Objective To assess the survival vulnerability of Oncomelania hupensis in Jiangxi Province under future climate scenarios, and to identify low-vulnerability areas for its survival in this province. Methods Village-level O. hupensis snail survey and O. hupensis snail control with chemical treatments in Jiangxi Province from 2016 to 2024 were captured from the Parasitic Disease Prevention and Control Information Management System of China Disease Prevention and Control Information System. Climatic data were primarily sourced from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), including annual average temperature, annual average precipitation, annual accumulated temperature above 10 °C, annual accumulated temperature above 0 °C, annual maximum temperature, annual minimum temperature, and annual average relative humidity, and nineteen bioclimatic variables were downloaded from the WorldClim website (https://www.worldclim.org/), including mean diurnal range, isothermality, temperature seasonality, and so on. Elevation and normalized difference vegetation index were catprued from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), and distance to rivers was downloaded from the WorldPop website (http://www.worldpop.org), and land use and land cover (LULC) data were downloaded from the Big Earth Data Center, Chinese Academy of Sciences (https://data.casearth.cn/), and nature reserve data were obtained from the China Nature Reserve Specimen Resource Sharing Platform (http://www.papc.cn/). Three Shared Socioeconomic Pathways (SSPs) from the Beijing Climate Center-Climate System Model version 2-Medium Resolution (BCC-CSM2-MR) global climate model were employed as future climate scenarios, including SSP126, SSP245, SSP585, and the biomod2 ensemble model in R package was used to simulate suitable habitats for O. hupensis snails in Jiangxi Province in 2050 and 2070 under these scenarios. A snail survival vulnerability index was constructed based on the area of suitable snail habitats, area covered by snail control through chemical treatment, area covered by nature reserves, and changes in snail habitat fragmentation, and a map of snail survival vulnerability distribution was plotted. Results The real area of snail habitats ranged from 78 486.76 to 85 309.47 hm², and the area of snail control with chemical treatment ranged from 10 138.98 to 13 240.16 hm² in Jiangxi Province from 2016 to 2024. There were 429 to 531 villages detected with snails during the nine-year period, and the number of actually snail-infested villages ranged from 645 to 686. A total of 818 snail-present points and 1 996 snail-absent points were obtained from snail survey records. The best performance of the biomod2 ensemble model was achieved if a weighted mean approach was used as the ensemble strategy, with a true skill statistic value of 0.799 and an area under the receiver operating characteristic curve of 0.957, and modeling identified annual average relative humidity and annual average precipitation as two most influencing climatic variables for snail distribution. Relative to the current areas of suitable snail habitats under present climate conditions, the area of suitable snail habitats was projected to expand by 24.49% to 46.28% in Jiangxi Province under future climate scenarios, and the proportion of nature reserves areas in the areas of suitable snail habitats was projected to decrease slightly from the current 2.77% to approximately 2.52%, while the proportion of areas of snail control through chemical treatment in areas of suitable snail habitats varied from 0.64% to 19.57%, and the percentage of changes in snail habitat fragmentation ranged from 3.86% to 12.23%. Based on these four indicators, the snail survival vulnerability index was estimated to range from –1.96 to 0.62 in Jiangxi Province. The arithmetic mean of the snail survival vulnerability index differed under three SSP scenarios (SSP126, SSP245 and SSP585), with the highest mean value (–0.69) in 2070 under SSP126, and the lowest mean value (–0.78) in 2070 under SSP585. Conclusions The snail survival vulnerability index ranges from –1.96 to 0.62 in Jiangxi Province under future climate scenarios, and the suitable habitats for O. hupensis snails appear an overall tendency towards expansion. Low-vulnerability snail habitats are mainly distributed along the shores of Poyang Lake and the Yangtze River in Jiangxi Province, partially overlapping with nature reserves. Intensified surveillance of O. hupensis snails is recommended in these areas in the future.

Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

AIM To explore the clinical effects of Jinfukang Oral Liquid combined with thymosin α1 on patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin.METHODS Seventy-five patients were randomly assigned into thymosin α1 group(15 cases)for 4-week administration,Jinfukang Oral Liquid group(30 cases)for 4-week administration,and combination group(30 cases)for 4-week administration.The changes in TCM clinical syndrome effects,immunity indices(CD3+T,Th,CTL,total NK,CD56dim CD16+NK,NKT,Treg,MDSC),lethality/inhibition ratios(CTL/Treg,total NK/Treg,NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC)and FACT-L scores were detected.RESULTS The Jinfukang Oral Liquid group and combination group demonstrated higher total effective rates than the thymosin α1 group(P＜0.05).After the treatment,the Jinfukang Oral Liquid group and combination group displayed increased NKT(P＜0.05)and decreased MDSC(P＜0.05),which were more obvious than those in the thymosin α1 group(P＜0.05),and higher NKT was observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group and combination group displayed increased lethality/inhibition ratios(P＜0.05),among which NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC were higher than those in the thymosin α1 group(P＜0.05),and higher CTL/MDSC,NKT/MDSC were observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group(except for physiological status,society and family status)and combination group(except for society and family status)displayed increased FACT-L scores(P＜0.05).CONCLUSION For the patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin,Jinfukang Oral Liquid single use or combined with thymosin α1 can enhance peripheral blood immune surveillance,inhibit immune escape,restore the balanced state of tumor immune responses,and improve TCM syndromes and life quality.

Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.

Objective To evaluate the effects of fasting and high-fat diet on the pharmacokinetics of rabeprazole sodium enteric-coated tablets in healthy Chinese subjects.Methods A single-center,randomized,open,two-agent,two-sequence,four-cycle,fully repeated crossover,single-dose trial design was used in this study,healthy subjects were assigned to receive single dose of rabeprazole sodium enteric-coated tablets 0.1 g in either fasting or high-fat diet state,and blood samples were taken at different time points,respectively.The concentrations of rabeprazole sodium enteric-coated in plasma were determined by liquid chromatography-tandem mass spectrometry(LC-MS/MS),the model method of the non-compartmental was used to calculate the pharmacokinetic parameters by Phoenix WinNonlin 8.2.Results The main pharmacokinetic parameters of rabeprazole sodium enteric-coated tablets in fasting state and high-fat diet state were as follows:Cmax were(339.63±156.47)and(318.86±132.13)ng·mL-1;t1/2 were(2.34±0.68)and(3.60±2.40)h;AUC0_t were(556.62±251.65)and(528.50±201.78)ng·mL-1·h;AUC0-∞ were(563.39±255.69)and(535.15±203.24)ng·mL-1·h;tmax were 3.65 and 6.99 h.After high-fat diet,the Cmax and AUC of rapeprazole sodium after high-fat and high-calorie diet decreased,Cmax decreased by 6.12％,AUC0-t decreased by 5.05％,AUC0-∞ decreased by 5.01％,andtmaxwas delayed by about 3.34 h.Cmax,AUC0-t and AUC0-∞ 90％confidence interval were 73.13％-115.10％,83.22％-112.28％and 83.40％-112.13％,respectively.Neither was between 85.00％-125.00％.Conclusion High-fat diet affects the absorption rate and degree of rabeprazole sodium enteric-coated,so it is suitable to be administered on an empty stomach.

Objective To compare the effect of moderate-intensity continuous training(MICT)and high-intensity interval training(HIIT)on gait and balance for stroke patients.Methods From December,2023 to December,2024,96 patients with post-stroke gait and balance dysfunction were se-lected from the First Affiliated Hospital of Bengbu Medical University,and randomly divided into control group(n=32),MICT group(n=32)and HIIT group(n=32).The control group received routine comprehensive reha-bilitation therapy,while MICT and HIIT groups received additional respective training,for four weeks.They were measured with symmetry indexes(SI)of mean pressure and footprint area during eyes-open and eyes-closed condition,as well as anterior-posterior and medial-lateral displacement of the center of mass,before and after treatment;while they were assessed with Berg Balance Scale(BBS),distance of 6-minute walk test(6MWT),time of Timed Up&Go test(TUGT)and 10-meter walk test(10MWT),and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results The main effects of time(F>351.683,P<0.001)and groups(F>4.945,P<0.05),and the interaction effects(F>16.919,P<0.001)were significant for BBS scores,distance of 6MWT,time of TUGT and 10MWT,and FMA-LE scores;and all the indicators were better in MICT group and HIIT group than in the control group(P<0.05)after treatment,and they were better in HIIT group than in MICT group(P<0.05)except BBS score.Un-der eyes-open condition,the main effects of time(F>64.684,P<0.001)and groups(F>9.472,P<0.001),and the interaction effects(F>10.562,P<0.001)were significant for SI of mean pressure and footprint area,and an-terior-posterior and medial-lateral displacement of the center of mass;and all the indicators were better in MICT group and HIIT group than in the control group(P<0.001)after treatment,and they were better in HIIT group than in MICT group(P<0.05).Under eyes-closed condition,the main effects of time(F>107.730,P<0.001)and groups(F>4.275,P<0.05),and the interaction effects(F>7.985,P<0.05)were significant for SI of mean pressure and footprint area,and anterior-posterior and medial-lateral displacement of the center of mass;and SI of mean pressure was better in HIIT group than in MICT group(P<0.05),the other indicators were better in MICT group and HIIT group than in the control group(P<0.001)after treatment.Conclusion Both HIIT and MICT can improve gait and balance for stroke patients,and HIIT is more effective on gait and static balance with eyes open,but similar on static balance with eyes closed.

