Clinical death refers to the permanent cessation of life functions. This article reviews the definition of clinical death and the various scenarios in which it occurs, classifies the process of clinical death, and discusses the criteria for determining uncontrollable cardiac death, controllable cardiac death and the criteria and workflow for determining brain death. It elaborates on the relationship between brain death and death, and proposes the areas to note when standardizing the medical documentation of death cases. Based on this, it introduces the content of the management system and workflow construction for death determination in medical institutions, including management structure, personnel qualifications, document norms, quality control system and training mechanism. Paying attention to the construction of the management system and workflow for death determination in medical institutions is of great significance for ensuring medical quality and safety, promoting the healthy development of organ donation, and maintaining the seriousness of legal and ethical practices.

Guidelines for Digital Ancient Books of TCM Indexing(T/CIATCM 119-2024)is based on the theoretical knowledge,disciplinary methods,and practical applications of TCM classical cataloging.Taking digital ancient books of TCM as the object,it systematically reveals the content of TCM knowledge,which is an essential indexing processing standard for building an intelligent retrieval system for TCM ancient books,and can provide support for the deep development and innovative utilization of TCM knowledge.It can not only promote the co-construction and sharing of ancient book resources in the TCM industry,but also promote the standardization construction and application of TCM information.This standard specifies the principles,methods,and examples of free indexing of digital ancient books of TCM based on their original content.It is applicable to the indexing and processing of digital ancient books of TCM for TCM professional libraries and related institutions,and to the data processing and construction of various types of TCM ancient book databases.

Tracheal intubation is the most commonly used way to establish artificial airway in intensive care unit patients, and it is the premise of respiratory support and treatment, the success of extubation is an important basis to measure the prognosis of patients. Influenced by many factors, extubation of patients may fail, resulting in prolonged hospitalization, increased medical expenses and increased incidence of complications. This article reviews the literature at home and abroad, and summarizes the main mechanism, risk factors and prevention strategies of extubation failure in intensive care unit patients, aiming at improving the recognition ability of clinical medical staff for extubation failure and providing reference for clinical management and follow-up research.

Guidelines for Digital Ancient Books of TCM Indexing(T/CIATCM 119-2024)is based on the theoretical knowledge,disciplinary methods,and practical applications of TCM classical cataloging.Taking digital ancient books of TCM as the object,it systematically reveals the content of TCM knowledge,which is an essential indexing processing standard for building an intelligent retrieval system for TCM ancient books,and can provide support for the deep development and innovative utilization of TCM knowledge.It can not only promote the co-construction and sharing of ancient book resources in the TCM industry,but also promote the standardization construction and application of TCM information.This standard specifies the principles,methods,and examples of free indexing of digital ancient books of TCM based on their original content.It is applicable to the indexing and processing of digital ancient books of TCM for TCM professional libraries and related institutions,and to the data processing and construction of various types of TCM ancient book databases.

Tracheal intubation is the most commonly used way to establish artificial airway in intensive care unit patients, and it is the premise of respiratory support and treatment, the success of extubation is an important basis to measure the prognosis of patients. Influenced by many factors, extubation of patients may fail, resulting in prolonged hospitalization, increased medical expenses and increased incidence of complications. This article reviews the literature at home and abroad, and summarizes the main mechanism, risk factors and prevention strategies of extubation failure in intensive care unit patients, aiming at improving the recognition ability of clinical medical staff for extubation failure and providing reference for clinical management and follow-up research.

Objective To explore the application effect of pressure moxibustion at Baihui and Guanyuan acupoints combined with butylphthalide in treating stroke patients in recovery phase.Methods A total of 108 stroke patients in recovery phase were randomly divided into observation group and control group,with 54 cases in each group.The control group was treated with bu-tylphthalide on the basis of conventional treatment,while the observation group was treated with pres-sure moxibustion at Baihui and Guanyuan acupoints combined with butylphthalide for 8 consecutive weeks.After the end of the treatment course,the efficacy was evaluated in both groups,and the func-tional status[the National Institutes of Health Stroke Scale(NIHSS),the Montreal Cognitive Assess-ment(MoCA),the Barthel Index(BI)],event-related potential P300,the levels of hemodynamic indicators[resistance index(RI),pulsatility index(PI),mean velocity(Vm)],cognitive function markers[lipoprotein-associated phospholipase A2(Lp-PLA2),alkaline phosphatase(ALP),humanβ-amyloid 1-42(Aβ-42)]and safety were compared between the two groups before and after treat-ment.Results The total effective rate in the observation group was 96.30％,which was significantly higher than 85.19％in the control group(P＜0.05).After 8 weeks of treatment,the MoCA and BI scores in the observation group were significantly higher than those in the control group,while the NIHSS score was significantly lower(P＜0.05).After 8 weeks of treatment,the latency in the observation group was significantly lower than that in the control group,while the amplitude and the differences in latency and amplitude before and after treatment were significantly higher(P＜0.05).After 8 weeks of treatment,Vm in the observation group was significantly higher than that in the con-trol group,while PI and RI were significantly lower(P＜0.05).After 8 weeks of treatment,the levels of Lp-PLA2,ALP and Aβ-42 in the observation group were significantly lower than those in the control group(P＜0.05).No serious adverse reactions occurred in patients in each group.Conclusion Pressure moxibustion at Baihui and Guanyuan acupoints combined with butylphthalide can improve cerebral blood flow and promote the recovery of cognitive and neurological functions in stroke patients in recovery phase.The mechanism may be related to the downregulation of Lp-PLA2,ALP and Aβ-42 expression.

