Objective To analyze the changes of liver and kidney function, blood glucose and lipid metabolism at different follow-up time points of different treatment regimens, and to provide reference for clinical optimization and adjustment of medication in HIV/AIDS patients. Methods The changes of liver and kidney function, blood glucose and lipid metabolism at seven follow-up time points were analyzed retrospectively. The baseline blood collection time of HIV /AIDS patients was set as the starting point, and the final follow-up time was set as the end point. The seven follow-up points were 0, 3, 6, 9, 12, 18 and 24 months respectively. Results There were statistically significant differences in the distribution of sex, age, education, marital status, WHO staging, infection route, and baseline CD4+T lymphocyte count among 605 enrolled patients based on different treatment regimens. Liver function: The level of T-Bil in group E was higher than that of baseline at 9M, 12M, 18M and 24M after treatment (P<0.01); In group F, the level of T-Bil was higher than that of baseline at 9M after treatment (P=0.001); The levels of ALT in group C at the six follow-up points after treatment were higher than the baseline (P<0.001); The level of AST in group C was higher than that of baseline after 3M and 6M treatment (P<0.05). Renal function: The level of UREA in group C was higher than that in baseline after 6M treatment (P=0.007); The level of UREA in group F was higher than that in the baseline after 12M treatment (P<0.001); The level of UA in group F was higher than that of baseline after 3M, 6M and 12M treatment (P<0.05). Blood lipid and blood glucose: The levels of Glu at some follow-up points after ART treatment in group A and group C were higher than that at baseline (P<0.05); The levels of TG at some follow-up points in group A, group E and group F after ART treatment were higher than those at baseline (P<0.05); The levels of TC at some follow-up points in group A, group B, group C, group E and group F after ART treatment were all higher than the baseline (P<0.05). Conclusion Regular monitoring of changes in laboratory indicators of different treatment regimens during ART is of great importance to the prognosis of patients. Different laboratory indicators should be monitored according to different treatment regimens to effectively prevent adverse reactions caused by different treatment regimens.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:Bacterial liver abscess is one of the common infectious diseases of the digestive system.Invasive Klebsiella pneumoniae liver abscess syndrome(IKLAS)refers to cases where,in addition to liver abscess,there are migratory infections foci or other invasive manifestations.The clinical characteristics and risk factors of IKLAS are not fully elucidated,and there is a lack of research on the effectiveness and cost-effectiveness of different treatment methods.This study aims to compare the clinical characteristics of patients with IKLAS and non-IKLAS,and explore effective and economical treatment methods. Methods:This retrospective study collected medical records of patients with Klebsiella pneumoniae liver abscess treated at Xiangya Hospital of Central South University from January 2010 to December 2023.A total of 201 patients were included,dividing into an IKLAS group(n=37)and a non-IKLAS group(n=164).Differences in demographics,symptoms and signs,laboratory indicators,imaging characteristics,comorbidities,treatment methods,treatment outcomes,and direct treatment costs between 2 groups were analyzed.The study also compared the effectiveness and costs of different treatment methods. Results:Compared with the non-IKLAS group,the proportion of patients with diabetes,Quick Sequential Organ Failure Assessment(qSOFA)≥2,immune deficiency,anemia,and thrombocytopenia in the IKLAS group was higher,and the level of procalcitonin at the onset in the IKLAS group was also higher(all P<0.05).In terms of symptoms and signs,the IKLAS group had a higher proportion of visual abnormalities and a lower proportion of complaints of abdominal pain(both P<0.05).In terms of complications,the incidence of combined pleural effusion,pulmonary infection,acute renal failure,respiratory failure,and multiple organ failure was higher in the IKLAS group(all P<0.05).The IKLAS group had a higher proportion of patients treated with antibiotics alone(24.32%vs 11.59%),while the non-IKLAS group had a higher proportion of patients treated with antibiotics combined with puncture and drainage(86.59%vs 64.86%,both P<0.05).The overall effective rate of the IKLAS group(83.78%)was lower than that of the non-IKLAS group(95.73%),and the treatment and drug costs were higher(all P<0.05).The treatment method of antibiotics combined with surgical resection of infectious foci showed a 100%improvement rate,antibiotics combined with abscess puncture and drainage had an 84.9%improvement rate,and in antibiotics alone had an 82.1%improvement rate,with statistical differences among the 3 treatment methods(P<0.05).In terms of treatment costs,antibiotics alone were the most expensive(P<0.05). Conclusion:Patients with IKLAS have poorer prognosis and higher direct medical costs.The combination of abscess puncture and drainage or surgery has a higher improvement rate and lower hospitalization costs compared to antibiotics alone,suggesting that surgical intervention may reduce antibiotic costs and save medical expenses.

