OBJECTIVE:To investigate the concepts and contents of the Chinese precision medicine,and to provide reference for the development of precision medicine in China.METHODS:By evidence-based evaluation method,using jingzhun yixue jingzhun yiliaoprecision medicineas keywords,all literatures were retrieved from CBM,CNKI,Wanfang,VIP,PubMed and Ovid EMBase databases up to Nov.17th,2015.The relevant information were extracted,including researchers (first author or correspondence author's unit belonged to China),domains and concepts.The concepts and contents of the Chinese precision medicine based on China's national condition were summarized and analyzed,and the difference between precision medicine and personalized medicine was compared.RESULTS:54 studies were included,the results indicated most studies (51 literatures) were published in 2015 by hospitals (28 literatures) and high schools (14 literatures);most literatures (23 literatures) presented the concept of precision medicine,followed by disease precision medicine (19 literatures) and relevant technology of precision medicine (7 literatures);a total of 39 literatures presented the specific concept of precision medicine.Besides genetic information involved in American precision medicine,the Chinese one expanded the disease diagnosis and treatment technology,as well as the application.Personalized medicine and precision medicine were in common partially,however,the latter one underlined the disease classification and diagnosis,which was more practicable.CONCLUSIONS:Chinese precision medicine involves disease diagnosis and treatment technology as well as influential factors based on genetic information,and includes disease classification and diagnosis so as to perform personalized precision intervention.The Chinese precision medicine is overall developed and focused.

Objective To explore the risk factors of early traumatic coagulation(TIC)in elderly patients with chest trauma.Methods The data of 113 elderly patients with chest trauma admitted in a hospital from January 2016 to January 2022 were retrospectively analyzed.Patients were divided into TIC group and non-TIC group according to whether they had early TIC.The risk factors of early TIC in elderly patients with thoracic trauma were analyzed by single factor and multi factor methods.Analysis of the predictive value of early TIC in elderly patients with thoracic trauma using multifactor model.Result Of all the patients included in the study,27 were determined as TIC,and the rest 86 were non-TIC.The results of univariate analysis showed that there were statistically significant differences in the data of shock index,platelet count at admission and plasma fibrinogen at admission between patients in TIC group and non-TIC group(P＜0.05).Multivariate analysis showed that the shock index at admission,platelet count at admission,and plasma fibrin at admission were all independent influencing factors of early TIC in elderly patients with chest trauma(all P＜0.05).The P value of multivariate model and independent variables predict the early TIC of elderly patients with chest trauma.The Yoden index is 36.95％,42.89％,75.58％and 78.85％respectively.Conclusion The shock index,platelet count and plasma fibrin at the time of admission can affect the early occurrence of TIC in elderly patients with chest trauma.

Objective To investigate the treatment for scarred vocal folds by transplanting human amniotic epithelial cells (hAECs)and injecting collagenase as well as hyaluronic acid (HA) for the intervention of the extracellular matrix (EMC),to observe the growth,distribution of hAECs and to assess the abilities of them for scarred vocal fold regeneration.Methods The lamina propria was injured by localized resection in thirty-eight vocal folds of twenty rabbits.hAECs were isolated from human amnion and marked by Lenti-GFP.After the formation of vocal fold scarring,hAECs were transplanted into ten vocal folds,collagenase and HA were injected into ten vocal folds,all three were injected into ten vocal folds,none were injected into eight vocal folds,and two normal vocal folds were used as control.At 1 month and 2 months after the transplanting,the survival,the distribution and the cytoactive of hAECs were examined by immunofluorescence method.Meanwhile,at 1 month,2 months,3 months and 6 months after the operation,HE staining was performed for histopathological research,Masson trichrome staining and immunohistochemical staining were used for collagen and fibronectin respectively.Results After implanted into the scarred vocal folds,hAECs could survive in vocal fold lamina propria for two months.The immunofluorescence analysis showed the cytoactive of hAECs.Six months postoperatively,compared with that in the normal vocal folds,collagen in the untreated scarred vocal folds more increased and disorderly distributed ; the changes in other three groups were between the two groups above,but the group injected with all of hAECs,collagenase and HA was better than other two groups.Besides,the mean density of fibronectin in the scarred untreated control group was more significantly increased than that in the normal vocal folds;the changes in other three groups were between the two groups above,but the group injected with all of hAECs,collagenase and HA was better than other two groups.Conclusion The transplanting of hAECs and the interventions of EMC by injecting collagenase as well as HA have better abilities in rabbit scarred vocal fold reparation and regeneration by promoting ECM secretion,rational distribution and part ordering arrangement.

