Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Bromodomain-containing protein 4(BRD4),a pivotal member of the bromodomain and extra-ter-minal domain(BET)family,is integral to the regulation of vital biological processes,including the cell cycle and gene ex-pression.Studies have identified extensive expression of BRD4 in cardiomyocytes and its influence on various signaling pathways.The dysregulation of BRD4 leads to significant alterations in these pathways,culminating in pathological states such as myocardial inflammation,fibrosis,oxidative stress,and hypertrophy.These changes are instrumental in the onset and progression of cardiovascular diseases.This review summarizes the advances in research on BRD4 and its inhibitors in the context of cardiovascular diseases,with a focus on providing insights for precise therapeutic interventions.

Atrial fibrillation(AF),a prevalent clinical tachyarrhythmia,has seen an increase in incidence with advancing age over recent decades.AF leads to severe complications,including stroke and heart failure,and is a sig-nificant cause of mortality.The pathogenesis of AF involves critical factors such as atrial electrical and structural remodeling,oxidative stress,and inflammatory responses.Recent studies highlight the pivotal role of macrophages in the initiation and progression of AF.This study focuses on the contributions of macrophages to the mechanisms of AF and summarizes cur-rent research findings.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

The general population cohort study in Beijing-Tianjin-Hebei area is a large-scale prospective longitudinal study conducted since 2017, which covers over 114 850 diverse populations from early life to senior age. Up to December 2021, 106 031 people had completed at least one follow-up, with an overall follow-up rate of 92.3%. Considering of the characteristics of the environmental and health problems in Beijing-Tianjin-Hebei area, in this cohort study we have focused on health problems of children and adolescents' growth and development, cardiometabolic diseases and their risk factors, aging and comorbidity, health hazards caused by air pollution. The long-term follow up of the general population cohort study in Beijing-Tianjin-Hebei area will contribute to establishing unique and invaluable data and biobank resource for scientific research. This paper aims to comprehensively describe the background, significance, current status and outcomes, limitations and challenges, and future plan and development of general population cohort study in Beijing-Tianjin-Hebei area, thus to provide reference for professionals both at home and abroad to carry out related research.

Objective To discuss progress in Qinghai Tibetan Thymidylate synthase enhancer in patients with gastric cancer (TSER),ERCC1 polymorphism of genes,gene expression and mRNA studies.Methods 210 cases of advanced gastric cancer were enrolled as required to complete the treatment and follow-up.TSER,ERCC 1 gene polymorphism were tested using PCR-RFLP method.Analysis of gastric cancer is based on the results of gene polymorphism and clinical pathological factors in relations.The expression of ERCC1 mRNA was detected by RTPCR,and tracking access after treatment.Analyzing the relationship among ERCC1 mRNA expression,clinical treatment of overall survival,total response rates and gene polymorphism.Results In patients with advanced gastric C/C in Qinghai ERCC1 gene frequency was 54.2％,C/T frequency was 42.7％,T/T ERCC1 gene frequency was 5.6％.ERCC1 mRNA expression and clinical effect in the treatment of pathological factors were not related,ERCC1 mRNA and gene ERCC1 polymorphism had no relevance.Conclusions Progress in Qinghai Tibetan TSER gene is highly expressed type 3R/3R in patients with gastric cancer.ERCC 1 gene polymorphisms with type C/ C is overexpressed.ERCC1,TSER gene polymorphism and clinicopathologic parameters in advanced gastric is not related.Extension of Tibetan ERCC1 mRNA in gastric cancer patients expression has no association with ERCC1 gene polymorphism.

Objective To investigate whether ligustrazine can reduce endotoxemia and inhibit the increase of lipopolysaccharide (LPS)-induced vascular permeability by suppressing Rho/ROCK signaling pathway in guinea pigs. Methods Eighteen of white male healthy guinea pigs were divided into three groups randomly and pretreated with intravenous injection of ligustrazine(3 or 6 mg/kg) or saline. 30 min later, LPS (100, 300, 1 000 μg/0.1 mL/site) and saline (0.1 mL/site) were administered intracutaneously at the dorsum of guinea pigs. Vascular permeability was determined by leakage area and absorbance of 610 nm (OD610) of Evans Blue dye after intracutaneous injection of LPS (100-1 000 μg/site). Results Dye leakage in the skin began to increase at 5 min, and revealed significant increase 2 h after LPS injection. Significant differences in the dye leakage area(F = 5.77, P < 0.05) and the OD610 (F = 7.736, P < 0.05) induced by 100, 300 and 1,000 ug/site of LPS administration were demonstrated between the control and ligustrazine groups (3 or 6 mg/kg). Conclusion Ligustrazine has protective effect on the hypermeability of endothelial cells induced by lipopolysaccharide, and inhibition of Rho/ROCK signaling pathway is a possible mechanism.

Purpose To detect the expression of Snai2 mRNA in gastric carcinoma and normal gastric mucosa and analyze its significance.Methods Total RNA was extracted with TRIzol from 30 cases of gastric carcinoma and mRNA was transcribed reversely into cDNA.The expression of Snai2 mRNA was examined by real-time PCR; then mRNA probes were prepared, the expression of Snai2 mRNA was detected by in situ hybridization on a tissue array,including normal gastric mucosa (20 cases) and gastric carcinoma (100 cases).Results Real-time PCR data showed they had different expression in different degrees of differentiation of the cancer: the poorer differentiation, the more expression (P<0.05). In situ hybridization results showed the positive rate in the carcinoma (54.2%) was higher than normal tissue (27.8%), with statistically significant difference (P<0.05).There were different positive rate in different degrees of differentiation: the poorer differentiation,the higher positive rate, but it had no statistical significance (P>0.05).Conclusions Snai2 could be a biomarker of malignant degree and disease progression,and used as a useful tool for evaluation of prognosis.

Objective: To observe the morphologic changes of pituitary adrenocorticotrophic hormone (ACTH) cells in Wistar rats at different altitudes, and clarify the mechanism of stress reaction to hypoxia in ACTH cells. Methods: Wistar rats were divided into three groups and moved to different altitudes (1700 m, 3100 m, 4050 m). After 12 days, changes of ACTH cells were observed by using immunohistochemisty, image analysis and electron microscopy. Results:The ratio (R) of immunoreactive cell area to scanned area and mean optical density (A) increased at higher altitude with statistically different R values between groups of 1700 m and 4050 m (P