Acute-on-chronic liver failure (ACLF) is an acute deterioration of liver function occurring on the basis of chronic liver disease, accompanied by failure of the liver and extrahepatic organs, and is associated with a high short-term mortality rate. Liver transplantation is the only curative treatment for patients with ACLF. However, the shortage of donor livers and limitations of the organ allocation system mean that only a minority of patients can receive transplants. The current organ allocation system based on the model for end-stage liver disease (MELD) score may underestimate the urgency of liver transplantation for ACLF patients. Therefore, it is urgent to develop better assessment tools to determine which ACLF patients are most likely to benefit from liver transplantation. This article reviews the current mainstream definitions of ACLF, the selection of candidates for liver transplantation in ACLF, and the prognostic scoring systems for liver transplantation in ACLF, both domestically and internationally, in order to provide a reference for the prognostic assessment of liver transplantation in ACLF patients.

Objective: To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students. Methods: From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students. Results: From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% ( χ 2=45.71); and smartphone addiction scores [ 24.00 (16.00, 32.00),25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00),3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00),5.00(0.00, 9.00)] all significantly increased ( Z =-17.43, -42.38, -41.57) (all P <0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 ( χ 2=85.15, 106.85, both P <0.05). After adjusting for covariates such as age, gender and family background, mixed effects models revealed dose response associations of anxiety and depressive symptoms with smartphone addiction among middle school students:mild anxiety symptom( OR =3.22), moderate to severe anxiety symptom ( OR =5.36), mild depressive symptom ( OR =3.32) and moderate to severe depressive symptom ( OR =6.13) were significantly associated with higher risks of smartphone addiction (all P <0.05). Interaction effect analysis found that co existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times ( OR =5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction ( S=1.64, AP =0.32)(both P < 0.05 ). Conclusions Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

In order to understand the difference and expression of genes in CEK cells before and af-ter baicalin interferes with IBV,further reveal and analyze the mechanism of baicalin interfering IBV replication in CEK cells in vitro.After IBV infected CEK cells for 2 h,9.75 mg/L baicalin liq-uid was added to interfere with CEK cells,which was recorded as the baicalin(H-IBV)group,and three replicate wells were set in the control group and the IBV(IBV)infection group.After 36 h culture,cell samples were collected and subject to transcriptome for sequencing.The results showed that there were 102 differentially expressed genes in H-IBV group compared with IBV in-fection group,among which 48 genes weresignificantly up-regulated and 54 genes were significantly down-regulated.Through functional annotation in GO and KEGG databases,it was found that dif-ferentially expressed genes were mainly annotated in biological processes such as cellular proces-ses,biological regulation,metabolism,and secondary pathways such as viral infectious diseases,signal transduction and interaction.Retinol metabolism pathway,phospholipid transfer to mem-brane,IL-27 mediated signaling pathway,MDA5/RIG-I and Toll-like receptor signaling pathway were significantly enriched in CEK cells,and the production of type Ⅰ interferon and interferon al-pha and the process of antiviral infection were also positively regulated.There were more differen-tial genes enriched in nucleic acid catalysis,immune system,and reaction,and interbiological reac-tion.Through the STRING network interaction map,it was found that most immune-related genes could form a 36-node interaction network centered on IRF7,TLR3 and STAT1.Therefore,com-pared with IBV group,the differentially expressed genes after baicalin treatment were mainly an-notated and enriched in the biological process,and the immune system and response were en-hanced,mainly through the positive regulation of IRF7 in the MDA5/RIG-I receptor signaling pathway and the inhibition of TLR3 signal transduction in the Toll-like receptor signaling path-way.Positive regulation of IL-27 mediated pathway and regulation of JAK-STAT signaling path-way were supplemented by activation of the expression of IRF7,TLR3,STAT1 and other related genes,and interaction with corresponding downstream proteins to promote the expression of IFN-α and regulatory cytokines,coupled with negative regulation of viral(defense)response and viral processes.Thus,baicalin interferes with IBV replication in CEK cells.