Objective To study the expression of regulator of cullins-1(ROC1)and ubiquitin binding enzyme 9(UBC9)in non-muscle invasive bladder cancer(NMIBC)and their relationship with clinicopathological features and prognostic value of transurethral resection of bladder tumor(TURBT).Methods Retrospective analysis was conducted on 104 patients with NMIBC who underwent TURBT at Northwest University First Hospital from April 2018 to February 2021.Immunohistochemistry was used to detect the expression of ROC1 and UBC9 in tissues.Follow-up was conducted for 3 years,and Kaplan-Meier curve analysis and COX regression analysis were used to identify factors affecting the prognosis of NMIBC patients.Results The positive rates of ROC1(67.31%)and UBC9(69.23%)in NMIBC cancer tissues were higher than those in adjacent tissues(9.62%,7.69%),and the differences were statistically significant(χ2=73.125,83.200,all P<0.001).There was a positive correlation between the expression of ROC1 and UBC9 in NMIBC cancer(r=0.719,P<0.001).The positivity rates of ROC1(87.23%,90.00%)and UBC9(89.36%,88.33%)in cancer tissues with a maximum tumor diameter of≥2cm,T1 stage were higher than those in cancer tissues with a maximum tumor diameter of<2cm(50.88%,52.63%),Ta/Tis stage(36.36%,43.18%),and the difference were statistically significant(χ2=15.474～33.188,all P<0.05).After TURBT surgery,there were 29 cases of local recurrence,10 cases of metastasis,and 2 deaths of bladder cancer,the 3-year progression-free survival(PFS)rate was 60.58%(63/104).The 3-year PFS of NMIBC patients in the ROC1 positive and negative groups was 47.14%(33/70)and 88.24%(30/34),and the 3-year PFS of patients in the UBC9 positive and negative groups was 47.22%(34/72)and 90.63%(29/32),the differences were statistically significant(Log-rank χ2=15.341,15.931,all P<0.001).Multivariate COX regression analysis showed that ROC1 positivity,UBC9 positivity,maximum tumor diameter≥2cm and T1 phase were risk factors affecting the prognosis of NMIBC patients(all P<0.001).Conclusion The expression of ROC1 and UBC9 is elevated in NMIBC,which is related to the maximum diameter and stage of the tumor.Combined detection of ROC1 and UBC9 can help evaluate the prognosis of NMIBC patients.

Idiopathic Pulmonary Fibrosis(IPF)is a progressive disease characterized by declining respiratory function and high mortality.Macrophages play a pivotal role in its pathogenesis.Through polarization into pro-inflammatory M1 and pro-fibrotic M2 phenotypes,they contribute to a complex immunoregulatory network.In the early disease stages,M1 macrophage-mediated inflammation causes lung tissue injury,while M2 macrophages drive fibrogenesis by releasing pro-fibrotic factors such as TGF-β.Recent research has revealed that exosomes derived from macrophages serve as carriers for miRNAs,with specific miRNAs(e.g.,miR-328,miR-142-3p)demonstrating significant roles in pulmonary fibrosis.miR-328 promotes fibroblast proliferation and accelerates collagen deposition,whereas miR-142-3p attenuates fibrosis by modulating the TGF-β signaling pathway.Targeted intervention against these macrophage-associated miRNAs shows potential for clinical translation,potentially offering novel approaches for the early diagnosis and targeted therapy of IPF.However,translating these strategies into clinical practice requires overcoming challenges related to production and delivery systems.In conclusion,a deeper understanding of the mechanisms and translational applications of macrophage-derived miRNAs in IPF holds promise for ultimately improving patient prognosis and clinical outcomes.

Idiopathic Pulmonary Fibrosis(IPF)is a progressive disease characterized by declining respiratory function and high mortality.Macrophages play a pivotal role in its pathogenesis.Through polarization into pro-inflammatory M1 and pro-fibrotic M2 phenotypes,they contribute to a complex immunoregulatory network.In the early disease stages,M1 macrophage-mediated inflammation causes lung tissue injury,while M2 macrophages drive fibrogenesis by releasing pro-fibrotic factors such as TGF-β.Recent research has revealed that exosomes derived from macrophages serve as carriers for miRNAs,with specific miRNAs(e.g.,miR-328,miR-142-3p)demonstrating significant roles in pulmonary fibrosis.miR-328 promotes fibroblast proliferation and accelerates collagen deposition,whereas miR-142-3p attenuates fibrosis by modulating the TGF-β signaling pathway.Targeted intervention against these macrophage-associated miRNAs shows potential for clinical translation,potentially offering novel approaches for the early diagnosis and targeted therapy of IPF.However,translating these strategies into clinical practice requires overcoming challenges related to production and delivery systems.In conclusion,a deeper understanding of the mechanisms and translational applications of macrophage-derived miRNAs in IPF holds promise for ultimately improving patient prognosis and clinical outcomes.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers