OBJECTIVE To evaluate the effectiveness and safety of warfarin anticoagulation therapy guided by gene test in patients undergoing left ventricular assist device （LVAD） implantation， and to analyze the influencing factors of warfarin anticoagulation efficacy. METHODS Patients who underwent LVAD implantation at the Heart and Vascular Center of Northern Jiangsu People’s Hospital from January 2023 to October 2024 and required warfarin anticoagulant therapy were selected as the study subjects. They were divided into genetic testing group （n＝51） and empirical treatment group （n＝17） based on whether they underwent CYP2C9 and VKORC1 gene test. The gene test group was given warfarin based on the predicted dose calculated by gene test， while the empirical treatment group was given warfarin by clinical doctors based on international normalized ratio （INR） experience， all patients were given warfarin once a day. Follow-up observation was conducted for 6 months to compare the effectiveness [time in therapeutic range（TTR）， the time required to reach INR for the first time， the incidence of embolic events， the incidence of INR＜1.5 events] and safety （the incidence of major and minor bleeding events，the incidence of INR＞3.5 events） of warfarin treatment between two groups of patients. According to whether the patient’s TTR was ≥60%， they were divided into TTR≥60% group （n＝20） and TTR＜60% group （n＝48）. Univariate and multivariate binary Logistic regression analysis were used to determine the factors affecting the anticoagulant effect of warfarin in patients. RESULTS The TTR of patients in the gene test group was significantly higher than that in the empirical treatment group （P＜0.05）. The incidence of INR＜1.5 events in the gene test group was significantly lower than in the empirical treatment group （P＜0.05）. The incidence of minor bleeding events and INR＞3.5 events in the gene test group were lower than in the empirical treatment group， but the difference was not statistically significant （P＞0.05）. The results of multivariate binary Logistic regression analysis showed that gene test was an independent protective factor for warfarin anticoagulant therapy [odds ratio （OR）＝10.842， 95% confidence interval （CI）： 1.211-27.037， P＝0.033]， and the combination of statins was an independent risk factor for warfarin anticoagulant therapy [OR＝0.196， 95%CI： 0.045-0.861， P＝0.031]. CONCLUSIONS Under the guidance of gene test， warfarin anticoagulation therapy for LVAD patients after implantation can improve TTR， shorten the anticoagulation target time， and has good safety； meanwhile， it should be noted that the combination of statins may enhance the anticoagulant effect of warfarin， thereby increasing the risk of bleeding in patients.

This paper reviews the published articles of recent years on the application of deep learning methods in automatic localization of acupoint, and summarizes it from 3 key links, i.e. the dataset construction, the neural network model design, and the accuracy evaluation of acupoint localization. The significant progress has been obtained in the field of deep learning for acupoint localization, but the scale of acupoint detection needs to be expanded and the precision, the generalization ability, and the real-time performance of the model be advanced. The future research should focus on the support of standardized datasets, and the integration of 3D modeling and multimodal data fusion, so as to increase the accuracy and strengthen the personalization of acupoint localization.
Deep Learning ; Acupuncture Points ; Humans ; Neural Networks, Computer

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious complication following cardiac surgical procedures. The conventional diagnostic methods relying on serum creatinine and urine output changes often exhibit delayed responsiveness. Therefore, there is an urgent need for highly sensitive and specific biomarkers to detect and identify high-risk patients with CSA-AKI at an early stage, allowing for timely intervention and improved clinical outcomes. In this paper, the relevant biomarkers of CSA-AKI were reviewed in order to provide valuable information for the subsequent research on CSA-AKI.

Objective To explore the feasibility of establishing a swine model of liver cirrhosis with portal hypertension by portal infusion of 80％ alcohol.Methods A total of 13 Guizhou miniature pigs were randomly divided into three groups,experiment group 1 (n=5),experiment group 2 (n=5) and control group (n=3).Experiment groups of pigs received portal infusion of 80％ alcohol in volumes of 5 ml in group 1,and 10 ml in group 2,and the pigs in control group received portal perfusion of saline in volumes of 10 ml.All animals were performed direct portal angiography,the portal vein pressures and diameter were also detected before,immediately and 6 weeks after the infusion.All animals underwent liver biopsies before and 6 hours,1-6 weeks after operation.And contrast-enhanced abdominal CT was performed before and 6 weeks after operation.All animals were dissected 6 weeks after operation,aud each leaf of liver specimens were performed histological examination.Results There was no statistically significant difference of the portal venous pressure and diameter before infusion and 6 weeks after infusion in the experiment group 1 and control group (all P＞0.05).In the experiment group 2,compared with pre infusion,the portal vein pressure and diameter were higher than those of immediately and 6 weeks after infusion (all P＜0.05).In both experiment group 1 and group 2,all pigs had developed into liver fibrosis,the METAVIR score of 2 pigs in group 1 and 5 pigs in group 2 respectively were up to grade 4.Conclusion Portal infusion of 80％ alcohol is more suitable for establishing a swine model of liver cirrhosis with portal hypertension.

Objective To study the changes of coagulation function and platelet-related parameters of patients with acute pancre-atitis(AP) and their clinical significance .Methods 36 patients with AP were served as the AP group ,38 healthy people ,the control group .Healthy people in the control group and patients in the AP group at the time of admission and remission were subjected to detection of serum amylase ,lipase ,leukocytes ,neutrophils ,lymphocytes ,platelets ,mean platelet volume(MPV) ,platelet distribution width(PDW),prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin activity (PTA) ,international normalized ratio (INR) ,fibrinogen(FIB) and D-dimer(D-D) levels .Results Levels of serum amylase ,lipase , TT ,INR ,FIB ,and D-D of patients in AP group were significantly higher than those in the control group(P<0 .01) ,while their PT , PTA levels were significantly lower than those in the control group (P<0 .01) .Differences of leukocytes ,neutrophils ,lymphocytes and MPV of AP patients between at the time of admission and remission were statistically significant (P<0 .01) .Conclusion De-tections of coagulation function and platelet-related parameters changes of AP patients contribute to evaluation of the patients′con-dition and prognosis .