To analyze the influencing factors and improvement paths of the service capacity of standardized township health centers in Guangxi under the background of "high-quality service at the grassroots level", providing useful reference for further deepening reform and promoting the healthy development of rural medical and health systems.

By the end of 2021, township health centers that have reached the recommended standard of "quality service primary line" service ability were selected as the research samples, and the coupled coordination degree model was combined with fuzzy set qualitative comparative analysis method to carry out empirical analysis.

Single factors cannot constitute a necessary condition for improving or decreasing the service capacity of township health centers. There are a total of four configuration paths for improving the service capacity of township health centers in Guangxi, among which the core sufficient conditions for playing a leading role are the number of high-level practicing (assistant) physicians, the number of registered nurses, and coupling coordination scheduling. The overall consistency of the solution is 0.920 (≥0.8), and the model has strong explanatory power.

The improvement of service capacity in township health centers in Guangxi is facilitated by the synergistic effect of multiple factors both internally and externally. The optimization and expansion of grassroots talent teams is the core combination element for the improvement of service capacity in township health centers, and the coupling and coordinated development of medical resource allocation and economy is the key element for the improvement of service capacity.

To establish a health emergency competency evaluation index system for public health personnel, so as to provide a theoretical basis for building a health emergency team.

The competency index was screened and the evaluation index frame was established by literature research method, expert association commercial method and Delphi method.The analytic hierarchy process was used to calculate the weight value of the importance of indicators at all levels, and the evaluation index system was formed.

A total of 21 experts were invited to conduct letter inquiries, and the recovery rate of the two rounds of expert letter inquiries was 100%.The Cronbach’s α coefficients of the expert letter consultation form were 0.968 and 0.963,expert authority level 0.865,Kendall’s W coordination coefficient in 2 rounds of correspondence suggested that experts had a high consistency (P<0.05). The evaluation index system of public health personnel’s competency in health emergency work included 3 first-level indicators,11 second-level indicators and 68 third-level indicators.The weights of the first-level indicators are respectively health emergency literacy (0.517 4), professional literacy (0.336 1) and personal literacy (0.146 6).

Good health emergency literacy is the basis for public health personnel to respond to public health emergencies.The weight of each index in this index system is determined by Delphi method and analytic hierarchy process, and the results are scientific and reliable.

To analyse the trend of COPD patients’ inpatient costs and its influencing factors in the context of the reform of DRG, and to provide reference for the reasonable control of COPD inpatient costs.

ITSA were used to analyse the trend of COPD patients’ inpatient costs in a tertiary general hospital from 2018 to 2022, and univariate analysis, stepwise regression analysis and RFM were used to analyse the factors influencing the inpatient costs and the degree of significance of COPD patients’ inpatient costs after the official operation of the DRG.

The results of ITSA showed that the overall inpatient costs of COPD patients decreased significantly and by an average of 1.82% per month during the DRG operation stage; the integrated medical service fee, drug fee, and consumable fee all showed a decreasing trend during the DRG operation stage, by an average of 1.06%, 1.67%, and 4.98% per month, respectively, but the proportion of the integrated medical service fee increased compared with that before the DRG reform by 7.18%; The stepwise regression results showed that the number of hospital days (β=0.584), admission status (β=0.294), whether surgery (β=0.125), whether traditional Chinese medicine (β=0.084), and drug share ratio (β=0.099) had a statistically significant impact on COPD hospitalisation costs (P<0.05); and the results of the Random Forest model analysis showed that hospital days, admission status, drug share ratio were the most important factors influencing COPD hospitalisation costs. status, and medication ratio were the key factors affecting COPD hospitalisation costs.

DRG can effectively promote medical institutions to strengthen cost management and reduce the economic burden of disease. Hospitals should further reduce the cost of COPD and the economic burden of patients by reducing the number of inpatient days, strengthening the management of critically ill patients, and promoting the rational use of drugs.

To evaluate the impact of DRG medical insurance payment reform on the quality development of a tertiary comprehensive hospital in Guangxi.