Objective To study the development and utilization of Li medicine resources in Hainan Province, analyze the existing problems and present specific suggestions for the rational exploitation and utilization of Li medicine resources.Methods SWOT analysis was carried out on the development and utilization of Li medicine in Hainan by means of literature analysis and field survey.Results The advantage of Li medicine lies in its long history and sufficient resources.The complicated ethnic factors within Li nationality hindered the development of Li medicine and resulted in the lack of basic research.Although the relevant policies and market demands have brought opportunities for the development of Li medicine, the rapid development of society may pose a potential threat to the development and protection of Li medicine resources.Conclusion The unique advantages of Li medicine ought to be used to create Li medicine brand.While Hainan is building its international tourism island, the health benefits of Li medicine should be promoted.Through the creation of Li medicine schools or departments, new professionals need to be trained to continue the development and utilization of Li medicine.

Objective To investigate the subtle changes of the brain function at olfactory region of MD patients with olfactory dysfunction at resting state, through the application of fMRI-BOLD. Methods This study enrolled 28 MD patients with olfactory dysfunction(Case group) who had been treated from February 2016 to March 2017, and 23 healthy volunteers (Control group) with matching gender, age and education background to the Case group.All subjects were examined by Symptoms Checklists-90(SCL-90), Hamilton Depression Rating Scale-24 (HAMD-24), 70% isopropyl alcohol inhalation test, and fMRI at resting state. The two independent samples t test was used to compare the two groups' educational years, psychological scales and olfactory test scores.Regional homogeneity(ReHo)analysis was conducted for the whole brain of subjects.The ReHo values at some brain regions of both groups were compared through two independent sample t-test.The ReHo values,extracted from the case group's brain regions with differences, were run through by Pearson correlation analysis.Results There was a negative correlation between the HAMD-24 score(r=-0.413,P=0.029)and the severity of olfactory decline in the MD patients with olfactory dysfunction.In addition,it was found by fMRI that Case group,as compared to Control group,demonstrate declined ReHo values at left orbital frontal gyrus(cluster=80,t=3.27),bilateral cingulate gyrus(right cluster=204,t=4.34,left cluster=204,t=3.63),bilateral middle frontal gyrus(right cluster=56,t=3.67,left cluster=28, t=3.50),rightinsular(cluster=40,t=3.53),bilateral amygdala(right cluster=76,t=3.66,left cluster=86,t=2.93),but increased ReHo values at bilateral inferior frontal gyrus(right cluster=44,t=3.62,left cluster=33,t=3.25), right thalamus(cluster=34, t=3.21)and bilateral gyri rectus(right cluster=45,t=3.78,left cluster=24,t=3.01)(AlphaSim correction,P<0.001).Moreover,there was a positive correlation between the ReHo value at left orbital frontal gyrus and the olfactory test distance(r=0.628,P<0.05).But the ReHo value at left orbital frontal gyruswas negatively correlated with HAMD-24 (r=-0.414,P=0.029). There was no correlation with other clinical data.Conclusion The abnormal brain functional activities of left orbital frontal gyrus at resting state might be related to the olfactory dysfunction of patients with depression.

