ObjectiveThe theory of homotherapy for heteropathy is one of the classical rules in traditional Chinese medicine. Taking this theory as a breakthrough point， this study employed gas chromatography-mass spectrometry （GC-MS） to elucidate the mechanism underlying the therapeutic effects of Zhuyuwan on both intrahepatic cholestasis （IC） and ulcerative colitis （UC） from the viewpoint of serum metabolic homeostasis. MethodsThe rat models of α-naphthylisothiocyanate （ANIT）-induced cholestasis and 2，4，6-trinitro-benzenesulfonic acid （TNBS）-induced UC were treated with low （0.6 g·kg^-1） and high （1.2 g·kg^-1） doses of Zhuyuwan by gavage. In the experiment regarding IC， 24 Sprague-Dawley （SD） rats were randomly assigned into four groups： normal， ANIT model， low-dose Zhuyuwan， and high-dose Zhuyuwan. In the experiment regarding UC， 24 SD rats were randomly allocated into four groups： normal， TNBS model， low-dose Zhuyuwan， and high-dose Zhuyuwan. Firstly， the two disease models and the intervention effects of Zhuyuwan on the two diseases were evaluated based on serum levels of biochemical indicators ［alanine aminotransferase （ALT）， aspartate transaminase （AST）， γ-glutamyltranspeptidase （γ-GT）， and total bile acid （TBA）］， colon damage score， colon weight index， disease activity index， and histopathological changes in rats. Secondly， the rat serum samples were analyzed by gas chromatography-mass spectrometry （GC-MS） to screen the common core pathways of the two disease models， and the expression of core genes in the pathways was determined by Real-time PCR， on the basis of which the biological mechanism of the treatment of the two disease models by Zhuyuwan was ultimately elucidated. ResultsThe results of the experiment regarding IC showed that the ANIT model group had higher ALT， AST， γ-GT， and TBA levels than the normal group （P<0.01）. Compared with the ANIT model group， the low-dose Zhuyuwan group showed declined ALT and TBA levels （P<0.01） and the high-dose Zhuyuwan group showed lowered ALT， TBA， AST， and γ-GT levels （P<0.01）. The results of the experiment regarding UC showed that compared with the normal group， the TNBS model group presented increases in the colonic damage score， colon weight index， and disease activity index （P<0.01）. Compared with the TNBS model group， the low-dose Zhuyuwan group showcased declines in colon weight index （P<0.01） and disease activity index （P<0.05）， and the high-dose Zhuyuwan group showed reductions in the colon damage score， colon weight index， and disease activity index （P<0.01）. GC-MS metabolomics analysis combined with qRT-PCR demonstrated that Zhuyuwan had a similar inverse regulatory effect on arginine metabolism disruption in the above two disease models. ConclusionZhuyuwan exhibited definite therapeutic effects on both IC and UC， and the regulation of arginine biosynthesis pathway is the core mechanism for the treatment of both diseases by Zhuyuwan.

ObjectiveThe theory of homotherapy for heteropathy is one of the classical rules in traditional Chinese medicine. Taking this theory as a breakthrough point， this study employed gas chromatography-mass spectrometry （GC-MS） to elucidate the mechanism underlying the therapeutic effects of Zhuyuwan on both intrahepatic cholestasis （IC） and ulcerative colitis （UC） from the viewpoint of serum metabolic homeostasis. MethodsThe rat models of α-naphthylisothiocyanate （ANIT）-induced cholestasis and 2，4，6-trinitro-benzenesulfonic acid （TNBS）-induced UC were treated with low （0.6 g·kg^-1） and high （1.2 g·kg^-1） doses of Zhuyuwan by gavage. In the experiment regarding IC， 24 Sprague-Dawley （SD） rats were randomly assigned into four groups： normal， ANIT model， low-dose Zhuyuwan， and high-dose Zhuyuwan. In the experiment regarding UC， 24 SD rats were randomly allocated into four groups： normal， TNBS model， low-dose Zhuyuwan， and high-dose Zhuyuwan. Firstly， the two disease models and the intervention effects of Zhuyuwan on the two diseases were evaluated based on serum levels of biochemical indicators ［alanine aminotransferase （ALT）， aspartate transaminase （AST）， γ-glutamyltranspeptidase （γ-GT）， and total bile acid （TBA）］， colon damage score， colon weight index， disease activity index， and histopathological changes in rats. Secondly， the rat serum samples were analyzed by gas chromatography-mass spectrometry （GC-MS） to screen the common core pathways of the two disease models， and the expression of core genes in the pathways was determined by Real-time PCR， on the basis of which the biological mechanism of the treatment of the two disease models by Zhuyuwan was ultimately elucidated. ResultsThe results of the experiment regarding IC showed that the ANIT model group had higher ALT， AST， γ-GT， and TBA levels than the normal group （P<0.01）. Compared with the ANIT model group， the low-dose Zhuyuwan group showed declined ALT and TBA levels （P<0.01） and the high-dose Zhuyuwan group showed lowered ALT， TBA， AST， and γ-GT levels （P<0.01）. The results of the experiment regarding UC showed that compared with the normal group， the TNBS model group presented increases in the colonic damage score， colon weight index， and disease activity index （P<0.01）. Compared with the TNBS model group， the low-dose Zhuyuwan group showcased declines in colon weight index （P<0.01） and disease activity index （P<0.05）， and the high-dose Zhuyuwan group showed reductions in the colon damage score， colon weight index， and disease activity index （P<0.01）. GC-MS metabolomics analysis combined with qRT-PCR demonstrated that Zhuyuwan had a similar inverse regulatory effect on arginine metabolism disruption in the above two disease models. ConclusionZhuyuwan exhibited definite therapeutic effects on both IC and UC， and the regulation of arginine biosynthesis pathway is the core mechanism for the treatment of both diseases by Zhuyuwan.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.

