Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

Article 1220 of the Civil Code of the People's Republic of China is specifically formulated for medical in-stitutions and medical personnel to rescue patients with life-threatening conditions,aiming to adjust the contradic-tion between the right of emergency rescue in medical institutions and the right of informed consent of patients.In view of the lack of relevant laws and regulations,poor organizational structure and loopholes in the system,medical institutions may have certain risks when implementing emergency treatment.After sorting out and examining the rele-vant provisions of the current law on emergency treatment in medical institutions,it is found that it is necessary to optimize the relevant legal provisions and judicial interpretations,establish and improve the case evaluation system with ethics committee as the core,improve the medical assistance fund and insurance system,and avoid the dilem-ma of"feeling and reason"for medical personnel.

OBJECTIVE The inhibitory effect of active ingredients of Tripterygium wilfordii Hook.F.(TWHF)(celastrol,triptolide,triptonide,wilforlide A,wilforgine and wilforine)on human carboxylester-ase 1(CES1)and CES2 was detected to investigate the herb-drug interactions(HDIs)of TWHF.METHODS Human liver microsomes catalysed hydrolysis of 2-(2-benzoyl-3-methoxyphenyl)benzothi-azole(BMBT)and fluorescein diacetate(FD)were used as the probe reaction to phenotype the activity of CES1 and CES2,respectively.The residual activities of CES1 and CES2 were detected by ultra-high performance liquid chromatography(UPLC)after intervention with celastrol,triptolide,triptonide,wilforlide A,wilforgine and wilforine(100 μmol·L-1).Kinetics analysis,involving half inhibitory concentra-tion(IC50),inhibition type and kinetic parameter(Ki),and in vitro-in vivo extrapolation(IVIVE),was carried out to predict the HDIs between these compounds and CES-metabolizing drugs.Molecular docking was performed to analyze the ligand-enzyme interaction.RESULTS Out of the six main con-stituents of TWHF,only celastrol exhibited strong inhibition towards both CES1 and CES2,with the inhibitory rates of 97.45%(P<0.05)and 95.62%(P<0.05),respectively.The IC50 was 9.95 and 4.02 mol·L-1,respectively,and the types of inhibition were all non-competitive inhibition.Based on the kinetics analysis,the Ki values were calculated to be 5.10 and 10.55 μmol·L-1 for the inhibition of celastrol on CES1 and CES2,respectively.IVIVE indicated that celastrol might disturb the metabolic hydrolysis of clinical drugs in vivo by inhibiting CES1.Molecular docking results showed that hydrogen bonds and hydrophobic contacts contributed to the interaction of celastrol and CESs.CONCLUSION The inhibitory effect of celastrol on CES1 and CES2 might cause HDIs with clinical drugs hydrolysed by CESs.

Objective To develop and evaluate the equivalence of the Mandarin test material for tracking of noise tolerance(TNT)test.Methods Six different speech materials were developed(themes including daily life,entertainment,family,festivals,outdoors,and school).Four-minute TNT tests were measured in 21 normal hear-ing subjects using six different test materials.For each session,the tolerable noise level(TNL)and TNT scores were acquired and calculated for 3 time windows(31～240 s,31～120 s,151～240 s).Results Statistic analysis showed significant differences in the TNL(F=43.611,P＜0.05)among the normal hearing listeners.There were statistically significant differences in standardize z-scored TNT scores of the six different materials in the three time windows(P＜0.05).Post-hoc comparisons revealed that all significant differences involved the family and daily life themes.Conclusion Entertainment,festival,outdoors and school themed test materials can serve as the materials of Mandarin tracking of noise tolerance test and can be appied in research and clinical testing.

Objective To evaluate the Mandarin tracking of noise tolerance(TNT)test material and compare the differences between the average tolerable noise level(aTNL)value obtained from assessment and the program-estimated tolerable noise level(eTNL).Methods A total of 25 subjects with normal hearing and aural communica-tional ability were selected to undergo two of the mandarin TNT tests successively(respectively test 1,C1;test 2,C2),and 13 of them completed the third test(C3)under the same test condition as test 2 at least 1 week later.The stimulus for the three test conditions was presented with"speech 0°,continuous noise 180°".Results The aTNL of 25 participants for C1 and C2 was 83.42±3.09 dB SPL and 83.50±3.18 dB SPL,respectively.The eTNL of 25 participants for C1 and C2 were 84.08±3.53 dB SPL and 83.95±3.85 dB SPL,respectively.The aTNL and eT-NL for 13 subjects who participated in C3 was 83.16±2.13 dB SPL and 83.18±2.64 dB SPL,respectively.The intra-session(C1 vs C2)and inter-session(C2 vs C3)test-retest reliability were 2.36 dB and 2.75 dB,respectively.Pearson correlation analysis showed that intra-session(r=0.837,P＜0.001)and inter-session(r=0.867,P＜0.001)test-retest reliability was good.There was no statistical difference between aTNL and eTNL in the other TNT tests(P＞0.05 for both)except that aTNL and eTNL were statistically different in C1(P＜0.01),and more than 90％of the subjects could obtain eTNL within 1 minute.Conclusion The test-retest reliability of Mandarin tracking of noise tolerance test is good,with advantages of high reliability and efficiency.

During the process of dairy farming,various factors such as physical injury and bacterial infection act upon body tissues or organs,leading to the disruption of skin or mucous tissue integ-rity and subsequent tissue injury and trauma.The healing of these injuries is a complex process that necessitates the coordinated efforts of different cells and involvement of diverse cytokines.A-mong them,the interaction between macrophages and myofibroblasts is indispensable for efficient tissue repair.Nod-like receptor protein 3(NLRP3),a pattern recognition receptor in the innate im-mune system,may play a regulatory role in modulating this intricate process.In this study,cow myofibroblasts and M1 type bone marrow-derived macrophages were cultured in vitro,followed by collection of cell culture supernatant for co-culture analysis.Both cytokine secretion levels in M1 type bone marrow-derived macrophages as well as expression patterns levels of myofibroblast growth factor protein and mRNA were detected.The regulatory mechanism underlying NLRP3 in-volvement in mediating interactions between these two cell types was investigated using NLRP3 inhibitor MCC950.The results showed that an effective method for culturing cow muscle fibroblasts in vitro was successfully established and myofibroblast conditioned medium(MFbCM)could regulate M1 macrophage secretion profiles.Moreover,M1 macrophage conditioned medium(M1?CM)was found to influence myofibroblast growth factor expression levels.Our findings sug-gest that NLRP3 plays a significant regulatory role during crosstalk between myofibroblasts and M1-type pro-inflammatory macrophages.