Objective To explore the current research situation,hotspots and development trend in the field of acupuncture and mox-ibustion intervention for post-stroke dysphagia(PSD). Methods The literature on acupuncture and moxibustion intervention for PSD was retrieved from CNKI,VIP and Wan-fang database from 1994 to December 31st,2023,and analyzed with VOSviewer and CiteSpace. Results A total of 1 816 articles were included,and the number of publications increased year by year,reaching a peak in 2021 with 180 articles.There were 274 core authors included in the literature,among which Cheng Hongliang,Zhou Hongfei and Feng Weixing were the authors with the highest publication volume.The First Affiliated Hos-pital of Tianjin University of Chinese Medicine was the most productive institution,and the connections between institutions were relatively scattered.The high-frequency keywords were swallowing dysfunction,stroke,acu-puncture and moxibustion therapy,as well as rehabilitation therapy,among which tongue triple acupuncture,elec-troacupuncture,nape acupuncture and scalp acupuncture were the most commonly used methods.In addition,acupuncture combined with rehabilitation training,electrical stimulation,or other methods for PSD and acupoint selection rules were also research hotspots.When evaluating the efficacy of acupuncture intervention for PSD,the focus gradually shifted from the effective rate to the use of videofluorographic swallowing study,water swal-lowing test,standardized swallowing assessment,surface electromyography and other indicators to evaluate the swallowing function and the severity of dysphagia. Conclusion Research on acupuncture and moxibustion interventions for PSD has developed rapidly,with hotspots in-cluding the selection of specific acupuncture and moxibustion techniques,the combination of acupuncture and moxibustion with other rehabilitation therapies,outcome indicators for acupuncture and moxibustion interven-tions in PSD,and the rules of acupoint selection.In the future,it is essential to strengthen academic exchanges and collaborations across institutions and regions.Greater emphasis should be placed on objective evaluation in-dicators of acupuncture and moxibustion therapies for improving the swallowing function in PSD patients,as well as on optimizing combinations of acupuncture and moxibustion with modern rehabilitation approaches,so as to better guide clinical practice.

Background/Aims: To evaluate temporal trends of atrial fibrillation (AF) prevalence in critically ill patients who received prolonged mechanical ventilation (MV) in the United States. Methods: We used the 2008 to 2014 National Inpatient Sample to compute the weighted prevalence of AF among hospitalized adult patients on prolonged MV. We used multivariable-adjusted models to evaluate the association of AF with clinical factors, in-hospital mortality, hospitalization cost, and length of stay (LOS). Results: We identified 2,578,165 patients who received prolonged MV (21.27% of AF patients). The prevalence of AF increased from 14.63% in 2008 to 24.43% in 2014 (p for trend < 0.0001). Amongst different phenotypes of critically ill patients, the prevalence of AF increased in patients with severe sepsis, asthma exacerbation, congestive heart failure exacerbation, acute stroke, and cardiac arrest. Older age, male sex, white race, medicare access, higher income, urban teaching hospital setting, and Western region were associated with a higher prevalence of AF. AF in critical illness was a risk factor for in-hospital death (odds ratio, 1.13; 95% confidence interval, 1.11 to 1.15), but in-hospital mortality in critically ill patients with AF decreased from 11.6% to 8.3%. AF was linked to prolonged LOS (2%, p < 0.0001) and high hospitalization cost (4%, p < 0.0001). LOS (–1%, p < 0.0001) and hospitalization cost (–4%, p < 0.0001) decreased yearly. Conclusions The prevalence of comorbid AF is increasing, particularly in older patients. AF may lead to poorer prognosis, and high-quality intensive care is imperative for this population.

Retinitis pigmentosa (RP) is a group of hereditary blinding fundus diseases caused by abnormalities in photoreceptors of the retina.RP is highly heterogeneous in hereditary and cdinical phenotypes.It can be divided into simple type RP and syndrome type RP.The main inheritance patterns are autosomal dominant,autosomal recessive inheritance and X-linked inheritance.With the popularization and clinical application of gene sequencing technology,more and more disease-causing genes have been discovered,and these genes are mainly expressed in photoreceptor cells and retinal pigment epithelial cell.ln-depth understanding of RP pathogenic genes not only provides a theoretical basis for RP diagnosis and genetic counseling,but also provides guidance for RP gene therapy.