This study selected data on all inpatient settlement cases in the hospital from 2020 to 2021, and calculated the DRG grouping of all cases according to the national CHS-DRG version 1.0 grouping plan. The interruption time series analysis method was further used to analyze the level and trend changes of indicators after the DRG policy reform in hospitals in December 2020. These indicators included total weight, case group index, cost consumption index, time consumption index, average length of stay, average hospitalization cost per visit, etc. They were used to evaluate the hospital’s medical service capacity, medical service efficiency, and medical safety, in order to understand the quality of the hospital.

A total of 72 089 cases were included in this study. Indicators such as cost consumption index (β=-0.242, P=0.001), time consumption index (β=-0.119, P=0.002), average length of stay (β=-1.543, P=0.011), proportion of high incidence cases (β=-0.028, P=0.026), and average cost of hospitalization (β=-3 669.366, P=0.026) showed an immediate decrease during the implementation of DRG policy.

After implementing the DRG policy reform, the hospital has significantly improved the efficiency of medical services, but still faces the challenge of adjusting structure and increasing quality.

To offer insights for enhancing the hierarchical medical system and guiding patient healthcare-seeking behaviors systematically, this study analyzes referral willingness and influencing factors of tertiary public hospitals and primary healthcare institutionsamong chronic disease patients in Sichuan Province.

A questionnaire survey was conducted on 297 chronic disease patients. Descriptive statistical analysis of the data was performed using SPSS 26.0 software. Chi-square tests were employed to analyze the downward referral willingness of chronic disease patients from tertiary public hospitals and the upward referral willingness to primary healthcare institutions.

Patients in large public hospitals showed low downward referral willingness (44.2%). Rural residence, prior medical consortium services, and greater distance from tertiary hospitals increased willingness. Primary healthcare patients exhibited a 28.1% upward referral willingness, influenced by occupation, age, and use of outpatient special disease policy services.

Referral willingness is generally weak in large public hospitals and primary healthcare institutions. Enhancing the comprehensive capacity of primary healthcare institutions, strengthening collaborative mechanisms and the level of medical services within medical consortia, along with expanding reimbursement policies for chronic diseases, contributes to promoting bidirectional patient referrals and advancing the formation of a tiered diagnosis and treatment system.

To evaluate the marginal effects of inputs on hospital outputs and the impacts of Integrated County Medical Community on hospital efficiency.

A stochastic frontier model was employed to estimate the production frontier and efficiency of each hospital, and a difference-in-difference method was utilized to identify the net effect of Integrated County Medical Community on hospital efficiency, including a heterogeneity analysis of this effect.

Our findings revealed that, in contrast to investments in fixed assets and equipment, hospital output exhibited a heightened elasticity in response to investments in beds, practicing physicians, and registered nurses. From 2016 to 2022, hospitals in Sichuan Province demonstrated an augmented level of efficiency, with a more conspicuous improvement observed subsequent to the initiation of Integrated County Medical Community. The net positive effect of this policy on hospital efficiency in was approximately 1.17 percentage points (P<0.001), where for-profit hospitals exhibited a greater sensitivity to this effect (P<0.05).

The Integrated County Medical Community pilot in Sichuan Province significantly improved the overall efficiency of hospitals, with a notably greater improvement observed in for-profit hospitals.

To investigate the test situation of pulmonary nodules among health examination population in a certain area and analyze its relationship with lifestyle and dietary habits.

A study was conducted on 10 580 individuals who underwent health examinations at the health management center of The Affiliated Hospital of Southwest Medical University from June 2022 to June 2023, regardless of occupation. All health examines underwent low-dose spiral computed tomography (LDCT) lung examination to screen for pulmonary nodule patients, the detection rate and imaging characteristics of pulmonary nodules were analyzed, and a questionnaire survey on their lifestyle and dietary habits was conducted, the relationship between the detection rate of pulmonary nodules and lifestyle and dietary habits were analyzed.