The patient survival rate of peritoneal carcinomatosis can be significantly improved by aggressive treatment. Imaging examination is crucial for clinical diagnosis and treatment of this disease. Fibroblast activation protein inhibitor (FAPI) PET/CT, as a hotspot of nuclear medicine research, provides a new way for the diagnosis of peritoneal carcinomatosis. This review summarizes the application of FAPI PET/CT in the diagnosis of peritoneal carcinomatosis, including the diagnostic value and limitations.

Objective:To discuss the efficacy and safety of stereotactic electroencephalography (SEEG) in epileptogenic foci excision in pediatric patients with drug-resistant epilepsy.Methods:A total of 126 pediatric patients (<18 years old) with drug-refractory epilepsy who received SEEG-guided epileptogenic foci excision in Epilepsy Center, Aviation General Hospital from January 2015 to March 2022 were selected. The clinical data and efficacy were retrospectively analyzed, and prognoses of these pediatric patients were evaluated by Engel grading 1 year after resection.Results:(1) A total of 1289 electrodes were implanted, with a mean of (10.09±2.92) electrodes per pediatric patient; 55 pediatric patients had unilateral implant and 71 had bilateral implant. Mean EEG monitoring time was (8.69±5.71) d, ranged 3-28 d. Epileptogenic focus could be located in 114 pediatric patients (90.5%) after initial implantation under SEEG monitoring, and secondary implantation for accurate positioning was given in 12 pediatric patients (9.5%). (2) Lobectomy was performed in 27 pediatric patients (21.4%), multi-lobectomy or tailored cortical resection in 36 (28.6%), tailored cortical resection on single lobe in 60 (47.6%), and tailored cortical resections on single lobe or hippocampal amygdala resection combined with corpus callosotomy in 3 (2.4%). Minimally invasive exploring hemostasis under SEEG was performed in 13 pediatric patients (17 electrodes) and postoperative CT was normal. A little asymptomatic epidural, subdural or cerebral parenchymal hematoma spontaneously absorbed was noted in 4 pediatric patients after implantation under SEEG monitoring. No perioperative infection, CSF leakage, death or severe disability was noted. (3) Mean follow-up was performed for (26.1±7.26) months; 66 (52.3%) pediatric patients reached Engel grading I, 33 (26.2%) reached Engel grading II, 21 reached Engel grading III (16.7%), and 6 (4.8%) reached Engel grading IV. Thirteen pediatric patients with failed resection received SEEG-guided epileptogenic foci excision for the second time: 8 (76.9%) had Engel grading I and 2 had Engel grading II 1 year after follow-up, accounting for 76.9% totally.Conclusion:SEEG-guided epileptogenic foci excision is safe and effective in drug-refractory epilepsy; for pediatric patients with poor initial results, SEEG can be used to relocate the epileptogenic focus, and a second resection of epileptogenic focus can also obtain good results.

Objective To investigate the effect of day chemotherapy on medical expenses of breast cancer patients.Methods The medical expenses of breast cancer patients in the First Affiliated Hospital of Guangxi Medical Universtiy from January 2019 to September 2023 were retrospectively investigated.Interrupted time series analysis was used to analyze the changes and trend of medical expenses and expenses structure of breast cancer before and after the implementation of day chemotherapy.Results The number of 8066 cases with breast cancer were included in this study.After day chemotherapy,the total expenses and each expense detail decreased significantly(P＜0.001).The total expenses,medicine expense,examination expenses and other expenses showed an upward trend before implementation of day chemotherapy(P＜0.05),the laboratory expenses showed a downward trend before implementation of day chemotherapy(P＜0.001).The total medical expenses decreased by 7306.34 yuan immediately after the implementation of day chemotherapy.The expenses of laboratory test,treatment,examination,nursing,medicine,health materials and other expenses were decreased by 599.59 yuan,1674.34 yuan,1470.66 yuan,91.37 yuan,3473.91 yuan,231.51 yuan and 436.73 yuan,respectively.Conclusion The implementation of day chemotherapy for breast cancer has significantly reduced all kinds of costs,which is conductive to reducing disease burden of patients.

