As a patented characteristic medicine of Yi ethnic minority， Pingxuan capsules have the effects of nourishing the liver and kidney， pacifying the liver， and subduing Yang. With the main indications of dizziness， headache， palpitations， tinnitus， insomnia， dreaminess， waist and knee soreness caused by liver-kidney deficiency and liver Yang upward disturbance， Pingxuan capsules are widely used in the treatment of posterior circulation ischemic vertigo， vestibular migraine， benign paroxysmal positional vertigo. However， the current knowledge is limited regarding the efficacy， syndrome differentiation， and safety of this medicine. On the basis of summarizing the experience of clinicians and the existing evidence， this study invites clinical experts of traditional Chinese and Western medicine， pharmaceutical experts， and methodological experts from relevant fields across China to conduct evidence-based evaluation of Pingxuan capsules. The evaluation follows the Specifications for the Development of Clinical Expert Consensus on Chinese Patent Medicines issued by the Standardization Office of the China Association of Chinese Medicine， and reaches 5 recommendations and 16 consensus suggestions. The consensus clarifies the clinical applications， efficacy， dose， course of treatment， combination of medicines， precautions， and contraindications of Pingxuan capsules in the treatment of vertigo and explains the safety of clinical application. This consensus is applicable to clinicians （traditional Chinese medicine， Western medicine， and integrated traditional Chinese and Western medicine） and pharmacists in tertiary hospitals， secondary hospitals， and community-level medical and health institutions across China， providing a reference for the rational use of Pingxuan capsules in the treatment of vertigo. It is hoped that the promotion of this consensus can facilitate the rational use of drugs in clinical practice， reduce the risk of drug use， and give full play to the advantages of Pingxuan capsules in the treatment of vertigo diseases. This consensus has been reviewed and published by the China Association of Chinese Medicine， with the number GS/CACM330-2023.

Multiple myeloma(MM)is a malignancy characterized by the abnormal proliferation of clonal plasma cells.It is often associated with coagulation abnormalities,posing risks of thrombosis,thromboembolism,and bleeding,including severe cases,which are related to de-creased quality of life,delayed or discontinued treatment,and reduced survival.Disease,individual-specific factors,and therapeutic agents affect the dynamic balance of coagulation,anticoagulation,and fibrinolytic systems in patients with MM.The diagnosis and treatment of un-derlying coagulation disorders are challenging due to the involvement of multiple mechanisms.In addition,newly introduced therapies such as immunomodulatory drugs,proteasome inhibitors,chimeric antigen receptor-modified T-cell therapy,and monoclonal antibodies also im-pact coagulation in patients with MM.This review discusses the influencing factors,pathophysiological mechanisms,and prevention and treatment strategies for coagulation abnormalities in MM.

Objective:To establish the predictive model for major adverse cardiovascular events(MACE) following endovascular repair in elderly patients with abdominal aortic aneurysm(AAA).Methods:The clinical data and postoperative MACE were retrospectively collected from elderly patients with AAA who underwent their first endovascular aneurysm repair(EVAR)in Beijing Hospital and Tibet Autonomous Region People's Hospital between January 2016 and December 2023.Patients were randomly divided into training and validation cohorts at a ratio of 7∶3.Predictive models were using logistic regression, LASSO regression, random forest, linear discriminant analysis, na?ve Bayes, k-nearest neighbor algorithm, support vector machine, decision tree, and AdaBoost.Models were evaluated using receiver operating characteristic(ROC)curves.Results:A total of 171 elderly AAA patients were enrolled, aged 60 to 94 years(mean 73.0 ± 7.5 years), of whom 145 were male.MACE occurred after EVAR in 30 patients(17.5%). LASSO regression identified monocyte count, history of coronary artery disease, the ratio of maximum AAA diameter to body mass index(DBR), neutrophil-lymphocyte count ratio(NLR), and age as significant predictors, yielding an area under the ROC curve(AUC)of 0.816.Logistic regression achieved an AUC of 0.813 in the training cohort and 0.772 in the validation cohort.Among all models, AdaBoost demonstrated the best performance, with an AUC of 0.92 in the validation cohort.Conclusions:Age, monocyte count, DBR, NLR and creatinine could predict the occurrence of MACE after EVAR in AAA patients.The AdaBoost model provides the most accurate prediction of postoperative MACE.