A total of 2 054 positive cases of pulmonary nodules were detected among 10 580 healthy individuals, with a detection rate of 19.41%. Among them, 320 cases were of type 1 nodules (3.02%), 1 425 cases were of type 2 nodules (13.47%), 218 cases were of type 3 nodules (2.06%), and 91 cases were of type 4 nodules (0.86%). There was a statistically significant difference in the classification of Lung RANDS for positive pulmonary nodules of different densities and sizes (P<0.05). There were statistically significant differences in the detection rate of pulmonary nodules among healthy individuals of different ages, genders, occupational environments, smoking habits, participation in physical exercise, and dietary habits (whether you have the habit of eating breakfast, whether you eat a high-oil diet, whether you eat fried products and the combination of meat and vegetables). Multivariate logistic regression results showed that males (OR=2.143, 95%CI: 1.151-3.9880), smokers (OR=2.234, 95%CI: 1.435-3.480), aged over 40 years old (OR=1.451, 95%CI: 1.031-2.040), not participating in physical exercise (OR=1.582, 95%CI: 1.157-2.165), and no habit of eating breakfast (OR=1.404, 95%CI:1.036-1.902), high oil diet (OR=1.409, 95%CI: 1.073-1.850) and eat fried products (OR=1.795, 95%CI: 1.269-2.539) were independent risk factors for pulmonary nodules in healthy individuals in this region (P<0.05).

The detection rate of pulmonary nodules in the health examination population in Luzhou region is relatively high, and related lifestyle and dietary habits may affect the occurrence of pulmonary nodules. It is recommended to actively carry out LDCT for people over 40 years old in this area, focusing on high-risk groups who smoke, do not participate in physical exercise, have habits of not eating breakfast, high oil diet and eating fried products. Early detection and management of high-risk pulmonary nodules can reduce the risk of lung cancer.

To explore the regulatory role of the NF-κB/NLRP3 signaling pathway in the anxiety and depressive-like behavior induced by acute sleep deprivation in mice.

Forty eight C57BL/6J mice aged 8 weeks were randomly divided into four groups: control group(CON), inhibitor group(LiCl), sleep deprivation group(SD), and inhibitor + sleep deprivation group (SD＋LiCl), with 12 mice in each group. The model of acute sleep deprivation in mice was established by modified multiple platform method(modified multiple platform method,MMPM), Elevated Plus Maze(EPM)、Open Field Test(OFT)、Forced Swim Test(FST) and Tail Suspension Test(TST)were used to evaluate the behavior of mice. HE staining was used to observe the pathological changes of hippocampal neurons. RT-PCR was used to detect the mRNA expression ofNF-κB and NLRP3 in hippocampal tissues.

Compared with the CON group, the body weight, hippocampal weight, and hippocampal organ coefficient of the SD group mice were significantly reduced (F=0.452, P=0.006; F=6.553, P=0.009; F=1.428, P=0.001).In OFT, Compared with the CON group, the LiCl group had no significant difference in the number of visits to the center(F=5.084,P=0.744), and the SD group significantly decreased(F=0.028,P=0.017). In EPM, the time of entering the open arm in the LiCl group was not significantly shorter than that in the CON group(F=0.09,P=0.113),but the SD group was significantly shorter(F=0.085,P=0.011). In FST,there was no significant difference in the immobility time between the LiCl group and the CON group(F=3.422,P=0.260). In TST, Compared with the CON group, the immobility time of the suspension tail increased in the SD group(F=11.218,P=0.005). HE staining results showed, Compared with CON group, pathological changes were found in hippocampus of SD group and SD+LiCl group. RT-PCR showed thatCompared with CON group, the mRNA expression of NF-κB and NLRP3 in LiCl group were not significantly different(F=4.629,P=0.147, F=15.555,P=0.107).However, the SD group were significantly increased (F=6.969,P<0.001,F=15.833,P=0.017).

NF-κB/NLRP3 pathway may play a regulatory role in the development of SD-induced anxiety-depression-like behavior in mice.

