Reflecting on the historical responsibility of Chinese medical ethics at present， it is necessary to place oneself in the grand context of promoting the process of building a community with a shared future for mankind. Safety， development， and civilization constitute the three important ethical dimensions of a community with a shared future for mankind， which are not only ethical orientations， but also ethical appeals. These provide an important direction for Chinese medical ethics to deeply consider its role in the process of a community with a shared future for mankind. The historical responsibilities of Chinese medical ethics in the process of promoting a community with a shared future for mankind mainly include： confronting moral and interest issues， adhering to the patient-centered approach， and ensuring patients’ life safety； playing the role of ethical regulation， achieving the practical effects of medical ethics， and maintaining social security and stability； implementing the responsibility of medical ethics education， shaping medical professionalism， and promoting the development of healthy China； inheriting the excellent traditional culture， pursuing medical excellence and justice， and promoting the development of social morality； pursuing common health values， building a community with a shared future between doctors and patients， and promoting the progress of human. A global community of health for all provides the most direct practical platform for Chinese medical ethics to fulfill its historical responsibility in the process of building a community with a shared future for mankind. It directly promotes Chinese medical ethics to the world， and Chinese ethics facing the world will play an increasingly important influence in self-renewal.

With the rapid development of social economy and the continuous improvement of human living standard, the incidence, fatality and recurrence rates of cardiovascular disease (CVD) are increasing year by year, which seriously affects people's life and health. Conventional therapeutic drugs have limited improvement on the disability rate, so the search for new therapeutic drugs and action targets has become one of the hotspots of current research. In recent years, the therapeutic role of the natural compound rosmarinic acid (RA) in CVD has attracted much attention, which is capable of preventing CVD by modulating multiple signalling pathways and exerting physiological activities such as antioxidant, anti-apoptotic, anti-inflammatory, anti-platelet aggregation, as well as anti-coagulation and endothelial function protection. In this paper, the role of RA in the prevention of CVD is systematically sorted out, and its mechanism of action is summarised and analysed, with a view to providing a scientific basis and important support for the in-depth exploration of the prevention value of RA in CVD and its further development as a prevention drug.

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: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

To analyze the in vitro antibacterial effects of colistin (COL) or tigecycline (TGC) in combination with imipenem (IPM), amikacin (AMK), and cefoperazone-sulbactam (CSL) against carbapenem-resistant Acinetobacter baumannii(CRAB), so as to provide evidence for screening effective combination regimens for clinical microbial infections.

ObjectiveTo explore the molecular mechanism of the chemo-resistance in NR2F1-mediated dormant ovarian cancer（OC） cells. MethodsThe expression of the NR2F1 molecule in OC patients and its relationship with the overall survival of patients were analyzed using the GEPIA database. Nuclear receptor subfamily 2 group F member 1（NR2F1） overexpressed OC cell and control cell were constructed by lentivirus in vitro transfection. The proliferation of OC cells was analyzed by CCK-8 method. Real-time fluorescent quantitative PCR（qRT-PCR） was used to analyze the mRNA expression of dormancy-related molecular genes in OC cells. Western blot was performed to analyze the protein expression levels of related molecules. The viability of OC cells treated with different chemotherapy drugs was analyzed by trypan blue exclusion method. Annexin V-FITC/PI double-staining assay was used to detect the apoptosis of OC cells treated by different chemotherapy drugs. Transcriptome sequencing technology was used to analyze the differentially expressed genes in NR2F1 overexpressed SKOV3 cell line， and the relevant signaling pathways were screened through KEGG enrichment analysis. qRT-PCR was performed to verified the mRNA expression level of drug resistance-related molecules in OC cells. The GEPIA database was used to further verify the correlation between the expression of NR2F1 and the drug resistance-related genes. ResultsThe NR2F1 expression is low in the tumor tissues and the high expression of NR2F1 correlates with poor overall survival in the OC patients. Compared with the control group， the proliferation ability of the NR2F1 overexpressed OC cell lines was significantly reduced. The expression of dormancy-related molecules， cyclin-dependent kinase inhibitor 1B（p27）， differentiated embryonic cartilage gene-2（DEC2） and transforming growth factor-β2（TGF-β2）， increased significantly in the NR2F1 overexpressed OC cell lines， and anti-apoptotic molecule B-cell lymphoma gene-2（BCL-2） also increased. In contrast， the expression of the proliferation-related molecule KI67 was decreased. In addition， the NR2F1 overexpressed OC cell lines significantly enhanced the resistance to chemotherapy drugs. Transcriptome sequencing and KEGG enrichment analysis showed that the upregulated genes in NR2F1 overexpressed OC cells were enriched in phosphatidylinositol-3-kinase-protein kinase（PI3K-Akt） signaling pathway， focal adhesion pathway， extracellular matrix-receptor interactions and signaling pathways regulating pluripotency of stem cells， and the downregulated genes in NR2F1 overexpressed OC cells were mainly enriched in cell cycle pathway. The results of qRT-PCR verification showed that drug resistance-related molecules kinesin family member 26B（KIF26B）， secreted protein acidic and rich in cysteine（SPARC）， collagen type Ⅵ alpha 1（COL6A1）， collagen type Ⅴ alpha 2 chain（COL5A2）， frizzled homolog 1（FZD1） and inhibin subunit beta A gene（INHBA） were up-regulated in NR2F1 overexpressed OC cells. GEPIA database analysis showed that the expression of NR2F1 in OC tumor tissues was positively correlated with the expression of drug resistance-related genes KIF26B， SPARC， COL6A1， COL5A2， FZD1 and INHBA. ConclusionsThis study shows that upregulation of NR2F1 may induce dormancy in OC cells and enhance their resistance to chemo-drugs. The NR2F1-mediated drug resistance of dormant OC cells might be associated with the PI3K-Akt signaling pathway and signaling pathways regulating pluripotency of stem cells， and closely related to the upregulation of KIF26B， SPARC， COL6A1， COL5A2， FZD1 and INHBA.

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: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.

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: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer. Methods: We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R. Results: Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices. Conclusions SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.