OBJECTIVE To provide direction and reference for the adjustment of the discount rate （DR） in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research， health technology assessment agencies in various countries/regions， as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR， adjustment trends， and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis， the effects of different DR on the incremental cost-effectiveness ratio （ICER） were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines， the base-case DR ranged from 1.5% to 5%， with 5% being the most common value； the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes， while in the Netherlands， Belgium， Poland and Czech Republic， DR for costs was higher than for health outcomes. In recent years， Korea， France and Ireland had lowered their DR in response to economic changes， whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%， and localized empirical research can be conducted using internationally common estimation methods.

Cardiovascular disease and cancer are the two leading chronic conditions contributing to global mortality. With the rising incidence of cancer, the prevalence of cancer therapy-related cardiovascular complications has also increased, driving the development of the emerging field of cardio-oncology. The advancement of precision medicine offers new opportunities for the individualized and targeted management of cardiovascular toxicities associated with cancer treatment. Artificial intelligence (AI) has the potential to overcome traditional limitations in medical data integration, dynamic monitoring, and interdisciplinary collaboration, thereby accelerating the application of precision medicine in cardio-oncology. By enabling personalized treatment and reducing cardiovascular complications in cancer patients, AI serves as a critical tool in this domain. This article provides an in-depth interpretation of the 鈥淎rtificial intelligence to enhance precision medicine in cardio-oncology: a scientific statement from the American Heart Association鈥?aiming to inform the integration of AI into precision medicine in China. The goal is to promote its application in the management of cardiovascular diseases related to cancer therapy and to achieve precision management in this context.

Objective To explore the effectivity and feasibility of uindirectional barbed suture for primary closure of common bile duct on Laparoscopic Exploration of Common Bile Duct Stones, Methods From January 2013 to August 2015,109 cases of primary closure of common bile duct after Laparoscopic Exploration of Common Bile Duct Stones were performed in this hospital.The characteristics of these cases were retrospectively comparatively analyzed.Results Conventional braided Sutures in 68 cases(group A),barbed Suture Devices in 41 cases (group B).There was no difference in postoperative hospital stay,intraoperative blood loss and complication rate between the two groups.Differences in bile duct incision suture time and operative time between the two groups were significantly different.Conclusion The application of uindirectional barbed suture for primary closure of common bile duct using barbed suture after Laparoscopic Exploration is a safe and effective way after treatment of choledocholithiasis.This method cuold reduce the difficulty of operation,and shorten the operation time and the learning curve.

Objective To clone fliH, fliⅠ, fliY and fliN genes that encoding flagellum-associated proteins of L. interrogans for construction of their prokaryotic expression systems, and to determine the loca- tions of Flirt, FliⅠ, FIiY and FIiN. Methods The fliH, fliⅠ, fliY andfliN genes were amplified by PCR and sequenced after T-A cloning. Prokaryotie expression systems of the target genes were constructed subsequently. Expression of target recombinant proteins were demonstrated by SDS-PAGE and BioRad Gel Image Analyzer, and Ni-NTA affinity chromatography was performed to extract the target expression prod- ucts. Rabbits were subcutaneously immunized with the four recombinant proteins respectively to obtain anti- sera. ELISA was performed to measure the titers of antisera and Western blot assay was used to determine the immunobinding abilities among the antisera and their antigens. Immunoelectron microscopy was selected to locate the position of FliH, FliⅠ, FliY and FIiN. Results Segments of fliH, fliⅠ, fliY andfliN genes with 924, 1365, 1065 and 318 bp in size were successfully obtained by PCR. Similarities of nucleotide and puta- tive amino acid sequences from the four genes were 100% compared with the reported sequences. The con- structed prokaryotic systems efficiently expressed rFliH, rFliⅠ, rFliY and rFliN with the outputs of approxi- mate 20% of the total bacterial proteins. The rabbits immunized by rFliH, rFliⅠ, rFliY or rFliN could pro- duce antibody. The antisera had the titers above 1:100 000, and could recognize the corresponding recombi- nant proteins and membrane proteins of L interrogans to display positive Western hybridization bands. Flirt, FliⅠ, FliY and FliN were found to distribute on the external surface of inner envelope, the internal surface of outer envelope or the interspaces between the two layers of L. interrogans envelope. Conclusion The pro- karyotic expression systems was successfully constructed in this study, which could efficiently express flagel-lum-associated proteins FliH, FliⅠ, FliY and FliN of L. interrogans. The antisera with high titers to recognize their protein antigens were also obtained. Flagellum-associated proteins Flirt, FliⅠ, FIiY and FIiN are the inner envelope proteins and/or outer envelope proteins of L. interrogans.

AIM To investigate whether ATP sensitive pota ss ium channels are involved in the protective effects of ischemic preconditioning on spinal cord in rabbits. METHODS Twenty seven male New Zealands white rabbits were randomly assigned to 3 groups (9 in each group):ischemia gro up(IC)、ischemic preconditioning group (IPC) and glibenclamide + ischemic precon ditioning group(G+I). In IC group, spinal cord ischemia was induced by an infrar enal aorta clamping for 20 min; IPC group underwent a 6 min ischemic preconditio ning followed by 30 min of reperfusion before the 20 min clamping; G+I group wer e administered glibenclamide (an ATP sensitive potassium channel blocker, 2 mg? kg -1 )intravenously 20 min before the ischemic preconditioning. Neurologic function was scored at 8,12,24 and 48 h after reperfusion. All animals were sa crificed at 48 h after reperfusion and the spinal cords (L 5～7 ) were remov ed for histopathologic study. RESULTS The neurologic function sco res in IPC group at each observe interval were higher than those in IC group and G+I group (P