To explore the application value of a recombinant antigen-based capture enzyme immunoassay (RAg-CEIA) in detection of recent human immunodeficiency virus type 1 (HIV-1) infection in the sentinel surveillance population.

Among the HIV/AIDS sentinel surveillance population in Yunnan province in 2015, the confirmed HIV-1 antibodies positive plasma specimens matching the detection criteria for recent HIV-1 infection were tested by HIV-1 RAg-CEIA. The recent HIV-1 infection specimens were classified by the normalized optical density (ODn) values, and then the HIV-1 incidence in population were estimated. The detection and analysis data were compared with those by BED capture enzyme immunoassay (BED-CEIA) and limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA), respectively.

A total of 51 313 plasma specimens were tested for HIV antibodies, in which 1 255 specimens were HIV-1 antibodies positive. 253 out of 373 specimens matching the detection criteria for recent HIV-1 infection were tested by the 3 assays, respectively. By RAg-CEIA, BED-CEIA and LAg-Avidity EIA, 88, 78 and 54 specimens were classified as recent HIV-1 infections, and the HIV-1 incidence in the sentinel surveillance population was 0.33% (95%CI: 0.26%~0.39%), 0.31%（95%CI: 0.24%~0.38%) and 0.31% (95%CI: 0.22%~0.39%), respectively. The differences between the HIV-1 incidence by the 3 assays were not statistically significant (P=0.927). Among the sub-populations, the HIV-1 incidence in men who have sex with men (MSM) were 3.50% (95%CI: 2.48%~4.52%), 3.92% (95%CI: 2.76%~5.08%）and 4.17% (95%CI: 2.79%~5.55%), respectively. The differences between the HIV-1 incidence by the 3 assays were not statistically significant (P=0.763). The ODn values by RAg-CEIA were linear correlation with those by BED-CEIA (Spearman’s rank correlation coefficient was 0.911), and those by LAg-Avidity EIA (Spearman’s rank correlation coefficient was 0.755), respectively.

HIV-1 RAg-CEIA can be effectively used in classification of recent HIV-1 infections and estimation of HIV-1 incidence, indicating that this approach has a good application prospect in detection of recent HIV-1 infection.

To investigate the mechanism of IGF2/JAK2/STAT3 on learning and memory impairment induced by aluminum maltol in rats.

A total of 32 SD rats were divided into normal saline control group and low, medium and high maltol aluminum exposure groups (10, 20 and 40 μmol/kg) by random number table, respectively, and intraperitoneally injected every other day for three months. After exposure, Morris water maze was applied to examine the learning and memory ability of rats, and HE staining was used to check the arrangement of hippocampal neurons. Real-time fluorescence quantitative PCR was applied to detect the relative expression level of IGF2 mRNA in hippocampus of rats. Western Blotting was used for detecting the relative protein expression levels of Cleaved Caspase3, IGF2, p-JAK2(Tyr1007/1008), and p-STAT3(Ser727) in the hippocampus of rats.

With the increase of aluminum dose, the escape latency of rats in the same day was prolonged, and the residence time in the target quadrant and the times of crossing the platform were gradually reduced (F=7.900, P=0.001; F=6.693, P=0.002). HE staining results showed that the number of neurons in CA1 region of hippocampus gradually decreased and the arrangement of neurons was obviously loose with the increase of aluminum dose (F=25.947, P<0.001). With increasing aluminum dose, apoptosis-associated protein Bcl-2 levels decreased gradually (F=83.235, P<0.001), Bax (F=153.189, P<0.001) and Cleaved Caspase3 (F=11.636, P<0.01) levels was gradually increased, and the relative expression levels of IGF2 mRNA and IGF2, p-JAK2 (Tyr1007/1008), p-STAT3 (Ser727) proteins decreased gradually with the increase of aluminum dose (F=18.423, P<0.001; F=11.072, P=0.001; F=55.161, P<0.001; F=10.481, P=0.001).

Aluminum maltol can induce cell apoptosis by inhibiting IGF2/JAK2/STAT3 pathway, which could damage the learning and memory ability of rats.