Objective To explore the effect of training mode based on action learning on improving the practicing ability of hospital pharmacists.Methods Thirty pharmacists who received training from September 2022 to December 2023 at Panzhihua Central Hospital were randomly divided into an education reform group(16 cases)and a routine group(14 cases).The education reform group adopted a routine teaching method based on action learning,while the routine group adopted a routine teaching method.The differences between the two groups of pharmacists in theoretical knowledge,practical operation,pharmaceutical services,emergency response,and comprehensive quality were compared.Results The pharmacists in the education reform group were better than the routine group in prescription review,clinical medication analysis,pharmaceutical services,emergency response,andcomprehensive quality.The difference was statistically significant(P＜0.05).Conclusion The teaching model based on action learning can effectively enhance the higher order thinking ability of pharmacists and help them better apply medical knowledge and skills to serve patients and physicians.

Objective To explore the application of Chinese Drug-Related Problems Classification System in the pharmaceutical care of inpatients in neurology department.Methods A total of 222 inpatients admitted to the Department of Neurology of Affiliated Jinhua Hospital,Zhejiang University School of Medicine from March to June 2022 were selected as the study subjects,and the work records of clinical pharmacists were retrospectively analyzed.The drug-related problems(DRP)were sorted and analyzed according to the Chinese Drug-Related Problems Classification System.Binomial Logistic regression model was used to analyse the influencing factors of DRP.Results Among the 222 patients,76(34.23%)had DRP and a total of 104 DRP were found.The main problem type of DRP was treatment safety(39.42%).The involving objects of DRP were all doctors.In the severity assessment,the most involved level was"DRP reached the patient,but the patient was not harmed"(81.73%).The main reason for DRP was"choice of drugs"(67.31%),followed by"usage and dosage"(26.92%).A total of 62(59.62%)DRP intervention schemes were accepted,and the overall acceptance rate of intervention schemes was 87.32%.In the end,61(58.65%)DRPs were resolved.The drug class with the largest number of DRP cases was antiplatelet drugs.Binomial Logistic regression analysis showed that the number of drug varieties[OR=1.097,95%CI(1.030,1.167)]was the influencing factor for the occurrence of DRP in neurology inpatients(P<0.05).Conclusion DRP is common in inpatients of neurology department.Chinese Drug-Related Problems Classification System is helpful for clinical pharmacists to review and sort pharmaceutical care data,summarize common problems and solving experience,and improve the effect of pharmaceutical care.

Objective To establish the ultra-high performance liquid chromatography(UPLC)chromatographic fingerprint of Notopterygii Rhizoma et Radix;To determine the contents of ferulic acid,nodakenin,ammijin,notopterol,isoimperatorin and volatile oil of Notopterygii Rhizoma et Radix from different producing areas;To provide reference for quality evaluation of Notopterygii Rhizoma et Radix.Methods Waters BEH C18 chromatographic column(2.1 mm×150 mm,1.7 μm)was used,with mobile phase acetonitrile-0.02%formic acid aqueous solution gradient elution,flow rate 0.25 mL/min,column temperature 25℃,detection wavelength 330 nm,injection volume 2 μL.UPLC fingerprints of 25 batches of Notopterygii Rhizoma et Radix were established,and the similarity analysis and chemometrics analysis were carried out.The contents of ferulic acid,nodakenin,ammijin,notopterol and isoimperatorin were determined simultaneously,and the contents of volatile oil was determined by steam distillation method.Results Totally 23 common fingerprint peaks were calibrated,11 known components were identified.According to the results of the cluster analysis and principal component analysis,25 batches of Notopterygii Rhizoma et Radix samples were divided into 3 categories,and the 6 potential differential components were screened out by orthogonal partial least squares-discriminant analysis(OPLS-DA).The results showed that the contents of notopterol and volatile oil from Sichuan Province were higher than those from Gansu Province and Qinghai Province.Conclusion The method established in the study is accurate and reliable,which can provide scientific basis and reference for the quality evaluation and control of Notopterygii Rhizoma et Radix.