Objective:To explore the therapeutic effect of anterior chamber puncture combined with laser peripheral iridectomy (LPI) on patients with acute primary angle closure glaucoma (PACG).Methods:A total of 85 patients (85 eyes) with acute PACG treated in the Qingdao Huangdao District Traditional Chinese Medicine Hospital from January 2019 to December 2022 were selected and divided into the study group (43 cases, treated with anterior chamber puncture combined with LPI) and the control group (42 cases, treated with drug antihypertensive combined with LPI) by random number table method. The best corrected visual acuity, intraocular pressure, corneal edema grade, central anterior chamber depth, angle opening range and postoperative complications were compared between the two groups.Results:Before surgery, there were no statistical differences in the best corrected visual acuity and intraocular pressure between the two groups ( P>0.05), and at 3, 6 and 12 months after surgery, the best corrected visual acuity and intraocular pressure in the two groups were significantly lower than those before surgery, and the study group were lower than those in the control group: (0.41 ± 0.09) logMAR vs. (0.47 ± 0.10) logMAR, (0.26 ± 0.05) logMAR vs. (0.31 ± 0.06) logMAR, (0.30 ± 0.07) logMAR vs. (0.34 ± 0.08) logMAR; (14.3 ± 3.6) mmHg(1 mmHg = 0.133 kPa) vs. (16.5 ± 3.2) mmHg, (15.0 ± 3.9) mmHg vs. (17.6 ± 3.6) mmHg, (17.4 ± 3.5) mmHg vs. (20.0 ± 3.8) mmHg, there were statistical differences ( P<0.05). Before surgery, there were no statistical differences between the two groups in central anterior chamber depth and angle opening range ( P>0.05), and at 3, 6 and 12 months after surgery, the central anterior chamber depth and angle opening range were higher in the both groups and the study group were higher than those in the control group: (2.94 ± 0.46) mm vs. (2.72 ± 0.45) mm, (3.01 ± 0.50) mm vs. (2.89 ± 0.48) mm, (2.93 ± 0.44)mm vs. (2.81 ± 0.47) mm; (244.0 ± 26.0)° vs. (236.1 ± 29.5)°, (256.5 ± 27.4)° vs. (248.3 ± 30.3)°, (250.7 ± 29.0)° vs. (241.5 ± 25.4)°, there were statistical differences ( P<0.05). There was no significant difference in preoperative corneal edema grade between the two groups ( P>0.05), and the corneal edema grade in the study group was lower than that in the control group at 3 d after operation, there was statistical difference ( P<0.05). The complication rate was 4.65%(2/43) in the study group and 14.29% (6/42) in the control group, there was no statistical difference ( χ2 = 2.31, P>0.05). Conclusions:The combination of anterior chamber puncture and LPI surgery is beneficial for controlling intraocular pressure, improving vision, and restoring anterior chamber depth in PACG patients, and its clinical efficacy is certain.

Multiple myeloma(MM)is a malignancy characterized by the abnormal proliferation of clonal plasma cells.It is often associated with coagulation abnormalities,posing risks of thrombosis,thromboembolism,and bleeding,including severe cases,which are related to de-creased quality of life,delayed or discontinued treatment,and reduced survival.Disease,individual-specific factors,and therapeutic agents affect the dynamic balance of coagulation,anticoagulation,and fibrinolytic systems in patients with MM.The diagnosis and treatment of un-derlying coagulation disorders are challenging due to the involvement of multiple mechanisms.In addition,newly introduced therapies such as immunomodulatory drugs,proteasome inhibitors,chimeric antigen receptor-modified T-cell therapy,and monoclonal antibodies also im-pact coagulation in patients with MM.This review discusses the influencing factors,pathophysiological mechanisms,and prevention and treatment strategies for coagulation abnormalities in MM.