Objective:To establish an animal model of trans-sutural distraction osteogenesis in SD rats.Methods:A self-designed V-shaped distraction device(distractor)was fabricated with the traction force(N)of 0,1.3,2.2,3.0,4.3 and 5.0 corresponding to the distraction length(mm)of 5,4,3,2,1 and 0 respectively,meeting the trans-sutural distraction osteogenesis requirements in skull of 5-week-old SD rats.The distractor was plased into the sagittal suture of 12 SD rats.Continuous sampling was conducted 1,3,5 and 7 days respectively(n=3)after operation.The tissue changes in the trans-sutural distraction area were observed by HE and Masson's trichrome staining.Inflammation levels were determined using Arg-1 immunofluorescence staining.The early angiogenesis was clarified through co-staining with CD31 and EMCN.Results:A stable trans-sutural distraction osteogenesis model was estab-lished,5 mm distraction osteogenesis width was observed completely within 7 days of distraction.Significant new bone formation was observed at 7 days after operation.Arg-1 expression increased and was concentrated at the bone margins,overlapping with the areas of new bone formation.EMCN expression gradually decreased,and by day 7 CD31 was predominant,indicating the basic maturation of blood vessels.Conclusion:This study successfully constructed a stable and effective trans-sutural distraction osteogenesis animal model,and provides an experimental basis for the investigation of its early continuous histological changes.

Objective To investigate the expression of PLCD3 mRNA in the synovium of osteoarthritis(OA)and its relationship with immune cell infiltration.Methods Based on the differentially expressed genes of OA found in the previous study,the expression of phospholipase Cδ3(PLCD3)mRNA was detected by col-lecting synovial samples from OA group and control group.CIBERSORT algorithm was used to analyze the infiltration pattern of immune cells in OA group and control group,and the correlation between PLCD3 and infiltrating immune cells was further analyzed.Results Compared with the control group,the relative expres-sion level of PLCD3 mRNA was significantly increased in synovial samples of OA group(P<0.05).The pro-portions of B cells naive,NK cells activated,M2 macrophages and mast cells activated in synovial tissues of OA group were relatively high(P<0.05).PLCD3 was positively correlated with the proportion of these four immune cells(P<0.05).Conclusion PLCD3 may be a key biomarker for the diagnosis of OA,which may be involved in the pathogenesis of OA by interacting with infiltrating immune cells.

The mutual recognition of medical examination results is significant for improving the utilization efficiency of limited resources in large public hospitals,promoting the sharing of quality medical resources,alleviating the high costs and diffi-culties of healthcare for the public,reducing pressure on medical insurance funds,and enhancing the efficiency of fund utiliza-tion.This study reviews the research on mutual recognition of medical examination results in China,analyzing it from four as-pects:regulatory norms,platform construction,policy awareness,and performance distribution.It identifies research hotspots and directions related to mutual recognition,clarifies the challenges and key points in the implementation of relevant policies,and suggests future research directions,including strengthening theoretical research,improving empirical studies,and innovating re-search methods.

Objective:To automatically classify hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) based on mul-titask learning algorithm using native T1 mapping images.Methods:A total of 203 patients admitted to Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University from January 2017 to December 2021 were enrolled, including 53 patients with HHD, 121 patients with HCM, and 29 patients with normal control (NC). Native T1 mapping images of all enrolled patients were acquired using MRI and processed by a multi-task learning algorithm. The classification performance of each model was validated using ten-fold crossover, confusion matrix, and receiver operator characteristic (ROC) curves. The Resnet 50 model based on the original images was established as a control.Results:The ten-fold crossover validation results showed that the MTL-1 024, MTL-64, and MTL-all models showed better performance in terms of area under the curve (AUC), accuracy, sensitivity, and specificity compared to the Resnet 50 model. In the classification task, the MTL-64 model showed the best performance in terms of AUC (0.942 1), while the MTL-all model reached the highest value in terms of accuracy (0.852 2). In the segmentation task, the MTL-64 model achieved the best results with the Dice coefficient (0.879 7). The confusion matrix plot showed that the MTL model outperforms the Resnet 50 model based on the original image in terms of overall performance. The ROC graphs of all MTL models were significantly higher than the original image input Resnet 50 model.Conclusions:Multi-task learning-based native T1 mapping images are effective for automatic classification of HHD and HCM.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.

Objective Explore the impact of payment by DRG on rehabilitation cases,evaluate the effect of DRG policy reform for rehabilitation cases and make relevant recommendations.Methods Rehabilitation cases admitted to designated medical institutions in Sichuan Province in 2020-2021 were extracted,and regression analyses were per-formed after Propensity Score Matching using the Difference in Differences method to evaluate the impact of DRG payment on the inpatient costs and the hospitalization days of rehabilitation cases,then analyze the net effect of the policy.Results After the implementation of DRG payment,the total hospitalization cost,drug cost,treatment cost,and examination cost of rehabilitation cases decreased to different degrees,and only the bed cost increased,in which the total hospitalization cost decreased by 21.8％(P＜0.05),and the cost structure of the cases changed to a certain extent compared with that before the implementation of DRG payment.In addition,the number of hospi-talization days for rehabilitation cases has not been effectively reduced under the DRG policy,but rather increased by 13.4％(P＜0.05).Conclusion DRG payment can effectively reduce the financial burden of rehabilitation cases,but it does not optimize the operational efficiency of hospitals.Whether payment by DRG is applicable to rehabilita-tion cases is open to further discussion,the health insurance department and hospitals should be in close contact to actively explore new modes of health insurance payment for rehabilitation cases.