Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

BACKGROUND:There is an internal relationship between hyperhomocysteinemia and vascular calcification.However,the pathogenesis of hyperhomocysteinemia promoting vascular calcification is still unclear. OBJECTIVE:To investigate the role of bone morphogenetic protein-2 in hyperhomocysteinemia-induced vascular calcification. METHODS:Human carotid wax samples were divided into a calcified group(n=29)and a non-calcified group(n=13)according to the presence or absence of calcified plaque.Sixteen ApoE-/-mice were randomly divided into a control group and a hyperhomocysteinemia group,with 8 mice in each group.Bone morphogenetic protein-2 vector was used to transfect rat thoracic artery smooth muscle A7r5 cells,and gradient concentration of homocysteine(50,100,200,and 400 μmol/L)was utilized to treat A7r5 cells.Calcification was detected by alizarin red staining and hematoxylin-eosin staining.The interaction of bone morphogenetic protein 2 with Runt-related transcription factor 2 was detected by immunofluorescence,and the expressions of bone morphogenetic protein 2,Runt-related transcription factor 2,and α-smooth muscle actin were detected by immunohistochemistry and western blot assay. RESULTS AND CONCLUSION:(1)Human carotid artery tissue staining revealed that compared with the non-calcification group,inflammatory cells increased and calcification positive rate increased in the calcification group(P<0.05).Compared with the non-calcification group,the expressions of bone morphogenetic protein-2 and Runt-related transcription factor 2 were up-regulated,and the expression of α-smooth muscle actin was decreased in the calcification group(all P<0.05).(2)The staining of mouse arterial specimens exhibited that,the positive rate of calcified area in the hyperhomocysteinemia group was significantly higher than that in the control group(P<0.05);serum homocysteine level in the hyperhomocysteinemia group was significantly higher than that in the control group(P<0.05).Compared with the control group,the expressions of bone morphogenetic protein-2 and Runt-related transcription factor 2 were up-regulated,and the expression of α-smooth muscle actin was decreased in the hyperhomocysteinemia group(all P<0.05).(3)A7r5 cell culture analysis demonstrated that with the increase of homocysteine concentration gradient,the degree of calcification,the content of bone morphogenetic protein-2 and Runt-related transcription factor 2 protein in A7r5 cells increased(P<0.05),and the content of α-smooth muscle actin protein decreased(P<0.05).(4)The A7r5 cell culture analysis of overexpressed bone morphogenetic protein 2 showed that the calcification degree of the overexpressed bone morphogenetic protein 2 group was increased compared with the corresponding control group,the β-sodium glycerophosphate group,and the homocysteine group.RUNt-related transcription factor 2 expression up-regulated(P<0.05)and α-smooth muscle actin expression down-regulated(P<0.05).(5)The expression of bone morphogenetic protein 2 increased in A7r5 cells cultured with homocysteine in calcified medium,and the expression of Runt-related transcription factor 2 increased with the increase of bone morphogenetic protein 2 expression.(6)The results confirm that bone morphogenetic protein-2 is a key target gene in the regulation of smooth muscle cell phenotypic transformation resulting in vascular calcification by hyperhomocysteinemia.Targeted regulation of bone morphogenetic protein-2 reduces hyperhomocysteinemia-induced vascular calcification.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.