This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension （OH） based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position， during which dysfunction of the middle jiao （焦） transformation and transportation， along with impaired pivot function， hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward"， placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend， the self-formulated Li's Shengqing Jiangzhuo Decoction （李氏升清降浊汤）is used to supplement qi， raise the clear， and strengthen the middle jiao. For cases where the turbid yin fails to descend， the self-formulated Wuxiang Qingzhuo Beverage（五香清浊饮）with modifications is applied to resolve phlegm， eliminate stasis， harmonize the middle， and descend the turbid.

This paper summarizes professor LI Guolie's clinical experience in treating orthostatic hypotension （OH） based on the theory of "raising the clear and directing the turbid downward". It is considered that the core pathogenesis of OH lies in the body's transition from a supine to an upright position， during which dysfunction of the middle jiao （焦） transformation and transportation， along with impaired pivot function， hinders the ascending of clear yang and the descending of turbid yin. Treatment should follow the general principle of "ascending the clear and directing the turbid downward"， placing emphasis on distinguishing the primary and secondary aspects. For cases where the clear yang fails to ascend， the self-formulated Li's Shengqing Jiangzhuo Decoction （李氏升清降浊汤）is used to supplement qi， raise the clear， and strengthen the middle jiao. For cases where the turbid yin fails to descend， the self-formulated Wuxiang Qingzhuo Beverage（五香清浊饮）with modifications is applied to resolve phlegm， eliminate stasis， harmonize the middle， and descend the turbid.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

AIM: To evaluate the clinical effect of toric implantable collamer lens(TICL)V4c for correcting moderate to high myopia with high astigmatism using vector analysis and quality of life impact of refractive correction(QIRC).METHODS: Retrospective case series. A total of 55 patients(90 eyes)with moderate to high myopia and high astigmatism who received TICL V4c implantation in the refraction surgery center of ophthalmology department in our hospital from January 2019 to December 2022 were collected. Followed-up for 1 a, the uncorrected distance visual acuity(UDVA), best corrected visual acuity(BCVA)and diopters were observed. Alpins vector analysis was used to evaluate the effect of astigmatism correction, and QIRC scale was used to evaluate patients' quality of life.RESULTS: At 1 a postoperatively, the UDVA of 98% eyes was the same or better than pre-operative BCVA, the safety index was 1.11±0.14, and the efficacy index was 1.11±0.15. The angle of error of 97% of the astigmatic eyes was within ±15°. The results of vector analysis showed that correction index was 0.83±0.13, angle of error was 1.00±4.49°, and index of success was 0.21±0.15. The total higher order aberrations under a pupil diameter of 6 mm was significantly increased compared with preoperatively(P<0.05), the QIRC score was significantly better than that before surgery(P<0.001), and the increase of total QIRC scores was positively correlated with preoperative spherical equivalent(rs=0.215, P<0.05), indicating that the higher degree of myopia before surgery the patients, the better the quality of life after TICL implantation.CONCLUSION: TICL V4c implantation for the correction of moderate to high myopia with high astigmatism is safe and effective, and the patients' quality of life significantly improved after surgery.

Objective:The 97.5th percentile upper reference limit (97.5th URL) of N-terminal prob-type natriuretic peptide (NT-proBNP) is influenced by multiple factors and depends on the inclusion criteria of apparently healthy people. In this study, the reference upper limit of NT-proBNP was established on apparently healthy people in Beijing area with abnormal hs-cTn as the exclusion criterion.Methods:According to the latest expert consensus recommendation standards of natriuretic peptide in the detection and clinical application of heart failure published by the Clinical Application Group of Cardiac Bio-Markers of the International Union of Clinical Chemistry, 1 635 healthy people without abnormal appearance of routine indicators such as sex, age, glycated hemoglobin, estimated glomerular filtration rate and medical history were collected. After excluding participants with potential myocardial injury according to hs-cTnI and/or hs-cTnT concentration>99th URL, NT-proBNP 97.5th URL was established in healthy subjects aged 21-40 years ( n=205), 41-50 years ( n=535), 51-60 years ( n=556) and >60 years ( n=339) based on non-parametric statistics. Results:The level of NT-proBNP was positively correlated with age ( r=0.254, P<0.001). The levels of NT-proBNP were positively correlated with hs-cTnI, hs-cTnT in males ( r=0.377 and r=0.429, both P<0.001). The levels of NT-proBNP were also positively correlated with hs-cTnI, hs-cTnT in females ( r=0.132 and r=0.296, both P<0.001). When hs-cTn>99th URL was used as the criterion to exclude patients with potential myocardial injury, among apparently healthy people aged 21-40 years old, 41-50 years old, 51-60 years old and >60 years old, male NT-proBNP 97.5th URL was 81.9 (90% CI 60.0-588.8), 141.2 (90% CI 100.0-263.6), 272.0 (90% CI 193.0-494.0) and 547.9 (90% CI 311.2-738.6), respectively; For females, the rates were 227.5 (90% CI 81.9-360.8), 153.2 (90% CI 128.2-239.5), 300.6 (90% CI 211.0-376.4) and 395.8 (90% CI 242.3-543.5) ng/L, respectively. Conclusions:This study confirmed that hs-cTn>99th URL can be used as an apparent population screening criterion for natriuretic peptide reference interval studies, which is helpful to remove conventional means to include individuals with occult myocardial injury in apparently healthy patients, so as to establish a more rigorous healthy cohort and establishing solid normal NT-proBNP reference interval.