Objective:To investigate the effect and mechanism of Acyl-CoA: lysocardiolipin acyltransferase 1 (ALCAT1) on hepatocyte steatosis and oxidative stress in fatty liver cell model.Methods:A fatty liver cell model was established and induced by free fatty acids (FFA). The expression of ALCAT1 in fatty liver cell model was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. The empty siRNA plasmid and ALCAT1 siRNA plasmid were constructed. For the fatty liver cell model group, human normal hepatocytes (L-02 cells) were transfected with empty siRNA plasmid for 24 hours, and then cultured with FFA for 24 hours. For the ALCAT1 interfering group, L-02 cells were transfected with ALCAT1 siRNA plasmid for 24 hours, and then cultured with FFA for 24 hours. And L-02 cells cultured in common medium were used as as blank control group. Lipid droplet deposition and mitochondrial morphology were observed under transmission electron microscopy. The expression levels of autophagy-associated proteins (microtubule-associated protein 1 light chain 3 (LC3)-Ⅱ and Beclin1) and key proteins of autophagy signal pathway (mammalian target of rapamycin (mTOR) and serine/threonine kinase (AKT)) were measured by Western blotting. The expression levels of oxidative stress products (malondialdehyde, 4-hydroxynonenal (4-HNE) and reactive oxygen species (ROS)) and inflammatory factors (interleukin-6(IL-6) and tumor necrosis factor (TNF)-α) were detected by enzyme-linked immunosorbent assay (ELISA) kits. Independent sample t test was used for statistical analysis. Results:The mRNA and protein expression levels of ALCAT1 of the fatty liver cell model group were both higher than that of negative control group (9.26±0.83 vs. 1.02±0.12, 0.35±0.02 vs. 0.17±0.01), and the differences were statistically significant ( t=9.82 and 6.83, both P<0.05). The results of electron microscopy indicated that the deposition of lipid droplets of the fatty liver cell model group and ALCAT1 interfering group were both higher than that of blank control group (17.67±3.52 and 7.67±0.33 vs. 4.33±0.33), the quantity of lipid droplets deposition of ALCAT1 interfering group was lower than that of fatty liver cell model group (7.67±0.33 vs. 17.67±3.52), and the differences were statistically significant ( t=3.76, 7.07 and 2.82, all P<0.05). The degree of mitochondria swelling of fatty liver cell model group was higher than that of blank control group and the degree of mitochondria swelling of ALCAT1 interfering group was lower than that of fatty liver cell model group. The results of Western blotting showed that the expression level of LC3-Ⅱof the fatty liver cell model group was higher than that of the blank control group (0.43±0.01 vs. 0.28±0.02), and the difference was statistically significant ( t=7.32, P<0.05). However there was no significant difference in the expression level of Beclin1 between fatty live cell model group and blank control group (0.93±0.05 vs. 0.98±0.05, P>0.05). The expression levels of LC3-Ⅱ and Beclin1 of the ALCAT1 interfering group were both higher than those of the fatty liver cell model group and blank control group (0.95±0.04 vs. 0.42±0.01 and 0.28±0.02, 2.07±0.06 vs. 0.93±0.05 and 0.98±0.05), and the differences were statistically significant ( t=13.30, 15.63, 14.05 and 13.02, all P<0.05). The expression levels of mTOR of the fatty liver cell model group and ALCAT1 interfering group were both lower than that of the blank control group (1.44±0.02 and 0.74±0.01 vs. 1.93±0.10), the expression level of mTOR of the ALCAT1 interfering group was lower than that of the fatty liver cell model group (0.74±0.01 vs. 1.44±0.02), and the differences were statistically significant ( t=4.83, 12.04 and 32.14, all P<0.05). The expression levels of phosphorylated AKT of the fatty liver cell model group and ALCAT1 interfering group were both lower than that of the blank control group (0.14±0.01 and 0.07±0.01 vs. 0.28±0.01), while the expression level of phosphorylated AKT of the ALCAT1 interfering group was lower than that of the fatty liver cell model group (0.07±0.01 vs. 0.14±0.01), and the differences were statistically significant ( t=8.59, 14.10 and 5.96, all P<0.05). The results of ELISA indicated that the expression levels of ROS, malondialdehyde, 4-HNE, IL-6 and TNF-α of the fatty liver cell model group and the ALCAT1 interfering group were all higher than those of the blank control group ((11.44±0.30) and (5.84±0.36) g/L vs. (1.72±0.38) g/L; (19.94±2.47) and (11.95±1.55) μmol/L vs. (1.47±0.18) μmol/L; (5.00±0.43) and (2.99±0.37) ng/L vs. (1.46±0.23) ng/L; (203.40±5.16) and (92.07±11.98) ng/L vs. (23.32±3.33) ng/L; (123.70±8.38) and (67.42±4.88) ng/L vs. (47.18±4.57) ng/L), and the differences were all statistically significant ( t=19.86, 7.86, 7.45, 6.74, 7.22, 3.49, 29.34, 5.53, 8.02 and 3.03, all P<0.05). While the expression levels of ROS, 4-HNE, IL-6 and TNF-α of the ALCAT1 interfering group were all lower than those of the fatty liver cell model group ((5.84±0.36) g/L vs. (11.44±0.30) g/L, (2.99±0.37) ng/L vs. (5.00±0.43) ng/L, (92.07±11.98) ng/L vs. (203.40±5.16) ng/L and (67.42±4.88) ng/L vs. (123.70±8.38) ng/L), and all the differences were statistically significant ( t=11.99, 3.51, 8.54 and 5.81, all P<0.05). There was no statistically significant difference in the expression of malondialdehyde between ALCAT1 interfering group and fatty liver cell model group ((11.95±1.55) μmol/L vs. (19.94±2.47) μmol/L, P>0.05). Conclusions:The expression of ALCAT1 is up-regulated in fatty liver cell model. Knockdown of ALCAT1 can inhibit the expression of mTOR pathway proteins, activate autophagy, alleviate hepatocyte steatosis, oxidative stress and inflammatory response.

