Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Objective To investigate the clinical efficacy of Yinhuo Guiyuan moxibustion as an adjunc-tive therapy to Yaotongning Capsules in treating kidney deficiency-related lumbago in patients with stage 3-4 chronic kidney disease.Methods Sixty patients with stage 3-4 chronic kidney disease admitted from Janu-ary 2021 to June 2023 were randomly divided into a control group and an observation group,with 30 cases in each group.Both groups received basic treatment interventions during the study period.The control group re-ceived Yaotongning Capsules orally,while the observation group received additional Yinhuo Guiyuan moxibus-tion therapy.Clinical efficacy,pain scores,renal function indicators,satisfaction scores,and adverse reaction rates were compared between the two groups.Results The total effective rate was significantly higher in the observation group(93.33％)than in the control group(73.33％,P＜0.05).At the 4th,8th,and 12th weeks of treatment,the VAS scores of both groups were lower than baseline values,with the observation group dem-onstrating significantly lower scores compared to the control group at the same time points(P＜0.05).After treatment,both groups showed reductions in BUN,Scr,and 24hUP levels,with the observation group showing lower levels than the control group(P＜0.05).The observation group demonstrated higher satisfaction scores than the control group(P＜0.05).No significant difference was found in adverse reaction rates between groups(x2=0.218,P=0.640).Conclusion Yinhuo Guiyuan moxibustion combined with Yaotongning Cap-sules is effective in treating stage 3-4 chronic kidney disease patients,effectively alleviating low back pain,improving renal function indicators,enhancing treatment satisfaction,with lower incidence of adverse reac-tions.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

Objective:To investigate the safety,efficacy,and prognosis of high-dose melphalan in combination with autologous hematopoietic stem cell transplantation (ASCT) for the treatment of multiple myeloma (MM). Methods:The clinical data of 17 patients with newly diagnosed MM who underwent ASCT as first-line consolidation therapy at the Yijishan Hospital of Wannan Medical College from March 2020 to October 2022 were retrospectively analyzed. The safety,efficacy,and prognosis of this treatment approach were evaluated. Results:Of the 17 patients,10 were male and 7 were female,with a median age of 56 (45-64) years. The stem cell engraftment rate was 100％,with a median neutrophil engraftment time of+10 (9-12) days and a median platelet engraftment time of+12 (10-21) days. The incidence of oral mucositis and intestinal infection after transplantation was 100％,with 2 cases of pulmonary infection,1 case of urinary tract infection,1 case of skin infection,and 11 cases of transient elevation of serum amylase. After transplantation,13 patients achieved a complete response (CR) or better,and the CR rate showed an increasing trend compared to before transplantation (13/17 vs 8/17;P=0.078). The median follow-up time was 18 (6-36) months,and 15 patients survived without progression,1 patient experienced disease progression,and 1 patient died due to clinical relapse and abandonment of treatment. The 2-year overall survival (OS) rate and progression-free survival (PFS) rate were approximately 90.0％ and 83.9％,respectively. Conclusion:High-dose melphalan in combination with ASCT as first-line consolidation therapy for MM can enhance the depth of patient response,further improve therapeutic efficacy,and the transplant-related complications are controllable,making it a viable option worth promoting in clinical practice.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

To improve patient-centered pharmaceutical management and pharmaceutical service capabilities in the pharmaceutical department of medical institutions,automation and information technology are indispensable.The Pharmacy Administration-Automation and Information Technology is one of the social organization standards of the Chinese Hospital Association as part 4-4 of Pharmaceutical Administration and Pharmaceutical Practice in Healthcare,which standardizes 32 key elements in four aspects:basic requirements for automation construction in medical institutions,construction of automation hardware equipment,construction of intelligent information platform,and quality management and continuous improvement.It can be used to guide medical institutions at all levels to select and optimize pharmacy automation equipment and information platforms.This article introduced the construction methods and contents of the pharmacy automation and information technology standards,to deepen the understanding of peers on this standard and promote its implementation.This article aimed to promote the modernization,informatization,and intelligence of pharmaceutical services in medical institutions,and improve the quality and efficiency of overall medical pharmaceutical administration and service.

Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93％and a HCV positive rate of 0.54％.The positive rate of HCV in male and female patients were 0.60％and 0.48％,respectively,with a statistically sig-nificant difference(x2=47.18,P＜0.001).The HCV positive rate in the 50-＜60 age group was the highest(0.76％),followed by the 40-＜50 age group(0.71％).Difference among all age groups was statistically signifi-cant(x2=696.74,P＜0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57％;775 patients were infected with HCV,with a positive rate of 2.21％.In 2020,HCV positive rates in hospitals of different scales were 0.46％-0.63％,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P＜0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19％-0.81％,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06％-0.82％,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95％and 3.48％,respectively.Followed by departments of orthopedics(7.72％),gastroenterology(3.77％),nephrology(3.57％)and general intensive care unit(ICU,3.10％)in 2003,as well as departments of gastroenterology(1.35％),nephrology(1.18％),endocrinology(0.91％),and general intensive care unit(ICU,0.79％)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.