Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To establish an immortalized human keloid fibroblasts(KFbs) cell line and identify its characteristics and functions.Methods:The specimen was obtained from a 32-year-old female patient who underwent surgical resection of an earlobe keloid at Peking University Third Hospital in November 2019. The keloid tissue obtained was removed from the subcutaneous fat and epidermis. It was then separated and cultured using the tissue sticking method to obtain primary KFbs, which were passaged using the trypsin digestion method. After the primary KFbs were infected with an SV40 lentivirus, purified by puromycin, and passaged, a human KFbs cell line was established. Chromosomal karyotype analysis, short tandem repeat (STR) profiling, and gender gene detection were conducted to identify the primary KFbs and the cell line. The CCK-8 method was used to assess the proliferation ability of the cells. Quantitative real-time PCR (qRT-PCR) and Western blotting were used to detect the mRNA and protein expression levels of specific genes (PGK1, ENO1, LDHA, GLUT1, TGF-β1, COL1, COL3, FN). The comparative analysis of relevant data between primary KFbs and the cell line was conducted using t-test, and P<0.05 indicated statistical significance. Results:The morphology of both the primary KFbs and the cell line was typically spindle-shaped. The cell line morphology was basically similar to that of the primary KFbs, which were continuously cultured and passaged for 20 generations. The gender gene(Amelogenin) detection showed both were females. The chromosome karyotyping of the primary KFbs and cell line was satisfactory, maintaining the fundamental characteristics of normal cells without undergoing malignant transformation. The STR identification results showed that no multiple alleles were found in the cell line, indicating a normal cell genotype. Furthermore, the cell line did not match any entries in known cell databases. After 24, 48, and 72 hours of culture, the proliferation ability of the cell line increased by 76.1%, 125.8%, and 60.3% compared to primary KFbs. The proliferation rates of the cell line were significantly faster than those of primary KFbs ( P<0.05). The mRNA and protein expression levels of the aforementioned genes in the cell line showed no significant changes compared to the primary KFbs ( P>0.05). Conclusion:An immortalized human KFbs cell line was successfully established, showing no significant changes in morphology, characterization, and function, while exhibiting a faster proliferation rate compared to that of primary KFbs.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To explore the causal relationship between thyroid dysfunction and sepsis based on the bidirectional two-sample Mendelian randomization (MR) method.Methods:The genome-wide association study (GWAS) dataset were selected to screen single nucleotide polymorphisms (SNP) associated with thyroid dysfunction as instrumental variable (IV) for genetic variation, using hypothyroidism and hyperthyroidism as exposure factor and sepsis as outcome factor. Potential causal relationship between thyroid dysfunction and sepsis was analyzed using a bidirectional two-sample MR method primary analysis method of inverse-variance weighted (IVW). Potential pleiotropic analysis of SNP was performed using the MR Egger regression intercept test. Sensitivity analysis was performed using the "leave one out" test. Reverse MR method was used to prove the causal relationship.Results:The GWAS data were screened based on the three main assumptions of MR, resulting in 101 SNP strongly associated with hypothyroidism and 10 SNP strongly associated with hyperthyroidism entering the MR analysis. The results of the MR using the IVW method showed that the risk of sepsis in individuals with hypothyroidism was 2.293 times higher than those without hypothyroidism [odds ratio ( OR) = 2.293, 95% confidence interval (95% CI) was 1.199-4.382, P = 0.012]. There was no significant difference in the risk of sepsis between hyperthyroid and non-hyperthyroid populations ( OR = 1.049, 95% CI was 0.999-1.100, P = 0.560). MR Egger regression intercept test showed that the included SNP did not have pleiotropy, and the MR-PRESSO test did not find outliers. Sensitivity analysis suggested that the results of MR were stable. The results of the reverse MR analysis showed that the reverse causal relationship between hyperthyroidism and sepsis was not proved ( OR = 0.996, 95% CI was 0.988-1.004, P = 0.338), which further confirmed the robust MR analysis result. Conclusion:The results of the bidirectional two-sample MR analysis show that hypothyroidism can increase the risk of sepsis onset, while there is no causal relationship between hyperthyroidism and sepsis.

Objective:To establish an immortalized human keloid fibroblasts(KFbs) cell line and identify its characteristics and functions.Methods:The specimen was obtained from a 32-year-old female patient who underwent surgical resection of an earlobe keloid at Peking University Third Hospital in November 2019. The keloid tissue obtained was removed from the subcutaneous fat and epidermis. It was then separated and cultured using the tissue sticking method to obtain primary KFbs, which were passaged using the trypsin digestion method. After the primary KFbs were infected with an SV40 lentivirus, purified by puromycin, and passaged, a human KFbs cell line was established. Chromosomal karyotype analysis, short tandem repeat (STR) profiling, and gender gene detection were conducted to identify the primary KFbs and the cell line. The CCK-8 method was used to assess the proliferation ability of the cells. Quantitative real-time PCR (qRT-PCR) and Western blotting were used to detect the mRNA and protein expression levels of specific genes (PGK1, ENO1, LDHA, GLUT1, TGF-β1, COL1, COL3, FN). The comparative analysis of relevant data between primary KFbs and the cell line was conducted using t-test, and P<0.05 indicated statistical significance. Results:The morphology of both the primary KFbs and the cell line was typically spindle-shaped. The cell line morphology was basically similar to that of the primary KFbs, which were continuously cultured and passaged for 20 generations. The gender gene(Amelogenin) detection showed both were females. The chromosome karyotyping of the primary KFbs and cell line was satisfactory, maintaining the fundamental characteristics of normal cells without undergoing malignant transformation. The STR identification results showed that no multiple alleles were found in the cell line, indicating a normal cell genotype. Furthermore, the cell line did not match any entries in known cell databases. After 24, 48, and 72 hours of culture, the proliferation ability of the cell line increased by 76.1%, 125.8%, and 60.3% compared to primary KFbs. The proliferation rates of the cell line were significantly faster than those of primary KFbs ( P<0.05). The mRNA and protein expression levels of the aforementioned genes in the cell line showed no significant changes compared to the primary KFbs ( P>0.05). Conclusion:An immortalized human KFbs cell line was successfully established, showing no significant changes in morphology, characterization, and function, while exhibiting a faster proliferation rate compared to that of primary KFbs.