Objective:To explore the evaluation dimensions and indicators of research hospital, provide empirical evidence for the construction of research hospital.Methods:Non-probability sampling was adopted, physicians from 9 hospitals in Shanghai that have a National Clinical Medical Research Center or Shanghai Clinical Medical Research Center were invited as survey participants. The physician participants were divided into senior and junior groups. For senior group, a questionnaire including 5 dimensions and 21 indicators was provided. The survey participants were consulted to determine whether the indicators can be used to measure this dimension, and also invited to propose additional dimensions and indicators for improvement.For junior group, two open questions were proposed to explore their needs of support in both clinical service and research.Results:Based on suggestions from the research participants, the research team, and other expert consultant, this article tried to propose 5 dimensions and 21 indicators for evaluating research hospitals. Among them, 11 were indicators compiled by the research team based on the literature review and agreed by more than 2/3 of senior physicians surveyed, while others were proposed based on the survey results. The research team planned to use the entropy method to determine the weights of different indicators, thus, the participants were not required to make judgments on the weights of dimensions and indicators.Conclusions:The evaluation of research hospitals has not yet formed a systematic consensus. Through the exploration and establishment of evaluation dimensions and indicators, identify hospitals that are closer to the development goals of research hospitals can provide a basis for future next-step practices.

DNA marker-assisted selection of medicinal plants is based on the DNA polymorphism, selects the DNA sequences related to the phenotypes such as high yields, superior quality, stress-resistance and so on according to the technologies of molecular hybridization, polymerase chain reaction and high-throughput sequencing, and assists the breeding of new cultivars. This study bred the first disease-resistant cultivar of notoginseng "Miaoxiang Kangqi 1" using the technology of DNA marker-assisted selection of medicinal plants and systematic breeding. The disease-resistant cultivar of notoginseng contained 12 special SNPs based on the analysis of Restriction-site Associated DNA Sequencing (RAD-Seq). Among the SNP (record_519688) was related to the root rot-resistant characteristics, which indicated this SNP could serve as genetic markers of disease-resistant cultivars and assist the systematic breeding. Compared to the conventional cultivated cultivars, the incidence rate of root-rot and rust-rot in notoginseng seedlings decreased by 83.6% and 71.8%, respectively. The incidence rate of root-rot respectively declined by 43.6% and 62.9% in notoginseng cultivation for 2 and 3 years compared with those of the conventional cultivated cultivars. Additionally, the potential disease-resistant groups were screened based on the relative SNP, and this model enlarged the target groups and advanced the breeding efficiency. DNA marker-assisted selection of medicinal plants accelerated the breeding and promotion of new cultivars, and guaranteed the healthy development of Chinese medicinal materials industry.

Objective To investigate the effect of microinvasive thread embedding on vertebral artery blood flow in cervical spondylotic vertebral arteriopathy and further ascerta in that microinvasive thread embedding is a new long-acting acupuncture method for treating cervical spondylotic vertebral arteriopathy.Method Sixty patients meeting the inclusion criteria were randomly allocated to acupuncture and thread embedding groups.The acupuncture group received conventional acupuncture and the thread embedding group, microinvasive thread embedding.The symptoms and function were scored using theEvaluation Scale for Cervical Vertigoand bilateral vertebral artery blood flow was measured using transcranial Doppler after one day and three weeks of treatment.Result The symptoms of vertigo improved somewhatin the thread embedding group at one day after treatment compared with before treatment (P<0.05).At three weeks after treatment,vertigo,neck-shoulder pain, abilities in daily living and working and the total score improved in both groups of patients (P<0.05), and vertigo and abilities in daily living and working improved significantly in the thread embedding group compared with the acupuncture group (P<0.05). Bilateralvertebral artery Vm increased significantly in both groups of patients after treatment(P<0.05) and increased more significantly in the thread embedding group than in the acupuncture group after one day and three weeks of treatment (P<0.05). PIof the rightvertebral arterydecreased somewhat in both groups after three weeks of treatment (P<0.05) but there was no statistically significant difference between the twogroups(P>0.05). The total efficacy rate was 83.3% in the thread embedding group, which was higher than 60.0% in the acupuncture group (P<0.05).Conclusion Microinvasive thread embedding can improve the symptoms, vertebral artery blood flow and the quality of life in patients with cervical spondylotic vertebral arteriopathy.

Objective To investigate the therapeutic effect of microinvasive PGLA thread embedding on neck pain due to cervical spondylosis. Method One hundred and five cervical spondylosis patients with complaints of neck pain were randomly allocated to three groups, 35 cases each. The thread embedding group received PGLA thread embedding therapy;the control group, acupuncture with thread-embedding needles (without thread embedding);the acupuncture group, conventional acupuncture. Result There was a significant difference in the relief of symptoms and signs between the thread embedding or acupuncture group and the control group (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score and the PPI score in the thread embedding and acupuncture groups (P<0.05). There were statistically significant post-treatment differences in the above scores between the thread embedding or acupuncture group and the control group (P<0.05). The total efficacy rate was 17.1% in the control group, 77.1%in the acupuncture group and 94.3%in the thread embedding group. The total efficacy rate was significantly higher in the thread embedding group than in acupuncture and control groups. Conclusion The therapeutic effect on neck pain due to cervical spondylosis is produced by PGLA thread stimulation of the acupoints and not by simple injurious stimulation with thread-embedding needles. PGLA thread embedding has a marked therapeutic effect on neck pain due to cervical spondylosis.