management system for medical consumable to perform prediction for the demand of monthly procurement,and rationality verification of consumable.The control group relied on individual experience of doctors.The predicted monthly procurement demand for medical consumables,the accuracy of verifying rationality of using medical consumables between two groups were compared,and the efficiencies of two kinds of management modes also were compared.Results:The accuracy rate of system group was 89.17%in predicting the monthly procurement demand for medical consumables,and the rate of checking accuracy and the rate of checking comprehensiveness of system group were respectively 87.50%and 91.67%in verifying rationality of using medical consumables,which were significantly higher than those of control group,and the differences were significant(x2=6.62,1.96,16.73,P<0.05).The durations of predicting the demand for procurement,and verifying and testing the rationality of consumables in system group were significantly shorter than these in control group[(3.54±0.45)s,(2.23±0.15)s],and the differences were statistically significant(t=1.97,1.65,P<0.05).Conclusion:The medical consumables auxiliary management system integrated with DRG management logic can significantly enhance the accuracy of monthly demand prediction for consumables and the recall rate and precision rate of rationality verification for consumables usage,while greatly improving work efficiency.It is conducive to enhancing the standardized and refined supervision level of consumables usage.

Receptor-interacting protein kinase 1 (RIPK1) plays an essential role in regulating the necroptosis and apoptosis in cerebral ischemia-reperfusion (I/R) injury. However, the regulation of RIPK1 kinase activity after cerebral I/R injury remains largely unknown. In this study, we found the downregulation of protein arginine methyltransferase 1 (PRMT1) was induced by cerebral I/R injury, which negatively correlated with the activation of RIPK1. Mechanistically, we proved that PRMT1 directly interacted with RIPK1 and catalyzed its asymmetric dimethylarginine, which then blocked RIPK1 homodimerization and suppressed its kinase activity. Moreover, pharmacological inhibition or genetic ablation of PRMT1 aggravated I/R injury by promoting RIPK1-mediated necroptosis and apoptosis, while PRMT1 overexpression protected against I/R injury by suppressing RIPK1 activation. Our findings revealed the molecular regulation of RIPK1 activation and demonstrated PRMT1 would be a potential therapeutic target for the treatment of ischemic stroke.

Objective To systematically review and quantitatively analyze the safety of biologic agents for the clinical treatment of psoriasis during pregnancy and lactation.Methods The literature from start of database to June 27,2023,was searched in MEDLINE(PubMed),Embase,Cochrane Library,and Web of Science by two researcher.Quality of included studies was assessed by the quality evaluation tool of case series from Australian JBI Evidence Based Healthcare Centre.According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA),a systematic review and was conducted to assess pregnancy or breastfeeding outcomes in psoriasis patients exposed to biologics within 3 months prior to pregnancy,during pregnancy or breastfeeding.Data on pregnancy and exposure characteristics were pooled,and the prevalence of adverse pregnancy outcome was summarized using a random effects model.Results A total of 54 studies involving 1206 pregnancies in 1177 female patients with psoriasis exposed to biologic agents were included in the analysis.Systematic review results demonstrated that the majority of the exposures were limited to early pregnancy,with pooled spontaneous abortion rates,elective abortion rates,overall mortality,preterm birth rates,incidence of low birth weights,and congenital anomalies similar to those of general population(P>0.05).Furthermore,no serious adverse reactions were reported during lactation.Conclusions The use of biologic agents in pregnant and breastfeeding women with psoriasis does not significantly increase the risk of adverse pregnancy outcomes and does not affect neonatal health or growth.However,the limited available safety data underscores the necessity of further studies to establish the relationship between psoriasis,biologic agents,and pregnancy/lactation outcomes,thereby providing comprehensive guidance for clinical practice.