Objective To compare the effect of moderate-intensity continuous training(MICT)and high-intensity interval training(HIIT)on gait and balance for stroke patients.Methods From December,2023 to December,2024,96 patients with post-stroke gait and balance dysfunction were se-lected from the First Affiliated Hospital of Bengbu Medical University,and randomly divided into control group(n=32),MICT group(n=32)and HIIT group(n=32).The control group received routine comprehensive reha-bilitation therapy,while MICT and HIIT groups received additional respective training,for four weeks.They were measured with symmetry indexes(SI)of mean pressure and footprint area during eyes-open and eyes-closed condition,as well as anterior-posterior and medial-lateral displacement of the center of mass,before and after treatment;while they were assessed with Berg Balance Scale(BBS),distance of 6-minute walk test(6MWT),time of Timed Up&Go test(TUGT)and 10-meter walk test(10MWT),and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results The main effects of time(F>351.683,P<0.001)and groups(F>4.945,P<0.05),and the interaction effects(F>16.919,P<0.001)were significant for BBS scores,distance of 6MWT,time of TUGT and 10MWT,and FMA-LE scores;and all the indicators were better in MICT group and HIIT group than in the control group(P<0.05)after treatment,and they were better in HIIT group than in MICT group(P<0.05)except BBS score.Un-der eyes-open condition,the main effects of time(F>64.684,P<0.001)and groups(F>9.472,P<0.001),and the interaction effects(F>10.562,P<0.001)were significant for SI of mean pressure and footprint area,and an-terior-posterior and medial-lateral displacement of the center of mass;and all the indicators were better in MICT group and HIIT group than in the control group(P<0.001)after treatment,and they were better in HIIT group than in MICT group(P<0.05).Under eyes-closed condition,the main effects of time(F>107.730,P<0.001)and groups(F>4.275,P<0.05),and the interaction effects(F>7.985,P<0.05)were significant for SI of mean pressure and footprint area,and anterior-posterior and medial-lateral displacement of the center of mass;and SI of mean pressure was better in HIIT group than in MICT group(P<0.05),the other indicators were better in MICT group and HIIT group than in the control group(P<0.001)after treatment.Conclusion Both HIIT and MICT can improve gait and balance for stroke patients,and HIIT is more effective on gait and static balance with eyes open,but similar on static balance with eyes closed.

Aim To explore the material basis and un-derlying mechanism of Qingre Huoxue Formula(QRHXF)in the treatment of non-small cell lung cancer(NSCLC)by applying network pharmacology,molecular docking technology and bioinformatics com-bined with animal experiments.Methods TCMSP,ECTM,and BATMAN databases were used to obtain active components and corresponding targets of QRHXF;GEO and DisGeNENT databases were con-ducted to acquire NSCLC-associated differential expres-sion genes.By intersecting them,the common targets were obtained.It was chosen to construct a herb-com-ponent-disease network and protein-protein interaction(PPI)network.Furthermore,DAVID database was used to perform gene ontology(GO)function and Kyo-to encyclopedia of genes and genomes(KEGG)path-way enrichment analyses.The molecular docking was presented by adopting Autodock Vina program to verify key targets.RNA-seq datawere downloaded from TC-GA database to obtain differential gene expression.Ka-planMeier(KM)analysis was performed to analyze the relationship between gene expression and overall sur-vival.Mouse subcutaneous tumor model of LLC was established.The effects of QRHXF on body weight,tumor volume and weight were monitored for pharmaco-dynamic analysis.Tumor tissues slides were stained with hematoxylin and eosin(HE)for histopathological examination.Immunohistochemistry(IHC)staining was employed for detecting Ki67 and EP300.Western blot was performed to measure the protein expression of TP53,CDK1 and NTRK1.Results The results of net-work pharmacology showed that a total of seven com-mon targets were screened from NSCLC and QRHXF,and the effect of QRHXF on anti-NSCLC may occur via multiple signaling pathways,including cell cycle.The results of molecular docking indicated that the main ac-tive components of QRHXF had low binding energy and stable docking conformation with the molecular target for treating NSCLC.According to bioinformatic analy-sis,there were significant differences in BRCA1,CDK1 and NTRK1 mRNA expression between tumor tissues and normal tissues,which were also prognostic factors for overall survival.Animal experimental research showed QRHXF inhibited subcutaneous tumor growth(P＜0.01)and improved the quality of life in mice with NSCLC.After QRHXF intervention,the density of tumor cells was significantly reduced,and necrotic are-as were increased.The expressions of Ki67 and EP300 were significantly decreased.Compared with the model group,Western blot showed up-regulation of TP53 and NTRKA(P＜0.05),whereas CDK1 were down-regu-lated(P＜0.05).Conclusion QRHXF exerted anti-NSCLC effects by regulating NTRK1,EP300,TP53,CDK1 and inducing cell cycle,cell cycle arrest and in-hibiting tumor growth,metastasis and angiogenesis.