Purpose To evaluate the value of tumors invasion in the central airway(TICA)in predicting the severe immune checkpoint inhibitor-related pneumonitis(S-CIP)in lung cancer patients using propensity score matching(PSM).Materials and Methods The intact data of 162 consecutive lung cancer patients who received treatment with immune checkpoint inhibitors in Xi'an International Medical Center Hospital from September 2019 to March 2022 were retrospectively collected.Patients were divided into S-CIP group(23 cases)and non-S-CIP group(139 cases)according to the presence of S-CIP.The demographic information of the patients,including gender,age,history of smoking,thoracic radiotherapy histology,baseline lung diseases,classification,TNM stage,tumor location as well as TICA were collected.A binary Logistic regression was used to analyze the confounding factors and independent risk factors of S-CIP and to predict the development of S-CIP.A 1:1 matching was performed by the nearest neighbor method for PSM.The PSM was used to pair the two groups,and the value of TICA in predicting S-CIP before and after PSM was compared.The receiver operating characteristic curve and the area under the curve were used for model performance based on TICA.Results Before PSM,the proportion of baseline lung diseases(78.3%vs.32.4%,OR=6.802,P=0.001),thoracic radiotherapy history(69.6%vs.30.2%,OR=5.300,P=0.002)and TICA(65.2%vs.27.3%,OR=5.882,P=0.001)in the S-CIP group was higher than those in the non-S-CIP group,and were independent risk factor for predicting S-CIP.After PSM,20 patients were included in each group.The presence of TICA was higher in S-CIP group than that in the non-S-CIP group(60.0%vs.20.0%,OR=6.000,P=0.013).The area under the curves of Logistic regression model based on TICA was 0.700(95%CI 0.534-0.866).Conclusion TICA is an independent risk factor for development of S-CIP,which has moderate degree of accuracy in predicting S-CIP,can be used for risk prediction and early intervention to reduce the poor prognosis of S-CIP patients.

Purpose To evaluate the value of tumors invasion in the central airway(TICA)in predicting the severe immune checkpoint inhibitor-related pneumonitis(S-CIP)in lung cancer patients using propensity score matching(PSM).Materials and Methods The intact data of 162 consecutive lung cancer patients who received treatment with immune checkpoint inhibitors in Xi'an International Medical Center Hospital from September 2019 to March 2022 were retrospectively collected.Patients were divided into S-CIP group(23 cases)and non-S-CIP group(139 cases)according to the presence of S-CIP.The demographic information of the patients,including gender,age,history of smoking,thoracic radiotherapy histology,baseline lung diseases,classification,TNM stage,tumor location as well as TICA were collected.A binary Logistic regression was used to analyze the confounding factors and independent risk factors of S-CIP and to predict the development of S-CIP.A 1:1 matching was performed by the nearest neighbor method for PSM.The PSM was used to pair the two groups,and the value of TICA in predicting S-CIP before and after PSM was compared.The receiver operating characteristic curve and the area under the curve were used for model performance based on TICA.Results Before PSM,the proportion of baseline lung diseases(78.3%vs.32.4%,OR=6.802,P=0.001),thoracic radiotherapy history(69.6%vs.30.2%,OR=5.300,P=0.002)and TICA(65.2%vs.27.3%,OR=5.882,P=0.001)in the S-CIP group was higher than those in the non-S-CIP group,and were independent risk factor for predicting S-CIP.After PSM,20 patients were included in each group.The presence of TICA was higher in S-CIP group than that in the non-S-CIP group(60.0%vs.20.0%,OR=6.000,P=0.013).The area under the curves of Logistic regression model based on TICA was 0.700(95%CI 0.534-0.866).Conclusion TICA is an independent risk factor for development of S-CIP,which has moderate degree of accuracy in predicting S-CIP,can be used for risk prediction and early intervention to reduce the poor prognosis of S-CIP patients.

Objective:To explore the therapeutic effect of anterior chamber puncture combined with laser peripheral iridectomy (LPI) on patients with acute primary angle closure glaucoma (PACG).Methods:A total of 85 patients (85 eyes) with acute PACG treated in the Qingdao Huangdao District Traditional Chinese Medicine Hospital from January 2019 to December 2022 were selected and divided into the study group (43 cases, treated with anterior chamber puncture combined with LPI) and the control group (42 cases, treated with drug antihypertensive combined with LPI) by random number table method. The best corrected visual acuity, intraocular pressure, corneal edema grade, central anterior chamber depth, angle opening range and postoperative complications were compared between the two groups.Results:Before surgery, there were no statistical differences in the best corrected visual acuity and intraocular pressure between the two groups ( P>0.05), and at 3, 6 and 12 months after surgery, the best corrected visual acuity and intraocular pressure in the two groups were significantly lower than those before surgery, and the study group were lower than those in the control group: (0.41 ± 0.09) logMAR vs. (0.47 ± 0.10) logMAR, (0.26 ± 0.05) logMAR vs. (0.31 ± 0.06) logMAR, (0.30 ± 0.07) logMAR vs. (0.34 ± 0.08) logMAR; (14.3 ± 3.6) mmHg(1 mmHg = 0.133 kPa) vs. (16.5 ± 3.2) mmHg, (15.0 ± 3.9) mmHg vs. (17.6 ± 3.6) mmHg, (17.4 ± 3.5) mmHg vs. (20.0 ± 3.8) mmHg, there were statistical differences ( P<0.05). Before surgery, there were no statistical differences between the two groups in central anterior chamber depth and angle opening range ( P>0.05), and at 3, 6 and 12 months after surgery, the central anterior chamber depth and angle opening range were higher in the both groups and the study group were higher than those in the control group: (2.94 ± 0.46) mm vs. (2.72 ± 0.45) mm, (3.01 ± 0.50) mm vs. (2.89 ± 0.48) mm, (2.93 ± 0.44)mm vs. (2.81 ± 0.47) mm; (244.0 ± 26.0)° vs. (236.1 ± 29.5)°, (256.5 ± 27.4)° vs. (248.3 ± 30.3)°, (250.7 ± 29.0)° vs. (241.5 ± 25.4)°, there were statistical differences ( P<0.05). There was no significant difference in preoperative corneal edema grade between the two groups ( P>0.05), and the corneal edema grade in the study group was lower than that in the control group at 3 d after operation, there was statistical difference ( P<0.05). The complication rate was 4.65%(2/43) in the study group and 14.29% (6/42) in the control group, there was no statistical difference ( χ2 = 2.31, P>0.05). Conclusions:The combination of anterior chamber puncture and LPI surgery is beneficial for controlling intraocular pressure, improving vision, and restoring anterior chamber depth in PACG patients, and its clinical efficacy is certain.

Objective:To establish the predictive model for major adverse cardiovascular events(MACE) following endovascular repair in elderly patients with abdominal aortic aneurysm(AAA).Methods:The clinical data and postoperative MACE were retrospectively collected from elderly patients with AAA who underwent their first endovascular aneurysm repair(EVAR)in Beijing Hospital and Tibet Autonomous Region People's Hospital between January 2016 and December 2023.Patients were randomly divided into training and validation cohorts at a ratio of 7∶3.Predictive models were using logistic regression, LASSO regression, random forest, linear discriminant analysis, na?ve Bayes, k-nearest neighbor algorithm, support vector machine, decision tree, and AdaBoost.Models were evaluated using receiver operating characteristic(ROC)curves.Results:A total of 171 elderly AAA patients were enrolled, aged 60 to 94 years(mean 73.0 ± 7.5 years), of whom 145 were male.MACE occurred after EVAR in 30 patients(17.5%). LASSO regression identified monocyte count, history of coronary artery disease, the ratio of maximum AAA diameter to body mass index(DBR), neutrophil-lymphocyte count ratio(NLR), and age as significant predictors, yielding an area under the ROC curve(AUC)of 0.816.Logistic regression achieved an AUC of 0.813 in the training cohort and 0.772 in the validation cohort.Among all models, AdaBoost demonstrated the best performance, with an AUC of 0.92 in the validation cohort.Conclusions:Age, monocyte count, DBR, NLR and creatinine could predict the occurrence of MACE after EVAR in AAA patients.The AdaBoost model provides the most accurate prediction of postoperative MACE.

Objective:To analyse the clinical application value of Lone-Star perineal exposure technique in performing abdominal perineal resection (APR).Methods:Conducted a retrospective review of 17 rectal cancer patients, including 13 males, 4 females, aged from 44 to 82 years old, with the average age of (67.6±9.7) years who underwent APR at Anqing Municipal Hospital from January 2020 to July 2024. The Lone-Star retractor-assisted (LSR) exposure method was employed for the perineal operation. After incising the skin and subcutaneous tissue, a Lone-Star retractor was utilized, with eight small hooks used to extend the incision in multiple directions, facilitating the release of deep tissues. The hooks were dynamically adjusted to optimize surgical field exposure.Results:All 17 patients were successfully underwent laparoscopic-assisted APR. Fifteen operations were independently performed by a single surgeon, while 2 required assistance for intraoperative arterial hemostasis. No perforations occurred, and all specimens had a negative circumferential resection margin (CRM). Postoperative complications were observed in 4 patients, including urinary retention in one, pulmonary infection in one, wound seroma in one, and stoma mucosal detachment in one, all of which were classified as Clavien-Dindo grade 3 or lower and cured.Conclusions:The LSR exposure technique may significantly improve perineal exposure during APR for rectal cancer. It could potentially enhance intraoperative safety and efficiency, and facilitate single-operator surgery.