Objective: To construct and to validate a nomogram prediction model based on Lipoprotein-associated phospholipase A2(Lp-PLA2) and Lipoprotein(a) [LP(a) ]for predicting the risk of major adverse cardiovascular events(MACE) in patients with coronary heart disease(CHD). Methods: A retrospective analysis was conducted on the clinical data of 442 patients with coronary heart disease(CHD). Among them,411 patients who completed follow-up were randomly divided into a training set(288 cases) and a validation set(123 cases) at a 7 ∶ 3 ratio.Independent risk factors for major adverse cardiovascular events(MACE) in CHD patients were screened through Lasso regression analysis and Cox regression analysis,and a nomogram prediction model was constructed. The predictive performance of the model was evaluated using time-dependent receiver operating characteristic curves(ROC),calibration curves,and decision curve analysis. Results: Variables were screened through Lasso regression and Cox regression analysis. The final model included nine independent predictors,namely age,smoking history,clinical phenotype of CHD,the number of coronary artery lesions,Gensini score,BNP,Lp-PLA2,LP(a), and the history of statin use. The area under the ROC curve in the training set was 0. 897,0. 885,and 0. 909 at 1,2,and 3 years,respectively; The area under the ROC curve in the validation set was 0. 885,0. 881,and 0. 923 at 1,2,and 3 years,respectively. These results demonstrated that the model had excellent discriminatory power. The calibration curves and decision curves demonstrated that the model had high clinical practicality in predicting the occurrence of MACE in CHD patients. Conclusion The nomogram prediction model based on LP-PLA2,LP(a)and other risk factors provides an effective tool for the prognosis assessment of CHD patients,facilitating the early identification of high-risk patients and enabling individualized intervention.

Objective To explore the risk factors for intracardiac thrombosis in dilated cardiomyopathy(DCM)pa-tients and to construct,validate,and evaluate a nomogram prediction model based on these factors.Methods 88 patients diagnosed with DCM and complicated with intracardiac thrombus,and 544 patients without intracardiac thrombus were included.The participants were randomly divided into training and validation sets at a ratio of 7∶3.Using both univariate and multivariate Logistic regression analyses,independent risk factors for intracardiac thrombosis in DCM patients were identified.A nomogram prediction model was constructed using R software.The model's validity and performance were assessed using the receiver operating characteristic(ROC)curve,the Hos-mer-Lemeshow goodness-of-fit test,calibration curve,and decision curve.Results The binary Logistic regression analysis showed that age,atrial fibrillation,left ventricular end-diastolic diameter(LVEDD),brain natriuretic peptide(BNP),and β-blockers were independently associated with intracardiac thrombosis in DCM patients.Based on these five factors,a nomogram was constructed and validated.The area under the ROC curve for the training set was 0.823(95%CI:0.760～0.887)and0.803(95%CI:0.705～0.901)for the validation set,in-dicating a good discriminative ability.The Hosmer-Lemeshow test results for the calibration curve were(χ2=6.679,P=0.572)for the training set and(χ2=2.588,P=0.958)for the validation set,indicating a good fit between predicted and observed outcomes.The decision curve showed a high net clinical benefit in the threshold range of 0.05～0.92.Conclusion Based on age,atrial fibrillation,LVEDD,BNP,and β-blockers,the nomo-gram prediction model exhibits good discriminative and calibration abilities,and high clinical benefit.It can effec-tively guide clinicians in early intervention of risk factors,reducing the risk of intracardiac thrombosis in DCM pa-tients.

Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective:To evaluate the value of growth differentiation factor 15(GDF-15)and hepatocyte growth factor(HGF)in mortality prediction for patients with chronic heart failure(CHF)during a 5-year follow-up.Methods:This prospective case-control study enrolled 141 CHF patients hospitalized at the First Affiliated Hospital of Anhui Medical University between August 2015 and September 2017, including 59 with preserved ejection fraction(HFpEF)and 82 with non-preserved ejection fraction(non-HFpEF). Using all-cause mortality as the endpoint during the 60-month follow-up, there were 93 cases in the survival group and 48 cases in the death group.Clinical baseline data of patients in the two groups were compared, and the prognostic value of GDF-15 and HGF for CHF was assessed using multivariate logistic regression analysis, receiver operating characteristic curves(ROC curves), the area under the ROC curve(AUC), and Kaplan-Meier survival curves.Results:The results of multivariate Logistic regression analysis showed that GDF-15, HGF, glomerular filtration rate, and body mass index were independent risk factors for CHF prognosis during the 60-month follow-up; The degrees of predictive ability on mortality in 60-months in patients with heart failure were estimated for GDF-15( AUC=0.769, 95% CI: 0.685-0.854), HGF( AUC=0.765, 95% CI: 0.676 to 0.854), body mass index( AUC=0.689, 95% CI: 0.594 to 0.783), and glomerular filtration rate( AUC=0.612, 95% CI: 0.518 to 0.705). The AUC values of GDF-15 and HGF were greater than those of the body mass index and the glomerular filtration rate.Using GDF-15=2 326 ng/L and HGF=1, 603 ng/L as the cut-off values, the Kaplan-Meier survival curves showed statistically significant differences in survival rates between the two groups( P<0.05)The mortality rate in the non-HFpEF group was higher when GDF15 ≥2, 326 ng/L and HGF ≥1, 603 ng/L(100%, 15/15)than that in the HFpEF group(50%, 2/4), and the difference was statistically significant( χ2=5.526, P<0.05). Conclusions:GDF-15, HGF, the estimated glomerular filtration rate and the body mass index are independent prognostic risk factors for CHF during a 60-month follow-up period.GDF-15 and HGF are independent predictors of all-cause death in patients with CHF, especially those with non-HFpEF during 5-years.

Emerging evidence has demonstrated the vital role of metabolism in various diseases or disorders. Metabolomics provides a comprehensive understanding of metabolism in biological systems. With advanced analytical techniques, metabolomics exhibits unprecedented significant value in basic drug research, including understanding disease mechanisms, identifying drug targets, and elucidating the mode of action of drugs. More importantly, metabolomics greatly accelerates the drug development process by predicting pharmacokinetics, pharmacodynamics, and drug response. In addition, metabolomics facilitates the exploration of drug repurposing and drug-drug interactions, as well as the development of personalized treatment strategies. Here, we briefly review the recent advances in technologies in metabolomics and update our knowledge of the applications of metabolomics in drug research and development.

Objective: To explore the value of vector angle of Lorenz plots(LPs) and the role of combining B-line slope in improving the diagnostic efficiency of arrhythmia． Methods: LPs of 119 cases with ventricular premature contraction (VPC group ) ，97 cases with supraventricular premature contraction(SPC group) ，52 cases with type II°I atrioventricular block ( Ⅱ ° Ⅰ group) and 54 cases with type Ⅱ ° Ⅱ atrioventricular / sinoatrial block ( Ⅱ ° Ⅱ group) were retrospectively analyzed．The B-line slope and vector angle were measured，and the differences between groups were compared. Receiver operating characteristic curve was used to analyze the diagnostic efficacy of B-line slope，vector angle and their combination between groups ，and MedCalc software was used for statistical comparison．The consistency of intra-observer and inter-observer measurements of B-line slope and vector angle was evaluated using Intra group correlation coefficient (ICC) and Bland-Altman plot. Results: There were significant differences between VPC group and SPC group，and between Ⅱ ° Ⅰ group and II°II group (P＜0. 05) ．The area under the curve (AUC) of B-line slope，vector angle，and the combination of the two in distinguishing ventricular and supraventricular premature contraction were 0. 81，0. 84 and 0. 87 respectively，and the AUC in distinguishing type Ⅱ ° Ⅰ and type Ⅱ ° Ⅱ atrioventricular / sinoatrial block were 0. 76，0. 78 and 0. 80 respectively．The ICC of vector angle was better than B-line slope (Intra-observer 0. 99 vs 0. 98，Inter-observer 0. 97 vs 0. 96) ． Conclusion Vector angle can be used to identify the type of arrhythmia，and has good intraobserver and interobserver consistency．Its combination with B-line slope has the highest accuracy in diagnosing arrhythmia，providing a new reference for clinical diagnosis and treatment.