Objective To investigate the anesthesia effects of different concentrations of sevoflurane combined with propofol during primary liver cancer resection surgery,as well as the changes in immune function in patients.Methods Using single-blind method,120 cases of primary hepatocellular carcinoma admitted to the Third Affiliated Hospital of Naval Military Medical University from January 2023 to September 2023 were prospectively selected as the study subjects,and the patients were randomly(using the randomized numerical table method)included in the control group(60 cases)and the observation group(60 cases).During hepatic cancer resection,the control group was given 0.5 alveolar minimum effective concentration(MAC)sevoflurane combined with propofol target-controlled infusion anesthesia,and the observation group was given 1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,and both groups were observed for 3 d postoperatively.The perioperative related indexes,the sedation and quality of awakening in the immediate moment of extubation,15 min after extubation,and 30 min after extubation,the cognitive function before and at 1 and 3 d postoperatively,vital signs before induction of anesthesia,after induction of anesthesia,at the moment of intubation,at the end of surgery,immune function before and 1 d postoperative,and adverse reactions during the observation period were compared between the two groups.Results The time for extubation,recovery of spontaneous respiration,recovery of orientation,and awakening in the observation group were(11.25±1.69)min,(9.76±1.34)min,(69.23±3.35)min,and(10.13±1.43)min,and the control group were(14.57±2.28)min,(13.55±2.76)min,(73.44±4.52)min,(14.26±2.25)min,all of which were shorter in the observation group than in the control group(P＜0.05).The Ramsay sedation score at the immediate moment of extubation was(4.16±0.22)in the observation group,and(3.21±0.10)in the control group;the standardized(Aldrete)score in the awakening room of the observation group at the immediate moment of extubation,and 15 min after extubation were(9.56±0.12)and(9.77±0.20),respectively,and the control group was(9.02±0.13),respectively,(9.05±0.17)points;the scores of the brief mental state examination(MMSE)scale in the observation group were(26.23±1.12)points and(25.17±0.98)points in the control group in the 1 d postoperative period,which were higher than those of the control group(P＜0.05).The heart rate(HR)at the moment of intubation and at the end of operation in the observation group were(73.08±4.10)beats/min,(75.27±6.03)beats/min,and the mean arterial pressure(MAP)was(81.56±4.49)mmHg and(86.07±5.48)mmHg,respectively,and in the control group the HR was(75.47±5.78)beats/min,(77.91±6.79)beats/min,and the MAP was(85.22±5.08)mmHg and(88.25±6.01)mmHg in the observation group,respectively,which were lower than those in the control group(P＜0.05).The whole blood natural killer(NK)cells,CD4+and CD4+/CD8+in the observation group at 1 d postoperatively were(35.62±5.54)％,(50.09±3.32)％,and(1.42±0.25),the control group were(24.12±4.09)％,(43.17±4.20)％,and(1.20±0.19),the observation group was higher than the control group(P＜0.05);whole blood CD8+was(26.55±3.02)％in the observation group and(28.71±4.45)％in the control group,the observation group was lower than the control group(P＜0.05).The total incidence of adverse reactions during the observation period was 16.67％in the observation group and 5.00％in the control group,which was higher than the control group(P＜0.05).Conclusion Compared with 0.5 MAC sevoflurane combined with propofol target-controlled infusion anesthesia,1.0 MAC sevoflurane combined with propofol target-controlled infusion anesthesia had less effect on hemodynamics and immune function in patients undergoing resection for primary hepatocellular carcinoma,and it could improve the quality of patients'awakening,cognitive function,and promote postoperative recovery,and the anesthesia was more effective,but it had more adverse effects.