OBJECTIVE To evaluate the clinical effect of Bushen Yuyin Tiaochong Decoction in the treatment of diminished o-varian reserve(DOR)infertility with kidney-yin deficiency.METHODS 60 DOR infertility patients with kidney-yin deficiency from the gynecology outpatient department of the Second Affiliated Hospital of Jiangxi University of Chinese Medicine from October 2020 to April 2023 were selected and divided into the placebo group and the kidney-tonifying group using the random number table method,with 30 cases in each group.Patients in both groups were given oral treatment with dehydroepiandrosterone(DHEA).The placebo group was additionally given placebo.The Bushen Yuyin group was additionally given Bushen Yuyin Tiaochong Decoction.The treat-ment course for both groups was 3 months.Changes in TCM syndrome scores and reproductive life quality scores were observed before and after treatment.Changes in serum follicle-stimulating hormone(FSH),anti-Mullerian hormone(AMH)and estradiol(E2)levels in patients were detected by ELISA.The occurrence of adverse reactions during treatment was observed,and the pregnancy rates of the two groups of patients after treatment were recorded.RESULTS After treatment,the total TCM syndrome scores of patients in the Bushen Yuyin group were significantly reduced(P<0.01),which was better than that of the placebo group(P<0.01);the reproduc-tive life quality scores of patients in both groups were significantly increased(P<0.05,P<0.01),the Bushen Yuyin group was better than the placebo group(P<0.05);the number of AFC in the Bushen Yuyin group was significantly increased(P<0.01),which was better than the control group(P<0.01);the serum AMH levels of patients in both groups were significantly increased(P<0.05,P<0.01),and the Bushen Yuyin group was higher than that of the placebo group(P<0.01);the serum E2 level of patients in both groups was significantly decreased(P<0.05,P<0.01),the Bushen Yuyin group was lower than the placebo group(P<0.01);the serum FSH level of patients in Bushen Yuyin group was significantly decreased(P<0.01),which was better than that of the placebo group(P<0.01);the total pregnancy rate of the Bushen Yuyin group was better than that of the placebo group(P<0.05);no significant ad-verse reactions were observed in both groups during the treatment period.CONCLUSION Bushen Yuyin Tiaochong Decoction can significantly improve the pregnancy rate of DOR infertile patients,enhance ovarian function while reducing TCM syndrome scores,im-prove the quality of reproductive life,and is highly safe.