OBJECTIVE: To investigate the characteristics of Vitamin D (VitD) and bone metabolism in patients with knee osteoarthritis (KOA) concurrent with osteoporosis (OP). METHODS: A retrospective analysis was performed on 240 patients who were admitted to the orthopedics department between March 2019 and March 2024. Patients were stratified into four distinct groups according to their respective disease categories.There were 90 patients in the simple KOA group, comprising 13 males and 77 females, age ranged from 50 to 91 years old with an average of (68.48±8.96) years old. There were 90 patients in the simple OP group, comprising 7 males and 83 females, age ranged from 52 to 88 years old with an average of (69.60±8.94 )years old. There were 30 patients in the KOA with OP group, comprising 1 male and 29 females, age ranged from 51 to 91 years old with an average of(69.03±7.93) years old. There were 30 patients in the physical examination group, comprising 5 males and 25 females, age ranged from 53 to 79 years old with an average of(64.93±6.51) years old. The general data and the levels of osteocalcin (OC), β-CrossLaps, parathyroid hormone(PTH) and VitD in each group were observed. RESULTS: The level of VitD in KOA with OP group (19.62±10.38) ng·ml^-1 and OP group (20.65±10.50) ng·ml^-1 was lower than that in physical examination group (27.46±8.00) ng·ml^-1 and KOA group (24.01±9.11) ng·ml^-1 (P<0.05). There were significant differences in β- CrossLaps and PTH levels among the four groups (P<0.001, P=0.019, respectively), while there was no significant difference in OC levels (P=0.763). Compared with the two simple disease groups, the KOA with OP group had higher levels of β - CrossLaps(0.81±0.30) ng·ml^-1 (P<0.001). There were significant differences in β-CrossLaps and PTH between the simple KOA group(0.54±0.22) ng·ml^-1, (46.03±18.08) pg·ml^-1 and the physical examination group (0.44±0.19) ng·ml^-1, (36.65±9.63) pg·mL^-1(P=0.038;P=0.006). There was a significant difference in PTH between the OP group(43.85±14.30) ng·ml-1, and the physical examination group, P=0.004. There was a significant difference in Kallgren-Lawrence grading between KOA with OP group and KOA group (P=0.006). Within KOA with OP group, the differences of β-CrossLaps and VitD levels among different K-L grades were statistically significant (P=0.016). The level of OC, β-CrossLaps and PTH within KOA with OP group was significantly different at different VitD levels (P=0.013, P=0.033, P=0.046). CONCLUSION Patients with KOA complicated by OP exhibit greater disturbances in bone metabolism and reduced VitD levels, particularly reflected by elevated β-CrossLaps. These findings underscore the importance of early monitoring of bone turnover and VitD supplementation in advanced-stage KOA with bone loss.
Humans ; Female ; Male ; Middle Aged ; Aged ; Vitamin D/blood* ; Osteoporosis/complications* ; Aged, 80 and over ; Osteoarthritis, Knee/complications* ; Retrospective Studies ; Bone and Bones/metabolism* ; Parathyroid Hormone/metabolism* ; Osteocalcin/metabolism*

Objective:To design an assisted management system for medical consumables that integrated management logic of diagnosis related groups(DRG)for disease,so as to standardize the use for medical consumables and to strengthen regulatory efficiency.Methods:The system was designed by a microservices architecture,and the data fusion of business data,data of diagnosis and treatment,and DRG data was realized through constructed data lake.A knowledge graph of associated rule for medical consumables was established,and the intelligent analysis function included prediction for demand,usage optimization,and anomaly detection was provided to assist management decision-making on the basis of inference for historical data and knowledge,and multi-dimensional data queries.A rule engine was deployed at key clinical nodes for real-time compliance review and intelligent alerts.A DRG-based business management process was constructed to cover full lifecycle of consumables,including admission,procurement,warehousing,storage,requisition,usage billing,and traceability,so as to realize real-time monitoring and early warning for consumable costs at the DRG level.Six clinical doctors with 2-3 years of experience in using medical consumable were selected as test users from Tangdu Hospital of the Air Force Medical University,and they were randomly assigned into a system group and a control group,with 3 subjects in each group.The system group utilized the auxiliary management system for medical consumable to perform prediction for the demand of monthly procurement,and rationality verification of consumable.The control group relied on individual experience of doctors.The predicted monthly procurement demand for medical consumables,the accuracy of verifying rationality of using medical consumables between two groups were compared,and the efficiencies of two kinds of management modes also were compared.Results:The accuracy rate of system group was 89.17%in predicting the monthly procurement demand for medical consumables,and the rate of checking accuracy and the rate of checking comprehensiveness of system group were respectively 87.50%and 91.67%in verifying rationality of using medical consumables,which were significantly higher than those of control group,and the differences were significant(x2=6.62,1.96,16.73,P<0.05).The durations of predicting the demand for procurement,and verifying and testing the rationality of consumables in system group were significantly shorter than these in control group[(3.54±0.45)s,(2.23±0.15)s],and the differences were statistically significant(t=1.97,1.65,P<0.05).Conclusion:The medical consumables auxiliary management system integrated with DRG management logic can significantly enhance the accuracy of monthly demand prediction for consumables and the recall rate and precision rate of rationality verification for consumables usage,while greatly improving work efficiency.It is conducive to enhancing the standardized and refined supervision level of consumables usage.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.

