Chronic liver disease is a general term for a variety of liver diseases， and its prevalence rate is increasing year by year. With the progression of the disease， patients may experience a variety of serious complications and even progress to liver failure. In recent years， a number of studies have revealed the association between ectopically colonized oral bacteria and chronic liver disease and explored their potential value in the diagnosis and treatment of chronic liver disease. This article systematically reviews the association of ectopically colonized oral bacteria with metabolic associated fatty liver disease， liver cirrhosis， and liver cancer and analyzes the mechanism for the influence of ectopically colonized oral bacteria on chronic liver disease， so as to provide a reference for the diagnosis and treatment of chronic liver disease using ectopically colonized oral bacteria.

ObjectiveTo evaluate the clinical efficacy of Shenqi Yangxin decoction in the treatment of ischemic cardiomyopathy （ICM） with Qi and Yin deficiency and blood stasis syndrome and its effect on serum hydrogen sulfide （H₂S） and calcium ion （Ca²⁺）. MethodsA total of 64 ICM patients with Qi and Yin deficiency and blood stasis syndrome who met the inclusion criteria were randomly divided into a control group （n=32） and a treatment group （n=32）. All patients received conventional Western medicine treatment. The treatment group was additionally given Shenqi Yangxin decoction. The TCM syndrome score， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， 6-minute walk test （6MWT）， New York Heart Association （NYHA） cardiac function classification， and serum H₂S and Ca²⁺ levels were compared between the two groups pre- and post-treatment. ResultsTwo cases dropped out from each group during the study. Finally， 30 patients in each group were included in the analysis. There were no significant differences in age， gender， course of coronary heart disease， underlying diseases， and laboratory tests between the two groups. Compared with baseline， the TCM syndrome score， MLHFQ score， and NT-proBNP in both treatment group and control group decreased significantly （P<0.01）， LVEF， 6MWT， and H₂S increased significantly （P<0.01）， and serum Ca²⁺ increased （P<0.05）. Compared with the control group after treatment， the MLHFQ score and NT-proBNP in the treatment group decreased （P<0.05）， the TCM syndrome score decreased significantly （P<0.01）， LVEF， 6MWT， and serum Ca²⁺ increased （P<0.05）， and H₂S increased significantly （P<0.01）. The improvement degree of the NYHA cardiac function classification in the treatment group was higher than that in the control group， but there was no significant difference. ConclusionShenqi Yangxin decoction is effective in treating ICM patients with Qi and Yin deficiency and blood stasis， which could significantly improve cardiac function and quality of life， and its therapeutic effect may be related to the regulation of serum H₂S and Ca²⁺ levels.

Evaluating the absorption of traditional Chinese medicine (TCM) formulations in skin has long been a challenge in cutaneous pharmacokinetic studies of TCM. In recent years, various new techniques, including diffusion cell, microphysiological system, matrix-assisted laser desorption/ionization mass spectrometry imaging, tape stripping, microdialysis/open-flow microperfusion, and confocal Raman microscopy technology, have been developed to characterize and predict the pharmacokinetic profiles of these formulations more accurately. This review systematically summarizes the application progress of these methods in the evaluation of cutaneous pharmacokinetics of TCM, highlights their technical features and suitable scenarios, and discusses future development trends, providing new research perspectives for further understanding the dynamic changes, spatial distribution characteristics of active ingredients in the skin, and the rationality of compatibility in topical preparations.

AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To determine the pathogenicity of a novel mutation(c.109_111del)in DKC1 gene of an adult patient,and to analyze the clinical phenotype,immunophenotype and telomere length,so as to provide clues for early clinical identification and diagnosis.Methods The clinical data and peripheral blood samples of the patient were collected for genetic testing and family analysis.The lymphocyte subsets of the patient were detected by Flow cytometry,and the telomere length of the patient and healthy controls were detected by Flow-FISH.Results The main clinical manifestations of the patient were mucocutaneous triad,bone marrow failure and infection.The telomere length of lymphocytes in the patient was significantly shorter than that of healthy controls of the same age,and the absolute value and percentage of lymphocyte subsets were abnormal.Conclusion The clinical manifestations of DC patients are diverse.Flow-FISH detection of telomere length is helpful for early diagnosis of DC patients.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To illustrate the clinical modeling and commissioning results of Monte Carlo dose calculation algorithm in RayStation treatment planning system (TPS) for a domestically developed synchrotron-based spot scanning proton therapy system (SAPT-PS-01).Methods:The proton pencil beam model in RayStation required integral depth dose curves, spot profiles and absolute dose as the input beam data. It was not necessary to collect beam parameters with range shifter. The integral depth dose curves of a single spot were measured by an 8 cm parallel ion chamber. A 2-dimensional scintillation detector was used to measure the in-air spot profile at 5 different depths including the isocenter plane. The absolute dose was calibrated by a 0.25 cm parallel ion chamber under the single energy layer irradiation with a field size of 10 cm × 10 cm. After modeling, the results of the beam model and the Monte Carlo dose calculation algorithm were validated from the range, spot profile, point-dose in a spread-out Bragg peak, planar dose in a clinical plan, point dose in an end-to-end test.Results:For the 94 energy layers, the maximum deviation between the calculated and measured range was 0.03 cm. The maximum difference between the calculated and measured in-air spot sigma was 0.015 cm, and the deviation of in-water spot sigma was measured within ±15%. Compared with the measured values, the calculated dose deviation of 138 measured points in the spread-out Bragg peak was within 3%. For the planar dose verification of clinical plans, the TPS-calculated dose distribution of 285 planes agreed well with the measurement with a minimum gamma-passing rate of 90%, and the gamma passing rate of almost 95% of planes were greater than 95%. The point dose measurements for 8 beams in the end-to-end tests under 4 clinical scenarios were within 5%.Conclusions:The acceptable beam model validation results and successful end-to-end test confirm that the Monte Carlo dose calculation algorithm modeling for the synchrotron-based spot scanning proton therapy system is accurate, which is applicable for the design of patient treatment plan.

