Perforin 2(MPEG 1)is a member of the MACPF(membrane attack complex/PRF membrane attack complex/perforin)superfamily,which is mainly secreted by cytotoxic T lymphocytes,natural killer cells and mac-rophages Through the formation of active pores on the target cell membrane,perforin 2 participates in altering the permeability-pressure of the target cell,or collaborates with granzymes to induce the apoptosis of target cells.Re-cently,with the development of molecular biology,MPEG 1 has been increasingly studied,and the unique gene se-quence and cell types of perforin 2 have specific functions and adaptive evolution in different immune cells,which may determine its performance and therapeutic potential in different disease states.

OBJECTIVE To investigate the effects of the split formulas of Biyuan Heji(BYHJ)on paranasal sinus mucosal in-flammation in rats with acute rhinosinusitis(ARS)based on the pathogenesis of"wind-cold transforming into lung-heat".METHODS Unilateral nasal cavity occlusion combined with nasal dripping of Staphylococcus aureus were performed to establish a rat model of ARS.SD rats were randomly divided into blank,model,BYHJ(wind-cold removal+lung-heat removal),lung-heat removal,wind-cold removal,and positive drug groups,with 6 rats in each group.The rats were treated with the corresponding drugs for 7 d and then the samples were collected.HE staining was used to observe the pathological changes of rat paranasal sinus mucosa tissues,ELISA was employed to determine the levels of interleukin-1β(IL-1β),IL-6,IL-8,IL-9,IL-10,and IL-12 in serum,immunohistochemis-try(IHC)was adopted to measure the protein expression of tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule(ICAM-1)in paranasal sinus mucosa tissues,and Western blot was used to detect the protein expression of phosphorylated p38 mito-gen-activated protein kinase(p38 MAPK),nuclear transcription factor-κB p50(NF-κB p50),and NF-κB p65 in paranasal sinus mucosa tissues.RESULTS The acute sinusitis rat inflammation model was successfully established.Compared with the model group,the water drinking,diet eating,and body weight of rats in the BYHJ group,wind-cold removal,lung-heat removal,and positive drug groups were significantly improved,the aggregation of inflammatory cells in the paranasal sinus mucosal tissue was reduced,and the levels of IL-1β,IL-6,IL-8,IL-9,and IL-12 in the serum were significantly reduced(P<0.01),IL-10 content significantly in-creased(P<0.01),the protein expression of TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 in the paranasal sinus mucosa was significantly decreased(P<0.01).The comparison between various traditional Chinese medicine groups showed that the decrease of IL-1β,IL-6,IL-8,IL-9,IL-12,TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 and the increase of IL-10 in the BYHJ group were better than those in the split formula groups(P<0.01),and the lung-heat removal group was better than the wind-cold removal group(P<0.01).CONCLUSION BYHJ and its split formulas can effectively inhibit the inflammatory response in rats with ARS.

OBJECTIVE To investigate the effects of the split formulas of Biyuan Heji(BYHJ)on paranasal sinus mucosal in-flammation in rats with acute rhinosinusitis(ARS)based on the pathogenesis of"wind-cold transforming into lung-heat".METHODS Unilateral nasal cavity occlusion combined with nasal dripping of Staphylococcus aureus were performed to establish a rat model of ARS.SD rats were randomly divided into blank,model,BYHJ(wind-cold removal+lung-heat removal),lung-heat removal,wind-cold removal,and positive drug groups,with 6 rats in each group.The rats were treated with the corresponding drugs for 7 d and then the samples were collected.HE staining was used to observe the pathological changes of rat paranasal sinus mucosa tissues,ELISA was employed to determine the levels of interleukin-1β(IL-1β),IL-6,IL-8,IL-9,IL-10,and IL-12 in serum,immunohistochemis-try(IHC)was adopted to measure the protein expression of tumor necrosis factor-α(TNF-α)and intercellular adhesion molecule(ICAM-1)in paranasal sinus mucosa tissues,and Western blot was used to detect the protein expression of phosphorylated p38 mito-gen-activated protein kinase(p38 MAPK),nuclear transcription factor-κB p50(NF-κB p50),and NF-κB p65 in paranasal sinus mucosa tissues.RESULTS The acute sinusitis rat inflammation model was successfully established.Compared with the model group,the water drinking,diet eating,and body weight of rats in the BYHJ group,wind-cold removal,lung-heat removal,and positive drug groups were significantly improved,the aggregation of inflammatory cells in the paranasal sinus mucosal tissue was reduced,and the levels of IL-1β,IL-6,IL-8,IL-9,and IL-12 in the serum were significantly reduced(P<0.01),IL-10 content significantly in-creased(P<0.01),the protein expression of TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 in the paranasal sinus mucosa was significantly decreased(P<0.01).The comparison between various traditional Chinese medicine groups showed that the decrease of IL-1β,IL-6,IL-8,IL-9,IL-12,TNF-α,ICAM-1,p38 MAPK,NF-κB p50,and NF-κB p65 and the increase of IL-10 in the BYHJ group were better than those in the split formula groups(P<0.01),and the lung-heat removal group was better than the wind-cold removal group(P<0.01).CONCLUSION BYHJ and its split formulas can effectively inhibit the inflammatory response in rats with ARS.

