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.

As a pivotal strategy to alleviate the shortage of organ donors, xenotransplantation has achieved remarkable advances in both pre-clinical and clinical studies in recent years, driven by continuous optimization of gene modification techniques and immunosuppressive regimens. Nevertheless, clinical translation still confronts formidable challenges, including rejection and heightened infection risks, which severely compromise long-term graft survival. Consequently, the role of immunosuppressive regimens in xenotransplantation has become increasingly prominent. This article summarizes the mechanisms underlying xenogeneic immune rejection, the latest developments in immunosuppressive regimens, cutting-edge strategies for inducing immune tolerance and the major hurdles facing clinical xenotransplantation. It delves into potential optimization strategies and directions for future clinical research, aiming to offer theoretical insights and practical guidance for the safe and effective application of clinical xenotransplantation.

OBJECTIVE To conduct a clinical comprehensive evaluation of five marketed thrombopoietin receptor agonists （TPO-RA） approved in China， providing quantitative evidence for drug selection and therapeutic decision-making in medical institutions. METHODS Relevant data on Romiplostim for injection， Eltrombopag olamine tablets， Herombopag olamine tablets， Avatrombopag maleate tablets， and Lusutrombopag tablets were collected. Based on the Chinese Rapid Guide for Drug Evaluation and Selection in Medical Institutions （Second Edition）， 12 formulations of these five TPO-RA were scored quantitatively and comparatively across five dimensions： pharmacological characteristics， efficacy， safety， cost-effectiveness， and other attributes. RESULTS The comprehensive scores of the 12 formulations ranged from 62.56 to 75.50 points， with most scoring ≥70 points. Using the highest-scoring formulation for each generic name as a representative， the overall rankings of the five TPO-RA were as follows： Lusutrombopag tablets （75.50 points）， Eltrombopag olamine tablets （75.10 points）， Avatrombopag maleate tablets （70.40 points）， Romiplostim for injection （63.93 points）， and Herombopag olamine tablets （63.52 points）. Lusutrombopag tablets scored relatively high in pharmacological characteristics， safety， and cost-effectiveness， while Eltrombopag olamine tablets performed well in efficacy and cost-effectiveness. The other formulations showed varying scores across evaluation dimensions. CONCLUSIONS The five TPO-RA demonstrate favorable overall clinical value， with Lusutrombopag tablets and Eltrombopag olamine tablets ranking higher in comprehensive scores， these two drugs should be prioritized in drug selection and formula optimization by medical institutions.

Objective To analyze the influenza-like illness (ILI) data in Ordos City from 2017 to 2023 and conduct nucleic acid detection of the virus to understand the local influenza epidemic situation, and to provide a reliable basis for influenza prevention and control in the city. Methods Real-time quantitative polymerase chain reaction (qPCR) was used to identify virus subtypes in ILI throat swab samples. Comparisons of positive rates were conducted using the chi-square test, with a significance level of α=0.05. Results From 2017 to 2023, a total of 3,283,434 outpatient and emergency visits were recorded at the Ordos City Central Hospital, including 74,159 ILI cases, with an ILI proportion of 2.26%. The majority of ILI cases (74.43%) occurred in children aged 0~14 years old. The overall positive rate of influenza virus nucleic acid detection was 10.87%, with the highest proportion being subtype A (seasonal H3) at 43.03%. The highest detection rate was observed in the 5~14 years age group, with statistically significant differences in positive rates across age groups (χ²=155.638, P<0.001). Influenza peaks occurred mainly from November to March of the following year. From January to April, three types of influenza were prevalent alternately or mixed, while from October to December, subtype A (seasonal H3) predominated. Positive rates varied significantly across months (χ²=250.923, P<0.001). The temporal trends of ILI proportions and PCR-positive rates were consistent. Conclusion Influenza in Ordos City exhibits distinct seasonal and age distribution characteristics, with alternating or mixed circulation of three virus types. Continued efforts are needed to strengthen influenza surveillance, especially the prevention and control of influenza in infants and adolescents.

BackgroundResident physicians represent a high-risk group for sleep disorders， exhibiting a significantly higher prevalence of such conditions compared with the general population， which severely impairs their physical and mental health. It is hypothesized that perceived stress negatively impacts sleep quality through psychological mechanisms， such as depleting self-control resources and triggering anxiety. However， this pathway warrants empirical validation. ObjectiveTo explore the mediating role of self-control and anxiety emotions in the association between perceived stress and sleep quality among resident physicians， and to elucidate the underlying psychological mechanisms， aiming at providing theoretical basis for developing targeted psychological interventions. MethodsA cross-sectional survey was conducted in April 2025. First- to third- year resident physicians at a hospital in Fuyang City were recruited as participants （n=372）. The Chinese Perceived Stress Scales （CPSS）， the Chinese version of the Dual-Mode of Self-Control Scale （DMSC-S）， the Pittsburgh Sleep Quality Index （PSQI）， and the Generalized Anxiety Disorder Scale-7 item （GAD-7） were used for group testing. The model 6 of the Process macro version 4.1 was ultilized to examine the mediating pathway of self-control and anxiety emotions between perceived stress and sleep quality. ResultsA total of 322 valid questionnaires were collected， yielding an effective responsive rate of 86.56%. Among the respondents， 146 （45.34%） reported poor sleep quality. The CPSS score and GAD-7 score of resident physicians were positively correlated with the PSQI score （r=0.727， 0.784， P<0.01）， while the DMSC-S score was negatively correlated with the PSQI score （r=-0.615， P<0.01）. Perceived stress directly and positively predicted poor sleep quality （B=0.124， P<0.01）， with the direct effect accounting for 31.39% of the total effect. Furthermore， perceived stress indirectly affected sleep quality through the independent mediating effects of self-control and anxiety emotions. The indirect effect values of 0.053 （95% CI： 0.019 - 0.091） and 0.192 （95% CI： 0.141 - 0.249）， accounting for 13.42% and 48.61% of the total effect， respectively. Perceived stress also impact sleep quality through the serial mediating effect of self-control and anxiety， with the indirect effect value of 0.026 （95% CI： 0.005 - 0.049）， accounting for 6.58% of the total effect. ConclusionThe perceived stress of resident physicians can influence sleep quality by impairing self-control， exacerbating anxiety， and through the serial mediation of both factors.

