Objective To analyze the effects of national centralized volume-based procurement(CVBP)on hospitaliza-tion expenses of patients undergoing artificial joint replacement under the Diagnosis-Related Group(DRG)payment model in a public hospital,and to provide evidence for advancing reforms in high-value medical consumables and healthcare payment sys-tems.Methods Data from patients undergoing artificial joint replacement in a tertiary public hospital in 2022 were collected.Statistical analysis was used to assess the surplus and deficit of DRG year-end settlements for these cases.By comparing cost com-positions across different medical insurance types,differences in total inpatient medical expenses,out-of-pocket payments,per-sonal medical insurance account expenditures,and pooled fund reimbursements were evaluated before and after CVBP implemen-tation.Results Following CVBP implementation,the sample hospital demonstrated significant improvements in reducing medical costs,alleviating patient financial burdens,and optimizing medical insurance fund utilization.Under the DRG payment model,operational performance remained stable.Post-CVBP,total hospitalization expenses,patient out-of-pocket payments,and pooled fund reimbursements all decreased significantly(P＜0.001).Conclusion The practice of centralized procurement of artificial joints can be extended to other high-value medical consumables,continuously promoting the reform of the medical and health sys-tem,and ultimately achieving mutually beneficial and sustainable development among healthcare providers,insurers,and patients.

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

Objective:To explore the efficacy in the treatment of chronic apical periodontitis caused by dental trauma in young permanent teeth with the combination of autologous platelet-poor plasma(PPP)and concentrate growth factors(CGF).Methods:80 young children with chronic apical periodontitis of permanent teeth admitted to the Department of Dentistry and Endodontics of Stomatological Hospital from September 2021 to September 2023 were included,and the patients were divided into three groups A,B and C using a computer-generated random number table.Group A was treated with bioceramic material iRoot BP Plus.Group B was treated with CGF,and Group C was treated with CGF combined with PPP.Clinical and imaging evaluations were performed af-ter treatment.Results:At the last follow-up,the treatment effectiveness rate of the CGF+PPP group was 85.71％,which was sig-nificantly higher than the 52.00％of the iRoot BP Plus group and 59.26％of the CGF group(P＜0.05).In terms of root develop-ment,the root canal length and root canal wall thickness increased more significantly in the CGF+PPP group after treatment(P＜0.05).Regarding the reduction in periapical lesion volume,the reduction in lesion volume in the CGF+PPP group was more obvi-ous(P＜0.05).Comparing the recovery status of the affected teeth after treatment,the proportion of normal pulp vitality and normal tooth color in the CGF+PPP group was significantly higher than that in the iRoot BP Plus group(P＜0.05).Conclusion:Autolo-gous platelet-poor plasma combined with CGF can more effectively promote tooth root development and lesion healing than iRoot BP Plus or CGF alone in the treatment of chronic apical periodontitis caused by trauma to young permanent teeth.

OBJECTIVE: Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently develop central nervous system damage, yet the mechanisms driving this pathology remain unclear. This study investigated the primary pathways and key factors underlying brain tissue damage induced by the SARS-CoV-2 beta variant (lineage B.1.351). METHODS: K18-hACE2 and C57BL/6 mice were intranasally infected with the SARS-CoV-2 beta variant. Viral replication, pathological phenotypes, and brain transcriptomes were analyzed. Gene Ontology (GO) analysis was performed to identify altered pathways. Expression changes of host genes were verified using reverse transcription-quantitative polymerase chain reaction and Western blot. RESULTS: Pathological alterations were observed in the lungs of both mouse strains. However, only K18-hACE2 mice exhibited elevated viral RNA loads and infectious titers in the brain at 3 days post-infection, accompanied by neuropathological injury and weight loss. GO analysis of infected K18-hACE2 brain tissue revealed significant dysregulation of genes associated with innate immunity and antiviral defense responses, including type I interferons, pro-inflammatory cytokines, Toll-like receptor signaling components, and interferon-stimulated genes. Neuroinflammation was evident, alongside activation of apoptotic and pyroptotic pathways. Furthermore, altered neural cell marker expression suggested viral-induced neuroglial activation, resulting in caspase 4 and lipocalin 2 release and disruption of neuronal molecular networks. CONCLUSION These findings elucidate mechanisms of neuropathogenicity associated with the SARS-CoV-2 beta variant and highlight therapeutic targets to mitigate COVID-19-related neurological dysfunction.
Animals ; COVID-19/genetics* ; Mice ; Brain/metabolism* ; Apoptosis ; Mice, Inbred C57BL ; SARS-CoV-2/physiology* ; Pyroptosis ; Gene Expression Profiling ; Transcriptome ; Male ; Female

