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.

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.

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.

ObjectiveTo assess the level of internal exposure to PCP in a community population in Shanghai， to investigate the factors affecting the level of PCP， and to analyze the correlation between the exposure and thyroid hormone levels. MethodsA total of 464 residents of a community in Shanghai were selected as the study subjects. A questionnaire survey was conducted to obtain the demographic information， dietary situation， lifestyle and behavioral habits， and disease history of the individuals， and blood samples were collected. Gas chromatography-electron trap was applied to determine the PCP levels in serum. Multicategorical logistic regression analysis was used to analyze the possible influencing factors of PCP exposure in humans. Thyroid hormone levels were used as the dependent variable and serum PCP as the independent variable. Multiple linear regression analysis was used to assess the association between PCP and thyroid hormones in the community population after controlling the confounding factors such as age， gender， literacy， annual personal income， and chronic diseases. ResultsThe detection rate of serum PCP in 464 subjects was 90.3%， and the median serum PCP level was 0.43 μg·L^-1. The differences in PCP levels among different age groups were statistically significant. There were no significant differences in PCP levels among different gender and BMI groups. The study of PCP exposure factors showed that age， frequency of using plastic products， consumption of freshwater fish， type of occupation， annual income， and consumption of tea or coffee were the potential influencing factors for PCP exposure. Among them， age， frequency of using plastic products， consumption of tea or coffee， and consumption of freshwater fish were positively associated with PCP levels， and annual personal income was negatively associated with it. The results of multiple linear regression analysis showed that among men， PCP levels were positively correlated with TSH （b=0.105， 95%CI：0.017‒0.313） and negatively correlated with FT4 （b=-0.026， 95%CI：-0.057‒0.004）， and among women， PCP levels were positively correlated with TSH （b=0.092， 95%CI：-0.211‒0.904） and FT3 （b=0.017， 95%CI：-0.058‒0.230） and negatively correlated with FT4 （b=-0.013， 95%CI：-0.011‒0.037）. ConclusionSerum PCP detection is common among community residents in Shanghai. Different demographic characteristics or behavioral habits may increase or decrease PCP exposure. PCP exposure then affects human thyroid hormone levels.