Objective To explore and analyze the implementation effect of the combined traditional Chinese medicine(TCM)and Western medicine DRG payment model in TCM hospitals,aiming to provide a reference for the reform of medical in-surance payment methods in such hospitals.Methods R language was utilized to statistically analyze the costs and other indica-tors of the sample hospitals before and after the implementation of the combined TCM and Western medicine DRG payment within 1-2 years.Results Following the implementation of the combined TCM and Western medicine DRG payment,there was a de-crease in average hospitalization costs and average length of stay,accompanied by an increase in CMI(average weight).The cost structure underwent changes:the proportions of western medicine fees and auxiliary examination fees decreased,whereas the pro-portion of TCM treatment fees increased.Significant statistical differences were observed in each group of data(p＜2.2e-16).Conclusion The combined TCM and Western medicine DRG payment reform model can facilitate TCM hospitals in reducing medical costs,controlling medical expenses,optimizing the cost structure,and promoting the development of TCM diagnosis and treatment characteristics.

OBJECTIVE To comprehensively evaluate the efficacy， safety and cost-effectiveness of insulin icodec in treating type 2 diabetes mellitus （T2DM）， providing evidence-based guidance for new drug selection in hospital and clinical medication decision-making. METHODS PubMed， Cochrane Library， Embase， CNKI， Wanfang， VIP and foreign health technology assessment （HTA） websites were searched by using rapid health technology assessment from inception to 15 July 2025 for systematic reviews/meta-analyses， pharmacoeconomic studies， and HTA reports on insulin icodec in the treatment of T2DM. After data extraction and quality assessment， the findings of the included studies were analyzed descriptively. RESULTS Ten systematic reviews/meta-analyses and three pharmacoeconomic studies were included. Among them， 4 systematic reviews/meta-analyses were of high quality； the overall quality of the 3 pharmacoeconomic studies was relatively good. Regarding efficacy， insulin icodec was superior to once-daily basal insulin in reducing glycated hemoglobin （HbA1c） and in achieving the target of HbA1c＜7% （P＜0.05）. No significant differences were observed between icodec insulin and comparators in lowering fasting plasma glucose （P＞0.05）. For safety， insulin icodec did not increase the incidence of any adverse events （AEs）， serious AEs， clinically significant hypoglycemia （random glucose＜3 mmol/L）， injection-site reactions， or allergic reactions， compared with once-daily basal insulin overall （P＞ 0.05）； however， insulin icodec was associated with a significant increase in body weight （P＜0.05）. Domestic economic evaluations indicated that insulin icodec was more cost-effective than insulin glargine and insulin degludec when its annual costs were in the range of 784.90-1 145.96 and 597.66-736.34 US dollars， respectively. CONCLUSIONS Insulin icodec demonstrates favorable efficacy and safety profiles in the treatment of T2DM； however， attention should be paid to the risk of weight gain. Under China’s healthcare system， insulin icodec demonstrates greater economic value only when the patient’s weekly required basal insulin dose falls within a specific range，and clinical practice requires individualization.

Objective To explore and analyze the implementation effect of the combined traditional Chinese medicine(TCM)and Western medicine DRG payment model in TCM hospitals,aiming to provide a reference for the reform of medical in-surance payment methods in such hospitals.Methods R language was utilized to statistically analyze the costs and other indica-tors of the sample hospitals before and after the implementation of the combined TCM and Western medicine DRG payment within 1-2 years.Results Following the implementation of the combined TCM and Western medicine DRG payment,there was a de-crease in average hospitalization costs and average length of stay,accompanied by an increase in CMI(average weight).The cost structure underwent changes:the proportions of western medicine fees and auxiliary examination fees decreased,whereas the pro-portion of TCM treatment fees increased.Significant statistical differences were observed in each group of data(p＜2.2e-16).Conclusion The combined TCM and Western medicine DRG payment reform model can facilitate TCM hospitals in reducing medical costs,controlling medical expenses,optimizing the cost structure,and promoting the development of TCM diagnosis and treatment characteristics.