Amorphous calcium phosphate（ACP）is a component of urinary stones，primarily forming mixed stones with calcium oxalate，while pure ACP stones are relatively rare. This article reports a case of a patient with an ACP bladder stone who was admitted due to progressive dysuria over 5 years，which had worsened in the past months. Upon admission，tPSA was 29.63 ng/ml. CT and enhanced MRI revealed multiple bladder stones and prostatic hyperplasia. The patient underwent ultrasound-guided prostate biopsy and transurethral cystolithotripsy with pneumatic lithotripsy. Postoperative infrared spectroscopy confirmed the stone composition as ACP，and prostatic adenocarcinoma was diagnosed by prostate biopsy pathology. Endocrine therapy was administered postoperatively，and follow-up imaging at 3 months showed no stone. This article presents the first reported case of an ACP bladder stone coexisting with prostate cancer，providing important clinical insights into the etiology of such stones and the rare local manifestations of prostate cancer.

Amorphous calcium phosphate（ACP）is a component of urinary stones，primarily forming mixed stones with calcium oxalate，while pure ACP stones are relatively rare. This article reports a case of a patient with an ACP bladder stone who was admitted due to progressive dysuria over 5 years，which had worsened in the past months. Upon admission，tPSA was 29.63 ng/ml. CT and enhanced MRI revealed multiple bladder stones and prostatic hyperplasia. The patient underwent ultrasound-guided prostate biopsy and transurethral cystolithotripsy with pneumatic lithotripsy. Postoperative infrared spectroscopy confirmed the stone composition as ACP，and prostatic adenocarcinoma was diagnosed by prostate biopsy pathology. Endocrine therapy was administered postoperatively，and follow-up imaging at 3 months showed no stone. This article presents the first reported case of an ACP bladder stone coexisting with prostate cancer，providing important clinical insights into the etiology of such stones and the rare local manifestations of prostate cancer.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.

Objective To investigate the effect of right stellate ganglion block(SGB)on postoper-ative shoulder pain in patients receiving laparoscopic cholecystectomy(LC).Methods A total of 104 pa-tients scheduled for LC from April to August 2022,32 males and 72 females,aged 18-64 years,ASA phys-ical status Ⅰ orⅡ,were selected and randomized into two groups:the stellate ganglion block group(group S,n = 51)and the control group(group C,n = 53).Immediately after intubation,0.2%ropivacaine 4 ml was used for ultrasound-guided right SGB in group S,and saline 4 ml was injected at the same site in group C.The number of cases of post-laparoscopic shoulder pain(PLSP)and the duration of PLSP were re-corded within 48 hours after operation.The VAS pain scores of PLSP were recorded to assess the level of PLSP immediately after operation(T1),2 hours after operation(T2),6 hours after operation(T3),12 hours after operation(T4),24 hours after operation(T5),and 48 hours after operation(T6).The number of effective compressions of the PCIA pump and the salvage analgesia were recorded.The adverse reactions such as nausea,vomiting,and abdominal distension were recorded.Results The incidence of PLSP and the rate of patients with PLSP lasting more than 10 hours in group S was significantly lower than those in group C(P＜0.05),and the degree of PLSP in group S was significantly lower than that in group C at T3-T5(P＜0.05).The number of effective compressions of the PCIA pump and the salvage analgesia rate in group S was significantly lower than those in group C(P＜0.05).The incidence of nausea in group S was significantly lower than that in group C(P＜0.05).Conclusion Right stellate ganglion block can reduce the incidence of PLSP in patients receiving LC,relieve the pain degree of PLSP,and reduce the incidence of adverse reactions.