ObjectiveTo quantitatively analyze and evaluate the content of China's assistive technology industry policies. MethodsBased on the three-dimensional framework of policy "objectives-instruments-intensity", this study examined 101 national-level assistive technology industry policies issued between 2011 and 2024. Policy text analysis was conducted to assess the matching and coordination among policy objectives, policy instruments and policy intensity. Furthermore, the policy modeling consistency (PMC) index model was applied to establish an evaluation system consisting of nine primary indicators and 35 secondary indicators, and six key policies were quantitatively evaluated. ResultsThe policy objectives mainly focused on optimizing the industrial development structure, also emphasized supportive environments for industrial development and the enhancement of innovation capacity. Policy instruments were dominated by supply-oriented and environment-oriented instruments, supplemented by demand-oriented instruments, aiming to strengthen technological foundations and competitiveness, promote standardized development, and facilitate industrial development and upgrading. Regarding the matching between policy objectives and instruments, multiple instruments were adopted to support different objectives, with different priorities. In terms of the matching between policy objectives and policy intensity, policies mainly emphasized improving the accessibility of assistive technology products and meeting the rehabilitation needs of different populations. Regarding the matching between policy instruments and policy intensity, supply-oriented instruments were more frequently adopted and showed higher policy intensity, indicating strong governmental efforts to optimize production factor allocation and enhance the capacity of market entities. The average PMC index score was 6.45, indicating relatively high policy quality, strong internal consistency, stable policy orientation, and clear objectives. The PMC scores for policy evaluation and policy instrument dimensions were relatively high, while some policies showed relatively narrow objectives. ConclusionChina's assistive technology industry policies demonstrate relatively high quality. Future policy development should further strengthen industrial innovation capacity, optimize the structure of policy instruments, and improve the alignment between policy objectives and instruments.

AIM: To analyze the changes in binocular visual function before and after small incision lenticule extraction(SMILE)in patients with different degrees of myopia.METHODS:A prospective non-randomized controlled study was conducted. A total of 94 patients(188 eyes)who visited the refractive outpatient department of the ophthalmology department of the General Hospital of the PLA from June 2022 to June 2023 and voluntarily chose SMILE were consecutively included. They were grouped according to the degree of myopia, including 24 cases(48 eyes)in the low myopia group(-3.00 D

Xenotransplantation is one of the effective ways to overcome the shortage of donor organs. However, the molecular incompatibility between xenotransplantation donors and recipients can cause rejection, which greatly limits the clinical application of xenotransplantation. In recent years, researchers have deeply explored the mechanism of xenotransplantation rejection through xenotransplantation models of pig-to-monkey and pig-to-brain death recipients, and found that the innate immune system plays an important role in rejection. Macrophages, as phagocytes in the innate immune system, not only damage xenografts through phagocytosis but also interact with other immune cells to influence the immune microenvironment of xenotransplantation. However, due to the heterogeneity of macrophages, their phenotypes and functions in xenotransplantation rejection remain unclear. Therefore, it is necessary to further explore the role of macrophages in xenotransplantation rejection. This article reviews the latest research progress of macrophages in xenotransplantation rejection, aiming to explore the mechanisms of macrophages in xenotransplantation rejection and provide references for future research.

Organ transplantation faces the challenge of a shortage of donors. Although xenotransplantation holds great potential, it is limited by rejection. Extracellular histones, as key members of damage-associated molecular patterns, have been proven in recent years to play a crucial role in transplant rejection by activating innate immunity, regulating the coagulation-inflammation network, and modulating adaptive immune responses. However, the specific functions and key mechanisms remain to be clarified. Therefore, this article reviews the structural characteristics of histones, their release pathways, the biological functions of extracellular histones, and their potential roles in xenotransplantation. It summarizes the latest research progress of extracellular histones in xenotransplantation, analyzes the shortcomings of existing research and the direction for future research, with the expectation of providing references for the application of extracellular histones in xenogeneic kidney transplantation.

Based on his extensive clinical experience and the team's mechanistic research, Professor XU Nenggui has proposed the academic concept that "the governor vessel governs the brain and treats cerebral viscus diseases", and established a novel acupuncture approach for encephalopathy treatment centered on the integrated theory of "governor vessel-brain-mind", and developed a staged acupuncture protocol of "governor vessel regulating spirit" for ischemic stroke. This article introduces the academic features of this method in treating post-stroke dysphagia from four aspects: theoretical framework, treatment principles and point selection, mechanistic research, and clinical case studies. In clinical application, the method emphasizes syndrome differentiation based on meridians, harmonization between the conception and governor vessels; precise acupoint selection to treat both form and spirit; stage-specific differentiation with targeted needling. Furthermore, Professor XU integrates basic research with clinical practice, focusing on the neurobiological mechanisms underlying the efficacy of acupuncture in treating post-stroke dysphagia.
Acupuncture Therapy/methods* ; Humans ; Deglutition Disorders/psychology* ; Stroke/complications* ; Meridians ; Acupuncture Points