The research on medical image segmentation is of great significance in advancing efficient and accurate automated image processing techniques.To address the problem of inaccurate segmentation results caused by significant variations in organ tissue shapes and blurred boundaries present in medical images,a novel network named MFMANet is proposed.Built upon a"U"-shaped architecture,the network integrates multi-scale information fusion modules and multi-attention modules.Specifically,multi-scale information modules capture multi-scale information in the shallow layers of the network to bridge the semantic gap between encoder and decoder features,thereby enhancing the network's ability to handle large variations in organ sizes.Regarding the issue of blurred boundaries,multi-attention mechanism utilizes Swin Transformer as the deep encoder-decoder network,employing channel and spatial attention instead of traditional skip connections to achieve finer feature extraction.Experimental results on the ACDC and Synapse public datasets show that the proposed method achieves improvements of 1.51%and 1.29%in Dice similarity coefficient as compared with MTUNet,fully demonstrating its effectiveness in enhancing segmentation network accuracy.

The research on medical image segmentation is of great significance in advancing efficient and accurate automated image processing techniques.To address the problem of inaccurate segmentation results caused by significant variations in organ tissue shapes and blurred boundaries present in medical images,a novel network named MFMANet is proposed.Built upon a"U"-shaped architecture,the network integrates multi-scale information fusion modules and multi-attention modules.Specifically,multi-scale information modules capture multi-scale information in the shallow layers of the network to bridge the semantic gap between encoder and decoder features,thereby enhancing the network's ability to handle large variations in organ sizes.Regarding the issue of blurred boundaries,multi-attention mechanism utilizes Swin Transformer as the deep encoder-decoder network,employing channel and spatial attention instead of traditional skip connections to achieve finer feature extraction.Experimental results on the ACDC and Synapse public datasets show that the proposed method achieves improvements of 1.51%and 1.29%in Dice similarity coefficient as compared with MTUNet,fully demonstrating its effectiveness in enhancing segmentation network accuracy.

Objective To evaluate the efficacy,safety and economics of romiplostim for treating primary immune thrombocytopenia(ITP)by rapid health technology assessment,and to provide an evidence-based basis for policy makers and clinical practice.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data and VIP databases and the official websites of health technology assessment agency were electronically searched to collect high-quality clinical evidence and pharmacoeconomics evaluation literature of romiplostim for the treatment of ITP from inception to January 18,2024.Two researchers independently screened the literature,extracted information,and accessed the quality of included the literature,the extracted results were categorized and evaluated.Results A total of 14 literature were included,in which 8 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.In terms of efficacy,treatment with romiplostim significantly elevated platelet response rate,sustained platelet response rate,and mean platelet count in patients with ITP compared with placebo(P＜0.05).Romiplostim did not show a significant advantage in elevating patients'platelet response rate and sustained platelet response rate compared with other agents used to treat ITP(P＞0.05).In terms of safety,the incidence of serious adverse events was statistically lower with romiplostim compared to placebo(P＜0.05),while no significant differences were seen in the incidence of adverse events,bleeding events and thrombotic events(P＞0.05).There were no significant differences in the incidence of adverse events,serious adverse events,bleeding events,or thrombotic events when comparing romiplostim to other drugs for the treatment of ITP(P＞0.05).From an economic standpoint,most studies considered eltrombopag to be more economic advantages than romiplostim.Conclusion Romiplostim has good efficacy and safety in the treatment of ITP,and no advantage was shown in terms of economy.

Objective To assess the nutritional status of vitamin D and associated factors among adults of six ethnic minority groups native to Yunnan Province,and provide evidence for policy making.Methods Between May 2019 and August 2020,a total of 690 adults were selected from Jinuo,Bulang,Jingpo,Deang,Achang and Pumi ethnic groups according to the sex and age composition in the 6th national census.A questionnaire survey and an anthropometric examination were conducted by trained health workers,and serum 25(OH)D levels were determined with high-performance liquid chromatography-tandem mass spectrometry.Results The median of serum 25(OH)D was 28.7(P25～P75∶24.3～33.8)ng/mL,and the prevalence of vitamin D sufficiency,insufficiency and deficiency were 44.2%、47.5%and 8.3%,respectively.There were significant differences in serum 25(OH)D levels among the six ethnic groups(χ2=139.29,P<0.01).Multivariate logistic regression showed that ethnic groups living in higher latitude areas(Pumi,Jingpo,Deang,and Achang),women,and those whose BMI≥24.0 were more likely to be vitamin D insufficient or deficient.Conclusion More than half of the ethnic adults suffer from vitamin D malnutrition which also varies across ethnicities.Further surveillance and interventions among key areas and populations are needed.