Objective To investigate the impact of naringenin(Nar)on insulin resistance(IR)in HepG2 cells and evaluate the role of mircoRNA-29b(miR-29b)expression in mediating this effect,thereby providing a foundation for further exploration into the mechanisms underlying naringenin's potential as a preventative and therapeutic agent for diabetes.Methods Insulin resistant HepG2(IR-HepG2)was established by stimulating HepG2 cells with 100 nmol/L insulin.Nar was treated with different concentrations(0,25,50,100 μg/ml)in IR-HepG2 cells.The effect of Nar on glucose consumption in IR-HepG2 cells was determined with glucose kit.miR-29b mimic and inhib-itor were transfected into IR-HepG2 cells of the 50 μg/ml Nar intervention group,and the expressions of insulin re-ceptor substrate-1(IRS-1),protein kinase B(Akt)/phosphorylated Akt(p-Akt),glucose transporter-4(GLUT4)genes and proteins in the insulin signaling pathway were detected by Real-time fluorescence quantitative reverse transcription polymerase chain reaction(RT-qPCR)and Western blot,respectively.Results Compared with IR-HepG2 model group,glucose consumption was increased in Nar intervention group with different concentrations(P＜0.01),among which 50 μg/ml Nar intervention group was the most significant(P＜0.001),and mRNA ex-pressions of IRS-1 and Akt were increased in Nar intervention group with different concentrations(P＜0.05),the mRNA expression of IRS-1 and Akt in 50 μg/ml Nar intervention group was the most significantly increased(P＜0.001),and GLUT4 mRNA expression in 50 μg/ml Nar intervention group was increased(P＜0.05).The pro-tein expressions of IRS-1 and p-Akt were increased in different Nar concentration groups(P＜0.001).Compared with IR-HepG2 model group,mRNA expression of IRS-1,Akt and GLUT4 and protein expression of IRS-1 and p-Akt were decreased in miR-29b mimic transfected cells(P＜0.001),mRNA expression of IRS-1,Akt and GLUT4 and protein expression of IRS-1 and p-Akt were not different in miR-29b inhibitor transfection group,Nar interven-tion model group and Nar intervention transfected miR-29b mimic group increased the mRNA expression of IRS-1,Akt and GLUT4(P＜0.001),and the protein expression of IRS-1 and p-Akt increased(P＜0.05).Compared with Nar intervention model group,Nar transfected miR-29b mimic with Nar intervention did not change the mRNA expressions of IRS-1,Akt and GLUT4,while the protein expressions of IRS-1 and p-Akt were increased(P＜0.05),Nar interfered with mRNA expression of IRS-1,Akt and GLUT4 and protein expression of IRS-1 and p-Akt in miR-29b inhibitor group(P＜0.001).Conclusion Nar can increase glucose consumption in IR-HepG2 cells,increase the expression of IRS-1,Akt and GLUT4 genes,and increase the expression of IRS-1 and p-Akt proteins in IR-HepG2 cells.Nar increases the expression of IRS-1 and p-Akt in IR-HepG2 cells by inhibiting the overexpres-sion of miR-29b,and improves insulin resistance in HepG2 cells.Nar,as a plant compound,is expected to be a potential drug for the prevention and treatment of diabetes.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To improve the understanding of primary pulmonary lymphoepithelioma-like carcinoma (PPLELC).Methods:A retrospective case series study was conducted. The clinical data of 31 patients with PPLELC who were admitted to the First Affiliated Hospital of Guangxi Medical University from January 2012 to June 2023 were retrospectively analyzed, and their clinical features were summarized. The correlations of organ metastasis, tumor stage, serum tumor markers, lactate dehydrogenase, and albumin with survival time were analyzed.Results:Among the 31 patients, 13 (41.9%) were male and 18 (58.1%) were female, aged (50±9) years old, with no smoking history in 24 cases (77.4%). The common clinical manifestations were cough(24 cases, 77.4%) and sputum (19 cases, 61.3%), and 7 patients (22.6%) were detected by physical examination; 24 cases (77.4%) had elevated levels of serum tumor markers, and the rest of the 7 cases (22.6%) had normal levels of various tumor markers. All of the patients had a single lesion, with a predominance of the right middle lung (8 cases, 25.8%), and 23 cases (74.2%) had lymph node metastasis. Immunohistochemical detection showed that the positive rate of CK was 67.7% (21/31), and the positive rates of squamous cell carcinoma markers CK5/6, p63 and p40 were 90.3% (28/31), 80.6% (25/31) and 77.4% (24/31), respectively. The positive rate of EBER in situ hybridization detection was 85.2% (23/27). Genetic testing showed 6 cases had epidermal growth factor receptor (EGFR) mutation. The median survival time [ M ( Q1, Q3)] of the groups without lymph node metastasis and with lymph node metastasis was 33.0 months (7.3 months, 9.3 months) and 19.0 months (7.0 months, 27.0 months), and the difference was statistically significant ( P < 0.001). The median survival time of patients with stage Ⅰ-Ⅱ and with stage Ⅲ-Ⅳ was 20.0 months (12.5 months, 42.0 months) and 18.5 months (6.5 months, 38.5 months), and the difference was statistically significant ( P = 0.002). One stage Ⅰ A patient was treated with surgery alone and survived at 92 months of follow-up. Ten cases were treated with immunotherapy and had a good outcome. Conclusions:PPLELC is prevalent in non-smokers, the lesions are mostly in the right middle lung, and it is easily misdiagnosed as squamous cell carcinoma. The positive EBER in situ hybridization detection can help the diagnosis; lymph node metastasis is common. Tumor stage, lymph node metastasis and CYFRA21-1 level may be correlated with the survival of patients. The patients can benefit from immunotherapy, and anti-angiogenic therapy combined with chemotherapy is an optional treatment regimen.