Objective:To analyze the current situation of the course of Pharmaceutical Analysis in the education and training of undergraduate students, explore the teaching reform and innovation to better accommodate the pharmacy education in the new era and build an advanced mode for training pharmaceutical talents with interdisciplinary expertise that meet the requirements and needs of job market. Methods:The first stage was to investigate the suggestions and needs of teaching reform; the second stage was to carry out the exploration and practice of the course reform; the third stage was to evaluate the teaching effect.Results:The demand survey showed that the teaching content, course design, and teaching methods of the Pharmaceutical Analysis need to be further optimized and expanded. Conclusion:By adjusting the teaching content, expanding teaching methods, innovating diversified teaching practices, and integrating the "curriculum ideology and politics" into the construction, the course reform has stimulated students' interest in learning and innovative spirit, strengthened their theoretical literacy and practical ability, and cultivated their international vision and lofty professional ethics.

Objective : To explore the relationship between the levels of plasma lipoprotein⁃associated phospholipase A2 (LP⁃PLA2 ), lipoprotein ( a) [ LP ( a)] and the SYNTAX score in patients with coronary heart disease (CHD) . Methods : A total of 416 patients diagnosed with CHD by coronary angiography ( CAG) were enrolled. According to the SYNTAX score, they were divided into three groups, 364 cases in the low⁃risk group (score of 0 - 22), 39 cases in the medium⁃risk group (score of 23 - 32), and 13 cases in the high⁃risk group (score of 33 or more) . And another 30 cases which CAG showed no significant narrowing of the coronary arteries were selected as the control group (CON), We detected and compared the differences of the levels of LP⁃PLA2 and LP(a) in various groups. According to the levels of LP⁃PLA2 and LP(a), CHD patients were divided into four groups, 225 cases in the LP⁃PLA2 and LP(a) normal group, 35 cases in the only LP(a) elevated group (≥300 mg/L), 43 cases in the only LP⁃PLA2 elevated group (≥175 ng/ml) and 113 cases in the LP⁃PLA2 and LP(a) elevated group. The differences of the SYNTAX score, stenosis degree score and lesion feature score were compared. Pearson correlation and multiple linear regression were used to analyze the correlation between the levels of LP⁃PLA2, LP( a) and the SYNTAX score, stenosis degree score and lesion feature score. Results : The levels of LP⁃PLA2 and LP (a) in the CHD group were significantly higher than those in the CON group (P < 0. 05) . The levels of LP⁃PLA2 and LP(a) in the subgroups according to the SYNTAX score were declining from the high⁃risk group to the low⁃risk group in decending order (P < 0. 05) . The SYNTAX score and stenosis degree score of the LP⁃PLA2 and LP(a) elevated group were significantly higher than those of the only LP⁃PLA2 elevated group, the only LP( a) elevated group, the LP⁃PLA2 and LP(a) normal group (P < 0. 05), but there was no significant difference in lesion feature score among the groups (P > 0. 05) . Pearson correlation analysis showed that the SYNTAX score, stenosis degree score and lesion feature score were positively correlated with the levels of LP⁃PLA2 and LP(a) (P < 0. 05) . The multiple linear regression showed that the SYNTAX score and stenosis degree score were independently correlated with the levels of LP⁃PLA2 and LP( a) after adjusting for confounding effects ( P < 0. 05 ), while lesion feature score was only independently correlated with the levels of LP⁃PLA2 ( P < 0. 05) . Conclusion The levels of LP-PLA2 and LP(a) show a positive correlation with the SYNTAX score in patients with CHD, and both can be used as indicators to determine the severity of coronary artery disease.