Objectives:To explore the progress in the application of cardiovascular related innovative patent technologies between China and the United States from 2014 to 2023,and to further analyze the differences in driving forces and policy orientations in the transformation of scientific and technological achievements between the two countries,providing reference data for improving the efficiency of the transformation of cardiovascular scientific and technological achievements in China.Methods:Based on the Himmpat patent database,we searched invention patent application data in the cardiovascular fields by using the Fuwai Subject Headings and adopting the method of the international patent classification(IPC)-title-claims-abstract,from January 1,2014 to December 31,2023(excluding utility model and design patents).Fourteen indicators regarding patent value evaluation were selected as independent variables and the transfer and transformation rate of invention patent family as the dependent variable.Then we construct univariate and multivariate prediction models by utilizing logistic regression to compare and analyze the differences in various predictors for the transformation rate of patent family in the cardiovascular field between the two countries,and calculate the respective population attributable fraction(PAF)for each predictor.Results:Over the past 10 years,there have been 45 413 invention patent family in the cardiovascular field in China,which exceeded the 35 582 invention patent family in the United States.The transformation rate of cardiovascular invention patent family in the United States was 49.77%,while in China it was only 9.18%.In the United States,the transformation rate of invention patent family's applicants involving medical institutions is significantly higher than that of universities,research institutions,and enterprises,with transformation rates of 63.75%,56.74%,50.00%,and 49.76%,respectively.In contrast,in China,the transformation rate of invention patent family in the cardiovascular field is 6.87%in medical institutions and 7.90%in universities,slightly higher in research institutions(10.99%),while the highest rate is in enterprises(15.83%).Moreover,the transformation rates of biomedical invention patent family is higher than that of medical devices in China(9.45%vs.7.81%),while the opposite is true in the United States(42.39%vs.59.03%).The results of PAF based on full multivariate logistic regression,the top three predictors for the transfer and transformation of invention patent family in China are applicants including enterprises(PAF=71.17%),overseas distribution country number more than one(PAF=30.76%),and invention authorized(PAF=29.95%).In the United States,citation frequency exceeding 10 times(PAF=46.92%),overseas distribution country number more than one(PAF=32.56%),and applicants including enterprises(PAF=20.54%)are the top three predictors for the transfer and transformation of invention patent family.Conclusions:Since the implementation of the 13th Five-Year Plan,the number of patent family applications for cardiovascular related inventions in China has surpassed that of the United States.However,the transfer and transformation efficiency of cardiovascular invention patents in China is significantly lower than that of the United States.In depth analysis of the reasons,this study finds it mainly lies in China's insufficient research and development potential for high-value patents,weak awareness of overseas market layout,insufficient motivation for universities and medical institutions to transfer and transform invention patents,and the underutilization of the transformation potential of medical device invention patents as well.

Objective To explore the therapeutic effect of extracorporeal shock wave combined with resistance training in elderly patients with primary sarcopenia.Methods A total of 90 elderly patients with primary sarcopenia were selected as research objects.All patients were numbered according to their admission numbers,corresponding to the numbers on the random number table one by one.Those with the corresponding numbers of even number at the end of the random number were assigned to control group(n=45,receiving resistance training),while the remaining were assigned to observation group(n=45,receiving extracorporeal shock wave besides the same treatment as control group).The changes of parameters measured by ultrasonic instruments in the two groups were analyzed.Results After 3 months of treatment,compared with control group,observation group had thicker muscle thickness,larger pennate angle,longer muscle bundle,larger Young's modulus in relaxation state and contraction state,and higher ASMI value(all P<0.05).In the observation group,ASMI value was positively correlated with muscle thickness,pennate angle,muscle bundle length and Young's modulus(relaxation state,contraction state)(r=0.361,0.339,0.378,0.353,0.398,respectively;P=0.015,0.023,0.010,0.017,0.007,respectively).Conclusion The combined treatment of extracorporeal shock wave and resistance training is feasible,and the imaging indicators of ultrasonic detection can be used as feasible indicators to assess the recovery of patients with sarcopenia.