The theory of " Sui Qi Suo De" originates from Zhang Zhongjing's Jin Gui Yao Lue and has been further developed by later generations of practitioners, offering significant guidance for clinical practice. Myelodysplastic syndromes (MDS) are common malignant disorders of the hematopoietic system, characterized by high heterogeneity and progressive mutational changes. In Traditional Chinese Medicine (TCM), MDS falls under the category of "marrow toxin exhaustion". This article applies the theory of " Sui Qi Suo De" in TCM to analyze the pathophysiological changes during different stages of MDS. Specifically, it explores the precursor stage (focusing on health maintenance and prevention before illness, addressing the " Suo De" of "gradual decline of vital qi"), the low-risk stage (strengthening the spleen and kidneys, clearing toxic pathogens, addressing the " Suo De" of "weakened vital qi invaded by pathogens"), and the medium-to-high-risk stage (detoxifying and reinforcing the body, harmonizing physical and mental health, addressing the " Suo De" of "dominant pathogens and declining vital qi"). The goal is to provide new directions and theoretical insights for the TCM treatment of MDS.

Objective To design and develop an intelligent triage model for earthquake casualties that is intended for medical rescue teams based on reinforcement learning and the feasibility of this model is verified via computer simulation.Methods The process,difficulty,and requirements of the triage of the injured during an earthquake medical rescue were analyzed.The Markov decision process was used to formally describe the problem.Subsequently,a triage model was designed and developed based on reinforcement learning.Finally,the effectiveness of the model was verified through simulation experiments.Results Compared with conventional triage strategies,this intelligent triage model showed significant advantages in terms of mortality rates and waiting time.Under experimental conditions,casualties decreased by nearly 50％,and the waiting time for both nonoperative casualties(T-class)and operative casualties(S-class)casual-ties also decreased.Conclusion The intelligent triage model can autonomously learn triage strategies,reduce the ca-sualty rate while lowering the waiting time for the injured,thereby effectively improving the efficiency of treatment of earthquake injuries.

The infectious clone plasmid of genotype Ⅰ Japanese encephalitis virus GX strain was suc-cessfully obtained by reverse transcription-polymerase chain reaction,where the cDNA of GX strain is divided into three fragments for amplification and the three fragments were sequentially cloned into pBR322 vector.After the infectious clone plasmid pGX was sequenced correctly,the pGX and pCAGGS-T7 eukaryotic plasmid were co-transfected into BHK-21 cells for virus rescue.The experimentalresults indicated that the Japanese encephalitis virus could be successfully res-cuedfrom BHK-21 cells.The plaque experiment and mouse experiment indicated that the rescued virus had similar replication ability and pathogenicity with wild type virus.It was confirmed that the infectious clone of genotype Ⅰ Japanese encephalitis virus GX strain was successfully construc-ted in this study.

The infectious clone plasmid of genotype Ⅰ Japanese encephalitis virus GX strain was suc-cessfully obtained by reverse transcription-polymerase chain reaction,where the cDNA of GX strain is divided into three fragments for amplification and the three fragments were sequentially cloned into pBR322 vector.After the infectious clone plasmid pGX was sequenced correctly,the pGX and pCAGGS-T7 eukaryotic plasmid were co-transfected into BHK-21 cells for virus rescue.The experimentalresults indicated that the Japanese encephalitis virus could be successfully res-cuedfrom BHK-21 cells.The plaque experiment and mouse experiment indicated that the rescued virus had similar replication ability and pathogenicity with wild type virus.It was confirmed that the infectious clone of genotype Ⅰ Japanese encephalitis virus GX strain was successfully construc-ted in this study.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.