Based on the target recognition ability of split aptamer and intelligent analytical capability of molecular logic gate,in this work,two split aptamers were integrated into"AND"logic gate to construct a novel ortho-nucleic acid fluorescence sensor for simultaneous detection of thrombin and myoglobin.When there was one target,the response of the signal was only a single fluorescence output signal,which was used as an evaluation standard for early low-risk judgment.When two targets coexisted,the split aptamer bound to the target to form a ternary complex and led to the head and tail ortho-nucleic acid effect respectively,and triggered the G4 chain to enhance the fluorescence signal of thioflavin T and the fluorescence signal quenching of Cyanine 3,which could be used as an evaluation criterion for early high-risk judgement.Under the optimal conditions,the linear range for detection of thrombin was 3-200 nmol/L,with a correlation coefficient of 0.9931 and a detection limit of 0.97 nmol/L,and the linear range for detection of myoglobin was 6-400 nmol/L,with a correlation coefficient of 0.9933,and a detection limit of 2.14 nmol/L.The method was applied to simultaneous determination of thrombin and myoglobin in clinical serum samples,and the recoveries were 85.4%-118.3%and 85.8%-119.9%,respectively,with relative standard deviations of less than 6.5%.Compared with the standard method,the relative error range was from-8.8%to 5.6%.In addition,the logical diagnosis results of 4 serum samples were high-risk of acute myocardial infarction in 2 cases and low-risk in 2 cases.The ″AND″ logic gate ortho-nucleic acid fluorescence sensing method showed many advantages such as high selectivity,rapidity,accuracy and simultaneous detection,which offered important reference for early diagnosis of acute myocardial infarction,and also provided a general detection design strategy and platform for simultaneous detection of biomarkers.

Objective To analyze the effects of national centralized volume-based procurement(CVBP)on hospitaliza-tion expenses of patients undergoing artificial joint replacement under the Diagnosis-Related Group(DRG)payment model in a public hospital,and to provide evidence for advancing reforms in high-value medical consumables and healthcare payment sys-tems.Methods Data from patients undergoing artificial joint replacement in a tertiary public hospital in 2022 were collected.Statistical analysis was used to assess the surplus and deficit of DRG year-end settlements for these cases.By comparing cost com-positions across different medical insurance types,differences in total inpatient medical expenses,out-of-pocket payments,per-sonal medical insurance account expenditures,and pooled fund reimbursements were evaluated before and after CVBP implemen-tation.Results Following CVBP implementation,the sample hospital demonstrated significant improvements in reducing medical costs,alleviating patient financial burdens,and optimizing medical insurance fund utilization.Under the DRG payment model,operational performance remained stable.Post-CVBP,total hospitalization expenses,patient out-of-pocket payments,and pooled fund reimbursements all decreased significantly(P＜0.001).Conclusion The practice of centralized procurement of artificial joints can be extended to other high-value medical consumables,continuously promoting the reform of the medical and health sys-tem,and ultimately achieving mutually beneficial and sustainable development among healthcare providers,insurers,and patients.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

Coronary restenosis is an important cause of poor long-term prognosis in patients with coronary heart disease. Here, we show that lysine methyltransferase SMYD2 expression in the nucleus is significantly elevated in serum- and PDGF-BB-induced vascular smooth muscle cells (VSMCs), and in tissues of carotid artery injury-induced neointimal hyperplasia. Smyd2 overexpression in VSMCs (Smyd2-vTg) facilitates, but treatment with its specific inhibitor LLY-507 or SMYD2 knockdown significantly inhibits VSMC phenotypic switching and carotid artery injury-induced neointima formation in mice. Transcriptome sequencing revealed that SMYD2 knockdown represses the expression of serum response factor (SRF) target genes and that SRF overexpression largely reverses the inhibitory effect of SMYD2 knockdown on VSMC proliferation. HDAC3 directly interacts with and deacetylates SRF, which enhances SRF transcriptional activity in VSMCs. Moreover, SMYD2 promotes HDAC3 expression via tri-methylation of H3K36 at its promoter. RGFP966, a specific inhibitor of HDAC3, not only counteracts the pro-proliferation effect of SMYD2 overexpression on VSMCs, but also inhibits carotid artery injury-induced neointima formation in mice. HDAC3 partially abolishes the inhibitory effect of SMYD2 knockdown on VSMC proliferation in a deacetylase activity-dependent manner. Our results reveal that the SMYD2-HDAC3-SRF axis constitutes a novel and critical epigenetic mechanism that regulates VSMC phenotypic switching and neointimal hyperplasia.