Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism (VTE) in grassroots hospitals. Methods Based on relevant guidelines and expert consensuses on VTE prevention and treatment, domestic and foreign literature was reviewed. A research and development team composed of clinical experts in VTE prevention and treatment, medical and nursing quality management experts, and information engineers conducted investigations and research in surrounding grassroots hospitals. Through evidence-based research and surveys, the team identified relevant business needs, user needs, and functional requirements of grassroots hospitals, and finally formulated a detailed design plan. The main program of system was written in Java. The interface obtained data from the hospital's data platform through Webservice and view interfaces. To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion, the XXL-JOB distributed task scheduling platform was adopted to handle VTE assessments by medical staff. Results After the clinical application of the intelligent VTE prevention and treatment system, the bleeding risk assessment rate increased from 26.20% at the initial system launch in January 2023 to 83.04% by the end of 2023. In January 2023, the implementation rates of mechanical prevention, pharmacological prevention, and combined prevention for medium-to-high-risk VTE patients were 21.39%, 16.39%, and 5.26%, respectively, which increased to 51.75%, 25.50%, and 25.65% in December 2023. Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve development efficiency, enhance the clinical practicality of the system, reduce the workload of medical staff, promote standardization and normalization in VTE prevention and treatment, strengthen closed-loop management of medical quality for VTE as a single disease, and effectively improve the prevention and treatment capabilities and levels of VTE within hospitals.

ABSTRACT Currently, there is a limited range of specialized oral preparations available for children, and it is common to find adult medications being used for pediatric purposes. This indicates a need for the development of new formulations specifically designed for children. Microparticle coating technology shows promise in masking the unpleasant taste of drugs, improving compliance and convenience in administration. Therefore, it can be considered an ideal approach for developing pediatric preparations. This article summarizes the current research and application status and development prospects of children's micro powder coating technology, providing reference for the application of micro powder coating technology in the field of children's oral preparations.

Pathological anxiety is among the most difficult neuropsychiatric diseases to treat pharmacologically, and it represents a major societal problem. Studies have implicated structural changes within the prefrontal cortex (PFC) and functional changes in the communication of the PFC with distal brain structures in anxiety disorders. Treatments that affect the activity of the PFC, including cognitive therapies and transcranial magnetic stimulation, reverse anxiety- and fear-associated circuit abnormalities through mechanisms that remain largely unclear. While the subjective experience of a rodent cannot be precisely determined, rodent models hold great promise in dissecting well-conserved circuits. Newly developed genetic and viral tools and optogenetic and chemogenetic techniques have revealed the intricacies of neural circuits underlying anxiety and fear by allowing direct examination of hypotheses drawn from existing psychological concepts. This review focuses on studies that have used these circuit-based approaches to gain a more detailed, more comprehensive, and more integrated view on how the PFC governs anxiety and fear and orchestrates adaptive defensive behaviors to hopefully provide a roadmap for the future development of therapies for pathological anxiety.
Anxiety ; Anxiety Disorders/therapy* ; Fear/psychology* ; Humans ; Neural Pathways ; Prefrontal Cortex

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

Objective:To explore the effect of decision-making assistance during the implantation selection of breast augmentation patients to provide a reference for improving decision-making aids.Methods:From June 2018 to June 2020, the decision-making assistance programs were used in the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People＇s Hospital for prosthesis selection in 51 breast augmentation female patients, aged 23 to 42 years, with an average of 31 years old. The BREAST-Q scale was applied to assess the postoperative results of augmentation patients. Postoperative breast satisfaction was also evaluated by the physicians.Results:With decision-making assistance, breast augmentation patients＇ satisfaction with breasts was (80.27±11.45) points, satisfaction with surgical results (83.41±12.29) points, social and psychological status scores (87.24±7.62) points, and sexual life status scores (85.49±7.90) points, physical condition score (73.94±8.98) points. There was no statistical difference in the scores of breast size between physicians and patients ( P>0.05). In the satisfaction score and total score of breast shape and feeling, physicians＇ scores were higher than patients＇ self-report scores, and the difference was statistically significant ( P<0.05). Conclusions:The patient self-reported postoperative outcomes are at a high level under the application of decision aid program. We can further improve the decision aid program for breast augmentation patients, adjust patient＇s surgical expectation, and realize shared decision making.

Objective:To evaluate the impact of the reform of the county medical community on the expenditure of medical insurance funds, and to provide references for maintaining the stability of the medical insurance fund and deepening the reform of the medical community.Methods:Medical insurance data of urban and rural residents in M County, Yunnan province from 2016 to 2019 were collected, and a discontinuous time series model was used to analyze the impact of county medical community reform on medical insurance fund expenditures.Results:Since the reform, the number of patients discharged from county-level hospitals has shown a downward trend, averaging a decrease of 25.996 people per month; yet increases have emerged with the average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure, averaging a monthly increase of 90.931 yuan, 50.014 yuan and 1.528 yuan respectively. The average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure of the township hospitals all showed an upward trend, averaging a monthly increase of 31.191 yuan, 38.678 yuan and 0.085 yuan respectively. The flow of external medical insurance funds of the medical community has shown a continuous upward trend, averaging a monthly increase of hospitalization fund expenditures of 33.005 yuan, and a monthly increase of outpatient overall fund expenditures of 4.896 yuan overall.Conclusions:The M County medical community should further strengthen the top-level design, explore the reform of medical insurance payment methods, improve the regional information platform, standardize the referral system, and strengthen supervision to deepen the construction of the medical community to ensure the sustainable operation of medical insurance funds.

Objective To study the relationship between serum betatrophin and early growth of macrosomia.Method Full-term macrosomia born in the Maternity and Children's Branch of Ruian People's Hospital of Zhejiang Province from January to June 2018 followed up to 6 months and their mother were enrolled in the prospective case-control study as the fetal macrosomia group.The full-term infants appropriate for gestational age,who met all the above requirements were randomly enrolled in the AGA group in a 1∶1 ratio.Enzyme linked immunosorbent assay (ELISA) was used to detect the level of blood betatrophin at birth and 6 months respectively,and the relationship between serum betatrophin level and the growth and development of infants was analyzed.Result A total of 4 823 live births were delivered during the study period,308 of them were full-term macrosomia,the incidence was 6.4％.30 cases were included in the macrosomia group and the AGA group,respectively.The level of blood betatrophin at birth and 6 months in the macrosomia group were higher than that in the AGA Group [(1 088.3 ± 67.8) ng/L vs.(929.5 ± 81.0) ng/L,(1 057.1 ± 114.2) ng/L vs.(976.4 ±76.6) ng/L],and the differences were statistically significant (P ＜ 0.01).The incidence of overweight was 26.7％ (8/30) in the macrosomia group and 6.7％ (2/30) in AGA group at 6 months of age,the difference was statistically significant (P ＜ 0.05).The level of blood betatrophin in overweight infants was statistically significantly higher than that in non-overweight infants (P ＜ 0.001).There was a positive correlation (P ＜ 0.001) between the level of blood betatrophin at the age of 6 months and the weight,body length,Z-score of weight/body length,triglyceride level at birth and the age of 6 months,and the level of umbilical blood betatrophin.But it was not correlated to gender,feeding pattern,other components of blood lipid,blood glucose and insulin in the cord blood and mother's blood,and the level of blood betatrophin in mother's blood (P ＞ 0.05).Conclusion The betatrophin is involved in the regulation of infant growth and development,which is associated with the occurrence of overweight.

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.