Thymectomy is the main treatment for thymoma and other thymic diseases. But the incidence of non-therapeutic thymectomy is high due to the difficulty in the differential diagnosis of anterior mediastinum lesions. Formerly, it was believed that the thymus gradually degraded and lost function with aging, and the preservation of the thymus was not valued. Recent studies have found that the removal of the thymus at all ages has adverse effects on overall health and leads to a significant increase in the risk of autoimmune diseases, malignancy, and all-cause mortality. Therefore, unnecessary thymectomy should be avoided. This article reviews the influence of thymectomy, including the changes of immunological indexes and clinical prognosis, and further discusses the current situation and avoidance methods of non-therapeutic thymectomy.

OBJECTIVE To systematically evaluate the efficacy and safety of glucokinase activators in the treatment of type 2 diabetes mellitus. METHODS PubMed， Cochrane Library， Web of Science， Embase and CNKI databases were searched from the inception to March 2022. Randomized controlled trials about glucokinase activators versus placebo （or other oral hypoglycemic agents） in the treatment of type 2 diabetes were included， data were extracted and meta-analysis was analyzed using RevMan 5.4 software. RESULTS A total of 9 studies with 215 0 patients were included. In terms of hypoglycemic effect， compared with control group， glucokinase activators significantly reduced glycosylated hemoglobin （HbA1c） [MD＝－0.40， 95%CI（－0.53， －0.26）， P＜0.000 01]， fasting blood glucose[MD＝－0.53， 95%CI（－0.85， －0.20）， P＝0.001] and 2 h postprandial blood glucose [MD＝－2.28， 95%CI（－2.68， －1.88）， P＜0.000 01] in diabetic patients. In terms of safety， the incidence of hypoglycemia caused by glucokinase activators was higher than control group on the whole [RR＝1.55， 95%CI（1.20，2.01）， P＝ 0.000 8]. According to the subgroup analysis of organs activated by glucokinase activator， the incidence of hypoglycemia in the pancreas-liver dual activator group [RR＝1.44， 95%CI（1.11，1.89）， P＝0.007] and liver-selective activator group [RR＝2.26， 95%CI（1.02，5.03）， P＝0.05] was higher than that in the control group， the difference was statistically significant. CONCLUSIONS Glucokinase activators can effectively reduce HbA1c， fasting blood glucose and 2 h postprandial blood glucose in patients with type 2 diabetes， but the risk of hypoglycemia remains to be addressed.

Objective: To observe the preventive effect of alkaline drinking water on hyperuricemia in mice. Methods: Sixty male SPF Kunming mice were randomly divided into six groups: pH 7.3, pH 8.0, pH 9.3 intervention groups, in which the mice were given water with pH values of 7.3±0.5, 8.0±0.5 and 9.3±0.6, respectively; the control group, model group and positive drug group ( with 2 g/L allopurinol ) were given double distilled water. Except for the control group, the mice in each group were given yeast by gavage (1.5 g/mL) for 13 days. On the 14th day, the mice were injected with 300 mg/kg potassium oxyzinate by intraperitoneal injection, and then fasted for 1 day. On the 16th day, serum uric acid, creatinine and urea nitrogen were detected, and renal tissues were stained to observe the morphology.The expression levels of neutrophil gelatinase-associated lipocalin ( NGAL ), tissue inhibitor of metalloproteinase 1( TIMP1 ), organic anion transporter 1 ( OAT1 ) and urate transporter 1 ( URAL-1 ) in renal tissues were determined bywestern blotting. The mRNA expression levels of URAL-1 and OAT1 were detected by real-time fluorescent quantita⁃tive polymerase chain reaction. Results: The level of serum uric acid was higher in the model group than in the control group and in the pH 9.3 intervention group (both P<0.05). The number and area of renal tubular lesions were less in the pH 9.3 intervention group than in the model group (all P<0.05). The relative expression levels of NGAL and URAT-1 proteins were lower in the pH 9.3 intervention group than in the model group, and the relative expression level of OAT1 protein was higher in the pH 9.3 intervention group than in the model group ( all P<0.05). The relativeexpression level of URAT-1 mRNA was lower in the pH 9.3 intervention group than in the model group, and the rela⁃tive expression level of OAT1 mRNA was higher in the pH 9.3 intervention group than in the model group ( all P<0.05 ). Conclusion Alkaline drinking water with pH value of 9.3±0.6 can effectively prevent hyperuricemia and acute kidney injury in mice.