Objective:To investigate the level of regulatory T (Treg) cells of peripheral blood and evaluate the correlation between Treg cells and disease activity in rheumatoid arthritis (RA) to further clarify the role of Treg cells in the pathogenesis of RA.Methods:The participants included 300 patients with RA, from the Second Hospital of Shanxi Medical University between January 2016 and September 2018 and 100 gender and age matched healthy individuals. The absolute numbers and proportion of Treg cells and helper T (Th) 17 cells and the ratio of Th17/Treg in peripheral blood of these individuals were detected by flow cytometry combined with standard absolute counting beads. Main statistical analysis methods were t test, spearman correlation and rank sum test. Results:Patients with RA had lower absolute numbers [(35±13) cells/μl vs (26±17) cells/μl, t=4.815, P<0.01] and percentage [(5.1±1.5)% vs (4.4±2.0)%, t=4.111, P<0.01] of Treg cells compared with those in healthy controls, while the number ( t=1.114, P=0.266) and proportion ( t=1.577, P=0.116) of Th17 cells were not significantly changed. RA patients, regardless of new onset (no prior treatment) or treatment with immunosuppressants, had significantly lower absolute numbers of Treg cells [healthy controls (35±13) cells/μl; the Treg cells in new onset patients was (31±17) cells/μl, t=1.974, P=0.049; Treg cells in treated patients was (24±16) cells/μl, t=5.978, P<0.01] but not Th17 cells than healthy controls. With the increase of disease activity score uses 28 joint counts (DAS28), the absolute counts of peripheral Treg cells trended to decrease [remission group (33±15) cells/μl, low activity group (31±17) cells/μl, moderate activity group (28±17) cells/μl, high activity group (24±16) cells/μl], and were negatively correlated with DAS28( r=-0.139, P=0.016) and erythrocyte sedimentation rate (ESR) ( r=-0.116, P=0.046). Conclusion:The absolute counts of peripheral Treg cells decreased significantly, which are associated directly with the pathogenesis of RA rather than high-dose glucocorticoids or immunosuppressive agents. Changes in circulating Treg cells number may play a prominent role in the disease process of RA, which provides clinical basis for evaluation of disease activity and exploration of new effective therapies.