【Objective】 To establish an enzyme-linked immunosorbent assay (ELISA) method for the determination of residual human coagulation factor Ⅺ in human prothrombin complex and validate the method. 【Methods】 Human factor Ⅺ was reacted with the capture antibody coated on the microtiter plate. After appropriate washing steps, biotinylated primary antibody was bound to the captured protein. Excess primary antibody was washed away and bound antibody was reacted with horseradish peroxidase conjugated streptavidin. TMB substrate was used for color development at 450 nm. The dilution reliability, accuracy, specificity, repeatability, intermediate precision, linearity, range and durability were verified. 【Results】 The verification results showed that the accuracy and specificity of this method met the experimental requirements, with an average recovery rate of 109.2% and RSD of 6.93%. The repeatability RSD was 6.78%, and the intermediate precision RSD was 6.75%, indicating good precision. The linear regression correlation coefficient of standard curve was 0.999 9, showing good accuracy and precision within the linear range. The durability was verified by the incubation time and the validity period of reagent kit opening. The results showed that the RSD of the incubation time change was 6.62%, indicating that the incubation time of this detection method was controlled between 28 to 32 minutes, and there was no significant impact on the results. The RSD of the detection results before and after the reagent kit was opened and stored under conditions for 7 days was 3.84%, indicating that the preservation of the reagent kit according to the conditions for 7 days after opening has no effect on the FⅪ detection results. Both indicated that the method had good durability. The dilution reliability results showed that there was a "hook" effect in the detection of FⅪ residue in human prothrombin complex, which could be solved by diluting 100 to 200 times. 【Conclusion】 This method can be used for the determination of FⅪ residues of human prothrombin complex in laboratory.

The healthy development of science and technology (Sci. & Tech) innovation is inseparable from Sci. & Tech ethics. The innovation subject is the driving force of Sci. & Tech innovation. The improvement of Sci. & Tech ethical management ability is conducive to improving the China’s Sci. & Tech ethics governance system. Therefore, this paper deeply analyzed the current status of Sci. & Tech ethics management of the 76 innovation subjects from five aspects, and found that the construction of Sci. & Tech ethics management of Chinese innovation subjects has achieved initial results, but there was still room for further improvement. Based on the problems existing in the Sci. & Tech ethics management of innovation subjects, this paper proposed six strategic suggestions that strengthening the construction and research of artificial intelligence ethics management systems, establishing and improving ethics committees and management systems, actively implementing the registration of Sci. & Tech ethics management information, regularly organizing and participating in various forms of Sci. & Tech ethics training, attaching importance to the reserve and cultivation of composite Sci. & Tech ethics management talents, and cooperating to establish a Sci. & Tech ethics case library, with a view to enhancing the Sci. & Tech ethics management ability of Chinese innovation subjects to adapt to the needs of the healthy development of Sci. & Tech in China.

Cerebrovascular diseases and cardiovascular diseases are among the top causes of death worldwide. In recent years, the concept of "brain-heart co-treatment" has gradually gained popularity. Cerebrovascular and cardiovascular diseases have similar pathological foundations, pathogenesis, comorbidities, and treatment methods. However, there is currently limited research on whether the two have a chronological order of the first onset and which is the index event of the other. However, elucidating the above issues is of great significance for the secondary prevention of cardiocerebrovascular diseases. This article reviews the correlation of onset time and influencing factors for ischemic stroke and myocardial infarction.