Objective:To analyze the relationship between serum GATA binding protein-3(GATA3)and eosinophilic cationic protein(ECP)and lung function indexes in children with obliterated bronchiolitis and their predictive value for poor prognosis.Methods:96 children with bronchiolitis obliterans admitted to our hospital from January 2022 to July 2024 were divided into mild group(34 cases)and moderate to severe group(62 cases)according to their severity.Serum GATA3,ECP levels and lung function indexes were detected in the two groups,and Pearson correlation was used to analyze the correlation between serum GATA3,ECP levels and lung function indexes.According to the levels of serum GATA3 and ECP,they were divided into high GATA3 group and low GATA3 group,high ECP group and low ECP group.The incidence of adverse prognosis in different groups was compared.Area under ROC curve(AUC)was used to evaluate the predictive efficacy of serum GATA3 combined with ECP for poor prognosis.Results:The levels of serum GATA3 and ECP in moderate and severe group were higher than those in mild group(P＜0.05).By Pearson correlation analysis,serum GATA3 and ECP levels were negatively correlated with tidal volume(VT),peak-to-expiratory volume(VPEFNE)and peak-to-time ratio(TPTEF/TE)in children with bronchiolitis obliterans(P＜0.05).The incidence of adverse prognosis in the high GATA3 group was higher than that in the low GATA3 group,and the incidence of adverse prognosis in the high ECP group was higher than that in the low ECP group(P＜0.05).ROC curve analysis showed that serum GATA3 combined with ECP had a sensitivity of 90.45％,specificity of 52.37％and AUC of 0.893 in predicting adverse prognosis of children with bronchiolitis obliterans.Conclusion:Serum GATA3 and ECP are closely related to pulmonary function indexes in children with bronchiolitis obliterans.The combined effect of GATA3 and ECP is better in predicting poor prognosis,and it has a certain suggestive role in evaluating the disease.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective:To analyze the relationship between serum GATA binding protein-3(GATA3)and eosinophilic cationic protein(ECP)and lung function indexes in children with obliterated bronchiolitis and their predictive value for poor prognosis.Methods:96 children with bronchiolitis obliterans admitted to our hospital from January 2022 to July 2024 were divided into mild group(34 cases)and moderate to severe group(62 cases)according to their severity.Serum GATA3,ECP levels and lung function indexes were detected in the two groups,and Pearson correlation was used to analyze the correlation between serum GATA3,ECP levels and lung function indexes.According to the levels of serum GATA3 and ECP,they were divided into high GATA3 group and low GATA3 group,high ECP group and low ECP group.The incidence of adverse prognosis in different groups was compared.Area under ROC curve(AUC)was used to evaluate the predictive efficacy of serum GATA3 combined with ECP for poor prognosis.Results:The levels of serum GATA3 and ECP in moderate and severe group were higher than those in mild group(P＜0.05).By Pearson correlation analysis,serum GATA3 and ECP levels were negatively correlated with tidal volume(VT),peak-to-expiratory volume(VPEFNE)and peak-to-time ratio(TPTEF/TE)in children with bronchiolitis obliterans(P＜0.05).The incidence of adverse prognosis in the high GATA3 group was higher than that in the low GATA3 group,and the incidence of adverse prognosis in the high ECP group was higher than that in the low ECP group(P＜0.05).ROC curve analysis showed that serum GATA3 combined with ECP had a sensitivity of 90.45％,specificity of 52.37％and AUC of 0.893 in predicting adverse prognosis of children with bronchiolitis obliterans.Conclusion:Serum GATA3 and ECP are closely related to pulmonary function indexes in children with bronchiolitis obliterans.The combined effect of GATA3 and ECP is better in predicting poor prognosis,and it has a certain suggestive role in evaluating the disease.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.